bluuebunny/crossref_metadata_2025 huggingface dataset:
Technological Change and Techno-Social Systems: Re-Examining Sustainable Development and Digitalisation in Africa
Authors: Sheikheldin Gussai H. , Hambly Helen
Published: October 2024

This article argues that understanding currently dominant technological change models in low-and-middle income countries is important to addressing challenges to sustainable development with enhanced knowledge and effective policies. Combining such understanding with using systems thinking, as a theoretical framework, helps in illuminating techno-social systems and their overlaps with economic and human development systems, therefore highlighting possible leverage points for interventions to usher technological change towards sustainable development objectives. The proposed conceptual synthesis between technological change models and systems thinking is then critically applied to case studies related to digitalisation in Africa, where challenges to sustainability are amplified by continuous pressure for technological advancement, making local capabilities a central issue. The case studies examine how continental digitalisation indicators are ahead of industrialisation and human development indicators, with similar issues in digitalising agri-food ecosystems. We show that, while Africa is currently increasing in digitalisation, correlations between digitalisation and sustainable development are not as direct, or necessarily positive, as initially assumed. Similar trends are seen in digitalisation and agri-food ecosystems, where farm-raised data is monetised off-farm, thus removing opportunities for farmers to realise return on their knowledge investment. Examining the cases, using the proposed synthesis approach, reveals that digitalisation can contribute to development indicators when coupled with enhancing employment in productive sectors and that the prevailing order of ‘technology-push, demand-pull’ models suggests more investment in technological improvement. The article contributes to theory by illuminating overlaps between two theoretical/conceptual areas and to praxis by informing alternative policy directions.
Raymond Limited: Deleveraging and Demerger
Authors: Dhamija Sanjay , Nayyar Reena , Bhatia Shikha
Published: October 2024

The case explores the possible implications of the decision to demerge Raymond Limited by Gautam Singhania, the chairman and managing director (CMD) of Raymond Limited (Raymond). In April 2023, Raymond Limited announced its plan to demerge its lifestyle businesses into Raymond Consumer Care Limited, paving the way for Raymond Limited to become a real estate company. The restructuring was carried out to have two debt-free listed entities in the lifestyle and real estate businesses. This demerger was planned after the company witnessed a turbulent time with a drastic revenue fall and resultant losses due to the COVID-19 pandemic. The case provides students with an opportunity to analyse the financial statements of a listed company affected by a negative macroeconomic event and the financial strategies employed by the company under such circumstances. It also allows the students to analyse the implications of the demerger strategy.
To Validate Use of Transmittance Sensor of Peripheral Pulse Oximeter for Forehead Pulse Oximetry in Newborns
Authors: Rehman Talha , Gupta Girish , Patra Saikat , Chetan Chinmay , Kumar Rakesh , Wasim Sanober
Published: October 2024

Introduction

Peripheral pulse oximeters with continuous monitoring of heart rate and saturation have revolutionized neonatal care. Motion artifacts, hypothermia, and poor perfusion are some of the barriers for reliable reading in the transmittance type of peripheral pulse oximeters. This study was planned to assess the effectiveness of transmittance sensors applied over the forehead for monitoring the heart rate and saturation.

Material and Methods

An observation study was conducted over a period of 1 month. Two pulse oximeters (Masimo RAD97) were applied simultaneously, one over the periphery (right hand/wrist) and the other over the forehead using an innovative headband. A total of 540 readings of heart rate and saturation (SpO2) from each site were recorded. A difference of more than 5 beats/minute in heart rate and 2% saturation were considered clinically significant.

Results

Forty-five neonates with mean gestational age of 35.3 ± 3.2 weeks and birth weight of 2109 ± 683 grams were enrolled. Forehead pulse oximeter could pick up the heart rate and SpO2 readings in all the babies. A statistically significant difference of 3.8 beats/minute in heart rate and 2.5% in SpO2 was noted ( p-value < 0.0001). The difference in heart rate was not clinically significant.

Conclusion

We propose that the transmittance type peripheral pulse oximeter sensors can be used over the forehead. It has the potential to avoid erroneous readings due to motion artifacts, hypothermia, or shock. Saturation nomograms for the forehead pulse oximetry need to be established before it can be used to monitor and manage the neonates for the same.
The Lack of Lewis Turning Point in India: Conceptualizing the Roles of Capital Intensity, Employment Opportunities, and Keynesian Investments
Authors: Padhi Satya Prasad
Published: October 2024

This research study aims to explain why the higher-growth phase in India, witnessed in the post-reform period of 1991–2011, failed to have the impact of significant increases in formal, modern sector employment or a transition toward the Lewis turning point. The article illustrates that it is more realistic to view a transition toward the Lewis turning point as involving increases in capital intensity. A desired increase in demand for labor will follow if the increases in capital intensity are associated with productivity growth in terms of increases in the share of intermediate goods specializations as output is increased. Autoregressive distributed lagged regression has been used to analyze whether investment behavior captures Young–Kaldor investments that can indicate growth in intermediate goods specialization. This is key to a higher pace of investment and specialized employment outcomes. The findings support existing literature, highlighting that increases in capital intensity constitute a significant factor explaining the lack of proper employment growth and the Lewis turning point. However, they also show that the problem is not with increases in capital intensity per se. Rather, the increases do not indicate dynamism regarding investments associated with intermediate goods specializations.

