bluuebunny/crossref_metadata_2025_split huggingface dataset:
Advocating for the Vulnerable
Authors: Matays Jennie , Scruth Elizabeth , Kawar Lina Najib , Cluff Sarah Comey , Fogli Alexandra , Salas Mary , Harrington Charlene 
Published: April 2023

IntroductionNursing homes have been disproportionally affected by the COVID-19 pandemic, particularly because of resident vulnerability, inadequate staffing, and poor quality of care.Current StateDespite billions of dollars in funding, nursing homes often do not meet minimum federal staffing requirements and are frequently cited for infection prevention and control deficiencies. These factors significantly contributed to resident and staff deaths. For-profit nursing homes were associated with more COVID-19 infections and deaths. Nearly 70% of US nursing homes are for-profit ownership, where quality measures and staffing levels are often lower than their nonprofit counterparts. Nursing home reform is urgently needed to improve staffing and care quality in these facilities. Some states, such as Massachusetts, New Jersey, and New York, have made legislative progress in establishing standards for nursing home spending. The Biden Administration has also announced initiatives, through the Special Focus Facilities Program, to improve nursing home quality and the safety of residents and staff. Concurrently, the “National Imperative to Improve Nursing Home Quality” report from the National Academies of Science, Engineering, and Medicine made specific staffing recommendations, including an increase in direct care registered nurse coverage.ConclusionThere is an urgent need to advocate for nursing home reform by partnering with congressional representatives or supporting nursing home legislation to improve care for this vulnerable patient population. Adult-gerontology clinical nurse specialists have an opportunity to leverage their advanced knowledge and unique skill set to lead and facilitate change to improve quality of care and patient outcomes.
Climate Change and Pregnancy: Risks, Mitigation, Adaptation, and Resilience
Authors: Fan Winnie , Zlatnik Marya G. 
Published: April 2023

ABSTRACT

Importance
Climate change is affecting the earth, resulting in more extreme temperatures and weather, rising sea levels, more frequent natural disasters, and displacement of populations of plants and animals, including people and insects. These changes affect food and housing security, vector-borne illnesses, and access to clean air and water, all of which influence human health.

Evidence and Results
There are a number of adverse health outcomes linked to heat, air pollution from wildfires, stress from natural disasters, and other elements of climate change. Pregnant people are especially vulnerable to the health harms resulting from climate change, namely, preterm birth, small for gestational age, hypertensive disorders of pregnancy, and other adverse reproductive health and birth outcomes. Strategies to minimize these harms include mitigation and adaptation.

Conclusions and Relevance
Physicians are in a unique position to protect the health of pregnant persons and children by advocating for policy changes that address climate change and providing clinical recommendations for patients to protect themselves from the health impacts of climate hazards.

Target Audience
Obstetricians and gynecologists, family physicians.

Learning objectives
After participating in this activity, physicians should be better able to describe the adverse health effects and pregnancy outcomes associated with elements of climate change; and identify strategies for patients to minimize the health harms from climate change, including mitigation, adaptations, and building resilience.
Automated Triage of Screening Breast MRI Examinations in High-Risk Women Using an Ensemble Deep Learning Model
Authors: Bhowmik Arka , Monga Natasha , Belen Kristin , Varela Keitha , Sevilimedu Varadan , Thakur Sunitha B. , Martinez Danny F. , Sutton Elizabeth J. , Pinker Katja , Eskreis-Winkler Sarah 
Published: April 2023

