bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Chinese “Discovery” of the Americas, Zheng He’s Voyages to the Indian Ocean, and Early Globalization
Authors: Yan Wu , Chen Zhongping , Church Sally K. 
Published: August 2023

Abstract
This article undertakes a thorough investigation of the assertion in recent publications, both Chinese and foreign, that Zheng He’s fleet “discovered” the Americas, and traces it back to its origins. It comprehensively examines all the major arguments that have been made concerning the question of whether Chinese people sailed to the Americas before Cristopher Columbus, from the pre-Qin dynasty to the early Ming dynasty. It reveals both contributions and problems of previous studies of the subject, pointing out how the various theories on this topic and surrounding discussion have evolved, the reliability and dubiousness of the various points of view, and the academic significance of the debate. As the long-standing academic dispute over this question, it has helped collect relevant American archaeological, written, and oral sources as well as other such historical data, and has brought to light related Chinese documents as well as ancient Chinese and foreign maps and other materials. The academic significance of the relevant scholarship also lies in the comparative study of the civilizations of ancient China and the Americas on opposite sides of the Pacific Ocean. Through the identification and thorough study of Chinese and foreign materials, careful, serious, and responsible historians have not only refuted the exaggerated claims for Chinese “discovery” of the Americas, but have also tried to reject the Sinocentrism that arises from these distortions. The scholars in China have also discovered, within the study of Zheng He’s maritime expeditions, the true aspects of their history that Chinese people can feel proud of. This article sifts through both the arguments and counterarguments as well as their respective evidence, and it pursues further textual research on relevant documents and materials for the purpose of examining the possibility for Chinese visits to the Americas before Columbus. Seen from the point of view of globalization, even if Zheng He’s fleet or other Chinese people reached the Americas before Columbus, their journey (which awaits confirmation) could not have had as much influence on the links between the New and Old Worlds as did those of later explorers. In spite of this, the seven large-scale voyages of Zheng He’s fleet in the Indian Ocean promoted maritime links within the Old World before Columbus’s great voyages in the Atlantic, making contributions to the history of globalization that are as important as those made later by Columbus.
Use of finer needles for venipuncture increases in vitro haemolysis despite reducing persistent pain and nerve injury: A retrospective study
Authors: Umemura Hiroshi , Takahashi Hiromichi , Fukuda Yoshiaki , Soma Hitoshi , Aoki Rumiko , Takei Norihisa , Nakayama Tomohiro 
Published: August 2023

Background Although venipuncture is minimally invasive, and is the most frequently performed medical procedure, it carries the small risk of causing persistent pain, including nerve damage. Recently, our hospital stopped using 22-gauge needles for venipuncture in outpatients and switched to using only 23- and 25-gauge needles. We investigated the impact of using only the finer needles on the incidence of persistent or neuropathic pain and the prevalence of haemolysis, as well as the impact of haemolysis associated with the needle change on other laboratory data. Methods We retrospectively collected and analysed data on venipuncture-associated pain complaints made during the 1-year period prior and 1-year period after the change in needles, as well as the frequency of haemolysis before and after the change. We also focused on 90 cases that showed significant haemolysis after the needle change and compared the serum aspartate aminotransferase, lactate dehydrogenase, and potassium levels before and after the needle change. Results The incidence of persistent pain was significantly reduced from 1 in 10,825 venipunctures before the change to 1 in 29,747 venipunctures after the change. Notably, no patients experienced neuropathic pain after the change. However, the prevalence of haemolysis was significantly increased. Additionally, the serum aspartate aminotransferase, lactate dehydrogenase, and potassium levels were significantly elevated in the cases that showed moderate to gross haemolysis after the needle change. Conclusion Using finer needles involves both advantages and disadvantages, and careful consideration is needed to determine which type of needle is in the best interests of the patient.
The relationship between typically developing school-age children’s screen time, participation and physical activity: An exploratory study
Authors: Nguyen Jennie Trinh , Brown Ted , Yu Mong-Lin 
Published: August 2023

