bluuebunny/crossref_metadata_2025 huggingface dataset:
Unilateral Vocal Fold Paralysis With Large Posterior Glottic Gap: Is Arytenoid Procedure Necessary?
Authors: Yılmaz Taner , Özer Furkan
Published: September 2021

Objectives:

For unilateral vocal fold paralysis (UVFP) with large posterior glottic gap medialization laryngoplasty (ML) + arytenoid adduction (AA), ML + adduction arytenopexy (AApexy), and ML alone using prosthesis with posterior extension are possible solutions. This study was carried out to elucidate the controversy among these solution options.

Methods:

Retrospective cohort. Tertiary referral center. One hundred forty patients with UVFP with large posterior glottic gap. Group 1 had 30 patients with ML + AA; Group 2 had 25 patients with ML + AApexy; Group 3 had 29 patients with ML using Isshiki prosthesis; Group 4 had 26 patients with ML using Montgomery prosthesis; Group 5 had 30 patients with ML using prosthesis with large posterior extension. Glottic closure using videolaryngostroboscopy, GRBAS, VHI-30, EAT-10, acoustic and aerodynamic analysis was carried out pre- and 1-year-postoperatively.

Results:

Preoperatively there was no significant difference in any parameters studied among all study groups ( P > .05). Except F0, speaking F0 and EAT-10, all other parameters in acoustic and aerodynamic analysis, glottic closure, GRBAS, and VHI-30 scores were significantly better postoperatively in Groups 1 and 2 compared to Groups 3 to 5 ( P < .05).

Conclusions:

In patients with UVFP and large posterior glottic gap, ML + AA and ML + AApexy seem to do better subjectively and objectively, acoustically and aerodynamically, when compared to ML using prosthesis with and without large posterior extension. ML alone does not appear to close posterior glottic gap. Therefore, it is a better and more reasonable option to perform arytenoid procedure when there is large posterior glottic gap in UVFP.
Silent Sinus Syndrome Secondary to Lymphoma: An Unusual Case With Radiological Evidence of Rapid Progression
Authors: Deekonda Praveena , Jones Huw A. S.
Published: September 2021

Objective:

To describe a case of silent sinus syndrome secondary to malignancy and discuss the pertinent clinical findings. Silent Sinus Syndrome (SSS) refers to a rare, asymptomatic condition whereby occlusion of the maxillary sinus ostium results in gradual resorption of air, creation of negative pressure and collapse of the maxillary walls.

Methods:

Review of medical records and literature review using NCBI/PubMed.

Results:

We describe a case of a 54-year-old gentleman presenting solely with enophthalmos. He had been diagnosed with stage IVa small lymphocytic lymphoma (SLL) 1.5 years prior to this, which was being managed with active surveillance. CT demonstrated severe bowing of the anterior and posterolateral wall, inferior displacement of the floor of the orbit and right enophthalmos, thus supporting a diagnosis of silent sinus syndrome. Compared to previous staging CT at the time of the lymphoma diagnosis these findings were entirely new, and soft tissue in the pterygomaxillary fissure was found to be enlarged. The patient underwent endoscopic sinus surgery and a right maxillary mega-antrostomy was performed to ventilate the maxillary sinus and prevent progression of eye symptoms. A biopsy was taken from the pterygopalatine fossa, which was confirmed to be chronic lymphocytic leukemia (CLL).

Conclusion:

This case is unique both in being secondary to malignancy, as well as being rapidly progressive given the presence of radiologically normal appearances 1.5 years prior to presentation. Although a rare condition, prompt recognition of SSS is vital to prevent ophthalmological complications. This report highlights malignancy as a potential cause in cases with focal bony remodeling.
Intermittent Vagal Nerve Stimulation-Associated Vocal Fold Movement Impairment
Authors: Yan Jennifer , Ongkasuwan Julina , Lambert Elton M.
Published: September 2021

Objectives:

Implanted vagal nerve stimulators (VNS) are an accepted therapy for refractory seizures. However, VNS have been shown to affect vocal fold function, leading to voice complaints of hoarseness. We present a case of intermittent VNS-related vocal fold paralysis leading to dysphonia and dysphagia with aspiration in a pediatric patient.

Methods:

This is a case report of a patient at a tertiary hospital evaluated in pediatric swallow and voice clinics. Patient and mother gave verbal consent to be included in this case report.

Results:

Indirect laryngeal stroboscopy was performed demonstrating full vocal fold mobility with VNS off and left vocal fold paralysis in lateral position and glottic gap with VNS on. Voice measures were performed demonstrating decreased phonation time, lower pitch, and decreased intensity of voice with VNS on. Flexible endoscopic evaluation of swallowing demonstrated deep penetration alone with VNS off and deep penetration with concern for aspiration with VNS on.

