bluuebunny/crossref_metadata_2025 huggingface dataset:
Providing Home Healthcare Services for Patients during Pandemics: Applicability in Developing Countries
Authors: Yousef Rana , Al Zubi Khalid
Published: December 2023

The need for a systematic way to provide routine healthcare services for patients during pandemics is one of the priorities of the healthcare sector, especially when the country is in lockdown. In this article, we study the possibility of providing healthcare services for patients at their homes during pandemics in developing countries where such a system is not available. We present a technology-based solution and examine the possibility of its adaptation through a number of theoretical perspectives that examine changes in healthcare systems in general. Examining the theories of change revealed that providing healthcare services at home is a must during pandemics, and it has a significant role in improving the healthcare sector and in providing valuable services to patients, especially when the county is on lockdown. However, a number of challenges do exist for 0its adaptation in developing countries. These challenges are concerned with the costs of developing and maintaining the new system, as well as ensuring a precise and accurate healthcare service to be delivered on time and without any faults or errors. Having a well-studied plan by the health sector, an efficient scheduling mechanism for the healthcare services’ requests, and a service monitoring system can overcome all challenges and ensure a better quality of life for patients.
The Information on Decision-making in Health: From Predictable to Unpredictable
Authors: de Lima e Souza Vanessa , Borges Maria Manuel
Published: December 2023

This study’s aim is to identify the information needs, sources, seeking behaviour and uses of information by health managers involved with decision-making in public health. An exploratory, qualitative and comparative study was performed to analyse the municipal and state spheres of public health administration in Brazil and the Department of Informatics of the National Health System at the federal level. Nine health managers were interviewed at different hierarchy levels. It was verified that the decision is subsidised by technical, scientific information and appropriation of experiences from different sources. The flow of information is bottom-up, associated with the flow of documents that feed the health information systems. There is a need for predictable and unpredictable information, originating mainly from the press and the Public Ministry. The municipal sphere is better structured to handle information than the state sphere. Unpredictable information needs to interfere with the routine of health management work activities and impact health managers’ decision-making. Information is seldom used in this decision-making process, with the weakness of the health information systems being pointed out as the main cause. The production of information for decision-making needs to be systematised to support decisions, making a synthesis of the different sources of existing information systems.
Crop Diversity and Resilience to Droughts: Evidence from Indian Agriculture
Authors: Pattanayak Anubhab , Srinivasan Madhumitha , Kumar K. S. Kavi
Published: December 2023

In India, agricultural intensification and technological specialisation have led to the prevalence of monoculture. Diversity within crop species has been gradually declining since the advent of the Green Revolution in the 1960s. Increasingly frequent weather shocks induce agrarian stress, thus creating a need for robust adaptation responses. Using district-level agricultural data for the period between 1966 and 2015, this article aims to assess whether crop diversification can cushion yield losses due to droughts. The results of this study indicate that diversification enhanced resilience against droughts during the Green Revolution period. However, post-Green Revolution, specialisation seems to have helped mitigate the adverse effects of rainfall deficit. In the absence of weather extremes, monoculture is found to be more lucrative due to both supply- and demand-side factors such as improved inputs, irrigation and infrastructure facilities, government’s support prices and consumption demand patterns. Crop diversification is identified as a potential adaptation strategy against certain types of weather extremes. However, in some cases, crop diversification alone is inadequate in enhancing the drought resilience of the cropping system in India. To ensure drought resilience, combining crop diversification with other measures such as enhancing irrigation and agricultural diversification needs to be considered.
Experimentation and simulation study of electromechanical response characteristics of a 2-2 type cement-based piezoelectric composite sensor
Authors: Dong Haiwei , Ma Bohan , Zhu Ziye , Li Zhe , Yang Xiaokun , Chen Jiangying
Published: December 2023

In the manuscript, the piezoelectric functional element was prepared by slicing and adding method using piezoelectric ceramic PZT-5H and ordinary silicate cement 42.5 was as base materials, and then a 2-2 type cement-based piezoelectric composite sensor was prepared by an encapsulated epoxy resin. The experimental and simulation analysis was carried out to obtain the quasi-static linear sensitivity of the electromechanical response of the sample under conditions of compressive loading. The development process of the sample from local failure to overall fragmentation was observed using a high-speed camera. Found that the electrical nonlinear threshold of 35 MPa appeared before the mechanical nonlinear threshold. Further, the results showed that when the loading frequency was increased from 5 to 15 Hz under equal amplitude, the response waveform remained unchanged, however, the electrical displacement was attenuated by 19.7%. Packaging schemes using various lengths and thicknesses of an epoxy layer were conducted by using simulation. It is indicated that, under the premise of ensuring the protection package and considering the manufacturing process, the length of the package side could increase appropriately, and the single-side package side length is set to 4 mm. When the thickness of the package layer becomes less, it would be better.
The Impact of Operative Correction of Equinus in Cerebral Palsy on Gait Patterns
Authors: Horsch Axel , Petzinger Lara , Deisenhofer Julian , Ghandour Maher , Klotz Matthias , Renkawitz Tobias , Putz Cornelia
Published: December 2023

Background:

This study aimed to evaluate gait outcomes and strength following the surgical correction of equinus in cerebral palsy (CP) based on different surgical procedures. We included the Baumann and Strayer procedures, as well as the Achilles tendon lengthening (ATL).

