bluuebunny/crossref_metadata_2025 huggingface dataset:
Disaster accountability for the response/recovery stage and the role of hybrid organisations: The case of the anti-phylloxera consortia's reports
Authors: De Matteis Fabio , Tafuro Alessandra , Dammacco Giuseppe
Published: December 2023

The historical literature appears limited in investigating the accountability and functioning of hybrid organisations engaged in countering natural disasters. Therefore, in the context of the phylloxera infestation disaster, this work aims to explore both the informative value and characters of some accountability documents and the role of anti-phylloxera consortia (public-private entities) during the response and recovery phases of the disaster. We apply content analysis through a thematic approach to two reports dating back to 1911 and 1912–1914, respectively, on the action of the anti-phylloxera consortia. On the one hand, this analysis highlights that the documents investigated have a relevant informative capacity, supporting knowledge dissemination and coordinated action. On the other hand, they account for the success of experimental vineyards in terms of agricultural parameters and re-gained productivity, but they do not present accounting data. Finally, the reports analysed show that public-private collaboration enacted by the consortia can be an effective tool for dealing with natural disasters and reducing their impact.
Extensive Urinary Tract Fungal Bezoars Causing Anuria: A Case Report
Authors: Alrabadi Adel , Alsabatin Nedal , Masadeh Hosam Marwan , Hadidy Azmi , Al-shudifat Abdulrahman
Published: December 2023

Fungal bezoar formation is a complication of fungal urinary tract infections that are usually caused by Candida species and other fungal types. They can form in any site along the urinary tract and may cause an obstruction to the urine flow that would require drainage by nephrostomy, a ureteric stent, and sometimes surgical intervention is needed. In this case report we discuss a case of an adult male who had an extensive fungal bezoar infection caused by Candida tropicalis causing him anuria and acute kidney injury. The bezoars were found in the bladder, the ureters, and both kidneys. The patient was treated with bilateral ureteric stent insertion and with fluconazole for 3 weeks. Bilateral ureteroscopy and urine culture were done after 2 months and they showed that the bezoars have been eradicated on both gross and microscopic levels.
Cardiometabolic Risk Factors Associated With Type 2 Diabetes Mellitus: A Mechanistic Insight
Authors: Chakraborty Snigdha , Verma Anjali , Garg Rajeev , Singh Jyoti , Verma Hitesh
Published: December 2023

A complex metabolic condition referred to as Type 2 diabetes mellitus (T2DM) is characterized by insulin resistance (IR) and decreased insulin production. Obesity, dyslipidemia, hypertension, and chronic inflammation are just a few of the cardiometabolic illnesses that people with T2DM are more likely to acquire and results in cardiovascular issues. It is essential to comprehend the mechanistic insights into these risk variables in order to prevent and manage cardiovascular problems in T2DM effectively. Impaired glycemic control leads to upregulation of De novo lipogenesis (DNL), promote hepatic triglyceride (TG) synthesis, worsening dyslipidemia that is accompanied by low levels of high density lipoprotein cholesterol (HDL-C) and high amounts of small, dense low-density lipoprotein cholesterol (LDL-C) further developing atherosclerosis. By causing endothelial dysfunction, oxidative stress, and chronic inflammation, chronic hyperglycemia worsens already existing cardiometabolic risk factors. Vasoconstriction, inflammation, and platelet aggregation are caused by endothelial dysfunction, which is characterized by decreased nitric oxide production, increased release of vasoconstrictors, proinflammatory cytokines, and adhesion molecules. The loop of IR and endothelial dysfunction is sustained by chronic inflammation fueled by inflammatory mediators produced in adipose tissue. Infiltrating inflammatory cells exacerbate inflammation and the development of plaque in the artery wall. In addition, the combination of chronic inflammation, dyslipidemia, and IR contributes to the emergence of hypertension, a prevalent comorbidity in T2DM. The ability to target therapies and management techniques is made possible by improvements in our knowledge of these mechanistic insights. Aim of present review is to enhance our current understanding of the mechanistic insights into the cardiometabolic risk factors related to T2DM provides important details into the interaction of pathophysiological processes resulting in cardiovascular problems. Understanding these pathways will enable us to create efficient plans for the prevention, detection, and treatment of cardiovascular problems in T2DM patients, ultimately leading to better overall health outcomes.
Plasma glial fibrillary acidic protein levels correlate with paramagnetic rim lesions in people with radiologically isolated syndrome
Authors: Schneider Raphael , Brand-Arzamendi Koroboshka , Reynold Lim Timothy , Lee Lisa Eunyoung , Guenette Melanie , Suthiphosuwan Suradech , Bharatha Aditya , Oh Jiwon
Published: December 2023

Background:

There are no specific, evidence-based recommendations for the management of individuals with radiologically isolated syndrome. Imaging and blood biomarkers may have prognostic utility.

Objective:

To determine whether plasma neurofilament light protein (NfL) or glial fibrillary acidic protein (GFAP) levels in people with radiologically isolated syndrome correlate with imaging measures that have been shown to be associated with negative clinical outcomes in people with multiple sclerosis.

