bluuebunny/crossref_metadata_2025 huggingface dataset:
Effective Leadership Differs Between Organizations: A Comparative Study of US and German Multinational Corporations in South Korea
Authors: Kim Soyeon , Shin Mannsoo
Published: May 2022

Effectively implementing leadership is critical for organizational success. In consideration of this issue, this study investigated effective leadership in US- and Germany-based multinational companies (MNCs) operating in South Korea. Drawing on transformational leadership (TL) theory and leadership contingency theory, the study clarified the contextual dependency of TL effectiveness. A survey was administered to 258 employees of the target MNCs, during which the participants were asked to rate their supervisors’ transformational leadership behaviors. The responses were empirically analyzed on the basis of the research framework. The findings showed that a leader’s group-focused TL behaviors indirectly influenced organizational commitment and that this relationship was mediated by psychological empowerment in the US-based MNCs. Conversely, a leader’s individual-focused TL behaviors demonstrated a pronounced effect on organizational commitment and that this association was also mediated by psychological empowerment in the Germany-based MNCs. The leadership behaviors that effectively empowered employees and increased their organizational commitment differed depending on the cultures prevalent in the organizations’ countries of origin. Adopting the two-dimensional model of TL, this study confirmed the contextual dependency of TL behaviors and suggested the need to incorporate an organization’s cultural context into predictions regarding the effects of certain leadership behaviors.
Gender Differences in the Relationship Between Achievement Motivation and Entrepreneurial Intention: A Conditional Process Model of Entrepreneurship and Gender
Authors: Kong Hyewon , Choo Seungyoup
Published: May 2022

This study focused on the roles of entrepreneurship and gender in the relationship between achievement motivation and entrepreneurial intention. Specifically, we tested a moderating role of gender and examined the moderated mediating role of entrepreneurship by gender in the relationship between achievement motivation and entrepreneurial intention. Based on the secondary data from the 2017 Korea Entrepreneurship Survey on 10,000 people, a conditional process model 15 (Hayes’ PROCESS macro) analysis was used to test the direct and indirect paths with respect to gender differences. The results indicate that the conditional direct effect of achievement motivation on entrepreneurial intention was not significant for women, but it was significant for men. Results also confirmed that the indirect effect of achievement motivation on entrepreneurial intention via entrepreneurship was stronger for women than for men. Therefore, the moderation hypothesis and the moderated mediation hypothesis were supported. The study contributes to the explanation of the black box between achievement motivation and entrepreneurial intention by emphasizing the role of gender as a moderator and entrepreneurship as a mediator of this relationship. This study focused on and confirmed the role of gender previously neglected in the relationship between achievement motivation and entrepreneurial intention and the role of entrepreneurship as a mediator to promote entrepreneurial activity among women. Therefore, this study extends existing research results by elaborating the relationship between achievement motivation and entrepreneurial intention.
Detecting Investment Fraud Using the Bias Ratio
Authors: van Vuuren Joshua , van Vuuren Gary
Published: May 2022

Hedge funds play an important role in investment markets, but high-profile frauds and market manipulation have necessitated increased scrutiny for the detection and prevention of such activities. Market metrics which signal fraudulent activity quickly, early, and reliably are scarce and sometimes provide fallacious results. The bias ratio in conjunction with other metrics could provide a solution as it compares the real asset return distribution to that of unbiased returns. High bias ratios combined with statistical moments which differ considerably from those expected from normal distributions provide compelling evidence for possible return manipulation. Application of these metrics to known fraud cases shows that—used historically and in tandem—they would have provided powerful early indicators of suspicious investment activity. Uncovering these frauds earlier could have potentially saved investors considerable resources. The bias ratio also shows promising results in detecting other possible market scams such as insider trading.
Clinical and functional outcomes of reconstruction following en bloc resection for the Campanacci grade III distal ulnar giant cell tumors
Authors: Kumar Vivek , Rustagi Ashish , Talwar Jatin , Yadav Rajat , Krishna Loveneesh G
Published: May 2022

Background: Wide resection of the tumor is essential for the treatment of Campanacci grade III giant cell tumor of the distal ulna but radioulnar convergence and dorsal displacement of the ulnar stump are known complications. Various reconstructive options to reduce these complications have been described in the literature. Methods: Seven patients with Campanacci grade III giant cell tumor distal end of the ulna were treated at our institute by extra-periosteal wide local excision of the tumor followed by reconstruction of the distal radioulnar joint by fixation of tricortical iliac crest graft to the distal end radius using two cancellous screws and extensor carpi ulnaris (ECU) tenodesis for stabilizing the residual ulnar stump. All patients were followed up for an average period of 3.5 years (32–48 months) at regular intervals. Functional outcome and complications if any, were recorded at every follow-up. Results: At final follow-up, the mean range of motion of wrist with 42.1° ± 5.9° of flexion, 72.9° ± 6.4° of extension, 82.1° ± 8.1° of supination and 85.0° ± 5.8° of pronation was achieved. The mean visual analog scale score at the final follow-up was 0.9 ± 0.9. The mean modified Mayo wrist score was 71.4 ± 6.4 with a mean modified Musculoskeletal Tumor Society score of 25.9 ± 0.8 and a mean Disability of Arm, Shoulder, and Hand score of 17.9 ± 1.6 at the final follow-up. The average time for the radiological union of iliac crest graft with the distal end radius was 13.3 weeks. None of the patient reported any complication or recurrence. Conclusion: The reconstruction of distal radioulnar joint by fixation of tricortical iliac crest graft with distal end radius and stabilization of ulnar stump by extensor capi ulnaris tenodesis after the wide resection of distal ulna giant cell tumor is recommended for good to excellent functional outcomes.
Effect of Wet and Dry Polishing Conditions by Two Finishing and Polishing Systems on the Surface Roughness and Color Changes of Two Composite Resin Restoratives: An In Vitro Comparative Study
Authors: Aydın Numan , Karao˘glano˘glu Serpil , Kılıçarslan Mehmet Ali , Oktay Elif Aybala , Ersöz Bilge
Published: May 2022

