bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of Oral Iron Chelator Deferiprone on Iron Overload and Oxidative Stress in Patients with Myelodysplastic Syndromes: A Study by the Israeli MDS Working Group
Authors: Merkel Drorit , Soffer Shelly , Filanovsky Kalman , Braester Andrei , Fibach Eitan , Dana Mutaz , Ofran Yishai , Greenbaum Uri , Nagler Arnon , Amitai Irina , Mittelman Moshe
Published: December 2023

Background: Most patients with lower risk myelodysplastic neoplasms or syndromes (MDSs) become RBC transfusion-dependent, resulting in iron overload, which is associated with an increased oxidative stress state. Iron-chelation therapy is applied to attenuate the toxic effects of this state. Deferiprone (DFP) is an oral iron chelator, which is not commonly used in this patient population, due to safety concerns, mainly agranulocytosis. The purpose of this study was to assess the effect of DFP, on oxidative stress parameters in iron-overloaded RBC transfusion-dependent patients with lower risk MDSs. Methods: Adult lower risk MDS patients with a cumulative transfusion burden of >20 red blood cell units and evidence of iron overload (serum ferritin >1,000 ng/mL) were included in this study. DFP was administered (100 mg/kg/day) for 4 months. Blood samples for oxidative stress parameters and iron overload parameters were done at baseline and monthly: reactive oxygen species (ROS), phosphatidylserine, reduced glutathione, membrane lipid peroxidation, serum ferritin, and cellular labile iron pool. The primary efficacy variable was ROS. Tolerability and side effects were recorded as well. A paired t test was applied for statistical analyses. Results: Eighteen patients were treated with DFP. ROS significantly decreased in all cell lineages: median decrease of 58.6% in RBC, 33.3% in PMN, and 39.8% in platelets (p < 0.01 for all). Other oxidative stress markers improved: phosphatidylserine decreased by 57.95%, lipid peroxidase decreased by 141.3%, and reduced gluthathione increased by 72.8% (p < 0.01 for all). The iron-overload marker and cellular labile iron pool decreased by 35% in RBCs, 44.3% in PMN, and 46.3% in platelets (p < 0.01 for all). No significant changes were observed in SF levels. There were no events of agranulocytosis. All AEs were grades 1–2. Conclusions: Herein, we showed preliminary evidence that DFP decreases iron-induced oxidative stress in MDS patients with a good tolerability profile (albeit a short follow-up period). No cases of severe neutropenia or agranulocytosis were reported. The future challenge is to prove that reduction in iron toxicity will eventually be translated into a clinically meaningful improvement.
A ética nos serviços de saúde: uma revisão de escopo
Authors: Lopes Priscila Pereira da Silva , Schaefer Rafaela , Domingues Camila Goulart , Berlitz Betina
Published: December 2023

Introdução: a ética nos serviços de saúde compreende os valores institucionais nas práticas de trabalho. Objetivo: caracterizar a produção bibliográfica no tema da ética nos serviços de saúde. Métodos: realizou-se uma revisão de escopo, através dos descritores Ética Profissional, Ética Organizacional e Serviços de Saúde, nas bases LILACS, MEDLINE e IBECS, e os mesmos descritores em inglês na base PubMed. Os critérios foram artigos em inglês, português e espanhol, publicados a partir de 2010, que abordassem o tema da ética nos serviços de saúde. Resultados: foramselecionados 37 estudos e identificadas quatro categorias analíticas: ética organizacional, problemas éticos, comitê de ética e ética profissional. Conclusão: além de órgãos para consultoria e auxílio nos problemas éticos, os aspectos contextuais da instituição e do trabalho são elementos essenciais que devem ser considerados para uma prática profissional ética.
Hospital‐Level Variability in Reporting of Ischemic Stroke Subtypes and Supporting Diagnostic Evaluation in GWTG‐Stroke Registry
Authors: Mullen Michael T. , Gurol M. Edip , Prabhakaran Shyam , Messé Steven R. , Kleindorfer Dawn O. , Smith Eric E. , Fonarow Gregg C. , Xu Haolin , Zhao Xin , Cigarroa Joaquin E. , Schwamm Lee H.
Published: December 2023

Background

Secondary prevention of ischemic stroke (IS) requires adequate diagnostic evaluation to identify the likely etiologic subtype. We describe hospital‐level variability in diagnostic testing and IS subtyping in a large nationwide registry.

Methods and Results

We used the GWTG‐Stroke (Get With The Guidelines–Stroke) registry to identify patients hospitalized with a diagnosis of acute IS at 1906 hospitals between January 1, 2016, and September 30, 2017. We compared the documentation rates and presence of risk factors, diagnostic testing, achievement/quality measures, and outcomes between patients with and without reported IS subtype. Recording of diagnostic evaluation was optional in all IS subtypes except cryptogenic, where it was required. Of 607 563 patients with IS, etiologic IS subtype was documented in 57.4% and missing in 42.6%. Both the rate of missing stroke pathogenesis and the proportion of cryptogenic strokes were highly variable across hospitals. Patients missing stroke pathogenesis less frequently had documentation of risk factors, evidence‐based interventions, or discharge to home. The reported rates of major diagnostic testing, including echocardiography, carotid and intracranial vascular imaging, and short‐term cardiac monitoring were <50% in patients with documented IS pathogenesis, although these variables were missing in >40% of patients. Long‐term cardiac rhythm monitoring was rarely reported, even in cryptogenic stroke.

