bluuebunny/crossref_metadata_2025 huggingface dataset:
Translating entrepreneurial intention to behaviour amongst micro and small entrepreneurs
Authors: Nungsari Melati , Ngu Kirjane , Wong Ni Shi Denise , Chin Jia Wei , Chee Shu Yee , Wong Xin Shi , Flanders Sam
Published: July 2022

Purpose

Entrepreneurship studies have established various antecedents leading to eventual entrepreneurship by measuring entrepreneurial intention (EI). However, evidence has shown that intention does not necessarily translate into behaviour, especially for complex behaviours such as creating a business venture. Hence, this paper aims to examine how contextual and individual factors interact with one another to promote or inhibit one’s translation of EI into entrepreneurial action in an emerging economy.

Design/methodology/approach

The authors adopt a retrospective qualitative approach by interviewing 37 Malaysian micro and small business owners. Then, multidimensional scaling is used to examine the interactions between the identified factors.

Findings

The authors find that social networks are the main influence on an individual’s propensity to start a business – it provides financial and social capital, provides other means of support such as practical help and business opportunities and instils passion and drive. Furthermore, organisations such as schools, universities and employers play an important role in instilling the motivation for a career shift to entrepreneurship and by providing opportunities to upskill. In addition, the findings indicate that entrepreneurial traits such as proactiveness, resourcefulness and passion enable individuals to overcome entrepreneurial structural constraints, such as lack of resources and negative action-related emotions. By contrast, the role of macro-environmental factors such as governmental support play less prominent roles in the narratives of the entrepreneurs.

Practical implications

This study has important implications for governments and policymakers in implementing support for those transitioning from salaried employment to self-employment and for entrepreneurship interventions to adopt a holistic approach that encompasses building one’s entrepreneurial knowledge, skills and mindsets, alongside providing external incentives.

Originality/value

The authors provide a more holistic approach to exploring the EI–behaviour gap. In addition, this study explored facilitators and barriers to entrepreneurship specific to the context of an emerging economy such as Malaysia, which is highly dependent on small-scale self-employment.
Implementing sustainability in food manufacturers’ operations and supply chains
Authors: Adams David Jeffery , Donovan Jerome , Topple Cheree
Published: July 2022

Purpose

The food industry and its associated agricultural production have very significant global environmental and social impacts. The purpose of this study is to apply and evaluate the use of institutional theory and extended resource-based view (ERBV) to sustainability in food manufacturing and its supply chains. This will provide an understanding of the pressures that facilitate sustainability responses in food manufacturers and their supply chains.

Design/methodology/approach

An investigation of the Nespresso company and a multinational confectionery company were used to highlight the pressures that an organisation can face with respect to sustainability and demonstrate its responses using institutional theory and ERBV.

Findings

Based on ERBV and institutional theory, the authors developed an integrated conceptual framework that is readily applicable to food manufacturers and their supply chains and improves our understanding of how they react.

Originality/value

To the best of the authors’ knowledge, this is the first time that both ERBV and institutional theory have been used to evaluate sustainability in food manufacturers and their supply chains. It is also the first time that the sustainability responses of the Nespresso company and another food manufacturer have been evaluated using these combined theories and this should improve our understanding of how these theories interact.
Structural predictors of choice: Testing a multilevel rational choice theory of crime
Authors: Thomas Kyle J. , Baumer Eric P. , Loughran Thomas A.
Published: July 2022

Extant research has provided support for the micro‐level predictions of rational choice models of crime. Yet, a central feature of the rational choice perspective in the broader social sciences—that it is multilevel in focus, situating individuals within broader community social structures—has been neglected within criminology. In this article, we discuss and test a model that links community structural characteristics to several individual expectations and preferences relevant to crime. Using data from the Pathways to Desistance study, we find that objective levels of neighborhood concentrated disadvantage influence individuals’ perceptions of, and preferences for, the risks, costs, and rewards associated with offending indirectly by affecting perceived disorder and perceived opportunities for legitimate avenues of success within one's neighborhood. The implications of a multilevel rational choice model of offending are discussed.
Rapid identification of flaxseed oil based on portable fiber optic Raman spectroscopy combined with an oil microscopy method
Authors: Su Yuancui , Li Yuanpeng , Tan Chengsen , Zeng Rui , Hua Yisheng , Hu Junhui , Wang Lihu
Published: July 2022

To explore a fast, simple, and accurate method to identify adulteration in flaxseed oil, the Raman spectral data of 130 samples containing flaxseed, canola, cottonseed, and adulterated oils were obtained using a portable fiber optic Raman spectrometer. The Raman spectral results showed that the Raman spectra of the flaxseed and canola oils had noticeable peak shifts, whereas the peak positions of the flaxseed and cottonseed oils were relatively similar. Clear peak intensity differences were observed in the flaxseed, cottonseed, and canola oils, mainly at 868 cm–1, 1022 cm–1, 1265 cm–1, and 1655 cm–1, with Raman shift intensities in the following order: Iflaxseed oil > Icottonseed oil > Icanola oil. Similarly, the peak intensity of the flaxseed and adulterated oils also exhibited certain differences (at 868 cm–1, 1022 cm–1, 1265 cm–1, and 1655 cm–1), and the Raman shift intensity tended to decrease gradually with the increasing content of canola and cottonseed oils in the flaxseed oil. Additionally, the results of Raman spectroscopy combined with the “oil microscopy” method exhibited large variations in the radar patterns of the flaxseed, canola, and cottonseed oils, whereas the radar patterns of the flaxseed and adulterated oils closely resembled each other. The results indicated that Raman spectroscopy in combination with oil microscopy more effectively revealed the subtle differences in the Raman shift intensity, serving as a more visual and comprehensive approach for differentiating the quality variations between pure flaxseed oil and other oil species and adulterated oil.

