bluuebunny/crossref_metadata_2025 huggingface dataset:
The relationship between regional inequalities in the provision of emergency health services and other health services
Authors: Boğa Erkan
Published: November 2023

In this research, it was aimed to examine relationship between regional inequalities in the provision of emergency health services and other health services in Turkey. The values of the number of emergency services and the population per emergency service for the years 2002-2021 were taken from the most up-to-date database published by the Ministry of Health in 2022 and were chosen as the dependent variables of the study. The “regional price level indices for consumption expenditures (PLI)” and “gross domestic product per capita, Statistical Regions Level 2 (PcGDP)” data compiled by TURKSTAT were used as independent variables. Number of emergency stations were significantly correlated with TR31 (İzmir) (r = 0.903; P < .01), TR32 (Aydin, Denizli, Muğla) (r = 0.771; P < .01), TR42 (Kocaeli, Sakarya, Düzce, Bolu, Yalova) (r = −0.798; P < .01), TR62 (Adana, Mersin) (r = 0.837; P < .01), TR63 (Hatay, K.Maraş, Osmaniye) (r = −0.749; P < .01), TR72 (Kayseri, Sivas, Yozgat) (r = −0.719; P < .01), TR83 (Samsun, Tokat, Çorum, Amasya) (r = 0.873; P < .01), TRA2 (Ağri, Kars, Iğdir, Ardahan) (r = −0.873; P < .01), TRB2 (Van, Muş, Bitlis, Hakkari) (r = −0.736; P < .01), TRC2 (Şanliurfa, Diyarbakir) (r = 0.697; P < .01), and TRC3 (Mardin, Batman, Şirnak, Siirt) (r = 0.574; P < .01). In total, 11 of 26 were significantly correlated with inequalities. Although the number of emergency services has increased since 2002 and the population density per emergency room has tended to decrease, regional inequalities also have an impact on the delivery of emergency services today.
Mapping the knowledge domains of medical textiles: A review
Authors: Liu Zhiqun , Yin Fangping , Ruan Nan , Gao Zongzhan
Published: November 2023

As the world’s textile industry shifts towards manufacturing high value-added textile structures and products, medical textiles have drawn extensive attention from researchers and the related research field is rapidly developing in recent years. To provide readers a systematic overview of this research field, a comprehensive bibliometric analysis of scientific publications related to the field in performed and visually presented using the software CiteSpace and VOSviewer in this paper. Totally 2839 papers have been retrieved and collected from the core database of Web of Science™. First, the papers are divided into several groups and quantitatively analyzed based on the year of publication, the citations in each year, and the disciplines involved in the papers. VOSviewer is adopted to analyze the collaboration among countries, organizations, and authors in the research community as well as their research output and influence in terms of citation. Then the major journals in the field are identified through performing co-citation analysis on source journals of all references cited in the retrieved papers. In addition, the highly cited papers and their references are listed in this paper. They offer researchers a glimpse of the internal relationship of scientific literature and the dynamic structure of scientific evolution. Finally, the co-occurrence analysis of keywords is also performed using VOSviewer and CiteSpace. The connection between various disciplines in the research field is revealed, so that the scientific development history, the research hotspots, and main research directions in the field can be traced.
Desmoplastic small round cell tumor of the abdomen: A case report
Authors: Li Runze , Liu Weizhen , Ye Lin
Published: November 2023

Rationale:

Desmoplastic small round cell tumor (DSRCT) is a rare malignant tumor with poor prognosis, usually involving the peritoneum. There are currently no standardized treatment approaches. This study helped to further advance our understanding of DSRCT, and help to guide therapy.

Patient concerns:

The patient, a 19-year-old male, presented with left-sided back pain with no obvious cause and occasional abdominal pain, and underwent abdominal electron computed tomography examination in our hospital suggesting consideration of small bowel mesenchymal tumor with possible multiple implantation metastasis in the abdominopelvic cavity.

Diagnoses:

After surgical treatment, the pathology report suggested a DSRCT, and immunohistochemistry and fluorescence in situ hybridization revealed EWSR1-WT1 gene rearrangement. Lung computer tomography and abdominal magnetic resonance imaging performed half a month later showed multiple solid nodules on the proximal septal surface of the right lung base, right posterior cardiac/right anterior inferior vena cava nodules, and multiple nodules in the abdominopelvic cavity, omenta, peritoneum, and around the liver or liver, all of which were considered as metastatic foci.

Interventions and outcomes:

Patient received 5 cycles of chemotherapy after surgery. The review results showed a smaller size than before. Currently, he continues to receive treatment.

Lessons:

The reported case has raised awareness of the importance of DSRCT in the treatment of chemotherapy, including its role in the differential diagnosis of abdominal tumors.
Sarcopenia predicts cardiovascular disease in chronic kidney disease at advanced stage and associated risks
Authors: Xuan Yingli , Pang Shiqing , Xie Weizhen , He Ruibin , Qin Li , Yuan Jiangzi
Published: November 2023

