bluuebunny/crossref_metadata_2025 huggingface dataset:
Backstepping sliding mode control for an active hydraulically interconnected suspension
Authors: Chen Tong , Zheng Minyi , Zhang Nong , Luo Liang , Liu Pengfei , Guo Yaohua
Published: March 2023

This paper presents a backstepping sliding mode control (BSMC) method for an active anti-roll hydraulically interconnected suspension (HIS) system. The proposed control strategy enables the active HIS system tracking desired anti-roll moment within the working area. Based on the tracking error, the BSMC controller calculates the flowrate of the control cylinder. This flowrate successively changes the pressure in the accumulators and cylinder chambers, and finally determines the output anti-roll moment of the HIS. The HIS system parameters uncertainty and the system’s nonlinear characteristic are both considered in the proposed BSMC controller. To comprehensively design and validate the proposed control method, a 4-DOF half car model and a corresponding nonlinear active anti-roll HIS model are firstly established. Next, a linear quadratic regulator (LQR) upper layer controller is designed to optimize the vehicle’s roll motion, and the result of the LQR controller is set as a tracking target. Thereafter, the proposed BSMC bottom layer controller is designed to track the target moment. Finally, numerical simulation and experiments on the test bench are conducted to validate the proposed control method. The simulation and bench test results indicate that the proposed active HIS performs well in tracking target and tolerating disturbance. The proposed active HIS expands about additional ±1000 N/m dynamic anti-roll moment compared to a passive HIS at each roll angle, and the response time is less than 70 ms. The field test results show that the active HIS with proposed control method improves anti-roll property compared with a passive HIS by 23.3% in the double lane change test.
Comparative study of microwave and thermal curing processes in terms of temperature characteristics and mechanical performance of carbon fibre composites
Authors: Kumar Rajeev , Zafar Sunny
Published: March 2023

In this work, carbon fibre composites were manufactured using vacuum-assisted resin infusion microwave curing and vacuum-assisted resin infusion thermal curing processes. The microwave curing as well as thermal curing heat generation mechanisms were studied along with the thickness of the carbon fibre composites. Microwave power levels of 180 W, 360 W, 540 W and 720 W and thermal power levels of 1000 W and 2000 W were used. The K-type thermocouples were placed between the layers of the carbon fibres to record temperature profile during the curing process. The role of power levels was studied on thermal gradient along with the thickness of composites, which influences the curing kinetics. The composites were evaluated for their degree of cure, density and void percentage. Mechanical performance of the composites was assessed in terms of uniaxial tensile test, three-point bend test and interlaminar shear strength test. It was observed that microwave-cured composites were manufactured with less time and energy compared to thermal curing. The mechanical performance of microwave-cured composites was also better than thermally cured composites.
Substance use disparities by age, race, sex, and sexual orientation among persons living with HIV in the Southern U.S.
Authors: Regan Timothy , Gette Jordan , McAfee Nicholas , Parker Jefferson
Published: March 2023

Background

Alcohol and drug use is overrepresented among individuals living with Human Immunodeficiency Virus (HIV) and is associated with poor health outcomes. Determining the extent to which substance use differs between demographic profiles of people living with HIV (PLWH) would determine at-risk groups that would benefit from intervention.

Methods

Cross-sectional screening data ( N = 1307, M age = 42.7 years, 66% male, 86% African American, 39% sexual minority) was examined from an HIV clinic in the southern U.S. largely treating underserved and low-income patients. Age, gender, race/ethnicity, sexual orientation, and their interactions were entered as predictors of substance use and related impairment in a series of zero-inflated negative binomial regressions.

Results

African Americans reported more drug use ( p = 0.004) and drug-related negative consequences ( p = 0.003). Notably, alcohol-related negative consequences of African American heterosexuals were much higher at younger ages, compared to sexual minorities (regardless of race) and White heterosexuals of all age groups ( p = 0.04).

Conclusions

Among PLWH in the U.S. South, African Americans may be uniquely at-risk with for problems related to drug-related functional impairment. Specifically, young heterosexual African Americans are at high risk for alcohol-related impairment. Implications are discussed.
Comparison of the Cost and Effect of Combined Conditioned Medium and Conventional Medium for Fallopian Tube Organoid Cultures
Authors: Chang Yu-Hsun , Wu Kun-Chi , Harnod Tomor , Ding Dah-Ching
Published: March 2023

