bluuebunny/crossref_metadata_2025_split huggingface dataset:
‘Plant, Sleep, Pick’: Ambivalent Smallholder Market Engagement and Inclusive Value Chains in Northwest Nepal
Authors: Lewison Elsie 
Published: May 2022

ABSTRACTInclusive value chain frameworks have been widely adopted by states and international development agencies as a strategy for addressing rural poverty. The approach aims to improve smallholder farmers’ linkages to agricultural markets and to increase the value of their products within these markets. Inclusive value chain initiatives targeting apple producers in northwestern Nepal are illustrative of this development approach. This article examines apple production in Jumla District, which has expanded rapidly over the last two decades, and shows how value chain development interventions have sought to accelerate a shift towards commercial agriculture by linking producers to agribusiness partners and upgrading production. A central assumption of these interventions is that farmers will aim to maximize profits through entrepreneurial strategies within targeted value chains. However, as this article demonstrates, a closer investigation of the political ecology of apple production in the region calls this assumption into question. The article argues that the popularity of apples in Jumla District must be situated within processes of agrarian change and livelihood diversification that have informed labour‐saving, risk‐averse approaches to apple market participation. The findings lend support to calls for strategies that prioritize autonomy and long‐term risk mitigation over competitive market integration.
Lived experiences of adolescents with fetal alcohol spectrum disorder
Authors: Skorka Kelly , Copley Jodie , McBryde Catherine , Meredith Pamela J. , Reid Natasha 
Published: May 2022

AimTo explore the lived experiences of adolescents with fetal alcohol spectrum disorder (FASD) to understand: the ways in which their challenges influence daily functioning; and the personal assets and external resources that facilitate participation.MethodSemi‐structured interviews were conducted with four adolescents (one identified as non‐binary, one male, and two female) with FASD aged 13 to 15 years. A photo elicitation approach facilitated participation, whereby adolescents first took photographs of their daily activities and environments. Photographs were subsequently used to generate discussion during the interviews. Data analysis involved using interpretative phenomenological analysis to generate themes.ResultsTwo superordinate themes and three subthemes relating to participants' lived experiences emerged from the interviews: (1) ‘anxiety challenges participation’ (subthemes [i] ‘need for external support’; [ii] ‘the power of positive relationships’; and [iii] ‘talents and interests facilitate participation’) and (2) ‘importance of a unique identity’.InterpretationFindings illustrated the barriers adolescents experienced regarding their daily functioning and independence. Additionally, incorporating strengths into daily activities appeared to reduce anxiety and improve participation, and adolescents desired for their unique characteristics to be recognized and appreciated. To support adolescents with FASD, service providers should consider incorporating strengths‐based approaches and an explicit focus on facilitating the development of positive self‐identities.What this paper adds

Anxiety often prevented adolescents' independent participation in social activities, requiring caregiver assistance.
Strengths (e.g. talents, positive relationships) facilitated adolescents' participation and reduced their anxiety.
Clinicians and researchers should consider strengths‐based approaches to interventions targeting participation.
Interventions for adolescents with fetal alcohol spectrum disorder could focus on developing a positive self‐identity.
Positive airway pressure therapy in heart failure patients comorbid with obstructive sleep apnea: Cardiovascular outcomes and nighttime‐duration effect
Authors: Lin Ruihan , Yi Minhan , Yan Wenjie , Zhang Yuan 
Published: May 2022