Methods:

A retrospective analysis was performed in patients with infantile, bilateral CP who received instrumental 3D gait analysis before and after surgical correction (18.66 months postoperatively). Patients were divided into 3 groups: Strayer surgery, Baumann surgery, and ATL. Gait performance and muscle strengths were compared between studied surgeries.

Results:

A total population of 204 patients (15.43 years) with 341 operated lower limbs (LLs) was analyzed. Dorsiflexion in swing and stance phases significantly improved in all groups postoperatively. The Strayer and the ATL group showed higher postoperative dorsiflexion than the Baumann group. However, no loss of strength was observed with the Baumann method. Maximum power improved in this group postoperatively. An 8.2% loss in calf muscle strength was recorded in the Strayer group.

Conclusion:

Operative pes equinus treatment successfully improved the gait of children and adults with CP postoperatively. There were differences in postoperative results between studied operative techniques regarding range of motion and power.

Level of Evidence:

Level III, retrospective cohort study.
Single Exercise for Core Symptoms and Executive Functions in ADHD: A Systematic Review and Meta-Analysis
Authors: Chen Ji-Wei , Zhu Kun
Published: December 2023

Objectives:

A systematic review and meta-analysis of studies of single exercise on core symptoms and executive function in adolescents with ADHD.

Methods:

Four databases were searched for studies of the effects of single exercise on core symptoms and executive functioning in adolescents with ADHD.

Results:

Thirteen studies were included, and a single session of exercise had small effect-size improvements in core symptoms and executive function in adolescents with ADHD: 10 to 13 year olds in the early adolescent–elementary school years and 18 to 24 year olds in the late adolescent–college years. Moderate-intensity continuous training, high-intensity interval training, single sessions of less than 30 minutes, and single sessions of 30 minutes and more significantly improved cycling training, attention, inhibition, substance use, and pre-study abstinence.

Conclusions:

A single session of exercise had an overall ameliorative effect on core symptoms and executive function in adolescents with ADHD.
Measuring Quality Care for Adult ADHD Patients: How Much Does Gender and Gender Identity Matter?
Authors: Clay Tarin , Callen Elisabeth F. , Alai Jill , Goodman David W. , Adler Lenard A. , Faraone Stephen V.
Published: December 2023

Objective:

Studies show adult ADHD presents differently in men and women, however few studies contrast ADHD in cisgender and gender diverse adults. We assessed care differences between these groups using previously identified quality measures (QMs).

Methods:

Using EHR data, we matched a group of male ADHD patients to a female group. We followed the same procedure with a cisgender group and one identified as gender diverse through a gender dysphoria diagnosis. QM achievement was measured using logistic regression models.

Results:

Most QMs exhibited increasing achievement over time for all groups. Variations in care quality between males and females persisted, with female patients achieving QMs more often. There were no appreciable differences between the cisgender and gender diverse groups.

Conclusion:

Though quality care for adult ADHD improved from 2010 to 2020, differences between male and female patients lingered. This effect was not observed in cisgender and gender diverse patients.
The Gay and Trans Panic Defense: Focusing on the Homicides, Not the Court Room Strategy
Authors: Andresen Warren Carsten
Published: December 2023

This study analyzes 351 homicides where defendants raised gay or trans panic defenses within the United States from 1970 to 2022. This work builds on prior research by focusing on gay men and trans women as distinct groups to examine the demographic and socio-economic variables of these victims and their killers. This study also explores how the offenders killed their victims, focusing on the fatal weapon, time of murder, and homicide location. Finally, this study investigates situational variables, including relationship between victim and killer, use of drugs/alcohol, offender’s stated motivation for murder, and whether the offender stole the victim’s property.
Exploring Gender Bias in Homicide Sentencing: An Empirical Study of Russian Court Decisions Using Text Mining
Authors: Zhuchkova Svetlana , Kazun Anton
Published: December 2023

This study explores the role of gender in sentencing in Russian homicide cases, particularly the “female discount” phenomenon. We use regression analysis on a dataset of 20531 court decisions acquired via text mining techniques. Our research indicates that female defendants in Russia tend to receive more lenient sentences than their male counterparts do. Crimes against intimate partners and family members result in more lenient sentences than those against nonrelatives and strangers. The gender of the judge does not significantly influence the sentencing of female offenders; however, male judges are generally tougher on male defendants. The findings show that the “social costs theory” functions differently for male and female offenders.
Does Indoxyl Sulfate Have a Role in Uremic Pruritus? A Laboratory and Interventional Study
Authors: Akl Essam Mohamed , El-Eraki Jeylan M. , Elfallah Assma A. , Mohamed Nelly H. , Maher Amr M. , Mansour Ahmed E. , Abdelsalam Osama H.
Published: December 2023

Background:

Pruritus is a common complaint in patients with end-stage renal disease. Indoxyl sulfate (IS) is a tryptophan end metabolite extremely renal excreted. Activated charcoal can interfere with IS intestinal absorption.

