bluuebunny/crossref_metadata_2025 huggingface dataset:
Valitrack study: Objective evaluation of medical compression wearing time and patient activity with the Accutrack® by Sigvaris Group sensor
Authors: Crébassa Vincent , Grenier Etienne M. , Batot Geraldine Mme , Matieu-Dupas Eve , Chaigneau Cyril M.
Published: November 2023

Introduction

Objective measurement of compliance is mandatory to evaluate therapeutic effects and clinical benefits of medical compression stockings. This Valitrack study evaluates the Accutrack sensor equipped with an accelerometer. The evaluation is done under controlled and free conditions and during washing.

Results

Global accordance results are excellent: Sensitivity (98.6%) and specificity (95.2%) and 92% of patients are not disturbed by the sensors when putting on the stockings.

Discussion

Thanks to its specificities one sensor per patient is sufficient. Its sensitivity distinguishes still and active positions. Only hand washing remains a false positive. The Accutrack sensor objectively measures compliance and will not be a bias because 96% of patients forget it.

Conclusions

Objective compliance measurement with Accutrack allows us to evaluate the efficacity of compression, the reasons of non-compliance, and the patient's actual physical activity according to its accelerometer time-stamped.
Who cares for those who care? The role of healthcare leaders’ regulation of followers’ emotions on follower job satisfaction
Authors: Kunst Hannah , Nguyen Helena , Johnson Anya , Mo Shenjiang , MacCann Carolyn
Published: November 2023

In Australia and worldwide, healthcare is experiencing a workforce crisis, making the maintenance or improvement of job satisfaction a critical focus for healthcare leaders. This study examines how healthcare leaders influence followers’ affective experience by regulating their followers’ emotions. Building on Affective Events Theory and Conservation of Resources Theory, we investigate the influence of leaders’ use of cognitive reappraisal and expressive suppression strategies on follower affect and job satisfaction. Data were collected from 337 healthcare workers and 54 leaders over two timepoints. Leaders’ reappraisal increased followers’ job satisfaction whereas suppression decreased job satisfaction (controlling for followers’ own emotion regulation strategies). These effects were mediated by followers’ affect and moderated by followers’ capacity to cope with change. Our results provide new theoretical and practical insights into how healthcare leaders regulate followers’ emotions.

JEL Classification: D23, J24, M50
Application of Game Refinement Theory to Automated Driving
Authors: Kang Xiaohan , Qiu Wenliang , Iida Hiroyuki , Ghosh Bidisha
Published: November 2023

In recent years, assisted driving and self-driving have captured the imagination of manufacturers, designers, technology providers, and the general public with the expectation of a sustainable, safer, and intelligent mobility in the near future. Self-driving or assisted driving vehicles are complex systems that integrate environmental perception, intelligent planning and decision-making, tracking, and control. With the increasing intelligence of vehicles, personalized design is an inevitable trend. A design that is in line with the driver’s personality can bring a better driving experience to the driver. Thus, classifying driving types while driving in a self-driving environment may play an important role in the construction of trajectory planning algorithms. This paper uses the motion-in-mind model from game refinement theory to model driver behavior. Further, a classification of the model parameters into three categories helped in distinguishing cautious, aggressive, and average drivers. The results showed that the self-driving environment can be successfully modeled as a game and adaptation to match the riders’ driving skills may improve satisfaction.
Evaluation of Auxiliary Signing for Driveway Assistance Devices at Low-Volume Access Points within One-Lane, Bidirectional Work Zones
Authors: Hankin Jordan , Chakraborty Meghna , Gates Timothy J. , Savolainen Peter , Holpuch Travis , Motz Matthew
Published: November 2023

Work zone traffic control presents unique challenges during single-lane closures on two-lane, two-way facilities. In these circumstances, traffic regulators (i.e., flaggers or temporary signals) ensure alternating one-way travel in the work zone. However, the use of traffic regulators becomes less practical at mid-segment low-volume access points, such as driveways and minor intersections, within the lane closure. These locations present additional risk for flaggers and, owing to financial infeasibility, are often rendered without traffic control. A recently developed experimental traffic control treatment, the driveway assistance device (DAD), is designed to provide guidance to motorists for a safe entrance into the lane closure from low-volume access points. As this device is relatively new, much is still unknown about the optimal device design and operation to provide the highest compliance. To address this, a field study was performed to evaluate driver compliance associated with DADs implemented at a series of driveways along a one-lane, two-way work zone along a state highway in northern Michigan. As little guidance exists for DAD auxiliary signage, the field study specifically sought to compare the effects of five different sign messages utilized with the DAD. The driver compliance data revealed that the most effective sign messages were those that included “Turn” instead of “Yield,” a prominent “WAIT” message at the top, in addition to a supplemental “No Turn on Red” sign. Based on these findings, DADs are recommended for continued experimental use along with appropriate auxiliary signage at work zones where one-lane, two-way traffic is being maintained.
Using Aggregated Fine Geo-Resolution Vehicle Telemetric Data to Predict Crash Occurrence
Authors: Shen Sijun , Zhang Fangda , Linwood Simon Lin , Lu Bo , Zhu Motao
Published: November 2023

