bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessing speaking through multimodal oral presentations: The case of construct underrepresentation in EAP contexts
Authors: Palmour Louise
Published: July 2023

This article explores the nature of the construct underlying classroom-based English for academic purpose (EAP) oral presentation assessments, which are used, in part, to determine admission to programmes of study at UK universities. Through analysis of qualitative data (from questionnaires, interviews, rating discussions, and fieldnotes), the article highlights how, in EAP settings, there is a tendency for the rating criteria and EAP teacher assessors to sometimes focus too narrowly on particular spoken linguistic aspects of oral presentations. This is in spite of student assessees drawing on, and teacher assessors valuing, the multimodal communicative affordances available in oral presentation performances. To better avoid such construct underrepresentation, oral presentation tasks should be acknowledged and represented in rating scales, teacher assessor decision-making, and training in EAP contexts.
Dialogue and the micro-processes of founder meaning-making during growth
Authors: Greenman Andrew , Holstein Jeannie
Published: July 2023

This article draws upon dialogic theory to explore how meaning is co-constructed in dialogue as founding entrepreneurs devise strategies for venture growth. Drawing from a longitudinal study of the impact of a UK University business growth programme upon such strategies, we identify ways in which dialogue influences the meanings attributed to the adoption of, or resistance to, growth strategies. ‘Productive’ dialogue emerging from a diverse range of relevant voices encouraged founders to reflect upon the meanings given to current growth initiatives whilst devising future strategies. Conversely, founders could use ‘degenerative’ dialogue to block the voices of others in order to resist change and protect existing meanings. We contribute to debate by utilising dialogic theory as a conceptual tool to illustrate how business growth programmes shape the meanings founders apply to embrace, or resist strategic change, to effect venture growth.
The present imperium
Authors: Seabrook Jeremy
Published: July 2023

The author reflects on current trends to explore the historical record of the injustices of colonial racism and slavery, and raises the question of whether this changed mood of regret over the past bears any relation to, or significance for, the ongoing depredations visited on the most impoverished of the world today. For these still appear largely invisible. In the process, he encompasses the growing threat of catastrophic global warming and environmental disaster – and some of the movements struggling against this. He excoriates a global system of continuous economic expansion whereby the poor have become a little less poor as the rich have become abusively, unimaginably richer.
Immersive technologies and consumer behavior: A systematic review of two decades of research
Authors: Ambika Anupama , Shin Hyunju , Jain Varsha
Published: July 2023

Immersive technologies, including augmented reality (AR), virtual reality (VR), mixed reality (MR), and three-dimensional (3D) views, are digitally expanding consumers’ reality, enabling never-before-seen experiences. As these technologies transform from a quirky novelty into a ubiquitous utility for consumers, we analyze the advances of the past two decades of research that elaborate on the influence of immersive technologies on consumer behavior. While the past reviews in this area have focused on a limited number of immersive technologies or their application in a sole industry, we holistically analyze and compare the influence of AR, VR, MR, and 3D on consumer behavior across various sectors. We adopt an integrated TCM (Theories, Contexts, and Methods)-ADO (Antecedents, Decisions, and Outcomes) framework to systematically review 129 studies from high-quality academic journals. The findings from this analysis present implications for future research, theory, and practice.

JEL Classification:

M31 Marketing
Platelet-Rich Plasma Injections for the Treatment of Ankle Osteoarthritis
Authors: Paget Liam D.A. , Reurink Gustaaf , de Vos Robert-Jan , Weir Adam , Moen Maarten H. , Bierma-Zeinstra Sita M.A. , Stufkens Sjoerd A.S. , Goedegebuure Simon , Krips Rover , Maas Mario , Meuffels Duncan E. , Nolte Peter A. , Runhaar J. , Kerkhoffs Gino M.M.J. , Tol Johannes L.
Published: July 2023

Background:

Ankle osteoarthritis is debilitating and usually affects relatively young people, often as a result of previous ankle traumas, frequently occurring in sports. Platelet-rich plasma (PRP) injections for ankle osteoarthritis have shown no evidence of benefit over the course of 26 weeks. Previous studies on PRP for knee osteoarthritis showed that clinically significant improvements with PRP occurred between 6 to 12 months in the absence of initial benefit. No studies have evaluated the effect of PRP from 6 to 12 months in ankle osteoarthritis.

Purpose:

To assess the efficacy of PRP injections in ankle osteoarthritis over the course of 52 weeks.

Study Design:

Randomized controlled trial; Level of evidence, 1.

Methods:

In this 52-week follow-up trial, 100 patients with ankle osteoarthritis were randomized to a PRP group or placebo (saline) group. Patients received 2 intra-articular talocrural injections: at inclusion and after 6 weeks. Patient-reported outcome measures were used to assess pain, function, quality of life, and indirect costs over 52 weeks.

Results:

Two patients (2%) were lost to follow-up. The adjusted between-group difference for the patient-reported American Orthopaedic Foot & Ankle Society score over 52 weeks was −2 points (95% CI, −5 to 2; P = .31) in favor of the placebo group. No significant between-group differences were observed for any of the secondary outcome measures.

