bluuebunny/crossref_metadata_2025 huggingface dataset:
‘Social Science Teacher? Anyone Can Become’: Examining Professional Subject Identity of Social Science Teachers in India
Authors: Subramanian Indira
Published: May 2024

Teacher identity can serve as an important lens to examine the way teachers traverse the various demands made of them by policymakers and stakeholders in the school system, with their own perspectives of self and their work. Official narratives and curriculum documents lead to the construction of a public identity and what it means to be a ‘good teacher’ in a broad and generic sense. However, much less attention is paid to teachers’ biographical accounts of their professional identity, from a stance as practitioners of a specific subject, and their lived experiences, thereof. This article reports on a qualitative study undertaken as a pilot project for a doctoral dissertation, where six social science teachers from Mumbai and Bangalore, participated in three online focus group discussions. The framework used to analyse the data is Goffman’s dramaturgical theory of impression management. Findings reveal that social science teachers present their professional identity using reified expressions of competence, idealise social science as a subject, and seek validation of their status as teachers of a nonutility subject. These are discussed in the context of recently proposed educational reforms in India, with the recommendation that policymakers must take cognizance of this fragile sense of subject identity and an acute sense of disempowerment facing social science teachers, who are not averse to accountability measures per se, to enhance their standing.
Sociodemographic and Clinicoradiological Profile in Acute Stroke Patients Admitted in a Tertiary Care Hospital
Authors: Rajasekhar G  , Yadavendra Reddy KB  , Soha Nimmanapalli Thaseen , Jose Angel , Reddy Ketham Reddy Girish , Kumar Gudluru Pujith
Published: May 2024

Introduction:

This study was carried out to know the demographic and clinicoradiological profile of acute stroke patients in our hospital, which will provide baseline data to plan for future preventive strategies for government and will help young physicians to deal with this disabling disease.

Materials and Methods:

A total of 250 patients with age >18 years were recruited for a hospital-based prospective analytical study. The participants were selected from those who attended the emergency department or were admitted to the hospital with a new onset of stroke, confirmed by neuroimaging such as computed tomography (CT) or magnetic resonance imaging (MRI). The study population comprised patients presenting with symptoms suggestive of acute stroke, above 18 years of age, and willing to provide informed written consent. Patients with old cerebrovascular accidents, transient ischemic attacks, stroke mimics, intracerebral bleed posthead trauma, or inconclusive or normal CT/MRI scans were excluded from the study.

Results:

Our study population ( n = 262) had a mean age of 60.1 ± 14.8 years, with 181 males (69%) and 81 females (31%). The stroke subtypes were as follows: ischemic (54.6%), hemorrhagic (42%), and subarachnoid hemorrhage (SAH) (3.4%). Hypertension (85.1%), alcohol consumption (63%), and dyslipidemia (59.5%) were the predominant risk factors in our patients. In our study, majority of the hemorrhagic stroke was distributed in capsuloganglionic area (77 patients), followed by temporoparietal area and intraventricular bleed (10 patients each). In our study, there were 143 patients with ischemic stroke, among which 58 were in the left middle cerebral artery (MCA), 46 in the right MCA, 6 in the left anterior cerebral artery (ACA), 14 in the right ACA, and 18 in posterior cerebral artery territories. In our study, the sensitivity of clinical localization of anterior circulation stroke was 94.35%, specificity of 89.47%, negative predictive value (NPV) of 70.83%, and positive predictive value (PPV) of 98.32%. Similarly, the sensitivity of clinical localization of posterior circulation stroke (PCS) was 89.47%, specificity of 94.35%, NPV of 98.32%, and PPV of 70.83%.

Conclusion:

The most common stroke subtype was ischemic (54.6%), followed by hemorrhagic (42%) and SAH (3.4%). Hypertension, alcohol consumption, and dyslipidemia were the predominant risk factors. Among hemorrhagic strokes, the capsuloganglionic area had the highest distribution. The clinical localization showed high sensitivity and specificity for both anterior and PCSs.
A modified “outside-in” Broström-Gould procedure yielding favorable outcomes for the management of chronic lateral ankle instability-a retrospective study with mid-term follow-up
Authors: Zhang Guolei , Li Wenqing , Yao Haibo , Tan Rongzhi , Li Chuyan
Published: May 2024

Purpose: There are various surgical interventions available for the management of Chronic lateral ankle instability (CLAI). The Broström-Gould procedure has gained widespread recognition among foot and ankle specialists for its favorable surgical outcomes. However, with advancements in anatomical understanding and medical technology, further enhancements to the effectiveness of the Gould procedure are warranted. This study introduces a all-inside modified “outside-in” Broström -Gould procedure as an alternative approach for addressing lateral ankle instability. Methods: From August 2020 to October 2022, 40 patients with lateral ankle instability who underwent arthroscopic repair of the modified “outside-in” Broström-Gould procedure were retrospectively analyzed. All patients received standard non-surgical treatment before surgery for more than 6 months without symptom relief. Visual Analogue Scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) and Karlsson-Peterson score were used to evaluate the postoperative effect. Results: All patients were followed up for (14.62 ± 2.04) months. One year after operation, all patients could walk normally, ankle instability sensation disappeared, varus stress test and anterior drawer test were negative. The VAS , AOFAS and Karlsson-Peterson scores of all patients were significantly better compared with those before operation, and the difference between before and after operation was statistically significant. Conclusions: The modified “outside-in” Broström-Gould procedure can effectively treat CLAI, which can obtain satisfactory results. The procedure is straightforward, the impact is minimal, and the aesthetics are pleasing.
Prompts, Pearls, Imperfections: Comparing ChatGPT and a Human Researcher in Qualitative Data Analysis
Authors: Wachinger Jonas , Bärnighausen Kate , Schäfer Louis N. , Scott Kerry , McMahon Shannon A.
Published: May 2024

