bluuebunny/crossref_metadata_2025 huggingface dataset:
Can air handling equipment be beneficial to children’s health? Results from a cross-sectional survey in 2010 and 2019 in China
Authors: Xu Yawei , Zheng Xiaohong , Zhao Zhuohui , Qian Hua
Published: July 2023

A growing number of studies have shown that the indoor residential environment is associated with respiratory and allergic diseases in children. This study aimed to investigate the prevalence of respiratory and allergic diseases among children in China and its correlation with using air handling equipment, based on the cross-sectional survey results of the China Children Homes Health Project in 2010 and 2019. The binary logistic regression model was used to explore the association between asthma, rhinitis, eczema and pneumonia and the use of air handling equipment in children. The prevalence of children’s respiratory and allergic diseases has decreased, and the usage rate of portable air purifiers and split air conditioners has increased in 2019 compared to 2010. The results showed that using a fresh air system with filters was negatively correlated with children’s pneumonia (adjusted odds ratio (aOR): 0.767, 95% confidence interval (95% CI): 0.704–0.835). The use of portable air purifiers was positively correlated with most diseases’ symptoms in two undertaken surveys. In 2019, the positive correlation between using split air conditioners and asthma-related symptoms decreased compared with 2010, while it was positively correlated with rhinitis, eczema and pneumonia. To avoid children’s allergic diseases and reduce respiratory symptoms, parents should choose appropriate air handling equipment.
Imagining permanence on the web: Tracing the meanings of long-term preservation among the subjects of web archives
Authors: Hegarty Kieran
Published: July 2023

This article explores how web archiving impacts the online communication practices of individuals whose personal websites have been archived by major public libraries. Drawing on interviews with website creators and analysis of their written reflections on the archiving process, it demonstrates how web archiving alters the meanings people attach to their online activity. In most cases, the preservation of their website in a national web archive sees individuals perceive their communication practices as having wider cultural and historical significance. These meanings are shaped by the distinctive interaction between archiving and archived actors and propelled by imaginaries surrounding the culture and history of the collecting institution. Based on these findings, this article argues that web archiving can be productively understood as an intervention in the dynamics of online sociality and calls for reflexive archival and research practices that attend to the short- and long-term impacts of altering the visibility of online material.
Knock-limited combustion of ethanol-, isobutanol-, and 2-methyl-3-buten-2-ol-gasoline blends in a direct-injected spark-ignition engine
Authors: Sakai Stephen , Rothamer David
Published: July 2023

Knock-limited combustion of alcohol-gasoline fuel blends was studied in a direct-injection spark-ignition engine. Ethanol, isobutanol (2-methyl-1-propanol), and methylbutenol (2-methyl-3-buten-2-ol) were splash-blended with a blendstock for oxygenate blending (BOB) gasoline. Ethanol was blended in fractions of 10%, 20%, and 30% by volume (E10, E20, and E30). Isobutanol and methylbutenol were blended to match the oxygen weight percentage of the ethanol blends, resulting in blends of 16%, 32%, and 49% (I16, I32, and I49) isobutanol by volume and 18%, 37%, and 56% (M18, M37, and M56) methylbutenol by volume. Neat BOB and gasoline primary reference fuels (PRF) with octane numbers (ON) of 87 (PRF87) and 100 (PRF100) were included for reference. The engine was operated at fixed speed, equivalence ratio, and injection timing while knock-limited spark advance was located across a range of intake pressures. Low-level alcohol blends E10 and M18 had similar knocking behavior and appeared to be slightly more knock-resistant than I16. For mid-level blends, E20 showed further improvement over I32 while M37 showed noticeably better knock resistance, able to match the knock-resistance of PRF100 for loads above 1000 kPa gross indicated mean effective pressure (GIMEP). For high-level blends, the difference between E30 and I49 was similar to their mid-level counterparts. However, M56 showed significant improvement over E30 and I49 throughout the entire range of loads tested. M56 exceeded the knock-resistance of PRF100 for loads above 700 kPa GIMEP. The improved knock-resistance combined with the increased volumetric energy density of methylbutenol resulted in improved fuel consumption and indicated efficiency. The overall results of this study indicate that the order of knock-resistance of these three alcohols, for direct-injection operation with injection during the intake stroke, is isobutanol < ethanol < methylbutenol when compared on an equal oxygen weight basis.
Characterisation of soot agglomerates from engine oil and exhaust system for modern compression ignition engines
Authors: Fayad Mohammed A , Martos Francisco J , Herreros José M , Dearn Karl D , Tsolakis Athanasios
Published: July 2023

The characteristics of soot in oil samples extracted from lubricating oil and exhaust system of a modern common rail compression ignition engine were studied. The morphological parameters of the soot agglomerates were calculated from micrographs obtained by a High-Resolution Transmission Electron Microscopy (HR-TEM). The morphological analysis indicated that the soot in oil agglomerates have a larger average primary particle size and overall larger agglomerate size (determined by the radius of gyration) compared to the agglomerates sampled in the exhaust system. This can be a consequence of the dehydrogenation of hydrocarbon (HC) chains from the oil around the soot agglomerates. The shape of the agglomerates is quantified by fractal dimension. The soot in oil agglomerates presented a slightly larger fractal dimension than those studied in the exhaust system. Therefore, it seems that soot in oil agglomerates were more compact than those found in the exhaust system. The impact on lubricating oil properties should be further investigated.
The Impacts of Intimate Partner Violence on Postpartum Depression: An Updated Meta-Analysis
Authors: Wei Xinyi , Wang Weiwei , Law Yik Wa , Zhang Huiping
Published: July 2023