Methods:

Cross-sectional analysis of people with radiologically isolated syndrome. Participants underwent magnetic resonance imaging (MRI) of the brain and cervical spinal cord, and plasma was collected. Plasma NfL and GFAP levels were measured with a single-molecule array, and correlations with MRI measures were assessed, including the number of: T1-black holes, white-matter lesions demonstrating the central vein sign, paramagnetic rim lesions, cervical spinal cord lesions and infratentorial lesions.

Results:

Plasma GFAP levels, but not NfL levels, showed correlations with the number of T1-black holes, white matter lesions demonstrating the central vein sign and paramagnetic rim lesions (all p < 0.05).

Conclusion:

We found correlations between plasma GFAP levels and imaging measures associated with poor clinical outcomes and chronic inflammation in individuals with radiologically isolated syndrome. Plasma GFAP may have prognostic utility in clinical trials and clinical practice.
Realistic fuel spray modeling for gasoline direct injection engine applications
Authors: Kim Sayop , Nocivelli Lorenzo , Zhang Anqi , Voice Alexander K , Pei Yuanjiang
Published: December 2023

Fuel spray modeling plays a critical role during modern gasoline direct injection (GDI) engine development due to fuel injection’s dominant impact on engine performance and emissions as well as the complex physical processes involved. In engineering three-dimensional (3D) computational fluid dynamics (CFD) simulations, the liquid-phase fuel atomization, evaporation, and mixing are usually modeled with the discrete droplet model (DDM) adopting a Lagrangian approach for multiphase CFD simulations. To this end, general practices heavily depend on the reduced order characterization of the injector nozzle flow. However, such simplified injector modeling may lead to insufficient representations of the complex spray dynamics. To tackle this problem, this study proposes a novel workflow to numerically evaluate GDI sub-cooled and flash-boiling sprays under engine-relevant conditions using a side-mounted GDI injector together with real gasoline fuel properties. The workflow introduces a one-way coupling (OWC) method leveraging high-fidelity nozzle flow simulations to provide realistic boundary conditions to the Lagrangian injector model. The proposed workflow was first verified in a constant volume chamber (CVC) environment and then implemented in a practical GDI engine setup to study spray morphology, fuel-air mixing, and wall-wetting propensity. In addition, detailed comparison was performed between the OWC method and the conventional rate of injection (ROI) routine. Quantitative analysis of spray characteristics was conducted to highlight possible source of discrepancies of the conventional ROI method.
Design and development of auxetic structures for enhancing ergonomic comfort in women’s intimate apparel (brassiere)
Authors: Ramzan Muhammad Babar , Imran Aqsa , Zaman Shahood uz , Ali Mumtaz , Islam Tayyaba , Rasheed Abher
Published: December 2023

Brassiere straps are commonly perceived as one of the most irritating and uncomfortable components of a brassiere, especially for women with heavier breasts. This study aimed to design and developed auxetic structures to enhance the ergonomics of intimate apparel. The brassiere straps were developed by using textured polyester and nylon yarns with auxetic weave structures in two different widths. Tests were conducted to evaluate Poisson’s ratio, tensile strength, and pressure distribution properties and overall ergonomics of developed straps. Subjective analysis was also performed by conducting wear trials. The development of polyester straps yielded excellent results compared to nylon. In the subjective analysis, the selected polyester sample consistently performed better than others, significantly enhancing ergonomics comfort, fit, and psychological comfort according to respondents’ preferences. Based on the results, Auxetic structure can be a better alternative for brassiere straps in active wear to avoid related health problems and to improve women’s experience.
Structural optimization design of BIW using NSGA-III and entropy weighted TOPSIS methods
Authors: Chen Hao , Lu Chihua , Feng Lie , Liu Zhien , Sun Yi , Chen Wan
Published: December 2023

Multi-objective optimization is always a difficult and hot problem for the static and dynamic performance and lightweight optimization design of a body-in-white (BIW). In this regard, a hybrid method coupled with NSGA-III and entropy weighted TOPSIS methods was put forward here. Effects of each design variable on the BIW performance was studied by means of the contribution method so as to optimize various design variables. Further, an experimental design was carried out by means of a radial basis function model to approximate each performance index of the automotive body. On the base of that, a comprehensive method where the Pareto frontier is searched by means of NSGA-III while the optimal solution is selected by means of the entropy weighted TOPSIS method was proposed based on lightweight, static and dynamic performances to analyze BIW performances to determine the contradictory optimal solution among various BIW factors. Afterward, our numerical verifications demonstrate that the BIW performances are improved significantly so that it can be feasible to optimize static and dynamic BIW performances and the lightweight performance of the BIW can be guaranteed accordingly.
The Anthropocene as a civil time unit
Authors: Stange Ulrich
Published: December 2023