Chronic kidney disease (CKD) has been associated with a higher risk of cardiovascular disease (CVD), and sarcopenia is a new risk factor for CKD. However, whether sarcopenia predicts CVD in CKD remains to be determined. Sarcopenia would predict CVD in CKD at advanced stage. This analysis included 101 patients with CKD at stage 3 or over to determine the prevalence of sarcopenia and cardiovascular disease in patients with CKD at stage 3 or over in our center. The patients were further categorized into sarcopenia group (N = 19) and non-sarcopenia group (N = 82) according to the diagnostic criteria for sarcopenia. Data on demographics, laboratory tests, and measurements of extracardiac adipose tissue thickness (EAT) was collected. The prevalence of sarcopenia in patients with CKD at stage ≥ 3 was 19%. Compared with non-sarcopenia group, patients from the sarcopenia group were older (P = .005), and presented longer disease durations (P = .002). The serum level of albumin was significantly decreased, (P = .047), and high-sensitivity C-reactive protein level (CRP) was significantly increased (P = .003) in sarcopenia group. In addition, the EAT was thicker in the sarcopenia group compared with non-sarcopenia group (P = .032). Furthermore, the le-stratified atherosclerotic cardiovascular disease (ASCVD) risk scores were positively correlated with inflammation, nutrition, body mass index (BMI) and disease duration of CKD in sarcopenia group (P < .001). Patients with CKD are prone to have sacropenia, which is associated with inflammation and malnutrition. Presence of sarcopenia in CKD patients predicts the risk of ASCVD.
Laparoscopy with transverse-abdominal extra-fascial hysterectomy for early-stage endometrial carcinoma, obesity, and large uterus: A case report
Authors: Zou Jian , Li Yang , Zhu Changkun
Published: November 2023

Rationale:

Removal of a large uterus poses a challenge in minimally invasive surgery for patients with early-stage endometrial cancer. This manuscript presents 3 cases performed the improved surgical procedure with minimal trauma.

Patient concerns:

Three patients with obesity (Body Mass Index: 31.93, 30.06, and 51.82 kg/m2) and large uterus (7.3 × 8.0 × 7.6 cm, 8.5 × 8.9 × 8.5 cm, and 8.3 × 10.1 × 6.9 cm) visited our hospital because of vaginal bleeding, and received dilation and curettage. Pathological examination revealed endometrial carcinoma.

Diagnoses:

Endometrial carcinoma, obesity.

Intervention:

Laparoscopy and transverse-abdominal extra-fascial hysterectomy were performed. First, we performed bilateral adnexectomy, pelvic lymph node dissection, and para-aortic lymph node sampling, and exposed and separated the para-uterine tissue and bladder before cutting off the uterus from the vagina through laparoscopy. Second, we made a 10 cm suprapubic transverse incision in the lower abdomen, clamped the vagina using right-angle forceps to follow the principle of tumor-free technique, placed the uterus in a surgical bag for retrieval the uterus immediately from the incision.

Outcome:

All 3 patients underwent intestinal recovery for 24 hours post operation; 50 mL blood was lost during the operation with a well-healing wound and no complication. Till date, there has been no recurrence or metastasis in any of them.

Lessons:

Improving the surgical procedure could enhance safety and ease of operation even in cases of obesity and a large uterus.
Pediatric Sertoli-Leydig Cell Tumors of the Ovary
Authors: Yang Bo , Chour William , Salazar Cristo Guardado , Zamiara Paul , Schmidt Ryan J. , Raca Gordana , Shillingford Nick , Zhou Shengmei , Warren Mikako , Parham David M. , Pawel Bruce , Wang Larry L.
Published: November 2023

Sertoli-Leydig cell tumors (SLCTs) are currently classified into 3 molecular subtypes: DICER1-mutant (younger patient age), FOXL2-mutant, and DICER1/FOXL2-wildtype. However, it is not clear whether all pediatric SLCTs are DICER1-mutant molecular subtypes and whether other molecular genetic aberrations besides DICER1 are involved in the pathogenesis and prognosis of these tumors. We studied comprehensive data for 8 cases of pediatric SLCTs, including clinicopathological features, pan-cancer–targeted next-generation sequencing/OncoKids panel, and chromosomal microarray analysis, to further analyze the correlation among clinicopathological features, molecular genetic aberrations, and prognosis. The ages of the patients ranged from 4 to 16 years (median, 14 y). Seven cases were moderately differentiated, and one was poorly differentiated with heterologous mesenchymal elements. Two cases had heterologous epithelium or retiform elements. Follow-up was available for all 8 patients (median, 49.5 mo). Seven patients were alive without evidence of recurrence or metastasis, and only case 5 developed metastases (synchronous bilateral pulmonary tumors with rhabdomyosarcomatous differentiation). All 8 tumors were found to harbor somatic hotspot DICER1 mutations, and 5 patients carried germline DICER1 mutations (2 of them had the phenotype of DICER1 syndrome). Together with recent studies, the DICER1 mutation frequency is 100% in pediatric SLCTs (n=27, age≤16 y). Copy number alterations were detected in 3 tumors; the only recurrent copy number alterations was the gain of whole chromosome 6 in case 5 and case 8. This is the first report describing clinicopathological features and molecular alterations in pediatric SLCTs. Our results demonstrate that all pediatric SLCTs belong to the DICER1-mutant molecular subtype, highlighting that somatic hotspot DICER1 mutation detection has high sensitivity (100%) for the auxiliary diagnosis of pediatric SLCTs (age ≤16 y). Some pediatric SLCTs harbor molecular genetic aberrations other than DICER1 mutation, and their significance needs further study.
Risk of Bowel Obstruction in Patients Undergoing Neoadjuvant Chemotherapy for High-risk Colon Cancer
Authors:   FOxTROT Collaborating Group
Published: November 2023

Objective:

This study aimed to identify risk criteria available before the point of treatment initiation that can be used to stratify the risk of obstruction in patients undergoing neoadjuvant chemotherapy (NAC) for high-risk colon cancer.

