bluuebunny/crossref_metadata_2025 huggingface dataset:
Technical Assistance for Systemic Change: Lessons Learned From a National Technical Assistance Center
Authors: Ward Caryn S. , Farmer Sophia , Livet Melanie
Published: May 2024

Despite the millions of dollars awarded annually by the United States Department of Education to build implementation capacity through technical assistance (TA), data on TA effectiveness are severely lacking. Foundational to the operationalization and consistent research on TA effectiveness is the development and use of standardized TA core competencies, practices, and structures. Despite advances toward a consistent definition of TA, a gap still exists in understanding how these competencies are used within an operationalized set of TA practices to produce targeted outcomes at both individual and organizational levels to facilitate implementation of evidence-based practices. The current article describes key insights derived from the evaluation of an operationalized set of TA practices used by a nationally funded TA center, the State Implementation & Scaling Up of Evidence Based Practices (SISEP) Center. The TA provided by the Center supports the uptake of evidence-based practices in K-12 education for students with disabilities. Lessons learned include: (1) the need to understand the complexities and dependencies of operationalizing TA both longitudinally and at multiple levels of the system (state, regional, local); (2) the relative importance of building general and innovation-specific capacity for implementation success; (3) the value of using a co-design and participatory approach for effective TA delivery; (4) the need to develop TA providers’ educational and implementation fluency across areas and levels of the system receiving TA; and (5) the need to ensure coordination and alignment of TA providers from different centers. Gaining an understanding into optimal TA practices will not only provide clarity of definition fundamental to TA research, but it will also inform the conceptual framing and practice of TA.
Strengthening the Science and Practice of Implementation Support: Evaluating the Effectiveness of Training and Technical Assistance Centers
Authors: Wandersman Abraham , Scheier Lawrence M.
Published: May 2024

Hundreds of millions of dollars are spent each year by U.S. federal agencies for training and technical assistance (TTA) to be delivered by training and technical assistance centers (TTACs) to “delivery system organizations” (e.g., federally qualified health centers, state departments of health, substance abuse treatment centers, schools, and healthcare organizations). TTACs are often requested to help delivery system organizations implement evidence-based interventions. Yet, counterintuitively, TTACs are rarely required to use evidence-based approaches when supporting delivery systems (in the use of evidence-based programs). In fact, evaluations of TTAC activities tend to be minimal; evaluation of technical assistance (if conducted at all) often emphasizes outputs (number of encounters), satisfaction, and self-reports of knowledge gained—more substantive outcomes are not evaluated. The gap between (a) the volume of TTA services being funded and provided and (b) the evaluation of those services is immense and has the potential to be costly. The basic question to be answered is: how effective are TTA services? This article introduces the special issue on Strengthening the Science and Practice of Implementation Support: Evaluating the Effectiveness of Training and Technical Assistance Centers. The special issue promotes 1) knowledge of the state of the art of evaluation of TTACs and 2) advances in what to evaluate in TTA. A major goal of the issue is to improve the science and practice of implementation support, particularly in the areas of TTA.
In search of career-life meaning: Enhancing the existential experience of a gifted learner
Authors: Maree Kobus
Published: May 2024

This article reports on how intervention research based on integrative career counselling enhanced the existential experience of a gifted learner. The participant of this study was a purposively selected gifted 17-year-old girl learner in search of a career that would help her experience meaning, purpose, and hope in and through her career-life. An explanatory (QUALITATIVE-quantitative) research design was used together with qualitative career construction counselling-based methods. A new standardised test was used to generate quantitative data. Savickas’ guidelines for analysing career construction-elicited data were implemented to identify themes and subthemes in the outcomes. The intervention helped the participant decide on a career through which she could experience meaning, purpose, and hope in her career-life. Longitudinal research is needed to determine the medium- and long-term influence of the type of intervention discussed here with gifted learners in individual as well as group contexts across the diversity spectrum.
Resistance to online learning technology: Theoretical and empirical perspectives
Authors: Ambalov Igor Alexander
Published: May 2024

The increasing popularity of online learning applications (OLAs) among institutions and individuals is an ongoing trend in information technology. While much of previous technology adoption research has been focused on adoption motivators or enablers, the lack of research on adoption inhibitors is the primary motivation for this study. The main focus is on dispositional resistance to change (RTC) and its role in individual OLA adoption decisions. A theoretical model integrating two fields of research, technology adoption and psychology, was developed to investigate the influence of RTC on key adoption predictors using a sample of 217 university-student OLA users. A combination of cognitive dissonance and self-verification theories was used to explain the mechanism of this influence, which was subsequently tested and verified. Findings indicate that RTC has a significant negative impact on effort expectancy and usage intention, but not on attitude and performance expectancy. This study contributes by theoretically underpinning and empirically validating the impact of RTC on OLA adoption decisions. Furthermore, it illustrates the importance of incorporating RTC into technology adoption studies in general and OLA studies in particular. This research provides the foundation for future work in this severely underexplored area.
Cell structure in steels induced by additive manufacturing
Authors: Wang Xiaobo
Published: May 2024

