Critical Research Research Articles

Addressing Equity and Justice in Age-Friendly Communities: Considerations for LGBTQ+ Older Adults of Color.

This research critically examined the concept of age-friendliness from the perspectives of older Black lesbian women living in New York City (NYC). The primary aim was to extend existing age-friendly frameworks to more inclusively meet the needs of older lesbian, gay, bisexual, transgender, and queer adults of color, promoting greater equity and justice. Applying principles from critical participatory action research, we collected and analyzed data from five focus groups consisting of five older Black lesbian women. Participants shared their daily experiences living in NYC and proposed ideas to enhance the age-friendliness of the city to better accommodate their unique needs and experiences. Participants called for greater attention to the interaction between identities and structures in relation to age-friendly communities. Historic and contemporary experiences of violence and discrimination, as well as the ever-shifting political context was identified as a key factor shaping their aging experiences. The need for affirming spaces with positive representation of their layered identities was emphasized in the context of age-friendly interventions. While dominant age-friendly frameworks are universally accepted for improving the health and well-being of older adults, the specific challenges of aging with multiple intersecting marginalized identities necessitate a critical perspective. Gerontology needs to take seriously how privilege and oppression operate within society, shaping health and aging trajectories of vulnerable and underserved populations.

Caught between a rock and a hard place: the liminality of the sport coaching ‘pracademic’

ABSTRACT The emergence of “pracademics” in the field of sport coaching, individuals who blend practical coaching expertise with scientific enquiry, has garnered increasing attention. Positioned to bridge the gap between academia and practice, pracademics are expected to bring practical wisdom and contextual knowledge into scholarly activities. However, we pose the need to critically examine the concept of the pracademic, and their service to both industry and academia while sounding a note of caution in an increasingly commercialised sector. We do so by exploring the retrospective reflections of an early career researcher (the lead author) in navigating the role of pracademic in an increasingly neoliberal space. We contend that caution is needed in the blind pursual towards the role of the pracademic, calling on greater collaborative efforts to protect early career academics, challenge neoliberal structures and for the continued engagement with thoughtful and critical research and knowledge exchange in sport coaching.

Impact of the COVID-19 pandemic on pediatric out-of-hospital cardiac arrest outcomes in Japan.

This study investigates the impact of the COVID-19 pandemic on pediatric out-of-hospital cardiac arrest (OHCA) outcomes in Japan, aiming to address a critical research gap. Analyzing data from the All-Japan Utstein registry covering pediatric OHCA cases from 2018 to 2021, the study observed no significant changes in one-month survival, neurological outcomes, or overall performance when comparing the pre-pandemic (2018-2019) and pandemic (2020-2021) periods among 6765 cases. However, a notable reduction in pre-hospital return of spontaneous circulation (ROSC) during the pandemic (15.1-13.1%, p = .020) was identified. Bystander-initiated chest compressions and rescue breaths declined (71.1-65.8%, 22.3-13.0%, respectively; both p < .001), while bystander-initiated automated external defibrillator (AED) use increased (3.7-4.9%, p = .029). Multivariate logistic regression analyses identified factors associated with reduced pre-hospital ROSC during the pandemic. Post-pandemic, there was no noticeable change in the one-month survival rate. The lack of significant change in survival may be attributed to the negative effects of reduced chest compressions and ventilation being offset by the positive impact of widespread AED availability in Japan. These findings underscore the importance of innovative tools and systems for safe bystander cardiopulmonary resuscitation during a pandemic, providing insights to optimize pediatric OHCA care.

The road less traveled: Developing pharmacist clinician-scientists through divergent training pathways.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Professional organizations have emphasized the growing need for pharmacists to possess advanced research skills; however, there is a scarcity of training programs aimed at nurturing clinician-scientists. This report outlines 3 critical care-focused research programs, each offering a unique approach to training clinician-scientists. Limited resources and formalized programs are available to bridge the gap between the demand for and availability of skilled clinician-scientists. Several programs have stepped forward to share their experiences in establishing and executing training initiatives aimed at cultivating skilled clinician-scientists in the critical care practice space. Enhancing the development of clinician-scientists for clinical and translational research is necessary in the critical care clinical pharmacy community.

