bluuebunny/crossref_metadata_2025 huggingface dataset:
Patterns of international marketing strategy
Authors: Solberg Carl Arthur , Durrieu François
Published: September 2022

Purpose

This paper aims to explore different strategic avenues in international markets. In particular, the authors investigate the role of four marketing tactics – marketing network, domestic network, standardization/adaptation and positioning. The authors aim at identifying optimal use of these strategic vehicles to achieve firm performance.

Design/methodology/approach

The authors construct a database of 132 Norwegian exporters and identify, through cluster analysis, three different categories of firms. They use multi-group analysis to explore strategy–performance pattern in each group.

Findings

All four strategic levers impact positively on the performance, but only two of them (marketing networks and positioning) with major impact. Standardization and domestic networks play a minor role. Based on these strategic levers, the authors identify three strategic groups (opportunists, networks seekers and global marketers) with different optimal export strategy patterns. The authors argue that these groups represent firms in different stages, epitomizing a learning process in three stages.

Research limitations/implications

A broader perspective of strategy variables should be included to get a more complete picture of the “optimal” model for different groups of exporters. Other marketing mix factors and the firm’s stance toward governance in international markets (operation modes) should therefore be included in the repertoire of strategy drivers determining group membership and to analyse their pattern.

Practical implications

Opportunists are advised to focus on positioning through domestic network relations; network seekers should concentrate on building marketing networks. Global marketers may carry out standardization strategies – preferably in collaboration with their marketing partners in export markets. For the two other groups, there is no evidence that speak in favour of such approach, nor for its counterpart, adaptation. For export promotion agencies, the authors suggest enhanced support to establish network partners.

Originality/value

The authors introduce strategic levers not yet explored in the export literature. Furthermore, they use a contingency causal approach to explain differences in strategy development (in international markets) and the link with performance.
A comparative study on determinants of housing mortgage prepayment of individual borrowers
Authors: Lee Sang Won , Ryu Su Bok , Kim Tae Young , Jeon Jin Q.
Published: September 2022

This paper examines how the macroeconomic environment affects the determinants of prepayment of mortgage loans from October 2004 to February 2020. For more accurate analysis, the authors define the timing of prepayment not only before the loan maturity but also at the time when 50% or more of the loan principal is repaid. The results show that, during the global financial crisis as well as the recent period of low interest rates, macroeconomic variables such as interest rate spreads and housing prices have a different effect compared to the normal situation. Also, significant explanatory variables, such as debt to income (DTI) ratio, loan amount ratio and poor credit score, have different effects depending on the macroenvironment. On the other hand, in all periods, the possibility of prepayment increases as comprehensive loan to value (CLTV) increases, and the younger the age, the shorter the loan maturity. The results suggest that, in the case of ultralong (40 years) mortgage loans recently introduced to support young people purchasing houses, the prepayment risk can be, at least partially, migrated by offsetting the increase in prepayment by young people and the decrease in prepayment due to long loan maturity. In addition, this study confirms that the accelerated time failure model compared to the logit model and COX proportional risk model has the potential to be more appropriate as a prepayment model for individual borrower analysis in terms of the explanatory power.
How strong is your social capital? Interactions in a non-transparent entrepreneurial ecosystem
Authors: Oladele Seun , Laosebikan Johnson , Oladele Femi , Adigun Oluwatimileyin , Ogunlusi Christopher
Published: September 2022

Purpose

The purpose of this study is to explore the strength and value-relevance of social capital in an entrepreneurial ecosystem. Entrepreneurial ecosystem (EE) provides a new perspective to explaining the configurations and interactions that shape entrepreneurial outcomes in regions. Research on the nature of interactions in EEs is still an ongoing debate. The authors draw from “organisational fields” studies to critically examine the interactions among actors in a non-transparent EE using the case of the Lagos region.

Design/methodology/approach

The methodology is based on a qualitative study of 40 semi-structured interviews with various ecosystem actors in the Lagos region, including financiers, government officials, universities, founders and venture capitalists. Additionally, data from the semi-structured interviews were triangulated with data obtained from a two-day focus group discussion Summit where Lagos’ EE issues were raised. This study analysed both data using thematic analysis.

Findings

This study suggests that in a non-transparent EE, four types of interactions are apparent: collaborative, stratified, clustered and unleveraged. Authors argue that in a non-transparent EE, there are blockages and distortions in the flow of resources to entrepreneurs and a higher proportion of entrepreneurs are unable to plug into the ecosystem to extract value for their businesses without a strong social capital.

Practical implications

The authors argue that entrepreneurs require deliberate effort to improve structural and relational social capital to plug into their ecosystem to extract value for their businesses.