Purpose:

The study aimed at evaluating the effect of wet and dry polishing systems on the resin composites’ surface roughness and color change.

Materials and Methods:

In the study, samples were prepared using nanoceramic (Ceram.x one) and nanohybrid (GrandioSO) resin composites. Two different finishing and polishing systems were used in the polishing of resin composites. Resin composite surfaces were finished and polished under wet and dry conditions. The initial surface roughness values (Ra) of the samples were measured using a profilometer, whereas the color changes were measured using a spectrophotometer. Then, the colors of the samples kept in coffee were measured on the 7th and 30th days. Surface roughness and color change values (ΔE00) were measured and statistically analyzed using the one-way analysis of variance (ANOVA) test ( P < .05).

Results:

Wet or dry use of polishing systems did not show a statistically significant difference between the surface roughness values of the resin composite ( P < .05). Wet and dry use of polishing systems showed similar color changes on the composite resins ( P < .05). Diamond-containing spirals on composite resins showed statistically less color change than aluminum-oxide-containing discs ( P < .05). Wet or dry use of polishing systems did not reduce the color change of the composite resins below the acceptability threshold (AT).

Conclusion:

Wet or dry use of polishing systems on composite resins did not affect surface roughness and color change. The use of diamond-containing polishing spirals that cause less color change can increase clinical success.
Changes in Macrophage Polarization During Tendon-to-Bone Healing After ACL Reconstruction With Insertion-Preserved Hamstring Tendon: Results in a Rabbit Model
Authors: Liu Shaohua , Lin Jinrong , Luo Zhiwen , Sun Yaying , Wang Chenghui , Chen Shiyi , Shang Xiliang , Chen Jiwu
Published: May 2022

Background:

Decreasing the proinflammatory M1 macrophages or shifting the polarization status from M1 to M2 phenotype is thought to be beneficial for tendon-to-bone healing. In anterior cruciate ligament reconstruction (ACLR), using an insertion-preserved hamstring tendon (IP-HT) graft compared with a free hamstring tendon (FHT) graft has been shown to reduce graft necrosis and improve healing. However, the role of macrophage polarization at the tendon-to-bone interface is unclear.

Hypothesis:

ACLR using IP-HT graft would facilitate the phenotype shift from M1 to M2 macrophages at the tendon-to-bone interface.

Study Design:

Controlled laboratory study.

Methods:

Unilateral ACLR was performed on 42 healthy New Zealand White rabbits (study group, 21 rabbits with IP-HT graft; control group, 21 rabbits with FHT graft). At days 1, 3, and 7 and weeks 3, 6, 12, and 24 postoperatively, 3 rabbits in each group were sacrificed to investigate and compare the expression of surrogate markers for M1 macrophages (inducible nitric oxide synthase [iNOS] and tumor necrosis factor α [TNF-α]) and M2 macrophages (CD206 and transforming growth factor β [TGF-β]) via immunohistochemical staining and evaluation.

Results:

In the control group, the percentage of iNOS- and TNF-α–positive cells from postoperative day 7 and week 3 increased then decreased by week 6; positive expression of CD206 and TGF-β was weaker and peaked at 3 weeks postoperatively. In the study group, high CD206- and TGF-β–positive expression was observed from weeks 3 to 12 and peaked at week 6, and positive expression of iNOS- and TNF-α was weaker and peaked on day 7. At both 7 days and 3 weeks, the percentages of iNOS- and TNF-α–positive cells in the control group were both significantly higher than in the study group ( P ≤ .04 for all). At 6 weeks, the percentages of CD206- and TGF-β–positive cells in the study group were both significantly higher than in the control group ( P = .02 and P = .04, respectively).

Conclusion:

More expression of surrogate markers for M2 macrophages was observed in the tendon-to-bone healing process after ACLR using IP-HT versus FTP graft.