This review discusses the cell structure induced by additive manufacturing (AM) with a focus on stainless steel 316L and maraging steel 18Ni-300 produced by laser powder bed fusion. The microstructural characteristics of AM cell structure are described. The central role of AM cell structure in the process–microstructure–property–performance relationship of AM steels is demonstrated, in which the methodology of modifying AM cells and the strengthening mechanism by AM cells are critically reviewed. The limitations of the current research mainly lie in the reproducibility of microstructures and the solution to the strength-ductility trade-off of AM steels. Finally, suggestions for further studies are presented: to establish a fine-scale process–microstructure–property–performance relationship of AM steels and to print novel composite materials through microstructure design.
Small-Sample Bias Correction of Inequality Estimators in Complex Surveys
Authors: De Nicolò Silvia , Ferrante Maria Rosaria , Pacei Silvia
Published: May 2024

Income inequality estimators are biased in small samples, leading generally to an underestimation. This aspect deserves particular attention when estimating inequality in small domains and performing small area estimation at the area level. We propose a bias correction framework for a large class of inequality measures comprising the Gini Index, the Generalized Entropy, and the Atkinson index families by accounting for complex survey designs. The proposed methodology does not require any parametric assumption on income distribution, being very flexible. Design-based performance evaluation of our proposal has been carried out using EU-SILC data, their results show a noticeable bias reduction for all the measures. Lastly, an illustrative example of application in small area estimation confirms that ignoring ex-ante bias correction determines model misspecification.
Effect of Lateral Extra-Articular Procedures Combined With ACL Reconstruction on the Rate of Graft Rupture in Patients Aged Older Than 30 Years: A Matched-Pair Analysis of 1102 Patients From the SANTI Study Group
Authors: Pettinari Francesco , Carrozzo Alessandro , Saithna Adnan , Ali Ahmad Abed , Alayane Ali , Barosso Marta , Vieira Thais Dutra , Sonnery-Cottet Bertrand
Published: May 2024

Background:

Clinical studies have demonstrated significant advantages of combined anterior cruciate ligament (ACL) reconstruction (ACLR) and lateral extra-articular procedures (LEAPs) over isolated ACLR in terms of reducing graft rupture and reoperation rates. However, most of the published studies have included young patients, and no studies have focused on patients aged >30 years.

Purpose/Hypothesis:

The purpose of this study was to compare the outcomes of isolated ACLR versus ACLR + LEAP at midterm follow-up in patients aged >30 years. The hypothesis was that patients who underwent combined procedures would experience significantly lower rates of graft rupture.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Patients >30 years of age who underwent primary ACLR + LEAP between January 2003 and December 2020 were propensity matched at a 1:1 ratio to patients who underwent isolated ACLR. A retrospective analysis of prospectively collected data was performed to determine graft rupture rates, knee stability, reoperation rates, and complications. Graft survivorship was assessed using the Kaplan-Meier method. Risk factors associated with the occurrence of graft failure were analyzed using a Cox proportional hazards model.

Results:

Two groups of 551 patients each were included in the study, and the mean follow-up was 97.19 ± 47.23 months. The overall mean age was 37.01 ± 6.24 years. The LEAP group consisted of 503 (91.3%) patients who had anterolateral ligament reconstruction and 48 (8.7%) patients who had a Lemaire procedure. Overall, 19 (1.7%) patients had graft failure: 15 (2.7%) in the no-LEAP group and 4 (0.7%) in the LEAP group ( P = .0116). The risk of graft failure was significantly associated with the absence of LEAP (31 vs 12; hazard ratio, 3.309; 95% CI, 1.088-10.065; P = .0350) and age between 30 and 35 years (hazard ratio, 4.533; 95% CI, 1.484-13.841; P = .0080). A higher rate of reoperation for secondary meniscectomy was found in the no-LEAP group (5.6% vs 2.2%; P = .0031).

Conclusion:

Patients aged >30 years who underwent combined ACLR and LEAP experienced a >3-fold lower risk of ACL graft failure compared with those who underwent isolated ACLR. Furthermore, the group without LEAP experienced a higher rate of secondary meniscectomy.
Quantitative MRI Analysis of Patellofemoral Joint Cartilage Health 2 Years After Anterior Cruciate Ligament Reconstruction and Lateral Extra-Articular Tenodesis
Authors: Nakanishi Yuta , Hegarty Paul , Vivacqua Thiago , Firth Andrew , Milner Jaques S. , Pritchett Stephany , Willits Kevin , Litchfield Robert , Bryant Dianne , Getgood Alan M.J.
Published: May 2024

Background:

The addition of an iliotibial band–based lateral extra-articular tenodesis (LET) to anterior cruciate ligament (ACL) reconstruction (ACLR) has been shown to reduce failure rates. However, there are concerns as to the potential overconstraint of tibiofemoral kinematics that may increase the risk of cartilage degradation. To date, no clinical study has investigated the effect of LET on patellofemoral joint articular cartilage health.

Hypothesis:

It was hypothesized that at 2 years postoperatively, (1) the addition of LET at the time of ACLR would have no effect on cartilage health on magnetic resonance imaging (MRI), and (2) higher cartilage relaxation values would be associated with worse patient-reported and functional outcomes.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A subset of patients from the STABILITY 1 randomized controlled trial were included. All patients underwent primary ACLR with a hamstring autograft. Patients were randomized to either LET augmentation or not. Cartilage status in the patellofemoral joint between the ACLR group and ACLR+LET group was compared using 2-year postoperative quantitative MRI and the ACL osteoarthritis scores of both the surgical and the contralateral nonsurgical knees. Objective functional outcomes and patient-reported outcome measures (PROMs) were attained.