Objectives:

To evaluate the serum level of IS and the effect of activated charcoal on uremic pruritus.

Materials and Methods:

In all, 135 participants were divided into 2 main groups. In total, 45 normal and healthy individuals as a control group and 90 patients on regular hemodialysis; 45 of these patients had uremic pruritus and the other 45 were not complaining of uremic pruritus. Serum IS was measured. Activated charcoal was used by patients with uremic pruritus. The severity of pruritus and Dermatology Life Quality Index (DLQI) were assessed.

Results:

The serum IS was significantly elevated in uremic patients than in control subjects ( P < .001) and significantly elevated in uremic patients without pruritus ( P < .001). Furthermore, there were positive significant correlations between the serum IS and both severity of pruritus ( P < .001) and DLQI ( P < .001). After activated charcoal usage, there was a significant decrease in IS level with the improvement of pruritus and quality of life of patients.

Conclusions:

IS may play a role in uremic pruritus. Activated charcoal could be considered a treatment for uremic pruritus.
Determinants of consumers’ intention to visit green hotels: Combining psychological and contextual factors
Authors: Ferreira Sandra , Pereira Olga , Simões Cláudia
Published: December 2023

Despite growing interest, the associations between contextual and psychological factors concerning consumers’ intentions to visit green hotels have been scarce in the literature. The main purpose of this investigation is to evaluate the intentions of consumers to visit green hotels and establish determinants of this intention. We developed and tested a research model grounded on the theory of planned behavior (TPB) and inclusion of the contextual factors, biospheric value and green trust. A quantitative study was carried out among consumers in Portugal. Findings revealed that consumers have high intentions to visit green hotels. The TPB variables (attitude, subjective norms, and perceived behavioral control) and the biospheric value positively affect behavioral intentions. Green trust has a positive influence on TPB variables. Similarly, the biospheric value impacts on attitude and subjective norms. The study withdraws implications for hotel managers to design effective marketing strategies in the context of green hotels.
Inclusion of autistic students in schools: Knowledge, self-efficacy, and attitude of teachers in Germany
Authors: Wittwer Jörg , Hans Sandra , Voss Thamar
Published: December 2023

To provide inclusive education to autistic students, it is important that teachers possess knowledge about autism, feel competent in teaching autistic students, and have a positive attitude toward the inclusion of autistic students. In this study, we explored knowledge, self-efficacy, and attitude concerning autism among N = 887 teachers in Germany. The results showed that knowledge about autism was only moderate and teachers held some typical misconceptions about autism. Moreover, teachers did not possess overwhelmingly high self-efficacy beliefs whereas their attitude toward inclusion of autistic students was rather positive. Experience with teaching autistic students was associated with more knowledge and higher self-efficacy. Also, female teachers were more knowledgeable about autism and felt more competent in teaching autistic students than male teachers. However, the type of school where teachers were working made hardly any difference in their knowledge, self-efficacy, and attitude. Overall, the results suggest that teachers in Germany need more autism training to increase their knowledge about autism and their self-efficacy beliefs in teaching autistic students.

Lay Abstract

Nowadays, autistic students are often enrolled in mainstream schools. To successfully include autistic students in general education, teachers need to possess knowledge about autism, feel competent in teaching autistic students, and have a positive attitude toward their inclusion. However, in Germany, little is known about the knowledge, the self-efficacy, and the attitude concerning autism among teachers working at mainstream schools. Therefore, we conducted a study in which we used items to assess knowledge, self-efficacy, and attitude. A total of 887 general education teachers participated in the study. The results showed that the level of knowledge about autism was moderate among teachers. Similarly, teachers did not hold overwhelmingly high self-efficacy beliefs. However, their attitude toward inclusion of autistic students was rather positive. At the same time, teachers who had experience with teaching autistic students possessed more knowledge and higher self-efficacy than teachers who had no experience with teaching autistic students. In addition, female teachers were more knowledgeable about autism and felt more competent in teaching autistic students than male teachers. In contrast, knowledge, self-efficacy, and attitude were rather similar among teachers from different types of schools. The findings suggest that teachers in Germany should possess more knowledge about autism and feel more competent in teaching autistic students. Therefore, it is important to systematically include autism trainings in teacher education programs.
Examining factors predicting sexual exploitation among victims of human trafficking
Authors: Kooffreh BE
Published: December 2023

