bluuebunny/crossref_metadata_2025 huggingface dataset:
Reawakening of Indigenous matriarchal systems: A feminist approach to organizational leadership
Authors: Defriend Courtney , Cook Celeta M.
Published: November 2023

Leadership models that uphold feminist qualities of mutuality, collaboration, and distribution of power can foster organizational and community success. Utilizing a systems perspective grounded in land-based analogies can assist with understanding the diversity and strength that come from entire ecosystems around wicked social issues. While Indigenous leadership models have supported such perspectives since time immemorial, current and ongoing acts of colonialism driven by patriarchal systems and violent gender-based policies and procedures have eroded matriarchal leadership models that sustained what is now known as Canada for generations. Reflections of two evolving Indigenous women in leadership note the opportunities to reawaken matriarchal values in organizational and community leadership as a powerful act of reconciliation.
Depressive Symptoms are Associated With C-Reactive Protein in Older Adults With Obesity
Authors: Heisey Henry D. , Qualls Clifford , Villareal Dennis T. , Segoviano-Escobar Martha Belen , Nava Maria Liza Duremdes , Gatchel Jennifer R. , Kunik Mark E.
Published: November 2023

Objectives

To test the hypothesis that depressive symptoms vary with high-sensitivity C-reactive protein (hs-CRP), among older adults with obesity.

Methods

This was a cross-sectional, secondary analysis of baseline data from two related lifestyle intervention trials. The study sample comprises 148 consecutively recruited, community-dwelling older adults (age >=65 years) without severe psychiatric illness and with body mass index >=30 kg/m2. Logarithmically transformed GDS was analyzed as the dependent variable. Independent variables included log-transformed hs-CRP and covariates: sex, age, and concurrent use of antidepressant medication at baseline. An additional analysis was performed using binary conversion of the GDS scores, wherein a cutoff score of 5 was considered positive for depressive symptoms.

Results

Sample mean GDS score was 2.7 (SD 3.0, range 0 – 14). A significant multivariate model of GDS scores (R2 = .089, F = 3.5, P = .010) revealed log-transformed hs-CRP ( P = .017) and male sex ( P = .012) as associated with depressive symptoms. Supplemental analysis demonstrated associations between depressive symptoms and log-transformed hs-CRP (OR 2.17, P = .001) and between depressive symptoms and male sex (OR 3.78, P = .013). Univariate logistic regression found hs-CRP to be associated with depressive symptoms.

Conclusions

In older adults with obese BMI, male sex and higher hs-CRP are associated with depression, even in a group with relatively minimal depressive symptoms. Hs-CRP may offer clinical utility as a biomarker for depression among older adults with obese BMI, even among those with non-severe psychiatric symptomatology.
“If You Don’t Have the Heart to Help, You Cannot Do This Job”: The Multidimensional Wellbeing of Community Health Workers Serving Refugees During the COVID-19 Pandemic
Authors: Schuster Roseanne C. , Wachter Karin , McRae Kenna , McDaniel Anne , Davis Olga I. , Nizigiyimana Jeanne , Johnson-Agbakwu Crista E.
Published: November 2023

Community health workers are members of two groups whose short- and long-term health has been uniquely shaped by the COVID-19 pandemic: health workers and the oft-marginalized populations that they serve. Yet, their wellbeing, particularly of those serving resettled refugees, before and during the pandemic has been largely overlooked. Drawing from a holistic conceptualization of wellness, this study examined the effects of the COVID-19 pandemic on a group of cultural health navigators (CHNs), who serve resettled refugees. We conducted semi-structured individual interviews with CHNs at a southwestern U.S. hospital system between July and August 2020, a critical time in the pandemic. Our analysis produced four themes that encapsulate the effects of the pandemic on CHN wellbeing: (1) “You fear for your life”: Chronic risk of COVID-19 exposure takes a toll on physical, emotional, and environmental wellbeing; (2) “It is stressful because it is completely new”: Uncertainty diminishes occupational, financial, and emotional wellbeing; (3) “If you don’t have the heart to help, you cannot do this job”: CHNs remain committed while facing challenges to their occupational wellbeing on multiple fronts; and (4) “Now, you cannot release your stress”: Loss of and shifts in outlets integral to social and spiritual wellbeing. The findings deepen empirical understanding of how the pandemic affected the holistic wellbeing of CHNs, as they continued to serve their communities in a time of crisis. We discuss the implications for addressing the multidimensionality of community health worker wellbeing in research, policy, and practice.
Assessing the Impact of a Hospice and Palliative Medicine Mentored Clinical Shadowing Experience for First-Year Medical and Dental Students: A Pilot Study
Authors: Engel Kirsten G. , Millham Lucia R. I. , Yeh Irene M. , Malecha Patrick W. , Brizzi Kate , Schwartz Andrea Wershof , Tolchin Dorothy W.
Published: November 2023