Introduction: In recent years, screen-based activities have become increasingly popular amongst children and adolescents. Several studies have found increased screen time to be associated with sleep disturbances, poorer academic performance and reduced physical activity. However, not much is known about children’s activity preferences and participation in relation to their screen time. This study investigated the association between school-aged children’s screen time use and their activity participation and physical activity. Method: A sample of 25 parents/caregivers with typically developing children aged 8–12 years in Australia participated. Parents/caregivers completed the Children Screen Time Use Report (CSTUR) and Children Participation Questionnaire-School (CPQ-S). Child participants completed the CSTUR, Preferences for Activities of Children (PAC), Perceived Meaning of Occupations Questionnaire (PMOQ) and Physical Activity Questionnaire-Children (PAQ-C). Data were analyzed using Spearman Rho correlations. Results: Findings from this study found no statistically significant associations between the CSTUR and PAQ-C subscales in children aged 8–12 years. However, there were several significant correlations found between CSTUR and the PAC, PMOQ and CPQ-S scale scores. Conclusion: Occupational therapists need to consider screen-based activities in school age children and the impact it can have on their daily participation.
The Impact of SGLT2 Inhibitors on Cardiovascular Outcomes in Patients With Heart Failure With Preserved Ejection Fraction
Authors: Starr Jessica A. , Pinner Nathan A. 
Published: August 2023

Objective To evaluate the role of sodium-glucose cotransporter-2 (SGLT2) inhibitors in patients with heart failure with preserved ejection fraction (HFpEF). Data sources A literature search of PubMed, the Cochrane Library, and Google Scholar databases (January 2015 to June 20, 2023) was performed with keywords: sodium-glucose co-transporter 2 inhibitors OR SGLT2 inhibitors OR bexagliflozin OR canagliflozin OR dapagliflozin OR empagliflozin OR ertugliflozin OR sotagliflozin AND heart failure OR heart failure with preserved ejection fraction, and terms related to CV outcomes including cardiovascular death, hospitalization, hospitalization for heart failure, mortality, death, and major adverse cardiovascular event (MACE). Study selection and data extraction The reference list from retrieved articles as well as relevant review articles was considered. Pivotal randomized controlled trials and meta-analyses with a primary or secondary end point of CV death or heart failure hospitalization were included. Studies conducted solely in a diabetic patient population were excluded. Data synthesis Dapagliflozin and empagliflozin, in a broad population of heart failure patients including, HFrEF, HFmrEF, HFpEF, and without diabetes, have shown consistent improvement in the combined outcome of CV death and hospitalization for heart failure (HR 0.80, 95% CI 0.73-0.87) and in the reduction of heart failure hospitalizations (HR 0.74, 95% CI 0.67-0.83). In patients with HFpEF, cardiovascular mortality was not demonstrated (HR 0.88, 95% CI 0.77-1.00). Rates of adverse events were low. Relevance to patient care and clinical practice Patients with HFpEF and NYHA class II-III with frequent symptoms or hospitalizations for heart failure derive the most benefit from SGLT2 inhibitors with an overall goal of a reduction in heart failure hospitalizations. Conclusions The treatment of HFpEF has made progress, but there is still work to be done. Now, SGLT2 inhibitor therapy can be used to further help with symptom control and reduce overall hospitalizations for heart failure.
Daptomycin Plus Oxacillin for Persistent Methicillin-Susceptible Staphylococcus aureus Bacteremia
Authors: Kufel Wesley D. , Zagoria Zoey , Blaine Bruce E. , Steele Jeffrey M. , Mahapatra Rahul , Paolino Kristopher M. , Thomas Stephen J. 
Published: August 2023

