bluuebunny/crossref_metadata_2025 huggingface dataset:
Incorporating circular economy in the architectural design process: design methodology using gamification tools
Authors: Ramadan Menatalla Mohamed Abdellatif , Gabr Aly Hatem
Published: December 2024

Purpose

The present study aims to formulate a framework acting as a design methodology for non-expert architects in circular economy (CE). This design methodology strives to define the circular architectural design process by identifying architectural circular design strategies, supporting tools, knowledgebases required and changing roles of architects. Such a framework may facilitate wider dissemination of circular design practices in architecture.

Design/methodology/approach

The design of the research methodology employs a three-phase strategy combining qualitative and quantitative methods. It captures knowledge from both literature and expert architects in CE. The first phase follows a qualitative strategy to capture explicit knowledge from literature. The second one follows an inductive approach through a survey to capture tacit knowledge of circular design from experts. The third one uses gamification, creating user-friendly, haptic and playful tools, namely, game board, wheel, cards, calculator and dynamic sunburst, to stimulate design thinking.

Findings

The study reveals 20 circular design strategies, translating them into 92 design actions that are applicable at early architecture design phases. It highlights artificial intelligence and digital market platforms as the easiest applicable tools in architecture circular design. This study reveals design for multiple use cycles as the most important required skill in circular design, while circularity consultation is the most vital new role for architects. The results confirm the reciprocating characteristic of the circular design process. According to circularity assessment, the “design with right resources” strategy has the highest circular impact, emphasizing using existing assets as the most impactful design action.

Originality/value

This paper presents a multi-dimensional methodological framework, depicting the relation between circular design strategies, supporting tools and required competencies for architects to be circular designers. This is coupled with a holistic circularity assessment from early stages, unlike existing stand-alone indicators, through the developed circularity calculator. The proposed design methodology acts as an accelerator model through gamification that features a step-by-step design process board, design strategies wheel, design actions cards, circularity calculator and dynamic class sunburst. This paper fulfills a geographical gap in circular built environment research by including experts from Africa with specific emphasis on Egypt.
Perceptions of climate change and pro-environmental behavior: case study on the adoption of liquefied petroleum gas in Cameroon
Authors: Patrick Arnold Ombiono Kitoto , Donald Djatcho Siefu , Rovier Djeudja , Pauline Ngo Tedga
Published: December 2024

Purpose

This study aims to identify climate change perception variables and socioeconomic variables likely to influence the adoption of liquefied petroleum gas (LPG) cooking behavior in Cameroon.

Design/methodology/approach

The study carries out a quantitative analysis using a Logit model mobilizing secondary data collected in the database of the Survey on the Capitalization of Achievements of the National Participatory Development Program.

Findings

The results show that the variables of flooding and temperature rise influence the likelihood of adopting LPG, alongside the variables of poverty, income, level of education and urban residence.

Practical implications

As well as in addition to improving the standard of living of poor households, these results suggest increasing the supply of LPG in peri-urban areas and raising awareness of the relationship between climate perception, biomass energy consumption and deforestation.

Originality/value

The originality of this study lies in the fact that it identifies the variables climate change perception variables and the socioeconomic variables likely to favor the adoption of LPG in the Cameroonian context.
A novel inverse kinematics and shape reconstruction method for continuum robots
Authors: Tang Shufeng , Ji Jingfang , Zhi Yun , Yuan Wei , Chang Hong , Wang Xin , Guo Xiaodong
Published: December 2024

Purpose

Continuum robots offer unique advantages in various specialized environments, particularly in confined or hard-to-reach spaces. Inverse kinematics and real-time shape estimation constitute crucial aspects of closed-loop control for continuum robots, presenting challenging problems. This paper aims to present an inverse kinematics and shape reconstruction method, which relies solely on the knowledge of base and end positions and orientations.

Design/methodology/approach

Based on the constant curvature assumption, continuum robots are regarded as spatial curves composed of circular arcs. Using geometric relationships, the mathematical relationships between the arc chords, points on the bisecting plane and the coordinate axes are established. On this basis, the analytical solution of the inverse kinematics of the continuum robots is derived. Using the positions and orientations of the base and end of the continuum robots, the Levenberg–Marquardt algorithm is used to solve the positions of the cubic Bezier curves, and a new method of spatial shape reconstruction of continuum robots is proposed.

Findings

The inverse kinematics and spatial shape reconstruction simulation of the continuum robot are carried out, and the spatial shape measurement experimental platform for the continuum robot is constructed to compare the measured and reconstructed spatial shapes. The results show that the maximum relative error between the actual shape and the reconstructed shape of the continuum robot is 2.08%, which verifies the inverse kinematics and shape reconstruction model. Additionally, when the bending angle of a single bending section of the continuum robot is less than 135°, the shape reconstruction accuracy is higher.

Originality/value

The proposed inverse kinematics solution method avoids iterative solving, and the shape reconstruction model does not rely on mechanical models. It has the advantages of being simple to solve, highly accurate and fast in computation, making it suitable for real-time control of continuum robots.
Using the balance sheet to assess earnings quality
Authors: Brightbill Kathryn , Rees Lynn
Published: December 2024

Purpose

We discuss the importance of the Financial Accounting Standards Board’s (FASB) emphasis on balance sheet primacy and examine whether balance sheet quality is associated with earnings quality.