Conclusions

Reporting of IS etiologic subtype and supporting diagnostic testing was low overall, with high rates of missing optional data. Improvement in the capture of these data elements is needed to identify opportunities for quality improvement in the diagnostic evaluation and secondary prevention of stroke.
The Cross-Shelf Regime of a Wind-Driven Supercritical River Plume
Authors: Yankovsky Elizabeth , Yankovsky Alexander
Published: December 2023

River plumes are a dominant forcing agent in the coastal ocean, transporting tracers and nutrients offshore and interacting with coastal circulation. In this study we characterize the novel “cross-shelf” regime of freshwater river plumes. Rather than remaining coastally trapped (a well-established regime), a wind-driven cross-shelf plume propagates for tens to over 100 km offshore of the river mouth while remaining coherent. We perform a suite of high-resolution idealized numerical experiments that offer insight into how the cross-shelf regime comes about and the parameter space it occupies. The wind-driven shelf flow comprising the geostrophic along-shelf and the Ekman cross-shelf transport advects the plume momentum and precludes geostrophic adjustment within the plume, leading to continuous generation of internal solitons in the offshore and upstream segment of the plume. The solitons propagate into the plume interior, transporting mass within the plume and suppressing plume widening. We examine an additional ultra-high-resolution case that resolves submesoscale dynamics. This case is dynamically consistent with the lower-resolution simulations, but additionally captures vigorous inertial-symmetric instability leading to frontal erosion and lateral mixing. We support these findings with observations of the Winyah Bay plume, where the cross-shelf regime is observed under analogous forcing conditions to the model. The study offers an in-depth introduction to the cross-shelf plume regime and a look into the submesoscale mixing phenomena arising in estuarine plumes.

Significance Statement

In this study, we characterize a novel regime of freshwater river plumes. Rather than spreading near to or along the coast, under certain conditions river plumes may propagate away from the coast and remain coherent for tens to over 100 km offshore. Cross-shelf plumes provide a mechanism by which freshwater and river-borne materials may be transported into the open ocean, especially across wide continental shelves. Such plumes carry nutrients critical for biological productivity offshore and interact with large-scale oceanic features such as the Gulf Stream. We use high-resolution numerical modeling to examine how the cross-shelf regime arises and support our findings with observational evidence. We also study the mixing phenomena and fluid instabilities evolving within such plumes.
Collective Self-Control as a Feature of Social Contexts: Theoretical Arguments and a Multilevel Empirical Test
Authors: Hay Carter , Forrest Walter , Stults Brian , Meldrum Ryan , Kirkpatrick Brennan
Published: December 2023

Objectives: We draw from prior theory and research to advance theoretical arguments for how self-control may operate as a collective concept in addition to being a powerful individual quality. Next, we empirically examine hypotheses regarding the potential effects of collective self-control on offending. Methods: We use data from the 2018 Florida Youth Substance Abuse Survey, a statewide survey of Florida middle school and high school students nested within more than 400 schools. Hierarchical Linear Modeling was used to estimate effects of individual- and school-level self-control on substance use and delinquency. Results: Variation in self-control is primarily between individuals rather than between schools, but a statistically significant amount of school-level variation was observed. Moreover, school low self-control was significantly related to substance use and delinquency, and school low self-control amplified the effects of individual low self-control. Conclusions: Self-control is a critical individual-level quality, but a unique contribution also comes from a collective-level conceptualization that considers that social groups and contexts vary in how much they promote the use of self-control.
Industry-Level Learning-by-Doing Rates and Corporate Development Activities
Authors: Ryu Wonsang , McCann Brian T.
Published: December 2023

Information economics and transaction cost economics are two prominent theoretical perspectives used by scholars to understand firms’ corporate development choices. Our study highlights the interplay of these two theories by examining how industry-level learning-by-doing (LBD) rates affect firms’ choices related to acquisitions and alliances. An industry LBD rate reflects the extent to which performance is dependent on own production experience. We argue that this rate also reflects the nature of knowledge in an industry: the higher the LBD rate, the more knowledge is created by own production experience and deeply embedded within routines in the industry. We explain how this suggests that while higher LBD rates might aggravate the overpayment risks emphasized by information economics, they might mitigate the misappropriation risks highlighted by transaction cost economics. We examine how these opposing effects can lead to complementary or opposing predictions about the relationship of LBD rates to several transaction decisions, including the likelihood of any transaction regardless of form, whether transactions that occur are more or less likely to be structured as acquisitions or alliances, and whether alliances that occur are more or less likely to be structured as joint ventures and with limited functional scope.
The populist critique of ‘Corrupted’ representative claim making
Authors: Jenkins David
Published: December 2023

