bluuebunny/crossref_metadata_2025 huggingface dataset:
Trojan horses: Creating a positive hidden (extra)curriculum through a Justice, Equality, Diversity and Inclusion (JEDI) initiative
Authors: Keshtiban Amir , Gatto Mark , Callahan Jamie L
Published: April 2023

In this paper, we describe a mechanism for subverting the institutional-level neo-liberal hidden curricula of responsibility learning in universities by using a positive hidden curriculum based on extra-curricular activities partnering staff and students. In our study, we leverage projects from an institution-sponsored Justice, Equality, Diversity and Inclusion (JEDI) initiative as notional ‘Trojan horses’ to instil within university students a more reflexive awareness of responsibility that they can take with them when they graduate. In delivering this positive hidden (extra)curriculum, staff are seemingly performing the formal agenda of the institution’s responsibility agenda while undermining its managerialist hidden curriculum by working in tandem with students. Our key findings – student reflection and voice – are evidence of the positive hidden curriculum implementation. Our contributions are twofold. First, we demonstrate that positive hidden curricula can serve as a tool of micro-activism to subvert managerialist hidden curricula. Second, we offer another dimension to Semper and Blasco’s interpersonal strategies for challenging the hidden curriculum by showing that collaborative projects between students and staff can be sites of a positive hidden (extra)curriculum. Collaborative initiatives such as the ones we describe in this article provide a tangible foundation for reconsidering creative and intrinsic approaches to responsible learning environments.
The Influence of the Metalworking Fluid on Tool Wear in Milling Inconel 718
Authors: Meier Linus , Eglin Michael
Published: April 2023

The understanding of tool wear mechanisms is fundamental to developing more productive machining processes. Therefore, the influence of different metalworking fluids on tool wear is studied when milling Inconel 718 using a rotating dynamometer, a stationary dynamometer, and a 3D microscope. A newly developed force model allows the interpretation of more than the maximal cutting force and explains the relation between tribological conditions, tool wear and process forces. In a novel setup, the coolant type was changed in the middle of the tool life to differentiate the direct influence of the coolant on the process forces and the indirect effect via tool wear. By fitting the model to the data, it is found that the metalworking fluid and the process parameters not only influence the wear rate globally, but also lead to different wear mechanisms. The 3D data of worn cutting edges confirms the existence of different wear mechanisms.
Artificial intelligence assisted telehealth for nursing: A scoping review
Authors: Choi Jeeyae , Woo Seoyoon , Ferrell Anastasiya
Published: April 2023

Background

Due to the COVID-19 pandemic, telehealth resurfaced as a convenient efficient healthcare delivery method. Researchers indicate that Artificial Intelligence (AI) could further facilitate delivering quality care in telehealth. It is essential to find supporting evidence to use AI-assisted telehealth interventions in nursing.

Objectives

This scoping review focuses on finding users’ satisfaction and perception of AI-assisted telehealth intervention, performances of AI algorithms, and the types of AI technology used.

Methods

A structured search was performed in six databases, PubMed, CINAHL, Web of Science, OVID, PsycINFO, and ProQuest, following the guidance of the Preferred Reporting Items for Systematic Review and Meta-Analysis Extension for Scoping Reviews. The quality of the final reviewed studies was assessed using the Medical Education Research Study Quality Instrument.

Results

Eight of the 41 studies published between 2017 and 2022 were included in the final review. Six studies were conducted in the United States, one in Japan, and one in South Korea. Four studies collected data from participants ( n = 3014). Two studies used image data ( n = 1986), and two used sensor data from smart homes to detect patients’ health events for nurses ( n = 35). The quality of studies implied moderate to high-quality study (mean = 10.1, range = 7.7–13.7). Two studies reported high user satisfaction, three assessed user perception of AI in telehealth, and only one showed high AI acceptability. Two studies revealed the high performance of AI algorithms. Five studies used machine learning algorithms.

Conclusions

AI-assisted telehealth interventions were efficient and promising and could be an effective care delivery method in nursing.
Understanding how virtual care has shifted primary care interactions and patient experience: A qualitative analysis
Authors: Wu Kelly , Dang Nguyen Marlena , Rouleau Geneviève , Azavedo Rhea , Srinivasan Diya , Desveaux Laura
Published: April 2023

Introduction

The widespread and rapid implementation of virtual care has introduced evolutionary changes in the context, process, and way primary care is delivered. The objectives of this study were to: (1) understand whether and how virtual care has shifted the therapeutic relationship; (2) describe the core components of compassionate care from the patient perspective and (3) identify how and in what circumstances compassionate care might be amplified.

Methods

Participants living in Ontario, Canada were eligible if they had interacted with their primary care clinician following the rapid implementation of virtual care in March 2020, irrespective of virtual care use. One-on-one semi-structured interviews were conducted with all participants and data were analyzed using inductive thematic analysis.

Results

Four themes emerged across 36 interviews: (1) Virtual care shifts communication patterns but the impact on the therapeutic relationship is unclear; (2) Rapid implementation of virtual care limited perceived quality and access among those who did not have the option to utilize it; (3) Patients perceive five key elements as central to compassion in a virtual context; and (4) Leveraging technology to fill gaps within and beyond the visit is a step towards improving experiences for all.