Background: All physicians encounter patients with serious illness. Medical students recognize the value of hospice and palliative medicine (HPM) and desire more knowledge and skills in this area. However, both pre-clinical and clinical HPM content are underrepresented within medical school curricula. Objectives: To conduct a pilot study examining the impact of a novel required HPM clinical experience on pre-clinical medical and dental students’ learning through mixed methods evaluation of student responses. Design: Students completed a two-part electronic survey following a half-day HPM mentored clinical shadowing experience (HPM-MCSE) which included an introductory session, a faculty-mentored shadowing experience and a debriefing session. Setting/subjects: 163 first-year students at Harvard Medical School in Boston, Massachusetts, USA in 2022. Measurements: The survey collected demographic information and student responses to both closed-ended (Likert-scale) and open-ended prompts. Data were analyzed quantitatively using descriptive statistics and qualitatively using constant comparative methodology. Results: 127 medical and dental students responded (78% response rate). Qualitative analysis yielded three overarching themes: acquisition of knowledge about operational dimensions of HPM, acquisition of knowledge about psychosocial dimensions of HPM, and personal impact including an awareness of discordance between expectations and lived experience of HPM practice. Of the 109 students who completed the entire survey, 67% indicated that this experience increased their interest in palliative care and 98% reported an increase in their understanding of how palliative care enhances patient care. Conclusions: Early clinical exposure to HPM for first year students stimulates multi-dimensional learning about HPM and evokes personal reflection about serious illness care.
Profile of Antimicrobial Consumption in Patients Assisted by a Palliative Care Team During the COVID-19 Pandemic in Brazil
Authors: Correa Tulio L , Quitete Matheus AC , do Nascimento Clara RS , Carbone Rafaela P , de Carvalho Ricardo T , Rocha Juraci A
Published: November 2023

Background

This study aimed to evaluate the profile of antimicrobial consumption in patients assisted by a palliative care (PC) team during the COVID-19 pandemic.

Methods

A retrospective observational study was conducted in a quaternary hospital. Patients assisted by the PC team in 2020 were selected. The clinical and demographic characteristics, as well as the outcomes, were assessed using electronic records.

Results

A total of 181 patients were included in the study, of whom 93.4% had used antimicrobials and 24.3% had had COVID-19. COVID-19 patients were more likely to receive at least one course of antimicrobial therapy. Patients who received polytherapy in the first course of treatment were more likely to die and to be still receiving antimicrobials at death. There was no significant difference in the length of hospital stay, new hospitalization in 12 months, nor the time to death among patients who received monotherapy or polytherapy during the first course of antimicrobial therapy.

Conclusions

There was a large amount of PC patients receiving antimicrobial therapy during the COVID-19 pandemic. SARS-CoV-2-positive patients were more likely to receive antimicrobial therapy.
What Is Wisdom? Sketch of a TOP (Tree of Philosophy) Theory
Authors: Sternberg Robert J.
Published: November 2023

This article proposes a sketch of a new theory of wisdom based on the tree of philosophy (TOP) model. It is argued that philosophy—love of wisdom—has developed branches over the millennia that reflect the different aspects of thought and action that need to be considered in a comprehensive theory of wisdom. Although there is not a full consensus on what these branches are, the TOP usually has as branches, at minimum, metaphysics—including epistemology and ontology—and ethics, logic, aesthetics, hermeneutics, and axiology. Each of these branches is considered, and its implications for a philosophically based theory of wisdom are considered. Whereas some other theories of wisdom attempt to synthesize recent psychological attempts to understand wisdom, the TOP theory attempts to synthesize the contribution of millennia of philosophical inquiry.
Digital inequalities in North Africa: Examining employment and socioeconomic well-being in Morocco and Tunisia
Authors: Bokhari Hasnain , Awuni Evans T
Published: November 2023

The term digital divide refers to disparities in digital access, infrastructure, and opportunities. However, it is important to recognize that information and communication technologies (ICTs) do not operate in isolation. They are influenced by social and structural factors. This study focuses on Tunisia and Morocco to examine access to and usage of digital technologies, factors shaping these patterns, and the impact of unequal access and usage on employment and socioeconomic well-being in the post-Arab Spring era. Using Afrobarometer household surveys from 2013 to 2022, encompassing 9595 respondents, we construct a digital inclusion index and disaggregate results to illustrate the dynamics of digital inequalities. We employ pooled logistic regression to explore the determinants of digital inclusion and examine how disparities shape well-being. Findings show improved digital inclusion in Morocco and Tunisia from 2013 to 2022, yet over 80% of their populations remain partially or entirely excluded. We confirm previous studies suggesting that digitalization mirrors or exacerbates preexisting inequalities, with gender, age, education, and socioeconomic status significantly influencing digital inclusion, indicating persistent inequalities and barriers. Our findings also have broader implications for the MENA region, emphasizing the need to address the complex interactions among sociodemographic factors, including gender, age, education, and socioeconomic disparities, in order to achieve equitable digital inclusion.
Investigating the role of bilingualism and gender on theory of mind using mouse-tracking and self-report
Authors: Xia Rowena J. , Haas Brian W.
Published: November 2023

Aims and Objectives:

Although there exists empirical support for the idea that bilingualism is associated with improved social cognition, the presence and the structure of this link remains inconclusive. There is currently a need to clarify the specific contexts in which these benefits may tend to emerge.