Conclusions:

While the majority of cases of vocal fold movement impairment associated with VNS have been noted to have a medialized vocal fold with VNS activation, we describe a case of intermittent vocal fold lateralization associated with VNS activation with resultant voice changes and aspiration.
The Relationship Between City “Greenness” and Homicide in the US: Evidence Over a 30-Year Period
Authors: Sanciangco Jonnell C. , Breetzke Gregory D. , Lin Zihan , Wang Yuhao , Clevenger Kimberly A. , Pearson Amber L.
Published: September 2021

Residents in US cities are exposed to high levels of stress and violent crime. At the same time, a number of cities have put forward “greening” efforts which may promote nature’s calming effects and reduce stressful stimuli. Previous research has shown that greening may lower aggressive behaviors and violent crime. In this study we examined, for the first time, the longitudinal effects over a 30-year period of average city greenness on homicide rates across 290 major cities in the US, using multilevel linear growth curve modeling. Overall, homicide rates in US cities decreased over this time-period (52.1–33.5 per 100,000 population) while the average greenness increased slightly (0.41–0.43 NDVI). Change in average city greenness was negatively associated with homicide, controlling for a range of variables (β = −.30, p-value = .02). The results of this study suggest that efforts to increase urban greenness may have small but significant violence-reduction benefits.
Co-developing peer interventions in health-related contexts: A case study from exercise referral
Authors: Portman Robert M , Levy Andrew R , Maher Anthony J , Fairclough Stuart J
Published: September 2021

Objective:

Peer support interventions can be successful in enhancing physical activity (PA) in a variety of health-related contexts. However, the evidence base remains equivocal, and ways to integrate structured peer support within the context of exercise referral schemes (ERSs) remain unexplored. In this regard, few studies consider the prospective acceptability of peer support interventions. Prior qualitative exploration can elicit insight into factors likely to influence peer intervention success, thus maximising the likelihood of developing and implementing effective peer support interventions. This study assessed the prospective acceptability of a peer support intervention for exercise referral.

Design/Setting:

Individual semi-structured interviews were conducted with 14 ERS clients ( n = 10) and providers ( n = 4) across two ERS sites in the North West of England, UK.

Method:

Interviews covered preferred demographic and personal characteristics of ERS peers and prospective peer roles. Interviews were analysed using thematic analysis.

Results:

A desirable ERS peer was perceived as someone who was positive and empathetic, with good interpersonal skills. ERS peers were considered to present a promising opportunity to enhance the accessibility of emotional, motivational and informational support among ERS clients while alleviating burden on ERS providers.

Conclusion:

Study findings have relevance to the integration of peer support in comparable ERS contexts, highlighting the value of developmental research to refine peer recruitment criteria and to facilitate ownership and support among providers across a variety of health-related contexts.
Understanding the Spirit of the Sectors: Exploring Identity in a New Era of Organizing
Authors: Langer Julie
Published: September 2021

While sector distinction debates often re-emerge during periods of cultural and institutional upheaval, none have considered an identity-orientation perspective. Identity orientation is a natural domain in which to address these debates as it considers the individualistic, relational, and collectivistic foundations of organizations. This study explores whether organizational members across sectors view their organization’s identity orientation differently. Findings suggest that member perceptions of identity orientation are significantly different across sectors and align with traditional sector values and motivations. However, no one sector can be defined solely as individualistic, relational, or collectivistic. These findings are discussed and future research paths laid out.
Developing an Online Psychological Trauma Education Course for College Students
Authors: Moss Amber , Swank Jacqueline M. , Schuermann Hope
Published: September 2021

Introduction

Individuals in various career fields will interact with people who have experienced trauma while engaging in their work responsibilities, and many have limited, if any, trauma training. Therefore, there is a need to provide trauma training within undergraduate degree programs.

Statement of Problem

Online learning is a viable method of meeting the need for psychological trauma education for undergraduate students.

Literature Review

Education in the United States has steadily moved toward more online formats, with many students preferring the flexibility of an online course. We discuss the literature on teaching about trauma and considerations for teaching the course online.

Teaching Implications

We outline components of an online undergraduate trauma education course focused on teaching students about psychological trauma. This includes presenting the course objectives, describing course assignments, and discussing considerations for the course which instructors can use in teaching about trauma.

