bluuebunny/crossref_metadata_2025_split huggingface dataset:
How speculative culture shapes green innovation performance: A dual regional and institutional lens
Authors: Ji Hao , Suo Lingling , Yu Yuanxin 
Published: February 2025

Background: Regional culture plays a crucial role in green innovation performance, yet its impact has not been sufficiently explored, particularly within the African context.Aim: The study aims to assess how speculative culture within regions affects corporate green innovation performance in the context of regional cultural integration.Setting: The research uses data from Chinese A-share listed companies from 2008 to 2020, specifically focussing on companies with various ties to Africa.Method: This study employs an empirical research method using multiple regression analysis, moderation analyses, along with robustness checks and endogeneity tests to ensure the validity and reliability of the findings.Results: Findings indicate that a speculative culture inhibits green innovation, a result that remains robust across various endogeneity tests. Traditional ecological culture, trust culture and cultural diversity mitigate this negative effect, while local clan culture exacerbates it. Stakeholder supervision and external regulatory pressure from the government effectively weaken the inhibitory effect of speculative culture.Conclusion: This study highlights the significant and complex role of regional cultures in shaping green innovation outcomes, underscoring the importance of institutions to counteract adverse cultural influences.Contribution: This research enhances the understanding of green innovation drivers by exploring the interactions between various cultural dimensions and their impact, emphasising the alignment of formal institutions to achieve sustainable green innovation. It offers several recommendations for enhancing corporate resilience and developing effective green innovation strategies.
A postcolonial analysis between theological methods: Osmer and the praxis cycle
Authors: Baron Eugene 
Published: February 2025

The article engages the theological methods that are commonly used within the disciplines of practical theology and missiology. These methods are the practical interpretive method of Osmer and the praxis cycle as used and discussed by J.N.J. (Klippies) Kritzinger. Through a postcolonial analysis, I discuss how such theological methods could be appropriate or how it might fall short of radically addressing issues of the poor amid oppressive structures in postcolonial contexts. The most striking finding of the article is how it showcases between the two theological methods: The praxis cycle’s first dimension of ‘self-identification’ and ‘self-knowledge’ (identification) as unique between the two. It is the questions of who am I, what are the power-relations, who are our interlocutors, what is mine and the ‘other’s’ ideological position? These are imperative questions especially for the liberation of those whom the researcher encounters.Contribution: The purpose of this article is to assist researchers in theology to become critical in their use of theological methods, especially when the research is intended to address the powerful oppressive systems in society that allows access to power and privileges to some people, but at the same time cause others to be treated as non-subjects or persons.
Effects of Opioid-based and Opioid-free Anesthesia in Patients Undergoing Elective Laparoscopic Surgeries
Authors: Swamy Akshay Hiryur Manjunatha , Sneka G. , Kumararadhya Girish Bandigowdanahalli , Chennabasappa Abhilash , Shivakumar K. G. , Umesh Sheema 
Published: February 2025

Abstract

Background:
The aim of anesthetic management of patients undergoing surgeries should be to allow physiological changes during surgery with minimal effects on the vitals and rapid recovery from anesthesia with minimal residual effects. Since opioid-based anesthesia is associated with opioid abuse and side effects peri- and postoperatively, we conducted this study to compare the effects of opioid-free anesthesia using dexmedetomidine and ketamine with opioid-based anesthesia using fentanyl in patients undergoing elective laparoscopic surgeries.

Materials and Methods:
A randomized prospective double-blinded study was undertaken on 70 adult patients undergoing elective laparoscopic surgeries. The patients were equally and randomly divided into two groups: patients in Group A were administered IV dexmedetomidine 1 μg/kg body weight and ketamine 25 mg and those in Group B were administered IV fentanyl 2 μg/kg body weight. Comparisons of parameters representing hemodynamic stability were done between the two groups, along with the depth of sedation and adverse effects, if any.

Results:
There was significantly less increase in heart rate in the dexmedetomidine group than that in the fentanyl group after intubation in intraoperative period as well as after extubation. There was an abrupt decrease in the respiratory rate (RR) at 60th min in the patients administered fentanyl, and the difference in the fall was statistically significant compared to in those administered dexmedetomidine. In the dexmedetomidine group, there was a good stability of RR with the baseline values at all time intervals. There was a decrease in the mean arterial pressure values in both the groups, the difference being statistically insignificant. The depth of sedation was better in the patients administered dexmedetomidine according to the Ramsay Sedation Score as compared to in those administered fentanyl. The incidence of adverse effects was also lesser in the patients administered dexmedetomidine than in those administered fentanyl.

