bluuebunny/crossref_metadata_2025 huggingface dataset:
Fun at Work: Need or Fad? Understanding the Effect of Social Connectedness in Job Search with Social Media
Authors: NV Subbarao , Chhabra Bindu , Mishra Manit
Published: October 2023

Social connectedness, a key determinant of intention to use in many social media applications is influenced by users’ hedonic (fun, enjoyment) and utilitarian (usefulness) perceptions. This study investigates the effect of social connectedness on job search through social media by using an extended technology acceptance model (TAM) as the theoretical framework. A hypothesized model is examined to understand how job search behaviour is influenced by social connectedness when applying for a job or choosing a company. Data gathered from 578 respondents via an online survey were analysed using covariance-based structural equation modelling (CB-SEM). The study results show social connectedness to have a statistically significant indirect effect on intention to use social media and to be mediated by both utilitarian and hedonic perceptions. However, the mediating influence of hedonic perceptions is perceived to be stronger to suggest job seekers perceive fun in the workplace as a stronger need. The study has implication for organizations to prioritize social connectedness as employee well-being, job performance, talent management and innovation efforts could be enhanced. The study extends and revalidates the TAM model in a job search context and supports its use as a valuable framework for understanding the impact of social connectedness in job search.
Internationalization of SMEs in a Developing Economy: Empirical Evidence from SMEs in the Western Province, Sri Lanka
Authors: Lakshman Duleepa , Kumarasinghe Janak , Weerasinghe Rukmal
Published: October 2023

Small and medium enterprises (SMEs) are critical to Sri Lanka’s economy, but their potential for internationalization remains underexplored. This study aims to identify the various antecedents of internationalization and the impact of identified antecedents on the internationalization of Sri Lankan SMEs. This study was conducted following a quantitative approach. Data were collected from 250 SMEs currently engaged in international business activities and located in the Western Province of Sri Lanka. Correlation analysis and multiple regression analysis were performed to test the hypothesis after ensuring the reliability and validity of the measurement items. The results of this study found that marketing and networking capabilities, among others, significantly influence the internationalization of SMEs. In addition, the study discovered that human capital, managerial capabilities, innovation capabilities, marketing capabilities, networking capabilities, financial capabilities and technological capabilities jointly influence the internationalization of Sri Lankan SMEs. The results of this study provide better insights for managers and owners to capitalize more on marketing capabilities and networking capabilities to achieve synergies by collaborating with local and international partners. In addition, study results benefit policymakers in formulating better policies to support SMEs in finding new markets and making information available about foreign markets to better develop their marketing and networking strategies.
Post-COVID-19 Condition Characterization: Insights From a Cross-Sectional Study in a Malaysian Rehabilitation Center
Authors: Zamli Akmal Hafizah , Misnan Nor Arisah , Lim Su-Yin , Zohdi Wan Najwa Wan Mohd , Baharum Nurakmal , Andiappan Kavitha
Published: October 2023

Although post-COVID-19 condition (PCC) is a major public health concern, studies on PCC in Southeast Asia are lacking. This study aimed to describe PCC symptoms and its functional impact among COVID-19 survivors undergoing outpatient rehabilitation in Malaysia. We evaluated 3037 patients with confirmed COVID-19, referred between November 2020 and September 2022, 3 to 6 months after infection. PCC was diagnosed in 71.1%. Fatigue and dyspnea were the most common symptoms. The PCC patients had reduced respiratory, ambulatory, and musculoskeletal function, and higher fatigue and pain scores, and were less likely to return to work (odds ratio [OR] = 0.55) compared with non-PCC patients. Recognition of PCC symptoms and its functional impact can guide early, tailored, rehabilitation interventions.
Externality and taboo: Resolving the Judaic pig puzzle
Authors: Leeson Peter T , Geloso Vincent , Snow Nicholas A
Published: October 2023

Judaic law famously bans pigs. For millennia, scholars have wondered why. This paper uses the economics of property rights to resolve the puzzle. We argue that the Judaic pig ban was an instrument for internalizing swine externalities. Free ranging pigs in search of sustenance trespass on agricultural landowners’ property, wreaking destruction. Activities that foster such pigs thus create negative externalities that can cripple agricultural economies. When the expected cost of swine externalities becomes large, internalization becomes worthwhile: lawmakers with a vested interest in the agricultural economy ban activities that foster free ranging pigs. That is what transpired in ancient Judah, where lawmakers were priests whose livelihoods depended on agriculture, where all swine ranged freely, and where the expected cost of swine externalities surged during the late Iron Age. Lawmakers invoked God to enjoin involvement with pigs because a supernatural injunction was cheaper to enforce than a natural one: in a land of faithful Hebrews, Yahweh’s swine prohibition enforced itself. The Judaic pig ban’s features are consistent with pig bans recently adopted by US states such as Montana, which everyone agrees are instruments for internalizing swine externalities.
Multidisciplinary Optimal Outcomes Reporting and Team Clinic Retention in Isolated Nonsyndromic Cleft Palate
Authors: Linkugel Andrew D. , Trivedi Prerak B. , Varagur Kaamya , Skolnick Gary B. , Menezes Maithilee D. , Dunsky Katherine A. , Grames Lynn M. , Locke Lauren C. , Naidoo Sybill D. , Snyder-Warwick Alison K. , Patel Kamlesh B.
Published: October 2023

Objective

Optimal Outcomes Reporting was recently introduced to categorize outcomes after cleft palate repair. We seek to propose an expanded version of Optimal Outcomes Reporting and to determine if correlation exists between the expanded outcomes and persistence with team care follow-up through age 9.

