bluuebunny/crossref_metadata_2025 huggingface dataset:
Mixed methods integration strategies used in education: A systematic review
Authors: Zhou Yi , Zhou Yuchun , Machtmes Krisanna
Published: December 2023

Mixed methods research (MMR) has been widely adopted in a plethora of disciplines. Integration is the pressing issue regarding the legitimation, the added value, and the quality of using MMR, though inadequate literature has discussed effective strategies used in the field of education, including school psychology, counseling, and teacher education. This study reviewed 119 recently published MMR articles in education using a four-dimension codebook with the goal to explore generic integration strategies and innovative strategies used by educational researchers in practice. As a result, three most commonly used generic integration strategies were identified, including (1) using a good mixed methods (MM) research question to guide research design, (2) using appropriate MM sampling strategy to obtain good data for achieving integration, and (3) using multiple MM data mixing strategies to facilitate integration. Moreover, five creative integration strategies were found at the method level: (1) using an innovative survey to collect both qualitative and quantitative data, (2) using visual support to collect data, (3) using high-tech methods to facilitate data collection, (4) using data visualization in mixing, and (5) quantitizing categorized QUAL data. This review summarizes and analyzes the effective integration strategies commonly used at the research design level and at the method level. It also provides valuable recommendations for educational researchers to explore creative strategies to achieve efficient integration when they conduct mixed methods research.
How Permeable Are the Beliefs of Future Secondary School Mathematics Teachers to Pre-Service Experiences? Looking Across Their Years of Training
Authors: Hanin Vanessa , Holm Jennifer
Published: December 2023

Even though it has been recognized that prospective teachers’ conceptions of the nature of mathematics, and of mathematics learning and teaching shape their teaching decisions, and, thereby, students’ engagement and achievement, to date no research has examined these conceptions from a person-centered perspective taking into account year of teacher education program. Cluster analysis revealed three distinct profiles: anti-socioconstructivist, socioconstructivist, and flexible. Although the same driving dimensions were present at the different stages of the training, the characterization of these three profiles fluctuated, in tandem with the process of construction of a professional identity, the increase of the field experience and the discovery of the complexities of the profession. The analysis of the pedagogical practices support the non-linearity of the beliefs-practices relationship.
Employability and Education Mismatch in the Moroccan Urban Workplace
Authors: Draissi Zineb , Rong Yu , Ebrahim Suliman Mohammed Abker
Published: December 2023

This study explores the skill demand and supply of the current Moroccan urban labor workforce. It seeks to understand the experience of skill mismatch, and how it affects employability. Using semi-structured interviews and a phenomenological approach, the study explores the nature of job queues as informed by recruiters and educators. A total of 27 interviews were conducted with recruits, recruiters, and university professors, all of whom were selected using a criterion-based approach coupled with snowball sampling. Over-education was affirmed among employees, and the findings yielded a crossover of skill sets. The job queue for a balanced labor market is oriented towards personal attitudes and capabilities related to the field of study. Finally, responses from both recruiters’ and professors’ interviews yielded a framework of education-job matches for the demand-supply sides, and oriented workplace-based employability.
Female Underperformance Hypothesis Revisited: Methodological Review and Empirical Testing
Authors: José Ibáñez María , Vásquez Lavin Felipe , Ponce Oliva Roberto D.
Published: December 2023

Comparison between the performance of female and male-managed firms has long been a subject of research interest. Although the argument is that firms run by women have lower performance than those run by men, there is no agreement on the effects of managerial gender on companies’ financial outcomes. This study conducts a methodological review of quantitative research on the relationship between female business leadership and firm performance from 2010 to 2020. This review identifies the most frequently used dependent and explanatory variables and econometric models in the literature. Most studies have not considered endogeneity bias in their model specifications; therefore, these results could be biased and unreliable. We select empirical models to test the female underperformance hypothesis using a sample of Chilean firms. Our findings suggest that managers’ gender does not significantly affect business performance when endogeneity is addressed. Our methodological review reveals a significant gap in the research on female managers and firm performance in the Latin American context, and the empirical test provides new evidence in this vein.
Perception of Correctional Officers’ Legitimacy in South African Correctional Centers
Authors: Bello Paul Oluwatosin , Matshaba Thabiso Donald
Published: December 2023

Studies from developed western societies have shown that the legitimacy of correctional officers is pivotal to incarcerated offenders’ voluntary compliance and deference. However, we are uncertain if such an assertion holds for incarcerated offenders in transitional African correctional settings, such as South Africa. From a cross-sectional survey of participants from selected correctional centers in South Africa (Male = 89.6%; African = 85.1%; Mage = 25 years, SD = 0.81), this paper explores incarcerated offenders’ perception of the legitimacy of correctional officers. Findings indicate that procedural justice, the effectiveness of the correctional officers, gender, and offender citizenship predicted the perception of correctional officers’ legitimacy. The implications of these findings for the effective management of custodial institutions are discussed.
The Effect of Collective Decision-Making on Productivity: A Structural Equation Modeling
Authors: Mirbagheri Seyed Mohsen , Rafiei Atani Ata Ollah , Parsanejad Mohammadreza
Published: December 2023

