bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploration of the Tumour Biological Significance of PCLO in Gastric Cancer: Results from a Large Central European Cohort
Authors: Bernhardt Maximilian , Behrens Hans-Michael , Krüger Sandra , Röcken Christoph
Published: November 2023

Introduction: A recent multiregional whole-exome sequencing of 48 tumour samples from 9 gastric adenocarcinomas discovered PCLO mutations in 23 (47.9%) tumour samples. Based on that unexpected high prevalence of PCLO mutations, we hypothesized a tumour biological significance of PCLO in gastric cancer (GC). Methods: Tumour samples (whole tissue sections) obtained from 466 patients resected for therapy-naive GC were stained with an anti-PCLO antibody. The histoscore for tumour cells and the presence of immunostaining of stromal cells and tumour vessels was documented for each case. An algorithm for PCLO immunopositivity was formed and correlated with clinicopathological patient characteristics. Results: 175 GCs were classified as PCLO positive within tumour cells, and 291 as negative. Stromal cells were positive for PCLO in 106 cases and tumour vessels in 84. PCLO-positive GCs more often showed an intestinal phenotype, a lower T category and were more commonly associated with Helicobacter pylori infection. A separate analysis of PCLO expression in intestinal and diffuse type GCs, respectively, showed no significant correlations. Patients with PCLO negative/low tumour cells showed a shortened overall (14.0 ± 1.4 vs. 16.0 ± 1.8 months) and tumour-specific survival (15.0 ± 1.6 months vs. 17.9 ± 3.6). Comparison of PCLOs genotype with its phenotype in 48 tumour samples obtained from nine cases showed no direct correlations with missense mutations. Conclusion: Our data provide evidence that PCLO is differentially expressed in GC and might delay tumour progression.
The (Personal) Experience of Values – Scheler and Hildebrand
Authors: Neumann Daniel
Published: November 2023

There are several problems in conceiving of value experience in early phenomenology. What exactly does the experience of a value consist in? How are we to determine the morality of an action that is based on a value which is, as a reality in and of itself, imposed on us from without? How is the experience of values related to the person and in what way can an intuitive value response be reconciled with the application of acquired, personal value stances? In a joint reading of the early works of Max Scheler and Dietrich von Hildebrand, I propose a systematic solution to these various problems which revolve around the non-reflective self-awareness that a value experience entails: we cannot experience the real, material value quality without changing as persons. Rather than reflecting on an object, we experience the value as ourselves, dynamically reacting to it in the context of a given situation.
ʿAjamī Literacies of Africa: The Hausa, Fula, Mandinka, and Wolof Traditions
Authors: Ngom Fallou , Rodima-Taylor Daivi , Robinson David
Published: November 2023

African ʿAjamī literatures hold a wealth of knowledge on the history and intellectual traditions of the region but are largely unknown to the larger public. Our special issue seeks to enhance a broader understanding of this important part of the Islamic world, exploring the ʿAjamī literatures and literacies of four main language groups of Muslim West Africa: Hausa, Mandinka, Fula, and Wolof. Through increasing access to primary sources in ʿAjamī and utilizing an innovative multimedia approach, our research contributes to an interpretive and comparative analysis of African ʿAjamī literacy, with its multiple purposes, forms, and custodians. Our Editorial Introduction to the special issue discusses the building blocks and historical development of ʿAjamī cultures in West Africa, outlines the longitudinal collaborative research initiatives that our special issue draws upon, and explores the challenges and opportunities for participatory knowledge-making that accompany the rise of digital technologies in the study of African literatures and literacies.
Consciousness Is Quantum State Reduction Which Creates the Flow of Time
Authors: Hameroff Stuart
Published: November 2023

In neuroscience, the flow of time is a conscious experience produced by the brain. But in physics, time is either a process, or a dimension in four-dimensional spacetime geometry. Could all three explanations be correct? The Penrose–Hameroff ‘Orch OR’ theory suggests consciousness is a sequence of discrete, irreversible quantum state reductions occurring at an objective threshold (‘objective reduction’, ‘OR’) a process in fundamental spacetime geometry. These ‘self-collapses’ of the quantum wavefunction are ‘orchestrated’ in microtubules inside brain neurons. Each Orch OR event selects microtubule states which purposefully regulate neuronal functions, and provide sequences of ‘NOW’ moments of conscious experience. Connected to fundamental spacetime geometry by Penrose ‘OR’, consciousness is quantum state reduction, a set of irreversible steps which ‘ratchet forward’ in the fine scale geometry of the universe, creating a flow of time.
Borderlands and Linguistic Mestizaje in US Puerto Rican Literature
Authors: DiLiberto Stacey L.
Published: November 2023

The effects of neocolonialism, multilingualism, and forced migration on the United States Puerto Rican community have produced notable literary expressions that merit further study for their use of code-switching and hybridization. Using Gloria Anzaldúa’s concept of the “Borderland” as a framework, this paper explores “Nuyorican” poetry as well as the bilingual, bicultural reality for Puerto Ricans in the United States who cross both physical and metaphorical borders and who find liberation living in between languages and cultures.
Writing and Unsettlement: Narratives of Migration in Bekim Sejranović and Hassan Blasim
Authors: Majstorovic Gorica
Published: November 2023