Conclusion

Instructors of higher education can use the activities and considerations discussed in this article as a guide in the development of an online trauma education course.
Robust model reference control for second-order descriptor linear systems subject to parameter uncertainties
Authors: Tian Guang-Tai , Duan Guang-Ren
Published: September 2021

This paper is devoted to designing the robust model reference controller for uncertain second-order descriptor linear systems subject to parameter uncertainties. The parameter uncertainties are assumed to be norm-bounded. The design of a robust controller can be divided into two separate problems: a robust stabilization problem and a robust compensation problem. Based on the solution of generalized Sylvester matrix equations, we obtain some sufficient conditions to guarantee the complete parameterization of the robust controller. The parametric forms are expressed by a group of parameter vectors which reveal the degrees of freedom existing in the design of the compensator and can be utilized to solve the robust compensation problem. In order to reduce the effect of parameter uncertainties on the tracking error vector, the robust compensation problem is converted into a convex optimization problem with a set of linear matrix equation constraints. A simulation example is provided to illustrate the effectiveness of the proposed technique.
Approach for short-term wind power prediction via kernel principal component analysis and echo state network optimized by improved particle swarm optimization algorithm
Authors: Tian Zhongda
Published: September 2021

In recent years, short-term wind power forecasting has proved to be an effective technology, which can promote the development of industrial informatization and play an important role in solving the control and utilization problems of renewable energy system. However, the application of short-term wind power prediction needs to deal with a large number of data to avoid the instability of forecasting, which is facing more and more difficulties. In order to solve this problem, this paper proposes a novel prediction approach based on kernel principal component analysis and echo state network optimized by improved particle swarm optimization algorithm. Short-term wind power generation is affected by many factors. The original multi-dimensional input variables are pre-processed by kernel principal component analysis to determine the principal components that affect wind power. The dimension of principal component is less than the original input data, which reduces the complexity of modeling. The convergence and stability of the echo state network can be improved by using the principal component of the input variable. The advantage is to reduce the input variables, eliminate the correlation between the input variables, and improve the prediction performance of the prediction model. Furthermore, an improved particle swarm optimization algorithm is proposed to optimize the dynamic reservoir parameters of echo state network. Compared with other state-of-the-art prediction models, the case studies show that the proposed approach has good prediction performance for actual wind power data.
Implementation of new high-rise building staircase pressure differential system improvements
Authors: Brzezinska Dorota , Fryda Marcin
Published: September 2021

The following technical note demonstrates full-scale staircase test results of the pressure differential system improvement method described by Fryda et al. in 2021. It is a continuation of experimental research on the impact of the escape route’s leakages on the pressure differential systems for staircases. Based on the lab experiments, it has been found that an additional throttle of the leak implemented in the pressure differential system improves its effectiveness and allows it to be more precisely adjusted to the required overpressure. The results presented in this article have confirmed this hypothesis and provided the opportunity to apply for new patent solutions of a special throttle of the leak control and pressure regulating system. The proposed new leakage-based improvements could increase the efficiency of existing systems based on proportional-integral-derivative controller and could also be installed in new buildings.
Bilateral Posterior Auricular Masses: A Case of Kimura’s Disease
Authors: Xie Fengyang , Kou Yan , Zhang ShuaiJun , Shi Li , Han Jie , Zhou Xuanchen
Published: September 2021

Kimura’s disease (KD) is currently considered a rare chronic inflammatory disease of unknown etiology. It is more common in the Asian population, especially in young and middle-aged men, and can involve the lymph nodes, salivary glands, and subcutaneous tissues. It has been reported in adults and children, and is often accompanied by elevated peripheral blood eosinophils and elevated serum immunoglobulin E (IgE). Herein, we report a case of KD in a 46-year-old man with bilateral masses behind the ears since childhood that had gradually enlarged over 40 years. The patient’s peripheral blood eosinophils were elevated, and interestingly, homocysteine levels were also elevated. After surgical resection of the bilateral posterior auricular masses, follow-up over 5 years indicated good recovery and no signs of recurrence.
The reasons of the unreasonable: Is political liberalism still an option?
Authors: Giovanola Benedetta , Sala Roberta
Published: September 2021

In this study, we claim that political liberalism, despite harsh criticism, is still the best option available for providing a just and stable society. However, we maintain that political liberalism needs to be revised so as to be justifiable from the perspective of not only the “reasonable” in a Rawlsian sense (that we define as “fully” reasonable) but also the ones whom Rawls labels as “unreasonable.” To support our claim, going beyond Rawls’s original account, we unpack the concept of unreasonableness and identify three different subsets that we label as the “partially reasonable,” the “non-reasonable,” and the “unreasonable.” We argue that both the “fully” reasonable and the “partially reasonable” would be included into the constituency of public justification; more specifically, we claim that the latter would support liberal institutions out of their reasons: we define these reasons as mutually intelligible reasons and claim that they allow to acknowledge the importance of a convergence approach to public justification. As for the “non-reasonable” and “unreasonable,” we claim that they cannot be included in the constituency of public justification, but they nonetheless could be compliant with liberal institutions if political liberalism offers them some reasons to comply: here, we claim that political liberalism should include them through engagement and propose reasoning from conjecture as an effecting way of offering reasons for compliance. In particular, we claim that through reasoning from conjecture, the “non-reasonable” could find conciliatory reasons to comply with liberal institutions on a stable base. With regard to the “unreasonable” in the strict sense, we claim that through reasoning from conjecture, their unreasonableness could be contained and they could find reasons—even if just self-interested—for complying with liberal institutions rather than defying them. In our discussion, we consider the different subsets not as “frozen” but as dynamic and open to change, and we aim to propose a more complex and multilayered approach to inclusion that would be able to include a wider set of people. To strengthen our argument, we show that the need for a wider public justification and for broader inclusion in liberal societies is grounded in respect for persons both as equal persons and as particular individuals. In particular, we claim that individuals’ values, ends, commitments, and affiliations activate demands of respect and can strengthen the commitment to the liberal–democratic order. Through a reformulation of the role of respect in liberal societies, we also show a kind of social and communitarian dimension that, we claim, is fully compatible with political liberalism and opens it up to “civic friendship” and “social solidarity,” which are constitutive elements for the development of a sense of justice and for the realization of a just and stable society.
Improving Caregiver Health through Systematic Assessment and a Tailored Plan of Care
Authors: Camicia Michelle , Lutz Barbara J. , Stram Douglas , Tucker Lue-Yen , Ray Cristine , Theodore Brian R.
Published: September 2021