The impact of ChatGPT and other large language model–based applications on scientific work is being debated across contexts and disciplines. However, despite ChatGPT’s inherent focus on language generation and processing, insights regarding its potential for supporting qualitative research and analysis remain limited. In this article, we advocate for an open discourse on chances and pitfalls of AI-supported qualitative analysis by exploring ChatGPT’s performance when analyzing an interview transcript based on various prompts and comparing results to those derived by an experienced human researcher. Themes identified by the human researcher and ChatGPT across analytic prompts overlapped to a considerable degree, with ChatGPT leaning toward descriptive themes but also identifying more nuanced dynamics (e.g., ‘trust and responsibility’ and ‘acceptance and resistance’). ChatGPT was able to propose a codebook and key quotes from the transcript which had considerable face validity but would require careful review. When prompted to embed findings into broader theoretical discourses, ChatGPT could convincingly argue how identified themes linked to the provided theories, even in cases of (seemingly) unfitting models. In general, despite challenges, ChatGPT performed better than we had expected, especially on identifying themes which generally overlapped with those of an experienced researcher, and when embedding these themes into specific theoretical debates. Based on our results, we discuss several ideas on how ChatGPT could contribute to but also challenge established best-practice approaches for rigorous and nuanced qualitative research and teaching.
Loneliness and Crowded Living Predicted Poor Health in a Sample of Cancer Patients During COVID-19 Pandemic
Authors: Zhang Amy , Koroukian Siran , Owusu Cynthia , Moore Scott E. , Momotaz Hasina , Albert Jeffrey M.
Published: May 2024

We investigated the influence of social determinants of health (SDOH), healthcare services, and health behaviors on mental and physical health outcomes of cancer patients between the first winter and the following post-vaccine summer of the COVID-19 pandemic. A three-wave online survey of individuals diagnosed with incident cancer between January 2019 and January 2020 was conducted between November of 2020 and August of 2021 in northeast Ohio. Descriptive analysis and mixed-effect regression analyses were performed. A total of 322 newly diagnosed cancer patients, with 40 African Americans and 282 Whites (215 from metropolitan areas and 67 nonmetropolitan) responded to the survey questions. In Wave 3 ending in August 2021, the survey respondents reported significantly reduced depression ( p = .019) on the Hamilton Depression Rating Scale and improved global health ( p = .036) on PROMIS. With age, comorbidity, and other demographic and medical variables controlled in the analyses, the feeling of loneliness ( p < .001) and crowded living space ( p = .001, p = .015) were the two most prominent factors associated with depression, irritability, and poor global health at baseline, with the lowest p values and persistent effect. Self-efficacy of taking preventive measures was associated with reduced depression ( p = .001) and improved global health ( p = .029). Increasing access to medicine ( p < .01) and satisfaction with telehealth appointments ( p < .01) were significantly associated with better global health and reduced irritability. Respondents who had private health insurance reported better health than those that had Medicare coverage only ( p < .05). This longitudinal, observational study demonstrated the impact of SDOH on health outcomes of cancer patients. Substandard living conditions resulting in loneliness and crowdedness, quality of medical care (e.g., quality telehealth and access to medicine), and personal behaviors (e.g., self-efficacy) were significantly associated with health outcomes in newly diagnosed cancer patients during the pandemic and should be given adequate consideration for the purpose of improving clinical care.
Travel Distance and Spanish-Speaking are Associated with Delays in the Treatment of Cleft Palate
Authors: Stanton Eloise W. , Rochlin Danielle , Lorenz H. Peter , Sheckter Clifford C.
Published: May 2024

Objective

Delayed repair of cleft palate is associated with worse speech outcomes. Social determinants of health may influence the timing of surgery; however, there are no population health investigations to evaluate factors such as travel distance, language barriers, and payer. This study sought to identify factors that may interfere with timely cleft palate repair.

Design

Retrospective cohort.

Setting

National/multi-center.

Patients/Participants

All cleft palate repairs within California were extracted from 2000–2021.

Main Outcomes Measures

The primary outcome was age at surgical repair, which was modeled with linear regression. Covariates included race, primary language, distance from patient home to hospital, socioeconomic status, primary payer, and managed care enrollment status.

