bluuebunny/crossref_metadata_2025 huggingface dataset:
Case Studies of Effective Learning Climates for Civic Reasoning and Discussion
Authors: Lyiscott JAMILA , De Los Ríos Cati V. , Clark Christopher H.
Published: November 2023

While the national media continues to highlight the tensions of cultural politics in education, there is a need for young people and educators to be equipped for the daunting local, national, and global challenges that mark their everyday lives. Many educators and young people alike are interested in engaging youth in civic reasoning and discourse that prepares them to meet those many challenges. This article highlights applications of civic reasoning and discourse in three contexts: a traditional high school social studies classroom, a hybrid school-community action project, and an out-of-school Youth Participatory Action Research program. We argue that these case studies show a path forward for developing students’ civic reasoning and discourse skills because the students turn toward and lean into what we define as moments of critical dissonance: in each case, the students and educators work together to engage, rather than avoid, complex sociopolitical realities, even while holding a variety of racial, ethnic, political, and cultural identities.
Lessons in Empowerment: The Civic Potential of Historically Grounded Conversations among Racially Marginalized Youth
Authors: Nelsen Matthew D.
Published: November 2023

Civic education is associated with the development of democratic capacity. However, this concept is measured using a limited battery of metrics (e.g., trust in government) that do not adequately capture the political sentiments of racially marginalized youth. Drawing from conversations with Chicago high school students and their teachers, I argue that democratic capacity should comprise a broader set of attitudes and behaviors, including political empowerment and acts of public voice. In the process, I identify one pedagogical technique associated with the development of empowerment: historically grounded conversations about politics that validate students’ distrust of government. Nationally representative survey data suggests that civic learning experiences of this kind are associated with feelings of political empowerment and that empowerment is associated with multiple forms of political participation, particularly among Black and Latinx youth. Overall, this study provides a path forward for those interested in reimagining civic education in the U.S.
Civics on the Move: The Politics of Latinx Civic Integration
Authors: Paiz Christian O. , García Bedolla Lisa , Gutiérrez Kris D.
Published: November 2023

Throughout the U.S., Latinx communities represent a growing and critical segment of local, regional, and national electorates, but they are underrepresented at the polls. Their political disengagement stems from their historical sociopolitical marginalization and a lack of investment in their political integration. To foster more civic engagement among Latinx students, we propose recognizing their communities’ past and present “lived civics,” which are the actions that address community concerns but are often forgotten or not considered as political. The conception of lived civics that we propose provides a road map for fostering Latinx agency and political efficacy, and our “civics on the move” framework aims to strengthen democratic institutions, ensuring that they represent the needs of this critical segment of the U.S. population.
Civic Preparation of American Youth: Reflective Patriotism and Our Constitutional Democracy
Authors: Carrese Paul
Published: November 2023

American elites’ continuing descent into polarization and the ongoing disintegration of civic culture and institutions highlight the need for educational leaders to learn from national consensus efforts in civics reform that have been forged by experts from the center left and center right. From a conservative perspective, this requires center-left colleagues to recognize the drawbacks of prioritizing civic engagement over civic education, the latter encompassing fundamental knowledge and civic virtues. The recent study Educating for American Democracy provides a balanced view of a national consensus framework for improvements that can be undertaken by states and localities, emphasizes civic knowledge and civic virtues as the foundation of informed participation, and features Tocqueville’s concept of “reflective patriotism” as indispensable to a healthy American constitutional democracy. I argue that if American elites do not invest in such preparation for informed, committed citizenship, we risk the kind of self-inflicted crisis that Lincoln addressed in 1838 when he warned of an impending national “suicide.”
12-Month Outcomes of Carotid Artery Stenting With CGuard MicroNET-Covered Stent: A Single-Center Study in 113 Patients
Authors: Tigkiropoulos Konstantinos , Sidiropoulou Katerina , Abatzis-Papadopoulos Manolis , Lazaridis Ioannis , Saratzis Nikolaos
Published: November 2023

Dual layer mesh stents constitute a novel treatment option for patients who undergo carotid artery stenting (CAS). The aim of this prospective study is to report 12 month outcomes of patients who underwent CAS with CGuard (Inspire MD, Tel Aviv, Israel) microNET self-expanding stent with embolic protection system in a tertiary center from October 2018 to March 2022. Primary endpoints included in-stent restenosis >70% verified by ultrasound (DUS), ipsilateral transient ischemic attack (TIA), and stroke at 12 months. Secondary endpoints included cardiovascular-related mortality (stroke, myocardial infarction, heart failure) and all-cause mortality during follow-up. One hundred thirteen patients were included in the study (male 72.5%), symptomatic 47.8%. Median follow-up was 25 months (2–48). By 12 months, there was one in-stent occlusion that manifested as stroke (1/113, 0.8%) but no other forms of in-stent restenosis. Two patients experienced contralateral TIA (1.7%). CVRM was 3.5% (4 MI) and all-cause mortality was 6% at follow-up. This prospective study shows that CAS with CGuard MicroNET-covered stent is safe with minimal neurological adverse events at 12 months follow-up. Larger, and longer-term studies are necessary to define CGuard long-term safety and protection against carotid-related stroke.
Increased Vaccine Uptake Among Eligible Patients at a Veterans Affairs Hospital Through an Inpatient COVID-19 Vaccination Program, Atlanta, Georgia, 2021
Authors: Fujita Ayako Wendy , Goolsby Tiffany A. , Powell Krista M. , Cartwright Emily J.
Published: November 2023

Objective:

Inpatient vaccination is an opportunity to increase vaccine uptake among patients at high risk for severe COVID-19 illness. We designed and implemented a hospital-based COVID-19 vaccination program with the aim of increasing documentation of vaccine eligibility and COVID-19 vaccination to eligible inpatients before discharge.