Fallopian tube epithelial cells (FTEC) are thought to be the cell of origin of high-grade serous ovarian carcinoma. FTEC organoids can be used as research models for the disease. Nevertheless, culturing organoids requires a medium supplemented with several expensive growth factors. We proposed that a combined conditioned medium based on the composition of the fallopian tubes, including epithelial, stromal, and endothelial cells could enhance FTEC organoid formation. We derived two primary culture cell lines from the fimbria portion of the fallopian tubes. The organoids were split into conventional or combined medium groups based on what medium they were grown in and compared. The number and size of the organoids were evaluated. Quantitative polymerase chain reaction (qPCR) and immunohistochemistry (IHC) were used to evaluate gene and protein expression (PAX8, FOXJ1, beta-catenin, and stemness genes). Enzyme-linked immunosorbent assay was used to measure Wnt3a and RSPO1 in both mediums. DKK1 and LiCl were added to the mediums to evaluate their influence on beta-catenin signaling. The growth factor in the combined medium was evaluated by the growth factor array. We found that the conventional medium was better for organoids regarding proliferation (number and size). In addition, WNT3A and RSPO1 concentrations were too low in the combined medium and needed to be added making the cost equivalent to the conventional medium. However, the organoid formation rate was 100% in both groups. Furthermore, the combined medium group had higher PAX8 and stemness gene expression (OLFM4, SSEA4, LGR5, B3GALT5) when compared with the conventional medium group. Wnt signaling was evident in the organoids grown in the conventional medium but not in the combined medium. PLGF, IGFBP6, VEGF, bFGF, and SCFR were found to be enriched in the combined medium. In conclusion, the combined medium could successfully culture organoids and enhance PAX8 and stemness gene expression. However, the conventional medium was a better medium for organoid proliferation. The expense of both mediums was comparable. The benefit of using a combined medium requires further exploration.
Reflective based learning for nursing ethical competency during clinical practices
Authors: Font Jiménez Isabel , Ortega Sanz Laura , González Pascual Juan Luis , González Sanz Pilar , Aguarón García Maria Jesús , Jiménez-Herrera María F
Published: March 2023

Background

A combination of theoretical and practical approaches is required to learn and acquire ethical competencies in caring. Occasionally, reflection on practical action differs from theoretical learning. In the context of reflective learning, issues such as ethical values can be discussed since they evoke conflict among nursing students.

Aim

To identify ethical conflicts encountered by nursing students during clinical placements and to determine their cooperation strategies.

Research design

Qualitative study with a content analysis according to Elo and Kinglas framework.

Participants and research context

Students enrolled in a nursing program at a Spanish university aged between 22 and 35, mainly women.

Methodology

The study includes 134 ethical reflections from nursing students in the last year of the nursing program, written during their clinical practices in a variety of learning environments. The research team analyzed the reflections using an inductive content analysis method.

Ethical considerations

Ethical permission was obtained by the management center according to Law 3/2028, and all the participants accepted to participate through the informed consent form.

Findings

Three main categories emerged from the analysis of the ethical reflections: (1) evaluation of professional performance and patient care; (2) the student as the protagonist of the dilemma; (3) student coping. Student dilemmas and concerns are related to ignorance, student-patient communication, mistakes made and self-confidence. Some situations conflict with the autonomy of patients and their rights, and can contribute to stressful situations for patients. Stress factors include hospital routines, which the patient cannot modify, and asymmetric relationships with staff, which encourage passivity.

Conclusion

All ethical problems detected by the students begin with the professional-patient relationship, including issues related to bad news, errors or malpractice. Reflection on the ethical values of nursing, both in the classroom and in clinical practices, allows students to develop a greater ethical awareness of care, enhancing their decision-making skills in ethical dilemmas.
Descriptions of long-term impact from inter-professional ethics communication in groups
Authors: Wälivaara Britt-Marie , Zingmark Karin , Fischer-Grönlund Catarina
Published: March 2023

Background

On a daily basis, healthcare professionals deal with various ethical issues and it can be difficult to determine how to act best. Clinical ethics support (CES) has been developed to provide support for healthcare professionals dealing with complex ethical issues. A long-term perspective of participating in inter-professional dialogue and reflective-based CES sessions is seemingly sparse in the literature.

Research aim

The aim was to describe experiences of impact of Inter-professional Ethics Communication in groups (IEC) based on Habermas’ theory of communicative actions, after 6 months from the perspective of an inter-professional team.

Research design

A qualitative inductive approach was chosen, and individual interviews ( n = 13) were conducted. Interview data were analysed using qualitative content analysis.

Participants

The participants, 10 females and two males, represented assistant nurses, registered nurses, physicians, occupational therapists, physiotherapists, welfare officers and psychologists. Each had attended at least four IEC sessions.

Ethical considerations

The study was approved by the Regional Ethical Review Board in Umeå, Sweden, and it has been undertaken in accordance with the Helsinki Declaration.

Findings

Overall, the descriptions expressed a perceived achievement of a deepened and integrated ethical awareness that increased the participants’ awareness of ethically difficult situations as well as their own ethical thinking, actions and approaches in daily work. Perspectives were shared and the team become more welded. They carried the memories of the reflections within them, which was perceived as supportive when encountered new ethically situations.

Discussion

Putting words to unarticulated thoughts may stimulate repeated reflections, leading to new insights and alternative thoughts.

