bluuebunny/crossref_metadata_2025 huggingface dataset:
How Green Entrepreneurship Evolved over the Past Two Decades? A Glance Through Bibliometric Analysis
Authors: Arora Neelika , Dhiman Neeraj , Shrivastava Rashmi
Published: December 2023

The goal of this study is to provide a rigorous bibliometric analysis of the subject of green entrepreneurship over the past two decades, giving valuable insights into the significant advancements in the sector. A sample of 2,861 studies from 2003 to 2022 were analysed using the VOSviewer software and with the R programming language. The analysis in the present study is categorized into two parts, that is, performance analysis and science mapping. This study concentrated on performance analysis and scientific mapping of articles. The finding shows that previous research on green entrepreneurship lacked synthesized findings and identification of major themes. This study highlights recently developed themes including social entrepreneurship, sustainable entrepreneurship and innovation that unlock potentially interesting directions for future research. The United States and the United Kingdom were the most productive nations in terms of citations, followed by China and a few European nations like Spain, Germany and the Netherlands. This study will be a resource for investigators in a variety of disciplines to assess the evolution of scholarly works on a certain theme over time, particularly for those working in the field of green entrepreneurship. This study has proposed a unique definition of green entrepreneurship through its thorough and rigorous analytical methods.
Optimization of a foot-and-mouth disease virus Southern African Territories–specific solid-phase competitive ELISA for small ruminant serum samples
Authors: Seoke LaToya , Fosgate Geoffrey T. , Opperman Pamela A. , Malesa Refiloe P. , Lazarus David D. , Sirdar Mohamed M. , Heath Livio
Published: December 2023

We optimized and verified a single-spot solid-phase competitive ELISA (ss-SPCE) to detect antibodies against structural proteins of Southern African Territories (SAT) serotypes of foot-and-mouth disease virus (FMDV) in small ruminants. Sera from goats vaccinated and experimentally challenged with a SAT1 FMDV pool were tested in duplicate at 4 dilutions (1:10, 1:15, 1:22.5, 1:33.8) to optimize the assay. To assess the performance of the assay in naturally infected animals, we evaluated 316 goat and sheep field sera collected during active SAT2 outbreaks. Relative to results of the virus neutralization test, the optimal serum dilution and cutoff percentage inhibition (PI) were 1:15 and 50%, respectively. At these values, the Spearman rank correlation coefficient was 0.85 ( p < 0.001), and the sensitivity and specificity (95% CI) were 80.3% (72.6, 87.2) and 91.1% (84.1, 95.9), respectively. Relative to the liquid-phase blocking ELISA and the nonstructural protein ELISA, the ss-SPCE exhibited divergent performance characteristics between the goat and sheep field sera. Repeatability was better for goats, but the correlation and agreement among all 3 assays were better for the sheep sera. The prevalence of SAT2 FMDV infection in the sampled sheep was 23.6%; sampled goats were seemingly FMDV-free. The ss-SPCE is an appropriate FMDV detection tool to investigate the role of small ruminants in the epidemiology of FMD in Africa.
“Postponing it Any Later Would not be so Great”: A Cognitive Interview Study of How Physicians Decide to Initiate Goals of Care Discussions in the Hospital
Authors: Chuang Elizabeth , Gugliuzza Sabrina , Ahmad Ammar , Aboodi Michael , Gong Michelle Ng , Barnato Amber E
Published: December 2023

Background

There are missed opportunities to discuss goals and preferences for care with seriously ill patients in the acute care setting. It is unknown which factors most influence clinician decision-making about communication at the point of care.

Objective

This study utilized a cognitive-interviewing technique to better understand what leads clinicians to decide to have a goals of care (GOC) discussion in the acute care setting.

Methods

A convenience sample of 15 oncologists, intensivists and hospitalists were recruited from a single academic medical center in a large urban area. Participants completed a cognitive interview describing their thought process when deciding whether to engage in GOC discussions in clinical vignettes.

Results

6 interconnected factors emerged as important in determining how likely the physician was to consider engaging in GOC at that time; (1) the participants’ mental model of GOC, (2) timing of GOC related to stability, acuity and reversibility of the patient’s condition, (3) clinical factors such as uncertainty, prognosis and recency of diagnosis, (4) patient factors including age and emotional state, (5) participants’ role on the care team, and (6) clinician factors such as emotion and communication skill level.

Conclusion

Participants were hesitant to commit to the present moment as the right time for GOC discussions based on variations in clinical presentation. Clinical decision support systems that include more targeted information about risk of clinical deterioration and likelihood of reversal of the acute condition may prompt physicians to discuss GOC, but more support for managing discomfort with uncertainty is also needed.
Preliminary Outcomes and Adaptation of an NDBI for Spanish-Speaking Families
Authors: Pickard Katherine , Guerra Karen , Hendrix Nicole , Khowaja Meena , Nicholson Chris
Published: December 2023

