bluuebunny/crossref_metadata_2025_split huggingface dataset:
Categorizing Care Delays and Their Impact on Hospital Length of Stay
Authors: Nadler Adam D. , Eid Shaker M. , Kisuule Flora , Michtalik Henry J. , Kantsiper Melinda E. , Harris Che M. , Gundareddy Venkat P. 
Published: November 2024

Background and Objective:
Unnecessary care delays of hospitalized patients increase the risk of hospital-related complications and drive up health care costs. While health systems focus on reducing the length of stay of hospitalized patients, not many studies looked at specific causes of the care delays that prolong length of stay. In this study, we sought to systematically identify and categorize the various care delays that contribute to prolonged length of stay on a hospital medicine service.

Methods:
We conducted a retrospective observational study looking at all inpatient encounters to the hospitalist service (N = 6633) for the fiscal year 2021. Observation status, COVID-19 positive, and other services’ discharged patients were excluded (N = 2849) leaving 3784 eligible encounters. The resulting 5% stratified random sample accounted for 190 encounters accounting for a total of 1152 patient-days. Using a standardized data extraction tool, a day-by-day review of the sample encounters was performed for all care delays. These care delays were categorized into specific groups (System, Discharge, Provider, Patient/Family, or Consultant related) and subgroups based on predetermined criteria.

Results:
The stratified sample was found to be comparable to the total patient population, with no statistically significant differences in key demographic and clinical metrics. About 30% of all patient-days had a care delay; 33% of these delays were attributable to system delays internal to the hospital such as waiting for imaging/procedures; 28% of delays were due to discharge barriers, driven overwhelmingly by a lack of available post-acute care beds, and about 20% of delays were attributable to the provider.

Conclusion:
Our study systematically looked at care delays that led to prolonged hospital length of stay. Most of these care delays were caused by either wait times for procedures and imaging studies or by a lack of post-acute care bed availability. Hospitals and health systems can use this approach to better determine which systemic changes are likely to be the most effective at reducing length of stay.
First-in-Human
Authors: Loft Mathias , Clemmensen Andreas , Christensen Emil Nørgaard , Denholt Charlotte Lund , Johannesen Helle Hjorth , Gillings Nic , Carlsen Esben Andreas , Clausen Malene Martini , Hutchings Martin , Andersen Thomas Lund , Ardenkjær-Larsen Jan Henrik , Kjaer Andreas 
Published: November 2024

Abstract
Hyperpolarized 1-13C-pyruvate magnetic resonance spectroscopy (MRS) and MRS imaging (MRSI) offer noninvasive and real-time direct assessment of the altered metabolism of cancer cells known as the Warburg effect—a key hallmark of cancer. When combined with simultaneously acquired 18F-FDG PET in a PET/MR scanner, coined hyperPET by us, this dual-modality may unveil cancer-type specific glucose metabolic phenotypes with potential implications for patient prognostication, treatment-response assessment, and prediction. We here present the first human data of simultaneously acquired hyperpolarized MRS/MRSI and PET performed in a PET/MR scanner—and the first human hyperpolarized MRS/MRSI data from a patient with lymphoma.
Biochemical recurrence after open radical prostatectomy in a single-center cohort with a minimum follow-up of 10 years
Authors: Stankovic Mladen , Mendes Joao , Wolff Laura , Wieder Teresa 
Published: November 2024

Purpose:
To investigate the long-term oncological outcomes and report biochemical recurrence (BCR)-free survival for men who underwent open radical prostatectomy at a single center.

Materials and methods:
A total of 360 patients who underwent open radical prostatectomy at our institution between 2003 and 2011 were included in this study. The BCR-free survival rates were calculated by Kaplan-Meier method and log-rank analysis. Multivariable Cox regression models were used to test the effect of other factors such as age, preoperative prostate-specific antigen (PSA), Gleason score, and surgical margins on BCR.

Results:
Median patient age was 65.4 years, with a median preoperative PSA level of 6.21 ng/ml. Operating time had a median duration of 155.1 minutes, ranging from 104 to 301 minutes. Nerve-sparing surgery was achievable in 48.1% of patients, including 34.2% undergoing bilateral procedures and 13.9% unilateral. In terms of surgical precision and outcomes, the overall rate of positive surgical margins was 23.6%, which decreased significantly to 11.1% in patients with localized prostate cancer. Lymph node involvement occurred in 3.6% of cases. Postoperative care statistics revealed a median catheterization duration of 9.1 days (range: 4–30 days) and a low rate of significant complications (4.4%). The early continence rate in a standardized pad test was 80.6%. At a median follow-up of 150.5 months, the 5-year and 10-year BCR-free survival rates for the entire cohort were 91.4% and 77.5%, respectively. The 10-year BCR-free survival rates were 84.8%, 81.5%, and 68.5% for low-, intermediate-, and high-risk patients, respectively. Furthermore, the 10-year BCR-free survival rates were 78.8% and 62.8% for localized and locally advanced prostate cancer, respectively. Preoperative PSA >20 ng/ml, postoperative Gleason sum ≥3 + 4, and positive surgical margins were associated with increased risk of BCR on multivariable Cox regression analysis.