Results

11 260 patients underwent surgical repair of a cleft palate. Black race was associated with delayed repair (22 additional days, P = .004, 95% CI 67.00–37.7) along with Asian/Pacific-Islander race (11 additional days, P = .006, 95% CI 3.26-18.9) compared to white race. Spanish-speaking patients had significantly later cleft palate repairs by 19 days, ( P < .001, 95% CI 10.8-27.7) compared with English-speaking. Further distances from the hospital were significantly associated with later cleft surgeries with out-of-state patients undergoing surgery 52 days later ( P < .001, 95% CI 11.3-24.3). Managed care plans and Medi-Cal were significantly associated with earlier surgical repair compared with private insurance.

Conclusion

Black, Asian Pacific Islander, and Spanish-speaking patients and greater distance traveled to hospital were associated with delayed cleft palate repairs. These results underscore the importance of addressing structural and social barriers to care to improve outcomes and reduce health disparities for patients with cleft palate.
Information Sharing Between Competitors With Endogenous Production Timing
Authors: Li Tian , Luo Huajiang , Shang Weixin
Published: May 2024

We study two competing firms’ incentives for demand information sharing and their production timing strategies. One firm adopts routine timing, where her production time is fixed according to her previous product models’ manufacturing time. The other firm uses strategic timing, where his production time can be strategically chosen to occur before, concurrently with, or after that of the routine-timing firm. The firms decide whether to disclose their private demand information and make quantity decisions based on the available demand information, either simultaneously or sequentially. We analyze the optimal production timing decisions for the strategic firm under different information sharing scenarios and find that a pre-emptive move is generally not optimal. We demonstrate that endogenous production timing can create incentives for information sharing and characterize the conditions under which both firms share information, one firm shares information, or neither firm shares information. Additionally, we uncover several interesting implications of information sharing under endogenous production timing: firms are more likely to share information in intensified competition, a firm may benefit from its rival’s superior information capability, and the option of information sharing enhances social welfare, which may also benefit from more intense competition.
Career-Related Teacher Support Scale: Validation Among Italian Adolescents and Assessment of the Effect on Career Decision Self-Efficacy Through Career Adaptability
Authors: Parola Anna , Marcionetti Jenny , Wong Lawrence P. W.
Published: May 2024

Teachers have a key role in adolescents’ career development. Nevertheless, few studies examined their effect on career outcomes. The present study has two objectives. First, to test the factorial structure of the Italian version of the Career-related Teacher Support Scale (CRTSS) with Italian adolescents. Second, to test how career-related teacher support leads to career decision self-efficacy through career adaptability. In Study I, 469 adolescents were asked to complete the CRTSS. A first-order model, a second-order model (hierarchical), a bi-factor model (hierarchical), and a single-factor model were compared to check the best model solution. Additionally, the measurement invariance was examined across male and female. Results reveal the superiority of the second-order (hierarchical) model and the invariance between males and females. In the Study II took part 228 adolescents. A structural equation modeling approach assessed the relationship between career-related teacher support, career adaptability and career decision self-efficacy. A mediation model showed a significant indirect effect of career-related teacher support on decision self-efficacy through career adaptability. Practical implications for interventions were discussed.
A Network Meta-Analysis of the Systemic Therapies in Unresectable Head and Neck Squamous Cell Carcinoma
Authors: Yuan Jinling , Shi Kexin , Chen Guanhua , Xu Weilin , Qiu Lei , Fei Yinjiao , Zhu Yuchen , Wu Mengxing , Li Yurong , Sun Xinchen , Cao Yuandong , Zhou Shu
Published: May 2024

The current standard treatment for locally advanced squamous cell carcinoma of the head and neck (LASCCHN) comprises concurrent radiotherapy (CRT) alongside platinum-based chemotherapy. However, innovative therapeutic alternatives are being evaluated in phase II/III randomized trials. This study employed a Bayesian network meta-analysis (NMA) using fixed effects to provide both direct and indirect comparisons of all existing treatment modalities for unresectable LASCCHN. Methods: We referenced randomized controlled trials (RCTs) from January 2000 to July 2023 by extensively reviewing PubMed, EMBASE, and Web of Science databases, adhering to the Cochrane methodology. Relevant data, including summary estimates of overall survival (OS) and progression-free survival (PFS), were extracted from these selected studies and recorded in a predefined database sheet. Subsequently, we conducted a random effects network meta-analysis using a Bayesian framework. Results: Based on the Surface Under the Cumulative Ranking (SUCRA) values, the league table organizes the various treatments for OS in the following order: IC + RT&MTT, MTT-CRT, IC + CRT&MTT, CRT, IC + CRT, MTT-RT, IC + MTT-RT, and RT. In a similar order, the treatments rank as follows according to the league table: IC + CRT&MTT, MTT-CRT, IC + CRT, IC + RT&MTT, CRT, IC + MTT-RT, MTT-RT, and RT. Notably, none of these treatments showed significant advantages over concurrent chemoradiotherapy. Conclusion: Despite concurrent chemoradiotherapy being the prevailing treatment for LASCCHN, our findings suggest the potential for improved outcomes when concurrent chemoradiotherapy is combined with targeted therapy or induction chemotherapy.
Nomogram for Risk of Secondary Venous Thromboembolism in Stroke Patients: A Study Based on the MIMIC-IV Database
Authors: Lan Folin , Liu Tianqing , Guan Celin , Lin Yufen , Lin Zhiqin , Zhang Huawei , Qi Xiaolong , Chen Xiaomei , Huang Junlong
Published: May 2024