Naturalistic, Developmental, and Behavioral Interventions (NDBIs) are an empirically supported intervention approach for young autistic children and their families. Spanish-speaking (SS) Latinx families have been underrepresented in autism intervention research, limiting our understanding of whether NDBIs are aligned with Latinx family values and belief systems. This study piloted a parent-mediated NDBI, Project ImPACT, within outpatient services for SS Latinx families. We aimed to examine the preliminary impact of Project ImPACT on family and child outcomes while using the Ecological Validity Model to evaluate program adaptations made by bilingual clinicians. Results from 15 families indicated good treatment completion and high satisfaction, alongside significant increases in child social communication skills and parent self-efficacy in supporting their child’s development. Mixed-methods data examining program adaptations indicated the need to provide additional information related to autism, bilingual language development, and service navigation, as well as adaptations to language and metaphors used in the program.
Professional Development Increases Child Care Providers’ NDBI Implementation and Children’s Language Outcomes
Authors: Landa Rebecca J. , Pfeiffer Danika , Holingue Calliope , Baker Emily
Published: December 2023

A majority of children’s language learning experiences occur in inclusive early child care and education settings. Few evidence-based professional development (PD) programs exist to empower early childhood education providers to use language instruction practices with children in inclusive classrooms. There is little research on providers’ implementation of naturalistic developmental behavioral intervention (NDBI) strategies to improve children’s language outcomes in whole-group inclusive instruction. We conducted a pilot cluster randomized controlled trial to test the hypothesis that providers in the Early Achievements for Child Care Providers (EA-CP) PD program would show greater gains in NDBI implementation fidelity during shared book reading relative to business-as-usual (BAU) providers. This hypothesis was confirmed. Compared to BAU providers, EA-CP providers exhibited significantly greater fidelity gains from pre-training to mid-training, post-training, and 12-week maintenance assessments. A secondary hypothesis was that toddlers with and without developmental delays in the EA-CP condition would exhibit greater vocabulary and communication gains than toddlers in the BAU condition. Analyses of children with and without delays showed significantly greater expressive vocabulary and story-related engagement and communication in the EA-CP group. For children with delays, positive effects favoring the EA-CP group but not statistically significant were found. Implications for research, practice, and policy are discussed.
The Dutch Version of the Orthognathic Quality of Life Questionnaire (OQLQ-NL): Validation for Cleft Patients
Authors: Ploumen Roan L.M. , Jonkman Ronald E.G. , Gilijamse Marjolijn , Baas Erik , Nienhuijs Marloes , Nolte Jitske W. , Becking Alfred G.
Published: December 2023

Objective

The aim of this study is to validate the Dutch version of the Orthognathic Quality of Life Questionnaire (OQLQ-NL) for cleft patients who received orthognathic surgery.

Methods

To compare the OQLQ-NL with the CLEFT-Q, we used a convenience sample of thirty-two cleft patients. Using the Cronbach's alpha coefficient for multiple item scales, internal reliabilities of the OQLQ-NL were evaluated. The OQLQ-NL was repeated at a two-week interval and the intraclass correlation coefficient was calculated, to establish of the test-retest reliability. The construct validity of the OQLQ-NL was evaluated by using Spearman's correlation to test its correlation with the CLEFT-Q.

Results

Thirty-two patients filled in the OQLQ-NL and CLEFT-Q. The OQLQ-NL had excellent results in internal reliability and test-retest reliability. The vast majority of the correlations between the domains and scales of the questionnaires were as expected. Data from this study and previous studies confirm the construct validity of the OQLQ-NL.

Conclusion

Our results suggest the OQLQ-NL is a valid and reliable instrument for measuring quality of life in cleft patients who have received orthognathic surgery in the Netherlands.
Enlargement of band gaps in holey phononic crystal strips
Authors: Wang Jianjun , Zhou Yunlei , Jiang Shan
Published: December 2023

This study proposes an effective strategy to enlarge the band gaps of holey phononic crystal strips. The approach involves identifying each band and its key influencing factors, then implementing targeted synthetic adjustments like geometry optimization and embedment to reposition the relevant bands, and finally achieving larger band gaps. The main band gap can be enlarged from 47% to 64% with slight modifications. Furthermore, this optimal result is only achieved through the synergistic action of different methods, each of which has small or even counteractive individual effects. The design strategy starts from large-scale to small-scale adjustments, culminating in specific case-by-case adjustments. It presents new possibilities for enhancing phononic crystals.
Performance Autoethnography: EM Not Afraid to Utter Their Emotional Truth
Authors: Yan Dave
Published: December 2023

In this performance autoethnography, the author uses the poetic language, rather than silence, to express the emotional truth associated with their lived experience. Exploring the convergence of multiple identities, they use Tweets as prompts to elicit deepest inner experiences, striving to elucidate situated knowledges that emerge from within. This creative-relational-and-performative process of producing an aesthetic text serves as a cathartic outlet, bringing forth the deeply personal, cultural, and political dimensions of being-in-the-world. The methodological consideration accentuates the significance of individual expression and encompasses the truth-seeking and poetical examination of everyday engagement with this (in)visible lifeworld.
The Role of Evaluation Theory and Practice in Narrowing the Research-to-Practice Gap
Authors: Berry Tiffany , Hite Brittany , Sloper Michelle , Umans Haley
Published: December 2023