Geologists are currently finalizing the specification of a new geological time unit, the Anthropocene Epoch, characterized by the Earth’s response to humans driving geological change. Once it is ratified we can use it also as a civil time unit. The standard for time reckoning used worldwide today is the Gregorian calendar, introduced in 1582. As a calendar of the Catholic church, it is structured around supernatural events and indeterminate religious dates. Astronomical year numbering has long fixed the arcane arithmetic and religious notations of the Gregorian calendar, but the origin of its time scale perpetuates the links to religious and supernatural dates. If we shift the origin of the astronomical time scale to the onset of the Anthropocene, we can update the calendar with a science based time scale that is anchored by real world data and events. Such a time scale would be better suited as a culturally inclusive standard in a multi-cultural world.
No Space for Reddit Spacing: Mapping the Reflexive Relationship Between Groups on 4chan and Reddit
Authors: Hagen Sal
Published: December 2023

4chan and Reddit have often been lumped together as similar home turfs for geeky, masculine-coded, problematic communities thriving under laissez-faire governance. However, stressing these similarities may overlook not only how the platforms have drifted apart in political-economic terms but also how their similarity encourages assertions of difference between its users. In dialogue with theories on ritual opposition and platform imaginaries, I interrogate this dialectic by tracing the relationship between groups on 4chan and Reddit. How has this relationship developed over time and between subgroups? What do the fractured, fluctuating cross-site associations teach us about the collectivity of both sites? By quantitatively mapping cross-mentions in large archives of Reddit, 4chan/b/, and 4chan/pol/, I identify a lopsided rivalry: 4channers consistently employed antagonistic phrases and stereotypes of Reddit, but 4chan’s relevance throughout Reddit is waning. I moreover find that a platform imaginary of 4chan as neutral, diverse, and unfiltered contradicts with the incessant discursive hostility of its users. The text thereby demonstrates how the collectivization of online subcultures is shaped by reflexive cross-site relations that feature a complex interplay between discursive boundary work, contrasting platform vernaculars, and political resentment.
Weaponizing John 8:32: The Complex Interconnections Between Religion and Politics on Brazilian Twitter
Authors: Russo Renato , Literat Ioana , Blikstein Paulo
Published: December 2023

Politics and religion are traditionally connected in large democracies, with many examples in the Global South. Recently in Brazil, a specific Bible verse has been assimilated into political expression and amplified by social media: John 8:32 (“And you shall know the truth, and the truth will set you free”). In this article, we employ thematic analysis of Twitter1 data referencing this verse, collected during the 2022 Brazilian presidential election. The analysis shows how the verse became symbolic shorthand for a bundle of values associated with political and religious righteousness, reinforcing the connections between conservative politics and religion. Strongly associated with the persona of former president Jair Bolsonaro, the verse was deployed by his supporters as a symbolic debunking tool against perceived misinformation but was also used ironically by Bolsonaro’s detractors to criticize the former president. By zooming in on the multifaceted use of this Biblical verse in the online political sphere, this article illuminates the multilayered interconnections between political expression on social media, religion, and misinformation in the context of Brazil.
“We Learn Through Mistakes”: Perspectives of Social Media Creators on Copyright Moderation in the European Union
Authors: Dergacheva Daria , Katzenbach Christian
Published: December 2023

Artists promoting their cultural production on social media platforms must navigate an algorithmic environment that involves visibility, content distribution, and growing algorithmic copyright moderation. The latter was experienced by EU-based social media creators when Article 17 of the Copyright in the Digital Single Market Directive was enforced in the EU (Directive [EU] 2019/790, 2019). This research focuses on the understanding and experiences of such creators regarding copyright content moderation of their work on social media platforms. Semi-structured interviews were conducted with 14 artists from EU countries, who were surveyed on digitization and digital access to cultural content. A multimodal framework was employed to analyze the copyright governance of creative practices and products, focusing on the regulative (i.e., the adoption of Article 17), normative (assumptions about legitimate and illegitimate behavior in specific communities), and discursive dimensions, as well as the influence of technological affordance on creative work. The findings contribute to the fields of cultural production and platform governance, as well as having policy implications. The anticipation of punishments from platforms due to copyright-related fears and the inability to use appeal processes directly influenced cultural production. Most interviewees employed self-censorship, avoidance, and content adjustment in their creative work before posting on social media platforms.
The Moderating Role of Innovation in the Relationship Between Business Sustainability and Organizational Performance in Companies of an Emerging Economy
Authors: Bernal-Torres César A. , Torres-Guevara Luz Elba , Aldana-Bernal Juan C. , Nicolás-Rojas Yoni Wildor , Pando-Ezcurra Tamara Tatiana
Published: December 2023