Being able to predict motor vehicle crashes which are a major public health concern would greatly improve traffic safety. The prevalence of mobile sensing platforms now allows spatially and temporally rich driving data to be collected relatively easily. Research efforts have been devoted to predicting crashes from such data. This paper seeks in particular to assess the feasibility and performance of using aggregated fine geo-resolution vehicle telemetric data for crash risk prediction. We acquired vehicle telemetric data from Geotab Inc., which recorded the frequency of hard acceleration, hard braking, harsh cornering, and the average magnitude of those harsh events among its registered commercial vehicles for every 150 × 150 m2 roadway segment within Columbus, Ohio between January and April 2018. We aggregated the data, obtained the crash history from the Ohio Police Accident Report, and leveraged three machine learning–based algorithms to predict the crash risk. The results suggest that aggregated vehicle telemetric data could provide acceptable predictions for crash risk at a roadway segment level. Our models’ predictive performances were further improved and maximized by including in the models both vehicle telemetric data and roadway geometric characteristics. Several factors, such as the aggregated count of hard accelerations and the presence of an intersection, were shown to be the factors that potentially made the greatest contribution to crash occurrence. We concluded that vehicle telemetric data could provide complementary and valuable information about crash likelihood monitoring, which may enable the police and city planners to implement proactive safety interventions. Yet the nature of traffic crashes is still complex and multi-dimensional.
Bidirectional Association Between Internet Use and Episodic Memory Among Older Adults: A Longitudinal Mediation Study
Authors: Zhao Xiaohang , Jin Lei , Sun Skylar Biyang
Published: November 2023

Using nationally representative longitudinal data from three waves of the China Health and Retirement Longitudinal Study (CHARLS), we assessed whether social participation and mental health were channels through which internet use and episodic memory mutually influenced each other. Cross-lagged panel models with multiple mediators were employed for the mediation analysis. The results reveal that social participation and depressive symptoms were mechanisms underlying the internet-cognition interplay. Among men, an increased chance of contacting friends served as a pathway connecting internet use with better episodic memory. Conversely, men with better episodic memory were more likely to use the internet partially due to their higher chances of having contact with friends and engaging in group activities. Among women, engagement in group activities and depressive symptoms were two channels through which internet use and episodic memory positively influenced each other. Our findings provide practical implications for slowing cognitive aging and narrowing the digital divide.
Role of Individual Differences in Executive Function for Learning From Distracting Multimedia Lessons
Authors: Lawson Alyssa P. , Mayer Richard E.
Published: November 2023

In multimedia learning, there is a lot of new information that learners are exposed to, making it a cognitively intensive process. Poorly-designed multimedia lessons can introduce distractions that must be dealt with by the learner. However, learners do not all share the same skill at managing incoming information or holding capacity, which could create individual differences in the impact of multimedia lessons on learning and lead to inequity in learning. In three experiments, learners saw a multimedia lesson varying in the amount of distracting material included: high (Experiment 1), moderate (Experiment 2), or low (Experiment 3). Learners took a posttest and completed tasks to assess individual differences in managing incoming information (executive function) and holding capacity (working memory capacity). When distractions were present (Experiment 1 and Experiment 2), executive function was related to posttest performance such that as executive functioning increased, performance on the posttest increased. However, when distractions were not present (Experiment 3), executive function was not related to posttest performance. Individual differences in working memory capacity were not related to posttest performance at any level of distraction. This indicates the importance of considering individual differences in learners' executive functioning in the design of multimedia lessons.
Utilizing attributive patterns as a linguistic classification tool of newspapers
Authors: Mintah Kingsley Cyril
Published: November 2023

The indices for the classification of newspapers have often focused on agenda-setting roles, economic position and size of newspapers, among others. Concerning newspapers in Africa, Moehler and Singh (2011) and Hasty (2005) assert that the only index for the classification of newspapers is ownership. The study, therefore, focuses on the patterns of the attributive mode of the transitivity system of Systemic Functional Grammar to propose a linguistic alternative index for classifying newspapers. The findings indicate that the patterns of attributions that occur are significant and viable enough to classify newspapers.
Understanding and Enabling “Communities” Within Smart Cities: A Literature Review
Authors: Al-Saidi Mohammad , Zaidan Esmat
Published: November 2023

Community-level interventions through technological updates and connectedness are quite popular within smart city visions. These interventions, under the collective label of smart and connected communities (SCC), promise to increase technology access, services, and the sense of entrepreneurship and organization at the community level. This paper addresses the lack of academic research investigating SCC with regard to its merits and linkages to the debate on smart cities. It reviews the academic literature on conceptions, constituents, and enablers of SCC. It highlights SCC as a concept with more issues and complexity than conventional smart city projects, particularly with regard to soft or human-related factors. While SCC is associated with diverse objectives, there are some basic elements of SCC projects such as a common direction, digitalization, optimization, better services, and participation. This paper also presents a range of critical factors and enablers based on previous studies. These factors include the features of communities and services as well as collaborative and institutional mechanisms. This paper shows the importance of the planning and design tasks in initiating SCC interventions. When designing successful and context-specific SCC projects, it is important to address the contextual environment of SCC through an informed SCC project design. This is particularly relevant for (ill-defined) communities with unconducive institutional context or no cooperation legacies. The success of SCC often depends on engagement and change management within communities as well as the development of context-specific, and often iterative, project designs.
The Role of Social Media in Nonprofit Organizations’ Fundraising
Authors: Elvira-Lorilla Teresa , Garcia-Rodriguez Inigo , Romero-Merino M. Elena , Santamaria-Mariscal Marcos
Published: November 2023

