bluuebunny/crossref_metadata_2025 huggingface dataset:
Buyer–Supplier Relationship Dynamics in Buyers’ Bankruptcy Survival
Authors: Mani Sudha , Astvansh Vivek , Antia Kersi D.
Published: July 2023

A bankrupt buyer firm's interactions with its suppliers during bankruptcy have critical implications for both parties and for the broader economy, yet these interactions remain poorly understood. The authors build on research on buyer–supplier relationship dynamics to demonstrate that accommodative and exploitative velocities—the rate and direction of change in the corresponding acts—serve as signals affecting bankruptcy survival. They show how signal characteristics (i.e., the variability in accommodative and exploitative acts) and signaler characteristics (i.e., whether the party undertaking the acts is the buyer or its suppliers) moderate the impact of accommodative and exploitative velocities on bankruptcy survival. Study 1 examines the bankruptcy survival outcome of 310 U.S. bankruptcies over 14 years and finds that a 1% increase in accommodative (exploitative) velocity increases (decreases) the buyer's survival by 39% (33%). Further, variability in accommodative acts weakens their effect, and suppliers' (vs. the buyer's) accommodative and exploitative velocities are less deterministic of the buyer's bankruptcy survival. Study 2 uses a scenario-based experiment to shed light on the mechanism underlying the impact of the two velocities on bankruptcy survival. The findings from both studies demonstrate the key role played by buyer–supplier interactions in a buyer's bankruptcy survival.
Physician Ownership for the Virtuous Practice of Medicine
Authors: Joa Brandon
Published: July 2023

The shift from physicians as owners or shareholders of practices to being employees of corporations is now a widespread trend with over 50% of physicians now considered employees. If continued, this trend will have profound effects on the medical profession and on physicians’ personal lifestyles and sense of agency. However, ownership is not a morally neutral consideration but is important for safeguarding the traditions of virtue in the medical profession. Virtue develops within localized communities of practice and thrives in settings that embody principles such as solidarity, subsidiarity, and participation found in Catholic social teaching. Ownership increases physicians’ investment in moral communities where they practice, affording physicians greater agency to benefit these communities according to their best judgment. This ownership can vary by type of organization and degree of shareholding. Because moral communities are the settings in which physicians form virtue, and ownership increases physicians’ commitment and investment in communities, I make a principled argument that physicians who value developing virtue should consider having ownership of their practices when planning their careers. Ownership will be an important aspect of any medical ethics based on virtue rather than on principlism.
Efficacy of rehabilitation interventions evaluated in common neurological conditions in improving participation outcomes: A systematic review
Authors: Kossi Oyéné , Raats Joke , Wellens Jonas , Duckaert Mathias , De Baets Stijn , Van de Velde Dominique , Feys Peter
Published: July 2023

Objective

Modern clinical rehabilitation practice aligned to the International Classification of Functioning, Disability and Health and the Convention on the Rights of Persons with Disabilities highlights the importance of attention to participation in the rehabilitation formulation. This systematic review investigates the efficacy of rehabilitation interventions evaluated in common neurological disorders reported to influence participation outcomes.

Data sources

PubMed, Web of Science and PsycINFO databases were searched from inception to 25 April 2023. Only randomised controlled trials were considered for inclusion.

Review methods

The data were extracted by two independent reviewers in the following categories: characteristics of the included study publications, description of intervention and outcome measures.

Results

A total of 1248 unique article records were identified through the databases. Twenty-eight randomized controlled trials were included with 15 publications having participation as a primary outcome measure. Articles were related to multiple sclerosis ( N = 4), spinal cord injury ( N = 2), stroke ( N = 16) and traumatic brain injury ( N = 6). Four publications showed significant differences in pre- and post-intervention within experimental groups. All four articles described participation as primary outcome measure.

Conclusion

There is a limited evidence of the identified rehabilitation interventions to improve participation in common neurological conditions. However, there was a paucity of articles involving individual with Parkinson's disease that met the inclusion criteria.
Fusion imaging versus ultrasound-guided percutaneous thermal ablation of liver cancer: a meta-analysis
Authors: Sheng Yangang , Sun Xueke , Sun Hongmei , Qi Jinyan , Li Hua , Luan Jiankui , Zhai Deyin
Published: July 2023

Background

Ultrasound-guided percutaneous thermal ablation has become an alternative treatment for small hepatocellular carcinoma (HCC). Recent evidence suggests that fusion imaging (FI) may improve the feasibility and efficacy of thermal ablation for HCC, while the clinical evidence remains limited.

Purpose

To compare FI versus ultrasound-guided thermal ablation for HCC.

Material and Methods

Relevant cohort or randomized controlled trials were found by searching Medline, Web of Science, Cochrane Library, and Embase. The pooling of results was performed using a random-effects model incorporating heterogeneity.