The present article focuses on unsettling language and place in texts by two contemporary migrant writers, Hassan Blasim (Iraq-Finland) and Bekim Sejranović (Bosnia-Norway). They fled war-torn areas while leaving a remarkable textual trace in Sejranović’s Diary of a Nomad (2017) and Blasim’s “The Nightmares of Carlos Fuentes” (2014). This article addresses the ways in which these authors engage migrant multilingualism and question the ethics of exploiting migrant lives as material for media consumption. It argues that their writings are politically engaged counternarratives that are boundary-crossing because they problematize disciplinary, linguistic, and narrative borderlines.
“Le fransè ke chparl ègzist”: Translanguaging in the Work of Katalin Molnár
Authors: Pshevorska Liana
Published: November 2023

The works of Franco-Hungarian Katalin Molnár (1951–) stand in stark contrast to most modern-day translingual writing in France. Inspired by her avant-garde aesthetics and migration experience, Molnár radically defamiliarizes French through Hungarian syntax, phonetic orthography, and visual modalities. This article examines her work through the critical lens of translanguaging—a practice that draws on the speaker’s internal linguistic inventory without differentiating between external, socio-politically defined individual languages (Otheguy et al.). Through translanguaging, Molnár subverts a common translingual practice of thematizing a language-learning path into French. Instead of witnessing her linguistic journey from a safe distance, francophone readers are placed into a language experience of their own, which invites empathy and a change of perspective. Molnár’s visual and linguistic defamiliarization of French moves her texts beyond the dichotomous native/foreign paradigm, inducing readers to participate in the co-creation of a multimodal language that melds the author’s ethical and aesthetic concerns.
7. Perceiving how they talk
Authors: Weizsäcker Georg
Published: November 2023

Chapter 7 discusses the “second-order listening belief”, which is the belief that the listener has about the talker’s first-order talking belief. It is the basis of the listener’s first-order listening belief and it may well be inaccurate. If so, this may explain possible biases of the first-order belief. Inaccurate or not, the second-order listening belief describes the meaning that the talker’s statement carries, from the perspective of the listener. The chapter also describes factors that reduce or increase the accuracy of understanding: the listener’s failure to realize the talker’s incentives to lie, the importance of context in the interpretation of a statement and, in particular, the ability to identify what information may be relevant to the talker.
Feminist alliances against precarity or capitalism? A continuation of the Butler–Fraser debate
Authors: Johansson Wilén Evelina
Published: November 2023

The relation between different forms of oppressive structures has been an object of dispute throughout the history of feminism. One of the most influential debates devoted to this issue is the one between Judith Butler and Nancy Fraser during the 1990s. Although the debate attracted a great deal of attention, and both thinkers have subsequently developed their theories by introducing novel concepts to describe oppression as well as the conditions of contemporary emancipatory movements, they have not continued to engage in each other's work. This article offers a critical reading of the positions that Fraser and Butler took in the 1990s debate, as well as an identification of shifts in their thinking ensuing from the debate. A particular interest of the article is their conceptualisations of the grounds for political alliances among groups with distinct experiences of oppression. The article not only offers a critique of both Butler's and Fraser's positions in the 1990s debate but also argues that the way in which Fraser's trajectory has come to directly address the issue of the capitalist social order, and which can also be read as an implicit self-critique, is more satisfactory than Butler's later work on precarity.
Expectation of Engagement in Employment in 5 Years: Findings Among Participants With Spinal Cord Injury
Authors: Krause James S. , Dismuke-Greer Clara E. , Reed Karla
Published: November 2023

The purpose of this study was to identify expectations of future engagement with employment among people with spinal cord injury (SCI), the underlying dimensions of engagement, and the relationship with demographic, SCI, and educational factors with engagement scales. Self-report data on the expectation of employment in 5 years were collected and analyzed from adult participants with traumatic SCI. Principal axis factor analysis with the varimax rotation was used to identify the underlying dimensions, and OLS was used to identify the relationship of demographic, SCI, and educational characteristics with the underlying dimensions. Most participants anticipated continuing to work about the same number of hours (61%), with 40% anticipating taking on more responsibility, 38% anticipating career advancement, and only 14% anticipating voluntary retirement. Factor analysis identified two underlying dimensions: job disengagement, measured by four items, and job engagement, measured by three items. Regression analysis indicated aging and years postinjury were highly related to both factors, with greater age and years postinjury related to disengagement. Completing a bachelor’s degree or higher was related to engagement. Non-Hispanic Blacks were more likely to have disengagement. Ambulatory participants were more likely to be engaged in employment. A relatively small number of items can easily measure individual expectations, particularly as they age with SCI.
Semantic Integration in It-Clefts: A Multifactorial Exploration of Agreement Variability in World Englishes
Authors: Yue Ming , Zhang Yi
Published: November 2023