Throughout the world, the implementation of innovative strategies to improves organizational performance is widely accepted. Therefore, it is becoming more and more common for companies, especially in developed countries, to implement such practices as opposed to emerging economies where their implementation is very uncommon. To understand this phenomenon, the objective of this paper is to analyze the role of innovation in the relationship between business sustainability and organizational performance in the context of an emerging economy. To achieve this goal, the study conducted a 73 items online questionnaire survey aimed at Colombian company managers, which was designed on a Likert scale from 1 to 7 and was open from March to October 2021. A total of 293 managers from an equal number of medium and large companies from different economic sectors in Colombia were surveyed using non-probability sampling techniques. The information was then analyzed using a Structural Equation Model. The results show that innovation plays a very limited positive role in the relationship between business sustainability and the companies organizational performance. Likewise, the results also indicate that companies give little or no importance to the circular economy practices as an innovation strategy that contributes to environmental care and better organizational performance.
Psychometric Properties of the Patient Advocacy Scale for Intensive Care Nurses
Authors: Vargas Mara Ambrosina de Oliveira , Aguilar Leocádio de Menezes Jennifer , de Farias Brehmer Laura Cavalcanti , Geri Tomaschewski-Barlem Jamila , Camponogara Silviamar , Schneider Dulcinéia Ghizoni , Ramos Flávia Regina Souza , Cardozo Daniela de Oliveira , Peter Elizabeth
Published: December 2023

Patient advocacy exercised by an intensive care nurse refers to the defense of the patient’s interests and rights and can be measured if, for that, there are valid, reliable and reliable instruments, that is, which have their psychometric properties proven. Therefore, the patient’s advocacy processes would be permanently monitored and evaluated, also, the practice would become more visible. Perform psychometric validation of the Patient Advocacy Scale for Intensive Care Nurses (EAPEnf-ICU). Instrumental research for instrument validation, with exploratory and confirmatory factor analysis. Carried out from January to June 2021 with 377 Brazilian intensive care nurses, selected by non-probabilistic convenience sampling. Data were collected by means of Google Forms, organized on Excel® 2010 software and analyzed on R software. The Ethics Committee approved the study. Participants received information about the research, agreed to respond to the questionnaire and were guaranteed anonymity. From the scale structural exploration by analyzing exploratory, confirmatory and internal consistency of the measurement instrument, the final version of the EAPEnf-ICU was composed of 54 items, distributed in 5 dimensions/factors: Factor 1—Clinical and organizational advocacy in intensive care; Factor 2—Barriers associated with the intensive care clinical and organizational complexity; Factor 3—Attitudes to promote the autonomy of patients and family members in intensive care; Factor 4—Barriers associated with divergences and ethical-professional limits in intensive care, and Factor 5—Intensive care nurse’s personal and professional background. Findings point that the instrument presented in this study is valid and reliable for assessing the aforementioned construct, as it presents theoretical and empirical consistency, identifying five dimensions related to the exercise of patient advocacy by the intensive care nurse.
Recycling Versus Leasing in Closed-Loop Supply Chain: A Comparative Analysis Anchored on Consumer Ownership Perceptions
Authors: Chen Haitao , Xu Qiang , Dong Zhaohui , Zhao Hetian
Published: December 2023

Manufacturers increasingly recycle end-of-life products to realize residual economic value and mitigate environmental impacts on the economic system. Concurrently, with the burgeoning growth of the product-service system, leasing models offer an alternative method to complete the material loop without direct collection. While prior research has delved into recycling channels, incentive mechanisms, and remanufacturing within closed-loop supply chain management, a comparative analysis between recycling and leasing strategies remains under-explored. This study seeks to bridge this gap by elucidating the manufacturer’s strategic decision-making process, factoring in consumers’ product ownership perceptions. We propose a manufacturer decision model anchored on consumer choices and segment it into three scenarios based on varying ownership perceptions. Our analysis contrasts market demand and profit outcomes across these scenarios. Notably, we discern that a hybrid strategy is optimal when ownership perception is low; however, when such perception is heightened, a dedicated recycling strategy proves more advantageous. Importantly, introducing a leasing option does not entirely overshadow the conventional sales market but is susceptible to being overshadowed itself. From a managerial standpoint, while integrating a leasing program might augment revenue streams, sole reliance on it is inadvisable. Furthermore, reshaping consumption paradigms to emphasize product functionality over ownership can pave the way for more expansive leasing strategies, optimizing revenue generation within a closed-loop framework.
Octa-Cluster: Different Perspectives on Quality of Life in Thailand
Authors: Kantachote Krittiya , Wiroonsri Nathakhun
Published: December 2023

Thailand’s gross domestic product per capita is higher than many of its neighboring countries, however, the quality of life in Thailand varies tremendously as wealth is concentrated among the rich. This study uses both quantitative and qualitative methods. K-Means clustering combined with a recent cluster validity index is used to split respondents into eight groups with similar behavior in each group. Extreme Gradient Boosting is then utilized to analyze important factors that affect quality of life. One-hundred and twenty in-depth interviews are then used to highlight how individuals view the quality of life in Thailand. This study has a significant impact as policymakers can utilize our models to improve the quality of life for Thai residents in each category.
Memorable Tourism Experience Research: A Systematic Citation Review (2009–2021)
Authors: Bai Wenxi (Bella) , Lai Ivan Ka Wai , Wong Jose Weng Chou
Published: December 2023

