Strategic Efforts Research Articles

Debulking of the Femoral Stem in a Primary Total Hip Joint Replacement: A Novel Method to Reduce Stress Shielding.

In current-generation designs of total primary hip joint replacement, the prostheses are fabricated from alloys. The modulus of elasticity of the alloy is substantially higher than that of the surrounding bone. This discrepancy plays a role in a phenomenon known as stress shielding, in which the bone bears a reduced proportion of the applied load. Stress shielding has been implicated in aseptic loosening of the implant which, in turn, results in reduction in the in vivo life of the implant. Rigid implants shield surrounding bone from mechanical loading, and the reduction in skeletal stress necessary to maintain bone mass and density results in accelerated bone loss, the forerunner to implant loosening. Femoral stems of various geometries and surface modifications, materials and material distributions, and porous structures have been investigated to achieve mechanical properties of stems closer to those of bone to mitigate stress shielding. For improved load transfer from implant to femur, the proposed study investigated a strategic debulking effort to impart controlled flexibility while retaining sufficient strength and endurance properties. Using an iterative design process, debulked configurations based on an internal skeletal truss framework were evaluated using finite element analysis. The implant models analyzed were solid; hollow, with a proximal hollowed stem; FB-2A, with thin, curved trusses extending from the central spine; and FB-3B and FB-3C, with thick, flat trusses extending from the central spine in a balanced-truss and a hemi-truss configuration, respectively. As outlined in the International Organization for Standardization (ISO) 7206 standards, implants were offset in natural femur for evaluation of load distribution or potted in testing cylinders for fatigue testing. The commonality across all debulked designs was the minimization of proximal stress shielding compared to conventional solid implants. Stem topography can influence performance, and the truss implants with or without the calcar collar were evaluated. Load sharing was equally effective irrespective of the collar; however, the collar was critical to reducing the stresses in the implant. Whether bonded directly to bone or cemented in the femur, the truss stem was effective at limiting stress shielding. However, a localized increase in maximum principal stress at the proximal lateral junction could adversely affect cement integrity. The controlled accommodation of deformation of the implant wall contributes to the load sharing capability of the truss implant, and for a superior biomechanical performance, the collared stem should be implanted in interference fit. Considering the results of all implant designs, the truss implant model FB-3C was the best model.

Beyond Bias: Aggregate Approaches to Conflicts of Interest Research and Policy in Biomedical Research.

Considerable efforts have been devoted to addressing the problem of conflicts of interest (COI) in health research, policy, education, and practice. An overwhelming body of evidence demonstrates that conflicts associate with deleterious outcomes for the biomedical research enterprise. Nevertheless, little has changed for research, specifically, since the Institute of Medicine's landmark Conflicts of Interest in Medical Research, Practice, and Education was published over a decade ago. In this article, we draw on interdisciplinary research on manufactured controversies in science-policy deliberation to argue that the development of meaningful COI policy has been stymied through argumentative "wedges" designed to delay consensus and policy formation. Argumentative wedges disrupt policy formation by mischaracterizing the evidence base, continuously redefining the terms of the debate and/or recommending overly narrow criteria for who should be allowed to participate in policy deliberation. In this article, we argue researchers and policymakers interested in better addressing the harmful effects of COI can improve their efforts through strategic efforts designed to disrupt the wedges of manufactured controversy. Additionally, we argue that efforts to address COI can be further enhanced through embracing a broader framework for COI inquiry. Specifically, we argue that aggregate approaches to COI can help to disrupt these wedges and provide a strong foundation for future policy.

African international students’ challenges, investment and identity development at a highly selective EMI university in Kazakhstan

This article documents the reflections of six African second-year master’s students on their international educational experiences in Kazakhstan with a special focus on their challenges, strategic learning efforts and identity development. It is guided by Norton’s conceptualisation of investment in identity, language learning, and social change. The qualitative data collected from a written narrative and two subsequent rounds of individual semi-structured interviews suggest that participants pursued their studies at an English-medium instruction university in Kazakhstan mainly because of the fully-funded scholarships. However, their expectations regarding the university and Kazakhstan were unclear, as they received no pre-departure orientation. Despite being satisfied with the high-quality education in the host institution, they faced challenges such as difficulty securing part-time work due to a lack of proficiency in local languages (Kazakh and Russian), enduring prolonged cold weather, and limited opportunities for socialising with other students. Most participants described Kazakhstan as ‘a peaceful and progressive country’; however, two participants experienced linguistic racism in the classroom. This study underlines the significance of addressing the issues of graduate employability and linguistic racism, along with implementing pedagogical interventions in all phases of study abroad and fostering a sense of intercultural citizenship among students.

