bluuebunny/crossref_metadata_2025 huggingface dataset:
Red Flags for Early Referral for Infant Mental Health: Content Validation of a Tool
Authors: Narayan Shweta , Kishore M Thomas , Seshadri Shekhar P , Thippeswamy Harish
Published: August 2023

Background:

There is growing evidence about the psychological distress and mental health issues experienced by infants with developmental problems. Problems related to developmental issues can be mitigated with early identification and intervention. A simple screening measure is needed to identify infants at risk for mental health issues to make informed decisions about further assessment and interventions. In this background, the present study aimed to develop a checklist to identify infants with psychological distress and at risk for mental health issues without the need to administer full-scale socioemotional tools and intended to be used by primary care professionals for early identification of risk factors followed by intervention to reduce the risk. Early identification of infants at risk in view of the limited resources would help in reducing the impact of early trajectories on the socioemotional health of any infant.

Aim:

The present study aims to develop a checklist for rapid screening. In view of the limited resources of low-income countries, early identification of infants at risk is important. This would help in reducing the impact of early trajectories on the socioemotional health of infants.

Methods:

The checklist was based on the “functional and emotional developmental approach” and a literature review of early indicators of psychological distress and mental health issues in infants. The checklist was prepared using objective terms which were further evaluated by mental health experts using standard methods. Accordingly, a content validity index (CVI) was calculated to determine the relevance and clarity of the items.

Result:

Based on the CVI, 16 items were retained in the final checklist, which was reported to have excellent relevance (CVI = 0.91) and clarity (CVI = 0.84).

Conclusion:

The checklist is concise with adequate content validity and has the potential to be used in primary care settings to screen infants at risk for psychological distress and mental health issues and make appropriate referrals.
Effects of Corporate Governance on Creative Accounting Practices: Evidence from NSE-listed Companies in India
Authors: Debbarma Juhendra , Roy Chinmoy
Published: August 2023

This paper investigates the effects of corporate governance on creative accounting practice in Indian NSE-listed public companies. To get insights and analysis of how mitigating effects of governance issues can impact creative accounting practices, a specific set of factors is identified and the multistage technique design is employed to collect samples of 51 companies with 255 firm-year observations for the years 2017–2021. The value of discretionary accrual as estimated using the modified Jones model. The panel data are used for analysis and testing the hypothesis with the help of Stata 15 version statistical software. The results of this study demonstrated that only audit independence has a considerable negative influence on creative accounting practice, indicating that increasing the number of audit independence could reduce unethical accounting manipulation in financial reporting practice. The paper digs further and provides additional details that the board size, return on asset and firm growth significantly appears under a flag of positive creative accounting practices. In contrast, the board’s independence, audit committee, firm size and leverage have no such influence on creative accounting practice. The study also recommends that companies should have an independent audit committee, so as to minimise the accounting irregularities in financial reports.
Board Attributes and Corporate Social Responsibility: A Systematic Literature Review and Future Research Perspectives
Authors: Pahuja Shuchi , Agrawal Anita
Published: August 2023

The relationship between board attributes and corporate social responsibility (CSR) has gained considerable attention from academicians and researchers in the past few decades. This systematic literature review paper aims to analyse empirical evidence on the impact of board characteristics on CSR. A content analysis of 159 articles extracted systematically from the Scopus and WOS databases revealed a significant upsurge in the area in the last decade mainly in the past three years. It was found that a large majority of the existing works were single-country studies mainly from the developed nations; though cross-country works and research from developing countries have gained momentum in recent years. The study highlighted important trends in publication in the area, the most researched as well as less analysed board attributes, various measures of CSR variables, the type of sample organisations considered, and commonly used research techniques. The study makes a useful contribution to the extant literature by providing insight into the existing works and indicating knowledge gaps and future research perspectives. The findings of the study would also be useful for the policy makers and regulators in further strengthening the corporate governance codes and regulations, so as to help organisations in improving their social performance.
Barriers and Enablers to Evaluating Outcomes From Public Involvement in Health Service Design: An Interpretive Description
Authors: Lloyd Nicola , Hyett Nerida , Kenny Amanda
Published: August 2023

While health services are expected to have public involvement in service (re)design, there is a dearth of evaluation of outcomes to inform policy and practice. There are major gaps in understanding why outcome evaluation is under-utilised. The aims of this interpretive descriptive study were to explore researcher participants’ experiences of and/or attitudes towards evaluating health service outcomes from public involvement in health service design in high-income countries. Additionally, the aims were to explore barriers and enablers of evaluation, and reasons for the use of evaluation tools or frameworks. Semi-structured interviews ( n = 13) were conducted with researchers of published studies where the public was involved in designing health services. Using framework analysis, four themes were developed that captured participants’ experiences: Public involvement is hard – evaluation is harder; power, a diversity of agendas, and the invisible public; practical and methodological challenges; and genuineness and authenticity matter. Evaluation is driven by stakeholder requirements, including decision-makers, funding bodies, researchers, and academics, and evaluation tools are rarely used. The public is largely absent from the outcome evaluation agenda. There is a lack of commitment and clarity of purpose of public involvement and its evaluation. Outcome evaluation must be multi-layered and localised and reflect the purpose of public involvement, what constitutes success (and to whom), and use the most appropriate methods. Multi-level supports should include increased resources, such as funding, time, and expertise. Without improved evaluation, outcomes of investment in public involvement in health service design/redesign remain unknown.
Risk Assessment of Sleep Disordered Breathing in Cleft Lip and/or Palate
Authors: Fisher Alec H. , Stanisce Luke , Nelson Zach J. , Cohen Marilyn A. , Matthews Martha S.
Published: August 2023