Methods:

We integrated a templated note into the electronic medical records and trained health care personnel to screen inpatients and document COVID-19 vaccine eligibility at the Atlanta Veterans Affairs Medical Center. Vaccination staff deployed to inpatient wards administered the vaccine to eligible and consenting patients at the bedside. We calculated the number of inpatients whose vaccine eligibility was assessed and documented during a 4-week period after health care personnel were trained. We used the Wald χ2 test to compare the proportion of eligible patients who were vaccinated before discharge 4 weeks before (March 29–April 23, 2021) and 4 weeks after (May 3-28, 2021) the training period.

Results:

During the 4 weeks before the training period, COVID-19 vaccine eligibility was not routinely assessed and documented. Of 793 inpatients discharged during the 4 weeks after the training period, 470 (59%) had COVID-19 vaccine eligibility documented. Of 86 patients who were eligible for vaccination, 61 (71%) received COVID-19 vaccination before discharge. COVID-19 vaccination rates during hospitalization increased significantly from 16 of 769 inpatients (2%) during the 4 weeks before training to 61 of 793 inpatients (8%) during the 4 weeks after training ( P < .001).

Conclusion:

An inpatient vaccination program that integrated COVID-19 vaccination into discharge planning increased vaccine screening and uptake. Future studies are needed to identify barriers to vaccination and strategies to increase vaccine uptake among those who are hesitant.
Learning and teaching care within the family: Experiential learning reflecting informal teaching
Authors: Ferreira Juliene Madureira , Midgette Allegra J.
Published: November 2023

The present study investigated how caregivers in Finland and the US recount learning and teaching care within the family, drawing on a new educational-psychological framework for care. This study applied thematic analysis to seven focus groups in the US and five focus groups in Finland composed of caregivers ( N = 45). The results suggest one main theme for learning, Imperfect Mirroring of Past Parenting and Present Parenting Practice, and two themes for teaching: Actions Tell More Than Words (US) and Teaching Them To be Independent and Caring Citizens (Finland). For learning, the findings indicate that childhood experiences are transformed into an informal guide for how care should (or should not) be practiced, highlighting how the lack of systematization in learning care contributes to caregivers’ need for self-teaching and unlearning what they experienced. In addition, caregivers tend to reproduce their learning experiences in teaching to care, and within this process, they focus more on pragmatic aspects of care. The various elements theorized in the Psychological Processes for Care Framework used, including identifying and anticipating others’ needs and deciding on the responsibility of addressing needs, were neglected in caregivers’ reports of teaching care. Implications argue in favor of psycho-educational programs for caregivers that can systematically address two pressing issues in learning-teaching care - the complexity involved in care processes and understanding the intersubjective nature of the construction of caring relationships.
Are They Really Helping Them to “Get Over It”? Bystander Behavior After Sexual Harassment Incidents in the Fashion Industry
Authors: Crowley Jocelyn Elise
Published: November 2023

Sexual harassment is a problem that continues to confront mostly women in the American workforce. One of the primary ways to reduce its prevalence and impact is through bystander intervention. A bystander is familiar with the incident and ultimately decides whether to proactively intervene, do nothing, or actually cause further damage to the victim by siding with the perpetrator. While bystanders can become engaged both prior to and during a sexually harassing event, or at the primary and secondary levels of prevention, they can also be involved after the incident, or at the tertiary level of prevention. This present study addressed tertiary prevention in real-life sexual harassment cases drawn from the fashion industry, whereby female models—as independent contractors represented by agencies and with few labor rights—were the victims, powerful men in the business were the key perpetrators, and other actors were the bystanders. Using thematic analysis to understand 18 accounts of harassment, this research identified bystander support from personal associates and some modeling agencies as institutions in the form of emotional resources and action-oriented advocacy. However, other modeling agencies more commonly engaged in bystander opposition, whereby they silenced their models who complained of harassment or continued to send models to work with known perpetrators in the business. This study thus draws attention to the ways in which some bystanders can help, but others can cause further harm through their particular employment relationships with victims that promote worker precarity. Implications for practitioners and public policy reforms for this industry are discussed.
Optimizing the contributing electro-erosive discharge parameters for reducing the electrode wear and geometric dimensional deviation in EDM of Ti-based superalloy
Authors: Ishfaq Kashif , Sana Muhammad , Kumar M Saravana , Ahmed Inzamam , Yang Che-Hua
Published: November 2023