Agreement variation is a critical issue in discussing syntactic configuration and semantic integration. Two competing hypotheses have been proposed to account for how semantic integration contributes to agreement variation: the lexical-grammatical hypothesis and the notional hypothesis. Using data from NOW, a large corpus of World Englishes, this study presents a multifactorial analysis of the probabilistic factors that constrain agreement variation in it-clefts, an important but low-frequency construction, with collective nouns as clefted constituents. We employ random forests and conditional inference trees to examine how the Outer circle varieties have developed preferences different from those of the Inner circle varieties for agreement patterns of it-clefts. The principal findings include: (1) singular agreement is the default pattern worldwide, while plural agreement appears probabilistically along the continuum of collective plurality; (2) Inner circle speakers use more plural agreement than Outer circle speakers, with British English users employing more plural agreement than American English users; and (3) Semantic integration exerts more influence on Inner circle speakers in agreement implementation than on Outer circle speakers, who are more easily affected by morpho-grammatical markers. The quantitative case study on the collective noun team corroborates the lexical-grammatical hypothesis that semantic integration encourages plural agreement. This focused attention on agreement variation in it-clefts with collective nouns as clefted constituents further suggests that the extraposition analysis, rather than the expletive analysis, offers a suitable theoretical model for the syntactic configuration of the it-cleft construction.
Contextual Factors and Adoption of Strategies Related to Opioid Prescribing Practices in Healthcare Settings: Cross-Sectional Study
Authors: Ory Marcia G. , Lee Shinduk , Alonzo Joy P. , Vollmer Dahlke Deborah , Pardo Nicole , Smith Matthew Lee
Published: November 2023

This study aimed to examine the association between different contextual factors (e.g., facility size, rurality, and perceived needs) and the adoption of a policy or strategy related to opioid prescribing practices in healthcare settings. Cross-sectional survey data was collected from a convenience sample of physicians ( N = 68). Logistic regression models were used to examine the effects of contextual factors on the dependent variables. Less than half reported having a policy restricting opioid prescribing practices, and 81% reported having one or more strategies for the safe use of chronic opioid therapy. After adjusting for other contextual factors, small practice size was positively associated with having a policy restricting opioid prescribing practices. This exploratory study provides insights for further investigation of how various contextual factors can influence policy adoption in different healthcare settings and practices to address major public health threats.
Exceeding traditional curvature limits of concentric tube robots through redundancy resolution
Authors: Anderson Patrick L , Hendrick Richard J , Rox Margaret F , Webster Robert J
Published: November 2023

Understanding elastic instability has been a recent focus of concentric tube robot research. Modeling advances have enabled prediction of when instabilities will occur and produced metrics for the stability of the robot during use. In this paper, we show how these metrics can be used to resolve redundancy to avoid elastic instability, opening the door for the practical use of higher curvature designs than have previously been possible. We demonstrate the effectiveness of the approach using a three-tube robot that is stabilized by redundancy resolution when following trajectories that would otherwise result in elastic instabilities. We also show that it is stabilized when teleoperated in ways that otherwise produce elastic instabilities. Lastly, we show that the redundancy resolution framework presented here can be applied to other control objectives useful for surgical robots, such as maximizing or minimizing compliance in desired directions.
An Assessment of Orthodontists’ Perception About Efficiency of Various Tooth Movements Carried Out Using Clear Aligner Therapy
Authors: Chawla Shilpa , Deshmukh Shailesh , Bhosale Veera
Published: November 2023

Background

With orthodontic patient demographics expanding to involve more adults, the demand for esthetic appliances is greater and orthodontists are keen on offering their patients more discreet and even invisible options. Clear aligners are a very viable option which offers all this, and it is noteworthy that more and more orthodontists in India are practicing the craft. Keeping this vision in mind, and the fact that aligners are revolutionary and here to stay, this study was conducted to assess the efficiency of various tooth movements carried out with clear aligner therapy as compared to traditional orthodontic treatment.

Aim

This questionnaire-based survey aimed to analyze and assess the orthodontists’ perception and experience of various tooth movements carried out with clear aligner in their routine clinical practice in India.

Methodology

A cross-sectional study was conducted by sending out a questionnaire on a virtual platform. It was approved by the Ethical Committee of the Dental Institute it was carried out in (Ref no: SDCH/IEC/OUT 2021/13). A sample size of 205 participants within the age group of 27–59 years was taken. The participants comprised of orthodontists practicing in various parts of India. A questionnaire, comprising of 22 closed-ended questions, was created on Google forms and circulated to participants using various social media platforms. The data of responses of participants were analyzed and evaluated with the help of chi-square test and p values were interpreted for the significance of responses.

Results

This survey analyzed the experience of orthodontists with respect to the various tooth movements carried out with clear aligners. There were mixed responses, but most of them suggested the aligners to be either same in effectiveness or poorer than the fixed appliances in carrying out various tooth movements.

