bluuebunny/crossref_metadata_2025 huggingface dataset:
Withdrawal of Open Offer: Impact  on Merger and Acquisition  Transactions in India
Authors: Dash Supriya , Ronald Bindu S , Prasad Sachchidanand , Hake Damodar Mayappa
Published: September 2024

Securities and Exchange Board of India (SEBI) and the Supreme Court of India have taken a tough stand to allow for a withdrawal of open offers under the Takeover Code, 2011. Analyzing the regulations, it is clear that withdrawal, which did not exist in the earlier takeover regulations, is now allowed under conditions that render the withdrawal of an open offer impossible to complete. SEBI is vested with wide discretionary power under Regulation 27(1)(d), which reads as “such circumstances” of the Takeover Code, 1997, and so carried forward as Regulation 23(d) in the Takeover Code, 2011. The authors analyze the interpretation of “such circumstances” through the various judgments, highlighting the authorities’ understanding of such withdrawal. The self-placed restriction on such discretionary power is analyzed for its impact on merger and acquisition transactions. The importance of circumstances like market situation, the financial situation of the acquirer, material adverse changes, and nonreceipt of lender approval, whether it deserves a place in the regulation, and if yes, the mechanism to misuse of such provision and the protection of investor becomes the center of the article. The prima facie shift from not allowing withdrawal to debating for more clauses for withdrawal to be allowed, the article provides suggestions as felt necessary.
Variability in the Spectrum of Reporting on the Schenck KD I Classification in the Orthopaedic Literature: A Systematic Review and Meta-analysis
Authors: Green Joshua S. , Marcel Aaron , Li Zachary I. , Moran Jay , Schenck Robert C. , Alaia Michael J. , Medvecky Michael J.
Published: September 2024

Background:

There has been a marked increase in the number of Schenck knee dislocation (KD) I injuries reported in the multiligament knee (MLK) injury (MLKI) and KD literature.

Purpose:

To examine the heterogeneity of the Schenck KD I classification in the MLKI and KD literature.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

A systematic literature search of PubMed, CINAHL, Scopus, Web of Science, EMBASE, and Cochrane Library was conducted for all studies that investigated KDs and/or MLKIs, utilized the Schenck or an MLKI classification system, and included patients with KD I or MLK 1 injuries. Pooled analysis determined the total number of KD I or MLK 1 injuries and the specific ligamentous tear patterns. Binary meta-analyses of the studies that reported neurovascular injury within each Schenck KD class compared the pooled odds ratio (OR) of vascular and neurological injury in unicruciate (KD I) and bicruciate (KD II-IV) injuries.

Results:

Included were 50 studies in which 3460 KD I injuries were reported out of 7872 KDs and MLKIs (43.9%). Of the 2912 patients reported to have had a Schenck KD I injury, 26 patients (0.9%) had a clinically and/or radiographically confirmed tibiofemoral KD. The overall prevalence of Schenck KD I injury with documented tibiofemoral KD was 26 of 7872 (0.3%). A total of 22 studies (n = 1702 patients) reported the specific ligamentous tear patterns; the most common patterns were posterior cruciate ligament (PCL)/lateral collateral ligament (LCL) (n = 526; 30.9%), anterior cruciate ligament (ACL)/LCL (n = 488; 28.7%), ACL/medial collateral ligament (MCL) (n = 408; 24.0%), and PCL/MCL (n = 198; 11.6%). Meta-analyses demonstrated that when compared with bicruciate KD or MLKI, unicruciate KD or MLKI was significantly less likely to have concomitant vascular injury (OR, 0.28; 95% CI, 0.15-0.51; P < .0001) and concomitant neurologic injury (OR, 0.49; 95% CI, 0.37-0.65; P < .00001).

Conclusion:

The number of true, clinically and/or radiographically confirmed unicruciate KDs was extremely rare, representing <1% of all reported Schenck KD I injuries. A misappropriation of these injury patterns as true KDs may be taking place, affecting outcome studies and potentially biasing published clinical results. An MLKI classification system must document whether a confirmed KD has occurred.
A Single-Surgeon 35-Year Experience With ACL Reconstruction Using Patellar Tendon Auto- and Allografts With the Transtibial Technique
Authors: Khan Zeeshan A. , Kerzner Benjamin , Kaplan Daniel J. , Riff Andrew J. , Chahla Jorge , Bach Bernard R.
Published: September 2024

Background:

Long-term follow-up for anterior cruciate ligament reconstruction (ACLR) is limited due to heterogeneity in the number of techniques utilized, the number of surgeons included, and attrition bias.

Purpose:

To analyze a single surgeon's 35-year experience with ACLR using the transtibial technique, with an emphasis on temporal trends in graft selection and subanalyses on rates of revision surgery, contralateral ACLR, and nonrevision reoperation among different demographic cohorts of patients.

Study Design:

Case series; Level of evidence, 4.

Methods:

All patients who underwent arthroscopically assisted single-bundle ACLR between 1986 and 2021 were identified from a prospectively maintained single-surgeon registry. Outcomes of interest included revision, reoperation, and contralateral rupture rates.