Background:

Global implementation of NAC for colon cancer, informed by the FOxTROT trial, may increase the risk of bowel obstruction.

Methods:

A case-control study, nested within an international randomized controlled trial (FOxTROT; ClinicalTrials.gov: NCT00647530). Patients with high-risk operable colon cancer (radiologically staged T3-4 N0-2 M0) that were randomized to NAC and developed large bowel obstruction were identified. First, clinical outcomes were compared between patients receiving NAC in FOxTROT who did and did not develop obstruction. Second, obstructed patients (cases) were age-matched and sex-matched with patients who did not develop obstruction (controls) in a 1:3 ratio using random sampling. Bayesian conditional mixed-effects logistic regression modeling was used to explore clinical, radiologic, and pathologic features associated with obstruction. The absolute risk of obstruction based on the presence or absence of risk criteria was estimated for all patients receiving NAC.

Results:

Of 1053 patients randomized in FOxTROT, 699 received NAC, of whom 30 (4.3%) developed obstruction. Patients underwent care in European hospitals including 88 UK, 7 Danish, and 3 Swedish centers. There was more open surgery (65.4% vs 38.0%, P=0.01) and a higher pR1 rate in obstructed patients (12.0% vs 3.8%, P=0.004), but otherwise comparable postoperative outcomes. In the case-control–matched Bayesian model, 2 independent risk criteria were identified: (1) obstructing disease on endoscopy and/or being unable to pass through the tumor [adjusted odds ratio: 9.09, 95% credible interval: 2.34–39.66] and stricturing disease on radiology or endoscopy (odds ratio: 7.18, 95% CI: 1.84–32.34). Three risk groups were defined according to the presence or absence of these criteria: 63.4% (443/698) of patients were at very low risk (<1%), 30.7% (214/698) at low risk (<10%), and 5.9% (41/698) at high risk (>10%).

Conclusions:

Safe selection for NAC for colon cancer can be informed by using 2 features that are available before treatment initiation and identifying a small number of patients with a high risk of preoperative obstruction.
Acupuncture for the treatment of pregnancy-related low back pain: a systematic review and network meta-analysis
Authors: Li Min , Xiao Zongyi , Tan Dongling , Zhao Daqiang , Chen Qi
Published: November 2023

Background

Despite the effectiveness of acupuncture in the treatment of musculoskeletal pain, many physical therapists are unwilling to use it on pregnant women. A recent systematic review of acupuncture for pregnant women did not include a comparison with sham acupuncture (SAcu). Thus, we aimed to explore the effects of acupuncture, SAcu, and standard care (SC) on pregnancy-related low back pain.

Methods

We searched five different medical literature databases (PubMed, Embase, MEDLINE, Springer, and Google Scholar) from inception to September 30, 2022. After screening, the following methods were identified: acupuncture, SAcu, and SC. The primary outcome was visual analog scale (VAS) intensity after the intervention. The secondary outcomes were the overall effects of treatment, quality of life (QOL), and QOL evaluated using the Short Form-36 Health Survey Questionnaire (SF-36).

Results

The network meta-analysis included eight studies and 864 patients. Acupuncture and SAcu were relatively more advantageous in terms of analgesic effects after intervention than SC, but there were no differences between them. In terms of overall effects in number of remissions and the SF-36, Acupuncture was found to be superior to other methods, and SAcu was better than SC. Acupuncture had the highest surface under the cumulative ranking curve, followed by SAcu and SC for all outcomes.

Conclusions

Acupuncture performs similarly to SAcu in pain relief and is more efficient than SC. Regarding the effectiveness of treatment and QOL, acupuncture therapy was superior to SAcu and SC.
Khushboo Pouch and Packaging – “adapt to change”: a case on succession planning
Authors: Shah Sweety , Meghrajani Indra Jairamdas , Thanki Heena
Published: November 2023

Learning outcomes

The learning outcomes after reading and analysing this case study are dealing with the challenges of family business; learning the importance of succession planning; accepting the next generation and the role of the first generation; and understanding the decision-making skills and roles of the generations in family business.

Case overview/synopsis

Khushboo Pouch and Packaging was the first-generation initiative of Mr Bhavesh Udeshi. Mitesh Udeshi, son of Bhavesh Udeshi and the business’s sole successor, joined the firm in 2019 after graduating with a Master of Business Administration degree. Mitesh had desired to join his family firm since he was a teenager and aid the business with emerging business ideas. As a fresher, he applied his newly acquired theories to the company’s operations. He initiated several changes in the company; however, his actions were ineffective. He introduced modifications to the business premises, production units, marketing tactics, accounting department and product line extension for two years. Mitesh had intended to restructure his traditional firm in rational and innovative ways, but none of his plans had come to fruition. He failed because the firm’s change management was confronted with denial, rage, bargaining and melancholy from both his father and the employees. Amidst non-acceptance and inconsistency, he found himself in a quandary. He had two options: remain in the family firm and persevere in making his ambitions a reality or resign, find a job and embark on a new path. Unfortunately, leaving would indicate surrendering defeat after a two-year struggle.

Study level/applicability

Programmes: Master of Business Administration (MBA), Bachelor of Business Administration (BBA) programmes, MBA in Entrepreneurship and small businesses, and Post graduate diploma in management (PGDM).