Memorable tourism experience (MTE) is currently a hot topic in academic research. However, there is few studies focus on exploring the knowledge infrastructure of the MTE of the existing literature. Thus, this study conducts an analysis of 279 articles indexed in the Web of Science database in the field of hospitality and tourism from 2009 to 2021. This review uses a mixed method including bibliometric analysis, citation network analysis, and content analysis. This study divides three research stages of MTE: initiation, consolidation, and application. Five research themes were identified: destination marketing and management, culture, information technology, hospitality, and special interest tourism. Finally, the research schemata and agenda are discussed. Overall, this study provides a guideline and comprehensive understanding of the existing literature of MTE for researchers. Besides, this review also indicates the potential directions for practitioners to develop strategies for the hospitality and tourism industry.
Prevalence, Causes and Consequences of Intimate Partner Violence in Saudi Arabia: A Scoping Review
Authors: Alqurashi Turki , Ali Parveen , Hinchliff Sharron
Published: December 2023

Intimate partner violence (IPV) is highly prevalent in many countries, including Saudi Arabia. Studies have shown that 1 in every 10 women in Saudi Arabia is a victim of IPV. This is slightly lower than the prevalence of IPV in the WHO African, Eastern Mediterranean, and South-East Asia Regions, where approximately 37% of women in long-term partnerships report having experienced physical and sexual IPV during their lifetime. This review identified and analyzed the available empirical studies that explore IPV in Saudi Arabia. Nineteen ( n = 19) studies were retrieved from three databases, including Medline, CINAHL, and PsycINFO, as well as Google and Google Scholar. Only empirical studies published in the English language and involving Saudi Arabian citizens were examined. We identified 13 studies that explored the prevalence of IPV and 11 studies that discussed factors associated with IPV. Eight studies examined the effects and consequences of IPV, six studies reported attitudes, perceptions, and knowledge related to IPV, and only three studies investigated victim response to IPV. Nineteen studies included women and only one study involved men as research participants. The findings suggest that previous studies undertaken in Saudi Arabia used quantitative approaches and gathered data via questionnaires, and therefore participants were not given the chance to describe how they defined different forms of IPV. More specifically, previous studies failed to explore the problem of IPV through the lens of Saudi men, creating a research gap related to defining their attitudes and perceptions of this phenomenon.
The Impact of Digital Economics on Environmental Quality: A System Dynamics Approach
Authors: Cao Zhenxiang , Peng Liqing
Published: December 2023

In the new era of high-quality economic development, the digital economy offers fresh perspectives and momentum for China to achieve a harmonious balance between innovation-driven growth and environmental protection. We develop a systematic dynamic model to examine the effects of the digital economy on China’s environmental quality. The findings indicate the following: (1) the digital economy initially suppresses but later promotes environmental quality; (2) by empowering primary, secondary, and tertiary industries, the digital economy advances industrial structure optimization and upgrading, leading to improved environmental quality; (3) the digital economy encourages the growth of R&D personnel and the accumulation of R&D capital stock, which fosters technological innovation and enhances environmental quality; (4) the synergistic development of the digital economy, industrial structure upgrading, and technological innovation offset the increase in energy consumption and pollution emissions caused by the digital economy’s scale effect, representing the most favorable scenario for enhancing environmental quality.
Global Research Pattern of Cognitive Distortion: A Bibliometric Analysis
Authors: Zaiden Fauziah , Mahfar Mastura , Senin Aslan Amat , Fakhruddin Faizah Mohd
Published: December 2023

Research on the concept of cognitive distortion has increased from year to year, especially in the areas of mental health and emotional disorders such as depression, anxiety disorder, stress disorder, and others. Therefore, it is necessary to understand the topic of interest and establish a network of cooperation to expand research toward integrated efforts. Bibliometric analysis was performed using Bibliometrix and Biblioshiny software packages on academic articles indexed on the Scopus and Web of Science (WoS) databases. Search criteria were applied, initially resulting in a total of 1,834 articles published between 1950 and 2021. The study pattern focuses on publication output, affiliated countries, co-authors, and the occurrence of author keywords. The findings of this study provide an overview of notable topics in cognitive distortion analytics through a quantitative analysis featuring tables, graphs, and maps. It also identifies the key performance indicators to produce articles and their citations. Studies show an increase in this field globally, especially since 2008 onwards. The data reveals that publications from the United States, United Kingdom, and Canada accounted for more than 50% of total number of publications in this field. This study indicates a global research pattern related to cognitive distortion, which may be useful for researchers, individuals, or policymakers to harness the existing potential and create opportunities for future research development.
The Interplay of Contextual Variables and Language Proficiency in Request Realization
Authors: Dashti Khavidaki Mansooreh
Published: December 2023