The associations between intimate partner violence (IPV) and postpartum depression (PPD) have been well established in previous reviews. However, none has explored potential differences between IPV subtypes or exposure times, which could help healthcare providers recognize the adverse impacts of various IPV subtypes and conduct comprehensive IPV screening. This study aimed to estimate the impacts of overall IPV and its subtypes (physical, psychological, and sexual) on PPD using an updated meta-analysis and to examine the potential role of IPV exposure time and regional income levels. Four English databases (Medline, PsycINFO, PubMed, and Web of Science) and two Chinese databases (China National Knowledge Infrastructure [CNKI] and Wanfang Database) were systematically searched. We included 76 studies with 388,966 samples. Random-effects models were used to pool the odds ratios (ORs) across studies. Overall, IPV and its subtypes had statistically significant impacts on PPD (overall: OR = 2.50, physical: OR = 2.31, psychological: OR = 2.22, sexual: OR = 1.75). A higher impact of IPV on PPD was observed in middle- and low-income regions ( OR = 3.01) than in high-income regions ( OR = 1.92). IPV during pregnancy ( OR = 2.73) had a greater impact on PPD than lifetime IPV ( OR = 2.24). This study provides updated evidence for the significant impact of IPV and its subtypes and exposure time on PPD. Women at risk of exposure to physical IPV, especially during pregnancy, are in urgent need of support to reduce the risk of PPD.
Percutaneous fixation of scaphoid fractures through the snuffbox: an anatomical study
Authors: Nguyễn Mỹ-Vân , Chaves Camilo , Crenn Vincent , Bellemère Philippe
Published: July 2023

The aim of the present anatomical study was to assess the dorso-radial approach for percutaneous fixation of scaphoid wist fractures. Through the anatomical snuffbox, cannulated screws or 1.2 mm K-wires were inserted into the scaphoids of 20 fresh-frozen cadavers. No tendon injuries were observed. There were two lesions of the radial artery, and three lesions of the sensory branches of the radial nerve. After dissection and three-dimensional CT reconstruction, the K-wire or screw position was described in relation to the scaphoid centroid and its longitudinal axis. The mean distance between the device and the scaphoid centroid was 2.8 mm (SD 1.4, range 0.6 to 6.1). The mean angle between the device and the scaphoid’s longitudinal axis was 29° (SD 11, range 6.5 to 54). Rather than percutaneous fixation, an open approach with a modest incision might be safer for identifying and protecting both the radial artery and the sensory nerves. This approach would make perpendicular fixation possible for specific patterns of scaphoid fracture orientated approximately 60° from the longitudinal axis.
The role of mean corpuscular volume and red cell distribution width in patients with metastatic renal cell carcinoma treated with tyrosine kinase inhibitors: the MARECAP retrospective study
Authors: Tommasi Chiara , Scartabellati Giulia , Giannarelli Diana , Giorgi Ugo De , Brighi Nicole , Fornarini Giuseppe , Rebuzzi Sara Elena , Puglisi Silvia , Caffo Orazio , Kinspergher Stefania , Mennitto Alessia , Cattrini Carlo , Santoni Matteo , Verzoni Elena , Rametta Alessandro , Stellato Marco , Malgeri Andrea , Roviello Giandomenico , Brunelli Matteo , Buti Sebastiano
Published: July 2023

Background:

Tyrosine-kinase inhibitors (TKIs) and immunotherapy represent the backbone treatment for metastatic renal cell carcinoma (mRCC) patients. The aim of the present study was to describe mean corpuscular volume (MCV) and red cell distribution width (RDW) in mRCC patients treated with pazopanib or cabozantinib, and to explore their potential impact on oncological outcomes.

Materials and methods:

We conducted a multicenter retrospective observational study in mRCC patients treated with pazopanib or cabozantinib between January 2012 and December 2020 in nine Italian centers. Descriptive statistics, univariate, and multivariate analyses were performed.

Objectives:

The primary endpoints were the incidence and trend over time of anemia, macrocytosis (elevated MCV), and anisocytosis (elevated RDW). The secondary endpoints were the correlations of MCV and RDW with objective response rate (ORR), progression-free survival (PFS), and overall survival (OS).

Results:

A total of 301 patients were enrolled; mean Hb value was 12.5 g/dl, a mean increase of 1 g/dl was observed at day 15 and maintained at 3 months. Most patients had baseline macrocytosis (MCV levels > 87 fl), with a significant mean increase after 3 months of treatment. At univariate analysis patients with macrocytosis had better ORR, longer PFS, and OS. About one third of patients had baseline anisocytosis (RDW > 16%), with a significant mean increase after 3 months of treatment. At univariate analysis, patients with RDW values ⩽ 16% had higher ORR, longer PFS, and OS. At multivariate analysis, baseline macrocytosis was significantly associated with better PFS in patients treated with pazopanib and baseline anisocytosis with shorter OS in all patients.

