bluuebunny/crossref_metadata_2025 huggingface dataset:
Transnational Students Facing Multiple Crises: Impacts of the COVID-19 Pandemic in Oaxaca, Mexico
Authors: Rodríguez-Cruz Marta
Published: May 2023

This article analyzes the impact of multiple crises — economic, educational, and health — generated by the COVID-19 pandemic among transnational students in Oaxaca, Mexico. The article explores the period between April 2020 and March 2021, the most critical moment of the pandemic in the United States and Mexico. Due to the impact of the pandemic on traditional fieldwork, we developed a qualitative, ethnographic, and virtual methodology. Specifically, we used semi-structured interviews conducted via Meet and telephone and virtual participant observations in online teaching platforms and WhatsApp groups. The main findings of the study reveal that students from transnational families faced three major intertwined crises — economic, educational, and health — from numerous places of differential vulnerability related to forced transnationalism, as generated by the illegality of undocumented Mexican migrants in the United States and their subsequent deportation.
Introduction: The Contemporary Relevance of Vilém Flusser
Authors: Jóri Anita , Hartmann Maren
Published: May 2023

In this article, we introduce Vilém Flusser’s theoretical trajectory from the philosophy of language and multilingualism to communication and media theory. Our focus lies on his works Kommunikologie [ Communicology] and Kommunikologie weiter denken [ Thinking Communicology Further]. Kommunikologie, which was written in Flusser’s mid-career in the 1970s, but only published in the 1990s, consists of a set of articles and lectures and offers, among other notions, a great distinction between dialogue and discourse. The article takes this differentiation and explains its advantages and limitations. This leads to the introduction of the concept of algorithmic mediation as a ‘communicological’ take on current media developments. This also allows us to return to Flusser’s question about the disappearing home and the need for windows to the world. We hence offer a combination of different aspects of his work less as a tool for the analysis of current developments than as a call for action.
Impact of a one-stop rapid access venous ulcer clinic on inpatient admissions
Authors: CR Keohane , M Alagha , MP O’Shaughnessy , DP Joyce , W Tawfick , MA Tubassam , SR Walsh
Published: May 2023

Objectives

Venous leg ulcers (VLU) are prevalent and require a large investment of resources to manage. We investigated whether the introduction of a rapid access see-and-treat clinic for VLU patients affected rates of unplanned inpatient admissions with VLU.

Methods

The Hospital Inpatient Enquiry database was consulted for data on admission rates, length of stay, bed-days used, and costs, across a 4-year period; 2 years since the introduction of the clinic, and the 2 years prior as a control.

Results

Two hundred and eighteen patients admitted with VLU accounted for 2,529 inpatient bed-days, 4.5 (2–6) admissions per month, and a median hospital stay of 7 (4–13) days across the study period. Median admissions decreased from 6 (2.5–8.5) per month before, to 3.5 (2–5) after introduction of the clinic ( p = 0.04). Bed-day usage fell from 62.5 (27–92.5), to 36.5 (21–44) days per month ( p = 0.035).

Conclusions

Admissions and bed-day usage for inpatient management of VLU fell after commencing a one-stop, rapid access clinic.
Calcium transients in nNOS neurons underlie distinct phases of the neurovascular response to barrel cortex activation in awake mice
Authors: Ahn Sung Ji , Anfray Antoine , Anrather Josef , Iadecola Costantino
Published: May 2023

Neuronal nitric oxide (NO) synthase (nNOS), a Ca2+ dependent enzyme, is expressed by distinct populations of neocortical neurons. Although neuronal NO is well known to contribute to the blood flow increase evoked by neural activity, the relationships between nNOS neurons activity and vascular responses in the awake state remain unclear. We imaged the barrel cortex in awake, head-fixed mice through a chronically implanted cranial window. The Ca2+ indicator GCaMP7f was expressed selectively in nNOS neurons using adenoviral gene transfer in nNOScre mice. Air-puffs directed at the contralateral whiskers or spontaneous motion induced Ca2+ transients in 30.2 ± 2.2% or 51.6 ± 3.3% of nNOS neurons, respectively, and evoked local arteriolar dilation. The greatest dilatation (14.8 ± 1.1%) occurred when whisking and motion occurred simultaneously. Ca2+ transients in individual nNOS neurons and local arteriolar dilation showed various degrees of correlation, which was strongest when the activity of whole nNOS neuron ensemble was examined. We also found that some nNOS neurons became active immediately prior to arteriolar dilation, while others were activated gradually after arteriolar dilatation. Discrete nNOS neuron subsets may contribute either to the initiation or to the maintenance of the vascular response, suggesting a previously unappreciated temporal specificity to the role of NO in neurovascular coupling.
On the origin of the ground effect
Authors: Long Lisa , Wong Jaime G
Published: May 2023