Results:

A total of 92 patients (43 patients in the ACLR group; mean age, 18.9 ± 3.2 years; 60.5% female; and 49 patients in the ACLR+LET group; mean age, 18.7 ± 3.2 years, 63.3% female) were included. No significant differences were seen in the mean values (ms) for adjusted T1ρ/T2 relaxation times in the medial patella (47.8/42.2 vs 47.3/43.2), central patella (45.5/42.5 vs 44.1/42.7), lateral patella (48.2/43.5 vs 47.3/43.0), medial trochlea (54.7/50.9 vs 56.4/50.9), central trochlea (53.3/51.1 vs 53.1/52.0), and lateral trochlea (54.9/52.1 vs 53.9/52.6) between the ACLR and ACLR+LET groups. No difference in overall ACL osteoarthritis scores was observed ( P = .99). An increase in medial patellar T2 relaxation times was associated with a decreasing International Knee Documentation Committee score ( P = .046), Knee injury and Osteoarthritis Outcome Score (KOOS) Symptoms subscale score ( P = .01), and total KOOS ( P = .01).

Conclusion:

There was no statistical difference in patellofemoral cartilage health between knees 2 years after primary ACLR with hamstring tendon autograft with or without LET. Statistically significant correlations were found between quantitative MRI relaxation times, functional outcome scores, and PROMs; however, the correlations were weak and the clinical significance is unknown.

Registration:

NCT02018354 (ClinicalTrials.gov identifier).
Continuous Sedation in Palliative Care in Portugal: A Prospective Multicentric Study
Authors: Ferraz-Gonçalves José António , Flores Alice , Silva Ana Abreu , Simões Ana , Pais Carmen , Melo Clarisse , Pirra Diana , Coelho Dora , Conde Lília , Real Lorena , Feio Madalena , Barbosa Manuel , Martins Maria de Lurdes , Areias Marlene , Muñoz-Romero Rafael , Ferreira Rita Cunha , Freitas Susete
Published: May 2024

Objective: This study aimed to survey the practice of palliative sedation in Portugal, where data on this subject were lacking. Methods: This was a prospective multicentric study that included all patients admitted to each team that agreed to participate. Patients were followed until death, discharge, or after 3 months of follow-up. Results: The study included 8 teams: 4 as palliative care units (PCU), 1 as a hospital palliative care team (HPCT), 2 as home care (HC), and 1 as HPCT and HC. Of the 361 patients enrolled, 52% were male, the median age was 76 years, and 285 (79%) had cancer. Continuous sedation was undergone by 49 (14%) patients: 26 (53%) were male, and the median age was 76. Most patients, 46 (94%), had an oncological diagnosis. Only in a minority of cases, the family, 16 (33%), or the patient, 5 (10%), participated in the decision to sedate. Delirium was the most frequent symptom leading to sedation. The medication most used was midazolam (65%). In the multivariable analysis, only age and the combined score were independently associated with sedation; patients <76 years and those with higher levels of suffering had a higher probability of being sedated. Conclusions: The practice of continuous palliative sedation in Portugal is within the range reported in other studies. One particularly relevant point was the low participation of patients and their families in the decision-making process. Each team must have a deep discussion on this aspect.
Decoding the Prevalent High-Risk Breast Cancers: Demographics, Pathological, Imaging Insights, and Long-Term Outcome
Authors: Alvarenga Pedro , Park Ji Yeon , Pinto Renata , Parente Daniella , Lajkosz Katherine , Westergard Shelley , Ghai Sandeep , Kim Raymond , Kulkarni Supriya , Au Frederick , Chamadoira Juliana , Freitas Vivianne
Published: May 2024

Objective: To investigate the features and outcomes of breast cancer in high-risk subgroups. Materials and Methods: REB approved an observational study of women diagnosed with breast cancer from 2010 to 2019. Three radiologists, using the BI-RADS lexicon, blindly reviewed mammogram and MRI screenings without a washout period. Consensus was reached with 2 additional reviewers. Inter-rater agreement was measured by Fleiss Kappa. Statistical analysis included Mann-Whitney U, Chi-square tests for cohort analysis, and Kaplan-Meier for survival rates, with a Cox model for comparative analysis using gene mutation as a reference. Results: The study included 140 high-risk women, finding 155 malignant lesions. Significant age differences noted: chest radiation therapy (median age 44, IQR: 37.0-46.2), gene mutation (median age 49, IQR: 39.8-58.0), and familial risk (median age 51, IQR: 44.5-56.0) ( P = .007). Gene mutation carriers had smaller ( P = .01), higher-grade tumours ( P = .002), and more triple-negative ER- ( P = .02), PR- ( P = .002), and HER2- ( P = .02) cases. MRI outperformed mammography in all subgroups. Substantial to near-perfect inter-rater agreement observed. Over 10 years, no deaths occurred in chest radiation group, with no significant survival difference between gene mutation and familial risk groups, HR = 0.93 (95% CI: 0.27, 3.26), P = .92. Conclusion: The study highlights the importance of age and specific tumour characteristics in identifying high-risk breast cancer subgroups. MRI is confirmed as an effective screening tool. Despite the aggressive nature of cancers in gene mutation carriers, early detection is crucial for survival outcomes. These insights, while necessitating further validation with larger studies, advocate for a move toward personalized medical care, strengthening the existing healthcare guidelines.
Against Dictatorship, against Backsliding? Examining the Effect of Serbian Anti-Government Protests on the 2020 Electoral Boycott
Authors: Kralj Karlo , Sircar Indraneel , Dolenec Danijela
Published: May 2024