The times are changing: A primer on novel clinical trial designs and endpoints in critical care research.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

Heterogeneity, Bayesian thinking, and phenotyping in critical care: A primer.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. To familiarize clinicians with the emerging concepts in critical care research of Bayesian thinking and personalized medicine through phenotyping and explain their clinical relevance by highlighting how they address the issues of frequent negative trials and heterogeneity of treatment effect. The past decades have seen many negative (effect-neutral) critical care trials of promising interventions, culminating in calls to improve the field's research through adopting Bayesian thinking and increasing personalization of critical care medicine through phenotyping. Bayesian analyses add interpretive power for clinicians as they summarize treatment effects based on probabilities of benefit or harm, contrasting with conventional frequentist statistics that either affirm or reject a null hypothesis. Critical care trials are beginning to include prospective Bayesian analyses, and many trials have undergone reanalysis with Bayesian methods. Phenotyping seeks to identify treatable traits to target interventions to patients expected to derive benefit. Phenotyping and subphenotyping have gained prominence in the most syndromic and heterogenous critical care disease states, acute respiratory distress syndrome and sepsis. Grouping of patients has been informative across a spectrum of clinically observable physiological parameters, biomarkers, and genomic data. Bayesian thinking and phenotyping are emerging as elements of adaptive clinical trials and predictive enrichment, paving the way for a new era of high-quality evidence. These concepts share a common goal, sifting through the noise of heterogeneity in critical care to increase the value of existing and future research. The future of critical care medicine will inevitably involve modification of statistical methods through Bayesian analyses and targeted therapeutics via phenotyping. Clinicians must be familiar with these systems that support recommendations to improve decision-making in the gray areas of critical care practice.

The Influence of Environmental Sustainability Orientations on organizational Performance: A Review

This comprehensive review addresses a critical research gap concerning the relationship between Entrepreneurial Orientation (EO), Environmental Sustainability Orientation (ESO), and organizational performance. The study advocates for future research to delve into this uncharted territory, providing valuable insights for organizations and policymakers to promote entrepreneurship and sustainable business practices. It suggests a deeper examination of EO, specifically Innovativeness, Proactiveness, and Risk-Taking, as independent variables, alongside organizational performance as the dependent variable. The review emphasizes the pivotal mediating role of ESO, highlighting its strategic significance in differentiating firms and enhancing performance. It affirms the positive influence of EO on ESO, subsequently improving organizational performance. The review stresses the managerial implications of integrating EO dimensions into strategies for a competitive advantage, along with the importance of embracing ESO for reputation enhancement and cost reduction through eco-friendly practices. The study encourages future researchers to explore additional EO variables and utilize diverse data analysis tools to enhance understanding of the intersection of entrepreneurial and sustainability orientations.

Biodiesel supply chain network design: a comprehensive review with qualitative and quantitative insights.

The global community is actively pursuing alternative energy sources to mitigate environmental concerns and decrease dependence on fossil fuels. Biodiesel, recognized as a clean and eco-friendly fuel with advantages over petroleum-based alternatives, has been identified as a viable substitute. However, its commercialization encounters challenges due to costly production processes. Establishing a more efficient supply chain for mass production and distribution could surmount these obstacles, rendering biodiesel a cost-effective solution. Despite numerous review articles across various renewable energy supply chain domains, there remains a gap in the literature specifically addressing the biodiesel supply chain network design. This research entails a comprehensive systematic literature review (SLR) focusing on the design of biodiesel supply chain networks. The primary objective is to formulate an economically, environmentally, and socially optimized supply chain framework. The review also seeks to offer a holistic overview of pertinent technical terms and key activities involved in these supply chains. Through this SLR, a thorough examination and synthesis of existing literature will yield valuable insights into the design and optimization of biodiesel supply chains. Additionally, it will identify critical research gaps in the field, proposing the exploration of fourth-generation feedstocks, integration of multi-channel chains, and the incorporation of sustainability and resilience aspects into the supply chain network design. These proposed areas aim to address existing knowledge gaps and enhance the overall effectiveness of biodiesel supply chain networks.