Conclusion:
This study concluded that opioid-free anesthesia using dexmedetomidine is better than opioid-based anesthesia using fentanyl for patients undergoing elective laparoscopic surgeries due to better perioperative hemodynamic stability, deeper sedation, and lesser adverse effects postoperatively.
Microdissection testicular sperm extraction for men with nonobstructive azoospermia who have a testicular tumor in situ at the time of sperm retrieval
Authors: Lin Hao-Cheng , Tang Wen-Hao , Chen Yan , Fang Yang-Yi , Hong Kai 
Published: February 2025

Abstract
Oncological microdissection testicular sperm extraction (onco-micro-TESE) represents a significant breakthrough for patients with nonobstructive azoospermia (NOA) and a concomitant in situ testicular tumor, to be managed at the time of sperm retrieval. Onco-micro-TESE addresses the dual objectives of treating both infertility and the testicular tumor simultaneously. The technique is intricate, necessitating a comprehensive understanding of testicular anatomy, physiology, tumor biology, and advanced microsurgical methods. It aims to carefully extract viable spermatozoa while minimizing the risk of tumor dissemination. This review encapsulates the procedural intricacies, evaluates success determinants, including tumor pathology and spermatogenic tissue health, and discusses the implementation of imaging techniques for enhanced surgical precision. Ethical considerations are paramount, as the procedure implicates complex decision-making that weighs the potential oncological risks against the profound desire for fatherhood using the male gametes. The review aims to provide a holistic overview of onco-micro-TESE, detailing methodological advances, clinical outcomes, and the ethical landscape, thus offering an indispensable resource for clinicians navigating this multifaceted clinical scenario.
Clinical Outcomes Following Arthroscopic Labral Repair in the Hip: A Case Series with Minimum 5-year Follow-up
Authors: Huang Yen-Chun , Chen Kun-Hui , Huang Tong-Fu , Ma Hsiao-Li , Chiang En-Rung 
Published: February 2025

Background:
Arthroscopic hip labral repair is a growing field with increased evidence to prove its practicality and clinical benefits. However, most existing literature on outcomes in Taiwanese patients contains relatively short-term follow-up.

Objectives:
To evaluate the clinical and functional outcomes at a minimum 5-year follow-up in patients undergoing arthroscopic treatment of labral tears.

Materials and Methods:
We conducted a retrospective analysis of 18 patients receiving primary hip arthroscopic labral repair at a single academic institution from June 2017 to June 2018. Patients with preoperative Tonnis osteoarthritis Grade 2, previous hip diseases, severe dysplasia, or previous ipsilateral hip surgery were excluded. Demographic profile and patient-reported outcomes (PROs) including modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), and Visual Analog Scale (VAS) were collected.

Results:
A total of 18 patients (20 hips) were included in our study with all patients being available at a minimum 5-year follow-up. The mean age was 42.8-year-old and 16.6% (3/15) patients were male. All PRO scores significantly improved from preoperative values with a mean follow-up of 63 ± 5 months (range, 61–76 months). The mean mHHS increased from 48.0 ± 24.4 to 79.1 ± 13.1, and the mean NAHS from 46.7 ± 16.1 to 64.1 ± 9.6. The mean VAS score decreased from 6.8 ± 2.5 to 2.5 ± 2.5. The mean patient satisfaction score was 8.7 ± 1.7. At 5-year follow-up, survivorship rates were 95% with one patient receiving total hip arthroplasty.

Conclusions:
Our study showed that arthroscopic labral repair continued to be a valid technique at a minimum 5-year follow-up based on 2 PROs, the VAS, and patient satisfaction. The PROs significantly improved postoperatively and were maintained during follow-up. However, the long-term survivorship of hip arthroscopic surgery has yet to be determined.
Prevalence of Musculoskeletal Manifestations and its Associated Factors in Patients with Type 2 Diabetes Mellitus in Ernakulam District: A Cross-Sectional Study
Authors: George Kelita , George Sobha , Bhavani Nisha , Bhaskaran Renjitha 
Published: February 2025

Abstract

Introduction:
India is referred to as the “Diabetes Capital of the World” with a weighted prevalence of diabetes of 11.4%. In addition to microvascular and macrovascular complications, musculoskeletal manifestations of diabetes mellitus (MMDMs) also cause significant pain, morbidity, and a decrease in quality of life. Previous studies in our country were from tertiary healthcare centres, and the actual community-based prevalence of MMDMs is unknown. The study aims to determine the prevalence of MMDMs and the factors associated with them in the Ernakulam district of Kerala.

