bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cultural Intelligence in EFL and ESP Learners: Metacognitive, Cognitive, Motivational, and Behavioral Knowledge
Authors: Karami Vahid , Izadpanah Siros 
Published: March 2022

One of the most significant current discussions in language learning is cultural intelligence. This research aims to study cultural learning determinants in EFL and ESP learners concerning their metacognitive, cognitive, motivational, and behavioral knowledge toward cultural intelligence in Iran. The studies so far indicate that cultural intelligence in EFL and ESP learners has not received as much attention as warranted. Moreover, rare studies have been done in this regard in the Iranian context. In this descriptive study, a nonrandom sampling method was applied to 323 university students who were 116 EFL learners (M.A and B.A English language students of Zanjan and Islamic Azad University) and 207 ESP (from the Zanjan University of Medical Sciences). The questionnaire was valid because it was standardized, and its reliability was checked via Cronbach’s alpha (

p

< 0.000). The result of data analysis showed that EFL students have more cultural intelligence compared to medical students. Thus, based on the results, the teachers should consider the importance of cultural factors in their classes. Regarding pedagogical implications, the findings of this study can be of great help to book designers, schoolteachers, and university lecturers.
Development of Advanced Heart Failure: A Population-Based Study
Authors: Subramaniam Anna V. , Weston Susan A. , Killian Jill M. , Schulte Phillip J. , Roger Veronique L. , Redfield Margaret M. , Blecker Saul B. , Dunlay Shannon M. 
Published: March 2022

Background:
Some patients with heart failure (HF) will go on to develop advanced HF, characterized by severe HF symptoms despite attempts to optimize medical therapy. The goals of this study were to examine the risk of developing advanced HF in patients with newly diagnosed HF, identify risk factors for developing advanced HF, and evaluate the impact of advanced HF on outcomes.

Methods:
This was a population-based, retrospective cohort study of Olmsted County, Minnesota, residents with a new clinical diagnosis of HF between 2007 and 2017. Risk factors for the development of advanced HF (2018 European Society of Cardiology criteria) were examined using cause-specific Cox proportional hazard regression models. The associations of development of advanced HF with risks of hospitalization and mortality were examined using the Andersen-Gill and Cox models, respectively.

Results:

There were 4597 residents with incident HF from 2007 to 2017. The cumulative incidence of advanced HF was 11.5% (95% CI, 10.5%–12.5%) at 6 years after incident HF diagnosis overall and was 14.4% (95% CI, 12.3%–16.9%), 11.4% (95% CI, 8.9%–14.6%), and 11.7% (95% CI, 10.3%–13.2%) in patients with incident HF with reduced, mildly reduced, and preserved ejection fraction, respectively. Key demographics, comorbidities, and echocardiographic characteristics were independently associated with the development of advanced HF. Development of advanced HF was associated with increased risks of all-cause hospitalization (adjusted hazard ratio, 3.0 [95% CI, 2.7–3.4];
P
<0.001), HF hospitalization (hazard ratio, 10.2 [95% CI, 8.7–12.1]), all-cause mortality (hazard ratio, 5.0 [95% CI, 4.5–5.6];
P
<0.001), and cardiovascular mortality (hazard ratio, 7.8 [95% CI, 6.7–9.1]).

Conclusions:
In this population-based study, development of advanced HF was common and was associated with markedly increased morbidity and mortality.
Intensive Versus Standard Treatment of Hyperglycemia in Acute Ischemic Stroke Patient: A Randomized Clinical Trial Subgroups Analysis
Authors: Torbey Michel T. , Pauls Qi , Gentile Nina , Falciglia Mercedes , Meurer William , Pettigrew Creed L. , Durkalski Valerie L. , Bleck Thomas , Bruno Askiel ,   for the Neurological Emergencies Treatment Trials Network and SHINE Trial Investigators
Published: March 2022

Background:
Benefit from blood glucose (BG) control during acute ischemic stroke may depend on glycemic parameters. We evaluated for associations between the SHINE (Stroke Hyperglycemia Insulin Network Effort) randomized treatment group and the SHINE predefined 90-day functional outcome, within-patient subgroups defined by various glycemic parameters.