Results:

A total of 2915 ACLRs were performed during the senior surgeon's career. The mean age for primary ACLR was 29.4 ± 14.8 years. During primary ACLR, 98.4% of patients received a central-third bone-patellar tendon-bone (BPTB) graft. Increasing patient age was associated with increasing allograft usage ( P < .01), with a significant temporal increase in allograft usage over the senior surgeon's career ( P < .01). There was a higher revision rate among younger patients ( P < .01), female patients aged 21 to 25 years ( P = .01), and patients who received an allograft during the primary procedure ( P = .04). The contralateral rupture rate showed no difference between sexes ( P = .34); however, patients who underwent ACLR with autograft had a greater rate of contralateral injury compared with those with allograft ( P < .01). The contralateral rupture rate was greater than the revision rate ( P < .01). The most common causes of nonrevision reoperation were failed meniscal repair, new meniscal tears, arthrofibrosis, and painful hardware removal.

Conclusion:

The findings of this single-surgeon registry reveal temporal trends in ACLR over a 35-year career. There was a trend toward increasing BPTB allograft use in ACLR, especially in older patients and revision cases. A greater revision rate was observed among younger patients, female patients, and those receiving allografts during primary surgery. Contralateral ACLR was more common than revision surgery.
Toward a Gender Equality at Work via Activism The Role of Transparent Internal Communication
Authors: Lee Yeunjae , Li Jo-Yun Queenie , Ma Xiao
Published: September 2024

Grounded in the Social Identity Model of Collective Actions (SIMCA), this study examines the role of strategic internal communication—specifically, transparent communication—in fostering gender equality at work via women’s workplace activism: collective actions and communicative behaviors. Results from an online survey of 402 female employees in South Korea suggest that transparent communication plays an important role in increasing women’s identification with their organizations, thereby fostering their efficacy and reducing perceived injustice. This, in turn, increased their active communicative behaviors and collective actions for promoting gender equality in the workplace. Theoretical implications for strategic internal Diversity, Equity, and Inclusion (DEI) communication are discussed along with avenues for future research.
Leading by Example: Supervisor Downward Feedback Seeking, Power Distance, and the Implications for the Feedback Environment
Authors: Mertens Shana , Schollaert Eveline
Published: September 2024

This study explores the relationship between supervisors’ feedback-seeking behavior (FSB) and (1) employees’ FSB and (2) employees’ perceptions of the feedback environment. It examines the moderating role of power distance perceptions in order to study FSB in high power distance contexts. Participants were asked to track feedback exchanges with their supervisor over a two-week period. Surveying 273 employees across 32 diverse organizations, the study reveals a positive correlation between supervisors’ FSB and employees’ FSB and their perceptions of the feedback environment. Employees seemed to mimic their supervisors’ seeking behaviors, emphasizing the importance of positive role modeling. Importantly, the relationship was more pronounced when power distance was high, indicating the significance of supervisors’ FSB in such contexts. The study challenges the traditional employee-centered perspective on FSB by focusing on FSB by individuals in leadership positions. Based on these findings, organizations can develop training interventions that encourage supervisors to model effective behaviors.
The “People’s Tour” as Conflict Pedagogy: Using Site Visits to Engage Students with the Struggle for Civil Rights
Authors: Rose Daniel
Published: September 2024

Winston-Salem, North Carolina, has a rich history of Civil Rights struggles and its people continue to resist racial oppression in systems of housing, labor, education, policing, transportation, and others. Dating to 1892, Winston-Salem State University (WSSU), a historically Black college/university (HBCU), has attracted students who have become organizers and activists in the fight for social justice in the local community. These include Theodosia Simpson, a leader of the radical Black women-led tobacco workers union; Carl Matthews, who started the first victorious lunch counter sit-in in North Carolina; and Dr. Larry Little, who co-founded the first official Black Panther Party chapter in the South. In that tradition, I have developed a “People’s History Tour of Winston-Salem” that takes current WSSU students outside the classroom to learn about the Civil Rights struggle at a variety of important sites. This critical pedagogy has students apply key sociological concepts that bolster their understanding of racial stratification and efforts to eradicate it. The goals of this assignment are for students to explore classroom curriculum about White supremacy, racial capitalism, and social movements at relevant historical and contemporary sites in Winston-Salem. By doing so, I aim for students to have transformative experiences that tie their readings and classroom discussions to the community spaces where that material comes alive.
Prevalence of Hemophilia and Clinicodemographic Characteristics of Hemophilic Patients Aged ≤ 18 Years in Thi-Qar, Iraq
Authors: Abood Ghada Mansoor , Dehiol Raid Kareem , Mones Hayfaa Mohammed
Published: September 2024

