bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prehospital tranexamic acid is associated with a survival benefit without an increase in complications: Results of two harmonized randomized clinical trials
Authors: Mazzei Michael , Donohue Jack K. , Schreiber Martin , Rowell Susan , Guyette Francis X. , Cotton Bryan , Eastridge Brian J. , Nirula Raminder , Vercruysse Gary A. , O'Keeffe Terence , Joseph Bellal , Brown Joshua B. , Neal Matthew D. , Sperry Jason L. 
Published: March 2024

INTRODUCTION
Recent randomized clinical trials have demonstrated that prehospital tranexamic acid (TXA) administration following injury is safe and improves survival. However, the effect of prehospital TXA on adverse events, transfusion requirements, and any dose-response relationships require further elucidation.

METHODS
A secondary analysis was performed using harmonized data from two large, double-blinded, randomized prehospital TXA trials. Outcomes, including 28-day mortality, pertinent adverse events, and 24-hour red cell transfusion requirements, were compared between TXA and placebo groups. Regression analyses were used to determine the independent associations of TXA after adjusting for study enrollment, injury characteristics, and shock severity across a broad spectrum of injured patients. Dose-response relationships were similarly characterized based upon grams of prehospital TXA administered.

RESULTS
A total of 1,744 patients had data available for secondary analysis and were included in the current harmonized secondary analysis. The study cohort had an overall mortality of 11.2% and a median Injury Severity Score of 16 (interquartile range, 5–26). Tranexamic acid was independently associated with a lower risk of 28-day mortality (hazard ratio, 0.72; 95% confidence interval [CI], 0.54–0.96; p = 0.03). Prehospital TXA also demonstrated an independent 22% lower risk of mortality for every gram of prehospital TXA administered (hazard ratio, 0.78; 95% CI, 0.63–0.96; p = 0.02). Multivariable linear regression verified that patients who received TXA were independently associated with lower 24-hour red cell transfusion requirements (β
= −0.31; 95% CI, −0.61 to −0.01; p = 0.04) with a dose-response relationship (β
= −0.24; 95% CI, −0.45 to −0.02; p = 0.03). There was no independent association of prehospital TXA administration on thromboembolism, seizure, or stroke.

CONCLUSION
In this secondary analysis of harmonized data from two large randomized interventional trials, prehospital TXA administration across a broad spectrum of injured patients is safe. Prehospital TXA is associated with a significant 28-day survival benefit and lower red cell transfusion requirements at 24 hours and demonstrates a dose-response relationship.

LEVEL OF EVIDENCE
Therapeutic/Care Management; Level III.
Identifying factors predicting outcomes after major trauma in older patients: Prognostic systematic review and meta-analysis
Authors: Iddagoda Mayura Thilanka , Trevenen Michelle , Meaton Claire , Etherton-Beer Christopher , Flicker Leon 
Published: March 2024

INTRODUCTION
Trauma is the most common cause of morbidity and mortality in older people, and it is important to determine the predictors of outcomes after major trauma in older people.

METHODS
MEDLINE, Embase, and Web of Science were searched, and manual search of relevant papers since 1987 to February 2023 was performed. Random-effects meta-analyses were performed. The primary outcome of interest was mortality, and secondary outcomes were medical complications, length of stay, discharge destination, readmission, and intensive care requirement.

RESULTS
Among 6,064 studies in the search strategy, 136 studies qualified the inclusion criteria. Forty-three factors, ranging from demographics to patient factors, admission measurements, and injury factors, were identified as potential predictors. Mortality was the commonest outcome investigated, and increasing age was associated with increased risk of in-hospital mortality (odds ratio [OR], 1.05; 95% confidence interval [CI], 1.03–1.07) along with male sex (OR, 1.40; 95% CI, 1.24–1.59). Comorbidities of heart disease (OR, 2.59; 95% CI, 1.41–4.77), renal disease (OR, 2.52; 95% CI, 1.79–3.56), respiratory disease (OR, 1.40; 95% CI, 1.09–1.81), diabetes (OR, 1.35; 95% CI, 1.03–1.77), and neurological disease (OR, 1.42; 95% CI, 0.93–2.18) were also associated with increased in-hospital mortality risk. Each point increase in the Glasgow Coma Scale lowered the risk of in-hospital mortality (OR, 0.85; 95% CI, 0.76–0.95), while each point increase in Injury Severity Score increased the risk of in-hospital mortality (OR, 1.07; 95% CI, 1.04–1.09). There were limited studies and substantial variability in secondary outcome predictors; however, medical comorbidities, frailty, and premorbid living condition appeared predictive for those outcomes.