Multinational corporations and grand challenges: part of the problem, part of the solution?

PurposeThe purpose of this study is to address the relationship between multinational corporations (MNCs) and grand challenges. Stressing the moderating impact of stakeholders and governments, it frames and introduces the six contributions of the special issue, equally divided into those illustrating how MNCs contribute to the existence of grand challenges and those exploring how MNCs contribute to addressing grand challenges.Design/methodology/approachBased on a review of the existing literature on the relationship between MNCs and grand challenges and recent developments in mainstream international business, the viewpoint emphasizes the need to move beyond a one-sided focus on the positive contributions of MNCs to grand challenges.FindingsThe special issue contributions reveal that even established MNCs are actively engaged in strategic efforts to perpetuate unsustainable practices and minimize the impact of societal rules and stakeholders. The contributions also highlight the complications when MNCs aim to tackle grand challenges.Practical implicationsDisplaying positive practices of how MNCs contribute to the solution of grand challenges should not be considered a functional substitute for regulatory action, contrary to the frequent assertion of MNCs and their political representatives.Originality/valueThis special issue is the first one in IB to address the relationship between MNCs and grand challenges from an empirical vantage point.

How Good Is Open Bicycle Network Data? A Countrywide Case Study of Denmark

Cycling is a key ingredient for a sustainability shift of Denmark's transportation system. To increase cycling rates, better bicycle infrastructure networks are required. Planning such networks requires high‐quality infrastructure data, yet the quality of bicycle infrastructure data is understudied. Here, we compare the two largest open data sets on dedicated bicycle infrastructure in Denmark, OpenStreetMap (OSM) and GeoDanmark, in a countrywide data quality assessment, asking whether the data are good enough for network‐based analysis of cycling conditions. We find that neither of the data sets is of sufficient quality, and that data conflation is necessary to obtain a more complete data set. Our analysis of the spatial variation of data quality suggests that rural areas are more prone to incomplete data. We demonstrate that the prevalent method of using infrastructure density as a proxy for data completeness is not suitable for bicycle infrastructure data, and that matching of corresponding features is thus necessary to assess data completeness. Based on our data quality assessment, we recommend strategic mapping efforts toward data completeness, consistent standards to support comparability between different data sources, and increased focus on data topology to ensure high‐quality bicycle network data.

THE INFLUENCE OF LEVERAGE, PROFITABILITY, AND COMPANY SIZE WITH MODERATION OF AUDIT QUALITY ON COMPANY VALUE

Companies in the D222 sector in Indonesia have the potential to dominate the global market. This study aims to explore how the value of companies in this sector is shaped by financing policies, such as leverage, and their ability to generate profits, namely profitability. Additionally, the research investigates the influence of company size on firm value. The urgency of this research is highlighted by the crucial role of audit performance in driving strategic efforts by companies to enhance their value. Sampled from the years 2020-2022 and drawn from companies listed on the stock exchange, the population consists of 26 companies. Purposive sampling was employed to select a sample of 19 companies in the D222 sector. The data was analyzed using multiple regression in SPSS version 27. The findings suggest that financing policies, specifically leverage, do not significantly impact firm value, whereas the ability to generate profits, namely profitability, has a significant positive effect on firm value. Company size does not seem to affect the increase in firm value. However, the role of Audit Quality as a moderator yields varying results. In terms of the relationship between financing policies, namely leverage, and firm value, Audit Quality does not appear to strengthen it. Similar results are found concerning the relationship between the ability to generate profits, namely profitability, and firm value. However, Audit Quality seems to enhance the relationship between Company Size and Firm Value. These findings provide valuable insights into the interplay of these factors within the processed food industry in Indonesia, aiming for dominance in the global market.