Methodology:

We sought to advance the field of bilingualism by examining the link between bilingualism and a specific form of social cognition, theory of mind. We measured theory of mind processing in a sample of adult bilinguals and monolinguals and measured patterns of decision-making using several different methods; task performance (accuracy and reaction time), implicit decision-making patterns (mouse-tracking), and self-report. We collected mouse-tracking data during two different tasks (false belief and cognitive–affective theory of mind) and self-report was measured using the perspective-taking (PT) subscale of the Interpersonal Reactivity Index (IRI).

Data and Analysis:

For each behavioral task, we compared reaction time, accuracy, and both mouse-tracking metrics between language groups. For self-report, we compared PT scores between language groups. We also tested for interactive effects of gender and language group on each dependent variable.

Findings:

Across all participants, bilingualism was not associated with any statistically significant improvements in theory of mind. However, we did observe that gender interacted with language group to affect maximal deviation values (mouse-tracking) during the false belief task and self-reported PT scores. Bilingualism tended to confer some improvements in self-reported theory of mind (PT subscale of IRI) in men, but not women.

Originality:

It is currently unknown if bilingualism is associated with improved theory of mind processing when measured using several different types of tasks and using mouse-tracking.

Significance/Implications:

These findings contribute to a growing body of evidence elucidating the complex relationship that exists between multiple language acquisition and social cognition.
We have never been human: Staging subjectivity from Diderot and Artaud to the aesthetics of the European refugee crisis
Authors: Darvay Daniel
Published: November 2023

This essay explores the shifting matrix underlying the pervasive theater that enacts the making and unmaking of human subjectivity by focusing on key historical transformations and prominent contemporary manifestations. Offering a comparative analysis of Denis Diderot’s theory of the actor, and Antonin Artaud’s theater of cruelty, I argue that the paradox of the human had led to human–artwork hybrids well before the digital age of the posthuman recast the body as virtuality. Drawing on a broader understanding and scope of human–artwork hybridization, I examine two different yet equally memorable and infamous responses in 2015 to the European refugee crisis: the Petra László video and Norbert Baksa’s Der Migrant. The aesthetic and cultural practices revolving around the staging of the European refugee crisis constitute a key sphere in which this hybridization is tested, played out and in the context of East-Central Europe, calibrated to a ballad tradition whose generic conventions were reinvented in conjunction with a growing national identity in the 19th century. The ballad of ‘The Walled-Up Wife’ has enjoyed sustained popularity in East-Central Europe, ever since its anachronistic ‘rediscovery’ in multiple national literatures around the mid 1800s. It deserves critical attention, for its extensive cultural history as well as its rich vernacular heritage can shed new light on the ways in which the idea of material embodiment comes to bear extended meanings for a reconceptualization of the human in digital spaces of aesthetic rather than merely socio-political signification.
Promoting socio-spatial and cognitive justice through critical pedagogies
Authors: Álvarez de Andrés Eva
Published: November 2023

Thousands of people are currently being excluded from the right to the city, which makes urgent a reflection on how to articulate innovative and critical learning actions to promote socio-spatial and cognitive justice in the emerging context. An analytical framework inspired in Giddens' and Fraser’s theories, is proposed for a systematic analysis of the literature on critical pedagogies, and for studying an articulated sequence of learning-action experiences happened over fifteen years. The analysis is supported by qualitative information harvested from the experience of the Polytechnic University of Madrid with the communities in Ginaw Rails Nord (Dakar, Senegal) and Las Sabinas (Madrid, Spain).The results critically question the hegemonic construction of knowledge and the predominant ways of categorisation, crossing the abyssal lines between the Global North and the Global South, showing that (1) transforming structures involves challenging power relations within and outside the educational structure, and engaging in plural and equitable learning-action communities from which dominant policies, practices, and discourses may be challenged; (2) practices and policies may be transformed through collective experimentation processes that contribute to the co-production of both the city and knowledge, and (3) transforming the discourses of dominant power requires questioning acquired knowledge and the way it is produced, assuming the commitment and responsibility for constructing and disseminating an emancipatory pedagogy through the ecologies of knowledge.
The voices of Japanese and U.S. elementary-school aged children with disabilities: Navigating stigmatization within peer groups
Authors: Kayama Misa , Haight Wendy
Published: November 2023

Children’s experience of disability-related stigmatization is a central social justice issue across cultures. Yet children’s voices are rarely heard by policy makers, and available programs for children with disabilities typically lack input from children’s own experiences. This paper presents a cross-cultural case study of how three children with disabilities in Japan and the U.S. responded to stigmatization from their “typically-developing” peers. We choose these cases for in-depth examination to contextualize and deepen our understanding of themes identified from our larger, ethnographic study. Similar to the participants in our larger study, these elementary school-aged children experienced disability-related stigmatization, including teasing and bullying. They actively responded to reduce their immediate exposure to stigmatization. Some of these responses, however, created additional challenges. For example, children’s physical fighting in response to teasing resulted in punitive discipline in the U.S. Children’s avoidance of peers undermined academic achievement and psychosocial development, especially in Japan where peer groups are central contexts for education. Furthermore, children’s responses to stigmatization often concealed their peer struggles or were misunderstood by educators, which delayed their access to appropriate support. We discuss social work implications for child-centered programs of support.
Stress and trauma among police officers: Implications for social work research and practice
Authors: Eikenberry Jacob , Mancini Michael , Linhorst Donald M , Schafer Joseph A , Brown Jasmine
Published: November 2023

