bluuebunny/crossref_metadata_2025 huggingface dataset:
The relationship between health literacy and adherence to personal protective anti-COVID-19 measures in health workers and their relatives: A mixed methods design
Authors: Gök Balci Umut , Sofuoğlu Zeynep , Merder Demet
Published: June 2024

In the fight against the COVID-19 pandemic, the importance of health literacy in individuals’ attitudes has increased. This study aimed to show whether there is a relationship between health literacy and adherence to personal protective anti-COVID-19 health behaviors in health workers and their relatives and to evaluate the barriers to adherence to personal protective anti-COVID-19 health behaviors. Designed as a cross-sectional mixed-methods study. Participants were asked to fill in an online survey form containing questions designed to determine their sociodemographic data, health literacy, adherence to protective anti-COVID-19 health behaviors, and barriers to adherence. The research results were evaluated with a confidence interval of 95% and margin of error of 0.05. Thematic content analysis was used to evaluate participants’ answers to the open-ended questions. In this study, data collected from 393 participants were analyzed. In the Disease Prevention and Health Promotion Subscale, the group of participants who adhered to wearing masks “at all times” obtained a higher average score from the Turkey Health Literacy Scale than other participant groups, while the participant group that “always” complied with hand washing and social distancing obtained higher average scores from the Turkey Health Literacy Scale and its two subscales compared to other participant groups. As a result of the thematic content analysis carried out in order to determine the situations that prevent the participants from complying with personal protective anti-COVID-19 health behaviors, the main themes were determined as “forgetting/not wearing the habit of wearing a mask,” “mask ergonomics” and “noncompliance with social distance.” This study shows that there is a positive relationship between health literacy and adherence to protective anti-COVID-19 health behaviors among health workers and their relatives and revealed major barriers to adherence to protective anti-COVID-19 health behaviors among health workers and their relatives.
Magnesium sulfate for postoperative pain in orthopedic surgery: A narrative review
Authors: Sbitan Lana , Nabhan Ayman Issa , Alafandi Bana Zuhair , Alzraikat Omar , Alzraikat Noor
Published: June 2024

Magnesium Sulfate (MgSO4) is a widely used adjuvant in anesthesia. Often administered with local anesthetics, it is known to reduce analgesic and opioid consumption while extending the duration of analgesia. MgSO4 applications extend to orthopedic surgeries, cardiovascular and urogenital procedures, offering extended postoperative pain relief. While commonly administered through various routes, there is a research gap concerning the comparative efficacy of intrathecal (IT) and intravenous (IV) MgSO4 administration. This narrative review aims to provide a comparison between IT and IV administration of MgSO4 particularly following orthopedic procedures, where pain management is paramount. A comprehensive literature search was conducted across several electronic databases, trial registries, and gray literature from inception to 2023. Inclusion criteria encompassed studies investigating the effects of perioperative IT administration of magnesium compared to perioperative IV administration of MgSO4 in patients undergoing surgery, with no language restrictions. Our search identified 4326 articles, of which 9 randomized controlled trials met our inclusion criteria. We summarized these selected articles. Four studies discussed IT magnesium sulfate (MgSO4) administration, 2 focused on IT administration in orthopedic surgeries, and 3 explored both IV and IT administration of MgSO4 in orthopedic surgery. IT MgSO4 shows promise in postoperative pain management, delaying block onset and extending duration. Personalized administration choice, considering patient factors and surgery type, is crucial. Further research is needed to refine strategies for better patient outcomes, particularly following orthopedic surgeries.
The value of using ELISA to detect orexin-A in cerebrospinal fluid in the diagnosis of narcolepsy
Authors: Zhan Qingqing , Deng Liying , Ding Yongmin , Wang Fen , Han Fang , Zhou Bing , Xie Liang
Published: June 2024

Orexin in cerebrospinal fluid (CSF) is a neuropeptide synthesized by a cluster of neurons in the lateral hypothalamus. It mainly functions to maintain arousal, regulate feeding, and participate in reward mechanisms. Radioimmunoassay (RIA) and enzyme-linked immunosorbent assay (ELISA) can detect CSF orexin. At present, RIA is widely used but is limited by various conditions, which is not conducive to its widespread development. We aimed to determine whether ELISA can replace RIA in detecting orexin in CSF. We investigated the results of 20 patients with central disorders of hypersomnolence, including 11 with narcolepsy type 1, 2 with narcolepsy type 2, 5 with idiopathic hypersomnia, and 2 with other causes of somnolence. RIA and ELISA were used to detect CSF orexin, and P values <.05 were considered to be significant. In the narcolepsy and non-narcolepsy type 1 groups, there was no correlation between the RIA and ELISA results (P > .05). In the narcolepsy type 1 group, the ELISA and RIA results were significantly different (P < .05), but this was not observed in the non-narcolepsy type 1 group (P > .05). The accuracy of ELISA to detect CSF orexin was lower than that of RIA (P < .05). ELISA cannot replace RIA in the measurement of CSF orexin, and RIA is recommended as the first choice when narcolepsy is suspected.
Dependable approaches to hypertension management: A review
Authors: Elendu Chukwuka , Amaechi Dependable C. , Elendu Tochi C. , Amaechi Emmanuel C. , Elendu Ijeoma D.
Published: June 2024