Methods:
The SHINE Trial randomized 1151 patients within 12 hours with acute ischemic stroke and hyperglycemia to standard (target BG 80–179 mg/dL) or intensive (target BG 80–130 mg/dL) BG control for 72 hours. We predefined 6 glycemic parameters: acute BG level, absence versus presence of diagnosed and undiagnosed diabetes, hemoglobin A1c, glycemic gap (acute BG–average daily hemoglobin A1c based BG), stress hyperglycemia ratio (acute BG/average daily hemoglobin A1c based BG), and BG variability (SD). Favorable functional outcome was defined by the SHINE Trial and based on the modified Rankin Scale score at 90 days, adjusted for stroke severity. We computed relative risks adjusted for baseline stroke severity and thrombolysis use.

Results:
Likelihood for favorable outcome was lowest among patients with undiagnosed diabetes compared to patients with true nondiabetes (adjusted relative risk, 0.42 [99% CI, 0.19–0.94]). We did not find any relationship between the favorable outcome rate and baseline BG or any of the glycemic parameters. No differences between SHINE treatment groups were identified among any of these patient subgroups.

Conclusions:
In this exploratory subgroup analysis, intensive versus standard insulin treatment of hyperglycemia in acute ischemic stroke patient subgroups, did not influence the 90-day functional outcomes, nor did we identify associations between these glycemic parameters and 90-day functional outcomes.
Electoral Violence and Supply Chain Disruptions in Kenya's Floriculture Industry
Authors: Ksoll Christopher , Macchiavello Rocco , Morjaria Ameet 
Published: March 2022

Abstract
Violent conflicts, particularly at election times in Africa, are a common cause of instability and economic disruption. This paper studies how firms react to electoral violence using the case of Kenyan flower exporters during the 2008 postelection violence as an example. The violence induced a large negative supply shock that reduced exports primarily through workers' absence and had heterogeneous effects: larger firms and those with direct contractual relationships in export markets suffered smaller production and loss of workers. On the demand side, global buyers were not able to shift sourcing to Kenyan exporters located in areas not directly affected by the violence or to neighboring Ethiopian suppliers. Consistent with difficulties in ensuring against supply-chain risk disruptions caused by electoral violence, firms in direct contractual relationships ramp up shipments just before the subsequent 2013 presidential election to mitigate risk.
Georgia Quality Improvement Programs Multi-Institutional Collection of Postoperative Opioid Data Using ACS-NSQIP Abstraction
Authors: Codner Jesse A , Falconer Elissa A , Ashley Dennis W , Sweeney John F , Saeed Muhammad I , Langer Jason M , Shaffer Virginia O , Finley Charles R , Solomon Gina , Sharma Jyotirmay 
Published: March 2022

Background Excessive postoperative opioid prescribing contributes to opioid misuse throughout the US. The Georgia Quality Improvement Program (GQIP) is a collaboration of ACS-NSQIP participating hospitals. GQIP aimed to develop a multi-institutional opioid data collection platform as well as understand our current opioid-sparing strategy (OSS) usage and postoperative opioid prescribing patterns. Methods This study was initiated 7/2019, when 4 custom NSQIP variables were developed to capture OSS usage and postoperative opioid oral morphine equivalents (OMEs). After pilot collection, our discharge opioid variable required optimization for adequate data capture and was expanded from a free text option to 4 drop-down selection variables. Data collection then continued from 2/2020-5/2021. Logistic regression was used to determine associations with OSS usage. Average OMEs were calculated for common general surgery procedures and compared to national guidelines. Results After variable optimization, the percentage where a total discharge prescription OME could be calculated increased from 26% to 70% ( P < .001). The study included 820 patients over 10 operations. There was a significant variation in OSS usage between GQIP centers. Laparoscopic cases had higher odds of OSS use (1.92 (1.38-2.66)) while OSS use had lower odds in black patients on univariate analysis (.69 (.51-.94)). On average 7 out of the 10 cases had higher OMEs prescribed compared to national guidelines recommendations. Conclusion Developing a multi-institutional opioid data collection platform through ACS-NSQIP is feasible. Preselected drop-down boxes outperform free text variables. GQIP future quality improvement targets include variation in OSS use and opioid overprescribing.
Barriers and enablers for young Aboriginal people in accessing public sexual health services: A mixed method systematic review
Authors: Ubrihien Ashley , Gwynne Kylie , Lewis David A 
Published: March 2022