Racial justice movements sparked by police killings of Black and Brown persons have led to a reassessment of the role of policing in America. This has promoted important conversations about how best to improve public safety and design law enforcement practices that are equitable and just across communities. A component of this conversation is addressing stress and trauma faced by police as a routine part of their duties, as it can affect the quality of policing. Job-related stress and trauma experienced by police officers are an international phenomenon, yet underexplored areas in social work research and practice. Police officers experience high levels of stress from routine exposure to traumatic situations, leading to high rates of post-traumatic stress disorder, substance use, and depression. Officers who are actively experiencing symptoms of stress and trauma are more likely to engage in misconduct, including the unnecessary use of force. This study explores the stress and trauma-related experiences of police officers. We conducted one-on-one, semi-structured interviews with 23 officers from an urban police department in St Louis, Missouri. Analysis of interviews addressed three areas: (1) stress and trauma experiences associated with police work, (2) negative effects of stress and trauma on officers, and (3) factors impacting officer access to treatment. We conclude that social work can contribute to improved policing outcomes by helping officers address their job-related stress and trauma through engaged research and practice.
Decanonizing the curriculum: English degree requirements in Canadian universities today, and the promise of a method-focused degree
Authors: Banting Sarah , Scarlett Madeline
Published: November 2023

This paper proposes that a curricular shift we call “decanonization” is shaping contemporary English Major degrees at Canadian universities. We believe it is a response to a complex set of challenges currently facing departments as they program their undergraduate degrees in English, and, in a qualified way, we endorse it as a positive change: it can be seen as a step toward decolonization. But we argue that some forms of decanonized degree have unfortunate implications. While we affirm that our colleagues across the country are doing everything they can to sustain robust, current degrees in challenging circumstances, those circumstances have resulted in some cases in what appears to be a hollowed-out, underdefined degree. We propose an alternate curriculum, based on method, that seems to us particularly promising in the current context.
Life cycle cost analysis of LED retrofit and luminaire replacements for four-foot T8 troffers
Authors: Liu L , Keoleian GA , Lewis GM
Published: November 2023

Lighting makes up 17% of electrical loads and the largest energy end use in commercial buildings. Linear fixtures are among the largest opportunities for energy efficiency improvement, given their long operating hours. With continued, rapid light-emitting diode (LED) development and more LED replacement products on the market, lighting replacement decisions become more complex and warrant re-examination. With a goal to inform building managers and other decision-makers with practical guidance on lighting replacement, this study is a life cycle cost (LCC) analysis that compares the cost–benefit of six replacement options (one fluorescent and five LED) for a 0.61 m by 1.22 m (2 ft by 4 ft) T8 recessed troffer based on data for 168 lighting products from an online vendor. Results show that direct wire (i.e. unballasted) LED retrofits are the least-cost option to replacing fluorescent lamps in terms of normalized LCC. Plug-and-play lamps suffer from a lock-in with ballasts, but their ease of installation can help spur LED adoption. In cases where an existing ballast is still usable, hybrid LED retrofits provide the least upfront cost option by deferring the cost of rewiring. LED luminaires can offer improved aesthetics and reliability; however, they have high upfront cost. Among them, luminaires with replaceable lamps offer lower cost than those without.
Comparison of health-related quality of life measures in asthma-COPD overlap
Authors: Liu Meishan , Yang Xuwen , Wang Ying , Lu Yong , Liang Lirong , Zhang Hong , Huang Kewu
Published: November 2023

Objective

The Asthma Quality of Life Questionnaire (AQLQ) and COPD assessment test (CAT) are used to assess the health status of asthma and chronic obstructive pulmonary disease (COPD), respectively. However, whether these questionnaires are appropriate in patients with asthma-COPD overlap (ACO) has not been reported. This study aimed to evaluate the performance of the AQLQ and CAT in subjects with ACO.

Methods

Subjects were enrolled from two previously described observational studies in Beijing, China. ACO was defined by a consensus definition from a roundtable discussion. All subjects completed the AQLQ, CAT, St George’s Respiratory Questionnaire (SGRQ), pulmonary function tests, and the Asthma Control Questionnaire (ACQ)-5. Cross-sectional construct validity was evaluated by correlating the AQLQ and CAT with SGRQ score and other measures of asthma and COPD severity.

Results

147 subjects with ACO were recruited. There were floor effects on non-respiratory components of the CAT, and ceiling effects on emotion domains of the AQLQ. Both questionnaires were significantly correlated with ACQ-5 score but were not correlated with FEV1% predicted or FVC% predicted. The AQLQ and CAT were strongly correlated with SGRQ score (r = −0.657 and r = 0.623, respectively). Multivariable linear regression analysis showed that the AQLQ (standardized β-coefficient = −0.449, p < .001) had a stronger association with SGRQ score compared with CAT (standardized β-coefficient = 0.211, p = .023).