Objective

Children with cleft lip and/or palate (CL/P) are at increased risk for Sleep Disordered Breathing (SDB), particularly Obstructive Sleep Apnea (OSA). At our institution, routine screening for SDB is performed using the Chevrin Pediatric Sleep Questionnaire (PSQ). This analysis is a practice audit looking at the outcomes of screening children with CL/P.

Design/Setting/Patients/Participants

A single-center, retrospective analysis was done of all non-syndromic patients with CL/P over the age of 36 months over a 4-year period. Children with known OSA were eliminated from analysis.

Main Outcome Measures

Univariate logistic regression was used to assess predictors for SDB (PSQ score > 8) amongst various patient, disease, and treatment characteristics. Outcomes of those screened were tracked.

Results

Of the 239 patients in the study cohort, 43 (18%) had positive PSQs. These subjects were more likely to have class III dental occlusion with maxillary retrusion (OR = 2.65, 95% CI: 1.2–5.8, p = 0.02). There were no differences amongst age, type of cleft, Veau classification, BMI, or history of pharyngeal surgery. One third of the group did not complete recommended testing. Twenty-five subjects with positive sleep screening underwent subsequent polysomnography and 21 (84%) had OSA.

Conclusion

Routine screening reveals a significant proportion of patients with CL/P with symptoms suggestive of OSA. While several patients did not complete confirmatory testing, those who completed a PSG had a high rate of identification of OSA. After excluding children with known OSA, patients with SDB are also likely to have class III dental occlusion and maxillary retrusion.
The 3-5-8 Cycle Post-Reform at the Malagasy Public Institutional Level: A Bridge to a New Pace
Authors: Zafitsara Jocelyne , Velo Njaratiana Mario Arthur
Published: August 2023

This paper explores the realities that Malagasy public institutions underwent after implementing the LMD system. This research draws on qualitative data, which purposely interviewed 16 participants. Findings revealed that many debates have arisen regarding the reform due to its lack of clarity. Opportunities and problems were seen in teaching and learning since the reform brought diplomas internationalization and infrastructure growth rather than teaching improvement. This study encourages a thorough reevaluation of the ongoing educational system to systematically answer the reform’s primary objectives: to advance quality pedagogical and learning productivities and upgrade research in academia through internet connectivity intensification. Meanwhile, create competition mechanisms for teachers as strategies to motivate and alert leaders to put research, regardless of discipline, in the right place. Since it has the power to abreast teachers with new content and information, notably to nurture teaching scientificity and ranking improvement of institutions.
How Many Terms Does It Take to Define Sexual Assault? Inconsistencies in U.S. Higher Education Sexual Misconduct Policies
Authors: Papp Leanna J. , Levitsky Sandra R. , Armstrong Elizabeth A. , Porter Kamaria B.
Published: August 2023

Campus sexual misconduct policies (SMPs) outline prohibited conduct. We sought to document the range of terms used to refer to forms of nonconsensual sexual contact in SMPs and to analyze the content of definitions provided for the term “sexual assault.” We coded the 2016-2017 SMPs from a sample of 381 U.S. schools. We identified 125 unique terms and documented both a terminological and conceptual morass around sexual assault. Policy language may have implications for students’ and administrators’ evaluation of experiences and reports of sexual assault.
“Are You—?” “Are You?” Queer Advocacy at Contemporary Neoliberal Rape Crisis Centers
Authors: Chen Melinda
Published: August 2023

Antirape scholarship has largely focused on survivors and their needs. However, little is known about victim advocates, who support survivors, and how advocates’ identities can affect their work. This article draws on semistructured interviews with 23 LGBTQ+ advocates to explore how they navigate their sexual, gender, and racial identities at rape crisis centers today. Results show that LGBTQ+ advocates choose the ways that their sexual and gender identities are visible or invisible at their agency, usually to improve LGBTQ+ survivor services. By examining LGBTQ+ advocacy, this article critically evaluates normativity in antirape work and advocates for a queer transformation of rape victim services.
Enhancing Home Monitoring of Patients With Heart Failure: Primary Care Experience With an Autonomous Foot-Measuring Device
Authors: Murugappan Thirunavukkarasu , Raut Rajeev
Published: August 2023