Caregivers often experience strain and negative effects on their well-being. We tested the effects of a caregiver assessment and tailored care plan for caregivers of patients transitioning home from an inpatient rehabilitation facility (IRF), a study involving two groups: usual care ( n = 225) (preimplementation) and intervention (postimplementation) ( n = 215). Caregivers in the intervention group were assessed using the 25-item self-reported Preparedness Assessment for the Transition Home during the IRF stay. A tailored care plan was implemented in response to the assessment. Caregivers in both groups completed the Modified Caregiver Strain Index and Global Health Scale at 30- and 90-day postdischarge. After adjusting for baseline and demographics, caregivers in the intervention group reported lower strain ( p < .01) and better overall health ( p < .05) at 30-day post-IRF discharge, relative to usual care. Implementing a systematic caregiver assessment and tailored care plan in the IRF may mitigate the adverse effects of caregiving.
Rapid Transitioning to Remote Learning: Shared Responsibility and Coping Strategies
Authors: Cao Joanne T. , Burgess Brigitte , Foster Jamye K. , Yaoyuneyong Gallayanee , Wallace Lacey K.
Published: September 2021

This study examined the impact of shared responsibility on the relationship between marketing and other business students’ coping strategies and their satisfaction with the rapid transitioning to remote learning and academic performance expectations. COVID-19 (coronavirus disease 2019) rapidly altered and challenged higher education to maintain pedagogical services provided to students, regardless of faculty or student readiness or experience. As such, shared responsibility can be critical in times of crisis when the university community must pull together for mutual success. Findings indicate that students’ sense of shared responsibility and healthy coping mechanisms lead to student satisfaction with the transition process and more positive academic outcomes. This study is the first to empirically examine shared responsibility in higher education during a crucial period to the authors’ knowledge. By promoting shared responsibility, marketing educators can improve student outcomes and identify those who may need additional support resources.
Biculturalism and Self-Esteem: Differential Associations Based on Cultural Domain
Authors: Garcia Peraza Paulette D. , Nguyen Angela-MinhTu D. , Corona Joshua , Amini Sadie S.
Published: September 2021

Acculturation is multidimensional in that it encompasses both heritage and dominant cultural orientations, and it can take place across multiple domains; therefore, biculturalism, an acculturation strategy involving strong orientations to both heritage and dominant cultures, can also occur for the domains of behaviors and practices, values and beliefs, and cultural identity. The current study is the first to compare the relations between biculturalism and self-esteem across these three cultural domains. Mexican American undergraduate students ( N = 219; Mage = 18.82 years, SD = 1.09), who were primarily women (72.15%) and born in the US (81.74%), responded to an in-person survey. We found that biculturalism is differentially associated with personal and collective self-esteem depending on the domain, with stronger associations for bicultural behaviors and weaker associations for bicultural values. Our findings highlight the importance of recognizing the multidimensionality of biculturalism in theory, research, and practice.
Inclusion, diversity, equity, and accessibility: From organizational responsibility to leadership competency
Authors: Mullin Anne E. , Coe Imogen R. , Gooden Everton A. , Tunde-Byass Modupe , Wiley Ryan E.
Published: September 2021

An awakening to systemic anti-Black racism, anti-Indigenous racism, and harmful colonial structures in the context of a pandemic has made health inequities and injustices impossible to ignore, and is driving healthcare organizations to establish and strengthen approaches to inclusion, diversity, equity, and accessibility (IDEA). Health research and care organizations, which are shaping the future of healthcare, have a responsibility to make IDEA central to their missions. Many organizations are taking concrete action critically important to embedding IDEA principles, but durable change will not be achieved until IDEA becomes a core leadership competency. Drawing from the literature and consultation with individuals recognized for excellence in IDEA-informed leadership, this study will help Canadian healthcare and health research leaders—particularly those without lived experience—understand what it means to embed IDEA within traditional leadership competencies and propose opportunities to achieve durable change by rethinking governance, mentorship, and performance management through an IDEA lens.
Teaching-Learning Column Introduction
Authors: Yancey Nan Russell
Published: September 2021

