bluuebunny/crossref_metadata_2025 huggingface dataset:
Radiomics Studies on Ischemic Stroke and Carotid Atherosclerotic Disease: A Reporting Quality Assessment
Authors: Beaudoin Ann-Marie , Ho Jan Kee , Lam Adrienne , Thijs Vincent
Published: February 2024

Objective: To assess the reporting quality of radiomics studies on ischemic stroke, intracranial and carotid atherosclerotic disease using the Image Biomarker Standardization Initiative (IBSI) reporting guidelines with the aim of finding avenues of improvement for future publications. Method: PubMed database was searched to identify relevant radiomics studies. Of 560 articles, 41 original research articles were included in this analysis. Based on IBSI radiomics reporting guidelines, checklists for CT-based and MRI-based studies were created to allow a structured and comprehensive evaluation of each study’s adherence to these guidelines. Results: The main topics covered included radiomics studies were ischemic stroke, intracranial artery disease, and carotid atherosclerotic disease. The reporting checklist median score was 17/40 for the 20 CT-based radiomics studies and 22.5/50 for the 20 MRI-based studies. Basic items like imaging modality, region of interest, and image biomarker set utilized were included in all studies. However, details regarding image acquisition and reconstruction, post-acquisition image processing, and image biomarkers computation were inconsistently detailed across studies. Conclusion: The overall reporting quality of the included radiomics studies was suboptimal. These findings underscore a pressing need for improved reporting practices in radiomics research, to ensure validation and reproducibility of results. Our study provides insights into current reporting standards and highlights specific areas where adherence to IBSI guidelines could be significantly improved.
Who are the “Heroes of CRISPR”? Public science communication on Wikipedia and the challenge of micro-notability
Authors: Simons Arno , Kircheis Wolfgang , Schmidt Marion , Potthast Martin , Stein Benno
Published: February 2024

Wikipedia’s influence in shaping public perceptions of science underscores the significance of scientists being recognized on the platform, as it can impact their careers. Although Wikipedia offers guidelines for determining when a scientist qualifies for their own article, it currently lacks guidance regarding whether a scientist should be acknowledged in articles related to the innovation processes to which they have contributed. To explore how Wikipedia addresses this issue of scientific “micro-notability,” we introduce a digital method called Name Edit Analysis, enabling us to quantitatively and qualitatively trace mentions of scientists within Wikipedia’s articles. We study two CRISPR-related Wikipedia articles and find dynamic negotiations of micro-notability as well as a surprising tension between Wikipedia’s principle of safeguarding against self-promotion and the scholarly norm of “due credit.” To reconcile this tension, we propose that Wikipedians and scientists collaborate to establish specific micro-notability guidelines that acknowledge scientific contributions while preventing excessive self-promotion.
Organizational trust breaches among nurses and aides: A qualitative study
Authors: Brewer Katherine C. , Dierkes Andrew M. , Norful Allison A.
Published: February 2024

Background

Healthcare worker retention and burnout are confounding issues. Trust among workers and their employer, that is, organization, is an important yet underexplored concept in research.

Research aim

The aim of this qualitative study is to explore organizational actions and systems that promote or denigrate trust among registered nurses and patient care aides (aides).

Research design

The study uses the Model of Psychological Contract as a theoretical framework. Focus groups were conducted to explore the concept of organizational trust and the consequences of broken trust.

Participants

Registered nurses (RNs) (n=6) and aides (n=6) participated in the study. Six focus groups (three RN and three aide) were conducted, with two participants per group. Focus groups were conducted online.

Ethical considerations

The study's methods were reviewed by the University of Pittsburgh Institutional Review Board.

Findings

Among RNs and aides, a sense of trust and feeling valued were important to their sense of relationship with their employers. Trust was breached when resources were scarce, employees did not feel validated and listened to, and problems were not addressed. RNs and aides described feeling devalued when compensation practices were unjust or inequitable, they had limited autonomy, and the employer created an organizational climate where business needs superceded human caring. Consequences of trust breach included burnout, dejection, and feelings of non-belonging.

Discussion

Tangible organizational resources (compensation and staffing) and intangible resources (value, respect, autonomy) are important to RNs and aides alike. Inability to provide these resources diminishes trust and even causes a sense of betrayal.

Conclusion

Future research can explore the concepts of organizational justice and interventions to restore lost trust and improve healthcare worker well-being. This is one of only a few identified studies to explore organizational factors and well-being among aides and more research among this healthcare worker population is warranted.
Development of the ethical decision-making competence scale
Authors: Pai Hsiang-Chu , Hwu Lien-Jen
Published: February 2024

Background

Developing confident capacity for ethical decision-making is vital in nursing education. However, no tool examines nursing students’ competence in ethical decision-making.

Aim

This study aimed to develop an Ethical Decision-Making Competence Scale (EDM-CS) to assess ethical care decision-making competencies in nursing students.

