bluuebunny/crossref_metadata_2025 huggingface dataset:
Barriers in Accessing Social Welfare Benefits for Families of Children With Intellectual and Developmental Disorders in Rural Karnataka: A Situation Analysis
Authors: Reddy Shanivaram K. , Jagnnathan Aarti , Ashraf Guddekoppa H. , Kumar Chennaveerachari Naveen , Thirthalli Jagadisha , Banerjee Ruma , Muralidhar Daliboina
Published: March 2021

Background:

Several government schemes exist for the welfare of families having children with intellectual and developmental disorders (IDDs) in India. However, these schemes are often not utilized. An understanding of the barriers to access these social welfare benefits, especially in rural areas of India, can aid in planning social action toward the implementation of these schemes.

Methods:

A situation analysis of the resources and potential barriers to access social welfare benefits for families of children with IDD was conducted in a rural community. Stakeholder interviews were conducted with families of children with IDD ( n = 20), government officials responsible for implementing education at the state level ( n = 5), local officials responsible for facilitating social welfare benefits ( n = 5), and nongovernmental organization (NGO) working in the area of children with IDD ( n = 3). Qualitative thematic analysis was used to understand the barriers to access social welfare benefits for the families of children with IDD.

Results:

Barriers encountered by families of children with IDD, local officials, and NGOs included lack of awareness about the available welfare schemes, unavailability of social welfare facilities in the local areas, lack of social auditing in the provision of social welfare schemes to the needy, and stringent process of application and regulation for financial aid under the National Trust schemes.

Conclusion:

There are multiple barriers to access social welfare benefits for families having children with IDD in rural Karnataka. There is a strong need to empower families, sensitize local officials, and advocate for social policies to effectively implement National Trust schemes in rural areas of Karnataka.
A Student’s Guide to the Classification and Operationalization of Variables in the Conceptualization and Design of a Clinical Study: Part 2
Authors: Andrade Chittaranjan
Published: March 2021

Students without prior research experience may not know how to conceptualize and design a study. This is the second of a two-part article that explains how an understanding of the classification and operationalization of variables is the key to the process. Variables need to be operationalized; that is, defined in a way that permits their accurate measurement. They may be operationalized as categorical or continuous variables. Categorical variables are expressed as category frequencies in the sample as a whole, while continuous variables are expressed as absolute numbers for each subject in the sample. Continuous variables should not be converted into categorical variables; there are many reasons for this, the most important being that precision and statistical power are lost. However, in certain circumstances, such as when variables cannot be accurately measured, when there is an administrative or public health need, or when the data are not normally distributed, it may be justifiable to do so. Confounding variables are those that increase (or decrease) the apparent effect of an independent variable on the dependent variable, thereby producing spurious (or suppressing true) relationships. These and other concepts are explained with the help of clinically relevant examples.
The magic bullet for rural development? Exploring the impacts of community telecenters in Bangladesh
Authors: Siddiquee Noore Alam , Faroqi Md Gofran
Published: March 2021

This paper explores the impacts of Bangladesh’s Union Digital Centers (UDCs) as government information and service delivery hubs in rural areas. Drawing on user-surveys and semi-structured individual interviews it demonstrates that the UDCs have produced generally positive yet modest impacts on governance of service delivery. It shows that the UDCs are at an early stage of development, and that they offer only a limited set of services. While they helped extend ICT-enabled services to sections of population that would otherwise have missed them, the UDCs do not have much to do with rural livelihoods and empowerment of the poor and marginalized groups. These findings point to current inadequacies and pitfalls of the UDC approach to development. We argue that enhanced viability and effectiveness of the UDC experiment would warrant embedding more value-added governmental services and further strengthening of their capacity, mandate, and connectivity with government agencies at various levels, among others.
Specialist palliative care staff’s varying experiences of talking with people with intellectual disability about their dying and death: A thematic analysis of in-depth interviews
Authors: Foo Baby , Wiese Michele , Curryer Bernadette , Stancliffe Roger J , Wilson Nathan J , Clayton Josephine M
Published: March 2021

Background:

The cognitive and communication challenges experienced by people with intellectual disability present difficulties for health professionals, particularly in the face of illness and dying.

Aim:

To explore the experiences of specialist palliative care staff in talking with people with intellectual disability about their dying and death, and factors that influence these conversations.

Design:

An inductive thematic analysis was conducted on data from a larger qualitative semi-structured interview study.

Setting/participants:

Twenty palliative care staff from health services across Australia were interviewed. Participants were employed in multidisciplinary specialist palliative care teams and had provided palliative care to dying persons with intellectual disability.

Results:

Specialist palliative care staff did not consistently talk with people with intellectual disability about their dying and death. Conversations were influenced by (a) the perceived capacity of the person with intellectual disability, (b) experience and expertise of palliative care staff, (c) the relationship between palliative care staff and dying person and (d) values of palliative care staff and other caregivers (namely family members and paid carers).

