bluuebunny/crossref_metadata_2025_split huggingface dataset:
Unraveling the Roots of Fiscal Crises in Contemporary Capitalist Nations and Strategies for Overcoming Them
Authors: Li Bin 
Published: July 2024

Since the 1980s, fiscal crises have notably impacted capitalist nations, a situation that intensified during the COVID-19 pandemic. Although theories of capital accumulation and economic crises often serve to explain these events, this study advocates for a broader perspective by viewing fiscal crises as a primary manifestation of the contradiction between socialized production and capitalist private ownership. This study examines the evolution of this contradiction through various stages of capitalism and highlights the potential pitfalls of common strategies adopted by capitalist nations, such as neoliberal policies that cut social welfare and public spending. The study then shifts its focus to China, exploring its unique dual fiscal system, which supports China’s rapid economic growth, offering a novel perspective on addressing the global fiscal crisis. JEL Classification: P16, F63, E62
Obesity and the Development of Arthritis Among Adults in the United States Using NHANES Data
Authors: Baah Emmanuel , Kohlmeier Martin 
Published: July 2024

Background: The alarming increase in the prevalence of obesity and arthritis in America in recent times is concerning both in terms of the deleterious health effects on the individuals and economic cost. The wear and tear on the musculoskeletal and the inflammatory effects of obesity may be the reasons for the rise in arthritis among individuals with obesity. Objective: To investigate the association between obesity and the development of arthritis among adults in the United States. Design: A total of 17 016 participants were included from the 2012 to 2018 National Health and Nutrition Examination Survey (NHANES). Most of the participants were aged 30 years and above (79.7%). The racial distribution included 64.0% Non-Hispanic whites, 15.3% Hispanics, 11.4% Non-Hispanics blacks, and 9.4% from all other races. Methods: Obesity was defined as a body mass index (BMI) > 30 kg/m², and the outcome variable of interest, arthritis status, was self-reported. Survey weighted logistic regression was performed to calculate the odds ratio (OR) and 95% confidence interval controlling for potential confounding factors. Result: Nearly 40% of all participants were individuals with obesity, and 27.5% reported having some form of arthritis. The risk of developing arthritis was higher in individuals with obesity (OR: 1.55, 95% CI: 1.35-1.80), women (OR: 1.94, 95%CI: 1.66-2.28), and individuals 30 years or older (OR: 10.81, 95% CI: 6.36-18.37) with non-Hispanic whites being the most affected race. The C-reactive protein (CRP) and white blood cell count (WBC) levels were higher in all individuals with obesity even though there was no statistical difference between individuals with obesity with and without arthritis. Conclusions: Obesity substantially heightens the risk of developing arthritis due to the mechanical stress on weight-bearing joints and subsequent chronic-low level inflammation contributing to disease progression.
Novel Intraoperative and Pathological Findings Related to Computed Tomography Angiography Spot Signs in Intracerebral Hemorrhage Patients: A Case Report
Authors: Zhang Qiang , Chen Zhi , Chen Yujie , Jiang Zhouyang , Li Wenyan , Li Yingpei , Yao Zhuo , Fu Wenchao , Fang Yanyu , Li Mo , Niu Yin 
Published: July 2024

Introduction: A spot sign on computed tomography angiography (CTA) scan is a widely recognized radiographic indicator of primary intracerebral hemorrhage (ICH) used to predict early hematoma expansion. Nonetheless, recent multicenter studies have indicated that its predictive value for hematoma expansion is not as significant as previously stated. Therefore, identifying the reasons for the poor performance of these studies is imperative. Case presentation: A 48-year-old man presented with a 9-hour history of alalia and right limb hemiplegia. Noncontrast computed tomography (CT) revealed a hematoma in the left frontal lobe, while CTA showed a spot sign within the hematoma, leading to a diagnosis of frontal lobe hemorrhage. During the surgical procedure, a blood clot was removed, revealing the presence of 3 mm of saccular tissue resembling an aneurysm. The process of exposing its complete form resulted in its rupture and bleeding. The location of this tissue at the top of the hematoma cavity corresponded to the CTA spot sign. Pathological examination confirmed that the characteristics of the tissue wall were consistent with those of a pseudoaneurysm. Conclusion: This case suggests that more stringent identification criteria should be established in studies predicting ICH expansion using the spot sign on CTA to differentiate and exclude pseudoaneurysms, thereby improving the accuracy of predicting early hematoma expansion using the CTA spot sign.
Assessing Fidelity in Yoga Interventions for Chemotherapy-Induced Peripheral Neuropathy: Decision-Making to Enhance Protocol Quality Adherence
Authors: Saint Kirin , Paul Tina , Patterson Clare , Yang Mingxiao , Bao Ting , Lou Galantino Mary 
Published: July 2024