In recent years, telemonitoring solutions have gained prominence for monitoring patients at home. However, patient and clinician enthusiasm, as well as adherence rates, have been inconsistent. This article presents a primary care evaluation of an autonomous foot-measuring home device, designed to monitor physiological changes in medium to high-risk chronic heart failure patients at risk of decompensation. The Heartfelt device garnered positive reception among the 13 participating patients. Remarkably, in 77% of cases (10 patients), the device captured and transmitted patient data on more than half of the days each month, while only 8% (one patient) managed to provide equivalent daily measurements using weighing scales. These results indicate that the Heartfelt device holds promise as an effective telemonitoring solution for patients who face adherence challenges with traditional telemonitoring systems, and self-management checks more generally. By adopting this technology, healthcare providers may be better equipped to proactively manage chronic heart failure patients and improve overall patient outcomes.
Neonatal iatrogenic calcinosis cutis caused by calcium gluconate extravasation
Authors: Pu Changsheng , Li Junqiu , Wang Menglei , Xie Yan , Su Yuxi
Published: August 2023

Background:

Calcium gluconate is widely used to treat neonatal hypocalcemia, severe hyperkalemia, and convulsions. However, extravasation of calcium gluconate can lead to iatrogenic calcinosis, causing symptoms such as local redness and swelling, cutaneous plaque, soft tissue calcification, and cutaneous tissue necrosis. Therefore, this study retrospectively analyzed the conservative treatment results of neonatal iatrogenic calcinosis.

Methods:

Data of neonates diagnosed with iatrogenic calcinosis cutis caused by calcium gluconate exudation between December 2012 and June 2021 were analyzed retrospectively. The clinical data included medical history, physical examination, laboratory findings, and radiographs. All the patients were conservatively treated, and the curative effect and prognosis were followed up by evaluating radiographs and limb function. Patients with complications, such as recurrence or limb dysfunction, were further followed up.

Results:

Overall, 16 neonates (sex: 10 male and 6 female infants; age: 17.5 ± 7.8 days) were included. Iatrogenic calcinosis cutis was located around the left wrist, right wrist, left ankle, and right ankle in four, one, six, and five patients, respectively. Calcification healed within 1–3 months (mean: 1.6 ± 0.6 months). After a follow-up of 0.5–8.5 years (mean: 3.5 ± 2.8 years), the appearance, joint function, local growth, and development of the lesion of the neonates with iatrogenic calcinosis cutis were consistent with those of the healthy ones.

Conclusion:

For neonatal iatrogenic calcinosis cutis without cutaneous and subcutaneous tissue necrosis, symptomatic support treatment is effective and does not affect the limbs’ appearance and function. Level of evidence: IV.
[Can’t] Delete: an intervention in mainstream news media representations of image-based sexual abuse
Authors: Gleave Josie , Waller Lisa
Published: August 2023

Cases of image-based sexual abuse (IBSA) – the creation or distribution of private sexual or nude images – are on the rise across the world and internet, but the public does not understand this issue as a form of sexual violence. This is due in part to the role of journalists and the news media as the first site where the general audience hears about new issues. Research into IBSA has not considered the role of the news media to educate the public, so this article seeks to explore this gap through the creation of an experimental work of journalism. The creative component is an interactive journalism feature hosted on a website that offers the audience opportunities to engage with victim perspectives within the context of an explanatory journalism article about IBSA. This approach seeks to be an example for future journalism about sexual abuse and improve public understanding of IBSA.
Plural Suffixation Skills in Developmental Language Disorders: A Preliminary Investigation From Bilectal Cypriot-Greek-Speaking Children With DLD
Authors: Petinou Kakia , Giannikas Christina , Papastefanou Theodora , Hadjigeorgiou Lia , Stamelou Ioanna
Published: August 2023

Young children are known to make significant progress in learning their native language during the first 4 years of their life. Nonetheless, delays or differences in patterns of language acquisition can be cautiously determined and be sensitive indicators of developmental issues. The current paper displays an investigation that examines plural suffixation skills in preschool bilectal Cypriot-Greek (CG)-speaking children with developmental language disorder (DLD) as compared with their age-matched typically developing peers. Predictions have been made based on the Interpretability Hypothesis (IH) theoretical context postulating that grammatical features (inflections for Tense and Case Features) will be differentially affected in DLD depending on the phonological saliency inherent to specific inflection typology. Developmental language disorder diagnosis was based on exclusionary criteria and on clinical markers based on the language samples analyzed for grammatical errors, including the omission of articles in obligatory contexts, clitic misplacement, incorrect suffixation of plural targets, agreement errors, omission of negation, and reduced Mean Length of Utterance in Words (MLUw). A non-real-word experimental paradigm was used to test subject performance of plural suffixation. Findings revealed that plural suffixation difficulty was not an all-or-none phenomenon. Both erroneous and correct responses were identified during both experimental tasks. In addition, errors were observed in both groups of preschool children; nonetheless, the proportion of errors was recorded to be higher in the DLD group.
Impact of cilostazol on prevention of late failure of autologous vein grafts
Authors: Mii Shinsuke , Guntani Atsushi , Kuma Sosei , Ishida Masaru , Yamashita Sho , Tanaka Kiyoshi , Okazaki Jin
Published: August 2023

Objectives

The effectiveness of postoperative medication for the prevention of late graft failure is controversial. We conducted the present study to investigate whether cilostazol improved the mid-term outcomes after infrainguinal autologous vein bypass for chronic limb-threatening ischemia (CLTI).