ObjectivesThe aim of the study is to develop and evaluate the performance of a deep learning (DL) model to triage breast magnetic resonance imaging (MRI) findings in high-risk patients without missing any cancers.Materials and MethodsIn this retrospective study, 16,535 consecutive contrast-enhanced MRIs performed in 8354 women from January 2013 to January 2019 were collected. From 3 New York imaging sites, 14,768 MRIs were used for the training and validation data set, and 80 randomly selected MRIs were used for a reader study test data set. From 3 New Jersey imaging sites, 1687 MRIs (1441 screening MRIs and 246 MRIs performed in recently diagnosed breast cancer patients) were used for an external validation data set. The DL model was trained to classify maximum intensity projection images as “extremely low suspicion” or “possibly suspicious.” Deep learning model evaluation (workload reduction, sensitivity, specificity) was performed on the external validation data set, using a histopathology reference standard. A reader study was performed to compare DL model performance to fellowship-trained breast imaging radiologists.ResultsIn the external validation data set, the DL model triaged 159/1441 of screening MRIs as “extremely low suspicion” without missing a single cancer, yielding a workload reduction of 11%, a specificity of 11.5%, and a sensitivity of 100%. The model correctly triaged 246/246 (100% sensitivity) of MRIs in recently diagnosed patients as “possibly suspicious.” In the reader study, 2 readers classified MRIs with a specificity of 93.62% and 91.49%, respectively, and missed 0 and 1 cancer, respectively. On the other hand, the DL model classified MRIs with a specificity of 19.15% and missed 0 cancers, highlighting its potential use not as an independent reader but as a triage tool.ConclusionsOur automated DL model triages a subset of screening breast MRIs as “extremely low suspicion” without misclassifying any cancer cases. This tool may be used to reduce workload in standalone mode, to shunt low suspicion cases to designated radiologists or to the end of the workday, or to serve as base model for other downstream AI tools.
Gadolinium Deposition Disease
Authors: Semelka Richard C. , Ramalho Miguel 
Published: April 2023

AbstractThis review describes the current knowledge of a form of gadolinium toxicity termed gadolinium deposition disease (GDD), supplemented with the opinions of the authors developed during 6 years of clinical experience treating GDD. Gadolinium deposition disease can also be considered a subset under the symptoms associated with gadolinium exposure rubric. Young and middle-aged White women of central European genetic origin are the most affected. The most common symptoms are fatigue, brain fog, skin pain, skin discoloration, bone pain, muscle fasciculations, and pins and needles, but a long list of additional symptoms is reported herein. The time of onset of symptoms ranges from immediate to 1 month after gadolinium-based contrast agent (GBCA) administration. The primary treatment is to avoid further GBCAs and metal removal through chelation. Presently, the most effective chelating agent is DTPA because of its high affinity with gadolinium. Flare development is an expected outcome, amenable to concurrent immune dampening. We emphasize in this review the critical nature of recognizing GDD when it first arises, as the disease becomes progressively more severe with each subsequent GBCA injection. It is generally very treatable after the first symptoms of GDD, often arising after the first GBCA injection. Future directions of disease detection and treatment are discussed.
Pathological Nodal and Vascular Involvement Significantly Impacts the Recurrence Risk in Different Time Frames in Patients With Resectable and Borderline Resectable Pancreatic Cancer
Authors: Takahashi Hidenori , Akita Hirofumi , Wada Hiroshi , Miyata Hiroshi , Eguchi Hidetoshi , Ohigashi Hiroaki , Sakon Masato , Ishikawa Osamu 
Published: April 2023

Objective:
To investigate the long-term dynamics of recurrence risk and the significance of prognostic variables using conditional recurrence-free survival (C-RFS) analysis in neoadjuvant treatment (NAT) for resectable (R) and borderline resectable (BR) pancreatic cancer (PC).

Background:
C-RFS analysis assesses the probability of achieving additional RFS according to the RFS already accrued.

Methods:
Patients with NAT and subsequent resection for R/BRPC were enrolled. In the C-RFS analysis, the actual 5-year RFS (5yRFS) rate was calculated separately in the subgroup that had already gained a given amount of RFS. The significance levels of prognostic variables associated with 5yRFS were assessed regarding their time-dependent dynamics in a conditional fashion.