The purpose of this study is to examine the relationship between common rationality (as a factor of convergence of employees and managers), collective decision-making (as one of the important methods of participation), and productivity (as an important indicator of organizational success). Structural equation modeling (SEM) is used to investigate the strength of these relationships. After the distribution of 98 questionnaires among organizational experts we used Smart PLS 2.0 to analyze the data. The results show that the indirect relationship between common rationality and productivity through a mediating variable of collective decision-making is stronger than the direct effect of common rationality on productivity. It means that common rationality as a substantial asset for an organization could be used to improve productivity but if managers want to utilize this asset, they should apply it through another mediator which is collective decision-making. Collective decision-making could facilitate the relationship between common rationality and productivity by creating synergy among employees, reducing biases, increasing decision quality, and reaching the optimal decision.
Pronunciation Teaching Perception Scale (PTPS) for In-Service Teachers
Authors: Ercan Halil , Demirezen Mehmet
Published: December 2023

This research aimed at developing a reliable scale to determine in-service language teachers’ perceptions about teaching pronunciation and contributing to the English Language Teaching (ELT) field. The participants of the study consisted of 132 English language instructors working in 42 secondary and high schools in the 2021 to 2022 academic year in North Cyprus. The conducted Exploratory Factor Analyses revealed that the scale consisted of five factors and 24 items. Besides that, the Confirmatory Factor Analysis results confirmed the 5-factor structure. Furthermore, it was proven that the whole scale and its sub-dimensions are highly reliable and suitable for the implementation in determining in-service language teachers’ perceptions of pronunciation teaching (χ2/ df = 1.314). It is believed that the newly developed scale would help researchers more reliably investigate perceptions of teaching pronunciation in various contexts.
Does a Share Name Change Have an Impact on the Pricing Efficiency of the Share?
Authors: Long Yue’e , Su Wunhong , Tan Yufan
Published: December 2023

This study examines the association between the pricing efficiency of individual shares during the post-period and the pre-period of renames, substantive renames, and those with non-substantive renames. Based on a sample of 567 firms in the Chinese A-share market, this study finds that the pricing efficiency of individual shares is significantly higher during the post-period than during the pre-period of a renaming announcement. Moreover, the results are robust to controls. In addition, the results are consistent with the argument that the firms experiencing substantive renames are more inclined to involve the firm-specific information content.

JEL classification: M41, G32, G12, G34, M21
Where You Lead, I Will Follow: Leader–Member Exchange,Motivation to Lead and Employee Counterproductive Work Behavior
Authors: Premru Maruša , Černe Matej , Buch Robert
Published: December 2023

The leader–follower relationship plays an important role in preventing employees from engaging in counterproductive work behavior (CWB). We investigate the interplay among perceived leader–member exchange (LMX), leaders’ motivation to lead (MTL), and CWB, specifically examining the cross-level effect of leaders’ MTL in the relationship between individuals’ LMX and CWB. We tested our hypotheses in two studies: a two-source field study in three large European Union companies (217 employees nested into teams with 31 unique leaders) and an experiment with 106 participants in which we manipulated LMX and MTL using vignette scenarios. Field study results indicated that individuals with higher levels of LMX exhibit lower levels of CWB. This relationship is more negative in cases of low MTL, indicating a trade-off effect of LMX and MTL. The experiment replicated these effects. We additionally tested a moderated-mediation model, which included the explanatory mechanism (mediator) of followers’ MTL. Taken together, this paper proposes and simultaneously tests interplay effects of followers’ dyadic perceptions of their relationships with leaders and leaders’ individual differences in reducing CWB. It develops and tests the role-modeling process of leaders’ MTL translation into followers’ MTL. The paper also shows the multilevel nature of the proposed model with a two-source examination (leader vs. follower perspective).
The Views of Classroom Teachers on the Instruction of Current Issues
Authors: Deniz Serkan , İzci Eyüp
Published: December 2023

The present study aimed to determine the views of classroom teachers on the inclusion or exclusion of current issues in classroom instruction, to investigate these views based on the definition of current issues, the methods and techniques employed in the instruction of current issues, the analysis of the instruction, and the positive and negative consequences of the instruction of these issues in the classroom. The present research was conducted with the case study method. The maximum diversity sampling method was employed to assign the study group members. The study group included 10 classroom teachers employed in seven primary schools in Battalgazi, Yesilyurt, Doğanşehir, and Hekimhan districts in Malatya province, Turkey. The study data were collected with a semi-structured interview form. Content analysis and continuous comparative data analysis were employed. The participants stated that the discussion of current issues in the classroom would lead to positive outcomes such as the development of student empathy, instruction of tolerance for different ideas, development of the problem-solving skills, sensibility, and communication skills, and negative outcomes such as problems in peer relations, behavioral disorders, negative reactions, and conflict. It was determined that classroom teachers mostly discussed controversial issues such as Covid 19, environmental pollution and natural disasters, and the student-initiated discussions on Covid 19 and natural disasters in the classroom. About 20% of the participating primary school teachers stated that the level of proficiency of their colleagues was low in the instruction of current events.
Publications in Educational Research Journals from Singapore, Japan, and South Korea (2008–2017): A Bibliometric Analysis
Authors: Li Jiayu
Published: December 2023

