bluuebunny/crossref_metadata_2025 huggingface dataset:
Unlocking the creative potential of health-care employees: a serial mediation model
Authors: Azila-Gbettor Edem M. , Nutsugah Francis Fonyee , Novixoxo Jewel Dela , Glate Stanley Nelvis , Honyenuga Ben Q.
Published: September 2024

Purpose

This study aims to investigate the mediating roles of servant leadership and employee vitality in the relationship between psychological ownership and employee creativity among healthcare workers in Ghana.

Design/methodology/approach

A sample of 736 public and private healthcare respondents was selected using a convenience sampling technique. Data collected using a self-reported questionnaire was analyzed via partial least square structural equation modeling.

Findings

The findings reveal that psychological ownership directly improves employee creativity, while servant leadership and employee vitality mediate the relationship between psychological ownership and employee creativity separately and complementarily.

Research limitations/implications

The research used self-reported data, increasing the potential for common method variance. However, sufficient care was taken to minimize these limitations.

Practical implications

This research makes valuable contributions to the field of healthcare practice literature. The findings suggest that management of health care entities should focus on creating a workplace culture that cultivates psychological ownership among employees and policies that enhance employee vitality and promote servant behavior to foster employee creativity.

Originality/value

This study represents one of the earliest attempts to examine a theoretical framework that connects servant leadership, employee vitality, employee creativity and psychological ownership within the context of the health service industry.
Exploring the potential impact of big data on the collection of sufficient, appropriate audit evidence: insights from auditors in the UAE
Authors: Huang Yiting , Ndiweni Esinath , Barghathi Yasser
Published: September 2024

Purpose

This paper aims to understand the impact of big data on the UAE audit profession. Mainly exploring whether the emergence of big data threatens the reliability of audit standards and whether audit standards need to be improved. Also, exploring the impact of big data on the collection of audit evidence.

Design/methodology/approach

Semistructured interviews were used to collect data, mainly targeting the audit-related workers of the Big Four and Non-Big Four audit firms in the UAE. Thematic analysis is adopted to analyze the original data, and the main factors affecting the audit standard and audit evidence collection.

Findings

This study found that the reliability of audit standards and the way audit evidence is collected can be affected by big data. It concludes that audit standards need to be improved and strengthened to include detailed essential elements associated with big data to ensure audit reliability, legitimacy and regularity. The results also identify the impact of big data on audit evidence in terms of adequacy, appropriateness, authenticity, consistency and reliability, as well as the impact on the validity and completeness of evidence collection. The research highlights the importance of big data skills and knowledge education, the contribution and challenges of big data to auditing, and the use of big data in future auditing.

Originality/value

This research provides specific empirical evidence from both Big Four and Non-Big Four audit firms in the UAE, which is lacking in the literature on the use of big data technology by auditors to assist audit works in UAE. It may serve as a reference for other researchers or those interested in relevant research.
Indian senior citizens activity in travelling behaviour: an empirical model
Authors: Adhikari Biranchi Narayan , Behera Ajay Kumar , Mahapatra Rabindra , Das Harish , Mohapatra Sasmita
Published: September 2024

Purpose

This paper aims to explore the outcomes of an analysis on day by day task – journey planning conduct of senior citizens by using a modern dynamic model and a family unit travel overview, gathered in Bhubaneswar, Odisha, of India in 2018. The task-journey planning display assumes an unique time–space-constrained planning development.

Design/methodology/approach

The main commitment of this paper is to reveal day by day task – journey planning conduct through a comprehensive dynamic framework. Numerous behavioural subtleties are revealed by the subsequent empirical model. These incorporate the role that income plays in directing outside time consumption decisions of senior citizens. Senior citizens in the most elevated and least salary classes will in general have minor varieties in time consumption decisions than those in middle pay classifications. Generally speaking, the time consumption decisions become progressively steady with expanding age, demonstrating that more task durations and lower task recurrence become progressively predominant with increasing age.

Findings

Day by day task-type and area decisions reveal a reasonable irregular utility-amplifying level headed conduct of senior residents. Unmistakably expanding spatial availability to different task areas is an urgent factor in characterizing every day outside task interest of senior residents. It is likewise evident that the assorted variety of outside task-type decisions decreases with rise in age and senior citizens are major touchy to auto journey hour than to travel or non-mechanized journey hour.

Originality/value

The fundamental constraint to the dynamic structure is that the mode decision model was viewed as exogenic to the demonstrating framework. The essential purpose behind this supposition that was that senior citizens in the Bhubaneswar are overwhelmingly customers of the local car. Coordination of the mode decision display part inside this structure would deliver a full task-based journey request model that could catch trip age, starting times, outing circulation and mode decision using a solitary demonstrating framework.
Predictors of clinical features in early‐onset severe systemic sclerosis: An analysis from a multicenter prospective observational Japanese cohort
Authors: Uesugi‐Uchida Saori , Fujimoto Manabu , Asano Yoshihide , Endo Hirahito , Goto Daisuke , Jinnin Masatoshi , Kawaguchi Yasushi , Tanaka Sumiaki , Tokunaga Takahiro , Makino Katsunari , Matsushita Takashi , Motegi Sei‐Ichiro , Yoshizaki Ayumi , Sato Shinichi , Hasegawa Minoru
Published: September 2024

