bluuebunny/crossref_metadata_2025 huggingface dataset:
Families’ Experiences With Online Instruction and Behavior Support During COVID-19
Authors: Kelly Elizabeth M. , Harbin Shawna G. , Schwartz Ilene S.
Published: June 2023

In the Spring of 2020, COVID-19 forced school buildings to close across the United States. As a result, many early learning programs and elementary schools moved their services online. Families of young children with challenging behaviors receiving complex educational and behavioral services in traditional brick-and-mortar classrooms were suddenly required to work closely with educators to support their children’s academic, social-emotional, and behavioral progress. This study used a qualitative approach to examine families’ experiences with children’s challenging behavior, online instruction, and behavior support during COVID-19 school building closures. Findings underscore important themes related to families’ perceptions of child challenging behavior at home, challenges with children’s meaningful participation in online instruction, families’ perceived responsibilities and priorities, and future recommendations. Implications for educators are discussed.
Ethics in the Early Intervention System: A Mixed Methods Exploration
Authors: Corr Catherine , Spence Christine M. , Chudzik Mia , Connor Susan , Bentley Brandie , Sawyer Grace , Kern Justin L. , Griffin Rachel , Ruiz Amber Brown , Jackson Ann
Published: June 2023

Early interventionists may frequently encounter ethical dilemmas due to the complex nature of early intervention (EI) service delivery (e.g., EI system infrastructure and building and sustaining collaborative relationships within the system). Therefore, the purpose of this research study was to explore the experiences of EI professionals related to ethical dilemmas. We used a sequential mixed methods design to first survey professionals about their experiences with ethical dilemmas ( n = 427). Then, we interviewed a smaller sample ( n = 45) to learn about early interventionists (EIs) experiences with ethics, including their constructed meanings of ethical dilemmas, the types of ethical dilemmas they have experienced, and their experiences and processes navigating ethical dilemmas. Results show that EI professionals define ethical dilemmas differently, which influences what they view as a dilemma and how they problem solve. Additionally, professionals identified the need for support and guidelines related to ethical dilemmas.
Immunohistochemical evidence of NF-kB activation in canine lymphomas, histiocytic sarcomas, hemangiosarcomas, and mast cell tumors
Authors: Schlein Lisa J. , Thamm Douglas H.
Published: June 2023

Increased or constitutive activation of nuclear factor kappa B (NF-kB) is a feature of many chronic disease processes, including cancer. While NF-kB overactivation has been documented extensively in human oncology, there is a relative paucity of data documenting the same phenomenon in veterinary medicine. To assess NF-kB activity, antibodies to p65 and p100/p52, which are components of NF-kB heterodimers, were first validated for specificity and canine cross-reactivity via Western blot and labeling of immortalized cell pellets. Then, nuclear labeling for these antibodies was assessed via QuPath software in over 200 tumor tissue samples (10 hemangiosarcomas, 94 histiocytic sarcomas, 71 lymphomas, and 28 mast cell tumors) and compared to immunolabeling in appropriate normal tissue counterparts. Greater than 70% of spontaneous canine tumors evaluated in this study had more nuclear p65 and p100/p52 immunoreactivity than was observed in comparable normal cell populations. Specifically, 144/204 (70.58%) of tumors evaluated had positive p65 nuclear labeling and 179/195 (91.79%) had positive p100/p52 nuclear labeling. Surprisingly, greater nuclear p100/p52 reactivity was associated with a longer progression-free survival (PFS) and overall survival (OS) in canine lymphomas. These results provide support and preliminary data to investigate the role of NF-kB signaling in different types of canine cancer.
Supply of opioids and information provided to patients after surgery in an Australian hospital: A cross-sectional study
Authors: Fong Ian SH , Yiu Chin Hang , Abelev Matthew D , Allaf Sara , Begley David A , Bugeja Bernadette A , Khor Kok Eng , Rimington Joanne , Penm Jonathan
Published: June 2023

Opioids are commonly prescribed to manage pain after surgery. However, excessive supply on discharge can increase patients’ risk of persistent opioid use and contribute to the reservoir of unused opioids in the community that may be misused. This study aimed to evaluate the use of opioids in Australian surgical patients after discharge and patient satisfaction with the provision of opioid information after discharge. This prospective cohort study was conducted at a tertiary referral and teaching hospital. Surgical patients were called 7–28 days after discharge to identify their opioid use and the information that they received after discharge. In total, 66 patients responded. Most patients underwent orthopaedic surgery (45.5%; 30/66). The median days of opioids supplied on discharge was 5 (IQR 3–5). In total, 40.9% (27/66) of patients had >50% of their opioids remaining. Patients undergoing orthopaedic surgery were less likely to have >50% of their opioids remaining ( P = 0.045), whilst patients undergoing urological or renal surgeries were significantly more likely ( P = 0.009). Most patients recalled receiving information about their opioids (89.4%; 59/66). However, the majority (51.5%; 34/66) did not recall receiving any information about the signs of opioid toxicity and interactions between opioids and alcohol. In conclusion, around 40% of patients had more than half of their opioid supply remaining after they ceased taking their opioid. Although most patients recalled receiving information about their opioids, more than half did not recall receiving any information about the signs of opioid toxicity or interactions between opioids and alcohol.
Driving Style Classification and the Effectiveness of Advanced Driving Assistance Systems: Differences between Teen and Adult Drivers
Authors: Ammar Dania , Li Meitang , Yu Bo , Guo Huizhong , Lin Brian , Kusari Arpan , Pulver Elizabeth , Bao Shan
Published: June 2023