This paper presents a bibliometric analysis of educational research in the Social Science Citation Index (SSCI) from 2008 to 2017. Using GraphPad Prism and VOSviewer tools, we analyzed 3,484 articles from South Korea, Singapore, and Japan. The annual number of published articles from South Korea and Japan increased significantly. Singapore was in the first place in the most accumulated citations, average Times Cited count and 10 high-impact factor journals, because universities in Singapore have extremely stringent criteria about promotion of their faculty and their publication venues. South Korea had the most number of articles in the top 10 most popular journals, which could owing to many South Korea scholars concern nation and regional journals have relative higher acceptance rate. Japan and South Korea had the most common studies concerning educational research. The annual number of articles showed strong positive correlations with research and development (R&D) expenditures and R&D expenditures as a percentage of GDP in South Korea.
Relationship Between Sports Policy, Policy Satisfaction, and Participation Intention During COVID-19 in Korea
Authors: Kim Dong-Kyu , Choi Chulhwan , Park Sung-Un
Published: December 2023

This study aimed to identify the effect of trust in and contents of sports-related policies during COVID-19 on public policy satisfaction and examine the relationship between policy satisfaction and sports participation intention. People living in Korea were selected as the study population using convenience sampling, and 441 responses were collected using an online questionnaire. Data were analyzed using SPSS 23.0. The results indicated that policy trust had a positive effect on policy satisfaction in the order of consistency, expertise, and existing policy performance. In addition, social equity, market responsiveness, and policy effectiveness, which are sub-factors of policy content, had a positive effect on policy satisfaction. Furthermore, sports policy satisfaction had a negative effect on sports participation intention. This study suggests that the government should equally consider policy trust and content when establishing sports-related policies and strive to establish policies based on the positive functions of sports.
The Impact of the Different Dimensions of Job Quality on Job Satisfaction in the Public and Private sector. What is Wrong with the Social Environment?
Authors: Fernández Puente Adolfo C. , Sánchez-Sánchez Nuria
Published: December 2023

This work considers the impact of the different job quality dimensions on Eurozone job satisfaction through the European Working Conditions Survey-2015. The econometric analysis, using a probit model (marginal effects), reveals that dimensions associated with Social environment, Skills and discretion, Prospects, and Earnings have a positive and significant impact on job satisfaction. The impact of Work intensity is negative and those related to Physical environment and Working time quality do not have a significant impact on job satisfaction. Regarding the differential impact of the different dimensions on the public and private sectors, both Prospects and Social environment are notably higher in the private sector. The greater impact of the first index is not justified, as is the case with the Social environment, by a lower index but, probably, by the greater variability of the index in the private sector. Our work emphasizes the relevance of studying variables associated to job quality when identifying the causes of job satisfaction. Greater understanding of these dimensions in the private sector would improve the situation in the public sector (and vice versa) and, therefore, workers’ job satisfaction. Of special interest are the possible improvements in the field of Social environment in the public sector, specifically in relationships between workers and their immediate bosses and in the distribution of work tasks.
How Much do Education, Experience, and Social Networks Impact Earnings in India? A Panel Data Analysis Disaggregated by Class, Gender, Caste and Religion
Authors: Hussain Yasser Razak , Mukhopadhyay Pranab
Published: December 2023

We estimate the returns (measured by hourly earnings) to education, experience, and social networking in India using individual-level panel data from the India Human Development Surveys. We combined the two latest waves of this survey using individual-level identifiers to generate a balanced panel and merged it with various household characteristics. We provide estimates of private returns for an additional year of education and experience by consumption quintiles, gender, caste, and religion in a fixed-effects Heckman model that controls for selection bias. This methodology improves upon estimates of all earlier studies on earnings in India, as most of the literature has relied on cross-section data or pseudo-panel data. We also examine the impact of social networking on earnings, which is under-explored in nationwide studies in India. We find that education significantly and positively affects earnings for all consumption quintiles, gender, caste (except schedule castes), and religious groups. Among economic groups, the highest returns are observed for the third quintile above the poverty line. Returns to females for an additional year of education are nearly double that of males but the difference in starting earnings keeps earnings of males higher for long periods. Among the castes, scheduled castes have the highest returns to education and other minorities among religious groups. Social networking positively impacts males, Hindus, and the quintile just above the poverty line. Experience positively impacts women’s earnings, general caste and scheduled caste, Hindus and Other minorities and two consumption quintiles (two and five) above the poverty line.
The Influence of Ambidextrous Knowledge Search on Technological Innovation: The Mediating Role of Knowledge Base
Authors: Gao Hui , Wu Suming
Published: December 2023