Background: Yoga interventions need fidelity monitoring to standardize the trial process and ensure adherence. We examined fidelity measures of current yoga trials and developed a fidelity assurance process in a phase III randomized clinical trial addressing chemotherapy-induced peripheral neuropathy among cancer survivors. Methods: We qualitatively analyzed the fidelity monitoring components in published clinical trials on yoga therapy for chemotherapy-induced peripheral neuropathy through a literature search in PubMed from inception to February 2023. Leveraging fidelity measures for community-based, complex interventions and yoga therapy reporting guidelines, we developed an instructor/participant-oriented fidelity checking approach in an ongoing phase III trial evaluating yoga for improving chemotherapy-induced peripheral neuropathy in cancer survivors. Two researchers independently assessed 4 of 8 video recordings of yoga instructor-led training sessions (50%) and participant-kept home practice logs using a developed fidelity checklist. Results: None of the 4 eligible yoga trials specifically have intervention fidelity measures. We prospectively incorporated yoga instructor training, virtual delivery, and participant engagement strategies in the phase III trial protocol following guidelines. All trial yoga instructors were trained under study protocol to ensure compliance and participant engagement. There was high intervention fidelity in all instructor-led virtual sessions: an average of 100% adherence to class structure and three-thirds on specific skills. Assessment of participant adherence to the established home yoga protocol was 63%. Conclusion: Yoga trials for chemotherapy-induced peripheral neuropathy need adequate fidelity measures. Our study provides a feasible fidelity-monitoring approach to ensure trial intervention delivery and protocol adherence by instructors and participants in oncological settings.
Challenges in designing a randomized, double-blind noninferiority trial for treatment of acne: The SD-ACNE trial
Authors: Barbieri John S , Ellenberg Susan , Grice Elizabeth , Tierney Ann , VanderBeek Suzette Baez , Papadopoulos Maryte , Mason Jennifer , Mason Anabel , Dattilo James , Margolis David J 
Published: July 2024

Background/aims: Excessive use of antibiotics has led to development of antibiotic resistance and other antibiotic-associated complications. Dermatologists prescribe more antibiotics per clinician than any other major specialty, with much of this use for acne. Alternative acne treatments are available but are used much less often than antibiotics, at least partially because dermatologists feel that they are less effective. Spironolactone, a hormonal therapy with antiandrogen effects that can address the hormonal pathogenesis of acne, may represent a therapeutic alternative to oral antibiotics for women with acne. However, the comparative effects of spironolactone and oral antibiotics in the treatment of acne have not been definitively studied. The Spironolactone versus Doxycycline for Acne: A Comparative Effectiveness, Noninferiority Evaluation (SD-ACNE) trial aims to answer whether spironolactone, in addition to standard topical therapy, is noninferior to doxycycline (an oral antibiotic) for women with acne. Several interesting challenges arose in the development of this study, including determining acceptability of the comparative regimens to participating dermatologists, identifying data to support a noninferiority margin, and establishing a process for unblinding participants after they completed the study while maintaining the blind for study investigators. Methods: We present the scientific and clinical rationale for the decisions made in the design of the trial, including input from key stakeholders through a Delphi consensus process. Results: The Spironolactone versus Doxycycline for Acne: A Comparative Effectiveness, Noninferiority Evaluation trial (NCT04582383) is being conducted at a range of community and academic sites in the United States. To maximize external validity and inform clinical practice, the study is designed with broad eligibility criteria and no prohibition of use of topical medications. Participants in the trial will be randomized to receive either spironolactone 100 mg/day or doxycycline hyclate 100 mg/day for 16 weeks. The primary outcome is the absolute decrease in inflammatory lesion count, and we have established a noninferiority margin of four inflammatory lesions. Secondary outcomes include the percentage of participants achieving Investigator Global Assessment success, change in quality of life, and microbiome changes and diversity. Conclusions: The Spironolactone versus Doxycycline for Acne: A Comparative Effectiveness, Noninferiority Evaluation trial will have substantial implications for the treatment of acne and antibiotic stewardship. In addition, this study will provide important information on the effect of these systemic agents on the development of changes to the microbiome and antibiotic resistance in a healthy population of patients.
The perspectives of caregivers and health service providers on barriers to clubfoot management in Puri-Urban health facility in Ghana
Authors: Agoalikum Shariphine , Acheampong Enoch , Bredu-Darkwa Peter , Bonah Sandra 
Published: July 2024