Results:
Among the total 397 patients, 160 survived for more than 5 years without recurrence after surgery (actual 5yRFS rate: 45%). The probability of 5yRFS incrementally increased based on the RFS already accrued. Pathological nodal and vascular involvement were significant influencers of 5yRFS. The patients with nodal involvement consistently remained at significantly higher risk of recurrence than those without, even after 5yRFS, whereas positivity of vascular involvement was significantly associated with the risk of recurrence only during the early postoperative period and lost its significance after 3yRFS accrued.

Conclusions:
In NAT for R/BRPC, the probability of gaining additional RFS increases as a function of RFS already accrued, and the significance of prognostic variables time-dependently evolves in their own patterns during the long-term postoperative period.
Supply chain agility and firm performance: testing serial mediations in pharmaceutical industry
Authors: Ahmad Rehan , Shahzad Khurram , Ishaq Muhammad Ishtiaq , Aftab Junaid 
Published: April 2023

PurposeThe supply chain agility (SCA) is becoming a source of competitive differentiation but debate on its antecedents which can result in optimal firm performance is still non-pervasive in the literature. Taking this gap into consideration, the current research aimed at investigating various enablers of supply chain agility of Pakistani pharmaceutical industry.Design/methodology/approachThe data were collected from 204 top executives working in different supply chain functions including planning, supplying, operations and purchasing in national and multinational pharmaceutical companies in Pakistan.FindingsThrough serial-mediation model, results revealed the strength of various SCA enablers, along with the mediating roles of delivery dependability.Originality/valueThis study adds in the literature on how various supply chain enablers and competencies help the organizations to achieve supply chain agility and performance, especially in a developing country.
Estimation of the global number of vapers: 82 million worldwide in 2021
Authors: Jerzyński Tomasz , Stimson Gerry V. 
Published: April 2023

Purpose
Nicotine is consumed by one in five of the global adult population, mostly by smoking tobacco cigarettes. Modern electronic cigarettes came onto the market from around 2007 and have considerable potential to improve population health by displacing tobacco smoking. The purpose of this study is to map the use of e-cigarettes, but this is difficult due to absence of data sources for many countries.

Design/methodology/approach
The global number of vapers was estimated to be 68 million in 2020. New data in 2021 offered an opportunity to update that estimate. The method of assumed similarity was used for countries with missing data. The average prevalence of vaping was calculated for each World Health Organization region, World Bank income classification group and the legal status of e-cigarettes in each country. The number of vapers was calculated for the adult population. The estimate was refined by adjusting for changes in market value size and the actual year of surveys.

Findings
Population prevalence data on e-cigarette used were available for 48 countries. We estimate that there were 82 million vapers worldwide in 2021: 9.2 million in the Eastern Mediterranean region; 5.6 million in the African region; 20.1 million in the European region; 16.8 million in the Americas; 16.0 million in the Western Pacific region; and 14.3 million in South-East Asia.

Originality/value
Global, regional and national estimates of the numbers of vapers are important indicators of trends in nicotine use, and monitoring the uptake of vaping is important to inform international and national policy.
Future libraries’ blockchain opportunities and challenges: a systematic literature review and research agenda
Authors: Bashir Faiza , Warraich Nosheen Fatima 
Published: April 2023

Purpose
The purpose of this study is to look into the concept of blockchain technology which stores data in a distributed, tamper-resistant setting and how this technology may affect the future library and information (LI) centers’ operations and policy. It explores the potential benefits and limitations of this technology, for LI centers are the core objectives of this paper.

Design/methodology/approach
A systematic review of both academic and practitioner literature was conducted. It followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (2020) standards.

Findings
The review shows that the decentralized nature of blockchain will transform the work in libraries and improve the inter-communication among communities. It can provide better privacy of user data thus increasing collaboration. However, there might be technological, financial, legal and social challenges that may act as hurdles to the realization of these goals in the true sense. The overall result shows that by keeping data updated, libraries can evaluate blockchain opportunities and make the best use of this technology.