Design/methodology/approach

We confirm that a firm’s market-to-book ratio is associated with variables that capture unrecognized intangible assets and therefore serves as a valid proxy for balance sheet quality.

Findings

We find that the explanatory power of earnings for contemporaneous returns is 24–50% higher for firms with higher quality balance sheets relative to firms with lower quality balance sheets, suggesting that the balance sheet is associated with earnings quality.

Practical implications

We interpret these results as providing empirical support for standard setters’ decision to give primacy to assets and liabilities and reinforces the importance of proper recognition and measurement of intangible assets.

Originality/value

Although a plethora of metrics exist that are meant to capture earnings quality, no research to date has explicitly linked the quality of a firm’s balance sheet to the quality of its earnings, despite the theoretical primacy of assets and liabilities.
Outsourcing solid waste management to community-based organizations in local governments
Authors: Rugeiyamu Rogers
Published: December 2024

Purpose

Urban-based local government authorities (LGAs) have embarked on outsourcing solid waste management to community-based organizations (CBOs) for attaining sustainable cities and community’s goal. However, the effectiveness of outsourcing this function to CBOs remains unclear. This study contributes to this debate by citing three urban LGAs from Tanzania.

Design/methodology/approach

This study was conducted in Tanzania specifically to urban LGAs. This study employed a qualitative research approach. Data were collected through interviews and focus group discussions with outsourced groups and analyzed through thematic approach.

Findings

This study found that outsourcing solid waste management benefits both LGAs and groups. On the one hand, LGAs collect revenues out of this arrangement and groups improve their income on the other. However, groups’ operational environment is confronted by poor infrastructure, inadequate collection tools and poor community awareness and readiness.

Research limitations/implications

This study focused on only three LGAs. Studies are recommended for other urban LGAs in Tanzania to extend the scope of the debate. Again, this study confined itself to the effectiveness of outsourcing solid waste collection to groups, but did not focus on how LGAs use revenue collected to improve the waste management, this welcomes further studies to be conducted.

Originality/value

The experienced operational environment creates difficulties for groups in waste collection and might result in some waste being uncollected.
Differences in capital structure between public and private hospitals: new evidence from a small country banking system using panel data
Authors: Neves Maria Elisabete , Ferreira Ivo , Serrasqueiro Zélia , Cancela Beatriz
Published: December 2024

Purpose

The objective of this article is to study the factors influencing the leverage and debt maturity of 48 Public Entities and 297 Private Entities, in the health sector in Portugal, in the period between 2015 and 2021, including the pandemic crisis, coronavirus disease 2019.

Design/methodology/approach

To test the proposed hypotheses, the panel data methodology was used, considering the GMM (Generalized Method of Moments) system estimation method.

Findings

Our findings suggest that in times of crisis, both public and private entities resort to long-term loans to finance additional expenses and guarantee the continuity of health services. Also, there is a strong dependence on short-term debt (short leverage [SLEV]), especially in the public sector, suggesting some financial imbalance in current management, with no margin of financial security. In private hospitals, a more considered strategic definition is demonstrated, without current management risks.

Originality/value

As far as the authors are aware, this article is original and covers an important gap in the literature when considering the determinants of debt maturity in public and private hospitals in Portugal, a country where the debate about the essence of the National Health System, it’s in the news every day.
Residential types, neighborhood security and public trust in Ghana police service: a comprehensive analysis
Authors: Dzordzormenyoh Michael K.
Published: December 2024

Purpose

This study investigates the impact of residential type and neighborhood security on public trust in the police in Ghana, while controlling for demographic factors and police-related variables.

Design/methodology/approach

Data were collected during the ninth round of the Afro-Barometer survey conducted in Ghana between 2019 and 2021 with a sample size of 2,369 participants. The study employed binary logistic regression analysis to examine the relationship between the independent variables (residential type and neighborhood security) and the dependent variable (trust in the police).

Findings

The results indicate that living in traditional housing is associated with lower levels of trust in the police compared with other residential types. Unexpectedly, neighborhood security did not emerge as a statistically significant predictor of police trust. However, police corruption and the use of force were negatively associated with trust, whereas police professionalism positively predicted trust. Interestingly, unnecessary police stops were positively associated with trust, possibly reflecting a complex relationship between police visibility and public perceptions. This study also revealed ethnic and regional variations in police trust, highlighting the need for culturally sensitive policing approaches.

Originality/value

This study stands out in three key aspects. First, it represents one of the first attempts to examine how residential type and neighborhood security influence public trust in law enforcement agencies in Ghana. Second, this study is among the few to investigate the relationship between neighborhood conditions and trust in police using a sample that is representative of the entire nation. Finally, these findings contribute to the understanding of the multifaceted nature of public trust in the police within the Ghanaian context and offer insights for policymakers and law enforcement agencies to enhance police-community relations.
Reconceptualizing HR change agency: introducing a framework and propositions for future research
Authors: Finnholm Johanna , Wallo Andreas , Allard Karin , Tengblad Stefan
Published: December 2024

Purpose

This paper critically examines the empirical literature on the human resource (HR) function during organizational change, identifying the competence required for HR practitioners and pinpointing gaps in previous research.