The ground effect is well known to pilots and aerodynamicists alike. However, the current explanations found in undergraduate (and pilot-focused) textbooks can be inconsistent, often attributing the phenomena to the interaction between tip vortices at the ground. Others invoke the method of images to show that, when the flow is forced to have a straight streamline on the ground, ground pressure must increase. These must prescriptively choose an airfoil circulation. Meanwhile, a simple panel code can be used to show both that the lift on an airfoil in ground effect is significantly two-dimensional, and that the circulation about an airfoil near the ground is not constant. In particular, circulation will be found to grow as altitude decreases, magnifying the ground effect. A simple graphical panel method solver is provided, such that this exercise is accessible to students without the longer task of writing a panel code for themselves. This exercise can provide students with greater insight into the Kutta condition, the method of images, and panel methods themselves. The resulting streamline pattern can also be used to explain the phenomenon to more general audiences, by observing the relationship between lift and streamline curvature.
Revisiting risk in the Global Production Network approach 2.0 - Towards a performative risk narrative perspective
Authors: Völlers Philip , Neise Thomas , Verfürth Philip , Franz Martin , Bücken Felix , Schumacher Kim Philip
Published: May 2023

Until the so-called GPN 2.0 approach placed it on the research agenda, risk had played a subordinate role in the literature on global production networks (GPN). In GPN 2.0, Knight's economic notion of risk is applied and defined as rationally calculable, in contrast to uncertainties. However, this still dominant conceptualization of risk falls short of an actor-centered focus, which is a focal point of the GPN 2.0 approach. Therefore, we advocate for a stronger conceptual integration of a social constructivist premise with a spatio-relational understanding of risk to enhance the explanatory power of GPN risk. This article highlights that GPN risk needs to be framed as becoming causally significant in the perception and expectations of organizational decision-makers. We argue that the organization-environment interaction causes the production and constitution of risk. In pursuit of an integrative research design, we develop a multi-scalar framework based on a performative risk narrative perspective.
Advanced Driver Training’s Impact on Teen Driver Skills
Authors: Goodman Anne M. , Shoots-Reinhard Brittany , Opalek Judy M. , Zhu Motao
Published: May 2023

Standard driver education in the United States focuses on basic skills and the knowledge needed to pass licensure examinations. Newly licensed teen drivers are at high risk of crashes and death. To date, few interventions have addressed advanced driving skills that are not taught in typical driver education programs. We investigated the effect of a single day advanced driver training course on crash-avoidance skills. We enrolled 785 teens in a controlled quasi-experimental trial of advanced driver training (ADT: “intervention group”) versus a waitlist comparison group. The ADT consisted of 2 h of classroom education and repeated execution, with instruction and feedback, of four driving skill drills on a controlled, closed course. The comparison group performed each drill once per assessment, with only basic instruction. We measured their ability to successfully execute the driving skill drills (i.e., slalom, wet braking and steering, emergency lane change, and spin avoidance) on the day of the ADT and 3 to 6 months after the baseline skills assessment. The intervention group improved more than the comparison group, particularly in the spin avoidance skills, including spin avoidance, keeping the car on the course, and maintaining an appropriate speed during the drill. Further exploration of the ADT concept as an improvement to driver education and safety is warranted.
Rugged terrain, forest coverage, and insurgency in Myanmar
Authors: Chow Wilfred , Han Enze
Published: May 2023

This paper examines whether non-monotonic patterns exist between forest coverage and conflict processes in Myanmar. Specifically, the paper finds that forest coverage and civil conflict follow an inverted U-shaped relationship: conflict decreases at extremely low and high densities of forest coverage but increases at medium and somewhat high forest densities. Following the logic of the variability of rugged terrain, we argue that this pattern reflects the dual mechanisms of refuge and tactical advantages for rebel groups, who intentionally use such terrain to maximize logistical advantage while minimizing the military advantages enjoyed by better equipped government forces.
Meaningful Improvements in Rett Syndrome: A Qualitative Study of Caregivers
Authors: McGraw Sarah A. , Smith-Hicks Constance , Nutter James , Henne Jeffrey C. , Abler Victor
Published: May 2023

Background

Rett syndrome is a rare neurodevelopmental disorder primarily affecting females. This syndrome is associated with many comorbidities and impairments related to motor function, breathing, sleep, expressive language, and repetitive hand movements. The Rett Syndrome Behaviour Questionnaire (RSBQ) is one measure used to assess changes in Rett syndrome–related manifestations or core symptoms. Little is known about how caregivers think about meaningful changes in the items that make up the RSBQ scale.

Methods

This qualitative study explored how caregivers of individuals with Rett syndrome viewed changes in the symptoms covered in the RSBQ. We conducted semistructured interviews with 40 caregivers and employed thematic analysis, identifying themes using an iterative process.