Hypertension, a prevalent chronic condition characterized by elevated blood pressure, is a significant global health burden, contributing to approximately 7.5 million premature deaths annually. While existing literature predominantly focuses on conventional treatment modalities, this paper offers unique insights into dependable approaches to hypertension management. Drawing upon epidemiological data, it highlights the increasing prevalence of hypertension across diverse populations, emphasizing demographic disparities and regional variations. This article underscores the need for tailored interventions considering individual risk profiles and socioeconomic determinants. Beyond conventional lifestyle modifications and pharmacological therapies, it explores emerging trends such as mindfulness-based interventions and integrative medicine in hypertension management. Additionally, it discusses the role of digital health technologies and telemedicine in enhancing patient engagement and remote monitoring, optimizing treatment outcomes. Furthermore, the paper addresses the evolving landscape of personalized medicine and genomic advancements in predicting individual responses to antihypertensive therapies, advocating for precision medicine approaches. This paper advocates for a holistic and patient-centered approach to hypertension management by offering a comprehensive overview of established and emerging strategies. It underscores the importance of interdisciplinary collaboration, continuous education, and innovative research endeavors to address the multifaceted challenges posed by hypertension and improve global cardiovascular health outcomes.
Establishment and validation of nomogram model for predicting major adverse cardiac events in patients with acute ST-segment elevation myocardial infarction based on glycosylated hemoglobin A1c to apolipoprotein A1 ratio: An observational study
Authors: Zhang Kang-Ping , Guo Qiong-Chao , Mu Nan , Liu Chong-Hui
Published: June 2024

The objective of the current study is to assess the usefulness of HbA1cAp ratio in predicting in-hospital major adverse cardiac events (MACEs) among acute ST-segment elevation myocardial infarction (STEMI) patients that have undergone percutaneous coronary intervention (PCI). Further, the study aims to construct a ratio nomogram for prediction with this ratio. The training cohort comprised of 511 STEMI patients who underwent emergency PCI at the Huaibei Miners’ General Hospital between January 2019 and May 2023. Simultaneously, 384 patients treated with the same strategy in First People’s Hospital of Hefei formed the validation cohort during the study period. LASSO regression was used to screen predictors of nonzero coefficients, multivariate logistic regression was used to analyze the independent factors of in-hospital MACE in STEMI patients after PCI, and nomogram models and validation were established. The LASSO regression analysis demonstrated that systolic blood pressure, diastolic blood pressure, D-dimer, urea, and glycosylated hemoglobin A1c (HbA1c)/apolipoprotein A1 (ApoA1) were significant predictors with nonzero coefficients. Multivariate logistic regression analysis was further conducted to identify systolic blood pressure, D-dimer, urea, and HbA1c/ApoA1 as independent factors associated with in-hospital MACE after PCI in STEMI patients. Based on these findings, a nomogram model was developed and validated, with the C-index in the training set at 0.77 (95% CI: 0.723–0.817), and the C-index in the validation set at 0.788 (95% CI: 0.734–0.841), indicating excellent discrimination accuracy. The calibration curves and clinical decision curves also demonstrated the good performance of the nomogram models. In patients with STEMI who underwent PCI, it was noted that a higher HbA1c of the ApoA1 ratio is significantly associated with in-hospital MACE. In addition, a nomogram is constructed having considered the above-mentioned risk factors to provide predictive information on in-hospital MACE occurrence in these patients. In particular, this tool is of great value to the clinical practitioners in determination of patients with a high risk.
Knowledge of cardiovascular diseases and associated risk factors in the general adult population of Jeddah, Saudi Arabia: A cross-sectional study examining gender disparities
Authors: Ghamri Ranya Alawy
Published: June 2024

To assess knowledge about cardiovascular diseases (CVD) among the general population, we emphasized gender-related disparities and other lifestyle and health-related factors. This cross-sectional study was conducted among 395 individuals from the general population of Jeddah, Saudi Arabia. An online questionnaire was administered to assess knowledge of CVD types, symptoms, and risk factors. The majority of participants identified coronary heart disease (73.7%) as having CVD, with no sex effect. Males had higher knowledge regarding cerebrovascular disease (44% vs 31.5%) and congenital heart diseases (60% vs 51.9%) as being part of CVD, while they had lower knowledge of peripheral arterial disease (44% vs 50.7%) than females, respectively (P < .05). Males exhibited better knowledge of heart attack and stroke symptoms than females. Knowledge was optimal for major CVD risk factors, such as smoking (90.6%) and high low-density lipoprotein cholesterol levels (85.1%); however, gaps were observed in recognizing diabetes (56.2%) and stress (69.4%) as factors for CVD. The mean overall knowledge score was 16.33 ± 5.72 25, with no difference between sexes (P = .239). Predictors of good CVD knowledge included university-level education, daily healthy food consumption, and perceived life as highly stressful; nonetheless, sex showed no significant effect. While the general population displayed a suboptimal understanding of CVD, notable sex disparities were observed, highlighting the need for tailored public health interventions. Emphasizing cognitive and behavioral aspects can foster better prevention and management strategies, given the evident gender disparities.
Normal sonographic measurements for kidney dimensions in Saudi adult population: A cross-sectional prospective study
Authors: Alyami Ali S. , Majrashi Naif A. , Elbashir Meaad , Ali Sarra , Shubayr Nasser , Refaee Turkey , Ageeli Wael , Madkhali Yahia , Abdelrazig Ali , Althobity Abdullah A. , Alwadani Bandar , AlShammari Qurain Turki , Hendi Ali M.
Published: June 2024