Conclusion

The outcome of IEC sessions 6 months following the last session can be described as an incorporated knowledge that enables actions in ethically difficult situations based on an ethical awareness both at a ‘We-level’ and an ‘I-level’.
Follow the Money: Analyzing Darknet Activity Using Cryptocurrency and the Bitcoin Blockchain
Authors: Dearden Thomas E. , Tucker Samantha E.
Published: March 2023

Transactions on the darknet are notoriously difficult to examine. Prior criminological research has generally used web scraping and qualitative text analysis to examine illegal darknet markets. One disadvantage of this process is that individuals can lie. Fortunately for researchers, the currency used for transactions on the darknet, cryptocurrency, is designed to be tracked. In this article, we examine transactions from a former darknet marketplace, AlphaBay. Using the blockchain, we examine the interconnectedness of both legal and illegal cryptocurrencies. In addition, we provide a structured approach to quantitatively examine the Bitcoin blockchain ledger, offering both the tools and our own experiences for other researchers interested in such approaches. While cybersecurity, information technology, accounting, and other disciplines can examine the financial data itself, we believe that criminologists can provide additional benefits in pattern analysis and organizing the context and theory around the transactions. Our results show that cryptocurrency transactions are generally identifiable (90%) and involve likely illegal transactions, transactions that attempt to obfuscate other transactions, and legal transactions. We end with a discussion of newer cryptocurrencies and related technology and how they will likely shape future work.
What is the Rate of Depersonalization and Burnout Among Hospital-Based Palliative Care Nurse Practitioners? A Review of Validated Instruments
Authors: Zogby Colleen B.
Published: March 2023

Nurse practitioners (NPs) account for one-third of all hospital palliative care (PC) consults, and are prone to burnout and depersonalization (DP). DP threatens personalized communication fundamental to PC. This literature review examines instruments validated to measure burnout and DP. An electronic literature review of instruments previously used to measure burnout and DP was conducted in six databases. Three instruments were included in the review; the Maslach Burnout Inventory (MBI)-Human Service Survey (HSS), the Burnout Assessment Tool (BAT), and the Oldenburg Burnout Inventory (OLBI). All three instruments measure DP or similar constructs and are validated in English, but only the OLBI and the BAT measure burnout with a sum score of the constructs. The OLBI has been validated on a single U.S. population study and as a patient-reported outcome measure (PROM) in Europe. The BAT is the newest instrument and has not been validated on any U.S. population.
Exploring the Measurement of Hospice Resilience
Authors: Baker Rogers Janna
Published: March 2023

Resilience is an emergency management concept that encompasses disaster preparedness, continuity of essential services, and recovery and transformation. Attention to healthcare resilience is growing; research on healthcare resilience has increased since events such as the 2014 Ebola epidemic and the COVID-19 pandemic. However, no studies have been conducted on resilience of hospices, despite a unique patient population and the important role hospices could play in public health emergencies. Quantifying hospice resiliency can aid in planning and response, as well as improving the ability of organizations to transform functionally in response to environmental changes; that is, their transformative capacity. This review examines four measures of resilience that have been applied to the healthcare sector. There are no measures of healthcare resilience that are validated and reliable with respect to the operational profiles of hospices. Further research is necessary to assess and develop valid and reliable measures of hospice resiliency.
Central line-associated Rhizobium radiobacter bloodstream infection in two allogeneic hematopoietic cell transplant recipients
Authors: Hartman Rachel E , Freyer Craig W , Athans Vasilios , McCurdy Shannon R , Frey Noelle V
Published: March 2023

Introduction

Rhizobium radiobacter is a gram-negative, opportunistic phytopathogen that rarely causes human infections. We report two cases of Rhizobium radiobacter central line-associated bloodstream infection (CLABSI) in allogeneic hematopoietic cell transplantation (alloHCT) recipients. We review previous reports and common microbiological characteristics associated with this organism.

Case reports

Two adult males developed R. radiobacter CLABSIs at day +81 and day +77 post-alloHCT. Patient one was asymptomatic on presentation while patient two was febrile. One patient had a polymicrobial infection, which has not been previously described. The presence of high-level ceftazidime resistance in both patients suggests third-generation cephalosporin resistance may be more common than previously recognized.

Management and outcome

For both patients, microbiologic clearance was achieved through peripherally inserted central catheter removal and initiation of intravenous cefepime. Antibiotic therapy was narrowed to oral levofloxacin for a total 14-day course from the time of first negative blood culture. There has been no subsequent recurrence of R. radiobacter infection at 12 and 5 months of follow-up for patients one and two, respectively.

Discussion

These two cases add to the scant literature characterizing R. radiobacter infection following alloHCT. Immunosuppressive agents for graft-versus-host disease prophylaxis may have predisposed these patients to R. radiobacter infection. Our reports, and previously reported cases, suggest R. radiobacter exhibits low virulence, mild symptom burden, and does not confer a high mortality risk. In the alloHCT setting, further accumulation of cases is needed to aid in understanding clinical features and characteristics of R. radiobacter infection.
Intravitreal dexamethasone to manage post endothelial keratoplasty cystoid macular oedema refractory to topical therapy
Authors: Panthagani Jesse , Law Elizabeth M. , Wong Caroline , Chipeta Chimwemwe , Roberts Harry , Myerscough James
Published: March 2023

Background/Objectives

To describe the visual and clinical outcomes of patients with post endothelial keratoplasty (EK) cystoid macular oedema (CMO) refractory to topical treatment with intravitreal sustained-release dexamethasone implant (Ozurdex).