As the clinical course of systemic sclerosis (SSc) varies widely, prognostic indicators have been sought to predict the outcomes of individual patients. Racial differences in SSc render it necessary to validate prognostic indicators in different patient cohorts. In this study, we aimed to assess clinical and laboratory parameters in Japanese patients with early‐stage SSc with diffuse cutaneous involvement and/or interstitial lung disease, and identify predictive factors for disease progression. We performed multivariate analyses of baseline clinical information to estimate symptoms 4 years later in Japanese patients with diffuse cutaneous SSc and/or SSc with interstitial lung disease. Patients were enrolled in the study within 5 years of disease onset at 10 Japanese SSc centers. Over 12 years, 115 patients followed up for 4 years were included in this study. The modified Rodnan skin score (mRSS) at 4 years correlated with the baseline mRSS and finger‐to‐palm distance, defined as the average length from the distal tip of the fourth finger to the distal palmar crease. The percentage predicted vital capacity (%VC) in year 4 positively and negatively correlated with initial %VC and the presence of anti‐topoisomerase I antibodies, respectively. The Health Assessment Questionnaire Disability Index (HAQ‐DI) at 4 years was positively and negatively associated with baseline HAQ‐DI and %VC, respectively. The occurrence of digital ulcers within 4 years was associated with the initial presence of digital ulcers, finger‐to‐palm distance, and the presence of digital pitting scars and anti‐topoisomerase I antibodies. This study identified several factors that may predict the progression of early‐stage SSc in Japanese patients. Finger‐to‐palm distance may be a useful tool for predicting the progression of skin thickening and the development of digital ulcers in the early stages of severe SSc, but larger, long‐term prospective studies are needed to confirm our findings.
Optimising POCUS programs: A summary of EMUG's recommendations for the development and maintenance of ED POCUS programs
Authors: Phillips Luke , Maclean Alastair , Monester Josh , Douglas Joanne , Davidson Stacey , King Gabriela
Published: September 2024

Objectives

Point‐of‐care ultrasound (POCUS) use is widespread in EDs and throughout those practising medicine. Between institutions and specialities, there is widespread variety and training. With this comes risk of patient harm and backlash to a clinically useful modality. Our objective is to form a statement that encompasses current published and unpublished guidance for creating and maintaining robust POCUS programs in EDs.

Methods

Emergency Medicine Ultrasound Group (EMUG) identified this gap and volunteers from the group undertook a literature search of current best practice and institution guidelines relating to POCUS programs. They contacted colleagues from other specialities to find and get access to other countries and colleges' POCUS guidelines. EMUGs regularly run discussion forums (Collab‐labs) and points from these were considered. Recommendations were then formed from these and recurrent unpublished obstacles the group had encountered. The result was reviewed by Clinical Leads in Ultrasound and POCUS users in Australasia.

Results

The recommendations were organised under five pillars: Infrastructure, Governance, Administration, Education and Quality.

Conclusion

These recommendations complement existing guidelines and are not intended to replace them; however, we hope to promote discussion and provide reference support for those developing POCUS programs. Implementing a comprehensive and robust ED POCUS program will ensure safe, effective, and standardised high‐quality POCUS use, with the aim of improving patient care across Australia and New Zealand. Patient safety will be enhanced through effective risk management and quality assurance and there will be consistency in POCUS education, training and credentialing across institutions.
Genomic characterization and identification of candidate genes for putative podophyllotoxin biosynthesis pathway in Penicillium herqueiHGN12.1C
Authors: Nguyen Duong Huy , Tran Quang Ho , Le Lam Tung , Nguyen Ha Hong Thi , Tran Hoa Thi , Do Thuy Phuong , Ho Anh Ngoc , Tran Quang Hong , Thu Hien Thi Nguyen , Bui Van Ngoc , Chu Hoang Ha , Pham Ngoc Bich
Published: September 2024

Previous studies have reported the functional role, biochemical features and synthesis pathway of podophyllotoxin (PTOX) in plants. In this study, we employed combined morphological and molecular techniques to identify an endophytic fungus and extract PTOX derivatives. Based on the analysis of ITS sequences and the phylogenetic tree, the isolate was classified as Penicillium herquei HGN12.1C, with a sequence identity of 98.58%. Morphologically, the HGN12.1C strain exhibits white colonies, short‐branched mycelia and densely packed hyphae. Using PacBio sequencing at an average read depth of 195×, we obtained a high‐quality genome for the HGN12.1C strain, which is 34.9 Mb in size, containing eight chromosomes, one mitochondrial genome and a GC content of 46.5%. Genome analysis revealed 10 genes potentially involved in PTOX biosynthesis. These genes include VdtD, Pinoresinollariciresinol reductase (PLR), Secoisolariciresinol dehydrogenase (SDH), CYP719A23, CYP71BE54, O‐methyltransferase 1 (OMT1), O‐methyltransferase 3 (OMT3), 2‐ODD, CYP71CU and CYP82D61. Notably, the VdtD gene in fungi shares functional similarities with the DIR gene found in plants. Additionally, we identified peltatin, a PTOX derivative, in the HGN12.1C extract. Docking analysis suggests a potential role for the 2‐ODD enzyme in converting yatein to deoxypodophyllotoxin. These findings offer invaluable insights into the synthesis mechanism of PTOX in fungi, shedding light on the relationship between host plants and endophytes.
Circulation of rare events in the liquid biopsy for early detection of lung mass lesions
Authors: Resnick Karen , Shah Anya , Mason Jeremy , Kuhn Peter , Nieva Jorge , Shishido Stephanie N.
Published: September 2024

Background

Lung cancer screening with low‐dose computed tomography (CT) scans (LDCT) has reduced mortality for patients with high‐risk smoking histories, but it has significant limitations: LDCT screening implementation remains low, high rates of false‐positive scans, and current guidelines exclude those without smoking histories. We sought to explore the utility of liquid biopsy (LBx) in early cancer screening and diagnosis of lung cancer.