Background A mixed method systematic review was undertaken to address the research question, Do young Australian Aboriginal people barriers in accessing public sexual health services? Aboriginal people are disproportionally affected by significantly higher incidence rates of sexually transmissible infections (STIs), compared to the rest of the Australian population. This problem is particularly acute for young people under 30 years of age who suffer from the consequences of STIs due to the number of sexual partners and challenges faced in accessing healthcare. Methods The study inclusion criteria were: papers published between January 1999 and September 2019 inclusive; published in any language, discussed healthcare barriers and facilitators; included people under 30 years of age; contained research with one or more of the following terms; Aboriginal, Health, Access, Barriers and Sexual Health; was published or discussed Australia research. Articles were extracted from MEDLINE, Embase, PsychINFO, Proquest Social Sciences, Open Grey and NLM Bookshelf. An initial search identified 770 articles; 23 duplicate articles were removed. 642 were excluded for not meeting inclusion criteria following a title and abstract review of articles. 60 articles underwent full text review by two reviewers and 15 articles were included in analysis. Results This review found that novel approaches to service delivery such as incorporating STI testing into other targeted initiatives, providing self-testing kits and achieving high levels of cultural competency were key facilitators to access. Whereas location of services, inconsistent service provision, shame and differing levels of knowledge about the effects of STIs were key barriers. Conclusions This systematic review identified barriers and facilitators of access to sexual health services for Aboriginal young people. System level changes are needed to improve physical environments, service integration and consistent provision of culturally competent services. This review highlights the need for further research focussed on assessing the real-world pressures of young Aboriginal people and how healthcare providers can better offer a person-centred service.
Acceptability of routine domestic abuse enquiry within sexual health services
Authors: Platt Elizabeth , Hepworth Eleanor , Rayment Michael , Melendez-Torres G.J. , Duff Fiona , Cohen Charlotte 
Published: March 2022

Background: Our sexual health services (SHS) introduced routine domestic abuse (DA) enquiry in April 2018 following targeted staff training. A survey was undertaken to ascertain attitudes towards the initiative. Methods: Between October 2019 and March 2020, patients were invited to respond to an anonymous questionnaire by SMS. Clinical staff were emailed a separate survey. Results: The patient response rate was 40% (226/562): 72% (161/226) female, 80% (179/226) heterosexual, 19% (42) LGBT, 47% (106) aged 25-34 and 25% (57) aged 18-24. Almost all (97%, 220) recalled routine enquiry at their clinic appointment; 91% (206) felt comfortable when asked, and 95% (214) found this acceptable. Fifty-one staff responded (36% response rate), 67% (34) female, 55% (28) heterosexual, 35% (18) LGBT. 43% (22) were nurses, 31% (16) doctors, 12% (6) health advisers and 8% (4) healthcare assistants. The majority of staff 96% (49) were confident with conducting routine enquiry, 92% (47) agreed patients found it acceptable; 92% (47) felt routine enquiry was appropriate and 92% (47) had received targeted training. Conclusion: Respondents were overwhelmingly in favour of routine DA enquiry within SHS, and this initiative could be easily adapted in other specialties alongside staff training.
A Novel Hemodynamic Index of Post-operative Right Heart Dysfunction Predicts Mortality in Cardiac Surgical Patients
Authors: Knio Ziyad O. , Thiele Robert H. , Wright W. Zachary , Mazimba Sula , Naik Bhiken I. , Hulse Matthew C. 
Published: March 2022

Introduction This study aimed to investigate whether mortality following cardiac surgery was associated with the pulmonary artery pulsatility index (PAPi): pulmonary artery pulse pressure divided by central venous pressure (CVP), and a novel index: mean pulmonary artery pressure (mPAP) minus CVP. Methods This retrospective analysis investigated all cardiac surgery patients in the Society of Thoracic Surgeons registry at a single academic medical center from January 2017 through March 2020 (n = 1510). The primary and secondary outcomes were mortality at 1 year and serum creatinine increase during index surgical admission, respectively. CVP, mPAP, PAPi, mPAP-CVP gradient, mean arterial pressure (MAP), and cardiac index (CI) were sampled continually from invasive hemodynamic monitors post-operatively. Associations with mortality were tested with univariate and multivariate analyses. The relationship with serum creatinine was investigated with Pearson’s correlation at alpha = .05. Results One-year mortality was observed in 44/1200 patients (3.7%). On univariate analysis, mortality was associated with minimums for mPAP, MAP, and CI and maximums for CVP, mPAP, PAPi, mPAP-CVP gradient, and CI (all P < .10). Model selection revealed that the only independently predictive parameters were minimum MAP (AOR = .880 [.819–.944]), maximum mPAP-CVP gradient (AOR = 1.082 [1.031–1.133]), and maximum CI (AOR = 1.421 [.928–2.068]), with model c-statistic = .770. A maximum mPAP-CVP gradient >20.5 predicted mortality with 54.5% sensitivity and 79.30% specificity, maintaining significance on survival analysis ( P < .001). Peak increase in serum creatinine from baseline demonstrated a weak association with all parameters (max |r| = .33). Conclusions Mortality was not predicted by the post-operative PAPi; rather, it was independently predicted by the mPAP-CVP gradient, MAP, and CI.
Parental drinking, mental health and education, and extent of offspring’s healthcare utilisation for anxiety/depression: A HUNT survey and registry study
Authors: Lund Ingunn Olea , Andersen Njål , Handal Marte , Ask Helga , Skurtveit Svetlana , Ystrom Eivind , Burdzovic Andreas Jasmina 
Published: March 2022