This study aims to identify risk factors for secondary venous thromboembolism (VTE) in stroke patients and establish a nomogram, an accurate predictor of probability of VTE occurrence during hospitalization in stroke patients. Medical Information Mart for Intensive Care IV (MIMIC-IV) database of critical care medicine was utilized to retrieve information of stroke patients admitted to the hospital between 2008 and 2019. Patients were randomly allocated into train set and test set at 7:3. Univariate and multivariate logistic regression analyses were used to identify independent risk factors for secondary VTE in stroke patients. A predictive nomogram model was constructed, and the predictive ability of the nomogram was evaluated using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA). This study included 266 stroke patients, with 26 patients suffering secondary VTE after stroke. A nomogram for predicting risk of secondary VTE in stroke patients was built according to pulmonary infection, partial thromboplastin time (PTT), log-formed D-dimer, and mean corpuscular hemoglobin (MCH). Area under the curve (AUC) of the predictive model nomogram was 0.880 and 0.878 in the train and test sets, respectively. The calibration curve was near the diagonal, and DCA curve presented positive net benefit. This indicates the model's good predictive performance and clinical utility. The nomogram effectively predicts the risk probability of secondary VTE in stroke patients, aiding clinicians in early identification and personalized treatment of stroke patients at risk of developing secondary VTE.
Efficacy and Safety of Direct Oral Anticoagulants in Cerebral Venous Thrombosis: Meta-Analysis of Randomized Clinical Trials
Authors: Chen Xi , Guo Linjuan , Lin Meiming
Published: May 2024

Current guidelines recommend the standard-of-care anticoagulation (vitamin K antagonists or low-molecular-weight heparin) in patients with cerebral venous thrombosis (CVT). Herein, we performed a meta-analysis of randomized clinical trials (RCTs) to assess the efficacy and safety of direct oral anticoagulants (DOACs) compared with the current standard of care in patients with CVT. We systematically searched the PubMed and Embase databases up to December 2023 to identify clinical trials on the effect of DOACs in patients with CVT. A Mantel-Haenszel fixed effects model was applied, and the effect measures were expressed as the absolute risk differences (RDs) and 95% confidence intervals (CIs). A total of 4 RCTs involving 270 participants were included. In the pooled analysis, DOACs and standard of care had low incidence rates of recurrent VTE and all-cause death, and similar rates of any recanalization (78.2% vs 83.2%; RD = −4%, 95%CI:−14% to 5%) and complete recanalization (60.9% vs 69.4%; RD = −7%, 95%CI:−24% to 10%). Compared with the standard of care, DOACs had non-significant reductions in the rates of major bleeding (1.2% vs 2.4%; RD = −1%, 95%CI: −6% to 3%), intracranial hemorrhage (1.9% vs 3.6%; RD = −2%, 95%CI:−7% to 3%), clinically relevant non-major bleeding (3.8% vs 7.4%; RD = −4%, 95%CI:−9% to 2%), and any bleeding (17.3% vs 21.4%; RD = −4%, 95%CI:−16% to 8%) in patients with CVT. DOACs and standard of care showed similar efficacy and safety profiles for the treatment of CVT. DOACs might be safe and a convenient alternative to vitamin K antagonists for thromboprophylaxis in patients with CVT.
Outcome of antiemetic prophylaxis among pediatric cancer patients receiving moderate to highly emetogenic chemotherapy at pediatric hemato-oncology ward of Tikur Anbessa specialized hospital: A prospective observational study
Authors: Hadero Hawaryaw Mathewos , Beyene Melak Gedamu , Baye Assefa Mulu , Sisay Eskinder Ayalew
Published: May 2024

Introduction

Chemotherapy-induced nausea and vomiting (CINV) is a major issue for chemotherapy pediatric patients, especially in developing countries due to limited access to essential antiemetics. This study aimed to assess antiemetic prophylaxis outcomes in pediatric cancer patients at Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia.

Methods

A longitudinal prospective observational study design was conducted among 201 pediatric cancer patients followed up to 120 h post-chemotherapy.

Results

The majority of patients (75.1%) received combination prophylactic antiemetics in the acute phase. Complete response (CR) was the highest in the acute phase (71.1%). Emesis episodes occurred most frequently on the first day of treatment (28.4%) and gradually decreased over time. History of motion sickness, platinum-based chemotherapy, and prior chemotherapy-induced vomiting (CIV) were associated with emesis during the acute phase whereas multiple-day chemotherapy, prior CIV, receipt of antiemetics, and a history of motion sickness in the delayed phase. However, the odds of CIV were reduced with steroid presence in the chemotherapy regimen.