Methods

Using the high‐definition single‐cell assay workflow, we analyzed 99 peripheral blood samples from three cohorts: normal donors (NDs) with no known pathology (n = 50), screening CT patients (n = 25) with Lung‐RADS score of 1–2, and biopsy (BX) patients (n = 24) with abnormal CT scans requiring tissue biopsy.

Results

For CT and BX patients, demographic information was roughly equivalent; however, average pack‐years smoked differed. A total of 14 (58%) BX patients were diagnosed with primary lung cancer (BX+). The comparison of the rare event enumerations among the cohorts revealed a greater incidence of total events, rare cells, and oncosomes, as well as specific cellular phenotypes in the CT and BX cohorts compared with the ND cohort. LBx analytes were also significantly elevated in the BX compared with the CT samples, but there was no difference between BX+ and BX− samples.

Conclusions

The data support the utility of the LBx in distinguishing patients with an alveolar lesion from those without, providing a potential avenue for prescreening before LDCT.
Estimating the effects of prenatal cannabis exposure on birth outcomes
Authors: Vanderziel Alyssa , Anthony James C. , Barondess David , Kerver Jean M. , Alshaarawy Omayma
Published: September 2024

Background and Objectives

Prenatal cannabis use prevalence in the United States has increased. Relaxation of state‐level cannabis policy may be contributing to the diminished risk perception of using cannabis. The main psychoactive constituent of cannabis, delta‐9‐tetrahydrocannabinol, crosses the placenta, interacting with functional cannabinoid receptors in the fetus. Here, we assess the association between prenatal cannabis exposure (PCE) and a set of birth outcomes.

Methods

Using the Michigan Archive for Research on Child Health, a prospective pregnancy cohort, we linked prenatal survey data with neonatal data from state‐archived birth records. Recruitment occurred in 23 clinics across Michigan. Pregnant participants with live birth records between October 2017 and January 2022, after exclusion for missing data on cannabis use, birth outcomes, and covariates, were included in the final analytic sample (n = 584). Analyses involved generalized linear models.

Results

An estimated 15% (95% confidence interval [CI]: 12%, 18%) of participants reported using cannabis during pregnancy. Covariate‐adjusted models revealed an association between PCE and birth size (ß = −0.3; 95% CI: −0.5, −0.003).

Discussion and Conclusions

Findings suggest a relationship between PCE and smaller birth size. Clinicians should follow guidelines outlined by the American College of Obstetricians and Gynecologists when counseling pregnant patients on cannabis use.

Scientific Significance

We detected a significant association between PCE and birth size. Most studies focus only on the extremes of birth size, however, use of z‐scores allow for assessment of the sex‐specific birth weight‐for‐gestational age distribution, increasing the accuracy of detecting an effect of cannabis exposure on birth size.
Early ileal resection in Crohn's disease is not associated with severe long‐term outcomes: The ERIC study
Authors: Grellier Nathan , Kirchgesner Julien , Uzzan Mathieu , Mclellan Paul , Stefanescu Carmen , Lefèvre Jérémie H. , Treton Xavier , Panis Yves , Sokol Harry , Beaugerie Laurent ,   the ERIC Study group, Seksik Philippe
Published: September 2024

Background

Early complicated Crohn's disease (CD) may require ileal resection as first‐line treatment.

Aim

To evaluate the long‐term outcomes of patients who underwent early ileal resection.

Methods

We conducted a retrospective study in two inflammatory bowel diseases (IBD) referral centres, including patients with ileocaecal resection and segmental ileal resection within 5 years of CD diagnosis. Early resection was defined as within 6 months of diagnosis, intermediate resection between 6 months and 2 years, and late resection between 2 and 5 years. The primary outcome was the cumulative risk of a second ileal surgery. Secondary outcomes included the use of postoperative treatments and morphological recurrence after initial surgery (Rutgeerts score ≥i2, or recurrence on imaging).

Results

Among 393 patients who underwent ileal resection within 5 years of diagnosis, 130, 128 and 135, respectively, had early, intermediate and late resection. The cumulative risk of second surgery at 10 years was not significantly different in the early resection group (25.0% [95% CI 17.4–35.2]), than the intermediate (16.8% [95% CI 10.5–26.2]; p = 0.17) or late resection group (22.7% [95% CI 15.1–33.3]; p = 0.83). The early resection group required fewer postoperative treatments than the late resection group with median survivals without treatments of 3.7 and 0.9 years, respectively (p = 0.002). Patients who had early resection had significantly less morphological recurrence than the late resection group (p = 0.02).

