bluuebunny/crossref_metadata_2025_split huggingface dataset:
Contending American Visions of North Korea: The Mission Civilisatrice versus Realpolitik
Authors: Cha Taesuh 
Published: November 2023

This article aims to situate US–DPRK relations in a broader historical and theoretical context, that is, part of the violent encounters between the West and the ‘Rest’ in modern times, to examine discursive causes of their animosity and devise preliminary solutions to usher in peace and reconciliation in the Korean Peninsula. Drawing on a postcolonial reading of the liberal internationalist project and the global nuclear order, as well as a reflexive realist critique of US foreign policy toward the rogue states, this research explores how two competing geopolitical discourses, the mission civilisatrice and realpolitik, have constructed the epistemological problématique of Washington’s approach to Pyongyang and contributed to internal tensions in it over time. After analyzing the historical trajectory of America’s contrasting understandings of the Korean question, I seek to offer their implications on the dramatic change in the bilateral relations in the Trump era. By interrogating Trump’s realist turn in grand strategy and its unexpected influence on the two Cold War enemies’ mini-détente in 2018–2020, this article asks how a genuine dialogue between the liberal, ‘civilized’ center and the illiberal, ‘barbarian’ periphery can be materialized in an alternative normative setting. In particular, I argue that Trump’s new realist trial posed a critical question on how to depart from old ontological assumptions that frame the dominant liberal internationalist/neoconservative approaches toward a more dialogical and equal negotiation and compromise. A peaceful resolution of the North Korean dilemma is inherently related to a larger reflexivist project that promotes a thorough interrogation of the self-righteous US identity and a great transformation of America’s imperialist monologue toward the Third World in general. Des visions américaines concurrentes de la Corée du Nord : Mission civilisatrice vs Realpolitik
Government resource allocation through related party transactions: Evidence from China
Authors: Wang Lu , Chi Jing , Liao Jing 
Published: November 2023

Using unique hand-collected data of related party transactions (RPTs) between state-owned enterprises (SOEs) and government noncorporate agencies in China, we investigate the behavior of government resource allocation and its impacts. We find that Chinese governments are more likely to allocate resources to SOEs with a politically connected chairperson of the board through RPTs. The results remain robust after considering endogeneity concerns. In SOEs with a politically connected chairperson, resources obtained through RPTs are not associated with improved economic outputs except for increased investment expenditures. In addition, resources obtained are associated with improved labor cost stickiness. Our results add new evidence of the political exchange between Chinese governments and SOEs facilitated by politically connected executives. JEL Classification: G30, G38
Behavioral and Psychiatric Health Problems in Iranian Children and Adolescents During the COVID-19 Pandemic: A Cross-Sectional Study
Authors: Talebi Mahdi , Kiani Mohammad Ali , Sany Seyedeh Belin Tavakoly , Chesneau Christophe , Peyman Nooshin 
Published: November 2023

Background: The COVID-19 pandemic caused the long-term quarantine of most children and adolescents. Behavioral and psychiatric health issues with child protection need to be evaluated in disasters. The present study aimed to examine the behavioral and psychiatric status of children and adolescents during the pandemic to address the effects of the pandemic and isolation on children’s and adolescents’ behavioral and psychiatric health. Methods: The present cross-sectional study was carried out on 322 students aged 10–18 attending public high and elementary schools in Esfahan, Iran. The parents completed the Child Symptom Inventory-4 (CSI-4). Results: Findings showed that 58% of students met the criteria for all psychiatric symptoms except for autism and Asperger’s disorder, and 5% suffered from more than one comorbid category of psychiatric disorders. The most common psychiatric disorders in boys and girls were ADHD (18.5%), ODD (15%), ADHD-C (13.5%), GAD (12.8%), ADHD:HI (11.5), and MDD (10.8%). Conclusions: Since most participants suffered from at least one comorbid category of psychiatric disorders, developing a psychological crisis intervention is essential to protect children and adolescents from such disasters and minimize their mental health outcomes.
Gender dysphoria: Reconsidering ethical and iatrogenic factors in clinical practice
Authors: Halasz George , Amos Andrew 
Published: November 2023

