bluuebunny/crossref_metadata_2025 huggingface dataset:
Quantifying Cross-Shelf Transport in the East Australian Current System: A Budget-Based Approach
Authors: Malan Neil , Roughan Moninya , Stanley Geoffrey J. , Holmes Ryan , Li Junde
Published: July 2022

Cross-shelf transport plays an important role in the heat, salt, and nutrient budgets of the continental shelf. In this study, we quantify cross-shelf volume transport and explore its dynamics within a high-resolution (2.5–6 km) regional ocean model of the East Australian Current (EAC) System, a western boundary current with a high level of mesoscale eddy activity. We find that the largest time-mean cross-shelf flows (>4 Sv per 100 km; 1 Sv ≡ 106 m3 s−1) occur inshore of the coherent western boundary current, between 26° and 30°S, while the strongest time-varying flows occur in the EAC southern extension, poleward of 32°S, associated with mesoscale eddies. Using a novel diagnostic equation derived from the momentum budget we show that the cross-shelf transport is dominated by the baroclinic and geostrophic component of the velocities, as the EAC jet is relatively free to flow over the variable shelfbreak topography. However, topographic interactions are also important and act through the bottom pressure torque term as a secondary driver of cross-shelf transport. The importance of topographic interaction also increases in shallower water inshore of the coherent jet. Downstream of separation, cross-shelf transport is more time-varying and associated with the interaction of mesoscale eddies with the shelf. The identification of the change in nature and drivers of cross-shelf transport in eddy versus jet dominated regimes may be applicable to understanding cross-shelf transport dynamics in other boundary current systems.

Significance Statement

Cross-shelf transport, i.e., the movement of water from the open ocean on or off the continental shelf, is not reported often as it is difficult to measure and model. We demonstrate a simple but effective method to do this and, using an ocean model, apply it to the East Australian Current System and show what drives it. The results show two distinct regimes, which differ depending on which part of the current system you are in. Our results help to place observations of cross-shelf transport in better context and provide a framework within which to consider the transport of other things such as heat and carbon from the open ocean to the continental shelf.
Crescent-Shaped Low-Temperature Distribution along the Convex Topography in the Southeastern Edge of Taiwan Bank in Summer
Authors: Lee Hung-Jen , Lee Ming-An , Ho Chia-Ying , Hsu Po-Chun , Wang Yi-Chen
Published: July 2022

Various physical mechanisms of ocean upwelling usually occur near or along coastal regions worldwide. Five upwelling zones of unequal intensity are found around the Taiwan Strait, and the Taiwan Bank (TB) upwelling zone has the most prominent characteristics of low temperature. In this study, satellite images, shipboard ADCPs (acoustic Doppler current profilers), and CTDs (conductivity–temperature–depth measures) were analyzed to investigate the processes of cold water upwelling around the TB shoaling zone. In addition, the MITgcm numerical model and the flexible cubic spline technique were also employed, allowing us to better understand those processes. The model results suggested that a combination of Ekman transport and the centrifugal force, driven by the geostrophic South China Sea Warm Current (SCSWC), constitutes a physical mechanism to contribute the vigorous upwelling in the TB shoal zone. The upwelling is largely driven by Ekman transport. However, the centrifugal force may explain why the upwelling with a crescent-shaped distribution of low temperatures along the convex topography of the southeastern edge of the TB shoaling zone is more prominent than expected, as it tends toward the so-called gradient wind balance. Sudden relaxation of the friction force occurred because of the very sharp shelf break (20–60 m) and steep slope topography; a discontinuous velocity zone around the shelf break could also lead to vigorous cold water upwelling.

Significance Statement

Extensive data concerning the Taiwan Bank (TB) shoaling zone have been collected in the past decade in an attempt to improve understanding of the process of cold water upwelling in the area. Because the Kuroshio invades the South China Sea from the east, and the South China Sea Warm Current flows northeastward around the southeastern edge of the TB, water circulation in and around the sandbar is very complicated. Thus, we expanded our model range from small to large scale to avoid the open boundary settings of small-scale model (including the temperature and salinity fields, wind stress, and the model driving forces), which were not easy to set up. Thus, we used a large-scale, high-resolution circulation model to study a small-scale ocean region. Physical processes of this upwelling can finally be verified in the small-scale region. To compensate for the insufficient resolution of the large-scale numerical model, our strategy was to utilize the flexible cubic spline technique to resolve the curvature of the markedly meandering currents. In light of scale analysis, the results showed that in addition to the critical contribution of Ekman transport to the upwelling, the effects of centrifugal forces on upwelling in the TB shoal zone need to be considered.
Diagnostics of Tropical Variability for Numerical Weather Forecasts
Authors: Gehne Maria , Wolding Brandon , Dias Juliana , Kiladis George N.
Published: July 2022