Conclusion:

For patients with ankle osteoarthritis, PRP injections did not improve ankle symptoms and function over 52 weeks compared with placebo injections.

Registration:

NTR7261 (Netherlands Trial Register).
From a Personal Commitment to a Safety Scale: Development and Validation of a Self-Reported Safety Practices Scale for Latino Day Laborers
Authors: King Yesmel A. , Atkinson John S. , Diamond Pamela , Hernandez Rodrigo A. , Fernández-Esquer Maria Eugenia
Published: July 2023

Latino Day Laborers (LDL) experience high rates of occupational injury while navigating worksite hazards without adequate safety equipment or training. As such, LDL implement simple safety behaviors which may not reflect standardized labor safety practices. This study aims to demonstrate the validity of a scale measuring LDL safety practices. A 22-item scale was developed through qualitative analysis of interviews with LDL. We first validated our scale in a cross-sectional study with 149 LDL. After conducting exploratory and confirmatory factor analysis, a final 15-item safety practices scale emerged. Lastly, we cross-validated our scale with a second sample of 318 LDL. The EFA resulted in three distinct dimensions of safety practices: preparation safety, harm mitigation, and proactive communication. The CFA results from both samples supported a three-factor model. Our study provided evidence for a valid and reliable scale to measure the safety practices of LDL.
Racial humility over competence: Addressing anti-Black racism and healthcare leadership responsibility
Authors: Massaquoi Notisha
Published: July 2023

Health leaders’ response to anti-Black racism should not solely be a reaction to the police brutality and violence faced by Black communities. As part of healthcare leadership practice, we are responsible for recognizing the profound impact of anti-Black racism on all aspects of society, organizations, policies, practices, and behaviours. Based on interviews with health leaders responsible for implementing anti-Black racism strategies in their organizations, racial humility has been proposed as a necessary skill required to dismantle anti-Black racism. This requires a non-negotiable commitment, evaluation, and assessment of accountability, as well as the power to disrupt the impact of historical inequities, disparities, and discrimination experienced by Black community members. Racial humility is perceived as creating an ongoing practice to address anti-Black racism in healthcare, moving leaders from competence and discussion to reflection and transformative action.
Expected to Work for Free: Social Work's Complicity in its Own Devaluation
Authors: Carreon Erin D.
Published: July 2023

By reviewing the historical gender, race, and class-based devaluation of community and social service work, this in-brief article reveals how the profession of social work continues to contribute to this devaluation through expectations for unremunerated work. The profession communicates these expectations through the Code of Ethics, unpaid student field placements, and managerialist workplace stratification. Social work professional, educational, and employing organizations have a responsibility to demonstrate the value of social service workers and the communities they serve by eliminating expectations for unpaid labor, encouraging staff to track and report unpaid hours, and supporting the organizing efforts of the social service workforce.
Restrictive Housing Placement and Length of Stay: A Latent Class Analysis With Mixed Distributions
Authors: Yan Shi , Zgoba Kristen M. , Pizarro Jesenia M.
Published: July 2023

On average, one in five incarcerated persons will spend some time in restrictive housing (RH) during their incarceration. Despite a growing body of research on the topic of RH, few have taken into account the heterogeneity of the incarcerated individuals’ pre-RH risk profiles. In the present study, we fill this gap by estimating a latent class analysis (LCA) model to explore the heterogeneity among a sample of incarcerated individuals in New Jersey. Our LCA has both dichotomous and count variables, and we specified a model with logit and Poisson functional forms. We then examine how the latent group membership predicted RH placement and length of stay using a hurdle model. We identified a four-group LCA model, and found that groups featuring misconduct records were more likely to experience RH and stay longer in RH. Prior criminal records were less predictive of these RH outcomes.
Court finance and floundering judicial reform in China
Authors: Yang Zhenjie , Li Linda Chelan
Published: July 2023

Decentralized court finance and personnel management practices have been criticized for breeding extra-judicial interventions and corruption in China. Determined to advance law-based governance and to constrain recalcitrant local leaders, the Chinese leadership under Xi Jinping in 2014 rolled out reforms to centralize local court finance to the provincial level with the aim to sever local courts from local influence. Despite high expectations, implementation is at best partial. Close to half of all provinces have not accomplished the required changes, and more than half of all court expenditure continues, to date, to remain reliant upon local governments. The direct reason is that provincial governments lack sufficient and sustainable fiscal capacity to finance the operation of local courts without central assistance. Different interests between major stakeholders, namely the courts and the fiscal bureaus, also add to coordination problems and difficulties in reform implementation, in particular the tension between fiscal adequacy pursued by the judiciary and fiscal management efficiency stressed by finance bureaus.
Effect of government subsidies on firm innovative performance in China’s shale gas industry
Authors: Xu Xiaofeng , Chen Xiangyu , Liu Yunfei , Huang Nuozhou
Published: July 2023

