bluuebunny/crossref_metadata_2025 huggingface dataset:
Value of information with manufacturer encroachment
Authors: Guan Huiqi , Yang (Ben) Zhibin , Gurnani Haresh
Published: October 2022

We study the value of information in a supply chain where the manufacturer introduces a direct‐selling channel to encroach in the retailer's market. Based on different information structures regarding the direct‐selling cost for the manufacturer, we analyze three models: incomplete information model, asymmetric information model, and full information model. By comparing the firms' profits in these models, we derive the value of the manufacturer's information acquisition and the value of sharing that information with the retailer. We find that the manufacturer's information acquisition may hurt the manufacturer but benefit the retailer simultaneously. However, we also find a win–win outcome for the manufacturer and the retailer due to the manufacturer's learning of its direct‐selling cost. Further, in expectation, the manufacturer always benefits from sharing its private cost information with the retailer, while the retailer does not. We also show that the direct‐selling channel is always valuable to the manufacturer, while the retailer's preference will depend on the information structure. Finally, we consider a supply competition model where the manufacturer competes with a spot supply source to sell to the retailer. In contrast to the case of no supply competition, the manufacturer sells less using direct selling. However, direct selling can become more valuable as it may contribute higher profit for the manufacturer due to the reduced wholesale price charged to the retailer. We find that supply competition can completely reverse the manufacturer's disincentive into incentive for information acquisition and facilitate information sharing with the retailer.
From prediction to decision: Optimizing long‐term care placements among older delayed discharge patients
Authors: Chuang Ya‐Tang , Zargoush Manaf , Ghazalbash Somayeh , Samiedaluie Saied , Kuluski Kerry , Guilcher Sara
Published: October 2022

This study examines long‐term care (LTC) discharge planning among older delayed discharge patients. While awaiting placements in alternate care such as LTC, these patients occupy hospital beds despite not requiring an intensive level of care. This study proposes a novel discharge decision model based on the Markov decision process (MDP) framework, which incorporates predictions regarding the patients' health trajectory and the associated hospital costs. Our machine learning (ML)‐based predictive analytics allow for considering heterogeneous health transitions, hence personalized decision making, leading to valuable information for reducing hospital costs. We also develop data‐driven cost functions using patient characteristics to estimate the person‐level costs associated with the decisions in the optimization model, that is, whether or not to discharge a patient to LTC. The data analyses and cost estimations are based on large historical data collected over 13 years in Ontario, Canada. To solve the resulting high‐dimensional MDP models, we develop an index policy, where each patient's index value is calculated using their health complexity (comorbidity), sex, age, and acute length of stay in the hospital. Using extensive numerical experiments, we illustrate the superior performance of the proposed index policy against some benchmarking policies and demonstrate the significance of predictive information in optimizing discharge decisions. Our results also indicate that the value of predictive information increases with LTC bed availability and decreases with hospital capacity. We also demonstrate that with the anticipated exacerbating mismatch between supply and demand, targeted prediction‐driven discharge policies, such as the proposed index policy, become even more critical.
New insight into morphological and genetic diversity of Phlyctema vagabunda and Neofabraea kienholzii causing bull's eye rot on apple and pear
Authors: Neri Fiorella , Crucitti Dalila , Negrini Francesca , Pacifico Davide , Ceredi Gianni , Carimi Francesco , Lolas Mauricio A. , Collina Marina , Baraldi Elena
Published: October 2022

Fungi of genera Phlyctema and Neofabraea are the causal agents of bull's eye rot, a major postharvest disease of pome fruits. To investigate their morphological and genetic diversity, isolates obtained in Italy and Chile from decayed fruit and rainwater between 2014 and 2019 were grown on two agar media, inoculated onto four fruit cultivars and compared using four marker genes. Consistent intra‐ and interspecies phenotypic differences were recorded among isolates identified as P. vagabunda (two main morphotypes, PvM‐I and PvM‐II, were distinguished) and N. kienholzii. In particular, the Chilean isolates belonging to PvM‐I showed low sporulation in vitro, while isolates belonging to PvM‐II showed the most abundant sporulation and also formed conidiomata deep within fruit tissue. Host cultivar influenced the disease incidence in unwounded, inoculated fruit. Cripps Pink and Golden Delicious apples favoured the formation of P. vagabunda conidiomata and macroconidia, while Granny Smith apples and/or Kaiser pears restricted sporulation of some isolates of PvM‐I. Mycelial cords of P. vagabunda and N. kienholzii were consistently recorded in inoculated fruit, suggesting their possible involvement as a source of inoculum. Propagules of P. vagabunda were present in rainwater collected from apple plants from September to October in Italy. According to sequence analysis of ITS, EF‐1α, TUB2 and ACT1 regions of the fungi, 12 distinct sequence types were identified, three of which were characteristic of isolates from the Southern Hemisphere. The condensed maximum‐likelihood phylogenetic tree separated the 50 P. vagabunda isolates into six phylogroups, suggesting a correlation with their geographical distribution.
Plagiodera versicolora feeding induces systemic and sexually differential defense responses in poplars
Authors: Liu Xuejiao , Zeng Yi , Yang Le , Li Menghan , Fu Mingyue , Zhang Sheng
Published: October 2022