Increasing severity of medical outcomes and associated substances in cases reported to United States poison centers

Introduction Poison centers provide free expert recommendations on the treatment of a wide variety of toxicological emergencies. Prior studies have called attention to the increasing complexity of cases reported to poison centers. We aimed first, to evaluate the trends in medical outcome severity, over a 15-year period in both the adult and pediatric populations. Second, we described the most frequently reported substances associated with major effect or death. Methods This is a retrospective review of exposures reported to the National Poison Data System from 1 January 2007 through 31 December 2021. All closed cases, for human exposures, reported during the study period were included. We assessed trends in frequencies and rates of medical outcomes and level of care received, among the adult (age greater than 19 years) and pediatric (age 19 years and younger) populations by reason for exposure. Results During the study period, the number of adult unintentional exposures resulting in major effect (37.4 percent) and death (65.3 percent) increased. The number of adult intentional exposures resulting in death increased by 233.9 percent and those resulting in a major effect increased by 133.1 percent. The rates of exposures resulting in major effect and death increased among both intentional and unintentional adult exposures. The number of pediatric unintentional exposures resulting in a major effect increased by 76.6 percent and the number of pediatric intentional exposures resulting in death and major effect increased by 122.7 and 190.1 percent, respectively. Moderate, major effect, and death rates increased in pediatric unintentional exposures and moderate and major effect rates increased in pediatric intentional exposures. Conclusions We found a worsening severity of medical outcomes in adult and pediatric cases reported to poison centers. Poison centers are increasingly managing complex cases. Monitoring trends in which substances are associated with severe outcomes is imperative for future strategic prevention efforts.

Production economics and marketing of Himalayan Yew in Mahankal rural municipality of Lalitpur District, Nepal

This study delves into the dynamic landscape of Himalayan yew cultivation in the Mahankal Rural Municipality of Lalitpur district, offering a comprehensive analysis of the socio-demographic factors influencing growers' practices. By examining variables such as gender, age, education, landholding, income, ethnicity, access to irrigation facilities, and marketing strategies, we present a nuanced understanding of the complexities involved. Agriculture emerges as the cornerstone of respondents' income, with Himalayan yew cultivation consistently proving to be financially lucrative, yielding revenues and gross margins that significantly bolster local farmers' economic well-being. The calculated Benefit-Cost Ratio underscores the profitability of Himalayan yew cultivation in Mahankal, advocating for its sustained expansion. Despite favorable climatic conditions, challenges persist in marketing and production domains. Limited primary marketing channels signify untapped potential, necessitating initiatives to foster growth and enhance efficiency. Technical obstacles highlight the need for innovative solutions and technical support to bolster the sustainability of Himalayan yew cultivation. In conclusion, this research underscores the promising prospects and profitability of Himalayan yew cultivation while emphasizing the imperative to address existing challenges. Strategic interventions and collaborative efforts are essential to empower local farmers and ensure the enduring success of this valuable industry. This study serves as a clarion call for concerted action to propel Himalayan yew cultivation to new heights in Mahankal and beyond.

Ukrainian Thoughts and Feelings based on One Year War Content Analysis

In the age of remarkable technological innovations such as AI, quantum computing, IoT, and blockchain, one could argue that the world is becoming an increasingly connected, advanced, enlightened, and peaceful place. Nevertheless, paradoxically, conflicts and wars are still born deeply rooted in complex strategic, historical, and economic dynamics, and continue to arise finding a direct representation in both physical and digital battlefields through powerful and dynamic environments like social media. This environment enabled unprecedented connectivity and ideas, thoughts, ideologies, and experiences exchange shaping the narrative, amplifying ideas, feelings, and experiences while directly addressing the underlying causes, dynamics, and implications of conflicts and war through a multifaceted and multi-nuanced approach. The outbreak and ongoing war in Ukraine took the international community off guard representing a significant turning point in the contemporary era that received immediately intensive global attention, united global humanitarian, and strategic efforts to support and help the ones in need, and reflected its geopolitical and economic global complexities, dynamics, and implications. At the same time, a high degree of disinformation and misinformation exists surrounding different aspects about this war e.g., actions taken, and impact produced on civilians, which contributes to creating an altered perspective of reality. While different conventional media and social media outlets together with research, governmental, and practitioner efforts revealed and reflected on the nature, major incidents, and their known impact on civilians and civilian objects as well as military personnel and military objects, yet limited attention and a lower voice is given through dedicated studies to thoughts and emotions of Ukrainian users in unconventional social media platforms like Telegram. This represents the knowledge gap tackled in this research by building a set of Machine Learning-based solutions for analysing the discourses and sentiments of Ukrainian users using the Design Science Research methodology in a Data Science research approach. From this analysis, reflection is provided to important days and incidents experienced by Ukrainian population since February 2022 in the first year of war.