Design/methodology/approach

The paper is based on an integrative literature review of empirical research. The review utilizes a competence model comprising three key elements: skills, motivation and the opportunities created by organizational conditions.

Findings

The review shows that while there is an ongoing discussion about the competence required by HR practitioners in organizational change, significant gaps remain in our understanding of how this competence translates into HR change agency. The typical normative descriptions of the role can be viewed as unrealistic as they fail to consider crucial contextual factors and the routine, rather mundane nature of HR change agency.

Practical implications

It is necessary to develop an understanding of the context and avoid wishful thinking when initiating change efforts. Furthermore, HR practitioners require enhanced training in crucial areas such as interpersonal skills, including communication, coaching and managing emotions.

Originality/value

The paper presents a new conceptual framework and research propositions, advocating a dynamic approach to understanding HR’s role in change. It explores how HR’s change competence, in terms of their skills and motivation to manage change, is linked to their opportunities to participate in change initiatives.
Lynn Good’s green dilemma: leading Duke Energy’s transition
Authors: Kumari Shwetha , Nair Jitesh
Published: December 2024

Research methodology

This case was developed from secondary sources. The secondary sources included news reports, industry reports, company websites, annual reports and company websites.

Case overview/synopsis

The case discusses the comprehensive renewable energy transition strategy that Lynn J. Good (Good), CEO and President of Duke Energy and the Chairman of its Board, was undertaking. In September 2019, Good revealed a new climate plan aimed at achieving net-zero carbon emissions with zero methane emissions from natural gas operations by 2030 and zero carbon emissions from electricity generation by 2050. Duke Energy is a Fortune 150 company headquartered in Charlotte, North Carolina and one of the major energy generation companies in the USA with two reportable business segments – Electric Utilities and Infrastructure (EU&I) and Gas Utilities and Infrastructure (GU&I). Good targeted interim carbon emission reduction targets of at least 50% from electric generation by 2030, 50% for Scope 2 and some Scope 3 upstream and downstream emissions by 2035 and 80% from electric generation by 2040. To achieve this, she invested in large electric grid upgrades and energy storage, as well as in research on zero-emission power generation technologies including hydrogen and advanced nuclear technologies. She helped update the grid system and improved customer experience. As part of the revamped climate strategy, Good invested in crucial energy infrastructure and improved affordability of electricity for customers, especially in the North Carolina region. Despite her efforts at curbing emissions, Good faced criticism from various quarters. This included criticism of Duke’s carbon-cutting plans in 2022 in its core North and South Carolina service zones. The company also faced charges of environmental pollution. Its 2024 strategy, which aimed to address a projected increase in demand for electricity using natural gas plants capable of running on hydrogen, was also met with skepticism by industry groups, advocates, activists and local governments.

Good had to face the conflict between environmental ambitions and technological realities that highlighted the difficulties in transitioning to a cleaner energy future. It remained to be seen whether she would be able to successfully navigate the various hurdles and help Duke Energy reach its 2030 emission targets.

Complexity academic level

This case was written for use in teaching graduate and postgraduate management courses in entrepreneurship and economics, politics and business environment.
Sustainability of California's Whole Person Care pilots integrating medical and social services for Medicaid enrollees via newly developed Medicaid benefits
Authors: Safaeinili Nadia , Chuang Emmeline , Fleming Mark , Ramanadhan Shoba , Pourat Nadereh , Brewster Amanda
Published: December 2024

Objective

To assess multi‐level factors influencing the sustainability of 26 social care pilots integrating medical and social services for Medicaid enrollees across California in newly developed Medicaid benefits.

Study Setting and Design

This qualitative study assessed the sustainability of Whole Person Care (WPC) pilots implemented between 2016 and 2021. Pilots (n = 26) represented a majority of counties in California.

Data Sources and Analytic Sample

Primary qualitative data were collected between June and August 2021 and included 58 hour‐long, semi‐structured individual and group interviews with administrators, middle managers, and frontline case management staff representing all WPC pilots. We used hybrid inductive–deductive thematic analysis to identify and analyze patterns, and outliers, in factors influencing sustainment. Deductive codes included established implementation science factors influencing the sustainability of new programs (e.g., innovation characteristics, capacity, processes and interactions, and context).

Principal Findings

Of 26 WPC pilots, 22 pilots sustained WPC by contracting with Medicaid managed care plans to provide services as part of newly developed Medicaid benefits. Three pilots chose not to sustain before the pilot period ended and one pilot decided not to sustain following completion of the full pilot. Factors influencing sustainability included: (1) program adaptability and flexibility; (2) funding structure and reimbursement requirements; (3) shared leadership with managed care plans; and (4) whether pilots chose to build out program infrastructure internally or contracted out core components to partner organizations. Many pilots, particularly those in rural areas, indicated that system and policy changes introduced as part of transitioning pilot services into Medicaid benefits reduced the sustainability of WPC for participating providers.