Dioecious plants have evolved effective defense strategies to deal with various biotic and abiotic stresses. However, little is known regarding sexual differences in their defense against herbivores. In this study, we investigated the mechanism of systemic defense responses in male and female Populus cathayana attacked by Plagiodera versicolora Laicharting. The results revealed that P. cathayana exhibits sexually differential responses to a defoliator. The percentage of damaged leaf area was greater in males than in females. Furthermore, the observed saccharide changes imply that males and females exhibit different response times to defoliators. The contents of flavonoids and anthocyanins were significantly increased in both sexes but were higher in females. Specifically, the jasmonic acid (JA) pathway plays an important role. Expression of pest‐related genes further revealed that hormones induce changes in downstream genes and metabolites, and upregulation of JA ZIM‐domain (JAZ) and CORONATINE INSENSITIVE 1 (COI1) was more significant in females. In the undamaged adjacent leaves, metabolite and gene changes displayed similar patterns to the damaged local leaves, but levels of JA, JAZ1, and COI1 were higher in females. Therefore, our data confirmed that plants initiate the JA pathway to defend against herbivores, that there is systematic signal transduction, and that this ability is stronger in females than in males. This study provides new insights into the resistance of dioecious plants to herbivory and adds a new theoretical basis for the systemic signal transduction of plants in response to biotic stress.
The vacuolar transporterLaMTP8.1 detoxifies manganese in leaves ofLupinus albus
Authors: Olt Philipp , Alejandro‐Martinez Santiago , Fermum Johann , Ramos Edith , Peiter Edgar , Ludewig Uwe
Published: October 2022

Manganese (Mn) is an essential microelement, but overaccumulation is harmful to many plant species. Most plants have similar minimal Mn requirements, but the tolerance to elevated Mn varies considerably. Mobilization of phosphate (P) by plant roots leads to increased Mn uptake, and shoot Mn levels have been reported to serve as an indicator for P mobilization efficiency in the presence of P deficiency. White lupin (Lupinus albusL.) mobilizes P and Mn with outstanding efficiency due to the formation of determinate cluster roots that release carboxylates. The high Mn tolerance ofL.albusgoes along with shoot Mn accumulation, but the molecular basis of this detoxification mechanism has been unknown. In this study, we identify LaMTP8.1 as the transporter mediating vacuolar sequestration of Mn in the shoot of white lupin. The function of Mn transport was demonstrated by yeast complementation analysis, in which LaMTP8.1 detoxified Mn inpmr1∆ mutant cells upon elevated Mn supply. In addition, LaMTP8.1 also functioned as an iron (Fe) transporter in yeast assays. The expression ofLaMTP8.1was particularly high in old leaves under high Mn stress. However, low P availability per se did not result in transcriptional upregulation ofLaMTP8.1. Moreover,LaMTP8.1expression was strongly upregulated under Fe deficiency, where it was accompanied by Mn accumulation, indicating a role in the interaction of these micronutrients inL.albus. In conclusion, the tonoplast‐localized Mn transporter LaMTP8.1 mediates Mn detoxification in leaf vacuoles, providing a mechanistic explanation for the high Mn accumulation and Mn tolerance in this species.
Promotion of physical activity after hospitalization for COPD exacerbation: A randomized control trial
Authors: Valeiro Beatriz , Rodríguez Esther , Pérez Paula , Gómez Alba , Mayer Ana Isabel , Pasarín Alejandro , Ibañez Jordi , Ferrer Jaume , Ramon Maria Antonia
Published: October 2022

Background and Objective

Physical activity worsens during exacerbations of chronic obstructive pulmonary disease (COPD) and notably after hospitalizations. Pedometer‐based interventions are useful to increase physical activity in stable patients with COPD. However, there is little information concerning the implementation of such programs following severe exacerbation. This study assessed the efficacy of a physical activity program after hospitalization for a COPD exacerbation.

Methods

We performed a prospective, 12‐week, parallel group, assessor‐blinded, randomized control trial in COPD patients hospitalized for an exacerbation. After discharge, physical activity and other secondary variables were assessed. Patients were allocated (1:1) to a physical activity promotion program (intervention group, IG) or usual care (control group, CG). Based on a motivational interview and accelerometer physical activity assessment, a patient‐tailored, pedometer‐based, progressive and target‐driven program was designed. Linear mixed effect models were used to analyse between‐group differences.

Results

Forty‐six out of 61 patients recruited were randomized and 43 (IG = 20, CG = 23) completed the study. In‐hospital and baseline characteristics were similar in both groups. After 12 weeks of intervention, the mean steps difference between groups was 2093 steps/day, p = 0.018, 95% CI 376–4012, favouring the IG. Only the IG significantly increased the number of steps/day compared to baseline (mean difference [95% CI] 2932 [1069–4795] steps; p = 0.004). There were no other between‐group differences.

Conclusion

After hospitalization for a COPD exacerbation, a patient‐tailored physical activity program based on a motivational interview and the use of pedometers, with progressive and customized targets, improved the number of steps/day.
Equal opportunity and poverty reduction: How should aid be allocated?
Authors: Guillaumont Patrick , Nguyen‐Van Phu , Pham Thi Kim Cuong , Wagner Laurent
Published: October 2022

This paper analyzes a model of aid allocation equalizing the opportunity between recipient countries to reach a common poverty reduction goal. We propose a fair and efficient aid allocation based on a multicriteria principle. The model considers structural handicaps in recipient countries in terms of lack of human capital and economic vulnerability, their initial poverty, and the natural gap between the growth rate required to reach a development goal and the observed one. We show that our proposed aid allocation favors poor and vulnerable countries with our multicriteria principle. It substantially differs from the observed allocation. Analyses also shed light on the impact of the donors' aversion to the low natural growth gap in recipient countries on the optimal aid allocation and the marginal efficiency of aid.
Clinical course of SARS‐CoV‐2 infection and recovery in lung transplant recipients
Authors: Trindade Anil J. , Chapin Kaitlyn C. , Gannon Whitney D. , Hoy Haley , Demarest Caitlin T. , Lambright Eric S. , McPherson Katie A. , Norfolk Stephanie G. , Robbins Ivan M. , Bacchetta Matthew , Erasmus David B. , Shaver Ciara M.
Published: October 2022

Background

Reports on outcomes following severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection in lung transplant recipients remain limited.