Conclusions:

mRCC patients treated with pazopanib or cabozantinib may have baseline macrocytosis and anisocytosis. A significant increase of Hb, MCV, and RDW after TKIs start was observed. Baseline macrocytosis is positively correlated with PFS in patients treated with pazopanib and baseline anisocytosis affects survival of patients treated with TKIs.
Wearing masks to prevent one epidemic may mask another
Authors: Svetina Lucija , Košec Andro
Published: July 2023

Background

With attempts at lifting most COVID-19 pandemic-related restrictions, other common respiratory viruses have caused more health concern than in earlier seasons in pediatric populations.

Objective

To explore the role of non-pharmaceutical interventions (NPIs) in a rebound in other respiratory viral pathogens, especially in light of general vaccination fatigue, COVID-19 boosters, and operational challenges in the healthcare system.

Methods

A research-based commentary supported with recent literature review.

Findings

Pandemic-related lockdowns in Europe, Australia, and New Zealand have created a significant population of susceptible young children without preexisting immunity due to lack of exposure during the colder months. Relying on NPIs for a prolonged period due to low vaccination rates may lead to increased respiratory infection susceptibility, especially among young children less than 5 years old. The key public health question is whether NPIs should be implemented in the long run and what are the long-term implications on the dynamics of endemic infections and population immunity.

Discussion

Prevention cannot be the only cure for any infectious disease, and long-term impact of NPIs depends on the dynamics of population susceptibility. The SARS-CoV-2 pandemic has reinforced the importance of vaccination and the knowledge on vaccine use combined with NPIs will be of great value in controlling other known and unknown respiratory pathogens. Combining NPIs and vaccination is paramount in disease control, and the discussion on how to prevent collateral damage to sensitive populations while relaxing NPI-related measures should also merit attention.
Definition of hip displacement and dislocation by acetabular dysplasia in children with cerebral palsy
Authors: Wang Nai Kuang , Shen Shih Hsien , Chen Brian Po Jung , Chang Chia Hsieh , Kuo Ken N
Published: July 2023

Purpose:

The acetabulum interacts with the femoral head in daily activities and may exhibit structural changes in the presence of hip disorders. This study aims to redefine hip disorders in children with cerebral palsy by structural characteristics of the acetabulum in relation to the degree of the migration percentage.

Methods:

The clinical and radiographic data of 70 patients (36 males, 34 females; mean age 8.2 years) with spastic cerebral palsy were retrospectively analyzed. The acetabular structure was measured by the acetabular index on reconstructed three-dimensional computerized tomography for precision of measurement. Any significant change in acetabular index measured on the reconstructive computerized tomography related to every 10% increment of migration percentage was regarded as clinically significant in hip disorders.

Results:

The acetabular index measured on the reconstructive computerized tomography showed an increasing trend with the increment of migration percentage. The most significant acetabular index measured on the reconstructive computerized tomography change occurred between the 20%–29% and 30%–39% migration percentage groups (p < 0.001), suggesting that a migration percentage of 30% is the starting point of hip disorder. A significant increase in the posterolateral acetabular index measured on the reconstructive computerized tomography occurred in migration percentages >50%, indicating posterolateral acetabular dysplasia. Hips with migration percentages from 80% to 100% had consistent acetabular indexes measured on the reconstructive computerized tomography values, suggesting complete dislocation and no more contact and interaction between the femoral head and acetabular fossa.

Conclusion:

Structural characteristics in the acetabulum reflect hip dysfunction and potentially classify hip disorders. Results suggest the migration percentage 30% as a starting point of hip disorder and 80% as a turning point of hip dislocation in children with cerebral palsy.

Level of evidence:

level IV, diagnostic study.
How Loud Does the Watchdog Bark? A Reconsideration of Losing Local Journalism, News Nonprofits, and Political Corruption
Authors: Usher Nikki , Kim-Leffingwell Sanghoon
Published: July 2023

Journalism has long been presumed to serve as a check on the powerful, shedding light on wrongdoing; however, as local newspapers reach market failure, extant theory predicts corruption will go unchecked. We operationalize corruption as federal prosecutions for public corruption (PPCs), defined by the US Department of Justice as crimes involving the abuse of public trust by federal, state, and local public officials. We examine changes in the local news media ecosystems: first, whether declines in local newspaper employment and circulation are associated with changes in PPCs; and second, whether efforts to supplement watchdog journalism with nonprofit journalism might mitigate associated declines in federal PPC. Our findings suggest nonprofit interventions in failing local commercial news markets may be an important safeguard for keeping public officials accountable.
Factors associated with HIV testing in people aged ⩾50 years: an integrated qualitative analysis of patients and healthcare providers
Authors: Youssef Elaney , Wright Juliet , Davies Kevin , Delpech Valerie , Brown Alison , Cooper Vanessa , Sachikonye Memory , de Visser Richard
Published: July 2023

Background:

Older people continue to be disproportionately affected by late HIV diagnosis, which results in increased morbidity and mortality. Despite high acceptance of HIV testing generally, older people are less likely to undergo testing than younger people. Two previous studies have been conducted, one focussing on patient-related and one focussing on clinician-related factors associated with HIV testing in older age (⩾50 years)

Objective:

This study is an integrated analysis from two linked studies – one focussed on patients, and one focussed on clinicians – to understand overlap in views and experiences of HIV testing in older age, to outline the clinical implications of the findings, and to highlight potential interventions to improve testing in this group.