Background:

The use of ultrasound-based measurements to determine renal size has proven valuable in the diagnosis of renal function and associated disorders. The dimensions of the abdominal organs are affected by an individual’s body age, height, sex, and weight. The objective of this study was to establish the standard sonographic parameters for renal dimensions and to determine the correlation between body measurements and renal dimensions in a population of healthy adults residing in Jazan City, Saudi Arabia.

Methods:

The present study was a prospective study conducted at a single center located in Jazan City from February to August 2022. Ninety-five participants underwent abdominal ultrasonography. The process of measuring renal size through sonography entails the measurement of various dimensions of the kidney, such as renal length, width, and thickness. The demographic information of the participants, including their sex, age, height, and weight, was documented. All analyses were performed using Statistical Package for the Social Sciences v27 software.

Results:

The dimensions of the right kidney, specifically the length, width, and thickness, had mean value of 9.79 centimeters (cm), 5.09 cm, and 4.10 cm, respectively. The left kidney had mean dimensions of 10.1 cm, 5.09 cm, and 4.10 cm for length, width, and thickness, respectively. The left kidney was larger than the right kidney. Furthermore, male participants exhibited larger kidney measurements than their female counterparts did. A noteworthy positive correlation was observed between the thickness of the left kidney and sex, whereas no significant correlations were found with age, weight, or height.

Conclusion:

The current study revealed that the kidney dimensions were observed to be larger in males as compared to females. The research findings indicate that there is no significant correlation between kidney dimensions and various demographic factors, such as age, height, weight, and sex. In addition, this study provides reference tables for further use.
Associations between waist-to-height ratio and abdominal aortic calcification: A cross-sectional study
Authors: Sun Lijie
Published: June 2024

Waist-to-height ratio (WtHR) is a validated biomarker of central obesity that appears to be preferable to other body composition measurements in the evaluation of cardiovascular disease. The goal of this research was to explore the connection between WtHR and abdominal aortic calcification (AAC) among adults. On the basis of data from the 2013 to 2014 National Health and Nutrition Examination Survey, multivariate logistic regression, sensitivity analysis, as well as smoothed curve fitting were used to evaluate the connection between WtHR and AAC. Subgroup analyses along with interaction tests were done to see if this link was consistent across populations. Among 3079 participants aged >40 years, there was a negative association between WtHR and ACC. Each 1-unit emergence of WtHR was related to a 2% reduction in the probability of severe AAC in the entirely adjusted model (odds ratio = 0.02, 95% confidence interval: [0.00–0.12]). Participants in the highest WtHR quartile were 39% less likely to acquire severe AAC compared with those in the lowest quartile. (odds ratio = 0.61, 95% confidence interval: [0.37–1.00]). This negative association was more pronounced in the diabetes subgroup. We discovered a reversed U-shaped association between WtHR as well as AAC score utilizing a 2-stage linear regression model, with an intersection point of 0.56. WtHR was negatively associated with AAC among US adults.
Bottlenecks to Learning Evidence-Based Practice
Authors: Kistler K. Brooke , Tyndall Deborah E. , Peery Annette
Published: June 2024

Background:

Evidence-based practice (EBP) competency is an expected outcome of baccalaureate education; however, research indicates nursing graduates enter practice with competency gaps.

Purpose:

The purpose of this study was to explore the challenges accelerated baccalaureate students experience when learning the steps of EBP.

Methods:

A qualitative, descriptive design was used to identify bottlenecks to student learning.

Results:

Learning the steps of EBP in an accelerated format was challenging for students. Data analysis revealed 3 types of bottlenecks that stalled learning: cognitive, procedural, and emotional.