JEL Classification O11, O14, O31
A Scoping Review of the Barriers and Facilitators to Clinician Engagement in Hospital-Based Palliative Care in Australian Hospitals
Authors: Meehan Edward , Parker Catriona , Ayton Darshini , Katz Naomi , Gold Michelle , Wang Yufei , Ralapanawa Dasuni , Kwok Xin , Banaszak-Holl Jane
Published: October 2024

Background: Current research has shown that inpatient palliative care (PC) services are under-utilized, poorly integrated, and frequently introduced too late during inpatient hospital stays. The aim of this study was to identify a comprehensive list of multi-disciplinary facilitators and barriers to inpatient PC in Australian hospitals through a scoping literature review. Methods: This review identified articles published since 2000 from 3 electronic databases (CINAHL Plus, MEDLINE and Embase), which included discussion of collaboration among non-palliative care clinicians and palliative care professionals in Australian hospitals. We used an inductive approach to identifying key domains of barriers and facilitators. Results: Thirty-four articles met inclusion criteria following full text review. Barriers and facilitators were categorized in 7 domains: (1) Patient concerns, (2) Family concerns, (3) Clinician knowledge, education, and experience in palliative care, (4) Recognition and acceptance of prognosis when a patient was dying or needing end of life treatment, (5) Reconciliation of individual and professional values around PC, (6) Clinician access to resources for PC in the hospital, and (7) Communication between the PC team and ward clinicians. Each domain included potentially substantial barriers to PC delivery and practice. However, given the small sample sizes and specialized settings of many included studies, it was difficult to draw conclusions on the relative significance of different barriers across hospitals. Conclusion: This review identified a number of barriers and facilitators across studies. Subsequent research needs to more comprehensively compare factors impacting PC use in order to improve implementation of PC across hospital settings.
Gender as a Moderator to Students’ Behavioral Intention Toward Online Learning
Authors: Gupta Sangeeta , Bajaj Ritu , Das Bhaskar , Kumar Vikas , Gupta Dhruv
Published: October 2024

The study has used the theoretical constructs of unified theory of acceptance and use of technology (UTAUT) model and explored the student's intention to use online learning through EdTech apps. Specifically, the moderating effect of gender has been analyzed. Primary data has been collected from Indian students enrolled in online learning during the COVID-19 pandemic. The partial least squares multi-group analysis (PLS-MGA) technique has been used for data analysis. Results have indicated that self-management of learning, perceived-playfulness, effort-expectancy, and performance-expectancy positively influence the use of online learning, while social influence had insignificant influence. Further, the perceived-playfulness was found to have a high impact on the behavior intention of female students in India.
Pulmonary Hyalinizing Granuloma: Case Report and Discussion of Diagnostic Challenges and Terminology
Authors: Orrego-Pereira Carmen , Machuca-Aguado Jesús , Sánchez-Bernal María Luisa , Rubio-Garrido Francisco Javier
Published: October 2024

Pulmonary hyalinizing granuloma (PHG) is a rare, benign condition characterized by slow-growing pulmonary nodules, often mimicking malignant lesions radiologically. Its pathogenesis is unclear but is thought to result from an exaggerated immune response to persistent antigenic stimuli. This report presents a case of a 71-year-old male with PHG, incidentally detected during imaging for acute appendicitis. Diagnostic challenges arose due to the radiological resemblance to metastatic disease, and inadequate biopsy samples. Surgical resection revealed fibrocollagenous nodules with perivascular inflammatory infiltrates. Immunohistochemistry and special stains excluded malignancy and infection. The clinical course of PHG is typically benign, with surgery being the treatment of choice for solitary lesions. However, the current terminology may be misleading, as the lesions are not true granulomas but rather fibrosing lesions. Further research is needed to clarify the underlying pathophysiology and improve diagnostic accuracy.
Chronicles of Involuntary Career Changes: A Qualitative Longitudinal Analysis
Authors: Brazier Caroline Éliane , Masdonati Jonas , Parmentier Michaël
Published: October 2024

Although extensive research on career transitions exists, little is known about the challenges and processes of involuntary career change. Building on Savickas’s theoretical framework of objective and subjective careers, we investigated the subjective experiences of involuntary career changes while apprehending their objective unfolding. Following a longitudinal qualitative design, we conducted two waves of semistructured interviews with 18 participants who had been forced to change careers due to health issues, migration, or saturated labor market in Switzerland. A four-step temporal thematic analysis covering case description, case comparison, case processes analysis, and processes comparison highlighted a spectrum of career change processes. At one end, individuals experienced synchronous progressions and regained meaning and control over their career combined with a rather linear status sequence. Conversely, some individuals underwent asynchronous developments consisting of either modest objective steps that instigated meaningful subjective experiences or status stagnation, leading to a loss of control and meaning. These findings underscore the variety of involuntary career change processes and unveil synchronicity as a key temporal element in involuntary career change processes. Implications for research and practice are discussed.
Integrating Climate Change Adaptation, Disaster Risk Reduction, and Social Protection for Enhanced Resilience: Evidence from the Somali Region, Ethiopia
Authors: Kebede Getahun Fenta , Gurmu Belay Womber , Weldegebriel Zerihun Berhane
Published: October 2024