Purpose: Clubfoot is a common disabling condition that is prevalent across all populations. Approximately, one out of 750 children globally suffers from clubfoot, and around 150,000 to 200,000 children are born with clubfoot every year with 80% of the cases occurring in developing countries. Clubfoot can result in mobility impairments when not properly managed and researchers have argued that understanding knowledge and perceptions are key components to early identification and effective management of clubfoot. The study explored the barriers to clubfoot management from the perspectives of caregivers and healthcare providers in Duayaw Nkwanta, Ghana. Methods: A total of 26 participants made up of 22 caregivers of children with clubfoot and six healthcare providers were purposively sampled for the study guided by a set of inclusion and exclusion criteria. Qualitative data were collected using a semi-structured interview guide through in-depth face-to-face interviews. Interviews were transcribed and analyzed thematically and presented as findings. Results: High cost of treatment, long travel distance, long hours spent at the treatment facility, non-availability of clubfoot treatment services, late reporting of clients for treatment, and non-compliance of parents/caregivers with treatment protocols were identified as the barriers to effective management of clubfoot. Conclusion: These findings have substantial implications for current interventions to effectively manage clubfoot in Ghana.
The Effect of First Metatarsal Shortening and Sagittal Displacement on Forefoot Pressure in Minimally Invasive Hallux Valgus Correction
Authors: Lopez Andres , Bakaes Yianni , Porter Giselle , Shi Glenn , Myers Paisley , Jackson J. Benjamin , Gonzalez Tyler , Haupt Edward T. 
Published: July 2024

Background Minimally invasive (MIS) treatment of hallux valgus (HV) deformity is increasing in popularity. A 2-mm diameter burr is used to create a distal first metatarsal osteotomy prior to capital fragment translation and fixation. The metatarsal will shorten by the burr’s diameter (2 mm). Plantar or dorsal capital fragment displacement may also cause load transference and possibly transfer metatarsalgia. The purpose of this study is to examine the effect of MIS HV on forefoot loading mechanics with respect to metatarsal shortening and sagittal plane displacement. Methods Four lower-limb cadaveric specimens were studied. A pedobarography pressure-sensing mat was used to record forefoot plantar pressure in a controlled weight-bearing stance position. Control and postosteotomy measurements were obtained with the capital fragment fixated in 3 possible positions: 0 mm, 5 mm dorsal, and 5 mm plantar displacement. Pedobarography data yielded pressure data within measurable graphical depictions. Raw mean contact pressure measurements were taken under the first and fourth metatarsal heads to establish medial and lateral forefoot loading pressure ratios. An a priori power analysis was performed based on previous peer-reviewed pedobarographic data, and our study was adequately powered. Results Around 40 measurements were recorded, and ratios of medial-to-lateral forefoot loading were constructed. Medial forefoot pressure control versus 0 mm displacement, and control versus dorsal displacement were not found to be statistically significant ( p = 0.525, p = 0.55, respectively). Medial pressure significantly increased when comparing control versus plantar displacement ( P = .006). Lateral pressure significantly increased with dorsal displacement of the osteotomy ( P = .013). Conclusion Our study found that MIS HV correction did not cause an increase in lateral forefoot pressure loading when sagittal plane displacements were controlled. Plantar displacement increased medial loading, and dorsal displacement increased lateral loading. It may be valuable for surgeons to consider metatarsal head position postosteotomy, as a decrease in medial loading and subsequent increase in lateral loading may lead to lateral forefoot pain and transfer metatarsalgia. Levels of Evidence: IV.
Electromyographic Analysis of Large Muscle Activity in Progressive Collapsing Foot Deformity
Authors: Bhatia Aanchal , Ajoy Shiv Manik , Galagali Dev Anand , Debur Ramesh 
Published: July 2024