Conclusions:

Faculty build EBP competency by making explicit the steps that help students progress. Scaffolded learning, collaborative partnerships, and reflective practices are recommended to support student learning in accelerated formats.
Neck Point-of-Care Ultrasound for the Identification of Tongue-Base Cysts in Infants With Stridor
Authors: Tomita Keiichi , Nosaka Shunsuke , Kuroki Koushin , Koinuma Goro , Morimoto Noriko , Ishiguro Akira , Uematsu Satoko
Published: June 2024

Tongue-base cysts, which are occasionally categorized as vallecular cysts, are a rare yet potentially life-threatening cause of stridor in pediatric patients. Studies reporting the use of point-of-care ultrasound (POCUS) to identify tongue-base cysts are lacking. We present the case series of four infants in whom tongue-base cysts were detected using neck POCUS.
Practice Facilitation and Clinical Performance Feedback Using the Electronic Health Record Improved Blood Pressure and Cholesterol Management in Small Primary Care Practices in New York City
Authors: Tabaei Bahman P. , De Leon Samantha , Glenn Lily , Pham-Singer Hang
Published: June 2024

Cardiovascular disease (CVD) disproportionately affects people of color and those with lower household income. Improving blood pressure (BP) and cholesterol management for those with or at risk for CVD can improve health outcomes. The New York City Department of Health implemented clinical performance feedback with practice facilitation (PF) in 134 small primary care practices serving on average over 84% persons of color. Facilitators reviewed BP and cholesterol management data on performance dashboards and guided practices to identify and outreach to patients with suboptimal BP and cholesterol management. Despite disruptions from the COVID-19 pandemic, practices demonstrated significant improvements in BP (68%-75%, P < .001) and cholesterol management (72%-78%, P = .01). Prioritizing high-need neighborhoods for impactful resource investment, such as PF and data sharing, may be a promising approach to reducing CVD and hypertension inequities in areas heavily impacted by structural racism.
Stroke Prevention and Management in Rural Georgia: Evaluating the Effectiveness of a Community Paramedicine Program
Authors: Calvert Brandon , Bayakly Rana , Newsome Teri
Published: June 2024

Context:

Stroke remains a major public health concern in the state of Georgia with high mortality, disproportionately affecting rural and socioeconomically disadvantaged communities. Georgia’s age-standardized stroke death rate is 10.8% higher than the national average, and related comorbidities remain elevated in adult Georgians, contributing to higher stroke prevalence.

Program:

The Georgia Department of Public Health piloted a Community Paramedicine (CP) program in 2 rural counties to improve stroke management, readmissions, and mortality. Various supportive interventions to address barriers to chronic disease management were provided by a local emergency medical service agency for 90 days. This study aims to evaluate the effectiveness of the CP care delivery model in improving stroke outcomes among high-risk individuals.

Implementation:

CP leverages emergency medical service infrastructure to provide community health services such as home visits, telemedicine, care coordination, education, and access to social support services. The Georgia Hospital Discharge data and Georgia death records were used to measure stroke rehospitalization and deaths at 30, 60, and 90 days post-discharge for stroke. We compared the health outcomes of high-risk individuals who participated in the CP program to those who did not.

Evaluation:

Multivariable analysis suggested a reduction in stroke mortality rates among the intervention groups in both counties.

Discussion:

The CP program demonstrated effectiveness in assisting patients with managing risk factors through medication adherence for conditions such as hypertension, hypercholesterolemia, and diabetes.
Menopause and estrogen associations with gut barrier, microbial translocation, and immune activation biomarkers in women with and without HIV
Authors: Peters Brandilyn A. , Hanna David B. , Xue Xiaonan , Weber Kathleen , Appleton Allison A. , Kassaye Seble G. , Topper Elizabeth , Tracy Russell P. , Guillemette Chantal , Caron Patrick , Tien Phyllis C. , Qi Qibin , Burk Robert D. , Sharma Anjali , Anastos Kathryn , Kaplan Robert C.
Published: June 2024

Objectives:

Estrogens may protect the gut barrier and reduce microbial translocation and immune activation, which are prevalent in HIV infection. We investigated relationships of the menopausal transition and estrogens with gut barrier, microbial translocation, and immune activation biomarkers in women with and without HIV.

Design:

Longitudinal and cross-sectional studies nested in the Women’s Interagency HIV Study.

Methods:

Intestinal fatty acid binding protein (IFAB), lipopolysaccharide binding protein (LBP), and soluble CD14 (sCD14) levels were measured in serum from 77 women (43 with HIV) before, during, and after the menopausal transition (∼6 measures per woman over ∼13 years). A separate cross-sectional analysis was conducted among 72 post-menopausal women with HIV with these biomarkers and serum estrogens.

Results:

Women in the longitudinal analysis were a median age of 43 years at baseline. In piece-wise linear mixed-effects models with cut-points 2 years before and after the final menstrual period to delineate the menopausal transition, sCD14 levels increased over time during the menopausal transition (Beta [95% CI]=38 [12, 64] ng/mL/year, p=0.004), followed by a decrease post-transition (-46 [-75, -18], p=0.001), with the piece-wise model providing a better fit than a linear model (p=0.0006). In stratified analyses, these results were only apparent in women with HIV. In cross-sectional analyses among women with HIV, free estradiol was inversely correlated with sCD14 levels (r=-0.26, p=0.03). LBP and IFAB levels did not appear related to the menopausal transition and estrogen levels.