The power of the Serbian Progressive Party (SNS) has been steadily growing ever since 2012. The party has successfully taken control of all levels of government in Serbia, and the country has suffered from gradual democratic backsliding as a result. In this article, we focus on two protest waves in Serbia between 2017 and 2019. Crucially, a number of opposition parties involved in the more recent protest wave boycotted the 2020 parliamentary election. This article analyzes the characteristics of the citizen-led response in local communities across Serbia and estimates its electoral impact using a difference-in-differences approach. The case of Serbia not only elucidates modes of citizen response and their impact in post-Communist Europe but also provides comparative insights for the potential for citizen-led resistance to mobilize against backsliding in other countries. The objectives of the article are twofold. First, the article uses an original data set of Serbian protest events between 2017 and 2019 to ascertain how the two protest waves were conducted, and how citizens respond to democratic backsliding. Second, using data on municipal-level turnout and SNS vote share in the 2020 parliamentary election, we examine the average electoral impact of protest and, related to that, we evaluate the success of opposition parties in mobilizing voters for the electoral boycott. The article investigates whether SNS-led democratic backsliding is resilient to sustained citizen-led mobilization or whether this bottom-up resistance challenges the notion that “stabilitocracies” such as Serbia are immune to fundamental political change.
Experimental investigation of warpage in thin CF/PEKK composite laminates consolidated under non-isothermal conditions
Authors: Al-Dhaheri Mariam A , Irfan Muhammad S , Cantwell Wesley J , Barsoum Imad , Umer Rehan
Published: May 2024

In this study, we investigated the effect of several processing conditions on warpage in carbon-fibre/PEKK composites manufactured under non-isothermal conditions. A multi-level factorial design of experiments was employed to study the effect of process and design parameters on warpage. Analysis-of-variance was used to establish the significance of the main factors as contributors to warpage. The number of plies and consolidation pressure were the factors that contributed significantly to warpage. A regression model was used to predict the warpage of panels consolidated using aluminium tooling, giving a reasonably good prediction of less than 18% difference. A panel with variable thickness was also manufactured, based on the prior observations, pressure and lay-up configurations were successfully altered to reduce warpage. DSC results showed that the warpage of semi-crystalline PEKK composites consolidated under non-isothermal conditions is a result of a differential in shrinkage across the laminate, as the degree of crystallinity varied with temperature and consolidation pressure.
Navigating Glucagon-Like Peptide Receptor Agonist Reinitiation Amid Access Barriers: An Adverse Drug Event Case Report
Authors: Denny Olivia , Baron Jeffrey , Albanese Nicole P.
Published: May 2024

Background: The expanding roles and popularity of glucagon-like peptide-1 (GLP-1) and GLP-1/glucose-dependent insulinotropic polypeptide (GIP) receptor agonists has created access barriers to medication use. We sought to describe an adverse drug event which occurred after reinitiation of a GLP-1 receptor agonist following a prolonged lapse in therapy due to poor medication access. Case Summary: Once-weekly injectable semaglutide was prescribed to an outpatient 33-year-old male for chronic weight management. After a delayed initiation due to global shortage, semaglutide was initiated and titrated over five months before a seven week lapse in therapy due to prior authorization interruption. Despite the extended treatment gap, the patient was directed to reinitiate semaglutide at the target dose rather than starting dose, which was followed by recurrent, symptomatic nausea and vomiting requiring medical intervention. Practice Implications: A prolonged lapse in GLP-1 receptor agonist therapy, typically defined as missing three or more doses of a once-weekly injectable, warrants consideration of reinitiation at a reduced dose, personalized to the patient’s prior gastrointestinal tolerability, efficacy goals, and therapy lapse duration. Therapy lapses with GLP-1 receptor agonists may be prevented by utilizing a multi-modal approach including extended dosing intervals, intermediate doses, agent interchange, efficient prior authorization communication, and cautious initiation of GLP-1 recent agonists while supply cannot meet demand.
Numerical investigation of CH4/H2/air micro-mixing combustion flow in a micro gas turbine combustor with different head-end structures
Authors: Wu Ruibing , Zeng Zhuoxiong , Liu Hong , Guo Kaifang
Published: May 2024

In order to investigate the premixed combustion characteristics of CH4/H2/air in a micro-mixing combustor, the effects of different micro-mixing head-ends (HE1, HE2, HE3) and hydrogen mixing ratios on the temperature distribution, heat transfer process, emission characteristic, flames shape are analyzed. The results show that compared with swirl head-end combustion, the micro-mixing combustion performance is better. Among the three head-ends, HE3 has the best combustion characteristics and stable flames. The temperature distribution in the high-temperature zone is uniform, and low-temperature zone is concentrated near the jet, which can suppress the flashback. The velocity and temperature gradient near the central axis of jet streams show a strong synergistic effect. The flames are plume shaped and flames stability is mainly influenced by the H2 combustion process. Increasing the jet diameter, decreasing the jet spacing and increasing the hydrogen mixing ratio all contribute to the flames stability, but these three methods can stabilize the flames by affecting fluid Reynolds number, interaction between small flames and combustion rate, respectively. Moreover, small jet diameter and high hydrogen mixing ratio can reduce OTDF, which contributes to improve outlet temperature uniformity.
Financing the future: Asymmetric association between green investment and electric vehicles
Authors: Tang Nan , Ge Yuemeng , Ali Sajid , Nazar Raima
Published: May 2024