Subjects/Methods

131 eyes from 111 patients undergoing solitary or combined EK (52 DSAEK (40.0%) and 79 DMEK (60.0%)) at Southend University Hospital between January 2020 and February 2022 with a minimum follow-up of 6 months were evaluated. Patients suspected of having CMO underwent spectral-domain macular optical coherence tomography (SD-OCT) Patients with diabetes were not included in this series.

Results

CMO was identified in 5.3% (n = 7) of cases, with 2 of these patients responding to topical corticosteroid treatment. The remaining 5 patients underwent intravitreal dexamethasone implant, with 1 patient requiring repeat implant due to CMO recurrence. All presented within 2 months postoperatively. 4 out of 5 eyes treated with intravitreal dexamethasone achieved a Snellen BCVA ≤6/9.5. 1 patient had an uncontrolled rise in intraocular pressure (IOP) despite maximal medical treatment requiring an urgent PreserFlo Ab-Externo MicroShunt.

Conclusions

The use of intravitreal sustained-release dexamethasone implant in the management of post EK CMO refractory to topical therapy is effective and safe in most cases, but patients should be monitored and treated promptly for any secondary IOP response.
Global migration: Moral, political and mental health challenges
Authors: Jarvis G. Eric , Kirmayer Laurence J.
Published: March 2023

Global migration is expected to continue to increase as climate change, conflict and economic disparities continue to challenge peoples' lives. The political response to migration is a social determinant of mental health. Despite the potential benefits of migration, many migrants and refugees face significant challenges after they resettle. The papers collected in this thematic issue of Transcultural Psychiatry explore the experience of migration and highlight some of the challenges that governments and healthcare services need to address to facilitate the social integration and mental health of migrants. Clinicians need training and resources to work effectively with migrants, focusing on their resilience and on long-term adaptive processes. Efforts to counter the systemic discrimination and structural violence that migrants often face need to be broad-based, unified, and persistent to make meaningful change. When migrants are free to realize their talents and aspirations, they can help build local communities and societies that value diversity.
The relationship of ADHD and trauma mortality: An NTDB analysis
Authors: Zwemer Catherine H , Mohseni Shahin , Forssten Maximilian Peter , Malyavko Alisa , Zebley James A , Qaddumi Waleed N , Cornejo Miglia , Sarani Babak , Kartiko Susan
Published: March 2023

Objective

Nearly 7% of the adult US population has symptomatic Attention Deficit Hyperactivity Disorder (ADHD), which is associated with an increased risk for traumatic injury. There is limited data on the outcome of hospitalized trauma patients with ADHD. This study aimed to use a large nationwide database to investigate the relationship between a diagnosis of ADHD and clinical outcomes in hospitalized patients after major trauma.

Methods

All patients 18 years or older in the National Trauma Database were retrospectively reviewed. Propensity score analysis was used to match patients with and without the diagnosis of ADHD at a 1:1 ratio based on age, sex, race, highest AIS in each region, comorbidities, and the presence of advanced directives limiting care. Outcomes of patients with ADHD admitted to the trauma service between the years 2015 and 2017 were compared to those without ADHD. The primary outcome of interest was in-hospital mortality, while the secondary outcomes included complications and hospital length of stay.

Results

There were 9399 patients included in the study with a diagnosis of ADHD. These patients were overall more likely to be younger, male, and Caucasian, compared to their matched counterparts without ADHD. ADHD was associated with a significantly lower in-hospital mortality than patients without ADHD. There was no difference in the ICU admission rate, ICU LOS, ventilator use, or complication rates between patients with and without ADHD.

Conclusion

A diagnosis of ADHD has a complex association with clinical outcomes after trauma. The current large national analysis found that patients with a diagnosis of ADHD had significantly lower overall in-hospital mortality.
‘Guru Rinpoche is Śivajī’: Ethnicity and ethnic boundary drift in Nepal’s ethnic art
Authors: Li Jingwei
Published: March 2023

This paper argues that ethnic paintings connotate situational ethnicity, adjusted by social change and ethnic boundaries. Based on anthropological fieldwork focusing on painter and mercantile communities, social-political connotations of ethnic art are discussed by applying an analysis of social semiotics in three discourses, employing the case of post-1990 Nepal. In particular: 1) Modern visual expressions of ethnicity are adopted into anti-hierarchical representations, as people engage in ethnic politics and cultural activities. 2) The two genres of ethnic painting, paubhā, and thangka, which were developed by traditional creators and informed by ethnicity, have experienced and developed a cross-boundary mode of operating in industries in response to social change. 3) In the market and mass media, the narrative of value construction regarding the tradition of ethnic art reveals a sign arena that identifies a drift toward the nation, the state, and civilization, prepensely attempting to mobilize semiotic resources through the lens of politics, the market, and global values.
A variable loading and automatic control test device for carpet resilience measurement
Authors: Çelik Halil İbrahim , Kaynak Hatice Kübra , Şahin Burak , Gültekin Elif
Published: March 2023