Methods

From April 1994 to March 2022, we performed 590 de novo infrainguinal bypass procedures using autologous vein grafts (AVGs) in three hospitals. The bypass grafts were classified according to the postoperative prescription of cilostazol. The loss of graft patency and major adverse limb events (MALEs) were set as endpoints. Patients who died within 30 days and grafts that lost primary patency within 30 days after surgery were excluded. Data up to 3 years were analyzed. The cumulative primary patency (PP), assisted primary patency (AP), secondary patency (SP), and freedom from MALE (ffMALE) rates were calculated by the Kaplan–Meier method and compared between the cilostazol group and the non-cilostazol group. After a propensity score matching, same statistical analyses were performed. In addition, a Cox proportional hazards regression analysis that included preoperative factors, intraoperative factors, and postoperative medications was performed to identify whether cilostazol is an independent predictor for the outcomes.

Results

A total of 523 AVGs met inclusion criteria. Kaplan–Meier curves showed that the cilostazol group was superior to the non-cilostazol group in all outcomes, while the cilostazol group was superior to the non-cilostazol group in AP and SP after a propensity score matching. A multivariable analysis showed that non-use of cilostazol was identified as an independent predictor for loss of AP, SP, and ffMALE.

Conclusions

Cilostazol improved the mid-term outcomes after infrainguinal autologous vein bypass.
Increased anti-thrombotic therapy is associated with decreased major adverse limb events in patients with low wound and foot infection scores
Authors: Png Chien Yi Maximilian , Beardsley Jenna G. , Khoury Mitri K. , Lee Sujin , Morrow Katherine L. , Bellomo Tiffany R. , Srivastava Sunita D. , Dua Anahita
Published: August 2023

Introduction

The optimal anti-thrombotic management of patients after lower extremity bypass has yet to be fully elucidated, in part due to significant heterogeneity in patient presentation and practice patterns. The Wound, Ischemia, and foot Infection (WIfI) score is a validated scoring system to assist in the management of patients with chronic limb threatening ischemia (CLTI). We hypothesized that performing a restriction analysis based on WIFI scores would assist in the postoperative anti-thrombotic management of patients undergoing infrainguinal bypass.

Methods

A retrospective cohort of infrainguinal bypass procedures completed at a single hospital system between January 2018 and January 2021 was selected, and preoperative WIfI scores were extracted for each patient. Patients with either Wound scores of 2 and 3, or Ischemia Scores of 0 and 1, or Foot Infection Scores of 3 were excluded. Based on the type of anti-thrombotic regimen on discharge, demographics, comorbidities, type of bypass, 30-day rates of graft occlusion, major amputation, mortality, and major adverse limb events (MALE) were analyzed. Statistical analysis included t-tests, chi square tests, and time-to-event survival analysis.

Results

230 procedures were included in the study. 69 (30.0%) patients were discharged on single antiplatelet therapy (SAPT), compared to 161 (70.0%) who were discharged on either dual antiplatelet therapy or anticoagulation (DAPT/AC). There was a higher prevalence of bypasses using prosthetic conduit in the DAPT/AC group (45.9 vs 31.8%, p = .047); no other demographic or procedural variable analyzed had any significant differences. At 30-days postoperatively, there was no significant difference in postoperative reintervention rates, however, the DAPT/AC group had significantly lower rates of mortality (1.2 vs 7.2%, p = .01), major amputation (1.2% vs 5.8%, p = .04), and MALE (3.7 vs 13.0%, p < .01). There were no significant differences in bleeding complications. Survival analysis demonstrated that MALE-free survival was higher in the DAPT/AC group compared to the SAPT group ( p < .01). On Cox regression analysis, DAPT/AC was associated with significantly decreased rates of MALE + mortality (Hazard Ratio (HR) 0.20 [0.06 – 0.66]).

Conclusion

Lower extremity bypasses patients with low Wound and low foot Infection scores who are discharged on DAPT/AC postoperatively have a significantly higher 30-day MALE-free survival rate compared to patients discharged on SAPT; consideration could be made to preferentially discharge such post-bypass patients on DAPT/AC.
China’s environmental pollution crisis: A comparative analysis of newspaper coverage of the Songhua River Spill
Authors: Li Haoyue Cecilia
Published: August 2023

This article scrutinizes global media coverage of the 2005 Chinese Songhua River Spill, a significant transboundary water pollution crisis. It compares media narratives in China’s Party press, liberal press, and U.S. newspapers, revealing divergences in the symbolic communication of environmental risk. China’s Party press altered its reporting in response to criticisms and new events. U.S. newspapers consistently targeted Chinese government institutions and officials. Meanwhile, China’s liberal newspapers provided nuanced, topic-specific accounts, navigating between journalistic professionalism and political restrictions.
Beyond the coaches eye: Understanding the ‘how’ and ‘why’ of maturity selection biases in male academy soccer
Authors: Hill Megan , John Thomas , McGee Darragh , Cumming Sean P.
Published: August 2023