Design

Retrospective cohort study.

Setting

Cleft team at large pediatric hospital.

Patients

Patients with isolated nonsyndromic cleft palate (n = 83) born from 2001-2012.

Main Outcome Measures

Patients who continued to present at age 5 or greater were assessed for optimal outcomes. Optimal outcomes were: surgery - no fistula or velopharyngeal insufficiency; otolaryngology - no obstructive sleep apnea or signs of chronic middle ear disease; audiology - no hearing loss; speech-language pathology - no assessed need for speech therapy.

Results

Of the 83 patients identified, 41 were assessed for optimal outcomes. Optimal outcome in any discipline was not associated with follow-up through age 9 (0.112 ≤  p ≤ 0.999). For all disciplines, the group with suboptimal outcomes had a higher proportion of patients from geographic areas in the most disadvantaged quartile of social vulnerability index, with the strongest association in the group with suboptimal speech outcome (OR 6.75, 95% CI 0.841-81.1).

Conclusions

Optimal outcomes and retention in team clinic were not statistically significantly associated, but clinically relevant associations were found between patients in the most disadvantaged quartile of social vulnerability and their outcomes. A patient-centered approach, including caregiver education about long-term care for patients with cleft palate, would allow for enhanced resource utilization to improve retention for patients of concern.
The Role of Doctor of Nursing Practice-Prepared Nurses to Improve Quality of Patient Care
Authors: Reynolds Staci S , Sabol Valerie K
Published: October 2023

Translating evidence-based practices (EBPs) and quality improvement (QI) initiatives to the bedside is a significant need among hospitals and outpatient settings to improve the provision of quality nursing care. However, health-care systems continue to struggle with implementing and sustaining EBPs. To improve the application of EBPs and QI initiatives, hospitals should consider using Doctor of Nursing Practice (DNP)-prepared nurses in Quality Improvement roles, as DNP graduates have acquired unique expertise in these topics. However, health-care settings do not routinely maximize the use of DNP-prepared nurses in these roles. This article provides an overview of the challenges to understanding the value and impact of DNP-prepared nurses, along with recommendations and opportunities for future practice.
Uptake of Innovations in Nursing: The Necessity for Implementation Science
Authors: Younas Ahtisham
Published: October 2023

Innovations are critical for improving clinical practice and nursing education, and for enhancing learning and practice change for frontline nurses and nursing students. Continuous innovation for delivering safe care and improving patient outcomes is needed. Merely demonstrating the effectiveness of research innovations is not enough to promote their uptake and use in practice. A 2021 study in cancer research reported that moving research into practice takes about 15 years. Implementation science, a systemic process of identifying the most relevant approaches to move research into practice, has emerged as an effective way to bridge the research-practice gap. The purpose of this article is to discuss why and how Implementation Science is necessary to promote the uptake of innovations in clinical and educational practice.
The Effects of an Innovation Process in Nursing Course on Students’ Creative Thinking and Entrepreneurial Skills: An Uncontrolled Before/After Study
Authors: Tuğrul Emel
Published: October 2023

Background: Creative thinking and entrepreneurship have an important place in innovation studies in the field of nursing. Purpose: This study aims to examine the effect of an Innovation Process in Nursing course on students’ creative thinking tendencies and entrepreneurship skills. Methods: An uncontrolled before/after design with non-probability sampling collected data on 70 nursing students in a 15-week Innovation Process in Nursing course using the Marmara Creative Thinking Dispositions Scale (MCTDS) and the University Students Entrepreneurship Scale. Data were analyzed using percentage, mean, standard deviation, and paired samples t-test. Conclusions: Scores on both the MCTDS and the University Students Entrepreneurship Scale improved significantly (p < 0.05) on post-test. Implications for Practice: Nurse educators should add courses on creative thinking and entrepreneurship to the curriculum.
On Repentance and Repair: Making Amends in an Unapologetic World, by Rabbi Danya Ruttenberg
Authors: Smith Rebecca
Published: October 2023

Rabbi Danya Ruttenberg's 2022 book, On Repentance and Repair: Making Amends in an Unapologetic World, questions the conventional wisdom that being quick to forgive is a virtue. Unless the person who has caused harm has acknowledged the harm, started to change, made restitution, apologized, and is now making different choices, forgiveness is not just unwarranted, it is potentially harmful to individuals and societies.
Amended Safety Assessment of Mentha piperita (Peppermint)–Derived Ingredients as Used in Cosmetics
Authors: Johnson Wilbur , Bergfeld Wilma F. , Belsito Donald V. , Hill Ronald A. , Klaassen Curtis D. , Liebler Daniel C. , Marks James G. , Shank Ronald C. , Slaga Thomas J. , Snyder Paul W. , Fiume Monice , Heldreth Bart
Published: October 2023