The low thermal conductivity, the small magnitude of modulus of elasticity, and the high chemical reactivity of Ti-6Al-4V make it difficult to machine this material using traditional processes. The intended requirements for the applications of the said alloy, like in biomedical and aerospace, further complicate its processing. Thereof, electric discharge machining (EDM) opted for this alloy. However, intrinsic issues of EDM, that is, electrode wear rate (EWR) and dimensional overcuts, restricted its utilization. Therefore, the potential of three powder-based additives and dielectric fluids against different electrode materials has been deeply envisaged to address the abovementioned issues. Because the choice of best dielectric has a direct bearing on heat input to the electrode which influences the melting/vaporization of the tool wear of the electrode. It is worth mentioning that these concerns have not been discussed so far in such a broad spectrum. Taguchi’s experimental design is used for experimentation. The results show that transformer oil performance is best rated compared to other dielectrics. Overall, the reduction in tool wear rate and overcut obtained with transformer oil is 21.3% and 21.4%, respectively, in contrast to the other dielectrics. The electrode of Cu outperforms for yielding the smaller value of overcut and tool wear rate. In the case of micro-additives, alumina has proved its potential for lowering the electrode wear rate. Deep and wide craters of a depth of 150 µm have been observed by using the brass electrode in kerosene oil, whereas the small and shallow craters of 38 µm depth have been encountered using the Cu electrode in the presence of transformer oil.
Developing a dynamic obstacle avoidance system for autonomous mobile robots using Bayesian optimization and object tracking: Implementation and testing
Authors: Wu Chung-Hsin , Chan Kuei-Yuan
Published: November 2023

This study addresses the challenges faced by autonomous mobile robots in dynamic environments where moving obstacles such as people, cars, and other mobile robots are prevalent. Current motion planning methods for mobile robots focus on stationary obstacles or equivalent static ones at each control moment, resulting in collisions with moving objects or the need for longer distances to avoid them. To address this issue, we propose a system that incorporates dynamic information about moving obstacles into the motion planning decision-making process. We developed an object tracking technique using 2D LiDARs to gather this information and optimized the relevant parameters using Bayesian optimization. The dynamic information of moving obstacles is saved in a costmap representation at each instant, allowing the robot to yield or ignore confronting obstacles based on the prediction of who shall pass first. Simulation and real-world testing demonstrate that our approach saves paths for mobile robots in dynamic environments and prevents them from colliding with dynamic obstacles, improving the practicality of mobile robots working alongside moving humans.
Experimental study on the pollutant emissions of premixed ammonia/methane/air flame within porous burner
Authors: Hashemi Seyed Mohammad , Wang Ping , Mao Chenlin , Cheng Kang , Sun Ying , Yin Zhicheng
Published: November 2023

In the present study, premixed ammonia-methane combustion within a two-layer porous burner was investigated experimentally in order to evaluate the pollutant emissions. The effects of alumina spheres diameter, equivalence ratio and ammonia fraction on the flame stability limits, CO and NO pollutant emissions were considered. The tests were performed for equivalence ratios from 0.8 to 1, ammonia fraction from 20% to 80% and a range of alumina spheres diameters from 5 to 40 mm. Measurements illustrated that increasing the equivalence ratio improved the flame stability limits regardless of ammonia fraction while flame stability limits decreased with increasing the ammonia fraction. Results indicated that for the mixtures with ammonia content less than 50%, increasing ammonia fraction caused increase in NO emission regardless to the equivalence ratio, while for mixtures with ammonia fractions higher than 50%, the NO emission decreased slightly as ammonia content increased. Meanwhile, with increasing the ammonia fraction, CO concentration decreased at examined equivalence ratios. It was found that increasing equivalence ratio increased the NO emission, while CO concentration decreased as equivalence ratio increased. Measurements proved that decreasing the diameter of alumina spheres caused decrease of NO and CO quantities regardless to equivalence ratio.
Unified supervised learning and optimization technique for wire electrical discharge machining of various grades of alloys: stochastic algorithm combined neural network approach
Authors: Biswas Shatarupa , Singh Yogesh , Mukherjee Manidipto
Published: November 2023

In the field of machining different grades of alloys using wire electrical discharge machining (WEDM), developing efficient techniques has been a challenge. Typically, specific supervised learning and optimization (SLO) methods are created for individual alloys, resulting in a time-consuming process. To address this issue, a unified SLO approach capable of handling various grades of alloys with different compositions and physical characteristics is proposed. In this study, three stochastic optimization tools are combined with a multi-layer neural network to determine the optimal SLO strategy. Five different alloy grades are considered, with inputs consisting of six variables, including chemical composition, and physical properties. The neural network architecture used is 19-500-500-4, and it is combined with a gray wolf stochastic algorithm, proving to be the most effective SLO methodology. The results indicate that regardless of the alloy grade, the pulse on time significantly affects the material removal rate, kerf width, and thickness of the recast layer (RL). Surface roughness is primarily influenced by alloy properties such as density, specific heat, and elements like Cr, Mo, and Ni. Additionally, the recast layer is dependent on factors such as V, Ti, thermal conductivity, and thermal diffusivity of the materials. Validation experiments demonstrate that the mean squared error of all responses for each alloy remains within 5.0%. This unified SLO approach provides a promising solution for optimizing the machining process of different alloy grades, reducing the need for separate techniques for each material.
Stress analyses of high-rated capacity large diameter offshore wind turbines: Analytical and numerical analyses of uniform corrosion effects
Authors: Okenyi Victor , Bodaghi Mahdi , Siegkas Petros , Mansfield Neil , Afazov Shukri
Published: November 2023