Originality/value

The focus on interaction in a non-transparent EE is a novel approach to studying interactions within EEs. In addition, the study is an early attempt to explore entrepreneurial interactions within the Lagos region.
A pathway to virtual team performance in the New Normal paradigm
Authors: Mahtta Mahek , Pillai Rajasshrie , Gunasekaran Angappa , Sivathanu Brijesh , Kaushik Neeraj
Published: September 2022

Purpose

In the postpandemic era, organizations have planned a combination of on-site and virtual work to portray the “New Normal”. The authors aim to analyze the effect of virtual team (VT)-building strategies on virtual team performance and HR performance in the “New Normal” context. This study aims to explore the drivers and barriers to VT performance and its contribution to HR performance.

Design/methodology/approach

The study utilized the grounded theory approach. Semistructured interviews with 114 VT leaders of national and multinational companies in India were conducted and NVivo 8.0 software was used to analyze data.

Findings

VT-building strategies contribute to VT collaboration and subsequently to VT performance. It was found that VT-building strategies catalyze VT collaboration which is impacted by the drivers and barriers of VTs, affecting VT performance and HR performance.

Practical implications

The primary contribution of this work is the development of a framework that delivers important insights to VT leaders, talent managers, HR professionals and academicians.

Originality/value

This study uniquely examines the VT-building strategies and VT performance through the “New Normal” paradigm lens. This study proposes a conceptual model for VT performance and HR performance. It also provides the team-building strategies, drivers and barriers for VT performance. This work offers the roadmap to achieve VT performance and HR performance. This research also contributes to the human resource management literature by discussing the VT performance and HR performance in the “New Normal” paradigm. It provides insights to VT leaders, talent managers, HR professionals and academicians.
A qualitative evaluation of staff experience in the delivery of a co-produced consultation service for personality disorder
Authors: Smith Holly , Finamore Chloe , Blazdell Julia , Dale Oliver
Published: September 2022

Purpose

Consultation services are recommended to support mental health staff working with service users diagnosable with personality disorder. However, there is scarce literature examining the impact of delivering and receiving consultation services. This study aims to investigate the impact of a pilot co-produced consultation service aiding clinical teams in the engagement of service users diagnosable with personality disorder.

Design/methodology/approach

This is a qualitative evaluation using a focus group and five semi-structured interviews to explore the experience of delivering and receiving the consultation service. Data were analysed using thematic analysis. Clinical and demographic characteristics were obtained on service users referred.

Findings

The consultation staff focus group produced two overarching themes: “Disrupting the system” and “Mirroring the service and the service users consulted”. The staff consultee semi-structured interviews produced two overarching themes: “Experience of working with personality disorder” and “Experience of the consultation service”. Staff described working with personality disorder as challenging. The consultation process was experienced as a helpful and reassuring space to gain a new perspective on the work. However, the service was felt to be limited; in that, it lacked follow-on treatment.

Originality/value

This study adds to the body of literature on consultation for service users diagnosable with personality disorder and demonstrates its function in service provision. It sheds light on staff experience of delivering and receiving a consultation service, including the use of a co-production model.
The differences between students’ fixed and growth mindsets: a case of study tour between Hong Kong and Canada
Authors: Sum Carmen , Lau Yui-yip , Chan Ivy
Published: September 2022

Purpose

The paper aims to address the gap in the literature related to students’ mindsets and learning activities through investigation of the differences in students’ expectations of, feelings towards, and perceptions of an overseas study tour based on their mindset. The study provides an in-depth analysis of students with different mindsets and proposes the use of overseas tours and intercultural learning to foster students’ growth mindset.

Design/methodology/approach

An overseas study tour hosted by a self-financing tertiary institution in Hong Kong was selected for investigation. 13 sub-degree students participated in the study tour during the summer term in 2018. Two types of primary data – quantitative (i.e., a questionnaire survey) and qualitative (i.e., in-depth interviews) – of fixed mindset and growth mindset students were collected for analysis.

Findings

The findings indicate differences in students’ expectations of, feelings towards, and perceptions of an overseas study tour depending on whether they demonstrate a fixed or growth mindset. The growth mindset students had more and higher expectations of the study tour, all of which were related to personal growth and development. The fixed mindset students did not have as much of a desire for personal development and their expectations were easily met. Both growth and fixed mindset students had positive feelings and perceptions of the tour.

Originality/value

Research on the application value of overseas study tours in helping students from self-financing tertiary institutions develop a growth mindset is scarce, and thus warrants further investigation.
Colliding without crashing – how a collision of perspectives creates innovation
Authors: Majekodunmi Jess
Published: September 2022

Purpose

Before the author became the Director of the Human Sciences Studio, the author was aware of many studies that established the value of diverse teams – especially for innovation. In 2020, Robyn Brennaman claimed in this very journal that “the business case has long since closed about the critical importance and value of diversity in the workplace”. Brennaman reasoned that homogeneity impedes innovation, that innovation is a precondition for business competitiveness, and therefore diversity has strategic value. And yet a truly diverse team – one that includes identity diversity, academic diversity and cognitive diversity – is too hard to find. The author explores three lessons learned from working with a team of people who think so differently to one another. The purpose of this article is to explore how a collision of perspectives can create innovation.

