bluuebunny/crossref_metadata_2025 huggingface dataset:
A DECISION MODEL FOR THE ASSESSMENT OF ENVIRONMENTAL SUSTAINABILITY RISKS OF THE AUTOMOTIVE INDUSTRY
Authors: Alioğulları Ecenur , Türkan Yusuf Sait , Çakmak Emre
Published: December 2023

The automotive industry is increasing its competitive power by undergoing more and more technological and digital changes every day. Along with this competitiveness, the concepts of sustainability, ethics, and reputation come to the fore. Sustainability includes social, economic, and environmental issues that meet all the needs of future generations and use limited resources efficiently. In this study, the environmental and sustainable supply chain risks of the automotive industry are examined through automotive industry reports, expert opinions, and a literature review. After nine risks were identified, 14 alternatives were developed to prevent them. In the study, a multi-level risk assessment method using Failure Modes and Effects Analysis and Entropy-based EDAS method was introduced and an application was carried out in the automotive sector. According to the entropy-based EDAS method, the most important alternative has been “The top management's determination of sustainability commitments and targets.
Transcranial Electrical Neurostimulation as a Potential Addiction Treatment
Authors: Brown Joshua W.
Published: December 2023

Addiction remains difficult to treat, but non-invasive transcranial electrical and magnetic neurostimulation methods may provide promising and cost-effective treatment approaches. We provide a narrative review of recent developments and evidence of effectiveness and consider newer technology that may yield improved treatment approaches. In particular, we review temporal interference electrical neurostimulation, which allows non-invasive and focal stimulation of deep brain regions. This provides a promising new potential approach to treat addiction, because many of the brain regions that seem most important for addiction are deeper in the brain, out of reach of existing technologies such as transcranial direct current stimulation.
Mortality Among Individuals Released From U.S. Prisons: Does Military History Matter?
Authors: McNeeley Susan , Morgan Mark A. , Logan Matthew W. , Hazelwood Andrea R. , Clark Valerie A.
Published: December 2023

The physiological effects of imprisonment are well-documented and include a heightened risk for various forms of mortality post-release. The incarceration-mortality nexus does not apply equally to all groups, however, and research shows that some demographics (i.e., vulnerable populations) experience a greater likelihood of death. In the current study, we analyze correctional data over a 10-year period (2010–2019; n = 36,716) from Minnesota to assess the extent to which formerly incarcerated military veterans differ from non-veterans in their relative risk of mortality, net of relevant control variables. We also examine whether specific risk factors for post-release mortality differ between these groups. Findings indicate that veteran status is not a significant predictor of all-cause, natural, or unnatural mortality among releasees, though several notable within-group differences were observed. Policy implications of the current study are discussed in relation to the provision of veteran-centric health care services and directions for future research are given.
Between the divine and digital: Parsing Modi’s charismatic avatar
Authors: Rai Swapnil
Published: December 2023

This article explores the production of Indian Prime Minister Narendra Modi’s saintly charismatic avatar and the mediations of this avatar that seek to bestow him with exceptional authority. It shows how Modi’s avatar is being incarnated along three intersecting axes. The first axis comprises the broader historical, cultural and religious discursive frameworks that construct Modi as an incarnate charismatic leader. It focuses on his strategic invocation of Mahatma Gandhi through political and persona branding. Next, it unveils how Modi’s charismatic avatar is shaped through embodied performances and the management of bodily optics. Finally, it analyzes the platforming of Modi’s charismatic avatar, which takes place through organized public relations machinery operating in digital realms. Together, these mediations work to advance a Moditva-oriented populist politics that promotes ideological salvation for the nation via a leader whose persona and authority are conceptualized in divine terms undermining the pluralist and inclusive tenets of the Hindu religion.
Hermeneutics for an anti-hermeneutic age: What the legacy of Jesús Martín-Barbero means today
Authors: Couldry Nick
Published: December 2023

This article, after discussing the obstacles to the initial reception of Martín-Barbero’s work on mediation in Europe, analyses its importance to contemporary media research in terms of three factors: mediation, inequality and complexity. Far from being less relevant today, those insights, and Martín-Barbero’s overall insistence on a hermeneutic approach to understanding culture are of huge relevant today in an age when the automation of cultural production and data extraction is characterized by an anti-hermeneutic drive.
Record of Early Cretaceous dinoflagellate cysts from well JM-A, Dhansiri Valley of Upper Assam Shelf, India
Authors: Geddada Divya , Narsimha Kanchi
Published: December 2023