Advanced driving assistance systems (ADAS) are designed to reduce potential crash risks and enhance driving safety. However, drivers’ interactions with ADAS may vary depending on their individual driving styles and characteristics. This study proposes a novel approach to classifying driving styles and explores how age and gender affect interactions with ADAS. The study utilized two naturalistic driving data sets comprising 148 drivers from four age groups: teens; younger adults; middle-aged adults; and older adults. Data were collected during two periods: baseline (without ADAS); and treatment (with ADAS). First, the K-means clustering algorithm was employed to divide trips into one conservative and two aggressive groups based on three driving behavior metrics: tailgating; speeding; and lane-changing. The aggressive-trip ratios were then calculated for each driver during each of the two periods. The Bayesian Gaussian mixture model was applied to determine the threshold values of the aggressive-trip ratios to classify drivers as conservative, moderate, or aggressive during each period. This allowed for identifying changes in driving style upon the activation of ADAS. The subsequent multinomial logistic regression model results showed that driving styles vary across age groups, with teens being the most aggressive drivers. Certain changes in driving style were observed, with some conservative drivers becoming aggressive or moderate and some aggressive drivers becoming conservative or moderate, but these differences were statistically non-significant. The findings of this study indicate that warning-based ADAS may not elicit significant changes in driving style, particularly among teenage drivers who are consistently the most aggressive drivers.
Transit Agency Assessment of Their Capability to Adopt New Mobility Strategies
Authors: Nastasi Sarah , Brakewood Candace , Hunter Michael , Watkins Kari
Published: June 2023

This research identified current challenges, constraints and interest in the implementation and management of new mobility services (on-demand and micromobility) for United States transit agencies. Twenty-four semi-structured interviews with employees of transit agencies were conducted, and NVivo, a qualitative analysis software, was used to classify agency involvement, constraints, and challenges with services. The most common constraints and challenges for on-demand services (cited by more than five agencies) were labor shortages, software performance, fare integration, vehicle shortages, and funding. For agencies not offering on-demand services, developing strong backbone networks with fixed-routes was a priority, and cost-effectiveness, service area design, and funding were additional concerns. The top constraints and challenges among transit agencies with respect to micromobility (cited by more than four agencies) included fare integration, obstruction of public space, funding, adequate supporting infrastructure, and development of equitable service. For integrating new mobility services, most transit agencies (14 of 20, 70%) expressed interest in becoming mobility managers, but larger agencies (those with more than 10 million unlinked passenger trips) were split between mobility manager and partner roles. This research suggests that transit agencies have evolved in the new mobility space, but some constraints and challenges still stand in their way. Policy makers and decision makers can help transit agencies by encouraging open-source software development, improving labor contracts, increasing funding opportunities, and coordinating land-use, transportation, and transit planning. Future research should continue investigating barriers to entry for new mobility services and identify how transit agencies can increase coordination with technology and micromobility companies.
Complement system in Anti-CD20 mAb therapy for cancer: A mini-review
Authors: Gao Yiwen
Published: June 2023

The complement system is an important part of innate immunity. Through complement-dependent cytotoxicity (CDC), it plays an important role in the clearance of invading pathogens but also cancerous host cells. Therapy with anti-CD20 monoclonal antibodies (mAbs), for example, rituximab and ofatumumab, is a well-established treatment for lymphoid malignancies, and CDC is one of the main mechanisms underlying their anti-cancer activity. However, there are still some issues with the clinical application of anti-CD20 antibodies. On the one hand, anti-CD20 can cause some clinical side effects; on the other hand, anti-CD20 has low potency in some patients, and increasing the dosage does not enhance its effectiveness in these patients. Previous studies have reported that a gain-of-function in a certain complement component can boost the cytolytic activity of anti-CD20 mAbs. Through reviewing the literature on complement system control and anti-CD20 mAbs, this article aims to provide a thorough understanding of the potential of targeting complement components in lymphoma therapy.
Predictors of Physician Follow-Up Care Among Patients Affected by an Incident Mental Disorder Episode in Quebec (Canada): Prédicteurs des soins du suivi médical des patients affectés par un épisode incident de troubles mentaux au Québec (Canada)
Authors: Fleury Marie-Josée , Rochette Louis , Gentil Lia , Grenier Guy , Lesage Alain
Published: June 2023

Objectives

This study identified predictors of prompt (1+ outpatient physician consultations/within 30 days), adequate (3+/90 days) and continuous (5+/365 days) follow-up care from general practitioners (GPs) or psychiatrists among patients with an incident mental disorder (MD) episode.