Design/methodology/approach

A viewpoint article based on the author’s experience in Innovation and position as Director | Human Sciences Studio at Accenture and winner of the Team Leader Award (Sponsored by Fujitsu) at the 2022 FDM everywoman in Technology Awards.

Findings

The author explores three lessons learned from working with a team of people who think so differently to one another. The deluge of information is a messy delight. Sharing knowledge alerts us to the our blind spots. Humility and vulnerability are vital.

Originality/value

This piece is entirely written by Jess Majekodunmi and is all the author’s own viewpoint.
Experimental removal of extracellular egg‐associated microbes has long‐lasting effects for larval performance
Authors: Yoon Su’ad A. , Harrison Joshua G. , Smilanich Angela M. , Forister Matthew L.
Published: September 2022

Maternally transmitted microbes are ubiquitous. In insects, maternal microbes can play a role in mediating the insect immune response. Less is known about how ecological factors, such as resource use, interact with maternal microbes to affect immunity.

In the context of a recent colonization of a novel host plant by the Melissa blue butterfly Lycaeides melissa, we investigated the interaction between host plant use and vertically transmitted, extracellular egg‐associated microbes in determining the strength of the insect immune response.

We reared larvae on two different host plant species: a native host Astragalus canadensis and a novel host Medicago sativa. Egg‐associated microbes were removed through a series of antimicrobial egg washes prior to hatching. Immune response was measured through three assays: standing phenoloxidase (PO), total PO and melanization.

We detected strong effects of microbial removal. Egg washing resulted in larvae with an increased immune response as measured by total PO—contrary to reports from other taxa. The effect of washing was especially strong for larvae consuming the native host plant.

This result may explain why consumption of the egg casing is not a universal behaviour in insects, due to negative effects on larval immunity.

Read the free Plain Language Summary for this article on the Journal blog.
‘The Centre is Nowhere’: British Art and the Global
Authors: Hart Imogen , Price Dorothy
Published: September 2022

What does it mean for art history to conjoin the terms ‘British art’ and ‘the global’? What is carried by the liminal space of the conjuncture? And what is forsaken? This special issue seeks to think through the pressures placed on British art since the mid‐nineteenth century as a national category of enquiry in the wake of unstable definitions of post‐colonialism, neo‐colonialism, globalization and the decolonial. Drawing on recent scholarly debates about the role and definitions of British art, the co‐authors explore some of the tensions inherent in trying to operate within a nationally and geographically defined field, the artificial borders of which are porous, malleable, and subject to regular political and cultural change. Acknowledging the shortcomings of both the global and the national as frameworks for art‐historical enquiry, we suggest different ways of steering a path between the two.
Post‐Impressionism: Universal, British, Global
Authors: Rose Sam
Published: September 2022

Starting from the possibility of a ‘global’ account of a style, this essay examines the consequences of the idea of post‐impressionism. Around 1910, Roger Fry drew on histories of world art and international art historiography to cast post‐impressionism as putatively universal, a style that was not just a new development, but was a rediscovery of a natural form of artistic creation. Seen this way, post‐impressionism also had the potential to go global: to have a causal role in the development of multiple international modernisms following its spatial circulation across the globe. The essay goes on to explore first how even within Britain local variations and divisions quickly came to undercut this specifically British articulation of a universal style. It then turns to aspects of post‐impressionism's subsequent circulations in India, Nigeria, Japan, and China to examine further how its putative universalism was transformed in a variety of locally specific ways.
Analysis of the extracorporeal anticoagulation effect of modified citrate infusion during continuous renal replacement therapy in critically ill patients
Authors: Guo Litao , Liu Yu , Zheng HaiRong , Shi Qindong , Wang Gang
Published: September 2022

Introduction

To analyze the anticoagulation effect of different local infusion methods of citrate underwent continuous renal replacement therapy (CRRT) in critically ill patients.

Methods

The study adopted a single‐centre retrospective design. Critically ill patients were divided into conventional group and modified group based on the infusion methods of citrate.

Results

The modified group had a longer mean treatment time (67.67 ± 18.69  hours vs. 52.11 ± 24.26 hours, p = 0.007), a lower transmembrane pressure (147.77 ± 66.85 cm H2O vs. 200.63 ± 118.66 cm H2O, p = 0.038), fewer citrate bag replacements (1.43 ± 0.50 times vs. 10.60 ± 3.19 times, p < 0.001), and more steady ionized calcium at the venous end (0.35 ± 0.06 mmol/L vs. 0.40 ± 0.05 mmol/L, p = 0.006) compared to the conventional group patients, with statistically significant differences. The incidences of citrate accumulation and tubing coagulation were marginally lower in the modified group.