Background There are various deformities described in the spectrum of Progressive Collapsing Foot Deformity (PCFD) which not only have adverse effects on the foot but also on the entire lower limb. Early lower limb muscular fatigue and pain during exertion is the most common complaint of patients with PCFD. Surface electromyography (sEMG) provides an accurate assessment of muscle activity. In this study, we aim to compare the activities of quadriceps, hamstrings, and gastrosoleus muscle groups of adult patients with PCFD with normal lower limbs and correlate the radiological parameters and functional effects of PCFD with the activities. Methods Thirty patients with bilateral PCFD and 30 controls underwent weight-bearing anteroposterior (AP), lateral, and hindfoot alignment radiographs of the foot. Radiographic parameters of PCFD were assessed. Surface electromyography was used to assess the quadriceps, hamstrings, and gastrosoleus activities, and this was compared between the 2 groups and correlated with radiological measurements of PCFD. Tegner activity questionnaire was used to assess the functional effects of collapsed arch. Results Electrical activities of all muscle groups were significantly higher in cases than controls. Meary’s angle and hindfoot moment arm had significant correlations with hamstring activity (P = .013) and gastrosoleus activity (P = .027), respectively. Tegner scores of cases were significantly lower than those of controls (P = .041). Conclusions The PCFD causes an increase in activity of large muscles of the affected lower limb which act on joints other than those in the foot. This finding may be due to several compensatory mechanisms that counteract the deforming forces. This may be a cause for the frequent complaint, early fatigue, and hence functional impairment. However, most radiological parameters did not correlate with muscle activities and larger study size may be required for further association. Levels of Evidence: Diagnostic: Level 3.
Simplifying venous outflow: Prolonged venous transit as a novel qualitative marker correlating with acute stroke outcomes
Authors: Yedavalli Vivek S , Lakhani Dhairya A , Koneru Manisha , Balar Aneri B , Greene Cynthia , Hoseinyazdi Meisam , Nabi Mehreen , Lu Hanzhang , Xu Risheng , Luna Licia , Caplan Justin , Dmytriw Adam A , Guenego Adrien , Heit Jeremy J , Albers Gregory W , Wintermark Max , Urrutia Victor , Huang Judy , Nael Kambiz , Leigh Richard , Marsh Elisabeth B , Hillis Argye E , Llinas Rafael H 
Published: July 2024

Background Prolonged venous transit (PVT), defined as presence of time-to-maximum [Formula: see text] 10 s within the superior sagittal sinus (SSS) and/or torcula, is a novel, qualitatively assessed computed tomography perfusion surrogate parameter of venous outflow with potential utility in pretreatment acute ischemic stroke imaging for neuroprognostication. We aim to characterize the correlation between PVT and neurological functional outcomes in thrombectomy-treated patients. Methods A prospectively-collected database of large vessel occlusion acute ischemic stroke patients treated with thrombectomy was retrospectively analyzed. Spearman’s rank correlation coefficient and point-biserial correlations were performed between PVT status (i.e., no region, either SSS or torcula, or both), 90-day modified Rankin score (mRS), mortality (mRS 6), and poor functional outcome (mRS 4-6 vs 0-3). Results Of 128 patients, correlation between PVT and 90-day mRS ([Formula: see text] = 0.35, p < 0.0001), mortality (r = 0.26, p = 0.002), and poor functional outcome (r = 0.27, p = 0.002) were significant. Conclusion There is a modest, significant correlation between PVT and severity of neurological functional outcome. Consequently, PVT is an easily-ascertained, qualitative metric that may be useful as an adjunct for anticipating a patient’s clinical course. Future analyses will determine the significance of incorporating PVT in clinical decision-making.
Cardioprotective effects of sodium glucose cotransporter 2 inhibitor versus dipeptidyl peptidase 4 inhibitor in type 2 diabetes: A meta-analysis of comparative safety and efficacy
Authors: Shrestha Abhigan Babu , Halder Anupam , Rajak Kripa , Jha Saroj Kumar , Lamichhane Ramesh , Oishee Arefin Naher , Chowdary Nayanika Tummala , Pokharel Pashupati , Shrestha Sajina , Adhikari Lukash , Adhikari Bikash , Rajak Aman , Haider Khan Jalal , Mainali Nischal 
Published: July 2024