“No-one’s contribution is more valid than another’s”: Committing to inclusive democratic methodologies

In this article, we explore the power and potential of democratic research methodologies in and beyond Critical Disability Studies research contexts. We centre two funded co-produced, participatory and arts-informed projects that have been co-designed and co-led with disabled young people and people living with chronic (respiratory) illness. We critically explore some key processes, which we suggest can mitigate forms of disablism and ableism inherent to research processes which traditionally make them undemocratic spaces of inequity. Our paper offers original analyses into the very notion of democratic research which have significant applications; driven as they are by the presence of disability. These include (i) Crip time - the recognition of (disabled) people’s need for flexible forms of time; (ii) virtual methods and intimacies as routes to equity in research leadership; and (iii) flexible and slow/er research approaches. We also draw upon the ways in which the Covid-19 global pandemic has reshaped methodologies and approaches to inquiry. We advocate that, as research communities, we must come together to keep hold of these new inclusive and hybridised ways of relating and engaging in what are problematically framed as “post-Covid” times. We conclude by emphasising the importance of always committing to disrupting power dynamics through centring flexibility, accessibility and inclusivity across our inquiry with marginalised others.

The welfare of ill and injured feedlot cattle: a review of the literature and implications for managing feedlot hospital and chronic pens

By definition, ill and injured animals are on the negative valence of animal welfare. For beef cattle kept in feedlot settings, advances in cattle health management have resulted in a greater understanding and prevention of illness and injury. However, the management of cattle once they become ill and injured is an understudied area, and there are gaps in knowledge that could inform evidence-based decision-making and strengthen welfare for this population. The aim of this review is to provide a comprehensive overview of the acquired knowledge regarding ill and injured feedlot cattle welfare, focusing on existing knowledge gaps and implications for hospital and chronic pen management and welfare assurance. Ill and injured feedlot cattle consist of acutely impaired animals with short-term health conditions that resolve with treatment and chronically impaired animals with long-term health conditions that may be difficult to treat. A literature search identified 110 articles that mentioned welfare and ill and injured feedlot cattle, but the population of interest in most of these articles was healthy cattle, not ill and injured cattle. Articles about managing ill and injured cattle in specialized hospital (n = 12) or chronic (n = 2) pens were even more sparse. Results from this literature search will be used to outline the understanding of acutely and chronically ill and injured feedlot cattle, including common dispositions and welfare considerations, behavior during convalescence, and strategies for identifying and managing ill and injured cattle. Finally, by working through specific ailments common in commercial feedlot environments, we illustrate how the Five Domains Model can be used to explore feelings and experiences and subsequent welfare state of individual ill or injured feedlot cattle. Using this approach and our knowledge of current industry practices, we identify relevant animal-based outcomes and critical research questions to strengthen knowledge in this area. A better understanding of this overlooked topic will inform future research and the development of evidence-based guidelines to help producers care for this vulnerable population.

Enhancing ECG signal classification through pre-trained stacked-CNN embeddings: a transfer learning approach

Rapid and accurate electrocardiogram (ECG) signal classification is crucial in high-stakes healthcare settings. However, existing computational models often struggle to balance high performance with computational efficiency. This study introduces an innovative computational framework that combines transfer learning with traditional machine learning to optimize ECG classification. We use a pre-trained Stacked Convolutional Neural Network (SCNN) to generate high-dimensional feature embeddings, which are then evaluated by an array of machine learning classifiers. Our models demonstrate exceptional performance, particularly when utilizing embeddings from SCNNs trained on diverse datasets. This underscores the importance of data diversity in improving classifier discrimination. Notably, Multilayer Perceptrons (MLPs) stand out for their ability to balance computational efficiency with strong performance, achieving test F1-scores of 0.94 and 1.00 in multi-class and binary tasks on the CinC2017 dataset, and 0.85 and 0.99 on the CPSC2018 dataset. Our approach consistently outperforms existing methods, setting new benchmarks in ECG classification. The synergy between deep learning-based feature extraction and traditional machine learning through transfer learning offers a robust, efficient, and adaptable strategy for ECG classification, addressing a critical research gap and laying the groundwork for future advancements in this crucial healthcare field.