Methods

Study data were extracted from the Quebec Integrated Chronic Disease Surveillance System (QICDSS), which covers 98% of the population eligible for health-care services under the Quebec (Canada) Health Insurance Plan. This observational epidemiological study investigating the QICDSS from 1 April 1997 to 31 March 2020, is based on a 23-year patient cohort including 12+ years old patients with an incident MD episode ( n = 2,670,133). Risk ratios were calculated using Robust Poisson regressions to measure patient sociodemographic and clinical characteristics, and prior service use, which predicted patients being more or less likely to receive prompt, adequate, or continuous follow-up care after their last incident MD episode, controlling for previous MD episodes, co-occurring disorders, and years of entry into the cohort.

Results

A minority of patients, and fewer over time, received physician follow-up care after an incident MD episode. Women; patients aged 18-64; with depressive or bipolar disorders, co-occurring MDs–substance-related disorders (SRDs) or physical illnesses; those receiving previous GP follow-up care, especially in family medicine groups; patients with higher prior continuity of GP care; and previous high users of emergency departments were more likely to receive follow-up care. Patients living outside the Montreal metropolitan area; those without prior MDs; patients with anxiety, attention deficit hyperactivity, personality, schizophrenia and other psychotic disorders, or SRDs were less likely to receive follow-up care.

Conclusion

This study shows that vulnerable patients with complex clinical characteristics and those with better previous GP care were more likely to receive prompt, adequate or continuous follow-up care after an incident MD episode. Overall, physician follow-up care should be greatly improved.
Multi-Tiered System of Supports—Interventionist Beliefs Scale: Development and Initial Validation With School Counselors
Authors: Edwin Mary , Bahr Michael W.
Published: June 2023

This article describes the development of the Multi-Tiered System of Supports-Interventionist Beliefs Scale (MTSS-IBS). The introduction reviews the importance between practitioner beliefs and MTSS success. Because there is no measure to assess the MTSS beliefs of school interventionists for the success of all students, we used a principal component analysis and a parallel analysis on MTSS-IBS responses from 379 school counselors who worked as MTSS interventionists. These analyses indicated a four-component structure, and subsequent internal consistency and construct validity analyses provided initial evidence of MTSS-IBS psychometric adequacy. We discuss applications of the MTSS-IBS in research and practice for enhancing MTSS implementation.
Impact of Simulated Rotating Shift Work on Mammary Tumor Development in the p53R270H©/+WAPCre Mouse Model for Breast Cancer
Authors: Streng Astrid A. , Van Dycke Kirsten C. G. , van Oostrom Conny T. M. , Salvatori Daniela C. F. , Hulsegge Gerben , Chaves Inês , Roenneberg Till , Zander Serge A. L. , van Steeg Harry , van der Horst Gijsbertus T. J. , van Kerkhof Linda W. M.
Published: June 2023

Epidemiological studies associate night shift work with increased breast cancer risk. However, the underlying mechanisms are not clearly understood. To better understand these mechanisms, animal models that mimic the human situation of different aspects of shift work are needed. In this study, we used “timed sleep restriction” (TSR) cages to simulate clockwise and counterclockwise rotating shift work schedules and investigated predicted sleep patterns and mammary tumor development in breast tumor–prone female p53R270H©/+ WAPCre mice. We show that TSR cages are effective in disturbing normal activity and estimated sleep patterns. Although circadian rhythms were not shifted, we observed effects of the rotating schedules on sleep timing and sleep duration. Sleep loss during a simulated shift was partly compensated after the shift and also partly during the free days. No effects were observed on body weight gain and latency time of breast cancer development. In summary, our study shows that the TSR cages can be used to model shift work in mice and affect patterns of activity and sleep. The effect of disturbing sleep patterns on carcinogenesis needs to be further investigated.
Barriers and enablers to implementing environmentally sustainable practices in healthcare: A scoping review and proposed roadmap
Authors: Aboueid Stephanie , Beyene Menilek , Nur Teeyaa
Published: June 2023

This scoping review sought to identify the barriers and enablers to implementing environmentally sustainable practices in healthcare, as well as propose a multi-phased approach to enable such implementation. The three concepts guiding the search were (1) environmental sustainability; (2) healthcare; and (3) barriers or enablers. The PRISMA checklist for scoping reviews was used to guide this search. A total of 16 articles were included and reviewed for data extraction. While most articles focused on healthcare in general, dentistry and surgery were the most recurring clinical areas of focus. Barriers and enablers were related to the individual (e.g. knowledge, skills, and attitude), institutional (e.g. budget, strategy, and readiness), geographical/infrastructural (e.g. infrastructure and public awareness), political (e.g. regulations and incentives), and other (e.g. patient awareness and knowledge). A key enabler identified was having transformational leadership with a clear vision and collaborative approach.
Sisterhood at a Distance: Doing Feminist Support Work Online
Authors: Bäckström Olofsson Hanna , Goicolea Isabel
Published: June 2023