Discussion

Virtual care has transformed the ways in which patient-clinician communication operates in primary care. Patients with access to virtual care described largely positive experiences, while those whose interactions were limited to phone visits experienced decreased quality and access to care. Attention must shift to identifying effective strategies to support the health workforce in building virtual compassion competencies.
Language learning strategies used by EFL students: Does their digital fluency matter?
Authors: Lee Jia-Ying
Published: April 2023

Major advances have been made in understanding language learning strategies (LLS). However, rapid changes in human interaction induced by the internet and web 2.0 warrant a re-assessment of LLS in today’s context, especially vis-à-vis digital nativeness. Therefore, a large-scale quantitative investigation involving 891 college students was conducted. Their LLS use patterns and frequency and their level of digital fluency were examined using two instruments: Oxford’s Strategy Inventory for Language Learning (SILL) and Teo’s Digital Natives Assessment Scale (DNAS). The participants reported moderate usage of all the strategies described in SILL. However, they reported using specific SILL categories (compensation, memory, and metacognitive) more frequently than others (social, cognitive, and affective). Participants with different levels of digital fluency showed significant variations in the frequency of use of LLS. Additionally, compared to previous generations, these modern participants adopted different usage patterns.
Meta-analysis to estimate the relative effectiveness of TBLT programs: Are we there yet?
Authors: Boers Frank , Faez Farahnaz
Published: April 2023

Bryfonski and McKay published a meta-analytic review of reports on the effectiveness of task-based programs relative to other types of programs. The aggregated effect in support of task-based programs was substantial. However, Boers et al. re-examined the 27 comparative studies from which this effect size was calculated and argued that, with one exception, they did not serve the intended purpose of the meta-analysis well. However, in a recent publication, Xuan et al. argue that a good number of the primary studies used by Bryfonski and McKay are in fact suitable for a meta-analysis if the programs they assess are re-defined as task-supported rather than task-based programs. Xuan et al. then conducted a meta-analysis of 16 of the 27 comparative studies that were originally included in Bryfonski and McKay’s analysis, confirming the benefits of programs that use tasks, albeit with a smaller aggregated effect size. The present article revisits these 16 studies and, in addition, examines a handful more recent ones published since Bryfonski and McKay’s original meta-analysis. The conclusion remains that the field is not ripe yet for a meaningful meta-analysis of the relative effectiveness of either task-based or task-supported programs. Interpreting the outcomes of the meta-analytic endeavours reported so far is especially difficult because of a lack of clarity in both the primary study reports and the meta-analyses of what constitutes a task-supported program and of what is understood by ‘task’.
Designing for diversity in Aotearoa / New Zealand Chinese language classrooms
Authors: Qi Grace Y. , Sun Susan Y. H. , Carvalho Lucila
Published: April 2023

There has been an increased interest in teaching and learning Chinese language across many schools in Aotearoa / New Zealand (NZ). Chinese language teachers, particularly those new to the Aotearoa/NZ schools and education system, are confronted with (1) an educational environment that calls for learner-centred pedagogies and (2) an increasingly diverse classroom that requires these teachers to adopt pedagogical strategies that address and cater for diversity. In response to these needs, this article discusses a case study of a research-informed professional development (PD) workshop designed to support Chinese language teachers to (1) identify ways that diversity manifests in the Aotearoa/NZ classroom and (2) figure out how to design for learning whilst accounting for diversity in Aotearoa/NZ. The workshop promoted a discussion on diversity from an inclusive, heterogeneous perspective, and introduced teachers to contemporary conceptual ideas connected to ‘teaching-as-design’, and to the Activity-Centred Analysis and Design (ACAD) framework. Teachers (N = 19) were randomly assigned to groups of three to five. Groups were encouraged to collaborate on the design of learning tasks that incorporated TBLT (Task-Based Language Teaching) and addressed diversity in the classroom. Analysis of their design activities and produced artefacts reveals that teachers’ understanding of diversity comprised many characteristics, they held a positive attitude towards being responsive to diversity, and were able to experiment with new design concepts and ideas using the ACAD toolkit. In particular, teachers were able to successfully expand the design of their learning tasks to include social and material design elements to address learner diversity. Findings also reveal teachers’ emerging awareness of their dual role as facilitators and as teacher-designers.
Hypercategorization and hypersexualization: How webcam platforms organize performers and performances
Authors: Stegeman Hanne M , Velthuis Olav , Jokubauskaitė Emilija , Poell Thomas
Published: April 2023

Webcam sex platforms simultaneously host thousands of live performances. To allow users to explore these, platforms categorize. On porn sites, this has led to extremely detailed, hypercategorized classification systems. Developing the concept of “categorization regime,” which refers to all categorization options on a platform, we examine hypercategorization on 50 webcam sex platforms. In the heavily stigmatized, yet immensely popular, webcam sex industry hypercategorization shapes working environments and conceptions of desirability. Through critical content analysis, we find that the examined platforms, employing over 1700 unique categories, categorize in detailed, messy, and elaborate ways. Analyzing examples from categorization systems for gender, ethnicity and body type, the article demonstrates that these categories both celebrate diversity and offer earning opportunities, yet also reinforce regressive discriminatory and fetishizing narratives about marginalized groups of webcam performers.
Artificial intelligence as a double-edged sword: Wielding the POWER principles to maximize its positive effects and minimize its negative effects
Authors: Chen Jennifer J , Lin Jasmine C
Published: April 2023