Methods:

This qualitative study utilised semi-structured interviews conducted with 20 clinicians who were not HIV care specialists, but who had recently seen an older person prior to their HIV diagnosis, and 20 people who had been diagnosed late with HIV aged 50+. Interviews were audio recorded, transcribed verbatim and thematically analysed. The combined synthesis reported here was planned a priori as part of a sequential design.

Results:

Seven clinician- and seven patient-related themes were associated with undergoing HIV testing in older age. This article discusses the four themes that were common to both groups: poor knowledge, incorrect symptom attribution, inaccurate perception of risk, and stigma.

Conclusion:

Both clinician and patient factors associated with testing will have to be addressed in order to increase HIV testing in older people, and reduce the likelihood of late diagnosis. Findings from overlapping themes suggest several areas for intervention: (1) routine screening as part of existing clinical contacts aimed at older people to eliminate the need to attribute symptoms to HIV or assess risk; (2) specific and tailored education materials for clinicians and older people which utilise appropriate modalities; (3) tailored HIV testing services: either specific clinics for older people at existing sexual health services, or dedicated services in primary care.
Prevalence and associated risk factors for failed obstetric fistula repair in East African countries: A systematic review and meta-analysis
Authors: Ejigu Neway , Seyoum Kenbon , Kene Chala , Gomora Degefa , Mengistu Shelema , Geta Girma , Eshetu Derese , Tadesse Shimelis , Mesfin Telila , Tekalign Yohannes , Atlaw Daniel
Published: July 2023

Objective:

Obstetric fistula repair failure is a combination of unsuccessful fistula closure and/or incontinence following a successful closure. There is an inconsistent finding on the failure of obstetric fistula repair in East Africa. Therefore, this systematic review and meta-analysis aimed to determine the pooled prevalence of failed obstetric fistula repair and its associated factors among women who have undergone fistula repair in East Africa.

Methods:

This systematic review and meta-analysis were written following the PRISMA guideline protocol. A web-based electronic search of PubMed, Google Scholar, and HINARI was performed to find primary studies. Additional articles were searched by cross-referencing references. A random-effects model was used to estimate the pooled prevalence of failed obstetric fistula repair. The heterogeneity of studies was weighed using I2 test statistics. Publication bias was assessed by Eggers and funnel plot test.

Results:

The 16 studies that met the inclusion criteria for this systematic review and meta-analysis of failed obstetric fistula repair were included. Nonetheless, one study was used for factor analysis but not in pooled prevalence analysis. The pooled prevalence of obstetric fistula repair failure in East Africa was 26.89% (95% confidence interval: 21.71, 32.07). Labor duration > 48 h (Pooled odds ratio = 2.46; 95% confidence interval 1.58, 3.82), fistula size >3 cm (Pooled odds ratio = 3.92; 95% confidence interval 2.19, 7.05), previous fistula repair (Pooled odds ratio = 3.20; 95% confidence interval 1.94, 5.29), Goh Type 4 fistulas (Pooled odds ratio = 6.07; 95% confidence interval 2.50, 14.75), completely destructed urethra (Pooled odds ratio = 3.35; 95% confidence interval 1.69, 6.65), and severe vaginal scaring (Pooled odds ratio = 3.89; 95% confidence interval 1.99, 7.62) were significantly associated with obstetric fistula repair failure.

Conclusions:

One in four women with obstetric fistula repair experienced repair failure. To fight the problem The Ministry of Health in every part of the country, in collaboration with obstetric care providers, shall intervene on factors affecting obstetric fistula repair failure to reduce or prevent the failure of obstetric fistula repair.
A quasi-experimental study on adult weight loss using a multidimensional approach among a rural population
Authors: Burrell Chelsea
Published: July 2023

Objectives:

The study aimed to investigate the effectiveness of a yearlong digital multidimensional weight-loss intervention among residents in a southern rural community. The intervention utilized a quasi-experimental design to assess weight loss and lifestyle habit changes in volunteer individuals living in a rural community in western North Carolina.

Methods:

The quasi-experimental design featured pre- and post-in-person health assessments, including anthropometric measures such as body composition, blood pressure, and lifestyle habits, through a health risk questionnaire. Upon completion of the in-person pre-assessment, participants received digital health education and challenges via email and challenge runner for 1 year. Following 12 months, participants were asked to complete the post-assessment to review their results. The multidimensional weight-loss intervention was communicated via newspaper and social media to promote participation among community members, utilizing a volunteer sample. Univariate analyses were conducted to determine age, weight, BMI, and body fat percentage. A paired sample t-test was conducted on pre- and post-weight as well as pre- and post-health scores. The health score was derived from the health risk questionnaire. A bivariate Pearson correlation was conducted for post-weight and post-health score analyses.

Results:

The average participant was female in their mid-40s ( N = 67). Results showed insignificant statistical mean differences between pre- and post-weight and pre- and post-health scores. A Pearson correlation indicated a moderate correlation r = −0.36, p = 0.003) between post-weight and post-health score. The negative correlation indicates changes in health behavior reflected in the health score improving as weight decreased.