As the wind energy sector grows, offshore wind turbines (OWTs) have been pushed to have higher power outputs. This has led to large-diameter OWT support structures that are capable of withstanding aerodynamic and hydrodynamic loads as well as corrosion. This research analyses a 15-megawatt (MW) OWT support structure using analytical and numerical models. The analytical model was applied based on the Euler-Bernoulli beam theory. Static and modal finite element models were also applied. The structural stability implications of uniform corrosion on the stress evolution of the monopile and tower at different corrosion zones were discussed. Analytical and numerical (finite element analysis) predictions of stress evolution for different wind velocities and uniform corrosion material loss showed an agreement. The analyses showed that material loss due to corrosion increased the stress levels in the support structure. The location of the maximum tensile stress changed from the submerged to the splash zone, indicating that the splash zone may accumulate more damage over time due to the reduction of the monopile thickness and generation of local pits. Predicting the stress evolution due to uniform corrosion could be instrumental in the future designs of OWTs. It can be integral to fatigue assessments for enabling more detailed and accurate life predictions.
A parameter optimization method of multi-layer nested slit resonator for the converter transformer noise in high voltage direct current converter station
Authors: Li Li , Sun Wei , Li Linyong , Chu Zhigang
Published: November 2023

We propose a parameter optimization method of multi-layer nested slit resonator (MNSR) for the converter transformer noise in a high voltage direct current (HVDC) converter station. With the optimization objective of achieving quasi-perfect sound absorption at the target frequencies and the structural parameters of MNSR as the optimization variables, the optimization model of the structural parameters of MNSR is established and then solved by the sequential quadratic programming algorithm (SQP). The theoretical and simulation results of the four validation cases show that the optimized MNSR can achieve quasi-perfect sound absorption at all target frequencies, which is consistent with the optimization objective. The parameter optimization design method provides an efficient method to design a dual-frequency quasi-perfect sound absorber for the converter transformer noise.
The Potential Value of Ki-67 in Prognostic Classification in Early Low-Risk Endometrial Cancer
Authors: Jia Mingzhu , Pi Jiangchuan , Zou Juan , Feng Min , Chen Huiling , Lin Changsheng , Yang Shuqi , Xiao Xue
Published: November 2023

Purpose

This study aims to determine the optimal cut-off value of Ki-67 to better predict the recurrence of early low-risk endometrial cancer (EC).

Methods

Seven hundred and forty-eight patients diagnosed with low-risk EC from West China Second Hospital of Sichuan University and the First Affiliated Hospital of Chongqing Medical University were retrospectively analyzed. The receiver operating characteristic curve (ROC) and Youden index were used to calculate the optimal cut-off value of Ki-67 expression. The clinicopathological indexes between two groups divided by cut-off value of Ki-67 were compared. The univariate and multivariate regression analyses were performed to investigate risk factors connected to the recurrence of early low-risk EC. The survival analysis was shown in Kaplan–Meier curve.

Result

Thirty-three patients were detected with tumor recurrence after primary surgery (4.4%); 33% was the optimal cut-off value of the Ki-67 index. A high Ki-67 was significantly associated with age ( P = .002), myometrial invasion ( P < .001), and the expression of P53 ( P = .007). The multivariate regression analysis verified that Ki67 ≥ 33% was an independent prognostic factor for predicting recurrence. The recurrence-free survival (RFS) and the overall survival (OS) in high Ki-67 group was significantly lower than that in low Ki-67 group ( P < .001 and P = .029, respectively). The prognostic values of ER, PR, and P53 in combination with Ki-67 were superior to each single predictor.

Conclusions

The optimal cut-off value of Ki-67 for predicting recurrence is 33%, which quantitatively defines the specific value of Ki-67 that causes high-risk recurrence in early low-risk EC.
Measuring in-service traction elevator reliability based on orthogonal defect classification and Markov analysis
Authors: Wang Qiang , Yang Chongjun , Zhou Juan , Xu Jiaqi , Chen Benyao , Zhu Kai , Wu Linlin , Xu Xiaomeng , Su Wanbing
Published: November 2023

To solve the challenge of accurate in-service traction elevator failure prediction, maintenance cycle and steady availability, a novel reliability model is proposed which combines orthogonal defect classification (ODC) and Markov analysis (MA). The elevator failure data are classified by the ODC method. Then, the failure rate and maintenance rate of the elevator parts are obtained based on triangular fuzzy theory. By analyzing the maintenance function of each part, the optimum maintenance cycle of the elevator is determined. Finally, the transient state and steady state equations are established by MA to determine the steady availability of elevators. A case study on elevator accidents and failure data is used to validate the effectiveness of the proposed method. The results show that the system steady state availability of elevators in the study was 0.9002.
Tribological devices in cycling: A review
Authors: Aubert Rémi , Roizard Xavier , Grappe Frédéric , Lallemand Fabrice
Published: November 2023