The research-to-practice gap describes the well-documented phenomena of researchers and practitioners working in silos, embedded in vastly different contexts. This “cultural divide” has several causes, including ineffective collaboration, inadequate understanding of context, and insufficient dissemination and translation of research. Evaluation theory and practice have been largely absent from discussions about solving the research-to-practice gap, despite remarkable alignment between these efforts and the core principles and goals of evaluation. In this article, we describe why the research-to-practice gap exists, current models and frameworks to address the gap, and how evaluation aligns with, and extends, efforts to create a bi-directional bridge between research and practice. This article is a call-to-action for professional evaluators who are poised to narrow this gap given that they work at the intersection of research and practice. Through authentic collaboration, researchers, practitioners, and evaluators can leverage our collective strength to address the pressing challenges faced by our communities.
Reflections on the Intersections Between Collaboration and Use in Evaluation Practice
Authors: Acree Jeremy G. , Tovey Tiffany L. S. , Petrulis Robert
Published: December 2023

In this reflective case, we examine the role and function of collaboration in use-oriented evaluation approaches. Reflecting on our experience evaluating a program that sought to integrate new technologies into K-12 teaching and pre-service teacher education, we found that the desire and pursuit of making evaluation useful can influence why, with whom, and how we choose to collaborate, in turn shaping the substance of our evaluative questions, methods, and findings. We structured our reflections using the Describe, Analyze, Theorize, Act model (Peters, 1991; Smith et al., 2015), a tool for systematically reflecting on evaluation situations and dilemmas to learn and refine future actions. Through this process, we uncovered both conceptual and practical implications regarding the relationship between use-oriented evaluation approaches and collaboration.
Profile of a large cohort of children with persistent fetal vasculature and their predictors of poor visual outcome in a tertiary eye hospital in Saudi Arabia
Authors: Alawi Abeer , Ahmad Khabir , AlZaben Khawlah , AlOhali Rawa , AlKahtani Abeer , AlBakri Amani
Published: December 2023

Purpose

To present the profile of a large cohort of children with persistent fetal vasculature (PFV) and identify their predictors of poor visual outcome in a tertiary eye hospital in Saudi Arabia.

Methods

This was a single-center study. Medical records of children diagnosed with persistent fetal vasculature between January 1990 and January 2020 at King Khaled Eye Specialist Hospital (KKESH), Riyadh, were reviewed. Data were collected on PFV type, presenting features, management, and visual acuity. Poisson regression with robust error variance was used to identify the predictors of poor visual outcome.

Results

Data of 175 eyes of 170 children with PFV were analyzed. Most had unilateral disease (n = 165, 96.2%), and over half of them (57.1%) were males. The main presenting complaints were leukocoria (n = 126, 72.0%), followed by smaller eye (n = 36, 20.6%), poor vision (n = 15, 8.6%), and strabismus (n = 13, 7.4%). Anterior, posterior, and combined PFV were present in 30.9%, 10.9%, and 58.3% eyes, respectively. In eyes with measurable visual acuity (n = 124), BCVA at the last follow-up was ≥20/100, <20/100–20/400, CF/HM and LP/NLP in 11 (8.9%), 32 (25.8%), 43 (34.7%), and 38 (30.6%) eyes, respectively. In the multivariable poisson regression analysis, eyes with posterior PFV were approximately two times more likely to have a BCVA of CF or worse than those with anterior PFV (Adjusted incidence ratio: 1.82 (95%: 1.23, 2.70; P = 0.003). Compared with eyes with primary or secondary IOL implantation, aphakic eyes or those with no cataract surgery were significantly more likely to have BCVA of CF or worse (adjusted incidence ratio: 1.84 [95%: 1.18, 2.86], p = 0.007 and adjusted incidence ratio: 1.64 [95%: 1.08, 2.50], p = 0.020, respectively).

Conclusions

The prognosis of PFV varies depending on the severity of the disease. Patients with posterior PFV had worse visual outcome than anterior or combined type. Whether primary or secondary, IOL implantation increases the probability of having BCVA better than CF.
It's game time: Improving basic psychological needs and promoting positive behaviours through gamification in physical education
Authors: Sotos-Martínez Víctor Javier , Tortosa-Martínez Juan , Baena-Morales Salvador , Ferriz-Valero Alberto
Published: December 2023

Student's motivation towards physical education (PE) classes is a key factor for increasing physical activity (PA) levels in children. In order to increase motivation in PE, new teaching techniques are needed, such as gamification. This study examines the potential influence of gamification in PE classes on motivation-related variables such as basic psychological needs (BPNs) and positive behaviours in primary school students, considering the perceptions of students and teachers. A total of nine teachers and 506 primary students participated in this study: 250 from a gamified group and 256 from a control group. The students filled in the BPNs in the Classroom Scale in order to measure three BPNs (autonomy, competence and relatedness). In addition, the perceptions, feelings, and behaviours of the students and teachers were analysed and classified through drawings, teacher's diaries, and focus groups. An improvement in the three BPNs, namely autonomy ( p < 0.001), competence ( p < 0.001) and relatedness ( p < 0.001), was observed for the gamified group compared to the control group. The qualitative findings showed a perceived increase in student motivation, participation, and cooperation behaviours. Students also reported values such as respect, and rejection of contempt and harassment. In short, gamification was associated with an increase in all BPNs and positive behaviours in primary school students in gamified PE classes compared to non-gamified classes.
The impact of guided versus supportive coaching on mental health app engagement and clinical outcomes
Authors: Camacho Erica , Chang Sarah M. , Currey Danielle , Torous John
Published: December 2023