The primary aim of this study is to investigate the factors predicting sexual exploitation among victims of human trafficking, specifically examining how traffickers’ means of control, types of sexual services, nature of recruiter relationships and female age groups play a role in this phenomenon. The data analysed spanned from 2002 to 2019 and were sourced from anonymised public data provided by the Counter-Trafficking Data Collaborative (CTDC), a global hub collecting information from counter-trafficking organisations worldwide. Utilising a binary logistic regression approach, the study identified that traffickers employ various means of control, such as debt bondage, taking earnings, threats, sexual abuse, false promises, use of psychoactive substances, exploitation of children, threat of law enforcement and withholding necessities, aligning with Biderman's Theory of Coercion. Additionally, victims experience prostitution, pornography and private sexual services, often recruited by intimate partners and friends. Furthermore, the study revealed that young women aged 30 years and above were less likely to experience sexual exploitation compared to younger girls.
In paediatric major trauma patients is admission hypocalcaemia associated with adverse outcomes?
Authors: Hibberd O , Barnard EBG
Published: December 2023

‘In [paediatric major trauma] is [admission hypocalcaemia] associated with [adverse outcomes]’.
Strategies for evaluating visual analytics systems: A systematic review and new perspectives
Authors: Islam Md Rafiqul , Akter Shanjita , Islam Linta , Razzak Imran , Wang Xianzhi , Xu Guandong
Published: December 2023

In recent times, visual analytics systems (VAS) have been used to solve various complex issues in diverse application domains. Nonetheless, an inherent drawback arises from the insufficient evaluation of VAS, resulting in occasional inaccuracies when it comes to analytical reasoning, information synthesis, and deriving insights from vast, ever-changing, ambiguous, and frequently contradictory data. Hence, the significance of implementing an appropriate evaluation methodology cannot be overstated, as it plays a pivotal role in enhancing the design and development of visualization systems. This paper assesses visualization systems by providing a systematic exploration of various evaluation strategies (ES). While several existing studies have examined some ES, the extent of comprehensive and systematic review for visualization research remains limited. In this work, we introduce seven state-of-the-art and widely recognized ES namely (1) dashboard comparison; (2) insight-based evaluation; (3) log data analysis; (4) Likert scales; (5) qualitative and quantitative analysis; (6) Nielsen’s heuristics; and (7) eye trackers. Moreover, it delves into their historical context and explores numerous applications where these ES have been employed, shedding light on the associated evaluation practices. Through our comprehensive review, we overview and analyze the predominant evaluation goals within the visualization community, elucidating their evolution and the inherent contrasts. Additionally, we identify the open challenges that arise with the emergence of new ES, while also highlighting the key themes gleaned from the existing literature that hold potential for further exploration in future studies.
Interact: A visual what-if analysis tool for virtual product design
Authors: Ciorna Vasile , Melançon Guy , Petry Frank , Ghoniem Mohammad
Published: December 2023

Virtual prototyping is increasingly used by businesses to streamline operations, cut costs, and enhance daily operations. This often includes a variety of modeling techniques among which, complex, black-box models. The path from model development to utilization in applied contexts is yet long. Domain experts need to be convinced of the validity of the models and to trust their predictions. To be used in the field, model capabilities need to be affordable, that is, allow rapid and interactive scenario building, even for non-experts. Complex relations governed by statistical interactions must be unveiled for users to understand unexpected predictions. We propose Interact, a model-agnostic, visual what-if tool for regression problems, supporting (1) the visualization of statistical interactions between features, (2) the creation of interactive what-if scenarios using predictive models, (3) the evaluation of model quality and building trust, and (4) the externalization of knowledge through model explainability. While the approach applies in various industrial contexts, we validate the application purpose and design with a detailed case study and a qualitative user study with engineers in the tire industry. By unraveling statistical interactions between features, the INTERACT tool proves to be useful to increase the transparency of black-box machine learning models. We also reflect on lessons learned concerning the development of visual what-if tools for virtual product development and beyond.
Against All Odds: Students’ Interest in, and Perceived Value of, Research and Nonresearch Psychology Subjects
Authors: Lloyd-Lewis Benjamin L. , Miller Dan J. , Krause Amanda E.
Published: December 2023

Although research literacy is necessary for the competent delivery of psychological services, many psychology students hold negative attitudes toward research subjects. The current study explored undergraduate students’ perceptions of research subjects relative to nonresearch subjects. A sample of 249 Australian (45.4%) and Singaporean (54.6%) first-year university students ( Mage = 21.27, SDage = 5.14, females = 75.9%) indicated their interest in, and perceived value of, 32 psychology subjects (based on title and a short description). They also nominated their most/least interested and valued subject and provided a free-text explanation for their selections. Participants perceived research subjects as significantly less interesting and valuable relative to nonresearch subjects ( d values were indicative of a large difference for interest and a small-to-medium different for value). Cluster analysis indicated that research subjects are seen as distinct, forming their own cluster. This finding was supported by thematic analysis of participants’ open-ended responses. Students considered research subjects to be especially difficult, requiring skills they did not possess or enjoy using (e.g., mathematics), and lacking relevance to their future studies and intended careers. The findings suggest that research methods instructors should aim to emphasize the relevance of research to practice in high interest areas (e.g., psychopathology).
Umpire Home Bias in Major League Baseball
Authors: Hsu Mike
Published: December 2023