In this study, a novel multifunctional carpet test device was proposed to overcome deficiencies of current technology, including manual operation error and fixed load. The newly developed test device can automatically perform short-term static loading, long-term static loading and thickness measurement on five samples, simultaneously. The application of the load is achieved by using pneumatic system elements and automation of the developed test device is obtained by a PLC (Programmable Logic Controller) software. The device was verified according to “trueness” and “precision” criteria via statistical analyses. As a result of trueness determination, the Mean Absolute Percentage Error (MAPE) values of the developed test device were between 0.001–0.023, in comparison to that of the traditional carpet thickness tester, which exhibits very close trend between two measurements. The precision analysis results revealed no significant difference in 95% confidence interval between developed test device and the carpet thickness tester. Moreover, the developed test device is capable for thickness loss test by brief moderate loading, prolonged heavy loading and carpet thickness measurement, following related international standards.
Treating post-angioplasty dissection in the femoropopliteal arteries using the tack endovascular system: Tack optimized balloon angioplasty II 24-month results
Authors: Brodmann Marianne , Werner Martin , Sood Ami , Gray William A
Published: March 2023

Objectives

The TOBA (Tack Optimized Balloon Angioplasty) II trial is a prospective, single-arm, multicenter study that investigated Tack treatment for patients with dissection after angioplasty in the superficial femoral artery and/or proximal popliteal artery. The Tack device is a nitinol-based, short (6 mm), stent-like implant with low outward force that can be deployed in a targeted fashion to treat vascular dissection. TOBA II primary results through 12 months have been published previously. This report provides follow-up safety and efficacy results through 24 months (RC).

Methods

The TOBA II trial enrolled 213 patients with Rutherford classification 2 to 4 and a de novo or non-stented restenotic lesion in the superficial femoral artery and/or proximal popliteal artery who developed a dissection of any grade after treatment with plain balloon or drug-coated balloon (DCB) angioplasty. Participants were followed for 30 days, 6 months, 12 months, 24 months, and 36 months following the procedure. Evaluations included clinically driven target lesion revascularization (CD-TLR), ankle-brachial index, Rutherford classification, peripheral artery questionnaire, quality of life assessed by the EQ-5D-3L, and the Walking Impairment Questionnaire.

Results

At enrollment, mean age was 68.2 ± 9.1 years, 70.9% were male, and 95.8% of patients were categorized as RC 2 or 3. The distribution of balloon types in the study were standard balloons: 42.3%; and drug-coated balloons: 57.7%. At 24-month follow-up, 167 patients (78.4%) had available data. The overall survival rate at 24 months was 95.4% and there were no major amputations during this time. After 24 months of follow-up, the Kaplan–Meier freedom from CD-TLR was 77.7%. Rutherford classification, ankle-brachial index, and quality of life were significantly improved compared with baseline through 24 months.

Conclusions

The TOBA II 24-month data demonstrate durable intermediate-term outcomes with the use of the Tack Endovascular System. Tack deployment was a safe and effective therapeutic option for dissection repair following angioplasty.
The EPPO’s legislative framework: Navigating through EU law, national law and soft law
Authors: De Matteis Luca
Published: March 2023

The legal framework under which the European Public Prosecutor’s Office (EPPO) is called to operate is particularly complex, given the need for this body to exercise its functions in the legal systems of the Member States, applying both Union and national law. While this may justify the many references to national law contained in the EPPO’s founding Regulation (2017/1939), several among these references present relevant interpretative issues, and may in some cases even have a misleading effect. The article aims at showing examples of these different scenarios. It also touches briefly on the relevance of soft law in the legal framework of the EPPO.
On the lawfulness of the EncroChat and Sky ECC-operations
Authors: Sagittae Georgios
Published: March 2023

Over the last years, cryptodatacommunications have become an important piece of evidence in criminal procedures all across the European continent. Especially due to the EncroChat- and Sky-operations, prosecution authorities were able to arrest and charge a large number of suspected criminals that probably would have remained unnoticed without the data acquired. As a result, the legality of the use of EncroChat- and Sky-data is increasingly being disputed in multiple courtrooms in various European countries. This article will therefore dive into European case law relevant in this respect and will on that basis discuss the lawfulness of both operations.
The role of flumazenil in generalised anxiety disorder: a pilot naturalistic open-label study with a focus on treatment resistance
Authors: Gallo Alexander T , Addis Stephen , Martyn Vlad , Ramanathan Hishani , Wilkerson Grace K , Bennett Kellie S , Hood Sean D , Stampfer Hans , Hulse Gary K
Published: March 2023

Background:

Anxiety disorders are highly prevalent and chronic disorders with treatment resistance to current pharmacotherapies occurring in approximately one in three patients. It has been postulated that flumazenil (FMZ) is efficacious in the management of anxiety disorders via the removal of α4β2δ gamma-aminobutyric acid A receptors.

Objective:

To assess the safety and feasibility of continuous low-dose FMZ infusions for the management of generalised anxiety disorder (GAD) and collect preliminary efficacy data.

