bluuebunny/crossref_metadata_2025 huggingface dataset:
Cabozantinib in Japanese patients with advanced hepatocellular carcinoma: Final results of a multicenter phase II study
Authors: Kato Naoya , Kudo Masatoshi , Tsuchiya Kaoru , Hagihara Atsushi , Numata Kazushi , Aikata Hiroshi , Inaba Yoshitaka , Kondo Shunsuke , Motomura Kenta , Okano Naohiro , Ikeda Masafumi , Morimoto Manabu , Kuroda Shingo , Kimura Akiko
Published: January 2023

Aim

Cabozantinib showed a favorable benefit–risk profile in Japanese patients with advanced hepatocellular carcinoma (HCC) in an open‐label, phase II study (NCT03586973). This analysis presents cumulative data to final database lock.

Methods

Patients with previously treated, advanced HCC received cabozantinib 60 mg/day. Progression‐free survival (PFS) and tumor response rates in prior‐sorafenib and sorafenib‐naïve cohorts were assessed by independent radiology committee (IRC) and an investigator. Liver function was evaluated by albumin–bilirubin (ALBI) score.

Results

Median cabozantinib exposure was 5.6 months. In the prior‐sorafenib cohort (n = 20), median PFS was 7.4 months per IRC assessment and 5.6 months per investigator assessment. In the sorafenib‐naïve cohort (n = 14), median PFS was 3.6 and 4.4 months per IRC and investigator assessment, respectively. Six‐month PFS rate per IRC and investigator assessment in the prior‐sorafenib cohort was 59.8% and 49.5%, respectively, and in the sorafenib‐naïve cohort was 16.7% and 35.7%, respectively. Disease control rate by both IRC and investigator assessment was 85.0% in the prior‐sorafenib cohort and 64.3% in the sorafenib‐naïve cohort. Median overall survival (Kaplan–Meier estimate) was 19.3 and 9.9 months in the prior‐sorafenib and sorafenib‐naïve cohort, respectively. Mean ALBI score remained relatively constant in patients able to continue treatment. The most frequent adverse events were palmar–plantar erythrodysesthesia syndrome, diarrhea, hypertension, and decreased appetite. No new safety concerns were identified.

Conclusions

Cabozantinib showed efficacy and a manageable safety profile in Japanese patients with advanced HCC.
Audit fee determinants in small municipalities: Further evidence from Connecticut small towns
Authors: Jamsheed Jacqueline T. , Patton Joseph T. , Lewis Marc B.
Published: January 2023

Guided by a call for research on small entities using innovative methodologies, this study is the first to analyse small municipality audit fees on a per capita basis. The research utilises a complete dataset of all 92 Connecticut municipalities that meet the study criteria and does not rely on samples or survey results. The measure of per capita was utilised to account for differences between town populations allowing for a more accurate comparison of audit fees and audit fee determinants across municipalities of differing populations. Consistent with the premise that auditee characteristics are an important consideration in audit fees, we find that when examining audit fees on a per capita basis in the subset of small municipalities: (1) smaller towns pay considerably more for audit services than larger towns, (2) towns with an ethics committee oversight function and best practices financial reporting practices have lower per capita audit fees than those that do not and (3) audit firm size, audit firm tenure and existence of audit/finance committee oversight have no significant impact on per capita audit fees. The results of this study help fill a void in the audit literature by providing insights into audit fee determinants in small municipalities by considering the added feature of a per capita analysis. The authors also sought to provide additional information for consideration in the International Auditing and Assurance Standards Board (IAASB) efforts to streamline standards for auditing of less complex entities.
Psychoeducational interventional programme during the COVID‐19 pandemic for nurses with severe occupational stress: A randomized controlled trial
Authors: Alkhawaldeh Ja'far M.
Published: January 2023

Background:

Occupational stress is generally acknowledged as a major issue in the health sector that may have a detrimental impact on nurses' psychological and physical health, particularly during the COVID‐19 epidemic.

Aim:

This study evaluated the effectiveness of a psychoeducational interventional programme in decreasing occupational stress and improving coping methods among nurses during the COVID‐19 pandemic.

Methods:

This study used a cluster‐randomized approach. Data were collected from 80 nurses working in two public health‐care centres from May to August 2020 in Jordan. Two centres were assigned randomly to the intervention and control groups. The psychoeducational programme was delivered to the intervention group in six sessions over 6 days for 2 weeks. The collected data were analysed using SPSS through descriptive and inferential statistics. Occupational stress and coping strategies were measured.

Results:

Repeated‐measures analysis of variance (ANOVA) indicated that the degrees of occupational stress and coping strategies significantly differed between study groups over the three points of data collection.