Conclusion

This questionnaire-based survey helped in analyzing the orthodontists’ perception on the use of clear aligners in their routine clinical practice in India. It most importantly helped in assessing various kinds of tooth movements achievable with clear aligners. It also helped in getting an opinion on the movements presently not possible with aligners alone. This study clearly suggests that the general perception amongst the orthodontists is that more advancement is needed as far as aligners are concerned before they become competent enough to deal with various tooth movements easily achievable with fixed appliances.
Sexual satisfaction and vaccine application in health professionals in the COVID-19 pandemic
Authors: Yığman Metin , Yığman Fatih , Özcan Cihat , Aytekin Cuma
Published: November 2023

Introduction:

The negative effects of the COVID-19 pandemic on sexual satisfaction have been emphasized in many studies. However, there is not much information about the effects of the COVID-19 pandemic on the sexual satisfaction of healthcare professionals. In addition, it is not known exactly how vaccination application affects sexual satisfaction. Therefore, in this study, we aimed to evaluate whether the sexual satisfaction of male health personnel would change with vaccination.

Materials and methods:

One hundred and two unvaccinated and 95 vaccinated male healthcare professionals participated in this study. The COVID-19 Phobia Scale (C19P-S) and The New Sexual Satisfaction Scale (NSSS) were administered to the participants.

Results:

We did not detect any difference in sexual satisfaction according to vaccine administration. However, we found significant relationships between COVID-19 anxiety and sexual satisfaction. On the other hand, age, fear of COVID-19, and previous COVID-19 infection story were predictive factors on sexual satisfaction.

Conclusion:

The effects of the COVID-19 pandemic on sexual satisfaction are multifaceted. Our findings indicate that fear of COVID-19, rather than vaccination, determines sexual satisfaction.
Identifying tumor markers-stratified subtypes (CA-125/CA19-9/carcinoembryonic antigen) in cervical adenocarcinoma
Authors: Zhang Zongkai , Li Yin , Wu Ying , Bi Rui , Wu Xiaohua , Ke Guihao , Zhu Jun
Published: November 2023

Objective

There is a lack of research evaluating the effect of tumor markers for prognosis in cervical adenocarcinoma. We aimed to develop and validate a preoperative tumor-marker-based model including clinicopathological factors to clarify the prognostic value of endocervical adenocarcinoma.

Methods

A total of 572 patients with cervical adenocarcinoma who were staged at the International Federation of Gynecology and Obstetrics (FIGO) IA–IIA were reviewed retrospectively. Preoperative serum carcinoembryonic antigen (CEA), carbohydrate antigen (CA)-125 and CA19-9 levels were measured. The survival and recurrence patterns were analyzed according to the tumor-marker-related stratification. The predictive values of biomarkers and clinical variables were assessed with Cox regression and competing risk models.

Results

Patients with elevated preoperative tumor markers had evidently poor overall survival and recurrence-free survival. The triple-elevated tumor marker (TETM) subgroup had the worst overall survival and progression-free survival than the triple-negative tumor marker (TNTM) subgroup and the single-elevated tumor marker (SETM) subgroup. The most important predictors for overall survival were elevated tumor markers, FIGO-stage, tumor differentiation, lymphovascular space invasion (LVSI) and lymph nodes metastasis. The most important predictors for recurrence-free survival were elevated tumor markers, FIGO-stage, tumor differentiation, LVSI and deep stromal invasion. Stratified analysis showed that elevated CA-125 and CA19-9 were significantly associated with postoperative distant metastasis. A decision curve analysis confirmed that a combination of tumor markers as predictors significantly outperformed the other common predictors used (FIGO-stage, intermediate and high-risk factors, tumor differentiation, lymph nodes).

Conclusions

Elevated preoperative serum CEA, CA-125, and CA19-9 levels exhibited poor overall survival and recurrence-free survival in cervical adenocarcinoma patients. Combined preoperative serum CA-125 and CA19-9 independently predicted distant metastasis in patients with endocervical adenocarcinoma.
A time and ensemble equivalent linearization method for nonlinear systems under combined harmonic and random excitation
Authors: Hickey John , Butlin Tore , Langley Robin , Onozato Naoki
Published: November 2023

An Equivalent Linearization technique, termed an Equivalent Linearization Time and Ensemble Expectation (EL-TEE) approach, is used to develop an alternative method for estimating the response of a nonlinear oscillator to a combination of deterministic harmonic and random white noise excitation. The approach is based on applying equivalent linearization and averaging over the time period of one harmonic excitation cycle. This gives a set of coupled nonlinear equations that can be solved for the response averaged over time and across the ensemble. The primary advantages of the proposed method are its computational speed, ability to return physically meaningful linearization matrices and that it can be applied to a wide variety of nonlinearities. The method is applied to three example test systems: the well-known single degree of freedom Duffing oscillator; a single degree of freedom system with a displacement constraint imposing a discontinuous nonlinearity; and a multi degree of freedom oscillator with a localized polynomial nonlinearity that has also been examined experimentally. It is shown that the response predicted matches well with Monte Carlo results from direct time integration at a fraction of the computational cost, and the method is capable of reproducing key results observed experimentally.
Investigating the influence of induced charge and surface charge heterogeneity on electrokinetic micromixing: A comparative analysis
Authors: Kumar Bansal Anshul , Nhaichaniya Gajendra Kumar
Published: November 2023