Results

In this meta-analysis, 15 studies involving 1472 patients (1831 tumors) for FI-guided ablation and 1380 patients (1864 tumors) for ultrasound-guided ablation were included. Pooled results showed that compared to conventional HCC ablation guided by ultrasound, the FI-guided procedure showed a similar technique efficacy rate (risk ratio [RR] = 1.01, 95% confidence interval [CI] = 1.00–1.02, P = 0.25; I2 = 30%). However, FI-guided tumor ablation was associated with a lower incidence of overall complications (RR = 0.70, 95% CI = 0.50–0.97, P = 0.03; I2 = 0%). Moreover, patients receiving FI-guided tumor ablation had a lower risk of local tumor progression during follow-up than those with ultrasound-guided ablation (RR = 0.61, 95% CI = 0.47–0.78, P < 0.001; I2 = 13%). Subgroup analysis according to FI strategy, imaging techniques in controls, and tumor diameter showed consistent results (p for subgroup difference all >0.05).

Conclusion

FI-guided thermal ablation may be more effective and safer than ultrasound-guided ablation for patients with HCC.
Fatigue Prevalence Among Palliative Care Cancer Patients in Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia: A Cross-Sectional Study
Authors: Alzhrani Abdulaziz A. , Alsuhail Abdullah I. , Rababah Ahmad A.
Published: July 2023

Objective: The aims of the current study are to assess the prevalence of cancer-related fatigue, to examine the difference in cancer-related fatigue severity in relation to patients’ characteristics (age, gender, type of cancer, and palliative performance status), and to explore the correlation between cancer-related fatigue and pain, dyspnea, insomnia, and depression among palliative care patients. Methods: A cross-sectional descriptive observational study conducted at Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia. The study included cancer patients who received palliative care services from January 2016 to December 2021. Clinical data of study participants were retrospectively collected from Palliative Care department patient registry. Symptoms were assessed and scored using Edmonton Symptom Assessment Scale. Data analysis was performed using SPSS statistical software. Results: A total of 2616 patients were included in the study, 52.3% were females and 47.7% were males. The median age of study participants was 56 years (range: 2-101 years). Among all study population, the highest reported cancer type was gastrointestinal malignancy (33.5%), while the least was unknown primary malignancy (1.4%). With regards to Edmonton Symptom Assessment Scale, pain (86.4%) and fatigue (83%) were the highest reported symptom in comparison to constipation (17.3%) and insomnia (7.1%). Conclusion: Cancer-related fatigue is a prevalent and concerning issue among palliative care patients. It is essential that healthcare providers recognize the prevalence of fatigue among patients with life-limiting illnesses, assess patients for fatigue routinely, incorporate strategies for managing fatigue, work closely with affected individuals and their families in order to guide the establishment of a personalized care plan that addresses the patient's unique needs and preferences.
Short-term dynamics of pride and state self-esteem change during the university-to-work transition
Authors: Diwan Ketaki A , Chung Joanne M , Meyers Christina , van Doeselaar Lotte , Reitz Anne K
Published: July 2023

Young adults differ in their self-esteem change during the university-to-work transition. The short-term processes (such as state changes) which are related to individual variability in change are not yet fully understood. In this pre-registered study, we examined experiences of pride as an emotional process underlying state self-esteem change in a sample of 232 Dutch master students over 8 months across their university-to-work transition. We used dynamic and multilevel structural equation models to analyze three waves of 14-day experience sampling data, examining momentary and daily associations between pride and state self-esteem on the within-person level. We examined correlated change in pride and state self-esteem, and the extent to which pride predicted variability in state self-esteem change. Results indicated positive within-person associations and considerable individual differences in pride–state self-esteem associations across moments and days. Across months, changes in pride and state self-esteem were positively correlated, but pride before graduation did not predict variability in later state self-esteem change. Pride–state self-esteem associations remained robust after accounting for feelings of joy, transitional valence, and timing of the transition. Findings indicated that pride uniquely predicted state self-esteem change during the education-to-work transition, which suggests that pride is a key emotion underlying self-esteem change.
Thermoplastic starch hybrid biocomposite films with improved strength and flexibility produced through crosslinking via carboxylic acid
Authors: Lai Di Sheng , Osman Azlin Fazlina , Adnan Sinar Arzuria , Ibrahim Ismail , Ahmad Salimi Midhat Nabil , @ Mustapha Mariatti Jaafar
Published: July 2023

Thermoplastic starch (TPS) suffers from its intrinsic low mechanical strength and high brittleness due to its strong hydrogen bonding and low chain mobility. The conventional way to crosslink the TPS film can improve the strength and stiffness of the films, but usually reduces the flexibility of the film, and increases its brittleness. In this study, the incorporation of the hybrid nanofiller [1 wt% nanocellulose (C) and 4 wt% nano bentonite (B)] into the TPS proved to improve greatly the films’ strength and flexibility. The hybrid nanofillers with ratio 4B:1C was incorporated into the crosslinked thermoplastic corn starch (CR-TPCS) film to increase the its flexibility and toughness and produced a high mechanical strength fully biodegradable film. Two different aqueous carboxylic acids: citric acid (CA) and tartaric acid (TA) with different pH values (2,4,6) as the green crosslinker were employed. Substantial increase of tensile strength (3.98 to 9.17 MPa), Young’s modulus (9.10 to 46.30 MPa) and elongation at break (55.2 to 135.7%) was observed for the CA- 4B1C/pH2 films compared to the CR-TPCS films. The melting temperature (Tm) of the CA-4B1C/pH2 improved compared to the TPCS/4B1C (un-crosslinked) film due to its crosslinking effect. Meanwhile, the CA-4B1C films exhibited the highest degree of substitution and di-esterification with the lowest swelling and water solubility properties due to the formation of a special “bridge” structure between the CA, nanocellulose and plasticizer. The “bridge” structure developed between the TPCS chains serves as the toughener to motivate higher chain stress relaxation and load endurance. The crosslinked “bridge structure” also proved to effectively reduce the retrogradation phenomenal in the TPCS films. This combination method of hybridization and crosslinking is an efficient, low cost, and environmentally friendly technique to overcome the low flexibility and brittleness problem of the TPS based packaging film.
Old and New Organizational Forms in a Complex Society: A Systems-Theoretical Perspective
Authors: Besio Cristina , Tacke Veronika
Published: July 2023