Conclusion

The modified local citrate infusion method can prolong treatment time, while reducing both the nursing workload and the occurrence of citrate accumulation.
A dark purple multifunctional ingredient from blueberry pomace enhanced with lactic acid bacteria for various applications
Authors: Dermengiu Nicoleta Eugenia , Milea Ștefania Adelina , Burada Bogdan Păcularu , Stanciu Silvius , Cîrciumaru Adrian , Râpeanu Gabriela , Stănciuc Nicoleta
Published: September 2022

Nowadays, large quantities of berries are still being dumped or used for composting and animal feeding. The objective of this study was to customize a technological design for appropriate valorization of blueberry pomace into a shelf‐life–stable, dark purple multifunctional ingredient, containing lactic acid bacteria (Lactobacillus casei), by freeze‐drying. The main anthocyanins in blueberries freeze‐dried inoculated pomace are malvidin 3‐O‐glucoside, peonidin 3‐O‐glucoside, and cyanidin 3‐O‐glucoside. A viable cells content of 4.75×108 CFU/g DW was found after freeze‐drying and the ability of the freeze‐dried powder to inhibit the DPPH radical was 171.98 ± 1.73 mMol Trolox/g DW. The results obtained from CIElab analysis show a tendency to red and blue, characteristic of blueberry anthocyanins. The bioaccesibility of anthocyanins from blueberry powder was 37.8% and the probiotic survival rate after passing through the digestion process was 49.56%. The inhibitory potential of the obtained powder on α‐amylase, pancreatic lipase, and α‐glucosidase and tyrosinase was assessed. A significant antidiabetic potential of the powder was found, with IC50 values for α‐amylase of 2.61 ± 0.24 mg/ml and for α‐glucosidase of 1.37 ± 0.01 mg/ml, significantly lower when compared to corresponding drugs used in current practices. The powder also showed a significant potential to inhibit tyrosinase, supporting the hypothesis that the pomace resulting from juice and wine manufacturing may be successfully used to develop multifunctional ingredients with significant health benefits.

Practical Application

Nowadays, food scientists and industry are seeking technological alternatives to obtain functional ingredients, due to the global interest in translating and applying scientific knowledge to address consumers’ health issues. In our study, a freeze‐drying customized design involving the use of the blueberry pomace, pectin, and Lactobacillus casei was applied to develop an ingredient with multiple functions. Besides a remarkable color, the powder showed good antioxidant activity, in vitro cells viability, and inhibitory activity against some metabolic syndrome–associated enzymes.
Leveraging aid for trade to mobilize climate finance in the least developed countries
Authors: Adhikari Ratnakar
Published: September 2022

The LDCs, which are not only highly vulnerable and least prepared to face climate‐related challenges but also resource‐strapped, can leverage AFT to mobilize climate finance. This, however, requires better appreciation of the need to enhance coordination, build capacity and achieve synergies between two important sources of development finance. Since this is an under researched area, this paper has made the attempt to fill the void by exploring, with the help of examples and where possible, various possibilities that exist. While indirect support for feasibility studies and project preparation can contribute to the foundational work in leveraging climate finance, direct support such as co‐financing, developing proof of concept or de‐risking projects to attract private investment, including through blended financing modality, is important to unlock the financing potential. At the same time, there is a need to maintain the right balance between mitigation and adaption when it comes to climate finance. One major limitation of the paper is that, in the interest of brevity, it narrowly focuses on select modalities and instruments such as development finance and private investment.
More than words: Geopolitics and language
Authors: Medby Ingrid A. , Thornton Pip
Published: September 2022

In this editorial introduction, we introduce the special section on Geopolitics and Language. We provide a brief overview of some of the ways in which geopolitical scholarship has engaged with themes of language to date, noting in particular the legacy of critical geopolitics – and indeed work that has emerged from its foundation. Further we discuss language itself, a concept we suggest is often implicit but rarely explicitly considered in geographical work. That is, despite rich bodies of work on, for example, the textual and discursive, there is still much to explore in the broader sense of the linguistic. This includes a growing body of work on speech and sound, translation, and decolonisation – all of which also point to the need to go further in geographical and geopolitical engagement with language. The aim of the paper, however, is finally to introduce the section's papers and their specific theoretical and empirical concerns. And this, we argue, is more than words of introduction but also an invitation – to further engagement and geopolitical curiosity.
Biases in reporting of adverse effects in clinical trials, and potential impact on safety assessments in systematic reviews and therapy guidelines
Authors: Westergren Tone , Narum Sigrid , Klemp Marianne
Published: September 2022

Background

Clinical trials are an important source of adverse effects data, including analyses in systematic reviews and recommendations in therapy guidelines. Trial publication bias may have profound effects on safety perceptions. This MiniReview presents and discusses biases in reporting of safety data in clinical trials and the implications for systematic reviews and guidelines.

Objectives

The objectives of this work are to analyse risk of gastrointestinal bleeding in systemic corticosteroid trials and to assess adverse effects reporting in a fluoxetine trial in depression (Treatment for Adolescents With Depression Study [TADS]) and descriptions of adverse effects in adolescent depression therapy guidelines.

Methods

We performed literature reviews and descriptive analyse of clinical trials with corticosteroids, and publications from the TADS trial. Risk of gastrointestinal bleeding from corticosteroids was analysed by meta‐analysis.