Green investment in electric vehicles represents a pivotal shift towards a sustainable future, promising to revolutionize our transportation systems while significantly reducing greenhouse gas emissions. This research aims to probe the linkage between green investment and electric vehicles across the top 10 economies with the highest electric vehicle adoption rates (China, USA, Norway, Germany, UK, France, Portugal, Netherlands, Belgium, and South Korea). Unlike earlier studies that primarily utilized panel data methods and overlooked the individual nuances of each country, our investigation employs the advanced ‘Quantile-on-Quantile’ technique. This novel approach enables us to delve into the relationships between variables within each specific country, thereby improving the precision of our analysis. As a result, this study provides a comprehensive global viewpoint, revealing nuanced findings about each nation's distinct characteristics. The study's findings express a positive connection between green investment and the electric vehicle stock in various segments of the sample economies. Furthermore, this research highlights diverse trends in these connections within different nations. The results emphasize policymakers’ need to conduct comprehensive evaluations and develop effective strategies to address changes in both green investment and electric vehicles.
A thermal energy analysis of binary (Go-Co/H2O) and ternary (Go-Co-Zro2/H2O) nanofluids based on characterization and thermal performance
Authors: Hussain Syed M , Ahmad Sohail , Ali Kashif , Al Mesfer Mohammed K , Danish Mohd , Jamshed Wasim , Irshad Kashif , Ahmad Hijaz
Published: May 2024

Hybrid or binary nanofluids have superior mechanical and thermal characteristics but the tri-hybrid nanofluids comprise of more embellished thermal properties, better physical strength, and enhanced stability. The present work characterizes the thermal and physical aspects of the hybrid and tri-hybrid nanofluids. The nano-composition of graphene oxide ( Go) and cobalt ( Co) is used in the amalgamation of hybrid nanofluid Go-Co/H2O, whereas the addition of zirconium oxide ( ZrO2) in this mixture gives rise to the ternary Go-Co-ZrO2/H2O hybrid nanofluid. The activation energy and viscous dissipation terms are also amended in the governing equations. The mathematical framework consists of a complex natured dynamical system. However, a numerical algorithm based on finite-difference discretization is developed which can solve the system numerically via the MATLAB software. A comparison with the existing literature is provided in order to validate the numerical procedure. From the outcomes, it is noticed that the temperature of hybrid as well as tri-hybrid nanofuid increases rapidly with change in concentration of zirconium oxide and cobalt. Temperature increases up to 20% by taking 0.1 volume fraction of both zirconium oxide and cobalt. Porous medium and activation energy resist the flow and concentration respectively. A comparative judgment evidently reveals that tri-hybrid Go-Co-ZrO2/H2O nanofluid has a substantial effect on temperature as equated to hybrid or pure nanofluid.
A Dynamic Collapse Concept for Climate Change
Authors: Steel Daniel , Belotti Giulia , Mittiga Ross , Mintz-Woo Kian
Published: May 2024

Despite growing interest in risks of societal collapse due to anthropogenic climate change, there exists no consensus about how collapse should be understood. In this article, we critically examine existing definitions and argue that none adequately address the challenges for conceptualizing collapse that climate change presents. We therefore propose an alternative conception, which regards collapse as a reduction of collective capacity resulting in a pervasive and difficult-to-reverse loss of basic functionality. Our conception is dynamic in that it focuses on the interrelations of constituent subsystems. It also distinguishes collapse from transformations needed to address climate change and provides insight into the relationship between collapse and sustainability.
Riding the Waves of Change: Using Qualitative Comparative Analysis to Analyze Complex Growth Patterns in Entrepreneurship
Authors: Du Yunzhou , Liu Qiuchen , Kim Phillip H. , Li Jiaxin
Published: May 2024

Studying temporal change using Qualitative Comparative Analysis (QCA) allows researchers to examine complex and dynamic causal pathways between configurations of time-based conditions and a desired outcome. No comprehensive QCA technique currently addresses complex temporal changes in a unified manner. To remedy these shortcomings, we introduce Growth Pattern QCA—a mixed-method technique for studying complex growth dynamics. We integrate a quantitative computational toolkit for calculating growth slopes with QCA and demonstrate it using an illustrative multiyear panel. We offer practical guidance for researchers to apply these mixed methods for analyzing and forecasting complex growth patterns in various entrepreneurship research settings. We also review existing techniques and provide a decision roadmap of time-related QCA methods for researchers to use the best option for their research objectives.
Early Utilization of Ketorolac in Cleft Palate Repair
Authors: Michalowski Alexandra , Modi Vikash
Published: May 2024

Objective

To determine the effect of ketorolac on opiate requirement and hospital length of stay after palatoplasty.

Design

This was a retrospective chart review.

Setting

This study was completed at an urban tertiary medical center.