To achieve the goals of carbon peaking by 2030 and carbon neutrality by 2060, the Chinese government must reduce fossil energy consumption, stimulate the extraction of unconventional natural gas such as shale gas, and construct a green, low-carbon cycle economic development system. This study investigates the impact of government subsidies on shale gas companies’ research and development (R&D) inputs and innovation performance from multiple perspectives, including internal and external environments and the nature of the companies. The sample consists of Chinese shale gas companies listed between 2013 and 2019. The findings were as follows. First, the investment made by shale gas firms in R&D mediates the relationship between government subsidies and firm performance in technological innovation. Second, the contribution of government subsidies to innovation performance differs in different internal and external regulatory environments. Finally, the intensity of intellectual property protection (IPP) positively moderates the direct and mediating models of government subsidies and innovation performance. Accordingly, the government should increase its contributions to the shale gas industry, improve the regulatory mechanism for donations, and strengthen the protection of intellectual property rights for the R&D of new shale gas technologies.
Postglacial establishment and expansion of marginal populations of sugar maple in western Québec, Canada: Palynological detection and interactions with fire, climate and successional processes
Authors: Paillard Jordan , Richard Pierre JH , Blarquez Olivier , Grondin Pierre , Bergeron Yves
Published: July 2023

An isolated sugar maple ( Acer saccharum Marsh.) stand is located in the boreal forest of Abitibi, about 75 km beyond its present northern range limit. When did this relatively thermophilous tree species establish after ice retreat? Were its populations more abundant than now sometimes in the past? If so, when and how did they expand then retracted? How did the species persist in boreal forest over time? What could have been the role of fire on this stand? To answer those questions, we reconstructed the postglacial fire and vegetation history from three lacustrine sediment sequences distributed along a c. 180 km latitudinal transect from southern boreal forests to the northern portion of deciduous forests. From north to south, those are lakes Labelle, Chasseur and Fur. We explored a procedure based on pollen accumulation rates in order to detect the probable presence of sugar maple within the lakes’ watershed. The procedure successfully indicates a sugar maple establishment c. 7800–5100 cal. BP at Fur, 5500–4400 cal. BP at Chasseur and c. 4000–2700 cal. BP at Labelle, in the north. At Fur, the subsequent sugar maple expansion happened 1 to 2 thousand years after establishment, during colder and moister climatic conditions favoring Pinus strobus L. replacement by Betula spp. c. 6000–5000 cal. BP. Sugar maple establishment, persistence or expansion is apparently not linked to a change in fire activity at Fur and Chasseur, but at Labelle, the species was more abundant during periods of shorter fire return intervals from 2000 to 500 years ago. Our study suggests that northern (Chasseur and Labelle) sugar maple establishment and possible expansion was probably more controlled by a complex interaction of inhibition and facilitation dynamics than by climate alone, a process reliant on the dominant vegetation’s composition and structure.
Future state of Norwegian glaciers: Estimating glacier mass balance and equilibrium line responses to projected 21st century climate change
Authors: Nesje Atle
Published: July 2023

Glaciers and ice caps in Norway are presently undergoing mass loss, areal reduction, and frontal retreat, mainly a result of increased summer ablation due to rising summer temperatures over Scandinavia, especially after 2000 CE. In this paper, the glacier mass-balance response of 10 Norwegian glaciers with continuous mass balance observations (>10 years) to climate projections from 1971–2000 to 2071–2100 have been estimated. Projected changes in mean summer temperature and mean winter precipitation from 1971–2000 to 2071–2100, applying the RCP8.5 emission scenario for five different regions in Norway; ‘Sogn og Fjordane’ and ‘Hordaland’, now Vestland County in western Norway, ‘Oppland’, now part of Innlandet County in eastern Norway, and Nordland County and Finnmark County, both in Northern Norway), range between +3.5°C and +5.0°C, and between +5% and +25%, respectively. These climate projections have been converted (by linear regression with overlapping observational mass-balance data) into specific surface glacier mass balance [winter balance ( Bw), summer balance ( Bs), and annual balance ( Ba) for 10 glaciers in Norway with mass-balance series [Ålfotbreen, Nigardsbreen (part of Jostedalsbreen), Austdalsbreen (part of Jostedalsbreen), Rembesdalskåka (part of Hardangerjøkulen), Blomstølskardsbreen (part of Søre Folgefonna), Storbrean, Hellstugubrean, Gråsubrean, Engabreen (part of Vestre Svartisen, Langfjordjøkelen (data: http://glacier.nve.no/glacier/viewer/ci/no/ ) yielding a total, cumulative surface glacier mass loss from 2000 to 2100 CE in the range of -85.2 ± 4 to -197.3 ± 10 m water equivalents. The estimated changes in equilibrium-line altitudes (ELAs), in the range of 230 ± 10 to 630 ± 30 m, indicate that the mean ELA may reach the upper part of 7 of the 10 glaciers included in this study [Ålfotbreen, Austdalsbreen, Rembesdalskåka, Blomstølskardsbreen, Gråsubrean, Engabreen and Langfjordjøkelen] by the end of the 21st century. The projected glacier mass loss and ELA rise, and thus changes in glacier length, area and volume, will most likely have profound consequences for future glacier hydrology (runoff), hydropower production, wildlife, ecosystems, glacier hazards, and tourism.
Pandemic ethics and beyond: Creating space for virtues in the social professions
Authors: Banks Sarah
Published: July 2023

Background

During the pandemic, social and health care professionals operated in ‘crisis conditions’. Some existing rules/protocols were not operational, many services were closed/curtailed, and new ‘blanket’ rules often seemed inappropriate or unfair. These experiences provide fertile ground for exploring the role of virtues in professional life and considering lessons for professional ethics in the future.

