bluuebunny/crossref_metadata_2025_split huggingface dataset:
Technical Efficiency of Primary Schools and Its Non-Input Determinants: A Case Study in Assam, North-Eastern India
Authors: Das Pinak Pratim , Mazumder Ritwik 
Published: May 2024

This abstract has measured the technical efficiency of government-aided lower primary schools in Hailakandi district, a disadvantaged and remote region of southern Assam in North-eastern India based on a robust sample of 95 schools covering 718 children. Enrolment, attendance and learning outcomes are taken as output indicators. The results indicate that inputs such as quality of school infrastructure and teachers’ contact hours influence the composite output index positively and significantly. However, among on-input factors, monthly frequency of mid-day meals, average body mass index (BMI) of interviewed children and educational qualifications of teachers have positive influences on school-level technical efficiency, while remoteness and lack of accessibility have a negative influence on the same. The study claims that school performance can be significantly improved if school infrastructure is enhanced by constructing separate and independent classrooms for each grade along with the appointment of teachers up to full capacity. JEL Codes: C51, C83, D24, I21, I28
The autonomy and governance of mutual aid organizations for civil servants’ welfare
Authors: Hanif Muhammad Zeeshan , Van de Walle Steven 
Published: May 2024

Civil servants’ mutual aid organizations can be characterized as premodern welfare state organizations. They are still very common in countries with well-developed social security systems but even more so in countries where these systems remain underdeveloped. They assist members and their families in times of sickness, disability or death, and provide dowries and scholarships. This paper systematically analyzes the autonomy and governance of 28 civil service mutual aid organizations in Pakistan. It reveals that mutual aid organizations are governed by four different types of boards and that most have low strategic human resource management (HRM), policy and structural autonomy. This study contributes novel empirical insights into mutual aid organizations as a phenomenon in public sector personnel studies that is often ignored. Overall, this study adds to the scant literature on mutual aid organizations, which has taken a welfare state perspective. Points for practitioners Mutual aid organizations are vital for civil servants’ welfare. Practitioners must prioritize enhancing their strategic human resource management autonomy for improved effectiveness. They must also advocate for increasing the policy autonomy of these organizations to address the evolving needs of civil servants and improve welfare outcomes. Their structural autonomy should also be enhanced to enable adaptability, reduce political influence, foster trust, and develop a more complementary relationship with government.
Mechanical behavior of glass fiber-reinforced hollow glass particles filled epoxy composites under thermal loading
Authors: Paramasivam Anandakumar , Kanny Krishnan , Turup Pandurangan Mohan , Ramachandran Velmurugan 
Published: May 2024

The use of hollow glass particle-filled fiber-reinforced composites for aircraft applications requires proper understanding of their behavior under in-service temperature conditions in order to exploit their usage in the exterior parts of aircraft and other space vehicles. In this study, the glass fiber reinforced composites containing 0–30 vol% of glass microspheres were subjected to testing for monotonic tensile and flexural loading from room temperature to the test temperature (40°C – 120°C). The evolution of microscopic damage under different temperatures was elucidated by digital image correlation (DIC) strain fields. The strain fields revealed a transition from homogeneous to non-homogeneous pattern as the temperature increases due to softening of the matrix. As the glass microsphere contents in the matrix increased, the tensile and flexural properties of the composites decreased, and their reduction was highest for the specimen containing a 30 vol% microsphere by volume. The tensile properties are slightly decreased by increasing the temperature. The tensile specimens tested at room temperature exhibited limited delamination and fiber pullout, while extensive delamination and fiber splitting occurred in the specimens tested at 120°C. The flexural results of the glass fiber reinforced composite specimens exposed at 120°C demonstrated a considerable decrease in flexural strength compared with room temperature for 0 vol%, 10 vol%, 20 vol% and 30 vol% glass microsphere volume fraction. Finally, the Weibull parametric investigation was performed to model the degradation of modulus for various GMS contents with temperature variations.
Comparison of clinical effects of coronary artery bypass grafting between left anterior small thoracotomy approach and lower-end sternal splitting approach
Authors: Jinghui Li , Yin Yang , Xiaokaitijiang Muhetaer , Yipeng Tang , Lianqun Wang , Yunpeng Bai , Zhejun Zhang , Nan Jiang , Qiang Wang , Qingliang Chen , Dong Xu , Dongyan Yang , Zhigang Guo , Feng Zhao 
Published: May 2024