This review, focussed on transmission efficiency and wear in cycling, presents existing friction measuring devices. It discusses their pros and cons and compares the lubrication regime they are in to the ones determined for elite cycling. Finally, it addresses technical guidelines for measuring friction forces from the transmission ( Ft). Ft depend on normal load and coefficient of friction (µ). Indeed, these factors are influenced by chain tension, alignment and velocity, sprocket size, lubricants and contamination. Such parameters also have an impact on lubrication regime which influences µ. To characterise Ft, measuring devices were developed. Forty devices were classified in five categories, ranging from those closest to ecological conditions to the most specific ones. Full transmission (FTR) and single speed rigs (SSR) results can be extrapolated into real cycling, although they are less accurate as they involve more elements. Dedicated rigs engender high precision measurements on precise phenomena. All lubrication regimes are encountered in elite cycling, which is in good accordance with most of the testing conditions presented in this review, especially FTR and SSR. If Boundary and Mixed regimes are unavoidable due to the reciprocating movements of the chain elements, they should be limited. The Elasto-Hydrodynamic regime is on target as it provides low µ and wear. In conclusion, the closer the measure is to real cycling, the higher the variability. Inversely, dedicated rigs are accurate but less representative of complete transmissions. Technology improvements now make FTR and SSR reliable enough to measure small differences, along with a strong protocol.
VirtualPain. Preliminary findings from a group-based digital therapeutics intervention for fibromyalgia
Authors: Vilalta-Abella Ferran , Porras-Garcia Bruno , Ghiţă Alexandra , Vacas-Moreira Montserrat , Prat-Galbany Mónica , Gutiérrez-Maldonado José
Published: November 2023

Introduction

Fibromyalgia (FM) is a disorder characterized by chronic pain, with significant medical, psychological, and socio-economic implications. Although there is limited evidence, cognitive-behavioral therapy (CBT) has shown to be effective in improving FM symptoms. An alternative to enhance CBT effectiveness is to incorporate digital therapeutics (DTx).

Aim

We conducted a pilot study to investigate whether the addition of a DTx intervention ( VirtualPain) to cognitive-behavioral group therapy (CBGT) can reduce pain perception and associated symptoms in patients with FM.

Method

Ten patients with FM were initially recruited from a public hospital in Barcelona. The treatment consisted of 6 weeks of VirtualPain group sessions and 16 weeks of CBGT. Measures of catastrophizing, self-efficacy, and coping were recorded before, during, and after the protocol. In the DTx sessions, pain intensity was recorded before and after each session.

Results

The program (DTx and CBGT) showed a significant improvement in pain-related self-efficacy and relaxation measures. Improvement in pain perception was observed only after the DTx intervention.

Conclusions

This study provides preliminary results regarding the added value of DTx ( VirtualPain) as part of a CBGT for FM. The use of the program has facilitated a significant reduction in pain perception in each of the VirtualPain sessions, which provides further evidence of how this technology can be beneficial for improving FM treatments.
Psychometric evaluation of Urdu-translated Amsterdam preoperative anxiety and information scale and assessment of preoperative anxiety in adult surgical patients of Karachi, Pakistan: A cross-sectional study
Authors: Farooqui Anoosh , Khalid Jamil Omer Bin , Muhib Muhammad , Shahid Ayesha , Maqsood Aafia , Lari Areeba , Ismail Aqsa
Published: November 2023

Objective:

The primary aim of this study was to develop an Urdu-translated version of the Amsterdam preoperative anxiety and information scale and perform a psychometric evaluation of it. A secondary aim was to estimate the prevalence of preoperative anxiety using Urdu-translated Amsterdam preoperative anxiety and information scale in patients undergoing surgery in Karachi, Pakistan, and the factors contributing to anxiety among them.

Method:

This cross-sectional survey included 267 patients enrolled for elective surgery under general anesthesia from March 5 to November 20, 2022. In psychometric analysis, face validity, criterion validity, construct validity, and reliability of Urdu-translated Amsterdam preoperative anxiety and information scale were determined. Face validity was evaluated by performing blind-back translation and a pilot study. Criterion validity was evaluated by correlating the Amsterdam preoperative anxiety and information scale with the visual analog scale for anxiety. Exploratory factor analysis and Cronbach’s α test were used to analyze construct validity and reliability, respectively. The associate variables were identified by performing a one-sample t-test and one-way analysis of variance on SPSS 26.

Results:

Cronbach’s α test is 0.85 for the Amsterdam preoperative anxiety and information scale anxiety scale and 0.70 for the need for information. 65.3% of the total variance is explained by the Urdu version of Amsterdam preoperative anxiety and information scale items in factor analysis and the intercorrelation of all items was >0.20 (mean: 0.575). Urdu-translated Amsterdam preoperative anxiety and information scale and visual analog scale for anxiety showed a good correlation ( r = 0.664, p < 0.001). The overall prevalence of preoperative anxiety among patients is 52.4% suggested by the Amsterdam preoperative anxiety and information scale cutoff score of more than 11. Females, students, and patients elected for major surgery shared significantly higher anxiety levels ( p < 0.05). The commonest factors contributing to anxiety are postoperative pain in 140 (52.4%) patients, fear of death in 115 (43.1%), and financial loss in 91 (34.1%).