Tropical precipitation and circulation are often coupled and span a vast spectrum of scales from a few to several thousands of kilometers and from hours to weeks. Current operational numerical weather prediction (NWP) models struggle with representing the full range of scales of tropical phenomena. Synoptic to planetary scales are of particular importance because improved skill in the representation of tropical larger-scale features such as convectively coupled equatorial waves (CCEWs) has the potential to reduce forecast error propagation from the tropics to the midlatitudes. Here we introduce diagnostics from a recently developed tropical variability diagnostics toolbox, where we focus on two recent versions of NOAA’s Unified Forecast System (UFS): operational GFSv15 forecasts and experimental GFSv16 forecasts from April to October 2020. The diagnostics include space–time coherence spectra to identify preferred scales of coupling between circulation and precipitation, pattern correlations of Hovmöller diagrams to assess model skill in zonal propagation of precipitating features, CCEW skill assessment, plus a diagnostic aimed at evaluating moisture–convection coupling in the tropics. Results show that the GFSv16 forecasts are slightly more realistic than GFSv15 in their coherence between precipitation and model dynamics at synoptic to planetary scales, with modest improvements in moisture convection coupling. However, this slightly improved performance does not necessarily translate to improvements in traditional precipitation skill scores. The results highlight the utility of these diagnostics in the pursuit of better understanding of NWP model performance in the tropics, while also demonstrating the challenges in translating model advancements into improved skill.
Impact of Increased Enoxaparin Dosing on Anti-Xa Levels for Venous Thromboembolism Prophylaxis in Trauma Patients
Authors: Bellfi Lillian T. , Zimmerman S. Anthony , Boudreau Ryan , Mosier Willard , Smith Alison , Rueb Nicole , Hunt John P. , Stuke Lance , Greiffenstein Patrick , Schoen Jonathan , Marr Alan
Published: July 2022

Introduction

Venous thromboembolism (VTE) contributes to significant morbidity in trauma patients while increasing hospital costs and length of stay. Standard trauma prophylaxis dosing with enoxaparin 30 mg twice daily may be inadequate to prevent VTEs. The objective of this study was to compare standard dosing of enoxaparin to an increased dose of enoxaparin 40 mg twice daily for trauma patients. We hypothesized that increasing thromboprophylaxis dosing leads to an increase in therapeutic anti-Xa levels and reduced VTE rates.

Methods

A retrospective study was performed from January 2020 to June 2021 at a Level I trauma center, following implementation of an increased enoxaparin dosing strategy. Patients with increased enoxaparin dosing were compared with those who received standard dosing. The primary outcome evaluated was the incidence of subtherapeutic anti-Xa levels. Secondary outcomes evaluated VTE rates and clinically significant bleed.

Results

A total of 204 trauma patients were identified. Ninety-one patients received an increased enoxaparin dose compared to 113 who received standard dosing. The baseline demographics of both groups were similar ( P > .05). Subtherapeutic levels were higher with standard dosing compared to the increased dose (50 vs 22%, P = .003). Higher VTE rates were observed with standard dosing compared to higher dosing (6.2 vs 3.3%) but with a lower incidence of major bleed (1.8 vs 4.4%). Overall annual VTE rates decreased from 1.6 to 1.3% after implementation of the increased dosing regimen.

Conclusions

This study demonstrated that an increased dosing strategy decreased rates of subtherapeutic anti-Xa levels and trended toward lower overall VTE rates in trauma.
Transforming paradise: Neoliberal regeneration and more-than-human urbanism in Birmingham
Authors: Oliver Catherine
Published: July 2022

In Birmingham, a badger visits me each evening outside my front door. Five years later, a fox meets me on a city street at 5 am. Two years after that, walking along the city’s canals, my eyes lock with a heron’s. A year later, a eucalyptus tree becomes my shade and respite in a disturbed city. Months later, as I get ready to leave the city, I encounter a group of parakeets. In this paper, I ask how these seemingly disparate encounters and relationships are intimately connected as part of Birmingham’s urban ecologies and larger stories of urban regeneration – and its consequences for thriving and precarious life in the city. I argue that the tension between thriving and precarity in Birmingham (and cities like it) results from new exertions of control whilst urban dwellers establish new forms of more-than-human urban cohabitation. The stories in this paper, relating to different non-human lives caught up in Birmingham’s transformation into a neoliberal city, demonstrate that serious consideration of more-than-human theory and experience is essential to the future of urban studies scholarship.
King in the North: evaluating the status recognition and performance of the Scandinavian countries
Authors: Røren Pål , Wivel Anders
Published: July 2022