Objective To compare the clinical effects of coronary artery bypass grafting (CABG) between the left anterior small thoracotomy (LAST) and lower-end sternal splitting (LESS) approaches for coronary artery disease. Methods In total, 110 patients who underwent LAST from October 2015 to December 2020 in Tianjin Chest Hospital were selected as the observation group. Patients who underwent the LESS approach during the same period were analyzed. The propensity score was calculated by a logistic regression model, and nearest-neighbor matching was used for 1:1 matching. Results The length of hospital stay and ventilator support time were significantly shorter in the LAST than LESS group. The target vessels in the obtuse marginal branch and posterior left ventricular artery branch grafts were significantly more numerous in the LAST than LESS group, but those in the right coronary artery graft were significantly less numerous in the LAST group. Conclusions CABG using either the LAST or LESS approach is safe and effective, especially in low-risk patients. The LAST approach can achieve complete revascularization for multivessel lesions and has the advantages of less trauma and an aesthetic outcome. However, it requires a certain learning curve to master the surgical techniques and has specific surgical indications.
Effect of neoadjuvant chemoradiation on anorectal function assessed with anorectal manometry: A systematic review and meta-analysis
Authors: Milito Pamela , Piozzi Guglielmo Niccolò , Hussain Mohammad Iqbal , Dragani Tommaso A. , Sorrentino Luca , Cosimelli Maurizio , Guaglio Marcello , Battaglia Luigi 
Published: May 2024

Aim: Improvement in oncological survival for rectal cancer increases attention to anorectal dysfunction. Diagnostic questionnaires can evaluate quality of life but are subjective and dependent on patients’ compliance. Anorectal manometry can objectively assess the continence mechanism and identify functional sphincter weakness and rectal compliance. Neoadjuvant chemoradiotherapy is presumed to affect anorectal function. We aim to assess anorectal function in rectal cancer patients who undergo total mesorectal excision, with or without neoadjuvant chemoradiation, using anorectal manometry measurements. Method: MEDLINE, Embase, and Cochrane databases were searched for studies comparing perioperative anorectal manometry between neoadjuvant chemoradiation and upfront surgery for rectal cancers. Primary outcomes were resting pressure, squeeze pressure, sensory threshold volume and maximal tolerable volume. Results: Eight studies were included in the systematic review, of which seven were included for metanalysis. 155 patients (45.3%) had neoadjuvant chemoradiation before definitive surgery, and 187 (54.6%) underwent upfront surgery. Most patients were male (238 vs. 118). The standardized mean difference of mean resting pressure, mean and maximum squeeze pressure, maximum resting pressure, sensory threshold volume, and maximal tolerable volume favored the upfront surgery group but without statistical significance. Conclusion: Currently available evidence on anorectal manometry protocols failed to show any statistically significant differences in functional outcomes between neoadjuvant chemoradiation and upfront surgery. Further large-scale prospective studies with standardized neoadjuvant chemoradiation and anorectal manometry protocols are needed to validate these findings.
(Un)wanted bodies and the internationalisation of higher education
Authors: Waters Johanna L , Adriansen Hanne Kirstine , Madsen Lene Møller , Saarinen Taina 
Published: May 2024