Supplementary materials

Teaching notes are available for educators only.

Subject code

CSS 3: Entrepreneurship
Agency problems in facility management (FM) outsourcing in the Ghanaian retail sector
Authors: Tannor Oliver , Dordaa Felix , Akparep John Yaw
Published: November 2023

Purpose

The aim of this study is to examine the agency problems that arise between retail property owners and outsourced facility management (FM) service vendors in Ghana.

Design/methodology/approach

This study was carried out using telephone and face-to-face interviews. Nine facility managers (n =9) and six retail property owners (n = 6) purposively selected participated in the interviews. The responses from the interviews were analysed using content analysis. To begin with the analysis, the recorded audio for each respondent during the interviews was transcribed to augment what was written during the interviews. The next step was the development of a coding framework where each of the agency problems was assigned unique codes and grouped under themes. Each response was assigned a predefined code based on the agency problems identified in the literature. The research team discussed the consistency of the thematic codes assigned to each of the responses to ensure that each response was captured under the appropriate agency problem theme it best represents.

Findings

The results showed that agency problems in FM outsourcing in the Ghanaian retail sector are related to disagreement on expenditure associated with maintenance and repairs and improper tenant information sharing and use by FM service providers. Based on the findings, it is recommended that property owners explore the mixed approach to FM to mitigate the risks of complete outsourcing of FM services. It is also recommended that a clear path on how tenant information can be shared be pre-agreed in FM contracts.

Originality/value

This study provides new literature relating to agency problems in outsourcing and may be the first of its kind for FM in the Ghanaian retail industry. The findings could serve as a starting point for service providers and their principals to find common grounds to understand each other and mitigate the agency problems that could arise and their overall impact on performance.
“I don't want a child”: an apolitical argument in climate change trials in Switzerland
Authors: Demay Clémence , Krähenbühl Mathilde
Published: November 2023

Purpose

This paper aims to explore how the argument of “eco-reproductive” concerns was mobilized in climate change trials in Switzerland. Looking at social movements' advantages and constraints when having recourse to the law, the authors interrogate why the symbolism of reproduction and kinship represented a political opportunity to defend the activists in a judicial system where judging is seen as an apolitical act.

Design/methodology/approach

This paper is grounded in legal research and research on social movements. While legal research focuses mainly on the study of legal and written sources, the authors used ethnography and conducted interviews to cross the perspectives of activists, their lawyers and judges.

Findings

In a context where positivist legal tradition remains strong, the “eco-reproductive” argument represented the advantage of being “apolitical,” thus audible in court. Used as socio-political tools, “eco-reproductive” concerns translated the activists' political claims into the legal arena. However, judges' conservative beliefs on family reinforced the depoliticization of activists' claims.

Originality/value

While research on “eco-reproductive” concerns has been significantly quantitative and exploratory, the authors look in depth at one case of application and highlight the limits of “eco-reproductive” concerns to appeal to decision-makers.
Performance management systems in a shared service centre: an exploration of organisational injustice
Authors: Lepistö Lauri , Lepistö Sinikka
Published: November 2023

Purpose

This study aims to explain how negative workplace interactions are formed by the application of a performance management system (PMS).

Design/methodology/approach

The study draws from unique in-depth interviews with service workers who resigned from an accounting shared service centre (SSC), discussing the reasons behind the resignations. Following an abductive approach, organisational justice theory is used to analyse the service workers' perceptions of negative interactions and to link the negative interactions to the use of the PMS.

Findings

The findings suggest that negative workplace interactions are characterised by cost consciousness, inequality and competitiveness. These interactions are attributed to the use of a PMS in the centre and are related to perceptions of distributive, procedural and interactional injustice.

Practical implications

Managers and leaders of shared service–type organisations should not rely on PMSs as an all-encompassing solution; instead, they should acknowledge the fairness of the use of PMSs. Moreover, HR professionals should choose and train employees to apply PMSs fairly. Fairness is important in work allocation, resourcing, monitoring, giving feedback, recognising good performance, promotion and interaction between peers.

Originality/value

This study contributes to the literature by taking an overall perspective on PMSs to analyse and explain the unintended negative consequences of a PMS in a highly scripted and monitored work environment that is usually considered appropriate for such a system's use. Through the analysis, the study highlights pitfalls in the use of a PMS and the importance of interactional injustice not only between but also within organisational levels.
Generations, events, and social movement legacies: Unpacking social change in English football (1980–2023)
Authors: Turner Mark , Ludvigsen Jan Andre Lee
Published: November 2023

This article critically employs the case of association football in England, from 1980 to 2023, as a social movement timescape, to examine the political consciousness and long‐term mobilisations of a generation of football supporter activists, and their capacity to influence politics, and respond to new, emerging, critical junctures, through networks of trust and shared memories of historical events. This is of crucial importance to sociology because it reveals the tensions between what are considered legitimate and illegitimate social practices which characterise contemporary society's moral economy. Focusing on temporal contestations over regulation, policing, governance and cultural rituals, the article deconstructs the role of generations in social movements, and critically synthesises relational‐temporal sociology and classic and contemporary work on the sociology of generations, to show how legacy operates as a multifaceted maturing concept of power and time. In English football's neoliberal timescape, the supporters' movement has reached a critical juncture; the future will require a new generation of activists, to negotiate, resist and contest the new hegemonic politics of social control and supporter engagement.
The distributional impact of SNAP on dietary quality
Authors: Feng Jinglin , Fan Linlin , Jaenicke Edward C.
Published: November 2023