Findings

Gastrointestinal bleeding definitions varied considerably between trials. The incidence was significantly increased in hospitalized, but not in ambulant, patients compared to placebo. We identified several biases concerning TADS safety reporting, including severity thresholds and nonpublication of most adverse effects data beyond the initial 12 weeks. Therapy guidelines on adolescent depression mentioned suicidality risk, but many failed to mention other adverse effects.

Conclusions

We identified several pitfalls in adverse effects reporting in clinical trials. These include heterogeneous disease definitions, reporting thresholds, and incomplete reporting. Trial bias may have great impact on risk assessments in systematic reviews and meta‐analyses.
The relationship between health worry, work distress, and affective symptoms during the COVID‐19 pandemic: The mediating role of hopelessness and helplessness
Authors: Broos Hannah C. , Llabre Maria M. , Saab Patrice G. , Leite Rafael O. , Port Jamie H. , Timpano Kiara R.
Published: September 2022

Objectives

The COVID‐19 pandemic presented both serious health threats and economic hardships, which were reflected in increased rates of mood and anxiety symptoms. We examined two separate distress domains, health worries and work distress, as predictors of mood and anxiety symptoms. Additionally, we considered whether these two domains might be uniquely associated with the development of dysfunctional beliefs, as a proposed mechanism to account for increased symptoms during the pandemic. Two separate models were considered to examine if associations remained stable through the first year of the pandemic.

Methods

Participants (N = 2152) were a representative sample of Florida adults. They completed online surveys at three waves: Wave 1 (April–May 2020), Wave 2 (May–June 2020), and Wave 3 (December–February 2021). Participants completed measures of COVID‐19 health worry and work distress, anxiety, and depression. They also reported their level of hopelessness and helplessness (indices of dysfunctional beliefs).

Results

In an early pandemic model (Wave 1‐Wave 2), health worry directly and indirectly predicted anxiety and depression via dysfunctional beliefs. In contrast, work distress only indirectly predicted both outcomes. In a longer‐term model (Wave 2‐Wave 3), health worry had direct and indirect effects on downstream anxiety but not depression. Pandemic work distress had no effect on depression or dysfunctional beliefs; however, it was associated with less anxiety.

Conclusions

Although health worry and work distress predicted later symptoms of anxiety and depression, they appeared to operate through different pathways. These findings provide guidance for the development of more effective interventions to reduce the impact of pandemics.
Painting to Learn the Technique of Psychoanalysis
Authors: Rogers Cathy
Published: September 2022

I describe an unusual approach to hone psychotherapy skills and enhance my understanding of complex psychological concepts. Using a few selected artworks, I discuss and illustrate how I used painting and the artworks themselves to enhance learning, explore theoretical confusions and express personal conflicts. I demonstrate how painting and the artworks themselves can enliven memory, illustrate the transference relationship, explore dreams and express deep anxieties experienced during a training psychoanalysis. I link the psychotherapist attuning to the transference in order to make interpretations, to the artist responding to the unexpected artwork emerging on the canvas.
Inferred costs and functional consequences of stone morphometry in the stone‐carrying displays of Black Wheatear (Oenanthe leucura)
Authors: Aznar Francisco Javier
Published: September 2022

Post‐mating courtship displays are often viewed as forms of sexual selection that allow individuals to assess fitness benefits from their mates based on honest signalling. However, display costs are not always easy to identify and quantify. Before each breeding attempt, male Black Wheatears Oenanthe leucura carry tens of heavy stones with the bill to form piles near the nest. The consequent increase of wing loading is considered the key display cost, and stone mass a key signal of male quality. However, males must also cope with neck and bill torques, and with outward‐pushing forces that tend to slip stones out of the bill; these effects partly depend on stone morphometry. I evaluated the effects of stone morphometry by comparing stones from two territory types differing in density (thus volume for a given mass), i.e. abandoned houses (less dense) versus rock outcrops (more dense). The comparison included samples of available stones to collect (ground), and stones actually collected by the birds (display). Regardless of territory type, display stones were significantly thinner, and generated higher estimated torques but lower outward‐pushing forces, than ground stones of the same mass. On average, display stones were also thicker in abandoned houses than in rock outcrops, but their mass was also significantly lower, which resulted in transport costs being similar between territory types. This suggests that males randomly select the stones that they can handle within the limits of local availability and, in abandoned houses, they have more difficulties in handling the heaviest transportable stones because many of these have too great a volume. This study calls for further experimental research on male performance and the cues that females use to assess the display. A broader conceptual framework is also necessary to address the behavioural and morphological consequences of carrying rigid objects with the bill.
Laparoscopic placement of left renal vein extravascular stenting in treatment of nutcracker syndrome: Techniques and long‐term outcomes
Authors: Yu Shuanbao , Cui Jinshan , Liu Junxiao , Du Haopeng , Li Peng , Fan Yafeng , Tao Jin , Dong Biao , Li Ziyao , Zhan Yonghao , Wei Yafei , Liao Kexue , Wang Shengzheng , Ren Xuanyi , Zhang Xuepei
Published: September 2022

Objectives

We aimed to assess the feasibility and efficacy of laparoscopic extravascular stent in treatment of nutcracker syndrome by transperitoneal or retroperitoneal approach.