Conclusion

Early ileal resection in CD is not associated with a higher risk of a second resection. It may be associated with reduced use of medical treatments and fewer morphological recurrences.
Momentary displays of compassion and the relationship between psychosis, mood and risk incidents on inpatient wards: An experience sampling study
Authors: Irwin Leanne , Berry Katherine , Bell Tobyn , Carter Lesley‐Anne , Udachina Alisa
Published: September 2024

Objectives

Psychosis can be thought of as a threat‐based experience. Compassion has been shown to be effective in reducing threat, although highly distressed individuals may struggle to be self‐compassionate. This study explored the effects of compassionate interactions with staff on inpatients with psychosis.

Method

Experience Sampling Method (ESM) was used to investigate the relationships between compassion from staff and paranoia, voice hearing, distress related to psychosis experiences, affect and risk incidents in daily life. Twenty‐two service users residing on inpatient mental health wards took part. Baseline measures of compassion, fears of compassion and affect were taken. Participants completed ESM assessments 10 times per day, over 6 days.

Results

Compassion from staff was associated with a small increase in voice hearing, but was not associated with paranoia, paranoia‐related distress, voice‐related distress, negative affect, positive affect, or risk incidents in daily life. Baseline fears of compassion moderated the relationships between compassion from staff and some of the service user outcomes. For inpatients scoring low on fears of compassion, compassionate interactions were associated with increased positive affect and lower paranoia. However, for those scoring high on fears of compassion, this relationship was reversed, and compassionate interactions were associated with higher paranoia and lower positive affect.

Conclusion

People with psychosis who have fears of compassion may benefit from receiving support to address these fears in order to experience the benefit from the compassion of staff. The results should be interpreted with caution due to the low number of observations and limited statistical power.
Cryptic species conservation: a review
Authors: Hending Daniel
Published: September 2024

Cryptic species are groups of two or more taxa that were previously classified as single nominal species. Being almost morphologically indistinguishable, cryptic species have historically been hard to detect. Only through modern morphometric, genetic, and molecular analyses has the hidden biodiversity of cryptic species complexes been revealed. Cryptic diversity is now widely acknowledged, but unlike more recognisable, charismatic species, scientists face additional challenges when studying cryptic taxa and protecting their wild populations. Demographical and ecological data are vital to facilitate and inform successful conservation actions, particularly at the individual species level, yet this information is lacking for many cryptic species due to their recent taxonomic description and lack of research attention. The first part of this article summarises cryptic speciation and diversity, and explores the numerous barriers and considerations that conservation biologists must navigate to detect, study and manage cryptic species populations effectively. The second part of the article seeks to address how we can overcome the challenges associated with efficiently and non‐invasively detecting cryptic species in‐situ, and filling vital knowledge gaps that are currently inhibiting applied conservation. The final section discusses future directions, and suggests that large‐scale, holistic, and collaborative approaches that build upon successful existing applications will be vital for cryptic species conservation. This article also acknowledges that sufficient data to implement effective species‐specific conservation will be difficult to attain for many cryptic animals, and protected area networks will be vital for their conservation in the short term.
Role of PD‐1 in Skin Cancer: Molecular Mechanism, Clinical Applications, and Resistance
Authors: Sharma Neha , Mazumder Rupa , Rai Pallavi , Debnath Abhijit
Published: September 2024

Skin cancer is a widespread worldwide health concern, manifesting in many subtypes such as squamous cell carcinoma, basal cell carcinoma, and melanoma. Although all these types occur frequently, they generally lack the possibility of being cured, emphasizing the importance of early discovery and treatment. This comprehensive study explores the role of programmed cell death protein 1 (PD‐1) in skin cancer, focusing on its molecular mechanisms in immune regulation and its critical role in tumor immune evasion, while also clarifying the complexities of immune checkpoints in cancer pathogenesis. It critically evaluates the clinical applications of PD‐1 inhibitors, spotlighting their therapeutic potential in treating skin cancer, while also addressing the significant challenge of resistance. This work further discusses the evolution of resistance mechanisms against PD‐1 inhibitors and suggests potential approaches to mitigate these issues, thereby enhancing the effectiveness of these therapies. The study further highlights the current state of PD‐1 targeted therapies and sets the stage for future research aimed at optimizing these treatments for better clinical outcomes in skin cancer.
Prognosis of Single Implant‐Supported Prosthesis in Patients With Primary Sjögren's Syndrome: A Five‐Year Prospective Clinical Study
Authors: Hosseini Mandana , Jensen Simon Storgård , Gotfredsen Klaus , Hyldahl Emil , Pedersen Anne Marie Lynge
Published: September 2024

Background

Primary Sjögren's syndrome (pSS) is a chronic systemic autoimmune disease characterized by hyposalivation. Currently, there is limited evidence for the prognosis of dental implant treatment in Sjögren's syndrome.

Aim/Hypothesis

We hypothesized comparable clinical outcomes of implant‐supported restorations in pSS‐patients and control subjects, and improvement in oral health‐related quality of life 5 years after restoration.

Material and Methods

Patients with pSS and matched (age, gender, and tooth region) control group were recruited between June 2016 and March 2020. The clinical and radiological examination were performed, and patient‐reported oral health impact profile (OHIP‐49) questionnaire was used 2 months (baseline), 1, 3, and 5 years after prosthetic treatment.