This study explored academy football coaches’ perceptions and experiences of managing individual differences in the maturity timing of male adolescent football players in an English Premier League academy. Using a longitudinal mixed method design, 98 under 12–16 players were assessed for maturity status, growth velocities, and match performance grade. Interviews with nine respective coaches were conducted in parallel. The qualitative and quantitative data were combined to generate a contextualised richer understanding and four archetypal case studies. Findings showed coaches perceive various advantages and disadvantages to players maturing either ahead or in the delay of their peers and had different expectations of performance based upon a players maturity status; biological maturity status and timing had large implications for selection and release decisions. This study highlights the challenges of developing, managing and selecting adolescent players in elite male youth football. Biological maturation confounds talent identification and development, and academy environments need to monitor maturity status and educate coaches and selectors on the complexities and intricacies of individual differences in maturity timing.
Beyond engaged pluralism? The question of labor in labor geography
Authors: Rutherford Tod D.
Published: August 2023

Labor geography is a vibrant, variegated subdiscipline, but there are also concerns over its lack of theoretical coherence. In this paper, I examine Open Marxist approaches that engage with post-structuralism and feminism based on Marx's concepts of abstract and concrete labor to frame a review of recent labor geography and related contributions on (a) social reproduction, difference, and class; (b) work, technology and precarity; and (c) labor's agency. I make three main arguments. First, while many conceptual tools for the analysis of social reproduction and difference exist within Marxism, because of their engagement with feminism and post-structuralism, these are being more fully developed. Second, Open Marxist contributions to this dialogue require greater emphasis upon the dialectical relationship between concrete, non-wage workers struggles against abstract labor and wage worker struggles of abstract labor within the totality of capitalism. Third, while important engagements are ongoing between Marxism, post-structuralism and feminism greater integration is neither needed nor desirable precisely because of Marxism's unique combination of conceptual coherence and open-endedness, which means that this interaction is a source of its theoretical development.
Non-ossifying fibroma of the mandible in a 4-year-old child: A rare case and review of the literature
Authors: Zheng Qiaoli , Kong Jihong , Zeng Teng , Cao Zhixing
Published: August 2023

Non-ossifying fibromas usually occur in the metaphysis of the long bones in children, and are extremely rare in the mandible. Here, we present a case of non-ossifying fibromas which occurred in the mandible of a 4-year-old boy. The patient had no complaint of ache. Laboratory blood examination of serum calcium, phosphorus, and parathormone levels was normal. Computed tomography of the maxillofacial region showed a well-defined osteolytic lesion affecting the right mandible. Microscopically, the lesion showed whorled bundles of spindle-shaped fibroblasts, as well as foam cells, mingled with scant multinucleated giant cells, without any bone formation. It is necessary to distinguish non-ossifying fibromas from other giant cell-containing lesions because of the extremely infrequent occurrence of this lesion in the mandible. We reviewed the histologic features of 14 cases of non-ossifying fibromas involved in the jaw.
Reducing Dietary Acid With Fruit and Vegetables Versus Oral Alkali in People With Chronic Kidney Disease (ReDACKD): A Clinical Research Protocol
Authors: Mollard Rebecca , Cachero Katrina , Luhovyy Bohdan , Martin Heather , Moisiuk Sharon , Mahboobi Sepideh , Balshaw Robert , Collister David , Cahill Leah , Tennankore Karthik K. , Tangri Navdeep , MacKay Dylan
Published: August 2023

Background:

Individuals with chronic kidney disease (CKD) can develop metabolic acidosis which, in turn, is associated with faster progression of CKD and an increased need for dialysis. Oral sodium bicarbonate (the current standard of care therapy for metabolic acidosis) is poorly tolerated leading to low adherence. Base-producing or alkalizing Fruit and vegetables have potential as an alternative treatment for metabolic acidosis as they have been shown to reduce acid load arising from the diet.

Objective:

This trial will evaluate the feasibility of providing base-producing fruit and vegetables as a dietary treatment for metabolic acidosis, compared with oral sodium bicarbonate.

Design:

A 2-arm, open-label, dual-center, randomized controlled feasibility trial.

Setting:

Two Canadian sites: a nephrology clinic in Winnipeg, Manitoba, and a nephrology clinic in Halifax, Nova Scotia.

Participants:

Adult participants with G3-G5 CKD and metabolic acidosis.

Measurements:

Participants will undergo baseline measurements and attend 5 study visits over 12 months at which they will have a measurement of feasibility criteria as well as blood pressure, blood and urine biochemistry, 5-repetition chair stand test (STS5), and questionnaires to assess quality of life and symptoms. Furthermore, participants fill out Automated Self-Administered 24-hour recalls (ASA-24) in the beginning, middle, and end of trial.

Methods:

A total of 40 eligible participants will be randomized 1:1 to either base-producing fruit and vegetables (experimental) group or sodium bicarbonate (control) group, beginning from a daily dose of 1500 mg.