As an effective means of acquiring knowledge resources, knowledge search is an important driving force for enterprises to obtain competitive advantages. Based on ambidextrous theory, organizational search theory and knowledge base theory, this study constructs a theoretical framework for the effect of ambidextrous knowledge search on technological innovation performance. And empirically tests the mediating mechanism of knowledge base with the data of knowledge-intensive enterprises. The results show that both exploratory and exploitative search have positive effects on technological innovation performance, and significantly, the positive impact of exploratory searches was higher than that of exploitative searches. Moreover, the balance and combination of knowledge search have a significant positive impact on technological innovation performance respectively. However, the effect of combination is stronger when two search dimensions are considered at the same time. There is a mediating effect between ambidextrous knowledge search and technological innovation performance. Specifically speaking, knowledge base plays a complete mediating role for ambidextrous balance whereas a partial mediating role for ambidextrous combination. The conclusions reveal the mechanism of ambidextrous knowledge search, which can provide a certain theoretical guidance for enterprises to search external knowledge and improve innovation practice.
Artificially Intelligent Billing in Spine Surgery: An Analysis of a Large Language Model
Authors: Zaidat Bashar , Lahoti Yash S. , Yu Alexander , Mohamed Kareem S. , Cho Samuel K. , Kim Jun S.
Published: December 2023

Study Design

Retrospective cohort study.

Objectives

This study assessed the effectiveness of a popular large language model, ChatGPT-4, in predicting Current Procedural Terminology (CPT) codes from surgical operative notes. By employing a combination of prompt engineering, natural language processing (NLP), and machine learning techniques on standard operative notes, the study sought to enhance billing efficiency, optimize revenue collection, and reduce coding errors.

Methods

The model was given 3 different types of prompts for 50 surgical operative notes from 2 spine surgeons. The first trial was simply asking the model to generate CPT codes for a given OP note. The second trial included 3 OP notes and associated CPT codes to, and the third trial included a list of every possible CPT code in the dataset to prime the model. CPT codes generated by the model were compared to those generated by the billing department. Model evaluation was performed in the form of calculating the area under the ROC (AUROC), and area under precision-recall curves (AUPRC).

Results

The trial that involved priming ChatGPT with a list of every possible CPT code performed the best, with an AUROC of .87 and an AUPRC of .67, and an AUROC of .81 and AUPRC of .76 when examining only the most common CPT codes.

Conclusions

ChatGPT-4 can aid in automating CPT billing from orthopedic surgery operative notes, driving down healthcare expenditures and enhancing billing code precision as the model evolves and fine-tuning becomes available.
Degenerative Thoracic Myelopathy: A Scoping Review of Epidemiology, Genetics, and Pathogenesis
Authors: Rujeedawa Tanzil , Mowforth Oliver D. , Davies Benjamin M. , Yang Cylene , Nouri Aria , Francis Jibin J. , Aarabi Bizhan , Kwon Brian K. , Harrop James , Wilson Jefferson R. , Martin Allan R. , Rahimi-Movaghar Vafa , Guest James D. , Fehlings Michael G. , Kotter Mark R.
Published: December 2023

Study Design

Literature Review.

Objective

Myelopathy affecting the thoracic spinal cord can arise secondary to several aetiologies which have similar presentation and management. Consequently, there are many uncertainties in this area, including optimal terminology and definitions. Recent collaborative cervical spinal research has led to the proposal and subsequent community adoption of the name degenerative cervical myelopathy(DCM), which has facilitated the establishment of internationally-agreed research priorities for DCM. We put forward the case for the introduction of the term degenerative thoracic myelopathy(DTM) and degenerative spinal myelopathy(DSM) as an umbrella term for both DCM and DTM.

Methods

Following PRISMA guidelines, a systematic literature search was performed to identify degenerative thoracic myelopathy literature in Embase and MEDLINE.

Results

Conditions encompassed within DTM include thoracic spondylotic myelopathy, ossification of the posterior longitudinal ligament, ossification of the ligamentum flavum, calcification of ligaments, hypertrophy of ligaments, degenerative disc disease, thoracic osteoarthritis, intervertebral disc herniation, and posterior osteophytosis. The classic presentation includes girdle pain, gait disturbance, leg weakness, sensory disturbance, and bladder or bowel dysfunction, often with associated back pain. Surgical management is typically favoured with post-surgical outcomes dependent on many factors, including the causative pathology, and presence of additional stenosis.