Methods:
A community-based cross-sectional study was done in 600 adults with diabetes in the Ernakulam district of Kerala. Cluster sampling was adopted. Through the probability proportional to sample size method, 20 clusters were identified with each having 30 participants. The study participants were clinically examined for various MMDMs.

Results:
The prevalence of MMDMs was found to be 44.83%. Osteoarthritis knee emerged as the most prevalent MMDM involving 22% of the participants, followed by frozen shoulder, in 12.2%. Diabetic cheiroarthropathy, trigger finger, and carpal tunnel syndrome were noted in 6.7%, 4.7%, and 3.8% of participants, respectively. Multivariable analysis showed a significant association between MMDMs and increased BMI, higher socioeconomic status, longer duration of diabetes, and unsatisfactory physical activity.

Conclusion:
This study highlights the need for regular musculoskeletal system assessment in patients with diabetes which needs to be made mandatory in clinical practice and also conducting screening for the same in the community level to prevent further complications and to improve quality of life.
Prospective Validation of Accuracy of American College of Radiologists- Thyroid Imaging Reporting and Data System (ACR-TIRADS) in Diagnosing Malignancy in Thyroid Nodule and a Prediction Score (TiPS) for Thyroid Malignancy
Authors: Sarayu Soumya , Nair Abilash , Khader Jabbar P. , Rema Sree P. P. , Meerasainaba Sulfekar , Kumar Sarath , Gomez Ramesh , Chellamma Jayakumari 
Published: February 2025

Abstract

Introduction:
Studies on diagnostic accuracy of revised ACR-TIRADS have been mostly retrospective and includes selection bias for surgery.

Methods:
Consecutive subjects >12 years of age, with palpable or ultrasound-revealed thyroid nodule, were included in the study. Nodules of size >1 cm or TIRADS score 4 or 5 >5 mm underwent ultrasound-guided FNAC. All Bethesda 4, 5 and 6 nodules underwent thyroidectomy. Patients with Bethesda 3 nodules were given options of close follow up or surgery.

Results:
There were 253 benign (Bethesda 2), 23 malignant (Bethesda 6) and 41 indeterminate (Bethesda 3,4,5) nodules. Among 41 indeterminate nodules, 19 underwent surgery of which 14 were malignant. 295 nodules had a definitive outcome (defined as final outcome variable); which could be a benign cytology report or a histopathology report. Proportion of thyroid cancer was 12.5%. ACR-TIRADS had a sensitivity of 100% and specificity of 60.5%, considering final outcome variable as gold standard and ACR-TIRADS 1-3 as test negative and score 4-5 positive. Lower age and higher serum TSH level were associated with malignancy (P < 0.05). Predictive scoring system was formulated with age, TSH, ACR-TIRADS and Bethesda. Cumulative score of 6 (IQR 4.5- 6.5) or above had a sensitivity and specificity of 96.2%, and 97.5% respectively and negative predictive value of 99.5%.

Conclusion:
Owing to high sensitivity, ACR-TIRADS can be considered as a good tool to rule-out malignancy, but not to predict the same due to lower specificity. Cumulative scoring system had high diagnostic accuracy for prediction of malignancy risk and can be a useful tool for selecting nodules for surgery.
Primary Hyperparathyroidism: Clinical, Biochemical, and Radio-Pathological Profiles of 804 Patients – A Retrospective Study from South India
Authors: Sadacharan Dhalapathy , Mathews Mano Z. , Sathya Anjali , Gopal Shanmugasundar , Chandrasekaran Sruti , Murthy Sivasubramaniam , Reddy Vijaya B. , Gopal Jayashree , Jeyapaul Muthukumaran , Sivasubramanian Sakthivel , Gopalakrishnan Vignesh , Ramji Bharath , Goli Dinesh , Sundararaman Gokulakrishnan , Mahadevan Shriraam 
Published: February 2025

Abstract

Introduction:
Primary hyperparathyroidism (PHPT) is a common endocrine disorder with variable clinical presentation. We intend to describe the clinical, biochemical, and radio-pathological profiles of PHPT patients managed over 13 years from South India.