Conclusions:

Specialist palliative care staff experience difficulties in talking with people with intellectual disability about their dying. Development of communication guidelines, resources and training for palliative care teams are urgently required to improve palliative care for this patient group. A more comprehensive research agenda on the needs of people with intellectual disability and their caregivers in palliative care is needed, with a particular focus on strategies to effectively communicate about dying and death.
End-of-life cost trajectories and the trade-off between treatment costs and life-extension: Findings from the Cost and Medical Care of Patients with Advanced Serious Illness (COMPASS) cohort study
Authors: Doble Brett , Wong Wei Han Melvin , Finkelstein Eric ,   on behalf of the COMPASS study team
Published: March 2021

Background:

Few studies have assessed how patient preferences influence end-of-life costs.

Aim:

To estimate mean monthly healthcare costs in 2019 Singapore Dollars (SGD) at five time points within the last year of life and identify how patients’ preferences for the trade-off between treatment cost containment and life-extension and other factors affect these costs.

Design:

Mean monthly costs were quantified in the last 1, 3, 6, 9, and 12-months before death. Univariate and multivariate analyses were conducted.

Setting/participants:

Billing records for 286 deceased participants in the Cost and Medical Care of Patients with Advanced Serious Illness (COMPASS) cancer cohort study in Singapore.

Results:

Mean monthly costs were $5140 (95% CI: $4750; $5520) in the 12-months before death and rose to $8350 (95% CI: $7110; $9590) 1-month before death. Participants preferring higher cost containment/less life-extension defied the trend of increasing costs closer to death (mean monthly costs of $4630 (95% CI: $3690; $ 5580) and $4850 (95% CI: $2850; $6850) (12-months and 1-month before death respectively). Participants preferring lower cost containment/more life-extension had costs that were $1050 (95% CI: $49; $2051) and $5220 (95% CI: $2320; $8130) higher than those preferring lower costs/less life-extension 12-months and 1-month before death respectively.

Conclusions:

On average, cancer patients in Singapore can expect to spend $61,680 in the last year of life. Of broader relevance is that patient preferences and other observable factors clearly influence these costs, suggesting that policymakers and patients can better predict and budget for end-of-life costs by considering these factors.
Telmisartan prevents high-fat diet-induced neurovascular impairments and reduces anxiety-like behavior
Authors: Huber Gianna , Ogrodnik Mikolaj , Wenzel Jan , Stölting Ines , Huber Lukas , Will Olga , Peschke Eva , Matschl Urte , Hövener Jan-Bernd , Schwaninger Markus , Jurk Diana , Raasch Walter
Published: March 2021

Angiotensin II receptor blockers (telmisartan) prevent rodents from diet-induced obesity and improve their metabolic status. Hyperglycemia and obesity are associated with reduced cerebral blood flow and neurovascular uncoupling which may lead to behavioral deficits. We wanted to know whether a treatment with telmisartan prevents these changes in obesity.

We put young mice on high-fat diet and simultaneously treated them with telmisartan. At the end of treatment, we performed laser speckle imaging and magnetic resonance imaging to assess the effect on neurovascular coupling and cerebral blood flow. Different behavioral tests were used to investigate cognitive function.

Mice developed diet-induced obesity and after 16, not 8 weeks of high-fat diet, however, the response to whisker pad stimulation was about 30% lower in obese compared to lean mice. Simultaneous telmisartan treatment increased the response again by 10% compared to obese mice. Moreover, telmisartan treatment normalized high-fat diet-induced reduction of cerebral blood flow and prevented a diet-induced anxiety-like behavior. In addition to that, telmisartan affects cellular senescence and string vessel formation in obesity.

We conclude, that telmisartan protects against neurovascular unit impairments in a diet-induced obesity setting and may play a role in preventing obesity related cognitive deficits in Alzheimer’s disease.
An Examination of Consistency in the Incremental Approach to Willingness to Pay: Evidence Using Societal Values for NHS Dental Services
Authors: Carr Katherine , Donaldson Cam , Wildman John , Smith Robert , Vernazza Christopher R.
Published: March 2021

Introduction

Willingness to pay (WTP) is used to generate information about value. However, when comparing 2 or more services using standard WTP techniques, the amounts elicited from participants for the services are often similar, even when individuals state a clear preference for one service over another. An incremental approach has been suggested, in which individuals are asked to first rank interventions and provide a WTP value for their lowest-ranked intervention followed by then asking how much more they are willing to pay for their next preferred choice and so on. To date, evaluation of this approach has disregarded protest responses, which may give information on consistency between stated and implicit rankings.

Methods

A representative sample of the English population ( n = 790) were asked to value 5 dental services adopting a societal perspective, using a payment vehicle of additional household taxation per year. The sample was randomized to either the standard or the incremental approach. Performance for both methods is assessed on discrimination between values for interventions and consistency between implicit and stated ranks. The data analysis is the first to retain protest responses when considering consistency between ranks.

Results

The results indicate that neither approach provides values that discriminate between interventions. Retaining protest responses reveals inconsistencies between the stated and implicit ranks are present in both approaches but much reduced in the incremental approach.