The significance of producing socially appropriate utterances, not just linguistically correct ones, has given rise to a plethora of studies on speech acts. In this regard, the performance of second and foreign language learners against the norms of the target language and the factors affecting them have yet to be thoroughly investigated. To contribute to this ongoing research, this study aimed to elicit pragmatic requestive features of Iranian EFL (English as a Foreign Language) learners with respect to (a) request directness, (b) request perspective, (c) internal modification, and (d) external modification in eight social situations. This study also examined whether language proficiency and two contextual factors of social power and social distance affect Iranian EFL learners’ requests in English. Participants were a total of 60 university students or graduates who had taken TOEFL in the past 2 years and were thus categorized into low and high proficiency levels. A Written Discourse Completion Test (WDCT) was employed to elicit requests. To achieve the objectives of this study, both descriptive statistics and two-way ANOVA were employed. The results showed a significant main effect for contextual factors; participants’ choice of requestive features was affected by the two social factors of power and distance. Proficiency, however, did not have a significant effect on the pragmatic performance of participants. The findings of this study showed pragmatic development of participants on the one hand and some evidence of their underdeveloped pragmatic performance on the other hand, which makes explicit instruction a necessity.
The Impact of Promotional Activities on the Purchase and Repurchase Intention of Energy Drinks in Yemen Under Different Levels of Awareness of the Potential Adverse Effects
Authors: Goaill Majid Mapkhot , Al-Hakimi Mohammed A. , Mohammed Al-Hattami Hamood , Ali Murshid Mohsen , Al-Mogahed Amal , Obad Sharf
Published: December 2023

Awareness among consumers in determining purchase intention (PI) and repurchase intention (RI) for energy drinks plays an important role. However, it has been overlooked in previous studies. In order to bridge this knowledge gap, we investigate the role of awareness of the potential negative effects of energy drinks (PAEEDs) as a moderating variable in the relationship of promotional activities with PI and RI among different young people. The data were collected from 415 students from Yemeni universities and analyzed using structural equations modeling via SmartPLS software. The results revealed that promotional activities affect PI among students with low awareness of the PAEEDs more than students with high awareness. In contrast, promotional activities affect RI among students with high or low awareness of the PAEEDs. This study provides additional evidence about the effects of energy drinks (EDs) promotional activities on PI and RI among young people in light of the awareness of these products and, thus, the urgent need for regulation and restrictions on youth consumption of EDs. Implications for theory and practice are discussed.
Being a “Warrior” to Care for the New Family: A Meta-ethnography of Nurses’ Perspectives on Municipal Postnatal Healthcare
Authors: Høgmo Bente Kristin , Alstveit Marit , Bondas Terese
Published: December 2023

Care in the postnatal period is a goal for all families with a newborn baby, and support from nurses might prevent long-term health problems and contribute to a positive postnatal experience. This meta-ethnography aims to integrate and synthesize qualitative studies that illuminate and describe nurses’ perspectives on municipal postnatal health care in high-income countries. Systematic literature searches for qualitative studies were conducted and 13 articles were included. The analysis followed the seven phases of Noblit and Hare. Being a “warrior” to care for the new family was identified as an overarching metaphor accompanied by three main themes: Stretching human boundaries, Stretching system boundaries, and Stretching knowledge boundaries. The overarching metaphor offers a deeper understanding of the nurses as “warriors” who despite tight timeframes and heavy workloads are stretching toward a caring relationship with the families. Being a warrior continuously pushing system boundaries puts the nurses in risk of being overstretched, balancing between their ideals and the reality. As more knowledge and clearer policies and procedures regarding the inclusion of fathers and LGBTQ parents in municipal postnatal healthcare are needed, more focus placed on the father or non-birthing parent, different cultural traditions and family constellations in practice and education is suggested.
Patient Reported Outcomes Following Revision Ankle Arthrodesis for Ankle Fusion Non-Union
Authors: Willegger Madeleine , Veljkovic Andrea , Jeyaseelan Lucky , Park Sam Si-Hyeong , Lowe Dani , Younger Alastair , Wing Kevin , Penner Murray
Published: December 2023

Category:

Ankle Arthritis; Hindfoot

Introduction/Purpose:

Ankle arthrodesis (AA) has, for many years, been considered the gold standard procedure for the surgical treatment of end stage ankle arthritis. Non-union following AA surgery is a devastating complication which subsequently requires revision surgery. However, data on outcomes including patient reported outcome measures (PROMs) following revision ankle arthrodesis (RAA) after failed AA is lacking. The aim of this study is to assess the outcome of RAA for symptomatic non-union after AA including PROMs.

Methods:

Prospectively collected data from a multicenter database of ankle arthritis surgery was analyzed. Demographic data and PROMs including Ankle Osteoarthritis Scale (AOS) and Short Form-36 (SF-36) health survey were collected at regular intervals. Surgeries were performed by six fellowship-trained foot and ankle surgeons between January 2003 and July 2015. 336 primary AA cases were identified, of which 27 (8%) underwent revision for symptomatic AA non-union.