Design:

Uncontrolled, open-label pilot study.

Method:

Participants had a primary diagnosis of generalised anxiety disorder (GAD) and received two consecutive subcutaneous continuous low-dose FMZ infusions. Each infusion contained 16 mg of FMZ and was delivered over 96 ± 19.2 h. The total dose of FMZ delivered was 32 mg over approximately 8 days. Sodium valproate was given to participants at risk of seizure. The primary outcome was the change in stress and anxiety subscale scores on the Depression Anxiety Stress Scale–21 between baseline, day 8, and day 28.

Results:

Nine participants with a primary diagnosis of GAD were treated with subcutaneous continuous low-dose FMZ infusions; seven participants met the criteria for treatment resistance. There was a significant decrease in anxiety and stress between baseline and day 8 and baseline and day 28. There was also a significant improvement in subjective sleep quality from baseline to day 28 measured by the Jenkins Sleep Scale. No serious adverse events occurred.

Conclusion:

This study presents preliminary results for subcutaneous continuous low-dose FMZ’s effectiveness and safety in GAD. The findings suggest that it is a safe, well-tolerated, and feasible treatment option in this group of patients. Future randomised control trials are needed in this field to determine the efficacy of this treatment.
Comparison of Prothrombin Complex Concentrate with Activated Factor VII Use for Bleeding Following Cardiopulmonary Bypass in Children
Authors: Benson John W. , Hraska Viktor , Scott John P. , Stuth Eckehard A. E. , Yan Ke , Zhang Jian , Niebler Robert A.
Published: March 2023

Objective

This study aims to compare the efficacy and safety of activated recombinant factor VII (rFVIIa) and prothrombin complex concentrate (PCC) in the treatment of bleeding complications following surgery requiring cardiopulmonary bypass (CPB) in children.

Design/Methods

This is a retrospective chart review of a single institution comprising patients aged 0 to 18 years old with congenital heart disease. Patients must have received either PCC or rFVIIa after coming off CPB. Our primary efficacy endpoint is time in the operating room from off-CPB to pediatric intensive care unit admission. Our primary safety endpoint is thrombosis through 30 days.

Results

Our primary efficacy outcome was significantly shorter in the PCC group compared with the rFVIIa group ( P < .0001). Similarly, secondary efficacy outcomes of packed red blood cell administration, chest tube output, and transfusion exposures all significantly favored PCC administration. However, CPB time was significantly longer, and body temperatures were significantly lower, in the rFVIIa group. Safety outcomes, including our primary safety outcome of thrombosis through 30 days, were similar between the two groups.

Conclusion

This study questions whether PCC could be favored over rFVIIa for hemostasis in children with congenital heart disease following CPB surgery. In addition, this study has found no difference when comparing PCC and rFVIIa in terms of safety outcomes, particularly thrombosis events. There are several limitations to this study due to the retrospective nature of the design and the differences between the two study groups. Despite the limitations, this study suggests that relatively early administration of PCC could be favored over delayed administration of rFVIIa to control recalcitrant post-CPB bleeding in the operating room.
Using an Antiracist Lens in School Counseling Research
Authors: Washington Ahmad R. , Byrd Janice A. , Williams Joseph M.
Published: March 2023

It is important for school counselors to learn more about antiracism and to incorporate antiracist concepts into their practice more consistently ( Holcomb-McCoy, 2021 ; Mayes & Byrd, 2022 ; Stickl Haugen et al., 2022 ). Operating from a critical political standpoint perspective ( Cushman, 1995 ; Prilleltensky, 1994 ), namely, critical race theory (CRT), we offer a conceptual framework for helping school counselors and counselor educators develop an antiracist lens that guides and informs their research agendas and research-informed practices.
Continual Evolution in Evidence-Based School Counseling: Proceedings From the 2022 Conference
Authors: Dimmitt Carey , Edirmanasinghe Natalie , Zyromski Brett
Published: March 2023

Evidence-based school counseling (EBSC)—and any useful way of organizing or thinking about professional practice—is constantly shaped by and in relationship with social and historical contexts. We are in a time of rapid cultural and educational upheaval, with ongoing calls for impactful systems-level social justice and antiracist school counseling (Holcomb-McCoy, 2022; Stickl Haugen, et al., 2022), with a youth mental health crisis (Office of the Surgeon General, 2021), and with a dire need for more school counselors in most parts of the country (Prothero, & Riser-Kositsky, 2022). How can EBSC continue to evolve to be most relevant and useful in these times? This special edition of Professional School Counselor, which consists of articles derived from the 2022 Evidence-based School Counseling Conference (EBSCC, ebscc.org), answers this question.
Microaffirmations: Small Gestures Toward Equity and Advocacy
Authors: Boyce-Rosen Nadiya , Mecadon-Mann Melissa
Published: March 2023