The aim of this study is to analyze the characteristics of feminist peer support in the context of online chat counseling. Based on 15 interviews with female lay supporters associated with a branch of the Swedish women's shelter movement targeting young women, we explore how the digital setting—characterized by distance and anonymity—affects the meaning and doing of feminist support. Our results show that core principles of feminist support—striving for equality and trust, the crafting of safe spaces, and sharing experiences—are all renegotiated and/or accentuated by the digital setting. The chat is experienced as enabling a more equal relationship and a high level of safety. The meaning of safety has largely shifted, however, from being associated with a feminist community to safety associated with solitude and distance. We further show a tension in the respondents’ understanding of shared experiences, stressing both the importance of situated knowledges and the value of not knowing who is seeking or offering support. By combining research and material on feminist support and online youth counseling, the article offers novel perspectives on feminist counseling and social work, the power dimensions of online counseling, and the virtual space as an arena for feminist activism.
Effect of natural fillers as reinforcements on mechanical and thermal properties of HDPE composites
Authors: Balaji Ayyanar C , Pradeep Mohan SK , Ramesh M , Rajeshkumar L , Marimuthu K , Sanjay MR , Siengchin Suchart
Published: June 2023

Demand for natural fibers has increased in recent years due to the requirement for biodegradable materials. Owing to the increasing awareness on the overuse and over-dumping of plastics in the environment, the current work focused on a solution by using tree leaves as a particulate reinforcement which is one of the common waste products of trees. In this regard, Norfolk pine (NOP) tree leaf particulates filled High-Density Polyethylene (HDPE) composites were fabricated through injection moulding technique with different filler weight % of 0, 10, 20, 30, 40, and 50 wt. %. The study of the crystalline structure of the fillers and the detection of functional compounds in the materials were carried out through X-ray diffraction (XRD) and Energy dispersive X-ray spectroscopic (EDX) analysis. Tensile strength, compressive strength, and flexural strength of the fabricated composite specimens were also assessed. Results revealed that the mechanical properties of the 30 wt. % pine tree leaf-filled HDPE composites were found to be superior when compared to pure HDPE composites. The failure surface morphology of the composite samples was examined using scanning electron microscopy (SEM). The melting point and decomposition of 30 wt. % NOP leaf particulate-filled HDPE composites specimen, whose mechanical properties were higher, were examined using thermo-gravimetric analysis (TGA) and differential scanning calorimetry (DSC). From the results, it was found that NOP fillers can be used as an effective reinforcement in polymer composites.
A Mindfulness-Based Intervention for Acute Care Nursing Staff: A Pilot Study
Authors: Brouwer Kent R. , Melander Sheila , Walmsley Lee Anne , Norton James , Okoli Chizimuzo
Published: June 2023

Purpose:The purpose of this study was to determine if a mindfulness-based smartphone application, used for 5 minutes a day for 30 days, could address burnout among acute care nursing staff. Methods: A pretest–posttest design with a midpoint evaluation was utilized. The sample included 31 nursing staff from cardiovascular acute care units. The Copenhagen Burnout Inventory, Cognitive and Affective Mindfulness Scale-Revised, Perceived Stress Scale, and Brief Resilience Scale were used to measure the impact of the intervention on participants. Findings: In a repeated measures analysis, there were no statistically significant changes in scores on the Brief Resilience Scale across the three timeframes ( F = 0.64, df = 1.42, p = .49). There were significant reductions over time for perceived stress ( F = 10.56, df = 1.74, p = .002) and personal burnout ( F = 11.8, df = 1.10, p = .007), and increased scores on mindfulness ( F = 4.76, df = 1.57, p = .039). Conclusions: The utilization of a mindfulness-based smartphone application may promote the health and well-being of cardiovascular nurses in acute care units. Mindfulness-based smartphone apps should be considered as a method of self-care, along with other holistic approaches to improve well-being.
Design and experiment of a type hole wheel garlic seed metering device
Authors: Li Yi , Wang Chensi , Wang Tingwei , Rong Linrui , Zhang Jiao , Cao Yazhou , Wang Changlin , Song Wenyuan , Zhu Lin , Guo Huiping
Published: June 2023

Aiming at the problems of low single-seed rate, high rate of missing seeds, high rate of multiple seeds, and low rate of upright seeds in the mechanized sowing of garlic seeds, this paper proposes a structural design scheme of a type hole wheel garlic seed metering device based on the characteristics of garlic species. Based on the agronomic requirements of garlic planting and the characteristics of garlic species, the mechanism of the hole wheel structure to improve the seed filling performance of the seed metering device was clarified, a structural parameter design of the key components of the device was established through theoretical calculations, and a single-factor simulation test was conducted using the Engineering Discrete Element Modelling (EDEM) software. Using the Design-Expert 11 data analysis software, a mathematical regression model of each test factor and test index was established, and the test factors were analyzed. The parameters were optimized, and the following was found to be the optimum parameter combination: seeding wheel speed of 30 rpm, profile hole depth of 18 mm, and adjustment length of the profile hole of 41 mm. The EDEM simulation test results showed a single-seed rate of 91.67% and a missing seed rate of 4.17%. The bench test results showed a single-seed rate of 89.2%, a missing seed rate of 5.0%, and a multiple seed rate of 5.8%. The field test results showed a single-seed rate of 88.44%, a multiple seed rate of 4.11%, a missing seed rate of 7.44%, a breakage rate of 1.11%, and an upright rate of 62.36%. The errors between the bench test/field test and the discrete element simulation test results were 2.7% and 3.5%, respectively, which were consistent with the simulation results, thus meeting the requirements of single-seed sowing using the garlic seed metering device.
Dynamic path-speed planning algorithm for autonomous driving on structured roads
Authors: Fang Liu , Xiaowen Zhao , Weixing Su , Yonggang Wen
Published: June 2023