Conclusion

The clinical entities encompassed by the term DTM are interrelated, can manifest concurrently, and present similarly. Building on the consensus adoption of DCM in the cervical spine and the recent proposal of degenerative cervical radiculopathy(DCR), extending this common nomenclature framework to the terms degenerative spinal myelopathy and degenerative thoracic myelopathy will help improve recognition and communication.
Serratia marcescens Endocarditis
Authors: Oliver Tucker , Vazquez Jose
Published: December 2023

Severe infections due to Serratia marcescens have been documented with increasing frequency in persons who inject drugs and are frequently associated with nosocomial outbreaks. S marcescens endocarditis is rare, and there are very few, if any, reported cases secondary to an infected wound acquired at home. We present such a case in an immunocompetent 50-year-old man with paraplegia for 30 years and chronic decubitus ulcers who likely contracted the rare opportunistic Serratia following sacral wound contact with unclean surfaces in his hotel room bathroom. While it is also possible that the organism was obtained during a hospital admission 2 months before the positive blood cultures, he was found sitting with his ulcer in direct contact with red-pigmented accumulations on the shower floor. Therefore, it is more likely that he acquired the infection outside of the hospital setting. Early and effective management with advanced cardiac techniques and appropriate antibiotic coverage resulted in a positive outcome.
Mandibular Brown Tumor Revealing Hyperparathyroidism in a Patient With Neurofibromatosis Type I: Case Report
Authors: Kabila Badr , Beqqali Basma , Obilat Samia , Haddad Siham El , Allali Nazik , Chat Latifa
Published: December 2023

The brown tumor is a non-neoplastic lesion resulting from an abnormality in bone metabolism in the context of primary, secondary, or tertiary hyperparathyroidism. They can affect any bone structure and be single or multiple. They are usually located on the long bones, pelvis, ribs, and collarbones. Facial localization is rare and is found in only 4.5% of brown tumors dominated by mandibular involvement. The treatment of a brown tumor depends on several elements: etiology, location, and symptomatology. It can regress or disappear after the treatment of hyperparathyroidism, thus avoiding surgical removal. Otherwise, excision of this mass is performed. We illustrate through this case a brown mandibular tumor revealing secondary hyperparathyroidism in a patient with a history of end-stage chronic renal failure on hemodialysis and associated neurofibromatosis type 1.
Informed Random Forest to Model Associations of Epidemiological Priors, Government Policies, and Public Mobility
Authors: Thapelo Tsaone Swaabow , Mpoeleng Dimane , Hillhouse Gregory
Published: December 2023

Background. Infectious diseases constitute a significant concern worldwide due to their increasing prevalence, associated health risks, and the socioeconomic costs. Machine learning (ML) models and epidemic models formulated using deterministic differential equations are the most dominant tools for analyzing and modeling the transmission of infectious diseases. However, ML models can be inconsistent in extracting the dynamics of a disease in the presence of data drifts. Likewise, the capability of epidemic models is constrained to parameter dimensions and estimation. We aimed at creating a framework of informed ML that integrates a random forest (RF) with an adapted susceptible infectious recovered (SIR) model to account for accuracy and consistency in stochasticity within the dynamics of coronavirus disease 2019 (COVID-19). Methods. An adapted SIR model was used to inform a default RF on predicting new COVID-19 cases (NCCs) at given intervals. We validated the performance of the informed RF (IRF) using real data. We used Botswana’s pharmaceutical interventions (PIs) and non-PIs (NPIs) adopted between February 2020 and August 2022. The discrepancy between predictions and observations is modeled using loss functions, which are minimized, interpreted, and used to assess the IRF. Results. The findings on the real data have revealed the effectiveness of the default RF in modeling and predicting NCCs. The use of the effective reproductive rate to inform the RF yielded an excellent predictive power (84%) compared with 75% by the default RF. Conclusion. This research has potential to inform policy and decision makers in developing systems to evaluate interventions for infectious diseases.

Highlights

This framework is initiated by incorporating model outputs from an epidemic model to a machine learning model. An informed random forest (RF) is instantiated to model government and public responses to the COVID-19 pandemic. This framework does not require data transformations, and the epidemic model is shown to boost the RF’s performance. This is a baseline knowledge-informed learning framework for assessing public health interventions in Botswana.
An Innovative Teaching Approach for Diabetes Mellitus in Laboratory Medicine Uses the Clinical Laboratory Diagnostic Pathway
Authors: Tong Yongqing , Chen Hongbin , Wang YingYing , Wu Zegang , Gu Jian , Wu Qian , Wang Jingwei , Luo Hongbo , Bao Anyu , Zheng Hongyun
Published: December 2023

Objectives

The routine teaching mode of diabetes mellitus (DM) is divided into various sub-majors of medical laboratory, which is not conducive to clinical laboratory physicians quickly mastering relevant knowledge. A novel DM laboratory testing pathway is established to improve teaching efficiency and enhance the effects of talent cultivation in laboratory medicine.

Methods

The guidelines and expert consensuses of DM were gathered from professional websites and databases. The clinical laboratory diagnostic pathway was formulated, and the questionnaire and mutual evaluation were used to evaluate the teaching effectiveness of 8-year undergraduate students enrolled in 2018 and enrolled in 2019, respectively.