This contribution demonstrates the potential of Niklas Luhmann’s organization theory to enrich current research on organizational phenomena. Although this theory originated more than half a century ago, we show that it is a powerful instrument to describe and understand the role that different old and new forms of organizations play in current crises and transformation processes. Hereby, we stress two combined advantages of the theory: (1) Luhmann offers a strong concept of organizations as self-referential networks of decisions. This helps to distinguish them from other social entities, for example, groups, social networks, or families. Moreover, the assumption of ‘substitutability of structures’ allows us to grasp the dynamics of a variety of organizations and does not fail to confront even ‘fluid’, ‘virtual’, ‘temporary’, and ‘unconventional’ forms of organization unknown at the time of the theory’s origin. (2) This theory of organization is unique as it is embedded in an encompassing theory of society that offers several concepts suitable to explain the reciprocal influence of organizations and broader social contexts. This prevents any under- and overestimation of the organization phenomenon in modern society.
‘Money Probably Has Something to Do with My Life’: Discourse and Materiality in the Working Lives of Start-Up Entrepreneurs
Authors: Musílek Karel , Jamie Kimberly , Learmonth Mark
Published: July 2023

This article contributes to an understanding of work-intensive entrepreneurial lives as part of analysing the intensification of work in society. It offers an empirical extension of Foucauldian analyses, which attribute commitment to work to the influence of neoliberal enterprise discourse while often neglecting the material conditions of entrepreneurial work. The article draws on moderate constructionism and materialist discourse analysis to offer an account that pays attention to discourse and material realities. This ethnographic study shows how participants evoked norms of enterprise discourse to explain their commitment to work. However, they also understood these norms to be fundamentally shaped by their material conditions. The major contribution of the article is to show that the interpenetration of discursive norms with the investment logic of enterprise tends to displace boundaries between work and personal life and shift temporal arrangements of work from work–life ‘balance’ to prospects of free time in the imagined future.
Investigation of machinability indicators during sustainable milling of 17-4PH stainless steel under dry and MQL environments
Authors: Yurtkuran Hakan , Boy Mehmet , Günay Mustafa
Published: July 2023

17-4PH steel, which has the perfect combination of corrosion resistance and high mechanical properties, is especially preferred in defense and aerospace applications, but its machinability is poor. Thus, an extensive research has been conducted on its milling under sustainable cutting regimes (dry and minimum quantity lubrication_MQL) to contribute to both more efficient use and sustainable machining. First, the changes in resultant cutting force ( Fr), the average surface roughness ( Ra), the mean roughness depth ( Rz) and total energy consumption ([Formula: see text]) were investigated after the experiments performed by applying the L18 orthogonal array. Subsequently, machining conditions were optimized for the minimization of machinability indicators with the Taguchi-based grey relational analysis technique. Finally, the predictive models for these indicators were developed by regression analysis. The order of importance for Fr and [Formula: see text] was the depth of cut and feed, while for Ra and Rz this ordering was found to be feed rate and cutting regime. Short curved chips formed in MQL cutting regime contributed positively to the minimization of the considered machinability indicators. Although the energy consumption due to spindle speed increased with increasing cutting speed in dry cutting environment, the decrease in material strength resulted in a decrease in [Formula: see text]. Since the cooling effect of MQL reduces the cutting temperature, material softening and thus the expected decrease in cutting resistance could not be achieved, so the decrease in [Formula: see text] was not as much as dry cutting. Optimum machining conditions were determined as MQL cutting regime, the cutting speed of 120 m/min, the cutting depth of 0.5 mm and feed rate of 0.05 mm/rev. The determination coefficients of the predictive models developed by regression analysis showed that these models can be used safely in up milling.
A novel deep learning model for fault diagnosis of rolling-element bearing based on convolution neural network and recurrent neural network
Authors: Song Xudong , Lyu Xinran , Sun Shaocong , Li Changxian
Published: July 2023