Integrating climate change adaptation, disaster risk reduction, and social protection is crucial for enhancing resilience in vulnerable communities. This study aims to assess the level of integration among these three approaches in the Somali Region, Ethiopia. A qualitative methodology, involving a meta-analysis of 122 projects and program documents was conducted to evaluate the integration levels of the approaches. Key informant interviews and focus group discussions were also used to gather qualitative insights from stakeholders. The findings reveal that the integration of the three approaches, in the form of adaptive social protection, is limited. While social protection and disaster risk reduction are combined more effectively, the inclusion of climate change adaptation remains insufficient. Duplication of activities is common in programs and projects, wasting resources. The study recommends implementing an adaptive social protection approach with clear institutional arrangements and stakeholder coordination to enhance resilience and resource efficiency.
Immunoediting Dynamics in Glioblastoma: Implications for Immunotherapy Approaches
Authors: Amin Tasbir , Hossain Amana , Jerin Nusrat , Mahmud Imteaz , Rahman Md Ahasanur , Rafiqul Islam SM , Islam S M Bakhtiar UL
Published: October 2024

Glioblastoma is an aggressive primary brain tumor that poses many therapeutic difficulties because of the high rate of proliferation, genetic variability, and its immunosuppressive microenvironment. The theory of cancer immunoediting, which includes the phases of elimination, equilibrium, and escape, offers a paradigm for comprehending interactions between the immune system and glioblastoma. Immunoediting indicates the process by which immune cells initially suppress tumor development, but thereafter select for immune-resistant versions leading to tumor escape and progression. The tumor microenvironment (TME) in glioblastoma is particularly immunosuppressive, with regulatory T cells and myeloid-derived suppressor cells being involved in immune escape. To achieve an efficient immunotherapy for glioblastoma, it is crucial to understand these mechanisms within the TME. Existing immunotherapeutic modalities such as chimeric antigen receptor T cells and immune checkpoint inhibitors have been met with some level of resistance because of the heterogeneous nature of the immune response to glioblastoma. Solving these issues is critical to develop novel strategies capable of modulating the TME and re-establishing normal immune monitoring. Further studies should be conducted to identify the molecular and cellular events that underlie the immunosuppressive tumor microenvironment in glioblastoma. Comprehending and modifying the stages of immunoediting in glioblastoma could facilitate the development of more potent and long-lasting therapies.
Fragility analysis of long-span lightweight steel structures subjected to combined earthquake and non-uniform snow loads
Authors: Hou Shiwei , Chen Zhijie , Zhang Hao , Han Junyan , Xu Xiaona
Published: October 2024

Lightweight steel structures are commonly used in industrial facilities due to their low weight, high strength, and excellent performance. The design of these structures for cold regions not only has to consider the effects of earthquakes but also the negative impact of snow loads. Industrial structures often have long spans, and the effects of uneven snow loads cannot be underestimated. However, relatively few studies have focused on the performance of lightweight steel structures under the influence of combined earthquake and non-uniform snow loads. Therefore, this study assessed the seismic fragility of a typical single-span, double-sloped lightweight steel factory under combined earthquake and non-uniform snow loads using incremental dynamic analysis. Non-uniform snow loads, as compared to uniform snow loads, substantially increase the structural displacement responses, thereby increasing the structural failure risk. The improved structural design developed in this study effectively decreases the impact of adverse loading scenarios and enhances the multi-hazard resilience of the structure. Accordingly, these results can serve as an important theoretical guide for enhancing the safety of lightweight steel structures subjected to multiple hazards in cold regions.
Humour and laughter as indicators of meeting leadership style in FOMC meetings
Authors: Andersen Gisle , Langerfeld Christian
Published: October 2024

This study explores the manifestation of meeting leadership styles through humour and laughter in Federal Open Market Committee (FOMC) meetings, focusing on differences across the tenures of Chairs Greenspan, Bernanke and Yellen. Quantitative and qualitative analyses of meeting transcripts from 1987 to 2017 highlight the role of humour. The study explores various functions of laughter and finds that laughter frequency and initiation of laughter differ among the chairs, reflecting their distinct leadership styles. The findings suggest that a more facilitative leadership style is marked by higher frequencies of laughter tokens. This research contributes to understanding the dynamics of meeting leadership and the strategic use of humour in professional settings.
On prison systems
Authors: O’Flaherty Brendan , Sethi Rajiv
Published: October 2024