Objectives. This study aims to determine the prevalence of hemophilia in Thi-Qar, Iraq and study clinical and demographic characteristics of patients with hemophilia. Methods. In this cross-sectional study, data were obtained by reviewing all patient medical records and interviewed with the patients and their parents in 2022. The total number of patients enrolled for this study was 110 children. Results. The prevalence of hemophilia in Thi-Qar was 9.5/100 000 population (18.7/100 000 males). Factor VIII inhibitors were positive in 13.1% of patients with hemophilia A (HA). Target joints were developed among 41.4% and 27.3% of patients with HA and hemophilia B, respectively. Hepatitis C virus was positive in 3% of those with HA. Inhibitors development and arthropathy were more among those with severe disease (22% and 46.3%, respectively). Conclusion. Hemophilia prevalence in Thi-Qar was higher than the total prevalence in Iraq reported by World Federation of Hemophilia in 2022.
Unique, better, model, leader: Claims of exceptionality in Hungary’s foreign policy and beyond
Authors: Hettyey András
Published: September 2024

In the IR literature, devoting attention to small state exceptionalism remains the exception. This paper aims to rectify this situation by analyzing claims of exceptionality of the successive Orbán governments of Hungary. It aims to shed light on Hungary’s foreign policy by making two core claims. First, based on a diverse range of sources, it shows that successive Hungarian governments have increasingly come to conceptualize Hungary as an exceptional, trail-blazing, model country in foreign policy and beyond, especially after 2018. Secondly, the paper shows how claims of exceptionality can lead to resentment and isolation in foreign policy, if and when they go hand-in-hand with collective narcissism.
Captured green aims: The case of Hungary
Authors: Éltető Andrea , Ricz Judit
Published: September 2024

The article aims to shed light on the environmental risks of the Hungarian autocratic economic policy coupled with increased state interventionism and the revival of industrial policies. Green economic strategies proliferate in democratic countries, but we know less about contemporary hybrid regimes. In the case of Hungary, we show that the pillars of green industrial policy do not exist in practice. There is however a façade and rhetoric of green aims which serve only as one tool among others to rent-seeking and keep the ruling power. By several illustrative cases, we describe the mechanisms of hollowing out, capturing environmental institutions, instrumentalising green aims and repressing civil initiatives as systemic characteristics for illiberal hybrid regimes.
Unfolding Stories of Children in Conflict with Law: Contextual Dynamics, Stigma and Its Impact on Schooling
Authors: Karre Sailu
Published: September 2024

Recent scholarship explains various causes of children in conflict with the law (CCL) by the discipline of criminology across the globe. However, despite this discourse, it has been unable to adequately address the intricate relationship between the local context and how children are accused before they become embroiled with the Juvenile Justice System (JJS) in India. This article explores such contextual dynamics surrounding children’s everyday relationships in different spaces they primarily associate with, which play a role in pushing them into entanglement with the legal system. The framework of child rights is used, which emphasises the voices of children, in an attempt to lay bare the nuanced contexts that lead to conflict with the law. I seek to foreground this argument through fieldwork conducted within an observation home (OH) during 2021–2022. Methodologically, this study adheres to situated ethics, ensuring ethical engagement with participants found through the purposive sampling method. Ten in-depth interviews were conducted with both school dropouts and school-going children who turned CCL, admitted to an OH, including three of their parents. The findings of the study indicate that children are conveniently accused, negatively framed and humiliated locally within the space of community, school and peer relations, including different disputes between families/communities, which potentially push them towards the JJS that impact schooling.
“Short, Modern, Smart”: Humanizing Healthcare Experiences Through Modernized Feedback
Authors: Russell Colleen , Maraccini Amber , Salmi Tami
Published: September 2024

Humanizing healthcare experiences is imperative for global healthcare organizations, emphasizing connections, empathy, and trust between patients, providers, and the broader community. Patients seek personalized, compassionate care, while employees prioritize supportive workplaces. Modernized feedback programs recognize consumer preferences for convenience and accessibility, leveraging technology like artificial intelligence (AI) for real-time insights. Northwestern Medicine's “Short, Modern, Smart” feedback program exemplifies this, focusing on efficiency, contemporary needs, and technology for action. Key considerations include (1) Short: Streamlining surveys for efficiency, (2) Modern: Prioritizing open-ended comments for personalized insights, and (3) Smart: Leveraging AI for proactive understanding. Recommendations for organizations include implementing formal change management, adopting unified metrics for comprehensive experience measurement, and leverage AI to connect feedback back to humans. In conclusion, humanizing healthcare starts with effective feedback collection and actioning. Northwestern Medicine's approach offers insights, emphasizing streamlined processes, personalized engagement, and technological empowerment, which organizations should prioritize for growth and continuous improvement.
Factors Associated With the Nursing Care Experience of Patients Admitted to Riyadh Region Hospitals
Authors: Sherim Mona Al , Hamidi Sami Abdulrahman AL
Published: September 2024

Introduction

In the contemporary healthcare landscape, the paradigm of patient experience and patient-centered care has emerged as a crucial point for healthcare reform, emphasizing the patient's active role in shaping healthcare systems.

Objective

This study aimed to investigate the patient experience level of nursing care and examine associated factors among hospitalized patients in Riyadh, Saudi Arabia.

Methods

Cross-sectional secondary analysis of patient experience data included more than 8,000 patients discharged from Ministry of Health hospitals in Riyadh during 2022G. The national survey examined patient perceptions of multiple aspects of nursing care. Although most patients gave high overall scores, lower scores were observed for nurse introductions and prompt responses to call buttons. There are opportunities to improve communication and response through interventions targeting nurse staffing, training, and incentives. A checklist called Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) was used to report the study.