AbstractBackgroundComorbidity of obstructive sleep apnea (OSA) and heart failure (HF) is becoming increasingly common. This is a global analysis of positive airway pressure (PAP) efficacy for the cardiovascular outcomes in those HF Patients with comorbid OSA.MethodsRelated randomized controlled trials were included. Analysed indicators covered primary outcomes (cardiac function, motor ability and life quality) and secondary outcomes (blood pressure and OSA‐accompanying symptoms). Weighted mean difference was used to analyse the PAP‐control difference in different experimental phases and the baseline‐post difference in different groups.ResultsCompared with control group, PAP was associated with a 3.48% increase in left ventricle ejection fraction (LVEF) (p < .00001) and little decrease in heart rate (HR) (p = .67). Over 6 h of mean nighttime use was associated with a greater increase in LVEF of 5.21% (p = .0002) and a significant reduction in HR of 3.81 bpm (p = .03). There was no significant difference between PAP and control group in their association with change in motor ability and life quality. Besides, PAP was associated with a 13.08 mm Hg decrease in systolic blood pressure and great improvements in OSA‐accompanying symptoms: Apnea–Hypopnea Index, −23.73 e/h; mean oxygen saturation, 1.86%; minimum oxygen saturation, 8.78%; Epworth Sleepiness Scale, −1.39 point; arousal index, −16.41 e/h. There was also no significant difference in diastolic blood pressure.ConclusionsPositive airway pressure treatment improves cardiac function in HF patients with comorbid OSA, but the improved magnitude is associated with the duration of nighttime use rather than the duration of treatment.
NCME Presidential Address 2021: Assessment Research and Practice in the Post‐COVID‐19 Era
Authors: Tong Ye 
Published: May 2022

AbstractCOVID‐19 is disrupting assessment practices and accelerating changes. With special focus on K‐12 and credentialing exams, this article describes the series of changes observed during the pandemic, the solutions assessment providers have implemented, and the long‐term impact on future practices. Additionally, this article highlights the importance of the balanced assessment system, the use of assessments both for learning and of learning, and using assessments to support for social justice, equity and inclusion. These desired uses and outcomes will continue to challenge assessment and measurement experts on how they design, develop, and implement assessments moving forward.
Nouveau signalement de Singhiella simplex (Singh, 1931) (Aleyrodidae) sur Ficus en Tunisie
Authors: Ben Halima Kamel Monia Kamel , Zouari Sana , Adouani Rihem , Ben Cheik Zohra 
Published: May 2022

New report of Singhiella simplex (Singh, 1931) (Aleyrodidae) on Ficus in TunisiaDuring September 2021, severe defoliation on Ficus microcarpa “Hawaii” (v) (Moraceae) was observed in several areas of Tunisia. Morphological identification showed the presence of Singhiella simplex (Singh, 1931) (Aleyrodidae). The whitefly was subsequently observed on various species of Ficus. When the paper was submitted (2021‐12‐26) this was the first report of S. simplex in Tunisia although another report has been published in the meantime.
Pilot phase results of a prospective, randomized controlled trial of narrowband ultraviolet B phototherapy in hospitalized COVID‐19 patients
Authors: Lau Frank H. , Powell Catherine E. , Adonecchi Giacomo , Danos Denise M. , DiNardo Andrew R. , Chugden Robert J. , Wolf Peter , Castilla Carmen F. 
Published: May 2022

AbstractCOVID‐19 morbidity and mortality are driven by poor immune regulation. Narrowband ultraviolet B (NB‐UVB) phototherapy is standard of care in a number of immune‐dysregulated diseases. To assess the efficacy of NB‐UVB phototherapy for improving COVID‐19 outcomes in high‐risk, hospitalized, we developed the Adaptive Photo‐Protection Trial. This is a multi‐center, prospective, double‐blinded, randomized, placebo‐controlled trial. The pilot phase results are reported here. Consecutive patients admitted with a positive COVID‐19 PCR were screened for eligibility. Enrolled subjects were computer randomized 1:1 to NB‐UVB or placebo phototherapy. Subjects were treated daily with escalating doses on 27% of their body surface area for up to 8 consecutive days. Primary outcomes were safety and efficacy, defined as persistent or painful erythema and 28‐day mortality. Comparisons were made via non‐parametric exact tests. Patients in treatment (n = 15) and placebo (n = 15) arms had similar demographics. No adverse events occurred. Twenty eight‐day mortality was 13.3% in treatment vs. 33.3% in placebo arms (p = 0.39). NB‐UVB phototherapy in hospitalized COVID‐19 patients was safe. Decreased mortality was observed in treated patients but this was statistically non‐significant. Given its low‐cost, scalability, and adjunctive nature, NB‐UVB has the potential to improve COVID‐19 outcomes. Continuation of this trial is warranted.
Analysis of non‐severe acute onset autoimmune hepatitis according to the presence of radiological heterogeneity
Authors: Fujiwara Keiichi , Fukuda Yoshihiro , Seza Katsushi , Saito Masaya , Koizumi Shuko , Yokosuka Osamu , Kato Naoya 
Published: May 2022