Results:

Mean follow-up of 27 AA non-union cases was 5.3 years (2-10). There were 16 (59%) males and 11 (41%) females, with a mean age of 62 years (44 - 81) and a mean BMI of 32 (26.5 – 45), respectively. At index AA, 12 (44%) cases were performed arthroscopically. Twenty-three (84%) AA non-union patients were actively smoking pre- and post-operatively, and 15 (56%) were diabetic. Overall union-rate following RAA was 85% (23/27). For RAA the pre-operative mean AOS score of 64.9 (38.8-81.5) improved to 49.1 (24.1-73) at latest follow-up. SF-36 PCS score improved from 27.2 (21.3 – 38.3) to 33.3 (19.1-54.2) and SF-36 MCS score improved from 41.2 (17.5-60.9) to 46.2 (29.3-65.9). Overall complication rate of RAA was 22%, with a re-operation rate of 15%.

Conclusion:

Revision ankle arthrodesis (RAA) for ankle fusion non-union resulted in a successful fusion of the ankle in 85% of patients with modest improvement in AOS and SF-36 scores. Indeed, even after successful RAA, patients report pain and disability levels comparable to that reported by primary AA patients pre-operatively. Additionally, complication and re-operation rates of RAA are high. This data emphasizes on the importance of achieving a primary fusion in AA. The presented patient reported outcomes may help the treating surgeon to counsel patients prior to RAA surgery to better set their expectations.
Bone Cutting Efficiency and Heat Generation Using a Traditional Fluted Burr and a Novel Fluteless Resurfacing Tool
Authors: Meldau Jason , LeDuc Ryan , Havey Robert , Muriuki Muturi , Kaczmarz Nadia , Schiff Adam
Published: December 2023

Category:

Basic Sciences/Biologics; Other

Introduction/Purpose:

Meticulous bone removal is a critical step in many orthopaedic foot and ankle procedures including arthrodesis, decortication, and hardware removal. Power tools, including burrs, allow for increased efficiency and potentially more uniform bone removal; however, due to friction generated, there is a known risk of thermal-induced osteonecrosis. A fluteless resurfacing tool (RT) has been manufactured in hopes of optimizing cutting properties by increasing cutting efficiency and decreasing bone-burr contact heat generation. The purpose of this cadaveric study was to compare the cutting rate and heat generated using a traditional fluted burr (FB) and a fluteless RT on human cadaveric bone (Figure 1). We hypothesized that during bone removal, the fluteless RT would provide faster cutting rates than a traditional burr.

Methods:

Twenty cadaveric metatarsals were tested with four predetermined cutting forces to evaluate heat generation and cutting rate for the fluted burr and fluteless resurfacing tool over 40 seconds or until a depth of 4 mm was reached. Cutting rate was calculated from displacement transducer data. Heat generation was measured by thermocouples placed in the bone adjacent to the burring site. Assuming a body temperature of 37°C, a 10°C increase in heat was used as the threshold of inducing osteonecrosis.

Results:

At 1.0 N and 1.7 N, the thermal osteonecrosis threshold was reached at comparable times between burrs, while the bone removed by the resurfacing tool was on average five times greater than fluted burr at 1.0 N and over twice as great at 1.7 N. Statistical analysis of these common cutting forces showed the resurfacing tool had significantly higher cutting rates (P < 0.01). As a result, the fluted burr produced higher temperatures for the same amount of bone removal (P < 0.01).

Conclusion:

In a cadaveric study, the fluteless resurfacing tool demonstrated higher bone cutting rates and lower heat generation for the same amount of bone removed than a traditional fluted burr.
Improved Survival Rates with Fixed Bearing Total Ankle Arthroplasty
Authors: Nadeau Elizabeth K. , Ottofaro Trevor D. , Morningstar Joshua L. , Gross Christopher E. , Scott Daniel
Published: December 2023

Category:

Ankle Arthritis

Introduction/Purpose:

With increasing numbers of total ankle arthroplasty (TAA) procedures being performed and a plethora of new survivorship data available, an updated literature review is needed to better understand the impact of different types of implants on outcomes of TAA. The purpose of this study is to compare the outcomes of fixed vs mobile bearing TAAs in the literature.

Methods:

A comprehensive search of MEDLINE for all articles published between 2004 and 2021 was conducted with a minimum two-year mean follow-up. Two reviewers evaluated each study to determine whether it was eligible for inclusion and abstracted the data of interest. Meta-analytic pooling of group results across studies was performed, examining implant survival and component failure. Seventy-three implant groups met inclusion criteria (only 3rd and 4th generation implants), composed of STAR (20), Salto (mobile bearing) (10), Salto Talaris (11 ), Hintegra (8), Zimmer (6), INBONE II (6), INBONE I (4), Infinity (4), Cadence (4). 41 groups (56.2%) were implanted with mobile bearing devices and 32 (43.8%) with fixed bearing implants. In total, 6498 subjects were included with a mean age of 61.77 years and mean BMI of 28.5 kg/m2. At mean follow-up of 62.2 months, the overall reoperation rate was 21.13% and metal component revision rate was 10.16%.