Conclusion:

This psychoeducational interventional programme is a valuable noninvasive method that can improve individual coping strategies to manage stress in practice during the COVID‐19 pandemic.
Dispositional and situational attributions for why the rich live longer than the poor
Authors: Bridger Emma K. , Tufte‐Hewett Angela , Comerford David A.
Published: January 2023

Despite considerable focus on predictors of attitudes towards economic inequality, there is less psychological research into attitudes towards other unequal outcomes between the rich and poor, including differences in health and life expectancy. Two studies examine whether causal attributions for these socioeconomic health inequalities predict attitudes towards them. A cross‐sectional study of 332 UK and US respondents showed that most respondents indicate a preference for some degree of income inequality but no life expectancy inequality between the richest and poorest in society. These preferences for equal life expectancy for the rich and poor were significantly less likely for respondents who viewed health inequalities to be caused by dispositional factors (e.g., self‐control, ability or effort). In a second pre‐registered cross‐sectional study (n = 602), dispositional attributions negatively predicted self‐reported concern about health inequality, whilst endorsing situational attributions (e.g., discrimination and prejudice, wages) was positively associated with concerns on this issue. Moreover, situational attributions positively predicted support for six policy proposals for reducing health inequality, while dispositional attributions were associated with increased support for some of these interventions and decreased support for others. Despite very distinct distribution preferences for income and life expectancy outcomes, causal attributions continue to predict attitudes towards health inequality and associated policy interventions.
SIX4 upregulates IDH1 and metabolic reprogramming to promote osteosarcoma progression
Authors: Li Bing , Dang Xiaoqian , Duan Jiafeng , Zhang Guangyang , Zhang Jia , Song Qichun
Published: January 2023

Metabolism reprogramming plays an important role in tumorigenesis and osteosarcoma metastasis. Sine oculis homeobox 4 (SIX4) is reported to be a key transcription factor that is involved in glycolysis reprogramming of cancer cells. However, the role of SIX4 in osteosarcoma progression remains unknown. The expression profile of SIX4 in OS was evaluated in surgery samples of osteosarcoma patients. Functional studies were performed in vitro and in vivo. We found that SIX4 is significantly overexpressed in osteosarcoma and related to the undesirable prognosis of osteosarcoma patients. SIX4 promotes progression of osteosarcoma via upregulating isocitrate dehydrogenase 1 (IDH1), which provides novel prognostic biomarkers and promising therapeutic targets for osteosarcoma patients.
Influence of alveolar bone height on the biomechanical behavior of roots restored with custom‐made posts‐and‐cores
Authors: Gontijo Isabela Guerra , Ferretti Marcela Alvarez , Monteiro Lara Christie , Caldas Ricardo Armini , Pecorari Vanessa Gallego Arias , França Fabiana Mantovani Gomes , Aguiar Flávio Henrique Baggio
Published: January 2023

Objetive

This study evaluated the influence of alveolar bone height and post type on compressive force resistance, fracture pattern, and stress distribution in endodontically treated teeth.

Materials and Methods

Bovine roots were endodontically treated and divided into eight groups (n = 10) according to alveolar bone height (normal alveolar bone and alveolar bone loss ‐ 2 and 5 mm from the margin of the crown, respectively) and post type (prefabricated glass fiber post, anatomic glass fiber post, customized milled glass fiber post‐and‐core and customized milled polyetheretherketone (PEEK) post‐and‐core). Mechanical fatigue was simulated (300.000 cycles/50 N/1.2 Hz). Compression force resistance (N) was analyzed by two‐way ANOVA and Tukey test (α = 0.05). Fracture patterns were described as percentages. Stress distribution was analyzed by finite element analysis.

Results

Significant diferences were found for alveolar bone height (P < 0.0001): normal alveolar bone groups showed higher mean values of compression force resistance compared to alveolar bone loss groups, while no significant differences were found for post type (P = 0.4551), and there was no double interaction between them (P = 0.5837). Reparable fractures were more predominant in normal alveolar bone groups, especially in the milled glass fiber and PEEK post‐and‐core groups. Stress distribution was similar in groups with prefabricated glass fiber posts and milled PEEK posts‐and‐cores, and the alveolar bone loss condition significantly increased stress concentration and strain values, mainly on apical dentin.

Conclusions

Alveolar bone loss due to physiological aging and/or periodontal disease may lead to increased risk of restored tooth failure, although milled glass fiber and PEEK posts‐and‐cores provide more reparable fractures.

Clinical Significance

Custom‐made glass fiber and PEEK post‐and‐cores are interesting options, since they enable clinicians to work with a single‐body post‐and‐core system that avoid several materials interfaces and fits well in the root canal provided promising results to improve the failure behavior of restored roots, as they offer more reparable fractures even in situations of alveolar bone loss.
Behavioural adjustment of children with intellectual disability and their sibling is associated with their sibling relationship quality
Authors: Hayden N. K. , Hastings R. P. , Bailey T.
Published: January 2023

Background

Understanding sibling relationship quality is important, as it is associated with mental health outcomes in both childhood and adulthood. Arguably, these relationships are even more important for individuals with intellectual disability, as siblings can be important sources of care, support, advocacy and friendship for one another. The intellectual disability field, however, has a tendency to assume that the relationship lacks reciprocity, and that it is the sibling with intellectual disability who affects the sibling, and that this effect is somehow ‘negative’.

Methods

We examined whether the behaviour problems and prosocial behaviour of 500 child sibling pairs, where one child has an intellectual disability, were associated with their sibling relationship quality. Measures included the Strengths and Difficulties Questionnaires and the Sibling Relationship Questionnaire. Family poverty, the gender of both children, birth order and whether the child with intellectual disability had autism or Down syndrome were also included in the analyses.