Although mobile mental health apps have the unique potential to increase access to care, evidence reveals engagement is low unless coupled with coaching. However, most coaching protocols are limited in their scalability. This study assesses how human support and guidance from a Digital Navigator (DN), a scalable coach, can impact mental health app engagement and effectiveness on anxiety and depressive symptoms. This study aims to detach components of coaching, specifically personalized recommendations versus general support, to inform scalability of coaching models for mental health apps. 156 participants were split into the DN Guide versus DN Support groups for the 6-week study. Both groups utilized the mindLAMP app for the duration of the study and had equal time with the DN, but the Guide group received personalized app recommendations. The Guide group completed significantly more activities than the Support group. 34% (49/139) of all participants saw a 25% decrease in PHQ-9 scores and 38% (53/141) saw a 25% decrease in GAD-7 scores. These findings show mental health apps, especially when supported by DNs, can reduce depression and anxiety symptoms when coupled with coaching, suggesting a feasible path for large-scale deployment.
What kinship is and is not in the work of Marshall Sahlins … and beyond
Authors: McKinnon Susan
Published: December 2023

This essay explores how anthropological assumptions about the differential place of kinship in kin-based and state-based societies shaped the work of Marshall Sahlins. On the one hand, I show how his expansive excursions into what kinship is, means, and does within the scope of kin-based societies clearly motivated some of his major contributions to anthropological theory: his critique of Western economic and biological determinisms; his exploration of the cultural dynamics of kinship as they articulate relations of hierarchy, power, and sovereignty; his rethinking of anthropological theories of structure; and his formulation of the concept of “performative” kinship. On the other hand, I analyze how these assumptions about the distinction between kin-based and state-based societies ultimately limited the scope of inquiry in his book, What Kinship Is—And Is Not. I then look beyond these limitations to more recent work in kinship studies that challenge the distinction between kin-based and state-based societies, and I end by arguing that, with regard to kinship studies, this distinction should best be left behind.
Statistical evaluation of three-point bending properties of sustainable aluminium sandwich panels with arched-core geometry
Authors: Lopes Rogério Teixeira , da Silva Rodrigo José , Santos Freire Rodrigo Teixeira , dos Santos Júlio Cesar , Christoforo André Luis , Panzera Tulio Hallak , Scarpa Fabrizio
Published: December 2023

This study presents the first assessment of sustainable aluminium sandwich panels with an arched-core geometry. The arches are constructed from recycled aluminium obtained from drink container cans and bonded to aluminium skins using a polymer system. Through statistical analysis, the research aims to investigate the influence of the adhesive system (castor-oil or epoxy), adhesive layer thickness (0.8 mm or 1.5 mm), and core arch configuration (aligned or alternated pattern) on the mechanical performance of the sandwich panels, evaluated through a three-point bending test. The Al-arched-core panels, with a support span of 150 mm and a width of 75 mm, achieve a maximum load of 500 N, equivalent to 51 kg per 150 × 75 mm2. Additionally, the panels exhibit a core shear modulus of up to 10 MPa, while the flexural modulus under pure bending is estimated to be approximately 7 GPa. The mechanical performance of the panels is further enhanced by utilising thicker adhesive layers. Employing alternated arches in the core improves the distribution of flexural stress along the panel. These Al-arched-core panels demonstrate suitable mechanical performance for secondary structural applications, offering a cost-effective and environmentally friendly fabrication process.
AUR – The Electoral Geography of Romanian Conservative Nationalism
Authors: Crăciun Claudiu , Țăranu Andrei
Published: December 2023

In December 2020, Romania held elections for its new Parliament amid the pandemic crisis. The voter turnout was historically low, at 31.84%. The Alliance for the Union of Romanians, a new party, won 9% of the vote, making it the fourth largest party in the Parliament. Having received only 0.29% of the votes in the local elections held 2 months prior, Alliance for the Union of Romanians’ success was unexpected. To explain this outcome, we analyse its programmatic choices, political strategy and symbolic and electoral geographies. The pandemic crisis allowed the consolidation of a nationalist and conservative constituency originating in the 2018 constitutional referendum to ban same-sex marriages. Romania’s example shows that a nationalist-conservative radical party can become viable if extra-political groups, networks and organisations are willing to lend significant local support to it.
Real-World Experience With the Angio-Seal Closure Device: Insights From Manufacturer and User Facility Device Experience Database
Authors: Ahrari Aida , Healy Gerard M. , Min Adam , Alkhalifah Fahd , Oreopoulos George , Teng Tan Kong , Jaberi Arash , Rajan Dheeraj K. , Mafeld Sebastian
Published: December 2023

Purpose:

Angio-Seal (Terumo Medical Corporations, Somerset, New Jersey) device is indicated for femoral arteriotomy closure. Real-world published data on complications are limited. We present 1 year of safety events involving Angio-Seal from the US Food and Drug Administration’s post-market surveillance database of Manufacturer and User Facility Device Experience (MAUDE). Steps for managing frequent device-related problems are discussed.