Conclusion:

The weight-loss intervention proved unsuccessful in clinical weight loss but demonstrated an association between healthy behavior changes and weight loss. However, further research is needed to solidify the current findings, as there were limitations identified in COVID-19.
Pre-operative risk stratification of high-risk prostate cancer patients can predict risk of biochemical recurrence for individual patients post radical surgery: A multi-institutional study
Authors: Devlin Conor M , Raslan Mutie , Deytrikh Andrew , Sinha Shacheesh , Murgatroyd Samuel , Yates David , Dooldeniya Mohantha , Smith Nicholas , Simms Matthew , Beekharry Ramprakash , Singh Rajindra , Molokwu Chidi , Chahal Rohit
Published: July 2023

Introduction:

The aim of this study was to identify which high-risk prostate cancer (HRPCa) patients would suffer biochemical recurrence (BCR) after radical prostatectomy (RP), providing a personalised % risk at initial consultation. BCR is more likely in HRPCa; however, the incidence is not equal in this cohort.

Method:

A total of 850 patients underwent RP for HRPCa in four institutions between 2013 and 2019. Immediate additional treatment post RP was exclusion criteria, leaving 832 patients. Patient demographics, pre-operative, histological features and incidence of BCR (PSA ⩾ 0.2 ng/mL) were recorded. Patients were risk-stratified patients according to having one, two or three high-risk factors. Chi-square test was used for categorical variables. Univariate analysis was performed, and BCR-free survival between groups was explored with Kaplan–Meier method.

Results:

Median follow-up was 48 months. Overall rate of BCR was 19.8%. Median time to BCR was 19 months. In the risk stratification analysis, 75% of patients had one risk feature. Multiple risk features carried a significantly higher risk of positive surgical margin and incidence of BCR ( p < 0.001), but not time to BCR ( p = 0.06) compared with single features. Univariate analysis demonstrated that the risk of BCR was greater with a PSA ⩾ 20 ng/mL compared to GS ⩾ 8 ( p = 0.05). Limitations of the study include limited follow-up time and BCR numbers for analysis.

Conclusion:

Overall, one in five high-risk patients will develop BCR by 4 years. However, those with multiple risk factors have a significantly increased risk. This aids the consultation regarding potential additional therapies alongside surgery in the treatment of HRPCa.

Level of evidence:

Not applicable
Impact of Local Official Corruption on Local Government Debt in China: The Mediating Role of Government Investment Efficiency
Authors: Li Yang , WenXiu Hu , ZhenXing Su
Published: July 2023

In the process of issuing and using local government debt, local officials may be corrupted by self-interest into inappropriately increasing the bond supply, leading to excessive expansion of local government debt and an increase in debt risk. Adopting the perspective of government investment efficiency, this paper employs a piecemeal causal steps approach to analyze the influence of local official corruption on local government debt. The results from panel data on 30 provinces in China show that the local official corruption triggers the expansion of local government debt. A mediation analysis reveals that the effect operates by impairing government investment efficiency. An analysis of regional heterogeneity further shows that the impact is weaker or even disappears in developed in comparison to underdeveloped regions, which further indicates that the anti-corruption campaign supports local government debt management, especially in developed regions. This paper not only explains the relationship between local official corruption and local government debt, but also provides new ideas for local government debt management.
Perceptions and Preferences of Senior High School Students About Written Corrective Feedback in Pakistan
Authors: Rasool Ushba , Mahmood Rabia , Zammad Aslam Muhammad , Barzani Sami Hussein Hakeem , Qian Jiancheng
Published: July 2023

Written corrective feedback (WCF) in enhancing writing proficiency has been the subject of numerous studies, but few studies have examined students’ perceptions about the value of feedback on their written errors. Language teachers use global tools and techniques to give students feedback on their written work. How feedback is delivered and received by students is valued differently. The current study concentrated on how students interpret written corrective feedback and which WCF tactics they favor in writing classrooms. To examine these objectives empirically, the researchers employed a self-administered questionnaire to collect data from 180 participants from a high secondary school in Multan, Pakistan. At the same time, 40 participants were interviewed for their opinions about written corrective feedback (WCF). Some participants expressed concerns about ambiguous feedback that confuses them about their errors, whereas most participants favored the feedback process as beneficial. The most preferred strategies were meta-linguistic explanation and direct written corrective feedback that facilitated writing proficiency and language knowledge. Overall, WCF guides errors to avoid and how to adapt their writing style for composing compelling manuscripts.
Improving School Quality in Junior High Schools in Ghana: Teachers’ Myth and Reality of a Decentralization Policy
Authors: Kwaah Christopher Yaw , Nishimuko Mikako
Published: July 2023

In the education decentralization processes, community participation in education governance has been argued to be essential for improving accountability to service beneficiaries. Therefore, this paper examined the perspectives of key actors on the impact of an educational decentralization policy on improving school quality education in Junior High Schools in Ghana. Participants in the study were 54 School Management Committee (SMC)/Parent-Teacher Association (PTA) members, 106 teachers, and 11 head teachers in 11 schools drawn from two districts in the Central Region of Ghana. Teachers filled out questionnaires and interviews were conducted with SMC/PTA members using a semi-structured interview guide and with 11 head teachers. The paper reveals that the education decentralization policy, with community participation at its heart, has given schools some autonomy in their decision-making process. However, the involvement of community members in school activities has been limited mainly to financing, with little emphasis on the decision-making process in school governance. The study recommends that there should be adequate support for communities to become more involved in the decision-making process, especially in implementing the School Performance Improvement Plan for Ghana to achieve Sustainable Development Goal (SDG) 4.
Near and Far Transfer in South Korean Teacher Education: The Moderated Mediation Effects of Social Capital and Intensive Reflection
Authors: Kim Hyeon-Jin , Joo Young Hyeo
Published: July 2023