A palynological study on subsurface Early Cretaceous sediments (1550–1860 m) in well JM-A located in Dhansiri Valley, Upper Assam Shelf has been carried out for determination of age and depositional environment. The palynological investigations resulted into the identification of the characteristic and diversified occurrence of Early Cretaceous dinoflagellate cysts comprising Batioladinium micropodum, Achomosphaera? neptuni, Batiacasphaera asperata, Lagenorhytis sp. cf. L. delicatula, Mendicodinium caperatum and Canningia sp. along with associated dinoflagellate cysts. The significant assemblage of spore-pollen assemblage represented by Cicatricosisporites australiensis, Ceratosporites equalis, Gleicheniidites circinidites, Contignisporites cooksonii, Microcachryidites antarcticus, Podosporites tripakshii and Callialasporites trilobatus has also been recorded. The Early Cretaceous sediments are regarded as Bamangaon Formation in Dhansiri Valley. The occurrence of dinoflagellate cysts suggests marginal marine environment for Bamangaon Formation deposited during the Early Cretaceous period corresponding to the Rift Phase. The Formation overlies the Metamorphic Basement Complex, and it is unconformably overlain by the sediments of Tura Formation of Ypresian (Early Eocene) age, deposited under subtidal to inner shelf environment during the Passive Margin Tectonic Phase.
Reanimating experimental psychology: Media archaeology, Hugo Münsterberg, and the ‘Testing the Mind’ film series
Authors: Blatter Jeremy
Published: December 2023

For historians of psychology, Hugo Münsterberg is best remembered as William James’ successor as director of the Harvard Psychological Laboratory and a pioneer of applied psychology. By contrast, for film and media studies scholars, Münsterberg is recognized less for his contributions to experimental psychology than for those to film theory, a field in which his penultimate book, The Photoplay: A Psychological Study (1916), is frequently claimed as an inaugural text. However, lost in the blind spots of both disciplinary perspectives has been a thorough examination of Münsterberg's collaboration with Paramount Pictures, translating psychological tests into experimental short films. Despite reaching millions of moviegoers in 1916, Münsterberg’s ‘Testing the Mind’ series has received little attention from historians of science and early cinema alike. One reason for this neglect is that, to date, not a single extant copy of a ‘Testing the Mind’ release has been located. This article is about the author's efforts, in collaboration with students, to reanimate these lost psychological tests for the screen through meticulous historical reconstruction based on the original scripts, journalistic accounts, and correspondence between Münsterberg and Paramount. This reconstructive process, I show, yields new insights into the relationship between psychology and early cinema and an opportunity for reflection on this promising new space for research at the intersection of media archaeology, the history of psychology, and experimental history of science.

Film URL: https://archive.org/details/munsterberg_paramount.pictographs
Hepatocellular carcinoma in cirrhotic versus non-cirrhotic liver: Treatment and survival differences in a nationwide cohort
Authors: Engstrand Jennie , Stål Per , Gilg Stefan , Jansson Anders , Strömberg Cecilia
Published: December 2023

Background and aims:

Numerous studies have reported superior outcome for patients with hepatocellular carcinoma (HCC) in non-cirrhotic compared to cirrhotic livers. This cohort study aims to describe the clinical presentation, disease course, treatment approaches, and survival differences in a population-based setting.

Methods:

Data on patients diagnosed with HCC in Sweden between 2008 and 2018 were identified and extracted from the Swedish Liver registry (SweLiv). Descriptive and survival statistics were applied.

Results:

Among the 4259 identified patients, 34% had HCC in a non-cirrhotic liver. Cirrhotic patients presented at a younger age (median = 64 vs 74 years, p < 0.001) and with a poorer performance status (Eastern Cooperative Oncology Group (ECOG) = 0–1: 64% vs 69%, p = 0.024). Underlying liver disease was more prevalent among cirrhotic patients (81% vs 19%, p < 0.001). Tumors in non-cirrhotic livers were diagnosed at a more advanced stage (T3–T4: 46% vs 31%) and more frequently with metastatic disease at diagnosis (22% vs 10%, p < 0.001). Tumors were significantly larger in non-cirrhotic livers (median size of largest tumor 7.5 cm) compared to cirrhotic livers (3.5 cm) (p < 0.001). Curative interventions were more commonly intended (45% vs 37%, p < 0.001) and performed (40% vs 31%, p < 0.001) in the cirrhotic vs non-cirrhotic patients. Median survival was 19 months (95% confidence interval (CI) = 18–21 months), in patients with cirrhosis as compared to 13 months in non-cirrhotic patients (95% CI = 11–15) (p < 0.001). In the multivariable Cox regression model, cirrhosis was not an independent predictor of survival, neither among curatively nor palliatively treated patients.

Conclusion:

These population-based data show that patients with HCC in a cirrhotic liver receive curative treatment to a greater extent and benefit from superior survival compared to those with HCC in a non-cirrhotic liver. The differences in survival are more attributable to patient and tumor characteristics rather than the cirrhotic status itself.

Clinical trial registration:

not applicable. Patient confidentially: not applicable.
Visceral fat sympathectomy ameliorates systemic and local stress response related to chronic sleep restriction
Authors: Azuara-Alvarez Lucia E , Díaz-Muñoz Mauricio , Báez Ruiz Adrián , Saderi Nadia , Ramírez-Plascencia Oscar Daniel , Cárdenas-Romero Skarleth , Flores-Sandoval Omar , Salgado-Delgado Roberto
Published: December 2023