This article introduces a discussion of faculty practices in journeying with nurse students in the preparation for success on the NCLEX-RN®. While veering from this column’s usual focus on the teaching-learning of nursing, it offers faculty the opportunity to join in a discussion of an issue that many nurse faculty consider to be of critical importance in nurse education.
Peplau’s Theory of Interpersonal Relations: A Case Study
Authors: Wasaya Farah , Shah Qamraiz , Shaheen Aziza , Carroll Karen
Published: September 2021

Theoretical frameworks offer guiding principles to guide nursing practice on well-defined nursing knowledge. Peplau’s theory of interpersonal relationship empowers nurses in their work for regaining health and well-being for people. Understanding the theory and the connectedness that arises from this theory provides a structure for nurse-patient relations, even working through a language barrier as evidenced by the case scenario detailed in this article.
More Thoughts About Models of Nursing Practice Delivery
Authors: Fawcett Jacqueline
Published: September 2021

This is the second of two essays about five models of nursing practice delivery—total patient care, functional nursing, team nursing, primary nursing, and the attending nurse. Primary nursing and the attending nurse are discussed in this essay. The other three models were discussed in a previous issue of Nursing Science Quarterly. Each model is described and its connection with nursing discipline-specific knowledge is discussed. The extent to which each model ascribes accountability for practice also is discussed.
Advancing Nursing Practice Through Mentoring and Teaching-Learning
Authors: Carroll Karen
Published: September 2021

In the article that follows this introduction, there are insights into the importance of a theoretical framework for nursing practice. The authors detail the impact to nursing practice a theoretical framework provides by using a case study approach. The introductory thoughts in this article focus on inspiring mentoring models and teaching learning models within theoretically based nursing science and practice.
The Self-Determination Theory: Health-Related Quality of Life in Adolescents with Congenital Heart Disease
Authors: Shackleford Jenna L. , Spratling Regena , Kelley Susan J.
Published: September 2021

The purpose of this paper is to present a conceptual-theoretical-empirical model addressing variables associated with self-management of care and adherence to treatment and its relationship to health-related quality of life for adolescents with congenital heart disease. There is limited research on adolescents with congenital heart disease regarding the relationship between autonomy, relatedness, competence, self-management of care and adherence to treatment, and health-related quality of life. The proposed Health-Related Quality of Life and Transition of Adolescents With Congenital Heart Disease to Self-Manage in Adulthood model, adapted from the Self-Determination Theory, will help to better understand these relationships.
Reflexivity: Should It Be Mandated for Qualitative Reporting?
Authors: Florczak Kristine L.
Published: September 2021

Reflexivity and its importance to the process of qualitative research is examined in this column. To that end, the definition of reflexivity is entertained followed by a discussion related to its inclusion in several versions of standards of qualitative research. Finally, a consideration of how reflexivity in articles should be written is undertaken.
Alcohol Disorders in Military Veterans: An Evaluation with the Roy Adaptation Model
Authors: Hallihan Hagar , Kapella Mary C. , Fink Anne M.
Published: September 2021

The purpose of this paper was to evaluate a role for the Roy adaptation model (RAM) for the nursing care of military veterans with alcohol use disorder. Parse’s criteria were used to critique the RAM. The RAM’s humanistic philosophy emphasizes the ability to develop new coping skills and adapt to complex environments. The framework can define physical, emotional, and social responses to stressors faced by veterans. The RAM could guide new research and practice initiatives that optimize the health of military veterans.
Searching for Significance During a Pandemic: A Muslim Perspective
Authors: Bahadur Dhaneesha , Baumann Steven L.
Published: September 2021

The authors in this article seek to describe the importance of keeping one’s beliefs and spiritual practices alive during the COVID-19 pandemic from a Muslim perspective, and it considers this challenge in light of the theory of religious coping and the growing literature on the benefits of mindfulness. It provides nurses and other healthcare providers a view into the beliefs and practices of a Muslim-American family and shows how faith practices can help people not only cope but grow in difficult times. Implications for nursing and healthcare are discussed.
Plagiarism in the Graduate Nursing Program: Occupation Stress or Lack of Knowledge?
Authors: Kratovil Amanda
Published: September 2021

Student plagiarism has always been a concern for nursing faculty. Faculty have noticed an increase in graduate student plagiarism during COVID-19. While research regarding plagiarism and graduate nurses and occupational stress and plagiarism is sparse, neurobehavioral research on decision-making provides some clues for faculty concerned about graduate nurses working and attending school during a pandemic.
Health Ownership: A Concept Analysis
Authors: Tlusty Gisele , Hanna Kathleen M.
Published: September 2021