Research design and aim

This article draws on an international qualitative survey conducted online in May 2020, which aimed to explore the ethical challenges experienced by social workers during Covid-19.

Participants and research context

607 social workers responded from 54 countries, giving written online responses. This article first summarises previously published findings from the survey regarding the range of ethical challenges experienced, then develops a new analysis of social workers’ accounts of ethically challenging situations from a virtue ethics perspective. This analysis took a narrative ethics approach, treating respondents’ accounts as stories featuring the tellers as moral agents, with implicit or explicit implications for their professional ethical identity and character. The article is illustrated with accounts from the 41 UK respondents, drawing particularly on two case examples.

Ethical considerations

Ethical approval was gained from Durham University and anonymity was ensured for participants.

Findings/results

This article explores the nature of the ethical space created during the pandemic showing how practitioners were able to draw more on ‘inner resources’ and professional discretion than usual, displaying virtues such as professional wisdom, care, respectfulness and courage as they took account of the specific contexts of their work, rather than simply adhering to blanket rules.

Conclusion

Exploring practice through a virtue ethical lens provides valuable lessons for ‘building back better’ in social and health care professions.
Multisystemic Resources Matter for Resilience to Depression: Learning From a Sample of Young South African Adults
Authors: Theron Linda , Ungar Michael , Cockcroft Kate , Fouche Ansie
Published: July 2023

This article interrogates the continuing emphasis on personal sources of resilience; it also amends the inattention to the protective factors and processes (PFPs) that support the mental health resilience of African emerging adults. To that end, we report a study that explored which PFPs distinguished risk-exposed South African 18- to 29-year-olds with negligible depression symptoms from those who reported moderate to severe symptoms. Using an arts-based approach, young people volunteered the PFPs they had personally experienced as resilience-enabling. An inductive thematic analysis of visual and narrative data, generated by young people self-reporting high exposure to family and community adversity ( n = 233; mean age: 24.63, SD: 2.43), revealed patterns in the PFPs relative to the severity of self-reported depression symptoms. Specifically, young people reporting negligible depression symptoms reported a range of PFPs associated with psychological, social, and ecological systems. In contrast, the PFPs identified by those reporting more serious depression symptoms were mostly restricted to personal strengths and informal relational supports. In the interests of youth mental health, the findings direct society’s attention to the criticality of facilitating young people’s access to a composite of resources rooted in personal, social, and ecological systems.
A TFEB-Amplified Renal Cell Carcinoma with Long-Term, Complete Immunotherapy Response: Retrospective Support for the Value of Molecular Classification
Authors: Smith Steven Christopher , Yu Jinxing , Paul Asit K
Published: July 2023

Recent years have seen the recognition and establishment of numerous subtypes of renal cell carcinoma (RCC), including adoption of an entire category of “molecularly defined renal carcinomas” in the fifth Edition of World Health Organization Classification. To add value, new diagnostic entities should be clinicopathologically distinct, or better, imply specific management and treatment angles, especially if adjunctive testing is needed for diagnosis. One such promising future treatment angle for a molecularly defined subtype, TFEB-amplified RCC, is immunotherapy, for which recent scholarship has demonstrated frequent expression of PD-L1. Herein, we report a case of metastatic TFEB-amplified RCC, where the patient experienced a long-term, complete response to PDL1-directed therapy, which had been serendipitously used years ago under a renal tumor subtype-agnostic indication. This promising experience suggests formal exploration of immunotherapy for these tumors.
Experimental evidences of nonlinear programmable electroacoustic loudspeaker
Authors: da Silveira Zanin Camila Elizabeth , Labetoulle Aurélie , De Bono Emanuele , Gourdon Emmanuel , Collet Manuel , Ture Savadkoohi Alireza
Published: July 2023

A two degrees-of-freedom system coupling an acoustical mode of a closed tube to an electroacoustic loudspeaker is considered. A model-inversion technique is presented to digitally program the impedance of the loudspeaker for reaching a targeted nonlinear behavior. Experimental results show that the programed nonlinearity can guide the system to both periodic and non-periodic responses while acoustical levels for activation of the nonlinearity are less than the ones for systems with passive nonlinear oscillators (94 and 100 dB in this paper compared to 138 dB in previous papers), allowing building applications. Moreover, it is spotted that the programed nonlinearity of the electroacoustic loudspeaker, even in its non-optimized form, performs nonlinear noise control for some frequency ranges. The main objective of this article is to show that it is possible to program the behavior of an electroacoustic loudspeaker.
Self-uncertainty and conservatism during the COVID-19 pandemic predict perceived threat and engagement in risky social behaviors
Authors: Syfers Lily , Jaurique Alexandria , Anjewierden Benjamin , Burke Sara E. , Hackett Justin D. , Rast David E. , Gaffney Amber M.
Published: July 2023