Results

Confirmatory factor analysis indicated an adequate model fit for the latent variables measuring sibling relationships. The final structural model found that the prosocial behaviour and internalising problems of the children with intellectual disability, their typically developing siblings' prosocial behaviours and sibling birth order were associated with intimacy–companionship in the sibling relationship. The internalising, externalising and prosocial behaviours of the children with intellectual disability, their siblings' externalising behaviours and sibling birth order were associated with antagonism–quarrelling in the sibling relationship.

Conclusions

We found that the behaviours of both the child with intellectual disability and their sibling were associated with both ‘positive’ and ‘negative’ dimensions of their sibling relationship. This indicates a bidirectional and reciprocal effect.
A short review of acculturation and addiction among immigrant and refugee communities in the United States and abroad
Authors: Marginean Valentina , Sheth Pankti , Varma Ashima , Vessie Arden
Published: January 2023

Purpose

To summarize recent evidence of the relationship between acculturation and substance use addiction among foreign‐born persons living in the United States (U.S.) and abroad.

Recent findings

Foreign‐born populations are increasing in many countries as a result of immigration and global refugee displacement. Acculturation and discrimination toward both populations have been related to the initiation of illicit substance use. The “immigrant paradox” may serve as a protective factor against the initiation and worsening prognosis of substance use disorders. Improving multilingual accessibility and frequency of use of clinical screeners may enhance addiction risk factor identification and potential interventions for foreign‐born populations living in countries of emigration, such as the U.S.

Foreign‐born persons compose a significant proportion of nurse–patient interactions in the U.S. and abroad. The unique sociological phenomenon of the immigrant paradox may serve as a protective factor for foreign‐born persons despite the increased risk for adverse childhood events, acculturation, and discrimination. Due to conflicting evidence, future studies should examine longitudinal outcomes of substance use exclusively among foreign‐born persons as well as protective and risk factors associated with immigrants and refugees, respectively.

Clinical relevance

Foreign‐born persons may experience unique risk factors associated with addiction. Future studies should focus on foreign‐born populations to explore if social constructs surrounding addiction can be extrapolated into other populations, including their second‐generation offspring. Differences surrounding migration contexts between immigrants and refugees may be important for clinical researchers to understand when designing research studies centered on these experiences. Nurses can play a significant role in identifying patients at risk for substance use by advocating for inclusive and comprehensive multilingual screeners.
MRI detection of brain gadolinium retention in multiple sclerosis: Magnetization transfer vs. T1‐weighted imaging
Authors: Cananau Carmen , Forslin Yngve , Bergendal Åsa , Sjöström Henrik , Fink Katharina , Ouellette Russell , Wiberg Maria Kristoffersen , Fredrikson Sten , Granberg Tobias
Published: January 2023

Background and Purpose

Evidence of brain gadolinium retention has affected gadolinium‐based contrast agent usage. It is, however, unclear to what extent macrocyclic agents are retained and whether their in vivo detection may necessitate nonconventional MRI. Magnetization transfer (MT) could prove suitable to detect gadolinium‐related signal changes since dechelated gadolinium ions bind to macromolecules. Therefore, this study aimed to investigate associations of prior gadolinium administrations with MT and T1 signal abnormalities.

Methods

A cohort of 23 persons with multiple sclerosis (MS) (18 females, 5 males, 57 ± 8.0 years) with multiple past gadolinium administrations (median 6, range 3‐12) and 23 age‐ and sex‐matched healthy controls underwent 1.5 Tesla MRI with MT, T1‐weighted 2‐dimensional spin echo, and T1‐weighted 3‐dimensional gradient echo. The signal intensity index was assessed by MRI in gadolinium retention predilection sites.

Results

There were dose‐dependent associations of the globus pallidus signal on gradient echo (r = .55, p < .001) and spin echo (r = .38, p = .013) T1‐weighted imaging, but not on MT. Relative to controls, MS patients had higher signal intensity index in the dentate nucleus on T1‐weighted gradient echo (1.037 ± 0.040 vs. 1.016 ± 0.023, p = .04) with a similar trend in the globus pallidus on T1‐weighted spin echo (1.091 ± 0.034 vs. 1.076 ± 0.014, p = .06). MT detected no group differences.

Conclusions

Conventional T1‐weighted imaging provided dose‐dependent associations with gadolinium administrations in MS, while these could not be detected with 2‐dimensional MT. Future studies could explore newer MT techniques like 3D and inhomogenous MT. Notably, these associations were identified with conventional MRI even though most patients had not received gadolinium administrations in the preceding 9 years, suggestive of long‐term retention.
Health insurers' use of quality improvement expenses to achieve a minimum medical loss ratio requirement
Authors: Born Patricia H. , Tice Sirmans E. , Steinorth Petra
Published: January 2023