Materials and Methods:

Angio-Seal MAUDE data from November 2019 to December 2020 was classified according to (1) mode of device failure, (2) complication, (3) treatment, and (4) Cardiovascular and Interventional Radiological Society of Europe (CIRSE) adverse event classification system.

Results:

There were 715 safety events, involving Angio-Seal VIP (93.1%), Evolution (5.7%), STS Plus (1.1%), and sizes 6F (62.5%) and 8F (37.5%). Failure mode involved unrecognized use of a damaged device (43.4%), failed deployment (20.1%), failed arterial advancement (6.3%), detachment of device component (4.9%), failed retraction (3.6%), operator error (1.1%), and indeterminate (20.6%). Of total, 44.8% of events were associated with patient harm. Complications involved minor blood loss (34.1%), hematoma (5.6%), significant blood loss (1.4%), and pseudoaneurysm (1.4%). Of total, 43.3% of cases required manual compression (MC), whereas 8.8% required more advanced intervention. Interventions included surgical repair (49.2%), thrombin injection (9.5%), balloon tamponade (6.3%), covered stent (4.8%), and unspecified (30.2%). Majority of safety events were CIRSE grade 1 (92.0%), followed by grades 2 (3.1%), 3 (4.6%), and 6 (deaths, 0.3%). Minority of devices were returned for manufacturer analysis (27.8%).

Conclusions:

The majority of safety events were associated with minor blood loss or local hematoma and could be addressed with MC alone. Most events were attributed to damaged device; however, very few devices were returned to manufacturer for analysis. This should be encouraged to allow for root cause analysis in order to improve safety profile of devices. System-level strategies for addressing barriers to under-reporting of safety events may also be considered.

Clinical Impact

Our study highlights important safety events encountered in real-world practice with Angio-Seal closure device. The MAUDE database captures real-world device malfunctions not typically appreciated in conventional clinical trials. Our study provides valuable insight for clinician-users on anticipating and managing the most common device malfunctions. Additionally, our data provide feedback for manufactures to optimize product design and direct manufacturer user training to improve safety. Finally, we hope that the study promotes system-level strategies that foster reporting of safety events and undertaking of root cause analysis.
Radiomic Models Predict Tumor Microenvironment Using Artificial Intelligence—the Novel Biomarkers in Breast Cancer Immune Microenvironment
Authors: Lin Guang , Wang Xiaojia , Ye Hunan , Cao Wenming
Published: December 2023

Breast cancer is the most common malignancy in women, and some subtypes are associated with a poor prognosis with a lack of efficacious therapy. Moreover, immunotherapy and the use of other novel antibody‒drug conjugates have been rapidly incorporated into the standard management of advanced breast cancer. To extract more benefit from these therapies, clarifying and monitoring the tumor microenvironment (TME) status is critical, but this is difficult to accomplish based on conventional approaches. Radiomics is a method wherein radiological image features are comprehensively collected and assessed to build connections with disease diagnosis, prognosis, therapy efficacy, the TME, etc In recent years, studies focused on predicting the TME using radiomics have increasingly emerged, most of which demonstrate meaningful results and show better capability than conventional methods in some aspects. Beyond predicting tumor-infiltrating lymphocytes, immunophenotypes, cytokines, infiltrating inflammatory factors, and other stromal components, radiomic models have the potential to provide a completely new approach to deciphering the TME and facilitating tumor management by physicians.
Weight Restoration and Symptom Remission for Longstanding, Untreated Anorexia Nervosa in a Remote Eating Disorder Treatment Program: A Case Study
Authors: Shepherd Caitlin B. , Boswell Rebecca G. , Genet Jessica , Oliver-Pyatt Wendy , Stockert Christine , Brumm Rebecca , Riebl Shaun , Piel Katie
Published: December 2023

For severe cases of anorexia nervosa (AN), including when poor prognostic factors like low body mass index (BMI) and longer illness duration are present, intermediate levels of care are often indicated. Current guidelines call for treatment programs to use an evidence-based practice approach to individualize treatment and optimize outcomes. Research supports the effectiveness of intermediate levels of care, including remote programs which increase access to treatment. However, conflicting evidence exists regarding the ability to safely weight restore clients during remote care, necessitating further research. This case report highlights the viability of treating clients with AN remotely using an evidence-based practice approach, resulting in weight restoration and symptom remission. The client presented with a longstanding history of severe binge-eating/purging AN with numerous medical complications but was motivated and treatment-compliant. Her eating disorder (ED) was conceptualized using a biopsychosocial perspective and treated using a multidisciplinary, evidence-based practice approach encompassing individual, group, and supportive interventions. She was successfully discharged from treatment after 150 days, having restored weight to a healthy range and showing substantial improvements in ED, depressive, and anxiety symptoms based on validated measures. This case contributes to the evidence that remote care can be an accessible and effective treatment option, even in cases of severe AN. The case highlights how an evidence-based practice approach can enable safe weight restoration via a personalized treatment plan that emphasizes the use of remote devices and self-monitoring.
Robot-Assisted Minimally Invasive Multivessel Coronary Bypass Guided by Computerized Tomography
Authors: Arslanhan Gökhan , Özcan Zeynep Sıla , Şenay Şahin , Baştopçu Murat , Koçyiğit Muharrem , Değirmencioğlu Aleks , Alis Deniz , Alhan Cem
Published: December 2023