Airborne GNSS reflectometry for coastal monitoring of sea state

Sea level rise and sea state variability, resulting from climate change and global warming, are critical research areas. However, current techniques for observing and monitoring these phenomena have limitations in terms of spatial and temporal resolution, particularly in dynamic coastal zones. GNSS Reflectometry (GNSS-R) is an emerging bistatic radar-based technique that utilizes the GNSS direct (transmitter-receiver) and reflected (transmitter-reflection point-receiver) signals to extract properties of the reflecting surface. This study explores the potential of airborne GNSS-R as a means to monitor sea state in coastal areas by using the Doppler spread and reflectivity as observables. The paper aims to derive a sea state factor from the reflected signal power and the Doppler shift distribution to analyze its correlation with wind speed and significant wave height data obtained from the ERA5 model. The experiment involved four flights conducted along the coast between Calais and Boulogne-sur-Mer, France, in July 2019. A GNSS software receiver processes the direct and reflected signals, tracking and re-tracking the reflected signals with the aid of a specular reflection model. The resulting in-phase and quadrature components are analyzed in the spectral domain every minute to estimate the power, the surface reflectivity, and the relative Doppler shift. The findings reveal that the sea state factor and Doppler spreading are sensitive to sea state conditions, correlated with the ERA5 parameters, and influenced by the elevation angle of GNSS satellites. At low elevations (E&lt;10°), the sea state factor demonstrates an inverse relationship (anti-correlation) with the wind speed and significant wave height, while the Doppler distribution shows a correlation with these parameters. Both correlations decrease with increasing elevation angle. This research underscores the potential of airborne GNSS-R for monitoring sea state variability in coastal areas enhancing our understanding of the relationships between GNSS-R measurements and sea state parameters.

Cancer cell membrane cloaked fluorescent liposomes loaded with metal-phenolic complex nanoparticles for combinatorial therapy against breast cancer

The development of innovative strategies for effective cancer treatment remains a critical research focus. In this study, we present a novel approach by designing cancer cell membrane-cloaked fluorescent liposomes loaded with metal-phenolic complex nanoparticles for combinatorial therapy against breast cancer. This multifaceted therapeutic system leverages the unique properties of cancer cell membranes, fluorescent liposomes, and metal-phenolic complexes to create a highly targeted and versatile treatment platform. Cancer cell membranes serve as natural camouflage, allowing these nanoparticles to evade the immune system and specifically target breast cancer cells. The inclusion of fluorescent liposomes not only aids in real-time imaging of treatment progress but also enhances the therapeutic effect by providing photodynamic therapy. Metal-phenolic complexes provide a multifunctional payload, offering both thermally assisted cytotoxicity and the ability to modulate cellular pathways critical in cancer progression. The enhanced internalization found in 4T1 cell lines demonstrates the targeted efficiency of our nanosystem. We also observed a significant increase in intracellular reactive oxygen species (ROS), increased cell death, and a significant decrease in colony formation treated with the synthesized nanoparticles. Alteration in mitochondrial membrane potential indicated the onset of cellular apoptosis, which eventually resulted in cell death. The biomimetic CSpFeTA NPs exhibited remarkable deep tumor tissue penetration and apoptotic cell death assisted by NIR irradiation. The development of such a sophisticated nanosystem represents a significant advancement in cancer therapy, opening new avenues for personalized and effective breast cancer treatment.

The Edifice of Vasculature-On-Chips: A Focused Review on the Key Elements and Assembly of Angiogenesis Models.

The conception of vascularized organ-on-a-chip models provides researchers with the ability to supply controlled biological and physical cues that simulate the in vivo dynamic microphysiological environment of native blood vessels. The intention of this niche research area is to improve our understanding of the role of the vasculature in health or disease progression in vitro by allowing researchers to monitor angiogenic responses and cell-cell or cell-matrix interactions in real time. This review offers a comprehensive overview of the essential elements, including cells, biomaterials, microenvironmental factors, microfluidic chip design, and standard validation procedures that currently govern angiogenesis-on-a-chip assemblies. In addition, we emphasize the importance of incorporating a microvasculature component into organ-on-chip devices in critical biomedical research areas, such as tissue engineering, drug discovery, and disease modeling. Ultimately, advances in this area of research could provide innovative solutions and a personalized approach to ongoing medical challenges.