Conclusion

The incremental approach does not improve discrimination between values, yet there is less inconsistency between ranks. The protest responses indicate that objections to giving values to the dental interventions are dependent on a multitude of factors beyond the elicitation process.
Research progress of imaging technologies for ischemic cerebrovascular diseases
Authors: Chen Li , Zhao Ningning , Xu Shan
Published: March 2021

Cerebrovascular diseases mainly affect the blood supply of the brain, which has a high demand for oxygen and glucose for the nerve tissues to perform its nerve functions. Ischemic cerebrovascular disease can not only cause stroke, but is also associated with a high incidence of asymptomatic infarction and minimal bleeding that can lead to cognitive and behavioral changes. These changes ultimately manifest as vascular dementia or cognitive impairment. In clinical settings, ischemic cerebrovascular disease can be classified as a transient ischemic attack, reversible ischemic neurological deficit, progressive stroke, complete stroke, marginal infarction, or lacunar infarction. In this review, the research progress of imaging technologies for ischemic cerebrovascular diseases was reviewed, with an aim to provide evidence for clinical practitioners.
Recommended dose of sufentanil during induction of general anesthesia to avoid coughing and drastic hemodynamic fluctuations in patients undergoing surgery
Authors: Chen Ping , Zeng Ping , Gong Yuan , Long Xiang
Published: March 2021

Background

Sufentanil-induced cough (SIC) is a common complication during anesthesia induction. We explored the recommended sufentanil dose that effectively avoids cough during general anesthesia using a clinical trial to analyze the effective dose (ED)50 and ED95 of sufentanil that avoids cough, hemodynamic fluctuations, and adverse reactions.

Methods

On the basis of sufentanil dose, 136 patients (ASA class I–II) were randomly allocated into the following groups: I, 0.1 μg/kg; II, 0.3 μg/kg; III, 0.5 μg/kg; or IV, 1.0 μg/kg. The number of coughing incidents, dizziness, panic, and chest tightness within 1 minute after sufentanil injection, and the patient’s heart rate (HR) and blood pressure 5 minutes after intubation were recorded and analyzed. Cough was assessed as follows: none, 0 times; mild, 1 to 2 times/minute; moderate, 3 to 4 times/minute; and severe, 5 times/minute or more.

Results

The ED50 and ED95 of cough incidence induced by intravenous sufentanil in patients during general anesthesia induction was 0.332 μg/kg and 1.423 μg/kg, respectively. The cough rate in group I was lower than the other groups. The incidence of dizziness, panic, chest tightness, hypertension, bradycardia, and tachycardia were not significantly different.

Conclusions

The recommended sufentanil dose during general anesthesia induction is 0.1 μg/kg.
Retropharyngeal chordoma extending to the spinal cord, mimicking a neurogenic tumor: a case report and literature review
Authors: Lee Sun Joo , Paeng Sung Hwa , Kang Mi Seon , Jung Soo Jin , Yoon Shin Ae , Park Ha Young , Yoon Hye Kyoung , Yang Young Il , Cho Hwa Jin
Published: March 2021

Chordomas are rare, locally aggressive bone malignancies with poor prognoses. However, those with minimal or no bone involvement are more easily resectable because of their well-delineated margins and thus have better prognoses. Such extraosseous chordomas of the spine are localized both intradurally and extradurally. Only a few case reports have focused on extraosseous, extradural spinal chordomas. Radiologically, this type of chordoma has a dumbbell shape; however, dumbbell-shaped spinal tumors are traditionally thought to be neurogenic tumors (i.e., schwannomas or neurofibromas). We herein report a unique case involving a woman with a dumbbell-shaped extraosseous chordoma protruding predominantly into the retropharyngeal space. A 44-year-old woman presented for evaluation of a left submandibular mass. A T2-hyperintense, gadolinium-enhancing mass was found in her cervical spinal canal, protruding through the C2/3 neural foramen into the retropharyngeal space with minimal vertebral involvement. The initial diagnosis was a neurogenic tumor, most likely a schwannoma. After subtotal removal, the pathologic diagnosis was a chordoma. Because chordomas and schwannomas have significantly different prognoses, caution is warranted when a dumbbell-shaped tumor is identified in the spine with minimal or no vertebral deterioration on radiology. This report also provides the first thorough review of extraosseous dumbbell-shaped intraspinal–extraspinal chordomas.
Spatial and seasonal patterns of rainfall erosivity in the Lake Kivu region: Insights from a meteorological observatory network
Authors: Bagalwa R.M. , Chartin C. , Baumgartner S. , Mercier S. , Syauswa M. , Samba V.C. , Zabona M.T. , Karume K. , Cizungu N.L. , Barthel M. , Doetterl S. , Six J. , Boeckx P. , Van Oost K.
Published: March 2021