Aims: Certain risk constellations of parental drinking, mental health and years of education are prospectively associated with offspring’s risk for a diagnosis of anxiety/depression, but it remains unknown how they may relate to other aspects of offspring’s mental health. We examined whether such risk constellations were also prospectively associated with the extent of offspring’s utilisation of healthcare services for anxiety/depression. Methods: The sample included 8773 adolescent offspring of 6696 two-parent families who participated in the Nord-Trøndelag Health Study in Norway. The exposures consisted of five parental risk constellations characterised by drinking frequencies and quantities, years of education and mental health previously derived based on the parental self-reports using latent profile analysis. The outcomes were the number of years in contact, and the total number of consultations/visits, with healthcare services for anxiety/depression in adolescents and young adults as recorded in healthcare registries in the period 2008–2014. Associations were examined using zero-inflated negative binomial regression models, accounting for demographics and offspring’s early mental health. Results: Parental risk constellations were not significantly associated with the extent of offspring’s healthcare utilisation for anxiety/depression during the seven-year study period, neither in respect of number of years nor in number of contacts. Conclusions: Offspring of four risky constellations were no more likely to use healthcare services for longer time periods or have more consultations/visits than offspring of the lowest-risk constellation. Parental risk constellations appear more informative for understanding disorder aetiology than for understanding management and treatment of anxiety and depression during adolescence and early adulthood.
Incidence of femoral fractures in children and adolescents in Finland and Sweden between 1998 and 2016: A binational population-based study
Authors: Salonen Anne , Laitakari Elina , Berg Hans E. , Felländer-Tsai Li , Mattila Ville M. , Huttunen Tuomas T. 
Published: March 2022

Background and objective: Femoral fractures in children have significant impact for patients, family, and trauma resources as they usually require hospitalization and surgical treatment. The aim of this study was to determine the incidence and trends of femoral fractures among children and adolescents hospitalized between 1998 and 2016 in Finland and Sweden. Methods: All patients younger than 17 years of age in Finland and Sweden with a femoral fracture treated surgically between 1998 and 2016 were included in the study. Data were collected from National Hospital Discharge Registries. Patients were classified by gender and age into four groups. The annual incidences per 100,000 were calculated using annual mid-year population census data obtained from the Official Statistics of Finland and Sweden. Results: In total, 6410 patients younger than 17 years of age diagnosed with femoral fracture were included in this study. The total incidence per 100,000 femoral fractures was 13.3 in Finland and 11.0 in Sweden. The incidence of femoral fractures decreased during the study period in all age groups, except for teenage Finnish girls. Most of the fractures were located in femoral shaft. Fractures of the upper and distal femur were rare. Male predominance was detected in all age groups older than 1 year. Conclusions: The incidence of femoral fractures decreased in all age groups except in teenage Finnish girls. Majority of femoral fractures were located in femoral shaft with male predominance. In children younger than 1 year of age, female predominance was found.
Preoperative measures predicting outcome after pancreatic resection in aged patients
Authors: Ahola Reea , Siiki Antti , Rinta-Kiikka Irina , Laitinen Ismo , Antila Anne , Jämsen Esa , Laukkarinen Johanna 
Published: March 2022