Conclusion:
Our long-term oncological results match or exceed those previously published in similar contemporary cohorts with long follow-up.
Self-Rated ECT Outcomes in Patients With Depression
Authors: Berger Shane R. , Kung Simon , Lapid Maria I. 
Published: November 2024

Objectives
Electroconvulsive therapy (ECT) is considered to be the most effective treatment for severe depression. This study investigated recent ECT outcomes for depression at a large tertiary center, which also provides community care.

Methods
Data were obtained from Mayo Clinic Rochester patients ages 18 and older who received an acute course of ECT between August 1, 2017 and April 30, 2024. Patients were included if there was a depressive disorder diagnosis (unipolar or bipolar) and a self-rated Patient Health Questionnaire-9 (PHQ-9) within 10 days of the start and end of the acute course. Patients were excluded if the starting PHQ-9 score was less than 10. The age, sex, number of acute course treatments, stimulus electrode lead placement, and PHQ-9 scores were collected. Response (PHQ-9 improvement ≥50%) and remission (PHQ-9 < 5) rates were calculated. Linear and logistic regressions were performed to investigate predictors of response and remission.

Results
Of 1206 patients identified, 408 met final inclusion and exclusion criteria. The response rate was 80.4%, and remission rate was 52.7%. Logistic regression for response showed no significant predictors; the P value for age just missed statistical significance (odds ratio, 1.0152; 95% confidence interval, 0.9991–1.0316; P = 0.0641). Logistic regression for remission showed only a lower baseline PHQ-9 score (odds ratio, 0.9465; 95% confidence interval, 0.9049–0.9891; P = 0.0152) as a significant predictor.

Conclusions
Our results affirmed the high efficacy of ECT in severe depression. No other established treatment for depression can report a response rate as high as 80% in a naturalistic study. This study supports the continued relevance and place of ECT for severe depression.
Leveraging the corporate university model to develop and deliver customized course content
Authors: Goldstein James C. 
Published: November 2024

Purpose
These experiences can provide two significant findings for researchers and other organizations seeking to develop similar training programs.

Design/methodology/approach
This paper documents how a financial institution developed a customized bank accounting course for its employees through the well-researched and frequently used “Corporate University Model.” It did so through leveraging the educational expertise of a local university professor, and the subject matter expertise of bank managers. The organization followed up on this success by developing a customized risk management course. As before, the bank utilized the Corporate University Model. However, the content was more specialized than that of the previous course since it related to the unique operations of the organization. Therefore, the bank found it necessary to make some adjustments to its development and delivery approach.

Findings
First, even though corporate universities are often depicted as complex separate entities within companies, the Corporate University Model can be successfully utilized to develop and deliver individual courses that are managed by individual departments. Second, the bank’s risk management course demonstrated how a professional instructor could be used in conjunction with a company’s subject matter experts to effectively deliver course content. This approach is very effective with course content that is unique to the organization’s specific operations.

Research limitations/implications
While literature indicates that corporate universities often involve the creation of a separate entity, which can be difficult to configure due to their complexity (Lui Abel and Li, 2012), the leveraging of the CU model to construct and deliver single courses has not been explored. Additionally, the existing models do not discuss how roles outlined in the CU model (Patrucco et al., 2017) may change due to content complexity. From a limitation standpoint, it would be helpful to apply this approach to additional courses and organizations. Additionally, data could be collected to evaluate course effectiveness by learning goal.

Practical implications
This case study shows that the CU model has value for individual courses that continue to reside and be managed in the departments that developed them. Additionally, it shows that even though a professional instructor may not have all requisite knowledge in more specific knowledge domains, this can be solved by involving SMEs in content delivery. This still allows the benefit of a professional instructor who is skilled in course delivery and development.

Originality/value
These findings provide insights that have not been described in other papers that detail the application of the Corporate University Model. This helps to expand the manner in which companies can attain its benefits.
Climate change and lethal violence: a global analysis
Authors: Amin Saqib 
Published: November 2024

Purpose
The study aims to uncover the relationship between rising temperatures, increased greenhouse gas emissions and the prevalence of lethal violence, encompassing suicides and homicides. It also sought to identify how climate change affects different economic strata in countries, notably in high and middle-income nations, and across Asia and Africa.

Design/methodology/approach
This study rigorously explored the link between global climate change and lethal violence across 201 countries from 1970 to 2020. Climate change was measured using annual surface temperature fluctuations and greenhouse gas emissions, while lethal violence was estimated using data on suicides and homicides.