Patients

Those who underwent palatoplasty with a pediatric otolaryngologist between 2010-2020.

Interventions

Incorporation of standing Ketorolac into the immediate post-operative pain regimen.

Main outcome measures

T-test analysis was performed to determine whether initiation of ketorolac within 24 h post-palatoplasty was correlated with shorter length hospitalization or reduced opiate requirement.

Results

A total of 55 pediatric subjects (49.1% female) were included in this study. Average age at time of surgery was 13 months (range 9.9-33.9 months). On two tailed t-test, use of ketorolac within the first 24 h after palatoplasty was associated with shorter length of stay (mean of 1.68 vs 2.57 days, t = 2.58, P = .01) and lower total opiate dosage during hospitalization (mean of 2.8 vs 9.16 morphine milligram equivalents, t = 3.37, P = .001).

Conclusions

Among patients undergoing palatoplasty, there is a significant relationship between the early utilization of ketorolac and decreased length of hospitalization as well as decreased opiate requirement. This has important consequences to help improve pain control with reduced opiates requirement as well as length of stay. Future prospective studies can help elicit the causative effect of Ketorolac on these parameters and can investigate whether use of Ketorolac has an effect on long term recovery and post-discharge opiate requirements as well.
Psychosocial Factors Distinguishing Men Who Have Attempted Suicide From Men With Suicidal Ideation and Non-suicidal Men: Findings From a Global Survey
Authors: Bennett Susanna , Robb Kathryn A. , Adán-González Romén , Zortea Tiago C. , O’Connor Rory C.
Published: May 2024

This study addresses our limited understanding of male suicide risk psychology. 2763 men participated in a global survey examining associations between suicidal history and measures of emotions, psychological pain, feelings towards self, and interpersonal connections. Results from multinomial logistic regression analyses indicated that higher levels of loneliness and mental health diagnosis increased the odds of being in the suicidal ideation group compared to controls. A mental health diagnosis and being non-heterosexual increased the odds of being in the suicide attempt group compared to controls. Higher levels of financial strain, mental health diagnosis, being non-heterosexual, having more restrictive attitudes to emotional expression, and lower levels of mattering to others, increased the odds of suicide attempt group membership compared to suicidal ideation.
A retrospective review of rasburicase utilization in pediatric and adult patients across a large health system
Authors: Kamel Anisa , Sanders Melissa , Dyk Hannah , Hamilton Tatum
Published: May 2024

Purpose

This study aimed to characterize rasburicase dosing and duration. Secondary objectives included characterizing the indication of rasburicase and identifying the utilization of prophylactic therapy for tumor lysis syndrome (TLS).

Methods

This retrospective review included patients 0 to 89 years old admitted between 1 January 2021 and 31 December 2021, and received at least one dose of rasburicase. Patients were excluded if they were >89 years old, pregnant, lactating, or received rasburicase outpatient.

Results

A total of 192 patients, 176 adults and 16 pediatric patients were included in the retrospective review. Of the total population, 184 received a fixed dose of rasburicase and 8 patients received a weight-based dose (0.15 mg/kg/dose) of rasburicase. The average dose administered was 3.4 mg for fixed and 2.99 mg for weight-based dosing. Nearly half (49.5%) the patients received rasburicase for an elevated uric acid but did not meet Cairo-Bishop criteria for TLS. Only 42.2% received at least one dose of allopurinol within 5 days prior to rasburicase and 18.8% received aggressive hydration within 72 h prior to rasburicase.

Conclusion

The majority of rasburicase administered was ordered as fixed dose for a uric acid level ≥7.5 mg/dL. Most patients did not meet criteria for laboratory or clinical TLS and less than half the patients received prophylactic allopurinol and/or aggressive hydration. These study results are supported by recent literature for fixed dose rasburicase as a safe and economical dosing strategy compared to weight-based dosing.
Self-Defense Training to Reduce Violence Against Women and Girls: An Integrative Review
Authors: Johnson Ashlyn M. , Cole Britt S.
Published: May 2024

Background:

Violence against women and girls (VAWG) is a serious threat to individual and public health with vast negative impacts, including numerous physical and mental health issues, as well as societal and economic consequences. Numerous women’s self-defense interventions have been proposed to reduce the risk of victimization.

Aims:

The current integrative review, based on Whittemore and Knafl’s framework, was completed to synthesize current evidence on women’s self-defense training, the impact of such training on outcomes related to VAWG, and evaluate the strength of evidence for women’s self-defense training interventions.

Methods:

A systematic literature search, guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, was performed including a comprehensive computer-assisted database search, as well as citation searching and website searching for studies that included quantitative outcomes related to VAGW published between 2011 and 2023. Data were extracted and analyzed in accordance with Whittemore and Knafl’s (2005) methodology, and the body of evidence was synthesized and best evidence recommendations developed based on the ©The Johns Hopkins Hospital/The Johns Hopkins University Evidence-Based Practice Model.

Results:

Ultimately, 19 publications met inclusion criteria and were included in this review. Key findings included strong evidence demonstrating that participants in women’s self defense training reported fewer incidents of attempted rape, completed rape, and nonconsensual sexual contact compared to controls, as well as fewer postraumatic stress disorder (PTSD) symptoms, among other positive outcomes.