Discussion

The AQLQ and CAT were both valid for assessing the health-related quality of life in subjects with ACO, but the AQLQ performed better than CAT.
Reflections of Black Married Working Mothers Managing Occupational Roles and Racism
Authors: Parnell Regina
Published: November 2023

Black married working mothers encounter forms of racism, on the job and in society. However, little attention is given to how these experiences affect their work and family lives. Qualitative thematic analysis was used to examine the narratives of 91 Black women, aged 20 to 55 years, to explore the effects of racism on their key occupational roles of wife, employee, and mother. Four major themes emerged for being a Black employee. Two themes were linked to Black mothering. Five themes were identified for being a Black wife. Also, two new culturally derived occupational roles emerged: advocate and pioneer. Findings suggest that Black married working mothers have unique transformative experiences in their occupational roles solely due to their minoritized status, which impacts their wellbeing. Occupation-based research should focus on racism’s impact on the wellbeing of minoritized groups as they engage in desired and meaningful occupational roles.
High on-treatment platelet reactivity in peripheral arterial disease: A systematic review
Authors: Goncalves Lauren N , van Velze Veerle , Klok Frederikus A , Gal Pim , Vos Rimke C , Hamming Jaap F , van der Bogt Koen E A
Published: November 2023

Objectives

To highlight current evidence pertaining to the measurement methods and prevalence of high on-treatment platelet reactivity (HTPR) in patients with PAD, as well as to evaluate the relationship between HTPR and recurrent adverse cardiovascular and limb events in PAD patients.

Methods

A systematic review of English-language literature on HTPR in patients with PAD. An electronic literature search of PubMed and Medline was performed in May 2021.

Results

A total of 29 studies with a total number of 11,201 patients with PAD were identified. HTPR during clopidogrel treatment ranges from 9.8 to 77%, and during aspirin treatment ranges from 4.1 to 50% of PAD patients. HTPR was associated with adverse clinical outcomes. The need for limb revascularisation was higher in patients with HTPR during clopidogrel use. Similarly, HTPR during aspirin use in the PAD population was predictive of adverse cardiovascular events (HR 3.73; 95% CI, 1.43–9.81; p = .007). A wide range of techniques were applied to measure platelet resistance, without consensus on cut-off values. Furthermore, differing patient populations, a variety of antiplatelet regimens, and differing clinical endpoints highlight the high degree of heterogeneity in the studies included in this review.

Conclusion

No consensus on technique or cut-off values for HTPR testing has been reached. Patients with HTPR are potentially at a greater risk of adverse limb-related and cardiovascular events than patients sensitive to antiplatelet therapy illustrating the need for clinical implementation of HTPR testing. Future research must aim for consistent methodology. Adaptation of antiplatelet therapy based on HTPR results requires further exploration.
Exploring the relationship between corporate networks and varieties of media capture
Authors: Robles-Rivera Francisco , Cárdenas Julián
Published: November 2023

Large corporations and media companies can form corporate networks through directors who hold positions on multiple boards, potentially enabling business elites to influence the media. This article investigates the relationship between corporate networks and media capture in two Latin American countries. We performed a network analysis of interlocking directorates to uncover these corporate networks, and conducted in-depth interviews with elites to identify two varieties of media capture: coordinated and competitive. Our findings indicate that media companies embedded in cohesive corporate networks are subject to coordinated media capture, whereas media outlets in fragmented corporate networks experience competitive media capture.
Decoding intervention for young students with mild intellectual disabilities: A single-subject design study
Authors: Fälth Linda , Selenius Heidi , Sand Christina , Svensson Idor
Published: November 2023

Students with intellectual disabilities need more time and explicit instruction to develop word decoding. Most previous research on interventions among these students is performed in English. Therefore, the current study examined the impact of a word-decoding intervention in Swedish on individual students with intellectual disabilities. A single-subject-design study was conducted with five students with mild intellectual disability in the fourth grade. They needed to enhance decoding, and Swedish was their first language. Their word and non-word decoding was measured during the baseline and intervention phases. The intervention with the Wolff Intensive Program was delivered by special education teachers supporting phonemic decoding and reading fluency training during 25 sessions. All five students developed their decoding as they decoded more words in a given time (NAP=0.84-1.00) and decreased their decoding errors in both word and nonword decoding (NAP=0.72-1.00). The results are promising but need to be confirmed in additional studies.
Analysis of the effect of cytomegalovirus infection in clinical outcomes and prolonged duration of SARS-CoV-2 shedding in intensive care unit patients with COVID-19 pneumonia
Authors: Shen Hsiao-Chin , Feng Jia-Yih , Sun Chuan-Yen , Huang Jhong-Ru , Chen Yuh-Min , Chen Wei-Chih , Yang Kuang-Yao
Published: November 2023

Background:

Coronavirus disease 2019 (COVID-19) is a global outbreak disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Cytomegalovirus (CMV) infection can occur in critical COVID-19 patients and is associated with adverse clinical outcomes.

Objective:

The aim of this study was to explore the clinical characteristics and outcome of CMV infection in critical COVID-19 patients.

Design:

This was a retrospective cohort study.

Methods:

From May to September 2021, SARS-CoV-2 reverse transcription polymerase chain reaction (RT–PCR)-confirmed COVID-19 patients with intensive care unit (ICU) admission were enrolled. CMV infection was confirmed by PCR. Baseline characteristics, critical illness data and clinical outcomes were recorded and analyzed.