This study aims to explore the effect of social media use on fundraising by nonprofit organizations (NPOs). To do so, we analyze the accounts of 83 Spanish nongovernmental development organizations on Facebook, Twitter, YouTube, and Instagram over a 5-week period. Our results show that social media can be a useful tool for NPO fundraising. Specifically, although mere presence on social media has no effect on the donations raised by the organization, the size of the NPO’s network (followers), its social media activity (posts), content (posts explicitly requesting donations), and follower engagement do influence fundraising. This study helps to highlight the usefulness of social media as a fundraising tool and to show the differences among platforms, format, and content of posts. In particular, NPOs who intend to increase fundraising should actively participate in social media—especially Twitter and YouTube—not overuse stories and increase posts that solicit donations.
Tackling late HIV diagnosis: Lessons from the UK in the COVID-19 era
Authors: Boardman Emily , Boffito Marta , Chadwick David R , Cheserem Emily , Kabagambe Samuel , Kasadha Bakita , Elliott Cindy
Published: November 2023

Introduction

Late diagnosis of HIV is associated with increased morbidity and mortality, and an increased risk of non-infectious comorbidities. On a societal level, late diagnosis leads to higher treatment and healthcare costs and is a major driver of HIV transmission. Despite improvements in other areas of the HIV care pathway, late diagnosis remains an individual and public health concern globally.

Objective

To examine the barriers to HIV testing and highlight successful strategies to improve prompt diagnosis. This review describes the prevalence of late diagnosis in the UK and discusses key factors that contribute to late diagnosis, including the effect of the COVID-19 pandemic. Late HIV diagnosis is lower in the UK than in most other European countries. In this review, pilot projects and ongoing initiatives that have reduced late diagnosis in the UK are highlighted; moreover, further strategies for improving prompt diagnosis are suggested.

Conclusions

Insufficient testing is the fundamental reason for late HIV diagnosis, with societal, systemic, and individual factors all contributing to inadequate testing. Improving access to testing, removing barriers to health-seeking behaviour, and ensuring all people with HIV indicator conditions are promptly tested are key to reducing the rates of late diagnosis globally.
An Animal: What is it?
Authors: Lee Keekok
Published: November 2023

This paper will argue that posing the question ‘what is an animal?’ is neither irrelevant nor futile. By looking more closely at four conceptions of what is an animal as held implicitly by the general public, by certain philosophers of animal liberation, by apologists for zoos and by the community of zoologists – it will attempt to show that the first three are partial and decontextualised. On the other hand, the zoological account is obviously more comprehensive, and it will be argued that, if suitably teased out, it involves a properly contextualised conception set against the notions of species, habitat, ecosystem and of evolutionary processes in the past (as well as the future). Such a rounder and more historical characterisation will transcend the usual polarisation between so-called individualism and holism in environmental philosophy. The transcendence of this perceived dichotomy is shown also to have practical implications for environmental policy-making with regard to issues like biodiversity and the saving of animals from extinction.
Competence-Based Curriculum in Tanzania: District School Quality Assurance Officers’ Understanding and Practices
Authors: Dismas Silvani , Nzima Ibrahimu , Kimaro Aurelia
Published: November 2023

This study focuses on investigation of district school quality assurance officers’ (DSQAOs) understanding of competence-based curriculum (CBC) and how they conduct CBC quality assurance in secondary schools in Tanzania. The study employed interpretive paradigm, qualitative approach, a case study design, and was guided by Bernstein's theory of the pedagogic device. Forty (40) respondents were purposively and conveniently selected including DSQAOs (n = 12), head of schools (n = 4), and teachers (n = 24). Data generation methods were semi-structured interviews, participant-assisted drawings, and documentary review; while content and thematic analyses were employed. Findings revealed that DSQAOs had varied understandings of CBC. Some understood CBC as a curriculum that supported students’ studies and learning environment. Others understood it as a curriculum that supported students’ acquisition of competences needed in their daily life; while others failed to explain its meaning. Moreover, DSQAOs conducted classroom observations and gave feedbacks for improving teaching and learning activities in schools. However, DSQAOs’ use of harsh language to teachers, limited time during school visit, inadequate report writing, and lack of clear conceptualization of CBC concepts hindered effective support to teachers. The study concludes that in order to conduct effective CBC quality assurance in schools, selection of competent DSQAOs and regular trainings are imperative.
Drivers of Sustainable Green Finance: Country’s Level Risk and Trade Perspective for OECD Countries
Authors: Wang Rong , Destek Mehmet A. , Weimei Chen , Albahooth Bayan , Khan Zeeshan
Published: November 2023