Practical implications
Given the huge investments by industry, academic research that explores potential ramifications and supports libraries is required. The adoption of blockchain was investigated in this study from a variety of perspectives for LI center’s while also providing directions for future research.

Originality/value
It is evident that globally there is progress in blockchain technology development in terms of research and adoption in many industries, but the intention to adopt blockchain by libraries is still a fantasy. The lack of empirical evidence in the existing literature justifies the gap that needs to be filled. This systematic review attempts to fill the gaps in the existing knowledge which may serve as a reference for future initiatives in this field.
Using affixed labels in persuasion: perceived product newness as a mediator
Authors: Ku Hsuan-Hsuan , Hsu Yun-Hsuan 
Published: April 2023

Purpose
Capturing consumers’ notice by differentiating a product from competing brands in attaching an affixed label featuring product claims, as an alternative front-of-package (FOP) cue, has been widely used in fast-moving consumer goods retailing. This paper aims to apply perceived product newness as the basis for examining how affixed labeling, manipulated in terms of design features and message claims, can impact consumer evaluation.

Design/methodology/approach
Four between-subjects experiments examined the persuasive impact of the use of affixed labels. In particular, how product evaluation, in response to affixed labeling, varied as a function of its shape (Study 1a), location (Study 1b), the combination of shape and location cues (Study 1c) and the strength of message claims conveyed by such labels (Study 2). Perceived product newness is assessed as a mediator for all studies.

Findings
The results show the power of affixed labels in persuasion. Specifically, consumers tend to perceive the item as newer, achieving persuasion, when the affixed label has a distinctive shape or location. Yet, incorporating several unusual design components fails to trigger an elevated result if a singular visual stimulus serves as a cue for an item’s newness. Further, the strength of claims highlighted in an affixed label correlates to positive impact on evaluations.

Research limitations/implications
This study offers an empirically based examination of consumers’ responses to affixed labeling and identifies perceived product newness as a mediator of the observed effect.

Practical implications
A salient, affixed label enables a credible cue for product newness, therefore, driving evaluation.

Originality/value
This paper contributes to understanding the influence on the persuasion of FOP labeling, with salience to retail promotional and sales messaging tactics.
Patient and wearable device authentication utilizing attribute-based credentials and permissioned blockchains in smart homes
Authors: Kembo Solomon Hopewell , Mpofu Patience , Jacques Saulo , Chitiyo Nevil , Mukorera Brighton 
Published: April 2023

PurposeCoronavirus Disease 2019 (COVID-19) necessitated the need for “Hospital-at-home” improvisations that involve wearable technology to classify patients within households before visiting health institutions. Do-It-Yourself wearable devices allow for the collection of health data leading to the detection and/or prediction of the prevalence of the disease. The sensitive nature of health data requires safeguards to ensure patients’ privacy is not violated. The previous work utilized Hyperledger Fabric to verify transmitted data within Smart Homes, allowing for the possible implementation of legal restrictions through smart contracts in the future. This study aims to explore privacy-enhancing authentication schemes that are operated by multiple credential issuers and capable of integration into the Hyperledger ecosystem.Design/methodology/approachDesign Science Research is the methodology that was used in this study. An architecture for ABC-privacy was developed and evaluated.FindingsWhile the privacy-by-design architecture enhances data privacy through edge and fog computing architecture, there is a need to provide an additional privacy layer that limits the amount of data that patients disclose. Selective disclosure of credentials limits the number of information patients or devices divulge.Originality/valueThe evaluation of this study identified Coconut as the most suitable attribute-based credentials scheme for the Smart Homes Patients and Health Wearables use case Coconut user-centric architecture Hyperledger integration multi-party threshold authorities public and private attributes re-randomization and unlinkable revelation of selective attribute revelations.
The impact of Lean adoption on organizational performance in a public service: the case of the Greek citizen’s service centers
Authors: Keramida Efthalia , Psomas Evangelos , Gotzamani Katerina 
Published: April 2023

Purpose
The purpose of this study is to determine the relationships between Lean adoption and organizational performance in a specific Greek public services subsector, namely, citizen’s service centers (CSCs).