This study analyzed the mediating influence of social capital and the moderated mediating effects of social capital and intensive reflection vis-à-vis near transfer (NT) and far transfer (FT). The results obtained from data pertaining to 401 elementary school teachers in Korea revealed the following: (1) NT positively influences FT; (2) there is a direct relationship between NT and social capital; and (3) social capital does not directly impact FT on its own but affects FT when combined with intensive reflection. The results offer crucial theoretical and policy implications for teacher education and professional development programs worldwide.
Racialization as a Strategic Orientation: Arab Organizations and the Construction of Ethnic Identity in the Cold War Era
Authors: Uyan Deniz
Published: July 2023

Arab Americans are fertile ground for scholars interested in studying processes of racialization and race-making. The ambiguous, or “in-between,” racial status of this population has caused some obstacles for scholars attempting to theorize the source and persistence of discrimination against this group. This article attempts to address these paradoxes by examining the history of Arab ethnic and racial activism in the civil rights/Cold War period and uses this empirical case to argue for an historical interpretation of Arab racialization. Specifically, this article asks two questions: “What international and historical contexts shaped the development of Arab ethnic identity in the United States?” and “How do these historical mechanisms inform and amend current theories of Arab racialization?” To answer these, the article employs a “theoretical frontier” analytic architecture to analyze archival sources documenting Arab ethnic advocacy and organizing strategies during the critical civil rights/Cold War period. The article finds that prominent Arab organizations and their leaders navigated a hostile American public that levied both politically and ethnically motivated attacks against their advocacy, and argues that this historical context in turn shaped later Arab organizations’ approach to formal recognition as an ethnic and racial group. Ultimately, the article argues that racialization—in this case, the decision by Arab organizations beginning in the mid-1970s to pursue a project of Arab ethnic advocacy disarticulated from its political origins—was an historical development that requires reckoning with within the theoretical literature on Arab ethnic formation.
Association of Health Literacy With the Prevalence of Cardiovascular Diseases and Their Risk Factors Among Older Japanese Health Management Specialists
Authors: Hirooka Nobutaka , Kusano Takeru , Kinoshita Shunsuke , Aoyagi Ryutaro
Published: July 2023

In this study, we aimed to determine the association between health literacy and the development of cardiovascular diseases (CVDs), among an older population. This cross-sectional study was conducted among Japanese health management specialists ( N = 593). Higher levels (communicative and critical) of health literacy and CVD risk factors (diabetes mellitus, hypertension, dyslipidemia, and obesity) were measured. The mean patient age was 71.3 years. Logistic regression analyses showed statistically significant associations between higher levels of health literacy and the prevalence of CVDs (β coefficient = −.091, p < .05) and metabolic risk factors (β coefficient = −.084, p < .01). There was a statistically significant association between health literacy and the count of CVDs (and its risk factors) (β coefficients of Poisson regression = −.036, p < .05). The results show health literacy to be fundamentally related to low prevalence of cardiovascular diseases and their associated metabolic risk factors.
Symptomatic Carotid Atheroma Inflammation Lumen-stenosis score compared with Oxford and Essen risk scores to predict recurrent stroke in symptomatic carotid stenosis
Authors: Gorey Sarah , McCabe John J , Camps-Renom Pol , Giannotti Nicola , McNulty Jonathan P , Barry Mary , Cassidy Tim , Cronin Simon , Dolan Eamon , Fernández-León Alejandro , Foley Shane , Harbison Joseph , O’Connell Martin , Williams David J , Marnane Michael , Martí-Fabregas Joan , Kelly Peter J
Published: July 2023

Background:

The Oxford Carotid Stenosis tool (OCST) and Essen Stroke Risk Score (ESRS) are validated to predict recurrent stroke in patients with and without carotid stenosis. The Symptomatic Carotid Atheroma Inflammation Lumen stenosis (SCAIL) score combines stenosis and plaque inflammation on fluorodeoxyglucose positron-emission tomography (18FDG-PET). We compared SCAIL with OCST and ESRS to predict ipsilateral stroke recurrence in symptomatic carotid stenosis.

Patients and methods:

We pooled three prospective cohort studies of patients with recent (<30 days) non-severe ischaemic stroke/TIA and internal carotid artery stenosis (>50%). All patients had carotid 18FDG-PET/CT angiography and late follow-up, with censoring at carotid revascularisation.

Results:

Of 212 included patients, 16 post-PET ipsilateral recurrent strokes occurred in 343 patient-years follow-up (median 42 days (IQR 13–815)). Baseline SCAIL predicted recurrent stroke (unadjusted hazard ratio [HR] 1.96, CI 1.20–3.22, p = 0.007, adjusted HR 2.37, CI 1.31–4.29, p = 0.004). The HR for OCST was 0.996 (CI 0.987–1.006, p = 0.49) and for ESRS was 1.26 (CI 0.87–1.82, p = 0.23) (all per 1-point score increase). C-statistics were: SCAIL 0.66 (CI 0.51–0.80), OCST 0.52 (CI 0.40–0.64), ESRS 0.61 (CI 0.48–0.74). Compared with ESRS, addition of plaque inflammation (SUVmax) to ESRS improved risk prediction when analysed continuously (HR 1.51, CI 1.05–2.16, p = 0.03) and categorically ( ptrend = 0.005 for risk increase across groups; HR 3.31, CI 1.42–7.72, p = 0.006; net reclassification improvement 10%). Findings were unchanged by further addition of carotid stenosis.