Practical Application

This study analyzed the Raman spectra of flaxseed, canola, cottonseed, and adulterated oils using fiber optic Raman spectroscopy. Combined with the oil microscopy method for comprehensive evaluation and analysis, it is feasible to effectively identify the quality differences among flaxseed, canola, cottonseed, and adulterated oils.
Physician gestalt for emergency department triage: A prospective videotaped study
Authors: Cheng Ming‐Tai , Sung Chih‐Wei , Ko Chia‐Hsin , Chen Yun Chang , Liew Chiat Qiao , Ling Dean‐An , Liao Edward Che‐Wei , Lu Tsung‐Chien , Ku Nai‐Wen , Fu Li‐Chen , Huang Chien‐Hua , Tsai Chu‐Lin
Published: July 2022

Objective

Appropriate triage in patients presenting to the emergency department (ED) is often challenging. Little is known about the role of physician gestalt in ED triage. We aimed to compare the accuracy of emergency physician gestalt against the currently used computerized triage process.

Methods

We conducted a prospective observational study in the ED at an academic medical center. Adult patients aged ≥20 years were included and underwent a standard triage protocol. The patients underwent system‐based triage using the computerized software the Taiwan Triage and Acuity Scale. The entire triage process was recorded, and triage data were collected. Five physician raters provided triage levels (physician‐based) according to their perceived urgency after reviewing videos. The primary outcome was hospital admission. The secondary outcomes were ED length of stay (EDLOS) and charges.

Results

In total, 656 patients were recruited (mean age 52 years, 50% male). The median system‐based triage level was 3. By contrast, the median physician‐based triage level was 4. The physician raters tended to provide lower triage levels than the system, with an average difference of 1. There was modest concordance between the two triage methods (correlation coefficient 0.30), with a weighted kappa coefficient of 0.18. The area under the receiver operating curve for the system‐ and physician‐based triage in predicting hospital admission were similar (0.635 vs. 0.631, p = 0.896). Attending physicians appeared to have better performance than residents in predicting admission. The variation explained (R2) in EDLOS and charges were similar between the two triage methods (R2 = 3% for EDLOS, 7%–9% for charges).

Conclusions

Emergency physician gestalt for triage showed similar performance to a computerized system; however, physicians redistributed patients to lower triage levels. Physician gestalt has advantages for identifying low‐risk patients. This approach may avoid undue time pressure for health care providers and promote rapid discharge.
Characteristics and predictors of off‐label use of antipsychotics in general population sample
Authors: Pirhonen Eero , Haapea Marianne , Rautio Nina , Nordström Tanja , Turpeinen Miia , Laatikainen Outi , Koponen Hannu , Silvan Jenni , Miettunen Jouko , Jääskeläinen Erika
Published: July 2022

Objective

Increasing number of people have been prescribed antipsychotics (APs) off‐label in recent decades. This study aimed to identify the characteristics and predictors of receiving prescription of antipsychotics off‐label.

Methods

The study sample was part of the Northern Finland Birth Cohort 1966 (n = 7071). Data included questionnaires and national register data. Information on prescribed medications was extracted from the national register. The sample was divided into three groups: Persons who had been prescribed APs off‐label (n = 137), individuals with non‐psychotic mental disorders without APs off label (n = 1478) and individuals who had been diagnosed with psychosis or bipolar disorder and who had been prescribed APs (n = 151). We compared sociodemographic, lifestyle and clinical characteristics between the off‐label and the comparison groups using logistic regression.

Results

The most common diagnoses in the off‐label group were depression (n = 96, 70.1%) and anxiety (n = 55, 40.1%). Compared with individuals with non‐psychotic mental disorders who were not prescribed APs off‐label, individuals with prescribed off‐label APs had a lower level of education, lower socioeconomic status, were less often married, had a higher level of somatic and psychiatric morbidity, were more often smokers and more often had a substance abuse disorder and heavy alcohol consumption. When comparing the off‐label group to individuals with psychosis or bipolar disorder who used APs, there were less differences, though individuals with psychosis or bipolar disorder had more markers of morbidity and a lower level of education.