Conclusions:

The Urdu-translated Amsterdam preoperative anxiety and information scale is a reliable, valid, and acceptable screening tool for preoperative anxiety. The prevalence of preoperative anxiety was high. The preoperative anxiety level is significantly associated with gender, employment status, and type of surgery.
Are Pay Decisions Based on Pre-Contract Efficiency Necessarily Correct? Evidence From Players Contracts of National Basketball Association
Authors: Wen Riguang , Cao Qun , Wang Huijuan
Published: November 2023

This article explores whether pay decisions based on pre-contract efficiency are necessarily correct. Overcoming methodology problems of previous studies, we use each player’s contract of National Basketball Association (NBA) as an observation. The empirical results show that managers indeed pay their employees according to an evaluation of their pre-contract efficiency. However, the pay decisions are not correct. Relative to the final year of the last contract, employees’ efficiency in the first year of the current contract decreases with increased salary. The reason is that managers put more weight on players’ efficiency in the final year of the last contract than on the average efficiency. Our findings deepen our understanding of the mechanism of compensation contract.
Is the Effect of Organizational Ambidexterity and Technological Innovation Capability on Firm Performance Mediated by Competitive Advantage? An Empirical Research on Turkish Manufacturing and Service Industries
Authors: Çelik Derya , Uzunçarşılı Ülkü
Published: November 2023

The strategic management literature reveals that organizational ambidexterity (OA) and technological innovation capabilities (TIC) have separate effects on competitive advantage (CA) and firm performance (FP). However, these two capabilities have not been investigated simultaneously and in comparison with the sector. The main aim of this study is to reveal the mediating role of CA in the effect of OA and technological innovation capabilities on FP. Using the research model based on quantitative data, the primary data were collected by applying an online survey to 770 people selected by the random sampling method from the textile/ready-made garment/leather sector representing the manufacturing sector and the information technology sector representing the service sector working under the Istanbul Chamber of Commerce (ICOC) in Istanbul. The data collected were analyzed using SPSS. The results showed that CA mediated positive and statistically significant effects of OA and technological innovation capabilities on FP, and this mediating effect differed by sectors. The current study provided insights into manufacturing and service sector firms. Based on these results, recommendations for researchers and firm managers are presented in the conclusion section.
“Reimagining the World”: The Possibility of a Culturally Sustaining and Humanizing Civic Education for Students in the Margins
Authors: Babb-Guerra Annaly
Published: November 2023

Schools in the United States have often been tasked with cultivating a political identity that is connected to the nation-state. In the civics classroom, this often means teaching a nation-state centered civic education, which can create a sense of disjuncture for some students. This year-long ethnographic study explores disenfranchised students living in the Virgin Islands’ political identities and interests and how their teachers responded to them. The findings suggest that students entered the classroom with developed and varied political interests and identities that would not necessarily be recognized in a traditional nation-state centered civics class. Teachers responded by providing a culturally sustaining and humanizing civic education that honored their students’ diverse political and cultural identities and interests.
Comparison of invasive and non-invasive measurements of cardiac index and systemic vascular resistance in living-donor liver transplantation: a prospective, observational study
Authors: Cho Hye-Yeon , Lee Ho-Jin , Hwang In Eob , Lee Hyung-Chul , Kim Won Ho , Yang Seong-Mi
Published: November 2023

Background

Based on the controversy surrounding pulmonary artery catheterization (PAC) in surgical patients, we investigated the interchangeability of cardiac index (CI) and systemic vascular resistance (SVR) measurements between ClearSight™ and PAC during living-donor liver transplantation (LDLT).

Methods

This prospective study included consecutively selected LDLT patients. ClearSight™-based CI and SVR measurements were compared with those from PAC at seven LDLT-stage time points. ClearSight™-based systolic (SAP), mean (MAP), and diastolic (DAP) arterial pressures were also compared with those from femoral arterial catheterization (FAC). For the comparison and analysis of ClearSight™ and the reference method, Bland-Altman analysis was used to analyze accuracy while polar and four-quadrant plots were used to analyze the trending ability.

Results

From 27 patients, 189 pairs of ClearSight™ and reference values were analyzed. The CI and SVR performance errors (PEs) exhibited poor accuracy between the two methods (51.52 and 51.73%, respectively) in the Bland-Altman analysis. CI and SVR also exhibited unacceptable trending abilities in both the polar and four-quadrant plot analyses. SAP, MAP, and DAP PEs between the two methods displayed favorable accuracy (24.28, 21.18, and 26.26%, respectively). SAP and MAP exhibited acceptable trending ability in the four-quadrant plot between the two methods, but not in the polar plot analyses.