In The Idea of Prison Abolition, Tommie Shelby evaluates arguments for and against the elimination of incarceration as a mode of punishment. In this article, we discuss and expand upon Shelby's arguments, using two very different systems—those of Norway and the United States—as examples to illustrate some general principles.
Psychology Students’ Experiences of the Objective Structured Clinical Examination as an Assessment of Professional Skills in Psychology
Authors: Sundström Anna E. , Glatz Terese , Hakelind Camilla , Bergbom Sofia , Edlund Sara
Published: October 2024

A challenge for professional psychology programs is the assessment of students’ professional competence. Despite its potential, objective structured clinical examination (OSCE) has not gained widespread use in the psychological field. However, at Umeå University and Örebro University in Sweden, the OSCE has been introduced at the Clinical psychology programs to assess professional competence. The aim of this study was to explore students’ perceptions of whether and how, preparing for and performing the OSCE benefits their professional learning and prepares them for clinical practice. A web-based questionnaire was administered to 88 psychology students who completed the OSCE and field training. Most of the students perceived the OSCE as a valuable experience that benefits their learning. The OSCE prepared them for clinical practice through practical hands-on training, and by providing essential experience in client interaction, increasing students’ confidence in the role as a psychologist. Students also reported that feedback from the OSCE was crucial for their ongoing learning, but that the authenticity of the examination can be improved. Based on these findings, recommendations for future OSCEs in professional psychology include appropriate preparations, providing constructive feedback as well as striving for high authenticity in the tasks of the OSCE stations.
Chemiluminescence Applied to Oxidation of Polyolefins
Authors: Kron Anna , Stenberg Bengt , Reitberger Torbjorn
Published: October 2024

This paper summarises the investigations of chemiluminescence (CL) measurements as a tool to assess the oxidative degradation of polyolefins. Different CL-measurements techniques are described and evaluated. Furthermore, CL-measurement parameters are described, as well as features, problems and implications of the CL-method. The correlation of integrated CL-emission to peroxide concentration in thermally aged polypropylene (PP) has been investigated with special emphasis. Finally, the importance of CL in relation to another luminescent phenomenon, thermoluminescence (TL), has been studied for polyethylene (PE) after ionising irradiation.
Rubber vs Countersurface Frictional Behaviour: How this Influences the Traction of Pneumatic Tyres
Authors: Veith Alan G.
Published: October 2024

The unique frictional behaviour of rubber is responsible for the ability of the pneumatic tyre to generate traction sufficient for vehicle control under a wide range of operational conditions. Unlike hard solids, the coefficient of friction (frictional force/normal force) between rubber and a clean hard countersurface can easily exceed 1.0. Under other conditions, ice near 0 deg C or at certain conditions on a wet highway, the coefficient can be near zero. After a brief survey of basic rubber friction theory, this wide range of traction capability (dry and wet pavements, ice and snow) is explained in terms of four frictional contact characteristics operating in the rubber countersurface interface. The relationship between these four characteristics and the major tyre and external factors that determine traction is established for the various environmental conditions. As with most complex systems, there is substantial interaction for the tyre (design) factors as a group and for tyre factors with external operational factors. The most important of these interactions are reviewed in addition to a discussion of traction capability under adverse or critical conditions where the maximum traction capability is needed.
Cellular uPVC: Principles and Applications
Authors: Thomas N.L.
Published: October 2024

A review is given of the production of rigid PVC foam and its various applications. The principles governing the choice of formulation ingredients and processing conditions are detailed, together with the influence of these variables on foam density and morphology. The effect of foaming on mechanical properties is also discussed.
Swelling Characteristics of Some Natural Rubber Based Elastomers
Authors: Sombatsompop N.
Published: October 2024

This paper outlines the swelling behaviour of natural rubber (NR) vulcanisates. The findings are discussed with respect to the effects of various parameters on swelling behaviour of NR vulcanisates, the parameters including crosslink characteristics (crosslink density and type), penetrant characteristics (shape and size), swelling temperatures, fillers and swelling related mechanical properties. The following are noted: (i) The degree of swelling is strongly dependent on crosslink density i.e. the higher the crosslink density the less is the swelling, (ii) The degree of swelling is also dependent on flexibility and mobility of crosslinks controlled by the type of crosslinks present in the rubber compounds, (iii) The degrees of swelling and deswelling (recovery of swelling) of crosslinked natural rubbers are dependent on penetrant characteristics and swelling temperature. Penetrants with smaller size and more symmetric in shape tend to cause higher degree of swelling, this effect being more pronounced as the swelling temperature is increased, (iv) The degree of swelling of ground flexible polyurethane (PU) filled NR vulcanisates reduces as the reinforcement between the filler and the rubber increases, the reinforcement improving as the particle size and moisture content of the PU filler are reduced. The effect of PU filler added into NR vulcanisates on swelling behaviour is similar to that found in carbon black filled NR vulcanisates, (v) The mechanical properties of the vulcanisates are found to deteriorate during swelling and to recover on the complete deswelling.
Metallic Stearates: A Review of their Function and Use as Release Agents for Rubber Compounds*
Authors: O'Rourke Stephen E. , Morris Richard H.
Published: October 2024

Metallic stearates have a long history of use in the rubber industry as release agents. They have been primarily used tkeeping uncured rubber from sticking to itself. Metallic stearates have also been used as mould release agents for cured rubber. The applications of these products are numerous and many rubber companies have found unique ways to utilise their physical and chemical properties. In this paper we will discuss these products in detail, including the following: chemistry, physical properties, compatibility with elastomers, environmental concerns, and their function as release agents for rubber.