Health insurer medical loss ratios (MLRs) are the percentage of premium dollar spent on medical claims and healthcare quality improvement expenses (QIEs). QIEs include activities to improve patient health outcomes and safety, reduce medical errors, and prevent hospital readmissions. The Affordable Care Act mandates minimum MLRs in certain health insurance markets lest rebates be paid to policyholders. QIEs are reported in all markets regardless of whether that market is subject to minimum MLR requirements. Using health insurer statutory filings for a sample of group market insurers from 2010 to 2018, we employ a mixed regression discontinuity/regression kink approach to evaluate whether QIEs are used by insurers as a potential strategy for meeting the minimum MLR requirement. We show that health insurers' QIE increase in the loss ratio until meeting the minimum MLR requirement, have a significant discontinuous jump at the threshold, and decrease above the threshold after the introduction of the MLR mandate.
Transformer‐optimized generation, detection, and tracking network for images with drainage pipeline defects
Authors: Ma Duo , Fang Hongyuan , Wang Niannian , Lu Hongfang , Matthews John , Zhang Chao
Published: January 2023

Regular detection of defects in drainage pipelines is crucial. However, some problems associated with pipeline defect detection, such as data scarcity and defect counting difficulty, need to be addressed. Therefore, a Transformer‐optimized generation, detection, and counting method for drainage‐pipeline defects was established in this paper. First, a generation network called Trans‐GAN‐Cla was developed for data augmentation. A classification network was trained to improve the quality of the generated images. Second, a detection and tracking model called Trans‐Det‐Tra was developed to track and count the number of defects. Third, the feature extraction capability of the proposed method was improved by leveraging Transformers. Compared with some well‐known convolutional neural network‐based methods, the proposed network achieved the best classification and detection accuracies of 87.2% and 87.57%, respectively. Furthermore, the F1 scores were 87.7% and 91.9%. Finally, two pieces of onsite videos were detected and tracked, and the numbers of misalignments and obstacles were accurately counted. The results indicate that the established Transformer‐optimized method can generate high‐quality images and realize the high‐accuracy detection and counting of drainage pipeline defects.
Psammogeton shivalikense sp. nov. (Apiaceae: Pimpinelleae), restricted to the Shivalik hills of Jammu and Kashmir (North‐West India)
Authors: Bhellum B. L. , Magotra Rani
Published: January 2023

The new species Psammogeton shivalikense (Apiaceae) is described and illustrated. It is similar to Psammogeton biternatum and P. canescens, but differs from these allied species in having smaller height, 1–3 bracts, 2–4 rays per umbel, 2–5 flowers per umbellet, densely hairy mericarps and hairs fringed with glands. A key to the species of Psammogeton in India their occurrence in adjoining countries distribution maps and photographs are provided.
Measuring esophageal compliance using functional lumen imaging probe to assess remodeling in eosinophilic esophagitis
Authors: Moosavi Sarvee , Shehata Christina , Kou Wenjun , Hirano Ikuo , Gonsalves Nirmala , Peterson Stephanie , Pandolfino John E. , Carlson Dustin A.
Published: January 2023

Background

Eosinophilic esophagitis (EoE) is associated with fibrostenotic remodeling that can be objectively assessed using the functional lumen imaging probe (FLIP). This is typically done using a metric called distensibility plateau (DP). We aimed to describe a novel measure of compliance of the esophageal body and evaluate the associated clinical characteristics in EoE.

Methods

One hundred seventy‐one adult patients with EoE (mean (SD) age 38 (12) years), 31% female and 35 healthy, asymptomatic controls who completed 16‐cm functional luminal imaging probe (FLIP) during endoscopy, were evaluated in a cross‐sectional study. The esophageal body DP and compliance were measured using a customized analysis program, with compliance calculated as (Δ esophageal body volume)/(Δ pressure) between two FLIP‐filled volumes.

Results

In controls, the median (5–95th percentile) DP was 19.8 mm (17.9–21) and esophageal body compliance was 0.37 ml/mmHg (0.18–1.1), which was greater than in EoE (DP 19 (11–21)), compliance 0.19 (0.02–0.71), p‐values <0.001. Among EoE patients, 70 (41%) had normal compliance (>0.2 ml/mmHg) and normal DP (>17 mm); 11 (6%) had normal compliance and reduced DP; 34 (20%) had reduced compliance and normal DP; and 56 (33%) had reduced compliance and reduce DP. Patients with both reduced compliance and DP had the greatest proportion of severe rings (61% with EREFS score 2–3) and stricture (100%).

Conclusion

FLIP provides an objective evaluation of biomechanical properties of the esophageal wall that appears enhanced by complementary application of metrics of DP and esophageal body compliance.
Xylan glucuronic acid side chains fix suberin‐like aliphatic compounds to wood cell walls
Authors: Derba‐Maceluch Marta , Mitra Madhusree , Hedenström Mattias , Liu Xiaokun , Gandla Madhavi L. , Barbut Félix R. , Abreu Ilka N. , Donev Evgeniy N. , Urbancsok János , Moritz Thomas , Jönsson Leif J. , Tsang Adrian , Powlowski Justin , Master Emma R. , Mellerowicz Ewa J.
Published: January 2023

Wood is the most important repository of assimilated carbon in the biosphere, in the form of large polymers (cellulose, hemicelluloses including glucuronoxylan, and lignin) that interactively form a composite, together with soluble extractives including phenolic and aliphatic compounds. Molecular interactions among these compounds are not fully understood.