Health ownership has been discussed by authors in many disciplines, but a definition does not currently exist for this concept. The purpose of this concept analysis was to explore health ownership in the context of healthcare delivery in the United States. Walker and Avant’s method was used to identify the defining attributes, antecedents, consequences, and empirical referents. Cases are provided to show a conceptual definition of health ownership. This concept analysis allows healthcare professionals to improve health outcomes by guiding individuals to take accountability, control, and accept responsibility for their health.
A Cultural Orientation Approach to Work Orientation: Mongolian Workers’ Jobs, Careers, and Callings
Authors: Park Jiyoung , Choi Yeeun , Chao Melody M. , Beejinkhuu Uurtsaikh , Sohn Young Woo
Published: September 2021

Culturally held beliefs about the self and its relations with others affect the way individuals view their work. In this study, we examined the associations between individualism-collectivism and the three work orientations (i.e., viewing work as a job, a career, or a calling). We also investigated whether the positive effects of a calling orientation can be generalized to a developing eastern country, Mongolia. Using a sample of 352 Mongolian workers, we found that those endorsing horizontal collectivism tended to view their work as a calling more than as a job or a career. Mongolians with a calling orientation reported having better satisfaction with job, salary, and life, more work meaningfulness, and less turnover intention than those viewing work as a job or a career. The results suggest that cultural orientations and work orientations are intertwined, and the positive roles of a calling orientation are generalizable to Mongolia.
A knowledge representation of decision communications in scheme for automotive troubleshooting service
Authors: Liang Jeremy S
Published: September 2021

Scheme processes about complicated engineering systems are certainly complex on account of the interdependencies among submodules in the same tier and between tiers of a segmented hierarchy. In the design process with decision mode, this effects in communications among groups of design decisions. It is important to extract and represent the knowledge relevant to the decision communications for developing design process with decision mode. There are two critical issues addressed regarding the modeling of communications: decision types and these are made in various tiers. To stress the above two issues, there are several fundamental communication models defined among decisions in this study. Meanwhile, a presented ontology to identify the knowledge connected with these communication models. Critical benefits of the ontology involve that a hierarchical communications between decisions can be extracted, and a decision task-flows with accessible, adaptable, and implementable features for developing more complex systems can be generated. The applicability of the ontology is shown by scheme for an automotive braking troubleshooting service example.
The role of inferences in reading comprehension: A critical analysis
Authors: Gauche Gilberto , Pfeiffer Flores Eileen
Published: September 2021

The central role attributed to inferences in reading comprehension can be traced back to the Construction-Integration (CI) model, and many of its theoretical assumptions are still shared by current models. This article analyses recent research in terms of how inferences have been conceived, how they relate to comprehension, and how the CI model’s theoretical legacy has been articulated. The main issues found are that the way inferences are currently conceived doesn’t satisfactorily distinguish them from ordinary comprehension and that a series of assumptions which plausibly apply to computational models have been often mistakenly attributed to interpersonal processes. This, added to the widespread usage of lab-created texts in experiments, hinders the faithful capturing of personal comprehension processes. Finally, we propose recommendations for future research based on conceptual clarity, metatheoretical awareness, and a meaning-based approach on language, so as to improve interresearcher communication, theoretical consistency, and ecological validity.
Working Against Gender-Based Violence in the American South: An Analysis of Race, Ethnicity, Gender, and Sexuality in Advocacy
Authors: Cayir Ebru , Spencer Mindi , Billings Deborah , Hilfinger Messias DeAnne K. , Robillard Alyssa
Published: September 2021

Non-profit organizations that address gender-based violence must create diverse, inclusive, and equitable workplaces for advocates so that they can adequately serve diverse survivors. Despite recent efforts, differential treatment and high turnover among minority advocates continue. Further strategies to eliminate discriminative organizational practices are needed. We interviewed 25 advocates employed by non-profit organizations in a Southeastern state to examine how race, ethnicity, gender, and sexuality shape their work experiences. Guided by constructivist grounded theory and intersectionality, data analysis yielded four major themes that covered white dominance in advocacy, essentialized womanhood and heteronormativity, serving communities of color, working in the Deep South. Patriarchal values, religious norms, and gender roles influenced how advocates’ work was received by the communities. Racial/ethnic minority, and sexual and/or gender minority advocates faced discrimination, tokenism, and negative stereotypes. Transforming organizational climate and policies is necessary to support minority advocates’ work engagement and ability to serve marginalized communities.
Effect of Two Bathing Methods on Physiologic Parameters in Pediatric Intensive Care
Authors: Öz Özgül , Uysal Gülzade , Düzkaya Duygu Sönmez
Published: September 2021