The Supplemental Nutrition Assistance Program (SNAP) is the nation's largest domestic food and nutrition assistance program for low‐income Americans. Recent studies that examined the effect of SNAP on dietary quality focus on the average effects. Using the USDA's 2012 National Household Food Acquisition and Purchase Survey (FoodAPS) and an unconditional quantile estimator, we examine the distributional impacts of SNAP on dietary quality as measured by Healthy Eating Index‐2010 (HEI‐2010). To identify the differential impacts of SNAP across the distribution of dietary quality, we exploit exogenous variation in state's maximum weekly unemployment insurance benefits and state outreach spending per capita as instrumental variables. We find that SNAP has no significant impact on households’ dietary quality on average. However, for households with initially low‐to‐intermediate dietary quality, SNAP participation reduces their HEI scores by over 17% or more than 7 points out of a total score of 100. The negative impacts of SNAP on these HEI quantiles are mainly driven by an increased acquisition of empty calories.
Archaeology in 2022: Counter‐myths for hopeful futures
Authors:   Black Trowel Collective, Berihuete‐Azorín Marian , Blackmore Chelsea , Borck Lewis , Flexner James L. , Frieman Catherine J. , Herrmann Corey A. , Kiddey Rachael
Published: November 2023

Archaeology in 2022 features more calls than ever for a socially and politically engaged, progressive discipline. Archaeologists increasingly respect and integrate decolonizing and Indigenous knowledge in theory and practice. They acknowledge and embrace the fluidity and diversity of sexes and genders, past and present. They document patterns of migration, ancient as well as contemporary, to combat retrograde and racist narratives that remain pervasive in the public sphere. At the same time, the field has a deep‐seated conservative bastion toward which many scholars retreat, arguing for an “objective” past that is free of political implications or interpretive ambiguity. As anarchist archaeologists, we see the myth of the objective past as one of many interconnected myths that have provided the basis for an archaeology that reifies and proliferates the current social order. We deconstruct myths relating to capitalist and colonialist ideologies of “human nature,” the assumed inevitability of the current order, and fatalistic commitment to dystopian or utopian futures. As alternatives, we present counter‐myths that emphasize the contingent and political nature of archaeological praxis, the creative and collaborative foundation of communities, the alternative orders that archaeology uncovers, and the role of a hopeful past for constructing the possibilities of different futures.
Robot‐assisted retroperitoneal lymph node dissection: Initial experience in Japan
Authors: Takahara Kiyoshi , Motonaga Tomonari , Okumura Jin , Yamakawa Shinji , Yagi Kota , Nakamura Wataru , Saruta Masanobu , Nukaya Takuhisa , Takenaka Masashi , Zennami Kenji , Ichino Manabu , Sasaki Hitomi , Sumitomo Makoto , Shiroki Ryoichi
Published: November 2023

For patients with testicular tumors who need the surgical management, open retroperitoneal lymph node dissection (O‐RPLND) is considered the gold standard treatment. However, recently, robot‐assisted RPLND (R‐RPLND) has gained popularity as a minimally invasive therapy alternative to O‐RPLND and laparoscopic RPLND. Here, we report the case of a 32‐year‐old man presenting with a left testicular teratoma with several enlarged left para‐aortic lymph nodes. After the orchiectomy, the patient underwent R‐RPLND with an operation time of 279 min, console time of 189 min, bleeding volume of 59 mL, and no significant complications, resulting in a successful outcome. To the best of our knowledge, this is the first reported case of R‐RPLND in Japan. Based on our experience, R‐RPLND may provide safe and effective outcomes; however, further research is required before the widespread implementation of this technique.
Introducing support for learner control: Temporal and organizational cues in instructional videos
Authors: Yu Qiuchen , Gou Jiangfeng , Li Yan , Pi Zhongling , Yang Jiumin
Published: November 2023

Instructional videos risk overloading learners' limited working memory resources due to the transient information effect. Learner control is one way to mitigate this concern, but has shown almost zero overall effect and considerable heterogeneity. Consequently, it is essential to identify when learner control is most beneficial. The present study examined the influence of cues on learners' behaviour, cognitive process, metacognition and learning performance in an interactive learning environment. Employing a 2 (temporal cues: without vs. with) × 2 (organizational cues: without vs. with) between‐subject design, 117 participants were randomly assigned to one of four conditions: no cues, temporal cues, organizational cues and temporal cues + organizational cues. Among these, temporal cues (ie, progress bar) serve as time‐related signals designed to regulate pacing, and organizational cues (ie, table of contents) provide a structural framework for the content. Significant cueing effects were observed for both cue types at germane cognitive load and transfer. Notably, our results indicate that organizational cues effectively guide learners' attention towards the underlying structure, thus promoting cognitive processing. These unique benefits are evident in improved topic recall, retention and monitoring accuracy. Importantly, combined temporal cues and organizational cues were seen to not only allow learners to exhibit more engagement behaviours (ie, skimming) but also assist learners in accurately judging their learning. These findings strongly support the recommendation to use cues to enhance the effectiveness of learner control.

Practitioner notes

What is already known about this topic

Instructional videos may overload limited working memory resources due to the transient information effect.

The overall effect of including learner control within educational technology was almost zero (g = 0.05) but showed higher heterogeneity.