Populism sets people against elites. Most discussions of populism focus on the dangers that come with assuming too homogenous a vision of a ‘pure’ people against a ‘corrupt’ elite. However, an obvious question to ask is what elites do, or might do, to court populists ire. In this paper, I draw on Michael Saward’s work on representation to construct an account of populism that focuses on the ways in which elites can conceivably corrupt (and have conceivably corrupted) the institutions responsible for generating the representative claims that are central to democratic life. Specifically, I will sketch an account of the way elites have operated, within the American context, to corrupt the representative functions performed by political parties, those centrally important institutions tasked with producing representative claims within contemporary capitalist, liberal, representative democracies. If we are to properly evaluate populism, whether as an ideology, movement or set of tactics, it is necessary to take seriously and evaluate the stories populists tell of how elites have corrupted democracy. To simply assume they are wrong and dismiss populist critiques of democratic failures as wrong is to replace critical analysis with elite apologism.
Active collision avoidance for teleoperated multi-segment continuum robots toward minimally invasive surgery
Authors: Li Jianhua , Li Dingjia , Wang Chongyang , Guo Wei , Wang Zhidong , Zhang Zhongtao , Liu Hao
Published: December 2023

Collision avoidance presents a challenging problem for multi-segment continuum robots owing to their flexible structure, limited workspaces, and restricted visual feedback, particularly when they are used in teleoperated minimally invasive surgery. This study proposes a comprehensive control framework that allows these continuum robots to automatically avoid collision and self-collision without interfering with the surgeon’s control of the end effector’s movement. The framework implements the early detection of collisions and active avoidance strategies by expressing the body geometry of the multi-segment continuum robot and the differential kinematics of any cross-section using screw theory. With the robot’s parameterized shape and selected checkpoints on the obstacle’s surface, we can determine the minimum distance between the robot and arbitrary obstacle, and locate the nearest point on the robot. Furthermore, we expand the null-space-based control method to accommodate redundant, non-redundant, and multiple continuum robots. An assessment of the avoidance capability is provided through an instantaneous and global criterion based on ellipsoids and possible movement ranges. Simulations and physical experiments involving continuum robots of different degrees of freedom performing various tasks were conducted to thoroughly validate the proposed framework. The results demonstrated its feasibility and effectiveness in minimizing the risk of collisions while maintaining the surgeon’s control over the end effector.
“I Want to Grow Older With Dignity”: Older LGBTQ+ Canadian Adults’ Perceptions and Experiences of Aging
Authors: Hurd Laura , Li Lynda Y. K.
Published: December 2023

The number of older LGBTQ+ adults is growing worldwide. Yet few studies outside of the United States have examined their experiences of aging. Drawing on the Health Equity Promotion Model and contextualized in Canada’s unique socio-political history, our study used multiple, in-depth, qualitative interviews to examine 30 older Canadian LGBTQ+ adults’ (aged 65–83) perceptions and experiences of growing older. Our descriptive thematic analysis identified three overarching categories: “Losses,” “gains,” and “needs.” Losses referred to the changes in the participants’ health, autonomy, and relationships that had occurred with age. Gains entailed positive later life changes, including increased wisdom, flexibility, and social connections. Finally, needs referred to those things that the participants deemed essential for aging well, namely, inclusive health care, meaningful activities, and supportive networks. We discuss the policy and practice implications of our findings for the fostering of health, well-being, and social inclusion amongst this often-marginalized population.
The complexity of the pursuit of happiness is associated with the success of well-being related behaviors in everyday life
Authors: Krasko Julia , Intelisano Sabrina , Luhmann Maike
Published: December 2023

Can people choose to be happy? To date we have no definite answer to this very old question. In this paper, we introduced and tested a new theoretical model of the pursuit of happiness in which we integrated individual happiness definitions, happiness-related intentions, and happiness-enhancing activities. Further, we tested different characteristics of happiness-enhancing activities that have previously been discussed in the literature as potentially relevant for the successful pursuit of happiness: the breadth (i.e., how many different facets of happiness are positively affected by one single activity), variety (i.e., how many different happiness-enhancing activities people conduct in daily life), and frequency (i.e., overall number) of happiness-enhancing activities. The results of an experience sampling study ( N = 473; 2815 daily-level data points) support our preregistered hypotheses: Individual definitions of happiness were predictive of intentions and well-being related behaviors in everyday life. Further, the engagement in broader and a higher number of happiness-enhancing activities was associated with higher levels of daily well-being. The variety of happiness-enhancing activities, however, did not predict daily well-being. Overall, we demonstrated that defining and pursuing happiness in a multifaceted manner is related to higher levels of well-being.
Post-operative interventional radiotherapy (brachytherapy) in advanced ocular surface and eyelid tumors as an alternative to surgical retreatment
Authors: Cuffaro Giovanni , Fionda Bruno , Piccinni Fabrizio , Pagliara Monica Maria , Sammarco Maria Grazia , Blasi Maria Antonietta , Molinario Clelia , Castri Federica , Tagliaferri Luca , Massi Daniela , Savino Gustavo
Published: December 2023

Purpose

The main purpose of treatment of advanced ocular surface and periocular malignant tumors is to eradicate the tumor while trying to preserve visual function and aesthetics. Our purpose is to describe the outcome of a retrospective case series of 10 patients with advanced ocular surface and periocular tumors treated surgically in first instance and then with postoperative interventional radiotherapy (IRT/Brachiterapy).