Background and objective: High-risk surgery on aged patients raises challenging ethical and clinical issues. The aim of this study was to analyze the preoperative factors associated with severe complications and returning home after pancreatic resection among patients aged ⩾ 75 years. Patients and methods: Patients aged ⩾ 75 years undergoing pancreatic resection in 2012–2019 were retrospectively searched from the hospital database. Preoperative indices (Clinical Frailty Scale, Skeletal Muscle Index, Geriatric Nutritional Risk Index, Charlson Comorbidity Index, and National Surgical Quality Improvement Program risk for severe complications) were determined. Postoperative outcome was evaluated by incidence of Clavien–Dindo 3b-5 complications, rate of returning home, and 1-year survival. Results: A total of 95 patients were included. American Society of Anesthesiologists Class 3–4 covered 50%, Clinical Frailty Scale > 3 22%, Charlson Comorbidity Index > 6 53%, and a sarcopenic Skeletal Muscle Index 51% of these patients. The National Surgical Quality Improvement Program risk for severe complications was higher than average among 21% of patients. Geriatric Nutritional Risk Index showed high risk among 3% of them. In total, 19 patients (20%) experienced a severe (Clavien–Dindo 3b-5) complication. However, 30- and 90-day mortality was 2.1%. Preoperative indices were not associated with severe complications. Most patients (79%) had returned home within 8 weeks of surgery. Not returning home was associated with severe complications ( p = 0.010). Conclusions: The short-term outcome after pancreatic resection of fit older patients is similar to that of younger, unselected patient groups. In these selected patients, the commonly used preoperative indexes were not associated with severe complications or returning home.
Adverse Outcomes Associated With Off-Label Agents Used to Treat Dementia Patients With Psychosis: A Case-Control Medicare Database Study
Authors: Rashid Nazia , Wetmore James B. , Irfan Muna , Abler Victor 
Published: March 2022

Introduction Currently, there are no Food and Drug Administration-approved therapies to treat dementia-related psychosis (DRP). This study investigated the association between using antipsychotics and the anticonvulsant divalproex (sodium valproate) to manage DRP and adverse outcomes. Methods A retrospective case/control matching study evaluated the risk of mortality, extrapyramidal symptoms (EPS), ischemic stroke, and cardiac arrest/ventricular arrhythmia (CA/VA) with ever-use of antipsychotics/divalproex in patients with DRP vs never-use. Results 49 509 patients were included; 76.8% used an antipsychotic/divalproex. Treatment ever-use was associated with an increased risk of all-cause mortality (odds ratio, 1.14; 95% CI, 1.10-1.18) and a smaller increase in the risk of EPS (1.10; 1.00-1.19) relative to never-use (adjusted for matching demographic variables, comorbid conditions, and disability) . Conclusions Current agents used for DRP were associated with increased risk of death and adverse outcomes. An increased risk of death was evident within 3 months of antipsychotic/divalproex initiation and persisted with long-term use.
Myopathy with oval inclusions in a domestic shorthair cat
Authors: Gougeon Eliot , Larcher Thibaut , Ledevin Mireille , McGrotty Yvonne , Méheust Pierre 
Published: March 2022

Case summary An 18-month-old castrated male domestic shorthair cat was presented with a 2-month history of collapse and severe weakness, particularly affecting the pelvic limbs. A biceps femoris muscle biopsy revealed excessive variability in myofibre size, mild necrosis, minimal centronucleation and scattered 10 μm intracytoplasmic oval inclusions. The inclusions appeared amphophilic with haematoxylin and eosin, blue with Gomori trichrome and unstained with nicotinamide adenine dinucleotide dehydrogenase tetrazolium reductase staining. ATPase staining revealed a normal mosaic pattern and atrophy of both type 1 and 2 myofibres. The pathological diagnosis was a myopathy with inclusions. In contrast to previous feline myofibre inclusions previously reported in the literature, inclusions were not identified after immunohistochemistry using anti-desmin, tubulin, spectrin, laminin, LAMP and LC3 antibodies. After supportive care and corticosteroid treatment, clinical improvement was noted and the cat was discharged 10 days after initial presentation. Clinical and neurological re-examinations were performed at 1, 3, 6 and 9 months after discharge. Owner contact at both 10 and 30 months post-discharge confirmed that persistent muscular weakness was present. Relevance and novel information This case report describes a novel and slowly progressive feline myopathy associated with oval amphophilic inclusions unreactive to immunostaining, which have not been previously reported in feline myopathies.