It is unclear whether embedding various cues in an instructional video improves the effectiveness of learner control.

What this paper adds

Both temporal and organizational cues aided in increasing learners' germane cognitive load and enhancing their transfer.

Organizational cues helped learners understand the underlying structure, thus facilitating deeper cognitive processing, improved metacognition and ultimately boosted learning performance.

Combined temporal and organizational cues lead to engagement behaviours and accurate self‐monitoring.

Implications for practice and/or policy

Providing instructional support is important in assisting learners with the complexities of learner‐controlled instruction.

Embedding cues help learners process the content deeply by giving learners control over the instructional video.
Nahrungsmittelallergie ‐ Neue Risiken durch vegane Ernährung? Überblick zu neuen Allergenquellen und aktuelle Daten zum Anaphylaxierisiko
Authors: Präger Lea , Simon Jan Christoph , Treudler Regina
Published: November 2023

Zunehmend mehr Menschen ernähren sich aus gesundheitlichen und Umweltaspekten ausschließlich von pflanzlichen Nahrungsmitteln (vegan). Dabei werden vielfach Hülsenfrüchte (wie Soja, Linsen, Erbsen), Schalenfrüchte (Cashew, Macadamia, Mandel, Pekan‐, Para‐ und Walnuss), Samen und Saaten (wie Chia, Leinsamen) oder (Pseudo‐)Getreide (wie Quinoa, Buchweizen) verzehrt. Vegane Milchalternativen sind Hafer‐, Mandel‐ und Sojadrinks, auch Käse‐ sowie Fleischersatzprodukte basieren oft auf einer Sojagrundlage. Gleichzeitig nimmt die Prävalenz von Nahrungsmittelallergien weltweit zu. Pflanzenallergene aus Hülsen‐ und Schalenfrüchten, die in der veganen Ernährung die Hauptproteinquelle ausmachen, zählen zu den häufigsten Auslösern von Nahrungsmittelallergien bei Erwachsenen. Dabei kommt es bei Allergien auf Speicherproteine (wie Gly m 5 und Gly m 6 aus der Sojabohne) zu teils schweren anaphylaktischen Reaktionen. Besonderes Augenmerk liegt weiter auf hochverarbeiteten Ersatzprodukten, die Pflanzenproteinisolate (zum Beispiel Erbsenmehl) in konzentrierter Form enthalten und damit allergologisch problematisch werden können. In diesem Artikel geben wir einen Überblick über wichtige Allergene und neue Allergenquellen in ausgesuchten veganen Nahrungsmitteln und betrachten die vegane Ernährung unter allergologischen Aspekten.
Epidemiologie reifzelliger T‐ und NK‐Zell‐Lymphome in Deutschland – Eine repräsentative Querschnittanalyse von GKV‐Routinedaten
Authors: Assaf Chalid , Dobos Gabor , Zech Immo‐Maximilian , Doess Axel , May Melanie , Jadasz Janusz
Published: November 2023

Hintergrund

Primäre kutane Lymphome sind seltene lymphoproliferative Neoplasien und gehören zur heterogenen Gruppe der Non‐Hodgkin‐Lymphome. Sie umfassen ein klinisch und histologisch breites Spektrum an Manifestationsformen, wobei kutane T‐Zell‐Lymphome (CTCL) mit 73% am häufigsten sind. Aufgrund der Seltenheit der Erkrankungen sind bevölkerungsbasierte Untersuchungen zur Versorgungssituation und Epidemiologie kaum vorhanden.

Patienten und Methodik

Auf Basis anonymisierter, alters‐ und geschlechtsadjustierter GKV‐Routinedaten von circa fünf Millionen gesetzlich Krankenversicherten wurde im Sechsjahreszeitraum (2012–2017) eine retrospektive Analyse zur Bestimmung von Prävalenz, Inzidenz und Letalität von Patienten mit reifzelligen T/NK‐Zell Lymphomen in Deutschland durchgeführt.

Ergebnisse

Insgesamt 1336 T‐Zell‐Lymphom‐Patienten konnten im Beobachtungszeitraum identifiziert werden. Die Sechsjahres‐Prävalenz liegt demnach zwischen 27,35 und 43,58 pro 100 000 Einwohner. Die Patienten waren zu 65% männlich mit einem durchschnittlichen Alter von 66 Jahren (SD 15). Es verstarben 246 Patienten (circa 20 %) innerhalb der 6 Jahre, pro Jahr bis zu 7 %. Die ermittelte Inzidenz bei 153 identifizierten Patienten im Jahr 2017 liegt bei 3,65 bis 3,92 pro 100 000 Einwohner.