In contemporary times, developed economies are adopting environmentally friendly initiatives such as green finance and energy efficiency. However, the factors affecting energy efficiency are widely explored, and green finance remains overlooked in the empirical literature. The present research examines the drivers of sustainable green finance in OECD economies during 2004–2021. The study uses several panel diagnostic tests and validates the mixed integration order of the variables. Still, the long-run equilibrium relationship is valid between financial inclusion, energy efficiency, human capital, foreign trade, composite risk, and green finance. Using panel autoregressive distributed lag model, the study found that financial inclusion, energy efficiency, foreign trade, and composite risk significantly improve green finance in the long run. However, only energy efficiency is effective in the short run. On the other hand, human capital exhibits a significant adverse influence on green finance. The long-run results are robust due to the significant estimates offered by panel dynamic ordinary least square. Besides, there exist one-way and two-way causal associations between variables. The study recommends improving the financial sector performance to enhance financial inclusivity, increase investment in the energy efficiency sector, and encourage trade in environmentally friendly initiatives.
Effect of Grass Components on the Temporal Response of Surface Soil Water to Precipitation and Air Temperature in the Loess Plateau
Authors: Liu Jianbo , Gao Guangyao , Chen Weiliang , Fang Weiwei , Su Changhong , Zhang Bing
Published: November 2023

The Loess Plateau of China is facing increasingly serious challenges related to water shortage issues despite the successful vegetation restoration. Surface soil water (0–40 cm) is crucial to water transfer and discharge in the soil-plant-atmosphere continuum, which is controlled by precipitation (P), air temperature (Ta), and plant components. This study selected one typical grass species and set different treatments of natural condition (NC), removing litter (CR), and only roots (OR), to analyze the responses of soil water storage (W) and its change (∆W) to P and Ta at different time scales (including daily, weekly and monthly scales). The results showed that P had significantly positive effects on W and ∆W, while Ta negatively influenced W and ∆W. Meanwhile, Ta also controlled the significance of P affecting W. P contributed more (53–63%) to ∆W variation at the daily scale, but Ta showed more effect (73–80%) at the weekly scale, and both of them contributed more than 77% at the monthly scale. P and Ta existed a threshold phenomenon for increasing soil water, where P thresholds were higher than 0.93, 4.98, and 28.17 mm and Ta threshold were lower than 28.69, 28.89, and 29.96°C at the daily, weekly and monthly scales, respectively. Moreover, grass components also affected the responses of ∆W to P and Ta, and the OR treatment displayed the lowest sensitivity and had the lowest loss rate of soil water. The total infiltration, total loss amount, and rainwater retention rate exhibited: NC > CR > OR. Overall, grass canopy and litter improved soil water condition, and the roots most strongly protected soil water after infiltration. This study can provide a better understanding of surface soil water responding to climate change under drought stress with water shortage implications, and may strength the management of grassland in semi-arid region.
Fertility preservation in prepubertal female patients: Medical and ethical considerations of offering ovarian tissue cryopreservation in pediatric patients
Authors: Dinicola Giulia Adele
Published: November 2023

In the USA, one child in 285 children is diagnosed with cancer every year, but thanks to improvements in medicine, the survival rate has reached 80%. However, cancer treatments, such as chemotherapy and radiation, are likely to affect their fertility later in life, limiting their ability to conceive. To reduce this risk, ovarian tissue cryopreservation is a surgical procedure that allows the ovarian tissue to be retrieved and cryopreserved in order to be reimplanted back into the abdomen and restore ovarian function in children who become infertile due to gonadotoxic treatments. A case study published in 2014 offered recommendations to help assess whether such a procedure should be offered to female patients who have not yet entered puberty. This paper will investigate whether, in light of more recent and updated literature, their recommendations may need to be revised.
Reconsidering FDA Guidelines: A Single-Center Experience of Prolonged Impella 5.5 Support
Authors: Valdes Carlos Alberto , Stinson Griffin , Sharaf Omar M. , Jimenez Contreras Fabian , Bilgili Ahmet , Ahmed Mustafa M. , Vilaro Juan , Parker Alex M. , Al-Ani Mohammad A. Z. , Demos Daniel , Aranda Juan , Bleiweis Mark , Beaver Thomas M. , Jeng Eric I.
Published: November 2023

Objective:

Impella 5.5 (Abiomed, Danvers, MA, USA) is approved by the US Food and Drug Administration (FDA) for mechanical circulatory support for ≤14 days. It is unknown whether prolonged support is associated with worse outcomes. We sought to review our single-center experience with Impella 5.5 and compare outcomes based on support duration.

Methods:

We retrospectively reviewed adult patients (≥18 years old) supported with Impella 5.5 at our institution (May 2020 to April 2023). Patients on prolonged support (>14 days) were compared with those supported for ≤14 days.

Results:

There were 31 patients supported with Impella 5.5 including 14 (45.2%) supported >14 days. Median support duration for those on prolonged support was 43.5 (interquartile range [IQR] 25 to 63.5) days versus 8 (IQR 6, 13) days for those who were not ( P < 0.001). Overall, the device-related complication rate was 9.7% and did not differ between groups ( P = 0.08). Overall, 30-day postimplant survival was 71% and did not differ by support duration ( P = 0.2). In-hospital mortality was 32% and did not differ between cohorts ( P > 0.99). Among those surviving to explant ( n = 22), long-term strategy included bridge to durable ventricular assist device (18%, n = 4), cardiac transplant (55%, n = 12), and cardiac recovery (27%, n = 6).