This paper investigates the performance of a micromixer by considering the combined effects of surface charge heterogeneity and the induced charge electrokinetic (ICEK) phenomenon. With the applied electric field, surface charge heterogeneity generates a recirculation zone within the microchannel, while conductive links induce micro-vortices. The main objective is to explore the influence of various control parameters on the mixing efficiency, including zeta potential, the number and orientation of conductive links, and applied electrical potential. The generated recirculation zone and induced micro vortices introduce chaotic perturbations within the microchannel, improving mixing performance. The results demonstrate that increasing the zeta potential on heterogeneously charged patches enhances the mixing performance, albeit at the expense of a reduced average outlet velocity. Additionally, a higher number of conductive links leads to increased mixing efficiency. The combination of mounting a conductive link inside the channel and applying a heterogeneous zeta potential patch on the wall substantially increased mixing efficiency. The influence of fluid rheology on mixing performance is also investigated, revealing that pseudoplastic fluids exhibit better mixing than dilatant fluids. Finally, the combined effects of all parameters are evaluated using the Taguchi method, resulting in an optimized mixing performance for the proposed micromixer. Micromixing efficiency exceeding 98% is achieved for all types of non-Newtonian fluids under optimal parametric conditions.
Design and control of active lower limb prosthesis with sensorial frame
Authors: Hernandez Ivan , Yu Wen
Published: November 2023

In this article, we have designed an active prosthesis for the lower limb of a human. The unique design incorporates an exoskeletal extension that serves as a low-cost sensory framework, providing feedback on residual signals, namely the states of the hip and thigh. The controller takes advantage of system modeling and employs a simple proportional–derivative control. A stability analysis has been conducted. We have also provided simulations and analysis of the active prosthesis to evaluate the effectiveness of the design and control.
“Academic-Mothers” in Higher Education with Adult Children: Navigating Social Isolation, Shifting Households, and Professional Challenges During the Pandemic
Authors: Jagganath Gerelene , Singh Shanta Balgobind
Published: November 2023

The COVID-19 pandemic led to the daily loss of lives, changing people’s mobility and relatedness, as well as bringing about disruption and transformation of health, education, economic, and cultural systems globally. The pandemic mitigation strategies, which encompassed domestic isolation, intensified household interactions and activities. Recent global studies indicate that the pandemic exposed long-standing inequities and vulnerabilities of systematically marginalized groups. It has also been argued that in academia the professional disenfranchisement and rights conflict between genders encompass differences in workload and professional support. In the South African higher education context, the pandemic created uncertainties for academic mothers who not only navigated these roles but who had diverse lived experiences of fluctuating COVID-19 infection rates and lockdown restrictions, changing household spatial arrangements, financial constraints, mental health challenges and the impact of civil unrest at the time. The disparate toll of the pandemic on academics, specifically those parenting children, performing gender-based household roles while simultaneously engaging in multiple academic duties, requires more attention in the South African context. This research article presents two autoethnographic accounts of the professional and social challenges experienced during various phases of the lockdown.
A Keynote Address: A Guide to Supporting Conference Speakers with Lived Experience of Cleft Lip and/or Palate
Authors: Ardouin Kenny , McWilliams Danielle , Bates Amanda
Published: November 2023

Although the value of diversity within academia and society is increasingly recognised, the role of speakers with lived experience at cleft and craniofacial conferences remains inconsistent. This perspectives article shares reflection from three academics with lived experience of cleft discussing the value of including lived experience speakers routinely within conferences and outlining common challenges and barriers to the involvement of “experts-by-experience”. Key considerations and recommendations are offered to help conference organisers and delegates to make the most of the lived experience perspective, while ensuring the conference experience is positive for lived experience speakers.
Higher Education's Position in Shaping the Workforce of the Future and the Importance of Adapting to the Digital Age
Authors: Manchanda Manisha , Arora Jyotsna
Published: November 2023

Changes in teaching and administration at universities are dramatic. These dramatic shifts are being prompted by a number of factors. Micro and Nano degrees, as well as digital transformation, online education, tech-savvy students, operating expenses, and other factors, are all instances of such influences. Students in higher education make use of a variety of digital technology to supplement traditional lecture-based classroom instruction. Technology from the Fourth Industrial Revolution has made its way into HEIs, requiring them to adapt to the digital revolution (DT) in all its forms. Recently, there has been a lot of interest in applying digital transformation methodologies to the education sector, as these methods allow us to characterise the numerous interrelationships among stakeholder in a digitally enabled environment of teaching and learning. The purpose of this research is to highlight the unique aspects of the digital shift implementation process in academic settings. In addition, we will discuss how digital learning fits within the larger context of contemporary universities. More research is needed to understand how universities can adapt to the fourth industrial age and digital transformation.
Sustainable Innovation in Small and Medium-Sized Enterprises: Environmental Regulations and Digitalization as Catalyst
Authors: Xiumei Xu , Ruolan Jing , Shahzad Umeair , Xiao Feng
Published: November 2023