Disturbance of sleep homeostasis encompasses health issues, including metabolic disorders like obesity, diabetes, and augmented stress vulnerability. Sleep and stress interact bidirectionally to influence the central nervous system and metabolism. Murine models demonstrate that decreased sleep time is associated with an increased systemic stress response, characterized by endocrinal imbalance, including the elevated activity of hypothalamic–pituitary–adrenal axis, augmented insulin, and reduced adiponectin, affecting peripheral organs physiology, mainly the white adipose tissue (WAT). Within peripheral organs, a local stress response can also be activated by promoting the formation of corticosterone. This local amplifying glucocorticoid signaling is favored through the activation of the enzyme 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1). In WAT, 11β-HSD1 activity is upregulated by the sympathetic nervous system, suggesting a link between sleep loss, augmented stress response, and a potential WAT metabolic disturbance. To gain more understanding about this relationship, metabolic and stress responses of WAT-sympathectomized rats were analyzed to identify the contribution of the autonomic nervous system to stress response-related metabolic disorders during chronic sleep restriction. Male Wistar rats under sleep restriction were allowed just 6 h of daily sleep over eight weeks. Results showed that rats under sleep restriction presented higher serum corticosterone, increased adipose tissue 11β-HSD1 activity, weight loss, decreased visceral fat, augmented adiponectin, lower leptin levels, glucose tolerance impairment, and mildly decreased daily body temperature. In contrast, sympathectomized rats under sleep restriction exhibited decreased stress response (lower serum corticosterone and 11β-HSD1 activity). In addition, they maintained weight loss, explained by a reduced visceral fat pad, leptin, and adiponectin, improved glucose management, and persisting decline in body temperature. These results suggest autonomic nervous system is partially responsible for the WAT-exacerbated stress response and its metabolic and physiological disturbances.
Attuning to Emotions in the History of Border-Making: The Estonian-Latvian Boundary Commission in 1920
Authors: Gibson Catherine
Published: December 2023

Borders are key sites for the amplification of emotions, yet historians have rarely made emotions into a focal point for studies of boundary-making processes. This article sets out fragmentary evidence for how to read across a fuller array of sources that move us beyond technocratic understandings of boundary commissions to highlight the range of emotional interactions which occurred between boundary commissioners and local populations. It draws on evidence from the Estonian-Latvian Boundary Commission, established in the summer of 1919 to demarcate the international border between the newly independent states of Estonia and Latvia. Petitions sent to the Boundary Commission by the border region inhabitants expressed fear, trepidation or anger about the border proposal and professed feelings of patriotic loyalty to the Estonian or Latvian state. The press derided the Boundary Commission, using humour to convey frustration and shock at the absurdity of the border proposal and tarnish the reputation of the commissioners by portraying them as hot-headed. The accumulating emotional toll of these public sentiments left the boundary commissioners feeling weary and disheartened. By attuning to moods and sentiments surrounding the work of the Estonian-Latvian Boundary Commission, this exploratory article calls for historians to consider emotions methodologically as part of a broader toolkit of approaches for studying histories of boundary-making and to reflect on the insights such perspectives can bring to the field.
Case report of systemic sclerosis: Uncommon manifestation of nephrotic syndrome post-renal crisis
Authors: Fujii Ai , Kondo Takaya , Katsura Yasutaka , Kumano Sho , Kita Serina , Nomura Kazutoshi , Yabe Tomohisa , Hayashi Norifumi , Fujimoto Keiji , Yokoyama Hitoshi , Furuichi Kengo
Published: December 2023

Kidney involvement in systemic sclerosis occurs in about 20% of cases, with scleroderma renal crisis as a significant complication. However, cases of glomerular disease with massive proteinuria are rare. We present a unique case of systemic sclerosis with the development of nephrotic syndrome. The report provides clinical details and podocyte pathological findings. A 40-year-old male with prior skin sclerosis was diagnosed with systemic sclerosis. Treatment with oral prednisone led to gradual improvement, but a year later, he experienced a systemic sclerosis renal crisis. Using the angiotensin converting enzyme (ACE) inhibitors improved kidney function. However, 3 months later, nephrotic syndrome was diagnosed. Despite an increased prednisolone dose, proteinuria persisted. A kidney biopsy revealed glomerular sclerosis and characteristic vascular changes. Immunofluorescent studies showed no deposits. Electron microscopy confirmed podocyte abnormalities.
Posterior Annulus Elevation Technique in Reducing Residual Regurgitation During Mitral Valve Repair in Children: A Randomized Controlled Trial
Authors: Rahmat Budi , Siswanto Bambang Budi , Fakhri Dicky , Sakidjan Indriwanto , Murni Tri Wahyu , Timan Ina Susianti , Kekalih Aria , Kurniawati Yovi , Fardhani Dwi Gunawan , Arya Wardana Putu Wisnu
Published: December 2023