Findings
The analysis revealed significant positive associations between escalating temperatures, heightened greenhouse gas emissions and lethal violence. These connections were evident across different economic levels and geographic regions in Asia and Africa.

Originality/value
This study emphasizes the urgent need for comprehensive interventions to combat human-induced climate change and mitigate its extensive negative impacts on society, particularly its association with increased violent behavior.
What innovation and technology delivers to internationalization? The case of European and Central Asia regions
Authors: Pereira José , Correia Aldina , Braga Alexandra , Alves Wellington , Ratten Vanessa , Braga Vitor 
Published: November 2024

Purpose
This study aims to analyze the impact of technology and innovation on businesses’ internationalization process as well as the relationship between innovation and technology and internationalization.

Design/methodology/approach
The study was based on quantitative analysis of secondary data from 30 economies in Europe and Central Asia, extracted from the Enterprise Surveys – The World Bank database, using the multivariate statistical techniques of multiple linear regression and cluster analysis.

Findings
The results suggest that innovation and technology (I&T) mutually and positively influence the internationalization of firms. In this sense, innovative firms are more successful in competing internationally and exposure to alternative business contexts culminates in innovation. The results suggest a positive relationship between the percentage of firms that introduced a process innovation, the percentage of firms with websites and the businesses’ internationalization.

Originality/value
The originality of this research is based on the methodological approach that allowed the identification of the most significant variables for stimulating the internationalization of firms based on innovation and technology. Given the predominance of economies with higher I&T and internationalization in Europe, it is proposed as future research projects to ascertain the reasons for such a phenomenon.
The impact of eco-innovation on companies’ financial performance: an analysis of key contributions and trends in the literature
Authors: Lopes José Luís , Basso Leonardo Fernando Cruz 
Published: November 2024

Purpose
This study aims to present a bibliometric analysis combined with a systematic review of the empirical literature to verify whether the relationship between the impact of eco-innovation and the financial performance of companies is corroborated.

Design/methodology/approach
This study uses bibliometric analysis and systematic review methods on 122 articles from Web of Science, Scopus and Science Direct, combining quantitative frequency and co-citation analysis with a qualitative exploration of themes in eco-innovation research.

Findings
In their research on eco-innovation, the authors found that there is a need to better understand the impact of eco-innovation on companies’ financial performance in the knowledge gaps.

Research limitations/implications
Research on eco-innovation identifies knowledge gaps and directions for future studies exploring environmental strategies to boost corporate commitment to sustainability.

Originality/value
This study finds that eco-innovation is decisive for enhancing operational performance and understanding its effect on companies’ financial outcomes, offering perspectives on how environmental practices influence organizational finance.
Rainfall is associated with divorce in the socially monogamous Seychelles warbler
Authors: Bentlage A. A. , Speelman F. J. D. , Komdeur J. , Burke T. , Richardson D. S. , Dugdale H. L. 
Published: November 2024

Abstract

Divorce—terminating a pair bond whilst both members are alive—is a mating strategy observed in many socially monogamous species often linked to poor reproductive success. As environmental factors directly affect individual condition and reproductive performance, they can indirectly influence divorce. Given current climate change, understanding how environmental fluctuations affect partnership stability has important implications, including for conservation. Yet, the relationship between the environment and divorce remains largely unstudied.

We examined the influence of temporal environmental variability on the prevalence of within‐ and between‐season divorce and the possible underlying mechanisms in a socially monogamous passerine.

Analysing 16 years of data from a longitudinal dataset, we investigated the relationship between rainfall and divorce in the Seychelles warbler (Acrocephalus sechellensis). First, we performed climate window analyses to identify the temporal windows of rainfall that best predict reproductive success and divorce. Then, we tested the effects of these temporal windows of rainfall on reproductive success and divorce and the influence of reproductive success on divorce whilst controlling for covariates.

Annual divorce rates varied from 1% to 16%. The probability of divorce was significantly associated with the quadratic effect of 7 months of total rainfall before and during the breeding season, with divorce increasing in years with low and high rainfall. This quadratic relationship was driven by a heavy rainfall event in 1997, as excluding 1997 from our analyses left a significant negative linear relationship between rainfall and divorce. Although the same temporal window of rainfall predicting divorce significantly influenced reproductive success, we found no significant correlation between reproductive success and divorce.