Results:

Seventy-two RT–PCR-confirmed COVID-19 patients with ICU admission were included during the study period and 48 (66.7%) patients required mechanical ventilation (MV). Overall, in-hospital mortality was 19.4%. Twenty-one (29.2%) patients developed CMV infection. Patients with CMV infection had a higher likelihood of diabetes, higher lactate dehydrogenase and lactate levels, and higher proportions of MV, anticoagulant, and steroid use. Patients with CMV infection were associated with longer duration of SARS-CoV-2 shedding, longer ICU and hospital stay, and fewer ventilator-free days. The independent risk factor for development of CMV infection was a higher accumulative steroid dose.

Conclusion:

CMV infection adversely impacted the outcomes of critical COVID-19 patients, resulting in longer ICU stays, longer mechanical ventilation uses and prolonged shedding of SARS-CoV-2.
Promoting Renewable Energy Consumption in Sub-Saharan Africa: How Capital Flight Crowds Out the Favorable Effect of Foreign Aid
Authors: Asongu Simplice A. , Eita Joel Hinaunye
Published: November 2023

The study assesses the effect of capital flight in the nexus between foreign aid and renewable energy consumption in 20 countries in sub-Saharan Africa using data for the period 1996 to 2018. The empirical technique employed is interactive quantile regressions, and the following findings are established. Foreign aid increases renewable energy consumption, while capital flight dampens the favorable effect of foreign aid on renewable energy consumption. The underlying significance and corresponding mitigating effect are exclusively relevant to the bottom (i.e., 10th) quantile of the conditional distribution of renewable energy consumption. The findings are robust to simultaneity and unobserved heterogeneity. Policy implications are discussed.

JEL Classification: H10; Q20; Q30; O11; O55
Extended Window Thrombolytics for Ischemic Stroke: A Telestroke versus In-person Experience
Authors: Murray Nick M. , Johnson Paul , McKasson Marilyn , Martinez Julie , Chatwin Stephen , Püttgen Adrian
Published: November 2023

Background and Purpose

Telestroke evaluation of patients with acute ischemic stroke is supported by American Heart and Stroke Association Guidelines. However, there is no data on outcomes or safety of administering IV thrombolytic stroke therapy using extended window criteria (>4.5 h since onset of symptoms with a hyperacute MRI diffusion T2/FLAIR mismatch) via telestroke. Here, we report adverse events and outcomes of extended-window thrombolysis by telestroke vs in-person care.

Methods

We performed a retrospective cohort review from 2020 to 2022 of prospectively collected multinstitutional databases from a large, not-for-profit health system with both in-person stroke and telestroke care. The primary outcome was frequency of symptomatic intracranial hemorrhage (sICH). Secondary outcomes were favorable functional outcome at hospital discharge (modified Rankin Scale, mRS, 0-3) and discharge disposition.

Results

A total of 33 patients were treated with extended-window thrombolysis (n = 20 in-person, n = 13 telestroke). The median NIH stroke scale was 6, and time since last known normal was similar (median [95% CI]: in-person 13 h [11-15 h] vs telestroke 12 h [9-16 h], P = .33). The sICH frequency was low and occurred in one patient (4.8% in-person vs 0% by telestroke). Favorable outcome at discharge was not different between in-person and telestroke care (median mRS [95% CI]: 2 [1-3] vs 1 [0-2], OR .0 [.0-1.8], P = .27), and discharge deposition was also similar.

Conclusions

In patients eligible for extended window acute stroke treatment with thrombolytics, there was no difference in adverse events between telestroke and in-person care.
Contraceptive use and associated factors among women of reproductive age on antiretroviral therapy in Awabel Woreda health centers, Northwest Ethiopia
Authors: Amsalu Menichil , worku Kalkidan , Ayalew Mulugeta , Alamneh Alehegn Aderaw
Published: November 2023

Background:

The family planning options for reproductive-age women who are in antiretroviral therapy should consider different types of contraceptive methods including condom use. There is a high unmet need and unplanned pregnancies in Ethiopia among HIV-positive women. Attention was not given towards contraceptive use for HIV women in Ethiopia including the study area. The study aimed to assess contraceptive use and associated factors among women of reproductive age (15–49 years) on Antiretroviral therapy in Awabel Woreda, Northwest Ethiopia.

Methods:

A facility-based cross-sectional study was conducted among 572 women of reproductive age who were receiving HIV care and treatment. Data were collected using interviewer-administered questionnaire, entered by Epidata3.1 and exported to IBM SPSS for statistics version 20 for analysis.Multivariable logistic regression was used to identify factors associated with contraceptive use and the presence of significant association was declared at p-value <0.05 and 95% confidence level.

Result:

A total of 526 out of 572 women have responded, with a response rate of 91.9%. Two-thirds (66.5% (95% CI: 63.5, 69.5)) of the study participants were using contraceptive methods at the time of the survey. Women living in areas (Adjusted Odds Ratio = 1.95; 95% CI: 1.16, 3.72), and those who disclosed their HIV status to their partner (Adjusted Odds Ratio = 2.61; 95% CI: 1.37, 4.95) were more likely to use contraceptives. While Women (Adjusted Odds Ratio = 0.41; 95% CI: 0.24, 0.69) and their partners (Adjusted Odds Ratio = 0.57; 95% CI: 0.34, 0.97) who had desire to have a child were less likely to use contraceptives.