Results

71.2% Of patients rated their nursing care experience as “very good.” No differences were seen between genders. However, Saudi patients reported higher satisfaction than non-Saudis ( p = .001). The top-scored nursing aspects were friendliness/courtesy (70.2% “very good”) and nurses’ skill level (65.8% “very good”). Lower ratings occurred for nurses who introduced themselves (54.0% “very good”) and for prompt response to call buttons (58.5% “very good”). Targeted improvements in communication and responsiveness could help address these gaps in patient experience scores between nursing care domains.

Conclusions

Most of the patients indicated overall positive nursing care experiences, which include opportunities for improvement in nurse introductions and responsiveness to patient needs. Boosting communication through nurses consistently introducing themselves and managing heavy workloads to allow faster call button response times could enhance patients’ perceptions of their nursing care quality.
Cultural Adaptation and Psychometric Evaluation of the Nursing Decision-Making Instrument Into European Portuguese
Authors: Paiva Ivo Cristiano Soares , Neves Teresa Margarida Almeida , Ventura Filipa Isabel Quaresma Santos , Vilela António Carlos Lopes , Moreira Isabel Maria Pinheiro Borges
Published: September 2024

Introduction

Nurses are continually faced with multiple demands to make decisions in their clinical practice. The Nursing Decision-Making Instrument (NDMI) assesses nurses’ decision-making styles during the several stages of this process.

Objectives

To adapt the NDMI into European Portuguese and evaluate the psychometric properties of the Portuguese version in a population of Portuguese nurses.

Methods

Descriptive study design was used to examine psychometric properties of NDMI. Nonprobability convenience sample of 339 Portuguese direct-care nurses. Data were collected using a questionnaire comprising sociodemographic and professional data and the NDMI–Portuguese version (NDMI-PT). An exploratory factor analysis (EFA; n = 125) and a confirmatory factor analysis (CFA; n = 214) were carried out using IBM SPSS (v. 24) and AMOS (v. 22).

Results

The EFA revealed a structure of four latent factors, which represent the reorganized stages of the decision-making process. The CFA found a good overall fit of the model (χ2/df = 2.13; comparative fit index [CFI] = 0.91; goodness of fit index [GFI] = 0.82; Tucker-Lewis Index [TLI] = 0.90; root mean square error of approximation [RMSEA] = 0.07; maximum-likelihood expected cross-validation index [MECVI] = 3.13). The psychometric analysis of the theoretical structure revealed that the four factors reflect the decision-making stages and have a better overall fit than the empirical structure (χ2/df = 1.82; CFI = 0.94; GFI = 0.86; TLI = 0.93; RMSEA = 0.06; MECVI = 2.55). The analysis of the construct reliability of the NDMI-PT revealed that the overall internal consistency was excellent ( α=0.96).

Conclusions

This study revealed that the empirical and theoretical structures were appropriate and valid for the sample under analysis. The NDMI-PT is a reliable and valid tool for assessing nurses’ decision-making styles. Studies should be conducted to gain further insight into the robustness of this validated tool.
Partisan Differences in Hiring and Social Discrimination against Nonbinary Americans
Authors: Pickett Justin T. , Sola Justin L. , Bushway Shawn D.
Published: September 2024

Discrimination based on gender identity is unjust and wreaks havoc on individuals’ lives. Nonbinary Americans report experiencing extensive and daily experiences with discriminatory events. Yet experimental evidence on how employers and members of the public evaluate and react to individuals (e.g., job applicants, social acquaintances) with different gender identities remains limited and is mixed. Using experimental data from two conjoint analyses, which we conducted with two national samples—one of active hiring managers (Experiment 1: N = 12,934 applicant choices, N = 924 active hirers) and one of members of the public (Experiment 1: N = 32,908 neighbor choices, N = 2,057 respondents)—we document wide partisan differences in the proclivity to discriminate against people who are nonbinary. Republicans are over 10 percentage points more likely to hire a binary than a nonbinary applicant and are 16 to 20 points more likely to want someone as a neighbor if the person is binary compared to nonbinary.
Investigation of tool traverse speed on surface integrity of nano composites processed by friction stir process
Authors: Vickram Kumaresan , Kumanan Somasundaram
Published: September 2024

This work examines the effects of different tool traverse speeds on the surface integrity of AA7075 reinforced with graphene oxide (GO), silicon carbide (SiC) and graphene nanoplatelets (GNPs) nanoparticles during Friction Stir Processing (FSP). Three different traverse speeds of 20, 25 and 30 mm/min, respectively, were used for FSP operations. The resulting nanocomposites were thoroughly analysed using methods including optical microscopy, tensile testing, fracture morphology analysis, microhardness testing, X-ray Diffraction (XRD), Field Emission Scanning Electron Microscopy-Energy Dispersive X-ray Spectroscopy (FESEM-EDAX) and non-contact surface interferometry. The results show that the creation of a refined microstructure with equiaxed grains was aided by tool traverse speeds between 20 and 25 mm/min. Notably, an Ultimate Tensile Strength (UTS) of 358 MPa, microhardness of 139 HV, refined crystalline size of 47.162 nm and average roughness (Ra) of 1.53 μm were obtained with the AA7075+SiC nanocomposite under tool traverse speed of 25 mm/min. On the contrary, surface layer defects developed at a traversal speed of 30 mm/min. Through the use of mechanical stirring and severe plastic deformation (SPD), this study aids in changing the microstructure of the airplane frames.
Book review: K. A. Gunasekaran, The Scar
Authors: Khan Fahad , Shuchi
Published: September 2024