This paper studies whether Major League Baseball umpires displayed home bias in their pitch calls, using data on pitch call accuracy from the 2010–2019 seasons to isolate evaluator bias from player performances. The main findings are consistent with umpire home bias, as home batters on average received more called balls on actual ball pitches and fewer called strikes on actual strike pitches, which work in their favor. The bias is not entirely explained by umpire, player, or stadium characteristics, nor is it attributable to umpiring inconsistencies.
Spontaneous Extraperitoneal Hematoma Related to May-Thurner Syndrome
Authors: Im Cherie , Shim Min Jung , Lee Seung-Yul , Lee Guy Mok , Kim In Jai
Published: December 2023

In this report, we describe a rare case: deep vein thrombosis due to May-Thurner syndrome with a spontaneous pelvic extraperitoneal hematoma. This unique challenge highlights balancing thrombosis treatment and bleeding risk. Endovascular treatment with delayed anticoagulation may be an alternative to surgery for stable retroperitoneal hematoma in May-Thurner syndrome patients.
The Novel Surgical Technique in the Cyanoacrylate Closure for Incompetent Great Saphenous Veins
Authors: Lee Changhun
Published: December 2023

Objective

The current Instructions for Use (IFU) of cyanoacrylate closure (CAC) is to start initial injection with the catheter tip positioned 5 cm distal to the sapheno-femoral junction (SFJ) to prevent endovenous glue-induced thrombosis (EGIT). However, this defensive design is responsible for the relatively long stump length. Although clinical studies on the long-term recurrence rate are still lacking, the long stump length can predict a higher long-term recurrence rate compared to other surgical methods. The author developed a novel surgical technique that can overcome the weakness of CAC, and the initial outcomes of this technique are described in this article.

Methods

This study retrospectively reviewed 25 great saphenous vein (GSV) in 20 patients who underwent CAC for incompetent GSV at our hospital. The procedure from puncturing the GSV to insertion of the catheter is the same as the conventional method. Place the catheter tip 2-3 cm below the SFJ before cyanoacrylate injection. After confirming the position of the SFJ with the longitudinal view of the ultrasound, press the GSV directly above the SFJ transversely with the second to fifth fingertips of the left hand. Then, the ultrasound probe is placed against the distal part of the fingertips, and CA injection is performed while GSV is monitored in real time.

Results

The mean stump length immediately after surgery was 19.3 (± 7.8) mm, with a range of .0-38.4 mm. The mean stump length after 1 week was 12.3 (± 7.4) mm and the range was .1-35.4 mm. The mean stump length after 1 month was 15.4 (± 10.1) mm, and the range was .0-35.4 mm. There was no case with EGIT or recanalization.

Conclusions

The author confirmed the possibility of safely reducing stump length with this novel surgical technique, and expect that this method can help overcome the weakness of CAC.
The Romanian Press in the Austro–Hungarian Empire (1867–1914): A Comparative Study Case of the Most Significant Magazines and Newspapers
Authors: Nicolaescu Alexandru
Published: December 2023

Thanks to the accelerated worldwide literacy process and technical innovations in the printing field, the written press reached its maximum development potential at the turn of the twentieth century. Because of their widespread availability, magazines and newspapers were used by the time's elites to disseminate new knowledge and technical innovations. Considering these aspects of the press, this study traces the thematic evolution of the educational and informational articles published by the most influential magazines and newspapers of the Romanians in the Austro–Hungarian Empire from 1867 to 1914. Significant personalities wrote the selected periodicals of the Romanians from Transylvania, where most Romanians lived during the Dual Monarchy. They were also appreciated by the Romanians who lived in the Kingdom of Romania. Hence, they generated fruitful debates of ideas that helped to develop the various Romanian cultures, societies, politics and economies. This study, which focused on the comparative analysis of the messages conveyed in the articles, found that newspapers and magazines had similar educational messages despite having diverse purposes. The dissemination of general information was approached differently by the two types of studied press. Based on this first comparative analysis of the most representative publications of Romanians from Transylvania, I conclude that their editors put forth well-thought-out educational messages, and the informational articles had the same characteristics as the European press of the period.
Managing concussion in the real world: Stakeholder perspectives of New Zealand Rugby's concussion management pathway
Authors: Salmon Danielle Margaret , Walters Simon , Brown James , Kerr Zachary Yukio , Clacy Amanda , Keung Sierra , Sullivan S John , Register-Mihalik Johna , Whatman Chris , Sole Gisela , Badenhorst Marelise
Published: December 2023