Results:

The mean follow-up of mobile bearing TAA studies (N=41) was 77.8 (range 24-188.4) months and fixed bearing studies (N=32) was 45.3 (range 24-85.2) months. Multivariate analysis of bearing type, controlling for follow-up duration, found fixed bearing implants had statistically significantly higher metal component survival rates (fixed=96.1%, mobile=87.9%, p=.001) ; however, there were no statistically significant differences in rates of reoperation (fixed=17.0%, mobile=24.8%, p=.768). When examining specifically tibial and talar component failure rates, there was no statistically significant difference between bearing type (fixed tibial=1.46%, mobile tibial=2.95%, p=.472) (fixed talar=2.19%, mobile talar=2.79%, p=.966). Overall implant survival rate at one, two, five, and ten years was 96.4%, 96.0%, 92.7%, and 79.4%, respectively, and did not differ by bearing type (Table 1).

Conclusion:

Implant survival was statistically significantly better for 3rd and 4th generation fixed bearing TAAs as compared to mobile bearing TAAs, controlling for length of follow-up. There was no statistically significant difference in total reoperation rate. This suggests that fixed bearing implants may offer improved implant survival compared to mobile bearing implants, though further research is needed to confirm these findings.
Increased Hospital Length of Stay for Obesity Class II and III Patients After Primary Total Ankle Arthroplasty: A NSQIP Analysis
Authors: Peairs Emily M. , Kim Billy I. , Anastasio Albert T. , Adams Samuel
Published: December 2023

Category:

Ankle Arthritis

Introduction/Purpose:

Obesity is a well-established risk factor for complications after total hip and knee arthroplasty. The incidence of total ankle arthroplasty (TAA) continues to grow, but few studies have evaluated TAA outcomes in patients with obesity. The present study sought to measure the impact of obesity on TAA outcomes using a national database.

Methods:

The 2012-2020 National Surgical Quality Improvement Program (NSQIP) database was queried for primary TAA (CPT:27002). 1,610 patients were identified and stratified by preoperative body mass index (BMI): non-obese (18 5-29.9kg/m2, n=760), obesity class I (30.0-34.9kg/m2, n=455), and class II and III (>35.0kg/m2, n=395). Preoperative and perioperative patient data, operative time, hospital length of stay (LOS), and 30-day complications were compared using univariable statistics. Multivariable analyses controlling for patient characteristics were employed to measure the effect of obesity on operative time and LOS.

Results:

Compared to the non-obese group, obesity class II and III patients were younger (61.9 versus 65.6 years;p < 0.001), more female (57.2% versus 42.0%;p < 0.001), higher ASA class (p < 0.001) and had more comorbidities such as hypertension, diabetes, and dyspnea (p < 0.001). Mean preoperative albumin was lower (p=0.013) and white blood count was higher (p < 0.001) in the obesity class II and III group. Home discharge rate was lowest in class II and III patients (88.6%;p=0.017). Multivariable regression revealed longer hospital LOS for obesity class II and III (μ=0.21; p=0.005) relative to the non-obese group. Obesity group was not associated with operative time or 30-day readmissions and reoperations.

Conclusion:

Obesity class II and III patients undergoing TAA had more comorbidities and longer hospital LOS compared to lower BMI patients. Despite the well-established association between obesity and postoperative complications after hip and knee arthroplasty, the present NSQIP analysis of 1,610 TAA patients did not find a greater burden of acute complications among patients with obesity.
Long-Term Outcomes After Total Ankle Arthroplasty: A Systematic Review
Authors: Lee Michael , Mathson Lucas , Andrews Clark , Jimenez Andrew , Law Brian
Published: December 2023

Category:

Ankle Arthritis; Ankle

Introduction/Purpose:

There is a paucity of aggregate literature reporting on long-term patient-reported outcomes (PROs) and implant failure after total ankle arthroplasty (TAA). The purpose of this study is to report an aggregate of literature on minimum 10-year patient-reported outcomes after total ankle arthroplasty.

Methods:

A systematic review on minimum 10-year PROs of TAA was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Pubmed, Scopus, and Cochrane Trials were queried on December 28th, 2022, with the following keywords: (ankle) AND (replacement or arthroplasty) AND (long-term or 10-year). Primary research articles were included if they reported minimum 10-year PROs for patients undergoing primary TAA and written in English. Forest plots with heterogeneity were created for PROs reported preoperatively and postoperatively in three or more studies. Long-term was defined as minimum 10-year follow-up. Survivorship was defined by implant failure which was determined uniquely by each study.

Results:

Six studies met the inclusion criteria with all 6 studies being level IV. A total of 277 ankles with average age range of 54-60.9 years were included in the study with follow up ranging from 10 to 24 years. The primary indication for total ankle replacement was osteoarthritis. Two of the six studies reported significant improvement in PROs following surgery. The remaining 4 studies also demonstrated improvement in PRO however no p values were reported. A forest plot was generated for the AOFAS score and I2 of 67% was calculated. Survivorship at a minimum of 10 year follow up ranged from 66-94.4%. Average time to implant failure ranged from 54.7-166 months.

Conclusion:

Patients undergoing primary TAA demonstrated improved outcomes at minimum 10-year follow-up. However, they demonstrated variable rates of survivorship ranging from 66-94.4% with average time to implant failure ranging from 54.7 – 166 months.