Conclusions:

High-risk patients with cardiogenic shock may be supported with Impella 5.5 beyond the FDA-approved duration without increased risk of complications or mortality.
Discharge transitional care programme for older adults after hip fracture surgery: a quasi-experimental study
Authors: Ko YoungJi , Hwang Jong-Moon , Baek Seung-Hoon
Published: November 2023

Background:

Hip fractures require extended periods of recovery and rehabilitation, subjecting older adults to discontinuous care. Discharge transition is a critical point of heightened vulnerability for older adults.

Aims:

This study aimed to evaluate the effectiveness of a transitional care programme on the physical functions and quality of life (QOL) of older adults after hip fracture surgery.

Methods:

Seventy-five older adults were assessed from pre-discharge to 6 weeks after hip surgery, and their physical functions, including walking status and activities of daily living, were measured. The QOL was measured using the European Quality of life-5 Dimensions-5 Levels (EQ 5D 5L).

Results:

There was a significant strong effect of time ( B = 10.565; 95% CI = 2.584–18.547; p = 0.009) on the EuroQol Visual Analog Scale (EQ-VAS) for the experimental group. However, there were no significant effects of time on physical functions and EQ-5D-5L scores.

Conclusions:

The discharge transitional care programme improved the EQ-VAS of older adults following hip fracture surgery 6 weeks post-surgery. However, there were no significant differences in physical functions and EQ-5D between the groups.
What are the Primary Drivers of Marketing Success?: Evidence From Brand-Level Data on Restaurants
Authors: Lynn Michael
Published: November 2023

A multivariate analysis of brand level data from the restaurant industry found that penetration increased with number of units for limited and full service restaurants (LSRs and FSRs) and with customer service experience ratings for FSRs. For both types of restaurants, average purchase frequency increased reliably with the number of units and with perceived value, but not with broader customer experience ratings or the existence of a reward program. Finally, average check size increased with service experience but only for FSRs. Given that brands differ much more in penetration than in average purchase frequency or average check size, these findings suggest that marketing success comes primarily from increased physical and mental availability, with brand differentiation, but not reward programs, also contributing to that success.
Impacts of Emotional Intelligence on Second Language Acquisition: English-Major Students’ Perspectives
Authors: Thao Le Thanh , Thuy Pham Trut , Thi Nguyen Anh , Yen Phuong Hoang , Thu Huynh Thi Anh , Tra Nguyen Huong
Published: November 2023

Emotional intelligence (EI) plays a critical role in English learning, as it fosters a better understanding of language nuances, enhances learner motivation, and improves communication skills, thereby leading to a more effective and enriching learning experience. However, the impact of EI on English language acquisition among Vietnamese learners remains underexplored creating a gap in educational studies. This study aimed to investigate the Vietnamese students’ perspectives of the impacts of EI on their second language acquisition (SLA). A mixed-methods approach was employed combining quantitative data collected through a questionnaire and qualitative data obtained from semi-structured interviews. The study involved 105 English-major students selected through convenience sampling. The findings revealed a positive correlation between EI and SLA, with characteristics such as motivation, self-confidence, interpersonal skills, a goal-oriented mindset, and emotional openness significantly impacting language learning outcomes. These findings have implications for language learning theory, pedagogy, and curriculum development, emphasizing the need to address learners’ emotional well-being and incorporate EI skills within language learning contexts. By integrating these elements, educators can create a conducive learning environment that enhances both linguistic and emotional competencies.
Energizing the Brand from Within: Kimpton's Secret Sauce for Success
Authors: King Ceridwyn , Callaway Leah
Published: November 2023

Every Thursday at 12pm Nick Gregory, General Manager of the soon to be new Kimpton property, Hotel Monaco Philadelphia, and his team of pre-opening managers, prepare for a meeting with their public relations firm, Cashman & Associates. After the meeting Nick is challenged with drafting the story line for Hotel Monaco and what it will mean to the city of Philadelphia. Since starting his Kimpton career 22 years ago, Nick realizes that no two properties are ever alike. He must decide how the Monaco will not only stand apart from their sister property Hotel Palomar, but also every other hotel in its competitive set.
Global Well-Being and Mental Health in the Internet Age
Authors: Vuorre Matti , Przybylski Andrew K.
Published: November 2023

In the last 2 decades, the widespread adoption of Internet technologies has inspired concern that they have negatively affected mental health and psychological well-being. However, research on the topic is contested and hampered by methodological shortcomings, leaving the broader consequences of Internet adoption unknown. We show that the past 2 decades have seen only small and inconsistent changes in global well-being and mental health that are not suggestive of the idea that the adoption of Internet and mobile broadband is consistently linked to negative psychological outcomes. Further investigation of this topic requires transparent study of online behaviors where they occur (i.e., on online platforms). We call for increased collaborative efforts between independent scientists and the Internet-technology sector.
The Posterosuperior Tetralogy Scoring System as a Practical Tool to Predict Shoulder Function After Posterosuperior Large-to-Massive Rotator Cuff Repairs
Authors: Guo Siyi , Zhu Yiming , Lu Yi , Zhang Pu , Zheng Tong , Qin Qihuang , Jiang Chunyan
Published: November 2023

Background:

Fatty infiltration (FI) or atrophy alone has been found to be inaccurate in predicting shoulder function after repair of large-to-massive rotator cuff tears (L/MRCTs), especially when a diverse extent of FI and atrophy presents in multiple rotator cuff muscles.