In the Lake Kivu region, water erosion is the main driver for soil degradation, but observational data to quantify the extent and to assess the spatial-temporal dynamics of the controlling factors are hardly available. In particular, high spatial and temporal resolution rainfall data are essential as precipitation is the driving force of soil erosion. In this study, we evaluated to what extent high temporal resolution data from the TAHMO network (with poor spatial and long-term coverage) can be combined with low temporal resolution data (with a high spatial density covering long periods of time) to improve rainfall erosivity assessments. To this end, 5 minute rainfall data from TAHMO stations in the Lake Kivu region, representing ca. 37 observation-years, were analyzed. The analysis of the TAHMO data showed that rainfall erosivity was mainly controlled by rainfall amount and elevation and that this relation was different for the dry and wet season. By combining high and low temporal resolution databases and a set of spatial covariates, an environmental regression approach (GAM) was used to assess the spatiotemporal patterns of rainfall erosivity for the whole region. A validation procedure showed relatively good predictions for most months (R2 between 0.50 and 0.80), while the model was less performant for the wettest (April) and two driest months (July and August) (R2 between 0.24 and 0.38). The predicted annual erosivity was highly variable with a range between 2000 and 9000 MJ mm ha−1 h−1 yr−1 and showed a pronounced east–west gradient which is strongly influenced by local topography. This study showed that the combination of high and low temporal resolution rainfall data and spatial prediction models can be used to improve the assessments of monthly and annual rainfall erosivity patterns that are grounded in locally calibrated and validated data.
Operation and approximation based on the history of failure modes recorded by SCADA system of Amougdoul Moroccan wind farm using FMECA maintenance model
Authors: Lamhour Kawtar , Tizliouine Abdeslam
Published: March 2021

The wind industry is trying to find tools to accurately predict and know the reliability and availability of newly installed wind turbines. Failure modes, effects and criticality analysis (FMECA) is a technique used to determine critical subsystems, causes and consequences of wind turbines. FMECA has been widely used by manufacturers of wind turbine assemblies to analyze, evaluate and prioritize potential/known failure modes. However, its actual implementation in wind farms has some limitations. This paper aims to determine the most critical subsystems, causes and consequences of the wind turbines of the Moroccan wind farm of Amougdoul during the years 2010–2019 by applying the maintenance model (FMECA), which is an analysis of failure modes, effects and criticality based on a history of failure modes occurred by the SCADA system and proposing solutions and recommendations.
Strategic Route Planning to Manage Transit’s Susceptibility to Disease Transmission
Authors: Hoover Sylvan , Porter J. David , Fuentes Claudio
Published: March 2021

Transit agencies have experienced dramatic changes in service and ridership because of the COVID-19 pandemic. As communities transition to a new normal, strategic measures are needed to support continuing disease suppression efforts. This research provides actionable results to transit agencies in the form of improved transit routes. A multi-objective heuristic optimization framework employing the non-dominated sorting genetic algorithm II algorithm generates multiple route solutions that allow transit agencies to balance the utility of service to riders against the susceptibility of routes to enabling the spread of disease in a community. This research uses origin–destination data from a sample population to assess the utility of routes to potential riders, allows vehicle capacity constraints to be varied to support social distancing efforts, and evaluates the resulting transit encounter network produced from the simulated use of transit as a proxy for the susceptibility of a transit system to facilitating the transmission of disease among its riders. A case study of transit at Oregon State University is presented with multiple transit network solutions evaluated and the resulting encounter networks investigated. The improved transit network solution with the closest number of riders (1.2% more than baseline) provides a 10.7% reduction of encounter network edges.
Effects of Asphalt Foaming on Damage Characteristics of Foamed Warm Mix Asphalt
Authors: Bairgi Biswajit K. , Hasan Md Amanul , Tarefder Rafiqul A.
Published: March 2021

In the asphalt foaming process, the foaming water content (FWC) controls the formation and characteristics of water bubbles. These water bubbles are expected to be expelled from the foamed warm mix asphalt (WMA) during mixing and compaction. However, foaming water may not be completely expelled, rather some of the microbubbles may be trapped in the foamed WMA even after compaction. These microbubbles, or undissipated water, can diffuse over time and cause damage to the foamed WMA. To this end, this study has determined the effects of foaming on the fatigue, moisture damage, and permanent deformation characteristics of foamed WMA. Foamed asphalt and mixtures were designed with varying FWCs and they were tested using linear amplitude sweep, multiple stress creep recovery, four-point flexural beam, and Hamburg wheel tracking tests. Primarily, asphalt foaming dynamics were assessed with a laser-based non-contact method. A simplified viscoelastic continuum damage concept and a three-phase permanent deformation model were used for damage evaluation. The study reveals that foaming softens the binder, which results in slightly higher rutting and moisture susceptibility, though an equivalent or slightly improved fatigue characteristic compared with the regular hot mix asphalt.
Long-Term Safety Analysis of Hard Shoulder Running on Freeways in Germany
Authors: Waleczek Helen , Geistefeldt Justin
Published: March 2021