K. A. Gunasekaran, The Scar. Orient BlackSwan Private Limited, 2023, 120 pp., ₹495 (Hardcover). ISBN: 978-93-5442-681-0.
Macular Edema Causing Spontaneous Closure of a Macular Hole After Unsuccessful Primary Surgical Repair
Authors: Ozkardes Cuneyt , Sanders Riley N. , Brooks H. Logan , Shakarchi Ahmed
Published: September 2024

Purpose: To describe the spontaneous closure of a chronic, persistent, stage 4 full-thickness macular hole (FTMH) that did not respond to surgical treatment but closed after an episode of cystoid macular edema (CME) secondary to acute iritis. Methods: A single case was evaluated. Results: A 71-year-old woman presented with decreased vision in the left eye for 6 months. A chronic stage 4 FTMH was identified. Surgical treatment consisting of pars plana vitrectomy and internal limiting membrane peeling was unsuccessful, and the patient declined a repeat operation. Two months later, she presented with acute iritis and CME. Imaging showed incidental closure of the FTMH. The iritis resolved after a sub-Tenon triamcinolone injection. At the 3-month follow-up, the FTMH remained closed without CME or iritis. Conclusions: This case highlights the potential importance of CME in the closure of a chronic FTMH after unsuccessful primary surgical repair and suggests clinicians should consider this mechanism in the management of chronic FTMH.
Bevacizumab First in DRCR Protocol AC vs Real-World Physician Treatment Choice for Diabetic Macular Edema: Two-Year Cost Analysis
Authors: Grewal Dilraj S. , Leung Ella , Busquets Miguel , Niles Philip , Gong Dan A. , Kolomeyer Anton M. , Aggarwal Nitika , Boucher Nick , Blim Jill , Kim Judy E. , Sanders Reginald , Hahn Paul ,   for the ASRS Health Economics Committee
Published: September 2024

Purpose: To compare the modeled costs of the Protocol AC bevacizumab-first treatment protocol (with a switch to aflibercept for sub-responders) with real-world costs for treatment-naïve patients with diabetic macular edema (DME) over a 2-year period. Methods: Published data from the Diabetic Retinopathy Clinical Research Network (DRCR) Protocol AC bevacizumab-first arm (154 eyes) were used to model 2-year treatment costs. Real-world costs were modeled using data from the Vestrum Health electronic medical records database from a 2016 to 2018 cohort of treatment-naïve eyes with DME (n = 1062) treated with antivascular endothelial growth factor monotherapy. The visual acuity (VA) before treatment in the real-world cohort was matched to Protocol AC. A secondary cost analysis further matched VA gains after treatment in the real-world cohort (n = 346) to Protocol AC. Results: In Protocol AC, the modeled 2-year DME treatment cost in the bevacizumab-first arm was $18,952, with a mean of 16.1 injections over 22.5 visits and 70% of eyes being switched to aflibercept by year 2. (Within 2 years, 57% of injections were bevacizumab and 43% were aflibercept.) Over the same period, the modeled 2-year real-world cost ($11,459) was 40% lower, with a mean of 8.6 injections over 13.8 visits (42% bevacizumab, 45% aflibercept, 13% ranibizumab). Even when matched for baseline VA and a 14-letter VA gain over 2 years, the real-world cost ($15,394) was still 19% lower than the modeled cost in the Protocol AC bevacizumab-first arm. Conclusions: The real-world cost of treating DME over 2 years was significantly lower than the DRCR Protocol AC bevacizumab-first cost. Application of Protocol AC findings into real-world utilization, as with step therapy mandates, should only be considered if the same intensive protocol could be followed. These data suggest that existing real-world costs that reflect physician choice are already significantly lower than protocol-mandated step therapy, even when controlling for similar VA outcomes.
Drusen Disappearance After Retinal Detachment Repair
Authors: Ahmed Ishrat , Wu David M.
Published: September 2024

Purpose: To describe a case of a drusenoid pigment epithelial detachment that resolved after retinal detachment (RD) repair using multimodal imaging. Methods: A single case was evaluated. Results: An 83-year-old woman with intermediate age-related macular degeneration had repair of a rhegmatogenous RD with subsequent resolution of macular drusen and improved visual acuity and metamorphopsia. Conclusions: RD repair may be associated with resolution of drusen, leading to improved functional outcomes.
River and drain: Ambiguity in the waterways of Accra
Authors: Foli Afra
Published: September 2024