Conclusion

Individuals who had been prescribed APs off label had a higher level of mental and somatic morbidity and poorer socioeconomic status than individuals with non‐psychotic mental disorders who did not use APs.
How Threats of Exclusion Mobilize Palestinian Political Participation
Authors: Weiss Chagai M. , A. Siegel Alexandra , Romney David
Published: July 2022

Do exclusionary policies mobilize minority political participation? We theorize that the threat of exclusionary policies creates and resurfaces grievances that facilitate mobilization. To test our theory, we leverage Donald Trump's announcement of a peace plan for the Israeli–Palestinian conflict, which posed a threat to the citizenship status of Palestinian citizens of Israel residing in the Triangle area adjacent to the West Bank. First, using more than 170,000 posts from public Facebook groups and pages, we show that Trump's announcement was indeed a more salient political event for Triangle residents. Then, employing locality‐level election data as well as records detailing the origin of citizens’ joining a Jewish‐Arab social movement, we use a difference‐in‐difference design to demonstrate that the threat to citizenship imposed by Trump's plan increased mobilization in the Triangle area. Our evidence from three distinct data sources suggests that threats of exclusion can mobilize minority political behavior.
Temporal trends in the management of metacarpal and phalangeal fractures in the 21st century: an analysis of Australian population‐based data
Authors: Sivakumar Brahman S. , An Vincent V. G. , Symes Michael J. , Graham David J. , Lawson Richard D. , Clarke Elizabeth
Published: July 2022

Background

Fractures of the hand, specifically the metacarpals and phalanges, are a common injury. Whilst many of these fractures can be treated non‐operatively, a number of advances have led to the increase in popularity of surgical intervention. The aim of this study was to assess and describe trends in management of phalangeal and metacarpal fractures in Australia over the last two decades.

Methods

A review was conducted of the Medicare Benefits Scheme (MBS), specifically querying the item numbers pertaining to the management of metacarpal and phalanx fractures. Data was recorded as the incidence per 100 000 patients.

Results

Overall, there was a statistically significant decrease in the incidence of closed reduction of metacarpal and phalanx fractures, with a converse statistically significant increase in open reduction internal fixation.

Conclusion

This study demonstrates that over the last 20 years, there has been a decrease in closed reduction of intra‐ and extra‐articular phalangeal and metacarpal fractures, with a converse but smaller increase in open reduction and fixation. These trends are likely multi‐factorial in aetiology, and should be monitored to guide resource allocation and health provision in the future.
Accelerating the 1.5°C energy transition for Canadian residential buildings through selective direct electrification with heat pumps
Authors: McDiarmid Heather , Parker Paul
Published: July 2022

Limiting global warming to 1.5–2.0°C in line with our climate commitments will require decarbonization of residential buildings. The traditional approach starts with major energy efficiency upgrades to the building envelope followed by switching to low‐carbon fuel sources for space and water heating. Building envelope retrofits have been a policy goal for over two decades in Canada and elsewhere, yet historical rates and associated emission reductions fall far short of what is required if we are to meet our climate targets. Alternatively, we propose direct fuel switching to electric heat pumps for space and water heating in regions with low‐carbon electricity. Using a database of 44,463 home energy profiles in Waterloo Region, Canada, we modeled the energy efficiency and greenhouse gas emission impacts of building envelope retrofits and direct electrification. While all retrofit plans achieved significant energy efficiency gains (17‐40%), so did direct electrification (70%) and building envelope retrofits plus electrification combined (70‐80%). Only plans that included electric heat pumps achieved greenhouse gas emission reductions of 90% or more. Compared to the conventional approach, direct electrification with heat pumps may be a simpler, more effective, and more realistic approach for policies aiming to decarbonize the residential sector.
Children's participation in child protection—How do practitioners understand children's participation in practice?
Authors: Woodman Elise , Roche Steven , McArthur Morag
Published: July 2022

Children's participation is essential to achieve good outcomes for children involved in child protection systems. Despite this, research has consistently found children report low levels of participation, are poorly consulted and feel inadequately involved in decisions about their lives. To explore how practitioners understand children's participation, 18 in‐depth interviews were conducted with statutory child protection practitioners in Australia. The interviews explored the ways child protection practitioners understand children's participation. Our findings show practitioners conceptualize children as rights holders and believe it is essential to hear directly from children about their needs and wishes to keep them safe. Practitioners identified the importance of transparent processes and decisions. Different understanding of participation emerged, with some participants talking about children as their central focus but not discussing meaningful participation of the child. It appeared that children's participation relied largely on the views and skills of individual workers, as well as their ability to incorporate meaningful participation in limited time and in complex practice environments where children's safety is a primary concern. Systemic changes to address time barriers, training practitioners to understand and implement participatory practice, and seeking children's input into service design, will support consistent and meaningful participation.
Records of personal assistance applications reveal young carers: Viewed from the rights of the child
Authors: Bergman Ann‐Sofie , Järkestig Berggren Ulrika
Published: July 2022

The aim of this article is to investigate how children's care responsibility is recognised in records of personal assistance carried out by the Swedish Social Insurance Agency (SSIA). The article consists of document analysis, examining how caring activities are made visible in the records, and professionals' views and actions regarding responsibilities placed on children. Data consist of 100 cases randomly selected from the SSIA register amongst applicants with children, focusing on parents' descriptions of their needs, the public officials' assessments, and statements from professionals. Recurring themes related to young carers were developed.
The human future. Space exploration, cooperation, and challenges ahead
Authors: Funes José G.
Published: July 2022

The year 2022 marks the 60th anniversary of the United Nations Declaration of Legal Principles Governing the Activities of States in the Exploration and Use of Outer Space. This could be a good opportunity to reflect upon the challenges that the developments of science and technology have presented to the theological thinking in the last decades. First, I would like to consider the historical context of the UN Declaration, then I will move to our present considering the challenges we face, to conclude with some implications for the theological thinking in a Catholic perspective.
Busulfan and cyclophosphamide‐based conditioning regimen still holds the promise of being a safe and efficacious regimen for allogeneic transplantation in patients with transfusion‐dependent thalassemia, even in high risk
Authors: Mehta Pallavi , Kapoor Jyotsna , Singh Aakanksha , Yadav Neha , Singh Reema , Halder Rohan , Verma Megha , Agrawal Narendra , Ahmed Rayaz , Bhurani Dinesh
Published: July 2022