Objective:

Robot-assisted minimally invasive coronary bypass surgery is one of the least invasive approaches that offers multivessel revascularization and accelerated recovery. We investigated the benefits of computed tomography angiography (CTA) guidance in robotic coronary bypass (RCAB) by analyzing perioperative outcomes.

Methods:

Between April 2022 and April 2023, 60 consecutive patients who underwent RCAB under preoperative CTA guidance were included. The intercostal space of the minithoractomy incision was determined based on the distance from the thoracotomy site to the midsection of the left anterior descending artery (LAD) on preoperative CTA. Peripheral vascular findings on preoperative CTA guided the decision for the cannulation site. Perioperative parameters and early outcomes were evaluated.

Results:

The mean age of the patients was 62.3 ± 10.5 years, and 51 patients were male (85.0%). The mean number of revascularized vessels was 2.9 ± 1.1. Left thoracotomy guided by CTA measurements was performed in the fourth intercostal space in 37 patients (61.7%) and in the third intercostal space in the remaining patients. Axillary cannulation was performed in 28 (46.7%) patients because of prohibitive findings in the iliac vessels and aorta. All target coronary arteries with an indication for bypass were revascularized with CTA-guided RCAB. The left internal mammary artery (LIMA) was anastomosed to the LAD in all patients, and the LIMA was anastomosed sequentially to the diagonal artery in 17 patients (28.3%). No operative mortality or cerebrovascular event was observed. One patient underwent reoperation due to bleeding.

Conclusions:

Robot-assisted minimally invasive multiple-vessel coronary bypass under preoperative CTA guidance is safe and can be performed with excellent results.
“It’s Just, You Don’t Have a Ride:” Transportation Experiences of Rural Women on Probation
Authors: Miles Colleen S. , Morse Diane S.
Published: December 2023

Increased incarceration rates of women in small county jails raises questions about how women experience reentry in often under-resourced rural areas. This study examined links between transportation, supervision requirements, and risk for women living in rural towns during probation. Travel data of 25 women and thematically analyzed interview data of four probation officers and five women representing 11 rural towns in a Northeastern State are understood using the vulnerable populations conceptual model (VPCM). Findings confirmed high travel need with limited transportation access, which corresponded to risk in mothering roles, housing, and relationship safety. Policy implications and future research are discussed.
The guillotine: Shadow, spectacle and the terror
Authors: Carrabine Eamonn
Published: December 2023

Of all the images generated by the French Revolution it is the guillotine that is the most notorious. From the beginning the apparatus constituted an elaborate visual spectacle, one that not only efficiently dispensed justice but also offered up a form of popular entertainment and ritualised collective vengeance. The paper seeks to shed fresh light on one of the most perplexing mysteries of the revolutionary era. How did enlightened individuals who had helped create the most democratic and egalitarian society yet seen in the world, descend into a totalitarian regime in which many thousands were arrested, tried without appeal and executed? Why did revolutionaries begin to kill one another, and how did the guillotine come to represent an ideal of Revolution? To answer these questions, the paper begins by looking more closely at the relationships between popular violence and state violence in the Revolution, before describing the invention of the guillotine and how audiences had to adjust to a new kind of spectacle, where terror emerges as a principle of government.
Prediction of difficult laryngoscopy and/or intubation among morbidly obese patients: Upper lip bite test versus modified Mallampati classification
Authors: Richa Freda , El-Hage Christine , Chalhoub Viviane , Yazbeck Patricia
Published: December 2023

Introduction:

We aim to compare the upper lip bite test with the modified Mallampati test as predictors of difficult laryngoscopy and/or difficult intubation among morbidly obese patients.

Methods:

A total of 500 morbidly obese patients (body mass index > 40 kg/m2) undergoing general anaesthesia with tracheal intubation are included in this prospective single-blinded observational clinical study. The preoperative airway assessment is obtained by the modified Mallampati test and upper lip bite test. The difficulty of laryngoscopy is assessed by an experienced anaesthetist in patients adequately anaesthetised and fully relaxed. The view is classified according to Cormack and Lehane’s classification. Modified Mallampati test III or IV and upper lip bite test III are considered positive tests. Difficult laryngoscopy is defined as Cormack and Lehane’s classification III and IV, whereas difficult endotracheal intubation is defined as an intubation difficulty scale ⩾ 5.

Results:

The incidences of Cormack and Lehane’s classification III and IV and intubation difficulty scale ⩾ 5 are 9.4% and 11.8% respectively. The specificity, positive predictive value and accuracy are higher with the upper lip bite test. The combination of the upper lip bite test and the modified Mallampati test improved these measures. The likelihood ratio + was significantly higher for the upper lip bite test (6.35 and 9.47) than for the modified Mallampati test (3.21 and 3.16).