Conclusions:

Further research is needed in more diverse populations at risk for violence and to identify key characteristics of effective interventions, including optimal content and dose.
Transnasal Endoscopy Acquires Esophageal Biopsies Adequate for Comprehensive Pathology Evaluation in Patients With Eosinophilic Esophagitis
Authors: Lopez-Nunez Oscar , Bernieh Anas , Kliewer Kara L. , Kemtur Pratibha , Bolton Scott M. , Mukkada Vincent A. , Schablein Ryan , Woods Christopher , Rothenberg Marc E. , Collins Margaret H.
Published: May 2024

Background:

Transnasal endoscopy (TNE) does not require general anesthesia, an attractive characteristic for monitoring eosinophilic esophagitis (EoE). We evaluated the adequacy of TNE-obtained esophageal biopsies using the EoE Histology Scoring System (EoEHSS).

Methods:

The Cincinnati Center for Eosinophilic Disorders database was searched for esophageal biopsies obtained by the same endoscopist, using either TNE or conventional endoscopy (CE). Whole-slide biopsy images were evaluated. The Mann-Whitney test was used for median (interquartile range) values and Fisher exact test for categorical variables. P ≤ .05 was considered significant.

Results:

Median age ( P = .82) or height ( P = .83) did not differ between TNE (n = 17) and CE (n = 17) groups. Although median largest piece size (mm2) differed between the groups (TNE: 0.59 (0.45, 0.86), CE: 2.24 (1.09, 2.82), P < .001), all 8 EoEHSS features were evaluated in each group; only 1 feature (lamina propria fibrosis) was missing in both groups (TNE: 19/34, CE: 11/34, P = .09). The median peak eosinophil count/high-power field differed (TNE: 3 (0, 29), CE: 16 (1, 66), P = .03), but overall grade (TNE: 0.17 (0.10, 0.29), CE: 0.22 (0.14, 0.46), P = .12), stage (TNE: 0.14 (0.10, 0.24), CE: 0.20 (0.10, 0.43), P = .15), and non-eosinophil-related individual EoEHSS scores did not differ.

Conclusions:

TNE- and CE-obtained esophageal biopsies are similarly sufficient for evaluation of key pathological features in EoE.
Triaging and Evaluation of Products of Conception in Abortions and Post-Partum Hemorrhage
Authors: Katzman Philip J. , Hecht Jonathan L
Published: May 2024

The proper evaluation of abortion specimens and placentas from stillbirth and post-partum cases is important for adequate clinical care of post-abortion and post-partum patients. The following topics will be reviewed: (1) the importance of evaluation of both fetal and placental tissue in first trimester abortions to confirm an intrauterine pregnancy versus an ectopic pregnancy; (2) the clinical history associated with an abortion specimen or retained products of conception (POC) influences how the pathologist should triage the specimen; (3) the criteria for diagnosis of a molar pregnancy, which is critical for clinicians to know which patients need follow-up; (4) the utility of genetic studies for both diagnosis and appropriate follow-up of the patient; and (5) the pathologic evaluation of specimens from patients with post-partum hemorrhage for placenta accreta spectrum and subinvolution of maternal vessels.
Punctate Inner Choroidopathy (PIC) disease recurrence with inflammatory choroidal neovascular membrane (iCNVM) post-COVID-19 vaccine
Authors: Scott Daniel Andrew Richard , Niederer Rachael Louise
Published: May 2024

Purpose

To report a recurrence of punctate inner choroidopathy (PIC) with an inflammatory choroidal neovascular membrane (iCNVM) after the Pfizer-BioNTech COVID-19 vaccine.

Methods

Case report.

Results

A 38-year-old female with a history of myopia and previous episodes of PIC and iCNVM presented with distorted vision in her right eye, seven days after receiving the first dose of the Pfizer-BioNTech COVID-19 vaccine. The patient exhibited active PIC lesions with iCNVM confirmed on multimodal imaging. Treatment with a combination of oral corticosteroids and intravitreal anti-VEGF injection led to disease resolution. Subsequent COVID-19 vaccinations, administered while the patient was immunosuppressed, did not lead to disease relapse. However, relapse occurred following the fourth COVID-19 vaccine, when the patient was not immune suppressed.

Conclusion

This case highlights the potential risk of PIC disease relapse following COVID-19 vaccination. Further research is needed to investigate the relationship between COVID-19 vaccination and PIC exacerbation, as well as to determine optimal management strategies in this population, including close observation and consideration of prophylactic immune suppression at the time of COVID-19 vaccine for high-risk individuals.
Ruthenium-106 (106Ru) plaque brachytherapy for treatment of circumscribed choroidal hemangioma
Authors: Bajpai Vidhi , Raval Vishal , Reddy P Vijay Anand , Kaliki Swathi
Published: May 2024

Purpose

To describe the clinical and imaging features of circumscribed choroidal hemangiomas (CCH) and their treatment outcomes with Ruthenium-106 (106Ru) plaque brachytherapy.

Methods

Retrospective study of 24 patients (24 eyes) diagnosed with CCH and treated with 106Ru plaque between 2017 and 2022. Analysis included pre- and post-treatment clinical and imaging features such as tumor regression, reduction in height, subretinal fluid (SRF) resolution, and change in best-corrected visual acuity (BCVA).