Researching in solidarity with marginalised groups: A meta-ethnography about research for educational justice and social transformation

This article uses meta-ethnography to identify the challenges of working in solidarity with the experiences and interests of marginalised and exploited social groups. It focuses on what the main challenges seem to be, and on how to overcome them in struggles to change education in just directions by means of educational research. It is therefore a paper of interest from a methodological and a research political perspective relating to how critical researchers challenge the status quo and undermine the dominant hegemony in education and education policy in their research. A clear message from the analysis concerns the importance of understanding of the ontological class position of research for change and what to do in research in the interests of justice based on this understanding. Another message relates to the subjective and objective sides of transformative action, and a third a two directional threat towards it.

Towards carceral protectionist territories: Relational geographies of anti-trafficking confinement in Nepal

The article draws on labour and migration bans in Nepal as a case study to advance nascent, yet growing attention towards trafficking borders in critical geographical research on anti-trafficking. It does so by highlighting a relational geography of carceral protectionist spaces which are encountered, navigated, and sometimes escaped by women citizens on the move who are pre-emptively rescued/‘saved’ from the possibility of being ‘trafficked.’ Specifically, we aim to extend these critical interventions on carceral protectionism in two interconnected ways. First, whilst extant research mainly focuses on institutions and actors within migrant destination states, we examine the operations of carceral protectionist spaces within the home countries of migrant women. Second, we tease out the ways carceral protectionist spaces can actively produce the very subjects they seek to deter or eradicate as they navigate and challenge these institutional spaces. Through the discussion, we develop threads of the conceptualisation of a carceral protectionist territory to indicate the multiple and diffuse, yet interconnected, sites through which women’s mobility aspirations are constrained by anti-trafficking infrastructures.

Evaluating osteoporosis and bone quality in the aging spine: modern considerations for surgical management in the geriatric population.

Surgical management paradigms of spinal pathologies in the aging population carry inherent substantial risks, with surgical complications being more prevalent among patients with osteoporosis compared to those with normal bone mineral density. In this narrative review, we aim to highlight important clinical understanding and considerations in perioperative evaluation and management of patients elected to undergo spinal surgery. Osteoporosis is a well-defined risk factor for mechanical complications following spinal surgery, and as such, perioperative optimization of bone health in the setting of surgery for geriatric patients remains a critical research area alongside intraoperative surgical augmentation techniques. Surgical techniques to circumvent challenges with instrumentation of poor bone mineral density have included augmentation of pedicle screw fixation, including segmental bicortical screw fixation techniques, cement augmentation with fenestrated screws, or use of expandable pedicle screws to improve bone-implant interface. Judicious selection of treatment modalities and subsequent perioperative optimization is paramount to minimize surgical complications. Contemporary guidelines and evolving paradigms in perioperative evaluation, optimization, and management of the aging spine include the advent of quantitatively evaluating computed tomography (CT) via assessment of the magnitude of Hounsfield units. Prescribing pharmacotherapeutic agents and monitoring bone health requires a multidisciplinary team approach, including endocrinologists and geriatricians to coordinate high-quality care for advanced-age patients who require surgical management of their spinal disorders.

Events-within-events and the online reproduction of their emotional dimensions: a case study of the Dubai 2020 expo

ABSTRACT Large-scale events are typically described as single, monolithic entities. In this paper, we argue that large-scale events actually comprise multiple sub-events or events-within-events and their online representations. We explore the theoretical implications of this shift in perspective for the study of audiences and event engagement through the lens of communication power theory. We also discuss the practical implications for event management. The paper uses the Expo 2020 Dubai as its case study to illustrate the richness of sub-events within large-scale events and to consider the role of digital communications. The discussion highlights the ways in which physical events' digital twins aim to solicit similar emotional responses by audiences as their physical counterparts. By adding complexity to our understanding of these sorts of events, we argue that large-scale events comprise multiple sub-events, taking place both face-to-face and online, that make large-scale events richer and more multifaceted than they are typically seen to be. Our research shows that event organisers will need to go beyond the creation of virtual event replicas if they want to take full advantage of the affordances of digital communication. The paper concludes by calling for more critical and interdisciplinary research on large-scale events and their online representations.