Results

Two factors characterized caregivers’ thoughts about meaningful changes in Rett syndrome manifestations. First, general features of these symptoms rendered them bothersome: the extent of bother compared to other symptoms, if or how they prevented desirable behaviors and their temporal qualities. Second, caregivers evaluated the meaning of improvements by considering the decrease in bother and the potential benefits of change. Improvements had social and psychological consequences for individuals with Rett syndrome and caregivers. In addition, implications for health, fine and gross motor skills, and communication were also substantial.
The Impact of Randomized Family-Centered Interventions on Family-Centered Outcomes in the Adult Intensive Care Unit: A Systematic Review
Authors: Wang Gary , Antel Ryan , Goldfarb Michael
Published: May 2023

Objective: To review the literature for randomized family-centered interventions with family-centered outcomes in the adult intensive care unit (ICU). Data Sources: We searched MEDLINE, EMBASE, PsycINFO, CINAHL, and the Cochrane Library database from inception until February 2023. Study Selection: We included articles involving randomized controlled trials (RCTs) in the adult critical care setting evaluating family-centered interventions and reporting family-centered outcomes. Data Extraction: We extracted data on author, year of publication, setting, number of participants, intervention category, intervention, and family-centered outcomes. Data Synthesis: There were 52 RCTs included in the analysis, mostly involving communication and receiving information (38%) and receiving care and meeting family member needs (38%). Nearly two-thirds of studies (N = 35; 67.3%) found improvements in at least 1 family-centered outcome. Most studies (N = 24/40; 60%) exploring the impact of family-centered interventions on mental health outcomes showed improvement. Improvements in patient-centered outcomes (N = 7/17; 41%) and healthcare worker outcomes (N = 1/5; 20%) were less commonly found. Conclusions: Family-centered interventions improve family-centered outcomes in the adult ICU and may be beneficial to patients and healthcare workers.
“Sharp as a Tack:” Acquisition, Influences, and Meaning of African American Church Dress
Authors: Gatterson Beverly Kemp , Marcketti Sara
Published: May 2023

In this study, we explored the church dress of African American women to determine the influences that motivated their style of dressing that seems to be disappearing today. Ten participants aged 70 to 100 were interviewed through an oral history approach. Analysis, including open and axial coding, was used to identify emergent themes. When viewed through the lens of Symbolic Interactionism, the participants both molded and created their identities through social interaction with fellow churchgoers. From the influence of their parents and family members in identifying the importance of church and dressing appropriately to working hard through sewing, borrowing, and shopping to creating outfits that represented their beliefs in God, to evaluating the dress of themselves, their peers, and younger women, the participants voiced a variety of reasons for wearing church dress.
Safety of an Initial Insulin Bolus in the Treatment of Diabetic Ketoacidosis
Authors: Fischer Daniel P. , Celmins Laura E.
Published: May 2023

Background Insulin is a mainstay of treatment in diabetic ketoacidosis (DKA) however controversy remains over the optimal dose and administration. An initial bolus dose of insulin prior to a continuous infusion is utilized despite a lack of data showing clinical benefit and potential for complications. Objective This study was designed to evaluate the safety and efficacy of an initial insulin bolus in the treatment of DKA. Methods A retrospective chart review of patients with DKA was conducted. Fifty-nine patients met inclusion for the bolus group and 108 in the no-bolus group. The primary outcome was a composite of interruption of insulin infusion, hypoglycemia (BG <70 mg/dL), or hypokalemia (K+ <3.4 mEq/L) occurring within eight hours of starting insulin. Secondary outcomes included time to discontinuation of insulin infusion, as well as time to discharge from the ICU and the hospital. Results Baseline characteristics were similar between groups. The majority of patients were classified as having mild DKA. The primary outcome occurred significantly more frequently in the bolus group (45.8% vs 25%, P = .003) which was primarily driven by incidence of hypokalemia. Time to anion gap closure (6:39 vs 9:00, P = .063) was shorter with a bolus, although not significantly so. This finding carried forward to non-significant differences in time to stopping insulin infusion as well as ICU and hospital discharge. Conclusion An insulin bolus prior to initiation of an insulin infusion was associated with significantly more adverse effects early in therapy without a corresponding benefit in time to resolution of DKA.
Breeding by intervening: Exploring the role of associations and deliberation in consumer acceptance of different breeding techniques
Authors: Nales Paul , Fischer Arnout R.H.
Published: May 2023

New plant breeding techniques may play an important role in improving food quality, global food security and sustainability. Previous breeding techniques have, however, met with substantial resistance from society. This study examined the role of associations and deliberation in the evaluation of breeding techniques. Breeding techniques studied included conventional breeding, gene-editing, genetic modification (cisgenesis and transgenesis), marker-assisted breeding and synthetic biology. By using focus group discussions that included individual tasks, we found that when participants relied on their spontaneous associations, gene-editing was evaluated similarly as genetic modification. However, after information provision and group discussion, gene-editing was preferred over genetic modification. Perceived naturalness was found to be the main reason for obtaining different levels of acceptance, not only between gene-editing and genetic modification but across all breeding techniques examined. These findings highlight the importance of associations and show that beliefs about naturalness remain crucial in understanding how consumers evaluate breeding techniques.
Severe Microcytic Hypochromic Anemia Masquerading as Conversion Disorder: A Case Report
Authors: Ahsan Mohd , Shukla Rashmi
Published: May 2023