The Expert Panel for Cosmetic Ingredient Safety (Panel) reviewed the safety of M piperita (peppermint)–derived ingredients. The Panel reviewed data relevant to the safety of these ingredients. Because final product formulations may contain multiple botanicals, each containing the same constituent(s) of concern, formulators are advised to be aware of these constituents and avoid reaching levels that may be hazardous to consumers. Industry should continue to use good manufacturing practices to limit impurities that could be present in botanical ingredients. The Panel concluded that M piperita (Peppermint) Oil, Extract, Leaf, and leaf-derived ingredients are safe in cosmetics in the present practices of use and concentration when formulated to be non-sensitizing, and that the available data are insufficient for determining that M piperita (Peppermint) Flower/Leaf/Stem Extract, M piperita (Peppermint) Flower/Leaf/Stem Water, and M piperita (Peppermint) Meristem Cell Culture are safe under the intended conditions of use in cosmetic formulations.
Long-Term Effect of TBX4 Germline Mutation on Pulmonary Clinico-Histopathologic Phenotype
Authors: Doughty Elizabeth S. , Norvik Christian , Levin Alice , Bodmer Jenna , Tran-Lundmark Karin , Abman Steven H. , Galambos Csaba
Published: October 2023

Tbx4 protein, expressed in mesenchyme of the developing lung, contributes to airway branching and distal lung growth. An association between pediatric onset of pulmonary arterial hypertension (PAH) and genetic variations coding for the T-box transcription factor 4 gene ( TBX4) has been increasingly recognized. Tbx4-related PAH onset has a bimodal age distribution, including severe to lethal PAH in newborns and later onset PAH. We present an autopsy study of a 24-year-old male with a heterozygous TBX4 variant, who developed pulmonary arterial hypertension at age 12 years. This unique case highlights the complex pulmonary histopathology leading to lethal cardiopulmonary failure in the setting of TBX4 mutation.
Intrahepatic Cholangiolitis in Cystic Fibrosis (ICCF): An Under-Appreciated Cause of Persistent Cholestasis in Infancy
Authors: Bernieh Anas , Bove Kevin , Garcia Victor , Tiao Gregory , Lazar Lauren , Sathe Meghana , Sanchez Julie , Gonzalez Raquel , Gonzalez-Gomez Ignacio
Published: October 2023

Liver histology in infants with cystic fibrosis (CF) and persistent cholestasis is seldom reported in detail. We extend previous observation of a distinctive intrahepatic cholangiopathy (ICCF) to 3 additional infants homozygous for CFTR pathological variants and a fourth infant with a heterozygous CFTR variant, summarizing our experience in 10 infants with CFTR variants and persistent cholestasis. Cholangiograms demonstrate abnormal extrahepatic ducts in 2 infants with CF, 1 with uniform dilatation interpreted as a choledochal cyst and the other with narrow patent ducts. Liver histology in 3 CF homozygotes had prominent ductular reaction with a focally destructive cholangiolitis (inflammation of small bile ducts). The CFTR heterozygote had generalized portal edema with ductular reaction and paucity but no cholangitis. Cholestasis slowly subsided in all infants. ICCF is characterized by severe ductular reaction, prominent cholangiocyte injury, and multifocal necrotizing cholangiolitis. Local aggregates of portal ceroid might suggest previous bile leakage from damaged ducts. ICCF in liver biopsies from infants with cystic fibrosis and persistent cholestasis is unrelated to the specific CFTR genotype. Liver biopsy findings and intraoperative cholangiogram help rule out biliary atresia. ICCF is an early manifestation of CF, a likely prototype for pathogenesis of cystic fibrosis liver disease later in life.
Choroidal neovascularization and MEWDS like reaction in a child: A rare case
Authors: Desira M. , Fitoussi R. , Comet A. , Denis D. , Stolowy N. , David T.
Published: October 2023

Purpose

To report a case of choroidal neovascularization (CNV) associated with Multiple Evanescent White Dot Syndrome (MEWDS) in a child.

Study Design

Case report.

Results

A 13-year-old child visited us with a month-long history of blurred vision in his right eye. His right fundus showed several subretinal white dots and an atrophic macular lesion corresponding to a CNV. Angiography and optical coherence tomography (OCT) were consistent with the diagnosis of MEWDS. The patient's condition poorly improved after an intravitreal injection of anti-vascular endothelial growth factor (anti VEGF) in his right eye.

Conclusions

We reported the case of CNV associated with MEWDS like reaction. The hypothesis of a triggered-MEWDS was highly suspected but no cause was found, which is often the case in paediatric inflammatory eye disorders. Long-term follow-up is needed to judge the evolution.
Wear and friction of self-lubricating coatings applied to spur gears in fluid-free aerospace actuation gearboxes
Authors: Finch Thomas , Vitu Tomas , Polcar Tomas
Published: October 2023