Schlussfolgerungen

Erstmalig in Deutschland wurden mithilfe von Abrechnungsdaten der gesetzlichen Krankenversicherung (GKV‐Routinedaten), valide epidemiologische Erkenntnisse von Patienten mit reifzelligen T‐ und NK‐Zell Lymphomen gewonnen. Weitere Analysen für tiefergehende Einblicke in die Versorgung der Patienten mit dieser seltenen Erkrankung sind wünschenswert.
S3‐Leitlinie “Aktinische Keratose und Plattenepithelkarzinom der Haut“ – Update 2023, Teil 2: Epidemiologie und Ätiologie, Diagnostik, Therapie des invasiven Plattenepithelkarzinoms der Haut, Nachsorge und Prävention
Authors: Leiter Ulrike , Heppt Markus V. , Steeb Theresa , Alter Mareike , Amaral Teresa , Bauer Andrea , Bechara Falk G. , Becker Jürgen C. , Breitbart Eckhard W. , Breuninger Helmut , Diepgen Thomas , Dirschka Thomas , Eigentler Thomas , El Gammal A. K. Stephan , Felcht Moritz , Flaig Michael J. , Follmann Markus , Fritz Klaus , Grabbe Stephan , Greinert Rüdiger , Gutzmer Ralf , Hauschild Axel , Hillen Uwe , Ihrler Stephan , John Swen Malte , Kofler Lukas , Koelbl Oliver , Krause‐Bergmann Albrecht , Kraywinkel Klaus , Krohn Steffen , Langer Thomas , Loquai Carmen , Löser Christoph R. , Mohr Peter , Nashan Dorothée , Nothacker Monika , Pfannenberg Christina , Salavastru Carmen , Schmitz Lutz , Stockfleth Eggert , Szeimies Rolf‐Markus , Ulrich Claas , Voelter‐Mahlknecht Susanne , Vordermark Dirk , Weichenthal Michael , Welzel Julia , Wermker Kai , Wiegand Susanne , Garbe Claus , Berking Carola
Published: November 2023

Aktinische Keratosen (AK) sind häufige Hautveränderungen bei hellhäutigen Menschen mit dem Potenzial, in ein kutanes Plattenepithelkarzinom (PEK) überzugehen. Beide Erkrankungen können mit erheblicher Morbidität verbunden sein und stellen eine große Krankheitslast insbesondere in der älteren Bevölkerung dar. Um einen evidenzbasierten Rahmen für die klinische Entscheidungsfindung zu schaffen, wurde die S3‐Leitlinie "Aktinische Keratose und kutanes Plattenepithelkarzinom" aktualisiert und um die Themen Plattenepithelkarzinom in situ (Morbus Bowen) und Cheilitis actinica, die Manifestation der AK am Lippenrot, erweitert. Die Leitlinie richtet sich dabei an Dermatologen, Allgemeinmediziner, HNO‐Ärzte, Chirurgen, Onkologen, Radiologen und Strahlentherapeuten in Klinik und Praxis sowie an andere medizinische Fachgebiete, politische Entscheidungsträger und Versicherungsgesellschaften, die sich mit der Diagnose und Behandlung von Patienten mit nicht‐melanozytärem Hautkrebs befassen. Für Patienten und deren Angehörige existiert eine gesonderte Patientenleitlinie. In diesem Teil behandeln wir die Themen Epidemiologie und Ätiologie, Diagnostik, Therapie des invasiven Plattenepithelkarzinoms der Haut, Nachsorge und Prävention.
Vocational education and numeracy acquisition of young adults: A comparison of education systems in German and English speaking countries
Authors: Kim Suehye
Published: November 2023

This study explores a pathway from social origin at adolescence to numeracy acquisition in young adulthood. A variation associated with vocational track attendance and numeracy acquisition between two different traditions of education systems is identified; namely, between education systems of German (Austria and Germany) and English (UK and US) speaking countries. Key results demonstrate that tracking at the level of upper and post‐secondary schooling is closely related to skills gaps that affect labour market outcomes. This implies that vocational programme graduates achieve comparatively weaker in numeracy tests in German‐speaking countries. In contrast, this effect of disadvantage in numeracy skills is not observed among young adults attending vocational tracks in English speaking countries. Also, the results suggest that a more stratified system might reinforce social inequality by increasing a skill gap in the use of numeracy in daily life. Drawing on empirical findings, the discussion underscores that policy interventions are necessary for mitigating the reproduction of skills inequality among young adults.
Transformation of higher education in Ukraine: Impact of the war and objectives for post‐war recovery
Authors: Lugovyi Volodymyr , Kalashnikova Svitlana , Talanova Zhanneta , Vlasova Inna
Published: November 2023

Processes of globalisation, sustainable development, the Covid‐19 pandemic, and other current circumstances influence the development of higher education. Higher education institutions in Ukraine also face challenges related to the military aggression by the Russian Federation since 2014, martial law since February 2022 and efforts to prepare for a post‐war recovery. The article outlines key areas that merit closer attention including an analysis of changes occurring in higher education in Ukraine before and during the war; the network of higher education institutions in Ukraine; admissions processes; trends in higher education quality assurance and enhancement; and international aid for the support and development of higher education in Ukraine. The analysis outlines changes that have taken place in higher education in Ukraine as a result of the destruction of infrastructure and a decrease in institutional capability of universities in eastern Ukraine and Crimea, as well as massive migration. We identify main innovations and specific features of the admissions process in 2022 compared to admissions processes in 2021. The government of Ukraine, following martial law, introduced restrictions that affected international academic mobility, which is carried out online, or to the extent possible as blended learning. Finally, we outline tasks for post‐war higher education recovery and development and underline the key role of universities in the post‐war recovery of Ukraine.
The association between malocclusion and health‐related quality of life in adolescents: A mediation analysis
Authors: Leite Sarah Debora Camardella , Herkrath Fernando José , Vettore Mario Vianna , Rebelo Maria Augusta Bessa , de Queiroz Adriana Corrêa , Pereira Juliana Vianna , de Herkrath Ana Paula Corrêa de Queiroz
Published: November 2023