Results

We included 23 patients with pSS and 24 matched control subjects (all women, mean age: 57.1 years). The overall DMFT (decayed‐missed‐filled‐tooth) was significantly higher (p = 0.008), symptoms of dry mouth were more severe (p = 0.001), and unstimulated and chewing‐stimulated saliva flow rates were significantly lower (p < 0.001) in pSS than in control group. All implants survived with no implant mobility. At implant sites, the plaque index and probing depths did not differ (p = 0.301 and 0.446, respectively), but the gingival index was significantly higher (p = 0.003) in pSS than control group. The mean marginal bone loss, prosthetic complications, and clinician‐reported aesthetic outcomes were similar in both groups after 5 years. The OHIP scores were significantly higher in the pSS than control group (p < 0.001) but reduced significantly in both groups (p = 0.026).

Conclusion

Replacement of missing single teeth with dental implants was successful in patients with pSS 5 years after restoration.
Clinical characteristics and post‐operative outcomes in children with malformation of cortical development related drug‐resistant epilepsy: 428 cases in one pediatric epilepsy center
Authors: Yu Hao , Sun Yu , Liu Chang , Wang Yao , Liu Qingzhu , Ji Taoyun , Wang Shuang , Liu Xiaoyan , Jiang Yuwu , Cai Lixin
Published: September 2024

Aims

To investigate post‐operative seizure outcomes, and predictors of surgical outcomes of the malformation of cortical development (MCD) in children with drug‐resistant epilepsy (DRE) and age‐specific characteristics.

Methods

We retrospectively analyzed clinical data from 428 children with MCD‐related DRE who underwent curative surgical treatment. Statistical analyses were conducted to identify correlative characteristics, prognostic predictors, and differences among various age groups.

Results

After more than 3 years of follow‐up, 81.3% of patients achieved Engel I outcomes. Prognosis was correlated with factors such as age at surgery, MRI findings, invasive EEG, pathology, acute postoperative seizures (APOS), and the number of preoperative and postoperative anti‐seizure medications (AEDs). Age at surgery and the number of preoperative AEDs (p < 0.001) were significant predictors of seizure recurrence. Distinct clinical characteristics were observed among different age groups.

Conclusion

Surgery is effective in terminating MCD‐related DRE. Younger age at surgery and fewer preoperative AEDs are associated with better prognoses. Clinical characteristics vary significantly with age.
The effectiveness of interventions to manage international wildlife trade
Authors: Öckerman Siri L. A. , Cheng Samantha H. , Bicknell Jake E. , Robinson Janine E.
Published: September 2024

A range of interventions have been established to manage international wildlife trade and protect traded species; however, there is little consensus as to whether, when, and how they are effective. Here, through a comprehensive, systematic review of >8000 articles, we appraise the evidence for the effectiveness of interventions on conservation, biological, and/or socio‐economic outcomes. Our systematic review examined four intervention types: “laws and regulations”, “detection and enforcement”, “efforts to reduce threats to species”, and “support local livelihoods”. We find that while laws and regulations were most well‐studied, with some reported positive outcomes, over half of articles reported unintended consequences including shifting exploitation and trade routes, increased illegal trade, and socio‐economic trade‐offs. Detection and enforcement efforts appeared effective in protecting target species but limited for high‐value species especially when combined with low reproductive rates. Efforts to reduce threats to species (particularly through area protection) had positive biological impacts, but some socio‐economic trade‐offs were reported. Evidence on community‐based approaches was limited but our review indicated positive synergies occurring between conservation and socio‐economic outcomes. Overall, socio‐economic outcomes were underrepresented, limiting understanding of potentially important socio‐ecological feedbacks. This review furthers understanding of relevant conditions, risks and enabling factors around effectiveness of wildlife trade interventions.
Monitoring change: A Behavior‐Centered Theory of Change for effective demand reduction interventions
Authors: Sánchez‐Mercado Ada , Moran Lisandro , Pineda María Daniela , Cardozo‐Urdaneta Arlene , Rodríguez Jon Paul
Published: September 2024

Behavior change campaigns are crucial in combatting illegal wildlife trade (IWT) by reducing demand, but assessing their impact requires robust strategies. The Behavior‐Centered Theory of Change (BC‐ToC) integrates Theory of Change frameworks with decision‐making models to design and evaluate interventions using behavioral and progress indicators. We used BC‐ToC to design two behavioral change interventions aimed at reducing demand for two threatened Venezuelan bird species: the Yellow‐shouldered Amazon (YSA) and the Red Siskin (RS). We developed workshops to engage community organizations and conservationists to identify audience groups, evaluate alternative behaviors considering impact and benefits, and define behavior‐based indicators for monitoring change. For YSA, two audience groups with similar demand motivations emerged: “common folks” (women, 20–70 yo, low education) and “young professionals” (20–30 yo, educated). Enjoying parrots through outdoor activities emerged as an alternative. For RS, the main audience segments were the breeder groups “South American node” (Venezuelan and Brazilian) and “Iberian node” (Spaniels and Portuguese). Iberian with wider age range (30–60 yo) and greater education than South American. Adopting responsible sourcing practices surfaced as the alternative behavior. We described behavioral levers, intermediary outputs, and indicators reflecting changes in knowledge, attitudes, norms, and control. We discussed challenges for adoption, emphasizing systemic barriers and the role of regulations, and provided ground‐tailored strategies for effective behavioral interventions.
Evaluating the impact of differing completion rates of a face‐to‐face DIABETES self‐management education programme on Patient Reported Outcome measures (DIABETES PRO): A feasibility trial protocol
Authors: Lewis Gemma , Irving Greg , Wilding John , Hardy Kevin
Published: September 2024