Aerospace actuation gearboxes operate in low-temperature environments where increased lubricant viscosity leads to significant no-load power losses. Replacing fluid lubricants with coatings applied to the gear teeth is one potential approach to improving gearbox efficiency. Here we develop an approach to determining average wear rates of coated gears using a power-recirculating test stand, profile measurements and a model of the tooth contact. Worn gears are inspected using scanning electron imagery, and energy dispersive X-ray and Raman spectroscopy to understand the wear mechanisms and failure modes. Average coefficients of friction are determined at 20°C and −40°C using a power-absorbing test stand and isolation of tooth friction losses by calculation. These methods are then demonstrated on a promising C/Cr composite coating.
An investigation of the wear and efficiency in non-standard internal spur gear set
Authors: Ravivarman R , Prabhu Sekar R
Published: October 2023

In this research, a finite-element model of internal gear drives with different tooth thickness factors (non-standard gear drives) is generated in order to investigate their performance characteristics. The finite-element analysis includes a focused mixture of non-standard internal gear set under enhanced bending and contact strength conditions for an accurate assessment of wear and efficiency. The analysis comprised gear sets having higher bending strength compared to the conditions in the standard internal gear drive to evaluate the tooth wear and its efficiency. A state-of-the-art semi-analytical nonlinear contact mechanics construction is executed to model a non-standard internal gear transmission unit. The tooth thickness of the non-standard internal gear is varied concerning the stresses and is quantified as a function. The computed results also extended with internal gear sets at varying operating parameters. The results evidently specify that power loss decreases with the proper combination of operating parameters. The results are presented and strategies concerning the design of a non-standard internal gear are also deliberated.
A decoupled approach to enhance the Elrod algorithm
Authors: Wang Xiang , Xu Wanjun
Published: October 2023

The Elrod algorithm is widely used for the study of bearing cavitation problems. However, the potential instability of the algorithm makes it difficult to use in practical applications. A simplified Elrod algorithm based on a decoupled technique was developed. The new algorithm is well-regularized because the tough switch function used for the shear flow term is removed. The most significant advantage of the algorithm is the stability, unlike the traditional algorithm where the accuracy of results irregularly depends on the choice of grids. The numerical experiments, including a journal bearing and a surface-dimpled thrust bearing, show that the simplified Elrod algorithm converges consistently for all cases studied, while the traditional Elrod algorithm fails to converge for cases with a special number of grids. The simplified Elrod algorithm is considered to be a robust alternative to the traditional Elrod algorithm.
Understanding ‘Gender Equality’: First-Time Parent Couples’ Practices and Perspectives on Working and Caring Post-Parenthood
Authors: Twamley Katherine , Faircloth Charlotte
Published: October 2023

This article explores the ways couples making the transition to parenthood think about, practise, and assess ‘gender equality’. The analysis draws on data from two qualitative, longitudinal projects in the UK with 36 mixed-sex couples, grounded in the sociology of intimacy and parenting culture respectively. Both projects explore gender relations at the transition to parenthood, with recent changes in UK parental leave as a backdrop, to interrogate couples’ ideals and practices. In this article, we outline four configurations of equality articulated by couples: ‘symmetry’, ‘breaking gender stereotypes’, ‘fairness’, and ‘equality as respect’, which were developed through collaborative analysis. We explore how different configurations shape gendered practices in early parenthood. The analysis provides novel insights into the ways in which ‘gender equality’ is differentially defined and practised; shaped by the political and cultural context in which parents live; and relational in nature – thereby contributing to debates around equality in gendered divisions of paid and unpaid work.
Equity, diversity and inclusivity: Once more, with feeling
Authors: Aust Rowan
Published: October 2023

This article examines how gratitude influences the practice of British television production workers. It does so through a case study which asked television production workers to consider their work through the prism of gratitude: were they grateful for their work? Using semi-structured interviews, the data revealed that yes, workers were grateful but still identified many punitive working practices. These practices have simultaneously been identified by the industry itself, and there is an improvement discourse through the equity, diversity and inclusivity agendas. I argue here that equity, diversity and inclusivity measures are ineffective – as they have been proven to be elsewhere – because they do not consider the feeling(s), such as gratitude, of working in television. In failing to make this a consideration, equity, diversity and inclusivity work cannot address the inequalities it is there to resolve. This is because understanding the felt experience illuminates the fuller encounter of working in a particular environment. This includes the potential inhibition that gratitude can catalyse through indebtedness. In understanding what these feelings catalyse when cooperating in what they know to be an unfair system, equity, diversity and inclusivity work can be progressed beyond a model predicated on assimilation, to something that achieves substantive change.
Host country cultural profile and the performance of foreign subsidiaries in Latin America
Authors: Correa da Cunha Henrique , Singh Vikkram , Farrell Carlyle
Published: October 2023

While cultural distance (CD) is a popular construct in international business (IB), most studies confound the distance and country profile effects. There is an ever-growing debate on measurement issues and distinguishing the effect of doing business in countries with different cultural profiles. While the vast majority of studies focus on the implications of CD, the objective of this study is to investigate how the cultural profile in the host country affects the financial performance of foreign subsidiaries in Latin America. We employ a quantitative approach with panel data, including over 4200 firm-year observations of the same foreign subsidiary firms in the 10 largest economies in Latin America. We measure cultural profile of the host country using the four original dimensions of Hofstede's framework. Then, we estimate the effects on the financial performance of foreign subsidiary firms using the original scale and by splitting the scale (e.g. degree of masculinity vs degree of femininity) to compare the effects of the opposite poles of the cultural dimensions. The findings reveal that certain cultural characteristics in the host country profile (e.g., individualism and femininity) positively impact performance. In contrast, other cultural traits have a negative (masculinity and collectivism) or no significant impact (uncertainty avoidance). Also, the firms can adjust positively to high and low power distance scores in the host country. This study offers novel insights into the implications of national culture for financial performance by showing that the host country's cultural profile significantly impacts foreign subsidiary firms’ performance.
Post-Procedural Form and Rape Ambiance: Policing Sexual Violence in Mare of Easttown
Authors: Dango Michael
Published: October 2023