Materials and Methods

We describe the clinicopathological features, treatments and outcome, in a retrospective case series of 10 patients with advanced tumors involving ocular surface (staging ≥ T2) and eyelids (staging ≥ T3), with involvement of periocular and/or orbit tissues. Patients were first surgically treated, most of them with incomplete excision, and then underwent a post-operative interventional radiotherapy (IRT/Brachytherapy) as an alternative to more invasive and disfiguring surgical retreatment. Tumor location, risk factors, staging, histological features, and follow-up timing were analyzed.

Results

Three patients had advanced eyelid basal cell carcinomas, 2 patients were diagnosed with eyelid and conjunctival squamous cell carcinomas, 3 as sebaceous carcinomas, and 2 as primary conjunctival melanomas. The mean follow-up time from IRT to last clinical follow-up was 58.6 weeks, range 28.4–168 (median 43.65, IQR 28.9–72.9). Two patients - one with ocular surface SCC, the other with conjunctival melanoma - had a local recurrence 23.4 and 40,9 weeks after IRT, respectively. An overview of the current knowledge on adjuvant or post-operative IRT is also provided.

Conclusions

IRT can be considered an effective therapeutic option to avoid more invasive surgical retreatment in advanced tumors involving eyelids and ocular surface.
Missing a beam in thine own eye: Motivated perceptions of collective narcissism
Authors: Baba Justyna , Cichocka Aleksandra , Cislak Aleksandra
Published: December 2023

This work examines lay beliefs about the societal implications of different forms of ingroup identity. While secure ingroup identity reflects a genuine attachment to one’s ingroup members, defensive forms of identity are aimed at satisfying individual enhancement motives through highlighting belongingness to an exceptional group. The latter can be exemplified by collective narcissism, a belief in ingroup greatness and entitlement to privileged treatment, which has been linked to undesirable intra- and intergroup outcomes. In three experiments (total N = 473), conducted in the context of national identities, we investigated how people perceive the manifestations of collective narcissism, contrasted with secure ingroup identity and low identity. Across all studies, participants expected the highest outgroup hostility and poorest intragroup relations from those high in collective narcissism. However, perceivers who were themselves high in collective narcissism were less likely to expect these undesirable manifestations, thus revealing a biased perception of similar others.
Oncological Applications of Quantum Machine Learning
Authors: Rahimi Milad , Asadi Farkhondeh
Published: December 2023

Background: Cancer is a leading cause of death worldwide. Machine learning (ML) and quantum computers (QCs) have recently advanced significantly. Numerous studies have examined the application of quantum machine learning (QML) in healthcare and validated its superiority over classical ML algorithms. Objectives: This review investigates and reports the oncological applications of QML. Methods: In March 2023, an electronic investigation of PubMed, Scopus, Web of Science, IEEE, and Cochrane databases was performed. The articles were screened based on titles and abstracts, and their full texts were examined. Results: Initially, a total of 207 articles were retrieved. Thereafter, 9 articles were included in the study, most of which were published from 2020 onwards. The results indicated the implementation of various QML techniques in different aspects of oncology, such as reducing mammography image noise, edge detection of breast cancer, clinical decision support in radiotherapy treatment, and cancer classification. Conclusion: These studies revealed that integrating quantum science with ML can significantly improve patient care and clinical outcomes. Future studies should explore the integration of QC and ML and the development of novel algorithms to enhance cancer prognosis, diagnosis, and treatment planning.
Current Controversy and Developments Regarding the Cytoreductive Prostatectomy for Oligometastatic Prostate Cancer
Authors: Tian Yuan , Mao Yifeng , Tang Zhizhong , Hu Mingqiu
Published: December 2023

Oligometastatic prostate cancer is a term that is most often used to refer to limited sites of disseminated tumor growth following primary radical prostatectomy (RP) or radiotherapy (RT), while de novo oligometastatic is a term that is used to refer to prostate tumors that have disseminated to limited sites before definitive treatment. In patients with de novo oligometastatic prostate cancer, treatment planning must thus consider the need to manage the primary tumor and the associated distant lesions. Traditionally, resectioning primary metastatic tumors is not thought to offer significant benefits to affected patients while increasing their risk of surgery-related complications. Recent clinical evidence indicates that patients undergoing cytoreductive prostatectomy (CRP) may observe substantial enhancements in overall survival rates while not experiencing a noticeable decline in their quality of life. Nevertheless, based on the current body of evidence, it is deemed inadequate to justify revising clinical guidelines. Consequently, it is not advisable to propose CRP for patients with oligometastatic prostate cancer. The present review was compiled to summarize available data regarding the indications, functional outcomes, and oncological outcomes associated with cytoreductive radical prostatectomy to provide a robust and objective foundation that can be used to better assess the value of this interventional strategy from a clinical perspective.
Revised concept of rete-like collateral formation: Rete mirabile does not exist in humans
Authors: Ota Takahiro
Published: December 2023