Introduction

Structured diabetes self‐management education (DSME) is internationally recommended for people with type 2 diabetes to support self‐management and to prevent associated long‐term complications. ‘Attendance’ at DSME is currently benchmarked as having completed a registration form and at least one active engagement with programme content, and ‘completion’ measured against ≥60% completion, despite landmark trials reporting outcomes based on the full completion of a programme. Little is known about the effectiveness of DSME on the psychological and emotional health of people with diabetes who complete less than the full DSME programme. We report a protocol for a single‐centre randomised feasibility study to assess the impact of differing completion rates of a face‐to‐face DSME programme on patient reported outcomes of self‐care, diabetes distress and quality of life in people with type 2 diabetes.

Methods

A randomised feasibility study in 120 people with type 2 diabetes due to attend a secondary care diabetes clinic in the North West UK for DSME. Participants will be randomised into one of the four groups: Group 1 full DSME programme, Group 2 60%, Group 3 10% and Group 4 0% (delayed education). Psychometric questionnaire scores will be evaluated at baseline and 3–4 months post‐intervention. Measures of feasibility (eligibility, recruitment and retention rates) will be reported.

Ethics and Dissemination

The DIABETES‐PRO study was approved by the London–Surrey Borders Research Ethics Committee (24/LO/0235). Results will be shared with study participants and published in peer‐reviewed journals.

Trial Registration

Clinicaltrials.gov NCT06419907.
Glycated haemoglobin variability and risk of renal function decline in type 2 diabetes mellitus: An updated systematic review and meta‐analysis
Authors: Wang Shihan , Song Shuoning , Gao Junxiang , Duo Yanbei , Gao Yuting , Fu Yong , Dong Yingyue , Yuan Tao , Zhao Weigang
Published: September 2024

Objective

To assess the association between glycated haemoglobin (HbA1c) variability and risk of renal function decline in type 2 diabetes mellitus (T2DM).

Research Design and Methods

A comprehensive search was carried out in PubMed, Embase, Web of Science and the Cochrane Library (until 12 March 2024). The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) statement guidelines were followed for this meta‐analysis. HbA1c variability was presented as indices of the standard deviation (SD), coefficient of variation (CV), HbA1c variability score (HVS) and haemoglobin glycation index (HGI). This meta‐analysis was performed using random‐effect models.

Results

Eighteen studies met the objectives of this meta‐analysis. The analyses showed positive associations between HbA1c variability and kidney function decline, with hazard ratio (HR) 1.26 (95% confidence interval [CI] 1.15–1.38) for high versus low SD groups, HR 1.47 (95% CI 1.30–1.65) for CV groups, HR 1.32 (95% CI 1.10–1.57) for HVS groups and HR 1.53 (95% CI 1.05–2.23) for HGI groups. In addition, each 1% increase in SD and CV was linked to kidney function decline, with HR 1.26 (95% CI 1.17–1.35), and 1.13 (95% CI 1.03–1.23), respectively. Also, each 1‐SD increase in SD of HbA1c was associated with deterioration in renal function, with HR 1.17 (95% CI 1.07–1.29).

Conclusions

The four HbA1c variability indicators were all positively associated with renal function decline progression; therefore, HbA1c variability might play an important and promising role in guiding glycaemic control targets and predicting kidney function decline progression in T2DM.
Non‐invasive metabolic biomarkers in initial cognitive impairment in patients with diabetes: A systematic review and meta‐analysis
Authors: Chen Meng‐Di , Deng Chao‐Fan , Chen Peng‐Fei , Li Ao , Wu Hua‐Ze , Ouyang Fan , Hu Xu‐Guang , Liu Jian‐Xin , Wang Shu‐Mei , Tang Dan
Published: September 2024

Aim

Diabetic cognitive impairment (DCI), considered one of the most severe and commonly overlooked complications of diabetes, has shown inconsistent findings regarding the metabolic profiles in DCI patients. This systematic review and meta‐analysis aimed to identify dysregulated metabolites as potential biomarkers for early DCI, providing valuable insights into the underlying pathophysiological mechanisms.

Materials and Methods

A systematic search of four databases, namely PubMed, Embase, Web of Science and Cochrane, was conducted up to March 2024. Subsequently, a qualitative review of clinical studies was performed followed by a meta‐analysis of metabolite markers. Finally, the sources of heterogeneity were explored through subgroup and sensitivity analyses.

Results

A total of 774 unique publications involving 4357 participants and the identification of multiple metabolites were retrieved. Of these, 13 clinical studies reported metabolite differences between the DCI and control groups. Meta‐analysis was conducted for six brain metabolites and two metabolite ratios. The results revealed a significant increase in myo‐inositol (MI) concentration and decreases in glutamate (Glu), Glx (glutamate and glutamine) and N‐acetylaspartate/creatine (NAA/Cr) ratios in DCI, which have been identified as the most sensitive metabolic biomarkers for evaluating DCI progression. Notably, brain metabolic changes associated with cognitive impairment are more pronounced in type 2 diabetes mellitus than in type 1 diabetes mellitus, and the hippocampus emerged as the most sensitive brain region regarding metabolic changes associated with DCI.