Methods

We performed a single‐center, observational study of outcomes in lung transplant recipients diagnosed with SARS‐CoV‐2 between 5/1/2020 and 3/15/2022 that were followed for a median of 123 days. We analyzed changes in spirometry, acute lung allograft dysfunction (ALAD) incidence, hospitalization, mechanical ventilation needs, secondary infection, and survival.

Results

In our cohort of 336 patients, 103 developed coronavirus disease (COVID) (27 pre‐Delta, 20 Delta, and 56 Omicron‐era). Twenty‐five patients (24%) required hospitalization and 10 patients ultimately died (10%). Among 85 survivors who completed ambulatory spirometry, COVID‐19 did not alter change in forced expiratory volume in 1 s (FEV1) or forced vital capacity (FVC) over time compared to the preceding 6 months. The pre‐COVID FEV1change was −0.05 ml/day (IQR −0.50 to 0.60) compared to −0.20 ml/day (IQR −1.40 to 0.70) post‐COVID (p = .16). The pre‐COVID change in FVC was 0.20 ml/day (IQR −0.60 to 0.70) compared to 0.05 ml/day (IQR −1.00 to 1.10) post‐COVID (p = .76). Although the cohort overall had stable lung function, 33 patients (39%) developed ALAD or accelerated chronic lung allograft dysfunction (FEV1decline >10% from pre‐COVID baseline). Nine patients (35%) with ALAD recovered lung function. Within 3 months of acute COVID infection, 18 patients (17%) developed secondary infections, the majority being bacterial pneumonia. Finally, vaccination with at least two doses of mRNA vaccine was not associated with improved outcomes.

Conclusions

This study describes the natural history of SARS‐CoV‐2 infection in a large cohort of lung transplant recipients. Although one third of patients develop ALAD requiring augmented immunosuppression, infection with SARS‐CoV‐2 is not associated with worsening lung function.

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Beyond compliance: Good citizenship during the COVID‐19 pandemic
Authors: Clarke Nick , Barnett Clive
Published: October 2022

In the UK, discussion of good citizenship during the COVID‐19 pandemic largely focused on compliance and non‐compliance with government rules. In this paper, we offer an alternative point of focus. Pandemic governance proceeded not only through rules/morality, but also through freedom/ethics. Good citizenship, therefore, involved practical reasoning in response to situations. We demonstrate this using diaries and other forms of writing collected by Mass Observation during the first six months of the pandemic. Responses to government rules and guidance varied by situation. Many people found governance through freedom/ethics confusing and burdensome. Faced with ethical dilemmas, they managed risks and responsibilities by deliberating, weighing justifications, and sometimes falling back on rules of thumb or heuristics. Discussion of good citizenship during future emergencies would benefit from a greater focus on situations, dilemmas, and justifications.
A large cohort study of the effects of Lewis, ABO, 13 other blood groups, and secretor status on COVID‐19 susceptibility, severity, and long COVID‐19
Authors: Moslemi Camous , Sækmose Susanne , Larsen Rune , Brodersen Thorsten , Didriksen Maria , Hjalgrim Henrik , Banasik Karina , Nielsen Kaspar R. , Bruun Mie T. , Dowsett Joseph , Kasperen Kathrine A. , Mikkelsen Susan , Hansen Thomas F. , Ullum Henrik , Erikstrup Christian , Olsson Martin L. , Ostrowski Sisse R. , Pedersen Ole B.
Published: October 2022

Background

Previous studies have reported Blood type O to confer a lower risk of SARS‐CoV‐2 infection, while secretor status and other blood groups have been suspected to have a similar effect as well.

Study design and methods

To determine whether any other blood groups influence testing positive for SARS‐CoV‐2, COVID‐19 severity, or prolonged COVID‐19, we used a large cohort of 650,156 Danish blood donors with varying available data for secretor status and blood groups ABO, Rh, Colton, Duffy, Diego, Dombrock, Kell, Kidd, Knops, Lewis, Lutheran, MNS, P1PK, Vel, and Yt.

Of these, 36,068 tested positive for SARS‐CoV‐2 whereas 614,088 tested negative between 2020‐02‐17 and 2021‐08‐04. Associations between infection and blood groups were assessed using logistic regression models with sex and age as covariates.

Results

The Lewis blood group antigen Lea displayed strongly reduced SARS‐CoV‐2 susceptibility OR 0.85 CI[0.79–0.93] p < .001. Compared to blood type O, the blood types B, A, and AB were found more susceptible toward infection with ORs 1.1 CI[1.06–1.14] p < .001, 1.17 CI[1.14–1.2] p < .001, and 1.2 CI[1.14–1.26] p < .001, respectively. No susceptibility associations were found for the other 13 blood groups investigated. There was no association between any blood groups and COVID‐19 hospitalization or long COVID‐19. No secretor status associations were found.