In this paper, we foreground the bodies of students and academics in studies of the internationalisation of higher education (IHE) and consider how internationalisation processes are shaped by embodiment and the geographies of (em)placement. Over the past 20 years, IHE has been extensively discussed within academic and policy circles. Such accounts have often been dominated by macro-level concerns. Within these discourses, the international mobility of students and academics have been a central focus. Although scholars within the social sciences are increasingly attentive to the social, cultural, and political dimensions of IHE, there has been little explicit discussion of bodies and the ways in which international mobilities are corporeal, involving in place/out of placeness and the politics and policies governing embodied (im)mobilities. This paper has two main objectives mapping on to two substantive sections. The first is to highlight the importance of the body within recent geographical scholarship and to juxtapose this with a notable absence within IHE research. The second is to consider where the body is present (explicitly or otherwise) in the bountiful literature on IHE and to draw out the meanings of this, arguing that paying attention to bodies exposes the (re)production of exclusionary hierarchies. The paper contributes to a growing corpus of work on the body within geography and extends critical geographies of the internationalisation of higher education.
A High Grade of Postoperative Knee Laxity Is Associated With an Increased Hazard of Revision Surgery: A Cohort Study of 4697 Patients With Primary ACL Reconstruction
Authors: Cristiani Riccardo , Forssblad Magnus , Helito Camilo P. , Edman Gunnar , Eriksson Karl , Stålman Anders 
Published: May 2024

Background: There is still debate regarding the association between arthrometric knee laxity measurements and subjective knee outcome and revision surgery after primary anterior cruciate ligament reconstruction (ACLR). Purpose: To assess whether arthrometric knee laxity (measured with the KT-1000 arthrometer) 6 months after primary ACLR was associated with the 1-, 2-, and 5-year subjective knee outcomes or revision ACLR at a 5-year follow-up. Study Design: Cohort study, Level of evidence 3. Methods: Patients who underwent primary ACLR with a hamstring tendon autograft at the authors’ institution between January 1, 2005, and December 31, 2017, with no concomitant ligamentous injuries, were identified. Anterior knee laxity (KT-1000 arthrometer, 134 N) was assessed 6 months postoperatively. The Knee injury and Osteoarthritis Outcome Score (KOOS) was collected preoperatively and 1, 2, and 5 years postoperatively. Patients who underwent revision ACLR at any institution in the country within 5 years of primary surgery were identified through the Swedish National Knee Ligament Registry. Results: A total of 4697 patients (54.3% male) with available KT-1000 arthrometer measurements were included (normal: side-to-side [STS] ≤2 mm, 3015 [64.2%]; nearly normal: STS 3-5 mm, 1446 [30.8%]; abnormal: STS >5 mm, 236 [5.0%]). The only significant difference in subjective knee outcome between the groups was for the KOOS Symptoms subscale at the 1-year follow-up (STS ≤2 mm, 79.9 ± 16.2; STS 3-5 mm, 82.5 ± 14.8; STS >5 mm, 85.1 ± 14.2; P < .001). No other significant differences between the groups were found preoperatively or at 1, 2, or 5 years postoperatively for any of the KOOS subscales. The hazard for revision ACLR within 5 years of the primary surgery was significantly higher for the groups with an STS of 3 to 5 mm (6.6%; 95/1446) (hazard ratio [HR], 1.42; 95% CI, 1.07-1.87; P = .01) and an STS >5 mm (11.4%; 27/236) (HR, 2.61; 95% CI, 1.69-4.03; P < .001) compared with the group with an STS ≤2 mm (3.8%; 116/3015). Conclusion: A high grade of postoperative knee laxity (STS 3-5 mm and STS >5 mm) 6 months after primary ACLR was associated with an increased hazard of revision ACLR within 5 years, but it was not associated with an inferior subjective knee outcome.
Interactions Between Serotonin Transporter Gene and Adverse Childhood Experience in a Generalized Additive Model: A Pilot Study
Authors: Niitsu Kosuke , Lee Chiyoung , Rice Michael J. 
Published: May 2024