The carotid rete is a physiological network between the external and internal carotid arteries (ICA) in lower vertebrates. However, true carotid rete does not exist in humans. This review aimed to contrast the physiological function of human “rete-like collaterals” with that of lower vertebrate “ rete mirabile”. An explanation for the development of rete-like collaterals in human intracranial arteries was also discussed. The rete mirabile (carotid, vertebral, spinal, and thoracic) in lower vertebrates has a specific physiological role and does not form vasculature for the same purpose in humans. Therefore, the term “ rete mirabile” should not be used for cases reported in humans. Instead, “rete-like collaterals” is preferred. In the literature, rete-like or arterial anastomosis was observed in the ICA cavernous portion and the intradural arteries. Based on the hypothesis of the segmental concept, it applies to the ICA and intracranial arteries. Whether in the ICA, middle cerebral artery, posterior cerebral artery, or posterior inferior cerebellar artery, the segmental concept is the same and should be considered to have formed secondary collaterals after segmental regress or dysgenesis of affected arteries. Summarily, the significance of this review lies in its reevaluation of vascular structures previously described as “carotid rete” in humans to a true and preferred term, “rete-like collaterals”. It also provides insights into the historical context and potential genetic factors associated with the formation of arteries in humans, contributing to a better understanding of human vascular anatomy.
Effectiveness of the preventive administration of vasoactive amines in counterbalancing significant patient blood pressure drops following nimodipine administration during mechanical thrombectomy procedures
Authors: Bernava Gianmarco , Tesoro Rosa , Boto José , Challita Myriam , Rosi Andrea , Hofmeister Jeremy , Yilmaz Hasan , Carrera Emmanuel , Brina Olivier , Reymond Philippe , Muster Michel , Kulcsar Zsolt , Lovblad Karl-Olof , Machi Paolo
Published: December 2023

Background

Focal vasospasm (FV) of the occluded vessel can occur during the endovascular treatment of acute ischemic stroke (AIS). Nimodipine is commonly used to treat vasospasm and can play a role in distinguishing it from artery narrowing due to iatrogenic dissection or residual clot. However, nimodipine administration can result in arterial hypotension and subsequent enlargement of the ischemic core.

Objective

To assess the efficacy of preventive and continuous vasoactive amine infusion to counterbalance nimodipine-induced hypotension.

Methods

We reviewed data from a prospective registry of patients treated for AIS between January 2019 and January 2022 who were administered nimodipine. All patients were equipped with an arterial cannula for invasive blood pressure measurement and given vasoactive amines preemptively before general anesthesia and throughout the procedure. Data obtained from invasive monitoring of mean arterial blood pressure (MABP) in a time-lapse of 25 min before and after nimodipine administration were analyzed.

Results

MABP significantly decreased after nimodipine administration but remained within the recommended range (81.79 ± 0.49 mmHg). Nimodipine was effective in reducing FV caused by stent retriever passage in 76.3% of cases. Furthermore, it proved valuable in diagnosing iatrogenic dissection (9.2%), residual clot (10.5%), or intracranial stenosis (4%).

Conclusions

Infusion of vasoactive amines effectively counteracted the intraarterial nimodipine effect, thus avoiding frank arterial hypotension during endovascular treatment. Nimodipine has been useful in differentiating the diagnosis of FV resulting from mechanical thrombectomy and other potential causes, such as iatrogenic dissection or residual clot.
Thriving Amidst the Pandemic: Teaching Gifted Students Online and the Role of Adaptation and Innovation
Authors: McCormick Kimberly M. , Guilbault Keri M.
Published: December 2023

During the COVID-19 pandemic, schools across the globe shifted to emergency remote instruction. This mixed methods study explored gifted education teachers’ experiences and perspectives regarding remote instruction during the first year of the pandemic. Technology training, preparation in gifted education pedagogy, and teachers’ perceptions of their effectiveness during remote instruction were examined. Qualitative and quantitative data were collected from 310 teachers across 31 states using an online survey and focus groups. Results revealed that teachers augmented traditional instruction to include strategies that facilitated student interaction, enrichment opportunities, timely feedback, and social and emotional curriculum. Teachers who reported receiving sufficient technology training felt better able to integrate creativity into their virtual lessons. Two major themes emerged describing how educators optimized their teaching practices: (a) 24/7 Learning Environment and (b) Personalization. Recommendations include the need for continued professional learning for administrators and educators to advance remote learning for gifted learners.
Bots Versus Humans: Discursive Activism During the Pandemic in the Iranian Twittersphere
Authors: Kermani Hossein , Bayat Makou Alireza , Tafreshi Amirali , Mohamad Ghodsi Amir , Ataee Homa
Published: December 2023

This article explores how the pandemic in Iran was discursively framed by automated accounts and human users. While there is a growing body of literature on bot activism, little is known about how bots and humans framed the pandemic in authoritarian regimes. Drawing on networked framing theory, we use both computational and qualitative methods to fill this gap. Our empirical analysis centers on a data set of 4,165,177 tweets collected between 27 January 2020 and 18 April 2020. We found that while anti-regime human users strongly criticized Iran’s regime, pro-regime bots countered with messages emphasizing the sacrifices of medical staff, the strength of Iran, and the failings of Western governments in managing the crisis. Our results suggest that Persian Twitter human users were largely against the regime, while the regime employed bots extensively to maintain balance. Human users used sarcasm, while pro-regime bots invoked religious and revolutionary sentiments metaphorically to defend the regime. By focusing on a relatively unexplored context, this article adds to the growing literature on bot activism.
Educational Improvement Science: The Art of the Improving Organization
Authors: Li (李军) Jun
Published: December 2023

Purpose

To advocate educational improvement science (EIS) as an emerging transdisciplinary field, I reflect on the three major pathways of educational advancement in human history, discern the misuses and pitfalls of reform, and theorize how education can be improved to better serve its mission.