This study investigated the role of oral health‐related functional limitations and social well‐being, self‐perceived health, psychosocial factors, and social support in mediating the impact of malocclusion on health‐related quality of life (HRQoL). A school‐based 6‐month cohort study was conducted with 376 12‐year‐old deprived adolescents. Measures at baseline included malocclusion (DAI score), dental caries, sociodemographic characteristics, psychosocial traits (self‐esteem, sense of coherence, oral health beliefs), and social support. The oral health‐related functional limitations and symptoms (social well‐being) domains of the CPQ11‐14, self‐perceived health, and HRQoL (Kiddo‐KINDL) were evaluated at the 6‐month follow‐up. Associations between observed and latent variables (social support, psychosocial factors, and HRQoL) were evaluated using structural equation modelling, according to the Wilson and Cleary theoretical model. Malocclusion was indirectly associated with worse HRQoL, mediated by functional limitations, social well‐being, and self‐perceived health. Better psychosocial status was directly associated with better HRQoL, and higher social support was indirectly associated with better HRQoL via psychosocial factors. Dental caries experience, female sex, and lower family income were indirectly associated with worse HRQoL. The impact of malocclusion on HRQoL was mediated by oral health‐related functional limitations, social well‐being, and self‐perceived health. Sociodemographic and psychosocial factors, and social support also impacted HRQoL.
Microscopical observations of the effects of tumour‐inhibitory and non‐inhibitory samples of gum tragacanth on Landschütz ascites tumour cells
Authors: MAYHEW E. G. , ROE E. M. F.
Published: November 2023

SYNOPSIS

The periodic acid‐Schiff (PAS) technique of Hotchkiss (1948) has been used to follow the action of tumour‐inhibitory, native gum tragacanth on cells of the Landschütz mouse ascites tumour in vivo. The results have been compared with those of various non‐inhibitory modified tragacanth samples and of gum karaya (kutira grade), and have been related to earlier studies of changes in mitosis and in cell permeability after treatment of the tumour with the same gums. PAS‐stained particles are observed surrounding the tumour cells and attached to their surfaces as early as 10 minutes after treatment with inhibitory gum and no similarly stained material, additional to that in control cells, is detected within the treated cells until 5 to 6 hours after commencement of treatment.

Non‐inhibitory gum samples formed PAS‐stained particles of different size and shape which were not bound to the surface of the tumour cell. No additional PAS‐stained material appeared within the cells after treatment with these samples.

It is concluded that the active gum causes growth inhibition by direct action at the surface of the tumour cell.
Incorporating Test‐Taking Engagement into Multistage Adaptive Testing Design for Large‐Scale Assessments
Authors: Bulut Okan , Gorgun Guher , Karamese Hacer
Published: November 2023

The use of multistage adaptive testing (MST) has gradually increased in large‐scale testing programs as MST achieves a balanced compromise between linear test design and item‐level adaptive testing. MST works on the premise that each examinee gives their best effort when attempting the items, and their responses truly reflect what they know or can do. However, research shows that large‐scale assessments may suffer from a lack of test‐taking engagement, especially if they are low stakes. Examinees with low test‐taking engagement are likely to show noneffortful responding (e.g., answering the items very rapidly without reading the item stem or response options). To alleviate the impact of noneffortful responses on the measurement accuracy of MST, test‐taking engagement can be operationalized as a latent trait based on response times and incorporated into the on‐the‐fly module assembly procedure. To demonstrate the proposed approach, a Monte‐Carlo simulation study was conducted based on item parameters from an international large‐scale assessment. The results indicated that the on‐the‐fly module assembly considering both ability and test‐taking engagement could minimize the impact of noneffortful responses, yielding more accurate ability estimates and classifications. Implications for practice and directions for future research were discussed.
The effects of water‐stress, temperature, and plant traits on the outbreak potential of a specialist and generalist spider mite species (Acari: Tetranychidae)
Authors: Barnes Cody L. , Wickwar Desireè , Yost Matt , Creech Earl , Ramirez Ricardo A.
Published: November 2023

The host‐generalist two‐spotted spider mite [Tetranychus urticae (Acari: Tetranychidae); TSM] and host‐specialist Banks grass mite [Oligonychus pratensis (Acari: Tetranychidae); BGM] are common pests of corn (Zea mays L.) in the arid western United States. Climate warming and decreased precipitation may promote conditions favoured by these spider mites. However, rapid evolution of spider mite resistance to commercially available acaricides is driving the need for alternative solutions for managing outbreaks. Planting of drought‐tolerant corn hybrids has been proposed to be a dual‐purpose strategy for mitigating water deficits for irrigation and reducing leaf conditions favourable for BGM outbreaks. However, understanding of the mechanisms responsible for reducing the BGM in the field is lacking and determining whether outbreaks of the TSM can also be averted using drought‐tolerant corn is a pressing concern. We conducted a 2‐year field study testing a drought‐tolerant corn hybrid and an analogous drought‐susceptible hybrid under water‐stress, with artificially infested spider mite populations. Drought‐tolerant corn had larger stem diameter, more massive cobs, and greater leaf water mass compared to the drought‐susceptible corn under water stress. We also found that the BGM populations were reduced on drought‐tolerant plants under water‐stress, as expected, but we found an opposite trend in the TSM. Lastly, water‐stressed leaves were warmer, transpired less, and had higher carbon concentration, which contributed to larger investment in eggs and growth in the BGM. We anticipate that further evaluation of irrigation and crop drought‐tolerance in management of agriculture systems for multiple pest species will be increasingly impactful in arid regions.