This article analyses a range of diverse and often conflicting practices in and around a waterway in Accra, Ghana, emphasising the ambiguity of their politics. Urban political ecology approaches have demonstrated how flows of (waste)water reveal power dynamics across scales. I extend such insights by developing an understanding of practices that are more ambiguous, complexifying otherwise linear dynamics of power. I do this by centring the narratives of those living and working in the waterway. Through providing needed attention to the everyday and micro-level interactions, this approach makes room for situated ambiguities within wider power dynamics. The argument is based on qualitative research along one primary waterway in Accra, along which people live, farm, dump waste and manage flood risk. These diverse practices suggest that, in addition to distributing risks in an often uneven fashion, the waterway also affords connection, solidarity and adaptability across urban divides. I argue that accounting for these practices does not deny the inequalities of the waterway's geography; rather, it encourages the development of a vocabulary to understand situated processes, even where they appear ambiguous. Embracing the ambiguities of the waterway allows us to fully consider the complex forms that power takes in different settings.
Extracurricular Enterprise and Entrepreneurship Education
Authors: Beaumont Emily , Preedy Sarah , Walmsley Andreas , Smith Kelly
Published: September 2024

Enterprise and entrepreneurship education (EEE) in higher education (HE) is expanding, emphasizing diverse outcomes and teaching methods. This special issue explores extracurricular EEE, which includes voluntary activities like business competitions, networking events, and guest speakers, aimed at enhancing entrepreneurial skills and promoting entrepreneurship as a career. These activities are currently facing challenges in sustainability, engagement and varying availability across institutions. Additionally despite evidence of the positive impacts of employability and entrepreneurial endeavors, research on the value of these activities remains limited. This speical issue intends to address this deficit and includes six research papers examining various aspects of extracurricular EEE and, collectively, providing valuable insights for educators and policymakers to enhance EEE practices.
Epidemiology of multimorbidity in Nepal: A systematic review and meta-analysis
Authors: Sinha Abhinav , Suman S. Shradha , Subedi Narayan , Sahoo Krushna Chandra , Poudel Mukesh , Chauhan Arohi , Sahoo Banamber , van den Akker Marjan , Weller David , Mercer Stewart W , Pati Sanghamitra
Published: September 2024

Background

Multimorbidity is rising in low-and middle-income countries such as Nepal, yet the research has not gained pace in this field. We aimed to systematically review the existing multimorbidity literature in Nepal and estimate the prevalence and map its risk factors and consequences.

Methods

We reviewed data collated from PubMed, Embase and CINAHL by including original studies that reported prevalence of multimorbidity in Nepal. The quality of included studies was assessed using the Appraisal Tool for Cross-sectional Studies. The summary of the review is presented both qualitatively as well as through meta-analysis to give pooled prevalence. We prospectively registered in PROSPERO (CRD42024499598).

Results

We identified 423 studies out of which seven were included in this review. All studies were conducted in a community setting except one which was hospital based. The prevalence reported across various studies ranged from 13.96% to 70.1%. The pooled prevalence of multimorbidity was observed to be 25.05% (95% CI: 16.99 to 34.09). The number of conditions used to assess multimorbidity ranged from four to nine. The major risk factors identified were increasing age, urban residence, and lower literacy rates.

Conclusion

A wide variance in the prevalence of multimorbidity was observed. Moreover, multimorbidity assessment tool/conditions considered for assessing multimorbidity were heterogeneous.
Inspection techniques in photovoltaic power plants: A review of electroluminescence and photoluminescence imaging
Authors: Redondo-Plaza Alberto , Zorita-Lamadrid Ángel Luis , Alonso-Gómez Víctor , Hernández-Callejo Luis
Published: September 2024

The growth of photovoltaic power plants in both size and number has spurred the development of new approaches in inspection techniques. The most commonly employed methods include visual inspections, current-voltage measurements, infrared thermography, and luminescence imaging. Luminescence, rooted in the electromagnetic radiation capture of semiconductor structures that make up solar cells, proves effective in detecting various failures that may occur throughout the lifespan of a photovoltaic module. This phenomenon can be induced either by injecting current into the photovoltaic module (Electroluminescence) or through optical excitation using an appropriate light source (Photoluminescence). This paper offers an overview of the conventional outdoor luminescence imaging technique, delving into its applications and limitations. Additionally, it provides a comprehensive review of innovative outdoor luminescence technique approaches. These novel techniques aim to address several limitations of conventional methods, such as the considerably lower luminescence emission intensity compared to solar radiation, the need for external energy sources for current injection, the required acquisition time, and the necessity of disconnecting the solar module.
Cancer Care and Nutrition Counseling: The Role of the Oncologist in Patient Learning and Behavior Change
Authors: Corr Patrick G. , Hudson William , Kalita Nikhil
Published: September 2024

Background

Cancer remains a leading chronic disease in the United States with a high burden of disease and challenging treatment protocol. Nutrition is critically linked to long-term health outcomes and recovery rates among cancer patients, but there remains a persistent gap in clinician training regarding functional nutrition. This study interviews patients to understand their experiences of nutrition support they received while in cancer treatment.