Metallic stearates can be supplied in various forms such as their dry neat state, dispersed in water and alcohol, and formulated with surfactants that provide a wettable grade. These various forms will be discussed as to their function and use in a rubber manufacturing facility.
Cognitive Impairment as A Vulnerability for Exploitation: A Scoping Review
Authors: Lambert Imogen , Wright Nicola , Gardner Alison , Fyson Rachel , Abubakar Aisha , Clawson Rachael
Published: October 2024

Exploitation is a form of abuse that occurs when one person unfairly manipulates another for profit or personal gain. Various individual and social characteristics have the potential to increase an individual’s risk of being exploited. Cognitive impairment is one potential vulnerability factor that has received minimal research attention. This scoping review aimed to investigate cognitive impairment as a factor that may increase an individual’s vulnerability to exploitation. Study inclusion criteria were: (a) empirical studies; (b) studies presenting extractable data related to cognitive impairment and exploitation; (c) studies exploring cognitive impairment as a vulnerability factor for exploitation; (d) studies published after 1998; and (e) studies available in English. A six-step search strategy was employed: (a) electronic searches of bibliographic databases; (b) screening reference lists of included studies; (c) forward citation tracking in Google Scholar; (d) expert recommendations; (e) website searches of relevant Non-Governmental Organizations (NGOs); and (f) a call for evidence. Twenty studies met the inclusion criteria. Three types of exploitation were reported: sexual ( n = 10), financial ( n = 8), and criminal ( n = 2). Intellectual disability ( n = 8) and mental health ( n = 8) were the most frequently described forms of cognitive impairment. The results indicate that cognitive impairment is a factor that increases vulnerability to exploitation. However, the limited number and disparate nature of the studies means that it is impossible to disentangle all the complexities in the relationship between cognitive impairment and exploitation. Further research is needed to understand if cognitive impairment increases vulnerability to all types of exploitation or if it results in varying levels of susceptibility to different types of exploitation.
Parental History of Childhood Maltreatment and Offspring Attachment Insecurity and Disorganization: Two Meta-Analyses
Authors: Sirparanta Aino Elina , Danner Touati Camille , Cyr Chantal , Miljkovitch Raphaële
Published: October 2024

Research findings have shown that parental history of childhood maltreatment (CM) increases the risk of insecure and disorganized attachment in offspring. However, the extent of the detrimental effects of childhood trauma on attachment in the next generation is unclear. The current meta-analyses aimed at synthesizing the available literature on the link between parental history of CM and offspring attachment insecurity and disorganization (with no restriction of offspring age). In total, 25 studies (23 unique samples; N = 2,592) comprising u = 61 effect sizes were included. Offspring age ranged from 12 to 79 months ( Mweighted = 18.69; SDweighted = 11.53). Findings from two three-level random effects meta-analyses revealed a weak but significant combined effect of parental history of CM on child attachment insecurity ( k = 20, u = 35, r = .06) and a non-significant effect on child attachment disorganization ( k = 12, u = 26, r = .03). For the meta-analysis on disorganization, effect sizes were weaker in more recent studies, and trim and fill analyses provided evidence of publication bias. These findings provide a nuanced view of the intergenerational transmission of childhood trauma phenomenon, whereby parents’ self-reported history of CM does not appear decisive for child attachment. Conclusions could not be drawn for specific types of CM because of the small number of studies. Research with more objective measures of parental exposure to CM is needed to gain a more comprehensive view of the possible intergenerational effects of CM on child attachment.
ENVISIONing a critical period to preserve development: communication delays in SCN1A+ dravet syndrome
Authors: Fine Anthony L.
Published: October 2024

[Box: see text]
Thinking (too?) fast and slow: An example of professional judgement and decision making processes in athletics
Authors: Abraham Andy , Collins Dave , Collins Rosie
Published: October 2024

Recently there has been interest in using examining coaching practice through a lens of Professional Judgement and Decision Making. One core theory of decision making, Recognition Primed Decision Making, examines how people make decisions in limited time scales. Alternatively, when time allows, there is an opportunity for people to engage in slower thoughtful and Type 2 judgement and decision making (DM). In both cases it is hypothesised that professional practitioners (coaches) should draw on formalistic scientific rather than substantive heuristics or rules to maintain a professional standard. However, despite these ideas relatively little is known about the actual decision-making behaviour of coaches in practice. Against this premise 12 long jump coaches were asked to identify the strengths and weaknesses of a long jump athlete and offer a view on how they would work to improve his performance. All coaches were asked to identify what they would do if their first approach didn't work. Findings suggest that coaches have an initial tendency to engage in RPD type behaviour but drawing mainly on substantive rules. Notably, uncertainty pushed coaches to become more considered, and formalistic. In conclusion, coaches have the capacity to be ‘professional’ in their DM behaviour but may not use this capacity as the first resort.
An investigation of ransomware incidents in the maritime industry: Exploring the key risk factors
Authors: Soner Omer , Kayisoglu Gizem , Bolat Pelin , Tam Kimberly
Published: October 2024