Rolling bearings are critical components that are incredibly prone to failure in the operation of mechanical equipment. Due to the complexity of the actual working conditions, multiple types, positions and scales of bearings are problematic to accurately and completely classify using conventional classification methods. In this study, a novel end-to-end deep learning framework consisting of a one-dimensional convolutional neural network (1D-CNN) and a module fused by long short-term memory (LSTM) and gated recurrent unit (GRU) is proposed to diagnose bearing failures, thus solving the problem of the poor accuracy of traditional fault identification. First, 1D-CNN is used to extract local features from bearing data thanks to its excellent local feature extraction capabilities. Second, global features are extracted from bearing data using LSTM and GRU, and classification is performed with Softmax. Finally, the proposed model is evaluated using Case Western Reserve University and the University of Cincinnati data, with accuracy rates of 99.99% and 99.83%, respectively. The experimental results indicate that the proposed model has good feasibility and performance.
Reduction of emissions and improvement of dynamic responses of a supercritical clean coal generation unit via neural network inverse control strategy
Authors: Mohamed Omar
Published: July 2023

Coal power plants have been a major source of undesirable emissions. Despite the technological advancements in renewable energies, coal units are still in-service in many developed and developing countries due to their reliability, adequacy, and flexibility for power delivery. There are some promising technologies for cleaner operation during power production from coal, including supercritical boiler (SC) design and carbon capture and storage (CCS), however, the challenging in innovating effective methods is still open to expand the boundary of knowledge in this speciality. This paper introduces a novel and simple method for reducing CO2 emissions and improving the dynamic responses of a 600 MW SC coal power plant by Artificial Neural Network (ANN) technique. A wide-range data-driven feedforward ANN model has been identified and verified for the various operations recorded as closed-loop data-sets, which covers all situations of startup, once-through mode, and even emergency shutdown of the unit. The closed-loop SC plant model has been augmented with an inverse multivariable coordinate NN controller, developed by analogous learning algorithm to improve the plant automation. With precisely selected setpoints, as operational rules, of temperature, pressure, and earliest possible power demand signals, the automated SC plant has been capable to operate with lower coal consumption - and thus lower emissions – than the existing operation strategy during startup, normal operation, and emergency shutdown modes. The improvement in dynamic responses have been quantified through simulations with comparison with existing performance, which have resulted in an overall average reduction of 2.143 Kg/s in coal consumption.
Variation in outpatient consultation fees of psychiatrists in Australia by state and territory
Authors: Coulston Caitlin , Leahey James
Published: July 2023

Objective

To determine bulk billing rates, and mean, median, and 10th and 90th centile fees for outpatient consultations with a psychiatrist in Australia in 2019, by state or territory.

Method

Medicare claims data for bulk billing rates and the mean, median, and 10th and 90th centile for fees charged in Australia in 2019 were requested, for item numbers for initial and ongoing consultations.

Results

There were high rates of bulk billing overall. Initial consultations were more likely to be bulk billed. There was variation in fees between states and territories. Fees were highest in the Australian Capital Territory.

Conclusion

There is variation in fees and bulk billing rates for outpatient consultations with a psychiatrist. Fees tend to be higher in states or territories with higher median personal income. Psychiatrists were more likely to bulk bill for initial consultations, with the exception of the Northern Territory. High rates of bulk billing may indicate psychiatrists are absorbing increasing costs of service provision.
Identifying Multilevel Community Supervision Challenges to Inform Diversion Approaches for People With Mental Illnesses
Authors: Waters Allison K. , Mercier Mariah Cowell , Disbennett Mackensie , Ziaii Suzanne , Cuddeback Gary S. , Velázquez Tracy , Van Deinse Tonya B.
Published: July 2023

Efforts to divert people with mental illnesses from the criminal legal system are widespread among mental health and criminal justice authorities. Most diversion efforts focus on directing individuals with mental illnesses to treatment; however, these treatment-focused interventions are an insufficient approach to diverting people with mental illnesses from the criminal legal system and fail to adequately address organizational and system-level factors that impact criminal legal system involvement. This study uses a social ecological approach to identify multilevel supervision challenges that probation officers face in diverting people with mental illnesses from future criminal legal system involvement. Twenty-six probation agency representatives from across the United States were interviewed as part of a larger study about supervising people with mental illnesses on probation. Salient themes indicate diversion targets related to (1) probation officer and agency capacity, (2) interorganizational relationships and roles, and (3) resources and systems in the local community. A comprehensive framework for diversion must include a both-and approach that maintains focus on individual-level supports and predictors of recidivism and violations, while also targeting the macro- or system-level factors that create the conditions for recidivism at the individual level.
Who Deserves Diversion? A Theoretical Critique of Mitigation, Consequentialism, and the Juvenile Court
Authors: Zane Steven N. , Mears Daniel P.
Published: July 2023

The juvenile court was created as a means of diverting youth from the criminal justice system, and, in turn, diversion within the juvenile court has been used for a variety of purposes. This paper argues that an understanding of diversion, and its implications, requires distinguishing deservingness and consequentialism. Analysis of the former goal entails a focus on mitigation and draws attention to a critical gap in scholarship—namely, how do juvenile courts decide which youth deserve diversion? While risk and needs assessments likely play a role, so, too, may mitigation assessments about which youth are more deserving of interventions that may impose less punishment and more rehabilitation. In advancing this argument, we discuss ways in which a focus on diversion, and on mitigation, help to illuminate fundamental tensions in juvenile justice. We discuss, too, ways in which this focus can help to advance research and policy.
Dynamic analysis and vibration control of a rotor-Active magnetic bearings system with base motion
Authors: Wu Huachun , Zhang Li , Zhou Jian , Hu Yefa
Published: July 2023