Two studies ( N = 676) highlight the nuanced relationship between conservatism and adherence to COVID-19 policy and recommendations intended to slow the spread of the pandemic in the United States. Study 1 provided evidence that conservative Americans who felt uncertain about themselves and the future experienced elevated levels of symbolic threat (attacks to sociopolitical identity; e.g., the pandemic threatening American democracy) and realistic threat (concrete attacks to material resources or well-being; e.g., the pandemic threatening physical health) in comparison to their more certain counterparts. In Study 2, the association between this form of uncertainty and frequency of risky social behaviors (behaviors that increase the risk of virus transmission) was partially mediated by threat perception for Americans both low and high in conservatism. We discuss findings as an integration of the motivated social cognition framework and uncertainty-identity theory. While self-uncertainty was more associated with greater overall COVID-19 threat perception for Americans high (vs. low) in conservatism, threat perception and frequency of risky social behaviors were associated with self-uncertainty in a manner that is consistent with prevailing liberal and conservative norms.
Deep reinforcement learning to discover multi-fuel injection strategies for compression ignition engines
Authors: Wimer Nicholas T , Henry de Frahan Marc T , Yellapantula Shashank
Published: July 2023

Over the past several decades, regulation of compression ignition engine emissions has become increasingly stringent as concern about the environmental and health implications of these emissions has grown. These changing constraints have led to a series of new, alternative fuel injection strategies that aim to maintain power output while reducing in-cylinder generated emissions by operating in the low-temperature combustion (LTC) regime. These advanced injection strategies are created and retuned for individual combinations of engine geometry, fuel, and emissions constraints. Deep reinforcement learning has been shown to be an effective alternative to traditional optimization approaches for highly combinatorial control problems, such as discovering the optimal injection schedules for compression ignition engines. In this study, we deploy a previously presented deep reinforcement learning framework to iteratively optimize a series of engine geometries over a range of increasingly strict NO x emissions regulations. We then examine the resulting injection schedules. We discuss the potential for using this deep reinforcement learning framework for fuel selection screening and for discovering unique injection strategies for different engine geometries and future emissions standards.
Normative Behaviourism: A Reply
Authors: Floyd Jonathan
Published: July 2023

Normative behaviourism says that the measure of political principles is how we respond to them in practice, not how they appear to us in theory, but is that a sustainable distinction? Does normative behaviourism end up relying on mentalism, or even utilitarianism? Does it assume too much of the data we either have now or could ever have? Does it bind us to the status quo or presume the end of history? All these are plausible worries, though perhaps not fatal ones, provided one remembers at least two things: first, that we judge this approach by comparing it to the alternatives; second, that we keep on experimenting, both in politics and philosophy alike, including with normative behaviourism itself.
The Role of Extracellular Vesicles in Colorectal Cancer
Authors: Xia Yujian , Yu Chaoran , Johann Helwig Ernest , Li Yousheng
Published: July 2023

Extracellular vesicles (EVs) are a class of spherical vesicles that are produced by active secretion of cells and encapsulated by phospholipid bilayers. In recent years, numerous studies have shown that EVs play pivotal roles in the regulation of intercellular communication between colorectal cancer (CRC) cells and target cells, and can regulate the proliferation, metastasis, and infiltration of tumor cells by regulating the microenvironment of tumor cells. EVs carry specific molecular substances in source CRC cells and are expected to serve as new molecular markers for the detection of cancers. This review highlights the current state of research and progress of potentially incorporating EVs in the diagnosis and treatment of CRC.
Early Experiences With Single-Position Prone Lateral Lumbar Interbody Fusion: Safety and Outcomes
Authors: Subramanian Tejas , Maayan Omri , Shahi Pratyush , Du Jerry , Araghi Kasra , Amen Troy B. , Shinn Daniel , Song Junho , Dalal Sidhant , Sheha Evan , Dowdell James , Iyer Sravisht , Qureshi Sheeraz A.
Published: July 2023

Background:

Performing lateral lumbar interbody fusion (LLIF) in a single prone position may pose many advantages over the traditional lateral decubitus position, but there are questions concerning its safety profile and outcomes.

Purpose:

We sought to study the safety and efficacy of LLIF performed with the patient in the prone position.

Methods:

We conducted a retrospective cohort study including patients who underwent primary LLIF in the prone position for degenerative lumbar conditions. Complications and patient-reported outcome measures (PROMs) (Oswestry Disability Index [ODI], and visual analogue scale [VAS] scores for leg and back pain) were collected. Patients who underwent single-position prone LLIF were then propensity score matched for age, race, comorbidity index, number of levels, body mass index, and smoking status with patients who underwent single-position lateral LLIF. Patient-reported outcome measures and complications were compared between the 2 groups. Two postoperative timepoints were defined: early (<6 months) and late (≥6 months).