Is Effective Recruitment Strategy Critical to Assess Brain Cognitive Function of Super Agers in Rural West Texas.

Our commentary aims to elucidate the importance of participant recruitment strategy in healthy brain aging study, particularly in rural West Texas, where more than 50% of the population are Hispanics and Latinos. The objective of our health aging study is to investigate the possible influence of biological, sociodemographic, and lifestyle factors on the occurrence of chronic diseases and dementia in the aging populations of West Texas. The success of this initiative is, in large part, reliant on high-quality, effective recruitment of participants. To that end, we propose an increase in our strategic recruitment efforts for both healthy, cognitively superior agers as well as those with mild cognitive impairment and patients with Alzheimer's disease in rural west Texas. We discussed, multi-advertising approaches, including ads in the local newspapers, local TV Channels and poster boards in senior centers.

Strategi Meningkatkan Daya Saing Bawang Merah Melalui Prediksi Harga

Shallots contribute significantly to the formation of food commodity inflation caused by high price fluctuations. Precise price forecasting is vital for all agribusiness actors, from farmers, traders, and consumers to production and inventory management. This research aims to identify the forecasting prices for shallot producers and consumers and formulate strategies to increase the competitiveness of shallots. This research uses the SARIMA method to capture seasonal elements in the data. The data used is time series data on shallot prices at the consumer and producer levels from January-November 2021. Determining the best SARIMA model uses the auto-arima technique, which shows that the best SARIMA for shallot prices at the producer level is ARIMA (2,1,2)(2,0,0)[12]. In contrast, the price of shallots at the consumer level is ARIMA (5,1,1)(1,0,1)[12]. The prediction results show that the dynamics of shallot prices in the future will continue to follow seasonal patterns as in previous years, namely, high prices during the lean season and religious holidays and low prices during the harvest season. The government needs to strengthen its policy of stabilizing shallot prices at both consumer and producer levels. Availability of agricultural inputs, adoption of technology for post-harvest and marketing, value-added innovation, and infrastructure improvements are strategic efforts to strengthen the competitiveness of shallots. Keywords: consumer price, price fluctuation, producer price, shallot

TherapyTok for Depression and Anxiety: A Quantitative Content Analysis of High Engagement TikTok Videos

PurposeTikTok is increasingly becoming a source of health information, peer support, and validation regarding mental health. The goal of this study was to analyze the content of TikTok videos related to depression and anxiety. MethodsThe sample included 100 videos, each with at least a million views, discussing either depression, anxiety, or both. The videos were retrieved from hashtag searches. The videos were coded for the type of mental health condition; specific content being discussed (e.g., symptoms or treatment); video presentation (i.e., personal experience, expert information, or general discussion), and more subcategories. Engagement statistics (i.e., likes, views, reposts, and number of comments) for each video were also recorded. ResultsThe engagement statistics were higher for personal experience videos than for videos from healthcare professionals. Anxiety was the subject of 57% of the videos irrespective of the search hashtags, and over two-thirds of the videos were created by females. The most discussed topics included the description or enactment of depression/anxiety symptoms (e.g., emotional displays); mention of being diagnosed by a healthcare professional was the least prevalent. DiscussionThese results suggest that depression and anxiety videos featuring personal experiences are prevalent on TikTok with higher engagement compared to similar videos by health professionals. The attribution of generic symptoms to these mental health conditions may result in self-diagnosis. There is a need for more strategic efforts to ensure quality of health content on TikTok and increased focus on digital health literacy to make young social media users critical consumers of online content.

Bimodal Transformer with Regional EEG Data for Accurate Gameplay Regularity Classification.