On freeways with high traffic demand, hard shoulder running (HSR) can be an effective traffic management measure to increase the capacity by providing an additional travel lane during peak hours. While the positive effects of HSR on traffic flow quality were documented in several studies, the implications of HSR on road safety are more ambiguous. This paper presents results of a study in which accident data for seven freeway sections with HSR on freeways in Germany were analyzed over a long period of 13 years. All investigated sections are equipped with variable speed limits. The evaluation of crash frequencies on the investigated freeway sections revealed a high safety level. By combining crash data and traffic data it is shown that crash occurrence depends on the prevailing traffic conditions, with congestion being the most critical traffic state in relation to safety. Therefore, safety improvements upstream of HSR segments can be related to the improved traffic flow and the reduction of congestion. In conclusion, the results of the investigation provide evidence that the implementation of HSR can improve road safety if state-of-the-art traffic control technology is applied and congestion can be relieved.
Exposure-Based Models of Trail User Crashes at Roadway Crossings
Authors: Schneider Robert J. , Schmitz Andrew , Lindsey Greg , Qin Xiao
Published: March 2021

Multi-use trails are popular for transportation and recreation, but pedestrians and bicyclists are exposed to motor vehicle traffic at trail crossings (locations where trails cross roadways), creating the risk of crashes, injuries, and fatalities. Many trail crossing design guidelines suggest best practices to make trail crossings safe, but few studies have quantified the statistical relationship between trail user crashes and a broad set of trail crossing characteristics. Our study developed one of the first trail crossing crash models using trail user crashes reported at 197 crossings in the city of Minneapolis, MN, and in the Milwaukee, WI, region between 2011 and 2018. We took advantage of widespread trail counting programs and historic aerial and street-level imagery to create and test more than 30 theoretically important potential explanatory variables. We addressed the challenge that many crossings had small numbers of crashes (or zero crashes) during the study period by using a Poisson-lognormal model. Our model showed significant associations between trail crossing crashes and trail traffic volume, roadway motor vehicle volume, three-way intersections where the trail crosses perpendicular to the mainline roadway, and total crossing length. Although not statistically significant, signalized intersections and limited sight lines between drivers and trail users near crossings may also be associated with more crashes. Future research can build on this study and expand systemic efforts to improve trail crossing safety.
Arthroscopic International Cartilage Repair Society Classification System Has Only Moderate Reliability in a Porcine Cartilage Repair Model
Authors: Puhakka Jani , Paatela Teemu , Salonius Eve , Muhonen Virpi , Meller Anna , Vasara Anna , Kautiainen Hannu , Kosola Jussi , Kiviranta Ilkka
Published: March 2021

Background:

The International Cartilage Repair Society (ICRS) score was designed for arthroscopic use to evaluate the quality of cartilage repair.

Purpose:

To evaluate the reliability of the ICRS scoring system using an animal cartilage repair model.

Study Design:

Controlled laboratory study.

Methods:

A chondral defect with an area of 1.5 cm2 was made in the medial femoral condyle of 18 domestic pigs. Five weeks later, 9 pigs were treated using a novel recombinant human type III collagen/polylactide scaffold, and 9 were left to heal spontaneously. After 4 months, the pigs were sacrificed, then 3 arthroscopic surgeons evaluated the medial femoral condyles via video-recorded simulated arthroscopy using the ICRS scoring system. The surgeons repeated the evaluation twice within a 9-month period using their recorded arthroscopy.

Results:

The porcine cartilage repair model produced cartilage repair tissue of poor to good quality. The mean ICRS total scores for all observations were 6.6 (SD, 2.6) in arthroscopy, 5.9 (SD, 2.7) in the first reevaluation, and 6.2 (SD, 2.8) in the second reevaluation. The interrater reliability with the intraclass correlation coefficient (ICC) for the ICRS total scores (ICC, 0.46-0.60) and for each individual subscore (ICC, 0.26-0.71) showed poor to moderate reliability. The intrarater reliability with the ICC also showed poor to moderate reliability for ICRS total scores (ICC, 0.52-0.59) and for each individual subscore (ICC, 0.29-0.58). A modified Bland-Altman plot for the initial arthroscopy and for the 2 reevaluations showed an evident disagreement among the observers.

Conclusion:

In an animal cartilage repair model, the ICRS scoring system seems to have poor to moderate reliability.

Clinical Relevance:

Arthroscopic assessment of cartilage repair using the ICRS scoring method has limited reliability. We need more objective methods with acceptable reliability to evaluate cartilage repair outcomes.
Index Symptoms and Prognosis Awareness of Patients With Pancreatic Cancer: A Multi-Site Palliative Care Collaborative
Authors: Johnson Alyson M , Wolf Steven , Xuan Mengdi , Samsa Greg , Kamal Arif , Fisher Deborah A
Published: March 2021

Background:

Pancreatic cancer has a poor 5-year survival and carries significant morbidity. Pain is a commonly studied symptom in pancreatic cancer; however, few studies examine the frequency of multiple patient-reported symptoms. Our aim is to ascertain patient-reported symptom burden at initial consultation with a palliative care provider and compare patient prognostic awareness to provider estimation of prognosis.