Objective To examine the treatment of gender dysphoria described in Bell v Tavistock (UK 2020). Bell documents the treatment and sequelae of a 16-year-old adolescent referred to the Tavistock with gender dysphoria. Her case highlights contrasts between gender affirming care and comprehensive care. Conclusions Consistent with other western centres, in the 2010s, the Tavistock began treating patients with gender dysphoria under the ‘Dutch protocol’ for gender affirming care. Bell reveals concerning lapses of clinical governance influenced by activists and linked to patient harm. The recent suspension of a senior child psychiatrist from an Australian public hospital service after questioning the evidence base and ethical foundation of gender affirming care underlines the need to resolve these uncertainties to address the crisis in the treatment of gender dysphoria.
Mental Health Reform Processes and Service Delivery Shift From the Hospital to the Community in Belgium and Hong Kong
Authors: Honyashiki Mina , Decoster Jeroen , Lo William Tak Lam , Shimazu Taichi , Usuda Kentaro , Nishi Daisuke 
Published: November 2023

Aim: We aimed to illustrate and compare the processes of mental health policies aiming at a service delivery shift from the hospital to the community using implementation science, and to identify important implementation strategies. Methods: This study had a comparative case study design. The cases were the Belgian mental health reform, and the person-centered model of mental health in Hong Kong, China. Several documentary sources were reviewed, including the published literature and websites. Data on policy processes were extracted, analyzed using directed content analysis, and categorized into constructs of the conceptual model for evidence-informed policy formulation and implementation arranged for the mental health policy. Results: Several similarities were identified in the strategies for active implementation and dissemination; official staff allocation, and training to the community psychiatric services, an approach to adjust the number of psychiatric hospital beds, and promoting collaboration between health care sectors and social welfare sectors. Under distinct social contexts, differences were found in all processes. Conclusions: Each of the described policy processes can serve as a model for countries in similar social contexts seeking to shift their psychiatric service delivery. Furthermore, our findings suggest widely applicable implementation strategies for policies aiming at a service delivery shift.
Case Report: Successful Treatment of Aberrant Left Subclavian Artery With a Right-Sided Aortic Arch
Authors: Matta Rishabh , Shah Anil , Bandesha Harmanpreet , Thiagarajasubramanian Shruthi , Muluk Satish 
Published: November 2023

Right sided aortic arches with concomitant aberrant left subclavian arteries are exceedingly rare anatomical variants. We present a case of a 45 year old male that presented with symptoms consistent with dysphagia and known right sided aortic arch with an aberrant left subclavian artery. Though previous reports of repair have indeed been reported, we confirm that a hybrid approach to these anatomic variants remain feasible and with symptom resolution for patients.
Investigating the role of treatment adherence in predicting marital satisfaction among women with coronary artery disease: A cross-sectional study from Iran
Authors: Rad Parvin Zandi , Gharibi Tayebeh , Vahedparast Hakimeh , Bagherzadeh Razieh 
Published: November 2023

IntroductionDespite the effect of coronary artery disease on sexual function and the relation between sexual function and marital satisfaction, few studies have investigated the effect of treatment adherence on marital satisfaction. The present study aims to investigate the role of treatment adherence in predicting marital satisfaction among women with coronary artery disease.MethodologyIn this cross-sectional study, 385 women with coronary artery disease in Bushehr-Iran, 2021, were selected using a convenient sampling method. The data were collected using the demographic form, Seyed Fatemi medication adherence scale, female sexual function index, and evaluation and nurturing relationship issues, communication, and happiness marital satisfaction scale. The data was analyzed using univariate and multivariate logistic regression tests.ResultsThe mean (± standard deviation) age of the participants was 52.19 ± 12.15 years old. Considering the effect of demographic variables, treatment adherence ( β = 0.164, P = 0.001) and sexual function ( β = 0.156, P = 0.001) were positive predictors of marital satisfaction.ConclusionTreatment adherence was a positive predictor of marital satisfaction. Healthcare providers should pay attention to the family consequences of non-adherence to treatment. Moreover, when counseling patients to adhere to the treatment, they should mention the physical benefits as well as psychological and family outcomes in order to motivate patients to follow their treatment.
Magnetic Resonance Imaging Characteristics of a Lateral Ligament Injury in Acute Ankle Sprains Among Athletes
Authors: Kim Jin Su , Kim Min Seok , Kim Do Kyun , Lee Sung Hyun 
Published: November 2023