Our findings suggest that rainfall impacts divorce. Given that this effect is likely not directly mediated by reproductive success, we discuss other possible drivers. Although the 1997 super El Niño event shows how heavy rainfall may affect socially monogamous partnerships, more data are required to estimate the robustness of this effect. By adding to the growing body of literature showing that environmental conditions influence the stability of socially monogamous partnerships, we provide novel insights that may also be important for conservation efforts in times of climate change.
Enforcing export controls learning from and using the financial system
Authors: Hilgenstock Benjamin , Ribakova Elina , Vlasyuk Anna , Wolff Guntram 
Published: November 2024

AbstractRussian imports of battlefield goods subject to export controls have surged since mid‐2022 and reached levels close to those prior to Russia's full‐scale invasion of Ukraine. Russia thus continues to be able to acquire foreign components critical for its military industry. These imports largely occur via mainland China, Hong Kong, Turkey and the United Arab Emirates, while other countries including Armenia, Georgia, Kazakhstan and the Kyrgyz Republic have also seen massive increases in tech imports that likely end up in Russia. The enforcement of export controls faces multifaceted challenges centred around complex supply chains, lack of transparency and opaque financial structures, issues familiar from anti‐money laundering (AML) and countering financing of terrorism (CFT) frameworks. We propose using a similar framework in export control enforcement: First, financial institutions need to play a role in monitoring trade in export‐controlled goods and blocking illicit transactions. Second, non‐financial companies could learn from banks' efforts in the AML/CFT sphere to implement proper due‐diligence procedures and to ensure export controls compliance. Public‐sector investigations and appropriate fines are critical to increase the incentives for firms to act. Technology sanctions will remain part of the economic statecraft toolbox. The Russia case will test their effectiveness and credibility.
Screening accuracy and developmental language disorder remain stable between 2.5 and 3 years
Authors: Nayeb Laleh , Lagerberg Dagmar , Sarkadi Anna , Salameh Eva‐Kristina , Eriksson Mårten 
Published: November 2024

AbstractAimThis study re‐evaluated the classification accuracy of language screening. This is because the new Swedish child health programme moved this screening from 3 to 2.5 years of age. Another aim was to investigate the stability of diagnoses between these two time points.MethodsChildren were recruited consecutively during 2016–2017 from three Child Health Services in Gävle, Sweden. Forty‐eight monolingual children (31 boys) and 93 bilingual children (38 boys) underwent language screening and a clinical examination by a speech and language pathologist at 2.5 years of age. They were re‐examined after 6 months (at 36–38 months) for clinical diagnosis.ResultsOf the 48 monolingual children, 45 retained their status at both 2.5 and 3 years of age, while three no longer met the criteria for development language disorder. Among the 93 bilingual children, 87 retained their 2.5‐year status at age 3, two no longer met the criteria, and four new cases were diagnosed. These differences were not statistically significant. All changes in screening parameters between 2.5 and 3 years were within the 95% Confidence Interval, indicating stable classification.ConclusionScreening accuracy and language status were robust between 2.5 and 3 years, providing no support for a wait‐and‐see approach.
Real‐world use of androgen‐deprivation therapy intensification for metastatic hormone‐sensitive prostate cancer: a systematic review
Authors: Raval Amit D. , Chen Stephanie , Littleton Natasha , Constantinovici Niculae , Goebell Peter J. 
Published: November 2024

ObjectiveTo conduct a systematic literature review of real‐world data (RWD) studies to summarise treatment patterns among men with metastatic hormone‐sensitive prostate cancer (mHSPC). While androgen‐deprivation therapy (ADT) is a primary treatment strategy for mHSPC, ADT intensification with androgen receptor pathway inhibitors (ARPIs) and/or chemotherapy is recommended by current guidelines and has improved clinical outcomes in the last decade.MethodsWe searched electronic databases (PubMed; Excerpta Medica dataBASE [EMBASE]) for eligible studies (retrospective or prospective observational RWD studies examining mHSPC treatment patterns) between database inception and July 2023, and manually screened the past 2 years of relevant conference proceedings.ResultsOf 2336 retrieved citations, 29 studies met the inclusion criteria, covering North America (United States, n = 21; Canada, n = 2), Europe (n = 8), and Asia (n = 6). Most studies utilised retrospective cohorts (n = 26) and included men with a median age of ≥70 years (n = 20). ADT monotherapy was predominantly used across geographies, followed by ADT + ARPI and ADT + docetaxel in the United States and Europe but not in Asia, where use of each combination remained low. Studies with recent electronic medical record data from cancer centres/registries showed >40% use of ADT + ARPI in the United States and Europe. Abiraterone was the most frequently used ARPI, followed by enzalutamide. Quantitative factors associated with ADT intensification were high disease burden, younger age, Eastern Cooperative Oncology Group performance status score of 0 to 1, fewer comorbidities, and oncologist physician specialty; qualitative factors were patient preference, unsatisfactory response to ADT, ability to tolerate adverse events, and absence of cost barriers.ConclusionWhile there was an increasing trend in ADT intensification for mHSPC over the study period across geographies, use remained suboptimal considering the high proportion of patients who were still receiving ADT monotherapy only. These findings highlight the need for interventions to further optimise current mHSPC therapies with high guideline concordance.