Advances in artificial intelligence (AI) over the last few decades are transforming the world, pervading nearly all sectors of society, including education, and many aspects of life. In the education discourse, interest in artificial intelligence has sparked various reactions and controversies—everything from appreciation for AI's capabilities to make teaching and student learning more efficient and effective to apprehension about their potential overuse and misuse. In this article, the authors discuss how artificial intelligence is a double-edged sword in early childhood education by presenting some of its positive effects (personalized learning, personalized interactive support, and increased accessibility to broadened learning experiences) and negative effects (overuse and misuse). Considering that young children are growing up in a nearly AI-ubiquitous world and are likely exposed to AI-powered tools, the authors propose applying the POWER (purposeful, optimal, wise, ethical, responsible) principles to maximize the benefits and minimize the drawbacks of AI use. Additionally, the authors recommend the integration of the POWER principles into AI literacy as an imperative for promoting the appropriate use of AI-powered tools.
Social policy and environment in Brazil: Why does community-supported agriculture matter?
Authors: Pedrosa Ana Paula , Xerez Romana
Published: April 2023

Recent political measures in Brazil, in conjunction with new environmental policies, could reverse previous achievements that had put the country at the forefront of social policy making. This article discusses the implications of Community-Supported Agriculture (CSA) for social policy. It is based on qualitative methods, namely, semi-structured interviews with subscribers from six administrative regions who participated through digital platforms. The results indicate that the factors determining consumer participation in CSA are health impact, strengthening local production, environmental concerns, and eating as a human right and political act. This article also demonstrates the need to promote participation among low-income and socially vulnerable families in CSA and to firmly connect food and nutrition security policy with health, and environment aimed at poverty alleviation. The novelty of this research lies in its consideration of the implications of CSA for environmental preservation and the promotion of a healthier and sustainable food system, namely for the low-income population, which can lead to the growth of eco-social policies in developing welfare states in the global south.
Critical Tiriti Analysis: A prospective policy making tool from Aotearoa New Zealand
Authors: Came Heather , O’Sullivan Dominic , Kidd Jacquie , McCreanor Tim
Published: April 2023

Restrictions on Indigenous peoples’ contributions to policymaking pervade post-settler societies like Australia, Canada and Aotearoa. Such effects are observed in spite of agreements like Te Tiriti o Waitangi in Aotearoa and the United Nations’ Declaration on the Rights of Indigenous Peoples. Te Tiriti, negotiated between the British Crown and Māori (Indigenous peoples of Aotearoa), may have been entered into honourably by both parties, but the Crown has consistently resisted its implementation. Contemporary colonialism is characterised by the entrenched and on-going displacement of Indigenous people’s authority by settler states, rationalised by race as a determinant of human worth. Impacts include land alienation, unsustainable resource exploitation and marginalising Indigenous voices from opportunities to make policy consistent with Indigenous values and preferred ways of living. Colonialism normalises institutional racism so that public policy outcomes are persistently unjust. This article describes Critical Tiriti Analysis (CTA), an original contribution to transforming colonial policy, which retrospectively evaluates whether any specific policy document is consistent with Te Tiriti. Substantial interest in CTA from policymakers, practitioners, and scholars led to the development of the tool as a prospective guide to making policy that is consistent with authoritative interpretations of Te Tiriti, and therefore, more likely effective in producing public policies which eliminate inequities. CTA was initially focused on health policy and built on a series of questions that arise from our interpretations of the text of Te Tiriti, contemporary Tiriti scholarship and jurisprudence, and our observations of the ways in which the method is being used by ourselves and others. Although deeply grounded in Aotearoa, we argue that CTA may be transferable to other colonial contexts, such as the Australian where treaties between First Nations and the state are being contemplated, and Canada which has passed legislation to implement the Declaration on the Rights of Indigenous Peoples.
Qualitative content analysis of school textbooks based on European Gender Equality Index
Authors: Gajda Aleksandra , Omelańczuk Iwona , Wołowicz Agnieszka
Published: April 2023

The main aim of the study was to identify the image of gender equality in Polish primary school textbooks. A thematic analysis of textbook content with elements of constant comparison method was carried out based on the six domains of the Gender Equality Index: work, money, knowledge, time power, and health. A total of 56 textbooks (32 Polish language textbooks and workbooks and 24 mathematics textbooks and workbooks) for primary school grades seven and eight were analysed. The content of the analysed textbooks seems to reflect the findings of the Gender Equality Index (GEI) regarding the Polish social reality and points to large gender polarisation and gender inequalities, in favour of men. The results are discussed based on theories of cultural understanding of gender and gender roles, as well as similar findings from other educational content studies.
Informality as a resource: A systems-theoretical take on the open method of coordination in education
Authors: Gain Vivien
Published: April 2023