Background: The current technique used in severe mitral regurgitation in children can occasionally lead to residual regurgitation. To address this issue, the posterior annulus elevation technique was developed to enhance coaptation and reduce residual lesions. This study aims to evaluate the effectiveness of this technique in reducing residual regurgitation during mitral valve repair in children. Methods: A total of 64 patients aged <18 years old undergoing mitral valve repair were randomized into two groups: the intervention (with posterior annulus elevation) group and the control group, which underwent conventional repair techniques. Various parameters, including coaptation area, residual mitral regurgitation, clinical outcomes, metabolic, and hemolytic markers, were measured on days 0, 5, 2 weeks, and 3 months after surgery. Results: The intervention group (n = 32) showed a significant reduction in residual mitral regurgitation compared with the control group (n = 32) on each evaluation. At three months after surgery, we found that the posterior annulus elevation technique could be a protective factor that reduces the chance of residual regurgitation compared with the control group (RR = 0.31; confidence interval: 0.18-0.54; P ≤ .001). Coaptation length and index were also found to be significantly higher in the intervention group ( P ≤ .001). Clinical outcomes, metabolic markers, and hemolysis marker did not show any significant differences between the two groups. Conclusions: The posterior annulus elevation technique demonstrated effectiveness in reducing residual mitral regurgitation and improving coaptation area in pediatric mitral valve repair. This technique showed better short-term surgical outcomes in children with mitral regurgitation compared with the conventional technique.
Strategies for Project Based Learning during the Pandemic: The Benefits of Reflective Learning Approach
Authors: Yulhendri Yulhendri , Prima Sakti Muhammad Rizki , Sofya Rani , Ritonga Mentari , Alisha Wyanet Putri , Sudjatmoko Agung , Susanti Nora
Published: December 2023

This study explored students’ experiences in online learning using a project-based learning. The exploratory approach was used with postmortem methods, self-assessment, and questionnaires to identify the factors that affect student Learning Orientation and Engagement in project-based learning (PjBL) during the COVID-19 pandemic. The reflection was able to explore positive and negative experiences, as well as the problems the students faced during online learning, particularly in the aspects of teaching. The study population was enrolled in an Economic Education Program that ran from January to June 2021, and consisted of 15 participants. Three core subjects were selected as the sample. This sampling considered the problems that many education stakeholders complained about, that is, the low professional competency of the study program during online learning. This is why the three subjects were chosen as the core subjects in achieving the main competencies for prospective economics teachers. Thus, PjBL was conducted on three subjects: Development Economics, Human Resource Economics, and Development Planning. After the assessment was carried out, the data showed that positive student learning experiences tended to be higher than negative ones, and P21 ability aspects were much higher than critical thinking and collaboration.
Exploring Entrepreneurial Ecosystems in Developed Countries: A Systematic Review
Authors: Mago Stephen , van der Merwe Stephan
Published: December 2023

Globally, entrepreneurial ecosystems (EEs) have gained attention as enablers of innovation and entrepreneurship. This paper explores entrepreneurial ecosystems in developed countries. Entrepreneurship is a globally important phenomenon for economic development and addressing socio-economic challenges such as unemployment, inequality, and poverty. Systematic literature review (SLR), with the aid of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) approach was used in the items selection process. A final sample of 28 primary articles was used. Additionally, bibliometric analysis was conducted using VOSviewer software to determine publication patterns and citation trends. More relevant and recent articles were incorporated into the bibliometric analysis to improve the results. Isenberg’s six domains of entrepreneurial ecosystems framework, supported by the Dynamic capabilities (DC) theory underpinned the study. Results show that though entrepreneurial ecosystems are prevalent, they face many challenges. However, opportunities are also available but may be difficult to access. Globally, scholars agree that entrepreneurial ecosystems enhance economic development, and they help to solve socio-economic challenges such as unemployment, inequality, and poverty. This paper recommends that entrepreneurial ecosystems should be fostered in all regions to promote economic development and provide solutions to solve socio-economic problems. Local and global leaders should invest in the development of entrepreneurial ecosystems to promote economic development. The original value is based on exploring the dynamic nature of entrepreneurial ecosystems in the global environment using a developed country perspective. The findings provide important insights to policymakers and other stakeholders for developing strategies and interventions for enhancing economic growth through entrepreneurship.
Gamification in Health Care Management: Systematic Review of the Literature and Research Agenda
Authors: Gajardo Sánchez Alfonso D. , Murillo-Zamorano Luis R. , López-Sánchez JoséÁngel , Bueno-Muñoz Carmen
Published: December 2023

This research aims to advance the understanding of gamification in health care management using a systematic review of the literature through a multiphase analysis. To do so, first, we extract the relevant bibliographic data for our research according to a methodology of data generation structured in six stages and a descriptive analysis oriented to the technical characterization of the data. Then, we codify all the information, identify the main attributes with the collaboration of two independent experts and check their validity using the evaluation of two focus groups of professionals in gamification and health care management. We found seven attributes: (1) health care users, (2) psychology, (3) behavior, (4) activities, (5) health field, (6) technology, and (7) gamification elements. Within each of these seven attributes, there are a series of main elements that are detailed in the following for each of them. (1) Health care users: their age and the role they play in the health system. (2) Psychology: cognition, positive and negative emotions. (3) Behavior: healthy behavior encouragement, such as compliance, collaboration and responsibility. (4) Activities: physical activity and food. (5) Health field: preventive medicine and chronic diseases. (6) Technology: cell phones. (7) Gamification elements: different elements, but the number of articles in which these elements and their interactions are studied in depth is limited. Our results point toward a promising present and future research agenda that is in parallel with the development of relevant fields for the sector, such as chronic diseases, health education and preventive medicine.
Enterprise Audits and Blockchain Technology
Authors: Dong Yang , Pan Haiying
Published: December 2023