Methods:
We analysed all patients who underwent evaluation and surgery for PHPT from July 2011 to April 2024.

Results:
A total of 862 PHPT patients underwent parathyroidectomy, with female preponderance (61.2%). Analysis was done on 804 patients (>20 years of age) excluding adolescent and paediatric age groups. The mean age was 43.8 years. The presentation in decreasing order of frequency was weakness and fatigue (84.2%); bone pain (35%); renal disease (20.8%) in the form of nephrolithiasis, nephrocalcinosis, or renal dysfunction; and neuropsychiatric manifestations (23.8%). Pathological fractures were observed in 4.5%, hypercalcaemic crisis in 2.6% of patients, and 1% had MEN I (Multiple Endocrine Neoplasia) syndrome. The mean albumin adjusted serum calcium level was 12.3 ± 1.01 mg/dl, and the median serum PTH level was 338 (80–3864) pg/ml. The sensitivity of the ultrasound neck and 99mTc Sestamibi scan was 97.5% and 98.3%, respectively, with a concordance of 93.4%. 25% underwent bilateral neck exploration and parathyroidectomy. Lesions were ectopic in 20 (2.4%) patients. The mean parathyroid gland weight was 1.45 ± 0.75 g. Histopathology revealed parathyroid adenoma (93.5%), parathyroid hyperplasia (1.6%), and parathyroid carcinoma (2.2%). The cure rate was 99.3%, while three patients had persistent disease. Hungry bone syndrome was observed in 12.1%.

Conclusion:
There is a changing trend in the clinical and biochemical profiles of PHPT patients in India to a milder form of the disease. The incidence of parathyroid carcinoma was slightly higher compared to a few other centres in India.
COVID-19 deaths at home in south of Iran: A cross-sectional study
Authors: Mirahmadizadeh Alireza , Janfada Maryam , Heiran Alireza , Askarinejad Amir , Moradian Mohammad Javad , Javadi Afshan , Kasraian Leila , Hamedi Andishe 
Published: February 2025

Objective:
To determine the causes of COVID-19 deaths at home.

Methods:
This descriptive cross-sectional study was conducted on confirmed COVID-19 deaths, which were confirmed to occur at home using the “Electronic Death Registration System (EDRS)” database, from February 20, 2020, to September 23, 2021, in the Fars province, south of Iran. A semi-structured, face-to-face survey consisting of 29 items was filled by the family caregivers, and the information was confirmed based on medical records.

Results:
One hundred and ninety-three deaths were included, with 60.1% male and 39.9% female. More than 75% of cases had at least one comorbid condition. Death was unexpected for 65.8% of the families and 45.1% of the deceased cases had been medically managed at home during the disease. According to the family caregivers’ opinion, the most frequent causes of death at home in their COVID-19 patients were early discharge/release from the hospital (28.5%), physician's reassurance to continue home quarantine/supportive care (14.5%), hopeless/oldest-old patient (11.9%), and family/relative recommendation to not to hospitalize their patient due to fears, myths, etc. (8.8%).

Conclusions:
In family caregivers’ belief, deaths at home might be related to healthcare system preparedness, physicians’ knowledge, and public education and empowerment.
Colposcopic Impression and Histological Outcomes: Can Looks Be Deceiving?
Authors: McKeown Ciaran David , Cheung Maria , Kumar Parijot , McCarthy Claire 
Published: February 2025

Introduction:
A colposcopic impression (CI) is formed based on the highest grade feature of any cervical lesion during a standard colposcopic assessment.

Methods:
A retrospective review of all cervical biopsies undertaken in 7-day period in an Irish tertiary level colposcopy department. The study received ethical approval in October 2023 by the hospital’s research advisory group (ref: 23609).