We have targeted the expression of a fungal α‐glucuronidase to the wood cell wall of aspen (Populus tremulaL. × tremuloidesMichx.) and Arabidopsis (Arabidopsis thaliana(L.) Heynh), to decrease contents of the 4‐O‐methyl glucuronopyranose acid (mGlcA) substituent of xylan, to elucidate mGlcA's functions.

The enzyme affected the content of aliphatic insoluble cell wall components having composition similar to suberin, which required mGlcA for binding to cell walls. Such suberin‐like compounds have been previously identified in decayed wood, but here, we show their presence in healthy wood of both hardwood and softwood species. By contrast, γ‐ester bonds between mGlcA and lignin were insensitive to cell wall‐localized α‐glucuronidase, supporting the intracellular formation of these bonds.

These findings challenge the current view of the wood cell wall composition and reveal a novel function of mGlcA substituent of xylan in fastening of suberin‐like compounds to cell wall. They also suggest an intracellular initiation of lignin–carbohydrate complex assembly.
Landscape‐scale dynamics of a threatened species respond to local‐scale conservation management
Authors: Jones Rachel , Bourn Nigel A. D. , Maclean Ilya M. D. , Wilson Robert J.
Published: January 2023

Landscape‐scale approaches are increasingly advocated for species conservation but ensuring landscape level persistence by enlarging the size of patches or increasing their physical connectivity is often impractical. Here, we test how such barriers can be overcome by management of habitat at the local (site‐based) level, using a rare butterfly as an exemplar. We used four surveys of the entire UK distribution of the Lulworth skipper Thymelicus acteon over 40 years to test how local habitat influences population density and colonization/extinction dynamics, and parameterized, validated and applied a metapopulation model to simulate effects of varying local habitat quality on regional persistence. We found the total number of populations in four distribution snapshots between 1978 and 2017 varied between 59 and 84, and from 1997 to 2017 34% of local populations showed turnover (colonization or extinction). Population density was closely linked to vegetation characteristics indicative of management, namely height and food plant frequency, both of which changed through time. Simulating effects of habitat quality on metapopulation dynamics 40 years into the future suggests coordinated changes to two key components of quality (vegetation height and food plant frequency) would increase patch occupancy above the range observed in the past 40 years (50–80%). In contrast, deterioration of either component below threshold levels leads to metapopulation retraction to core sub‐networks of patches, or eventual extirpation. Our results indicate that changes to habitat quality can overcome constraints imposed by habitat patch area and spatial location on relative rates of colonization and local extinction, demonstrating the sensitivity of regional dynamics to targeted in situ management. Local habitat management therefore plays a key role in landscape‐scale conservation. Monitoring of population density, and the monitoring and management of local (site‐level) habitat quality, therefore represent effective and important components of conservation strategies in fragmented landscapes.
Space resource utilization of dominant species integrates abundance‐ and functional‐based processes for better predictions of plant diversity dynamics
Authors: Zhang Pengfei , Borer Elizabeth T. , Seabloom Eric W. , Soons Merel B. , Hefting Mariet M. , Kowalchuk George A. , Adler Peter B. , Chu Chengjin , Zhou Xiaolong , Brown Cynthia S. , Guo Zhi , Zhou Xianhui , Zhao Zhigang , Du Guozhen , Hautier Yann
Published: January 2023

Sustainable ecosystem management relies on our ability to predict changes in plant diversity and to understand the underlying mechanisms. Empirical evidence demonstrates that abundance‐ and functional‐based processes simultaneously explain the loss of plant diversity in response to human activities. Recently, a novel indicator based on percent cover (CoverD) and maximum height (HeightD) of the dominant plant species – space resource utilization (SRUD) – has proven to give robust and better predictions of plant diversity dynamics than community biomass. Whether the superior predictive ability of SRUD is due to its capacity to simultaneously capture abundance‐ and functional‐based processes remains unknown. Here, we tested this hypothesis by quantifying mechanistic links between changes in SRUD and biodiversity in response to nutrients and herbivores. Furthermore, we assessed the relative contribution of dominant, intermediate and rare species to reduced density of individuals by combining null model analysis with field experiments. We found that SRUD successfully captured changes in ground‐level light availability and changes in the number of individuals to predict plant diversity dynamics, and each of CoverD and HeightD partly and independently contributed to both processes. Comparative results from null model analysis and field experiments confirmed that individual losses of dominant, intermediate and rare species followed non‐random processes. Specifically, compared with random loss process, rare species lost proportionally more individuals and thus disproportionately contributed to species loss, while dominant and intermediate species lost less. Our results demonstrate that SRUD captures both abundance‐ and functional‐based processes thus explaining why SRUD provides more accurate predictions of changes in species diversity. Given that rare species can play an important role in shaping community structure, resisting against invasion, impacting higher trophic levels and providing multiple ecosystem functions, reducing the SRU of dominant species could alleviate the risk of exclusion of rare species by mitigating abundance‐ and functional‐based competition processes.
Improving safety in anesthetized patients undergoing magnetic resonance imaging—Concept of time‐out in the MRI suite and measures to improve adherence to time‐out protocol
Authors: Joselyn Anita Shirley , Teddy Dan Anna , Jose Riya , Shanthini Sharon , Joseph Lallu , Rai Ekta , Williams Aparna
Published: January 2023

Background

The time‐out protocol introduced by the Joint Commission is an important tool to prevent adverse events and improve safety in various health‐care environments. However, its implementation and utilization involve human, social, behavioral as well as system issues.