Background: It is important to identify the location and pattern of lateral ligament injuries that are related to the development and prognosis of chronic ankle instability in athletes with ankle sprains. Purpose: To describe the location and pattern of lateral ligament injuries on magnetic resonance imaging (MRI) in elite-level or amateur athletes with acute ankle sprains and to further assess the risk of associated concomitant injuries. Study Design: Cross-sectional study; Level of evidence, 3. Methods: The anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) of 110 athletes with an ankle lateral ligament injury (mean age, 24.7 years) were evaluated. MRI scans were evaluated for the location and pattern of ATFL and CFL tears such as sleeve avulsions as well as concomitant deltoid ligament injuries, bone contusions, and osteochondral lesions of the talus (OLTs). Results: On MRI, 52 (47.3%) athletes had an isolated ATFL tear, 56 (50.9%) athletes had both ATFL and CFL tears, and 2 (1.8%) athletes had an isolated CFL tear. ATFL injuries occurred at the fibula, midsubstance, and talus in approximately equal numbers, whereas the majority of CFL injuries occurred at the calcaneal insertion. Concomitant deltoid ligament injuries were identified in 18 (16.4%) athletes. In addition, concomitant bone contusions and OLTs were identified in 38 (34.5%) and 6 (5.5%) athletes, respectively. Using linear-by-linear analysis, CFL injuries correlated with concomitant deltoid ligament and bone injuries ( P = .023 and P = .001, respectively) and a sleeve injury pattern ( P = .005). Conclusion: After an acute ankle ligament rupture, almost all athletes involved in this study had injured their ATFL, and approximately 50% had a concomitant injury to the CFL. The rate of sleeve-type CFL injuries at the calcaneal insertion was high, and concomitant deltoid ligament injuries and OLTs were associated with this pattern of injury.
History Repeats Itself: The Relevance of Historical Pandemics to the Medical School Curriculum
Authors: Jones M , Quenby S , Odendaal J 
Published: November 2023

Introduction The dramatic global impact of the coronavirus pandemic has increased consideration on epidemiological progressions of pandemics. Measures implemented to reduce viral transmission have been largely historical, comparable in nature with the 1918 and 2009 influenza pandemics, demonstrating the importance of clinicians’ awareness on historical pandemics. Despite this, literature suggests medical students’ knowledge on previous pandemics is poor. Objectives This study aims to gather stakeholder information from UK medical students on the importance of including the history of pandemics in the medical school curriculum. Methods A cross-sectional cohort study conducted via a mixed question type online survey was distributed to all UK medical schools to explore stakeholder views. Grounded theory emergent coding was used to generate themes to free-text answers and SPSS and Excel were used to analyse quantitative data using pivot tables and Fishers exact tests. Results Two hundred and forty-one students consented to take part from eight medical schools in the UK with 98% of these students completing the questionnaire. 34% of students reported having teaching on pandemics with 78% of students stating it would be beneficial. Knowledge was poor with 5.7% of students achieving 100% on knowledge-based questions. 72% of students believed that learning about the history of medicine would be beneficial with 87% of these students referring to ‘benefiting (the) future’ in their answers. Additionally, 79% of students thought it would be beneficial to learn about historical pandemics with reference to the current COVID-19 pandemic. Conclusion To date, this is the only UK based study assessing stakeholders’ views on including the history of pandemics in the medical school curriculum. Our findings demonstrate that medical students wish to have more historical content included in their degree to better prepare tomorrow's doctors for situations that may occur when history repeats itself.
Experiences of engaging a death doula: qualitative interviews with bereaved family members
Authors: Rawlings Deb , Van Dinther Kristine , Miller-Lewis Lauren , Tieman Jenifer , Swetenham Kate 
Published: November 2023