Conclusions

Multi‐level factors including program adaptability, funding, leadership, and capacity to build out infrastructure influenced the sustainability of WPC pilots. These findings have significant implications for health equity as equitable distribution of services, resources, and benefits from these programs can be supported through sustained implementation over time.
The Presence and Pathogenic Roles of M(IL‐33 + IL‐2) Macrophages in Allergic Airway Inflammation
Authors: Guo Han , Zhao Yang , Zhang Zhaoqi , Xu Yanan , Chen Yifang , Lei Tong , Zhao Yong
Published: December 2024

Background

Macrophages, one of the most abundant immune cells in the lung, have drawn great attention in allergic asthma. Currently, most studies emphasize alternative activated (M2) polarization bias. However, macrophage function in allergic asthma is still controversial. Interleukin (IL)‐9 contributes to the development and pathogenesis of allergic airway inflammation. We sought to investigate the IL‐9‐producing macrophage and its role in allergic asthma.

Methods

The model of ovalbumin (OVA)‐induced allergic airway inflammation was employed to evaluate IL‐9 production in macrophages of lung tissues. We used 22 cytokines or stimuli to screen for IL‐9‐producing mouse macrophage subset in vitro. Real‐time PCR, flow cytometry, ELISA, and RNA‐seq to explore the subset. Conditional IL‐33 receptor knockout (Lyz‐ST2KO) mice and cellular adoptive transfer experiment were used to characterize the potential roles of M(IL‐33 + IL‐2) in allergic asthma.

Results

We identified a unique pathogenic IL‐9‐producing macrophage in OVA‐induced allergic airway inflammation. We found that only IL‐33 significantly induced IL‐9 production in mouse macrophages, and IL‐2 collaborated with IL‐33 to promote IL‐9 production, referred to as M(IL‐33 + IL‐2). Importantly, human monocyte‐derived macrophages produced IL‐9 after IL‐33 and IL‐2 stimulation. Using Lyz‐ST2KO mice and adoptive transfer of M(IL‐33 + IL‐2), we found that M(IL‐33 + IL‐2) significantly promoted pathogenesis in OVA‐induced allergic airway inflammation. M(IL‐33 + IL‐2) has a distinctive gene expression profile with high expression of IL‐9, IL‐5, and IL‐13 and its polarization is dependent on JAK2‐STAT3‐IRF1 pathway.

Conclusions

The identification of M(IL‐33 + IL‐2) subset extends the diversity and heterogeneity of macrophage subsets and may offer novel therapeutic strategies for the treatment of allergic inflammation.
Impact of general vs. regional anaesthesia on one‐year clinical outcomes and healthcare utilisation after lower limb arthroplasty: a retrospective study
Authors: Ho Chun‐Ning , Wang Wei‐Ting , Hung Kuo‐Chuan , Liu Wei‐Cheng , Liao Shu‐Wei , Chen Jen‐Yin , Lan Kuo‐Mao
Published: December 2024

Introduction

General anaesthesia and regional anaesthesia are used for hip and knee arthroplasty but their impact on long‐term outcomes remains unclear. This study aimed to compare one‐year clinical outcomes and healthcare utilisation in patients receiving general or regional anaesthesia for hip or knee arthroplasty.

Methods

Using data from the TriNetX Global Collaborative Network, we conducted a retrospective analysis of 247,142 patients aged 40–90 y who underwent hip or knee arthroplasty between 2010 and 2023. After propensity score matching, 12,558 patients were included in the general anaesthesia and regional anaesthesia cohorts. The primary outcome was one‐year all‐cause mortality. Secondary outcomes included one‐year incidence of dementia; cerebral infarction; pneumonia; major depression; care provider dependency; and readmission rates. Subgroup analyses according to sex, age (40–70 y vs. > 70 y) and timeframe (2010–2016 vs. 2017–2023) were also performed.

Results

There was no significant difference in one‐year mortality (hazard ratio 1.12, 95%CI 0.89–1.41, p = 0.322). General anaesthesia was associated with a lower incidence of major depression (hazard ratio 0.82, 95%CI 0.70–0.97, p = 0.021) and care provider dependency (hazard ratio 0.47, 95%CI 0.38–0.58, p < 0.001), but higher readmission rates (hazard ratio 1.22, 95%CI 1.16–1.29, p < 0.001) than regional anaesthesia. Subgroup analysis revealed that patient characteristics including sex and age, as well as evolving peri‐operative care practices over time, may influence the comparative outcomes of general and regional anaesthesia in patients undergoing elective hip or knee arthroplasty.

Discussion

Although general anaesthesia and regional anaesthesia showed comparable one‐year mortality, general anaesthesia was associated with lower risks of major depression and care provider dependency but higher readmission rates than regional anaesthesia. These findings suggest that the choice of anaesthesia may have important implications for long‐term outcomes beyond mortality.
Pre‐operative imaging for inguinal hernia: routine or waste? A single institution perspective
Authors: Rockliff Aaron , Roomy Aqeel , Ho Simon , Wijeratne Shiran
Published: December 2024

Introduction

Inguinal hernia is a very common surgical problem in Australia. This study aims to assess at a single institution the perioperative use of imaging for these patients, and the accuracy of that imaging.