Conclusions

Our results suggest that MI, Glu, and Glx concentrations and NAA/Cr ratios within the hippocampus may serve as metabolic biomarkers for patients with early‐stage DCI.
The influence of paraventricular nucleus of the hypothalamus soluble guanylate cyclase on autonomic and neuroendocrine responses to acute restraint stress in rats
Authors: Busnardo Cristiane , Crestani Carlos C. , Fassini Aline , Scarambone Bianca M. , Packard Benjamin A. , Resstel Leonardo B. M. , Herman James P. , Correa Fernando M. A.
Published: September 2024

The paraventricular nucleus of the hypothalamus (PVN) regulates physiological and behavioural responses evoked by stressful stimuli, but the local neurochemical and signalling mechanisms involved are not completely understood. The soluble guanylate cyclase (sGC) within the PVN is implicated in autonomic and cardiovascular control in rodents under resting conditions. However, the involvement of PVN sGC‐mediated signalling in stress responses is unknown. Therefore, we investigated the role of sGC within the PVN in cardiovascular, autonomic, neuroendocrine, and local neuronal responses to acute restraint stress in rats. Bilateral microinjection of the selective sGC inhibitor ODQ (1 nmol/100 nl) into the PVN reduced both the increased arterial pressure and the drop in cutaneous tail temperature evoked by restraint stress, while the tachycardia was enhanced. Intra‐PVN injection of ODQ did not alter the number of Fos‐immunoreactive neurons in either the dorsal cap parvocellular (PaDC), ventromedial (PaV), medial parvocellular (PaMP), or lateral magnocelllular (PaLM) portions of the PVN following acute restraint stress. Local microinjection of ODQ into the PVN did not affect the restraint‐induced increases in plasma corticosterone concentration. Taken together, these findings suggest that sGC‐mediated signalling in the PVN plays a key role in acute stress‐induced pressor responses and sympathetically mediated cutaneous vasoconstriction, whereas the tachycardiac response is inhibited. Absence of an effect of ODQ on corticosterone and PVN neuronal activation in and the PaV and PaMP suggests that PVN sGC is not involved in restraint‐evoked hypothalamus‐pituitary‐adrenal (HPA) axis activation and further indicates that autonomic and neuroendocrine responses are dissociable at the level of the PVN.
Risk of aspiration pneumonia and hospital mortality in Parkinson disease: A systematic review and meta‐analysis
Authors: Chua Wei Yu , Wang Jia Dong James , Chan Claire Kar Min , Chan Ling‐Ling , Tan Eng‐King
Published: September 2024

Background and Purpose

This study was undertaken to conduct a meta‐analysis on the prevalence of aspiration pneumonia (AP) and hospital mortality in Parkinson disease (PD) as well as the risk of AP in PD patients compared to controls.

Methods

We searched MEDLINE and Embase from inception to 19 March 2024 to identify cross‐sectional, cohort, and case–control studies comparing the frequency of AP and hospital mortality in PD patients. We computed risk ratios (RRs) with accompanying 95% confidence intervals (CIs) for each study and pooled the results using a random‐effects meta‐analysis.

Results

A total of 781 studies were initially screened, and 13 studies involving 541,785,587 patients were included. Patients with PD had >3 times higher risk of AP compared to controls (RR = 3.30, 95% CI = 1.82–6.00, p < 0.0001). This increased risk was similar in both cohort studies (RR = 3.01, 95% CI = 1.10–8.24, p = 0.03) and case–control studies (RR = 3.86, 95% CI = 3.84–3.87, p < 0.00001). The prevalence of AP in 12 studies was 2.74% (95% CI = 1.69–4.41), and hospital mortality was 10% in six studies (10.0%, 95% CI = 5.32–18.0). Prevalence of AP was higher in studies with smaller sample size (5.26%, 95% CI = 3.08–8.83 vs. 2.06%, 95% CI = 1.19–3.55, p = 0.02).

Conclusions

Our meta‐analysis showed that patients with PD had >3 times higher risk of AP, with an average 2.74% prevalence and 10.0% hospital mortality. Early recognition and treatment of AP in PD patients will help reduce morbidity and mortality. A multidisciplinary holistic approach is needed to address the multifactorial causes of AP.
Development and validation of an electronic Symbol‐Digit Modalities Test for remote monitoring of people with multiple sclerosis
Authors: Dini Michelangelo , Gamberini Giulia , Tacchini Marta , Boschetti Angela , Gradassi Alessandro , Chiveri Luca , Rodegher Mariaemma , Comi Giancarlo , Leocani Letizia
Published: September 2024

Background

Computerized cognitive tests may extend the reach of cognitive screening and monitoring to those with mobility issues or living in remote areas. Moreover, it could enable frequent and autonomous remote cognitive assessments in people with multiple sclerosis (pwMS) on account of its reduced economic and organizational costs. This may further improve our understanding of longitudinal trends and significantly improve the standard of care for pwMS living in remote areas or with mobility limitations. We aimed to evaluate the psychometric properties of an electronic Symbol‐Digit Modalities Test (eSDMT) designed to allow pwMS to perform a rapid cognitive assessment independently from home using their own PC/laptop.