Results

The mean age at presentation was 36 years (range, 16–57). The most common tumor location was the temporal quadrant ( n = 19) with macular involvement ( n = 13). Associated features were macular SRF ( n = 22) and inferior exudative retinal detachment ( n = 10). Nineteen of the 24 patients underwent primary treatment, whereas 5 patients underwent plaque as a salvage treatment. The mean tumor apex dose was 40 Gy. At a median follow-up of 7.5 months (range 3–65 months), 18 eyes showed complete regression, whereas 6 eyes showed partial regression. The mean height decreased from 4.8 (SD 1.28) mm at presentation to 2.5 (SD 1.63) mm. Median BCVA improved from logMAR 1.2 (IQR 0.4–2) at baseline to logMAR 1.05 (IQR 0.1–1.95) ( p = 0.4). Complete resolution of the macula and tumor SRF was observed in 15 (68%) and 13 (57%) eyes, respectively. The radiation-related complications observed were radiation maculopathy (4 eyes), retinopathy (1 eye), and vitreous hemorrhage (1 eye).

Conclusion

Ruthenium-106 plaque brachytherapy is effective for CCH (> 3 mm height) as a primary and salvage treatment for tumors unresponsive to other modalities.
The Protection of EGCG Against 6-OHDA-Induced Oxidative Damage by Regulating PPARγ and Nrf2/HO-1 Signaling
Authors: Xu Qi , Chen Yujie , Chen Dan , Reddy Manju B
Published: May 2024

6-Hydroxydopamine (6-OHDA) is a classic neurotoxin that has been widely used in Parkinson’s disease research. 6-OHDA can increase intracellular reactive oxygen species (ROS) and can cause cell damage, which can be attenuated with (-)-Epigallocatechin-3-gallate (EGCG) treatment. However, the mechanism by which EGCG alters the 6-OHDA toxicity remains unclear; In this study, we found 6-OHDA (25 μM) alone increased intracellular ROS concentration in N27 cells, which was attenuated by pretreating with EGCG (100 μM). We evaluated the intracellular oxidative damage by determining the level of thiobarbituric acid reactive substances (TBARS) and protein carbonyl content. 6-OHDA significantly increased TBARS by 82.7% ( P < .05) and protein carbonyl content by 47.8 ( P < .05), compared to the control. Pretreatment of EGCG decreased TBARS and protein carbonyls by 36.4% ( P < .001) and 27.7% ( P < .05), respectively, compared to 6-OHDA alone treatment. Antioxidant effect was tested with E2-related factor 2 (Nrf2), heme oxygenase-1(HO-1) and peroxisome-proliferator activator receptor γ (PPARγ) expression. 6-OHDA increased Nrf2 expression by 69.6% ( P < .001), HO-1 by 173.3% ( P < .001), and PPARγ by 122.7% ( P < .001), compared with untreatment. EGCG pretreatment stabilized these alterations induced by 6-OHDA. Our results suggested that the neurotoxicity of 6-OHDA in N27 cells was associated with ROS pathway, whereas pretreatment of EGCG suppressed the ROS generation and deactivated the Nrf2/HO-1 and PPARγ expression.
Reflecting on the contributions of Professor Tsionas in time series analysis, asset price modelling, and forecasting
Authors: Mamatzakis Emmanuel C
Published: May 2024

While Professor Tsionas is widely acclaimed for his ground-breaking works in Bayesian panel econometrics and frontier analysis models, his substantial impact in time series analysis in finance remains relatively less known. Nonetheless, the doctoral thesis of Professor Tsionas focussed on asset pricing models, serving as a foundation for his subsequent research pursuits in time series analysis and forecasting. Characterised by elegance and simplicity, Professor Tsionas conceptualised econometric models and Bayesian estimation methods that have been applied to fields such as banking, finance, macro-finance, and tourism. In addition, his insights into time series analysis have informed decision-making processes in these fields.
Teachers learning to use student voice in primary physical education – ready, steady, go!
Authors: Ní Chróinín Déirdre , Parker Melissa , Coulter Maura , Sweeney Tony
Published: May 2024

Primary physical education lags behind student voice developments in research and practice internationally ( Gillett-Swan and Baroutsis, 2023 ) and in post-primary physical education ( Howley and O'Sullivan, 2021 ; Iannucci and Parker, 2022a ). Furthermore, evidence is lacking on how to guide primary teachers learning to implement student voice pedagogies in physical education successfully. This research begins to fill this gap by focusing on the research question: What direction can be taken from primary teachers’ experiences of learning to enact student voice in physical education? Insight on what mattered in teachers’ learning to enact student voice can guide how to promote student voice pedagogies as everyday primary physical education pedagogies. Within a professional learning community ( n = 10), nine primary teachers enacted student voice pedagogical strategies over a six-month period. Data sources included recordings of monthly collective meetings with teachers ( n = 7), mid-point ( n = 4) and/or end-point ( n = 6) individual interviews with the teachers, blog posts ( n = 2), conference presentations ( n = 2), and three focus groups with children ( n = 12). Drawing on teachers’ and children's experiences, a roadmap for teachers getting started with enactment of student voice pedagogies is presented with attention to: starting small, starting smart, and not stopping. Teachers valued the outcomes of enactment of student voice pedagogies for the children in their classes in ways that changed their teaching approaches and sustained their commitment to student voice pedagogies. The roadmap presented can be used to support teachers learning how to enact student voice as an everyday pedagogy in primary physical education.