Participants and research context

Original items were obtained by employing a focus group and the Delphi method. A cross-sectional design was used to confirm the items remained on the scale. Additionally, the scale’s reliability and validity were assessed. The EDM-CS was completed by 498 nursing students. An exploratory factor analysis (EFA) was used to examine the factor structure based on data from group 1 ( n = 250). A second-order confirmatory factor analysis (CFA) was used to examine the model’s fitness based on data from group 2 ( n = 248). This study was conducted between August 2022 and July 2023.

Ethical considerations

The Institutional Review Board of Chung Shan Medical University Hospital approved this study’s design and procedure.

Results

From the original 34 items, nine were deleted in the EFA. Thus, the EDM-CS had 25 items and a four-factor structure (ethical judgement, ethical sensitivity, ethical motivation, and ethical action), which explained 60.97% of the total variance. A second-order CFA identified a second-order factor termed ‘ethical decision-making competence’ with 18 items (root mean square residual = 0.052). The EDM-CS scores correlated significantly and positively with the scores on the Scale of Protective Factor-24 (r = 0.47, p < .001), which indicated good convergent validity. Cronbach’s alpha coefficient of the final EDM-CS was 0.90 and ranged from 0.73 to 0.80 for the four subscales.

Discussion and conclusion

The EDM-CS was validated to fit the data adequately. It can be used to evaluate clinical nursing students’ ethical decision-making abilities and to develop education strategies to improve their ethical care competence.
The Impact of COVID on Kerala Fish-vending Women
Authors: Jament Johnson , Osella Caroline
Published: February 2024

This article discusses women’s role in Kerala’s small-scale marine fishing industry and changes that took place during COVID-19. Pandemic conditions enabled and accelerated the restructuring of Kerala’s fishing industry practices, leaving marginal groups even more marginal. Small-scale producers and sellers were edged out by larger players in a new wholesale market. Meanwhile, female vendors who utilised public transport and face-to-face sales methods found themselves locked out from new retail methods introduced during the pandemic, which made use of smartphone apps, online platforms, and private light vehicles. Underemployed workers with access to digital technology and mobility moved in to fill the lockdown retail gap. The Gulf states’ continuing squeeze on jobs and resultant migration slow-down contributed to these trends. Female fish-vending activity has also been affected by Kerala’s acceleration of bourgeois respectability norms. The state government’s modernisation and centralisation policies also led to the shrinking of women’s spaces in fish auction markets. Recent inequalities in digital and mobility access sit on top of longstanding entrenched class and status inequities and conservative gender norms, while the enduring chronic ‘wicked problem’ of Kerala’s unemployment levels demands urgent attention.
The Knowledge, Attitudes and Practices According to Facemask Practice During COVID-19 Pandemic
Authors: Hariyanayagam Gunasekaran Gobi , Li Foo Yen , Yusoff Aida Farhana , Sabri Wan Mohd Akmal Wan , Gunasekaran Sera Selvanthan Sundram , Gunasekaran Shargunan Selvanthan
Published: February 2024

The use of facemask as precaution from COVID-19 cross-transmission have been strongly advocated by healthcare agencies as a public health management strategy to mitigate the pandemic burden on the healthcare system. This cross-sectional study aimed to investigate the knowledge, attitudes and practices (KAP) according to facemask practice during COVID-19. Descriptive statistics, chi-square test, t-test and one-way analysis of variance (ANOVA) and multivariable linear regression was used to identify factor contributing to knowledge while Binomial analysis was used to investigate factors contributing to practice. Among 268 participants included in the study, those with medical-grade facemask had better knowledge score (88.8%) compared to non-medical facemask (86.3%) and those without facemask (78.6%). Majority of participants had positive attitudes on controlling COVID-19 pandemic (88.8%), the ability in overcoming the pandemic (99.2%) and use of facemask in a public place (98.9%). Participants using medical-grade facemask (Adjusted Odds Ratio; AOR 5.9, 95% CI 1.9–18.0; p = .002) have appropriate practices towards COVID-19. However, participants using medical-grade facemask were 9.2 times (AOR 9.2, 95% CI: 3.5–24.5, p < .001) more likely to reuse of facemask without washing. The results highlight adequate KAP among respondents. However hygienic use of facemask need to be disseminated among general population.
Platelet-Rich Plasma vs Extracorporeal Shock Wave Therapy in the Treatment of Plantar Fasciitis at 3-6 Months: A Systematic Review and Meta-analysis of Randomized Controlled Trials
Authors: Daher Mohammad , Covarrubias Oscar , Herber Agustin , Oh Irvin , Gianakos Arianna L.
Published: February 2024

Background:

Plantar fasciitis (PF) is a common foot disorder with variability in treatment strategy. Two effective management techniques include platelet-rich plasma (PRP) injections and extracorporeal shock wave therapy (ESWT). The purpose of this meta-analysis is to compare the effectiveness of PRP vs ESWT in the management of PF.

Methods:

A systematic search was performed of PubMed, Cochrane, and Google Scholar for randomized controlled trials comparing PRP to ESWT. Studies met inclusion criteria if mean and SDs for visual analog scale (VAS) pain scores and plantar fascia thickness (PFT) were reported. Mean differences were used to compare VAS pain score and PFT between PRP and ESWT.