Aims

The SMART aim of the current project was to increase the utilization of the time‐out protocol to more than 80% from baseline of 13%, over 6‐month period in all the magnetic resonance imaging (MRI) procedures performed at a tertiary care, teaching institute in South India.

Methods

The Plan, Do, Study, Act (PDSA) cycle and root cause analysis strategies were utilized in this quality improvement initiative. The time‐out protocol was modified for MRI environment and put into practice to improve safety. Six months after the initiation of this safety protocol, our audit showed only a 13% compliance to the time‐out protocol. A multimodal strategy was utilized by involving all the stakeholders, educational interventions, and placing reminders for following the time‐out protocol, to affect change and achieve improvement in safety.

Results

The compliance to time‐out protocol increased from 13% to 86% and the run chart showed that a special cause variation indicated by six points above the centerline at 86%. When analyzing individual components of the time‐out, the greatest improvement was noted in the ferromagnetic check of the personnel involved, namely, the Anesthesiologist, radiographer, and anesthesia technician. There were no delays in the list because of adherence to the time‐out protocol.

Conclusion

Time‐out protocol in an MRI suite provides a final check to the anesthesia team before the anesthetized patient is wheeled into MR gantry. Using quality improvement methodology, we increased the compliance of time‐out protocol in the magnetic resonance imaging environment. Our study is an example how other institutions in India and elsewhere can adapt similar improvement strategies to enhance patient safety.
Chemokine receptors on human regulatory T cells during cutaneous leishmaniasis
Authors: Brelaz de Castro Maria Carolina Accioly , de Freitas e Silva Rafael , de Andrade Cavalcante Marton Kaique , Silva Larissa Layne Soares Bezerra , Santos dos Gomes Fabiana Oliveira , de Brito Maria Edileuza Felinto , Pereira Valéria Rêgo Alves
Published: January 2023

The aim of this work was to define the population of regulatory T cells (Tregs) which are circulating in the blood of Leishmania infected individuals clinically displaying a lesion (active disease–AD) and sub‐clinical (SC) ones. We have individually collected blood samples, processed the PBMC and stained with fluorochrome‐conjugated antibodies against CD3, CD4, Foxp3, CD25, CTLA‐4, Ki‐67, CCR4, CCR5, and CCR7. Cells were analyzed by flow cytometry. Our results suggest that CD25 and CTLA‐4 are upregulated in Tregs of AD patients when compared to SC and uninfected (UN) controls. Moreover, Tregs proliferate upon infection based on Ki‐67 nuclear antigen staining. Finally, we have observed that these Tregs of SC and AD patients upregulate CCR4, but not CCR5 and CCR7. There is an increase in the number of circulating Tregs in the blood of Leishmania infected individuals. These cells are potentially more suppressive based on the increased upregulation of CD25 and CTLA‐4 during clinical infection (AD) when compared to SC infection. Tregs of both SC and AD cohorts are proliferating and express CCR4, which potentially guide them to the skin, but do not upregulate CCR5 and CCR7.
Long‐term service agreement in electricity supply chain with renewable energy penetration
Authors: Kouvelis Panos , Matsuo Hirofumi , Xiao Yixuan , Yuan Quan
Published: January 2023

We study a long‐term service agreement (LTSA) between an original equipment manufacturer (OEM) of a conventional power generator and a utility firm in the electricity supply chain. The OEM offers the LTSA to the utility firm, which specifies the service fee and the maintenance interval. The utility firm dynamically chooses among different resources (conventional, renewable, or emergency) to meet energy demand. An LTSA contracts on a generator's long‐term production schedule (i.e., the usage time and number of starts). We first characterize that the conventional generator's optimal operating mode (i.e., on or off) follows a two‐threshold policy, which shows a hysteresis phenomenon. Then, the optimal production from different resources can be obtained by minimizing the utility firm's cost of the current period. We prove that the OEM's optimal LTSA design on the maintenance interval and service fee can be solved sequentially, and capture the trade‐off between the service margin and the usage of conventional generator. Our numerical results show that the utility firm starts the conventional generator less often as the maintenance service fee of a start increases and the minimum conventional output decreases. The OEM has incentives to reduce the minimum output to make the conventional generator more flexible, but such improvement may not benefit the utility firm. Finally, increasing renewable penetration leads to more frequent cycling of the conventional generator and less conventional output. With more renewable generation and less conventional and emergency generation, higher renewable penetration reduces the utility firm's cost, the OEM's profit, and the total emission.
Bridging the gap: Applying analytics to address gender pay inequity
Authors: Anderson David , Bjarnadóttir Margrét Vilborg , Ross David Gaddis
Published: January 2023