Limitations:

Using self-administered dietary assessments, lack of supervision over the consumption of study treatments and the possible disappointment of the control group for not receiving fruit and vegetables would be considered as limitations for this study. However, we are planning to undertake proper practices to overcome the possible limitations. These practices are discussed throughout the article in detail.

Conclusions:

This study will generate data on base-producing fruit and vegetables consumption as a dietary treatment for metabolic acidosis in CKD. The data will be used to design a future multi-center trial looking at slowing CKD progression in people with metabolic acidosis.

Trial Registration:

This study is registered on clinicaltrials.gov with the identifier NCT05113641.
Australian women's judgements about using artificial intelligence to read mammograms in breast cancer screening
Authors: Carter Stacy M , Carolan Lucy , Saint James Aquino Yves , Frazer Helen , Rogers Wendy A , Hall Julie , Degeling Chris , Braunack-Mayer Annette , Houssami Nehmat
Published: August 2023

Objective

Mammographic screening for breast cancer is an early use case for artificial intelligence (AI) in healthcare. This is an active area of research, mostly focused on the development and evaluation of individual algorithms. A growing normative literature argues that AI systems should reflect human values, but it is unclear what this requires in specific AI implementation scenarios. Our objective was to understand women's values regarding the use of AI to read mammograms in breast cancer screening.

Methods

We ran eight online discussion groups with a total of 50 women, focused on their expectations and normative judgements regarding the use of AI in breast screening.

Results

Although women were positive about the potential of breast screening AI, they argued strongly that humans must remain as central actors in breast screening systems and consistently expressed high expectations of the performance of breast screening AI. Women expected clear lines of responsibility for decision-making, to be able to contest decisions, and for AI to perform equally well for all programme participants. Women often imagined both that AI might replace radiographers and that AI implementation might allow more women to be screened: screening programmes will need to communicate carefully about these issues.

Conclusions

To meet women's expectations, screening programmes should delay implementation until there is strong evidence that the use of AI systems improves screening performance, should ensure that human expertise and responsibility remain central in screening programmes, and should avoid using AI in ways that exacerbate inequities.
Patient and parent perspectives on the utility of telemedicine for initial surgical gender care consultations: A cross-sectional survey
Authors: Martínez Joseph A , Hijaz Baraa , Subedi Sangeeta , Boskey Elizabeth R , Ganor Oren
Published: August 2023

Introduction

The COVID-19 pandemic has expanded the use of telemedicine to patient populations that were previously constrained to in-person visits. Few studies have investigated the role that telemedicine plays in shaping the care of these patient populations. This project explores the impact of telemedicine for one such population: patients and parents of gender-diverse individuals seeking gender-affirming surgery.

Methods

A 10-question survey using previously validated questions was completed by 34 patients and 9 parents of patients (aged 15–31) who received virtual care at the Center for Gender Surgery at Boston Children's Hospital between March 2020 and April 2021. The survey was divided into two parts. The first section collected demographic information. The second assessed participant perspectives on remote surgical gender care through a series of Likert-type and open-ended questions.

Results

A total of 100% of the respondents felt that their telemedicine visit was convenient; 60% (18) of the patients and 87% (7) of the parents stated that they look forward to future use of this modality. Free responses highlighted common perspectives on remote surgical gender care, including the increased accessibility of gender-affirming care through telehealth, the limitations of telehealth for addressing physical and relational aspects of gender care, patients’ desire for autonomy and privacy during telehealth visits, and parents’ desire to be involved throughout their children's gender journey.

Conclusion

These results demonstrate the unique ability of telemedicine, if implemented thoughtfully, to enhance outcomes for patients seeking surgical gender affirmation.
Students Know Best: Modeling the Influence of Self-Reported Proficiency, TOEIC Scores, Gender, and Study Experience on Foreign Language Anxiety
Authors: Almusharraf Norah , Bailey Daniel R.
Published: August 2023

Understanding how second language proficiency and other key learner characteristics relate to language learning anxiety subcomponents can help inform the type and quantity of content instructors approach foreign language (FL) students with when teaching English. This study seeks to understand how FL proficiency (i.e., TOEIC reading, TOEIC listening, and self-reported), FL study experience, and gender influence levels of foreign language classroom anxiety and second language writing anxiety. To accomplish the research goals, 245 students completed a questionnaire measuring foreign language classroom anxiety and second language writing anxiety. Three hierarchical linear regressions were used to test the study’s models, and structural equation modeling was used to confirm and illustrate the observed relationships. Overall, self-reported FL proficiency was a stronger predictor of anxiety than actual FL proficiency. Findings further indicate that FL listening and self-reported proficiency significantly negatively correlate with FL speaking anxiety but not writing anxiety. Only FL reading proficiency significantly influenced FL writing anxiety; however, this relationship disappeared when self-reported FL proficiency was added to the model. Further, differences in how FL proficiency influences FL anxiety when controlling for years of experience studying EFL and gender are discussed. Recommendations on how instructors can approach language instruction to assist highly anxious students in the EFL context are also discussed.
Risk Factors for Neurologic Deficits in Patients With Spinal Epidural Abscess: An Analysis of One-Hundred-Forty Cases
Authors: Sircar Krishnan , Jung Norma , Kernich Nikolaus , Zarghooni Kourosh , Eysel Peer , Yagdiran Ayla , Herren Christian
Published: August 2023

Study Design

retrospective study.