Methods:

Data were extracted from the standardized Quality Data Collection Tool (QDACT). Adults with pancreatic cancer seen by a palliative care provider were included. Descriptive statistics were used to describe demographic features, symptom prevalence and burden, as well as assess patient prognosis awareness defined by congruence or incongruence with provider estimated prognosis.

Results:

285 patients were included in our analysis. The average age was 68 years (SD: 12.4), 87.2% were white, 50% male. The mean number of moderate/severe symptoms was 2.6 (SD: 2) out of 9 symptoms. Tiredness (66.7%), appetite (64.5%) and pain (46.2%) had the highest rates of moderate/severe symptom burden. Patients with a prognosis of 1-6 months had the lowest proportion of congruence with provider estimation (56.5%).

Conclusion:

Our study suggests targets to improve patient-centered care of pancreatic cancer. Patients commonly have multiple symptoms that are moderate/severe at time of palliative care referral. While pain has been well-reported, tiredness and decreased appetite are more prevalent at initial visit. This emphasizes the importance of assessing multiple symptoms and working closely with palliative care for early referral. Overall, one third of patient prognosis estimates differed from the provider assessment of prognosis. Our data support the importance of early referral to palliative care to manage symptoms and better prepare patients for end-of-life care.
Staking out an inshore commons: Pound-netting in Gilded Age America
Authors: Ress David
Published: March 2021

Controversy over the expansion of pound netting in the largest US fisheries of the late nineteenth century marked an early conflict between those who considered fisheries a commons and those who sought to establish property rights in a fishery. Pound-netters physically staked out a specific part of the sea for their exclusive use, and their conception of their property rights resulted in significant overfishing of important food – and oil – fish species. Here, just as with the commons that many economists argue inevitably result in over-exploitation of a resource, regulation was rebuffed and the fisheries collapsed.
‘Astounding it is, what Lidice carries’: The transport of Czechoslovak weapons for the Algerian National Liberation Front in 1959
Authors: Krátká Lenka
Published: March 2021

This article describes the detention in 1959 of the Czechoslovak ship Lidice, which was carrying weapons for the Algerian National Liberation Front, by the French Navy. Using documents from Czech archives, the study offers insights into this affair from two perspectives: first, that of the shipmaster and the officer for political affairs, who were aboard the ship during the detention; and second, that of the highest governmental and Communist Party authorities in Prague, which were concerned with the diplomatic and political aspects of the case.
Continuity and change in the maritime dimension of the North Atlantic Treaty Organization (NATO)
Authors: Usewicz Teresa
Published: March 2021

This article concerns the maritime dimension of the North Atlantic Treaty Organization (NATO). It presents an analysis of NATO’s past naval experience and key maritime achievements to gauge the extent to which they have contributed to the organization’s longevity, and to question whether strengthening its maritime dimension would affect the organization’s durability. The main findings of the research underscore the importance of the Alliance’s maritime safety efforts.
Navigating the Great Barrier Reef: The Inner and Outer Routes, 1815-1860
Authors: Morgan Kenneth
Published: March 2021

This article examines naval surveying voyages undertaken between 1815 and 1860 by Phillip Parker King, Francis Price Blackwood, Owen Stanley and Henry Mangles Denham to discuss the improvements to the navigation of the Inner and Outer shipping routes along the Great Barrier Reef. The Inner Route lay between Australia’s east coast and the western edge of the reefs while the Outer Route was situated in open sea beyond the eastern edge of the reefs. These were some of the most dangerous waters for ships in the Pacific off Australia’s east coast. The article analyses the improvements to both routes resulting from the surveying of the naval commanders referred to above; it explains why the choice between the Inner and Outer routes was difficult to make; and it shows that the Outer Route was increasingly favoured by merchant vessels.
Rijeka as a socialist port: Insights from Jugolinija's early years, 1947-1960
Authors: Normand Brigitte Le
Published: March 2021

To understand the distinctiveness of ports under state socialism, it is necessary to shift the focus from the built environment to flows of people, goods, knowledge and capital. In so doing, this article examines the operation of Yugoslavia's main shipping line, Jugolinija, from its inception in 1947 until 1960. This enterprise was based in the port of Rijeka, with both firm and port experiencing rapid growth during this period. The impact of state socialism can be seen in the primacy of the political over the profitability of the firm, with Jugolinija used to advance Yugoslavia's foreign trade and foreign policy, its interests being subordinated to the project of building self-managed socialism. It can also be seen in the unique challenges posed by having to operate at the intersection of the global market and a highly regulated economy – a situation that also created opportunities for the firm as a whole, as well as for its employees, who had access to foreign currency, travel and knowledge of the world. Jugolinija's privileged access to the world in what was still very much a closed society also created opportunities for ‘leaks’ of personnel and goods. Finally, socialist ideology left its imprint on Jugolinija's operations and shaped the ways in which its employees understood their work and the place of the firm within the Yugoslav economy. While it is tempting to see state socialism as ‘getting in the way’ of Jugolinija's business, in actuality the firm was remarkably successful both at operating within the Yugoslav socialist state framework, and capitalizing on the opportunities provided by access to the global market. Jugolinija's employees, in turn, profited from the mobility that came with working for the firm, sometimes at the expense of the enterprise and the state.
A Multisite Evaluation of Prosecutor-Led Pretrial Diversion: Effects on Conviction, Incarceration, and Recidivism
Authors: Davis Robert C. , Reich Warren A. , Rempel Michael , Labriola Melissa
Published: March 2021