Conclusions

A considerable number of participants could not achieve a CR. It is important for clinicians to be cognizant of risk factors that influence the outcome of antiemetic prophylaxis to achieve better control of CINV among pediatric cancer patients.
“Don’t respond”: sexting and scrolling in First Nations’ queer literature
Authors: Alizzi Arlie
Published: May 2024

Queer and trans First Nations literatures offer a complex range of perspectives on social media use. In this piece, written as a letter addressing an anonymous brotherboy character called Benny, who is based on a person that catfished and harassed me online, I examine three Indigenous books that present complex, critical, or disillusioned accounts of social media use, exploring the forms of deception, harassment, racism, and creativity enabled by digital media. I engage loosely with the practice of ficto-criticism to produce this article. Ficto-critical writing, a method of anthropological and cultural studies, subverts traditional academic writing; presenting a hallucinatory form of self-narration and anthropological writing. Using this interdisciplinary and experimental approach, this article experiments with the concept of anonymity and privacy, key themes in the writing of queer First Nations authors on the topic of the internet.
PTSD, depression, and migration-related experiences among Syrian refugees living in camp vs urban settings
Authors: Isik Esra , Sismanlar Sahika Gulen , Tekeli-Yesil Sidika
Published: May 2024

Despite the increased heterogeneity of living conditions of refugees in recent years, there is a lack of robust epidemiological data about the relationship between refugees’ mental health and their living contexts. The current study aims to compare frequencies of pre-migration traumatic events and post-migration difficulties between refugees living in camps and those living in cities; and to identify the prevalence of post-traumatic stress disorder (PTSD), depression, and factors associated with them. A field survey was conducted among 1,470 refugees living in camps and urban settings of Turkey. The survey instruments included a socio-demographic form, the Harvard Trauma Questionnaire, the Post-migration Living Difficulties Scale, and the PTSD and depression modules of the Mini-International Neuropsychiatric Interview. Both PTSD and depression were more common in urban settings than in camps. Both disorders were associated with living context and migration-related experiences. Pre-migration traumas were more frequent among refugees living in cities than in those living in camps, while post-migration difficulties were more common in the refugees living in camps. The living context is potentially a critical determinant of refugee mental health. Camp and urban refugees may have different experiences and needs. In particular, refugees living in some urban settings may be at higher risk for having psychological problems.
Finite element model updating and response prediction of a frame structure based on optimal sensor placement
Authors: Wang Xiaoguang , Liang Peng , Ma Ming , Zhou Zhenwei , Wu Gang , Song Shuai
Published: May 2024

This paper proposes an approach for finite element (FE) model updating and response prediction of frame structures based on optimal sensor placement (OSP), which integrates sensor placement optimization, mode expansion, and model updating techniques. Firstly, sensor optimization layout and modal testing analysis are conducted on a bolted laboratory frame structure. The covariance-driven stochastic subspace identification (SSI-COV) method identifies the real-world structure’s natural frequencies, modal damping, and mode shapes. Secondly, the complete mode shapes are expanded using the measured incomplete modal data from the limited number of sensors. Thirdly, a multi-objective function based on frequency and mode shapes is established to adjust the parameters of the FE model. This ensures that the updated model accurately represents the dynamic properties of the actual structure within a specific frequency range. Finally, the Rayleigh damping of the frame structure is estimated, and the damping matrix is assembled to enhance the accuracy of dynamic response prediction in the updated model. By comparing the response prediction results of the updated FE model with and without considering the updated damping effects to the measurement data of the real-world structure, it is demonstrated that the proposed method considering updated damping effects can more effectively predict the structural response.
The absorbent digital welfare state: Silencing dissent, steering progress
Authors: Hjelholt Morten Flemming
Published: May 2024

This paper explores the intricate dynamics of digital welfare within the context of late-capitalist welfare states, focusing on the advanced digitalisation initiatives of Denmark. It offers a critical analysis of the concept of ‘digital welfare’ – defined as the integration of digital technologies into the frameworks of social protection. Central to the research is how the Danish welfare state, recognised for its e-government leadership, engages with and incorporates critiques to sustain its approach to digital transformation. Utilising Boltanski's theories on the absorption of capitalist critique and Mathiesen's ‘silently silencing’ concept, the study examines the state's proficiency in assimilating criticism. The findings reveal the persistent flexibility of late-capitalist governance systems, especially in how digital welfare policies are leveraged to reconnect citizens with state mechanisms while simultaneously mitigating dissent. The research highlights the necessity for ongoing investigation into the implications of digitalisation for welfare institutions and societal structures at large.
Transfer of ESTs in international law: A climate justice approach
Authors: Gupta Vindhya , Jadhav Dhanaji , Ronald Bindu
Published: May 2024

Early industrialization of the developed countries has enabled their leadership in technological innovation, including environmentally sound technologies. ESTs are technologies that help prevent, control, or reduce greenhouse gas emissions. Endorsed as an integral part of climate action, a binding obligation to ensure access for global south to these technologies remains missing from international environment law and international intellectual property rights law. Transfer of technology also faces certain economic barriers such as lack of infrastructure and human resources that enable adoption and absorption of ESTs. Moreover, there exists ideological differences between developed countries and developing and least developed countries regarding mechanism of technology transfer, creating an impasse in international negotiations to achieve EST transfer. In this paper the author has attempted to reframe the discussion on transfer of ESTs through a climate justice perspective. An incorporation of the practical aspects of the common but differentiated responsibilities of the developed countries into the TRIPS regime, in the form of binding obligations to technology transfer and financial assistance, or relaxations in patent protections, may provide adequate resolution. A balanced and rational approach to EST transfer, beyond the exigencies of global politics, is necessary for the continued prosperity of the Earth.
Learning experiences from ECEC professionals during an international field visit: The Berlin, The Hague, and Schiedam Study
Authors: Fukkink Ruben Georges , Egert Franziska
Published: May 2024