CONCLUSION
This review was able to identify potential predictors for older trauma patients. The identification of these factors allows for future development of risk stratification tools for clinicians.

LEVEL OF EVIDENCE
Systematic Review and Meta-Analysis; Level III.
Evaluating Accuracy and Reproducibility of Large Language Model Performance in Pharmacy Education
Authors: Most Amoreena , Hu Mengxuan , Yang Huibo , Liu Tianming , Chen Xianyan , Li Sheng , Xu Steven , Liu Zhengliang , Sikora Andrea 
Published: March 2024

AbstractThe purpose of this study was to compare performance of ChatGPT (GPT-3.5), ChatGPT (GPT-4), Claude2, Llama2-7b, and Llama2-13b on 219 multiple-choice questions focusing on critical care pharmacotherapy. To further assess the ability of engineering LLMs to improve reasoning abilities and performance, we examined responses with a zero-shot Chain-of-Thought (CoT) approach, CoT prompting, and a custom built GPT (PharmacyGPT). A 219 multiple-choice questions focused on critical care pharmacotherapy topics used in Doctor of Pharmacy curricula from two accredited colleges of pharmacy was compiled for this study. A total of five LLMs were evaluated: ChatGPT (GPT-3.5), ChatGPT (GPT-4), Claude2, Llama2-7b, and Llama2-13b. The primary outcome was response accuracy. Of the five LLMs tested, GPT-4 showed the highest average accuracy rate at 71.6%. A larger variance indicates lower consistency and reduced confidence in its answers. Llama2-13b had the lowest variance (0.070) of all the LLMs, but performed with an accuracy of 41.5%. Following analaysis of overall accuracy, performance on knowledge- vs. skill-based questions were assessed. All five LLMs demonstrated higher accuracy on knowledge-based questions compared to skill-based questions. GPT-4 had the highest accuracy for knowledge- and skill-based questions, with an accuracy of 87% and 67%, respectively. Response accuracy from LLMs in the domain of clinical pharmacy can be improved by using prompt engineering techniques.
Automated Detection of Sleep Apnea Using Machine Learning: A Novel Approach Using Smartphone and Microphone for Breathing Sound Analysis
Authors: Bhatt Om 
Published: March 2024

AbstractIn this study, we evaluate the accuracy of a novel setup in the detection of apneas and hypopneas and estimating the apnea-hypopnea index (AHI). The study device setup consists of a microphone placed underneath the nose and a smartphone to collect the data. We recruited patients who were referred to the St. Josephs Hamilton Sleep Clinic for a sleep study. Data from our study device is collected simultaneously with polysomnography (PSG) in the sleep lab. A total of 26 patients were recruited, of which 2 dropped out during the data collection. Data from the microphone was too noisy for interpretation in 3 patients. Across the remaining 21 patients, the AHI based on their PSG ranged from 2 to 125 events/h, with an average AHI of 34 events/h. We used regression models trained on microphone audio data to identify noise and we developed an algorithm based on root-mean-square of the audio data for automatic detection of apneas and hypopneas. With reference to the PSG, our study device had a sensitivity of 94% and specificity of 87% in detecting apneas/hypopneas across a cumulative 120.9 hours of sleep data and more than 3700 such events. Our study device was able to accurately predict the AHI to within 4.3 events/h (+/-3.1). As such, we can conclude that our study device is accurate in identifying apneas/hypopneas, estimating the AHI and at ruling out cases of severe sleep apnea and can potentially be used as a screening test for this purpose. Our study device has the practical advantages of being very low cost and potentially more accessible as a screening tool, though further validation studies are needed to study accuracy across a larger population and for use at-home.
Effects of some macroeconomics variables on estimated tax evasion: evidence from Sub-Saharan Africa
Authors: Ya'u Abba , Umar Mohammed Abdullahi , Yunusa Nasiru , Rengasamy Dhanuskodi 
Published: March 2024