Mare of Easttown figures a social environment that is both city and family at once, making it impossible to disentangle stranger rape and forms of acquaintance, date, or intimate partner rape—and therefore to locate the “problem” of rape as one of crimes to be solved by the police; or of ordinary heterosexuality, requiring more radical cultural transformation. Completing filming after the summer 2020 resurgence of the Black Lives Matter movement in the wake of the police murders of George Floyd and Breonna Taylor, the role of the police is further compromised in Mare of Easttown. I read the show’s episodic anxieties—its increasingly unrealistic plot developments that push at the borders of each episode in order to keep them open—as managing these ambivalences: between stranger and intimate rape; between “crime” and “the family”; between the public and the private; between trust in law enforcement and critique.
Combination of Minimally Invasive Methods for the Treatment of Varicose Veins
Authors: Ren Hongcheng , Wang Bin , Shao Changgang , Chi Guoqing , Liu Rui , Jiang Yan , Wang Yufeng , Ding Mingchao , Wang Huaming
Published: October 2023

Objective

The aim of the study was to evaluate the efficacy and safety of the combination of minimally invasive methods for the treatment of incompetent great saphenous vein and perforating veins.

Methods

Between December 2019 and October 2020, F-care radiofrequency ablation combined with ultrasound-guided foam sclerotherapy and residual perforator ligation and concomitant microphlebectomy were adopted for all eligible patients. The clinical symptoms scores, complications, and quality of life were recorded.

Results

49 patients (64 limbs) with a mean age of 63.29 ± 10.14 years, and 60.9% 4 were male. The 1-year truncal closure rate was 63/64 (98.4%). 1 A significant improvement in the Venous Disability Score, the Venous Segmental Disease Score, the Venous Clinical Severity Score and Chronic Venous Disease Quality of Life Questionnaire Score, at 12 months after the combination of minimally invasive treatment, were observed in the study. One patient developed intermuscular vein thrombosis that was successfully managed with rivaroxaban.

Conclusions

The combination of minimally invasive methods is a safe and effective method for the treatment of lower extremity varicose veins. Further large-scale, prospective, multi-center studies are needed to further verify the findings of this study.
Aneurysmal recurrence and retreatment modalities after Woven EndoBridge (WEB) device implantation: A systematic review and meta-analysis
Authors: Kobeissi Hassan , Ghozy Sherief , Pakkam Madona , Bilgin Cem , Tolba Hatem , Kadirvel Ramanathan , Brinjikji Waleed , Kallmes David F
Published: October 2023

Background

The Woven EndoBridge (WEB) device is used to treat wide-neck bifurcation aneurysms (WNBAs). We conducted a systematic review and meta-analysis to determine the retreatment rate strategies following aneurysmal recurrence of WEB device treated WNBAs.

Methods

This study is reported following the PRISMA 2020 guidelines. We conducted a systematic review of the literature using PubMed, Scopus, Embase, and Web of Science. Data were pooled using a random-effects model. We calculated pooled prevalence and corresponding 95% confidence intervals (CI).

Results

We included 11 studies. The overall retreatment rate was 171/1875 aneurysms (10.3%; 95% CI  =  8.3–12.9). Stent-assisted coiling was used to treat 59 aneurysms (36.7%; 95% CI  =  26.4–48.5), and flow diverters were used to treat 44 aneurysms (18.7%; 95% CI  =  9.9–32.5). Following retreatment, the complete occlusion rate was 57/91 aneurysms (62.8%; 95% CI  =  48.2–75.3) and the adequate occlusion rate was 24/91 aneurysms (26.4%; 18.4%–36.4%). The most common aneurysmal recurrence site was the anterior communicating artery (44/136 aneurysms, 32.4%; 95% CI  =  25.0–40.7).

Conclusions

Roughly 10% of WNBAs initially treated with the WEB device will undergo retreatment. Retreatment is an effective strategy for WEB-treated aneurysms, with high rates of adequate and complete occlusion. Future studies should work to identify risk factors for aneurysmal recurrence.
Comics in Science and Health Communication: Insights From Mutual Collaboration and Framing a Research Practice
Authors: Tavares Rui , Alemany-Pagès Mireia , Araújo Sara , Cohn Neil , Ramalho-Santos João , Azul Anabela Marisa
Published: October 2023