Blockchain technology has become more common in the audit industry, posing new problems for traditional audit work. Researchers have been studying the effect of customers’ use of blockchain technology on audits, especially on audit risk and audit methods. This paper examines audit cases of Chinese enterprises that use blockchain technology. It analyzes the effect of the use of blockchain technology on the audit and the new audit problems. It also examines an Australian blockchain audit case using a questionnaire. This case study showed that the application of new technologies to the audit industry may lead to increased inherent risks and control risks. The audit methodology is uncertain and there are two possible approaches: (1) a combination of direct, indirect, account-level, and entity-level evidence and (2) an increase in indirect and entity-level evidence. This paper puts forward the reference case of the Australian blockchain audit experience and suggestions for developing blockchain audits in China.
Old Wine in New Skins? Community Markets for Conservation and its Performance in Northern Zambia
Authors: Bwalya Bridget , Chenjelani Zulu Promise
Published: December 2023

This study examined the performance of the Community Markets for Conservation(COMACO), an integrated conservation and development program, in achieving its twin goals of conservation and increased income among rural households in Zambia. It narrows the knowledge gap on achievements of reformulated ICDPs focused on markets. Random sampling was used to select 143 respondents while purposive sampling was employed to recruit focus group discussants and key informant interviewees. Data was collected through structured and semi structured interviews, focus group discussions, field observations, and desk analysis. Qualitative data were analyzed using thematic analysis while quantitative data was analyzed using chi-square tests and measures of central tendency. Results show a significant relationship (χ2 = 143.0; p ≤ .0001) between market linkages and levels of conservation agriculture (CA)practice among COMACO households. We found that 72% of COMACO households linked to markets and provided with agricultural inputs had adopted CA. The dependency on COMACO for markets by farmers is unsustainable. There is little evidence on COMACOs success in reducing deforestation. COMACO’s ban on charcoal production and herbicide and mineral fertilizer use seem unrealistic given the low access to clean domestic energy and the high weed burden of CA. We conclude that the COMACO model is a repackaging of old ideas on ICDPs which yield mixed results and is in this sense is simply old wine in new skins. We recommend farmer training in value addition of their produce, branding, and linkages to markets so that they could sell to other aggregators and not be dependent on COMACO.
Sociodemographic and Workplace Determinants of Quality of Life (Qol) Among Quarry Workers in Nigeria: A Cross Sectional Study
Authors: Njaka Stanley , Yusoff Dariah Mohd , Kueh Yee Cheng , Anua Siti Marwanis , Oswald Edeogu Chuks
Published: December 2023

By engaging in one form of works, people earn means of support, establish their identities, perceive life as meaningful and establish social network with others. The quality of life is a product of several factors inherent in the work environment. Quality of life is an important topic in every organization as it determines the future of the organization. This study assessed the sociodemographic and workplace determinants of Quality of life (Qol) among quarry workers in Nigeria. A cross-sectional study was conducted among the respondents. Data were collected using self-administered questionnaires consisting of socio-demographic characteristics, Standard Nordic Musculoskeletal Questionnaire and World Health Organization Quality of life BREF questionnaires (WHOQOL-BREF). A total of 266 quarry workers involved in this study were selected through systematic random sampling technique. The data were analyzed using SPSS version 26. Simple and multiple logistic regression were used to identify the determinants of quality of life among the respondents. The result showed that majority of the respondents (74.1%) had poor quality of life with variation across four domains of physical, environmental, socio relationship and psychological. Following multiple logistic regression modeling, WRMSDs (ORadj 4.24, 95% CI [1.84, 9.77], p-value = .001) and the poor work design (ORadj 3.22, 95% CI [1.52, 6.82], p-value = .002) remained significant determinants of Qol. This study showed poor quality of life among quarry workers in Ebonyi state, Nigeria. Those with WRMSDs and had poor work design were more likely to have poor quality of life compared to those who had no WRMSDs and work in well-designed workplace.
The Differential Effects of LMX and Regulatory Focus on Promotive and Prohibitive Voice
Authors: Wang Chaoyu , Kim Jeeyoung , Chung Myung-Ho
Published: December 2023

Employee voice plays a crucial role in driving constructive change within organizations. However, there is a lack of understanding regarding the distinct antecedents of different types of voice behaviors, namely promotive and prohibitive voice. This study aims to address this gap by examining the influence of interpersonal factors, such as leader-member exchange (LMX), and individual factors, specifically regulatory focus, on both types of voice behavior. By focusing on LMX and regulatory focus, we explore how these factors uniquely and interactively affect promotive and prohibitive voice. The study collected data from 167 Chinese employees in Guangdong province and Hong Kong. Our findings reveal a positive linear relationship between LMX and promotive voice, indicating that a strong leader-member relationship enhances employees’ willingness to contribute proactive ideas and suggestions. In contrast, we observed a curvilinear relationship between LMX and prohibitive voice, consistent with the “too-much-of-a-good-thing” effect. Furthermore, our study examines the unique effects of promotion and prevention focus on promotive and prohibitive voice, respectively. However, we did not find significant interaction effects between LMX and regulatory focus on voice behavior. These results suggest that the impact of LMX and regulatory focus on voice behavior operates independently rather than in combination. Theoretical implications of our findings contribute to the understanding of voice behavior, leadership, and regulatory focus literature.
The effects of context and characteristics of women entrepreneurs on innovation performance
Authors: Chávez-Rivera María Eulalia , Ruíz-Jiménez Jenny María , Fuentes-Fuentes María del Mar
Published: December 2023