Results:

Six randomized controlled trials, comparing a total of 214 subjects in the PRP group and 218 subjects in the ESWT group, were analyzed. A significantly greater statistical improvement was seen in the PRP group in VAS pain (mean difference = −0.67 [95% CI −1.16, −0.18], P = .007) and plantar fascia thickness (PFT) (mean difference = −0.56 [95% CI −0.77, −0.35], P < .001).

Conclusion:

PRP had a statistically higher pain reduction than ESWT, but the difference does not reach clinical significance in this meta-analysis.
A survey on countermeasures of railway vehicle stability decrease caused by the evolution of hollow-worn wheels
Authors: Wang Zegen , Gong Dao
Published: February 2024

With the problem that the lateral vibration acceleration of the frame of a certain type of Electric Multiple Units (EMU) gradually approaches the limit value as the running mileage increases, the tracking test was conducted on the whole vehicle’s wheel tread wear and the frame’s vibration response. It was found that as the tread hollow-worn increased, the vehicle stability would deteriorate. In order to improve vehicle stability, an optimisation method of EMU stability is proposed based on controlling the evolution of hollow-worn wheels. The results show that after optimisation by this method, the hollow-worn state of the wheel tread is significantly improved; the equivalent conicity of the worn wheel is reduced by 16.39%, and the maximum lateral vibration acceleration of the frame is reduced by 32.02%, so the vehicle stability is also significantly improved; meanwhile, the ride comfort and safety of the vehicle still meet the requirements of the standard.
Hospital Discharge Process: Context-Sensitive Care
Authors: Dimech Nadine , Cassar Maria , Carabott James
Published: February 2024

The transition from hospital to home after surgery is a vulnerable time for all cardiac surgical patients, particularly older adults. This postoperative phase presents multiple physical, physiological, emotional, and socioeconomic challenges, not only for patients but also for their families and informal caregivers, who often describe this period as stressful and overwhelming. Health-care professionals, particularly nurses, play an integral role in a patient's discharge process; the challenges can be ameliorated through timely discharge planning and effective discharge education. The context-sensitive solutions shared in this paper propose enhancing nurses’ discharge practices to provide individualized care and to facilitate the hospital-to-home transition.
Opportunities from adversity: The enabling impact of the COVID-19 pandemic for the actions of Finnish and Californian food and beverage ventures
Authors: Perttunen Erika , Jung Summer D , Talvinko Maria , Björklund Tua A
Published: February 2024

Crises act as critical episodes for entrepreneurs, bringing about unexpected changes and heightened uncertainty. Yet crises can also have an enabling impact, creating new opportunities. This study explores how the COVID-19 pandemic enabled new opportunities for 30 Finnish and 34 Californian food and beverage ventures. We demonstrate how the pandemic enabled the ventures’ crisis responses through various different types of mechanisms in various pairings and with different logics of enablement. Our findings suggest that the crisis profile and entrepreneurial action interact to shape the impact of the crisis and the ability of ventures to leverage its enabling effect. The enabler mechanisms can result straightforwardly from changes not only in resources and demand, but also in a more complex manner due to the ideological shifts arising from crises. Also, the mechanisms pair with each other to enable ventures’ actions, either working concurrently or consecutively. Oftentimes, the creative manner in which the ventures leverage these pairings resembles bricolage. Better awareness of how the crisis-induced enabler mechanisms operate and interact can lead to more effective and resilient crisis responses.
Using interview excerpts to facilitate focus group discussion
Authors: Geampana Alina , Perrotta Manuela
Published: February 2024

The use of interviews and focus groups is well-established in the social science methods literature. However, discussion on how research can combine these two methods in creative ways is less common. While researchers are generally aware of the potential of focus groups for further probing issues that emerge in one-on-one interviews, few studies detail how this might be achieved in practice. In this article, we describe and reflect on a focus group elicitation strategy that uses individual interview excerpts to facilitate discussion in group settings. In our reflection, we draw on a study that investigated the sharing of embryo images in fertility treatment. The article contributes to the methods literature firstly, by reflecting on the novel use of individual interview material in focus groups and secondly, by discussing the re-enactment of interview excerpts as an effective audio elicitation tool to be used in the later stages of research.
Unsupervised deep learning approach for structural anomaly detection using probabilistic features
Authors: Wan Hua-Ping , Zhu Yi-Kai , Luo Yaozhi , Todd Michael D
Published: February 2024