Conclusion:

The upper lip bite test is a test with high sensitivity, specificity, negative predictive value and accuracy making it a favourable test for identifying easy and difficult intubations and laryngoscopies in morbidly obese patients.
Vasculitis in the Central Nervous System: Etiology, Characteristics, and Outcomes in a Large Single-Center Cohort
Authors: Hoshina Yoji , Delic Alen , Wong Ka-Ho , Lyden Stephanie , Kadish Robert , Smith Tammy L. , Wright Melissa A. , Shimura Daisuke , Clardy Stacey L.
Published: December 2023

Background and Purpose

For the management of central nervous system (CNS) vasculitis, it is crucial to differentiate between primary and secondary CNS vasculitis and to understand the respective etiologies. We assessed the etiology, characteristics, and outcomes of patients with CNS vasculitis.

Methods

A single-center retrospective chart review was conducted at the University of Utah, Department of Neurology, between February 2011 and October 2022.

Results

The median age of the 44 included patients at diagnosis was 54 years; 25.0% were men. Compared to primary CNS vasculitis, secondary CNS vasculitis exhibits higher fever incidence (observed in infectious and connective tissue disorder [CTD]-associated vasculitis), low glucose levels (mostly in infectious vasculitis) and unique cerebrospinal fluid oligoclonal bands (observed in infectious and CTD-associated vasculitis). Patients with inflammatory cerebral amyloid angiopathy (CAA) were older and more commonly had microhemorrhage than primary angiitis of the CNS (PACNS). All patients with CTD-associated vasculitis had a known history of CTD at presentation. Brain biopsies were performed on 10 of 17 PACNS patients and 4 of 8 inflammatory CAA patients, confirming vasculitis in 7 and 4 patients, respectively. Intravenous methylprednisolone was the predominant induction therapy (63.6%), and cyclophosphamide was the most used adjunctive therapy. Cyclophosphamide, rituximab, azathioprine, and mycophenolate mofetil were utilized as maintenance therapy, often with concurrent prednisone. Patients with inflammatory CAA had a higher tendency for relapse rates than PACNS.

Conclusions

This study highlights the variations in patients’ characteristics, symptoms, and treatment for CNS vasculitis. Understanding these differences can lead to more efficient diagnostic and management strategies.
The rise of chronic reachability and the accelerated, flexible society: The social construction of the pager, 1987–1999
Authors: Verhoef Jesper
Published: December 2023

Despite having been extremely popular in the 1980s and 1990s, the pager has received scant academic attention. Drawing on speed theory, this article provides a discourse analysis of popular representations of the beeper in the Netherlands between 1987 and 1999. It shows that it was first merely “emergency professionals” who were expected to be reachable whenever, wherever. However, the 1990s saw a growing number of occupations adopt the pager, which, additionally, was deployed to speed up tasks. Pagers enabled but also required people to work more efficiently and be more flexible. Articles and advertisements helped naturalize the idea that this was commonsensical. After 1994, an unprecedented pager marketing campaign sold the wider populace on the expectation of continuous reachability, which rapidly became the new norm. Advertisements successfully presented the pager as a communication technology that enabled reachability, yet—unlike its main competitor, the mobile phone—shielded users from constant availability. It thus offered autonomous reachability. All the same, journalists took issue with the reachability boom and flexibilization that pagers helped bring about. They criticized that pagers helped usher in a 24/7 economy, which in turn led to a stress society. Ultimately, then, this article demonstrates that the provenance of our sped-up society—or at least the pervasive idea that we live in one—is to be found before mobile phones and the Internet became ubiquitous.
From a dynamic integrated climate economy (DICE) to a resilience integrated model of climate and economy (RIMCE)
Authors: Bertolami Orfeu , Gonçalves Carmen Diego
Published: December 2023

The emergence of cascaded risks we face at the Anthropocene raises new problems and demands for action. Climate change can be seen as the most critical world risk: it reflects the effect of human actions that promote several risks, it potentiates disasters and catastrophes caused by natural phenomena, and it can, ultimately, threaten human survival on the planet. Risks in the Anthropocene are a matter of governance and local actions. A reflexive analysis, in the context of the so-called risk societies, and of resilient local communities to cope with the impact of risks of climate change is carried out. A Resilience Integrated Model of Climate and Economy (RIMCE) is proposed. The model is based on the idea of a social economic view, which involves nation-states that focus on local communities, citizen responsibility, rights, and behavior, materialized through networks of social capital and solidarity. This local cooperation to cope with climate crises, is the motivation for a new tax, the resilience social tax. With this reflection, we hope to contribute to the understanding of the economic ties attached to anthropogenic risks, proposing criteria to change behaviors, and advocating public participation in defining local actions to restore the optimal operating conditions of the Earth System.
Critical analysis of the AI impact on the patient–physician relationship: A multi-stakeholder qualitative study
Authors: Čartolovni Anto , Malešević Anamaria , Poslon Luka
Published: December 2023

Objective

This qualitative study aims to present the aspirations, expectations and critical analysis of the potential for artificial intelligence (AI) to transform patient–physician relationship, according to multi-stakeholder insight.