Conversion disorder is a psychiatric illness in which an affected person experiences signs and symptoms of voluntary motor or sensory dysfunction in absence of any underlying neurological or medical condition. According to recent studies, fewer people initially labelled with a diagnosis of conversion have subsequently been found to have an organic disorder. We report a case of 13-year-old female, with a provisional diagnosis of conversion disorder later on, after detailed evaluation came out to be a case of severe anemia. Patient was transferred to the Psychiatry Department in view of the possibility of conversion symptoms. Detailed assessment of routine blood work (complete blood count with general blood picture) yielded severe microcytic hypochromic anemia (hemoglobin = 4.1 gm/dL). The patient was advised accordingly and an urgent blood transfusion was advised. It is mandatory that before labelling someone as having conversion disorder, rule out all essential and possible organic etiologies which can explain the clinical presentation, as it can be life-threatening.
Brazil’s Emergence in the United States’ ‘Backyard’: Domestic Leadership and Systemic Status
Authors: Mukherjee Hoimi
Published: May 2023

This article studies Brazil’s emerging power status crisis due to policy shifts under President Jair Bolsonaro. In addition to studying the material bases, diplomatic relations and perceptions that shape emerging power status, this article also addresses how political elites shape such status. While the crisis of status is explained through domestic political and economic instabilities, this article points to the role of the United States in fomenting such instabilities. The US–Brazil bilateral relations between 2003 and 2022 are analysed through realist and power transition theory to outline the systemic dynamics of Great Power and Emerging Power interactions. Narratives of Brazil’s emergence were premised on steady economic growth, regional preponderance, and formulation of a globalist foreign policy under former President Lula. There were divergences of interests between Lula’s globalist foreign policy and the US interests in Latin America. Recent disclosures show that Lula was controversially arrested due to US interference in his trial in 2018 while he was favored to win the Presidential election. Bolsonaro secured the victory and initiated sharp policy shifts, aligning closely with the US. Bolsonaro’s policies consolidated an expansive American presence in South America, reducing Brazilian leadership roles and creating a crisis in status. This article contextualizes American interference in Brazil’s domestic politics and the erosion of status by examining the role played by individuals in impacting systemic status.
Feasibility and Acceptability of Parenting for Lifelong Health Program in Mainland China
Authors: Wang Weiwei , Liu Shiqin , Liang Yuzhu , Lachman Jamie M. , Fang Zuyi , Zhang Huiping
Published: May 2023

Purpose: Parenting for Lifelong Health for Young Children (PLH-YC) is a program to prevent child maltreatment. This study aimed to examine the feasibility, acceptability and preliminary effects of the adapted program for Chinese parents. Methods: A pre–post single-arm pilot trial was conducted with 21 Chinese parents. A mixed-method design was utilized to collect questionnaire-based quantitative data and qualitative data of interviews and focus group discussions. Results: Program implementation was feasible, with overall high recruitment, enrollment, attendance, acceptability and fidelity. Quantitative results demonstrated reductions in general child maltreatment, physical and emotional abuse, child behavioral problems, and improvements in positive parenting. Thematic analyses identified reduced violent discipline, psychological aggression, and child behavioral problems, strengthened parent–child bonds, increased parenting confidence, and decreased family conflict. Conclusion: The adapted PLH-YC program for Chinese parents has shown good feasibility and acceptability, and exhibited a significant association with reduced child maltreatment. Further randomized controlled trials are required.
Prognosis of Maxillary Central Incisors in Patients with Bilateral Cleft Lip/Palate
Authors: Green Mark A. , Ritchie Collin , Flanagan Sarah , Nuzzi Laura , Padwa Bonnie L.
Published: May 2023

Evaluate periodontal bone support of maxillary central incisors (MCI) in patients with bilateral complete cleft lip and palate (BCCLP). Determine if syndromic diagnosis, age at time of alveolar bone graft (ABG), presence of maxillary lateral incisor (MLI), history of dentofacial orthopedics, maxillary expansion, and pre-maxillary osteotomy are associated with the periodontal bone support of MCI.

Retrospective radiographic study.

Tertiary care children's hospital

One hundred seventy-nine patients with BCCLP (22 syndromic) who had post-operative ABG cone beam computed tomography (CBCT) scans taken between 2002-2018.

Crown to root (C/R) ratio of MCI measured on CBCT scans.

The C/R ratio in 65% of MCI indicated periodontally compromised teeth. Presence of a MLI improved bone support on adjacent MCI when compared to those missing a MLI (51.4% vs 28.4%, P = .010). There was no significant difference in C/R ratios for syndromic diagnosis, age at ABG, history of dentofacial orthopedics, maxillary expansion, and pre-maxillary osteotomy.

The majority of MCI in patients with BCCLP are periodontally compromised but bone support is improved when cleft adjacent lateral incisors are present.
Hydro-mechanical coupling behavior and statistical damage constitutive model of deep marble with disturbance
Authors: Wang Zhiliang , Wang Shumin , Wang Jianguo
Published: May 2023