PurposeMost research on tax evasion focused on microeconomic variables revolving around perceptions and decisions of individual taxpayers. However, a new wave of research is now investigating the role of macroeconomic variables in inducing tax evasion. This study adds to the limited studies in this new direction of research. Previous studies found that inflation, low gross domestic product (GDP) growth and gross fixed capital formation causes recession, increases unemployment, raise interest rates, hurts both domestic and foreign direct investments. This study examined the relationship between these variables and estimated tax evasion in Sub-Saharan Africa.Design/methodology/approachThe study adopts a correlation research design with 2,300 data points collected from 23 countries in Sub-Saharan Africa. Specifically, tax to GDP ratio, gross fixed capital formation per GDP and the GDP annual growth report from each country for the period 2011–2020 was retrieved. Generalised least square regression technique was employed to analyse the data due to the presence of heteroskedasticity in the model and random effect was utilized based on the Hausman test. To avoid misspecification and biased result; therefore, all relevant test was conducted including the multicollinearity test.FindingsThe results indicate that GDP annual growth and gross fixed capital formation have a significant negative impact on estimated tax evasion in Sub-Saharan Africa. The findings further indicate a negative but insignificant relationship between inflation and estimated tax evasion in Sub-Saharan Africa. The study concludes that both GDP annual growth rate and gross fixed capital formation negatively influence estimated tax evasion and the policy implications in the African continent were discussed.Originality/valueThe new findings on the effects of GDP annual growth, growth fixed capital formation and inflation on estimated tax evasion provide novel knowledge that is currently lacking in the current literature, specifically Sub-Saharan African continent.
Disentangling the relationship between institutional influence, transformational leadership and performance in higher educational institutions in India: a three-way interaction model
Authors: Victor Leema Rose , Siluvaimuthu Mariadoss , George Hesil Jerda , Parayitam Satyanarayana 
Published: March 2024

PurposeThe present study aims to investigate the relationship between institutional influence and performance, mediated through transformational leadership (TL) and moderated by barriers, situational factors, communication and implementation.Design/methodology/approachUsing a structured survey instrument, data were collected from 370 faculty members from 31 higher educational institutions in southern India. After checking the psychometric properties of the instrument, the authors used Hayes’s PROCESS to test the direct hypotheses and three-way interactions.FindingsThe results revealed that TL mediated the relationship between institutional influence and performance. Further, the findings supported the three-way interactions between (1) institutional influence, barriers and communication positively affecting TL; and (2) TL, situational factors and implementation affecting the performance of faculty members.Research limitations/implicationsThis study underscores the importance of TL for the smooth functioning of higher educational institutions and achieving superior performance, especially in the new normal context after the global pandemic.Practical implicationsThis study makes several significant recommendations to administrators in higher educational institutions, in addition to contributing to the vast literature on TL. The study suggests that administrators must invest resources in developing TL skills so that employees reach their fullest potential and contribute to achieving organizational goals. In addition, leaders in organizations need to exercise a transformational style to combat the new normal post-pandemic academic environment.Originality/valueThis study provides new insights into the importance of TL style and institutional influence to enhance performance. To the best of our knowledge, the conceptual model developed and tested the first of its kind in India, significantly contributing to theory and practice.
The different impact of utilitarian and hedonic attributes on web-based retail shopping behaviour through the lens of extended technology acceptance model
Authors: Taufique Khan Md. Raziuddin , Sabbir Md. Mahiuddin , Quinton Sarah , Andaleeb Syed Saad 
Published: March 2024

PurposeAcknowledging previous scholarly focus on functional attributes in understanding technology acceptance behaviour, the current study aims to offer a novel perspective by integrating eight different dimensions of utilitarian and hedonic attributes to examine their influence in delivering a holistic web-based retail shopping experience.Design/methodology/approachThe research model was tested and validated through data collected from 370 online shoppers across both hedonic and utilitarian product ranges. Hypotheses were tested using covariance-based structural equation modelling with multi-group analysis to examine the moderation effect.FindingsThe findings strongly support the model confirming eight new utilitarian and hedonic dimensions that influence web-based retail shopping behaviour. The findings also confirm that hedonic attributes remain important even for utilitarian product purchasing.Practical implicationsThe key managerial implication is the demonstrated need to balance utilitarian and hedonic attributes in web-based retail platforms, where previously, there has been an overemphasis on functional features. Web-based retailers should consider the optimal blend of utilitarian (e.g. information quality) and hedonic (e.g. aesthetic) attributes in the design of a retail shopping site, irrespective of the product category.Originality/valueThis study integrates multiple dimensions of utilitarian and hedonic attributes into a single model and highlights the interplay of these attributes, thus extending the technology acceptance model. This paper also advances scholarship through its identification of attribute impact across different product categories.
Trends and population attributable risk estimates for individual and community-level factors of neonatal mortality in Pakistan (1990–2018)
Authors: Kamal Asifa , Naz Lubna , Shakeel Abeera 
Published: March 2024