Background: There has been an emerging trend of adopting a death doula, a non-medical advocate and guide for people at the end of life and their families. While there has been growing empirical research regarding the work of death doulas, no studies have been undertaken with the families who have engaged them. Objectives: To understand the experiences of families who used a death doula in terms of what they did for the patient and family; to understand the benefits and drawbacks of using a death doula; and to use family insight to determine cultural shifts towards death and dying, and what the death doula phenomenon tells us around our attitudes towards death and dying. Methods: We recruited and interviewed 10 bereaved family members to learn about their experiences using a death doula. This qualitative research took an interpretive phenomenological approach, and thematic analysis was used to analyse the data. Results: The most valuable attribute the families gained from death doulas was an increase in death literacy resulting in personal empowerment. Empowerment enabled positive end-of-life experiences for the family and personalised deaths for the patient. A novel finding was that the connections and knowledge shared between the death doula and family had a resonant effect, resulting in families being more comfortable with death and keen to share their knowledge with others. Therefore, family engagement of a death doula led to an increase in community awareness around death and dying. Conclusion: Family members’ experience with a death doula was overwhelmingly positive, empowering them practically and emotionally to deliver the best end-of-life care. Empathy and sharing of knowledge by death doulas were valued by families and resulted in an increase in death literacy which provided families with opportunities to ‘pay it forward’. Furthermore, the relationships formed between doulas and families have the potential for a lasting, resonant effect.
Evaluation of parameters used in echocardiography and ultrasound protocol for the diagnosis of shock etiology in emergency setting
Authors: Ramadan Asmaa , Abdallah Tamer , Abdelsalam Hassan , Mokhtar Ahmed , Razek Assem Abdel 
Published: November 2023

Abstract
Background
Early recognition and appropriate treatment has shown to decrease morbidity and mortality in patients with undifferentiated shock. There are many ultrasound protocols in shock; each protocol combines core ultrasound elements such as IVC and cardiac assessment which includes detection of cardiac tamponade, left ventricular function and right ventricular strain.Valvular assessment is absent in majority of ultasound protocols, while lung ultrasound is included in some of them.

Objective
In this study we investigated which parameters used in Echo – US protocol help differentiate shock types.

Methods
This cross sectional study was conducted on 150 patients with shock (140 patients were included while, 10 patients were excluded).Sensitivity and specificity of different parameters used in the Echo-US protocol were analyzed to detect which parameters can diffentiate shock types.

Results
Velocity time integral of Aorta and IVC maximum diameter were good discriminators for distributive shock, with area under the ROC curve (AUC) = 0.8885 (95% CI 0.8144 to 0.9406) and 0.7728 (95% CI 0.6832 to 0.8473) (Z = 10.256 p < 0.0001) and (Z = 5.079 p < 0.0001) respectively. Left ventricular systolic function, presence of pneumonia, pneumothorax or valve vegetations were of great value in differentiating shock types, while CUST, FAST, TAPSE and RV diameter were not useful in differentiating shock types.

Conclusion
Ultrasound and echocardiography are powerful tools that can be used to identify shock etiology when the clinical picture overlaps.
The perceived self-efficacy of senior, middle, and operations managers of the incident command system dealing with emergencies and disasters during the COVID-19 pandemic
Authors: Aminafshar Asiye , Sartipi Majid , Pakzad Abdolrazzagh 
Published: November 2023

Abstract
Background
Natural disasters, health, terrorism, infectious diseases, and social unrest affect more than 200 million people worldwide each year. The present study is an attempt to evaluate the self-efficacy of senior, middle, and operational managers of the Incident Command System (ICS) of Zahedan University of Medical Sciences in Iran.

Methods
The study examined the perceived self-efficacy of 103 senior, middle, and operational managers of the Incidence Command System (ICS) of Zahedan University of Medical Sciences in 2021. Sampling was done by census using a designed questionnaire based on Bandura’s self-efficacy concepts. Based on Factor Analysis, 4 factors were extracted. The factors were labeled and analyzed.

Results
The number of people who had passed the crisis management course was 57. Seventy-one participants reported their participation in crisis management. The score obtained by men in Factor 3 (F3) was significantly higher than women, but not in other factors. People with stable employment scored far higher in Factor 1 (F1) than those with unsustainable employment conditions. Those who had passed the Crisis Management courses had a higher average score, but only in the three factors 1, 2, and 4, this difference was significant.