To study the effect of excavation disturbance on hydro-mechanical coupling characteristics of deep marble, both artificially disturbed and intact marble samples were tested under different osmotic pressures. The stress-strain curve, characteristic stress, failure mode and strain energy were then compared between the disturbed and the intact samples under osmotic pressure. Finally, a statistical damage constitutive model was proposed to consider osmotic pressure and initial deformation based on assuming that the micro-element strength of marble obeys Weibull distribution. It is found that the disturbed sample has slightly lower peak stress and damage stress than the intact sample, but its resistance to hydraulic damage decreases significantly. In the initial stage of loading, the ratio of elastic strain energy of the intact sample is generally lower than that of the disturbed one. The characteristic points of the elastic strain energy ratio curve can be a good reference to determine the damage stress. This finding makes up for the deficiency of possible failure of the single definition of damage stress. The proposed statistical damage constitutive model can well reproduce the stress-strain responses under different osmotic pressure. At the same strain level, the rock damage is more significant if the osmotic pressure is higher. This study is of great significance to the development of deep rock mechanics theory and its application in engineering practice.
Counseling High Conflict: Navigating the Complexities of High Conflict Divorce
Authors: Schmidt Chris D. , Grigg Jenai
Published: May 2023

Practicing counselors will, at some point, work with clients from high-conflict separations/divorces (HCS/D); however, often they have received very little educational training for these experiences. To effectively treat these clients/client families, all counselors should have a working knowledge of the major processes and critical factors involved in these situations. This manuscript emphasizes the role of the counselor within HCS/D, seeks to give both an overview of and describe the complexities of HCS/D that counselors need to understand, and identifies areas of concern and focus for counselors functioning within distinct modalities.
Experimentally investigating the influence of changing payload stiffness on outer loop iterative learning control strategies with shaking table tests
Authors: Madabhushi Srikanth SC , Hruby Jaroslav , Wham Brad Parker
Published: May 2023

Shaking tables are widely used across numerous engineering research and industrial sectors, including mechanical (e.g. automotive and aerospace testing), electrical (e.g. instrumentation testing) and civil (e.g. structural and geotechnical testing) engineering. It is commonly required to replicate the shake table motions accurately and precisely. Iterative learning control algorithms can be used to complement traditional proportional–integral–differential feedback control algorithms to optimize drive signals using a test payload prior to the real experiment. Historically, the design of these test payloads has focused on matching the mass of the actual payload and neglected its dynamic response. In this study, experimental results from shake table tests using multiple geotechnical containers with dry and saturated beds that exhibit a range of stiffnesses and material damping when shaken are presented. Errors between the demanded and achieved motions are explored and compared to the changing secant stiffness abstracted from the dynamic shear stress–strain loops of the payload. A clear trend emerges that demonstrates increased errors as the payload stiffness deviates from the constant stiffness test payload originally used with the open loop iterative learning control, and further the errors are not necessarily bounded by test payloads significantly softer or stiffer than the actual specimen. The findings support that in cases where repeatable, accurate and precise shake table motions are required for payloads that exhibit a complex material response that is not readily modelled mathematically, it may be necessary to reproduce the specimen’s overall dynamic response during the iterative learning control process.
Tourism Actors’ Responsible Behavior: A Systematic Literature Review
Authors: Schönherr Sarah
Published: May 2023

Responsible tourism studies have neglected divergent tourism actors’ contribution to sustainable tourism development via their behavior, as well as the impact of recent crises on research. Thus, a bibliometric and thematic analysis was conducted, involving an examination of 154 recent studies that were clustered around four research streams: (1) tourists’ responsible behavior; (2) residents’ responsible tourism accounts; (3) tourism businesses’ responsible actions; and (4) destination management’s role in responsible tourism, showing that responsible tourism research is predominantly focused on tourists’ responsibility. Tourism businesses and residents are less frequently investigated. Similarly, the role of destination management is only recently emerging, while governments’ contribution to responsible tourism has been neglected in research. Environmental responsibility studies dominate on the tourist and resident level, while corporate social responsibility (CSR) studies prevail on the business level. This literature review identifies research priorities in order to derive an agenda for future research.
Disciplinary Sanctions for Police Misconduct: An Empirical Analysis of Sanction Severity
Authors: Worden Robert E. , Harris Christopher J. , Kim MoonSun
Published: May 2023

The imposition of appropriate sanctions for substantiated police misconduct is important, but social science offers little evidence about whether the severity of sanctions is related to the gravity of the misconduct, or disparities indicative of biased decision-making, or simply arbitrary decision-making. We examine the application of sanctions for police misconduct in one agency, analyzing sanctions imposed in 1,946 sustained personnel complaints filed against 1,026 officers between 1987 and 2001. We find that the nature of the misconduct accounts for some of the variation in sanction severity, with internal bureaucratic violations sanctioned more severely than officers’ improprieties vis-à-vis citizens. Among the latter, sanctions tend to be less severe than those prescribed by either citizens or police officers. We also find that sanction severity is affected by officers’ characteristics, but also that much of the variation in sanctions is unaccounted for, suggesting a large degree of unstructured decision-making.
The effect of cognitive load on code-switching
Authors: Liu Hong , Liu Zhixin , Yuan Meng , Chen Tingyu
Published: May 2023

Aims and objectives:

This study explores the effect of cognitive load on code-switching (CS), by examining whether an increase in cognitive load can lead to a different amount and/or pattern of CS use, and whether there is an interplay between the effect of cognitive load and the effect of social factors (i.e., language and use, and attitudes towards CS).