Conclusion:

Women with HIV may experience heightened innate immune activation during menopause, possibly related to depletion of estrogens.
Submental Flap Versus Radial Forearm Free Flap for the Reconstruction of Medium Size Soft Tissue Defect in the Oral Cavity
Authors: Zubiate Illarramendi Imanol , Cariati Paolo , Monsalve Fernando , Fernandez Solis Jose , Ferrari Silvano , Martínez Lara Ildefonso
Published: June 2024

The aim of this work is to compare the functional and esthetic outcome of the submental flap and radial forearm free flap for the reconstruction of medium-sized soft tissue defect in the oral cavity. Patients diagnosed with squamous cell carcinoma of the oral cavity and reconstructed with a submental flap or radial forearm free flap between 2015 and 2020 were reviewed and analyzed. Tumor site, complication at the donor site, complication at the recipient site, duration of the hospital stay, local or cervical recurrence, and esthetic results were also analyzed to compare the difference in outcomes between the two groups. Submental flap represents a safe and useful reconstructive recourse for head and neck reconstructive surgeons when it is correctly indicated. Lower rate of complication at the donor site, better esthetic result, and a shorter hospital stay represent the strengths of this flap when it is not necessary to perform compartment surgery. However, more studies are needed with a larger number of patients.
The silent information regulator 1 agonist SRT1720 reduces experimental intracerebral hemorrhagic brain injury by regulating the blood–brain barrier integrity
Authors: Xing Gebeili , Mu Lei , Han Bing , Zhu Runxiu
Published: June 2024

Intracerebral hemorrhage (ICH) is a significant public health matter that has no effective treatment. ICH-induced destruction of the blood–brain barrier (BBB) leads to neurological deterioration. Astrocytic sonic hedgehog (SHH) alleviates brain injury by maintaining the integrity of the BBB after ICH. Silent information regulator 1 (SIRT1) is neuroprotective in several central nervous system diseases via BBB regulation. It is also a possible influential factor of the SHH signaling pathway. Nevertheless, the role of SIRT1 on BBB and the underlying pathological process associated with the SHH signaling pathway after ICH remain unclear. We established an intracerebral hemorrhagic mouse model by collagenase injection. SRT1720 (a selective agonist of SIRT1) was used to evaluate the effect of SIRT1 on BBB integrity after ICH. SIRT1 expression was reduced in the mouse brain after ICH. SRT1720 attenuated neurobehavioral impairments and brain edema of ICH mouse. After ICH induction, SRT1720 improved BBB integrity and tight junction expressions in the mouse brain. The SHH signaling pathway-related factors smoothened and glioma-associated oncogene homolog-1 were increased with the intervention of SRT1720, while cyclopamine (a specific inhibitor of the SHH signaling pathway) reversed these effects. These findings suggest that SIRT1 protects from ICH by altering BBB permeability and tight junction expression levels. This process is associated with the SHH signaling pathway, suggesting that SIRT1 may be a potential therapeutic target for ICH.
Electroacupuncture alleviates diabetes-induced mechanical allodynia and downregulates bradykinin B1 receptor expression in spinal cord dorsal horn
Authors: Chi Hengyu , Hu Qunqi , Li Xiang , Kang Yurong , Zheng Yu , Jiang Mingjian , Xu Xinnan , Wang Xiaoxiang , He Xiaofen
Published: June 2024

Objective

Diabetic neuropathic pain (DNP) is one of the most prevalent symptoms of diabetes. The alteration of proteins in the spinal cord dorsal horn (SCDH) plays a significant role in the genesis and the development of DNP. Our previous study has shown electroacupuncture could effectively relieve DNP. However, the potential mechanism inducing DNP’s genesis and development remains unclear and needs further research.

Methods

This study established DNP model rats by intraperitoneally injecting a single high-dose streptozotocin; 2 Hz electroacupuncture was used to stimulate Zusanli (ST36) and Kunlun (BL60) of DNP rats daily from day 15 to day 21 after streptozotocin injection. Behavioral assay, quantitative PCR, immunofluorescence staining, and western blotting were used to study the analgesic mechanism of electroacupuncture.

Results

The bradykinin B1 receptor (B1R) mRNA, nuclear factor-κB p65 (p65), substance P, and calcitonin gene-related peptide (CGRP) protein expression were significantly enhanced in SCDH of DNP rats. The paw withdrawal threshold was increased while body weight and fasting blood glucose did not change in DNP rats after the electroacupuncture treatment. The expression of B1R, p65, substance P, and CGRP in SCDH of DNP rats was also inhibited after the electroacupuncture treatment.

Conclusion

This work suggests that the potential mechanisms inducing the allodynia of DNP rats were possibly related to the increased expression of B1R, p65, substance P, and CGRP in SCDH. Downregulating B1R, p65, substance P, and CGRP expression levels in SCDH may achieve the analgesic effect of 2 Hz electroacupuncture treatment.
Digital finance and SME financial inclusion in Africa
Authors: Umar Umar Habibu , Baita Abubakar Jamilu , Hamadou Issa , Abduh Muhamad
Published: June 2024

Purpose

This study examined the impact of digital finance on SME financial inclusion in Africa.