The practice of using microaffirmations enables positive outcomes through small acts of active listening that encourage feelings of inclusion and shared cultural intimacy. Microaffirmations can be intersectional and are beneficial to a wide range of populations, including people of color, LGBTQIA + individuals, and people with disabilities. School counselors are trained and positioned to have knowledge of practical, evidence-based interventions to help school communities process the negative impacts of microaggressions and daily racism. This article describes the benefits of implementing microaffirmations in school settings and proposes a layered framework for implementation within school communities. We discuss recommendations for training faculty and staff on using microaffirmations and implications for school counselor practice. We also address the importance of using evidence-based school counseling practices as part of framework implementation.
An Evolution of Entrepreneurial Ecosystem Studies: A Systematic Literature Review and Future Research Agenda
Authors: Thai Quoc Hoang , Mai Khuong Ngoc , Do Tung Thanh
Published: March 2023

This study aims to conduct a systematic literature review (SLR) of the entrepreneurial ecosystem (EE) to synthesize and advance the knowledge of how it is investigated and evolved in the previous periods. This study pursues the PRISMA method to review selected EE research and the work of Garrard is applied to construct a SLR matrix to analyze EE literature in peer-reviewed English publication. A total of 100 studies published in 58 journals between 1993 and 2021 were gathered and evaluated. The results indicate three major findings. First, the research on EE has been emerged in the past decades. Second, EE has been defined in several ways and sectors, but the common definition of EE can be expressed through five criteria. Third, the most well-known theory, framework, and measurement of EE are clarified, while the nomological network of EE research was concurrently developed providing the summary of what has been examined. This study provides crucial implications for both theory and practice. In theoretical context, this study gives an updated summary of the trends of EE research; the most popular definition, theory framework, measurement, and nomological network of EE; and the agenda for future research; providing comprehensive overview of EE research and generates new insights for further research in this field. In practice, this study stimulates the awareness of the governors, managers, and other stakeholders of a specific region on building a healthy and effective EE and provides them the methods to improve the EE to generate successful entrepreneurship.
Adoption of Blockchain Technology in Supply Chain
Authors: Alsmadi Ayman Abdalmajeed , Alrawashdeh Najed , Al-Gasaymeh Anwar , Alhawamdeh Loai Naser , Al_Hazimeh Amer Moh’d
Published: March 2023

Supply chain management processes and systems in different industries include multiple variables. This study examines the adoption of blockchain technology in supply chain in Malaysia. Data were collected through questionnaire designed as open ended question through 300 respondents while only 256 is used according to completed surveys, statistical analysis of the data obtained in this study was carried out by one sample t-test using the statistical software package (SPSS). we find that, perceived ease, Inter-Organizational Trust, Perceived Usefulness, Data transparency and confidentiality have significant impact on adoption Blockchain in supply chain, while Blockchain technology simplifies inventory financing. The paper use open ended questions so in future can use different kind of scale and different variables which can affect the adoption decisions.
What Really Drives Loyalty in the Fast-Moving Consumer Goods Market?
Authors: Morkūnas Mangirdas , Grišmanauskaite˙ Marija Kotryna
Published: March 2023

This article seeks to determine the real drivers of customer loyalty in the fast-moving consumer goods (FMCG) market. The study uses beer consumers in Lithuania as an empirical base for the research. A combination of qualitative (experiment) and quantitative (cross-sectional study and partial least squares structural equation modelling) research techniques are applied. The results reveal that loyalty in the FMCG market is driven by purchase frequency, promotion, price and perceived quality via moderating variables such as brand trust and brand satisfaction. Moreover, they demonstrate that consumers mostly do not recognize their favourite product among similar products; therefore, taste properties or other physical attributes of some FMCG products do not significantly contribute to the formation of brand loyalty.

JEL classification: M31, M39
Women Walking the Corporate Tightrope: Depictions of Men and Women’s Work Relationships in Success-at-Work Books
Authors: Webber Gretchen R. , Giuffre Patti
Published: March 2023

Women’s empowerment and “success at work” self-help workshops, webinars, and advice books proliferate in our neoliberal economy. These initiatives purport to help women navigate workplaces and overcome their limitations to be more successful at work. Through a qualitative content analysis of 15 advice books published from 2013 to 2020, this article analyzes how women’s and men’s work relationships are depicted in popular press career advice books that are marketed for women. We identify three main themes. First, men are described as baffled by women’s “strange ways,” so women are warned to be aware of men’s uneasiness and tread carefully in their work relationships. Second, men are depicted as enemies, yet women are told to rely on powerful men to achieve success. Third, women are instructed to ignore and downplay sexism in their workplace interactions. We conceptualize the work that women are expected to do as “tightrope labor,” in which women must carefully navigate contradictory gender expectations. Women are expected to walk a tightrope with (1) handling men’s discomfort with women; (2) identifying “menemies” and mentors; and (3) managing sexism. We argue that relationship depictions in career advice fault women for career failures, burden them with extra labor, and bolster neoliberal feminist rhetoric.
Heart Rate Variability Biofeedback for Mental Health Treatment: A Policy Brief
Authors: Kim Sonya
Published: March 2023