Methodology:

Thirty-one Chinese-English bilinguals participated in a picture recall experiment consisting of three sessions, with an incremental increase in cognitive load which was achieved by manipulating the number of attentional targets that should be attended to. The increase in cognitive load was validated by a self-report survey adapted from Paas. Information on social variables was collected by a language use questionnaire.

Data and analysis:

The amount and pattern (intraclausal vs interclausal) of CS were coded and quantified. One-way analysis of variance (ANOVA) was performed to compare the within-participant use of CS across the sessions. Hierarchal regression analyses were also conducted to examine how cognitive load and the social variables of interest predicted the between-participant variation of CS in each session.

Findings/conclusions:

The results showed that the participants used significantly less intraclausal CS in Session 3, in which they reported the highest degree of cognitive load. In addition, the results of hierarchical regression analyses for overall CS use in Session 2 confirmed the significant effect of cognitive load. The influence of attitudes towards CS was also shown to be another significant predictor with large effect size. However, in the more demanding Session 3, none of the factors of interest could predict between-participant variation in CS use.

Originality:

This study is among the first to examine how cognitive load affects nonlaboratory CS.

Significance/implications:

This study argues for a recognition of the cognitive processing basis of socially driven language use, linking sociolinguistic and psycholinguistic perspectives on the use of CS.
Using text-based vignettes in qualitative social work research
Authors: Bain Katrin
Published: May 2023

Text-based vignettes are widely used within qualitative social work research yet there is little guidance on how to construct and integrate them into the research process. This article discusses the uses, benefits and limitations of written vignettes as part of semi-structured interviews and focus groups with social workers and related professionals. It provides clear guidelines on how to design a vignette. This includes the choice of scenario, characteristics of the protagonist, type of vignette, research setting, length, vignettes in semi-structured interviews and pre-testing. Text-based vignettes have been successfully used in social work research on six continents in a variety of research contexts including single context, comparative, cross-sectional, longitudinal and replication studies. Written vignettes are a useful tool to elicit (professional) values, attitudes and decision-making processes in a time efficient manner that produces focused, in-depth knowledge without the need to use real practice examples that could potentially include sensitive data or breach confidentiality. Vignettes have been used to explore a wide range of topics including but not limited to adult safeguarding, care planning, child protection and multi-agency working together. There is some debate whether vignette responses mirror real-life actions. The value of vignette data goes beyond documenting real-world decision-making. It can uncover tacit social work knowledge and unquestioned beliefs to show how they interplay in decision-making.
Serum Ionized Calcium as a Prognostic Biomarker in Type B Aortic Dissection After Endovascular Treatment
Authors: Zhu Hongqiao , Hu Bei , Zhang Heng , Li Haiyan , Zhou Jian , Jing Zaiping
Published: May 2023

Objective:

Lower serum ionized calcium (iCa2+) was reported to be associated with a higher risk of adverse events in patients with cardiovascular diseases. This study aimed to investigate the associations between preoperative serum iCa2+ and outcomes of type B aortic dissection (TBAD) patients receiving thoracic endovascular aortic repair (TEVAR).

Methods:

Between January 2016 and December 2019, 491 TBAD patients received TEVAR in a single center. Patients with acute or subacute TBAD were included. Serum iCa2+ (pH 7.4) was obtained from the arterial blood gas analysis before TEVAR. The study population was grouped into the hi-Ca group (1.11 mmol/L ≤ iCa2+ < 1.35 mmol/L) and lo-Ca group (iCa2+ < 1.11 mmol/L). The primary outcomes were all-cause mortality. The secondary outcomes were any major adverse clinical events (MACEs), which included all-cause mortality and aortic-related severe complications. To eliminate bias, 1:1 propensity score matching (PSM) was conducted.

Results:

Overall, 396 TBAD patients were included in this study. In the total population, there were 119 (30.1%) patients in the lo-Ca group. After PSM, 77 matched pairs were obtained for further analysis. In the matched population, the 30-day mortality and 30-day MACEs between the two groups presented significant differences (p=0.023 and 0.029, respectively). At 5 years, cumulative incidences of mortality (log-rank p<0.001) and MACEs (log-rank p=0.016) were significantly higher in the lo-Ca group than that of the hi-Ca group. Multivariate cox regression analysis indicated that lower preoperative iCa2+ (hazard ratio for per 0.1 mmol/L decrease, 2.191; 95% confidence interval, 1.487–3.228, p<0.001) was an independent risk factor for 5-year mortality after PSM.

Conclusions:

Lower preoperative serum iCa2+ might have an association with 5-year mortality in TBAD patients after TEVAR. Serum iCa2+ monitoring in this population may facilitate the identification of critical conditions.

Clinical Impact

Our present study found that the cutoff value of preoperative serum iCa2+ 1.11 mmol/L, which is slightly lower than the lower limit of the normal range of 1.15-1.35 mmol/L, worked relatively well for discerning the high-risk and low-risk TBAD patients at 5 years. Serum iCa2+ monitoring in TBAD patients receiving TEVAR may facilitate the identification of critical conditions.
Comparing the Effects of Warm Footbath and Foot Reflexology on the Fatigue of Patients Undergoing Radiotherapy: A Randomized Clinical Trial
Authors: Mazloum Seyed Reza , Rajabzadeh Mahla , Mohajer Samira , Bahrami-Taghanaki Hamidreza , Namazinia Mohammad
Published: May 2023

Background and Aim:

Fatigue is a common side effect of radiotherapy. While warm footbath and foot reflexology can both reduce fatigue, it is still unclear which method is more effective in reducing fatigue. This study aimed to compare the effects of warm footbath and foot reflexology on the fatigue of patients undergoing radiotherapy.