Conducting research into the multifaceted aspects of environmental regulation and the pivotal role played by digitalization in promoting sustainable innovation represents an invaluable compass guiding the path toward green development. However, it receives little attention in Small and Medium-Sized Enterprises (SMEs). This study examines the impact of environmental regulations on sustainable innovation in SMEs and the moderating role of digitalization. Findings from a panel of 871 SMEs over the period 2012-2020 reveal that command control and public-participative regulations have a U-shaped relationship with green innovation in SMEs, with digital tools accelerating their effects. Market-incentive regulations exhibit an inverted U-shaped effect, with digitalization enhancing the benefits of pursuing green incentives. These insights emphasize the importance of tailored approaches that consider regulatory diversity and the transformative potential of digitalization in promoting green development within SMEs.
Inadequate Coping Strategies of Men who Have Committed Sexual Aggression Against Women: A Study of Their Developmental Antecedents
Authors: Gauthier Alexandre , Deli Caroline , Garant Etienne , Proulx Jean
Published: November 2023

Several researchers have found that men who have committed sexual aggression have inadequate coping strategies (e.g., paraphilic sexual fantasies, substance abuse). However, very few researchers have empirically examined the factors potentially associated with the development of these strategies. In 2011, Maniglio hypothesized that the inadequate coping strategies of men who have committed sexual aggression are the result of childhood victimization, mediated by internalized psychological problems. The present study therefore empirically tested this hypothesis in a Canadian sample of 205 men who had committed sexual aggression against women, of whom 37 committed sexual murder. Structural equation modeling (SEM) resulted in the identification of several direct and indirect trajectories leading from childhood victimization (psychological, physical, sexual) to the development of inadequate coping strategies (paraphilic sexual fantasies, alcohol and drug use) mediated by internalized psychological problems (e.g., anxiety, depression, social isolation). The theoretical and clinical implications of these developmental trajectories are discussed.
Decrease of over-elevation in adduction after surgery of medial rectus muscles in partially refractive accommodative esotropia
Authors: Acar Zeynep , Altintas Ozgul , Ozkan Berna , Yılmaz Tuğan Büşra , Turkseven Kumral Esra , Ercalik Yesim
Published: November 2023

Significance

The course of over-elevation in adduction after strabismus surgery has been evaluated in a small number of research in the literature, we believe our study is the first to report the results in a specific group of esotropia (ET) patients.

Aim

To report the course of postoperative over-elevation in adduction in patients who underwent surgery for horizontal deviation on the medial recti in partially accommodative ET.

Methods

The medical charts of patients who had partially accommodative ET with over-elevation in adduction were reviewed retrospectively. A scale from −4 to +4 was used to grade the oblique muscle function. Among these, 17 patients who were operated solely on the horizontal rectus muscles were identified. The primary outcome measure was the degree of improvement in over-elevation in adduction after medial rectus surgery.

Results

Nine (52.9%) of the 17 patients (mean age: 5.18 ± 2.24 months) were males and 8 (47.1%) were females. The mean follow-up period was 17.06 ± 15.32 months. Overall, 15 patients (88.2%) achieved surgical success. The mean inferior oblique overaction was found 1.44 ± 0.56 preoperatively and the final postoperative mean inferior oblique overaction was 0.53 ± 0.51 ( P = 0.001). Postoperative over-elevation in adduction after 3 months was significantly decreased compared to the preoperative value ( P = 0.003, P = 0.001, P = 0.001 at 3rd and 6th months and final visits respectively).

Conclusion

Over-elevation in adduction accompanying partially refractive accommodative ET seems to regress after medial rectus weakening surgery. This finding should be considered in the presurgical evaluation of these patients.
Using Walter Benjamin to rethink children's non-participation in play activities
Authors: Han Shin Ae , Tobin Joseph
Published: November 2023

In this article, the authors reflect on examples they have recorded of children spending time on the thresholds of their classmates’ activities during activity-area times. They use these examples to reconceptualize some commonplace understandings of the places and practices of everyday life in contemporary preschools. They do so by drawing on three related concepts of Walter Benjamin: the arcades (akin to the contemporary shopping mall), the threshold, and the flâneur (who observes the sites and crowds of the city without joining in). They draw parallels between Benjamin's writings on the flâneurs who occupied the thresholds of the 19th-century Paris arcades and the young children who look on without entering the learning and play areas of the contemporary progressive preschool classroom. Following Benjamin, it is suggested that children may remain on the thresholds of activities not just because of shyness or bewilderment but also to experience the pleasures of anticipation and, in some cases, as acts of quiet resistance. Although Benjamin's writings have been rarely applied to the field of early childhood education, they can stimulate new understandings of children's lives in preschool and provoke implications for rethinking aspects of preschool teaching practice.
How and why alpha should depend on sample size: A Bayesian-frequentist compromise for significance testing
Authors: Wulff Jesper N , Taylor Luke
Published: November 2023