High-speed and high-precision rotating machinery is widely applied in industry, which promotes the rapid development of non-contact bearings represented by active magnetic bearings (AMBs). The rotor-AMBs system is usually installed on the base. Due to the base motion, it affects the dynamic characteristics of the rotor-AMBs system. In this paper, the dynamic analysis of the rotor-AMBs system with base motion is carried out. The dynamic model of the system with base motion is first derived, and the control model is then established. The influence of the inherent property of the base, the excitation mode of the base motion, and the control method for the rotor-AMBs system are analyzed with numerical simulation. In addition, the combination of feedforward control and PID control is employed to eliminate the vibration disturbance caused by the base motion and improve the suspension accuracy of the rotor. The experimental results show that the proposed hybrid control can effectively reduce the vibration of the rotor-AMBs system with base motion.
Timing of Sexual Assault Disclosure: A Study of College Women
Authors: Bhuptani Prachi H. , Fleming CJ Eubanks , Orchowski Lindsay M.
Published: July 2023

The present study examined correlates of immediate (within 48 h) and delayed (after 48 h) sexual assault disclosure among a sample of 83 college women who experienced sexual victimization since age 14. The use of physical resistance and experiencing a “freeze response” was positively associated with delayed disclosure. Identifying the perpetrator as a friend/acquaintance, compared to a was a romantic partner, increased the likelihood of immediate disclosure. Other individual characteristics (i.e., assault characteristics, a history of childhood sexual abuse, attitudes towards seeking help, and sexual assertiveness) and microsystem-level characteristics (i.e., perceived social support) did not impact the timing of disclosure.
A retrospective, real-life analysis of metronomic oral single-agent cyclophosphamide for the treatment of platinum-pretreated advanced ovarian carcinoma in Italy
Authors: Gebbia Vittorio , Martorana Federica , Scandurra Giuseppina , Valerio Maria Rosaria , Cufari Salvatore , Vigneri Paolo , Sanò Maria Vita , Scollo Paolo
Published: July 2023

Introduction

Metronomic oral cyclophosphamide (MOC) presents many potential advantages, such as significantly less severe side effects than standard regimens, ease of administration, and the delivery of a dose-dense but not necessarily dose-intense treatment. These observations prompted us to evaluate in a retrospective, multicenter study the efficacy and toxicity of MOC in a real-life series of pretreated cancer patients.

Methods

The study is a multicenter, retrospective analysis of the activity of single-agent MOC in patients with recurrent or residual epithelial ovarian, fallopian tube, or primary. Eligible patients were continuously treated with MOC at 50 mg/day until progression, toxicity, or death. Overall response rate (ORR), stable disease (SD), and disease control rate (DCR) were reported.

Results

The study included 62 patients. Three patients reached a complete response rate (5%), 11 had a partial response rate (18), and 15 had stabilization of disease (24) for an ORR of 23% and a DCR of 47%. Patients with low-grade indolent tumors showed an ORR and an SD rate higher than that observed in non-indolent ones (33% vs. 18% and 28% vs. 14%, respectively). Overall, progression-free survival was 3.5 months (range 1–9 months).

Conclusion

Single-agent MOC is active and very well tolerated in a significant fraction of patients with refractory, recurrent, or residual epithelial ovarian, fallopian tube, or primary peritoneal cancer. In the vision of a practical approach, single-agent MOC may be a useful palliative treatment option for patients with poor tolerance to high-dose regimens or widely pretreated. Further studies are needed better to characterize the role of such an approach in clinical practice.
Good Theories Predict: Unveiling the Untapped Potential of “Necessity” Theorizing
Authors: Lee Wangoo , Lu Lu
Published: July 2023

In this paper, we seek to introduce the concept of necessity logic of causality, which, despite its inherent merits in parsimony and predictive accuracy, has not received adequate attention. Our paper begins by providing a comprehensive review of various causal logic, including sufficiency, necessity, and contributory. We then critically examine the key assumptions of necessary causation (i.e., non-additivity, determinism, and asymmetry), and highlight the benefits of necessary causalities in theoretical innovation. Also, we workshop methodological protocols for necessity theory testing. Subsequently, we explore the potential of integrating necessity theories in the hospitality and tourism field by drawing on conceptual-contextual theorizing, leading to the development of “homegrown” theories. We also contend that necessary causality in transdisciplinary research can facilitate broader knowledge exchange to neighboring domains. We conclude by identifying promising research areas for necessity theorizing and testing in hospitality and tourism research.
Service evaluation of multi-family therapy for anorexia groups between 2013–2021 in a specialist child and adolescent eating disorders service
Authors: Yim See Heng , White Sam
Published: July 2023