As games have been applied across various fields, including education and healthcare, numerous new games tailored to each field have emerged. Therefore, understanding user behavior has become crucial in securing the right players for each type of game. This study provides valuable insights for improving game development by measuring the electroencephalography (EEG) of game users and classifying the frequency of game usage. The multimodal mobile brain-body imaging (MOBI) dataset was employed for this study, and the frequency of game usage was categorized into "often" and "sometimes". To achieve decent classification accuracy, a novel bimodal Transformer architecture featuring dedicated channels for the frontal (AF) and temporal (TP) lobes is introduced, wherein convolutional layers, self-attention mechanisms, and cross-attention mechanisms are integrated into a unified model. The model, designed to differentiate between AF and TP channels, exhibits functional differences between brain regions, allowing for a detailed analysis of inter-channel correlations. Evaluated through five-fold cross-validation (CV) and leave-one-subject-out cross-validation (LOSO CV), the proposed model demonstrates classification accuracies of 88.86% and 85.11%, respectively. By effectively classifying gameplay frequency, this methodology provides valuable insights for targeted game participation and contributes to strategic efforts to develop and design customized games for player acquisition.

PENDIDIKAN PRA-NIKAH

Pre-marital education is learning for prospective brides and grooms who want to get married. Pre-marital education provides initial insight for prospective brides and grooms to prepare themselves both mentally and spiritually to form a family. Islamic education starts from family education, while family education according to Islamic teachings starts from pre-marital, pre-natal and post-natal education, starting from choosing a mate to the grave. Therefore, if we want a family with a Muslim personality or what is often called a sakinah mawadah warahmah family, then educate our family with Islamic education.Pre-marital education is one of the components of family education that encounters many problems in the field, either because couples are not ready to get married, economic factors or factors of infidelity that occur in the household. Marriage is a sacred event in the life journey of two individuals. There are many hopes for the longevity of a marriage. So that marriage hopes can berealized, pre-marital and parenting education is needed, which is an important and strategic effort. Pre-marital education is preparation by the prospective bride and groom before marriage, it is hoped that it can reduce disharmony in the household, even reduce the occurrence of divorce, so that a sakinah mawadah wa rahmah family will be created.

The Strategic Effort to Ensure Successful Breastfeeding Practice in the Workplace: An Indonesian Expert Opinion

BackgroundBreastfeeding has benefits for both the child and the mother. However, breastfeeding can be a challenge for working mothers due to inadequate time and space for expressing breastmilk, employer perceptions of reduced productivity, regulations prohibiting children in the workplace, and the lack of childcare close to the workplace.MethodologyThe experts from different backgrounds were invited to provide their views on this matter. This report summarizes the discussion of multidisciplinary experts on the recommendations about breastfeeding practices for mothers and the workplace.ResultsImproving education and knowledge, implementing a lactation promotion model, seeking information, and making plans and arrangements are recommended for successful breastfeeding practices.ConclusionThe aspects of the lactation promotion model can be the key to successful breastfeeding for working mothers.

Challenges and Opportunities in Inclusive Education with ICT: Teachers’ Perspectives in the Canary Islands during the COVID-19 Pandemic

This study intends to explore the challenges and opportunities in inclusive education using Information and Technologies (ICTs) during the COVID-19 pandemic from the perspective of teachers based in the Canary Islands. It focuses on the digital division and the implications involved while examining the impact of health on students with special needs (SEN) and Specific Educational Support Needs (SENS). For this research, a validated questionnaire was used to assess educators’ perceptions and attitudes toward the use of ICT in inclusive education practices. It reveals insights into the need for enhanced ICT training, age and gender disparities perceived in ICT proficiency, and the essential role of continuous professional development for teachers. The study highlights the importance of developing inclusive and comprehensive training strategies, as well as the need for educational institutions to provide effective digital resources and platforms. The findings show that students perceive both their ICT skills and the effectiveness of remote teaching methods as moderate, thus emphasizing the necessity for strategic interventions and collaborative efforts to enhance digital competencies in this educational sector.