Busulfan and cyclophosphamide (BuCy)‐based regimen has been used as a standard myeloablative chemotherapy for haematopoietic stem cell transplantation in thalassemia. However, treosulfan‐based conditioning regimen has emerged due to concerns of toxicities. We retrospectively analysed the safety and efficacy of fludrabine/Bu/Cy/antithymocyte globulin (ATG) versus treosulfan/thiotepa/fludrabine regimens for Hematopoietic Stem Cell Transplant (HSCT) in transfusion‐dependent thalassemia (TDT) conducted at our institute (2013–2021). In 75 patients, 36 (48%) received Flu/Bu/Cy/ATG whereas 39 (52%) received Treo/Thio/Flu. Median age was 6 (1–12) and 9 (1–15) years, respectively. Number of patients with Classes I, II, and III were 14, 10, and 12 in Flu/Bu/Cy/ATG versus 2, 19, and 18 in Treo/Thio/Flu group, respectively. Graft was growth factor mobilized bone marrow in Flu/Bu/Cy/ATG versus peripheral blood stem cell in Treo/Thio/Flu group. Mean stem cell dose was 3.82 (2.2–9.1) versus 5 (1.65–8.01) 106/kg in Flu/Bu/Cy/ATG versus Treo/Thio/Flu group, respectively. Neutrophils and platelets engrafted at a median of 16 (14–21) and 16 (9–47) days in Flu/Bu/Cy/ATG and 15 (10–20) and 13 (9–41) days in Treo/Thio/Flu group. Median duration of follow‐up was 28 (23–32.9) months. Five (6.6%) patients had rejection (all secondary). Venoocclusive disease was observed in 2 (5.7%) versus 4 (10.3%) patients (p = .047), respectively. Flu/Bu/Cy/ATG had 4 (11.4%) patients with acute GVHD versus 15 (38.5%) patients which had significant impact on survival (p = .038). We observed chronic GVHD in 4 (11.4%) and 11 (28.2%) patients, respectively, with significant impact on survival (p = .031). Four (5.1%) patients had TRM in Treo/Thio/Flu group, in contrast to none in Flu/Bu/Cy/ATG group. Mixed chimerism was common in Flu/Bu/Cy/ATG {20 (57.1%)} versus Treo/Thio/Flu group {12 (30.1%)}. Five‐year Event Free Survival (EFS) and OS of entire cohort were 87% + 4% and 94% + 3%, respectively. Estimated TFS, EFS, OS of Flu/Bu/Cy/ATG versus Treo/Thio/Flu was 97.1% + 2.9% versus 89.2% + 5.1% (p = .251), 97 + 3% versus 80.7 + 6% (p = .041) and 100% versus 90.4 + 5% (p = .067), respectively. In our experience, Flu/Bu/Cy/ATG regimen is safe and effective even in high‐risk TDT. However, one needs to be vigilant for mixed chimerism.
Crack path and regularities for ball‐bearing fracture in the very‐high‐cycle fatigue regime
Authors: Shanyavskiy Andrey A. , Soldatenkov Aleksey P.
Published: July 2022

The process of fatigue spalling in the rings of ball bearings at durability exceeding 108 cycles under in‐service loading conditions is analyzed on the basis of fractography and the slices prepared in radial planes of rings. The cracks are shown to originate at subsurface from carbides inherent in the bearing steel or inclusions permissible by sizes for the material. Subsequently, the development of cracks perpendicular to the ring raceway surface takes place similarly as in the very‐high‐cycle fatigue (VHCF) regime with the elliptical “fish‐eye” formation. The subsequent crack growth was demonstrated step‐by‐step up to the ring material fragment separation. The total crack path by alternating stops of propagation and new crack nucleation under conditions of mixed‐mode I + II + III mechanisms with the crack branching was discussed. In the final stage, the crack grows towards the ring raceway and either appears on the raceway surface or coalesces with a similar adjacent crack followed by fatigue spalling formation.
Competitive events during nest‐building influence offspring growth and behaviour, but not testosterone deposition in the egg yolk in Western Bluebirds (Sialia mexicana)
Authors: Hernández América , Hernández‐Martínez Alejandro , Nicolás Leticia , Torres Roxana , Montoya Bibiana
Published: July 2022

The environmental stressors that females face before egg‐laying, such as competition for resources, can impact the fitness prospects of the female as well as her offspring through hormone‐mediated maternal effects. In obligate secondary cavity‐nesting species, suitable nest‐holes are a limited resource, so gaining access to nest‐sites may require competition with other individuals. In the Western BluebirdSialia mexicana, we experimentally evaluated whether female exposure to increased competition for nest cavities (reduced available nest‐holes plus exposure to a competitor's decoy and vocalizations) during the period of nest construction affects her offspring's developmental trajectory, survival probability and behaviour through an increase in the concentration of testosterone in the egg yolk. Chicks from experimental females had a lower body mass at age 3 days, followed by a faster growth rate during the rapid growth phase, a slower growth rate during the slow growth phase and larger tarsus at age 15 days (only male offspring). Additionally, experimental chicks exhibited a lower breathing rate. However, female exposure to stronger competition for nest cavities during nest construction did not affect testosterone concentration in the egg yolk. Differential testosterone deposition in yolk is therefore apparently not the underlying mechanism of the effects observed, which may be attributed to changes in females' parental behaviour triggered by competition for breeding sites.
Social media adoption behaviour: Consumer innovativeness and participation intention
Authors: Kamboj Shampy , Sharma Manika
Published: July 2022