Ransomware is a subset of malicious cyberattacks that aim to hold an organization’s data or critical infrastructure at ransom, compromising or blocking access. If the attack is public or made public after the initial attack, it can also severely jeopardize an organization’s reputation. Given the direct and immediate impact ransomware attacks can have and the lack of in-depth sharing, additional research is needed to analyze ransomware incidents in order to understand the underlying causes of incidents in addition to the detection and prevention methods. In this paper, 22 public ransomware incidents within the marine industry have been investigated to determine their causal factors and commonalities. To investigate causal factors, DEMATEL (Decision Making Trial and Evaluation Laboratory) and a fuzzy set are used in order to enable an organization to better adhere to operational requirements and cyber risk management strategies to increase cyber resilience against ransomware incidents. The study’s findings highlight the fact that network layer cyber security mitigations, strategies for securely utilizing RDP (Remote Desktop Protocol) protocols, and investments in operating systems (OS) and software security are essential components of preventing future ransomware incidents. This study concludes by suggesting several suitable control and preventative measures to improve system safety.
Staged Creativity and Co-creation of Meanings: The Commodification of Spaces for Cosplay in Japanese Cosplay Culture
Authors: Hu Huichuan
Published: October 2024

Cosplay is a fan culture that involves dressing up as and performing fictional characters from popular media texts. Since the late 2000s, commercial enterprises in Japan have been creating and exploring new places for cosplay, such as rental studios and real-life locations, and marketing them to cosplayers for profit-seeking purposes. Based on fieldwork at cosplay events and rental studios, as well as interviews with staff, cosplayers, and chiefs of companies, I explore and discuss various ways in which spaces for cosplay are commodified in Japan. I argue that part of cosplayers’ creative spatial experience within rental studios and locations is predicted and staged by place providers. Still, cultural meanings are co-created by both cosplayers’ creative agency and place providers’ attempts to control cosplayers’ consumer behaviours. This co-creation is the result of the power dynamics between cosplayer users and place providers, along with the employment of cosplayers’ subcultural and online social capital by place providers. This study contributes to the understanding of how cultural meanings are co-created between cultural organisations and their users. It also broadens critical discussions on the collaboration between corporations and prosumers.
Long-acting muscarinic antagonist and long-acting β2-agonist combination for the treatment of maintenance therapy–naïve patients with chronic obstructive pulmonary disease: a narrative review
Authors: Buhl Roland , Miravitlles Marc , Anzueto Antonio , Brunton Stephen
Published: October 2024

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. Faster lung function impairment occurs earlier in the disease, particularly in mild-to-moderate COPD, highlighting the need for early and effective targeted interventions. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2024 report recommends initial pharmacologic treatment with a long-acting muscarinic antagonist (LAMA) and long-acting β2-agonist (LABA) combination in group B (0 or 1 moderate exacerbation not leading to hospitalization, modified Medical Research Council score of ⩾2, and COPD Assessment Test™ score of ⩾10) and E (⩾2 moderate exacerbations or ⩾1 exacerbation leading to hospitalization and blood eosinophil count <300 cells/µL) patients. In randomized controlled trials (RCTs), LAMA/LABA combination therapy improved lung function, St. George’s Respiratory Questionnaire (SGRQ) total score, and Transitional Dyspnea Index (TDI) focal score and reduced the use of rescue medications, exacerbation risk, and risk of first clinically important deterioration (CID), compared with LAMA or LABA monotherapy. However, there is limited evidence regarding the efficacy and safety of LAMA/LABA combination therapy versus LAMA or LABA monotherapy in maintenance therapy–naïve patients. This review discusses the rationale for the early initiation of LAMA/LABA combination therapy in maintenance therapy–naïve patients with COPD. In post hoc analyses of pooled data from RCTs, compared with LAMA or LABA monotherapy, LAMA/LABA combination therapy improved lung function and quality of life and reduced COPD symptoms, risk of first moderate/severe exacerbation, risk of first CID, and use of rescue medication, with no new safety signals. In a real-world study, patients initiating LAMA/LABA had significantly reduced risk of COPD-related inpatient admissions and rate of on-treatment COPD-related inpatient admissions over 12 months than those initiating LAMA. Consequently, LAMA/LABA combination therapy could be considered the treatment of choice in maintenance therapy–naïve patients with COPD, as recommended by the GOLD 2024 report.
Optimizing the combination of chemotherapeutic drugs along with radiotherapy for extranodal NK/T-cell lymphoma
Authors: Luo Fei , Zhong Qiu-Zi , Liu Xin , Hou Xiao-Rong , Qian Li-Ting , Qiao Xue-Ying , Wang Hua , Zhu Yuan , Cao Jian-Zhong , Wu Jun-Xin , Wu Tao , Zhu Su-Yu , Shi Mei , Zhang Hui-Lai , Zhang Xi-Mei , Su Hang , Song Yu-Qin , Zhu Jun , Zhang Yu-Jing , Huang Hui-Qiang , Wang Ying , He Xia , Zhang Li-Ling , Qu Bao-Lin , Yang Yong , Hu Chen , Deng Min , Wang Shu-Lian , Qi Shu-Nan , Li Ye-Xiong
Published: October 2024