AbstractAimDiagnosis of acute onset autoimmune hepatitis (A‐AIH) has been difficult in that patients may not have typical clinicopathological features of AIH. In our previous reports of severe and fulminant AIH, two‐thirds of them showed radiological heterogeneity: hepatic heterogeneous hypoattenuation on unenhanced computed tomography (CT) reflecting heterogeneous distribution of massive hepatic necrosis (severe centrilobular necrosis), which would be beneficial for the diagnosis. In the present study, we analyzed non‐severe A‐AIH patients with or without radiological heterogeneity and tried to find novel clinical features for supporting the early diagnosis.MethodsClinical, biochemical, immunological, radiological and histological features of 42 patients with non‐severe A‐AIH at community hospitals between 2010 and 2020 were analyzed.ResultsOf 42, 28 patients on whom CT scans were performed and who could be fully analyzed were enrolled. Five patients showed hepatic heterogeneous hypoattenuation on unenhanced CT. There was no significant difference in clinical, biochemical, immunological and histological features at diagnosis between the two groups according to the presence of radiological heterogeneity, although mean minimum prothrombin time activity during the course was lower in patients with heterogeneity without statistical significance (p = 0.080). All responded to treatment well and achieved initial remission within 3 months.ConclusionsIt is possible that patients with non‐severe A‐AIH show radiological heterogeneity reflecting centrilobular necrosis which is one of important diagnostic features of A‐AIH. Accordingly, radiological heterogeneity might be beneficial for the diagnosis of A‐AIH in combination with conventional clinicopathological features if it is detected in the absence of features suggestive of other liver diseases.
Comprehensive assessments of immuno‐oncology drug‐based combination therapies as first‐line treatment for advanced renal cell carcinoma
Authors: Harada Ken‐ichi , Miyake Hideaki , Furukawa Junya , Fujimoto Naohiro , Fujisawa Masato 
Published: May 2022

AbstractOver the last decade, there have been substantial progress in the field of systemic therapy for advanced renal cell carcinoma. Through the transition from treatment with cytokines to molecular‐targeted agents, and currently to immuno‐oncology drugs, the prognostic outcomes of patients with advanced renal cell carcinoma have been markedly improved. In particular, based on the promising outcomes of recently conducted pivotal randomized clinical trials, immuno‐oncology drug‐based combination therapy by either dual immune checkpoint inhibition or combined inhibition of an immune checkpoint and tyrosine kinase, is currently regarded as a standard of care for treatment‐naïve advanced renal cell carcinoma patients. However, insufficient data are available with respect to the selection of optimal systemic therapies for advanced renal cell carcinoma in the first‐line setting due to the lack of a head‐to‐head comparison between approved immuno‐oncology drug‐based combination therapies. In this review, therefore, we summarize interesting findings associated with first‐line combination therapies for advanced renal cell carcinoma obtained from both randomized clinical trials and real‐world clinical practices, in order to present useful guidance to help make treatment decisions for patients with treatment‐naïve advanced renal cell carcinoma.
Exceso de trabajo o fragmentación. Transacciones familiares y tiempo de trabajo en periodo de COVID‐19
Authors: CLOUET Hadrien 
Published: May 2022

Resumen¿Cómo cambió el tiempo de trabajo de las personas asalariadas obligadas a teletrabajar por las medidas sanitarias francesas en 2020? A partir de un estudio cualitativo que combina entrevistas, observaciones directas y cuestionarios en una empresa municipal de aguas, se observa que el teletrabajo reestructura el tiempo de trabajo y redistribuye el poder regulador. Durante los confinamientos, la jornada laboral se prolonga y los ritmos de trabajo se modifican, con importantes variaciones según la configuración familiar: el confinamiento en familia frena la prolongación de la jornada pero favorece su fragmentación, efecto que se invierte en caso de confinamiento en solitario.
Inside the ‘efficacy gap’: Migration policy and the dynamics of encounter
Authors: Hagen‐Zanker Jessica , Mallett Richard 
Published: May 2022