Conclusions

During LDLT, CI and SVR demonstrated poor interchangeability, while SAP and MAP exhibited acceptable interchangeability between ClearSight™ and FAC.
Effects of “two-heart” nursing mode on the psychological state and quality of life of stroke patients
Authors: Zhou Feifei , Tao Xumei , Wang Liping , Shen Bo , Fang Honglian
Published: November 2023

Background

Evidence-based nursing (EBN) intervention is a nursing approach that uses credible scientific research findings as evidence, in conjunction with patient needs, to provide personalized nursing care tailored to the specific needs of patients. EBN has been widely applied in clinical practice and has achieved remarkable results. However, there are limited studies evaluating the efficacy of EBN on cognitive impairment, psychological disorders, and quality of life in stroke patients. This study aims to explore the clinical effects of the EBN, which we call “two-heart” nursing mode on cognitive function, limb function, mental state, and quality of life of stroke patients.

Methods

A total of 92 stroke patients were divided into two groups: the traditional group (n = 46) and the two-heart group (n = 46). The traditional group received conventional nursing care, while the two-heart group received the double-heart nursing mode in addition to conventional nursing care. The cognitive function, limb function, living ability, mental state, quality of life, and nursing satisfaction of both groups were compared.

Results

The cognitive function in the two-heart group (26.81 ± 3.15 points) was better than the traditional group (23.61 ± 3.74 points; P = 001); limb function in the two-heart group (86.16 ± 6.73 points) was improved compared to the traditional group (79.57 ± 5.19 points; P = 0.002), and the living ability of patients in the two-heart group (68.53 ± 5.87 points) was superior to the traditional group (60.79 ± 5.96 points; P = 0.003). Similarly, the quality of life of patients in the two-heart group (81.13 ± 6.69 points) was higher than the traditional group (70.78 ± 6.63 points; P = 0.003), and the mental state of patients in the two-heart group (43.61 ± 4.13 points, 43.19 ± 4.16 points) was better than that in the traditional group (50.59 ± 3.76 points, 51.49 ± 4.43 points; P = 0.003). However, the nursing satisfaction score in the two-heart group (97.83%) was slightly higher than the traditional group (95.65%; P = 0.068).

Conclusions

The two-heart nursing mode can improve cognitive function, limb function, and mental state, as well as enhance the quality of life of stroke patients. This approach is worthy of clinical promotion and application.
Longitudinal relationship between screen time, cardiorespiratory fitness, and waist circumference of children and adolescents: a 3-year cohort study
Authors: Lehnhard Aline Rosso , Sehn Ana Paula , de Castro Silveira João Francisco , Burns Ryan Donald , Reuter Cézane Priscila , Franke Silvia Isabel Rech
Published: November 2023

Purpose

The aim of this study was to examine the interaction between screen time and cardiorespiratory fitness (CRF) in their longitudinal association with waist circumference (WC) during a follow-up of 3 years from childhood to adolescence.

Methods

Observational 3-year longitudinal study with 401 students (224 females), seven to 15 years of age at baseline. The CRF was evaluated by estimating peak oxygen uptake (VO2peak) from an indirect field-based test and body mass index. Screen time was assessed using self-reported questionnaires. Moderation analyses were tested using a multiple linear regression model with adjustments for sex, age, puberty stage, and ethnicity.

Results

A statistically significant interaction term was observed (B = -0.0003; 95% CI: -0.007; -0.0001). Since screen time was contextualized as the independent variable, the results show that relationship between screen time and WC varies across different CRF levels.

Conclusion

The findings suggest that higher CRF can attenuate the harmful association that increased sedentary behavior might have on abdominal adiposity.
Clinical factors associated with need for neurosurgical care in young children with imaging for macrocephaly: a case control study
Authors: Rohde Jessica F. , Campbell Jeffrey , Barbera Julie , Taylor Elena , Ramachandra Ashok , Gegg Christopher , Scherer Andrea , Piatt Joseph
Published: November 2023

Background

Macrocephaly is present in 2.3% of children with important neurosurgical conditions in the differential diagnosis. The objective of this study was to identify clinical associations with actionable imaging findings among children with head imaging for macrocephaly.

Methods

We conducted a case-control study of head imaging studies ordered for macrocephaly among children 24 months and younger in a multistate children’s health system. Four neurosurgeons reviewed the images, determining cases to be a ‘concern’ if neurosurgical follow-up or intervention was indicated. Electronic health records were reviewed to collect patient-level data and to determine if surgery was performed. Controls were matched 3:1 to cases of ‘concern’ in a multivariate model using conditional logistic regression.

Results

In the study sample (n = 1293), 46 (4%) were concern cases, with 15 (1%) requiring surgery. Significant clinical factors associated with neurosurgical concern were bulging fontanel [aOR 7.47, (95% CI: 2.28–24.44), P < 0.001], prematurity [aOR 21.26, (95% CI: 3.76–120.21), P < 0.001], any delay [aOR 2.67, (95% CI: 1.13–6.27), P = 0.03], and head-weight Z-score difference (W_diff, defined as the difference between the Z-scores of head circumference and weight) [aOR 1.70, (95% CI: 1.22–2.37), P = 0.002].