Aiming at the problem of local path planning for structured roads, this paper proposes a framework of local path-speed planning for autonomous driving, which takes safety as the premise and improves driving efficiency. The framework simulates human driving thinking and divides the local path planning of autonomous driving into two parts: lane decision and path-speed planning. In the part of the lane decision, a lane decision algorithm based on driving risk field and safe distance is proposed, which can ensure driving efficient and ensure that the planning vehicle is always in a low-risk driving environment. In the part of the lane change path-speed planning, a candidate path generation algorithm based on uniform sampling of lane change time and a cost function considering lane change timeliness, driving safety, speed smoothness, and path continuity are proposed to achieve optimal path selection and speed planning. In the experiment part, there are six different driving tasks. In six scenes, the local path-speed planning framework proposed in this paper can plan a safe, efficient, and smooth driving path and a safe planning speed. Taking the scenario of detouring low-speed obstacles as an example, the path-speed planning algorithm proposed is compared with the path-speed planning algorithm based on discrete optimization in Hu et al. It has been verified that the algorithm proposed can ensure that planner is always at low environmental risks and drive with high driving efficiency.
Wonder and loss in Céline Sciamma's Petite maman
Authors: Lachman Kathryn M
Published: June 2023

This article reads Céline Sciamma's 2021 film Petite maman in relation to the widespread isolation and loss experienced during the Covid-19 pandemic. The film offers a poignant meditation on the mother–child relationship and the vital role of wonder and imagination in mourning. Drawing on Descartes and feminist philosophers Luce Irigary and Catherine Malabou, this article seeks to understand why wonder is so critical to empathy and presence. It then traces the ways in which Sciamma introduces wonder into the film: through the circulation of stories and objects, through a heightened diegetic use of sound that draws the spectator in, through references to fairy tales, through an elastic approach to time and a blurring of spatial and generic boundaries, through the positioning of the camera at the child's eye level, through an astonishing series of doubles and mirrors that provoke curiosity rather than fear, and through a queering of the characters’ relations to one another and to their surroundings. Ultimately, Sciamma's Petite maman explores the creative and reparative potential of wonder in forging more expansive, fluid notions of self, opening up new intergenerational connections among women, and coming to terms with the loss.
The Changing Natures of the Medical Register: Doctors, Precarity, and Crisis
Authors: Jacob Marie-Andrée , Saksena Priyasha
Published: June 2023

This article interrogates the relationship between registration, the professions, and modern crises, using the Medical Register as an illustration. We start by surveying briefly the history of the regulation of health workers in the United Kingdom to contextualise the mechanisms of registers and registration. Under the initial model of registration, one could be in or out of the ‘principal list’, and various routes enabled health practitioners to obtain full registration and its ensuing privileges. That model still influences ordinary understandings of registration, but the paper identifies other categories of registration emerging in the middle of the 20th century, starting with the international crisis of the Second World War and up until the recent coronavirus pandemic. Drawing on historical and contemporary work, we show that there are multiple ways one can be on the Register, with some more precarious than others. In turn, we debunk the idea of the Register as a document immune from political choices and instead shed light on the details of its intimate engagement with modern forms of governance.
The Roles of Nurses as Marketers: A Literature Review
Authors: Amiri Nabeel Al , Ali Manal
Published: June 2023

Marketing is an important branch of management in every business. It manages the exchange relationships between buyers and sellers. In the healthcare industry, exchange relationships involve various stakeholders, including marketers, healthcare providers, patients, and others. The study aims to figure out the role of nurses, who form the largest segment of the workers in healthcare organisations, in marketing for their profession, services, and organisations, and identify the impact of their marketing role on their profession and organisational performance. Besides, the study aims to come up with a model that displays the findings, including the relationships between nurse’s roles in marketing and its influence on organisational performance. To achieve these goals, the authors adopted the literature review research method to summarise the findings of published articles in academic journals. The study has revealed that nurses should consider building their image and improving healthcare services using a well-structured marketing plan. Furthermore, the study suggested a model that links building a positive professional image and enhancing the healthcare services by nurses to improve their organisational performance moderated by internal marketing of the organisation towards nurses.
Can Job Insecurity Promote Organizational Citizenship Behaviour? Hotel Employees’ Coping Mechanism to COVID-19
Authors: Srivastava Shalini , Madan Poornima , Mohapatra Mamta , Vishnani Sushma
Published: June 2023