Background: The preferred antibiotic salvage regimen for persistent methicillin-susceptible Staphylococcus aureus bacteremia (MSSAB) is unclear. Ertapenem with cefazolin or an antistaphylococcal penicillin has been primarily described, but identifying alternative carbapenem-sparing options may support antibiotic stewardship efforts and decrease the risk of antibiotic-associated Clostridioides difficile infection. Objective: We sought to evaluate the effectiveness and safety of daptomycin plus oxacillin (D/O) for persistent MSSAB. Methods: This was a single-center, retrospective cohort of patients with persistent MSSAB who received D/O between January 1, 2014, and January 1, 2023. Adult patients were included if they had blood cultures positive for MSSA ≥72 hours and received D/O combination for ≥48 hours. Patients were excluded if they were pregnant, incarcerated, or received another antibiotic considered to have excellent activity against MSSA. The primary outcome was time to MSSA bacteremia clearance post-daptomycin initiation. Secondary outcomes included microbiological cure, hospital length of stay, 90-day all-cause mortality, MSSA bacteremia-related mortality, 90-day readmission for MSSAB, and incidence of antibiotic-associated adverse effects. Time to MSSAB clearance post-D/O initiation was plotted using Kaplan-Meier estimation. Results: Seven unique patient encounters were identified including 4 with endocarditis. Despite a median MSSA bacteremia duration of 7.8 days, median clearance was 2 days post-daptomycin initiation. All achieved microbiological cure, and no adverse effects were reported. Ninety-day all-cause mortality, MSSAB-related mortality, and 90-day readmission for MSSAB occurred in 28.6%, 14.3%, and 14.3% of patients, respectively. Conclusions and Relevance: D/O was an effective, well-tolerated salvage regimen in this cohort and may represent a carbapenem-sparing option for persistent MSSAB.
Comparison of Early Versus Late Adjunctive Vasopressin and Corticosteroids in Patients With Septic Shock
Authors: Alshehri Abdulmajeed M. , Kovacevic Mary P. , Dube Kevin M. , Lupi Kenneth E. , DeGrado Jeremy R. 
Published: August 2023

Background Vasopressin (VP) and hydrocortisone (HC) have been shown to improve outcomes in patients with septic shock. However, there is very little literature addressing the impact of the timing of the combination. Objective This study was conducted to evaluate the impact of early versus late initiation of both VP and HC on time to shock reversal in septic shock patients. Methods This was a retrospective study conducted at a tertiary academic medical center. Data were collected from system-generated reports, which were used to identify patients with septic shock who were admitted to an intensive care unit (ICU) and received both VP and HC. The primary endpoint was time to shock reversal. Patients were divided into the “early” group if both VP and HC were initiated within 12 hours of vasopressor initiation or into the “late” group if either VP or HC (or both agents) were initiated after 12 hours of vasopressor initiation. Results A total of 122 patients were included in the analysis. Early initiation was associated with a shorter time to shock reversal (34 hours vs 65 hours; P = 0.012) compared to late initiation. There were no differences in ICU length of stay, mortality, the number patients requiring renal replacement therapy, or the duration of mechanical ventilation in either group. Conclusion and relevance Our study addressed a major gap in the literature and suggests that adding the combination of VP and HC within 12 hours of septic shock may be associated with improved patient outcomes.
Interpreting International Mindedness in Dutch State-funded International Schools: an educational leadership perspective
Authors: Scott Andrew 
Published: August 2023