Civil structures may deteriorate during their service life due to degradation or damage imposed by natural hazards such as earthquakes, wind, and impact. Structural performance anomaly detection is essential to provide an early warning of structural degradation limit states in order to prevent potential catastrophic failure. Data-driven machine learning approaches have been widely used for this, due to their capability in capturing features sensitive to damage-induced anomalies from structural health monitoring (SHM) data, assuming that such data are available. Although machine learning models have been used, many are challenged by the vast operational and environmental variability that can corrupt SHM data and by (typically) strongly correlated information from different sensors in the SHM data. This paper proposes an unsupervised deep learning approach for the detection of structural anomaly based on a deep convolutional variational autoencoder (DCVAE) for feature extraction coupled with support vector data description (SVDD) for anomaly detection. The proposed DCVAE-SVDD method has several appealing strengths. First, the variational latent encoding is used to capture the features of monitoring data through a probability distribution. The integration of the Kullback–Leibler divergence in the loss function provides accurate estimation of the probability distributions. Second, the DCVAE designed with convolutional and deconvolutional operations utilizes the correlation among multisensor data to avoid loss of correlation features and achieve better performance in feature extraction. Third, the SVDD is utilized to create a minimum-volume hypersphere that contains the anomaly-sensitive statistical features of the state. The hypersphere accurately separates anomaly-sensitive statistical features of reference states of structure from the anomalous ones. A computational frame model and a laboratory grandstand model are used to evaluate the performance of the proposed method for detecting structural anomaly. The results demonstrate the superiority of the proposed DCVAE-SVDD in detection accuracy over the other commonly used structural anomaly detection methods (deep autoencoder combined with SVDD autoregressive model with one-class support vector machine, and principal component analysis).
Rural home care nurses’ experiences with continuing nursing education
Authors: Pavloff Michelle , Labrecque Mary Ellen , Bally Jill , Kirychuk Shelley , Lasiuk Gerri
Published: February 2024

Purpose: Rural home care nurses require access to continuing nursing education to address the increasing complexity of client care needs. There is currently limited literature on continuing nursing education for rural home care nurses. The purpose of this study was to explore the continuing nursing education experiences of rural home care nurses. Sample: Purposive and snowball sampling were used to recruit registered nurses who worked in publicly funded rural home care in one western Canadian province, in communities with a population of less than 10,000 people. Twenty rural home care nurses participated in semi-structured telephone interviews. Methods: This study used interpretive description as its method of inquiry and analysis. Data was collected between December 2020 and May 2021 and the analysis was supported using NVivo 12 software. Findings: Key findings from this study contribute to the description of western Canadian rural home care nursing roles and the degree of autonomy required to provide expert care in the home environment. Rural home care nurses’ experiences with continuing education are impacted by external factors including (1) Chameleonic Practice (One-Person Show, Professional Intersection, Becoming their Person), (2) Foundational Instability (Roadblocks to Learning, Stretched Thin, Rural Repatriation) and (3) Learning Leadership (Filling the Learning Bucket, Finding a Way, Learning Reciprocity). Conclusions: The findings of this study suggest that the continuing nursing education experiences of rural home care nurses is dependent on many factors. Significant policy changes and updated standards of practice are required to support safe client care through the delivery of evidence-informed continuing nursing education.
Endovascular Treatment of a Forty-Year-Old Post-Traumatic Knee Arteriovenous Fistula
Authors: Theodoridis Panagiotis , El Kanty Aouatif E. , Kourampi Islam , Iatrou Nikolaos , Dimopoulos Christos , Bisdas Theodosios
Published: February 2024

Arteriovenous fistulas (AVFs) of the lower extremity are uncommon. The main causes are traumatic or iatrogenic, with 15% of traumatic AVFs occurring in the popliteal vessels. Herein, we present a 60-year–old female with a traumatic AVF caused after a car accident 40 years ago. The patient presented with right leg venous claudication and symptoms of congestive heart failure. Duplex ultrasound of lower limb vessels revealed an AVF at the distal part of the tibiofibular trunk. The patient was successfully managed with an endovascular approach using a coil-assisted covered endovascular repair technique of the tibiofibular bifurcation (CERTIFIB) with excellent results and distal vessels patency. At 3 months follow-up, patient presented with an impressive regression of 3 cm of the lower extremity oedema and improvement of both claudication and heart failure.
Return to Play After Hook of Hamate Fracture: A Systematic Review and Meta-Analysis
Authors: Luxenburg Dylan , Patel Nikhil , Narasimman Manish , Weinerman Jonathan , Russo Jean-Paul , Martin Anthony , Minaie Arya , Dodds Seth
Published: February 2024

In athletes, a hook of hamate fracture is concerning in terms of time to return to sport and effect on performance upon return. This study aims to analyze the treatment of hook of hamate fractures in athletes to determine their rates of return to play, timelines of recovery, and performance level upon return to play. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to perform this analysis. The PubMed database was queried to perform the literature search. Data were pooled and analyzed. P values <.05 were considered significant. Data were analyzed using the Comprehensive Meta-Analysis software to determine heterogeneity. Twenty studies with 823 patients sustaining hook of hamate fractures that reported any competitive level of play were included in the analysis. Of the 823 patients, 778 (94.5%) were able to return to play with 91.2% (506/555) of patients demonstrating similar or improved performance. The mean time to return to play was 45 days (range: 21-168 days). Treatment included surgical excision for 787 patients (95.6%), open reduction and internal fixation for 18 patients (2.2%), stress reduction/casting for 13 patients (1.6%), and loss to follow-up or surgery refusal for 5 patients (0.6%). A very high number of athletes return to play following a hook of hamate fracture at the same or improved level of performance. In our study, the majority of injuries were treated with surgical excision of the fractured hook of hamate fragment. Most athletes returned to their sport at an average of 45 days.
Interspecialty Variation in Perioperative Health Care Resource Usage for Carpal Tunnel Release
Authors: Malik Azeem Tariq , Lin James S. , Jain Sonu , Awan Hisham , Khan Safdar N. , Goyal Kanu S.
Published: February 2024

Background:

We investigated whether any interspecialty variation exists, regarding perioperative health care resource usage, in carpal tunnel releases (CTRs).