The study assessed the association between job insecurity (JI) and organizational citizenship behaviour (OCB) of hotel employees during COVID-19. Furthermore, this study analysed the impact of Organizational identification (OI) and affective commitment (AC) as serial mediators between JI and OCB relationship. A three-wave survey was conducted on a sample of 524 employees of 14 hotels in India. The study used structural equation modelling and PROCESS ( Hayes, 2013 ) Model 6 for testing a few hypotheses. This study found a significant association between JI and OCB of the hotel employees during COVID-19, with OI and AC as serial mediators. The present study’s noteworthy contribution lies in using the job preservation motivation framework to investigate the associations among JI, OCB, OI and AC, which have mostly been unmapped particularly in the hotel sector in India.
Designing Demand Driven Price Sensitive Supply Chain Model for Indian Farmers
Authors: Tripathi Prateek Kumar , Singh Chandra Kant , Patel Shubhi , Singh Rakesh , Deshmukh Arun Kumar
Published: June 2023

Small and marginal farmers (SMFs) in developing countries, perennially struggle with low marketable surplus, inadequate storage facilities, poor market access and logistical constraints that in turn leave them with distressed sales of their produce to exploitative middlemen in the agricultural supply chain. Addressing such pressing concerns, the present study aims at proposing a market-facilitating demand-centric agricultural supply chain model where the income of the farmers is directly linked with risk-adjusted actual market movement. The price-sensitive model, being a facilitator for direct marketing, makes farm produce marketable by designing a cost-effective and scientifically managed shared warehouse, and minimizing market volatility risk through diversification among a group of contributing farmers. Empirical validation of this simulation-based modelling was tested on three essential year-round food staples – Tomato, Onion and Potato (TOP) – against the prevailing market settings. Interestingly, instead of immediately selling agricultural produce to market intermediaries due to a lack of storage options, if farmers shared the associated storage cost among themselves and distributed the market returns by proportionate crop sales to fulfil the demand, they could not only realize better returns during the season but also could turn off-season market unpredictability into their favour. The model is focused on enhancing SMFs’ income in the emerging economy context, and its empirical approach for risk minimization strategy is indeed proposed for the first time in the available literature. The finding, demonstrably, substantiates that the policy implication of the proposed model for SMFs in the fruits and vegetables (F&V) segment could improve market access and derive fair returns.
Groundwater Markets in South Asia: A Bibliometric Assessment of Challenges and Opportunities for Sustainable Irrigation Development
Authors: Parakh Dishant , Chaudhuri Sriroop
Published: June 2023

Uninhibited drafting and plummeting groundwater levels have entailed a slew of eco-environmental and socio-economic crises across vast swathes of South Asia, leading to social turmoil over the demand-supply gap in the irrigation sector. We adopted a mixed-method approach, combining systematic bibliometric assessment with contextual analysis, to highlight to the regional water authorities (RWAs) the core tenets of groundwater markets (GWMs), already operating in various capacities and forms in different parts of South Asia, as a potential option to address the crisis. GWMs, occurring along a farmer-water-irrigation continuum, have mixed impacts on groundwater-dependent socio-ecologies, ranging from beneficial to counter-productive. Given the dire projections of groundwater depletion in the near future and the inadequacy of the state machineries to meet surging irrigation demand, a critical policy question that we approached in this narrative was: Can GWMs be institutionalized as a regulatory tool for ‘supply-side’ management of irrigation resources? To that end, we helped RWAs grow a deeper understanding of the complexity and interdisciplinarity associated with the vast network of actors and agencies interlocked within GWMs. By the same token, we urged the RWAs to consider a collective space—potentially in the form of a groundwater users’ association (GWUA)—as a prerequisite to imagining GWMs in an institutional mould. We present a critique of current world experiences with GWUAs and reflect on the socio-environmental barriers to establishing a functional GWUA. We outline tentative means for RWAs to build credibility and increase acceptability of GUWAs at the grassroots, including capacity building, value-based standard operating procedures and harnessing solidarity and social responsibility. In conclusion, we offer RWAs a simple system of a ‘reality’ check, to evaluate the ground conditions and feasibility of contemplating GWMs in the first place.
Creating International Student Experiences Through Academic–INGO Partnerships
Authors: Steppe Johnathan D. , Thompson Jon , Blake Barbara J.
Published: June 2023

Introduction:

Short-term experiences in global health (STEGH) provide nursing students with opportunities to develop global health competencies through immersion in another culture. Skills that students obtain by participating in STEGHs can inform future practice with diverse patient populations. However, educators encounter unique challenges to the quality and sustainability of STEGHs.

Methods:

This article describes an academic partnership between a baccalaureate nursing program and a community-based international nongovernmental organization (INGO), how the partnership informed development of STEGH for nursing students, the benefits of the program for students and community, and the lessons learned through the process.

Results:

Academic–INGO partnerships provide unique benefits for creating sustainable, rigorous STEGHs that are informed and guided by the needs of the hosting community.