BACKGROUND: While most people experience potentially traumatic events (PTEs), including Adverse Childhood Experiences (ACEs), the stress reactions to PTEs on mental health outcomes are highly heterogeneous. Resilience is influenced by a complex biopsychosocial ecological system, including gene serotonin transporter-linked promoter region or 5-HTTLPR /rs25531 by ACEs interactions. AIMS: This pilot study investigated the gene-by-environment interactions on mental health outcomes in adults enrolled in a health care profession program using a generalized additive model (GAM). METHODS: Seventy health care college students (mean age = 27.4 years, 67.1% women) participated in this cross-sectional study. Saliva samples were collected from students to analyze 5-HTTLPR/rs25531. Participants completed the ACE Questionnaire and the Mental Health Inventory. GAMs with different interaction terms were built adjusting for age, gender, and race. The value of the effective degree of freedom (EDF) quantifies the curvature of the relationship. RESULTS: Among participants with the long allele of 5-HTTLPR/rs25531, a linear pattern was found between the total ACE score and mental health outcomes (EDF = 1). Conversely, among participants with the short allele, EDF was approximately 2, indicating a curved association suggesting that mental health worsens in individuals exposed to up to four types of ACEs. CONCLUSIONS: The impact of up to four ACEs on mental health was stronger among individuals with the short allele of 5-HTTLPR/rs25531 than those with the long allele. Although this study does not claim to provide a definite approach to analyzing gene-by-environment interactions, we offer a different perspective to explore the relationship.
The Impact of Baseline Vitamin D Level in Patients Receiving Gefitinib-Directed Therapy for EGFR-Mutant Non–Small-Cell Lung Cancer
Authors: Noronha Vanita , Kolkur Manali , ArunKumar R , Adak Supriya , Patil Vijay , Menon Nandini , Shah Minit , Prabhash Kumar 
Published: May 2024

Background: There is contradicting evidence on vitamin D levels and cancer mortality rates. In this study, we aimed to evaluate the impact of baseline vitamin D level on the outcome in patients with epidermal growth factor receptor (EGFR)-mutant advanced non–small-cell lung cancer (NSCLC) who received either gefitinib or gefitinib with chemotherapy (pemetrexed and carboplatin) as first-line therapy in a prospective randomized study. Methods: This was a post hoc analysis of a phase III randomized trial comparing gefitinib with gefitinib with carboplatin and pemetrexed in patients with advanced NSCLC with activating EGFR mutations in the first-line setting. As a part of regular practice, baseline vitamin D levels were measured using circulating 25(OH) levels in blood. We included 334 patients who had baseline vitamin D levels in the study and evaluated the effect of the vitamin D level on oncologic outcomes. Results: There were 136 (40.7%) patients with a sufficient (>20 ng/mL) baseline vitamin D level, and 198 (59.3%) patients who were deficient in vitamin D (<20 ng/mL). The median progression-free survival (PFS) in patients with normal vitamin D levels was 17 months, whereas that in patients with deficient vitamin D levels was 15 months, with a hazard ratio of 1.45 (95% confidence interval [CI] = 1.03-2.06). The median overall survival (OS) in patients with normal vitamin D levels was 28.6 months, whereas that in patients with deficient vitamin D levels was 28.5 months, with a hazard ratio of 1.17 (95% CI = 0.81-1.68). On multivariate analysis, only 2 factors impacted the PFS, the baseline vitamin D level, and the treatment regimen; other factors like age, sex, disease stage, and performance status did not. Conclusions: Baseline vitamin D levels have a significant impact on PFS, whereas OS is not affected by the baseline vitamin D levels on patients receiving targeted therapy for EGFR-mutant lung cancer. Trial registration: The trial was prospectively registered with the Clinical Trial Registry of India, registration number CTRI/2016/08/007149. The date of the registration was 5 August 2016.
Durability and sustainability of polyethylene terephthalate water bottles using computer aided design/computer aided engineering elements
Authors: Ikhries Ibrahim I. , Al-Shawabkeh Ali F. , Al-Adwan Ibrahim M. , Al-Najdawi Nijad A. 
Published: May 2024