Results

Clinical laboratory physicians developed and approved the DM clinical laboratory diagnostic pathway, which included the entire process of DM diagnosis and differential diagnosis, drug selection, treatment impact monitoring, prognosis evaluation, etc. The results of the questionnaires showed that, in comparison to the teaching mode used with the students enrolled in 2018 and enrolled in 2019, the percentages of more improvement and significant improvement were significantly increased ( P < 0.01) and the percentages of no improvement and slight improvement were significantly decreased ( P < 0.01). Following the instruction of the DM clinical laboratory diagnostic route, the results were greatly improved, including points emphasized and the accuracy of responding to questions, among other things, according to the teachers’ and students’ mutual evaluation ( P < 0.05).

Conclusions

To enhance the teaching quality in laboratory medicine, it is required to build the disease clinical laboratory diagnostic pathway for a novel teaching method. This may boost teachers’ and students’ confidence and broaden their knowledge.
A Student-Designed Multimodal Sex- and Gender-Based Women's Health Elective Program: Advocacy Curriculum for Medical Students
Authors: Conroy Lauren M , Ghafir Danna , Narayan Maitreyi , McSpedden Hunter , Neher Samuel , Hashmi S Shahrukh , Lunstroth Rebecca
Published: December 2023

OBJECTIVES

The objective of this article is to describe the design and implementation of a multimodal, student-driven, sex- and gender-based women's health (SGBWH) elective with a curricular focus on patient and legislative advocacy. In this single arm, pre/post design, interventional study, we detail and evaluate the use of social media, newsletters, and round-table discussions in conjunction with a traditional lecture-based educational format to engage medical students in a virtual learning environment.

METHODS

We developed a 22-week SGBWH curriculum for pre-clinical and clinical medical students, which included a series of lectures on multi-specialty and gender-inclusive topics related to SGBWH, small group discussions with community leaders and legislators involved in women's health advocacy, and other self-directed resources such as social media, a website, and digital newsletters. Students were surveyed before and after completing the curriculum to assess for increases in self-reported confidence in advocating for their female and gender minority patients.

RESULTS AND CONCLUSION

One hundred and one students completed the anonymous pre- and post-elective surveys. There was statistically significant improvement in 8 of the 12 self-reported confidence measures. Eight (8%) participants identified their sex as male. Fifty-five (55%) participants stated future interest in primary care specialties (Internal Medicine, Family Medicine, Obstetrics and Gynecology, and Pediatrics). Our curriculum improved medical students’ self-reported confidence in advocating for their female and gender minority patients when controlling for sex and specialty interest of participants. The success of our multimodal approach demonstrates the value in incorporating resources such as social media as tools for education and advocacy in the evolving landscape of medical education.
Street characteristics and human activities in commercial districts: A clustering-based approach application for Shenzhen
Authors: Yang Chendi , Ma Rui , Fang Hongqiang , Lo Siu Ming , Lo Jacqueline TY
Published: December 2023

As a significant public place, the commercial area has a potential correlation between its built environment and human activities. However, the current research primarily concentrates on the internal environment of the store and customer satisfaction, while the impact of some environmental features of the outer space of the business district on visitors is seldom systematically discussed. This study takes four commercial districts in Shenzhen as examples, and the streets were categorized into five types based on street characteristics using the cluster analysis method. The relationship between each type of street and the population distribution in the region was subsequently discussed. To this end, a holistic approach was adopted, integrating multi-source urban data such as street view panorama, points of interest (POI), and street and building vectors to describe the built environment. Furthermore, the distribution of people at different times, based on location-based services (LBS) data, was combined to establish statistical models of various streets in commercial districts and evaluate the relationship between street characteristics and human activities. The results demonstrate that the relationship between population distribution and spatial characteristics is different in the five types of streets. Different types of streets have their own advantages, and human activities in the business district are often not affected by this advantage, but by other characteristics. The impact of these factors varies significantly between weekdays and weekends. By systematically categorizing street types and assessing the impact of environmental factors on pedestrian flow, this study sheds new light on the renewal and development of urban commercial districts in the future.
An inductive method for classifying building form in a city with implications for orientation
Authors: Rhee Jinmo , Krishnamurti Ramesh
Published: December 2023

The utilization of deep learning for form analysis facilitates the classification of an extensive number of forms based on their morphological features. A critical consideration for implementing such analysis methods in architectural or urban forms is whether building orientation should be embedded within the data. Orientation functions as a form variable significantly influenced by environmental, social, and cultural contexts within a city. In contrast to other domains where forms are extrapolated in relation to their context, in the city, domain orientation uniquely characterizes building form. In this paper, we introduce a pipeline for constructing an extensive building form dataset and scrutinizing the morphological identity of building forms, with a particular focus on the implications of building orientation as a manifestation of urban locality. Through a case study situated in Montreal, we engage in a comparative analysis employing two distinct datasets—those with orientation-embedded forms and those with orientation-normalized forms. Our research aims to investigate the typo-morphological characteristics of the building forms of the city and to examine how building orientation contributes to the identification of these traits and mirrors urban locality.
First Metatarsophalangeal Arthrodesis in Hallux Rigidus and Hallux Valgus: A Comparison of Patient Reported and Clinical Outcomes
Authors: Scheinberg Mila , Sanchez Thomas , Shah Ashish
Published: December 2023

Category:

Midfoot/Forefoot; Bunion

Introduction/Purpose:

No prior study has compared the patient reported outcomes of first metatarsophalangeal arthrodesis between hallux rigidus and hallux valgus patients. Furthermore, we sought to examine the impact of postoperative radiographic hallux alignment on outcomes scores within each group.