Conclusions

Head imaging for macrocephaly identified few patients with findings of concern and fewer requiring surgery. A greater head-weight Z-score difference appears to represent a novel risk factor for neurosurgical follow-up or intervention.
A comparative study of transgender women accessing HIV testing via face-to-face and telemedicine services in Chiang Mai, Thailand during the COVID-19 pandemic and their risk of being HIV-positive
Authors: Homkham Nontiya , Manojai Natthaporn , Patpeerapong Pongpeera , Apiputthipan Rattawit , Srikummoon Pimwarat , Kummaraka Unyamanee , Chiawkhun Phisanu , Rankantha Apinut , Traisathit Patrinee
Published: November 2023

Background

Due to the restricted availability of health services in Thailand, there are still some transgender women (TGW) who do not have access to HIV counseling and testing. Telehealth, which is accessible to individuals who are reluctant to undergo face-to-face interviewing, played an especially important role during the COVID-19 epidemic. The objectives of this study are to compare the characteristics, pattern of accessing HIV testing, and the HIV-positive rates of TGW between the face-to-face and telemedicine services.

Methods

We conducted a cross-sectional study to compare the access to HIV testing and the HIV-positive rates among TGW via face-to-face service and telemedicine services and examined the influence of potential associated factors on the risk of being HIV-positive.

Results

Of the 637 TGW participants, 26 (4.1%) were HIV-positive. Accessing the telemedicine service increased in the third and fourth COVID-19 waves (28.1% in the first and second vs. 71.9% in the third and fourth). There was no difference in the risk of being HIV-positive between the types of service. Having sex work experience (adjusted odds ratio (aOR) = 5.92; 95% confidence interval (CI): 1.57–22.30) and either never having been or tested more than 1 year ago were independently significantly associated with a higher risk of being HIV-positive (aOR = 4.05; 95% CI: 1.11–14.77).

Conclusion

The telemedicine service became more popular among TGW during the COVID-19 pandemic and was not related to a higher risk of being HIV-positive. Moreover, it proved to be an effective alternative channel to access HIV testing, especially for intravenous drug users. Sex work experience and irregular HIV testing are key risk factors for HIV infection in TGW seeking either the telemedicine or face-to-face service.
Implementation of the Richmond Agitation-Sedation Scale (palliative version) on an inpatient palliative care unit
Authors: Bush Shirley H. , Bronicki Katarzyna , Dionne Michel , Lelievre Natasha , Lawlor Peter G. , Kabir Monisha
Published: November 2023

Background

The Richmond Agitation-Sedation Scale – Palliative version (RASS-PAL) tool is a brief observational tool to quantify a patient’s level of agitation or sedation. The objective of this study was to implement the RASS-PAL tool on an inpatient palliative care unit and evaluate the implementation process.

Methods

Quality improvement implementation project using a short online RASS-PAL self-learning module and point-of-care tool. Participants were staff working on a 31-bed inpatient palliative care unit who completed the RASS-PAL self-learning module and online evaluation survey.

Results

The self-learning module was completed by 49/50 (98%) of regular palliative care unit staff (nurses, physicians, allied health, and other palliative care unit staff). The completion rate of the self-learning module by both regular and casual palliative care unit staff was 63/77 (82%). The follow-up online evaluation survey was completed by 23/50 (46%) of respondents who regularly worked on the palliative care unit. Respondents agreed (14/26; 54%) or strongly agreed (10/26; 38%) that the self-learning module was implemented successfully, with 100% agreement that it was effective for their educational needs.

Conclusion

Using an online self-learning module is an effective method to engage and educate interprofessional staff on the RASS-PAL tool as part of an implementation strategy.
Development of an intervention to manage benzodiazepine dependence and high-risk use in the context of escalating drug related deaths in Scotland: an application of the MRC framework
Authors: Berry Karen , Matheson Catriona , Schofield Joe , Dumbrell Joshua , Parkes Tessa , Hill Duncan , Kilonzo Mary , MacLennan Graeme , Stewart Duncan , Ritchie Trina , Turner Michael
Published: November 2023

Background

Scotland has the highest rate of drug related deaths (DRD) in Europe. These are deaths in people who use drugs such as heroin, cocaine, benzodiazepines and gabapentinoids. It is a feature of deaths in Scotland that people use combinations of drugs which increases the chance of a DRD. Many deaths involve ‘street’ benzodiazepines, especially a drug called etizolam. Many of the ‘street’ benzodiazepines are not licensed in the UK so come from illegal sources. People who use opiates can be prescribed a safer replacement medication (e.g., methadone). While guidance on management of benzodiazepines use highlights that there is little evidence to support replacement prescribing, practice and evidence are emerging.

Aim

To develop an intervention to address ‘street’ benzodiazepines use in people who also use opiates.

Methods

The MRC Framework for Complex Interventions was used to inform research design. Co-production of the intervention was achieved through three online workshops with clinicians, academics working in the area of substance use, and people with lived experience (PWLE). Each workshop was followed by a PWLE group meeting. Outputs from workshops were discussed and refined by the PWLE group and then further explored at the next workshop.

Results

After these six sessions, a finalised logic model for the intervention was successfully achieved that was acceptable to clinicians and PWLE. Key components of the intervention were: prescribing of diazepam; anxiety management, sleep, and pain; and harm reduction resources (locked box and a range of tips), personal safety conversations, as well as a virtual learning environment.

Conclusion

A co-produced intervention was developed for next stage clinical feasibility testing.