Objectives

In addition to surgical treatment of spinal epidural abscesses (SEA), a conservative, medical treatment for patients without acute neurologic deficits has been proposed. However, the risk factors for neurologic deficits are unclear. This study aims to identify factors predisposing patients with SEA to neurological impairment.

Methods

All patients treated for SEA between 2008 and 2021 were identified from a prospective vertebral-osteomyelitis registry of a tertiary referral centre. Patient demographics, comorbidities, pathogens, degree of osseous destruction, location of SEA and preoperative neurologic status were retrospectively collected. Differences between patients with (Group 1) and without (Group 2) pretreatment neurologic deficits were assessed by univariate and logistic regression analysis.

Results

A total of 140 patients with SEA were included. Forty-three patients (31%) had a neurologic deficit and 97 patients (69%) had no neurologic deficit prior to therapy. The prevalence of diabetes mellitus (35% vs 19%, P = .03), median visual analogue scale leg pain (8 vs 5, P = .01), median American Society of Anesthesiologists (ASA) Score (3 vs 2.6, P = .003) and mean Body-Mass-Index (29 vs 26, P = .02) differed between Group 1 and 2 in univariate analysis. In multivariable analysis, diabetes mellitus (odds ratio = 2.7), female sex (odds ratio = 2.5) and ASA-Score (odds ratio = 2.4) were significant contributors for neurologic deficits.

Conclusions

In patients with a SEA without neurologic deficits, the ASA score and diabetes mellitus should be considered, especially in female patients. These patients may be at a higher risk for developing a neurologic deficit and may benefit from an early surgical treatment.
Mapping the Pain Points in the Motherhood Sphere: A Focus on Women Entrepreneurs in the Philippines
Authors: Lobo Kris G. , Basuil Dynah A. , Escartin Maria Corinna D. , Faustino Christine Marie D. , Caliso Rose Ann Camille C.
Published: August 2023

Policies, programmes and other measures have been in place to foster an enabling environment for women’s entrepreneurship to flourish further in the Philippines. However, despite this seemingly successful growth of women’s entrepreneurship in the country, women still face difficulties in prospering in entrepreneurship. Guided by the 5M gender-aware framework, this study mapped the pain points affecting women in entrepreneurship in the Philippines by conducting a focus group discussion composed of 40 entrepreneurs. Individual and institutional/structural factors and actors that play pivotal roles in enabling a more conducive entrepreneurial environment for women (i.e., government, education, NGOs, men, house helpers) were identified. More significantly, this article emphasized the need for men’s involvement in empowering women entrepreneurs in various capacities and aspects of their lives, especially in the motherhood sphere. Acknowledging men and involving them in women’s economic activities can potentially address the gap in entrepreneurship.
Racial/Ethnic Differences in Accelerated Credit and Inequalities in College Completion
Authors: Daniels Hollie , Lakin Trinity , Reynolds John
Published: August 2023

According to the theory of effectively maintained inequality, families advantaged by income or race/ethnicity attend colleges and complete their degrees at higher rates due to both quantitative and qualitative distinctiveness from other families. This study extends this line of research by investigating whether the distribution and payoffs of accelerated credits from Advanced Placement, International Baccalaureate, and dual enrollment programs likewise follow a pattern of perpetuating racial/ethnic gaps in college completion. We hypothesize that racial inequality in college outcomes will be maintained by the concentration of minority students in lesser-rewarding types of accelerated credit and by racial differences in the payoff of specific types of accelerated credit. Using institutional data from a large public four-year university in Florida, we find notable racial/ethnic differences in amount and type of accelerated credit. Event history analyses suggest that these differences account for a relatively small portion of the Black/White difference in college completion. Overall, the results provide little support for theories of maintained inequality, and we conclude accelerated credit programs do not meaningfully contribute to the racial stratification of higher education among college matriculants.
The Factors Associated With Performance Among Infection Prevention and Control Linked Nurse During Covid-19 Pandemic
Authors: Fitria Nita , Yulianita Henny , Sugiharto Firman , Astari Dewanti Widya , Eriyani Theresia
Published: August 2023

Background

Infection Prevention and Control Linked Nurses (IPCLN) are the spearhead of implementing the Infection Control Prevention Program. The performance of nurses in preventing and controlling infections during the Covid-19 pandemic greatly influenced the quality of services.

Objective

This study aimed to determine the factors that influence the performance of IPCLN during the Covid-19 pandemic.

Methods

Cross-sectional study was performed on 34 nurses at Cicendo Eye Hospital with a total sampling technique. The questionnaire in this study included knowledge, motivation, supervision, and the performance of nurses which had previously been tested with these characteristics with a result of Cronbach's alpha of 0.75. Data were analyzed using univariate, bivariate, and multivariate analyses.