Conclusions:

The prevalence of contraceptive use among reproductive-age women who were on antiretroviral therapy (ART) was lower than a systematic review done in Ethiopia and higher than the national target. Intervention targeting on implementation of contraceptive methods, and counseling about contraceptives to address their question of fertility desire and knowledge were recommended.
Dynamic scenario modelling of the role and influence of Brundtland and vulnerability upon sustainability in the UK in the Anthropocene
Authors: Phillips Jason
Published: November 2023

The Brundtland report and vulnerability are two of the fundamental perspectives of the environment-human system and relationship. However, the Brundtland report and its incarnations has been argued as anthropocentric in nature and fostering weak sustainability, thus resulting in vulnerability occurring. Furthermore, how the report and its incarnations has been interpreted and implemented by governments, businesses, and organisations is significant in determining sustainability outcomes. It is therefore appropriate and necessary to develop a fundamental dynamic understanding of how Brundtland and vulnerability over time may influence past and present-day sustainability outcomes at specified spatial scale. Consequently, building upon previous research, this paper develops a fundamental dynamic scenario model for the United Kingdom using the Sustainability Dynamics Framework. The model indicates that the UK has been significantly influenced by its interpretation and implementation of the Brundtland report, which has primarily focussed upon the economic and social development aspects. This has resulted in the present-day very weak to weak sustainability occurring for Brundtland-based factors, and weak unsustainability occurring for vulnerability factors. Based upon the historical and present-day modelled scenarios, the paper concludes that the UK is at a tipping point in respect to its environment-human system and relationship. A fundamental transformation is necessary to return the UK to optimum or below-optimum environment-human system thresholds and a more conducive co-evolutionary relationship. Unless this happens, then the risk of significant stress within the environment-human system will only continue to increase, with the possibility of a systemic crisis occurring, or possibly an environmental or societal collapse in the worst-case scenario.
A Brief Report on Measurement Invariance for the Ethnic Identity Scale Among College-Attending Emerging Adults
Authors: Allison Kelsie K. , Meca Alan , Cruz Bethany , Wright Allison , Veniegas Taryn
Published: November 2023

Ethnic-Racial Identity (ERI) development research has been critical in further understanding youths’ psychological adjustment. The Ethnic Identity Scale (EIS) has been used extensively in this field of research to measure ERI. However, it has not been assessed for full measurement invariance, which is essential to ensure its effectiveness in measuring ERI differences across different ethnic-racial and gender groups. Thus, the current study sought to establish full factorial measurement invariance of the EIS between emerging adult college students across ethnic-racial groups (i.e., Asian American, Black/African American, Hispanic/Latinx, and non-Hispanic White/European American) and genders (i.e., male and female). Participants included 7165 students ( Mage = 19.71 years, SD = 1.50) from 31 colleges and universities across various U.S. regions. Results established full factorial measurement invariance for the EIS across groups. Additionally, we examined construct validity by establishing that associations between ERI and psychological adjustment were consistent across groups. Implications and limitations are discussed.
Longer Screws Decrease the Risk of Radiographic Pseudarthrosis Following Elective Anterior Cervical Discectomy and Fusion
Authors: Chanbour Hani , Bendfeldt Gabriel A. , Johnson Graham W. , Peterson Keyan , Ahluwalia Ranbir , Younus Iyan , Longo Michael , Abtahi Amir M. , Stephens Byron F. , Zuckerman Scott L.
Published: November 2023

Study Design

Retrospective cohort study.

Objectives

In patients undergoing elective anterior cervical discectomy and fusion (ACDF), we sought to determine the impact of screw length on: (1) radiographic pseudarthrosis, (2) pseudarthrosis requiring reoperation, and (3) patient-reported outcome measures (PROMs).

Methods

A single-institution, retrospective cohort study was undertaken from 2010-21. The primary independent variables were: screw length (mm), screw length divided by the anterior-posterior vertebral body diameter (VB%), and the presence of any screw with VB% < 75% vs all screws with VB% ≥ 75%. Multivariable logistic regression controlled for age, BMI, gender, smoking, American Society of Anesthesiology grade, number of levels fused, and whether a corpectomy was performed.

Results

Of 406 patients undergoing ACDF, levels fused were: 1-level (39.4%), 2-level (42.9%), 3-level (16.7%), and 4-level (1.0%). Mean screw length was 14.3 ± 2.3 mm, and mean VB% was 74.4 ± 11.2. A total of 293 (72.1%) had at least one screw with VB% < 75%, 113 (27.8%) had all screws with VB% ≥ 75%, and 141 (34.7%) patients had radiographic pseudarthrosis at 1-year. Patients who had any screw with VB% < 75% had a higher rate of radiographic pseudarthrosis compared to those had all screws with VB% ≥ 75% (39.6% vs 22.1%, P < .001). Multivariable logistic regression revealed that a higher VB% (OR = .97, 95%CI = .95-.99, P = .035) and having all screws with VB% ≥ 75% (OR = .51, 95%CI = .27-.95, P = .037) significantly decreased the odds of pseudarthrosis at 1-year, with no difference in reoperation or PROMs (all P > .05).