Background: Sodium glucose cotransporter 2 inhibitors are recommended for the treatment of heart failure due to their cardioprotective effects, despite primarily being used as antidiabetic medications. However, the comparative profile of two antidiabetic drugs, sodium glucose cotransporter 2 inhibitors with dipeptidyl peptidase 4 inhibitor remains unclear. Study hypothesis: This study aims to compare the safety and efficacy profiles of sodium glucose cotransporter 2 inhibitors versus dipeptidyl peptidase 4 inhibitor drugs. Methods: A comprehensive search was conducted in PubMed, Scopus, Web of Science, Google Scholar, and ClinicalTrials.gov using appropriate Medical Subject Headings terms from inception until February 23, 2023. The outcomes were pooled using a random-effects model for hazard ratio with a 95% confidence interval. A p-value of <0.05 was considered statistically significant. Results: Twelve studies were included after systematic screening, with a sample size of 745,688 for sodium glucose cotransporter 2 inhibitors and 769,386 for dipeptidyl peptidase 4 inhibitor. The mean age in each group was 61.1 (8.52) and 61.28 (9.25) years, respectively. Upon pooling the included articles with sodium glucose cotransporter 2 inhibitors versus dipeptidyl peptidase 4 inhibitor, the primary outcome of all-cause death demonstrated an hazard ratio of 0.64 (0.57, 0.70), I2: 65.54%, p < 0.001, and major adverse cardiovascular events yielded an hazard ratio of 0.76 (0.65, 0.86), I2: 87.83%, p < 0.001. The secondary outcomes included myocardial infarction with an hazard ratio of 0.84 (0.78, 0.90), I2: 47.64%, p < 0.001, stroke with an hazard ratio of 0.81 (0.75, 0.87), I2: 36.78%, p < 0.001, and hospitalization with an hazard ratio of 0.62 (0.53, 0.70), I2: 83.32%, p < 0.001. Conclusion: Our findings suggest that compared to dipeptidyl peptidase 4 inhibitor, initiating treatment with sodium glucose cotransporter 2 inhibitors provides cardiovascular disease protection and may be considered in patients with type 2 diabetes.
The Role of Supervisory Communication Frequency in Moderating the Impact of Innovation Knowledge Management on Innovation Performance
Authors: Chen Chih-Hung 
Published: July 2024

Innovation Performance (IP) serves as a measure of a company’s effectiveness in translating innovative endeavors into tangible outcomes, encompassing new products, processes, services, and enhancements to existing offerings. This study investigates the relationship between IP, Innovation Knowledge Management (IKM), which includes Innovation Culture (IC) and Knowledge Management (KM), and Supervisory Communication Frequency (SCF). SCF refers to the frequency and quality of communication between supervisors and subordinates, influencing the impact of IKM on IP. Using a structured questionnaire, 320 valid responses were collected from companies listed on the Taiwan Stock Exchange (TWSE). Data analysis employed Structural Equation Modeling (SEM) and Process Macro Model 1, with reliability and validity assessed based on criteria from Hair et al. and Fornell and Larcker. Discriminant validity was confirmed with construct correlations lower than the square root of the average variance extracted (AVE). Path analysis revealed significant differences in IP scores across SCF frequency groups (F (4, 315) = 12.47, p < .001), with three monthly interactions showing the highest mean IP score (M = 3.6905, SD = 0.9375). These findings highlight the importance of regular supervisor-employee interactions alongside robust KM and IC practices for optimal innovation outcomes. JEL Code: O32 - Management of Technological Innovation and R&D; M15 - IT Management; L25 - Firm Performance: Size, Diversification, and Scope; O31 - Innovation and Invention: Processes and Incentives