Employers are under increasing pressure from regulators, investors, and their own employees to address gender pay inequity in their compensation structure. However, managers tasked with measuring and closing gender and other pay gaps have few helpful quantitative tools at their disposal. We design and implement an algorithm that measures whether an employer has a pay gap and suggests salary adjustments to close it, all while supporting the employer's goals with respect to equity, culture, and incentives in its pay structure. We present our approach through a case study of one of the first firms we worked with. We also discuss the application of the approach at other organizations ranging from 75 to 130,000 employees. Our work not only provides management personnel with an accessible solution to a problem of growing social and practical importance but also demonstrates how the operations management toolkit may be applied to improve human resources management and address an important social problem.
Isolation and identification of Epicoccum nigrum as the causal agent of brown spot disease in Solanum tuberosum in China
Authors: Jin Mengjun , Yang Chengde , Wang Yidan , Wei Lijuan , Osei Richard
Published: January 2023

Brown spots occurring on potato leaves affect the normal growth of host plants. Recently, a new brown spot disease with some black dots was discovered on potato leaves in Dingxi, China. To confirm the causal agents of potato brown spots, the diseased lesions were collected and disinfected, and only one type of isolate, with football‐shaped conidia, was obtained from disinfected diseased leaves in three experimental fields. Pathogenicity tests of four representative isolates revealed that they can cause disease symptoms on 50%–75% of wounded and non‐wounded potato leaves. In addition, a typical isolate, DXPH, was identified based on morphological and molecular characteristics, and the colony and conidial characteristics were similar to those of Epicoccum sp. Multilocus sequence analysis showed that the internal transcribed spacer (ITS), RNA polymerase II second largest subunit (RPB2) and β‐tubulin (Tub2) genes of DXPH were 100%, 100% and 99% identical to the sequences of Epicoccum nigrum (CBS 140523), respectively. Additionally, antagonistic evaluation confirmed that the representative pathogenic strain DXPH showed greatest inhibition of the mycelial growth of Colletotrichum coccodes and Fusarium chlamydosporum in vitro, with antagonistic effects of 66.67% and 61.56%, respectively. Our findings provide evidence that E. nigrum can be pathogenic to potatoes in vivo in China, while retaining a biocontrol capacity on C. coccodes, Fusarium spp. and Botrytis cinerea in vitro, which will be helpful for the effective control of potato brown spot disease and management of the use of E. nigrum as a biological control agent.
Is Colour incompatibility analytic?
Authors: Knowles William Bondi
Published: January 2023

It is widely believed that some a priori necessary truths are not analytic in the sense of transformable by substitution of synonyms into logical truths. One much‐cited example comes from the supposed incompatibility between colour predicates. The idea is that sentences like “Nothing is both blue all over (or uniformly or at a point) and also red” are not transformable into a logical truth in the same way as “Nothing is both a bachelor and married” because the requisite conceptual link between “bachelor” and “not married” is absent between “blue” and “not red”. This paper examines whether colour exclusion may be more like the bachelor case than it initially appears. It transpires that the most promising line of thought is not, however, as has been argued at length in the literature, that “blue” in some more or less convoluted way manages to mean “not red”. Instead it is suggested that the requisite conceptual link may reside in the oft‐ignored qualifications (“all over”, “uniformly”, etc.), without which there is no incompatibility in the first place.
Reply: A response to the study by Hyldgaard et al.
Authors: Hyldgaard Charlotte , Bendstrup Elisabeth , Kreuter Michael
Published: January 2023

See related Letter
A response to the study by Hyldgaard et al.
Authors: Shiroshita Akihiro , Rebeiro Peter F.
Published: January 2023

See related Reply
Education as social policy: New tensions in maturing knowledge economies
Authors: Carstensen Martin B. , Emmenegger Patrick
Published: January 2023

Education has long played an important role in social policy as a means for strengthening labour market integration and increasing social mobility. The shift towards a knowledge economy has placed education policy even more centrally in efforts to provide the institutional preconditions for making economic efficiency compatible with social inclusion. To provide conceptual and theoretical context to the special issue, this paper first explores the key tension in the role of education in modern economies between serving concerns for efficiency and inclusion. Second, it argues that it remains possible for education policy to balance between efficiency and inclusion, but that the capacity of advanced economies to do so is politically mediated. Finally, the paper reviews the four main arenas in which such mediation processes take place—the parliamentary arena, the corporatist arena, the state, and public opinion—and how the contributions to the special issue study these.
Grass xylan structural variation suggests functional specialization and distinctive interaction with cellulose and lignin
Authors: Tryfona Theodora , Bourdon Matthieu , Delgado Marques Rita , Busse‐Wicher Marta , Vilaplana Francisco , Stott Katherine , Dupree Paul
Published: January 2023