Evaluation of hydrometallurgical black mass recycling with simulation-based life cycle assessment

Abstract Purpose The recycling of lithium-ion batteries is an emerging field faced with the challenge of recovering more than the most valuable elements from the batteries. While the literature presents many innovative approaches to the problem, an overview of the technical and environmental prospects of hydrometallurgical black mass recycling remains crucial. The goal was to analyze the impacts of a black mass process flowsheet and suggest ways to further reduce the impacts of battery recycling. Methods The flowsheet was drafted from the literature by combining both state-of-the-art and experimentally demonstrated unit processes by starting with the leaching system, where reductive leaching is performed using only the copper and iron impurities already present in the black mass. The process targeted copper, manganese, cobalt, nickel, and lithium recovery, and three scenarios for manganese recovery were investigated. The flowsheet was simulated using HSC Sim software, and the mass and energy balances were adapted into internally consistent life cycle inventories. The scope was “gate-to-gate” in Europe and CML methodology was used for impact assessment. Results and discussion Assuming that mechanical pre-treatment carries more environmental benefits than burdens, the results indicated that hydrometallurgical black mass recycling had a tentatively lower environmental footprint compared to virgin raw materials in all impact categories except ozone depletion, the results indicated that hydrometallurgical black mass recycling had a tentatively lower environmental footprint compared to virgin raw materials in all impact categories except ozone depletion. Sulfuric acid and neutralizing chemicals were among the most significant contributors to the impacts, and therefore further analysis was conducted based on an experimental study on low acid leaching with a low (&lt; 0.5 M) initial sulfuric acid concentration instead of the baseline 2 M. This reduced the impacts by approximately 30–40% in all categories by decreasing downstream chemical consumption, and more significantly decreased ozone depletion. The challenges and opportunities for further process improvement were also considered. Conclusions The study highlights the importance of process optimization to improve the environmental sustainability of battery chemical production, but also revealed critical research gaps in the experimental literature. Rather than focusing on a single unit process, experimental black mass recycling research should aim at finding solutions that are optimal for the up- and downstream units, such as minimization of aluminum in the black mass and acid consumption.

Injury severity prediction and exploration of behavior-cause relationships in automotive crashes using natural language processing and extreme gradient boosting

Addressing the global challenge of traffic crashes necessitates transcending traditional statistical models, which often fail to fully capture the interactions between factors causing crashes. This oversight restricts the predictive accuracy and adaptability of current methodologies. Additionally, there is a notable gap in research that examines the links between behavior-cause relationships and crash injury severity. Our study deploys Natural Language Processing (NLP) and Frequent Pattern (FP) growth algorithm to mine crash narratives for behavior-cause connections, combines with the predictive strength of eXtreme Gradient Boosting (XGBoost) and the interpretative clarity offered by SHapley Additive exPlanations (SHAP), our approach not only predicts crash injury severity with satisfactory precision but also explains the influence of specific behavior-cause and environment conditions on crash outcomes. The integration of NLP and XGBoost, complemented by SHAP insights, has shown promising results with an accuracy of 0.79, outperforming traditional discrete choice models and competes closely with other machine learning approaches, including Support Vector Machines, Random Forest, Categorical Boosting (CatBoost), and Light Gradient Boosting Machine (LightGBM). Through detailed textual analysis and the establishment of a behavior-cause matrix, identifying five broad crash causes linked to 141 specific crash cause with behaviors, we uncover critical patterns such as the prominence of distracted driving in severe crashes. This comprehensive approach not only fills a critical research gap by linking behavior-cause relationships with injury severity but also sets the stage for developing targeted interventions to enhance road safety.