Methods

Seventy‐six patients with nutcracker syndrome were retrospectively enrolled from a tertiary referral center, and underwent transperitoneal (63 patients) or retroperitoneal (13 patients) laparoscopic extravascular stent from March 2011 to December 2020. Surgical parameters, complications, imaging and clinical outcomes were collected and analyzed.

Results

All procedures were successfully carried out without open conversion. The median operation time, estimated blood loss, and postoperative hospital day were 120 (interquartile range [IQR]: 90–144) min, 20 (IQR: 10–30) ml, and 7 (IQR: 6–9) days. At a median follow‐up of 52 (range: 9–127) months, 60 (79%) patients had complete symptom resolution, 14 (18%) patients had significant symptom improvement, and 2 (3%) patients reported no symptom improvement. Ninety‐four percent (50/53) of hematuria, 91% (30/33) of proteinuria, and 89% (25/28) of flank/abdominal pain resolved after extravascular LRV stenting. No significant differences were detected in surgery parameters and recovery rates of clinical symptoms between two approaches (each p > 0.05). However, patients with transperitoneal approach need longer to achieve complete recovery compared with retroperitoneal approach (8.7 vs. 1.5 months, p = 0.016).

Conclusions

Laparoscopic extravascular stent performed either transperitoneally or retroperitoneally is a feasible and effective option in treatment of nutcracker syndrome. Retroperitoneal laparoscopic extravascular stent required shorter time to achieve complete recovery, which should be considered whenever possible in surgical decision‐making.
Learning limb‐specific contingencies in early infancy
Authors: Sen Umay , Gredebäck Gustaf
Published: September 2022

Most research with the mobile paradigm has the underlying assumption that young infants can selectively move the limb causing the contingent feedback from the mobile while avoiding irrelevant motor responses. Contrary to this long‐held belief, others have argued that such differentiation ability is not fully developed early in life. In the current study, we revisited the traditional mobile paradigm with a contemporary research approach (using high‐precision motion capture techniques, a yoked‐control design, and a large sample size) to investigate whether response differentiation ability emerges before 5 months of age. The data collected from 76 infants (aged between 115 and 159 days) revealed that infants can learn sensorimotor contingencies by increasing the movement of the connected leg relative to their baseline level. However, they did not differentially increase the movement of the leg causing an effect in the environment compared with that of other limbs. Our results illustrate that response differentiation ability emerges later than previously suggested.
Online versus face‐to‐face cheating: The prevalence of cheating behaviours during the pandemic compared to the pre‐pandemic among Turkish University students
Authors: Yazici Sedat , Yildiz Durak Hatice , Aksu Dünya Beyza , Şentürk Burcu
Published: September 2022

Background

During the COVID‐19 period, academics and higher education institutions have shown deep concern about academic integrity related to measurement and evaluation issues that have arisen in online education.

Objectives

To address this concern, this paper examined the prevalence of cheating behaviour among university students before and during the pandemic by comparing self‐reported cheating behaviours of students and academics' perceived levels of cheating behaviours of their students.

Methods

A correlational design was employed aligned with study objectives.

Results and Conclusions

The results indicate that although both groups reported a significant increase in cheating incidents in online education, instructors' perceived frequency of student cheating is remarkably greater than students' self‐report cheating incidents. Contrary to the perceptions of instructors and stakeholders in education, students did not report a very drastic cheating increase in online education during the pandemic. The strongest predictive power for online cheating behaviours was the cheating behaviours in face‐to‐face education. Whereas the sensitivity of institutions and course instructors toward cheating behaviour was negatively associated with cheating behaviours in face‐to‐face education, this situational factor did not show a significant effect in distance education. Regarding individual factors, we found a significant relationship between cheating behaviours and gender, discipline, whereas no significant relationship was found in terms of student GPA. Consequently, in order to minimize the threats to the validity of scores associated with cheating, faculty should be supported through faculty development programs and resources so that they can develop authentic assessment strategies for measuring higher‐order thinking skills.
Radiofrequency ablation of atrial fibrillation—50 W or 90 W?
Authors: Mueller Julian , Nentwich Karin , Ene Elena , Berkovitz Artur , Sonne Kai , Chakarov Ivaylo , Barth Sebastian , Waechter Christian , Behnes Michael , Akin Ibrahim , Halbfass Philipp , Deneke Thomas
Published: September 2022

Background

This study sought to evaluate the short and midterm efficacy and safety of the novel very high power very short duration (vHPvSD) 90 W approach compared to HPSD 50 W for atrial fibrillation (AF) ablation as well as reconnection patterns of 90 W ablations.