Comics have been used as a tool for learning, teaching, understanding, raising awareness and changing behaviours. Researchers are taking more advantage of this medium as comics in research has become a growing field. Notwithstanding, comics as research practice/method has received less attention, particularly the research framework involved in making comics. Here, we detail the research process through the drawing to create a comic about non-alcoholic fatty liver disease. We argue that deciding on visual choices intersecting the perspectives of both artist and researchers whilst promoting reflexivity can be best understood through mutual collaboration. We depict examples of how the active inter/trans/disciplinary research environment, incorporating perceptions, experiences, tensions, from the artist and researchers, and respective disciplines, also informed by patient testimonies, resulted in (new) meanings and ways of thinking in terms of visual content and structure. Particularly when creating the characters and when using multimodality and resources afforded by comics –visual metaphor, anthropomorphism, and scientific sketchnote–, to portray the human body and bring familiarity and simplicity to complex cellular and metabolic events. We end with a comic strip framing comics as research practice, outlining the active engagement during the drawing processes and the research framework that combined a mixed method research approach for creating a tool useful towards understanding science and health promotion.
Possibilities and Pitfalls for Dealing with Large Longitudinal Qualitative Datasets
Authors: Devonald Megan , Jones Nicola
Published: October 2023

The Gender and Adolescence: Global Evidence programme is a decade long cross-country longitudinal study of adolescents in low- and middle-income countries. The programme’s large sample size and variety of contexts make it an important case study of how to deal with large and complex qualitative datasets. In this methodological article, we explore some of the challenges and opportunities that occur when working with large datasets of longitudinal qualitative research. We provide examples of lessons learnt during GAGE data collection, coding, analysis and data management. This paper also explores the use of the qualitative data analysis software MAXQDA for simplifying the analysis of longitudinal data and providing opportunities for novel analytical techniques. We find that large longitudinal qualitative datasets can provide extremely rich and detailed data; however, there needs to be attention to key processes to ensure rigour and effectively utilise the breadth and depth of the data. These include mechanisms to work effectively with large teams of researchers, strong data management and coding procedures, and using qualitative software to manage and simplify data.
A comprehensive review addressing the factors influencing generic drug substitution
Authors: Jouni Fatima , Mansour Maribelle , Hatem Georges , Awada Sanaa
Published: October 2023

Generic drug substitution is a common practice in healthcare systems worldwide to promote cost-saving treatments while maintaining therapeutic effectiveness. Several factors influence this substitution, including regulatory policies, safety and efficacy considerations, patient and physician preferences, and market dynamics. This review comprehensively analyzes how these factors interact and influence generic drug substitution in healthcare settings and across various therapeutic classes and highlight the importance of balancing cost-saving measures with maintaining patient safety and therapeutic efficacy. Policies and guidelines established by health authorities in each country influence the approval, interchangeability, and substitution of generic drugs. Bioequivalence and therapeutic equivalence are critical factors, particularly in drugs with narrow therapeutic indexes. Moreover, physicians’ acceptance and willingness to prescribe generic drugs, as well as patient acceptance and compliance with generic drug use, play a vital role in promoting generic substitution.
Assessing medication-related burden of community-dwelling individuals with chronic conditions in a small island state
Authors: Sacco Katya , West Lorna M Bonnici , Grech Lauren M , Krska Janet , Cordina Maria
Published: October 2023

Objectives

Medication taking in the management of chronic conditions causes a significant burden on individuals. The aim of this study was to explore the medication-related burden in ambulatory adult patients with chronic conditions in Malta.

Methods

A cross-sectional survey utilising the living with medicines questionnaire V3 (LMQ V3) was conducted in Maltese residents over the age of 18 years, taking at least 1 medication for a chronic condition and recruited through community events. The overall LMQ score, the domain scores and the visual analog scale data were analysed to determine relationships with the demographic factors.

Results

A total of 337 responses were analysed revealing a moderate (42.4%) to high medication (36.8%) related burden. The drivers of medication-related burden were primarily: ‘side-effects of prescribed medication’ (r = −0.843, p < 0.001), ‘attitudes/concerns about medicine use’ (r = −0.830, p < 0.001) and ‘impact/interferences to day-to-day life’ (r = −0.820, p < 0.001). Lack of autonomy to vary the dosage regimen resulted in a higher burden (r = −0.260, p < 0.001). Males experienced an overall higher burden ( p = 0.046) especially related to practical difficulties ( p = 0.04), cost-related burden ( p = 0.04) and side-effects of prescribed medication ( p = 0.01).

Conclusion

Medication-related burden is complex and multi-faceted as demonstrated by the findings of this study. Healthcare professionals should seek to identify and address factors causing this burden to improve patient outcomes.
Explaining the technological acceptance of 5G: Quantitative and qualitative insights from China and the United States
Authors: Liang Fan , Campbell Scott W.
Published: October 2023

This study examines people's acceptance of the fifth generation (5G) of wireless and mobile communication technologies at a time when such services and devices were just approaching consumer availability. It utilizes the Technological Acceptance Model to the frame analysis of key perceptions of 5G technology, as well as the social climate surrounding it. Quantitative and qualitative data were gathered from adult samples in China and the United States to assess how they understand and perceive 5G technology. The results show that perceived technological features (e.g., perceptions of usefulness and speed) explain the favorable attitudes and adoption intentions in the two countries, whereas personal privacy concerns explain the negative attitudes and intentions. The results also demonstrate that, while 5G technology was often regarded as an instrument for national elevation in China, we see more concerns about rumored negative effects of the technology on health in the United States.
Initial exploration of a novel fusion protein, IL-4/IL-34/IL-10, which promotes cardiac allograft survival mice through alloregulation
Authors: Lee Young S. , Cheng I-Ting , Raquel Godoy-Ruiz , Weber David J. , Scalea Joseph R.
Published: October 2023