Methods

Sixty‐two participants underwent a neuropsychological evaluation, and then performed the eSDMT in the clinic. Forty‐two participants also repeated the eSDMT at home. We assessed concurrent validity (eSDMT vs. oral SDMT), test–retest reliability (in the clinic vs. at home), discriminant validity (pwMS with/without cognitive impairment), and other psychometric characteristics of the eSDMT (effect of age, sex, and education on test scores).

Results

We observed good‐to‐excellent concurrent validity (r ≥ 0.84, all p < 0.0001) and test–retest reliability (intraclass correlation coefficients [ICCs]>0.87, all p < 0.0001). Discriminant validity was excellent (area under the curves [AUCs] >0.84, all p < 0.0001). eSDMT scores were only slightly influenced by demographic characteristics (all R2 < 0.200).

Conclusions

We provided evidence which supports the use of our eSDMT as a feasible, valid, and reliable remote assessment of cognitive function in pwMS. Future studies will investigate long‐term reliability and predictive power.
One‐step multiple kernel k‐means clustering based on block diagonal representation
Authors: Chen Cuiling , Li Zhi
Published: September 2024

Multiple kernel k‐means clustering (MKKC) can efficiently incorporate multiple base kernels to generate an optimal kernel. Many existing MKKC methods all need two‐step operation: learning clustering indicator matrix and performing clustering on it. However, the optimal clustering results of two steps are not equivalent to those of original problem. To address this issue, in this paper we propose a novel method named one‐step multiple kernel k‐means clustering based on block diagonal representation (OS‐MKKC‐BD). By imposing a block diagonal constraint on the product of indicator matrix and its transpose, this method can encourage the indicator matrix to be block diagonal. Then the indicator matrix can produce explicit clustering indicator, so as to implement one‐step clustering, which avoids the disadvantage of two‐step operation. Furthermore, a simple kernel weighting strategy is used to obtain an optimal kernel, which boosts the quality of optimal kernel. In addition, a three‐step iterative algorithm is designed to solve the corresponding optimization problem, where the Riemann conjugate gradient iterative method is used to solve the optimization problem of the indicator matrix. Finally, by extensive experiments on eleven real data sets and comparison of clustering results with 10 MKC methods, it is concluded that OS‐MKKC‐BD is effective.
KRILLSCAN: An automated open‐source software for processing and analysis of echosounder data from the Antarctic krill fishery
Authors: Menze Sebastian , Macaulay Gavin J. , Zhang Guosong , Lowther Andrew D. , Krafft Bjørn A.
Published: September 2024

Krillscan software was developed to automatically process echosounder data and achieve an accelerated and transparent analysis of backscatter data that allows calculation of target biomass. Herein, the fishery for Antarctic krill (Euphausia superba, Henceforth Krill) was used as a case study to develop the approach. Implementation of a sustainable management strategy for the krill fishery is complicated by a lack of regularly updated krill abundance data on spatiotemporal scales of the fishery. To increase krill biomass data availability, automatic echosounder data processing and swarm detection software was tested against traditional manual scrutinization with LSSS software and agreed with only minor offsets in estimated nautical area scattering coefficients. In addition to automatic processing and data transfer, Krillscan also has a graphical user interface to supervise automatic krill swarm detection. Echogram size can be compressed up to 100 times and raw data are processed faster than generated, thereby enabling near‐real time analysis and data transfer. Compressed data can be transmitted online to allow fishing vessels to conduct surveys without having scientific personnel with special expertise on board.
Elevating water table reduces net ecosystem carbon losses from global drained wetlands
Authors: Liu Ning , Wang Quancheng , Zhou Ronglei , Zhang Ruiyang , Tian Dashuan , Gaffney Paul P. J. , Chen Weinan , Gan Dezhao , Zhang Zelong , Niu Shuli , Ma Lei , Wang Jinsong
Published: September 2024

Drained wetlands are thought to be carbon (C) source hotspots, and rewetting is advocated to restore C storage in drained wetlands for climate change mitigation. However, current assessments of wetland C balance mainly focus on vertical fluxes between the land and atmosphere, frequently neglecting lateral carbon fluxes and land‐use effects. Here, we conduct a global synthesis of 893 annual net ecosystem C balance (NECB) measures that include net ecosystem exchange of CO2, along with C input via manure fertilization, and C removal through biomass harvest or hydrological exports of dissolved organic and inorganic carbon, across wetlands of different status and land uses. We find that elevating water table substantially reduces net ecosystem C losses, with the annual NECB decreasing from 2579 (95% interval: 1976 to 3214) kg C ha−1 year−1 in drained wetlands to −422 (−658 to −176) kg C ha−1 year−1 in natural wetlands, and to −934 (−1532 to −399) kg C ha−1 year−1 in rewetted wetlands globally. Climate, land‐use history, and time since water table changes introduce variabilities, with drainage for (sub)tropical agriculture or forestry uses showing high annual C losses, while the net C losses from drained wetlands can continue to affect soil C pools for several decades. Rewetting all types of drained wetlands is needed, particularly for those formerly agriculture‐used (sub)tropical wetlands where net ecosystem C losses can be largely reduced. Our findings suggest that elevating water table is an important initiative to reduce C losses in degraded wetlands, which could contribute to policy decisions for managing wetlands to enhance their C sequestration.