Clinical Relevance:

Using IP-HT grafts in ACLR may facilitate postoperative healing by shifting the local status of macrophage polarization at the tendon-to-bone interface.
Developing Digital Communication Competency in the Business Classroom
Authors: Joglekar Yogini , Purdy David , Brock Sabra , Tandon Ayushi , Dong Amy
Published: May 2022

The COVID-19 pandemic has cast digital communication competency into sharp relief. Rapid virtualization of how we work and learn has highlighted this challenge for business education. In response, the business communication syllabus must evolve to include digital communication competencies. Most of our students are comfortable with computer and Internet usage. However, our research uncovers a gap between their perceived and actual digital communication competency, as well as indications of stress in their online relationships. This article offers suggestions on creating a business communication syllabus in tune with learner and business needs given that digital communication is rapidly becoming the norm.
Relationship Status-Based Health Disparities during the COVID-19 Pandemic
Authors: Thomeer Mieke Beth
Published: May 2022

Previous research finds that marriage is a privileged family form with health benefits. These health advantages may have shifted during the pandemic, as more time was spent at home and resources strained. This study compares differences in three health outcomes across relationship statuses between April and December 2020 using a nationally-representative US survey, the Household Pulse Survey (N = 1,422,733). As the pandemic progressed, larger differences emerged when comparing married and never married respondents’ probabilities of fair or poor health, depression, and anxiety as never married people had the steepest decline in health, even adjusting for pandemic-related stressors (e.g., food insufficiency). Yet, widowed and divorced/separated respondents’ greater probabilities of these three health outcomes compared to married respondents’ narrowed over this same period. During the pandemic, relationship status and self-rated health patterns were similar for men and women, but for mental health there was evidence that the growing advantage of marriage relative to never being married was more pronounced for men, whereas the shrinking advantage of marriage relative to being previously married was more pronounced for women. This study identifies the unique health needs for never married adults during the pandemic, demonstrating that social conditions around the pandemic likely exacerbated health disparities by relationship status.
COVID-19 Pandemic Response and Adaptations by International Community Access to Child Health (ICATCH) Projects in Low- and Middle-Income Countries
Authors: Das Anirudha , Nanda Vishakha , Lauden Stephanie M. , Behrmann Ann , González de Rivas María del Rosario , Kurbasic Mirzada , Okolo Angela , Oyerinde Koye , Smith Sherri , Vides Manuel , Jacobs Troy , Umoren Rachel
Published: May 2022

Background. The health personnel in low/low and middle-income countries have faced significant challenges during the COVID-19 pandemic. The International Community Access to Child Health (ICATCH) grants support locally initiated projects in those countries. The aim of this study was to highlight how the challenges countered by grant project teams continuing their projects and demonstrating their skills to adapt to an increasingly difficult environment. Methods. This was a mixed methodology study for which data were obtained from the evaluation of annual reports submitted by the projects. The annual reports review comprised of answers to questions on whether project objectives were met, problems or barriers encountered, and reviewer feedback in the form of specific concerns or recommendations. The reports were analyzed both quantitatively and qualitatively. Results. A total of 34 (92%) of annual reports were included with 17 (94%) received in 2020 and 17 (89%) in 2021. Compared to 2020, in 2021 the projects that indicated meeting objectives increased by more than half from 29% to 58%. Over one third of the projects encountered barriers in both years. The percentage of projects with major concerns decreased by almost 2/3 in 2021 while unexpected expenses decreased by 1/3. Four themes emerged from the qualitative analysis: Concerns over COVID-19, Barriers to accomplishing project goals, Positivity around adaptations, and Despair over lack of ability to overcome challenges. Conclusions. ICATCH funded projects demonstrated resiliency and adaptations to meet program objectives despite the challenges posed by the COVID-19 pandemic demonstrating greater success in 2021.
The Impact of Obesity Assessed by Different Criteria on the Metabolic Parameters in Children and Adolescents in Georgia
Authors: Tskhvedadze Nino , Janjgava Shota , Tananashvili David , Giorgadze Elene
Published: May 2022

The aim of our study was comparative analysis of anthropometric characteristics in children and adolescents significantly correlated with the parameters of metabolic syndrome. The study group is consisted of 113 children and adolescents (study group) with excessive body weight and obesity (group 1—BMI percentile; group 2—waist circumference; group 3—waist to height ratio). The control group consisted of 113 children and adolescents without. Comparative analysis of obtained data have been carried out by multiple regression analysis. BMI percentile is more an indicator of a generalized obesity; WC and WHR percentiles better describe visceral obesity and metabolic disorders—insulin resistance, hypertension and dyslipidemia. However, the WHR Percentile may be a more useful tool. To assess obesity in children and adolescents, it is necessary to evaluate together BMI, WC, and WHR percentiles. It can be also concluded that these findings indicate the need to continue research in this direction.
Guilt, Uncertainty, Education Needs, and Knowledge of Mothers With Children Experiencing Precocious Puberty
Authors: Young Ahn Hye , Hee Yoo Kyung , Ryeong Song Mi
Published: May 2022