The WHO argues that a pharmacy-first approach should no longer be the reflexive treatment for mental health diagnoses. Heart rate variability biofeedback (HRVB) demonstrably treats various conditions—especially effective at regulating emotion, particularly managing and alleviating anger, stress, anxiety, and depression, common co-morbid diagnoses for rehabilitation medicine patients. HRVB trains users to study their biofeedback data in real time, alter bodily functions previously believed to be automatic, and garner health benefits. Despite convenience, relatively low cost, and empowering patients to manage their own symptoms, the current lack of reimbursability, and the lack of Phase III RCTs limit HRVB application. Ideally, the confidence of practitioners, patients, and insurers would follow the known efficacy of HRVB for the treatment of mental health conditions.
Digital Contingency Management in the Treatment of Substance Use Disorders
Authors: Dallery Jesse , Defulio Anthony , Raiff Bethany R.
Published: March 2023

Contingency management (CM) provides incentives based on drug abstinence or other treatment goals; it is one of the most efficacious and cost-effective psychosocial interventions for substance use disorders. However, CM remains severely underused in clinical care. Digital methods to deliver CM could dramatically expand access. These methods include information and drug sensing technologies to obtain objective evidence of drug abstinence, authenticate the end-user's identity, and deliver incentives immediately. Digital CM has been applied successfully to cigarette smoking, alcohol misuse, and more recently illicit drug use. Policies should continue to evolve to promote the delivery of digital CM based on decades of research.
National Health Guidelines for Social Connection: What Is the Evidence in Support and What Might the Guidelines Say?
Authors: Holt-Lunstad Julianne
Published: March 2023

National health guidelines provide policy makers and the public with recommendations for various behavioral factors known to promote health and reduce disease risk, such as diet and physical activity. Given public health concerns about social isolation, loneliness, and other forms of lacking social connection, the evidence supports establishing national health guidelines for “social connection.” The aggregate body of scientific evidence demonstrates social connection protects health and reduces health risks, pointing to clear relevance for public health. Taken together with national trends suggesting greater social disconnection, there is a compelling case for national preventative efforts. This article summarizes evidence on the health relevance of social connections, potential opportunities, and challenges in establishing and implementing guidelines, the process of establishing guidelines, and provides illustrative evidence-based examples of potential recommendations.
Making a market in environmental credits II: Watershed moments
Authors: Robertson Morgan , Lave Rebecca , Doyle Martin
Published: March 2023

This pair of papers examines and describes the state action necessary to make markets function as environmental policy instruments and as strategies of governance. We do this through a detailed look at the mechanics of environmental credit compliance markets in the US states of Oregon, Ohio, and North Carolina in which stream credits are privately created and sold to developers who have impacted protected stream systems. In this paper, we observe that the governance of streams as water resources requires the state to create a scalar hierarchy that fixes certain characteristics of streams at certain scales of state action. These fixes attempt to resolve, bracket, or ignore the temporal and spatial variability of streams that can confound governance; however, these variabilities are essential to the scientific study of streams. At each of the four distinct scales, four different operations crucial to market function were observed; at each scale, elements of natural variability were fixed or confined to be expressed only within the given scale. These observations reveal principles of how scale functions within environmental governance, as well as failures where gaps and resistances appear that create unforeseen outcomes in market-led policy. In three different state settings, the establishment of a fixed scale of governance is made in different ways that depend on the local institutional and social context. However, they all act to render an unruly set of temporal and spatial flows as instead occurring within certain fixed scalar boundaries, and thus amenable to governance with markets.
Factors associated with pain reporting and severity of pain in the prehospital setting
Authors: Quinn Rory J , Masterson Siobhan , Willis David , Hennelly David , Deasy Conor , O'Donnell Cathal
Published: March 2023

An effective pain management strategy requires understanding of the epidemiology of pain in the population of interest and accurate measurement upon which to base quality improvement plans. The aims of this study were to estimate the incidence of pain in the prehospital setting and to explore features that impact on (1) documentation of pain; (2) severity of pain reported by patients. This retrospective cohort study included 212,401 care episodes attended by National Ambulance Service practitioners during 2020. Descriptive analysis of patient and care episode characteristics and regression analyses for the outcomes pain recorded and severity of pain were performed. We also used text pattern-matching of the notes field to estimate the proportion of patients in pain for whom a pain score assessment had not been documented. Sixty-five percent of all patients had a pain score documented and 29.5% were in pain (11% in severe pain). Likelihood of pain being recorded was most strongly associated with: Glasgow Coma Scale (GCS) Score, working diagnosis of the patient, location of the incident, and patient age. Likelihood of pain severity was most strongly associated with: transport status of patient, GCS score, and patient age. We treated missing data as a separate category and found consistent associations between the outcomes and missing data. We also found that pain was a symptom in approximately 15% of cases where no formal pain score assessment was documented. The data showed associations between routinely collected variables and the likelihood of pain recording and pain severity. Our findings also demonstrate the impact of missing data. To mitigate missing data impact, we suggest that EMS agencies consider making pain score assessment a mandatory requirement of their reporting for every patient. We also recommend that services report the extent and impact of missing data when measuring clinical performance.