Conclusions:

SCAIL predicted recurrent stroke, had discrimination better than chance, and improved the prognostic utility of ESRS, suggesting that measuring plaque inflammation may improve risk stratification in carotid stenosis.
Dalit Consciousness Movements in Uttar Pradesh: A Literary Survey
Authors: Singh Rakshita , Singh Pankaj
Published: July 2023

This article examines the Dalit movements and transition in the way of protest of Dalits for their economic, political, social and legal rights. India’s deprived sections are known as Dalits and are the most marginalized groups in India. They had always raised their voices and protested movements in one or another way against the inequality and discrimination they have faced. This article is a literary survey and narrates the history of the Dalit movement in Uttar Pradesh till the contemporary period. The article is divided into three parts in three different eras, that is, their emancipation in medieval history and before the post-colonial period, then the Dalit movement in the post-colonial period, and after independence and rise of the Bahujan Samaj Party, and the last Dalit movement in the contemporary period.
The Rural Lifeworld as a Pathway to Career Identity: Lessons From a Non-School Internship Study
Authors: Yahn Jacqueline J. , Ricket Allison
Published: July 2023

This case examines two Appalachian Ohio organizations outside the boundaries of formal schooling that address issues of youth outmigration and sustainable community development through non-school internships. Twenty-five participants who completed internships from 2016–2020 were interviewed on topics related to their career pathways, social capital acquisition, and community connections. This case relates to the 3rd wave of economic development which has elevated social capital and cross-sector collaboration, but also the emerging 4th wave of economic development that finds communities prioritizing people and “place-making”. The key finding — participants’ career narratives — indicates place plays an emotional and material role in fostering entrepreneurship education and similar forms of workforce development in rural areas.
Detecting Hemopneumothorax With Lung Sonography: A Case Report
Authors: Cheong Issac , Tamagnone Francisco Marcelo
Published: July 2023

Hemopneumothorax is a rare but serious complication that can occur in patients with central venous catheters, trauma, or underlying lung disease. It involves the accumulation of blood and air in the pleural cavity, which can cause hypovolemic shock if left untreated. Lung sonography is a noninvasive, nonionizing radiation imaging technique, and easily accessible diagnostic tool that can be performed at the bedside in critically ill patients, for the diagnosis of hemopneumothorax. A case is reported of a 60-year-old female with a medical history of leukemia who developed hypovolemic shock due to right hemothorax caused by a perforation of the superior vena cava by a central venous catheter. The patient underwent emergency surgery and her condition improved, but later presented with symptoms of hemopneumothorax, which was diagnosed using lung sonography. Emergency placement of a pleural drainage tube was performed, but unfortunately, the patient’s condition deteriorated, and she received end-of-life care. Prompt diagnosis and management of hemopneumothorax are essential to prevent life-threatening complications, and lung sonography is a valuable diagnostic tool, in the diagnosis of critically ill patients.
Plant economic strategies in two contrasting forests
Authors: Sun Kuo , Sun Ruojun , Li Yibo , Ji Hongchao , Jia Bingrui , Xu Zhenzhu
Published: July 2023

Background

Predicting relationships between plant functional traits and environmental effects in their habitats is a central issue in terms of classic ecological theories. Yet, only weak correlation with functional trait composition of local plant communities may occur, implying that some essential information might be ignored. In this study, to address this uncertainty, the objective of the study is to test whether and how the consistency of trait relationships occurs by analyzing broad variation in eight traits related to leaf morphological structure, nutrition status and physiological activity, within a large number of plant species in two distinctive but comparable harsh habitats (high-cold alpine fir forest vs. north-cold boreal coniferous forest).

Results

The contrasting and/or consistent relationships between leaf functional traits in the two distinctive climate regions were observed. Higher specific leaf area, photosynthetic rate, and photosynthetic nitrogen use efficiency (PNUE) with lower N concentration occurred in north-cold boreal forest rather than in high-cold alpine forest, indicating the acquisitive vs. conservative resource utilizing strategies in both habitats. The principal component analysis illuminated the divergent distributions of herb and xylophyta groups at both sites. Herbs tend to have a resource acquisition strategy, particularly in boreal forest. The structural equation modeling revealed that leaf density had an indirect effect on PNUE, primarily mediated by leaf structure and photosynthesis. Most of the traits were strongly correlated with each other, highlighting the coordination and/or trade-offs.