Introduction. Childhood illnesses not only affect the child, but also the family members. Objective. The purpose of this study was to investigate the guilt, uncertainty, education needs, and knowledge of mothers with children experiencing precocious puberty. Methods. Data were collected in August, 2017. The participants of the study were the mothers of children experiencing precocious puberty. A total of 111 copies of questionnaires were collected. Descriptive statistics, independent t-test, one-way ANOVA, Pearson’s correlation coefficient were used for the analysis, using the SPSS 24.0 program. Results. Mothers of children experiencing precocious puberty require psychological interventions that can alleviate their guilt and uncertainty, as well as enhance their knowledge of the emotional support needed by their children. Conclusion. Mothers with children experiencing precocious puberty had a high level of education needs to know, but the knowledge they knew was insufficient. Future studies need to focus on developing education programs for mothers dealing with their child’s precocious puberty.
Working on relationalism
Authors: Jackson Patrick Thaddeus , Heo Sujin
Published: May 2022

In this essay, we elucidate the insufficiency of a simple binary choice between substantialism and relationalism or between dualist and nondual/incarnational sensibilities. We highlight the ways that all translations of these sensibilities into the scholarly form of life encounter characteristic problems and challenges precisely because the very practice of scholarly writing is always and already inclined towards a more dualist way of going on.
The Perception of European Geography in Mughal-Period Persian Texts: A Preliminary Exploration
Authors: Govil Aditi
Published: May 2022

Geography, as known to the Mughal court and the Persian-writing authors of Mughal India, should have expanded in respect of Europe once the Portuguese and then the Dutch, English and French merchants arrived in India. An exploration of Persian texts containing geographical information, including lists of places in the world with their coordinates, reveals that while both Indian and European geographers followed the same Hellenistic system of coordinates, there was very meagre information about Europe added in Mughal-period texts to what had already been recorded in earlier Arabic-Persian works, and this remained pretty meagre. Even the discovery of the New World was rarely noticed and so its implications were not at all comprehended.
Book review: Farhat Hasan, Paper, Performance, and State: Social Change and Political Culture in Mughal India
Authors: Hassan Basharat
Published: May 2022

Farhat Hasan, Paper, Performance, and State: Social Change and Political Culture in Mughal India (Cambridge: Cambridge University Press), 2021, 155 pp. ₹731.
Review Article: Irfan Habib and Tarapada Mukherjee (late), Braj Bhūm in Mughal Times: The State, Peasants and Gosā’ins
Authors: Shrimali Krishna Mohan
Published: May 2022

Irfan Habib and Tarapada Mukherjee (late), Braj Bhūm in Mughal Times: The State, Peasants and Gosā’ins (New Delhi: Primus Books, 2020), 286 pp., ₹1,095 (Hb).
Rebellion and Ethnogenesis in Colonial North-Eastern Bengal: The Garos as Pagul Panthis
Authors: Misra Sanghamitra
Published: May 2022

In the closing decades of the eighteenth and in the early decades of the nineteenth century, Peasant insurrection was endemic to the north-eastern borders of Bengal, including the submontane region of Gird Garrow, a characteristic shared with the contiguous Garo Hills. Locating these conditions of insurrection within changes in the order of the regional economy under the Company’s rule, the article elucidates the economic rationale of ‘primitive violence’ and reflects on the processes generated by the state itself in the course of subjugation of the Garo peasants in the region.
Book review: K. L. Tuteja, Religion, Community and Nation: Hindu Consciousness and Nationalism in Colonial Punjab
Authors: Habib Irfan
Published: May 2022

K. L. Tuteja, Religion, Community and Nation: Hindu Consciousness and Nationalism in Colonial Punjab (New Delhi: Primus Books), 2021, 372 pp., ₹1,250 (Hb).
Knowledge, Attitude and Beliefs of Nurses Regarding Antibiotic use and Prevention of Antibiotic Resistance
Authors: Lalithabai Diana S. , Hababeh Mohamad O. , Wani Tariq A. , Aboshaiqah Ahmad E.
Published: May 2022

Introduction

Resistance to antibiotics is a threat confronting health care system worldwide. Nurses play a significant role in combating this threat.

Objectives

The present study examined the knowledge and attitude of nurses towards antibiotic use and prevention of antibiotic resistance.

Methods

The research involved a cross-sectional study conducted in a multi-cultural tertiary healthcare setting. The participants were 341 nurses. A structured self-administered questionnaire with a good validity and reliability (α = 0.7) was used.

Results

The nurses surveyed showed moderate awareness of antibiotic resistance and a fair attitude towards its prevention. There was no significant correlation of demographic features with their overall knowledge and attitude ( p > 0.05).

Conclusions

Nurses perform a crucial part in infection control, but often lack knowledge of methods to prevent antibiotic resistance. This paucity highlights the importance of tailored interventions to help nurses improve their awareness of antibiotic resistance and create a favorable attitude towards its prevention.
The Impact of Choice Architecture on Sepsis Fluid Resuscitation Decisions: An Exploratory Survey-Based Study
Authors: Mansoori Jason N. , Clark Brendan J. , Havranek Edward P. , Douglas Ivor S.
Published: May 2022

Background

Discordance with well-known sepsis resuscitation guidelines is often attributed to rational assessments of patients at the point of care. Conversely, we sought to explore the impact of choice architecture (i.e., the environment, manner, and behavioral psychology within which options are presented and decisions are made) on decisions to prescribe guideline-discordant fluid volumes.