Method:

A randomized clinical trial study was conducted on 62 patients undergoing radiotherapy. Eligible patients were randomly assigned to the 2 groups. Patients in the footbath group immersed their feet in 41°C water for 20 minutes every night for 2 weeks starting from the seventh day of radiotherapy. Patients in the reflexology group received 20 minutes of foot reflexology every night for 2 weeks starting from the seventh day of radiotherapy. Fatigue was measured by the Multidimensional Fatigue Inventory (MFI) once on the seventh day of radiotherapy and 3 more times on days 7, 14, and 28 after the start of the intervention. Data were analyzed by SPSS20 and descriptive/inferential statistics.

Results:

The total MFI score of both groups declined significantly over time ( P < .001). The reflexology group indicated a significant reduction from 90.9 ± 3.2 in the pre-test to 56.0 ± 3.7 on the 28th day in, while the footbath group indicated it from 90 ± 2.6 in the pre-test to 71.4 ± 2.8 on the 28th day.

Conclusion:

Our results showed that foot reflexology and warm footbath reduced the fatigue of patients undergoing radiotherapy. However, foot reflexology was more effective in reducing the fatigue of patients undergoing radiotherapy than warm footbath. It is recommended that simple and low cost non-pharmacological interventions such as foot reflexology to decrease of side effect of radiotherapy among cancer patients should be widely performed. Trial registration: Iranian Registry of Clinical Trials (IRCT20190625044009N1).
The impact of COVID-19 on endoscopy and cancer screening: a focus on access and equity
Authors: Gardner Julianna G. , Feld Lauren D.
Published: May 2023

The SARS-CoV2 pandemic has had a profound and lasting impact on healthcare delivery. Gastrointestinal endoscopy services were limited during the early phases of the pandemic, which has resulted in ongoing procedural backlog. Procedural delays have had continuing effects including delayed colorectal cancer (CRC) diagnoses and exacerbation of existing disparities in the CRC-screening and treatment pathways. In this review, we outline these effects as well as the variety of strategies that have been proposed to eliminate this backlog, including increased endoscopy hours, re-triaging of referrals, and alternative CRC-screening strategies.
Dietary Self-Management Using Mobile Health Technology for Adults With Type 2 Diabetes: A Scoping Review
Authors: Zheng Yaguang , Campbell Rice Brynne , Melkus Gail D’Eramo , Sun Mingui , Zweig Susan , Jia Wenyan , Parekh Niyati , He Hanbin , Zhang YiLan , Wylie-Rosett Judith
Published: May 2023

Objective:

Dietary self-management is one key component to achieve optimal glycemic control. Advances in mobile health (mHealth) technology have reduced the burden of diabetes self-management; however, limited evidence has been known regarding the status of the current body of research using mHealth technology for dietary management for adults with type 2 diabetes.

Methods:

Literature searches were conducted electronically using PubMed, CINAHL (EBSCO), Web of Science Core Collection, PsycINFO (Ovid), EMBASE (Ovid), and Scopus. Keywords and subject headings covered dietary management, type 2 diabetes, and mHealth. Inclusion criteria included studies that applied mHealth for dietary self-management for adults with type 2 diabetes and were published in English as full articles.

Results:

This review (N = 15 studies) revealed heterogeneity of the mHealth-based dietary self-management or interventions and reported results related to physiological, dietary behavioral, and psychosocial outcomes. Twelve studies applied smartphone apps with varied functions for dietary management or intervention, while three studies applied continuous glucose monitoring (CGM) to guide dietary changes. Among 15 reviewed studies, only three of them were two-arm randomized clinical trial (RCT) with larger sample and 12-month study duration and 12 of them were pilot testing. Nine of 12 pilot studies showed improved HbA1c; most of them resulted in varied dietary changes; and few of them showed improved diabetes distress and depression.

Conclusion:

Our review provided evidence that the application of mHealth technology for dietary intervention for adults with type 2 diabetes is still in pilot testing. The preliminary effects are inconclusive on physiological, dietary behavioral, and psychosocial outcomes.
Finding Room for Indigenous Women in Educational Leadership: Why Structured Mentorship and Training Are Needed
Authors: Prado Ana
Published: May 2023