Background:

Extranodal natural killer/T-cell lymphoma (ENKTCL) has a unique treatment principle. However, the optimal combination of drugs along with radiotherapy (RT) is unknown.

Design:

Retrospective cohort study.

Objectives:

We screened multiple drug combinations to identify the most efficacious therapeutic combinations.

Methods:

We reviewed 3105 patients who received 40 chemotherapy regimens with different combinations of 9 drug classes and/or RT. Least absolute shrinkage and selection operator and multivariable Cox regression analyses were used to screen efficacious single drugs and identify optimal combinations for overall survival (OS). Inverse probability of treatment weighting (IPTW) and multivariable analyses were used to compare survival between treatment regimens.

Results:

Screening and validation revealed RT, asparaginase (ASP), and gemcitabine (GEM) to be the most efficacious single modality/drug. RT remained an important component of first-line treatment, whereas ASP was a fundamental drug of non-anthracycline (ANT)-based regimens. Addition of RT to non-ANT-based or ASP/GEM-based regimens, or addition of an ASP-drug into ANT-based or GEM/platinum-based regimens, improved 5-year OS significantly. Use of ASP/GEM-based regimens was associated with significantly higher 5-year OS (79.9%) compared with ASP/ANT-based (69.2%, p = 0.001), ASP/methotrexate-based (63.5%, p = 0.011), or ASP/not otherwise specified-based (63.2%, p < 0.001) regimens. The survival benefit of ASP/GEM-based regimens over other ASP-based regimens was substantial across risk-stratified and advanced-stage subgroups. The survival benefits of a combination of RT, ASP, and GEM were consistent after adjustment for confounding factors by IPTW.

Conclusion:

These results suggest that combining ASP/GEM with RT for ENKTCL is an efficacious and feasible therapeutic option and provides a rationale and strategy for developing combination therapies.
Posterior lower uterine segment caesarean hysterotomy, an innovative surgical technique to avoid classical hysterotomy: Case report and discussion
Authors: Kime Kyungu M , Bazzett-Matabele Lisa , Nassali Mercy N , Hofmeyr G Justus
Published: October 2024

A 40-year-old patient underwent laparotomy at term gestation for a 25-cm lower abdominal mass arising from the lateral wall of the uterus, with an extensive secondary blood supply from the lower uterus and bladder, preventing access to the anterior lower uterine segment. The gravid uterus was exteriorised over the patient’s thighs. A transverse posterior lower uterine segment hysterotomy was performed and a healthy 2920 g baby was delivered. A copper T 380A intrauterine device was placed at the fundus and the insertion tube passed through the cervix for retrieval after the surgery. A Foley catheter uterine tourniquet was applied to allow bloodless excision of the tumour. Histological examination confirmed a leiomyoma with extensive hyalinisation. The few prior reports of posterior lower uterine segment caesarean hysterotomy were mainly for uterine torsion or placenta accreta spectrum. It is useful to be aware of this simple though counter-intuitive approach when faced with technical difficulties.
Personalized messaging enhances hospital debt collection while prosocial appeals fail: Evidence from a field experiment
Authors: Saulitis Andris
Published: October 2024

Objective

This study aimed to understand how different communication strategies influence patients’ behaviour in paying unpaid hospital bills. The research focused on a healthcare system where patients have to pay a significant portion of their medical costs out-of-pocket.

Methods

The research was conducted in collaboration with a debt collection agency in Latvia. The field experiment involved 9196 individuals with unpaid hospital bills. These individuals received randomly assigned reminders through mobile text messages and e-mails. The study compared the effectiveness of personalized messages, which included the recipient's name, with generic reminders and messages that appealed to social norms or public good contributions.

Results

The findings revealed that personalized messages, specifically those that included the recipient's name, significantly improved payment rates compared with generic reminders. Conversely, messages that used social norms or public good appeals did not have a significant impact on payment rates.

Conclusions

The study highlights the importance of personalized communication strategies in improving hospital debt collection. Even simple, cost-effective modifications in communication, like adding the recipient's name, can significantly enhance payment compliance. This approach not only keep the financial books of healthcare providers balanced but also suggests that personalized strategies can be extended to other areas of healthcare management. However, while these findings are promising, they indicate that more personalized and nuanced communication strategies are needed to address the broader issue of unpaid hospital bills effectively.
Perspectives of patients with osteoarthritis for using digital technology in rehabilitation at a public community centre in the Cape Metropole area: A qualitative study
Authors: Prins Gabriela B. , Nizeyimana Eugene , Ernstzen Dawn V. , Louw Quinette A.
Published: October 2024

Objectives

To explore the perspectives of people with osteoarthritis (OA) on the use of digital technology into their rehabilitation program, including their awareness, views on accessibility, affordability and willingness to accept digital modalities for rehabilitation delivery.