With the emergence of social media, the trends of selfies have become common across various social networking platforms as a distinctive way of self‐presentation. It has aroused the interest of various scholars to comprehend the consumer adoption behaviour for social media. Thus, built on the innovation diffusion theory (IDT) and theory of planned behaviour (TPB) perspective, this paper developed a model to empirically test whether and how critical factors of consumer selfie‐posting behavioural intention on social media affect behavioural intention and word‐of‐mouth to consequently enhancing their adoption behaviour towards social media to post selfies. The data were gathered from 353 young consumers who post their selfies clicked via smartphone on their social media accounts. The results revealed that consumer innovativeness and participation intention directly and indirectly affect consumer adoption behaviour for social media to post their selfies. Additionally, the study identified that among all critical factors, participation intention and perceived behaviour control have strongest influence on behavioural intention to post selfies followed by consumer innovativeness, attitude towards selfie‐posting and subjective norms. The study contributes to the extension of TPB by adding participation intention and positive WOM, adoption of social media. This research validated the significant roles of consumer innovativeness, participation intention, positive WOM and intention to post selfies in predicting the adoption behaviour. Practitioners and marketers of social media sites can improve the usability and effectiveness of positive WOM and intention to post selfies to attract more young consumers.
‘Standing up for Myself’ (STORM): Development and qualitative evaluation of a psychosocial group intervention designed to increase the capacity of people with intellectual disabilities to manage and resist stigma
Authors: Scior Katrina , Cooper Rebecca , Fenn Kristina , Poole Laurie , Colman Sophie , Ali Afia , Baum Sandra , Crabtree Jason , Doswell Sophie , Jahoda Andrew , Hastings Richard , Richardson Lisa
Published: July 2022

Background

People with intellectual disabilities are at risk of experiencing stigma and require the skills and confidence to deal with stigma in their daily lives.

Method

Development and piloting of a 5‐session manualised psychosocial group intervention designed to increase the capacity of people with intellectual disabilities aged 16+ to manage and resist stigma. Ten pre‐existing groups (N = 67) in third sector and education settings participated. Interviews with participants (n = 26), facilitators (n = 9) and significant others (n = 7) 2–4 months after the intervention assessed perceived impact.

Results

Perceived benefits of the intervention for participants included increased understanding, improved connections with others, drive for advocacy, increased activity and self‐efficacy, and opportunity to process difficult events and emotions. Differential impact depending on individuals' pre‐existing self‐advocacy skills was noted.

Conclusions

This early‐stage study indicates that further evaluation is merited to examine feasibility and outcomes of the STORM intervention.
Critical evaluation of contrasting evidence on whether male circumcision has adverse psychological effects: A systematic review
Authors: Morris Brian J. , Moreton Stephen , Bailis Stefan A. , Cox Guy , Krieger John N.
Published: July 2022

Objective

To conduct the first systematic review critically examining evidence on whether early male circumcision has short‐ and long‐term adverse psychological effects.

Methods

We searched PubMed, EMBASE, SCOPUS, Cochrane Library, and Google Scholar.

Results

Twenty‐four studies with original data met the inclusion criteria. These comprised 11,173 total males, 4340 circumcised in infancy and 6908 uncircumcised. Nineteen were rated 1+, 2++ or 2+, and 5 were rated 2– by SIGN criteria. Neonatal circumcision, particularly without anesthetic, increased vaccination pain response, but had little effect on breastfeeding or cognitive ability. Studies reporting associations with sudden infant death syndrome, autism, alexithymia and impaired sexual function and pleasure had design flaws and were rated 2–. Sexual arousal, touch, pain, and warmth thresholds measured by quantitative sensory testing were not diminished in neonatally circumcised men. Neonatal circumcision was not associated with empathy in men, contradicting the hypothesis that procedural pain causes central nervous system changes. After correcting all associations with socioaffective processing parameters for multiple testing only higher sociosexual desire, dyadic sexual libido/drive, and stress remained significant. The relatively greater sexual activity found in circumcised men might reflect reduced sexual activity in uncircumcised men overall owing to pain and psychological aversion in those with foreskin‐related medical conditions (reverse causality). Most studies employed case‐control designs with limited follow‐up. Studies beyond childhood were prone to confounding.