Objectives

Understand patient experiences and needs regarding cancer treatment (i.e., surgery, chemotherapy, radiation, and/or immunotherapy) and available nutrition counseling.

Methods

This was a multi-phase study incorporating survey data (n = 50) and follow-up, semi-structured interviews (n = 20) of cancer patients in the Mid-Atlantic United States. Interview participants included those undergoing active cancer treatment (n = 7) and those in remission at the time of contact (n = 13). Participants shared their experiences receiving treatment and their perspectives regarding the quality of care they received in outpatient oncology clinics. Central to this study was a discussion regarding the quality of nutrition counseling they received while in treatment.

Results

Five themes emerged through data collection and analysis: (1) patients need additional education regarding nutrition, (2) personalized resources are not readily available, (3) perceptions from patients that oncologists receive little formal nutrition training related to cancer, (4) oncologists’ attitude toward nutrition may influence patient care, and (5) patients seek nutrition information through informal sources. Commonly, patients had little access to licensed dieticians or other professionals capable of providing lifestyle recommendations.

Conclusions

The results of this study are being used to develop a clinician toolbox of resources, recommendations, and services that can be shared with patients seeking additional information regarding nutrition and diet change.
From the Pearl River Delta to the Greater Bay Area: State spatial selectivity, contingent socio-spatial processes, and variegated geographies of China’s city-regionalism
Authors: Liu Yongshen , He Shenjing
Published: September 2024

This paper revisits China’s city-regionalism based on a multi-scalar reading of state entrepreneurialism, with a special focus on the transition from the Pearl River Delta (PRD) to the Greater Bay Area (GBA). We first propose a multi-scalar theoretical framework of state entrepreneurialism to comprehend China’s city-regional development. At the national scale, the central state maintains planning centrality by establishing normative goals through national political mandates and orchestrating socio-spatial reconfiguration of city-regions using various planning techniques (e.g., zoning, annexation, connectivity, and place-making), which demonstrates state spatial selectivity. At the local scale, city-regional development, led by the local state, pivots on the mandates and resorts to market instruments. Place-specific contexts and development trajectories give rise to distinctive ‘regional models’ and contingent socio-spatial processes. From a historical-geographical perspective, these contingent socio-spatial processes represent both the outcome of and the precondition for successive waves of state spatial selectivity in city-regional development. Building upon the dynamic interplay between state spatial selectivity and contingent socio-spatial processes, we present a periodised analysis to delve into the ongoing transformation from the PRD to the GBA. Amidst evolving global-local conjunctures and shifting national political mandates, state spatial selectivity within the PRD-to-GBA transformation is categorised into three periods: (1) 1980s to early 1990s: exploiting zoning technologies to institutionalise exceptionality within delimited areas for undertaking market-oriented experiments; (2) mid-1990s to 2000s: empowering entrepreneurial cities to drive market-oriented development while managing their size, internal hierarchy, and external connections; and (3) 2010s onwards: an intensified planning centrality at the national scale and the reinvention of zoning technologies to emphasise relationality, reshaping the urban-regional and cross-border dynamics of the GBA within an ‘integration’ framework. In conclusion, this paper reflects on the variegated geographies of China’s city-regionalism – the socio-spatially distinctive, temporally evolving and ultimately polymorphic, multi-scalar construction of Chinese city-regions.
‘Everybody needs to learn more’: A thematic synthesis of the first-hand experiences of autistic students in primary schools
Authors: Atkinson Elizabeth , Wood-Downie Henry , Wright Sarah
Published: September 2024

Autistic students are more likely to experience mental health difficulties and have poorer academic outcomes than their non-autistic peers. However, most research into school experiences has focussed on secondary-aged students, or parents and school staff's perceptions of the primary school experiences of autistic students. The current systematic literature review explores the experiences of autistic students in primary school. Databases (PsycInfo, ERIC, SCOPUS and CINAHL) and hand searching were utilised to identify qualitative research. The research was included if it explored current and retrospective accounts of autistic people, internationally. Studies were excluded if they did not include the voice of at least one autistic person. Twenty-two studies met the inclusion criteria and were analysed using thematic synthesis. Four analytical themes (‘We all have different experiences of school’, ‘We don’t do things wrong we do them differently, and I need you to understand’, ‘Good relationships make it better’ and ‘Success matters but the environment is key’) were generated. There were both positive and negative accounts, with some students detailing the long-term negative effects of primary schooling on their mental health. Overall, students in the review felt everybody needed to learn more about autism, as well as provide specific and subtle support based on individual needs. Strengths, limitations and implications for practice are discussed.