Perilaku Petani Milenial Provinsi Jawa Barat dalam Penerapan Climate-Smart Agriculture (CSA) pada Tanaman Hortikultura

Millennial farmers become superior and competitive human resources as determinants of the progress of agricultural development. Millennial farmers must be adaptive to digitalization technology and innovation and environmentally friendly cultivation techniques to face agricultural development, including climate change challenges. Climate-smart agriculture (CSA) behavior is the strategic effort of millennial farmers as an approach to dealing with the impacts of climate change on the agricultural sector, as well as efforts by the agricultural industry to reduce its impact on climate change through efficient management of crops, land and soil, and water. The management is based on three pillars of CSA: 1) Increasing agricultural productivity and income, 2) Improving adaptation and resilience to climate change, and 3) Reducing greenhouse gas emissions. This study aims to analyze CSA implementation behavior based on the Theory of Planned Behavior (TPB) by examining the direct and indirect effects of attitude variables, subjective norms, perceived behavioral control, and intentions. These variables are measured by integrating TPB with the CSA context. The research sample was 198 respondents of Millennial Farmer Ambassadors and Andalan Farmer Ambassadors in West Java Province, conducted in 2023. This research uses a quantitative approach with the Structural Equation Model-Partial Least Square (SEM-PLS) method to analyze complex models with many variables—data collection techniques using questionnaire instruments that have been valid and reliable. The results showed that attitude, perceived behavioral control, and intention significantly influence behavior both directly and indirectly through intention (p-value < α 0.05). Meanwhile, subjective norms do not substantially affect behavior directly or indirectly through intention (p-value > α 0.05). So, it is necessary to develop interventions that strengthen the formation of positive intentions and the need for practical support for subjective norms related to CSA implementation behavior in millennial farmers.

Using passive acoustic data to understand sustainable vessel operations

Marine vessels support diverse ocean economic sectors. As society works towards a sustainable ocean economy, a variety of vessel initiatives are emerging. Passive acoustic monitoring (PAM) offers a method to evaluate these initiatives. Here we review efforts related to vessel noise management in marine protected areas (MPA) and benefits of vessel speed reduction programs (VSRs). Monitoring marine vessel activity and related underwater noise across a network of protected areas, like the U.S. National Marine Sanctuary system, helps managers ensure the quality of habitats used by a wide range of species. Network-wide comparisons of vessel noise revealed a spectrum of conditions, providing robust metrics to help prioritize management and inform condition assessments. These same vessel noise metrics provided insight on noise reduction related to changes in vessel operations during multiple VSRs. The metrics are complementary to other noise reduction metrics currently used to evaluate VSRs. With the growth in VSRs, there is a need to communicate noise reduction at scales relevant to the targeted vessels, typically larger than individual VSRs. Coordinated efforts are advancing to meet these needs. With strategic, systematic, and sustained efforts, PAM can continue to provide key insight on efforts to realize sustainable marine vessel operations.

From MedWreck to MedRec: A Call to Action to Improve Medication Reconciliation.

In moments that matter, clinicians frequently make treatment decisions based upon incomplete, inaccurate, and outdated medication histories. Poorly reconciled medications often lead to a series of unfortunate events - MedWreck. There is a need for a national, coordinated, strategic effort to widen important ongoing initiatives to improve medication reconciliation.

Nursing student volunteers and their level of involvement during the COVID-19 pandemic: a systematic review

Abstract Objective Many strategic efforts were made to address nurses’ shortage in controlling Coronavirus disease 2019 (COVID-19), including recruiting student health volunteers. This review aimed to explore the contribution and involvement of nursing student volunteers during COVID-19. Methods A systematic review was registered in PROSPERO International CRD42021283069. Electronic databases for article search included: SCOPUS, EBSCO MEDLINE, PubMed, ProQuest, Springer, Sage Pub, and hand searching. The critical appraisal study quality using The Joanna Briggs Institutes. Data extraction and synthesis used Population, Intervention, Comparison, Outcome, and Design (PICO and D) framework with thematic analysis. Results Twelve studies were enrolled from 2545 retrieved, with 4 synthesized themes: (1) determinant of the involvement of nursing student volunteers during COVID-19, which includes 3 subthemes: motivations, perception, and barriers, (2) expectations and actual condition of nursing students as volunteers, (3) the need for nursing student volunteers, and (4) the impact and level of student volunteers’ contribution. All student volunteers contribute to providing direct or indirect services to patients. Conclusions This review provides an overview of nursing student volunteers’ needs useful in developing competency frameworks and the role of culturally sensitive volunteers in education and training. In the future, student volunteers could choose the appropriate volunteer program and location according to their competence.