International field visits aim to provide transformative learning experiences that stimulate the professional development of staff, but outcomes may vary among programs. In this mixed-methods study, we investigated the transformative learning experiences of Dutch and German professionals (n = 28) from early childhood education and care (ECEC) who participated in a blended intensive exchange program with mutual field visits. Our findings indicate a transformative learning process in which the participants developed an awareness of cultural differences, moved to understanding these differences and, occasionally, to adaptation of new professional beliefs related to the interaction with young children. However, it proved difficult to implement new practices in the own centers after the program. We discuss how international exchange programs may foster transformative learning and the professional development of ECEC staff.
In-plane and out-of-plane compressive properties of regular and graded cellular cores of sandwich panels fabricated by additive manufacturing
Authors: Coelho Bernardo , Copin Etienne , Deus Augusto Moita , Fatima Vaz Maria
Published: May 2024

Cellular materials with a gradient of properties become appealing as cores of the sandwich panels due to the possibility of improving strength and absorbed energy in lightweight components. 2D cellular structures designated by honeycombs have an anisotropic behaviour when loaded under in- and out-plane. Thus, when proposing new designs, it is essential to analyse how the in-plane arrangement with a gradient in cell wall thickness affects in-plane and out-of-plane mechanical properties. This work aims to study graded cellular structures in comparison with regular hexagonal honeycombs. Structures were manufactured by laser powder bed fusion using an aluminium alloy. Regular arrangements were formed with cells with the same thickness, while graded structures possessed a radial gradient of cell thickness. Three types of innovative gradients, where cell length varies radially along concentric layers, were analysed. The compressive properties of regular and graded structures were evaluated when loaded both under in-plane and out-of-plane conditions. Compression behaviour was assessed, both experimentally and by numerical modelling. Even though there is a mismatch between numerical and experimental results, they exhibit the same trends. All graded samples showed an increased mechanical performance when loaded under out-of-plane conditions in comparison with the results from tests under in-plane loading with values, for example, of stiffness four hundred times larger, absorbed energy around thirty times higher and with yield stress four times larger. The results showed that the graded samples attain higher values of strength, stiffness and absorbed energy in comparison with regular hexagonal honeycombs, for the same relative density.
New insights into career-related continuous learning in construction companies: Supervisor conceptions of career support
Authors: Rautio Krista , Uusiautti Satu
Published: May 2024

In a time when the construction industry shares the challenge of labour shortage, more attention should be paid to how attractive careers in the construction field are in the first place. The constantly evolving working environment is causing significant changes in careers and career management in the field, leading to the need to explore company practices that can contribute to the development of fulfilling careers. In this research, we investigated how supervisors in construction companies perceive career support for their employees. This was a phenomenographic study in which 23 supervisors of five construction companies in Finland were interviewed. The analysis showed that the supervisors’ perceptions could be categorized into six support types varying between company, professionally, and individually oriented perspectives. Based on the analysis, needs for continuous learning in the construction field can be identified more broadly, highlighting also the various opportunities to advance careers in the field.
Analysis of the Parotid Glands on an Energy Spectrum CT Iodine Map to Evaluate Irradiation-Induced Acute Xerostomia in Patients With Nasopharyngeal Carcinoma
Authors: Chen Runfan , Xie Jiangao , Chen Jianmin , Li Xiaobo , Lin Qingliang , Xu Qizhen , Chen Yanyan , Wang Lili , Zheng Rong , Xu Benhua
Published: May 2024

Objective: This prospective study aims to evaluate acute irradiation-induced xerostomia during radiotherapy by utilizing the normalized iodine concentration (NIC) derived from energy spectrum computed tomography (CT) iodine maps. Methods: In this prospective study, we evaluated 28 patients diagnosed with nasopharyngeal carcinoma. At 4 distinct stages of radiotherapy (0, 10, 20, and 30 fractions), each patient underwent CT scans to generate iodine maps. The NIC of both the left and right parotid glands was obtained, with the NIC at the 0-fraction stage serving as the baseline measurement. After statistically comparing the NIC obtained in the arterial phase, early venous phase, late venous phase, and delayed phase, we chose the late venous iodine concentration as the NIC and proceeded to analyze the variations in NIC at each radiotherapy interval. Using the series of NIC values, we conducted hypothesis tests to evaluate the extent of change in NIC within the parotid gland across different stages. Furthermore, we identified the specific time point at which the NIC decay exhibited the most statistically significant results. In addition, we evaluated the xerostomia grades of the patients at these 4 stages, following the radiation therapy oncology group (RTOG) xerostomia evaluation standard, to draw comparisons with the changes observed in NIC. Results: The NIC in the late venous phase exhibited the highest level of statistical significance ( P < .001). There was a noticeable attenuation in NIC as the RTOG dry mouth grade increased. Particularly, at the 20 fraction, the NIC experienced the most substantial attenuation ( P < .001), a significant negative correlation was observed between the NIC of the left, right, and both parotid glands, and the RTOG evaluation grade of acute irradiation-induced xerostomia ( P < .001, r = −0.46; P < .001, r = −0.45; P < .001, r = −0.47). The critical NIC values for the left, right, and both parotid glands when acute xerostomia occurred were 0.175, 0.185, and 0.345 mg/ml, respectively, with AUC = 0.73, AUC = 0.75, and AUC = 0.75. Conclusion: The NIC may be used to evaluate changes in parotid gland function during radiotherapy and acute irradiation-induced xerostomia.
Preventing Diabetic Foot Re-Ulceration Through an Innovative Pressure and Temperature Monitoring Clinical Device
Authors: Thorne Claire Saliba , Gatt Alfred , DeRaffaele Clifford , Attard Geoffrey , Formosa Cynthia , Papanas Nikolaos
Published: May 2024