Drawing on institutional and upper echelons theories, this study delves into the underexplored intersection of gender, context, and innovation performance among women entrepreneurs in Ecuador. Based on a sample of 45 women entrepreneurs, the study employs a fuzzy-set qualitative comparative analysis (fsQCA) and identifies six distinct paths to innovation performance. Contrary to initial expectations, our research findings substantiate that both institutional and social factors play a key role in fostering innovation in women-led firms in Ecuador. This innovation is facilitated by establishing close and frequent interpersonal connections, as well as by the age of the female entrepreneurs. Conversely, certain individual variables traditionally associated with innovation, such as education level or prior experience, manifest only sporadically. Our research enriches the discourse in gender and innovation studies by employing a multilevel approach and provides valuable insights into female entrepreneurial leadership’s contribution to advancing developing economies.

JEL CLASSIFICATION: O32; J16
Biomechanical Fixation Analysis of Minimally Invasive Chevron Osteotomy
Authors: Nunes Gustavo Araujo , Carvalho Kepler A.M. , Mansur Nacime Salomao Barbachan , de Cesar Netto Cesar
Published: December 2023

Category:

Bunion

Introduction/Purpose:

The original fixation for minimally invasive Chevron-Akin ( MICA) was described with two screws: a proximal screw reaching two cortices before fixing the metatarsal head and a distal parallel screw that can reach only one cortical before fixing the head. Despite this, some authors questioned the need for two screws and were able to reproduce good results from this technique using only one screw to fix the osteotomy. Notably, no biomechanical studies evaluate this osteotomy's most stable and safe fixation. This work aims to perform a biomechanical analysis based on finite element analysis (FEM) to compare different MICA fixation configurations using screws. Our hypothesis is that the fixation of the original technique with two screws is the safest.

Methods:

A Three-dimensional (3D) virtual model of a foot computer tomography (CT) image was made using the Rhinoceros™ program. The element finite analysis was performed with the SimLab™ program using the Optistruct solver. From these 3D virtual models, an extracapsular chevron osteotomy with 130 degrees with 70% of lateral translation was done and fixated. Five internal fixation configurations with screws were used for fixation of MICA and assessed by FEM -: original MICA fixation with 2 screws, 2 intramedullary screws, 2 bicortical screws, 01 intramedullary screw, and 01 bicortical screw. The simulated 150 N and 300 N loads were applied to the middle foot. The FEM evaluated the total and localized displacements of the osteotomy site. For the analysis of stresses, the variables maximum principal (traction) and minimum principal (compression) were used. The equivalent von Mises stress (VMS -S) was used for the metallic implants and for the bone (VMS -O).

Results:

The classical fixation for MICA showed the lowest values for total and localized displacement, minimum and maximum total stress, and VMS-S and VMS-o in both conditions( 150 and 300 N). The localized displacement was statistically lower for MICA screws compared to the other fixation configurations (p < 0.05) The maximum total stress was statistically lower for MICA screws compared to the other fixation configurations (p < 0.05)

Conclusion:

The classical fixation for MICA yields better results in terms of total and localized displacement, minimum and maximum total stress, and VMS in both conditions. These results demonstrate that the classical fixation for MICA described in the original technique is biomechanically the most efficient and safe.
Comparable Outcomes of Cartiva Implant, Cheilectomy, and Fusion for Hallux Rigidus of the 1st Metatarsophalangeal Joint: A Matched Cohort Study
Authors: Comfort Spencer M. , Marchetti Daniel , Duncan Parker , Dornan Grant J. , Haytmanek C. Thomas , Clanton Thomas O.
Published: December 2023

Category:

Midfoot/Forefoot; Other

Introduction/Purpose:

The primary goal of treating hallux rigidus of the 1st metatarsophalangeal (MTP) joint of the foot is to reduce pain. Treatment options include cheilectomy, interposition arthroplasty, and arthrodesis for more severe disease. Recently, the use of a synthetic cartilage implant (Cartiva, Stryker Inc., MI, USA) has been introduced with the advantage of motion preservation. While a Level 1 study has demonstrated similar outcomes of fusion and Cartiva, other comparative studies have shown less favorable results for the Cartiva implant. The purpose of this study was to evaluate minimum 2-year patient reported outcomes (PROs) of the Cartiva implant for the treatment of hallux rigidus in the 1st MTP joint in comparison to a matched cohort of patients treated with fusion or cheilectomy.