Methods

Data were collected retrospectively for 215 adult patients who underwent inguinal hernia repair at a single public hospital. Clinical, operative, and imaging findings were collected and recorded.

Results

The study included 215 patients who had surgery on 240 groins. 90% of patients had preoperative imaging, with 70% undergoing ultrasound, and 28% undergoing CT scan. 82% of patients who had imaging had a clinically palpable hernia. Ultrasound and CT had high sensitivity for the presence of hernia, 97.5% and 90.6%, respectively. Ultrasound was inaccurate at assessing for direct versus indirect hernia, correlating with operative findings only 62% of the time.

Conclusion

Data suggest that imaging is being overused for investigation of groin hernias, and imaging findings do not appear to alter operative management.
Nonattendance in preventive child health examinations associated with increased risk of school‐aged obesity in Denmark
Authors: Heuckendorff Signe , Brund René Børge Korsgaard , Eggertsen Charlotte Nørkjær , Thomsen Janus Laust , Fonager Kirsten
Published: December 2024

Aim

The aim of this study is to investigate associations between attending routine preventive child health examinations in general practice and the risk of obesity and overweight at age six, focusing on psychosocial risk factors.

Methods

Data from nationwide Danish registers on 725 926 children born between 2000 and 2012 were analysed. Information on examination attendance and BMI was obtained. Regression analyses assessed the association between examination attendance and obesity or overweight risk.

Results

Non‐attendance in preventive child health examinations was associated with a risk of obesity of 18%–31% at age six. The highest risk was observed in children of parents with low educational attainment who missed all examinations, a four‐ to five‐fold increase compared to children of parents with high educational attainment who attended all or missed only one exam. A smaller association of one to 2% was found between missing examinations and risk of overweight in the general population. However, children of parents with low educational attainment who did not attend were 8%–9% more likely to have overweight.

Conclusion

Associations were found between obesity and overweight and not attending preventive child health examinations in general practice. Further research is needed to understand the mechanisms and develop targeted interventions to address health disparities in childhood obesity.
Does mindfulness facilitate letting be? A longitudinal investigation of nonattachment as a mediator in the association between mindfulness, well‐being, and affect at trait and state levels
Authors: Yu Ben C. L. , Ng Jacky C. K. , Chio Floria H. N. , Mak Winnie W. S.
Published: December 2024

This research investigated the mediating role of nonattachment in the association between mindfulness and well‐being. Study 1, a 2‐week ecological momentary assessment (EMA) study with 2446 responses from 69 participants, showed that state mindfulness at time (t) − 1 was not significantly associated with nonattachment at t and (positive and negative) affect at t + 1. However, nonattachment at t significantly mediated the association between state mindfulness at t and (positive and negative) affect at t. Study 2, a 2‐month study with three waves of measurement (n = 224), showed that trait mindfulness at baseline could not predict psychological well‐being at 2‐month follow‐up through nonattachment at 1‐month follow‐up. However, this mediating relationship was significant when all these variables were measured at baseline. People who are mindful at one moment may experience higher nonattachment and better well‐being at the same moment; the beneficial effect could not be sustained over time among people who are largely non‐meditators.
The benefits of physical literacy for human flourishing: A machine learning–based exploration of adolescents
Authors: Jiabin Lin , Shanshan Zhu , Xiaomei Lai , Kaixin Yang , Ying Yu
Published: December 2024

Physical literacy is a multidimensional concept considered fundamental for lifelong participation in physical activity. Although theories on the relationship between physical literacy and human flourishing have been proposed, no comprehensive study of this relationship in adolescents has been found. This study aimed to predict human flourishing variables (physical activity, physical health, mental health, and academic performance) that correlate highly with adolescents' physical literacy. A sample of 1004 primary and middle school students was recruited and six machine learning algorithms (decision tree, random forest, AdaBoost, CatBoost, LightGBM, and k‐nearest neighbours) were used. Random forest predicted physical activity, physical health, and mental health in the overall sample, with an accuracy of 53 percent, 86 per cent, and 91.7 percent, respectively; AdaBoost predicted academic performance with an accuracy of 98 per cent. Overall sample and sex subgroup predictions were generally consistent, with “sense of self and self‐control” and “self‐expression and communication with others” as the most significant variables. Family‐type subgroup analysis results varied greatly, suggesting that one‐child families should focus on “knowledge and understanding,” whereas multi‐child families should focus on “self‐expression and communication with others.” Awareness of adolescents' underlying characteristics may yield greater benefits when intervening through physical literacy.
PHAX enhanced LIN28B‐mediated PBX3 mRNA stability to promote esophageal cancer development
Authors: Peng Jie , Lv Liang , Zhou Yuqian , Wang Xuehong , Hu Changmei
Published: December 2024