Several authors have underlined that processes of Europeanisation of education emerge despite the European Union’s lack of formal power in this area. This article argues on the contrary that its lack of power precisely enables the EU to open up a range of possibilities for its involvement in this sector, among which the ET2020 Working Groups (WG) of the Open Method of Coordination (OMC). Based on observations of WG meetings and interviews with key actors, and using Niklas Luhmann’s systems-theory, we aim to show how the distance separating the ET2020 WG from the formal circuits of European decision-making acts as a resource for the development of a European discourse on education. Alongside the ordinary legislative procedure based on voting and implementing collectively binding decisions, the alternative political circuit of the OMC is based on the irritation of a set of education sector stakeholders through the creation and dissemination of reports of ‘good practices’. In doing so, the ET2020 Working Groups illustrate how politics transforms itself and redefines its boundaries when it is structured at the European level rather than at the level of the nation-state.
Outgroup Bias and the Unacceptability of Tax Fraud
Authors: Mendoza Aviña Marco , Blais André , Arel-Bundock Vincent , de la Feria Rita , Harell Allison
Published: April 2023

In countries with well-developed welfare state systems, it is often claimed that racial or ethnic minorities impose a heavy burden on social assistance programs without contributing to public goods. In this study, we consider the attitudinal effects of anecdotal reports of tax cheating by minorities. We conduct survey experiments in France and the United States to assess if people react more harshly to tax fraud perpetrated by members of a minority group rather than the majority group. We find no evidence that minority status affects judgments and perceptions about tax fraud, including among those on the right end of the political spectrum. Tax fraud is considered unacceptable regardless of the culprit’s origin.
Understanding Binge Drinking Quitting Intention and Behaviour Using an Extended TPB
Authors: Machaka-Mare Zivai M. , Mpinganjira Mercy , Maduku Daniel K.
Published: April 2023

Background

Binge drinking is a social problem that is highly prevalent in South Africa, particularly among the youth. The behaviour has negative consequences on the health of individuals and society.

Focus of the Article

This empirical study drew from the Theory of planned behaviour and decomposed the theory’s determinants of intention into two components each, to investigate intention to quit binge drinking. Social support from the Social cognitive theory was also investigated as a determinant of intention to quit. Furthermore, the study investigates the determinants quitting binge drinking behaviour.

Research Hypotheses

The study proposed that attitude (affective and instrumental); subjective norms (injunctive and descriptive), perceived behavioural control (self-efficacy and perceived controllability) and social support positively and significantly predict intention to quit binge drinking. Intention, perceived controllability and self-efficacy were hypothesised to predict actual behaviour of quitting binge drinking.

Importance to the Social Marketing Field

This study contributes theoretical knowledge through the use of an extended TPB model that focuses on the desired behaviour of quitting binge drinking and provides specific determinants that social marketers can use when designing interventions. The two-component TPB used in the study also provides social marketers distinctive and specific knowledge on which aspects from the original one component significantly influence the intention to quit. The implications are discussed from a social marketing perspective.

Methods

A cross-sectional, quantitative online survey was used to collect data from a convenient sample of 810 respondents. Partial Least Squares Structural equation modelling was used to analyse the data including testing the hypothesis and age group–based multigroup analysis.

Results

Instrumental attitude, injunctive norms, descriptive norms, self-efficacy and social support were found to significantly and positively predict intention to quit binge drinking explaining 49.2% variance in intention. However, the influence of affective attitude was negative and insignificant. Intention and self-efficacy positively explained 16.2% of variance in behaviour.

Recommendations for Research/Practice

It is recommended that social marketers focus on instrumental attitude injunctive, descriptive norms, self-efficacy as well as social support when designing interventions to promote quitting binge drinking behaviour.

Limitations

The main limitation of the study is it provides a broad ranging overview which calls for more experimental efforts to be done on the ground for practitioners promoting positive behaviour change.
Health Outcomes of Sexual Minority Women Who Have Experienced Adverse Childhood Experiences: A Scoping Review
Authors: Bochicchio Lauren , Porsch Lauren , Zollweg Sarah , Matthews Alicia K. , Hughes Tonda L.
Published: April 2023

Sexual minority women (SMW; e.g., lesbian, bisexual) report higher rates of almost every negative physical health (e.g., asthma, arthritis, cardiovascular disease), mental health (e.g., depression, anxiety), and substance use outcome compared to heterosexual women. Adverse Childhood Experiences (ACEs) have been identified as risk factors for negative health outcomes. Despite this, no study to date has synthesized existing literature examining ACEs and health outcomes among SMW. This gap is important because SMW are significantly more likely than heterosexual women to report every type of ACE and a higher total number of ACEs. Therefore, using a scoping review methodology, we sought to expand understanding of the relationship between ACEs and health outcomes among SMW. Using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for. Scoping Reviews protocol, we searched five databases: Web of Science, PsycInfo, CINAHL, PubMed, and Embase for studies published between January 2000 and June 2021 that examined mental health, physical health, and/or substance use risk factors and outcomes among adult cisgender SMW who report ACEs. Our search yielded 840 unique results. Studies were screened independently by two authors to determine eligibility, and 42 met full inclusion criteria. Our findings provide strong evidence that ACEs are an important risk factor for multiple negative mental health and substance use outcomes among SMW. However, findings were mixed with respect to some health risk behaviors and physical health outcomes among SMW, highlighting the need for future research to clarify these relationships.
The Technological Carnivalesque in Niantic’s Pokémon Go
Authors: Palmer Grant
Published: April 2023