Purpose/Hypothesis:

The Posterosuperior Tetralogy Scoring System (PS-Tetra Score), which integrates FI and atrophy, was proposed to predict shoulder function after surgery. It was hypothesized was that a PS-Tetra Score ≥3 would be a risk factor for poor shoulder function after repair of posterosuperior L/MRCTs and would possess greater diagnostic value than using isolated FI or atrophy of the supraspinatus (SSP) or infraspinatus (ISP).

Study Design:

Case-control study; Level of evidence, 3.

Methods:

A total of 187 arthroscopic repairs of posterosuperior L/MRCTs were reviewed. Magnetic resonance imaging evaluations were performed of FI and atrophy of the SSP and ISP, teres minor hypertrophy, tendon retraction, and acromiohumeral distance. A postoperative American Shoulder and Elbow Surgeons (ASES) score of 70 was used to subgroup patients according to shoulder function. Univariate and multivariate analyses were performed to determine the risk factors of poor shoulder function (ASES ≤70). The diagnostic values of different indicators for predicting shoulder function were evaluated.

Results:

In univariate analysis, female sex, higher Goutallier grade of the SSP and ISP, positive SSP tangent sign, and PS-Tetra Score ≥3 was significantly associated with ASES score ≤70, whereas in binary logistic regression analysis, a PS-Tetra Score ≥3 was the only significant risk factor for poor shoulder function. The occurrence rate of poor function in shoulders with a PS-Tetra Score of 0, 1, 2, 3, and 4 was 0% (0/52), 0% (0/52), 19.57% (9/46), 58.06% (18/31), and 83.33% (5/6), respectively. PS-Tetra Score ≥3 possessed higher crude agreement (87.70%), specificity (90.97%), positive predictive value (62.16%), and area under the receiver operating characteristic curve (0.814) than the other 3 indicators, with relatively high negative predictive value (94.00%) and moderate sensitivity (71.88%).

Conclusion:

PS-Tetra Score ≥3 was a risk factor of poor shoulder function after repair of posterosuperior L/MRCTs and possessed greater diagnostic value than using isolated FI or atrophy of SSP or ISP alone for predicting shoulder function.
The future of banking: What are the actual barriers to bank digitalization?
Authors: Ulrich-Diener Florian , Dvouletý Ondřej , Špaček Miroslav
Published: November 2023

The banking sector must confront challenges arising from globalization, the demand for new business models (BMs), increasing regulation, and ever-advancing digitalization. In this context, innovative competitors, namely FinTechs, are challenging banks and forcing them to rethink existing strategies and structures. In particular, the digital transformation of BMs that have been in place for decades represents a major challenge for companies and their executives. In this article, 407 German bank representatives were surveyed to identify, quantify, and analyze implementation barriers in the context of bank digitalization from a decision-maker’s perspective. By applying structural equation modeling, the authors quantified a variety of barriers and tested their influence on the degree of digitalization at banks. The study uncovered structural relationships between barriers expressed as observed variables— personal involvement, strategic corporate management, technology and regulation, and employees—and the degree of digitalization as a latent variable of banks. The findings increase bank practitioners’ understanding and awareness of barriers to digitalization and contribute to the field of bank digitalization.

JEL Classification: G21, M1, O33
India’s Quest for Defence Indigenisation: A Case Study of the Indian Navy
Authors: Patel Priyanka , Patil Sameer , Vishwanathan Arun
Published: November 2023

India, like all major military powers, has been making sustained attempts at indigenously meeting its defence requirements. However, when one looks at the macro picture, it is apparent that the country has had limited successes in inducting defence platforms or weapon systems that are indigenously designed, tested, manufactured and inducted into the military. There have been some exceptions to this like the HF-24 Marut fighter jet, the Light Combat Aircraft Tejas, the Main Battle Tank Arjun, Leander class frigates, Indigenous Aircraft Carrier Vikrant, Kolkata and Vishakhapatnam class destroyers and the Arihant nuclear submarine. While these examples only prove the general rule, they also point out India’s relative success in creating domestic capacity to build naval platforms. As India embarks on the path of Atmanirbharta (self-reliance), it is crucial for the political and military decision-makers to understand what, why and how the above-mentioned projects, particularly the naval ones, became successful, so that their success can be replicated elsewhere. The article attempts to understand the reasons behind the Navy’s successes. These successes have been the result of an institutionalised—as opposed to an individual-centric—approach by the Navy to create in-house design capabilities, organisational structure, planning procedure, capacity building efforts and linkages with other stakeholders like naval Defence Public Sector Units, Defence Research and Development Organisation and other scientific establishments and industry. This has made the Indian Navy more successful as compared to the other two services of the Indian military when it comes to designing, testing, constructing and inducting indigenous naval platforms.
India’s Military Modernisation: Role and Impact of France
Authors: Sinha Shreya
Published: November 2023