Design/Approach/Methods

Employing a multiperspectival approach, I critically re-examine educational reforms and improvements worldwide and conceptualize the emerging transdisciplinary field through an extensive literature review, etymological analysis, international comparisons, and socio-historical, -cultural and -philosophical reflections.

Findings

In this paper, I advance the concept of neo-improvementalism for EIS by elucidating its philosophical assumptions, disciplinary fundamentals, and theoretical frameworks through historical and comparative lenses. I identify and construct disciplinary knowledge of EIS comprising two categories, namely, subject matter knowledge and profound knowledge, adopted from improvement science. I then highlight three methodological approaches of EIS and the building of professional improvement communities empowering individual and institutional improvement capabilities. I propose that EIS is the art of the improving organization for classes, schools, and/or more broadly defined educational agencies.

Originality/Value

This study recognizes the significance of EIS and research thereon, especially discipline-building and exploration based on local characteristics in a global vision, and the cultivation of new frontiers of educational research and practices.
A Cross-Cultural Study on the Role of Message Framing in the Promotion of Fair-Trade Buying Behavior
Authors: Phan The Anh , Nguyen Pham Ngoc Quyen , Pham Ngoc Anh , Phan Nhan
Published: December 2023

This cross-cultural study investigates the differential effects of message framing techniques in promoting fair-trade consumption between Eastern and Western cultures. A total of 414 Vietnamese participants from Vietnam and 342 American participants recruited through Amazon Mechanical Turk were randomly assigned to two message framing conditions. It emphasizes the interconnected nature of fair-trade consumption behavior, influenced by message framing, processing fluency, and justice restoration effectiveness. The findings provide practical insights for marketers in effectively engaging consumers in purchasing fair-trade products. This study contributes to the literature by illuminating the impact of message framing strategies on consumer behavior toward fair-trade products in different cultural contexts. Marketers can leverage cultural orientations and message processing styles to develop more effective communication strategies for promoting fair-trade product adoption. Specifically, loss-framed messages may be more persuasive in increasing purchase intention among Vietnamese consumers, while gain-framed messages may resonate better with American consumers. Additionally, messages emphasizing the positive outcomes and benefits of fair-trade products for farmers and producers can enhance consumers’ likelihood of purchasing such products.
Prevalence & Risk Factors for Perinatal Stroke: A Population-Based Study
Authors: Roy Bithi , Webb Annabel , Walker Karen , Morgan Catherine , Badawi Nadia , Nunez Carlos , Eslick Guy , Kent Alison L , Hunt Rod W , Mackay Mark T , Novak Iona
Published: December 2023

Objectives

The study objective was to calculate the birth prevalence of perinatal stroke and examine risk factors in term infants. Some risk factors are present in healthy infants, making it difficult to determine at-risk infants.

Study Design

Prospective population-based perinatal stroke data were compared to the Australian general population data using chi-squared and Fisher's exact tests and multivariable logistic regression analysis.

Results

Sixty perinatal stroke cases were reported between 2017 and 2019. Estimated stroke prevalence was 9.6/100,000 live births/year including 5.8 for neonatal arterial ischemic stroke and 2.9 for neonatal hemorrhagic stroke. Eighty seven percent had multiple risk factors. Significant risk factors were cesarean section ( p = 0.04), 5-min Apgar score <7 ( p < 0.01), neonatal resuscitation ( p < 0.01) and nulliparity ( p < 0.01).

Conclusions

Statistically significant independent risk factors do not fully explain the cause of perinatal stroke, because they are not a direct causal pathway to stroke. These data now require validation in a case-control study.
Prevalence of Cesarean Section Among Nurses: Predictors and Effect on Exclusive Breastfeeding
Authors: Alhassan Abdul Rauf
Published: December 2023

Introduction

The prevalence of cesarean sections (CSs) in both industrialized and developing nations is a significant issue for public health officials, particularly in light of the knowledge of their socioeconomic underlying determinants.

Objective

To ascertain the prevalence of CS delivery among nurses, their predictors, and the effect it has on exclusive breastfeeding practice in Tamale, Ghana.

Methods

This study used a quantitative technique and an analytical cross-sectional design. Data analysis was done using Statistical Package for the Social Sciences, and variable associations and predictions were identified using chi-square and logistics regression analysis.

Results

There were 326 fully completed and returned questionnaires; the majority (40.0%) of respondents were registered general nurses (RGN). The majority of respondents (56.0%) were between the ages of 31 and 40. The prevalence rate of CS delivery was 21.1%. Predictor variables were; Community health nurses/RGN (adjusted odds ratio [AOR] = 3.7, 95% confidence interval [CI] = 1.2–11.0), and second degree/first degree level of educational attainment (AOR = 36.0, 95% CI = 2.4–528.9). The effects of CS delivery on exclusive breastfeeding were; low confidence to exclusively breastfeed, opting to combine both breastfeeding and artificial feeding, and less likely to practice exclusive breastfeeding.