In management research, fixed alpha levels in statistical testing are ubiquitous. However, in highly powered studies, they can lead to Lindley’s paradox, a situation where the null hypothesis is rejected despite evidence in the test actually supporting it. We propose a sample-size-dependent alpha level that combines the benefits of both frequentist and Bayesian statistics, enabling strict hypothesis testing with known error rates while also quantifying the evidence for a hypothesis. We offer actionable guidelines of how to implement the sample-size-dependent alpha in practice and provide an R-package and web app to implement our method for regression models. By using this approach, researchers can avoid mindless defaults and instead justify alpha as a function of sample size, thus improving the reliability of statistical analysis in management research.
Characterising hospitalisation risk for chronic obstructive pulmonary disease exacerbations: Bedside and outpatient clinic assessments of easily measured variables
Authors: Heerema Joshua , Hug Sarah , Bear Natasha , Hill Kylie
Published: November 2023

Objective

To identify the characteristics of people with chronic obstructive pulmonary disease (COPD) who require hospitalisation for exacerbations.

Methods

People with COPD were recruited either during hospitalisation or from out-patient respiratory medicine clinics. Hospital admissions were tracked throughout the 5-months recruitment period. For participants who were admitted, hospital readmissions were tracked for at least 30 days following discharge. Participants were grouped as either needing; (i) no hospital admission during the study period (no admission; ø-A), (ii) one or more hospital admissions during the study period but no readmission within 30 days of discharge (no rapid readmission; ø-RR) or (iii) one or more hospital admissions with a readmission within 30 days of discharge (rapid readmission; RR).

Results

Compared with the ø-A group ( n=211), factors that independently increased the risk of ø-RR ( n=146) and/or RR ( n=57) group membership were being aged >60 years, identifying as an Indigenous person (relative risk ratio, 95% confidence interval 7.8 [1.8 to 34.0]) and the use of a support person or community service for activities of daily living (1.5 [1.0 to 2.4]. A body mass index ≥25 kg/m2 was protective.

Conclusions

Variables recorded at the bedside or in clinic provided information on hospitalisation risk.
Emergency and Compassionate Use of a Novel Ascending Endograft for Ascending and Arch Aortic Pathology
Authors: Patel Himanshu J. , Preventza Ourania , Roselli Eric E. , Atkins Marvin D. , Brinkman William , Coselli Joseph , Desai Nimesh , Estrera Anthony , Fleischman Fernando , Taylor Bradley S. , Reardon Michael J.
Published: November 2023

Purpose:

Patients with complicated ascending aortic pathology, including patients with acute type A aortic dissection may be at extreme risk for open repair. Thoracic endovascular aortic repair (TEVAR), infrequently used for the ascending aorta, may be considered an alternative in this setting. We describe early results for emergency and compassionate (E&C) use of a novel endograft, specifically designed for use to treat pathology of the ascending aorta.

Materials and Methods:

This case series evaluated 19 patients (mean age, 68.84±13.12 years; 57.9% female) treated with ascending TEVAR for acute and chronic acute (4), subacute (1), or chronic (1) aortic dissection or pseudoaneurysm (13). Six of the 19 patients (31.5%) were treated under compassionate use and 13 patients (68.4%) were treated under the emergency use exemption. Ten patients (52.6%) received additional devices to extend treatment into the arch and descending aorta.

Results:

Device delivery was achieved in all patients (100%). Thirty-day mortality and stroke occurred in 3 patients (15.8%) and in 1 patient (5.3%), respectively. In 1 patient (5.3%), with an Unanticipated Adverse Device Event, the aorta ruptured when the endograft eroded into the adventitial portion of dissection site at the posterior aspect of the ascending wall. Devices were explanted in 2 patients (10.5%), 353 and 610 days after the index procedure, respectively. Six patients had endoleaks (31.6%), including type I (n=2, 10.5%), type II endoleaks (n=3, 15.8%), and indeterminate endoleak (n=1, 5.3%).

Conclusions:

Delivery and deployment of a novel ascending thoracic stent graft with or without an additional branched arch extension is feasible in patients with complex anatomy and pathology, including acute aortic dissection and pseudoaneurysm. Additional experience with this novel device will further refine the patient population most suitable for endovascular ascending aortic repair for these pathologies.

Clinical Impact

This study describes a novel stent graft specifically designed for treatment of ascending aortic pathology, including acute type A dissection. The patients described in this series constituted a group outside the formal US FDA sponsored clinical trial, and were those accepted as part of an emergency and compassionate use basis.
Use of Traditional Remedies for Treatment of Diabetic Foot Ulcers: A Cross-Sectional Study at a Tertiary Center in Saudi Arabia
Authors: Edrees Khalid M. , Alqahtani Alanood I. , Alkhatieb Maram T.
Published: November 2023