Discussion

This study uncovers a new association to reduced SARS‐CoV‐2 susceptibility for Lewis type Lea and confirms the previous link to blood group O. The new association to Lea could be explained by a link between mucosal microbiome and SARS‐CoV‐2.
THE APPLICATION OF ENDOSCOPE AND IMAGE PROCESSING FOR DETERMINING REMAZOL RED DYE CONCENTRATION IN WATER SAMPLES
Authors: Nazibudin Nazatul Akmal , Zainuddin Mohamad Faiz , Tengku Nazruddin Tengku Nur Adriana , Deny Rona Techly , Kadaruddin Khairunnisa
Published: October 2022

Remazol dyes are widely used in textile industry, which are then discharged to the environment as waste products. Studies on bioremediation and decolorization of dye waste normally employ expensive spectrometers or colorimeters. This study proposes a low-cost procedure to determine the concentration of Remazol red dye with the use of a digital endoscope and image processing technique. The concentration of Remazol red dye considered in this study ranges from 0.001 to 0.700 g/L. An endoscope is used to capture digital images of dye samples. Reg-green-blue (RGB) images of the samples are converted to grayscale images, which are then converted to a mean grayscale index (MGI). The MGI is then calibrated with real concentration of dye samples. Three calibration curves were developed for three different ranges of dye concentration of 0.001- 0.010 g/L, 0.020 – 0.100 g/L, and 0.100 – 0.700 g/L, with a coefficient of determination (R2) of 0.961, 0.9793, and 0.9903, respectively.
NUMERICAL SIMULATION ON THE TENSILE STRAIN HARDENING BEHAVIOUR OF ENGINEERED CEMENTITIOUS COMPOSITES (ECC)
Authors: Zheng Woo Chee , Teo Wee , Shirai Kazutaka
Published: October 2022

Numerical simulation for evaluating tensile strain hardening behaviour of engineered cementitious composites (ECC) materials are extremely limited. This paper presents a finite element (FE) model developed to determine the multiple-cracking and strain hardening behaviour of ECC under uniaxial tension. A nonlinear FE program, ATENA was used in this study. A constitutive law based on individual crack-based model derived by the traction-separation relationship, or also known as tensile function was implemented in the model. Model calibration with parameter modifications were illustrated. The final simulation result predicts accurately the experiment tensile stress strain curves, including the tensile strain hardening response, ultimate tensile strength and tensile strain capacity. This includes validation from ECC specimens tested by various researchers. It has found that accuracy of the model is improved by lowering the crack opening displacement corresponds to the first cracking. The finding from this study would be useful in the future for further parametric analyses and structural optimization design of ECC members.
“My Life Sucks Right Now”: Student-Athletes’ Pandemic-Related Experiences With Screen Time and Mental Health
Authors: Camiré Martin , Sabourin Camille , Gladstone Martin Eden , Martin Laura , Lowe Nicolas
Published: October 2022

The COVID-19 pandemic, and associated stay-at-home orders, instigated far-reaching disturbances in the lives of student-athletes, which included school closures and sport cancellations. The purpose of the study was to examine first-hand student-athletes’ pandemic-related experiences with screen time and mental health. A total of 22 Canadian high school student-athletes were individually interviewed in 2021. Interviews occurred online via videoconferencing and were subjected to a reflexive thematic analysis, which led to the creation of three themes: (a) pandemic life is a major grind, (b) screen time during COVID times: I feel guilty, but what else can I do? and (c) mental health during COVID times: mostly pain, but there is a silver lining. Results are discussed in terms of their implications for research and practice as it pertains to formulating endemic initiatives best supporting the many student-athletes confronting the psychosocial aftereffects of having lived through a global pandemic.
Usage of social media in epidemic intelligence activities in the WHO, Regional Office for the Eastern Mediterranean
Authors: Abbas Heidi , Tahoun Mohamed Mostafa , Aboushady Ahmed Taha , Khalifa Abdelrahman , Corpuz Aura , Nabeth Pierre
Published: October 2022

Social media platforms are a massive source of information being used for monitoring and detecting various actual events such as natural disasters and disease outbreaks. This paper aims to present the experience of WHO, Regional Office for the Eastern Mediterranean in using social media for the detection and monitoring of COVD-19 pandemic alongside the other event-based surveillance tools. Over the period of 29 January 2020 to 31 May 2021, information was collected from social media and other media outlets (web news) as being the source of health information for early detecting and monitoring the situation of COVID-19 events. Signals were categorised into new events and event updates; where event updates captured from social media were categorised into official and unofficial. A total of 10 160 COVID-19 information were captured, out of which 95.8% (n=9732) were detected through social media. None of the information captured were discarded. 50.0% (n=11) of the COVID-19 events in the Eastern Mediterranean Region (EMR) were primarily captured from social media compared with 4.5% (n=1) primarily captured from other media outlets. Almost all (99.4%) of the event updates captured from social media were official updates. Real-time, transparent and relevant information posted on different social media platforms, especially the governmental official social media accounts, strengthened the early detection and follow-up of public health events in the EMR, especially during the current COVID-19 pandemic.
Impact of the COVID-19 pandemic on access to and utilisation of services for sexual and reproductive health: a scoping review
Authors: VanBenschoten Hannah , Kuganantham Hamsadvani , Larsson Elin C , Endler Margit , Thorson Anna , Gemzell-Danielsson Kristina , Hanson Claudia , Ganatra Bela , Ali Moazzam , Cleeve Amanda
Published: October 2022

Introduction

The COVID-19 pandemic has negatively impacted health systems globally and widened preexisting disparities. We conducted a scoping review on the impact of the COVID-19 pandemic on women and girls’ access to and utilisation of sexual and reproductive health (SRH) services for contraception, abortion, gender-based and intimate partner violence (GBV/IPV) and sexually transmitted infections (STIs).