The potential adverse consequences associated with poor concussion management highlights the need to improve the translation of concussion guidelines into consistent use in real-world sport settings. To facilitate this process, New Zealand Rugby developed a community concussion management pathway to support concussion recognition, diagnosis, and management. This study adopted a pragmatic, descriptive qualitative approach to explore key stakeholders’ perceptions of the concussion management pathway, with the aim to inform policy and practice. Interviews were conducted with 123 participants, including players, parents, coaches, healthcare professionals, and school and provincial union representatives. The framework method was used to analyze data. Themes were organized according to the principles of realist process evaluation that considers contextual factors and mechanisms influencing a program's operation to produce specific outcomes. Contextual factors influencing the concussion management pathway's implementation included governing bodies’ support, existing local resources, general concussion attitudes, or concussion severity. The optimal functioning of the concussion management pathway ( mechanism) was influenced by (i) pathway resources, (ii) roles and relationships, (iii) buy-in and support towards the concussion management pathway, and (iv) diligence and communication. Outcomes identified included (i) hitting the target (optimally managed and enhanced awareness) or (ii) missing the mark (dissatisfaction or management gaps). Overall, participants found the concussion management pathway valuable. However, the acceptability of certain policy-related aspects and the underlying attitudes associated with these perceptions, are some areas requiring further investigation and support. Tailoring programs according to end-users’ perceptions is crucial in developing context-sensitive interventions appropriate for a specific setting. These findings may act as a foundation for investigations of concussion management in other settings.
Gibsland, Louisiana’s memoryscape of Bonnie and Clyde: Putting the past in the present
Authors: Holden William N
Published: December 2023

A memoryscape is a place where memories are anchored in space. One cannot travel back in time to when an event occurred, but one can travel in space to where an event occurred. On 23 May 1934, Bonnie Parker and Clyde Barrow were ambushed and killed near Gibsland, Louisiana, by a posse of law enforcement officers. There is a monument at the ambush’s location, and since 1993, there has been the Authentic Bonnie and Clyde Festival commemorating the ambush and culminating with its re-enactment. The re-enactment demonstrates putting the past into the present, and while watching it, one feels being taken back in time to when the ambush occurred and experiences living history. The ambush’s re-enactment commemorates not only the end of Bonnie and Clyde’s crime wave but also the beginning of the end of the Public Enemy Era.
The incidence and risk factors of proximal lower extremity deep vein thrombosis without pharmacologic prophylaxis in critically ill surgical Taiwanese patients: A prospective study
Authors: Lin Ting-Lung , Liu Wen-Hao , Lai Wei-Hung , Chen Ying-Ju , Chang Po-Hsun , Chen I-Ling , Li Wei-Feng , Liu Yueh-Wei , Ley Eric J , Wang Chih-Chi
Published: December 2023

Background:

Venous thromboembolism (VTE) in critically ill patients has been well-studied in Western countries. Many studies have developed risk assessments and established pharmacological protocols to prevent deep venous thrombosis (DVT). However, the DVT rate and need for pharmacologic VTE prophylaxis in critically ill Taiwanese patients are limited. This study aimed to prospectively determine the DVT incidence, risk factors, and outcomes in critically ill Taiwanese patients who do not receive pharmacologic VTE prophylaxis.

Methods:

We conducted a prospective study in a surgical intensive care unit (SICU) of a tertiary academic medical center in Taiwan. Adult patients admitted to SICU from March 2021 to June 2022 received proximal lower extremities DVT surveillance with venous duplex ultrasound. No patient received pharmacologic VTE prophylaxis. The outcomes were the incidence and risk factors of DVT.

Results:

Among 501 enrolled SICU patients, 21 patients (4.2%) were diagnosed with proximal lower extremities DVT. In a multivariate regression analysis, hypoalbuminemia (odd ratio (OR) = 6.061, 95% confidence interval (CI): 1.067–34.421), femoral central venous catheter (OR = 4.515, 95% CI: 1.547–13.174), ICU stays more than 10 days (OR = 4.017, 95% CI: 1.270–12.707), and swollen leg (OR = 3.427, 95% CI: 1.075–10.930) were independent risk factors for DVT. In addition, patients with proximal lower extremities DVT have more extended ventilator days ( p = 0.045) and ICU stays ( p = 0.044).

Conclusion:

Our findings indicate critically ill Taiwanese patients have a higher incidence of DVT than results from prior retrospective studies in the Asian population. Physicians who care for this population should consider the specific risk factors for DVT and prescribe pharmacologic prophylaxis in high-risk groups.
EPidemiology Of Cardiogenic sHock in Scotland (EPOCHS): A multicentre, prospective observational study of the prevalence, management and outcomes of cardiogenic shock in Scotland
Authors: Warren Alex , McCall Philip , Proudfoot Alastair , Gillon Stuart , Abu-Arafeh Ahmad , McKnight Angus John , Mudie Rosemary , Armstrong David , Tzolos Evangelos , Livesey John Andrew , Sinclair Andrew , Baston Veronica , Dalzell Jonathan , Owen Deborah , Fleming Lucy , Scott Ian , Puxty Alex , Lee Matthew MY , Walker Fiona , Hobson Simon , Campbell Euan , Kinsella Michael , McGinnigle Eilidh , Docking Robert , Price Grant , Ramsay Alex , Bauld Richard , Herron Suzanne , Lone Nazir I , Mills Nicholas L , Hartley Louise
Published: December 2023

Background:

Despite high rates of cardiovascular disease in Scotland, the prevalence and outcomes of patients with cardiogenic shock are unknown.