This study compared the outcome of an innovative in-shoe pressure and temperature measuring device as an adjunct to standard clinical care for diabetic foot versus standard clinical care alone. It included 88 participants with Type 2 diabetes mellitus with a history of one or more plantar foot ulceration who were already using prescription orthoses. These were randomly divided into the control group ( n = 44, standard care only) and the experimental group ( n = 44, standard care plus the innovative device). Both groups were monitored for re-ulceration for one year. Overall, the control group exhibited a higher number of re-ulcerations ( n = 14) with 2 amputations in comparison with the experimental group (only 2 ulcerations and no amputations) at the end of the study. In conclusion, this innovative in-shoe pressure and temperature measuring device appears to reduce re-ulcerations by offering objective data for clinical decision making in the management of the diabetic high-risk foot.
“Just” a painful period: A philosophical perspective review of the dismissal of menstrual pain
Authors: Wiggleton-Little Jada
Published: May 2024

Science and society typically respond to dysmenorrhea—or painful menstrual cramps—as a normal, natural, and inevitable part of menstruation. This normalization has greatly contributed to the systemic dismissal of painful menstrual cramps. Stigma, secrecy, and the expectation to “cope” fuel the normalization of menstrual pain. In this article, I argue that the normalization of menstrual pain restricts the ability to share an excruciating menstrual pain in a way that would otherwise elicit alarm or concern. This can cause clinicians to downgrade menstrual pain, and even menstruating persons to downgrade their own pain. I refer to the dismissal of menstrual pain as an example of a pain-related motivational deficit. A pain-related motivational deficit describes instances in which an utterance fails to motivate due to societal practices and ideas that make it difficult to recognize the import of the embodied experience being shared.
Factors affecting return to work following arthroscopic rotator cuff repair
Authors: Kalejman Ivan Perez , Pasqualini Ignacio , Larrague Catalina , Gallego Federico , Tanoira Ignacio , Ranalletta Maximiliano , Rossi Luciano A
Published: May 2024

Background

Prolonged work absence following arthroscopic rotator cuff repair (ARCR) is a major concern, yet factors influencing return to work are poorly understood. The primary aim of this study is to retrospectively assess the proportion of patients who successfully resume equivalent occupational demands after ARCR, along with the time taken for their return to work.

Methods

Eighty-three patients underwent ARCR. Work intensity and worker's compensation status were recorded. Patients were interviewed at ≥12 months to determine return to work rate and timing.

Results

In total, 83 patients were included, with a median age of 58.7 (±8.36) and a follow-up of at least 12 months. 98.8% returned to work at a median of eight weeks. Heavy manual labor significantly delayed return to work compared to light work (HR 0.15 95% CI). Receiving worker's compensation was associated with delayed return to work (HR 0.26 95% CI).

Conclusion

This study found that nearly all patients returned to work following ARCR, but high-intensity manual labor and worker compensation status significantly delayed their return to work. Patients with physically demanding jobs and those receiving workers’ compensation had a 60–85% lower likelihood of returning to work at any given time point compared to light work and noncompensated patients.
Challenges and Prospects for Urban Peacebuilding in Post-Siege Marawi City, Philippines: People, Places, and Practices
Authors: Simangan Dahlia
Published: May 2024

Much has been written about rebuilding conflict-affected societies, but its implementation in urban contexts needs further examination. In urban studies, some scholars have highlighted the relationship between urban dynamics and the conditions for peace and conflict. Meanwhile, critical peace scholars have emphasised the value of everyday practices for peacebuilding. This study situates the conventional peacebuilding components of security, reconciliation, and development within Marawi City's people, places, and practices to advance an integrated framework for analysing urban peacebuilding. The data for analysis draws on focus group discussions around the issues of security (e.g., clearance of unexploded ordnances), reconciliation (particularly the return of displaced persons), and development (i.e., the resumption of livelihoods). Results show that identity, spatiality, and relationality are entangled in post-conflict cities like Marawi, posing complex and unique challenges to peacebuilding efforts. Therefore, sustaining peace in post-conflict cities needs careful consideration of the urban characteristics of the people, places, and practices that influence peacebuilding.
Transcutaneous Retrobulbar Amphotericin B Injection for Invasive Fungal Sinusitis with Orbital Involvement: A Systematic Review
Authors: Abdulbaki Hasan , Callander Jacquelyn K. , Fastenberg Judd H. , Russell Matthew S. , Vagefi M. Reza , Kersten Robert C. , Loftus Patricia A.
Published: May 2024

Background

Orbital involvement of invasive fungal sinusitis (IFS) is an ominous prognostic marker that should prompt rapid intervention. Transcutaneous retrobulbar administration of amphotericin B (TRAMB) is an off-label adjunctive treatment that can increase drug penetrance into diseased orbital tissue. To date, there is a lack of consensus regarding the use of TRAMB for treatment of IFS with orbital involvement.