The aims of the service evaluation were to examine the effectiveness of multi-family therapy for anorexia nervosa (MFT-AN) on family relationships, as well as to understand families’ experiences of MFT in a specialist child and adolescent eating disorders service between 2013–2021. Mixed-methods were used ( t-tests and reflexive thematic analysis). Delivery was in-person in 2013–2019, and moved online from 2020 due to COVID-19. Responses from a total of 57 families and 190 people were analysed. MFT improved family functioning from pre-to post MFT as measured by the Systemic Clinical Observation in Routine Evaluation (SCORE-15). Sub-group analysis by family roles showed that at four-month follow-up, the effects were no longer significant among parents. On the contrary, preliminary analysis showed that although young people did not report any improvement at post-intervention, family functioning was reported to increase at follow-up. Four themes were constructed: being together as a family and as a group; individuality: everyone’s recovery is different; MFT as an emotion ‘hotpot’, and in-person versus virtual groups: not a one-size-fits-all. More robust follow-up data are needed to ascertain the effects of online MFT-AN.
Developing organisational excellence: Applying benchmarking for guiding and measuring police agency performance – Abu Dhabi Police case study
Authors: Neyroud Peter , AlMansoori Brigadier Khalfan , Davies Amanda , AlKaabi Faisal Ahmed Mohamed
Published: July 2023

The process of developing organisational excellence requires identifying benchmarks and a model or framework to guide the operationalisation of an organisation's aspirations. Developing evidence through application of strategies to meet benchmark criteria requires commitment at all levels of an organisation to demonstrate a sustained quality level of achievement through continuous improvement to standards of excellence. This article presents the process and outcomes for a police organisation (Abu Dhabi Police [ADP]) utilising the European Foundation for Quality Management (EfQM) criteria to guide development and measurement of organisational excellence. In 2021 ADP were awarded a 6 Star Global Award from the EfQM. This case study explores the extent to which EfQM is an effective framework for organisational excellence in policing.
From content to context: A qualitative case study of factors influencing audience perception of the trustworthiness of COVID-19 data visualisations in UK newspaper coverage
Authors: Tong Jingrong
Published: July 2023

Drawing from 18 audience interviews, this article examines audience perception of the trustworthiness of COVID-19 data visualisations in UK newspaper coverage. The findings suggest that overall, the participants viewed the selected COVID-19 data visualisations as largely trustworthy. Their perception was unaffected by the types of data visualisations. The trustworthiness of data visualisations had no clear connection with their likability and learnability. Instead, the participants’ trust was influenced by the perceived problematic presentation of data visualisations, such as the inappropriate use of bars to represent data or the failure to present data in context. It was also affected by the participants’ understanding of the problems about data (production and presentation), their assessment of the credibility of data sources and news outlets, and their personal lived experiences and information gained from other sources. All of these were related to the social context surrounding data and data visualisations, rather than merely the content of data visualisations. The findings reveal that the social construction nature of data and data visualisations creates a space for the participants to question data visualisations’ trustworthiness. The close connection between trust in data visualisations and trust in data, a socially constructed product, suggests that the trustworthiness of data visualisations transcends the control of journalists and news media, extending to the context of data and its visualisations. This qualitative research reveals the importance of context to audience trust in data visualisations in the UK.
The persistence of organizational performance problems the public services in Ghana: The perspective of societal culture
Authors: Amoako-Asiedu Emelia , Ohemeng Frank Kwaku Loius , Obuobisa-Darko Theresa , Parku Kenneth
Published: July 2023

Performance management (PM) has been one of the most profound initiatives of public services reforms in both developed and developing countries in the last three decades. Despite its acceptance as a tool to enhance efficiency, effectiveness, and accountability, many continue to question its efficacy to enhance organizational performance in public services. This is because organizational performance problems continue to persist in the sector. How then can this persistence of organizational performance problems be explained? For some scholars, the answer lies in examining the behaviour of employees and thus moving away from the instrumentality of PM. While this is laudable, what influences employees’ behaviours for them to engage in activities that make nonsense of the existence of PM has not been greatly articulated. In this paper, we attempt to contribute to this discussion by focusing on how societal culture influences behaviour, which in turn affects management of performance both internationaly and across cultures. We, therefore, argue that the inability of PM to effectively achieve its objectives is due to the high prevalence of informal societal culture that influences behaviours detrimental to rational performance PM in the public sector. We examine these behaviours from Hofstede’s four cultural dimensions with a focus on Ghana.
Reflections from an insider researcher ‘doing’ feminist participatory action research to co-produce a research agenda with British Pakistani women; a seldom heard group
Authors: Iqbal Halima , West Jane , McEachan Rosemary R. C. , Haith-Cooper Melanie
Published: July 2023

Participation of community stakeholders in health research priority setting is an emerging trend. Despite this, the involvement of marginalised groups in research prioritisation is limited and where they are involved, sample sizes are small, where individuals are merely consulted with, rather than coproducing the research agenda. Without addressing power dynamics inherent in research prioritisation with marginalised groups, their engagement in the research process can be tokenistic and the resulting research agenda unreflective of their needs. This article, therefore, aims to generate knowledge on how feminist participatory action research was used to co-produce an obesity research agenda with British Pakistani women, a seldom heard population, living in deprived areas. The methodology enabled Pakistani women to be involved in all stages of the project, culminating in the co-production of an obesity research agenda that accurately reflects their unmet needs. Women’s engagement in the project led to their increased confidence, the formation of relationships that lasted beyond the research project, improvements to their lifestyles, and engagement in further research. Feminist participatory action research may be used by researchers as a guiding methodology due to its ability to improve women’s lives and develop research agendas for women’s health.
Intelligent wearable and portable security detection technologies integrated into protective equipment: A review
Authors: Zhu Ning , Zhao Wei , Yan Xuefeng , Shen Yue , Ma Yan
Published: July 2023