PurposePakistan ranks third globally in terms of newborn deaths occuring within the first 24 hours of life. With a neonatal mortality rate of 42.0%, it carries the highest burden compared to neighboring countries such as Bangladesh (17%), India (22.7%) and Afghanistan (37%). While there has been a decline in neonatal mortality rates in Pakistan, the pace of this decline is slower than that of other countries in the region. Hence, it is crucial to conduct a comprehensive examination of the risk factors contributing to neonatal mortality in Pakistan over an extended period. This study aims to analyze the trends and determinants of neonatal mortality in Pakistan over three decades, providing valuable insights into this persistent issue.Design/methodology/approachThe study focused on neonatal mortality as the response variable, which is defined as the death of a live-born child within 28 days of birth. Neonates who passed away during this period were categorized as “cases,” while those who survived beyond a specific timeframe were referred to as “noncases.” To conduct a pooled analysis of neonatal mortality, birth records of 39,976 children born in the five years preceding the survey were extracted from four waves (1990–2018) of the Pakistan Demographic and Household Survey. The relationship between risk factors and the response variable was examined using the Cox Proportional Hazard Model. Neonatal mortality rates were calculated through the direct method using the “syncmrates” package in Stata 15.FindingsDuring the extended period in Pakistan, several critical protective factors against neonatal mortality were identified, including a large family size, improved toilet facilities, middle-aged and educated mothers, female children, singleton live births, large size at birth and longer birth intervals. These factors were found to reduce the risk of neonatal mortality significantly.Originality/valueThis study makes the first attempt to analyze the trends and patterns of potential risk factors associated with neonatal mortality in Pakistan. By examining a large dataset spanning several years, the study provides valuable insights into the factors influencing neonatal mortality.Peer reviewThe peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-09-2022-0604
How CEO transformational leadership affects business model innovation: a serial moderated mediation model
Authors: Yao Nan , Guo Tao , Zhang Lei 
Published: March 2024

PurposeThis study aims to reveal how chief executive officer (CEO) transformational leadership affects business model innovation (BMI) by exploring the serial mediating role of top management team (TMT) collective energy and behavioral integration and the moderating role of TMT-CEO value congruence.Design/methodology/approachThe sample of 520 TMT members from 127 enterprises in North China was collected through a two-wave questionnaire survey. Hierarchical regression and bootstrapping were used to test the hypothetical relationships proposed in this study.FindingsThe results indicate that TMT collective energy and behavioral integration play a serial mediation role between CEO transformational leadership and BMI. TMT-CEO value congruence positively moderates the relationship between CEO transformational leadership and TMT collective energy as well as the serial mediation effect.Practical implicationsThe results suggest that CEOs can stimulate TMT collective energy by demonstrating transformational leadership behaviors, thereby promoting TMT behavioral integration and ultimately achieving BMI. In addition, to enhance the effectiveness of CEO transformational leadership, enterprises should take measures to ensure that TMT members hold values that are consistent with those of CEOs.Originality/valueBased on social cognitive theory, the mediating mechanism and boundary conditions of CEO transformational leadership that affect BMI are revealed by this study, thus opening the “black box” of the relationship between the two. It also supplements research on the role of TMT among the antecedents of BMI.
Using data as poetry and text in case study research – poetic representations of adult learner experiences in neighbourhood houses
Authors: Ollis Tracey , Harrison Ursula , Ryan Cheryl 
Published: March 2024

PurposeWe argue this method of inquiry better represents the participants' learning, lives and experiences in the formal neoliberal education system prioritising performativity, categorising and ranking students.Design/methodology/approachThe paper explores using poetry as a research method to reveal the learning experiences of adult learners, who have often had disruptive experiences of the formal schooling system and return to study in community-based education spaces. Inspired by Laurel Richardson’s transgressive technique of presenting sociological data through poetry as method, we use poetic representations of these learners' lives alongside case study research methodology. The research was conducted in conjunction with Neighbourhood Houses in Victoria, Australia. Qualitative data were generated through conducting multiple case studies of learners across various adult community education (ACE) sites. In this research, some case studies were presented in the traditional method of writing biography, others were written in the form of found poetry, which we refer to as data as poetry and text. The paper uses found poetry through participant-voiced poems written from interview transcripts. We argue this method of inquiry better represents the participants' learning, lives and experiences in the formal neoliberal education system prioritising performativity, categorising and ranking students. Our findings highlight the benefits of using poetry to communicate data in case study research as it effectively represents the experiences of adult learners' lives in a creative and concise form, transgressing normative practices of writing education research. These poetic representations of data reveal learner experiences in an embodied and agentic way while providing readers with a deep and rich understanding of these crucial adult learning spaces.FindingsOur findings highlight the benefits of using poetry to communicate data in case study research as it effectively represents the experiences of adult learners' lives in a creative and concise form, transgressing normative practices of writing education research.Originality/valueThis research paper is empirical research and has not been submitted elsewhere for publication.