Design

We conducted an electronic, survey-based study using a septic shock clinical vignette. Physicians from multiple specialties and training levels at an academic tertiary-care hospital and academic safety-net hospital were randomized to distinct answer sets: control (6 fluid options), time constraint (6 fluid options with a 10-s limit to answer), or choice overload (25 fluid options). The primary outcome was discordance with Surviving Sepsis Campaign fluid resuscitation guidelines. We also measured response times and examined the relationship between each choice architecture intervention group, response time, and guideline discordance.

Results

A total of 189 of 624 (30.3%) physicians completed the survey. Time spent answering the vignette was reduced in time constraint (9.5 s, interquartile range [IQR] 7.3 s to 10.0 s, P < 0.001) and increased in choice overload (56.8 s, IQR 35.9 s to 86.7 s, P < 0.001) groups compared with control (28.3 s, IQR 20.0 s to 44.6 s). In contrast, the relative risk of guideline discordance was higher in time constraint (2.07, 1.33 to 3.23, P = 0.001) and lower in choice overload (0.75, 0.60, to 0.95, P =0.02) groups. After controlling for time spent reading the vignette, the overall odds of choosing guideline-discordant fluid volumes were reduced for every additional second spent answering the vignette (OR 0.98, 0.97, to 0.99, P < 0.001).

Conclusions

Choice architecture may affect fluid resuscitation decisions in sepsis regardless of patient conditions, warranting further investigation in real-world contexts. These effects should be considered when implementing practice guidelines.

Highlights

Time constrained clinical decision making was associated with increased proportion of guideline-discordant responses and relative risk of failure to prescribe guideline-recommended intravenous fluids using a sepsis clinical vignette. Choice overload increased response times and was associated with decreased proportion of guideline-discordant responses and relative risk of guideline discordance. Physician odds of choosing to prescribe guideline-discordant fluid volumes were reduced with increased deliberation as measured by response times. Clinicians, researchers, policy makers, and administrators should consider the effect of choice architecture on clinical decision making and guideline discordance when implementing guidelines for sepsis and other acute care conditions.
Implementing Kolb´s Experiential Learning Cycle by Linking Real Experience, Case-Based Discussion and Simulation
Authors: Wijnen-Meijer M. , Brandhuber T. , Schneider A. , Berberat P.O.
Published: May 2022

BACKGROUND

Background: To prepare medical students for their future, they must become acquainted with clinical practice, for example by means of simulations, clerkships and discussing patient cases. By connecting these different approaches, according to Kolb´s experiential learning cycle, the learning effect can be strengthened.

Methodology

In the development of a didactical program for students who are being prepared for their role as general practitioners, we have adopted a new didactic approach, in which educational formats are interlinked, according to Kolb´s experiential learning cycle. The content of these courses is determined by the Entrustable Professional Activities (EPAs) for the clerkship in family medicine, combined with the most common chief complaints of patients in the GP's practice. In 2019, the first course was implemented at the Technical University of Munich, Germany, with 6 medical students. A first seminar discusses patients who the students have seen for themselves during their clerkship in family medicine. In addition, matching theory is discussed and skills are practiced. In the next seminar, students apply the acquired knowledge and skills in scenarios with standardized patients. Students evaluated the courses as positive. The evaluations show they find discussing personally experienced patient cases and the opportunity to practice very valuable.

Conclusions

A course design according to Kolb's Experiential learning cycle, which integrates experience, theory and simulation, is a valuable addition to existing forms of teaching in medical education. Students appreciated both discussing personally experienced patient cases and the opportunity to re-practice similar cases in a simulated environment. To gain more insight into the learning effects, it is recommended to further explore this approach in a different context.
Reflective Essays During Clerkship Following a Pre-clerkship Leadership Curriculum
Authors: Wiseman Melanie , Hartzell Joshua , Kelly William F. , Hemmer Paul A. , Stein Michael
Published: May 2022

Introduction

Leadership curricula in medical student education require assessment - to determine if leadership skills can be taught to medical students and applied during clinical and medical team interactions to aid in medical student leadership development.

Objectives

To examine whether medical students applied principles of their pre-clerkship leadership curriculum (character, competence, context, and communication elements across four levels: personal, interpersonal, team, and organizational) during an internal medicine clerkship.

Methods

Using art as a prompt, Uniformed Services University (USU) internal medicine clerkship students completed a structured reflection on a critical incident. Medical student essays written during a 10-week internal medicine clerkship at USU in 2019 were collected. 158 medical student submissions were de-identified and analyzed.

Results

Sixty-four submissions (40.5%) focused on leadership or leadership and professionalism. Students identified as male (n = 34, 53%), female (21, 33%), or not reported (9, 14%). Most, 48 (75%), did not describe PITO explicitly in their essay. They instead focused on personal and interpersonal aspects (17, 27%) of leadership, the attending physicians they worked with (33, 52%), and effective leadership strategies (46, 72%). The most common themes written about were responsibility (30, 47%), teamwork (18, 28%), competence (17, 27%), and character/integrity (15, 23%).