Methods

We systematically searched peer reviewed literature and quantitative reports, published between December 2019 and July 2021, focused on women and girls’ (15–49 years old) access to and utilisation of selected SRH services during the COVID-19 pandemic. Included studies were grouped based on setting, SRH service area, study design, population and reported impact. Qualitative data were coded, organised thematically and grouped by major findings.

Results

We included 83 of 3067 identified studies and found that access to contraception, in-person safe abortion services, in-person services for GBV/IPV and STI/HIV testing, prevention and treatment decreased. The geographical distribution of this body of research was uneven and significantly less representative of countries where COVID-19 restrictions were very strict. Access was limited by demand and supply side barriers including transportation disruptions, financial hardships, limited resources and legal restrictions. Few studies focused on marginalised groups with distinct SRH needs.

Conclusion

Reports indicated negative impacts on access to and utilisation of SRH services globally, especially for marginalised populations during the pandemic. Our findings call for strengthening of health systems preparedness and resilience to safeguard global access to essential SRH services in ongoing and future emergencies.
Effectiveness of BNT162b2, mRNA-1273, and ChAdOx1-S vaccines against severe covid-19 outcomes in a nationwide mass vaccination setting: cohort study
Authors: Bouillon Kim , Baricault Bérangère , Botton Jérémie , Jabagi Marie-Joëlle , Bertrand Marion , Semenzato Laura , Le Vu Stéphane , Drouin Jérôme , Dray-Spira Rosemary , Weill Alain , Zureik Mahmoud
Published: October 2022

Objective

To estimate the effectiveness of the three covid-19 vaccines by Pfizer-BioNTech (BNT162b2), Moderna (mRNA-1273), and Oxford-AstraZeneca (ChAdOx1-S) in people after receiving two doses.

Design

Cohort study.

Setting

Nationwide, population based data in France, from the French National Health Data System (Système National des Données de Santé), between 27 December 2020 and 30 April 2021.

Participants

Adults aged ≥50 years receiving a first dose of BNT162b2, mRNA-1273, or ChAdOx1-S were randomly selected (1:1) and matched on the date of vaccination with one unvaccinated control. Individuals were matched on year of birth, sex, region of residence, and residence in a nursing home (for individuals aged ≥75 years). All individuals were followed up until 20 August 2021.

Main outcome measures

Primary outcome measure was vaccine effectiveness estimated at least 14 days after the second dose against covid-19 related hospital admission using Cox proportional hazards models adjusted for baseline characteristics and comorbidities. Vaccine effectiveness against covid-19 related death in hospital was also investigated.

Results

11 256 832 vaccinated individuals were included in the study (63.6% (n=7 161 658) with the BNT162b2 vaccine, 7.6% (n=856 599) with the mRNA-1273 vaccine, and 28.8% (n=3 238 575) with the ChAdOx1-S vaccine), along with 11 256 832 matched unvaccinated controls. During follow-up (up to 20 August 2021), 43 158 covid-19 related hospital admissions and 7957 covid-19 related deaths in hospital were registered. Compared with unvaccinated controls, vaccine effectiveness of two doses against covid-19 related hospital admission was 91% (95% confidence interval 91% to 92%), 95% (93% to 96%), and 91% (89% to 94%) for the BNT162b2, mRNA-1273, and ChAdOx1-S vaccines, respectively. Similar results were observed for vaccine effectiveness of two doses against covid-19 related deaths in hospital (BNT162b2, 91% (90% to 93%); mRNA-1273, 96% (92% to 98%); and ChAdOx1 nCoV-19, 88% (68% to 95%)). At 5-6 months after receiving the second dose of vaccine, effectiveness remained high at 94% (92% to 95%) for the BNT162b2 vaccine and 98% (93% to 100%) for the mRNA-1273 vaccine. Vaccine effectiveness of ChAdOx1-S estimated at 3-4 months was 90% (63% to 97%). All three vaccines remained effective at the time of circulation of the delta variant of SARS-CoV-2 between 1 July and 20 August 2021 (effectiveness between 89% and 95%).

Conclusions

These findings provide evidence indicating that two doses of ChAdOx1-S is as effective as two doses of mRNA vaccines in France against the alpha and delta variants of SARS-CoV-2. The effectiveness of ChAdOx1-S should be further examined with a longer follow-up and in the light of the circulation of new SARS-CoV-2 variants of concern.
Coexistent anti-GFAP and anti-MOG antibodies presenting with isolated meningitis and papillitis: more support for overlapping pathophysiology
Authors: Martin Andrew J , Strathdee James , Wolfe Nigel
Published: October 2022

Background

Anti-myelin oligodendrocyte glycoprotein (MOG)-associated disorders are heterogeneous and associated predominantly with central nervous system demyelination. Anti-glial fibrillar acidic protein (GFAP) conditions are much rarer and involve meningoencephalomyelitis with papillitis in addition to characteristic imaging findings and are generally a severe condition. Multiple autoantibodies can exist in patients and may support overlapping pathophysiological mechanisms. The co-occurrence of MOG and GFAP antibodies, however, is rare, with only two cases previously reported.