Immune mediated graft loss still represents a major risk to transplant recipients. Creative approaches to immunosuppression that exploit the recipient's own alloregulatory mechanisms could reduce the need for pharmacologic immunosuppression and potentially induce immune tolerance. In the process of studying recipient derived myeloid derived suppressor cells (MDSCs), we identified key alloregulatory MDSC mechanisms, mediated by isolatable proteins IL-4, IL-34, and IL-10. We sought to purify these proteins and fuse them for subsequent infusion into transplant recipients as a means of inducing an alloregulatory response. In this introductory investigation, we leveraged molecular engineering technology to create a fusion protein (FP) of three cytokine coding sequences of IL-4, IL-34, and IL-10 and demonstrated their expressions by Western Blot analysis. Following purification, we tested whether FP IL-4/IL-34/IL-10 (FP1) can protect heart transplant allografts. Injection of FP1 significantly prolonged allogeneic cardiac graft survival in a dose-dependent fashion and the increase of graft survival time exceeded survival attributable to IL-34 alone. In vitro, MDSCs cells were expanded by FP1 treatment. However, FP1 did not directly inhibit T cell proliferation in vitro. In conclusion, newly developed FP1 improves the graft survival in cardiac transplantation mouse model. Significant additional work to optimize FP1 or include other novel proteins could supplement current treatment options for transplant patients.
Making a difference? A retrospective review of peripherally inserted central catheters: A single-center experience in Colombia
Authors: García-Zambrano Laura , Morales-Gómez Daniel , Dennis-Halley Michael J. , Román-Ortega Carlos F , Cabrera-Rivera Paulo A. , Parra Marcela
Published: October 2023

Introduction:

Peripherally inserted central catheters (PICCs) are an effective tool as a medical device in patients who require them. However, it is a procedure that has been associated with multiple complications and possible negative outcomes for the health of the patients. This paper seeks to describe the main complications derived from the insertion and maintenance of peripherally inserted central venous catheters (PICCs), based on the experience of a vascular accesses group in a cardiovascular center in Colombia.

Methods:

A retrospective cross-sectional analytical study of the adult population undergoing PICC insertion at the Fundación Cardioinfantil-Instituto de Cardiología, during the period between 2019 and 2020 by the vascular access program, was performed.

Results:

The frequency of any registered complication was 15.9% for 2019 and 11.2% for 2020. Bleeding at the procedure site occurred in 15.3% during 2019 and 7.0% in 2020, making it the most frequent complication during the procedure. All the variables of complications associated with infection (bacteremia, phlebitis, and catheter-related infection) showed a decrease in 2020 compared to the previous year. The central line-associated bloodstream infection registered for the year 2019 was 1.94 bacteremia’s/1000 catheters-day compared to 0.29 bacteremia’s/1000 catheters-day.

Conclusions:

There has been a 4.7% reduction in the frequency of any registered complication after the implementation of the vascular access groups. Global and specific complications decreased significantly from 2019 to 2020. Notably, bacteremia, a common post-procedure complication, showed a substantial decrease in frequency compared to national and worldwide literature. It is also been described that complications associated with infection showed a decrease in 2020 compared to 2019. Whether or not all these findings are directly or somewhat related to the results stemming from the vascular access groups still needs further investigation.
Cecal Dieulafoy lesion is a rare cause of lower gastrointestinal bleeding: A case report
Authors: Saha Bibek , Takkellapati Divya , Beckman Thomas J.
Published: October 2023

Dieulafoy lesions are a rare but life-threatening cause of gastrointestinal bleeding. Colonic Dieulafoy lesions are exceptionally rare, comprising only 2% of these lesions. We present a case of cecal Dieulafoy lesion as an unusual cause of lower gastrointestinal bleeding—along with hemoptysis. An 81-year-old male with pulmonary hypertension presented with a one-day history of hematochezia. He subsequently developed new small-volume hemoptysis/hematemesis with increasing oxygen requirements. Bronchoscopy revealed old blood in the left lower lobe, with no active bleeding. The hemoptysis was attributed to severe pulmonary hypertension. Colonoscopy revealed a 2-mm cecal Dieulafoy lesion with spurting bleeding, which was clipped. We report a rare case of cecal Dieulafoy lesion with only 13 other published cases. Our case was complicated by hemoptysis creating an interesting diagnostic dilemma. In patients bleeding from both oral and anal orifices, a brisk upper gastrointestinal bleed—as well as independent causes involving the gastrointestinal and respiratory tracts—should be considered.
First report of Mycobacteria avium complex (Mycobacteria intracellulare) in a cat from Southeast Asia
Authors: Han Hock Siew , Gunn-Moore Danièlle
Published: October 2023

Case summary

A 3-year-old castrated male domestic shorthaired cat, with indoor–outdoor access, was presented for chronic, progressive multinodular to generalised subcutaneous nodules covering much of its body. Previous medical treatment with doxycycline had been unhelpful. Fine-needle aspiration of the nodules revealed intra- and extracellular multibacillary negative staining rods in pyogranulomatous inflammation. Bacterial culture and susceptibility studies isolated Mycobacterium intracellulare, with zimine as the drug of choice for treatment. Initial triple therapy with rifampicin, azithromycin and pradofloxacin was ineffective, and was changed to triple therapy with clofazimine, clarithromycin and doxycycline once drug susceptibility was known, which was given for 3 months, after which long-term therapy with clofazimine and clarithromycin was continued.