Recent years have witnessed a resurgence of interest in prosecutor-led pretrial diversion programs, yet up-to-date research on the effectiveness of these programs is lacking. Participants in four prosecutor-led diversion programs, Cook County, IL (separate analyses for misdemeanor and felony participants), Milwaukee County, WI (two distinct programs varying in participant risk level and treatment intensity), and Chittenden County, VT, were propensity-score matched to comparison defendants (total n = 5,040). All programs yielded a significant decrease in instant case conviction (mean odds ratio = .12) and use of jail sentences (mean odds ratio = .33). There was also a trend toward reduced re-arrest at 2 years (mean odds ratio = .79). Three of four diversion programs significantly delayed onset of first re-arrest. Taken together, results support the effectiveness of a diverse set of prosecutor-led pretrial diversion programs that varied in charge severity, participant risk level, and program duration and intensity.
“Train Your Brain” Cognitive Intervention Group Program for Singaporean Older Adult Patients With Mild Cognitive Impairment: A Pilot Feasibility Study
Authors: Granland Kim A. , Thompson Claire L. , Dong Yanhong
Published: March 2021

The “Train Your Brain” (TYB) cognitive intervention group program was developed based on previous research with the goal of remediating cognitive impairments for elderly Singaporean people with mild cognitive impairment (MCI). This study reports a pilot evaluation of feasibility (defined as participant attendance, retention rate, satisfaction and usefulness) and preliminary efficacy of the TYB program. Nineteen participants with MCI aged ≥ 50 years were recruited from a memory clinic in Singapore, with 14 receiving the TYB intervention. Participants were allocated in order of recruitment into consecutive identical groups for a 9-session program on brain health and cognitive training. Participants received pre- and post-intervention measures of cognition and completed feedback forms reporting on satisfaction with, and utility of, the TYB program. TYB was well attended (85% attendance for the first 6 sessions; 83% for the full 9-session TYB program). Participant satisfaction was high, with positive participant feedback reporting that TYB offered useful cognitive strategies which participants could implement in their daily life. Despite the small sample size and absence of control group, repeated-measures t-tests revealed significant pre- to post-intervention intra-individual improvement in global cognition measured by the Montreal Cognitive Assessment, and in executive function on the Brixton Spatial Anticipation Test. This pilot study provides supportive preliminary evidence for feasibility of TYB, with suggestions of efficacy of this program as a culturally and linguistically appropriate intervention for English-speaking older adults with MCI in Singapore.
Multi-scale semi-analytical model for fatigue life prediction of trans-tibial prosthetic sockets
Authors: Mankai Wahbi , Ben Smida Brahim , Chafra Moez , Ben Cheikh Ridha
Published: March 2021

The trans-tibial socket is an essential component of the prosthesis that connects it to the residual limb. Socket misalignments and permanent deformations reduce the comfort of the amputee. In order to forestall such issues, sufficient information about the socket lifespan needs to be acquired, which is fairly difficult given the lack of calculation methods that estimate the fatigue life in the literature. In this paper a semi-analytical model is proposed based on experimental results. It highlights the effects of the amputee average daily walking time on the socket fatigue life. A proportionality relationship is demonstrated linking the Burgers model parameters at the structural scale to those at the macroscopic scale. Hence, it becomes possible to evaluate the permanent deformation that induces a misalignment in the socket. These results are useful for the designers to predict the fatigue life of the socket, and also for clinicians to monitor the mechanical degradation of the trans-tibial socket and schedule maintenance or replacement.
Deployable space grids with lockable joints
Authors: Pérez-Valcárcel Juan , Muñoz-Vidal Manuel , López César Isaac , Suárez Riestra Félix , Freire Tellado Manuel
Published: March 2021

The use of deployable structures in architecture began in the 1960s, based on the pioneering work of Emilio Pérez Piñero. It has had an interesting development using bundle or scissor modules, but with solutions that are always based on through-bolted joints. In this document, a new system for deployable space grids is proposed. This new system is based on the use of self-lockable joints, opening up a new and interesting field of design possibilities. The resulting space grids can be deployed by means of joints arranged on the bars that have a self-locking mechanism which is engaged in the final open position. This configuration overcomes the significant buckling that is characteristic of deployable structures with through-bolted joints. Different solutions are proposed for various uses, and the data from the theoretical and experimental analysis are provided.
Peer Effects on Investment Decisions: Do Industry Leaders and Young Firms Behave Differently?
Authors: Rashid Abdul , Said Ayanle Farah
Published: March 2021