Methods

This study was conducted from June to December 2021, using an anticipatory ethics approach and sociology of expectations as the theoretical frameworks. It focused mainly on three groups of stakeholders; namely, physicians (n = 12), patients (n = 15) and healthcare managers (n = 11), all of whom are directly related to the adoption of AI in medicine (n = 38).

Results

In this study, interviews were conducted with 40% of the patients in the sample (15/38), as well as 31% of the physicians (12/38) and 29% of health managers in the sample (11/38). The findings highlight the following: (1) the impact of AI on fundamental aspects of the patient–physician relationship and the underlying importance of a synergistic relationship between the physician and AI; (2) the potential for AI to alleviate workload and reduce administrative burden by saving time and putting the patient at the centre of the caring process and (3) the potential risk to the holistic approach by neglecting humanness in healthcare.

Conclusions

This multi-stakeholder qualitative study, which focused on the micro-level of healthcare decision-making, sheds new light on the impact of AI on healthcare and the potential transformation of patient–physician relationship. The results of the current study highlight the need to adopt a critical awareness approach to the implementation of AI in healthcare by applying critical thinking and reasoning. It is important not to rely solely upon the recommendations of AI while neglecting clinical reasoning and physicians’ knowledge of best clinical practices. Instead, it is vital that the core values of the existing patient–physician relationship – such as trust and honesty, conveyed through open and sincere communication – are preserved.
A cross-sectional study of career paths for Swedish registered nurses with a doctoral degree: When aspirations and possibilities collide
Authors: Hylén Mia , Striberger Rebecka , Sjögran Lotta , Carlson Elisabeth , Samuelsson Maria , Eriksson Anna
Published: December 2023

Registered nurses with a doctoral degree are important for the quality of care, nursing education, and nursing research. Still, postgraduate career paths are criticized for being too vague. To enable career path development, mapping of the current situation appears fundamental. The objective was therefore to chart the current professional positions and work conditions and to explore the future career aspirations of registered nurses with a doctoral degree in Sweden. A cross-sectional survey study was conducted including 118 participants, all nurses with a doctoral degree earned between 2016 and 2022. This study is reported in accordance with STROBE. The participants reported a significant change from hospital-based positions before doctoral studies, towards university-based positions after graduation. This is clearly in contrast to their expressed aspiration to hold a shared position, remaining in contact with the clinical context. In conclusion, a national collaboration is needed and wanted regarding career opportunities for registered nurses with a doctoral degree in Sweden. Furthermore, career paths within nursing science need to be established within the clinical context.
Examining the Lyrical Content and Musical Features of a Crowd-Sourced, Australian Pandemic Playlist
Authors: Putter Kaila C. , Krause Amanda E. , Vidas Dianna , North Adrian C.
Published: December 2023

A recent examination of charting popular music before and during the first six months of the COVID-19 pandemic indicated that popular music lyrics during turbulent socioeconomic conditions had more negatively valenced words, providing support for the Environmental Security Hypothesis. However, the use of chart data alone cannot speak to what individuals are listening to against the backdrop of COVID-19. The present mixed-methods case study examined a crowd-sourced playlist ( n = 55 songs) created by Australian residents during an extended lockdown in September–October 2021. Qualitative analysis of the lyrics demonstrated that the selected music expresses a closeness to others, references to the current situation (such as illness and staying at home), negative emotions (including confusion and fear), a positive outlook (expressing perseverance and a will to survive), and a changing sense of time. Quantitative analyses compared the “pandemic playlist” songs to charting songs during the first six months of the pandemic in 2020 and the same period in 2021 ( n = 28 and 26 songs, respectively) with regard to their musical features (using scraped Spotify API data) and lyrical content (using Diction). The findings indicated that the songs included in the “pandemic playlist” differed significantly from the charting songs in 2020 and 2021 by being higher in energy (relative to 2020 and 2021) and less acoustic (relative to 2021). Additionally, the lyrics of the “pandemic playlist” songs had significantly more positively valenced words. These differences suggest that people believed music selected in response to the pandemic ought to be upbeat and realistic (playlist suggestions), but popular songs were relatively pensive and reflected uncertainty and isolation (chart data). These findings broaden our understanding of music listening behaviors in response to societal stress.
Family background and the choice of Hispanic Philology among liberal arts students in China
Authors: Gao Wenxuan , Abad David Doncel
Published: December 2023

This article focuses on how family backgrounds affect the choice to study Hispanic Philology in China. Specifically, our aim is to study the mediating effects of the motivation of choice, and the conditional indirect effect of parental values. The sample comprised 9,60 students at sixteen Liberal Arts Majors departments in twenty-one universities. To reach our goal, we combined four analytical methods, including: Principal Components analysis, Binary Logistic regression, Mediating Effects, and Moderation Effects. The results revealed that student choice was influenced by family backgrounds. Both intrinsic and extrinsic motivation play a partially mediating role, while parental values affect the strength and direction of that relationship as the moderating variable.