Methods:

A retrospective review of 98 patients who received primary metatarsophalangeal arthrodesis from January 2010 to March 2020. Clinical complications including non-union were collected. PROMIS Physical Function, PROMIS Pain Interference, and the Foot Function Index Revised Short Form scores were obtained via telephone. Patients were grouped based on preoperative radiographic alignment of the first hallux yielding 43 hallux rigidus and 55 hallux valgus patients. Clinical and patient reported outcomes were compared between these pathologies.

Results:

No differences in the rate of wound complications, radiographic union, and revision surgery were found. At median of 2.4 years (3.9 IQR) postoperatively, PROMIS and FFI scores did not vary by pathology group. For both groups, PROMIS scores were similar to the general population of the United States. In sub-analysis, the postoperative dorsiflexion angle in the hallux rigidus group and the postoperative hallux valgus angle in the hallux valgus group were correlated with more favorable outcomes scores.

Conclusion:

We found no differences in the patient reported outcomes of first metatarsophalangeal arthrodesis in hallux rigidus and hallux valgus patients. The radiographic measures of hallux alignment most directly related to the underlying pathology may correlate with patients’ perceived level of pain and function postoperatively.
Fixation in Missed Lisfranc Injuries: Should This Be Attempted?
Authors: Moonot Pradeep , Dakhode Shubham , Karwande Nikhil
Published: December 2023

Category:

Trauma; Midfoot/Forefoot

Introduction/Purpose:

The Lisfranc injuries are not so uncommon. However, subtle injuries are often either missed or misdiagnosed as “mid foot sprain” during initial assessment. Missed lisfranc injuries causes various problems like chronic pain, fallen medial arch, functional loss etc. The decision regarding whether to fix such missed or chronic injuries or to do an arthrodesis is still a topic of debate. So the purpose of this study was to evaluate the outcomes of delayed fixation of missed lisfranc injuries.

Methods:

A total of 10 patients with missed lisfranc injuries (more than 6 weeks after injury) were included in the study. Most of the patients had previous history of subtle, low energy injuries to their foot which was treated conservatively. All the patients preoperatively underwent weight bearing radiographs of foot and distance between lateral border of medial cuneiform and medial border of 2nd metatarsal base were measured for degree of displacement. Patients were treated with an open reduction and internal fixation as opposed to arthrodesis. Outcomes were assessed using VAS score, American Orthopaedic Foot & Ankle Society (AOFAS) Mid foot score, post operative radiographic evaluation and return to work time. Out of 10 patients, 70% were female and 30% were male. The average time interval between injury and surgery was 9.6 + 2.50 weeks. The mean age was 41.5 and mean follow up duration was 33.6 + 12.98 months.

Results:

The average degree of displacement between lateral border of medial cuneiform and medial border of 2nd metatarsal base was 5.14 mm. At final follow up no patients had radiographic signs of a late diastasis at the Lisfranc joint. The pre operative VAS score improved from 7.5 + 1 to 1.6 + 0.69 post operatively. One patient had developed arthritis at 1st and 2nd TMT joints but did not had any symptoms. The average AOFAS mid foot score pre & post operatively was 37.6 + 10.8 & 84.2 + 6.54 respectively, with two patients having excellent outcome, six patients having good outcome and two patients having fair outcome. At final follow up all patients could perform their ADL & recreational activities independently.

Conclusion:

Subtle, low velocity missed lisfranc injuries can be well managed with open reduction and internal fixation. In our series, delayed fixation resulted in decreased pain scores and a fair to good functional outcome and returned to their pre injury work.
Hindfoot Stability Test: Introduction and Validation of a Diagnostic Test of Subtalar Instability in Deltoid Ligament injury Associated with Ankle Fractures
Authors: Mason Lyndon W. , Philpott Matthew , Bond Alistair P.
Published: December 2023

Category:

Ankle; Trauma

Introduction/ Purpose:

Deltoid ligament complex (DLC) injury repair in the presence of an ankle fracture remains a topic of controversy in the current literature. No work in the current literature has commented on hindfoot and subtalar instability in the presence DLC injury associated with ankle fracture fixation.

Objective

Our aim was to introduce and validate a new method for assessment of hindfoot instability, when fixing an ankle fracture with associated DLC injury.

Methods:

DLC injury, specifically superficial DLC, controls not only the ankle but the subtalar joint and medial longitudinal arch. Valgus stressing can unmask subtalar instability. It was noted by referencing the hindfoot position to a line parallel with the lateral aspect of the fibula, the lateral fibula line, subtalar instability was proabbale. We used six morphologically normal cadaveric specimens to validate the test.