The abnormal expression of PHAX was observed in esophageal cancer, however, its specific function and mechanism remain to be further elucidated. We demonstrated that PHAX, LIN28B, and PBX3 were upregulated in esophageal cancer, while TET2 was downregulated. Elevated PHAX correlated with adverse outcomes among esophageal cancer patients. PHAX or PBX3 knockdown not only inhibited esophageal cancer cell proliferation, and promoted apoptosis and autophagy in vitro, but it also repressed tumor growth and lung metastasis in mice. Mechanically, PHAX stabilized PBX3 mRNA through interacting with LIN28B. PBX3 directly bound to the TET2 promoter region and inhibited its expression. In conclusion, PHAX directly bound to LIN28B and enhanced LIN28B‐mediated stabilization of PBX3 mRNA, leading to upregulation of PBX3. PBX3 then transcriptionally repressed TET2 expression to promote esophageal cancer cell proliferation, and suppress apoptosis and autophagy. Targeting this signaling cascade could represent a promising therapeutic strategy for esophageal cancer.
Targeting Hepatocellular Carcinoma: Schisandrin A Triggers Mitochondrial Disruption and Ferroptosis
Authors: He Lin‐wei , Lin Chang‐jie , Zhuang Lin‐jun , Sun Yi‐hui , Li Ye‐cheng , Ye Zhen‐yu
Published: December 2024

The main focus of this research was to examine SchA's role in the hepatocellular carcinoma (HCC) development. LO2 and Huh7 cell viability were assessed using the MTT assay. The experiments included flow cytometry, colony formation, transwell, wound healing, and immunofluorescence assays to evaluate apoptosis levels, cells colony‐forming ability, ROS levels, invasion and migration ability, and mitochondrial membrane potential. Biochemical kits was utilized for checking the ATP, mitochondrial DNA, MDA, GSH, and Fe2+ levels in the Huh7 cells, and western blot for measuring the ferroptosis and AMPK/mTOR related‐protein expression levels. The MTT assay demonstrated that SchA significantly reduced the vitality of Huh7 cells ranging from 10 to 50 μM, whereas it exhibited no discernible impact on LO2 cells. Additionally, SchA significantly inhibited colony‐forming ability, invasion ability, and migration ability within the concentration range of 10 to 50 μM, with a reduction of 68% in colony formation at 50 μM. SchA also induced apoptosis in a dose‐dependent manner. Moreover, SchA was observed to significantly elevate ROS levels dose‐dependently, down‐regulate mitochondrial membrane potential (JC‐1) at 20 and 50 μM, and reduce the levels of ATP and mtDNA dose‐dependently. Various concentrations of SchA resulted in a notable elevation in MDA and Fe2+ levels as well as ACSL4 protein expression, accompanied by a reduction in GSH level and the protein expression of GPX4 and SLC7A11. Furthermore, SchA induced the activation of the AMPK/mTOR pathway in Huh7 cells, as evidenced by the increased phosphorylation level of AMPK and decreased phosphorylation level of mTOR. SchA might inhibit the progress of HCC through mitochondrial ferroptosis and dysfunction mediated by AMPK/mTOR pathway.
Effect of SLC22A1 polymorphism on the pharmacokinetics of proguanil in Korean: A semi‐physiologic population pharmacokinetic approach
Authors: Khwarg Juyoung , Yang Eunsol , Park Chan Song , Ji Sang Chun , Yu Kyung‐Sang , Lee SeungHwan
Published: December 2024

Proguanil, an antimalarial drug, undergoes hepatic uptake by the polymorphic organic cation transporter 1 (OCT1) and is subsequently metabolized by the cytochrome P‐450 2C19 (CYP2C19) enzyme into its active metabolite, cycloguanil. This study aims to evaluate and mechanistically characterize the effect of genetic polymorphism of SLC22A1, which encodes OCT1, on the pharmacokinetics (PKs) of proguanil and cycloguanil in Korean. This study was based on a post hoc analysis of the PK results of a CYP2C19 mediated drug–drug interaction study (NCT04568772). Among the 16 CYP2C19 normal metabolizers enrolled in the previous study, 13 were prospectively genotyped for six SLC22A1 single nucleotide polymorphisms (SNPs) associated with a decreased function of OCT1. Among these, only the SNP SLC22A1 1022C>T (rs2282143) was observed, with four subjects being heterozygous (CT) and nine subjects homozygous for the wild‐type allele (CC). The CT genotype showed a 1.2‐fold higher systemic exposure of proguanil and a 0.6‐fold lower exposure of cycloguanil compared to those in subjects with the CC genotype, resulting in a 0.5 to 0.6‐fold lower metabolic ratio. Based on the PK and genotype data, a parent‐metabolite joint population PK model including a well‐stirred liver compartment was developed using a nonlinear mixed‐effect modeling approach. The OCT1 activity of the CT genotype was estimated to be 0.42‐fold lower compared to the CC genotype. In conclusion, the genetic polymorphism of SLC22A1 1022C>T increased the systemic exposure of proguanil, while decreasing the systemic exposure of cycloguanil by reducing the hepatic uptake of proguanil, as mechanistically described by a population PK approach.
Immigrant Nurses and Allied Professionals Seeking to Validate Their Qualification in Finland
Authors: Metsälä Eija , Karjalainen Anne
Published: December 2024