Methods:

The 2010 to 2021 PearlDiver Mariner Database, an all-payer claims database, was queried to identify patients undergoing primary CTRs. Physician specialty IDs were used to identify the specialty of the surgeon—orthopedic versus plastic versus general surgery versus neurosurgery. Multivariate logistic regression analysis was used to identify whether there was any interspecialty variation between the use of health care resources.

Results:

A total of 908 671 patients undergoing CTRs were included, of which 556 339 (61.2%) were by orthopedic surgeons, 297 047 (32.7%) by plastic surgeons, 44 118 (4.9%) by neurosurgeons, and 11 257 (1.2%) by general surgeons. In comparison with orthopedic surgeons, patients treated by plastic surgeons were less likely to have received opioids, nonsteroidal anti-inflammatory drugs, oral steroids, and preoperative antibiotic prophylaxis but were more likely to have received steroid injections and electrodiagnostic studies (EDSs) preoperatively. Patients treated by neurosurgeons were more likely to have received preoperative opioids, gabapentin, oral steroids, preoperative antibiotic prophylaxis, EDSs, and formal preoperative physical/occupational therapy and less likely to have received steroid injections. Patients treated by general surgeons were less likely to receive oral steroids, steroid injections, EDSs, preoperative formal physical therapy, and preoperative antibiotic prophylaxis, but were more likely to be prescribed gabapentin.

Conclusions:

There exists significant variation in perioperative health care resource usage for CTRs between specialties. Understanding reasons behind such variation would be paramount in minimizing differences in how care is practiced for elective hand procedures.
A case of spontaneous brain arteriovenous malformation occlusion: Imaging analysis and clinical debate
Authors: Milazzo Nicola , Pizzuto Silvia , Gratieux Julie , Sgreccia Alessandro , Di Maria Federico , Coskun Oghuzan , Condette-Auliac Stephanie , Boulin Anne , Rodesch Georges , Consoli Arturo
Published: February 2024

The spontaneous occlusion of brain arteriovenous malformations (bAVMs) is a rare event, particularly for unruptured ones. Associated factors include single-venous drainage and small nidus size. Most of the previously reported cases were ruptured bAVMs. We report the case of a middle-aged male patient with an unruptured, rolandic, left-sided bAVM associated with a 30-year history of refractory epilepsy. We documented the spontaneous thrombosis of the venous drainage of the AVM without any sign of bleeding. Finally, we underline the difference between ruptured-induced occlusion and truly spontaneous thrombosis of the bAVMs.
Why do Citizens Choose to Read Fact-Checks in the Context of the Russian War in Ukraine? The Role of Directional and Accuracy Motivations in Nineteen Democracies
Authors: Tulin Marina , Hameleers Michael , de Vreese Claes , Aalberg Toril , Corbu Nicoleta , Van Erkel Patrick , Esser Frank , Gehle Luisa , Halagiera Denis , Hopmann David Nicolas , Koc-Michalska Karolina , Matthes Jörg , Mihelj Sabina , Schemer Christian , Stetka Vaclav , Strömbäck Jesper , Terren Ludovic , Theocharis Yannis
Published: February 2024

The recent surge of false information accompanying the Russian invasion of Ukraine has re-emphasized the need for interventions to counteract disinformation. While fact-checking is a widely used intervention, we know little about citizen motivations to read fact-checks. We tested theoretical predictions related to accuracy-motivated goals (i.e., seeking to know the truth) versus directionally-motivated goals (i.e., seeking to confirm existing beliefs) by analyzing original survey data ( n = 19,037) collected in early April to late May 2022 in nineteen countries, namely Austria, Belgium, Brazil, Czech Republic, Denmark, France, Germany, Greece, Hungary, Italy, Netherlands, Poland, Romania, Serbia, Spain, Sweden, Switzerland, UK, and USA. Survey participants read ten statements about the Russian war in Ukraine and could opt to see fact-checks for each of these statements. Results of mixed models for three-level hierarchical data (level 1: statements, level 2: individuals, and level 3: countries) showed that accuracy motivations were better explanations than directional motivations for the decision to read fact-checks about the Russian war in Ukraine.
Implementing health worker training on sepsis in South Eastern Nigeria using innovative digital strategies: an interventional study
Authors: Otu Akaninyene , Onwusaka Obiageli , Otokpa Daniel E. , Edadi Ukam , Udoh Ubong , Yougha Peter , Oduche Chinelo , Okuzu Okey , Jacob Shevin T. , Rylance Jamie , Effa Emmanuel
Published: February 2024

Background:

Sepsis is a leading cause of morbidity and mortality especially in low- and middle-income countries such as Nigeria. Training of health workers using digital platforms may improve knowledge and lead to better patient outcomes.