Methods and Results

Consecutive patients undergoing first AF ablation with vHPvSD (90 W; predefined ablation time of 3 s for posterior wall ablation and 4 s for anterior wall ablation) were compared to patients using HPSD (50 W; ablation index‐guided; AI 350 for posterior wall ablation, AI 450 for anterior wall ablation) retrospectively. A total of 84 patients (67.1 ± 9.8 years; 58% male; 47% paroxysmal AF) were included (42 with 90 W, 42 with 50 W) out of a propensity score‐matched cohort. 90 W ablations revealed shorter ablation times (10.5 ± 6.7 min vs. 17.4 ± 9.9 min; p = .001). No major complication occurred. 90 W ablations revealed lower first pass PVI rates (40% vs. 62%; p = .049) and higher AF recurrences during blanking period (38% vs. 12%; p = .007). After 12 months, both ablation approaches revealed comparable midterm outcomes (62% vs. 70%; log‐rank p = .452). In a multivariable Cox regression model, persistent AF (hazard ratio [HR]: 1.442, 95% confidence interval [CI]: 1.035–2.010, p = .031) and increased procedural duration (HR: 1.011, 95% CI: 1.005–1.017, p = .001) were identified as independent predictors of AF recurrence during follow‐up.

Conclusions

AF ablation using 90 W vHPvSD reveals a similar safety profile compared to 50 W ablation with shorter ablation times. However, vHPvSD ablation was associated with lower rates of first‐pass isolations and increased AF recurrences during the blanking period. After 12 months, 90 W revealed comparable efficacy results to 50 W ablations in a nonrandomized, propensity‐matched comparison.
An environmental impact study of inter‐dental cleaning aids
Authors: Abed Rawan , Ashley Paul , Duane Brett , Crotty John , Lyne Alexandra
Published: September 2022

Aim

The aim of this study was to compare the environmental footprint of eight inter‐dental cleaning aids.

Materials and Methods

A comparative life cycle analysis was conducted based on an individual person using inter‐dental cleaning aids every day for 5 years. The primary outcome was a life cycle impact assessment. This comprised of 16 discrete measures of environmental sustainability (known as impact categories), for example, greenhouse gas emissions (measured in kilograms of carbon dioxide equivalent, or kg CO2e), ozone layer depletion (measured in kilograms of chloroflurocarbon equivalent, or kg CFCe), and water use (measured in cubic metres). Secondary outcomes included normalized data, disability‐adjusted life years, and contribution analysis.

Results

Inter‐dental cleaning using floss picks had the largest environmental footprint in 13 of 16 impact categories. Depending on the environmental impact category measured, the smallest environmental footprint came from daily inter‐dental cleaning with either bamboo inter‐dental brushes (five impact categories, including carbon footprint), replaceable head inter‐dental brushes (four impact categories), regular floss (three impact categories), sponge floss (three impact categories), and bamboo floss (one impact category).

Conclusions

Daily cleaning with inter‐dental cleaning aids has an environmental footprint that varies depending on the product used. Clinicians should consider environmental impact alongside clinical need and cost when recommending inter‐dental cleaning aids to patients.
A novel approach for the detection of cognitive impairment and delirium risk in older patients undergoing spine surgery
Authors: Barreto Chang Odmara L. , Whitlock Elizabeth L. , Arias Aimee D. , Tsoy Elena , Allen Isabel E. , Hellman Judith , Bickler Philip E. , Miller Bruce , Possin Katherine L.
Published: September 2022

Background

Postoperative delirium is a common postsurgical complication in older patients and is associated with high morbidity and mortality. The objective of this study was to determine whether a digital cognitive assessment and patient characteristics could identify those at‐risk.

Methods

Patients 65 years and older undergoing spine surgeries ≥3 h were evaluated as part of a single‐center prospective observational cohort study at an academic medical center, from January 1, 2019, to December 31, 2020. Of 220 eligible patients, 161 were enrolled and 152 completed the study. The primary outcome of postoperative delirium was measured by the Confusion Assessment Method for the Intensive Care Unit or the Nursing Delirium Screening Scale, administered by trained nursing staff independent from the study protocol. Baseline cognitive impairment was identified using the tablet‐based TabCAT Brain Health Assessment.

Results

Of the 152 patients included in this study, 46% were women. The mean [SD] age was 72 [5.4] years. Baseline cognitive impairment was identified in 38% of participants, and 26% had postoperative delirium. In multivariable analysis, impaired Brain Health Assessment Cognitive Score (OR 2.45; 95% CI, 1.05–5.67; p = 0.037), depression (OR 4.54; 95% CI, 1.73–11.89; p = 0.002), and higher surgical complexity Tier 4 (OR 5.88; 95% CI, 1.55–22.26; p = 0.009) were associated with postoperative delirium. The multivariate model was 72% accurate for predicting postoperative delirium, compared to 45% for the electronic medical record‐based risk stratification model currently in use.