Design/methodology/approach

The study obtained data from the International Monetary Fund's Financial Access Survey and World Development Indicators covering the period from 2011 to 2022. Heteroskedastic panels corrected standard errors (HPCSE) and feasible generalized least squares regressions were employed in the analysis.

Findings

The findings indicate that digital finance (volume and intensity) significantly improves SME financial inclusion in Africa.

Research limitations/implications

Due to the paucity of data, the study covered only 17 African countries over 12 years (2011–2022).

Practical implications

The findings imply the need for African central banks and other relevant regulatory bodies to establish effective regulations mandating Deposit Money Banks and other financial institutions to operate agent banking. This would facilitate access to financial services for SME owners. Such measures could financially include more unbanked SME owners, especially those in rural areas. Moreover, these initiatives must be strongly supported by introducing user-friendly digital financial technologies and registering more financial technology (fintech) companies.

Social implications

Implementing necessary measures to enhance access to digital financial services for SMEs in Africa is likely to reduce unemployment and poverty and contribute to the economic growth and development of the region.

Originality/value

This study provides empirical evidence showing how digital finance affects SME financial inclusion in Africa.
Adaptive structures in civil engineering – state of the art
Authors: Schwegmann Lisa , Zabel Volkmar , Koch Steffen
Published: June 2024

Purpose

Adaptive load-bearing structures pursue the approach of saving mass within a load-bearing structure by adding external energy, thus saving materials and resources. This paper provides an overview of current research developments and shows some examples of existing prototypes.

Design/methodology/approach

First, basic terms and definitions from the research field of adaptive structures are introduced. After a brief historical insight, the numerical methods and prototypes used are presented as examples. The paper concludes with a summary of the state-of-the-art and open questions.

Findings

The current state of the art shows that the idea of adaptive structures offers great potential for more sustainability and resource efficiency in the construction industry. However, it also shows that research is still at the basic stage and that there are still some gaps in research.

Originality/value

The implementation of adaptive load-bearing structures is just one of many different approaches to greater sustainability in the construction sector. The issue of adaptive structures is a highly interdisciplinary field of research. The following paper is a literature review intended to summarize and critically evaluate the state-of-the-art research in this field. In the final section, some open questions are addressed, indicating that this research topic is still evolving.
A framework to assess Industry 4.0 readiness in Brazilian small and medium service enterprises
Authors: Barbosa Ava Santana , Delgado Joanna Carneiro , Alcântara Letícia Conceição Quintela de , Santos Carlos Jefferson de Melo , Sant’Anna Angelo Marcio Oliveira
Published: June 2024

Purpose

This paper aims to propose a framework to assess the readiness of Brazilian small and medium service companies to use Industry 4.0 technologies to improve the efficiency of processes, reinforcing the idea that evaluating and planning the implementation is as important as the use, without the need for big investments.

Design/methodology/approach

The paper presents two applications on the readiness level of small and medium enterprises, with support from researchers and stakeholders. The literature seems to focus more on the maturity level than on providing a sequence of operational steps or decision support. It would lead to better implementation of I4.0 technologies in assessing the company’s readiness level to adopt them.

Findings

The authors analyze the relevant case studies in Brazilian small and medium service enterprises based on the proposed framework to investigate the main challenges and hardships for Industry 4.0 readiness in the current scenario and outline directions to increase their readiness for adopting key Industry 4.0 technologies. Moreover, the case studies consolidate a fundamental advantage to small and medium enterprise service: a guided implementation provides more knowledge about products, processes and I4.0 technologies, even in unsuccessful case studies.

Practical implications

The need was identified when studying market trends with the digital transformation provided by Industry 4.0 technologies and, in parallel, the difficulties of small and medium service companies in adapting to this new scenario. Through the proposed framework, an action plan can be drawn up with well-defined objectives, goals and activities so that the service enterprises can increase their Industry 4.0 readiness level within three months.

Originality/value

A relevant aspect is that this study is based on feedback from stakeholders and managers, which makes the analyses and conclusions from empirical points of view without relevant theoretical knowledge of the relationship between I4.0 technologies. Therefore, the proposed framework made it possible to diagnose the organization’s external and internal environments, allowing the ideal condition and the current situation of the companies to be compared, as argued in the Industry 4.0 readiness literature review.
The value relevance of integrated reporting quality: evidence from Asia
Authors: Radwan Soltan Ramadan Ali , Xiongyuan Wang
Published: June 2024

Purpose

Integrated reporting (IR) aims to overcome the limitations of traditional reporting by merging financial information and sustainability data. Therefore, this paper aims to investigate whether IR quality is value-relevant for investors in the voluntary Asian context.

Design/methodology/approach

The study uses OLS regression to estimate the impact of IR quality on the market value of equity using data from Asian firms that prepare IR, presented on the International Integrated Reporting Council (IIRC) website for 2015–2022. The study uses content analysis to assess IR quality. Alternative measures of firm value, propensity score matching and instrumental variable estimation are used to validate the robustness of the main results.