This article focuses on the challenges faced by educational leaders of international schools in conceptualising international mindedness. Further articles are planned which will focus on how the wider social and school context influence educational leaders’ promotion of international mindedness, and on why educational leaders are drawn to values-leadership models in its promotion. The use of the term international mindedness has grown significantly over the last thirty years. It is now in common usage in many international schools (Hayden et al, 2015), and is used specifically by both the International Baccalaureate and the International Primary Curriculum to describe the core values that underpin the educational programmes they offer. It is a broad concept whose advocates claim it encapsulates the values and ideals of international education that seek to promote greater global understanding and awareness (Hill, 2014). However, the value and appropriateness of the term remain contested (Haywood, 2015; Savva and Stanfield, 2018). There is also a growing body of literature that has highlighted the importance of educational leaders in promoting school-wide values (Hallinger and Huber, 2012; Day et al, 2016). If we are to better understand the significance of international mindedness to the wider field of international schools, we need to develop a greater awareness of what shapes educational leaders’ understanding of a core value such as international mindedness, and what it is they hope to achieve within the wider social and school context within which they are operating. The first section of this article explores how international mindedness is conceptualised and the current debates surrounding it, presenting a conceptual framework for international mindedness that draws on academic literature from the wider field of international education. The second section is based on empirical research carried out into educational leadership in a group of international schools.
The Learning Experience Designer Skillset: Employer Expectations
Authors: Waight Consuelo L. , Edwards Malaika T. , Waight Judy E. 
Published: August 2023

The Problem Learning designers are central to employee capability transformations, and their contributions became invaluable during Covid-19. Resultantly, jobs for learning experience (LX) designers became more noticeable. Yet not much is known about LX designer skills. While there are assumptions that a LX designer may be similar to an instructional designer or technologist, there is no empirical evidence. The Solution In defining the skills of an LX designer, the employer’s voice is essential. In this study, we applied a case study design and examined 25 LX designer job announcements (JAs) across eight industries. The Stakeholders Through this study, employers can introspect on the development of their JAs and their expectations of LX designers. Professors who teach learning and instructional design courses can strengthen their course content alignment with the LX designer skillset. Researchers can use the suggested studies to further the LX designer discourse.
Genetic liability to frailty in relation to functional outcome after ischemic stroke
Authors: Cai Huan , Zhang Hao , Liang Jialin , Liu Zhonghua , Huang Guozhi 
Published: August 2023

Background: Frailty appears to be associated with unfavorable prognosis after stroke in observational studies, but the causality remains largely unknown. Aims: The aim of this study is to investigate the potential causal effect of frailty on functional outcome at 3 months after ischemic stroke using the Mendelian randomization (MR) framework. Methods: Genetic instruments for frailty index were identified in a genome-wide association study meta-analysis including 175,226 individuals of European descent. Corresponding genetic association estimates for functional outcome after ischemic stroke at 90 days were taken from the Genetic of Ischemic Stroke Functional Outcome (GISCOME) network of 6021 patients. We performed inverse-variance weighted MR as the main analyses, followed by several alternate methods and sensitivity analyses. Results: In univariable MR, we found evidence that genetically predicted higher frailty index (odds ratio (OR) = 5.12; 95% confidence interval (CI) = 1.31–20.09; p = 0.019) was associated with worse functional outcome (modified Rankin Scale score ⩾3) after ischemic stroke. In further multivariable MR adjusting for potential confounding traits including body mass index, C-reactive protein, inflammatory bowel disease, and smoking initiation, the overall patterns between genetic liability to frailty and poor functional outcome status remained. Sensitivity analyses with complementary methods and with model unadjusted for baseline stroke severity (OR = 4.19; 95% CI = 1.26–13.90; p = 0.019) yielded broadly concordant results. Conclusions: The present MR study suggested a possible causal effect of frailty on poor functional outcome after ischemic stroke. Frailty might represent a potential target for intervention to improve recovery after ischemic stroke.
Assessing housing exposures and interventions that impact healthy cities: a systematic overview of reviews
Authors: Richards GC , Carpenter J , Okpalugo E , Howard DJ , Heneghan C 
Published: August 2023