Results:

Twenty single-position prone LLIF patients were included (35% 1-level, 35% 2-level, 15% 3-level, and 15% 4-level). No intraoperative complications were reported. Eleven (55%) patients experienced transient postoperative anterior thigh weakness. Five (25%) patients experienced postoperative complications such as anemia, urinary retention, ileus, and new-onset sensory symptoms. Oswestry Disability Index, VAS leg, and VAS back scores all improved at the >6-month time point compared with preoperative states. There were no significant differences at any postoperative time point for PROMs between prone and lateral LLIF groups. Among the matched cohort, complications were observed in 3 (21%) of patients compared with only 1 (7%) in the lateral group although this difference was not statistically significant.

Conclusion:

This retrospective study suggests that prone LLIF procedures may be safe and effective. Ergonomic and logistic benefits from the approach may make it a beneficial approach for surgeons to begin implementing.
Barriers and facilitators of self-management behaviors among patients with chronic obstructive pulmonary disease and chronic comorbidities: A mixed-methods investigation
Authors: Muellers Kimberly A , O'Conor Rachel , Russell Andrea M , Wismer Guisselle , Griffith James W , Wolf Michael S , Wisnivesky Juan P , Federman Alex D
Published: July 2023

Objectives

We investigated how individuals with chronic obstructive pulmonary disease (COPD) and multi-morbidity (MM) navigate barriers and facilitators to their health management.

Methods

We conducted a mixed-methods study using semi-structured interviews and survey assessments of adults with COPD, hypertension, and/or diabetes. We recruited 18 participants with an average age of 65, with 39% being male, 50% Black, and 22% Hispanic/Latino/a. Five investigators used an iterative, hybrid-coding process combining a priori and emergent codes to analyze transcripts and compare quantitative and qualitative data for themes.

Results

Participants reported a generalized approach to their health rather than managing MMs separately. Individuals with good or mixed adherence found daily routines facilitated regular medication use, while those with poor adherence experienced complex prescriptions and life stressors as barriers. Walking was viewed as beneficial but challenging due to limited mobility. Most participants viewed diet as important to their MMs, but only two reported high diet quality and many held inaccurate beliefs about healthy diet choices.

Discussion

Participants with MM were highly motivated to engage in self-management activities, but some individuals experienced barriers to maintaining them. Emphasizing an individualized clinical approach to assessing and solving patient barriers may improve self-management outcomes in this complex population.
Exploring the subjective beliefs of expert coaches on ‘talent’ and player selection in German table tennis
Authors: Koopmann Till , Faber Irene R , Lath Franziska , Loffing Florian , Schorer Jörg
Published: July 2023

Player development programmes in sports are considered crucial pillars for the development of young players and countries’ international sporting success. As resources are limited, coaches preferably decide which players to select for these programmes at a young age. This is particularly true for early-starting sports such as table tennis. However, the selection criteria used by coaches and the decision-making processes in player selection contexts are widely unknown. To address this gap, we conducted 15 in-depth semi-structured interviews with table tennis coaches with high expertise in the identification and development of talented young players. Here we show that the concept of ‘talent’ and the process of player selection in table tennis are highly complex phenomena with three main areas of interest identified: (a) general aspects regarding ‘talent’ (in table tennis), (b) specific selection criteria including individual as well as environmental aspects, and (c) the process of player selection. One main finding is that coaches see ‘talent’ as dependent on various factors including (relative) age, maturation as well as practice and previous experience. Furthermore, coaches appear to include both individual (e.g., technical skills) and environmental criteria (e.g., parents’ support) in their decision-making process. Finally, the interviews revealed that player selection decisions are usually made by multiple coaches during group meetings, suggesting the relevance of group processes and dynamics. In summary, this study provides new findings regarding the understanding and discovery of ‘talent’ in table tennis that can help practitioners and open new avenues for further research on player selection in sports.
There is low adoption of injury prevention programs in community netball
Authors: Davies Lauren , Saad Tess , Smith Michelle D
Published: July 2023

Although neuromuscular injury prevention programs decrease injuries, implementation is challenging. Netball Australia developed the Netball KNEE program – a netball-specific warm-up program designed for netball coaches, players and support staff to enhance movement efficiency and prevent injury. It contains exercises for warm-up/footwork, strength, balance/landing and agility. This study aimed to explore the Reach, perceived Effectiveness, Adoption, Implementation and intended Maintenance of the Netball KNEE program in community netball. Community netball coaches ( n = 257) from 52 community netball clubs completed an online survey on their familiarity with the KNEE program (Reach), satisfaction and perceived effectiveness (Effectiveness), use of the program in training (Adoption), use of specific program components and provision of feedback (Implementation) and intended future use of the program (Maintenance). 66.5% of coaches who responded to the survey were familiar with the KNEE program (Reach), and 43.0% of coaches reported using the program weekly (Adoption). Most coaches who were familiar with the program were satisfied with it (87.2%) and perceived it to be effective in reducing injuries (77.0%) (perceived Effectiveness). Only 58.7% of the 155 of coaches who adopted the program reported using all activity categories (warm up/footwork, strength, balance/landing and agility) (Implementation). Warm up/footwork activities were reported to be used most commonly (by 99.4% of coaches). Reported provision of feedback on program key principles (e.g., take off, landing, deceleration, changing direction) was variable (54.2%–97.4%) (Implementation). Study findings suggest the need for strategies to improve the reach, adoption and implementation of the KNEE program in community netball.
Hybrid Lanczos-switching models for solving large linear systems and their parallel versions
Authors: A Bakar Maharani , Thalib Rehana , A Pratama Danang , Aleng Nor Azlida , Abd Malik Siti Madihah , Mashuri Mashuri
Published: July 2023