Discussion:

By partnering with community-based INGOs, faculty can design STEGHs that offer robust learning opportunities that facilitate the development of global health competencies while providing thoughtful, sustainable outreach for communities.
Transition Tasks: Individualized Education Program Involvement for Students With Emotional and Behavioral Disorders
Authors: Tuttle Prince Angela
Published: June 2023

A transition-age youth with an Individualized Education Program (IEP) has the right to a free, appropriate public education that includes postsecondary transition planning and services. Because students with emotional-behavioral disorders (EBD) experience adverse outcomes during and after high school, they may benefit from a transition-focused IEP. With the support of multiple practitioners, these students can be more involved in their education program. This article demonstrates how to use transition tasks to promote a student with EBD’s involvement in their IEP in four areas: assessment tasks, evaluation tasks, IEP meeting preparation, and IEP meeting participation.
Cleft Lip and/or Palate: Children's Experiences of Stigma in Colombia
Authors: Arias-Urueña Liliana , Chandler Amy , Harden Jeni
Published: June 2023

Objective

Given prior craniofacial research reporting higher risk for negative social interactions, this study aimed to explore experiences of stigma described by children with cleft lip and/or palate (CL/P).

Design

Qualitative interviews were conducted with children in three sessions (totaling 90–180 min) using creative activities in their homes and/or and walking interviews in their neighborhood. Interview transcriptions were interpreted primarily with thematic analysis following theoretical frameworks of the stigmatization process and self-stigma concept.

Setting

Participants were recruited through Operation Smile Colombia. Interviews took place at children's homes and neighborhoods within three Colombian regions (Boyacá, Bogotá and Cundinamarca).

Participants

Children (N = 12) with CL/P aged between 6–12 years were interviewed.

Results

Themes fit within the stigmatization process, starting with labeling and stereotyping, such as a range of mockery, and group separation by peers highlighting their not belonging and being socially ‘other’. Status loss themes included negative appraisals of cleft-related differences and being perceived as ‘ill’ and ‘imperfect’. Social exclusion themes reflected limited social interactions and loneliness. Self-stigma themes included shame about speaking with peers and anticipation of negative social interactions.

Conclusions

The study results suggest that the process of stigmatization and self-stigma adversely affect social interactions for children with a cleft in multiple ways. Healthcare practitioners and policy makers can help address the potential consequences of stigma by implementing interventions at micro, meso and macro levels.
Reliability and Validity of the CLEFT-Q in a Chinese Context
Authors: Ding Yuzhe , Kuang Wenying , Zhang Xinyu , Zhang Wenjuan , Xu Jingyi , Yan Jianan , Guo Yanyu , Zheng Jie , Yuan Wenjun
Published: June 2023

Objective

To develop an appropriate Chinese version of the CLEFT-Q through translation and cultural adaptation and to evaluate its reliability and validity.

Design

The English CLEFT-Q was translated into Chinese following the International Society for Pharmacoeconomics and Outcomes Research guidelines, including cognitive debriefing interviews, and its reliability and validity were assessed.

Participants

Patients (N = 246) were mostly in active orthodontic treatment, had a mean age of 14.7 ± 4.4 years, 29% were female, and were born with isolated cleft lip ± alveolus (12%), cleft palate (1%), or cleft lip and palate (87%).

Main Outcome Measures

The Chinese CLEFT-Q, including 13 subscales covering Appearance, Health-Related Quality of Life (HRQOL), and Facial Function. Criterion validity instruments included the Negative Physical Self, Satisfaction with Life Scale, and Scale of Positive and Negative Experience.

Results

The wording of 67 items was adapted in the final translation. The internal consistency of the Chinese version of the CLEFT-Q was high based on Cronbach's alphas of 0.85 to 0.98 and split-half reliability of 0.85 to 0.92. Exploratory and confirmatory factor analyses yielded three factors, which demonstrated construct validity by broadly matching the structure of the original CLEFT-Q. The Appearance and HRQOL dimensions had weak to moderate correlations (r = −0.35 to 0.67) with the corresponding instruments for criterion validity.

Conclusions

The Chinese version of the CLEFT-Q is a patient-reported outcome measure that can reflect the quality of life of Chinese patients with cleft lip and/or palate with good reliability and validity.
Change in Lower Lip Position After Le Fort I Advancement in Patients with Bilateral vs. Unilateral Cleft Lip and Palate
Authors: Schechter Jill , Alcon Andre , Verzella Alexandra , Shetye Pradip , Flores Roberto
Published: June 2023

To compare lower lip changes after Le Fort I advancement surgery in patients with a cleft.

Single institution, retrospective review.

Academic tertiary referral hospital.

Skeletally mature patients with a cleft who underwent one-piece Le Fort I advancement surgery who had a lateral cephalogram or cone-beam computed tomography (CBCT) scan preoperatively and at least 6 months postoperatively. Patients who underwent concomitant mandibular surgery or genioplasty were excluded. 64 patients were included: 45 male and 19 female, 25 with BCLP and 39 with UCLP. The mean age at surgery was 18.4 years.

Single jaw one-piece Le Fort I advancement surgery.

Standard lateral cephalometric landmarks of the bony skeleton and soft tissue were compared before and after Le Fort I advancement. Pearson correlation coefficients (r) were calculated to measure the correlation between lower lip position and other soft and hard tissue changes.

After comparable maxillary advancements [BCLP: 7.2 mm (95% CI: 6.2-8.3 mm), UCLP: 6.4 mm (95% CI: 5.7-7.0 mm)] the horizontal upper-to-lower lip discrepancy significantly improved in both groups. The lower lip became thinner and more posteriorly positioned. Changes in lower lip position correlated strongly with mandibular bony landmarks and moderately with upper lip position, but poorly with maxillary landmarks.