Conclusion

In this prospective cohort study of spine surgery patients, age, cognitive impairment, depression, and surgical complexity identified patients at high risk for postoperative delirium. Integration of scalable digital assessments into preoperative workflows could identify high‐risk patients, automate decision support for timely interventions that can improve patient outcomes and lower hospital costs, and provide a baseline cognitive assessment to monitor for postoperative cognitive change.
Literary representations of borders and partitions in provincial memory cultures (Northern Ireland and Upper Silesia)
Authors: Drong Leszek
Published: September 2022

Northern Ireland and Upper Silesia exhibit numerous analogies when it comes to their local communities' experience of borders, divisions and partitions. The experience is reflected in recent partition narratives which prove that geopolitical and administrative interventions in space and territory are likely to create and define more than just lines on the maps and new jurisdictions. Borders and partitions are felt and endured, often imprinted on provincial memories, both individual and communal. Border crossings, borders in the mind and actual experiences connected with being partitioned and living in a borderland have determined, for the last 100 years, the parameters of what I call provincial memory in Northern Ireland and Upper Silesia, making them markedly different from national memory cultures in Ireland/Britain and Poland, respectively. The transcultural memory of partitions and borders, preserved in contemporary literary accounts of the past, informs the main thrust of the narratives of belonging in both regions. By exploring related examples of partition narratives and attitudes of regional writers to borderlands and partitions, this essay argues for a recognition, in the respective contexts of Northern Ireland and Upper Silesia, of significant differences between the discursive performances of provincial memory cultures and national ones.
Design and Validation of a Smile‐Necklace Plate for Treating Inferior Patellar Pole Avulsion Fractures: A Review and Hypothesis
Authors: Zhu Wanbo , Xu Lei , Xie Kai , Li Xinyuan , Zhang Xianlong , Fang Shiyuan , Yang Jiazhao
Published: September 2022

The patella's inferior pole transmits force generated by contraction of the quadriceps muscle to the tibial tuberosity through the attached patellar ligament, thus completing knee extension. Therefore, fractures of the patella's inferior pole disrupt the coherence of mechanical transmission in the lower extremities. There appears to be no consensus among trauma centers regarding the treatment of infrapatellar pole fractures, primarily because there is no consistent design or application of internal fixation for this type of fracture. We designed a new internal implant similar to the smile necklace based on our previous study. This smile‐necklace plate (SNP) has the advantage of both plate fixation and tension‐band wiring fixation, permitting early rehabilitation, especially in osteoporotic comminuted infrapatellar pole fractures. Finite element analysis helped verify the biomechanical advantages of the SNP in comparison with existing studies. Hence, this novel implant is a promising treatment option for inferior pole patellar fractures.
Different Prevalence of Neuropathic Pain and Risk Factors in Patients with Knee Osteoarthritis at Stages of Outpatient, Awaiting and after Total Knee Arthroplasty
Authors: Li Li , Zeng Zhaohui , Zhang Hanle , Xu Linghui , Lin Yuanyuan , Zhang Yu , Deng Ming , Fan Pei
Published: September 2022

Objective

Neuropathic pain (NP) plays an important role in patients with knee osteoarthritis (KOA). However, the prevalence of NP at different treatment stages including outpatient, awaiting and after total knee arthroplasty (TKA) have not been compared. The understanding of this issue and identify risk factors can help physicians develop individualized strategies to manage the pain of KOA. Therefore, the aim of the study is to investigate the prevalence and risk factors of NP at different treatment stages of KOA.

Methods

Patients diagnosed as KOA between August 2016 and August 2020 were enrolled in this cross‐sectional study and divided into three groups according to treatment stage, including outpatient stage, awaiting TKA stage (pre‐TKA) and after TKA stage (post‐TKA). A numeric rating scale (NRS) and PainDETECT questionnaire were used to evaluate nociceptive pain and NP. Patient demographics, radiological assessments using Kellgren–Lawrence (K‐L) grade, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were analyzed. Data analysis and statistics were processed using SPSS 20.0 and examined by ANOVA with/without Bonferroni correction or Kruskal–Wallis test. A chi‐square test was used to determine cross‐table data and calculate the odds ratio (OR) value.

Results

Of the 921 patients, the prevalence of possible and likely NP was 17.5% (56/320) and 2.5% (8/320) in the pre‐TKA group compared with 3.4% (8/233) and 0.4% (1/233) in the outpatient group and 1.4% (5/368) and 0.5% (2/368) in the post‐TKA group, respectively. In the pre‐TKA group, higher NRS (NRS >3; OR = 10.65, 95% CI: 3.25–34.92, P < 0.001) and WOMAC pain score (score > 10; OR = 4.88, 95% CI: 2.38–10.01, P < 0.001) conferred an increased risk of unclear pain. Age, gender, BMI and K‐L grade showed no significant differences among the unlikely, possible and likely NP groups.

Conclusion

Prevalence of NP is different at stages of out‐patient, awaiting and after TKA in patients with KOA. Patients awaiting TKA have the highest prevalence of NP compared with patients in outpatient and post‐TKA groups. In the patients waiting for TKA, higher NRS (NRS >3) and WOMAC pain scores (score > 10) are risk factors of NP.