Conclusion

The highest quality evidence suggest that neonatal and later circumcision has limited or no short‐term or long‐term adverse psychological effects.
Influence of the Atlantic Ocean thermal anomaly on the Longsnout seahorse Hippocampus reidi in a Brazilian estuary
Authors: Freret‐Meurer Natalie V. , Fernández Tatiane C. , Vaccani Amanda C.
Published: July 2022

One of the consequences of climate change is an increase in the temperature of the oceans, which is considered to be one of the greatest impacts on biodiversity. Fish may respond to this impact in several ways, including shifts in their patterns of occurrence. The present study investigated the variation in the structure of a H. reidi population between 2015 and 2017 in the northern Guaíba Island area, highlighting a possible relationship to thermal anomaly associated with the El Niño phenomenon. The seahorse population monitoring was performed monthly, recording sex ratio, abundance, juvenile and adult proportion, depth of occurrence, total length and the holdfast which the seahorse were found attached. The influence of the El Niño event on the study population was evaluated by the correlation of the thermal anomaly data reported for the Tropical South Atlantic Index. Seahorse density on northern Guaíba island was positively and significantly correlated with water temperature, but the sex ratio and number of juveniles were not. The diversity of holdfasts used increased over the study period and was inversely proportional to the thermal anomaly. These results suggest that the thermal anomalies caused by the El Niño in the South Atlantic might trigger migration behaviour in the study species, providing a large aggregation during that period in Guaíba island.
Facial skin characteristics and concerns in Indonesia: A cross‐sectional observational study
Authors: Du Yaping , Doraiswamy Chandraprabha , Mao Jie , Zhang Qian , Liang Yan , Du Zheng , Vasantharaghavan Renuka , Joshi Manoj Kumar
Published: July 2022

Background

Facial skin characteristics and appearance vary according to ethnicity. While much of this knowledge is derived from the Caucasian population, lately there have been efforts to gain such understanding in various regions in Asia.  In this paper, we have built an understanding of such features in Indonesia. In Indonesia, a section of females wears a traditional veil (hijab) to cover the scalp and part of face. The influence of the hijab on facial skin attributes was also investigated.

Methods

In a cross‐sectional observational study design involving 419 female volunteers in Jakarta, Indonesia, facial skin attributes (colour, radiance, hydration, trans‐epidermal water loss [TEWL], wrinkles, fine lines, pores, and sebum levels) and conditions (melasma, post‐inflammatory hyperpigmentation (PIH), solar lentigines/ senile lentigines, seborrheic keratoses and acne) were assessed by trained operators and dermatologists using standard validated instruments and scales.

Results

With age, facial skin colour showed darkening in cheek; forehead on the other hand showed slight lightening. The skin evenness and radiance decreased, substantially. Aging attributes measured in terms of lines, wrinkles, and under‐eye dark circles showed deterioration with age; the decline was progressively faster than colour change. Facial image data analysis corroborated these findings. Skin hydration remained similar across the age groups even though the skin barrier function measured in terms of TEWL improved with age. Sebum levels in the skin were similar up to the age of 50 but declined in the next group of 50–60 year. Pore severity increased with age. Melasma, seborrheic keratosis and PIH showed a high prevalence (>∼50%) at the young age group (20–30 years), itself. Melasma prevalence attained 100% in the age group of 41–50 year and onwards, and its severity similarly showed a steady rise with age. PIH on the other hand showed a steady decline with age. Solar lentigines prevalence (∼30%) did not change much across age groups, and the severity scores were similar in age groups up to 50 year but increased substantially in 51–60‐year age groups. Seborrheic keratosis was similar (∼47%) in age groups up 20–40 year but steadily increased in upper age groups. Its severity was similar in the age groups of 20–30 year and 31–40 year but showed a two‐fold increase in subsequent age groups. Acne was 10% in the age group of 20–30 year and declined gradually to 0.7% in the 51–60‐year age group. Hijab wearers showed slight protection in skin colour darkening and improvement of evenness and radiance but were similar on aging (fine lines and wrinkles on crow's feet, under eye and peri‐oral areas) markers to non‐wearers. In general, in majority of age‐groups, hijab wearers showed a higher prevalence of melasma, solar/senile lentigines, seborrheic keratosis and PIH.
Blindness and vision loss in Japan: A spatio‐temporal analysis
Authors: Baptista Emerson Augusto
Published: July 2022

Objectives: To analyze the spatio‐temporal patterns in the prevalence of blindness and vision loss (BVL) across Japanese prefectures from 1990 to 2019. Methods: The spatial Bayesian hierarchical regression model is used to estimate the risks and trends in the prevalence of BVL in Japanese prefectures. Three models are tested: (1) purely spatial model, (2) spatio‐temporal model, and (3) spatio‐temporal interaction model. Results: Overall, the purely spatial results suggest that relative risks do not have a consistent spatial pattern over time. There are a few prefectures with exceptionally high (1.5 to 4.9) and low (0.3 to 0.5) risks that appear to emerge and disappear over time. In addition, an increased risk, characterized by posterior probabilities above 0.8 (excess risk), can be seen in some prefectures in Japan in a very heterogeneous way. On the other hand, the spatio‐temporal results show that the period between 2005 and 2007 seem to work as a spatial transition of BVL prevalence in Japanese prefectures. Conclusions: Overall, no evidence of a spatial pattern is found, such as a north–south divide, either in the purely spatial model or in the spatio‐temporal interaction model.
Impact of narrowing perioperative antibiotic prophylaxis for left ventricular assist device implantation
Authors: Allen Lauren , Bartash Rachel , Minamoto Grace Y. , Cowman Kelsie , Patel Snehal , Vukelic Sasa , Nnani Daryl U. , Fauvel Daphenie , Guo Yi
Published: July 2022

Background

Although infections are a significant potential complication among patients undergoing left ventricular assist device (LVAD) implantation, standardized surgical infection prophylaxis (SIP) regimens are not well defined. At Montefiore Medical Center, a 4‐drug SIP regimen containing fluconazole, ciprofloxacin, rifampin, and vancomycin was previously utilized. In January 2020, the antimicrobial stewardship program implemented a 2‐drug SIP regimen of vancomycin and cefazolin to limit exposure to broad‐spectrum antibiotics. This study evaluated LVAD‐associated infection rates prior to and following the SIP revision.