Le Fort I advancement results in posterior displacement of the lower lip and better lip competence, thereby improving facial harmony. This lower lip change is not predictable by degree of maxillary advancement, and does not differ in patients with BCLP vs. UCLP.
‘Running Towards the Bullets’: Moral Injury in Critical Care Nursing in the COVID-19 Pandemic
Authors: Griffin Martyn , Hamilton Peter , Harness Oonagh , Credland Nicki , McMurray Robert
Published: June 2023

The COVID-19 pandemic placed unprecedented strain on healthcare professionals around the globe, particularly those working in intensive care units. It was reported that instances of moral injury – a betrayal of what is ethically right by those in positions of power – were widespread in these organizational settings. In this paper, we explore these emerging findings to ask: What are the experiences and implications of moral injury in critical care nursing during the pandemic? Drawing on 103 interviews with 54 critical care nurses, we offer insights into the experience of moral injury in a workplace experiencing crisis, focusing on (i) unsafe staffing levels, (ii) inadequate equipment, and (iii) inability to provide patients with a dignified death. We provide accounts of the implications of moral injury ranging from debilitating anxiety to post-traumatic stress disorder and sectioning, as well as widespread feelings of anger and guilt leading to an intention to leave the profession.
Concordance of MTOR Pathway Mutations and the Diagnosis of Renal Low-Grade Oncocytic Tumor (LOT)
Authors: Siegmund Stephanie E. , Al-Obaidy Khaleel I. , Tsai Harrison K. , Idrees Muhammad T. , Akgul Mahmut , Acosta Andres M. , Hirsch Michelle S.
Published: June 2023

The differential diagnosis for oncocytic renal tumors spans the spectrum from benign entities to more aggressive renal cell carcinomas (RCC). Recent work has characterized a provisional renal oncocytic neoplasm, namely the low-grade oncocytic tumor (LOT), which demonstrates overlapping morphologic features with oncocytoma and chromophobe RCC, but also has a unique immunoprofile (ie, diffusely positive for KRT7, negative for KIT) and a high rate (80% to 100%) of mTOR pathway gene alterations. Given the diagnostic overlap among oncocytic tumors, we looked for concordance between mTOR pathway mutations and LOT. Thirty low-grade renal oncocytic neoplasms underwent histologic review and immunohistochemistry for KRT7 and KIT. Tumors were classified as “determinate” (eg, LOT) for tumors with solid, nested or vaguely tubular growth and diffuse KRT7 staining and negative KIT, or “indeterminate” if the morphology and/or immunostains did not fully support a definitive LOT diagnosis. Next-generation sequencing was performed without any knowledge of the diagnoses, and identified mTOR pathway mutations in 80% (12/15) of the determinate tumors, compared with 7% (1/15) in the indeterminate group. One determinate tumor was reclassified as papillary RCC ( MTOR mutation negative) and 6 indeterminate tumors were confirmed to be oncocytoma (N = 4), clear cell RCC or papillary RCC with reverse polarity, respectively. Overall, integration of morphology, immunohistochemistry, and molecular data enabled a final definitive diagnosis for 70% of tumors (21 of the total 30), with a high concordance (93%) for LOT specifically in the determinate group; the remaining 9 tumors (30%) were classified as renal oncocytic neoplasm, not otherwise specified.
Comparing the effectiveness of biosimilar filgrastim (Nivestim®) versus original filgrastim (Neupogen®) for stem cell mobilization in adult and pediatric healthy donors
Authors: Muffarrej Duaa , Hashem Hasan , Tbakhi Abdelghani , Najjar Rula
Published: June 2023

Introduction

Filgrastim is used for the mobilization of stem cells in healthy donors. Though several biosimilar filgrastim products have been approved, there is limited literature evaluating biosimilar products for stem cell mobilization. Therefore, we conducted this study to compare the effectiveness of the original filgrastim, Neupogen®, to the biosimilar product, Nivestim®, for stem cell mobilization(SCM) in healthy donors.

Methods

This was a retrospective study that included all healthy donors: adults and pediatrics, who received Neupogen® or Nivestim® for stem cell mobilization between 2014 and 2016 at a comprehensive cancer center. Donors received filgrastim at a dose of 5 mcg/kg every 12 h for 4 days to achieve the target CD34  +  cell count of 5–10 × 106 CD34 + /kg of recipient body weight. Additional doses of filgrastim were administered and/or the dose increased if target CD34  +  was not achieved. The primary endpoint was the number of doses required to achieve the target CD34  +  cell count.

Results

Over the study period, 89 donors received Neupogen® and 68 received Nivestim®. The median age of donors was 19.5 years (3–64) in the Nivestim® group and 15 years (2–16) in the Neupogen® group. The median number of doses required for SCM was eight doses (6–10) in the Nivestim group and eight (6–16) in the Neupogen® group.

Conclusion

Biosimilar Nivestim® was as effective as the original, Neupogen®, for stem cell mobilization for healthy adult and pediatric donors. Larger randomized studies are necessary to evaluate the safety and transplant outcomes of the use of Nivestim®.