Case

A 53-year-old man presented with headache and fevers, with quick resolution, though with the later development of asymptomatic papillitis. He had a full recovery without the need for immunotherapy. He underwent extensive investigations and was found to have both anti-GFAP and anti-MOG antibodies in the cerebrospinal fluid. Extensive other immunological and infectious investigations were negative. Imaging was largely unremarkable.

Conclusions

This is the third case of overlapping anti-GFAP and anti-MOG antibody-associated syndrome of self-limited lymphocytic meningitis, serving to expand the phenotype. Clinicians should consider testing for GFAP and MOG antibodies in otherwise unexplained meningitis, particularly with associated papillitis. This case may also help provide future insights into the pathophysiology of each condition.
Effect of living arrangements on cognitive function in Chinese elders: a longitudinal observational study
Authors: Lin Yanwei , Zhang Qi , Wang Tingxian , Zeng Zhirong
Published: October 2022

Objective

To examine how living arrangement as a social contextual factor can affect Chinese elders’ cognitive function.

Setting and participants

Our sample consists of 2486 Chinese elders from two waves (2014 and 2018) of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) that was administered in 22 of China’s 31 provinces using a multi-stage, disproportionate, purposive random sampling method. The CLHLS aims to better understand the determinants of healthy longevity in China and collects extensive data on a large population of fragile elders aged 80–112 in China.

Outcome measures

Cognitive function was measured by the Mini-Mental State Examination (MMSE). Living arrangement was divided into living in an institution, living alone and living with household members. Generalised linear regressions were carried out to examine the associations between baseline characteristics and cognitive function, while controlling age, gender and residential area.

Results

A total of 2486 participants were included in the study at baseline in 2014. Of these, 1162 (46.7%) were men and 1324 (53.3%) were women. The mean age at baseline was 75.07 (±8.31) years. The mean years of schooling were 2.86 (±3.68). The number (proportion) of the three living arrangements (lived in institutions, lived alone and lived with household members) were 93 (3.8%), 463 (18.6%) and 1930 (77.6%), respectively. Among all participants, cognitive function declined over time. Those who lived alone presented with the highest MMSE scores at baseline and showed the lowest decline after 4 years. Living arrangements had significant effects on decreasing cognitive function.

Conclusion

Chinese elders living in institutions were most vulnerable to cognitive decline. Living alone was not a risk condition in itself for the elderly in terms of cognitive decline. In addition, the benefits of living with household members to support cognitive function were not found in our study.
Systematic review and meta-analysis of Veress needle entry versus direct trocar entry in gynecologic surgery
Authors: Marchand Greg J , Masoud Ahmed , King Alexa , Brazil Giovanna , Ulibarri Hollie , Parise Julia , Arroyo Amanda , Coriell Catherine , Goetz Sydnee , Moir Carmen , Christensen Ashley , Alexander Tia , Govindan Malini
Published: October 2022

Objective

Although many studies have been performed, no consensus exists as to the ideal entry for laparoscopic gynecologic surgery. We sought out to compare the safety of direct trocar insertion with that of the Veress needle entry technique in gynecologic laparoscopic surgery.

Design

Systematic review with meta-analysis.

Setting

We searched Medline, ClinicalTrials.Gov, PubMed, Cochrane CENTRAL, SCOPUS, and Web of Science from their inception through 31 July 2021 for relevant studies. We included only controlled trials and ultimately seven trials were included in our meta-analysis.

Participants

Inclusion criteria included women undergoing gynecological laparoscopic surgery.

Intervention

The intervention of direct trocar insertion technique compared with Veress needle entry technique.

Main outcome measures

We compared five different outcomes associated with the efficacy and complications of laparoscopic entry.

Results

The pooled analysis showed that Veress needle entry was associated with a significant increase in the incidences of extraperitoneal insufflation (RR=0.177, 95% Cl (0.094 to 0.333), p<0.001), omental injury (RR=0.418, 95% Cl (0.195 to 0.896), p<0.001), failed entry (RR=0.173, 95% Cl (0.102 to 0.292), p<0.001), and trocar site infection (RR=0.404, 95% Cl (0.180 to 0.909), p<0.029). There was no significant difference between the two groups regarding the visceral injury (RR=0.562, 95% Cl (0.047 to 6.676), p<0.648).

Conclusions

When excluding all data apart from gynecologic surgery, the Veress needle entry technique may have an increased incidence of some, but not all complications of laparoscopic entry. It may also have a higher incidence of failed entry compared with direct entry techniques. Care should be taken in extrapolating these general results to specific surgeon experience levels.

Trial registration number

CRD42021273726
Glucocorticoid Therapy in Respiratory Illness: Bench to Bedside
Authors: Amratia Dhruv Atool , Viola Hannah , Ioachimescu Octavian C
Published: October 2022

Each year, hundreds of millions of individuals are affected by respiratory disease leading to approximately 4 million deaths. Most respiratory pathologies involve substantially dysregulated immune processes that either fail to resolve the underlying process or actively exacerbate the disease. Therefore, clinicians have long considered immune-modulating corticosteroids (CSs), particularly glucocorticoids (GCs), as a critical tool for management of a wide spectrum of respiratory conditions. However, the complex interplay between effectiveness, risks and side effects can lead to different results, depending on the disease in consideration. In this comprehensive review, we present a summary of the bench and the bedside evidence regarding GC treatment in a spectrum of respiratory illnesses. We first describe here the experimental evidence of GC effects in the distal airways and/or parenchyma, both in vitro and in disease-specific animal studies, then we evaluate the recent clinical evidence regarding GC treatment in over 20 respiratory pathologies. Overall, CS remain a critical tool in the management of respiratory illness, but their benefits are dependent on the underlying pathology and should be weighed against patient-specific risks.
Unveiling confinement in pure gauge SU(3): flux tubes, fields, and magnetic currents
Authors: Baker M. , Chelnokov V. , Cosmai L. , Cuteri F. , Papa A.
Published: October 2022