Disposing of plastic water bottles contributes to environmental pollution and waste buildup. Choosing recycling options helps mitigate these adverse impacts and supports a more sustainable approach to waste management. Polyethylene terephthalate constitutes the primary component in water bottles. This study focuses on a water bottle design model, subjecting it to simulations that replicate stresses encountered during storage, transportation, and usage. Polyethylene terephthalate bottles successfully underwent stress analysis, surpassing all stipulated requirements, the results indicate stress values below the yield point and safety factors exceeding one. This affirms the product’s superior quality and its ability to withstand even the most rigorous conditions. The analysis further identified peak stress values (59.819, 65.124, and 34.330 MPa) in distinct scenarios, noting that the bottle may incur damage beyond the critical vertical load of 88.4 N. These findings underscore the efficacy of the proposed process in validating stresses in water bottles pre-manufacture. Consequently, this approach aids in waste reduction and addresses environmental challenges associated with recycling, including resource and energy consumption, contamination, and inefficiencies in recycling systems. In essence, this study constitutes a substantial contribution to the realm of sustainable bottle design. It stands out as one of the few comprehensive investigations into the structural impact on the durability and sustainability of water bottles. This research has the potential to emerge as a significant advancement in the development of more environmentally friendly bottle designs.
Six Years’ Experience With a Novel Dissection-Specific Stent-Graft to Prevent Distal Stent-Graft-Induced New Entry
Authors: Shehab Maysam , Wanhainen Anders , Tegler Gustaf , Lindstrom David , Yoon William , Mani Kevin 
Published: May 2024

Introduction: Thoracic endovascular aortic repair (TEVAR) in chronic dissection is associated with a risk for distal stent-graft-induced new entry (dSINE) in up to a quarter of cases. We assess the mid-term outcome of a novel dissection-specific stent-graft (DSSG), which is a custom-made device based on the Cook Alpha platform, with a modified graft design and a distal endovascular elephant trunk without any supporting stent to reduce the radial force on the dissection membrane at the distal landing zone. Methods: A retrospective single-center study of chronic dissection patients at high risk of dSINE who received an elective endovascular repair with DSSG from January 2017 to June 2023. The primary outcome is Kaplan-Meier (KM) estimated freedom from dSINE during follow-up. Secondary outcomes included technical success, aortic remodeling, and anatomical evaluation of the distal landing zone in cases with dSINE during follow-up versus those without. Results: Thirty patients (24 males) with a median age of 66 years [range=31-78] underwent elective TEVAR with the DSSG. The majority, n=27 (90%), had previous aortic repair; 7 (23%) had established connective tissue disease, and 6 (20%) had established dSINE after previous stent-graft implantation as an indication for TEVAR. Technical success was achieved in n=29 (97%). Median follow-up was 38.5 months (4.3-76.4), and KM estimated freedom from dSINE at 1 and 3 years was 95.6% (SE 0.043) and 89% (SE 0.081), respectively Four cases developed dSINE during follow-up. The median distance from the distal stent-graft to the coeliac trunk was 74mm (range=18-123) in the dSINE group versus 26mm (range=0-74) in the non-dSINE group (p=0.049). Median proximal tangential aortic angulation in the distal landing zone was 38.5° (range=26°-50°) in the dSINE group compared to 21° (range=3-61°) in the non-dSINE group (p=0.052). Conclusions: The Use of a novel DSSG with low radial force for TEVAR in the setting of chronic dissection is safe and feasible, with remodeling outcomes comparable with standard TEVAR. The reduced distal radial force in the DSSG does not eliminate the risk for dSINE over time, with new entries occurring, particularly in cases where the distal landing zone is in a tortuous aortic segment and not close to the coeliac trunk. Clinical Impact Using the novel dissection-specific stent-graft with reduced radial force is safe and feasible but does not completely eliminate the risk of dSINE occurring over time. The exact positioning of the distal stent-graft in a straight aortic segment, close to the coeliac trunk, may be of importance to further mitigate the risk.