Aim: There are direct links between housing and health. However, there is a lack of systematic reviews that bring together the evidence to outline the health impacts of exposures in housing and housing interventions. This article aims to address this gap by synthesising systematic reviews on the themes of housing exposures and interventions. Methods: We searched four databases: Scopus (Elsevier), PsycINFO (OvidSP), Science Citation Index and Social Science Citation Index (Web of Science Core Collection), and the Sociology Collection (Proquest). We used keywords related to ‘health’ and ‘city*’ and included all types of reviews. We extracted data into a predesigned extraction form and synthesised information narratively. Results: 745 articles were identified and screened, of which 256 reviews were included and 16 (6%) related to housing. All reviews related to housing exposures found that poor housing, including crowding, coldness, dampness, mould, and indoor air pollution had a negative impact on health. Most reviews found that housing interventions such as housing refurbishment, heating, and energy efficiency interventions positively impacted health outcomes. An online toolkit was developed to disseminate and communicate this research: https://www.healthycitiescommission.org/toolkit/ . Conclusion: Governments have a pivotal role in addressing health issues related to housing interventions and exposures in housing. This includes interventions through building regulations following international guidance and financial assistance to encourage housing modifications that will improve health.
Assessing the Effects of Pulsed Electromagnetic Therapy on Painful Diabetic Distal Symmetric Peripheral Neuropathy: A Double-Blind Randomized Controlled Trial
Authors: Tassone Erica E. , Page Jeffrey C. , Slepian Marvin J. 
Published: August 2023

Background: Significant complications of diabetes include pain and the loss of sensation in peripheral limbs. Pain management of diabetic symmetric peripheral neuropathy (DSPN) remains challenging. This study reports on utilizing pulsed electromagnetic field therapy (PEMF) to reduce pain and improve skin perfusion pressure (SPP) in subjects with DSPN. Methods: A randomized, sham-controlled, double-blind, clinical trial was conducted on subjects afflicted with foot pain associated with DSPN. Following informed consent, 182 subjects with diabetes and confirmed DSPN were entered into the trial for a period of 18 weeks. Subjects were randomized into active PEMF treatment or nonactive sham and instructed to treat to their feet for 30 minutes, twice daily and report daily pain scores. Some patients in the active arm experienced a transient low field strength notification (LFSN) due to improper pad placement during treatment. Skin perfusion pressure measurements were also collected at two and seven weeks to assess peripheral arterial disease effects via measurement of local microcirculatory flow and blood pressure. Results: Patients in the active arm who did not receive an LFSN experienced a clinically significant 30% reduction in pain from baseline compared to sham ( P < .05). Though not statistically significant, SPP in the active group trended toward improvement compared to sham. Conclusions: Pulsed electromagnetic field therapy appears effective as a nonpharmacological means for reduction of pain associated with diabetic peripheral neuropathy and holds promise for improvement of vascular physiology in microcirculatory dysfunction associated with diabetic peripheral arterial disease.
Comparing Current Practice Habits for Treatment of Subcondylar Fracture Among Craniomaxillofacial Surgeons
Authors: Schopper Heather K. , Dunn Brandyn , Davila Richard , Sykes Kevin J. , Flynn John P. , Kriet J. David , Humphrey Clinton D. 
Published: August 2023

Study Design Survey. Objective Subcondylar fractures stand out as a particular challenge when treating maxillofacial trauma. The fracture site is often difficult to access and adjacent to critical structures like the facial nerve. Current treatment paradigms vary widely and we endeavored to elucidate these approaches from surgeons across the full breadth of Craniomaxillofacial Surgery. Methods A survey was designed to gather general background training and experience information, perceived indications for ORIF of subcondylar fractures, options for treating subcondylar fractures, and reasoning for choosing or not choosing a given treatment approach. The survey was sent to members of AO CMF and the American Academy of Facial Plastic Surgery. Responses were collected for 4 weeks. Results 514 total responses to the survey were obtained (response rate 17%). Of these, 43 (8.4%) identified as Otolaryngology trained, 417 (81.1%) as OMFS trained, and 54 (10.5%) as Plastic Surgery trained. While there was broad agreement in the indications for open repair, surgical approaches differed by specialty background as well as AO faculty member status. Those with less experience were less likely to perform open approaches due to lack of comfort with this skill set. Conclusions There are some key differences in approaches to treatment of subcondylar fractures based upon specialty background and experience level. This provides an opportunity for further education to ensure optimal treatment for patients.