Conclusion

Even though CSs and exclusive breastfeeding practices are both problems facing nurses, CSs seem to compound the problem of exclusive breastfeeding among nurses.
Career Regret and Health-Related Quality of Life among Medical Students: A Nationwide Cross-Sectional Study in Jordan
Authors: Khanfar Asim N. , Alshrouf Mohammad A. , Albandi Alaa M. , Odeh Qusai B. , Hammad Nouran H. , Abu Jbara Fahed Khaled , AlRyalat Saif Aldeen
Published: December 2023

OBJECTIVES

Medical students have a lower quality of life (QoL) when compared to the general population. This lower QoL is associated with multiple factors such as burnout and depressive symptoms. QoL can be reflected in the degree of career satisfaction and career regret. We aim to study the prevalence of career regret in Jordanian medical students and its association with QoL and other related factors

METHODS

This national cross-sectional study consisted of an anonymous online survey distributed to medical students enrolled in all six Jordanian medical schools over a period of 6 weeks. A validated tool was used to assess QoL and students were asked a series of questions related to their career satisfaction and career regret.

RESULTS

A total of 544 medical students completed the survey. The mean age was 21.5 ± 1.63 years (range 17-29), with 45.6% being males. The overall mean physical health score was 45.9 ± 5.17, and the overall mean mental health score (mental component summary (MCS)) was 42.04 ± 5.52. 76.3% of students have regretted studying medicine, citing stress as the main reason. There was a significant relation between the year of study and the percentage of career regret. Additionally, mean MCS was significantly lower in students who were frequently or always thinking about dropping out of medical school.

DISCUSSION

The high percentage of career regret and the low mental QoL in Jordanian students are alarming findings, highlighting an underlying source of psychological distress in Jordanians. This calls for further investigations into the psychological health of medical students, as well as interventions to prevent the development of consequences that can impact both students and their future patients.
Material flows as Earth politics: Concepts, methods, and approaches for transdisciplinary diagnostics and repair at Muizenberg East, Cape Town
Authors: Green Lesley
Published: December 2023

Muizenberg East, in Cape Town, South Africa, is a peri-urban landscape that encompasses sewage works, tourist beaches, a nature reserve, a waste dump, a Ramsar site for the protection of migrating birds, shack settlements, and a corporate office park. The complex and contradictory uses of this land demonstrate the limitations of social-ecological analysis and ecosystem service approaches to environmental governance. Mapping contemporary struggles over food, housing, aquifer contamination, air pollution, conservation space, safety, and farmland, the study proposes that a new materialist approach combining emerging transdisciplinary fields that focus on material flows and metabolism offers a big-picture science for landscape diagnostics and repair. It is argued that the Earth processes such as metabolism, thermodynamics, and flow offer an integrative basis for environmental governance based on partnerships with Earth processes. Such a constitutional shift in approaches to local governance offers the possibility of amplifying habitability without inserting new modes of profit-taking into the web of life.
Depression and Global Mental Health in the Global South: A Critical Analysis of Policy and Discourse
Authors: Limenih Gojjam , MacDougall Arlene , Wedlake Marnie , Nouvet Elysee
Published: December 2023

Over the past two decades, depression has become a prominent global public health concern, especially in low- and middle-income countries (LMICs). The World Health Organization (WHO) and the Movement for Global Mental Health have developed international guidelines to improve mental health services globally, prioritizing LMICs. These efforts hold promise for advancing care and treatment for depression and other mental, neurological, and substance abuse disorders in LMICs. The intervention guides, such as the WHO's mhGAP-Intervention Guides, are evidence-based tools and guidelines to help detect, diagnose, and manage the most common mental disorders. Using the Global South as an empirical site, this article draws on Foucauldian critical discourse and document analysis methods to explore how these international intervention guides operate as part of knowledge-power processes that inscribe and materialize in the world in some forms rather than others. It is proposed that these international guidelines shape the global discourse about depression through their (re)production of biopolitical assumptions and impacts, governmentality, and “conditions of possibility.” The article uses empirical data to show nuance, complexity, and multi-dimensionality where binary thinking sometimes dominates, and to make links across arguments for and against global mental health. The article concludes by identifying several resistive discourses and suggesting reconceptualizing the treatment gap for common mental disorders.
Promotion of nutritional behaviors in the prevention of cardiovascular diseases: application of the health belief model in primary health care centers
Authors: Midjani Nasrin , Hossaini Fatemeh Alsadat , Sharifi Nader
Published: December 2023

Background

Cardiovascular diseases (CVD) are the most important cause of death in many countries of the world, including Iran. This study aimed to investigate the effect of educational intervention based on the Health Belief Model (HBM) on the promotion of nutritional behaviors to prevent CVD among the all people (aged 30–59 years).