Conclusion
Even training the temporary staff is an organizational investment that can return benefits to the system. This enhances their perceived self-efficacy and promotes their commitment to the organization. Therefore, empowering these managers should be a priority.
HBV pregenome RNA as a predictor of spontanous HBeAg seroconversion in HBeAg-positive chronic hepatitis B patients
Authors: Song Guangjun , Yang Ruifeng , Jin Qian , Liu Juan , Rao Huiying , Feng Bo , Xie Yandi 
Published: November 2023

Abstract
Background
Previous studies have indicated that HBV pregenome RNA (HBV pgRNA) could predict HBeAg seroconversion among the chronic hapatitis B (CHB) patients treated with pegylated interferon (Peg-IFN) or nucleos(t)ide analogues (NAs). However, the data about the prediction of HBV pgRNA for spontaneous HBeAg seroconversion is limited.

Methods
One hundred thirteen CHB patients with HBeAg-positive in the immune active phase were followed up for 76 weeks without antiviral treatment. Based on the laboratory test results of liver function, HBeAg, anti-HBe, and HBV DNA at week 76, patients were assigned to two groups: spontaneous HBeAg seroconversion (group A, n = 18) and non-spontaneous HBeAg seroconversion group. Among the latter group, 36 patients were selected as controls (group B, n = 36).

Results
At week 12, between group A and group B, there was a significant difference in the level of HBV pgRNA (group A 6.35 ± 1.24 log10 copies/ml and group B 7.52 ± 0.79 log10 copies/ml, P = 0.001), and the difference enlarged at week 28. The receiver operating characteristic curves (AUROCs) of the HBV pgRNA level and the ∆HBV pgRNA at week 28 were 0.912 (P = 0.001, 95% CI: 0.830–0.994), and 0.934 (P = 0.001, 95% CI: 0.872–0.996), respectively. The optimal cutoffs of HBV pgRNA and the reduction from baseline (∆HBV pgRNA) at week 28 for spontaneous HBeAg seroconversion prediction were 5.63 log10 copies/ml and 1.85 log10 copies/ml, respectively. The positive predictive value and negative predictive value of HBV pgRNA and ∆HBV pgRNA at week 28 were 86.7% and 87.2%, 87.5% and 89.5%, respectively. And the combination of the HBV pgRNA level and the HBV pgRNA decreased could provide better prediction.

Conclusions
HBV pgRNA is a sound predictor for spontaneous HBeAg seroconversion among the CHB patients in immune active phase. Dynamic monitoring of HBV pgRNA is helpful for clinical treatment decision.
Evaluation of the impact of COVID-19 pandemic on hospital-acquired infections in a tertiary hospital in Malaysia
Authors: Ismaeil Rehab , Nahas Abdul Rahman Fata , Kamarudin Norhidayah Binti , Abubakar Usman , Mat-Nor Mohamad Basri , Mohamed Mohamad Haniki Nik 
Published: November 2023

Abstract
Background
Infection prevention measures are the gold standard for preventing the spread of hospital-acquired infections (HAIs). COVID-19 pandemic caused major disruptions in infection prevention measures, and this has implications on the rate of HAIs. This study assessed the impact of COVID-19 pandemic on the rate and the types of HAIs at Sultan Ahmed Shah Hospital.

Method
This is a retrospective cohort study that compared the rate of HAIs from April to October 2019 (pre COVID period) and April to October 2020 (during COVID period). Data was collected through the review of patients’ electronic medical records.

Results
There were a total of 578 patients included in the selected wards during the pre- and during the pandemic. Thirty-nine episodes (12.1%) of HAIs were report in the pre COVID period and 29 (11.3%) during COVID-19. In both periods, hospital-acquired pneumonia (HAP) was the most frequent HAI among the patients. There was a rise in catheter-associated bloodstream infections (CLABSI) (0.8%) and ventilator associated pneumonia (VAP) (1.1%) during the COVID-19 period. The most common bacteria were methicillin-resistant Staphylococcus aureus (MRSA) (28.2%) and Enterococcus faecalis (17.9%) in the Pre COVID-19 period, and Pseudomonas aeruginosa (27.6%) and Stenotrophomonas maltophilia (6.9%) during COVID-19.

Conclusion
Our research concluded that the rates of HAIs during the COVID-19 pandemic were not significantly impacted by the improved in-hospital infection prevention efforts to control the pandemic. There is need for further efforts to promote adherence to preventive practices.