India’s vision for Atmanirbhar Bharat adopted in 2020 attempts to make the country and its citizens self-reliant in all aspects. India, being the third largest military spender after the US and China, has also worked towards achieving self-reliance in defence production while maintaining a constant push towards ‘Make in India’. The Indian embassy in Paris has reiterated France’s commitment and complete support to India’s vision of self-reliance in areas of defence industrialisation, joint research, and development in India across a broad spectrum of advanced capabilities. The first part of the article examines the historical background of evolving security relationship between India and France, analysing defence and security cooperation as a principal pillar of their Strategic Partnership. The second part of the article attempts to study the impact of France on India’s military modernisation through the transfer of resources and technology, and through co-development and co-production of equipment. It tracks France’s role in assisting India to reduce dependence on Russia for their military hardware requirements, in its path towards indigenous defence production. The concluding part of the article extrapolates the findings onto the future in order to examine the challenges faced by India in its attempt towards military modernisation. It also seeks to examine challenges in the partnership between the two actors and its impact on France’s role in India’s defence modernisation.
Effects of Mobile Stroke Unit dispatch on blood pressure management and outcomes in patients with intracerebral haematoma: Results from the Berlin_Prehospital Or Usual Care Delivery in acute Stroke (B_PROUD) controlled intervention study
Authors: Schwabauer Eugen , Piccininni Marco , Freitag Erik , Ebinger Martin , Geisler Frederik , Harmel Peter , Hille Annegret , Lorenz-Meyer Irina , Rohrpasser-Napierkowski Ira , Kurth Tobias , Rohmann Jessica L , Endres Matthias , Schlunk Frieder , Weber Joachim , Wendt Matthias , Audebert Heinrich J
Published: November 2023

Introduction:

In patients with acute intracerebral haemorrhage (ICH) and elevated systolic blood pressure (BP), guidelines suggest that systolic BP reduction to <140 mmHg should be rapidly initiated. Compared with conventional care, Mobile Stroke Units (MSUs) allow for earlier ICH diagnosis through prehospital imaging and earlier BP lowering.

Patients and methods:

ICH patients were prospectively evaluated as a cohort of the controlled B_PROUD-study in which MSU availability alone determined MSU dispatch in addition to conventional ambulance. We used inverse probability of treatment weighting to adjust for confounding to estimate the effect of additional MSU dispatch in ICH patients. Outcomes of interest were 7-day mortality (primary), systolic BP (sBP) at hospital arrival, dispatch-to-imaging time, largest haematoma volume, anticoagulation reversal, length of in-hospital stay, 3-month functional outcome.

Results:

Between February 2017 and May 2019, MSUs were dispatched to 95 (mean age: 72 ± 13 years, 45% female) and only conventional ambulances to 78 ICH patients (mean age: 71 ± 12 years, 44% female). After adjusting for confounding, we found shorter dispatch-to-imaging time (mean difference: -17.75 min, 95% CI: −27.16 to −8.21 min) and lower sBP at hospital arrival (mean difference = −16.31 mmHg, 95% CI: −30.64 to −6.19 mmHg) in the MSU group. We found no statistically significant difference for the other outcomes, including 7-day mortality (adjusted odds ratio: 1.43, 95% CI: 0.68 to 3.31) or favourable outcome (adjusted odds ratio = 0.67, 95% CI: 0.27 to 1.67).

Conclusions:

Although MSU dispatch led to sBP reduction and lower dispatch-to-imaging time compared to conventional ambulance care, we found no evidence of better outcomes in the MSU dispatch group.
Validation of the novel GLAS algorithm as an aid in the detection of liver fibrosis and cirrhosis based on GP73, LG2m, age, and sex
Authors: Hemken Philip M. , Qin Xuzhen , Sokoll Lori J. , Jackson Laurel , Feng Fan , Li Peng , Gawel Susan H. , Tu Bailin , Lin Zhihong , Hartnett James , Hawksworth David , Tieman Bryan C. , Yoshimura Toru , Kinukawa Hideki , Ning Shaohua , Liu Enfu , Meng Fanju , Chen Fei , Miao Juru , Mi Xuan , Tong Xin , Chan Daniel W. , Davis Gerard J.
Published: November 2023

Background

Diagnosis of liver disease at earlier stages can improve outcomes and reduce the risk of progression to malignancy. Liver biopsy is the gold standard for diagnosis of liver disease, but is invasive and sample acquisition errors are common. Serum biomarkers for liver function and fibrosis, combined with patient factors, may allow for noninvasive detection of liver disease. In this pilot study, we tested and validated the performance of an algorithm that combines GP73 and LG2m serum biomarkers with age and sex (GLAS) to differentiate between patients with liver disease and healthy individuals in two independent cohorts.