Conclusion

Although the students’ explicit use of the PITO model was limited, student essays centered on themes that reflected leadership concepts taught in pre-clerkship years, such as character, competence, and responsibility. This study demonstrates that an internal medicine clerkship rotation can feasibly implement a leadership reflection.
Investigation on the density of Al2O3/R1234yf, TiO2/R1234yf and CuO/R1234yf nano-refrigerants
Authors: BS Bibin , Gundabattini Edison
Published: May 2022

Nano-enhanced refrigerant is one of the promising heat transfer fluids in refrigeration systems. It has the capability to boost the efficiency of vapour compression refrigeration and air conditioning systems. In heat transfer application, the density of the fluid plays a crucial role in identifying various heat transfer characteristics such as the Reynolds number, Nusselt number, the friction factor and the pressure loss. Compared to thermal conductivity and viscosity, determining the density of nanofluids has received very less attention in research. The liquid and vapour densities of alumina (Al2O3), titanium dioxide (TiO2) and cupric oxide (CuO) nanoparticles suspended in 2,3,3,3-tetrafluoropropene (R1234yf) are investigated in this study. The Pak and Cho model was adopted to examine the densities of nano-refrigerants as the volume concentration of particles in the base refrigerant and temperature varies from 1% to 5% and 273 to 323 K respectively. The models are validated using the experimental studies conducted by various researchers on different nano-refrigerants. The analysis results indicated that the liquid and vapour densities of CuO/R1234yf nano-refrigerant are 10.3% and 62.93% greater than that of Al2O3/R1234yf at 5% particle concentration. From the liquid and vapour density point of view, the CuO/R1234yf nano-refrigerant is superior over Al2O3/R1234yf and TiO2/R1234yf. Results also indicated that at 308 K the liquid phase density of CuO added with R1234yf nano-refrigerant is higher by 12.99% and 8.65% than R134a and R141b respectively. Hence CuO/R1234yf significantly enhances the performance of refrigeration systems.
Participatory governance in China: ‘Informal public participation’ through neighbourhood mobilisation
Authors: Cao Liu
Published: May 2022

Public participation is an emergent feature of urban governance in Nanjing, China. Though introduced to address social conflicts around urban redevelopment, the fact is that government-led public participation did not successfully soothe tensions, but resistance instead played a role like ‘public participation’ which influenced the governing processes. This Chinese case thus requires us to rethink the limitations of Western governance theories in explaining this Chinese story. With the purpose to research urban political studies beyond the West to have more plural and heterodox voices to depict a diversity of urban knowledge, this paper focuses on this heterodox phenomenon in China to understand how Chinese insurgent urbanism reconfigured and made a new form of urban governance. Through critical investigation of public participation in Nanjing, this paper argues that public participation is the buffer that mediates and ‘repairs’ the inconsistencies between different levels of governmental agencies, while also because of this disjointed and stratified administrative feature, resisting by appropriating government policies thus can influence the governing processes and become a way of ‘informal public participation’. By introducing the concept of ‘informal public participation’, this paper’s research findings shed light on governance studies about how participatory governance is made through both governmental approaches and bottom-up insurgent urbanism, and also illustrates how resistance can reshuffle power dominance in urban politics to make a new form of urban governance.
Sanitation potpourri: Criteria for planning mix of sanitation systems for citywide inclusive sanitation
Authors: Mitra Anant , Narayan Abishek S , Lüthi Christoph
Published: May 2022

Sanitation is a universal need and thus requires universal access. Despite having the world’s largest sanitation campaign, only 37% of urban India has access to safely managed sanitation systems. Due to the heterogeneity of Indian cities, a mix of different sanitation systems is required to meet the demands of these rapidly urbanising cities. The Manila principles on Citywide Inclusive Sanitation (CWIS) propose a mix of technologies as a key pillar in achieving the Sustainable Development Goals on urban sanitation. However, there is a lack of understanding on the criteria to consider when planning the technological options for CWIS. The mega-city of Chennai is chosen as a case study, and mixed methods including a Faecal Waste Flow diagram (SFD), Social Network Analysis (SNA) and interviews are applied. This study then presents a set of 14 contextually relevant criteria for the implementation of sewered and non-sewered technologies in the city. The SFD shows that 35% of Chennai’s faecal waste remains unsafely managed while using SNA identified that the water and sanitation utility, the municipal corporation and the slum clearance board are the best placed stakeholders in the city to create a change in the sanitation situation. Furthermore, 17 drivers and barriers for the implementation of non-sewered technologies are identified. The criteria catalogue was also theoretically tested for an example ward in Chennai. The findings of the study show that a catalogue of physical, technical, institutional and financial criteria is useful for planning a mix of technologies with the CWIS approach.
Strategic archetypes of planning processes: Model and evidence
Authors: Gerrits Lasse , Marks Peter K , Pagliarin Sofia , Rauws Ward
Published: May 2022