Health care professional's qualifications earned in one country may not be recognised in another country and will require validation. The aim of the study was to investigate the experiences of immigrant healthcare professionals seeking the recognition of their education credentials in Finland. Altogether 11 professionals applying to a programme to validate their qualification were interviewed using semi‐structured interviews. Data was analysed by using inductive thematic analysis. The study was able to identify four factors promoting healthcare professionals' participation in validation education: (1) readiness for the Finnish employment market; (2) support from relatives and acquaintances; (3) the significance of language used to deliver validation education; and (4) the importance of the cost‐free nature of the program. The challenges were described by five main themes: (1) access to and commencement of validation education; (2) foreign language‐related challenges; (3) access to information about the education; (4) decisions about leaving the home country; and (5) discrimination and racism. Based on this study, seven recommendations are provided for education policy and practice to facilitate access to and commencement of validation education.
Fostering Engagement in AI‐Mediate Chinese EFL Classrooms: The Role of Classroom Climate, AI Literacy, and Resilience
Authors: Wang Xiaochen , Gao Yang , Wang Qikai , Zhang Panpan
Published: December 2024

The rise of artificial intelligence (AI) has significantly impacted education, yet few scholars have explored AI‐assisted classrooms, particularly in language education in China. Understanding the roles of classroom climate, AI literacy, and resilience is essential, as these factors foster positive learning environments and enhance student engagement. In this sense, this study, grounded in Social Cognitive Theory, employs structural equation modelling to investigate factors influencing classroom engagement in AI‐assisted Chinese English as a Foreign Language (EFL) classrooms. It examines data from 606 university EFL learners to explore the interactions among these variables and the mediating role of resilience. The findings indicate that classroom climate, AI literacy, and resilience all significantly predict classroom engagement, highlighting the importance of both environmental and cognitive factors in fostering active student participation. Furthermore, resilience serves as a crucial mediator, linking classroom climate and AI literacy to engagement. This study provides some insights for educators and policymakers, emphasising the need to cultivate supportive classroom environments, promote AI literacy programs, and strengthen students' resilience to optimise engagement in AI‐assisted educational settings.
Teaching Methods of Piano Playing: Concept of Universalism and Author's Philosophy
Authors: Ma RunTao
Published: December 2024

This research aimed to determine the methods for teaching piano by focusing on the synthesis of the concept of universalism and the author's philosophy of pedagogy, which affect the piano performance. Using an uneven scale, the author revealed that at baseline, the traditional approach to teaching piano was common (58%). However, this educational approach does not reflect the principles of universalism, which prevents the attainment of high results among the majority of students and does not demonstrate the potential for utilising an individualised approach to learning. The obtained results influenced the development of a teaching methodology that included a preliminary analysis of the repertoire, the enhancement of musicality during the interpretation of sounds and melodies, the acquisition of skills in sound contrast and polyphony, and the development of performance dynamics and creativity. Using the sociometric rating index, the researchers determined that the author's approach ( = 1.37) was of the highest importance for improving piano skills because it was aimed at developing playing skills of varying complexity. On the basis of the respondents' piano composition performance quality, it was evident that the execution technique for pre‐existing musical compositions ( = 9.7) exceeded that of improvised pieces ( = 9.3). The results obtained contribute to the development of technical and creative skills in piano performance, employing principles of universalism that influenced the creation of the author's methodology. The research prospects are related to a comparative analysis of the effectiveness of teaching piano under different author's methods.
Prostate cancer burden in South Asia: A systematic analysis of global burden of disease data (1990–2021)
Authors: Kumar Vijay , Jena Diptismita , Zahiruddin Quazi Syed , Roopashree R. , Kaur Mandeep , Srivastava Manish , Barwal Amit , Prasad G. V. Siva , Rajput Pranchal , Syed Rukshar , Sharma Gajendra , Kumar Sunil , Chilakam Nagavalli , Bushi Ganesh , Sathik Hassan Basri Jahubar , Mehta Rachana , Sah Sanjit , Shabil Muhammed , Gaidhane Abhay M. , Serhan Hashem Abu
Published: December 2024

Objectives

The objectives of this study were to analyze trends in prostate cancer incidence, incidence, mortality, and disability‐adjusted life years (DALYs) from 1990 to 2021 via data from the Global Burden of Disease (GBD) study in South Asia. Additionally, the study projects future prostate cancer incidence rates up to 2031 to inform public health interventions in South Asia.

Methods

Data covering South Asian countries such as Bangladesh, Bhutan, India, Nepal, and Pakistan were obtained from the GBD 2021 portal. Age‐standardized rates (ASRs) for prostate cancer metrics, including incidence (ASIR), prevalence (ASPR), mortality (ASMR), and DALYs (ASDR), were analyzed via joinpoint and ARIMA modeling techniques. Geographic variations in ASRs were mapped via QGIS software.

Results

The prostate cancer ASIR, ASPR, and ASDR significantly increased from 1990 to 2021, particularly among individuals aged 60–65 years. The highest incidence and mortality rates were observed in Pakistan. The total percentage change in incidence in India was the highest at 61%. Projections indicate a continued rise in prostate cancer incidence, with South Asia's ASIR expected to reach 9.34 per 100 000 by 2031.