Xylan is the most abundant non‐cellulosic polysaccharide in grass cell walls, and it has important structural roles. The name glucuronoarabinoxylan (GAX) is used to describe this variable hemicellulose. It has a linear backbone of β‐1,4‐xylose (Xyl) residues that may be substituted with α‐1,2‐linked (4‐O‐methyl)‐glucuronic acid (GlcA), α‐1,3‐linked arabinofuranose (Araf), and sometimes acetylation at the O‐2 and/or O‐3 positions. The role of these substitutions remains unclear, although there is increasing evidence that they affect the way xylan interacts with other cell wall components, particularly cellulose and lignin. Here, we used substitution‐dependent endo‐xylanase enzymes to investigate the variability of xylan substitution in grass culm cell walls. We show that there are at least three different types of xylan: (i) an arabinoxylan with evenly distributed Araf substitutions without GlcA (AXe); (ii) a glucuronoarabinoxylan with clustered GlcA modifications (GAXc); and (iii) a highly substituted glucuronoarabinoxylan (hsGAX). Immunolocalization of AXe and GAXc in Brachypodium distachyon culms revealed that these xylan types are not restricted to a few cell types but are instead widely detected in Brachypodium cell walls. We hypothesize that there are functionally specialized xylan types within the grass cell wall. The even substitutions of AXe may permit folding and binding on the surface of cellulose fibrils, whereas the more complex substitutions of the other xylans may support a role in the matrix and interaction with other cell wall components.
Leaf anatomy does not explain the large variability of mesophyll conductance across C3 crop species
Authors: Xiong Dongliang
Published: January 2023

Increasing mesophyll conductance of CO2 (gm) is a strategy to improve photosynthesis in C3 crops. However, the relative importance of different anatomical traits in determining gm in crops is unclear. Mesophyll conductance measurements were performed on 10 crops using the online carbon isotope discrimination method and the ‘variable J’ method in parallel. The influences of crucial leaf anatomical traits on gm were evaluated using a one‐dimensional anatomical CO2 diffusion model. The gm values measured using two independent methods were compatible, although significant differences were observed in their absolute values. Quantitative analysis showed that cell wall thickness and chloroplast stroma thickness are the most important elements along the diffusion pathway. Unexpectedly, the large variability of gm across crops was not associated with any investigated leaf anatomical traits except chloroplast thickness. The gm values estimated using the anatomical model differed remarkably from the values measured in vivo in most species. However, when the species‐specific effective porosity of the cell wall and the species‐specific facilitation effect of CO2 diffusion across the membrane and chloroplast stoma were taken into account, the model could output gm values very similar to those measured in vivo. These results indicate that gm variation across crops is probably also driven by the effective porosity of the cell wall and effects of facilitation of CO2 transport across the membrane and chloroplast stroma in addition to the thicknesses of the elements.
Feminist Sensory Ethnography
Authors: Guzman Elena H. , Hong Emily
Published: January 2023

In this article, we call for a feminist sensory ethnography that centers relations of care, subjectivity, and power between filmmakers, film "subjects," and audiences. Through in‐depth discussion of two films, Smile4Kime (Guzman 2023) and Nobel Nok Dah (Hong, Lai, and Mihai 2015) we explore three techniques of feminist sensory ethnography—a multisensorial theory of the flesh, sensory accompaniment, and narrative intimacy—that draw on feminist and non‐Western genealogies of sensory knowledge production. We see this move away from observational filmmaking as a “politic of necessity” (Moraga and Anzaldúa 2015) through which the sensory is imbued with embodied knowledge.
Can volume‐reduced plasma products prevent transfusion‐associated circulatory overload in a two‐hit animal model?
Authors: Bulle Esther B. , Klanderman Robert B. , de Wissel Marit B. , Roelofs Joris J. T. H. , Veelo Denise P. , van den Brom Charissa E. , Kapur Rick , Vlaar Alexander P. J.
Published: January 2023

Background and Objectives

Transfusion‐associated circulatory overload (TACO) is a pulmonary transfusion complication and a leading cause of transfusion‐related morbidity and mortality. Volume overload and rising hydrostatic pressure as a consequence of transfusion are seen as the central pathway leading to TACO. A possible preventative measure for TACO could be the use of low‐volume blood products like volume‐reduced lyophilized plasma. We hypothesize that volume‐reduced lyophilized plasma decreases circulatory overload leading to a reduced pulmonary capillary pressure and can therefore be an effective strategy to prevent TACO.

Materials and Methods

A validated two‐hit animal model in rats with heart failure was used. Animals were randomized to receive 4 units of either solvent‐detergent pooled plasma (SDP) as control, standard volume lyophilized plasma (LP‐S) or hyperoncotic volume‐reduced lyophilized plasma (LP‐VR). The primary outcome was the difference between pre‐transfusion and post‐transfusion left ventricular end‐diastolic pressure (ΔLVEDP). Secondary outcomes included markers for acute lung injury.

Results

LVEDP increased in all randomization groups following transfusion. The greatest elevation was seen in the group receiving LP‐VR (+11.9 mmHg [5.9–15.6]), but there were no significant differences when compared to groups receiving either LP‐S (+6.3 mmHg [2.9–13.4], p = 0.29) or SDP (+7.7 mmHg [4.5–10.5], p = 0.55). There were no significant differences in markers for acute lung injury, such as pulmonary wet/dry weight ratios, lung histopathology scores or PaO2/FiO2 ratio between the three groups.

Conclusion

Transfusion with hyperoncotic volume‐reduced plasma did not attenuate circulatory overload compared to standard volume plasma and was therefore not an effective preventative strategy for TACO in this rat model.