Intelligent wearable devices for security detection integrate flexible electronic components into protective equipment, enabling the detection of metals, explosives, human physiological conditions, and hazardous chemicals. While numerous studies have investigated various security detection technologies, a systematic literature review providing a comprehensive overview of the preparation and applications of intelligent wearables for security detection is lacking. Therefore, this paper aims to fill this gap by conducting a comprehensive examination of the application of intelligent wearables for security detection in specialized and temporary disposal environments. Additionally, the paper addresses existing challenges and discusses future directions for achieving greater progress in this domain.
Clinical Reflections and Treatment Adaptations for Avoidant Restrictive Food Intake Disorder: A Case Study
Authors: Webb J. , Dhopatkar N. , Croft P. , Himmerich H. , Baillie C. , Dodwell L. , Tchanturia K.
Published: July 2023

Avoidant Restrictive Food Intake Disorder (ARFID) is a serious eating disorder, characterised by problematic eating habits that cause significant nutritional deficiencies. Having only been recently acknowledged as a distinct category, there is little research regarding best practice guidelines, especially among the adult population. In addition, ARFID often coexists with autism, and very little is known about how the diagnoses affect each other, further complicating treatment options. This case study reflects on the treatment of a young autistic woman with ARFID within an inpatient eating disorder setting. Using principles of food exposure, food trials were introduced as a way to increase food variety as well as overall nutrition. Results are promising, with the patient reaching a much safer weight and being able to increase her repertoire of food. While results are not generalisable to a wider population, it is hoped that similar approach could be used with other individuals who have ARFID and autism when aiming to increase nutrition and variety.
The deep learning algorithm estimates chest radiograph-based sex and age as independent risk factors for future cardiovascular outcomes
Authors: Liao Hao-Chun , Lin Chin , Wang Chih-Hung , Fang Wen-Hui
Published: July 2023

Objectives

Chest X-rays (CXRs) convey much illegible physiological information that deep learning model (DLM) has been reported interpreting successfully. Since the electrocardiogram age established by DLM was revealed as a heart biological marker, we hypothesize that CXR age has similar potential to describe the heart and lung states. Therefore, we developed a DLM to predict sex and age through CXR and analyzed its relation with future cardiovascular diseases (CVD).

Methods

A total of 90,396 CXRs aged 20 to 90 were collected and separated into a development set with 53,102 CXRs and demographic information pairs, a tuning set with 7073 pairs, an internal validation set with 17,364 pairs, and an external validation set with 12,857 pairs. The study trained DLM with development set for estimating age and sex and compared them to actual information.

Results

The mean absolute errors of predicted age were 4.803 and 4.313 years in the internal and external validation sets, respectively. The area under the curve of sex analysis was 0.9993 and 0.9988 in the internal and external validation sets, respectively. Patients whose CXR age was 5 years older than chronologic age lead to higher risk of all-cause mortality (hazard ratio (HR): 2.42, 95% confidence interval (CI): 2.00–2.92), cardiovascular (CV)-cause mortality (HR: 7.57, 95% CI: 4.55–12.60), new-onset heart failure (HR: 2.07, 95% CI: 1.56–2.76), new-onset chronic kidney disease (HR: 1.73, 95% CI: 1.46–2.05), new-onset acute myocardial infarction (HR: 1.80, 95% CI: 1.12–2.92), new-onset stroke (HR: 1.45, 95% CI: 1.10–1.90), new-onset coronary artery disease (HR: 1.26, 95% CI: 1.04–1.52), and new-onset atrial fibrillation (HR: 1.43, 95% CI: 1.01–2.02).

Conclusions

Using DLM to predict CXR age provided additional information for future CVDs. Older CXR age is an accessible risk classification tool for clinician use.
Longitudinal Predictors of PROMIS Satisfaction With Social Roles and Activities After Shoulder and Knee Sports Orthopaedic Surgery in United States Military Servicemembers: An Observational Study
Authors: Highland Krista B. , Kent Michael , McNiffe Nicholas , Patzkowski Jeanne C. , Patzkowski Michael S. , Kane Alexandra , Giordano Nicholas A.
Published: July 2023

Background:

Satisfaction with social roles and activities is an important outcome for postsurgical rehabilitation and quality of life but not commonly assessed.

Purpose:

To evaluate longitudinal patterns of the Patient-Reported Outcomes Measurement Information System (PROMIS) Satisfaction with Social Roles and Activities measure, including how it relates to other biopsychosocial factors, before and up to 6 months after sports-related orthopaedic surgery.