Patients with diabetic foot ulcer (DFU) are prone to major complications including amputations. Traditional remedies (TR) have been used to treat DFU around the world. This study aims to identify the prevalence of TR among patients with DFU in our local cohort and its effect on DFU. 1408 patients were included in the analysis. Data were collected retrospectively from patients’ medical records. DFU characteristics include grading ulcers using the Wagner scale (WG) and infections (cellulitis and osteomyelitis). Ulcer management (UM) includes medical treatment, self-medical treatment, traditional treatment, and medical-traditional treatment. The mean age of the cohort was 60 years (SD = 12.4). The mean duration of diabetes was 18.6 years (SD = 9.3) and the mean duration of open wounds was 206.9 days (SD = 545.6). The majority were males (71%) and had type 2 diabetes (96%, SD = .204). Forty-three percent of patients were treated with TR (29% were self-prescribed and 14% prescribed by a physician) while 48% had medical treatment and 10% were self-treated using medical treatment. More than two-thirds of the cohort had cellulitis and/or osteomyelitis at the time of presentation. The use of traditional treatment was significantly associated with higher WG (WG 4 OR =  1.936, 95% CI: 1.338-2.800; WG 5 OR =  2.937, 95% CI:1.614-5.346; P < 0.05). Moreover, osteomyelitis was associated with medical-traditional treatment (OR = 1.608, 95% CI: 1.006-2.572; P < 0.05) and increased wound depth (WG 3 OR =  1.969, 95% CI: 1.193-3.250; WG 4 OR =  1.874, 95% CI: 1.115-3.15; P < 0.05). There is high use of TR for the treatment of DFU in our cohort. High Wagner-grade of foot ulcers and the presence of osteomyelitis were highly associated with DFU. This study showed for the first time the use of traditional potions by medical physicians. Both physicians and patients need to be made aware of the detrimental effects of using traditional methods on DFU.
“It's one of the most important things we carry for us”: How mobile hotspots support people experiencing homelessness
Authors: Rhinesmith Colin
Published: November 2023

Previous studies have examined the benefits and challenges of using mobile phones to support people experiencing homelessness. However, few studies have considered how mobile Wi-Fi hotspots support unhoused individuals and couples through public library lending programs. This paper seeks to address a gap in mobile communication scholarship by contributing insights from a qualitative study of library patrons who checked out mobile hotspots from the Boston Public Library in Massachusetts, USA. The findings show that although mobile hotspots provided many benefits for public library patrons in general, these devices facilitated mobile communication with a different sense of urgency for six people experiencing homelessness who also happened to be in romantic relationships. More concretely, the study found that mobile Wi-Fi hotspots reduced stress and anxiety for unhoused patrons because without the devices, patrons without fixed residences worried they could not be found; that hotspots kept unhoused patrons more connected, and therefore safer, in their tents despite the cold weather and a lack of electricity; and that unhoused patrons were concerned about their devices getting stolen because of their precarious situation. Although the unhoused patrons who participated in this study also shared their recommendations regarding how mobile hotspot lending programs in public libraries could be improved, they also mentioned that the benefits of hotspot availability far outweighed their challenges. The findings have implications for those working to address homelessness, including community-based organizations, government agencies, and policymakers who seek further insights into the positive role that mobile hotspot devices can play in supporting positive health outcomes for individuals and couples experiencing homelessness.
Physical Examination Versus Ultrasonography for Detection of Ulnar Nerve Subluxation in Professional Baseball Pitchers
Authors: Looney Austin M. , Day Hannah K. , Reddy Manoj P. , Paul Ryan W. , Nazarian Levon N. , Cohen Steven B.
Published: November 2023

Background:

Despite the importance of accurately detecting ulnar nerve subluxation in vulnerable athletes, few studies have compared the performance of physical examination and ultrasound in this population.

Purpose/Hypothesis:

The purpose of this study was to compare the diagnostic validity of physical examination versus ultrasound in detecting ulnar nerve subluxation at the cubital tunnel of the elbow in professional baseball pitchers. It was hypothesized that ultrasound would more sensitively detect ulnar nerve subluxation.

Study Design:

Cohort study (diagnosis); Level of evidence, 2.

Methods:

Physical and sonographic examinations for ulnar nerve subluxation were performed on 186 elbows of 95 consecutive male professional baseball pitchers (age, 17-30 years) as a routine part of their spring training assessments. Provocative maneuvers consisting of the Tinel and elbow flexion-compression tests were evaluated over the cubital tunnel. The validity of physical examination for detecting ulnar nerve subluxation at the elbow was determined using ultrasonographic examination for comparison.

Results:

Ulnar nerve subluxation was detected by physical examination in 58 (31.2%) elbows and by ultrasonography in 61 (32.8%) elbows. Of the 58 elbows with positive physical examination, 47 were positive on ultrasound. Using a positive ultrasound as a reference, the accuracy of the physical examination was 86.6%, with 77% sensitivity and 91.2% specificity. The positive and negative predictive values of physical examination were 81% and 89.1%, respectively. There was no relationship between nerve instability and positive provocative tests overall, in dominant versus nondominant arms, or in right versus left arms ( P > .05 for all).

Conclusion:

Physical examination had moderate sensitivity and high specificity for detecting ulnar nerve subluxation at the cubital tunnel of the elbow when compared with ultrasound. These findings suggest that when detecting the presence of a subluxating ulnar nerve is most important, it may be advisable to obtain an ultrasound evaluation instead of relying on a physical examination; however, physical examination alone may be appropriate for ruling out subluxation.