Methods

A retrospective review of patients who underwent LVAD implantation from 1/2018 to 4/2021 was performed. Infections were classified using the International Society for Heart and Lung Transplantation definitions. Infection rates at 2 weeks, 30 days, and 90 days post‐implantation in the 4‐drug SIP regimen (1/2018‐12/2019) and the 2‐drug SIP regimen (1/2020 to 4/2021) were compared.

Results

A total of 71 patients were included. The number of patients with LVAD‐associated infections (including surgical site infections) was not significantly different in either SIP group at 2 weeks (9% vs. 4%, p = .64), 30 days (9% vs. 11%, p = .99), or 90 days (19% vs. 14%, p = .75). There was no statistically significant difference in 30 or 90‐day mortality. LVAD‐associated gram‐negative (7% vs. 7%; p > .99) and fungal (5% vs. 0%; p = .51) infections were uncommon. The most common organism isolated was Staphylococcus aureus, and the most common type of infection was pneumonia in both SIP groups.

Conclusion

No significant difference in LVAD‐associated infections or infection‐related mortality was observed with de‐escalation of perioperative antibiotics. Additional studies with larger sample sizes are needed to endorse the findings of this study.
Haplotype‐resolved genome assembly of Bletilla striata (Thunb.) Reichb.f. to elucidate medicinal value
Authors: Jiang Lan , Lin Mengfei , Wang Han , Song Hui , Zhang Lin , Huang Qingyu , Chen Renrui , Song Cheng , Li Guohui , Cao Yunpeng
Published: July 2022

Bletilla striata, commonly known as baiji, is a species used in traditional Chinese medicine; it is highly regarded for its medicinal applications and therefore has high economic value. Here, we report a high‐quality haplotype‐resolved genome of B. striata, haplotype A (2.37 Gb, with a scaffold N50 of 146.39 Mb and a contig N50 of 1.65 Mb) and haplotype B (2.43 Gb, with a scaffold N50 of 150.22 Mb and a contig N50 of 1.66 Mb), assembled from high‐fidelity (HiFi) reads and chromosome conformation capture (Hi‐C) reads. We find evidence that B. striata has undergone two whole‐genome duplication (WGD) events: an ancient WGD event shared by most monocots and a recent WGD event unique to all orchids. We also reconstructed the ancestral orchid karyotype (AOK) of 18 ancient chromosomes and the evolutionary trajectories of 16 modern B. striata chromosomes. Comparative genomic analysis suggests that the expanded gene families of B. striata might play important roles in secondary metabolite biosynthesis and environmental adaptation. By combining genomic and transcriptomic data, we identified the 10 core members from nine gene families that were probably involved in B. striata polysaccharide (BSP) biosynthesis. Based on virus‐induced gene silencing (VIGS) and yeast two‐hybrid experiments, we present an MYB transcription factor (TF), BsMYB2, that can regulate BSP biosynthesis by directly interacting with eight key BSP‐related genes: sacA1, HK1, scrK1, scrK2, GPI1, manA1, GMPP1 and UGP2_1. Our study will enhance the understanding of orchid evolution and accelerate the molecular‐assisted breeding of B. striata for improving traits of medicinal value.
Frail older people and those in deprived areas remain at risk from covid-19, even after vaccination
Authors: Saul Helen , Gursul Deniz , Antonelli Michela , Steves Claire
Published: July 2022

The study

Antonelli M, Penfold RS, Merino J, et al. Risk factors and disease profile of post-vaccination SARS-CoV-2 infection in UK users of the COVID Symptom Study app: a prospective, community-based, nested, case-control study.
Lancet Infect Dis
2022;22:1.

To read the full NIHR Alert, go to:
https://evidence.nihr.ac.uk/alert/older-people-at-risk-from-covid-even-after-vaccine/
Models of lifelong care for children and adolescents with chronic conditions in low-income and middle-income countries: a scoping review
Authors: Reif Lindsey K , van Olmen Josefien , McNairy Margaret L , Ahmed Saeed , Putta Nande , Bermejo Raoul , Nugent Rachel , Paintsil Elijah , Daelmans Bernadette , Varghese Cherian , Sugandhi Nandita , Abrams Elaine J
Published: July 2022

Globally, non-communicable diseases (NCDs) or chronic conditions account for one-third of disability-adjusted life-years among children and adolescents under the age of 20. Health systems must adapt to respond to the growing burden of NCDs among children and adolescents who are more likely to be marginalised from healthcare access and are at higher risk for poor outcomes. We undertook a review of recent literature on existing models of chronic lifelong care for children and adolescents in low-income and middle-income countries with a variety of NCDs and chronic conditions to summarise common care components, service delivery approaches, resources invested and health outcomes.
Diagnostic accuracy of ultrasound, CT and their combination in detecting cervical lymph node metastasis in patients with papillary thyroid cancer: a systematic review and meta-analysis
Authors: Yang Jian , Zhang Fengyan , Qiao Ying
Published: July 2022

Objectives

To determine the diagnostic accuracy of ultrasound (US), CT and their combination in detecting cervical lymph node metastasis (CLNM) in patients with papillary thyroid cancer (PTC).