Methods

This semi-experimental study was conducted on all people (aged 30–59 years) referring to the primary healthcare centers of Jahorm city, southern Iran, from September 2021 to July 2022. In this study, 100 participants (50 participants for the intervention group and 50 for the control group) were selected using a multistage cluster random sampling method. The data collection tool was a questionnaire with confirmed validity and reliability. Also, the food consumption frequency checklist was used. The educational intervention included holding four sessions, each lasting for 60 min. The methods used for training included lectures, questions and answers, and group discussions. Before the intervention and three months after, the intervention and control groups completed the questionnaire. The obtained data were analyzed by SPSS 17.

Results

after the educational intervention, the mean score of knowledge (4.84 ± 0.84; 2.76 ± 1.41; p < 0.001), perceived susceptibility (9.52 ± 1.81; 8.76 ± 1.9; p = 0.004), perceived severity (14.78 ± 1.66; 13.80 ± 2.23; p = 0.015), perceived benefits (10.66 ± 1.79; 7.52 ± 1.99; p < 0.001), perceived barriers (5.92 ± 2.81; 12.68 ± 10.24; p < 0.001) and practice (178.78 ± 14.35; 147.36 ± 13.19; p < 0.001) showed a significant difference between the intervention and control groups.

Conclusion

The results showed that the educational intervention effectively improved people (aged 30–59 years) knowledge and HBM constructs to prevent CVD. Also, improving people’s performance regarding CVD prevention behaviors will be successful by implementing an educational intervention based on the HBM.
Epidemiology and factors associated with preterm births in multiple pregnancy: a retrospective cohort study
Authors: Seetho Samita , Kongwattanakul Kiattisak , Saksiriwuttho Piyamas , Thepsuthammarat Kaewjai
Published: December 2023

Objective

Multiple pregnancies carry an increased risk of maternal and perinatal complications, notably prematurity. Few studies have evaluated the risk factors for preterm births in multiple pregnancies within the Thai population. This study aims to ascertain maternal and perinatal outcomes and identify factors linked to preterm births in multiple pregnancies.

Methods

This study was carried out at Khon Kaen University, Faculty of Medicine, Department of Obstetrics and Gynecology in Thailand. We reviewed the medical records of women with multiple pregnancies who delivered at a gestational age of more than 20 weeks between January 1, 2012 and December 31, 2021. We excluded patients with incomplete data or those for whom data were missing.

Results

Out of 21,400 pregnancies, 427 were multiple pregnancies, constituting approximately 1.99%. Over the ten-year period, 269 multiple pregnancies (65.1%) resulted in preterm births. Of these, 173 (64.3%) were monochorionic twins, and 96 (35.7%) were dichorionic twins. Monochorionic twins had a notably higher rate of preterm delivery (AOR, 2.06; 95%CI 1.29—3.30). Vaginal delivery was observed in 7.9% of the cases, while cesarean sections were performed for both twins in 91.5% of cases. In 0.5% of the cases, only the second twin was delivered by cesarean section. In terms of neonatal outcomes, 160 infants (19.4%) weighed less than 1,500 g at birth, and there were 78 perinatal deaths (9.4%). Birth asphyxia was noted in 97 cases (20.2%) among monochorionic twins and in 28 cases (8.1%) for dichorionic twins.

Conclusion

The prevalence of multiple pregnancies was 1.99%, with 65.1% resulting in preterm births. Neonatal complications were notably more frequent in monochorionic twins. Monochorionic placenta and antepartum complications emerged as significant risk factors for preterm birth.
Safety and feasibility of ultra-long construct navigated minimally invasive spine surgery with adjuvant radiotherapy in extensive spinal metastasis : a comparative analysis
Authors: Santipas Borriwat , Ruangchainikom Monchai , Wilartratsami Sirichai , Jiamamornrat Supachat , Panatreswas Nhathita , Luksanapruksa Panya
Published: December 2023

Background

Our study compares the outcomes of extensive spinal metastasis patients treated with Ultra-Long Construct Navigated Minimally Invasive Spine Surgery (UNMISS) with Adjuvant Radiotherapy to those receiving only radiotherapy. Spinal metastasis often necessitates interventions like radiotherapy, chemotherapy, or surgery, with an increasing trend towards surgical management. minimally invasive spine surgery has demonstrated advantages over traditional open surgery, with fewer complications and better postoperative outcomes. Radiotherapy continues as a standard for those unsuitable for surgery.

Methods

This retrospective study included extensive spinal metastasis patients treated between January 2017 and December 2020. We compared patients undergoing UNMISS in conjunction with radiotherapy to patients receiving radiotherapy alone, evaluating demographic data, disease characteristics, and treatment outcomes (VAS, survival) to establish statistical significance.

Results

Twenty-three patients were included in our study. Fourteen patients underwent UNMISS, and nine patients received radiotherapy alone. There was no difference in baseline characteristics of patients. The longest construct in our case series involved T1 to iliac. Both cohorts showed significant improvement in pain scores post-treatment (p = 0.01). However, the UNMISS group demonstrated significantly lower post-treatment VAS scores (p = 0.003), indicating enhanced pain relief. Survival outcomes did not differ significantly between the two groups.

Conclusion

The UNMISS should be considered as an alternative treatment in a patient with symptomatic extensive spinal metastasis. The primary goal of this technique is to stabilize the multiple levels of spinal metastasis and decompression of the neural element if needed. This technique is safe and has a better outcome in pain improvement than the patient who received radiotherapy alone.