Design/methodology/approach
An online structured questionnaire survey was distributed to all the Greek CSCs, and 672 employees responded and fully completed the questionnaire. Exploratory and confirmatory factor analyses were applied to assess the measurement model’s reliability and validity. The relationships between the latent constructs were examined through structural equation modeling.

Findings
The study revealed that Greek CSCs adopt at a medium to high extent the following principles: understanding customer needs, establishment of value streams, creating flows within the value streams and value perfection. The data also revealed a valid latent factor reflecting the Lean application, namely, “Lean adoption,” which, according to the findings, contributes to the organizational performance of Greek CSCs.

Research limitations/implications
The small percentage of the responding employees of the Greek CSCs, given their large population and the subjective nature of the data collected, constitute the main limitations of the present study.

Practical implications
The findings of this research will serve as a reference source for managers and decision-makers of CSCs in order for them to set the foundations for successfully adopting the Lean principles and therefore improve their organizational performance in terms of operational performance and satisfaction with employees and citizens.

Originality/value
Building on the public sector literature, to the best of the authors’ knowledge, this is the first study that evaluates the adoption of Lean principles in the Greek CSCs and defines the relationships between Lean adoption and organizational performance.
Potentials, opportunities and challenges of ecotourism development in selected historical and sacred sites of North Shewa Zone, Amhara region, Ethiopia
Authors: Mekonnen Habtamu , Mekonen Sefi 
Published: April 2023

Purpose
Ecotourism has emerged as a new hope of the tourism sector and is expected to overcome past pitfalls of mass tourism. Therefore, the purpose of this paper is to assess the potentials and challenges of ecotourism development in the historic and sacred sites of North Shewa Zone, Ethiopia.

Design/methodology/approach
Data were collected through interview, household questionnaire, field observation and focused group discussion. The collected data were analyzed using Statistical Package for Social Science (SPSS version 23) and Excel.

Findings
Based on household’s perception, churches and monasteries were mentioned as the main (17.58%) ecotourism attractions that have crucial role in ecotourism development in the area followed by biodiversity resources (17.23%) and Holy Water (16.01%). These existing ecotourism potentials and opportunities were discussed on the basis of five dimensions, i.e. historical and sacred attractions, biological attractions, cultural attractions, infrastructures and institutional potentials. The mean score values of a five-point Likert scale level of agreement or disagreement of respondents were between 2 and 4.5, implying overall responses of respondents spread between agree and strongly agree.

Originality/value
The findings reveal that although the historic and sacred sites of the area have potential ecotourism opportunities, different anthropogenic activities are affecting its development. The researchers recommended awareness creation programs, promotion of sites, development of infrastructures, employments of well-trained professionals and allocation of sufficient budgets as a mechanism to use the ecotourism potential and solving the existing challenges.
Statistics in the context of economic theory
Authors: Kucharska- Stasiak Ewa 
Published: April 2023

PurposeThe intent of this paper is to discuss the use of statistical mathematics in property valuation and the wider question concerning the role of mathematics in the field of economics.Design/methodology/approachThis paper reviews the evolution of the application of mathematics, including statistics in economics and drawing conclusions about applicability and effectiveness of quantitative modelling in property valuation.FindingsThis paper discusses the future use of statistical models in valuation and the need to recognise the relationships between market participants and the increasingly complex environment, and their impact on value. This would suggest adopting modelling techniques from behavioural economics.Practical implicationsThis paper highlights the difference between quantitative and qualitative models and discusses the role that each can play in property valuation.Originality/valueThis paper provides insights on the development of statistical modelling and discusses the application of the same in property valuation.