Findings

The findings of this paper suggest that IR quality is value-relevant and has positive market reactions. Additional analyses show that the positive impact of IR quality is more salient for companies with high organizational complexity and high growth, and the impact is still significant during the COVID-19 pandemic period. Furthermore, the authors document that earnings quality and analyst forecast accuracy mediate the relationship between IR quality and market value.

Research limitations/implications

The study has some limitations, primarily stemming from the relatively small sample size and the fact that the majority of the data represents Japan.

Practical implications

The findings of this study have implications for standard setters, governmental agencies interested in adopting IR, as well as investors and businesses about the effects of IR quality.

Originality/value

Most of the recent studies are concentrated on mandatory IR adoption in South Africa. This study is unique in concentrating on the value relevance of IR quality in the voluntary Asian context.
The quest for sustainability – green transformational leadership towards green performance: a time-lagged study – symmetric and asymmetric analysis
Authors: Aslam Nadia , Shi Da , Sahibzada Umar Farooq
Published: June 2024

Purpose

Drawing upon the natural resource-based view (NRBV), the present study explores the role of green dynamic capability (GDC) as a mediating variable in the relationship between green transformational leadership (GTL) and green innovation (GI) in the hotel industry. The research further assesses green performance (GP) as a resultant factor of GI.

Design/methodology/approach

The research was conducted in Italian luxury hotels to assess the efficacy of our conceptual framework among workers in the hospitality industry. The study utilized a three-wave, two-week time-lagged design (N = 303). In addition, the study also intends to apply partial least squares structural equation modeling (PLS-SEM) and fuzzy qualitative comparative analysis (fsQCA) to have distinctive discernment into model rapport.

Findings

The results of the study indicate the linkage between GTL and GI. Furthermore, the study also found the partial mediation of GDC. The results show numerous combinations using fsQCA that can be utilized to increase GP.

Originality/value

There is little empirical evidence to study GTL and GI in hospitality studies. This work empirically investigates GTL, GDC and GI relationships to fill a knowledge gap. It also explains undiscovered factors and provides causal recipes to improve GP using fsQCA.
Mapping the research landscape of corporate strategy and capital structure: a bibliometric analysis
Authors: Panchal Shobha , Chand Subhash
Published: June 2024

Purpose

The aim of this study is to analyze the existing literature available on corporate strategy and capital structure with the help of a bibliometric analysis.

Design/methodology/approach

A total of 133 studies indexed in the Scopus database over the period from 1979 to 2024 are included and analyzed using the Biblioshiny package in RStudio along with VOSviewer for network visualization. Additionally, this study used biblioMagika and OpenRefine to harmonize and clean the data.

Findings

This study identified the leading contributors in terms of countries, authors, sources, and documents and used various analysis techniques. The USA, Canada, and the UK exhibited the most significant level of contribution. Furthermore, Bradford’s Law is applicable to the results of this study. The bibliographic coupling resulted in the five clusters indicating emerging themes in the field.

Research limitations/implications

The study’s findings will contribute to the academic landscape by providing an exhaustive examination of the concerned research field and will guide potential researchers for future research avenues. This study will also highlight the need for managers and policymakers to factor in diverse corporate strategies when shaping an organization’s capital structures.

Originality/value

To the best of the authors’ knowledge, this study represents the first attempt to map the landscape of this field through the presentation of insights derived from bibliometric analysis.
Antibiotic susceptibility and genome analysis of Enterococcus species isolated from inpatients in one hospital with no apparent outbreak of vancomycin‐resistant Enterococcus in Japan
Authors: Fujii Ayumi , Kawada‐Matsuo Miki , Nguyen‐Tra Le Mi , Masuda Kanako , Tadera Kayoko , Suzuki Yujin , Nishihama Saki , Hisatsune Junzo , Sugawara Yo , Kashiyama Seiya , Shiba Hideki , Aikawa Tomonao , Ohge Hiroki , Sugai Motoyuki , Komatsuzawa Hitoshi
Published: June 2024

To prevent nosocomial infection, it is important to screen for potential vancomycin‐resistant Enterococcus (VRE) among patients. In this study, we analyzed enterococcal isolates from inpatients in one hospital without any apparent outbreak of VRE. Enterococcal isolates were collected from inpatients at Hiroshima University Hospital from April 1 to June 30, 2021 using selective medium for Enterococci. Multilocus sequence typing, antimicrobial susceptibility testing, and whole‐genome sequencing were performed. A total of 164 isolates, including Enterococcus faecium (41 isolates), Enterococcus faecalis (80 isolates), Enterococcus raffinosus (11 isolates), Enterococcus casseliflavus (nine isolates), Enterococcus avium (12 isolates), Enterococcus lactis (eight isolates), Enterococcus gallinarum (two isolates), and Enterococcus malodoratus (one isolate), were analyzed. We found one vanA‐positive E. faecium, which was already informed when the patient was transferred to the hospital, nine vanC‐positive E. casseliflavus, and two vanC‐positive E. gallinarum. E. faecium isolates showed resistance to ampicillin (95.1%), imipenem (95.1%), and levofloxacin (87.8%), and E. faecalis isolates showed resistance to minocycline (49.4%). Ampicillin‐ and levofloxacin‐resistant E. faecium had multiple mutations in penicillin‐binding protein 5 (PBP5) (39/39 isolates) and ParC/GyrA (21/36 isolates), respectively. E. raffinosus showed resistance to ampicillin (81.8%), imipenem (45.5%), and levofloxacin (45.5%), and E. lactis showed resistance to ampicillin (37.5%) and imipenem (50.0%). The linezolid resistance genes optrA and cfr(B) were found only in one isolate of E. faecalis and E. raffinosus, respectively. This study, showing the status of enterococci infection in hospitalized patients, is one of the important information when considering nosocomial infection control of VRE.
Same‐Sex Unions in Hong Kong and the Misuse of Comparative Law: Sham Tsz Kit v Secretary for Justice
Authors: Ramsden Michael
Published: June 2024