This article explores the networked, affective, and embodied gameplay and potential of Niantic’s 2016 augmented reality smartphone game, Pokémon Go. Following affective critique in videogame and digital studies (Anable, Hayles, et al.,) and literary notions of the “grotesque and carnivalesque” (Bakhtin), I emphasize the important and often overlooked role of embodiment in hypertext, hypermedia, and digital smartphone technology. By framing Pokémon Go in relation to Shelley Jackson’s 1995 hypertext, Patchwork Girl, I identify a specific transformative moment that reactivates Bakhtin’s carnivalesque through the embodied gameplay of the digital mobile network. Pokémon Go’s digitally mediated gameplay demonstrates how mobile gaming, and perhaps all mobile computing, in general, serves to further expand the transformative implications and uncertain possibilities of embodiment as the digital takes on new forms. This observable, transductive transformation, I argue, demonstrates a reactivation of Bakhtin’s carnivalesque in the digitally mediated mode of the technological carnivalesque.
Amputation of the Unsalvageable Leg in Vascular Patients with Cancer
Authors: Wafi Arsalan , Kolli Vijay , Azhar Bilal , Poole Grace , Budge James , Moxey Paul , Loftus Ian , Holt Peter
Published: April 2023

Objectives

The aim of this study was to compare outcomes of major lower limb amputation (MLA) in patients with and without cancer and with cancer patients receiving palliation over amputation for their unsalvageable limb.

Methods

Cancer patients who underwent a major amputation or palliation between 2013 and 2018 were included. Comparison groups were cancer-MLA (active/managed cancers), non-cancer MLA (historic cancer or no cancer history) and cancer-palliation at presentation with unsalvageable limbs. Prospectively collected data was retrospectively analysed for outcomes including survival, postoperative complications, length of stay, suitability for rehabilitation and discharge destination.

Results

262 (cancer and non-cancer) patients underwent MLA and 18 patients with cancer received palliation. Of those amputated, 26 (9.9%) had active or managed cancer, of which 12 were diagnosed in the 6 months before MLA. Cancer-MLA patients presented with more acute ischaemia compared to non-cancer patients. Median survival was significantly different between the cancer-MLA (14.1 [9.5 - 29.5, 95% CI] months), non-cancer MLA (57.7 [45 - 73.6, 95% CI] months) and cancer-palliation (.6 [.4 - 2.3, 95% CI] months) groups, P < .001. A significantly higher proportion of cancer-MLA patients (10/26, 38.5%) were deemed unsuitable for rehabilitation in post-operative assessment compared to non-cancer MLA (21/236, 8.9%) patients, P < .001. There was a variation in destinations of discharge, with a greater proportion of cancer-MLA patients (4/26, 15.4%) going to a nursing home compared to non-cancer MLA (10/236, 4.2%) patients, P = .016.

Conclusion

Cancer is prevalent among vascular amputees, with a large proportion being occult diagnoses. Cancer is associated with poorer outcomes following amputation, but survival remains significantly better compared to palliation in cancer patients presenting with unsalvageable limbs.
Mycotic Abdominal Aortic Aneurysm Secondary to BCG Therapy for Non-muscle Invasive Urothelial Carcinoma of the Bladder
Authors: Godard Levi , Lee Linda , McGuinness Brandon , Shirsat Hemlata , Hoag Nathan
Published: April 2023

Bacillus Calmette-Guerin (BCG) therapy for treatment of bladder cancer is a rare cause of Mycobacterium bovis infected aortic aneurysm. Typical presentations have included general malaise, fever, and lower back pain. We present a case with lower back pain and constipation as presenting symptoms, leading to diagnosis of mycotic aneurysm presumed secondary to intravesical BCG therapy. Treatment included open surgical repair with femoral vein grafting and anti-tubercular therapy. This case highlights the importance of a high index of suspicion for less common infectious complications of BCG therapy.
No Difference in 30-day Mortality Between Patients Undergoing Bilateral Simultaneous Total Knee Arthroplasty With Technology Assistance Compared to Conventional Instrumentation
Authors: Cohen Jordan S. , Agarwal Amil R. , Gu Alex , Harris Andrew , Kinnard Matthew J. , Golladay Gregory J. , Thakkar Savyasachi C.
Published: April 2023