Methods:

We undertook a prospective observational cohort study of consecutive patients with cardiogenic shock admitted to the intensive care unit (ICU) or coronary care unit at 13 hospitals in Scotland for a 6-month period. Denominator data from the Scottish Intensive Care Society Audit Group were used to estimate ICU prevalence; data for coronary care units were unavailable. We undertook multivariable logistic regression to identify factors associated with in-hospital mortality.

Results:

In total, 247 patients with cardiogenic shock were included. After exclusion of coronary care unit admissions, this comprised 3.0% of all ICU admissions during the study period (95% confidence interval [CI] 2.6%–3.5%). Aetiology was acute myocardial infarction (AMI) in 48%. The commonest vasoactive treatment was noradrenaline (56%) followed by adrenaline (46%) and dobutamine (40%). Mechanical circulatory support was used in 30%. Overall in-hospital mortality was 55%. After multivariable logistic regression, age (odds ratio [OR] 1.04, 95% CI 1.02–1.06), admission lactate (OR 1.10, 95% CI 1.05–1.19), Society for Cardiovascular Angiographic Intervention stage D or E at presentation (OR 2.16, 95% CI 1.10–4.29) and use of adrenaline (OR 2.73, 95% CI 1.40–5.40) were associated with mortality.

Conclusions:

In Scotland the prevalence of cardiogenic shock was 3% of all ICU admissions; more than half died prior to discharge. There was significant variation in treatment approaches, particularly with respect to vasoactive support strategy.
The fragility index in randomised controlled trials of interventions for aneurysmal subarachnoid haemorrhage: A systematic review
Authors: Ramesh Aravind V , Munby Henry NP , Thomas Matt
Published: December 2023

Background:

Fragility analysis supplements the p-value and risk of bias assessment in the interpretation of results of randomised controlled trials. In this systematic review we determine the fragility index (FI) and fragility quotient (FQ) of randomised trials in aneurysmal subarachnoid haemorrhage.

Methods:

This is a systematic review registered with PROSPERO (ID: CRD42020173604). Randomised controlled trials in adults with aneurysmal subarachnoid haemorrhage were analysed if they reported a statistically significant primary outcome of mortality, function (e.g. modified Rankin Scale), vasospasm or delayed neurological deterioration.

Results:

We identified 4825 records with 18 randomised trials selected for analysis. The median fragility index was 2.5 (inter-quartile range 0.25–5) and the median fragility quotient was 0.015 (IQR 0.02–0.039). Five of 20 trial outcomes (25%) had a fragility index of 0. In seven trials (39.0%), the number of participants lost to follow-up was greater than or equal to the fragility index. Only 16.7% of trials are at low risk of bias.

Conclusion:

Randomised controlled trial evidence supporting management of aneurysmal subarachnoid haemorrhage is weaker than indicated by conventional analysis using p-values alone. Increased use of fragility analysis by clinicians and researchers could improve the translation of evidence to practice.
Effectiveness of the Ponseti method for congenital clubfoot in patients with arthrogryposis: A systematic review and meta-analysis of observational studies
Authors: Bravin Augusto Cesar , Ferraz Ferreira Gabriel , Nogueira Monica Paschoal
Published: December 2023

Purpose:

The aim of this systematic review was to address the Ponseti method in arthrogrypotic clubfoot treatment and evaluate the success, complication, and recurrence rates.

Method:

A systematic review was performed in the PubMed, Scopus, Embase, and Web of Science databases on 9 January 2023, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Success, recurrence, and complication rates were evaluated and analyzed. Risks of bias and the quality of the studies were also evaluated.

Results:

Five case series, including 53 patients (102 feet), were identified. According to this model, the initial success rate was 91% (95% confidence interval = 0.79–0.96) with I2 = 43%, and the final success was 68% (at 5.8 years of follow-up). Recurrence rate was 30% (95% confidence interval = 0.14–0.52).

Conclusion:

Ponseti method is indicated in the initial treatment of arthrogrypotic clubfeet, as it is a minimally invasive method with a high correction rate (91%). However, a high recurrence rate (30%) requires early detection and adequate treatment.