Results:

Ten cadaveric specimens were used for validation of the hindfoot stability test. Pre-injury, no specimen illustrated bisection5-injury, all specimens showed bisection of the calcaneal tuberosity by the lateral fibular line on hindfoot stability test.

Conclusion:

The hindfoot stability test assesses hindfoot stability on valgus stressing of the hindfoot using the calcaneal tuberosity bisection of the a line drawn from the lateral border of the fibula as a reference point for instability. This was validated using morphologically normal cadavers.
How Do Causes of Readmission Following Orthopaedic Surgery Differ Between Races? A Five-Year Analysis of the NSQIP Database.
Authors: Bergstein Victoria E. , O’Sullivan Lucy , Levy Kenneth H. , Vulcano Ettore , Aiyer Amiethab A.
Published: December 2023

Category:

Other

Introduction/Purpose:

Previous studies have reported conflicting data regarding 30-day readmission rates between patients of different races following orthopaedic surgery. Differences in specific reasons for 30-day readmission between races following orthopaedic surgery have yet to be explored.

Methods:

The ACS-NSQIP database was utilized to identify patients who underwent orthopaedic surgery and were readmitted within 30 days. Data was collected from 2015–2019, and patients were stratified into one of five race groups: American Indian/Alaskan Native, Asian, Black/African American, Native Hawaiian/Pacific Islander, and White. Analysis of variance (ANOVA) with Bonferroni post-hoc analysis for multiple comparisons was used to compare differences in continuous variables between racial groups. Chi-square analysis with post-hoc analysis of adjusted standardized residuals was used to compare differences in categorical variables between racial groups.

Results:

In total, 975,857 patients from the ACS-NSQIP database were included in the study. All-cause readmission rate was significantly different across races. Asian and Native Hawaiian/Pacific Islander patients had significantly lower readmission rates (2.7% and 2.8%, respectively), whereas Black patients had significantly greater readmission rates (3.9%) (p < 0.01). Black patients had significantly greater readmission rates for deep incisional SSI, wound disruption, renal insufficiency, and pulmonary embolism, and a lower readmission rate for pneumonia compared to other races. Asian patients had a lower readmission rate for pulmonary embolism, wound disruption, superficial incisional SSI, and vein thrombosis requiring therapy.

Conclusion:

Specific causes of 30-day readmission were significantly different between races, with Black patients experiencing higher readmission rates and Asian and Hawaiian/Pacific Islander patients experiencing lower readmission rates overall. Our findings can inform which complications should be more carefully monitored in certain patient populations, and how peri- and post-operative management can be adjusted accordingly.
How Does Lateral Column Lengthening Correct the Flatfoot? A Cadaveric Study
Authors: Abd-Ella Mohamed Mokhtar
Published: December 2023

Category:

Hindfoot; Basic Sciences/Biologics

Introduction/Purpose:

Since its description by Evan for correction of overcorrected clubfoot cases, lateral column lengthening ( LCL) has been widely used for correction of pes planovalgus deformity of any etiolog. The main indication is correction of forefoot abduction manifested radiologically as talonavicular uncoverage. It was reported by many authors that LCL improved forefoot abduction and talonavicular uncoverage, but it was also noticed that LCL corrects the flattening of medial longitudinal arch. The mechanism by which LCL corrects the medial longitudinal arch is still not clearly understood. It was also reported that LCL is associated with forefoot supination, but the exact mechanism of supination is not understood. This study aimed to try to understand the mechanism by which LCL changes the shape of the foot.

Methods:

LCL osteotomy using Hintermann technique was performed in ten fresh frozen below knee cadaveric specimens. After completion of the osteotomy, the talus and leg were removed to monitor how the foot moves under the talus with opening of the osteotomy to change the shape of the foot. The amounts of osteotomy displacement medially, laterally and planetary were observed and measured. After that, the whole plantar skin was removed and plantar ligaments were dissected to study the influence of plantar ligaments on the plane of motion of the osteotomy and the effect of the osteotomy on plantar ligaments.

Results:

With opening of the osteotomy, the distal portion did not move in pure adduction. Instead, it moved medial and plantar, working as a dorsolateral opening wedge . So, the distal portion was adducted and plantarflexed correcting the forefoot abduction and the flat arch. Because the osteotomy opens dorsally and laterally only, the lateral part of the distal portion was plantar flexed more than the medial part, and this is the cause of forefoot supination. After dissection of plantar ligaments, it was found that the long and short plantar ligaments prevent the osteotomy from opening inferiorly . It was possible to move the distal portion in pure adduction only after cutting the long and short plantar ligaments. Plantar fascia was relaxed after opening of the osteotomy.

Conclusion:

This mayexplain how the LCL osteotomy corrects the flat medial longitudinal arch and how it causes supination and lateral side overload. Based on this study, Cotton osteotomy should be added to LCL to correct the supination. Also, plantar fascia tightening can not be the cause of medial longitudinal arch correction as it actually becomes more lax after opening of the osteotomy.