Background: Bilateral simultaneous total knee arthroplasty (BSTKA) has decreased in frequency due to concerns about higher rates of early mortality and complications than unilateral or staged surgeries. Purpose: We sought to evaluate whether technology assistance (encompassing robotics and computer assistance) decreases early mortality following BSTKA. Methods: We conducted a retrospective cohort study using a national all-payer claims database. Patients who underwent BSTKA from October 2015 to December 2020 were identified. Univariate and multivariable analyses were conducted to compare outcomes in patients who underwent BSTKA with technology assistance compared to conventional instrumentation. The primary outcome was 30-day postoperative mortality. Secondary outcomes were respiratory failure and fat embolism. A post-hoc analysis was performed to evaluate length of stay, readmission, and other medical complications. Results: A total of 14,870 patients who underwent BSTKA were included in this study. Of these, 860 patients underwent technology-assisted BSTKA, and 14,010 patients underwent BSTKA without technology assistance. After a multivariable analysis, patients who underwent technology-assisted BSTKA had equivalent odds of 30-day mortality compared to those who underwent BSTKA without technology assistance. Technology assistance was not protective against the development of acute respiratory failure or fat embolism. Conclusion: This retrospective cohort study found no differences in the rates of 30-day mortality, respiratory failure, or fat embolism after technology-assisted BSTKA compared to conventional BSTKA. On the post-hoc analysis, technology use was associated with a decreased length of stay, lower readmission risk, and decreased rates of deep vein thrombosis, pulmonary embolism, and blood transfusion.
More than just noise: Association of pulsatile tinnitus with anxiety, depression, and reduction of quality of life
Authors: Amans Matthew , Mattay Raghav , Hills Nancy K , Smith Eric , McCoy David , Narsinh Kazim , Meisel Karl
Published: April 2023

Background

While many of the causes of pulsatile tinnitus (PT) are treatable with endovascular approaches, the risks of treatment must be balanced with the risks of the underlying cause and the psychological impact of symptoms on patients. While many physicians have anecdotal experience, the comorbid relationship of depression and anxiety with PT is unknown. The objectives of this study are to quantify the prevalence of depression and anxiety, and, to identify the demographic risk factors for impactful depression and anxiety in patients with PT.

Methods

Subjects recruited from online PT groups filled out secure online questionnaires that included demographic questions, validated Tinnitus Functional Index (TFI) as well as PHQ-9 and GAD-7 questionnaires to assess the prevalence of concurrent depression and anxiety, respectively.

Results

Sample included 515 surveys (84% female, 65% unemployed, mean(sd) age = 46.4 years (14.2)). Median symptom duration was 1.9 years. Data showed 46% and 37% of patients with moderate to severe depression and anxiety, respectively. Higher TFI scores were associated with moderate to severe depression (OR 1.07; 95% CI 1.06–1.09, p < 0.001) and anxiety (OR 1.05, 95% CI 1.04–1.06, p < 0.001), with TFI subscores also independently being associated in a univariate analysis.

Conclusions

The prevalence of moderate to severe depression and anxiety in the PT population, which was previously unknown, is estimated in our study to be 46% and 37%, respectively. Significant association of TFI score with increased depression and anxiety scales adds further evidence of the impact of PT on the psychological health of these patients.
Algorithm for evaluating ophthalmic artery pseudo-occlusion during intra-arterial chemotherapy for retinoblastoma
Authors: Maddy Krisna , Luther Evan , Walker Ariel , Hackett Ashia , Lu Victor , Starke Robert
Published: April 2023

Background and importance

Intra-arterial chemotherapy infusion for retinoblastoma is typically performed via selective catheterization of the ophthalmic artery. Anastomoses between the external carotid and the ophthalmic arteries have also been utilized when the ophthalmic artery cannot be catheterized directly. However, these are not present in every patient.

Clinical presentation

A 10-month-old boy presented with bilateral retinoblastoma and underwent one round of intra-arterial chemotherapy (IAC) via direct catheterization of the ophthalmic arteries. Combined with adjuvant laser therapy, they experienced symptomatic improvement and tumour regression. However, during subsequent treatment sessions both ophthalmic arteries did not have anterograde flow and attempts to catheterize their origin were unsuccessful. Unfortunately, no targetable anastomoses between the external carotid and ophthalmic arteries were identified for drug delivery. Due to the patient's anatomy, balloon occlusion of the ECA was felt to be unsafe. As a salvage technique, a balloon was inflated in the left internal carotid artery (ICA) distal to the ophthalmic take-off to redirect flow into the ophthalmic. Repeat angiography with the distal ICA occluded showed improved flow into the ipsilateral ophthalmic artery. IAC was then successfully delivered through the left ICA.

Conclusion

This case illustrates the importance of utilizing creative endovascular techniques for targeted intra-arterial drug delivery when other conventional measures fail as these patients often have limited, and potentially higher risk, therapeutic alternatives.
Evaluation of ocular blood flow in the assessment of symptomatic carotid stenosis
Authors: Jones Matthew T , Sanchez Sebastian , Patel Rishi R , Raghuram Ashrita , Miller Jacob M , Hashimoto Ryuya , Kardon Randy , Samaniego Edgar A
Published: April 2023

Background and Purpose

The degree of internal carotid artery (ICA) stenosis determined by criteria from the North American Symptomatic Carotid Endarterectomy Trial (NASCET) is not the most accurate index to assess distal flow compromise. Distal ICA perfusion is also determined by factors such as tandem carotid stenosis and collateral circulation. Quantification of end-organ ocular perfusion using non-invasive laser speckle flowgraphy (LSFG) may provide insights into distal ICA flow. This study prospectively assessed the degree of ICA flow using LSFG.