Results:
In total, 47 patients were recruited. The mean age of patients in this cohort was 39 years of age (range 25–64, standard deviation 11.3). Of these, 14 (29.8%) had previously attended for colposcopic assessment and been discharged. The most common referral smear was atypical squamous cells of undetermined significance (n = 23; 49%). All patients referred with abnormal cytology were also positive for human papillomavirus. The majority of assessments and biopsies were undertaken by qualified nurse colposcopists (n = 24; 51.1%). A total of 6 (12.8%) patients had CI of high-grade disease, with 4 (66.6%) confirmed histologically. A CI of low-grade disease was given for 35 (74.5%) patients. Of these, 25 (71.4%) had confirmed cervical intraepithelial neoplasia (CIN1) on biopsy. In 8 (22.9%) cases when low-grade disease was suspected, histology of CIN2 or higher was returned.

Conclusion:
The positive predictive value for suspected high-grade lesions (66.6%) within the time frame studied was lower than the target of 75%. The PPV for suspected low-grade lesions was higher (71.4%), although underestimation of grade was noted in 22.9% of cases. The implementation of a formal scoring system may help improve the sensitivity and specificity in identifying high-grade diseases in this unit.
The impact of academic skills training on academic self-efficacy and motivation in nursing and midwifery students: A quasi-experimental study
Authors: Kordsalarzehi Fatemeh , Salehipour Sajad , Hamedani Mahsa Asadollahi , Jahromi Rokhsare Zarei , Arbabisarjou Azizollah , Ghaljeh Mahnaz 
Published: February 2025

BACKGROUND:
Improving academic performance and achievement in students depends on many factors. Two important factors to achieve the above goals are creating academic self-efficacy and motivation in students. This study was conducted to determine the impact of academic skills training on academic self-efficacy and motivation in nursing and midwifery students at Zahedan University of Medical Sciences.

MATERIALS AND METHODS:
This quasi-experimental study was performed on 120 nursing and midwifery students in 2022. Students were selected through convenience sampling and then randomized into the intervention (N = 60) and control (N = 60) groups. Data collection tools included a demographic form and a self-efficacy and motivation academic scale. For students in the intervention group, first completed the demographic form and the self-efficacy and motivation academic scale. Then, they attended eight 90-minute sessions of academic skills training held two sessions weekly for 4 weeks online. Again, students completed scales at baseline as well as 4 weeks after the sessions were finished. For students in the control group, however, did not receive any intervention. Data were analyzed in Statistical Package for the Social Sciences (SPSS) software.

RESULTS:
The mean scores in academic self-efficacy and motivation showed no significant difference between the intervention and control groups before the intervention (P > 0.05). While 4 weeks after the implementation of academic skills training, the two groups were significantly different between the mean self-efficacy and motivation (P < 0.001).

CONCLUSION:
To have motivated and successful students in the field of education, it is necessary for decision-makers to increase self-efficacy and motivation in students through appropriate planning in the field of holding meetings to teach academic skills and provide the basis for students’ academic achievement.
Investigating the relationship between anthropometric indicators of the mother during pregnancy with the weight, height, and head circumference of the infant at birth: A mother-infant cohort study
Authors: Asadi Leila , Mohebbi-Dehnavi Zahra , Tabatabaei Razieh Sadat , Dadbinpour Ali , Vakili Ghasem Abad Mahmood 
Published: February 2025

BACKGROUND:
The growth and development of the fetus inside the womb depends on several factors, including the weight gain of the mother during pregnancy. The aim of the current research is to determine the relationship between anthropometric indicators of the mother during pregnancy and the weight, height, and head circumference of the infant at birth.

MATERIALS AND METHODS:
The present study is a Historical cohort study that was conducted on 1623 pregnant mothers from the beginning of pregnancy to delivery by census method in 4 reference and specialized gynecology and obstetrics hospitals affiliated to Shahid Sadougi University of Medical Sciences in Yazd from 2016 to 2021. The tools used were the questionnaires approved by the Ministry of Health and the Research Council of the University to conduct the mother-infant cohort. Data analysis was performed with SPSS Software Version 22 with analytical statistical tests.

RESULTS:
The baby’s weight had a significant negative relationship with the mother’s weight and the mother’s body mass index at the beginning of pregnancy. The baby’s height had a significant positive difference with the body mass index at the beginning of pregnancy. The baby’s head circumference had a positive and significant relationship with the mother’s weight in the third trimester of pregnancy.

CONCLUSION:
According to the results of the study and the importance of the health of the mother during pregnancy due to the effect on the health of the fetus, it is recommended to monitor the weight of mothers more sensitively from before pregnancy to the end of pregnancy.