A characteristic signature of quark confinement is the concentration of the chromoelectric field between a static quark–antiquark pair in a flux tube. However, the structure of this flux tube, and hence of the confining force, has not been completely understood. Here we perform new lattice measurements of field distributions on smeared Monte Carlo ensembles in SU(3) gauge theory. On the basis of these simulations we demonstrate that the confining force can be understood using the analogy with the basic principles of electromagnetism as elucidated by Maxwell. We derive a chromomagnetic Lorentz force density coupling the chromoelectric field to chromomagnetic currents and integrate this force density over the flux tube interior to obtain a Maxwell-like force that squeezes the flux tube in the transverse direction. We show that the strength of this transverse confining force is equal to the value of the string tension calculated numerically from the chromoelectric field on the midplane between the quarks, verifying the consistency of these two complementary pictures of confinement.
Asymptotically flat vacuum solution for a rotating black hole in a modified gravity theory
Authors: Das Arghya Ranjan , Mukhopadhyay Banibrata
Published: October 2022

The theory of f(R)-gravity is one of the theories of modified Einstein gravity. The vacuum solution, on the other hand, of the field equation is the solution for black hole geometry. We establish here an asymptotically flat rotating black hole solution in an f(R)-gravity. This essentially leads to the modified solution to the Kerr black hole. This solution exhibits the change in fundamental properties of the black hole and its geometry. It particularly shows that radii of marginally stable and bound orbits and black hole event horizon increase compared to those in Einstein gravity, depending on the modified gravity parameter. It further argues for faster spinning black holes with spin (Kerr) parameter greater than unity, without any naked singularity. This supports the weak cosmic censorship hypothesis.
Speech Prosody in Mental Disorders
Authors: Ding Hongwei , Zhang Yang
Published: October 2022

In response to uncovering brain mechanisms underlying vocal communication and searching for biomarkers for mental illnesses, speech prosody has been increasingly studied in recent years in multiple disciplines, including psycholinguistics. In this article, we provide an up-to-date synthesis of the theoretical foundation and empirical evidence to profile linguistic and emotional prosody in the proper characterization of mental disorders, including schizophrenia, autism, Alzheimer's disease, and depression. Our review reveals a need to develop theoretically motivated and methodologically integrated approaches to the study of context-driven comprehension and expression of pragmatic-affective prosody, which will help elucidate the core features of socio-communicative problems in individuals with mental disorders. We propose that comprehensive models within and across the conventional cognition-emotion-language trichotomy need to be developed to integrate current findings and guide future research. In particular, there needs to be due emphasis on investigating multisensory and cross-modal effects in normal and pathological prosody research. Our review calls for multidisciplinary efforts to address the challenging issues to inform and inspire the advancement of linguistic theories and psychiatric diagnosis and treatment.
Recent Advances in the Hydrogel-Based Biomolecule Delivery System for Cartilage Tissue Engineering
Authors: Guan Jingyan , Feng Jingwei , Lu Feng
Published: October 2022

Many investigations have been conducted to explore new therapeutic approaches for cartilage tissue regeneration owing to the limited repair ability of cartilage. Delivery of therapeutic biomolecules is a promising strategy for enhancing tissue regeneration. However, the direct delivery of therapeutic biomolecules in vivo generally leads to a rapid loss of product or the possibility of spreading to nontarget sites, which may weaken their therapeutic effectiveness and impair the translation of these strategies into clinical practice. Recently, new tissue engineering strategies using controlled delivery systems have been considered to overcome these weaknesses by regulating the spatiotemporal distribution of the therapeutic biomolecules. Hydrogels are promising carriers for the development of biomolecule delivery systems because they are highly tunable and can be fabricated to encapsulate bioactive biomolecules and control their release. Moreover, their favorable biocompatibility and ability to integrate into host tissue may facilitate their use in tissue regeneration in a wide variety of situations. This review summarizes recent strategies for the design of hydrogels as biomolecule delivery systems for cartilage regeneration.
Radiation Dose-Effect Relation in Patients with Esophageal Squamous Cell Carcinoma: A National Cancer Center Data and Literature-Based Analysis
Authors: Han Weiming , Li Chen , Deng Wei , Ni Wenjie , Chang Xiao , Gao Linrui , Wang Shijia , Wang Xin , Xiao Zefen
Published: October 2022