Conclusions

We can conclude that the variations in leaf functional traits in north-cold boreal forest were largely distributed in the resource-acquisitive strategy spectrum, a quick investment-return behavior; while those in the high-cold alpine forest tended to be mainly placed at the resource-conservative strategy end. The habitat specificity for the relationships between key functional traits could be a critical determinant of local plant communities. Therefore, elucidating plant economic spectrum derived from variation in major functional traits can provide a fundamental insight into how plants cope with ecological adaptation and evolutionary strategies under environmental changes, particularly in these specific habitats.
Diagnostic accuracy of the peripheral venous pressure variation induced by an alveolar recruitment maneuver to predict fluid responsiveness during high-risk abdominal surgery
Authors: Desebbe Olivier , Vallier Sylvain , Gergelé Laurent , Alexander Brenton , Marx Alexandre , Ben Jaoude Elias , Kato Hiromi , Toubal Leila , Berna Antoine , Duranteau Jacques , Vincent Jean-Louis , Joosten Alexandre
Published: July 2023

Background

In patients undergoing high-risk surgery, it is recommended to titrate fluid administration using stroke volume or a dynamic variable of fluid responsiveness (FR). However, this strategy usually requires the use of a hemodynamic monitor and/or an arterial catheter. Recently, it has been shown that variations of central venous pressure (ΔCVP) during an alveolar recruitment maneuver (ARM) can predict FR and that there is a correlation between CVP and peripheral venous pressure (PVP). This prospective study tested the hypothesis that variations of PVP (ΔPVP) induced by an ARM could predict FR.

Methods

We studied 60 consecutive patients scheduled for high-risk abdominal surgery, excluding those with preoperative cardiac arrhythmias or right ventricular dysfunction. All patients had a peripheral venous catheter, a central venous catheter and a radial arterial catheter linked to a pulse contour monitoring device. PVP was always measured via an 18-gauge catheter inserted at the antecubital fossa. Then an ARM consisting of a standardized gas insufflation to reach a plateau of 30 cmH2O for 30 s was performed before skin incision. Invasive mean arterial pressure (MAP), pulse pressure, heart rate, CVP, PVP, pulse pressure variation (PPV), and stroke volume index (SVI) were recorded before ARM (T1), at the end of ARM (T2), before volume expansion (T3), and one minute after volume expansion (T4). Receiver-operating curves (ROC) analysis with the corresponding grey zone approach were performed to assess the ability of ∆PVP (index test) to predict FR, defined as an ≥ 10% increase in SVI following the administration of a 4 ml/kg balanced crystalloid solution over 5 min.

Results

∆PVP during ARM predicted FR with an area under the ROC curve of 0.76 (95%CI, 0.63 to 0.86). The optimal threshold determined by the Youden Index was a ∆PVP value of 5 mmHg (95%CI, 4 to 6) with a sensitivity of 66% (95%CI, 47 to 81) and a specificity of 82% (95%CI, 63 to 94). The AUC’s for predicting FR were not different between ΔPVP, ΔCVP, and PPV.

Conclusion

During high-risk abdominal surgery, ∆PVP induced by an ARM can moderately predict FR. Nevertheless, other hemodynamic variables did not perform better.
Effect of nalbuphine plus ropivacaine on vaginal labor in epidural analgesia
Authors: Liu Guo-hua , Liu Li-wen , Ou Lian-chun , Cao Xiao-sheng , Pang Zhao , Wen Xue-jin , He Quan-yan , Yin Biao
Published: July 2023

Background

Various approaches using epidural analgesia have been employed for relieving labor pain and promoting spontaneous delivery. We aimed to evaluate the effect of nalbuphine and ropivacaine versus fentanyl and ropivacaine on the duration of delivery in parturients.

Methods

Clinical data of 160 full-term primiparous women who received either nalbuphine or fentanyl in combination with ropivacaine infusion for epidural labor analgesia in our hospital from December 2020 to May 2022 were retrospectively analyzed. The participants were divided into two groups based on anesthesia methods: nalbuphine group (NR group, n = 78) received 0.2 mg/mL nalbuphine combined with 0.1% ropivacaine hydrochloride for patient-controlled epidural analgesia (PCEA) and fentanyl group (FR group, n = 82) received 2 ug/mL fentanyl citrate and 0.1% ropivacaine hydrochloride for PCEA. Both groups received an epidural blockade for labor analgesia at lumbar 2–3 interspace. The duration of the first, second, and third stages of labor, the onset of analgesia, and time before delivery (T0), 15 min of analgesia (T1), 30 min of analgesia (T2), full opening of the uterine opening (T3),exerts force during childbirth(T4), heart rate (HR), blood pressure (BP), blood saturation (SpO2), visual analogue pain scale (VAS) score, Ramsay sedation score, and modified Bromage score, and 5 min were recorded at 2 h postpartum (T5). The neonatal Apgar score, neonatal behavioral neurological assessment (NBNA) score, maternal nausea, vomiting, and itchy skin were recorded.

Results

Compared with the FR group, the first stage of labor duration (p < 0.05) and total duration of labor (p < 0.05) were shortened and the onset of analgesia (p < 0.05) was increased in the NR group. NR group had lower incidence of urinary retention than FR group (p < 0.05). The maternal and neonatal investigational parameters and scores had no significant difference between the two groups.

Conclusions

Nalbuphine combined with ropivacaine in epidural block labor has a faster onset of analgesia and has a lower incidence of urinary retention than fentanyl combined with ropivacaine, and nalbuphine shortens the duration of the first and total stages of labor. Both nalbuphine and fentanyl can reduce pain during labor, have little effect on maternal hemodynamics, and have no significant effect on neonatal Apgar or NBNA scores.