Methods

Eighteen patients with symptomatic carotid stenosis underwent LSFG evaluation. LSFG was used to extract ocular blood flow metrics recorded simultaneously in the retina, choroid, and optic nerve head. The following ocular flow parameters were measured with LSFG: mean blur rate (MBR), flow acceleration index (FAI), and rising rate (RR). Syngo iFlow perfusion imaging was used to objectively quantify contrast flow in the ICA and brain parenchyma during digital subtraction angiography. Time to peak (TTP) and contrast delay were extracted from seven different regions of interest (ROIs).

Results

MBR, FAI, and RR were correlated with NASCET degree of stenosis. FAI and RR also improved after stenting. TTP improved after stenting in three ROIs. A moderate negative correlation was observed between FAI and contrast delay.

Conclusions

LSFG non-invasively quantifies end-organ blood flow distal to the ICA origin. LSFG metrics have the potential to quantify end-organ perfusion and determine if a proximal carotid stenosis is symptomatic.
Prediction of delayed cerebral ischemia after cerebral aneurysm rupture using explainable machine learning approach*
Authors: Taghavi Reza M , Zhu Guangming , Wintermark Max , Kuraitis Gabriella M , Sussman Eric S , Pulli Benjamin , Biniam Brook , Ostmeier Sophie , Steinberg Gary K , Heit Jeremy J
Published: April 2023

Background

Aneurysmal subarachnoid hemorrhage results in significant mortality and disability, which is worsened by the development of delayed cerebral ischemia. Tests to identify patients with delayed cerebral ischemia prospectively are of high interest.

Objective

We created a machine learning system based on clinical variables to predict delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage patients. We also determined which variables have the most impact on delayed cerebral ischemia prediction using SHapley Additive exPlanations method.

Methods

500 aneurysmal subarachnoid hemorrhage patients were identified and 369 met inclusion criteria: 70 patients developed delayed cerebral ischemia (delayed cerebral ischemia+) and 299 did not (delayed cerebral ischemia−). The algorithm was trained based upon age, sex, hypertension (HTN), diabetes, hyperlipidemia, congestive heart failure, coronary artery disease, smoking history, family history of aneurysm, Fisher Grade, Hunt and Hess score, and external ventricular drain placement. Random Forest was selected for this project, and prediction outcome of the algorithm was delayed cerebral ischemia+. SHapley Additive exPlanations was used to visualize each feature's contribution to the model prediction.

Results

The Random Forest machine learning algorithm predicted delayed cerebral ischemia: accuracy 80.65% (95% CI: 72.62–88.68), area under the curve 0.780 (95% CI: 0.696–0.864), sensitivity 12.5% (95% CI: −3.7 to 28.7), specificity 94.81% (95% CI: 89.85–99.77), PPV 33.3% (95% CI: −4.39 to 71.05), and NPV 84.1% (95% CI: 76.38–91.82). SHapley Additive exPlanations value demonstrated Age, external ventricular drain placement, Fisher Grade, and Hunt and Hess score, and HTN had the highest predictive values for delayed cerebral ischemia. Lower age, absence of hypertension, higher Hunt and Hess score, higher Fisher Grade, and external ventricular drain placement increased risk of delayed cerebral ischemia.

Conclusion

Machine learning models based upon clinical variables predict delayed cerebral ischemia with high specificity and good accuracy.
Knowledge and attitudes towards cervical cancer prevention among women in Khartoum state, Sudan
Authors: Siddig Emmanuel Edwar , Ahmed Ayman , Ahmed Eiman Siddig , Mohammed Mona Ali , Kunna Ezzan , El-Sadig Sarah M , Ali Yousif , Hassan Rana Alamin , Ali Eman Taha , Mohamed Nouh Saad
Published: April 2023

Background:

Cervical cancer is considered the third leading cause of death among women worldwide, and human papillomavirus was identified as a major causative agent for developing cervical cancer.

Objectives:

This study aimed to assess the knowledge and attitudes towards cervical cancer prevention among women in Khartoum state, Sudan.

Design:

A community-based cross-sectional study implemented in Khartoum state, Sudan, from 1 August 2020 to 1 September 2020.

Methods:

We conducted a descriptive cross-sectional community-based study using an electronic questionnaire for data collection. Descriptive statistics, frequency, mean, and percentage were computed.

Results:

The study included 716 female participants with a mean age of 27.6 + 8.7 years. 580 (81.0%) and 229 (32.0%) had heard about cervical cancer and Pap test, respectively. cervical cancer was assumed related to alcohol consumption 109 (15.2%), giving birth to many children 51 (7.1%), ageing 118 (16.5%), and having many sexual partners 335 (46.8%). In addition, 300 (41.9%) attributed cervical cancer to having human papillomavirus infection, 256 (35.6%) to the prolonged use of contraceptives, and 162 (22.6%) to smoking. Knowledge about the best time to be vaccinated against human papillomavirus, 110 (15.4%) stated it is better after marriage. Regression models to predict the effectors on participants’ knowledge and attitudes showed a low standard deviation of the estimates with higher values of the adjusted R2 [R: 0.041, 0.017, and 0.006; std: 1.527, 0.417, and 0.426]. This indicates the combined influence of occupation, educational level, family income, and marital status on the participant’s knowledge and attitude levels.