Complex planning processes bear the hallmarks of evolution, in that actors seek to obtain the results that serve their needs best. That is, seek to increase their fitness. As in biological evolution, there are multiple pathways toward fitness. With the rise of adaptive planning approaches, the question how such pathways can be identified in strategic planning processes becomes pivotal. To answer this question, we adapt the fitness landscape model from biology and analyze several strategic planning processes. The analysis demonstrates that one can trace how different pathways to fitness emerge, and which pathways are more successful given the circumstances. We then synthesize these pathways into six strategic archetypes of actor behavior and of interactions between actors.
Posterior Polar Hemispheric Choroidal Dystrophy: Case Report and Presentation of Genetic Screening
Authors: Tabbaa Tarek , Daroszewski Daniel , Sobol Warren
Published: May 2022

Purpose:

Posterior polar hemispheric choroidal dystrophy is a rare dystrophy affecting the choroid and retina with a characteristic clinical appearance that distinguishes it from a broad variety of other retinal diseases. The disease process has a morphology described in the literature that preferentially affects the outer macula and spares the fovea with no arteriolar attenuation or optic nerve pallor.

Methods:

This case report illustrates the use of multimodal retinal imaging, visual field testing, electroretinogram, and genetic testing of a patient who we believe fits the clinical pattern established by previous studies describing this condition.

Results:

Fundus imaging in addition to further imaging modalities such as fluorescein angiography helped further characterize this disease process and aided in the diagnosis. In addition, genetic testing revealed unique allele variants found in this patient.

Conclusions:

By taking a multifaceted approach to the diagnosis of retinal pathology, clinicians can make informed decisions regarding patient care.
Retinoblastoma in the Presence of Persistent Fetal Vasculature
Authors: El Hamichi Sophia , Feria Anzaldo Estephania , Gold Aaron S. , Dubovy Sander R. , Murray Timothy G.
Published: May 2022

Purpose:

This work aims to report the challenging diagnosis, treatment, and follow-up of a patient with persistent fetal vasculature (PFV) and retinoblastoma (RB).

Methods:

A 22-month-old boy presented with unilateral RB stage VB in the right eye and PFV in both eyes. The patient was treated with transpupillary laser ablation and systemic chemotherapy.

Results:

Treatment resulted in complete tumor regression. Two years after the last systemic chemotherapy treatment, magnetic resonance imaging (MRI) showed increased signal intensity with progressive optic nerve enhancement, where intraneural malignancy could not be excluded. Enucleation of the right eye was performed. Histopathologic review showed no residual active malignancy in the enucleated globe.

Conclusions:

This case demonstrates the importance of a thorough clinical examination to establish the correct diagnosis and to rule out RB before any surgery. This case also highlights the importance of regular follow-ups after tumor regression with full a ophthalmologic examination, B-scan, and periodic MRI.
Coverage of Specialty Drugs for Psoriasis and Psoriatic Arthritis by Commercial Insurance Companies
Authors: Learned Christine , Alsukait Sara , Fiumara Kristin R , Ortega Melissa , Chambers James D , Rosmarin David
Published: May 2022

Background

Specialty medications provide effective treatment with limited adverse effects to patients with psoriasis and psoriatic arthritis; however, variable coverage and high costs often create a barrier to treatment for patients with commercial health insurance.

Objective

We aimed to evaluate coverage of psoriasis and psoriatic arthritis specialty medications by commercial insurance companies.

Methods

We compiled data regarding specialty drug coverage for psoriasis and psoriatic arthritis using Tufts Medical Center Specialty Drug Evidence and Coverage (SPEC) database and analyzed the data for any notable trends. The SPEC database lists coverage decisions for 158 specialty drugs by 17 of the largest US commercial health plans, as well as data regarding the types of evidence cited by these insurance plans when making coverage decisions.

Results

Our results showed that insurance plans tend to be more restrictive than the U.S. Food and Drug Association (FDA) label when covering medications for psoriasis and psoriatic arthritis. Furthermore, medications for psoriatic arthritis tended to be less restricted than for psoriasis, and medications were most commonly approved as second line agents for both indications.

Conclusion

Our analysis confirms that variability in insurance coverage exists for the indications of psoriasis and psoriatic arthritis.
Common Pitfalls in the Management of Vaginismus in Couples With Subfertility in India
Authors: Ramanathan Vijayasarathi , Gautham Kavitha , Ramasubramaniam Uma Maheswari
Published: May 2022