While the educational system attempts to recover from the last few years of teacher attrition and lower enrollments in teacher education programs, there is an opportunity within adult education to both promote and mentor indigenous women in educational leadership roles by providing education, resources, and opportunities during their training. As long as indigenous women educators are still left out of academic leadership spaces, the lack of diverse voices of women in educational leadership is an issue worth exploring. A troubling lack of mentorship, support, and opportunities exacerbates the exclusion of indigenous women educational leaders. The purpose of this paper is to explore ways that adult education programs and human resource development interventions can and should help prepare indigenous women for positions in educational leadership. Educational leadership training in higher education institutions must include structured mentorship and networking programs, efforts to understand how indigenous women learn and lead, and an embracing of alternate, indigenous ways of leading.
Utility of Repetitive Nerve Stimulation in the Diagnosis of Myasthenia Gravis in the Inpatient Setting
Authors: Clifford Katherine M , Wu Connie K , Post David , Shaik Ruba , Muppidi Srikanth
Published: May 2023

Objectives

Sensitivity and specificity of Repetitive Nerve Stimulation (RNS) is typically reported from outpatient centers, and we hypothesized that these values might not apply to hospitalized patients with higher grades of weakness. RNS may be helpful in rapidly confirming diagnosis of myasthenia gravis (MG) in the inpatient setting, as results from confirmatory antibody testing are often delayed. We sought to characterize the sensitivity and specificity of RNS in the inpatient setting to assist in the early diagnosis of MG.

Methods

We performed a retrospective analysis of all adult patients who had inpatient RNS at our center from 2016 to 2021. Inclusion criteria included RNS performed at least at one site and a neurological evaluation which prompted an electrodiagnostic study to evaluate for neuromuscular junction (NMJ) pathology. Descriptive statistics and Fisher exact analysis were performed.

Results

Of the 32 identified hospitalized patients, 6 had greater than 10% decrement on slow RNS, confirming NMJ dysfunction. Five were diagnosed with MG, and 1 with Lambert-Eaton myasthenic syndrome. Of the 26 patients with normal RNS, 25 ultimately had alternative causes of weakness. One was later diagnosed as seronegative MG based on clinical improvement with acetylcholinesterase inhibitors. In our inpatient population, the overall sensitivity and specificity of RNS were 83.3% and 96.2% respectively. There was a statistically significant association between a positive RNS and diagnosis of MG ( P = .0002).

Conclusions

RNS is a highly sensitive and specific test for the diagnosis of MG in an inpatient setting, and these results are likely more rapidly available compared to antibody testing.
Algorithmic management: Assessing the impacts of AI at work
Authors: Kelly-Lyth Aislinn , Thomas Anna
Published: May 2023

Algorithmic outputs are increasingly shaping the employee experience, presenting a host of risks and impacts with far-reaching consequences. This contribution considers how algorithmic impact assessments should complement, as well as inform, an overarching ‘top-down’ framework for the governance of algorithmic management systems. While generalised obligations are crucial, identifying risk mitigations on a case-by-case basis can provide significant added value by (i) identifying and evaluating risks and impacts, and facilitating context-specific responses; (ii) striking a balance between generalised requirements and complete self-regulation; and (iii) ensuring that due regard to anticipated impacts and risk mitigation is built in from the design and development stages, through to deployment in the workplace. The criteria for an effective impact assessment obligation in the algorithmic management context are identified, including the appropriate stages, actors, and procedure. The Good Work Charter, which operates as a synthesis of legal principles, rights, and obligations, as well as ethical principles as they apply to the workplace, is proposed as an assessment framework. Finally, the article compares the proposed model with the existing obligation to carry out data protection impact assessments for high-risk data processing. The shortcomings of the latter obligation are explored, and a legislative approach to avoid duplication is proposed.
Form, genre, voice, and authority in human geography: A speculative genealogy
Authors: Brigstocke Julian
Published: May 2023

This speculative genealogy of trends in the written forms of geographical scholarship, 2020–2043, explores the dramatic transformations in the discipline that came with a ‘neo-formalist’ turn towards critical reflection on and experiment with the formal aspects of geographical writing, including structure, genre, voice, and style. At the start of the 2020s, the forms, genres, and styles of academic geographical writing in Anglophone research journals were still rather homogeneous in form. Experiments with form were mostly restricted to sub-disciplinary silos. Following a series of important scholarly interventions, the discipline started to reflect more earnestly on the different kinds of authority that are claimed through the use of particular written forms and authorial personas. Whereas in the early decades of the 21st century, authorial personas were mostly confident, self-assured, decisive, and expressing a ‘mastery’ of concepts, the turn towards greater critical analysis of geography's written forms led to a proliferation of authorial personas, often rejecting personas associated with ‘mastery’ and instead exploring hesitation, anxiety, indecision, passivity, improvisation, unreliability, plurality, failure, humour, and self-deprecation, as ways of claiming different, more egalitarian forms of epistemic authority. This genealogy concludes that despite the problem of eclecticism, this turn towards greater methodological reflection on geography's written forms has greatly enriched the discipline from the mid-2020s until today.
Automation and environmental dispositions
Authors: Ash James
Published: May 2023

To think through the dispositions automated systems attempt to generate, it is key to understand how automated systems relate to the environments in which they operate. Developing Lin et al.’s important arguments around dispositions towards automation, this short response suggests the concept of disposition can be broadened to think about non-human dispositions more widely. To do this, the response forwards the notion of environmental disposition; a kind of fundamental state that all entities find themselves in, whereby entities are compelled to enter a more or less provisional position or grounding in an environment or milieu.