Methods

Medline (via PubMed), Web of Science, Embase were searched to identify studies published till 5 December 2021 that used US and CT to detect CLNM in patients with PTC. The primary outcomes were sensitivity, specificity and diagnostic ORs in neck-level-based (lymph nodes are analysed by neck level) or patient-based (lymph nodes are analysed by patient) analysis. Secondary outcomes were sensitivity, specificity and DORs in the central and lateral compartments.

Results

Fourteen studies (6167 patients with 11 601 neck lymph nodes) met the inclusion criteria. Based on the neck-level-based analysis, the pooled sensitivity, specificity and DORs were 0.35 (95% CI 0.34 to 0.37), 0.95 (95% CI 0.94 to 0.95) and 13.94 (95% CI 9.34 to 20.82) for US, were 0.46 (95% CI 0.44 to 0.47), 0.88 (95% CI 0.87 to 0.89) and 7.24 (95% CI 5.46 to 9.62) for CT, were 0.51 (95% CI 0.49 to 0.52), 0.85 (95% CI 0.84 to 0.86), 6.01 (95% CI 3.84 to 9.40) for the combination of US and CT. In the patient-based analysis, the pooled estimates of sensitivity, specificity and DOR were 0.41 (95% CI 0.36 to 0.46), 0.92 (95% CI 0.89 to 0.94) and 7.56 (95% CI 4.08 to 14.01) for US, were 0.49 (0.44 to 0.54), 0.91 (0.89 to 0.94), 9.40 (5.79 to 15.27) for CT, and were 0.64 (95% CI 0.57 to 0.71), 0.83 (95% CI 0.77 to 0.88), 8.59 (95% CI 5.37 to 13.76) for the combination of US and CT.

Discussion

These findings suggest US, with a DOR almost twice that of CT in the neck-level-based analysis, was superior to CT in detecting CLNM in patients with PTC, especially in the lateral compartment. The combination of US and CT increased the sensitivity from 41%–49% for the individual modalities to 64% for combined modalities in the patient-based analysis.
Prevalence of anabolic steroid users seeking support from physicians: a systematic review and meta-analysis
Authors: Amaral Julio Mario Xerfan , Kimergård Andreas , Deluca Paolo
Published: July 2022

Objectives

To estimate the overall prevalence of androgenic-anabolic steroids (AAS) users seeking support from physicians. Secondary objectives are to compare this prevalence in different locations and among subpopulations of AAS users, and to discuss some of the factors that could have influenced the engagement of AAS users with physicians.

Design

Systematic review and meta-analysis.

Data sources

MEDLINE, PsycINFO, Web of Science and SciELO were searched in January 2022.

Eligibility criteria

Quantitative and qualitative studies reporting the number of AAS users who sought support from physicians, with no restrictions of language or time of publication.

Data extraction and synthesis

Two independent reviewers extracted data and assessed the quality of studies, including publication bias. A random-effects meta-analysis was performed to estimate the overall prevalence of AAS users seeking support from physicians, followed by pooled prevalence rates by studies’ location and the subpopulation of AAS users.

Results

We identified 36 studies published between 1988 and 2021, involving 10 101 AAS users. The estimated overall prevalence of AAS users seeking support from physicians is 37.12% (95% CI 29.71% to 44.52%). Higher prevalence rates were observed in studies from Australia (67.27%; 95% CI 42.29% to 87.25%) and among clients of the needle and syringe exchange programme (54.13%; 95% CI 36.41% to 71.84%). The lowest prevalence was observed among adolescent AAS users (17.27%; 95% CI 4.80% to 29.74%).

Conclusion

Our findings suggest that about one-third of AAS users seek support from physicians, with remarkable differences between locations and subpopulations of AAS users. Further studies should investigate the factors influencing the engagement of AAS users with physicians.

PROSPERO registration number

CRD42020177919.
Impact of time-varying exposure on estimated effects in observational studies using routinely collected data: protocol for a cross-sectional study
Authors: Wang Wen , Liu Mei , Xu Jiayue , Li Ling , Tan Jing , Guo Jeff Jianfei , Lu Kevin , Li Guowei , Sun Xin
Published: July 2022

Introduction

Time-varying exposure is an important issue that should be addressed in longitudinal observational studies using routinely collected data (RCD) for drug treatment effects. How well investigators designed, analysed and reported time-varying exposure, and to what extent the divergence that can be observed between different methods used for handling time-varying exposure in these studies remains uncertain. We will conduct a cross-sectional study to comprehensively address this question.

Methods and analysis

We have developed a comprehensive search strategy to identify all studies exploring drug treatment effects including both effectiveness and safety that used RCD and were published in core journals between 2018 and 2020. We will collect information regarding general study characteristics, data source profile, methods for handling time-varying exposure, results and the interpretation of findings from each eligibility. Paired reviewers will screen and extract data, resolving disagreements through discussion. We will describe the characteristics of included studies, and summarise the method used for handling time-varying exposure in primary analysis and sensitivity analysis. We will also compare the divergence between different approaches for handling time-varying exposure using ratio of risk ratios.

Ethics and dissemination

No ethical approval is required because the data we will use do not include individual patient data. Findings will be disseminated through peer-reviewed publications.