Methods

To develop the algorithm, prototype immunoassays were used to measure GP73 and LG2m in residual serum samples collected between 2003 and 2016 from patients with staged fibrosis and cirrhosis of viral or non-viral etiology (n = 260) and healthy subjects (n = 133). The performance of five predictive models using combinations of age, sex, GP73, and/or LG2m from the development cohort were tested. Residual samples from a separate cohort with liver disease (fibrosis, cirrhosis, or chronic liver disease;n = 395) and healthy subjects (n = 106) were used to validate the best performing model.

Results

GP73 and LG2m concentrations were higher in patients with liver disease than healthy controls and higher in those with cirrhosis than fibrosis in both the development and validation cohorts. The best performing model included both GP73 and LG2m plus age and sex (GLAS algorithm), which had an AUC of 0.92 (95% CI: 0.90–0.95), a sensitivity of 88.8%, and a specificity of 75.9%. In the validation cohort, the GLAS algorithm had an estimated an AUC of 0.93 (95% CI: 0.90–0.95), a sensitivity of 91.1%, and a specificity of 80.2%. In both cohorts, the GLAS algorithm had high predictive probability for distinguishing between patients with liver disease versus healthy controls.

Conclusions

GP73 and LG2m serum biomarkers, when combined with age and sex (GLAS algorithm), showed high sensitivity and specificity for detection of liver disease in two independent cohorts. The GLAS algorithm will need to be validated and refined in larger cohorts and tested in longitudinal studies for differentiating between stable versus advancing liver disease over time.
D-allose Inhibits TLR4/PI3K/AKT Signaling to Attenuate Neuroinflammation and Neuronal Apoptosis by Inhibiting Gal-3 Following Ischemic Stroke
Authors: Luo Yaowen , Cheng Junkai , Fu Yihao , Zhang Min , Gou Maorong , Li Juan , Li Xiaobing , Bai Jing , Zhou Yuefei , Zhang Lei , Gao Dakuan
Published: November 2023

Background

Ischemic stroke (IS) occurs when a blood vessel supplying the brain becomes obstructed, resulting in cerebral ischemia. This type of stroke accounts for approximately 87% of all strokes. Globally, IS leads to high mortality and poor prognosis and is associated with neuroinflammation and neuronal apoptosis. D-allose is a bio-substrate of glucose that is widely expressed in many plants. Our previous study showed that D-allose exerted neuroprotective effects against acute cerebral ischemic/reperfusion (I/R) injury by reducing neuroinflammation. Here, we aimed to clarify the beneficial effects D-allose in suppressing IS-induced neuroinflammation damage, cytotoxicity, neuronal apoptosis and neurological deficits and the underlying mechanism in vitro and in vivo.

Methods

In vivo, an I/R model was induced by middle cerebral artery occlusion and reperfusion (MCAO/R) in C57BL/6 N mice, and D-allose was given by intraperitoneal injection within 5 min after reperfusion. In vitro, mouse hippocampal neuronal cells (HT-22) with oxygen–glucose deprivation and reperfusion (OGD/R) were established as a cell model of IS. Neurological scores, some cytokines, cytotoxicity and apoptosis in the brain and cell lines were measured. Moreover, Gal-3 short hairpin RNAs, lentiviruses and adeno-associated viruses were used to modulate Gal-3 expression in neurons in vitro and in vivo to reveal the molecular mechanism.

Results

D-allose alleviated cytotoxicity, including cell viability, LDH release and apoptosis, in HT-22 cells after OGD/R, which also alleviated brain injury, as indicated by lesion volume, brain edema, neuronal apoptosis, and neurological functional deficits, in a mouse model of I/R. Moreover, D-allose decreased the release of inflammatory factors, such as IL-1β, IL-6 and TNF-α. Furthermore, the expression of Gal-3 was increased by I/R in wild-type mice and HT-22 cells, and this factor further bound to TLR4, as confirmed by three-dimensional structure prediction and Co-IP. Silencing the Gal-3 gene with shRNAs decreased the activation of TLR4 signaling and alleviated IS-induced neuroinflammation, apoptosis and brain injury. Importantly, the loss of Gal-3 enhanced the D-allose-mediated protection against I/R-induced HT-22 cell injury, inflammatory insults and apoptosis, whereas activation of TLR4 by the selective agonist LPS increased the degree of neuronal injury and abolished the protective effects of D-allose.

Conclusions

In summary, D-allose plays a crucial role in inhibiting inflammation after IS by suppressing Gal-3/TLR4/PI3K/AKT signaling pathway in vitro and in vivo.
The impact of lower caseloads in public employment services on the unemployed
Authors: Böheim René , Eppel Rainer , Mahringer Helmut
Published: November 2023

In a randomised controlled trial in Austria, lowering caseloads for caseworkers in a Public Employment Office led to more meetings with unemployed clients, more job offers, more programme assignments, and more sanctions for noncompliance with job search requirements. It shortened unemployment spells through faster job entry, but also through more exits from the labour force in the 2 years following treatment. The duration of unemployment was reduced for a number of subgroups of the unemployed, but not all benefited from increased employment. For women and foreigners, lower caseloads led to more time out of the labour force. The quality of jobs after unemployment, measured by wages, did not change. A cost–benefit analysis suggests that lower caseloads not only shorten unemployment but also save public costs.