Relevance and novel information

Slow growing M intracellulare, a member of the Mycobacterium avium complex (MAC), has never been reported to cause disease in cats from Singapore and, by extension, Southeast Asia. The infection in this patient resulted in subcutaneous nodules, which started on the face, then spread to the feet and much of the rest of its body. This is in contrast to that commonly reported for infection with M avium, which is also a member of MAC, and may not only present with similar signs in cats, but also progress to systemic spread. Susceptibility studies suggest clofazimine as the drug of choice when treating this infection, and this case supports its use as empirical therapy for veterinarians treating this disease in this region while awaiting culture and sensitivity results.
Use of high-flow oxygen therapy in a cat with cardiogenic pulmonary edema
Authors: Pouzot-Nevoret Céline , Hocine Leïla , Allaouchiche Bernard , Her Jiwoong
Published: October 2023

Case summary

A 7-month-old female spayed domestic shorthair cat was presented for respiratory distress due to cardiogenic pulmonary edema. Despite initial treatment and oxygen delivery in an oxygen tent, the cat still showed signs of severe respiratory effort and oxygen saturation measured via pulse oximetry was below 85%. Because the owners declined mechanical ventilation, the cat was transitioned to high-flow oxygen therapy (HFOT). HFOT allowed significant improvement of the respiration parameters within 15 mins without causing clinical complications. The cat was briefly anaesthetised for the placement of the nasal cannula on initiation of HFOT, and the interface was well tolerated thereafter. The cat was transitioned to an oxygen cage after 16 h, weaned from oxygen 4 h later and was discharged after 3 days of hospitalisation. Long-term follow-up showed no abnormalities, and the leading hypothesis was transient myocardial thickening.

Relevance and novel information

The first use of HFOT in a dyspneic cat is described in this study. HFOT could be a life-saving option for cats with severe hypoxemia or do-not-intubate orders that fail to respond to conventional oxygen therapies.
Limb sparing in a cat with a humeral osteosarcoma using a customised three-dimensional printed endoprosthesis
Authors: Malak Anthony , Parr William CH , Levien Andrew S , Basa Rachel M
Published: October 2023

Case summary

A 12-year-old male neutered Bengal cat presented for a left thoracic limb lameness of several weeks’ duration. Abnormal advanced imaging findings depicted the presence of an irregularly marginated osteolytic lesion in the proximal-mid diaphysis of the left humerus. A histopathological evaluation of the humerus confirmed a diagnosis of osteoblastic osteosarcoma. Limb-sparing surgery was planned with a custom-designed three-dimensional printed endoprosthesis. Mild neuropraxia was noted immediately postoperatively and deemed to have resolved by the 2-week follow-up. Stereotactic radiation was planned, though pulmonary metastasis was noted on planning CT. The cat was euthanased 90 days postoperatively owing to the development of pulmonary clinical signs.

Relevance and novel information

This is the first reported case of a humeral limb salvage procedure in a cat using a custom-designed three-dimensional printed endoprosthesis. Although the survival time in this case was short, the patient maintained an adequate quality of life and limb function was preserved.
The spread of COVID-19 vaccine information in Arabic on YouTube: A network exposure study
Authors: Zeid Nour , Tang Lu , Amith Muhammad “Tuan”
Published: October 2023

Objective

The Arabic-speaking world had the lowest vaccine rates worldwide. The region's increasing reliance on social media as a source of COVID-19 information coupled with the increasing popularity of YouTube in the Middle East and North Africa region begs the question of what COVID-19 vaccine content is available in Arabic on YouTube. Given the platform's reputation for being a hotbed for vaccine-related misinformation in English, this study explored the COVID-19 vaccine-related content an individual is likely to be exposed to on YouTube when using keyword-based search or redirected to YouTube from another platform from an anti-vaccine seed video in Arabic.

Methods

Only using the Arabic language, four networks of videos based on YouTube's recommendations were created in April 2021. Two search networks were created based on Arabic pro-vaccine and anti-vaccine keywords, and two seed networks were created from conspiracy theory and anti-vaccine expert seed videos. The network exposure model was used to examine the video contents and network structures.

Results

Results show that users had a low chance of being exposed to anti-vaccine content in Arabic compared to the results of a previous study of YouTube content in English. Of the four networks, only the anti-vaccine expert network had a significant likelihood of exposing the user to more anti-vaccine videos. Implications were discussed.

Conclusion

YouTube deserves credit for its efforts to clean up and limit anti-vaccine content exposure in Arabic on its platform, but continuous evaluations of the algorithm functionality are warranted.