Conclusion:

This study revealed that the participant’s knowledge and attitudes levels are mainly driven by their occupation, educational level, family income, and marital status altogether. This underscores the need for a countrywide community engagement campaign through health education and raising awareness sessions, and massive social media to sensitize the community and healthcare providers about the risk of cervical cancer and the available prevention and control measures.
Privacy, promotionalism and the proliferation of state-performed criminal record screening in the Netherlands: How a restrictive legal framework can still result in a steep increase of criminal background checks
Authors: Zand-Kurtovic Elina van ’t , Boone Miranda
Published: April 2023

The Netherlands has endorsed a unique system regarding the management, disclosure and screening of criminal records. Disclosure to third parties is strongly restricted, yet all (potential) employees can request a government agency to provide a risk assessment − known as a Certificate of Conduct (‘VOG’ in Dutch) − for every kind of employment application to determine whether they are fit for a given job. This article explains how and why this Dutch policy approach, deemed respectful of individual privacy rights, can nonetheless go hand in hand with the promotion, proliferation and pervasiveness of criminal record screening. It challenges the often dichotomic approach of the comparative literature on criminal record policies and helps understand that privacy protection alone cannot be fully equated with the rehabilitation and re-entry in society of people with a criminal history. Although the Dutch criminal record system avoids any unnecessary publicity of criminal record data, it nonetheless triggers adverse impairments on reintegration processes through stigmatisation and exclusion resulting from the ubiquitous use of Certificates of Conduct in the labour market. This questions the promotion of the Dutch screening instrument as an exemplary model for criminal record information sharing within Europe.
The Qianke system in China: Disorganisation, discrimination and dispersion
Authors: Li Enshen
Published: April 2023

In the Chinese criminal legal system, the term ‘Qianke’ (前科) is conceptually interchangeable with the idea of a criminal record that lists one’s past crimes, convictions and sentences. In this article, by situating Qianke within the context of China’s distinct criminal justice and social governance ethos, my central claim is that the status quo of the Qianke system features disorganised, discriminatory and dispersed modes of social and penal controls. Specifically, the management of Qianke represents an uncoordinated structure in which criminal record data are regulated by divergent rules and institutions but remain under the complete control of the state. Although largely inaccessible to the general public, the discriminatory effect of Qianke is sweeping. By and large, it is characterised by the imposition of restraints on not only individuals with a criminal record but also their families in accessing equal opportunities in education, employment and public services. This distinctive form of state discrimination is informed by an emerging concern with risk prevention within Chinese criminal justice policy which is further enhanced by Qianke’s orchestrated penetration into the social system (e.g. via the Social Credit System). Moving from the criminal legal system to the social system, Qianke also serves as a tool of control aimed at managing individuals with a criminal history in a way that is conducive to the state’s prioritised governance agenda.
Fashion as ‘Force for Change’? How Ideologization Reshapes the Work of Intermediaries in the Legitimation of Culture
Authors: Brans Luuc , Kuipers Giselinde
Published: April 2023

What happens when politics enters strongly aesthetic cultural fields? This article proposes a novel conceptual framework, which we propose to call ideologization, to understand how political-ideological considerations influence cultural legitimation. We build on theories of legitimation and cultural intermediaries to examine the strategic case of fashion as a cultural production field at the intersection of aesthetics and economics. Combining an analysis of frames in fashion magazines since the 1980s with critical discourse analysis of British Vogue in turning-point year 2020, we theorize ideologization as consisting of three elements: aesthetic agenda-setting; the reimagination of relations between producers, consumers and intermediaries; and the generation of discursive contradictions. This process of ideologization, which we see across cultural fields since the late 2010s, has strong implications for intermediaries who act as framers and brokers of legitimate culture. We conclude by proposing future research to further develop the ideologization framework and detail the long-term impact of political-ideological logics on cultural fields.
The incidence of palmaris longus in the heterogeneous Israeli population
Authors: Cohen Joshua , Silver Natan , Steinberg Kobi , Simon Chad , Zinger Gershon
Published: April 2023

We evaluated the frequency of absence of the palmaris longus tendon in the heterogeneous Israeli population. Nine hundred and fifty wrists were evaluated using a modified Mishra/Schaeffer technique (thumb/little-finger opposition with resisted wrist flexion), which was validated by ultrasound scanning. The geographical and ethnic origin of volunteers was documented. When physical examination was equivocal, any vague, superficial structure was subsequently identified as the median nerve by ultrasound. Physical examination reliably identified palmaris longus only when a structure was clinically obvious (visually or by palpation). There was bilateral absence of the palmaris longus in 21% and unilateral absence in 15% of participants. Frequency of bilateral absence varied between 4.5% and 30%, depending on geographical origin ( p = 0.0007). The incidence of palmaris longus tendon varied significantly by geographical, but not by ethnic origin.

Level of evidence: II