Objectives:

To assess the effectiveness of a digital health educational module on sepsis in improving the knowledge of medical doctors in Cross River State Nigeria on the diagnosis and management of patients presenting with sepsis.

Design:

Quasi-experimental analytical study.

Methods:

We developed and deployed a sepsis module through an innovative application (Sepsis tutorial app) to doctors in Calabar, Nigeria. We assessed quantitative pre- and post-intervention knowledge scores for those completing the tutorial on sepsis between both assessments. A user satisfaction survey evaluated the content of the tutorial and the usability of the app.

Results:

One hundred and two doctors completed the course. There were more males than females (58.8% versus 41.2%). Over half (52%) were junior doctors, a minority were general practitioners and house officers (3% and 5%, respectively), and 72.6% had practiced for periods ranging from 1 to 15 years post-qualification. Gender and age appeared to have no significant association with pre- and post-test scores. The oldest age group (61–70) had the lowest mean pre- and post-test scores, while general practitioners had higher mean pre- and post-test scores than other cadres. The majority (95%) of participants recorded higher post-test than pre-test scores with a significant overall increase in mean scores (25.5 ± 14.7%, p < 0.0001). Participants were satisfied with the content and multimodal delivery of the material and found the app usable.

Conclusion:

Digital training using context-responsive platforms is feasible and may be used to close the critical knowledge gap required to respond effectively to medical emergencies such as sepsis in low- to middle-income settings.
Development of educational package and participatory consumer groups to improve food handling practices in food establishments in Sri Lanka
Authors: Hirimuthugoda Lasantha Krishan , De Silva Padmal , Abeykoon Palitha
Published: February 2024

Objectives:

Improper food handling contributes to many foodborne diseases and food outbreaks globally leading to witnessed morbidities and mortalities. The study aims to develop an educational package and participatory consumer groups to improve food handling practices among food handlers and in food establishments in the Regional Director of Health Services area, Kalutara, Sri Lanka.

Methods:

The study developed an educational package and participatory consumer groups to improve the food handling practices among food handlers and in food establishments. The critical knowledge gaps were identified during the first component of this study, which was conducted as a descriptive study, and the findings were further discussed in the Focus Group Discussion. Posters, info sheets, and workshops were used for educational packages, and four consumer groups were formed. The second component of the study following the development of the interventions was continued as a three-arm, non-randomized controlled community trial for 4 months in the Regional Director of Health Services, Kalutara.

Results:

The educational package for food handlers was introduced as a package of a workshop, info sheets, posters to display at workplaces, and short refresher training two weekly to direct good food handling practices in food establishments. Consumer groups were strengthened to exercise their legal rights on their purchases and the ratings showed improvements in the hygiene levels with repeated consecutive visits.

Conclusions:

The novel educational package and participatory consumer groups are designed and implemented to improve food handling practices among food handlers and in food establishments.
Splash of body fluids among healthcare support staff in Ghana: a cross-sectional study
Authors: Tawiah Philip Apraku , Appiah-Brempong Emmanuel , Okyere Paul , Ashinyo Mary Eyram
Published: February 2024

Background:

Exposure to splash of body fluids is one of the common ways of transmitting blood-borne infections from patients to healthcare practitioners. Globally, there is a paucity of evidence on exposure to splash of body fluids among hospital housekeepers. This study, therefore, investigated splash of body fluid and its predisposing factors among healthcare support staff in the Greater Accra region, Ghana.

Methods:

An analytic cross-sectional survey was conducted among support staff in 10 major hospitals between 30 January and 31 May 2023. A multi-stage sampling procedure was the overarching technique employed, and study participants were recruited through simple random and probability proportional-to-size sampling techniques. The data analyses were conducted using STATA 15 software. The preliminary association between exposure to splash of body fluids and predisposing factors was established through Chi-square, Fisher’s exact, and Mann–Whitney U tests. Log-binomial regression analyses were employed to validate the factors related to splash of body fluids at a significance level of p-value < 0.05.

Results:

The investigation was conducted among 149 healthcare support staff. The exposure to splash of body fluids over the past 1 year was 53.7% (95% CI: 45.3%–61.9%). The types of body fluids that were mostly encountered through these splash exposures were amniotic fluids (36.3%) and urine (23.8%). Several factors were found to be significantly associated with splash of body fluids, namely: employed as a healthcare assistant [APR = 1.61 (1.16, 2.22)], holding a supervisory position [APR = 0.24 (0.11, 0.51)], having a system in place for reporting body fluid splashes [APR = 0.61 (0.44, 0.85)], male healthcare support staff [APR = 0.62 (0.41, 0.93)], and adherence to standard precautions most of the time [APR = 1.66 (1.11, 2.48)].