Objective

This systematic review aims to synthesize the indications, efficacy, and potential complications of TRAMB.

Methods

PubMed, EMBASE, and Web of Science databases were probed for systematic review. Article search was conducted through June 2023 using the keywords “invasive fungal sinusitis,” “invasive fungal rhinosinusitis,” “rhino-orbital mucormycosis,” “rhinosinusitis,” “orbital,” “retrobulbar,” and “amphotericin.”

Results

In suitable cases as determined by radiologic and clinical evaluation, TRAMB administration has the potential to improve orbital salvage rates and improve versus stabilize visual acuity. Treatment complications are more likely with deoxycholate than with liposomal amphotericin formulations. The existing literature describing use of TRAMB is limited due to its retrospective nature, but the increase in IFS cases since 2020 due to the COVID pandemic has broadened the literature.

Conclusions

TRAMB is an effective adjunctive treatment in IFS with mild-to-moderate orbital involvement when used in combination with standard of care debridement, systemic antifungal therapy, and immunosuppression reversal. Prospective longitudinal studies and multi-institutional randomized trials are necessary to determine the definitive utility of TRAMB.
The influence of renal impairment and race on maintenance warfarin dosing in a multi-ethnic Southeast Asian population
Authors: Tan Olivia , Lau Yee How , Chua Terrance SJ , Hon Jin Shing , Loke Michelle , Fam Jiang Ming
Published: May 2024

Background

Warfarin remains an important anticoagulant in certain patient groups. Though primarily liver-metabolised, recent research suggests renal function influences warfarin dosing. This has yet to be explored in a Southeast Asian population.

Objectives

To investigate the impact of renal impairment and ethnicity on warfarin dosing in a multi-ethnic Asian population.

Methods

A retrospective cohort analysis on patients seen at the institution’s anticoagulation clinic (ACC) between 2010 and 2019 was conducted.

Results

Among 3610 eligible patients, 70.7% had no/ mild renal impairment (eGFR≥60 ml/min/1.73m2), 24.7% had moderate renal impairment (eGFR 30 to <60ml/min/1.73m2), and 4.5% had severe renal impairment (eGFR<30 ml/min/1.73m2). Patients with moderate renal impairment required a 19% lower maintenance warfarin dose (β = 0.81, 95% CI 0.79–0.84, p < .001), and those with severe renal impairment needed a 30% lower dose (β = 0.70, 95% CI 0.66–0.75, p < .001) compared to patients with normal kidney function. Ethnically, 84.4% were Chinese, 9.5% Malay, and 6.1% South Asian. Compared to Chinese, Malays required an 18% larger maintenance dose (β = 1.18, 95% CI 1.12–1.23, p < .001), and South Asians needed an 83% larger dose (β = 1.83, 95% CI 1.73–1.94, p < .001). Compared to patients with normal renal function of the same race, South Asians with impaired renal function required a 16% lower dose, while Malay and Chinese patients needed 21% and 23% lower doses, respectively.

Conclusion

In this large multi-ethnic Asian study, renal function and ethnicity significantly affected maintenance warfarin dosing. South Asian patients required larger doses but were less affected by renal impairment compared to Chinese and Malays.
Septicemia caused by Enterococcus coli in a pregnant woman after cerclage—A case report
Authors: Daghestani Mazin H
Published: May 2024

The objective of this case report is to discuss a case of septicemia caused by Escherichia coli following cervical cerclage. The study described a case of a 42-year-old female patient who visited the Ante-natal Clinic for a follow-up appointment during the 8th week of gestation. The patient had previously undergone successful in vitro fertilization treatment following 16 years of primary infertility. A routine ultrasound scan revealed cervical dilatation of 2–3 cm. The patient was advised to undergo cervical cerclage insertion. Two days after the surgery, she presented with pneumonia and also experienced vaginal bleeding, necessitating the removal of the cervical cerclage. Unfortunately, the patient suffered a stillbirth. Her condition deteriorated the following day, leading to septic shock and multiple organ dysfunction. After receiving the treatment, the patient was discharged; 2 days after being discharged the patient’s blood culture and sensitivity results indicated a significant growth of Escherichia coli and a diagnosis of toxic myocarditis. Following 2 months of intensive treatment, the patient showed significant improvement; however, there was the presence of some mild renal impairment and he was ultimately discharged home. Maternal sepsis poses a significant risk to the health and lives of pregnant women. Escherichia coli stands out as a primary causative agent after cervical cerclage.