Introduction. Despite receiving definitive chemoradiotherapy (dCRT) with radiation dose (RTD) of 50.4 Gy, survival of esophageal carcinoma was dismal. The effect of RTD in cancer control and radiotoxicity, and the extent to which local-regional control (LRC) influenced survival remain vague. This study aimed at evaluating RTD-effect relationship in esophageal squamous cell carcinoma (ESCC). Methods. 1440 dRT/CRT-treated ESCC patients were enrolled. Restricted cubic spline regression model was applied to reveal nonlinear relationship between RTD and survival/radiotoxicity. Linear regression analysis (LRA) was performed to evaluate correlations between LRC and overall survival (OS) or progression-free survival (PFS). Results. For 1440 dRT/CRT-treated ESCC patients, with RTD escalating, hazard ratios (HRs) of OS, PFS, LRC declined until RTD exceeded 60 Gy, then increased. HR of treatment-related mortality was stable until RTD exceeded 60 Gy, then increased. HR of LRC was lower for majority of patients treated with RTD≥60 Gy, except for those with KPS<80, T1-2 lesion, or without lymph node metastasis. LRA revealed strong correlations between LRC and OS/PFS. 45.5% and 44.9% of OS and PFS improvements were owing to improved LRC. Conclusions. RTD of 60 Gy was well tolerated, with favorable survival resulted of LRC improvement in local-advanced ESCC. Further stratification analyses based on radiation sensitivity will be helpful to determine potential beneficiaries of RTD escalation.
Optimizing Intermodal Transport and Hub Location Problem for ECOWAS in the Context of Improving Intra-African Trade
Authors: Jihui Shi , Agyemang Kesewa Opoku , Zhaolin Cheng
Published: October 2022

Trade within Africa is at an all-time low, with a lack of an optimal intermodal transportation network and a high cost of business serving as a deterrent to trade. This research studies Intra-African Trade within ECOWAS using a hierarchical spatial aggregation process to identify 27 nodes. Distance-based weighted centrality measures employed TOPSIS to model a ranked node centrality of Economic Community of West African States (ECOWAS) intermodal transport of railway, road, and waterway networks. The ten highest-ranking nodes identified from the mixed-integer linear program adopted as candidate hubs, thus selecting Ibeshe ferry terminal in Lagos and Tema Harbour in Accra for waterway; Thies, Ibadan, Conakry, Monrovia and Thies for railway; and Thies and Ibadan for road. We conclude with sensitivity analysis and a discussion of management implications for ECOWAS. This paper demonstrated that a limited number of transshipment hubs would encourage interregional trade and cut point-to-point transportation costs and lead to economic growth and development.
Executive Stock Ownership and Enterprise Digital Transformation: Interest Convergence or Trench Defense
Authors: Chen Na , Yang Shuili
Published: October 2022

Digital transformation gives enterprises new development momentum and vitality. The existing research studies mainly focused on the economic consequences of the digital transformation of enterprises, and few literatures pay close attention to the driving factors of digital transformation. In particular, they ignored the important role played by the core element of executives. To fill this gap, this study empirically examines the influence mechanism of executive ownership on enterprise digital transformation based on Chinese A‐share manufacturing listed companies from 2008 to 2021. The results show that there is an inverted U‐shaped relationship between executive ownership and enterprise digital transformation. When the shareholding ratio is low, “interest convergence” is dominant; when the shareholding ratio is high, “trench defense” is more obvious. Heterogeneity analysis shows that the nature of property rights and the degree of industry competition can alleviate the threshold effect of executive ownership on digital transformation, while ownership concentration will aggravate the threshold effect of executive ownership on digital transformation. This study not only enriches the research on the influencing factors of digital transformation but also provides practical guidance for enterprises to improve the design of incentive mechanism and promote the digital transformation of enterprises.
Anticancer Effect of Polyphyllin I in Suppressing Stem Cell-Like Properties of Hepatocellular Carcinoma via the AKT/GSK-3β/β-Catenin Signaling Pathway
Authors: Liao Mianmian , Du Haiyan , Wang Bing , Huang Jinzhen , Huang Danping , Tong Guangdong
Published: October 2022

Polyphyllin I (PPI), also called Chong Lou saponin I, is a steroidal saponin isolated from the rhizome of Paris polyphylla. PPI has been demonstrated to have strong anticancer activity. However, its effect on the stemness of liver cancer stem cells (LCSCs) is not completely understood. Herein, we aimed to investigate the effect of PPI on the stem cell-like features of LCSCs and hepatocellular carcinoma (HCC). LCSCs were enriched in a serum-free medium and treated with PPI, sorafenib (Sora), or PPI and Sora. Several endpoints, including spheroid formation and differentiation, cell proliferation, surface markers of LCSCs, PPI binding targets, and stemness-associated protein expression, were evaluated. Immunofluorescence staining, quantitative real-time polymerase chain reaction, siRNA transfection, and coimmunoprecipitation ubiquitination assays were conducted for in-depth mechanistic studies. Evaluation of in vivo antitumor efficacy demonstrated that PPI effectively inhibited the proliferation of liver cancer cells and the self-renewal and differentiation of LCSCs. Flow cytometry indicated that PPI suppressed the expression of the stem cell surface markers EpCAM and CD13. Molecular docking showed a high affinity between PPI and proteins of the Wnt/β-catenin signaling pathway, including AKT, GSK-3β, and β-catenin, with the binding energies of -5.51, -5.32, and -5.40 kcal/mol, respectively, which suggested that PPI might regulate the Wnt/β-catenin signaling pathway to affect the stem cell-like properties of HCC. Further ex vivo experiments implied that PPI activated the AKT/GSK-3β-mediated ubiquitin proteasomal degradation of β-catenin and subsequently attenuated the prooncogenic effect of LCSCs. Finally, the anticancer property of PPI was confirmed in vivo. It was found that PPI inhibited the tumor growth in an HCC cell line xenograft model. Taken together, molecular docking analysis and experimental data highlighted the novel function of PPI in suppressing the stem cell-like characteristics of LCSCs via the AKT/GSK-3β/β-catenin signaling pathway.