Conclusion:

Healthcare support staff were highly exposed to splash of body fluids. Gender, supervisory role, category of worker, reporting systems, and adherence to standard precautions were associated with exposure to splash of body fluids. Facility managers are advised to enhance the efficiency of reporting systems.
Content-Form Interaction in the Acquisition of Temporal Markers by Mandarin-Speaking Children
Authors: Tang Tempo Po-Yi , Hsu Yu-Yin , Lau Dustin Kai-Yan , Leung Man-Tak
Published: February 2024

Aspect markers (AMs), temporal adverbs (TAs) and temporal nouns (TNs) are used by young Mandarin-speaking children to express time. However, the factors that affect the relative acquisition trajectories of these categories remains unclear. Accordingly, this study adopts Weist’s time-concept model to examine the patterns of acquisition between and within the above three categories of temporal markers in the Mandarin system of time. Specifically, temporal markers were extracted from language samples obtained from 82 Mandarin-speaking children aged 2 to 5 years, who were divided into three groups by age. The results indicated that the token counts and the type counts of temporal markers were significantly higher among the older children, who were also more capable of using more categories of temporal markers, and were more likely to use multiple markers in single utterances. Of the three categories of temporal marker, AMs emerged earliest, and the participants’ repertoires of AMs stopped expanding sooner than their TA and TN repertoires did. As measured by token use, AMs were mastered earliest. Within each of the three categories, the acquisition of temporal-marker subgroups also varied according to two semantic features: temporal remoteness and specificity. The findings were consistent with Weist’s principles, and suggest that language-general time concepts (content) and language-specific syntactic properties (form) interact to shape the acquisition of temporal markers by Mandarin-speaking children, with the additional role being played by the semantic features of temporal remoteness and specificity within each category. Theoretical and clinical implications are also discussed.
Cohort Differences in Aging Self-Perceptions Among Japanese Older Adults
Authors: Nakagawa Takeshi , Ito Daisuke , Yasumoto Saori
Published: February 2024

Various individual resources for successful aging have improved during the last decades. However, a limited number of studies have examined historical changes in how older individuals view their own aging. This study examined cohort differences in aging self-perceptions among Japanese older adults. Using nationally representative data obtained 9 years apart in 1987 and 1996, we compared two cohorts born in the 1920s versus the 1930s. To control for relevant correlates, we identified case-matched controls based on age, sex, and education (age range = 60–65 years; n = 499 per cohort). Results indicated that the later-born cohort held more positive self-perceptions of aging than the earlier-born cohort, even after adjusting for relevant correlates. The correlates with self-perceptions of aging did not differ across cohorts. Our findings suggest that self-perceptions of aging have improved over the historical time. We discuss the potential role of societal forces on personal views on aging.
Understanding Ethnoracial Disparities and Advancing Mental Health Equity Through Clinical Psychological Science: Introduction to Special Issue
Authors: Lui P. Priscilla , Rodriguez-Seijas Craig
Published: February 2024

Mental health disparities persist in countries such as the United States and across the world. Research with disparity populations is underrepresented in mainstream clinical psychological journals, and existing science has not focused on group specific lived experiences. Achieving mental health equity requires examination of determinants of psychopathology and health disparities and personal and cultural attributes that promote mental health. Clinical psychological science ideally also encourages and values research with underrepresented minority and underserved populations, novel and underused study designs, and research produced by diverse scholars. Our special issue highlights research that considers systematically culture specific processes, examines not only individual- but also community-level factors that relate to psychopathology and mental-health care, and challenges structural limitations in the current literature. We review these articles that incorporate innovative and community engaged approaches and showcase the importance of diversity in researcher and research participant demographics and perspectives in the advancement of equity in clinical psychological science.
AO Spine Guideline for the Use of Osteobiologics (AOGO) in Anterior Cervical Discectomy and Fusion for Spinal Degenerative Cases
Authors: Meisel Hans Jörg , Jain Amit , Wu Yabin , Martin Christopher T. , Cabrera Juan Pablo , Muthu Sathish , Hamouda Waeel O. , Rodrigues-Pinto Ricardo , Arts Jacobus J. , Viswanadha Arun-Kumar , Vadalà Gianluca , Vergroesen Pieter-Paul A. , Ćorluka Stipe , Hsieh Patrick C. , Demetriades Andreas K. , Watanabe Kota , Shin John H. , Riew K. Daniel , Papavero Luca , Liu Gabriel , Luo Zhuojing , Ahuja Sashin , Fekete Tamás , Uz Zaman Atiq , El-Sharkawi Mohammad , Sakai Daisuke , Cho Samuel K. , Wang Jeffrey C. , Yoon Tim , Santesso Nancy , Buser Zorica
Published: February 2024

Study design

Guideline

Objectives

To develop an international guideline (AOGO) about the use of osteobiologics in anterior cervical discectomy and fusion (ACDF) for treating degenerative spine conditions.

Methods

The guideline development process was guided by AO Spine Knowledge Forum Degenerative (KF Degen) and followed the Guideline International Network McMaster Guideline Development Checklist. The process involved 73 participants with expertise in degenerative spine diseases and surgery from 22 countries. Fifteen systematic reviews were conducted addressing respective key topics and evidence was collected. The methodologist compiled the evidence into GRADE Evidence-to-Decision frameworks. Guideline panel members judged the outcomes and other criteria and made the final recommendations through consensus.