Results

The mean score of IPCLN knowledge in this study was 14.82 ± 4.01, motivation 92.47 ± 15.85, supervision 34.74 ± 5.89, and performance 7.94 ± 2.71. There is a relationship between knowledge ( p = .000), motivation ( p = .000), and supervision ( p = .000) on nurse performance. Motivation is the dominant factor influencing IPCLN performance compared to knowledge and supervision (Stand. Estimate = 0.5121; 95% CI = 0.1301–0.487; p < .001).

Conclusion

Motivation is a dominant factor in IPCLN performance in this study. However, hospital management needs to maximize and make policies to improve IPCLN performance in terms of motivation. These policies can be through providing incentives for nurses, developing free continuing education programs, and issuing funds for nursing education scholarships.
Income Perspective of Contract Farming Across Globe: A Bibliometric Review
Authors: Mehla Preeti , Kumar Rajiv
Published: August 2023

The purpose of this article is to provide a report on scientific production in the field of the role of contract farming in farmers’ income and pinpoint research gaps. For this purpose, content and citation analysis using R-based Biblioshiny and visualization using VOSviewer were performed. A total of 228 articles were selected from Scopus database which were reduced to 159 in accordance with their relevancy. The analysis shows that although farmer income is one of the most significant social sustainability issues, the field is still underrepresented and has received considerable academic attention only in recent years. The majority of contemporary studies have come from a South Asian perspective, with India and the USA being the two major contributors. The currently available literature focuses mainly on a few key aspects, such as the advantages, difficulties, and historical background of contract farming. However, several crucial issues, such as the sustainability of contract farming, farmers’ bargaining power, and autonomy are not addressed. Hence, empirical data is scant. The major limitation is the reliance on a single data source, namely Scopus, and it is highly probable that additional beneficial researches that are not included in Scopus will continue to be overlooked.
Torsades De Pointes Complicating Acute Myocardial Infarction, Twisting the Prognosis
Authors: Iragavarapu Tammiraju , Krishna Kartheek
Published: August 2023

Introduction

Torsades de pointes (TdP), a form of polymorphic ventricular tachycardia that manifests in the setting of an acquired or congenital QT interval prolongation. Polymorphic VT can occur in hyper acute phase or healing phase of an acute myocardial infarction. The presence of necrotic area caused by the infarction explains the existence of a possible circuit as well as the appearance of a re-entry arrhythmia.

Aims and Objectives

Our aim is to study the incidence of long Qt induced TdP in acute MI patients and its prognostic implications. We also want to analyze the impact of primary percutaneous transluminal coronary angioplasty in the management of these subset of patients.

Methods

In this cross-sectional observational study done from May 2021 to May 2022, We have studied 320 cases of acute MI, of which 6 were found to have TdP (1.9%). Four patients had inferior wall myocardial infarction and 2 patients had Non-ST elevation MI. Thrombolysis was done in 2 cases. Two cases underwent primary angioplasty. One case was recommended for coronary artery bypass grafting. All cases underwent appropriate electrolyte correction, besides cardioversion, as needed.

Results

All patients with TdP had prolonged QT interval. 50% of patients had mild hypokalemia. Two patients had complete heart block. Three patients had severe left ventricular dysfunction. Patients who underwent primary angioplasty survived. Thrombolysis had less impact on survival in Acute Mi with TdP.

Conclusion

Early percutaneous coronary angioplasty, combined with electrolyte correction, improves the prognosis in TdP complicating acute MI.
Earthquake response of head-mounted equipment in advanced nuclear reactors
Authors: Mir Faizan Ul Haq , Tilow Kaniel , Nguyen Nam , Song Brian , Clavelli Matthew , Kosbab Benjamin D , Whittaker Andrew S
Published: August 2023

The seismic response of safety-related equipment mounted on the head of an advanced reactor, including pumps, control rod drive mechanisms, and reactor monitoring devices, will affect the design and layout of many advanced reactors. High earthquake-induced accelerations in such equipment may challenge their seismic qualification and trigger the need for additional support framing on the reactor head. Base isolation is a design solution that can drastically reduce seismic demands on equipment. This article describes a set of earthquake-simulator experiments conducted on a scale-model of a base-isolated reactor vessel including four representations of head-mounted equipment, with frequencies spanning from 4.5 to 27 Hz. Dynamic responses of the head-mounted equipment, including displacements, accelerations, and strains, were measured in the experiments for three support conditions: conventional, and seismically isolated using single concave Friction Pendulum (SFP) bearings and triple Friction Pendulum (TFP) bearings. Seismic isolation was effective at reducing equipment responses (accelerations, displacements, and strains) with respect to those in the conventionally supported vessel across a range of seismic inputs. Companion numerical studies highlight the accuracy to be expected in the calculation of different response quantities for lightly damped equipment. The importance of characterizing damping in head-mounted, safety-related equipment through physical experiments to support design and risk assessment is made clear through the numerical simulations.