Lanczos iterative methods for solving a large sparse linear systems typically face the latent breakdown which strikes every time these methods are deployed. A number of approaches to deal with this issue have been investigated. One of them is by switching between the solvers preemptively breakdown. However, the problem is not fully solved yet. Here, we propose switching models combined with particular Lanczos iterative methods. The first model is by using the last iterate as the switching point with an unlimited number of iterations, the second model is by using the iterate with the minimum residual norm as the initial point and the third model is by using the iterate with the minimum of minimum residual norms as the switching point. These three models lead algorithms of SLULast, SLUMinRes, and SLUMoM, respectively. The parallel version of the proposed algorithms is also provided to speed up their convergence. In this case, we constructed the parallel of SLUMoM and we call it pSLUMoM. The numerical results showed that our switching models performed better than the existing switching strategy in terms of robustness and efficiency. In fact, under a parallel framework, pSLUMoM showed a performance gain of up to 50% in our experiments.
Influence of the direction of suture strands on the tensile strength after flexor tendon repairs
Authors: Moriya Koji , Maki Yutaka , Koda Hisao , Kuroda Takuma , Tsubokawa Naoto
Published: July 2023

We assessed the influence of different directions of suture strands using the double Tsuge repair on the resistance to gap formation and mode of failure. In total, 25 porcine flexor digitorum profundus tendons were split into two groups. One group was repaired using a conventional double Tsuge suture created by two bands of looped suture placed longitudinally parallel (parallel method), and the other group was repaired using a new technique comprising two bands of looped suture placed in a crossed fashion in the anterior and posterior half of the tendon (cruciate method). The repaired tendons were subjected to linear, non-cyclic load-to-failure tensile testing. The cruciate method had a significantly higher mean load at a 2-mm gap tensile load (29.7 N [SD, 8.3]) than the parallel method (21.6 N [SD, 4.9]) and failed significantly more often due to suture pull-out. The direction of a core suture and its location within the tendon affect both gap resistance and the mode of failure of repair when using the double Tsuge suture technique, with a cruciate configuration achieving a greater gap resistance than a parallel one.
Eligibility for free healthcare
Authors: Jones Laura
Published: July 2023

Charges within the National Health Service are complex and often poorly understood. It is widely accepted that money should not be a barrier to accessing vital health services in this country. However, it is still necessary for healthcare to be paid for. This leads to a complex set of regulations determining who pays for services and what services they must pay for. This can cause confusion and fear for those unable to navigate the complex system. Doctors who are not aware of the charging systems may be poorly placed to support and advocate for their patients. This article seeks to explore and summarise the charges present within the NHS, in order to understand who is eligible for free healthcare.
Clinical impact of videocapsule endoscopy and device-assisted enteroscopy in non-bleeding small bowel lesions
Authors: Topa Matilde , Nandi Nicoletta , Scaramella Lucia , Puricelli Michele , Pennazio Marco , Sidhu Reena , Sanders David S. , Tontini Gian Eugenio , Penagini Roberto , Vecchi Maurizio , Elli Luca
Published: July 2023

Background:

Videocapsule endoscopy (VCE) and double-balloon enteroscopy (DBE) are part of the diagnostic and therapeutic work-up of indications other than suspected small bowel bleeding (OSBB). The literature is currently lacking studies describing these procedures in this particular setting.

Objectives:

We assessed the clinical impact of VCE and DBE in a large monocentric cohort of OSBB patients, as compared to a control group of suspected small bowel bleeding (SSBB) patients who underwent enteroscopy over the same period.

Design:

Monocentric, retrospective, cohort study.

Methods:

We collected the data of consecutive patients with OSBB undergoing VCE and/or DBE from March 2001 to July 2020. The demographic and clinical parameters of the patients, technical characteristics, and adverse events for each procedure were collected. The impact of VCE and DBE was defined in terms of diagnostic yield (DY). The patients were subdivided according to the main indication into four groups: celiac disease, Crohn’s disease (CD), neoplasia, and persistent gastrointestinal symptoms.

Results:

A total of 611 VCEs and 387 DBEs were performed for OSBB. The main indications were complicated celiac disease and CD. The DYs of VCE and DBE overall were 53 and 61.7%, respectively, with some variance among the four groups. We report no statistical differences in the DY of VCE and DBE in SSBB vs OSBB (57.7% vs 53%, p = 0.0859 and 68.8% vs 61.7%, p = 0.0582, respectively). OSBB patients were significantly younger than those with SSBB. However, similarly to SSBB ( k = 0.059), poor agreement between the enteroscopic techniques was found in the OSBB population ( k = 0.109). The safety of both procedures in OSBB was comparable to that in SSBB patients.