Results

Five conditional recommendations were created. A conditional recommendation is about the use of allograft, autograft or a cage with an osteobiologic in primary ACDF surgery. Other conditional recommendations are about the use of osteobiologic for single- or multi-level ACDF, and for hybrid construct surgery. It is suggested that surgeons use other osteobiologics rather than human bone morphogenetic protein-2 (BMP-2) in common clinical situations. Surgeons are recommended to choose 1 graft over another or 1 osteobiologic over another primarily based on clinical situation, and the costs and availability of the materials.

Conclusion

This AOGO guideline is the first to provide recommendations for the use of osteobiologics in ACDF. Despite the comprehensive searches for evidence, there were few studies completed with small sample sizes and primarily as case series with inherent risks of bias. Therefore, high-quality clinical evidence is demanded to improve the guideline.
Technological and Institutional Space, Entrepreneurial Activities and Innovation in Asian Economies
Authors: Tohyama Hironori
Published: February 2024

The East Asian region has shown increased innovation performance over the past 20 years. At the same time, individual economies within the region have shown divergent performance. This article investigated the relationship between institutional potentials, entrepreneurial activities and innovation in 12 Asian economies in order to address the question of why innovation performance in Asian economies has been dynamic as well as divergent. We empirically examine the question in the following two steps. First, we apply a multiple factor analysis to a range of indicators of multiple institutional domains that are relevant to a technological system, and we show that there can be diversity of institutional space underlying a technological architecture. Second, we investigate how and to what extent technological and institutional dimensions—derived from multiple factor analysis (MFA)—affect innovation performance by using an ordered logit model. We find that there is a diversity of technological and institutional systems available for innovation activities, leading to different innovation systems, and that entrepreneurial activity is essential for a technological and institutional potential to be linked with innovative activity. The positive synergy between innovation, technological and institutional potentials and entrepreneurial activities results in different trajectories for Asian economies to lead to increasing innovation performance. This finding implies that there can be multiple ways for emerging economies to be able to develop innovative capabilities. It also contributes to innovation policy, because it allows policymakers in emerging economies to understand how to build a synergy between institutional spaces and entrepreneurs’ activities for innovation performance.
Sex differences in clot, vessel and tissue characteristics in patients with a large vessel occlusion treated with endovascular thrombectomy
Authors: van der Meij Anne , Holswilder Ghislaine , Bernsen Marie Louise E , van Os Hendrikus JA , Hofmeijer Jeannette , Spaander Fianne HM , Martens Jasper M , van den Wijngaard Ido R , Lingsma Hester F , Konduri Praneeta R , BLM Majoie Charles , Schonewille Wouter J , Dippel Diederik WJ , Kruyt Nyika D , Nederkoorn Paul J , van Walderveen Marianne AA , Wermer Marieke JH
Published: February 2024

Introduction:

To improve our understanding of the relatively poor outcome after endovascular treatment (EVT) in women we assessed possible sex differences in baseline neuroimaging characteristics of acute ischemic stroke patients with large anterior vessel occlusion (LVO).

Patients and methods:

We included all consecutive patients from the MR CLEAN Registry who underwent EVT between 2014 and 2017. On baseline non-contrast CT and CT angiography, we assessed clot location and clot burden score (CBS), vessel characteristics (presence of atherosclerosis, tortuosity, size, and collateral status), and tissue characteristics with the Alberta Stroke Program Early Computed Tomography Score (ASPECTS). Radiological outcome was assessed with the extended thrombolysis in cerebral infarction score (eTICI) and functional outcome with the modified Rankin Scale score (mRS) at 90 days. Sex-differences were assessed with multivariable regression analyses with adjustments for possible confounders.

Results:

3180 patients were included (median age 72 years, 48% women). Clots in women were less often located in the intracranial internal carotid artery (ICA) (25%vs 28%, odds ratio (OR) 0.85;95% confidence interval: 0.73–1.00). CBS was similar between sexes (median 6, IQR 4–8). Intracranial (aOR 0.73;95% CI:0.62–0.87) and extracranial (aOR 0.64;95% CI:0.43–0.95) atherosclerosis was less prevalent in women. Vessel tortuosity was more frequent in women in the cervical ICA (aOR 1.89;95% CI:1.39–2.57) and women more often had severe elongation of the aortic arch (aOR 1.38;95% CI:1.00–1.91). ICA radius was smaller in women (2.3vs 2.5 mm, mean difference 0.22;95% CI:0.09–0.35) while M1 radius was essentially equal (1.6vs 1.7 mm, mean difference 0.09;95% CI:−0.02–0.21). Women had better collateral status (⩾50% filling in 62%vs 53% in men, aOR 1.48;95% CI:1.29–1.70). Finally, ASPECT scores were equal between women and men (median 9 in both sexes, IQR 8–10vs 9–10). Reperfusion rates were similar between women and men (acOR 0.94;95% CI:0.83–1.07). However, women less often reached functional independence than men (34%vs 46%, aOR 0.68;95% CI:0.53–0.86).

Discussion and conclusion:

On baseline imaging of this Dutch Registry, men and women with LVO mainly differ in vessel characteristics such as atherosclerotic burden, extracranial vessel tortuosity, and collateral status. These sex differences do not result in different reperfusion rates and are, therefore, not likely to explain the worse functional outcome in women after EVT.