Level of evidence:

Level III

PROSPERO Protocol:

CRD42020210373
Hereditary spastic paraplegia: Novel insights into the pathogenesis and management
Authors: Awuah Wireko Andrew , Tan Joecelyn Kirani , Shkodina Anastasiia D , Ferreira Tomas , Adebusoye Favour Tope , Mazzoleni Adele , Wellington Jack , David Lian , Chilcott Ellie , Huang Helen , Abdul-Rahman Toufik , Shet Vallabh , Atallah Oday , Kalmanovich Jacob , Jiffry Riaz , Madhu Divine Elizabeth , Sikora Kateryna , Kmyta Oleksii , Delva Mykhailo Yu
Published: December 2023

Hereditary spastic paraplegia is a genetically heterogeneous neurodegenerative disorder characterised primarily by muscle stiffness in the lower limbs. Neurodegenerative disorders are conditions that result from cellular and metabolic abnormalities, many of which have strong genetic ties. While ageing is a known contributor to these changes, certain neurodegenerative disorders can manifest early in life, progressively affecting a person’s quality of life. Hereditary spastic paraplegia is one such condition that can appear in individuals of any age. In hereditary spastic paraplegia, a distinctive feature is the degeneration of long nerve fibres in the corticospinal tract of the lower limbs. This degeneration is linked to various cellular and metabolic processes, including mitochondrial dysfunction, remodelling of the endoplasmic reticulum membrane, autophagy, abnormal myelination processes and alterations in lipid metabolism. Additionally, hereditary spastic paraplegia affects processes like endosome membrane trafficking, oxidative stress and mitochondrial DNA polymorphisms. Disease-causing genetic loci and associated genes influence the progression and severity of hereditary spastic paraplegia, potentially affecting various cellular and metabolic functions. Although hereditary spastic paraplegia does not reduce a person’s lifespan, it significantly impairs their quality of life as they age, particularly with more severe symptoms. Regrettably, there are currently no treatments available to halt or reverse the pathological progression of hereditary spastic paraplegia. This review aims to explore the metabolic mechanisms underlying the pathophysiology of hereditary spastic paraplegia, emphasising the interactions of various genes identified in recent network studies. By comprehending these associations, targeted molecular therapies that address these biochemical processes can be developed to enhance treatment strategies for hereditary spastic paraplegia and guide clinical practice effectively.
Hotels in France During and Post COVID-19: A Change Management Case Study
Authors: Eddial Hajar
Published: December 2023

COVID had strongly impacted the tourism sector. According to the ministry of Europe and foreign affairs, the sector saw a decline of almost 50% in international tourism revenues generated in the first 7 months of 2020. The restrictions imposed on travel and closure of borders to reduce the number of active COVID-19 cases caused several hotels to be closed or rethink their management methods to survive. The aim of this case study is first, to understand the impact of this health crisis in France and to list the different strategies used in the literature review to overcome COVID-19 impact. Second, the study focuses on Accor group in France, the dilemma they faced, and the different strategies put in place to bounce back from the crisis and support change. This study demonstrates that alternative strategies and change processes can be used in times of crisis to survive and remain competitive.
Inadequate Orientation and Ineffective Communication: The Case of the Intern
Authors: Garrick Arlene , Arendt Susan W. , Bosselman Robert
Published: December 2023

This case explores communication disconnects resulting in a fragmented orientation, a disengaged intern, and a disgruntled Food and Beverage (F & B) manager. Good communication is essential in all business operations. Disengaged and uninformed employees can adversely impact business operations and profitability. Implementing effective communication tools and strategies in departments is vital to optimize performance and stay competitive. An organization that has effective policies and procedures but does not disseminate the information may have undesirable outcomes. Misunderstandings and dissatisfied employees may result if there is misalignment between employee actions and formal policies and procedures.
Utilization of Medications for Opioid Use Disorder Among West Virginia Medicaid Enrollees Following Medicaid Coverage of Methadone
Authors: Harris Samantha J. , Landis Rachel K. , Li Wenshu , Stein Bradley D. , Saloner Brendan
Published: December 2023

Background:

West Virginia entered an institution for mental disease Section 1115 waiver with the Centers for Medicare & Medicaid Services in 2018, which allowed Medicaid to cover methadone at West Virginia’s nine opioid treatment programs (OTPs) for the first time.

Methods:

We conducted time trend and geospatial analyses of Medicaid enrollees between 2016 and 2019 to examine medications for opioid use disorder utilization patterns following Medicaid coverage of methadone, focusing on distance to an OTP as a predictor of initiating methadone and conditional on receiving any, longer treatment duration.

Results:

Following Medicaid coverage of methadone in 2018, patients receiving methadone comprised 9.5% of all Medicaid enrollees with an opioid use disorder (OUD) diagnosis and 10.6% in 2019 ( P < 0.01). In 2018, two-thirds of methadone patients either had no prior OUD diagnosis or were not previously enrolled in Medicaid in our observation period. Patients residing within 20 miles of an OTP were more likely to receive methadone (marginal effect [ME]: −0.041, P < 0.001). Similarly, patients residing in metropolitan areas were more likely to receive treatment than those residing in nonmetropolitan areas (ME: −0.019, P < 0.05). Metropolitan patients traveled an average of 15 miles to an OTP; nonmetropolitan patients traveled more than twice as far ( P < 0.001). We found no significant association between distance and treatment duration.

Conclusions:

West Virginia Medicaid’s new methadone coverage was associated with an influx of new enrollees with OUD, many of whom had no previous OUD diagnosis or prior Medicaid enrollment. Methadone patients frequently traveled far distances for treatment, suggesting that the state needs additional OTPs and innovative methadone delivery models to improve availability.