Conclusions

The growing burden of prostate cancer in South Asia highlights the need for enhanced screening programs, public awareness, and healthcare infrastructure improvements. Without intervention, the increasing incidence and mortality rates could strain healthcare resources, emphasizing the urgency of region‐specific public health strategies.
Perceptions of Frail Older Adults on Contributing Factors Causing the Onset of Crises Leading to Hospital Admissions: A Qualitative Study
Authors: Hoitinga Gercora , Macneil‐Vroomen Janet , Kolk Daisy , Rijkenberg Saskia , Melkert Karianne , Buurman Bianca M.
Published: December 2024

Aim

To explore frail older people's perceptions of factors contributing to a health crisis, describe similarities and depict these in a chronological, aggregated patient journey map.

Design

An exploratory‐descriptive qualitative study.

Methods

Frail older patients visiting the emergency department of a metropolitan academic hospital in the Netherlands during the first 6 months of 2021 were recruited by purposive sampling. Semi‐structured interviews were conducted and analysed thematically. Patient journey mapping was used to identify, combine and depict chronological similarities in perceptions.

Results

Fifteen interviews contained five themes: continuity of healthcare, self‐perception on frailty, self‐management, impact of support system within an urban environment and acute event before the emergency department visit. The patient journey map identified uncoordinated care by healthcare providers, deterioration from at least 6 months before the emergency department visit and a time demarcation at 4 weeks before the emergency department visit with an unexpected event leading to an acute health problem.

Conclusion

While patients were aware of the health event leading to the acute hospitalisation, they were less aware of the impact of contributing cascading events in the months before. The journey map suggests that strategies can be applied to inform older adults, be more patient‐oriented and provide an anticipated plan towards advance care, healthy ageing and admission avoidance.

Impact

Findings showed contributing factors to a health crisis were not interpreted accordingly, creating a cascade of problems, difficult to counter when someone is already frail. By generating knowledge, standardising frequent assessments of daily life and intervening at an earlier stage by making use of the patient journey map, the risk of a potential crisis and hospitalisation could be reduced or even avoided.

Reporting Method

COREQ (COnsolidated criteria for REporting Qualitative research).

Patient or Public Contribution

No patient or public contribution.
The Age‐Friendly Learning Healthcare System: Replicating electronic health record based documentation metrics for 4Ms care
Authors: Butler Jorie M. , Farrell Timothy W. , Puckett Megan , Nanjo Claude , Warner Phillip , Shields David , Supiano Mark A. , Kawamoto Kensaku
Published: December 2024

Background

University of Utah Health (UUH) is an academic medical center that achieved “committed to care excellence” in age‐friendly care in 2021 and has a long‐standing culture of quality improvement central to a learning health system. University of California San Francisco (UCSF) developed electronic health record (EHR) documentation metrics for inpatient assessment of the 4Ms (What Matters, Medication, Mentation, and Mobility) based on the Institute for Healthcare Improvement's recommended care practice for an Age‐Friendly Healthcare System. In partnership with UCSF, we replicated the assessment and action EHR metrics with local adaptations for each of the 4Ms at UUH.

Methods

The UCSF team shared 4Ms documentation metrics and Structured Query Language code used to assess 4Ms care at UCSF. At UUH, this code was adapted for a different relational database management system and local clinical context. We assessed 4Ms care, individual M, and composite measures of all 4Ms, for all patients aged 65 and older admitted to UU Hospital between January 1, 2019 and December 31, 2021. We conducted a clinical validation of individual patient cases to confirm accuracy of 4Ms queries.

Results

In the 3‐year study period, 16,489 qualifying patients, mean age 74.2, were admitted to UU Hospital in a total of 25,070 admissions with mean length of stay of 6.08 days. We were able to replicate 14 of the 16 EHR metrics of individual 4Ms developed at UCSF and five composite measures. For the composite measure addressing completeness of 4Ms care, 50% of patient encounters had all 4Ms administered during their encounter.

Conclusion

Indicators of the completeness of 4Ms care can be measured using EHR data to validate implementation of the 4Ms at multiple academic medical centers. Key lessons to support future scaled‐up assessments include the importance of adapting EHR measures to local activities and involving expert data analysts.
Psychological Wellness and Altruism: How Early‐Life Risks Shape Adult Preferences
Authors: Habyarimana Jean Baptiste , Kakkar Vikas
Published: December 2024

Theoretical concerns suggest that psychological wellness risks experienced during one period can influence endogenous preferences in subsequent periods. This study examines the relationship between childhood psychological wellness risk and altruistic attitudes in adulthood. We find that a one standard deviation increase in the likelihood of experiencing childhood psychological distress predicts a 0.28% to 2.32% decrease (in standard deviation terms) in the desire for dynasty‐building and generosity during adulthood. Additionally, we find evidence for the altruism‐habit formation hypothesis. We suggest that experiencing psychological wellness risk leads to more self‐interest–oriented choices rather than altruism‐oriented preferences later in life. These results remain robust across multiple robustness analyses.