AbstractIn recent years, migration has become an important policy priority within and beyond the European Union. While the discourse that surrounds the contemporary migration policy agenda is one of the technocratic migration management, this overarching narrative conceals an underlying goal of prevention. Preventive efforts are increasingly geared towards stopping migratory movements before they have even begun. The effectiveness of such an approach remains contested and unclear. This article builds on the theoretical work of Czaika and de Haas (Population and Development Review, 2013, 39, 487) to explore the limits of prevention strategies designed to change minds, alter plans and redirect behaviours. It does so by drawing on insights from our own research into migration decision‐making, alongside wider literature on individual sense‐making, and connecting these to ongoing debates around policy effectiveness. In doing so, we show how the nature of localised encounters between ‘target’ populations and implemented policies can create potential sources of policy failure.
The Healthcare Environment Survey: A multicountry psychometric evaluation of nurses’ job satisfaction
Authors: Nelson John , Vrbnjak Dominika , Thomas Patricia L. , Gözüm Sebahat , de Barros Alba Lucia Bottura Leite , Itzhaki Michal 
Published: May 2022

AbstractAimTo evaluate the properties of a reduced‐item Healthcare Environment Survey measuring nurses’ job satisfaction across eight countries.BackgroundThere is currently no rigorously tested international measure of nurses’ job satisfaction that can be used internationally to improve the nurse work environment.MethodsNursing staff from 11 hospitals in eight countries participated in this study. The original 57‐item, 11‐facet Healthcare Environment Survey was evaluated for reliability, validity, and measurement invariance: Cronbach's alpha was used to test for reliability; construct, discriminate, and convergent testing were used to test validity; and invariance testing including configural, metric, and scalar tests were used to study measurement invariance between the countries.Results2,046 nursing staff completed the survey. Reliability was established for all six subscales and the combined composite score. Both validity and measurement invariance were supported in every test conducted. An excellent model fit was found for the final 19‐item, 6‐facet Healthcare Environment Survey that explained 82% of the variance of nurses’ job satisfaction.ConclusionsFindings suggest the instrument is an efficient measure of nurses’ job satisfaction across multiple countries. Longitudinal testing for invariance will be needed to ensure the model remains a good fit. Testing more countries will also verify model fit.Implications for nursingThe instrument can be used to measure nurse job satisfaction globally.Implications for nursing policyThe instrument can be used to assess interventions to improve the social (patient, unit manager, and coworker) and technical (professional rewards, autonomy, and professional growth) aspects of nurse job satisfaction.
“The pediatric dentist is different”: A qualitative study of young children's caregivers' experiences of oral health care in the Galapagos Islands
Authors: Burgette Jacqueline M. , Wu Shelly X. , Divaris Kimon 
Published: May 2022

AbstractBackgroundLittle is known about factors influencing children's access to and use of oral healthcare services in the Galapagos Islands, a resource‐limited setting.AimWe sought to understand caregivers' experiences and factors influencing their children's use of dental services on San Cristobal Island in the Galapagos Archipelago.DesignA community‐based qualitative interview study was carried out among 25 caregivers of children aged 6 months to 10 years. Participants were recruited via a random walk door‐to‐door approach in 10 neighborhoods, and interviews were conducted by a trained research assistant who is native of the Galapagos Islands. We employed a grounded theory‐based qualitative data analysis based on inductive coding to identify and report major emerging themes and illustrative participant quotes.ResultsTwo major themes emerged related to children's oral health care. Participants expressed their preference for care provided by paediatric versus general dentists and recognized the important role of school‐based dental care programs, acknowledging their strengths and weaknesses.ConclusionsParticipants' lived experiences were informative and helped improve our understanding of factors influencing children's use of dental services in the Galapagos Islands. Above and beyond their local relevance, these themes and insights are likely applicable to other global communities that experience similar barriers of access to oral healthcare services.
Internet‐based cultural competence training for White undergraduate students at a predominantly White university
Authors: Robey Nyx , Dickter Cheryl 
Published: May 2022