Methods:

Patients >18 years old who underwent surgery for treatment of 1st MTP joint hallux rigidus with Cartiva implant, cheilectomy, or fusion performed by two surgeons (T.O.C. or C.T.H.) between January 2009 and January 2020 were identified. A 2:1 matched control cohort of patients who underwent cheilectomy or fusion was constructed using a nearest neighbor, greedy algorithm based on age, sex, prior surgery, and Coughlin osteoarthritis grade. Minimum 2-year follow-up was obtained with patients completing subjective questionnaires including Foot and Ankle Ability Measure (FAAM) with Activities of Daily Living (ADL) and Sport subscales, Short Form-12 (SF-12), Tegner activity scale, and patient satisfaction with surgical outcome. Demographics and patient-reported outcomes were compared between groups.

Results:

Follow-up was obtained for 22/27 (82%) Cartiva patients (mean age 54±19) at median 4.3 years and 41/49 (84%) control patients (mean age 58±11) at median 3.5 years. Prevalence of Coughlin grade was similar between Cartiva and control groups (6 vs 10 grade 1, 8 vs 15 grade 2, 2 vs 6 grade 4, 6 vs 10 grade 5; p=.93), respectively. There was no significant difference in median post-operative FAAM-ADL (96 vs 95, p=.53), FAAM-Sport (92 vs 89, p=.89), SF-12 PCS (56 vs 51, p=.054), SF-12 MCS (56.3 vs 57.5, p=.50), Tegner score (4 vs 3, p=.30), or patient satisfaction (9 vs 9, p=.91) between Cartiva and control cohorts, respectively. Revision surgery was required for 3 (14%) Cartiva patients and 4 (10%) control patients (p=.70).

Conclusion:

Patients treated with a Cartiva synthetic cartilage implant for 1st MTP joint hallux rigidus had similar patient-reported outcomes and revision rate compared to patients treated with cheilectomy or fusion for Coughlin grade 2-5 osteoarthritis.
Does Total Ankle Replacement Help to Improve Physical Activity in Patients 2 Year Post-Operatively? A Pilot Activity Monitoring Study
Authors: Hakeem Samir , Nicolas Andrea Pujol , Ramaskandhan Jayasree R. , Smith Karen M. , Siddique Malik
Published: December 2023

Category:

Ankle Arthritis

Introduction/Purpose:

Step count and activity monitoring are objective tools to measure improvement in functional ability in patients undergoing Total ankle replacement (TAR); this area is underexplored in literature. Activity monitoring sensors provide additional information on physical activity and energy expenditure in addition to step counts. These carried out in a real-life environment helps us to understand the impact of intervention in improving physical activity. The aim of this study was to study physical activity patterns in the community in patients who underwent TAR surgery.

Methods:

10 patients who underwent a TAR between 2017 and 2019 were recruited. Exclusion criteria included previous reconstructive surgery, h/o infection, PVD, neurological disease and other joint replacements. Written consent was obtained. Patients were provided with ActivPAL TM activity monitor to wear over a 7-day period along with a self-reported diary to record activity patterns. This was carried out pre-operatively and 2 years. Data from sensors were downloaded and activity patterns were analysed with SPSS IBM 28 statistical package.

Results:

10 patients (7 males, 3 females) were recruited. Mean age of patients were 65.16 years (52.4 to 78.1yrs).there was a trend for improvement in Sitting / Lying (hours) from 121.36 to 132.56 (p=0.367) and Standing (hours) 25.53 to 33.23 (p=0.411), although this did not achieve statistical significance. Step count (in hours) improved from 8.8 hrs to 10.8 hrs (p=0.05); Step count increased from 38544 to 47074 (p=041) from pre-op to 2 years. Energy expenditure (metabolic equivalents) improved from 192.3 to 219.5 (p=0.033).

Conclusion:

At 2 years post-operatively, TAR patients showed considerable improvement in step count and energy expenditure compared to pre-operative levels. The results of this novel study helps us to understand the functional improvements in terms of physical activity and energy expenditure gained from TAR surgery
Effectiveness of Hospital-Based Systemic Rehabilitation in Improving Ankle Function after Surgery in Chronic Ankle Instability Patients
Authors: Lee Sung Hyun , Jo Yang Hun
Published: December 2023

Category:

Sports; Other

Introduction/Purpose:

We investigated the therapeutic effect of a postoperative hospital-based systemic rehabilitation protocol on ankle function in chronic ankle instability (CAI) patients.

Methods:

Thirty-five patients who underwent a modified Broström procedure for CAI were recruited in this prospective randomized controlled trial. Fifty-minute sessions of hospital-based rehabilitation were performed three times weekly for 12 weeks in the intervention group. Education-based rehabilitation was conducted at home in the control group. The outcomes were evaluated at baseline (T0), 12 weeks (T1), and 16 weeks (T2). The primary outcome was the foot and ankle outcome score (FAOS). Ankle motor strength and spatiotemporal gait metrics were assessed as secondary outcomes.

Results:

There were time and group interaction effects on the pain, symptoms, activities of daily living, sports activities, and quality of life (QOL) domains of the FAOS (P < 0.05, all). The patients in the intervention group showed larger improvements in all domains of the FAOS than did the control group at both T1 and T2 (P < 0.05, all). The time and group interaction effects on invertor and evertor strength were also significant (P = 0.047 and P = 0.044). Invertor and evertor strength improved significantly more in the intervention group than in the control group at T1 and T2 (P < 0.05, all). The preferred walking velocity, cadence, step length on the affected side, and double stance phase duration tended to improve over time.