Conclusion:

VCE and DBE are effective and safe in suspected OSBB, where their role is similar to that in SSBB, their main indication.
Arthroscopic Bankart repair versus nonoperative management for first-time anterior shoulder instability: A cost-effectiveness analysis
Authors: Li Zachary I , Hurley Eoghan T , Garra Sharif , Blaeser Anna M , Markus Danielle H , Shen Michelle , Campbell Kirk A , Strauss Eric J , Jazrawi Laith M , Gyftopoulos Soterios
Published: July 2023

Purpose

Arthroscopic Bankart repair (ABR) may be more effective than nonoperative management for patients with anterior shoulder instability following first-time dislocation. The purpose of the study was to determine the most cost-effective treatment strategy by evaluating the incremental cost-effectiveness ratio (ICER) for ABR versus nonoperative treatment.

Methods

This cost-effectiveness study utilized a Markov decision chain and Monte Carlo simulation. Probabilities, health utility values, and outcome data regarding ABR and nonoperative management of first-time shoulder instability derived from level I/II evidence. Costs were tabulated from Centers for Medicaid & Medicare Services. Probabilistic sensitivity analysis was performed using >100,000 repetitions of the Monte Carlo simulation. A willingness-to-pay (WTP) threshold was set at $50,000.

Results

The expected cost for operative management higher than nonoperative management ($32,765 vs $29,343). However, ABR (5.48 quality-adjusted life years (QALYs)) was the more effective treatment strategy compared to nonoperative management (4.61 QALYs). The ICER for ABR was $3943. Probabilistic sensitivity analysis showed that ABR was the most cost-effective strategy in 100% of simulations.

Discussion

ABR is more cost-effective than nonoperative management for first-time anterior shoulder dislocation. The threshold analysis demonstrated that when accounting for WTP, ABR was found to be the more cost-effective strategy.
A holistic view of facilitators and barriers of electronic health records usage from different perspectives: A qualitative content analysis approach
Authors: Griesser Anna , Bidmon Sonja
Published: July 2023

Background:

Electronic health records (EHR) are seen as a promising endeavour, in spite of policies, designs, user rights and types of health data varying across countries. In many European countries, including Austria, EHR usage has fallen short when compared to the deployment plans.

Objective:

By adopting a qualitative approach, this research aimed to explore facilitators and barriers experienced by patients and physicians across the entire EHR usage process in Austria.

Method:

Two studies were conducted: In Study 1, discussions were held with four homogeneously composed groups of patients ( N = 30). In Study 2, eight expert semi-structured interviews were conducted with physicians to gain insights into potential facilitators and barriers Austrian physicians face when utilising personal EHR.

Results:

A wide range of barriers and facilitators were identified along the entire EHR usage spectrum, emerging on three different levels: the micro-level (individual level), the meso-level (level of the EHR system) and the macro-level (level of the health system). EHR literacy was identified as a booster to support EHR adherence. Health providers were identified as crucial gatekeepers with regard to EHR usage.

Conclusion:

The implications for mutual benefits arising out of EHR usage among the triad of health policymakers, providers and patients for both theory and practice are discussed.
Stroke clinical coding education program in Australia and New Zealand
Authors: Kilkenny Monique F , Sanders Ailie , Burns Catherine , Sanders Lauren M , Ryan Olivia , Read Carla , Lum On Miriam , Ranta Anna , Purvis Tara , Inman Carys , Cadilhac Dominique A , Carter Helen , Rowlands Stella , Nedkoff Lee , Olaiya Muideen T ,   on behalf of the Australia and New Zealand Stroke Coding Working Group
Published: July 2023

Background:

Accurate coded diagnostic data are important for epidemiological research of stroke.

Objective:

To develop, implement and evaluate an online education program for improving clinical coding of stroke.

Method:

The Australia and New Zealand Stroke Coding Working Group co-developed an education program comprising eight modules: rationale for coding of stroke; understanding stroke; management of stroke; national coding standards; coding trees; good clinical documentation; coding practices; and scenarios. Clinical coders and health information managers participated in the 90-minute education program. Pre- and post-education surveys were administered to assess knowledge of stroke and coding, and to obtain feedback. Descriptive analyses were used for quantitative data, inductive thematic analysis for open-text responses, with all results triangulated.

Results:

Of 615 participants, 404 (66%) completed both pre- and post-education assessments. Respondents had improved knowledge for 9/12 questions ( p < 0.05), including knowledge of applicable coding standards, coding of intracerebral haemorrhage and the actions to take when coding stroke (all p < 0.001). Majority of respondents agreed that information was pitched at an appropriate level; education materials were well organised; presenters had adequate knowledge; and that they would recommend the session to colleagues. In qualitative evaluations, the education program was beneficial for newly trained clinical coders, or as a knowledge refresher, and respondents valued clinical information from a stroke neurologist.

Conclusion:

Our education program was associated with increased knowledge for clinical coding of stroke. To continue to address the quality of coded stroke data through improved stroke documentation, the next stage will be to adapt the educational program for clinicians.