AbstractCollege students from underrepresented racial groups often experience racial prejudice and discrimination from their White peers at predominantly White institutions (PWIs). White university students may be misinformed about race and unaware of their privilege. In this study, we investigated the effects of online training that aimed to increase participants' cultural competence through multicultural knowledge, awareness of their own privilege, and skills. White college students at a PWI completed a 4‐week training program adapted from a 1‐day in‐person workshop. The training provided 1‐h weekly online sessions in which White participants (n = 72) were provided resources aimed to develop cultural competence. It utilized student‐acted role plays, reflection questions, articles, and videos to create an interactive experience for students. Results demonstrated that participants showed significant increases in cultural competence and acknowledgment of their White privilege directly following the fourth training session. Further, they exhibited decreases in racial colorblindness. This study suggests that a brief, online training may increase cultural competence in undergraduates which can potentially improve the climates of university campuses.
Thoracoscopic management of iatrogenic cardiac perforations
Authors: Langenaeken Tom , van den Berg Mats , Kaya Abdullah , Yilmaz Alaaddin 
Published: May 2022

AbstractAimsIatrogenic cardiac perforation is an uncommon but potentially fatal complication of invasive cardiac procedures. When nonsurgical management fails, urgent cardiac surgery is required. The standard surgical approach is usually through full sternotomy. However, we propose a less invasive and equally effective technique with video‐assisted thoracoscopic surgery (VATS).MethodsThis single‐center retrospective study in a tertiary hospital identified all patients requiring surgical intervention due to iatrogenic cardiac perforation over a period of 5 years. Patients were grouped by surgical approach, being either sternotomy or VATS. Primary endpoints were operating time, length of ICU stay, hospital stay, 30‐day mortality, and all‐round mortality.ResultsTwenty‐five patients were identified: 11 in the sternotomy group and 14 in the VATS‐group. Preoperative baseline characteristics were equal. Significant difference was found for 30‐day mortality (p < .05). There was no difference for the other endpoints.ConclusionsVATS is a promising alternative to standard sternotomy for iatrogenic cardiac perforations after invasive cardiac procedures.
Treatment of diabetes mellitus has borne much fruit in the prevention of cardiovascular disease
Authors: Yagyu Hiroaki , Shimano Hitoshi 
Published: May 2022

AbstractCardiovascular (CV) disease is the most alarming complication of diabetes mellitus (DM), and a strategy aiming at cardiovascular event prevention in diabetes mellitus has long been debated. Large landmark clinical trials have shown cardiovascular benefits of intensive glycemic control as a ‘legacy effect’ in newly diagnosed type 2 diabetes mellitus. In contrast, we have learned that excessive intervention aimed at strong glycemic control could cause unexpected cardiovascular death in patients who are resistant to treatments against hyperglycemia. It has also been shown that the comprehensive multifactorial intervention for cardiovascular risk factors that was advocated in the current guideline provided substantial cardiovascular event reduction. The impact of classical antidiabetic agents launched before 1990s on cardiovascular events is controversial. Although there are many clinical or observational studies assessing the impact of those agents on cardiovascular events, the conclusions are inconsistent owing to variable patient backgrounds and concomitant antidiabetic agents among the studies. Moreover, most of them were not large‐scale, randomized, cardiovascular outcome trials. In contrast, GLP‐1RA (glucagon‐like peptide‐1 receptor agonist) and SGLT2 (sodium‐glucose cotransporter 2) inhibitors have demonstrated undeniable cardiovascular benefits in large‐scale, randomized, controlled trials. Whereas GLP‐1RAs decrease atherosclerotic disease, especially stroke, SGLT2 inhibitors mainly prevent heart failure. SGLT2 inhibitors are superior to GLP‐1RAs with respect to hard renal outcomes. Therefore, it can be said that drugs such as GLP‐1RAs and SGLT2 inhibitors that prevent cardiovascular events, in addition to their glucose‐lowering effect, are incredible novel tools that we have gained for use in diabetic treatment.