Methods

A qualitative, descriptive design was conducted. Patients with OA who receive care at a public community rehabilitation centre in the Western Cape, South Africa were eligible to participants. Semi-structured interviewed were conducted and Atlas.ti 23 software was used for thematic analysis.

Results

The findings showed that the participants had limited awareness and exposure to telerehabilitation (TR), along with minimal digital literacy and skills. They were sceptical about the effectiveness of TR and concerned about the inherent lack of physical interactions with health professionals. However, some acknowledged TR's potential benefits for accessibility, convenience, family involvement and long-term community health improvement. Participants were willing to learn more about TR.

Conclusion

Considering the benefits of TR in lower resource settings such as South Africa, investment to increase awareness and patient education and training in TR may assist in enhancing access and quality of care. Resources dedicated to TR and management buy-in in low-and-middle income countries (LMICs) is necessary to facilitate the fit-for-context roll-out of TR.
Navigating recovery: A qualitative interview study of patients’ experiences of a structured group-based educational programme after transient ischemic attack or minor stroke
Authors: Buus Amanda Agnes Østervig , Christiansen Lene Kjærhauge , Bundgaard Karin
Published: October 2024

Patients with transient ischemic attack (TIA) and minor stroke often struggle with long-term cognitive and psychological difficulties that impact their reintegration into work and leisure activities. The aim of the study was to evaluate the impact of a structured group-based stroke educational (SSGE) programme on patients’ ability to cope with a changed everyday life. Seven semi-structured qualitative interviews were conducted between February and March 2022 and analysed using thematic content analysis. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was applied. The analysis uncovered three themes: ‘the existence of remaining challenges’; ‘the significance of support from resource individuals’; and ‘a sense of safety and confidence derived from the educational programme’. This study provides pivotal knowledge of how the SSGE programme supported patients’ long-term ability to navigate challenges after a TIA or minor stroke. The group-based format facilitated crucial exchanges of experience and knowledge with healthcare professionals and peers. However, the necessity for healthcare professionals to initiate post-support groups were underscored, as patients lacked the physical and mental strength to organise these on their own.
Cranial nerves bridging the middle ear and cerebellum causing cerebellar peduncle abscess: A case report
Authors: Shrestha Prabin , Sandhu Mani Ratnesh S , Jensen Katherine J , Shidoh Satoka , Yamaguchi Satoshi
Published: October 2024

Cerebellar abscess is a reported complication of chronic suppurative otitis media (CSOM) and is life threatening at times. It usually develops by direct spread of CSOM through the bony erosion in the petrous bone or by thrombophlebitis of the sigmoid sinus. However, an alternative pathway of infection transmission from the petrous bone to the cerebellum through the anatomical bridge of the cranial nerves has possibly not been described before. A 63-year-old female patient with CSOM and cholesteatoma developed ataxia and right facial palsy. Computed tomography (CT) showed bone erosion of the right petrous bone suggesting middle ear infection. Post-contrast MRI revealed an enhancement of swollen 7th/8th nerve complex, suggesting neuritis, and cholesteatoma in the right petrous bone. It also showed ring enhancing lesion in the cerebellar peduncle of the same side suggesting brain abscess. Surgical intervention was performed emergently and pus aspirated. She also underwent mastoidectomy and removal of cholesteatoma later by the otolaryngology team and finally got better. This case illustrates that CSOM can cause cerebellar abscess by spreading infection via anatomical bridge of the cranial nerves without direct invasion from the temporal bone or thrombophlebitis of sinus.
Exploring Message Framing's Impact on Parent-Child Communication about Sport-Related Concussions in Youth Sports
Authors: Hartman Daniel E. , Quick Brian
Published: October 2024

Recognizing the pivotal role parents play in shaping their children’s attitudes and behaviors regarding sport-related concussions (SRCs), this study investigates message framing on parents’ intentions to discuss SRCs with their children. More specifically, parents were encouraged to talk to their children about the importance of recognizing SRCs and well as reporting them to their coach. In doing so, one message emphasized the benefits of youth athletes recognizing and reporting SRCs and the other highlighted the barriers. Among 249 parents with a child between the ages of 9 and 15, parents perceived benefits to SRC communication positively predicted communication intentions, while SRC knowledge and barriers had no effect. Knowledge interacted with both barriers and benefits to predict parent communication intentions. The study underscores the importance of carefully crafted messaging promoting parent-child SRC communication, highlighting the need for interventions emphasizing parents to initiate conversations about SRC with their child by highlighting the benefits of child reporting and recognizing SRCs. The results are discussed with an emphasis on the practical implications of these findings with a focus on promotional efforts aimed at parents and youth coaches.