Vaginismus is described as an involuntary pelvic muscular spasm that occurs due to “fear of pain” associated with vaginal penetration which prevents a woman from experiencing penovaginal sexual intercourse despite her wish to do so. In the context of heterosexual couples with subfertility, untreated vaginismus may result in unconsummated marriage and/or reduced quality of sex life and/or can affect a woman’s perception about her potential of femininity and motherhood. Though vaginismus is an easily diagnosable and treatable condition in many instances, it often gets ignored or inadequately/inappropriately managed. There is paucity of practice-informed clinical data on management of vaginismus in couples with subfertility that is contextualized to the Indian setting. The present viewpoint is based on real-world clinical scenarios who presented as couples to a tertiary fertility center with unconsummated marriage as their chief complaint. The intent of this viewpoint is not only to highlight the common pitfalls in the management of vaginismus but also showcase a clinically proven interdisciplinary management approach for assessment and management of vaginismus and any associated sexual problems.
Open Shoulder Stabilization for Anterior Glenohumeral Instability: The Latarjet Procedure
Authors: Morris Jesse H. , Barrazueta Gustavo A. , Cvetanovich Gregory L.
Published: May 2022

Background:

Traumatic anterior glenohumeral instability is a commonly encountered shoulder pathology among young active patients. Nonoperative management and arthroscopic techniques are associated with high rates of reoccurrence, particularly in patient populations with known major risk factors.

Indications:

The coracoid process transfer (Latarjet procedure) is typically reserved for cases of anterior glenohumeral instability where glenoid deficiency exceeds 20% to 25% or when soft tissue stabilization techniques have failed.

Technique Description:

We use a standard open deltopectoral approach. The coracoid process is exposed and released from the pectoralis minor and coracoacromial ligament. An osteotomy is performed using an oscillating saw and completed with an osteotome to harvest the bone block, leaving the conjoint tendon intact. Soft tissue is cleared from the graft, and it is predrilled/measured. We use a subscapularis splitting technique to access the joint and expose the anterior glenoid. All bony surfaces are prepared. We drill into the glenoid at the premeasured offset. The graft is provisionally fixed into place with K wires, then secured with 2 parallel cannulated screws. The capsule is repaired to make the graft extraarticular. The subscapularis split is repaired in addition to standard closure.

Results:

The Latarjet procedure is very successful for restoring stability. Rates of recurrent dislocation range from 0% to 10% across various studies, and revision rates are as small as 3%. This is much lower than those seen following soft tissue stabilization, particularly in high-risk patient populations. Patient reported outcomes show good function and high rates of return to sport. Complication rates are generally higher, with some studies reporting up to 25% incidence. Musculocutaneous and axillary nerve injuries may occur, and graft overhang can lead to glenohumeral arthritis. Certain complications are unique to the procedure, including graft lysis, coracoid fracture, nonunion, and hardware issues.

Discussion/Conclusion:

The Latarjet procedure is very useful in cases of anterior glenohumeral instability with significant glenoid bone loss or following failed soft tissue stabilization. Its utilization may continue to grow in future years as technique innovations develop and surgical indications expand.
Case Report: Orthotic Treatment of Cranial Asymmetry Arising from Large Wormian Bone
Authors: Kanack Melissa D. , Greaney John , Ganske Ingrid M.
Published: May 2022

Wormian bones are accessory bones found within fontanelles and sutures. They are thought to be an anatomic variant, though presence of several Wormian bones may be associated with pathological conditions such as osteogenesis imperfecta. Positional deformational plagiocephaly results from external forces on the infant skull leading to brachycephaly or asymmetric flattening. Severe cases are commonly treated with a cranial orthotic helmet that guides remodeling of the growing skull into a more symmetric shape. There is little reported about the association between Wormian bones and development of plagiocephaly. We present a case of a patient with occipital cranial asymmetry (cranial asymmetry index 10.4%) who underwent CT scan to rule out lambdoidal synostosis. This demonstrated patent sutures and a large right-sided Wormian bone. He was successfully treated with helmet therapy to address the contralateral deformational plagiocephaly. Wormian bones may be an under-recognized cause of asymmetrical cranial shape, potentially coexisting with deformational plagiocephaly. This case reports a role for orthotic therapy in these situations, as in isolated deformational plagiocephaly, to minimize asymmetry exacerbated by positioning on the contralateral side.
Instructors reflect on how their preservice preparation and ongoing professional development prepared them to address oppressive dynamics in adult ESOL programs in the United States
Authors: Housel David A
Published: May 2022

For decades, researchers have asserted that the preservice preparation for instructors of adult emergent bi/multilingual learners (EBLs) in the United States can be inconsistent, and access to ongoing professional development (PD) can be insufficient to address the demands of the 21st century classroom. A previous study conducted by the author revealed that instructors of adult EBLs felt adequately prepared to teach English, but they often felt ill-equipped to address the learning challenges and oppressive dynamics that might manifest in their adult English to Speakers of Other Language (ESOL) classrooms. This convergent mixed methods study was a preliminary attempt to address these issues. Eighty-five participants recruited throughout the United States were asked to reflect on the degree to which challenges, like learning dis/abilities, and oppressive dynamics, like racism and sexism, were addressed in their preservice preparation and ongoing PD through a 20-item survey instrument administered via Qualtrics. The findings revealed that issues closely related to language teaching were more commonly addressed, but learning challenges and oppressive dynamics were inadequately addressed, if at all. Suggestions included interweaving discussions of these issues and dynamics throughout preservice coursework but exploring them more extensively in ongoing PD. Limitations of the study and areas for future research were also identified.