To determine the effect of traditional and disposable bed baths performed in the pediatric intensive care unit (PICU) on the physiologic parameters of children. This research was conducted as a randomized controlled trial with children who were monitored in the PICU. It was found that the pulse and blood pressure immediately after the bath were higher for both bath applications and was the lowest 30 minutes after the bath ( p < .05). Children who used traditional baths had a lower body temperature than those who used the disposable bed bath after bathing for the second day. Oxygen saturation averages were found that within the group to be the highest 30 minutes after bathing methods ( p < .05). Both bathing methods applied in the PICU had a positive effect on physiologic parameters. It may be recommended to regularly perform the most appropriate bathing for patients with stable hemodynamics in PICUs.
Response to Tyrosine Kinase Inhibitors in Real-World Patients With Chronic Myeloid Leukemia
Authors: Szeto Andy H. , Bucci Tyler , Deal Allison , Zhu Anqi , Ahmad Majd , Cass Amanda S. , Sketch Margaret R. , Kemper Ryan , Zeidner Joshua F. , Foster Matthew C. , Muluneh Benyam , Crona Daniel J.
Published: September 2021

Background:

Tyrosine kinase inhibitors (TKIs) are the front-line therapy for chronic myeloid leukemia (CML), where phase 3 clinical trials have demonstrated their safety and efficacy. However, trial patients may not be representative of real-world patients (RWPs).

Objective:

To evaluate RWP clinical factors associated with effectiveness and safety in CML patients treated with TKIs.

Methods:

Patients with CML treated with at least 30 days of imatinib, dasatinib, nilotinib, or bosutinib between 2014 and 2018 were included. Patients were stratified into categories based on the number of factors that would have precluded enrollment into pivotal TKI phase 3 trials (0, 1, ≥2). End points included complete hematologic response (CHR), early molecular response (EMR), major molecular response (MMR), adverse event (AE)-induced dose decreases, treatment interruptions, and treatment discontinuations.

Results:

Final analyses included 174 patients. Patients with ≥2 factors had a higher risk of dose decreases (relative risk = 1.54; 95% CI = 1.02-2.34; P = 0.02) and a shorter time to dose decrease (hazard ratio = 2.43; 95% CI = 1.23-4.97; P = 0.006) compared with patients with 0 factors. Significant differences were observed in CHR at 1 month and MMR at 3 months between patients with 0 and ≥2 factors ( P = 0.03 and P = 0.04, respectively).

Conclusion and Relevance:

Approximately 60% of our RWPs would have been excluded from the pivotal phase 3 TKI trials. These data suggest that RWPs require more precise dosing to achieve CML clinical milestones and to mitigate AEs, but findings should be validated prospectively.
Role of P16 Expression in the Prognosis of Patients With Laryngeal Cancer: A Single Retrospective Analysis
Authors: Allegra Eugenia , Bianco Maria Rita , Mignogna Chiara , Caltabiano Rosario , Grasso Maria , Puzzo Lidia
Published: September 2021

Background

A possible oncogenic role of human papillomavirus (HPV) in head and neck cancers (mainly oropharynx tumors) has been suggested. This significant association has been considered true for oropharynx tumors; however, the association between HPV infection and laryngeal carcinomas is yet to be established. The aim of this study was to evaluate the relationship between p16 expression and long-term overall, disease-free, and disease-specific survival (OS, DF, and DSS, respectively) in patients surgically treated for laryngeal carcinoma.

Materials and Methods

Seventy-four previously untreated laryngeal carcinoma patients who underwent surgical treatment were considered for this retrospective study. The tissue specimens were processed for immunohistochemical p16 protein (surrogate HPV marker) detection.

Results

Survival analysis of the p16 expression of the primary tumor showed that the 5-year OS rates were 90% and 29.7% for the p16-positive and negative groups, respectively ( P = .003). The 5-year DFS and DSS also differed between both groups ( P < .001), whereas the 5-year DSS seemed to be related to tumor/lymph node classification and p16 expression. However, only p16 expression was identified as an independent prognostic factor associated with OS and DSS.

Conclusions

Surgically treated p16-positive laryngeal cancer patients may represent a subset of patients with a better prognosis than their p16-negative counterparts.
Overview in Breast Cancer Screening in Lebanon
Authors: Sbaity Eman , Bejjany Rachelle , Kreidieh Malek , Temraz Sally , Shamseddine Ali
Published: September 2021