Study Design:

Cohort study (diagnosis); Level of evidence, 3.

Methods:

Participants (N = 223) who underwent knee and shoulder sports orthopaedic surgeries between August 2016 and October 2020 completed PROMIS computer-adaptive testing item banks and pain-related measures before surgery and at 6-week, 3-month, and 6-month follow-ups. In a generalized additive mixed model, covariates included time point; peripheral nerve block; the PROMIS Anxiety, Sleep Disturbance, and Pain Behavior measures; and previous 24-hour pain intensity. Patient-reported outcomes were modeled as nonlinear (smoothed) effects.

Results:

The linear (estimate, 2.06; 95% CI, 0.77-3.35; P = .002) and quadratic (estimate, 2.93; 95% CI, 1.78-4.08; P < .001) effects of time, as well the nonlinear effects of PROMIS Anxiety ( P < .001), PROMIS Sleep Disturbance ( P < .001), PROMIS Pain Behavior ( P < .001), and pain intensity ( P = .02), were significantly associated with PROMIS Satisfaction with Social Roles and Activities. The cubic effect of time ( P = .06) and peripheral nerve block ( P = .28) were not. The proportion of patients with a 0.5-SD improvement in the primary outcome increased from 23% at 6 weeks to 52% by 6 months postsurgery, whereas those reporting worsening PROMIS Satisfaction with Social Roles and Activities decreased from 30% at 6 weeks to 13% at 6 months.

Conclusion:

The PROMIS Satisfaction with Social Roles and Activities measure was found to be related to additional domains of function (eg, mental health, behavioral, pain) associated with postsurgical rehabilitation.
Asynchronous conferencing through a secure messaging application increases reporting of medical errors in a mature trauma center
Authors: Lee Joy L , Isenberg Scott , Adams Georgann , Thurston Maria , Hammer Peter M , Mohanty Sanjay K , Jenkins Peter C
Published: July 2023

Background

Medical errors occur frequently, yet they are often underreported and strategies to increase the reporting of medical errors are lacking. In this work, we detail how a Level 1 trauma center used a secure messaging application to track medical errors and enhance its quality improvement initiatives.

Methods

We describe the formulation, implementation, evolution, and evaluation of a chatroom integrated into a secure texting system to identify performance improvement and patient safety (PIPS) concerns. For evaluation, we used descriptive statistics to examine PIPS reporting by the reporting method over time, the incidence of mortality and unplanned ICU readmissions tracked in the hospital trauma registry over the same, and time-to-loop closure over the study period to quantify the impact of the processes instituted by the PIPS team. We also categorized themes of reported events.

Results

With the implementation of a PIPS chatroom, the number of events reported each month increased and texting became the predominant way for users to report trauma PIPS events. This increase in PIPS reporting did not appear to be accompanied by an increase in mortality and unplanned ICU readmissions. The PIPS team also improved the tracking and timely resolution of PIPS events and observed a decrease in time-to-loop closure with the implementation of the PIPS chatroom.

Conclusions

The adoption of clinical texting as a way to report PIPS events was associated with increased reporting of such events and more timely resolution of concerns regarding patient safety and healthcare quality.
Prevalence and significance of DDX41 gene variants in the general population
Authors: Cheloor Kovilakam Sruthi , Gu Muxin , Dunn William G. , Marando Ludovica , Barcena Clea , Nik-Zainal Serena , Mohorianu Irina , Kar Siddhartha P. , Fabre Margarete A. , Quiros Pedro M. , Vassiliou George S.
Published: July 2023

Germ line variants in the DDX41 gene have been linked to myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML) development. However, the risks associated with different variants remain unknown, as do the basis of their leukemogenic properties, impact on steady-state hematopoiesis, and links to other cancers. Here, we investigate the frequency and significance of DDX41 variants in 454 792 United Kingdom Biobank (UKB) participants and identify 452 unique nonsynonymous DNA variants in 3538 (1/129) individuals. Many were novel, and the prevalence of most varied markedly by ancestry. Among the 1059 individuals with germ line pathogenic variants (DDX41-GPV) 34 developed MDS/AML (odds ratio, 12.3 vs noncarriers). Of these, 7 of 218 had start-lost, 22 of 584 had truncating, and 5 of 257 had missense (odds ratios: 12.9, 15.1, and 7.5, respectively). Using multivariate logistic regression, we found significant associations of DDX41-GPV with MDS, AML, and family history of leukemia but not lymphoma, myeloproliferative neoplasms, or other cancers. We also report that DDX41-GPV carriers do not have an increased prevalence of clonal hematopoiesis (CH). In fact, CH was significantly more common before sporadic vs DDX41-mutant MDS/AML, revealing distinct evolutionary paths. Furthermore, somatic mutation rates did not differ between sporadic and DDX41-mutant AML genomes, ruling out genomic instability as a driver of the latter. Finally, we found that higher mean red cell volume (MCV) and somatic DDX41 mutations in blood DNA identify DDX41-GPV carriers at increased MDS/AML risk. Collectively, our findings give new insights into the prevalence and cognate risks associated with DDX41 variants, as well as the clonal evolution and early detection of DDX41-mutant MDS/AML.