Conclusion:

Postoperative hospital-based rehabilitation helped improve CAI pain, symptoms, independence in activities of daily living, sports activity levels, and QOL more effectively than did conventional rehabilitation at home.
Intermediate Term Clinical Outcomes in Total Ankle Arthroplasty: The CU Total Ankle Registry
Authors: Hunt Kenneth , Buckley Sara E. , Hewitt Michael A. , Stark Samuel D.
Published: December 2023

Category:

Ankle Arthritis; Ankle

Introduction/Purpose:

Total ankle arthroplasty (TAA) is a common procedure to treat end stage ankle osteoarthritis. Despite recent increase in popularity, there is limited literature assessing clinical and patient-reported outcomes (PROs) in TAA procedures using 5 current generation implants. These measures are an important tool for physicians to better assess patient performance in daily activities. The purpose of this study is to characterize both PROs and clinical outcomes in primary and revision TAA surgeries using current generation prostheses performed by non-design surgeons at a single institution.

Methods:

Our institution maintains a prospective outcomes registry for patients undergoing TAA at our institution. Patient demographics, relevant case information, PROs and complications are collected. Collected PROs include PROMIS Physical Function (PF), Pain Interference (PI), Depression, Global Physical Health (GPH), Global Mental Health (GMH), and Foot and Ankle SANE. Records are categorized as a primary TAA, or revision involving either a polyethylene only exchange or complete hardware removal and replacement. Differences between groups were determined non-parametrically using Mann-Whitney U tests. In all statistical tests, a p value of less than 0.05 was considered significant.

Results:

A total of 259 patients were included for analysis; 223 primary and 36 partial or full revision. Average length of stay was 1.6 ± 1 days. There were 18 reoperations (6.95%), with no implant failures within 1 year. Five patients underwent implant revision at an average of 2.5 years. Of these, one was related to delayed infection at year 3, two due to hardware failure in year 2, and 2 polyethylene exchanges in years 2 and 5. All physical health PRO measures showed significant improvements post-operatively (p < 0.0001). Patients reported significant reductions in pain following TAA at 3-months (Figure 1a), and significant improvement of physical function after 6-months (Figure 1b). There were no significant changes in Depression or GMH (Figure 1d).

Conclusion:

Total ankle arthroplasty is a safe and effective procedure for end-stage ankle arthritis. Patients experience improvement in all physical health PRO metrics at all post-operative time points after 3 months. Complication and early failure rates are lower than that reported in the literature. Long term outcomes and implant longevity will be tracked using the CU Total Ankle Registry. Total ankle arthroplasty improves quality of life in patients suffering from ankle osteoarthritis. Further follow-up and patient enrollment in the CU Total Ankle Registry will help us to identify risk factors for complications and define implant lifespan.
Is There Improvement in Plantar Pressures Patterns Following Total Ankle Replacement? – A Prospective Novel 1 Year Follow Up Study
Authors: Hakeem Samir , Nicolas Andrea Pujol , Porter Anna , Ramaskandhan Jayasree R. , Smith Karen M. , Galloway Steven , Siddique Malik
Published: December 2023

Category:

Basic Sciences/Biologics; Ankle

Introduction/ Purpose:

The aim of this study was to investigate plantar pressures changes with gait in patients presenting with ankle arthritis pre and post TAR.

Methods:

Patients who were listed for a primary TAR with a 3 component mobile bearing prosthesis were included. Exclusion criteria included refusal of consent, previous surgery to foot, h/o infection, peripheral vascular disease, neurological disease and other LL joint replacements. Gait analysis was carried out using TekscanTM plantar preasure (PP) analysis system and PP) were recorded pre- operatively and 1 year post-operatively. Gait asymmetries were recorded in Percentage for ST parameters. 11 patients were recruited to this study. Mean age were 70.5 years.

Results:

Improvement centre of pressure pattern restoration and Force percentage curve (FP) patterns from pre-op to 1 Year. Improvement in foot progression angle was seen in 6 out of 11 patients (54.5%). Plantar pressure analysis showed deviation from reference ranges for 1) differences in centre of pressure (COP) 2) changes to hindfoot vs. forefoot loading ratio 3) change in loading pattern at heel in KPa (p < 0.05) 4) differences in gait parameters (reduction in cadence, walking velocity, increase in active propulsion time; p< 0.05) 5) changes to foot progression angles. These findings correlate with MOX-FQ scores (p>0.565) for pain, difficulty with walking/standing and difficulty with social activities. Gait asymmetries improved at 1 year for step velocity (76.1 to 93.4%) and mid stance time (76.04 to 93.5% in 8/11patients)(p < 0.05).

Conclusion:

This study shown that TAR surgery helps in restoring centre of pressure, force percentage curve patterns and reduces asymmetries in step velocity and mid stance times during gait at 1 year post surgery. Plantar pressure analysis is a useful tool to study improvement in function in this patient group.