Breast cancer (BC) is the most common cancer in women and men combined, and it is the second cause of cancer deaths in women after lung cancer. In Lebanon, the same epidemiological profile applies where BC is the leading cancer among Lebanese females, representing 38.2% of all cancer cases. As per the Center for Disease Control, there was a decline in BC mortality rate from 2003 to 2012 reflecting the adoption of national mammographic screening as the gold standard for BC detection by Western countries. The aim of this review study is to summarize current recommendations for BC screening and the available modalities for detecting BC in different countries, particularly in Lebanon. It also aims at exploring the impact of screening campaigns on BC early stage diagnosis in Lebanon. Despite the considerable debates whether screening mammograms provides more harm than benefits, screening awareness should be stressed since its benefits far outweigh its risks. In fact, the majority of BC mortality cases in Western countries are non-preventable by the use of screening mammograms alone. As such, Lebanon adopted a public focus on education and awareness campaigns encouraging early BC screening. Several studies showed the impact of early detection that is reflected by an increase in early stage disease and a decrease in more aggressive stages. Further studies should shed the light on the effect of awareness campaigns on early breast cancer diagnosis and clinical down staging at a national scope; therefore, having readily available data on pre- and post-adoption of screening campaigns is crucial for analyzing trends in mortality of breast cancer origin and reduction in advanced stages diseases. There is still room for future studies evaluating post-campaigns knowledge, attitudes, and practices of women having participated, emphasizing on the barriers refraining Lebanese women to contribute in BC screening campaigns.
Military Transportation in State Freight and Defense Community Plans
Authors: Miller Chad R.
Published: September 2021

The US Department of Defense (DoD) makes extensive use of the US multimodal transportation network to move material for operational support, keep facilities supplied, and move personnel. Federal agencies, especially the US Department of Transportation, work closely with the DoD. States and localities also play a critical role in defense infrastructure. This research examines state freight and defense community plans to identify how the transportation needs of the DoD are being addressed in state planning. The findings are 72% of the 50 state freight plans mention defense transportation, while 34% considered defense transportation needs in-depth. About 6 of 19 identified state defense community plans mention transportation, but only 3 have specific defense transportation goals. Nationally, the DoD and federal agencies work closely together to maintain the nation’s defense transportation network, but at the local and state level closer cooperation on transportation issues should be developed. Military readiness remains high, but efficiencies in the system can be improved.
Criminal Histories of Intimate Partner Homicide Offenders
Authors: Zeoli April M. , Kwiatkowski Christine C. , Wallin Mikaela A. , Brown Kylei
Published: September 2021

This exploratory study investigates intimate partner homicide (IPH) offenders’ criminal histories to examine opportunities for criminal justice system intervention. Data were collected from the Michigan Violent Death Reporting System and Michigan State Police for the 117 IPHs committed in 2014 and 2015 in Michigan. Descriptive statistics on types of criminal charges and convictions for the 103 IPHs committed by aggressors (e.g., not in self-defense) are presented, with relatively few domestic violence charges or convictions. Twenty-nine percent of offenders had no criminal history. Findings highlight a need for more effective and greater implementation of interventions for both criminal justice system-involved and not-involved offenders.
The management of dialysis access thrombosis during the COVID-19 pandemic
Authors: Seet Christopher , Lindsey Ben , Sivaprakasam Rajesh , McCafferty Kieran , Forbes Suzanne , Akhtar Mohammed Rashid , Khurram Muhammad , Mohamed Ismail H
Published: September 2021

Background:

Maintaining patent access is essential for haemodialysis dependent end stage renal failure patients. The COVID-19 pandemic has significantly affected surgical and interventional radiology services worldwide. We aimed to review the impact COVID-19 has caused to the management of acute dialysis access thrombosis.

Methods:

We conducted a single centre retrospective review of outcomes of patients with arteriovenous fistula and arteriovenous graft thrombosis between March and May 2020, which coincided with the first peak of the COVID-19 pandemic in London, and a similar period in the previous year, March–May 2019. Outcomes in both cohorts of patients were compared, including attempts at salvage, salvage success, 1-month patency rates after salvage and subsequent surgery on the same access. We also analysed the use of tunnelled haemodialysis lines (THL), either due to failed salvage attempts or when salvage was not attempted.

Results:

There was a similar incidence of access thrombosis in both periods (26 cases in 2019, 38 in 2020). There were 601 patients dialysing via an arteriovenous fistula or graft in 2019, and 568 patients in 2020. Access salvage, when attempted, had similar success rates and 1-month patency (salvage success 74% vs 80%, p = 0.39; 1-month patency 55% vs 62%, p = 0.69). The proportion of patients where access salvage was not attempted and a THL inserted was significantly higher in 2020 compared to 2019 (32% vs 4%, p = 0.007). There were more patients who subsequently had surgery to salvage or revise the same access in 2019 compared to 2020 (62% vs 13%, p < 0.001).

Conclusions:

During the peak of the COVID-19 pandemic, there were fewer attempts at access salvage. This was a conscious decision due to increased pressure on the healthcare system, access to emergency interventional radiology or operative theatres and the perceived risk/benefit ratio of access salvage. The long-term effects of this change in practice remain unknown.