Lay abstract

The school environment can be a difficult place for autistic children which impacts their well-being and academic performance. Most research into school experiences has looked at the experiences of students at secondary schools or at adults who support autistic students. In this research we used a set of keywords to search for studies that included the voices of autistic students (both current and past) about what primary school was like for them. After a detailed search process, 22 studies from a range of countries were located. The results from each of these studies were analysed and sorted into themes: ‘We all have different experiences of school’, ‘We don’t do things wrong we do them differently, and I need you to understand, ‘Good relationships make it better’, and ‘Success matters but the environment is key’. The results highlighted that although primary school was a positive for some students, for many it was a time of stress, with the negative impact lasting a long time. The participants felt that everybody needs to learn more about autism and that school staff should provide support that is based on their needs but does not make them stand out as different.
People are people: Cross-country similarities in parents’ perceptions of ASD service provision for their child with ASD
Authors: Reed Phil , Mustary Kaneez , Kiari Isabel , Nyoni Joachim , Osborne Lisa A.
Published: September 2024

The current report provided some indicators of comparative perceptions of autism spectrum disorder (ASD) provision across five diverse countries (Bangladesh, Greece, Kenya, the United Kingdom and Zambia) in terms of parent perceptions of ASD and its diagnosis, school provision, and predictors of satisfaction of school provision. It was hoped that the use of a single procedure to collect such data would provide needed information from low-to-middle-income countries, in comparison to the better studied higher-income countries. Two hundred parents of children diagnosed with ASD (40 in each country) completed a series of scales about the ASD characteristics and school provision. The results suggested more similarities than differences, with key concerns being the lack of support on offer from authorities, and the quality of the provision provided, irrespective of how that provision was provided. There were some differences between the countries in terms of speed of diagnosis, and the factors relating to those could be interestingly explored in terms of social and religious attitudes to disability.
The relation between family familiarity with autism and developmental outcomes
Authors: Morris Isabelle F , Mansolf Maxwell , Sherlock Phillip R , Calub Catrina , Camargo Carlos A , Kelly Rachel S , Lyall Kristen , McEvoy Cindy T , Northrup Jessie , Wilkening Greta , Wright Rosalind J , Zelazo Philip David ,   on behalf of program collaborators for Environmental influences on Child Health Outcomes
Published: September 2024

The course of typical and atypical child development likely varies depending on families’ understanding and support for their child's developmental needs. Analyzing longitudinal data ( N = 823 children with autism) from 37 cohorts, we explored the relation between family familiarity with autism (defined by the presence of an autistic sibling) and children's cognitive and social development and emotional/behavioral outcomes. Greater autism familiarity was associated with earlier age of diagnosis, but also with neurodevelopmental outcomes, over and above age at diagnosis. In early childhood, children in the autism familiar group performed better on the Mullen Scales of Early Learning compared to those in the unfamiliar group (mean T-score differences of 3–5). The later a child was diagnosed, the stronger the relation between autism familiarity and higher scores on receptive language and visual reception. Age at diagnosis was associated with more parent-rated problems on a range of Child Behavior Checklist scores in middle childhood and adolescence. Findings indicate that greater autism familiarity is associated with more positive cognitive developmental outcomes for children on the spectrum. Although correlational, these findings are consistent with the possibility that autistic children's development can be viewed as adaptation within a context that can be more (or less) supportive of children's developmental needs.
Bilateral Hydrocele of the Canal of Nuck in an Adult Female: A Case Report
Authors: Dhanju Gurinder , Kirkpatrick Iain , Goubran Ashraf , Mina Fady
Published: September 2024

Bilateral hydrocele of the canal of Nuck (HCN) is very rare, in adult females. Primary care physicians can misdiagnose this pathology without diagnostic imaging. A 37-year-old female complained of right lower quadrant (RLQ) pain, for a few months, reported to the emergency room. A non-reducible bulging protrusion was visualized in the RLQ. After performing the necessary blood work, the emergency physician ordered an emergent sonogram and computed tomography (CT). A transvaginal sonogram was performed to exclude gross adnexal masses, in the RLQ. An HCN canal was suspected in the right inguinal region. A non-contrast CT demonstrated a bilateral HCN, with the left significantly smaller than the right. In this case, a bilateral surgical excision of the hydrocele was recommended. Owing to the recurrence of the HCN, a cyst aspiration was not suggested. Physicians should consider the diagnosis of HCN in any female presenting with inguinolabial swelling. Sonography, CT, and magnetic resonance imaging (MRI) are the three diagnostic imaging techniques commonly used to diagnose this pathology. A multimodality approach is sometimes necessary when the sonography diagnosis is no definitve.
Age-related histone H3.3 accumulation associates with a repressive chromatin in mouse tibialis anterior muscle
Authors: Masuzawa Ryo , Rosa Flete Hemilce Karina , Shimizu Junya , Kawano Fuminori
Published: September 2024

The present study aimed to investigate age-related changes in histone variant H3.3 and its role in the aging process of mouse tibialis anterior muscle. H3.3 level significantly increased with age and correlated with H3K27me3 level. Acute exercise successfully upregulated the target gene expression in 8-wk-old mice, whereas no upregulation was noted in 53-wk-old mice. H3K27me3 level was increased at these loci in response to acute exercise in 8-wk-old mice. However, in 53-wk-old mice, H3.3 and H3K27me3 levels were increased at rest and were not affected by acute exercise. Furthermore, forced H3.3 expression in the skeletal muscle of 8-wk-old mice led to a gradual improvement in motor function. The results suggest that age-related H3.3 accumulation induces the formation of repressive chromatin in the mouse tibialis anterior muscle. However, H3.3 accumulation also appears to play a positive role in enhancing skeletal muscle function.