In 2023, the Hong Kong Court of Final Appeal (CFA) handed down a significant decision requiring the creation of an alternative legal framework to recognise same‐sex unions. The judgment marked the culmination of two decades of strategic litigation challenging various forms of sexual orientation discrimination in Hong Kong, yet it fell short of recognising same‐sex marriage. The CFA's rejection was based upon an originalist construction of the Hong Kong Basic Law, the city's ‘mini constitution’, alongside a comparative analysis of select supranational human rights regimes. This note reflects upon the interpretive techniques used by the CFA and interrogates its reasons for denying the existence of a constitutional right to same‐sex marriage in Hong Kong. It argues that the CFA's use of an originalist construction was misplaced and inconsistent with its prior jurisprudence. The note also reflects on the CFA's selective use of comparative and international law, and the hazards associated with using external sources to control the interpretation of domestic public law norms.
Dissociation and the insanity defense: A review of U.S. Federal appellate case law
Authors: Haroon Haseeb
Published: June 2024

Pathological dissociation is relatively common in the United States and may be associated with violent or criminal behavior. Dissociative Disorders, especially Dissociative Identity Disorder, are considered controversial diagnoses by some in the psychiatric and legal professions. Individuals who offend during dissociative states may not be criminally responsible if they meet the legal standard for insanity, however, insanity pleas based on dissociative symptoms are rare. This review examined Federal appellate case law for potential legal barriers to the insanity defense for dissociative conditions and any restrictions imposed on related expert evidence. Few rulings directly addressed these questions but there do not appear to be any unique barriers for dissociation‐related insanity pleas. Some cases provided valuable insights regarding the admission of expert evidence, effective expert testimony, and the role of defense counsel.
Water use of co‐occurring loblolly (Pinus taeda) and shortleaf (Pinus echinata) in a loblolly pine plantation in the Piedmont
Authors: Boggs Johnny , Sun Ge , Domec Jean‐Christophe , McNulty Steve
Published: June 2024

Measuring water use in co‐occurring loblolly pine (Pinus taeda L.) and shortleaf pine (Pinus echinata Mill.) enhances our understanding of their competitive water use and aids in refining watershed water budget model parameters. This study was conducted in a 12‐ha forested headwater catchment in the Piedmont of North Carolina, southeastern U.S., from 2018 to 2019 (pre‐thinning) to 2020 (post‐thinning). Sap flux density (J
s), species‐level transpiration (T
s), and watershed‐level transpiration (T
w) were quantified. Water use efficiency (WUE) in loblolly and shortleaf pines was compared, alongside an investigation into how both species' J
s and T
s responded to atmospheric vapor pressure deficit (VPD). Loblolly pine had 19%–36% higher J
s than shortleaf pine. Daily T
s for loblolly pine ranged from 15.0 to 29.0 L/day while T
s in shortleaf pine ranged from 3.0 to 6.8 L/day. The T
s was significantly higher in loblolly pine when compared to shortleaf pine likely due to higher canopy position and higher growth rates of the former. WUE, defined by annual tree biomass growth per tree water use, was not significantly different between the two. Daily J
s and T
s in both species responded nonlinearly to VPD, with loblolly pine being more sensitive and variable. Species‐specific water use should be considered when quantifying T
w and developing reliable models to predict the effects of forest management practices on water resources.
The role of the World Health Organization in male contraceptive development
Authors: Kidula Nancy , Nguyen Brian T. , Habib Ndema , Festin Mario , Toskin Igor , Kiarie James
Published: June 2024

The World Health Organization has been involved in male contraceptive development for over 50 years. In line with its functions and mandate, World Health Organization works with diverse stakeholders to support research, develop norms and standards, engage member states, facilitate prequalification, introduction and scale up, measurement, and tracking of contraceptives. World Health Organization has a key role in galvanizing global efforts to ensure universal access to contraception services irrespective of income group. Regarding male contraceptive development, World Health Organization has provided technical leadership, supported early research, created and supported research centers, built research capacity in various countries, and standardized semen analysis procedures. In this paper, a detailed description is provided with examples across the various stages of male contraceptive development. Limited funding to World Health Organization is a key challenge.