Conclusion

Longer screws taking up ≥75% of the vertebral body protected against radiographic pseudarthrosis at 1-year. Maximizing screw length in ACDF is an easily modifiable factor directly under the surgeon’s control that may mitigate the risk of pseudarthrosis.
Foreign Aid and Economic Growth in South Asian Countries
Authors: Shah Birendra Narayan , Bhuyan Md Iqbal , Salam Rukshana , Sungsik Kim
Published: November 2023

This study employs panel data from 2000 to 2019 to examine and analyze the impact of foreign aid on growth in six South Asian nations, which are Bangladesh, Bhutan, India, Nepal, Pakistan, and Sri Lanka. The motivation of this study is to furnish empirical support for resolving the ongoing discourse on the relationship between foreign aid and economic growth. To this end, the article employs three panel regression models: pooled ordinary least-squares, random effect, and fixed effect, and estimates them using White cross-sectional standard errors and covariance. The empirical results reveal that foreign aid and population have a negative and considerable impact on Asian countries’ economic progress; whereas, gross capital formation has positive and significant effects. The empirical results of this study have important implications for both donors and aid recipient countries. It suggests that to get positive influence from aid, the recipient countries should enhance the quality of governance on the other side; the donor should provide a huge amount of aid for reforming the institutions’ quality and capacity building to developing countries. Furthermore, these countries should prefer to receive a grant as aid rather than a loan to reduce the debt burden. Government should develop the appropriate policies that help to increase government revenue and reduce the unnecessary current expenditure. To increase government revenue, the tax base should be regulated rather than being reliant on foreign loans. Also, advised channeling remittance into the productive sector and reducing the trade deficit by substituting imports through attracting foreign direct investment.
To use or not to use ChatGPT and assistive artificial intelligence tools in higher education institutions? The modern-day conundrum – students’ and faculty’s perspectives
Authors: Bissessar Charmaine
Published: November 2023

Students’ use of Artificial Intelligence tools to complete assignments spawns issues in academic integrity. The purpose of this study was to explore students’ and faculty’s perspectives on the benefits and challenges of using ChatGPT and assistive Artificial intelligence (AI) tools to complete assignments. This descriptive phenomenological qualitative methodology study encompassed interviews with eight students who used Large Language Models (LLMs) AI tools to complete their assignments and nine students who did not. It also contains interviews with six Faculty and their perspectives on students’ use of Large Language Models (LLMs) AI tools to complete their assignments and their thoughts on the benefits and challenges. The participants were purposively selected. The data were coded based on Braun and Clarke’s (2013) six steps in thematic analysis. Descriptive, in vivo, and evaluative coding were used. Additionally, data were examined semantically and latently using reductionist analysis to determine the final themes. Five components of the Unified Theory of Acceptance and Use of Technology (UTTAUT) were applied to the data collected and provided the framework for the study. Behavioural intention served as the foundation. Effort and Performance Expectancies, and facilitating conditions were exemplified in participants’ responses about the use of ChatGPT, Grammarly, and other AI assistive tools, plagiarism/academic integrity, and social influence were indicated when participants (both Students and Faculty) suggested the need for the development of policies and procedures toward the appropriate use of AI tools. Effort and performance expectancies and habits were found in the data collected in the form of consideration of the pros of using AI tools such as ChatGPT and assistive tools. These include the time saved by generating information, examples for both students and Faculty, and help in the teaching/learning process, and one participant found that it motivated her. The cons cited were students’ lack of creativity and the inability to think critically, the cost of the AI assistive tools (related to the component Price), the bandwidth needed to use them, the digital divide, and the false information generated. This study has significance for the use of ChatGPT and assistive AI tools in education and the ethical implications. It is recommended that specific policies be established and enacted to ensure the appropriate use of assistive and Artificial Intelligence (LLMs) tools.
A pathway activity-based proteomic classifier stratifies prostate tumors into two subtypes
Authors: Sun Rui , Tan Lingling , Ding Xuan , A Jun , Xue Zhangzhi , Cai Xue , Li Sainan , Guo Tiannan
Published: November 2023

Prostate cancer (PCa) is the second most common cancer in males worldwide. The risk stratification of PCa is mainly based on morphological examination. Here we analyzed the proteome of 667 tumor samples from 487 Chinese PCa patients and characterized 9576 protein groups by PulseDIA mass spectrometry. Then we developed a pathway activity-based classifier concerning 13 proteins from seven pathways, and dichotomized the PCa patients into two subtypes, namely PPS1 and PPS2. PPS1 is featured with enhanced innate immunity, while PPS2 with suppressed innate immunity. This classifier exhibited a correlation with PCa progression in our cohort and was further validated by two published transcriptome datasets. Notably, PPS2 was significantly correlated with poor biochemical recurrence (BCR)/metastasis-free survival (log-rank P-value < 0.05). The PPS2 was also featured with cell proliferation activation. Together, our study presents a novel pathway activity-based stratification scheme for PCa.