This study examines the influence of peer firms on a firm’s investment policy in Pakistan during the period 2001–2017. It also investigates the heterogeneity in peer effects by taking into account a firm’s age and its leadership role in the industry. The system-GMM estimation results suggest that peer firms significantly influence a firm’s investments on both tangible and intangible assets. Yet, peer effects are more pronounced for tangible investment. We also observe that young firms are more prone to imitate the investment decisions of their industry peers. However, the findings indicate that mimicking is not a tactical behaviour for industry leader firms. These findings have important implications for both the firm management and the owner community.
Disparities in Depression Status Among Different Industries in Transition Economy: A Cross-Sectional Study of Mongolia
Authors: Batbold Ochirbat , Pu Christy
Published: March 2021

Transition economies tend to rely on rapid growth of specific industries and hence often leads to disparities in health status among the working population. This study aims to determine the depression status in different industries and occupational groups in Mongolia, a country that is experiencing an economic transition. We conducted a cross-sectional survey between July and September 2018 in Ulaanbaatar, Mongolia. A total of 1784 employees from 22 private and public companies were enrolled in this study. The Patient Health Questionnaire–9 (PHQ-9) was used to determine the severity of depression. Prevalence of depression is evaluated using weighted analysis. The association between occupational groups (white, blue, and pink collars), industries, and PHQ-9 score was analyzed using linear regression. In multiple regression, the workers in the transportation, public administration, and education industries exhibited the highest depression scores ( P < .001). Traditional variables such as age, sex, and marital status remained significant predictors in our model. Industrial types should not be overlooked in identifying depression in the working population. This is especially true for a transition economy like Mongolia. Analysis by industries is essential to promote stress management in the future among vulnerable groups in specific industries.
Valuing beneficiary voice: Involving children living in out-of-home care in programme evaluation
Authors: Knight Ruth L , Kingston Kylie L
Published: March 2021

This article charts the innovative evaluation journey an Australian nonprofit organisation, The Pyjama Foundation (PJF), has taken when designing an evaluation instrument to gain feedback from programme beneficiaries. PJF sought to develop a formal, targeted approach to hear the perspectives of children living in out-of-home care, who are involved with their Love of Learning educational programme. The design process included two focus group discussions with foster carers, programme volunteers, and child development experts. From this, an evaluation survey for children to use was developed. The survey’s underpinning conceptual framework, based on key protective factors influencing educational outcomes for children in out-of-home care, is a key contribution of this research. In addition, the design and implementation issues PJF encountered contribute insights for other nonprofit organisations and evaluators and academic knowledge towards evaluations involving children and vulnerable stakeholders. Hearing children’s views on programmes they are involved in is vital in helping to develop safe spaces for children to engage, where their thoughts are valued and opinions matter. As such, the processes detailed within this article support the development of evaluation practices that value children’s voices.
Our Father who art in Town Hall: Do local councils have power to pray?
Authors: Beck Luke
Published: March 2021

Many local councils in Australia commence their meetings with prayer. Case law in the United Kingdom holds that English local councils do not have power to commence their meetings with prayer. This article argues that the reasoning of the UK case law applies with equal force in Australia with the result that the practice of many Australian local councils of incorporating prayers into their formal meetings is unlawful.
Detection of circulating microfilariae in canine EDTA blood using lens-free technology: preliminary results
Authors: Lavabre Typhaine , Polizopoulou Zoe S. , Isèbe Damien , Cioni Olivier , Rebuffel Véronique , Blandin Pierre , Bourgès-Abella Nathalie , Trumel Catherine
Published: March 2021

Dirofilaria immitis causes life-threatening heart disease in dogs, thus screening of dog populations is important. Lens-free technology (LFT) is a low-cost imaging technique based on light diffraction that allows computerized recognition of small objects in holographic images. We evaluated an algorithm capable of recognizing microfilariae in canine whole blood using the LFT. We examined 3 groups of 10 EDTA blood specimens, from dogs with microfilaremia (group A), healthy dogs (B), and dogs with hematologic modifications other than microfilaremia (C). The LFT analyzer photographed repeated series of 5 images of all samples. The algorithm declared a sample positive if a microfilaria was detected on ≥1, ≥2, or ≥3 of the 5 images of a series. Microfilariae were detected visually in the images in 9 of 10 cases in group A; no microfilariae were seen in the images from groups B and C. Of the 30 cases, there were 14, 4, and only 3 false-positives with the 1 of 5, 2 of 5, and 3 of 5 image cutoffs, respectively. There were no false-negatives, regardless of cutoff. LFT seems useful for detecting microfilaria and could have application in clinical pathology.
We Can Move Mountains: Engaging in State-Level Policy Work
Authors: Bostaph Lisa M. Growette , Wintrow Melissa
Published: March 2021

An increasing number of academic researchers are becoming involved in state-level policy work as a result of existing local partnerships or direct requests by agency directors or elected officials. Most faculty and policymakers do not receive any training in doing such collaborative work and, for each party in the partnership, it can often seem like landing on another planet or, at the very least, visiting a foreign country, with different jargon, players, and stakes. This essay provides a brief guide to navigating the world of state-level partnerships in policymaking.