The Scandinavian states’ pursuit of status in world politics is well documented. However, little is known about whether these endeavors have resulted in higher status for these states. In this article, we suggest that the Scandinavian countries represent a useful case to explore whether similar foreign policy profiles and common club membership equalizes or exacerbates the unequal distribution of status recognition in world politics. To measure the status recognition of Sweden, Denmark, and Norway, we use a network centrality measure of diplomatic representation and exchange from 1970 to 2010. We also measure how well the states have performed to increase their status recognition given their available status resources (measured by military capabilities and wealth) and their status-seeking effort (measured by relative diplomatic outreach). Our results show that Sweden has received significantly more recognition and performed much better than both Denmark and Norway in the measured period. We offer three explanations for these developments. First, the spoils of seeking status using the Scandinavian brand is akin to a regional zero-sum game in which Sweden, as the most visible state of the three, is the main beneficiary of the status recognition in the direction of the club. Second, status recognition often lags achievements or increases in status resources because the beliefs of foreign policy practitioners are only updated sporadically. This status lag is especially visible when states struggle to convert their resources into status (Norway), or when they succeed in maintaining their status despite experiencing a drop in status resources (Sweden). Third, an increase in status resources will only influence status recognition if it plays into a corresponding narrative. Sweden, in contrast to the nouveau riche Norwegians, has managed to rearticulate its foreign policy in a way that has attracted recognition in world politics.
Health Inequalities in Older Norwegians and the Mediating Role of Social Networks
Authors: Adhikari Nabaraj , Uddin Shahad
Published: July 2022

This study aims to contribute to understanding how social networks serve as an intervening pathway leading to socioeconomic health inequality among older adults in Norway. Longitudinal survey data from the second and the third waves of the Norwegian Life Course, Ageing, and Generation Study were used in this paper. Hayes PROCESS was used to estimate the mediating effect of the contact frequency and the support potential of friends on the impact of social-economic position (SEP) at wave 2 on health outcomes at wave 3. The total indirect effect of the income on physical health observed was 0.04. The total indirect effect of the highest level of education attained on physical health observed was 0.12. The result showed a social-economic gradient in health among older adults in Norway where the social network is a crucial pathway via which SEP influences peoples’ health.
Does Taxing TNC Trips Discourage Solo Riders and Increase the Demand for Ride Pooling? A Case Study of Chicago Using Interrupted Time Series and Bayesian Hierarchical Modeling
Authors: Abkarian Hoseb , Hegde Sharika , Mahmassani Hani S
Published: July 2022

This paper studies the tax intervention applied to transportation network company (TNC) trips starting on January 6, 2020 in the City of Chicago. An interrupted time series (ITS) with an autoregressive integrated moving average (ARIMA) methodology is employed to infer the causal impact of the intervention on the percentage of shared trips and the counts of shared and private trips. Analysis is conducted at a community area level, either as pickup or drop-off. The results show a significant but small increase in the share of shared trips as well as the count of shared trips, specifically on weekends because of the intervention. Private trips, on the other hand, are found to have decreased on the weekdays, but potentially increased on the weekends. A Bayesian hierarchical model is then employed to combine information across community areas, examine a posteriori if there are significant spatial differences, and estimate the common treatment effect. The analysis suggests minimal spatial differences across community areas. The common treatment effect on weekdays ($1.75 tax difference) is a 3.78 percentage point increase in the share of shared trips, a 27% increase in the count of shared trips, and a 12% decrease in the count of private trips (at an approximate base of 10% market share of shared trips). Thus, the intervention likely shifted demand toward pooled rides, reducing congestion caused by TNCs. However, there is little evidence that this shift is sufficient to offset or reverse the systematic trend of declining use of shared rides.
Demographic Transition and the Industrial Revolution in England: Inverse Rural and Urban Processes
Authors: Friedlander Dov , S. Okun Barbara
Published: July 2022

We present a model of 19th Century population change in England & Wales. The model highlights contrasting demographic and economic processes in rural and urban sectors as core explanations for rural to urban migration, stemming from labor surpluses in the former and labor shortages in the latter. This massive migration transformed the geographic distribution of the population, in tandem with the economic transformation caused by the Industrial Revolution. We argue that demographic literature on historical population processes in England & Wales in the 19th Century has paid insufficient attention to the role of internal migration.
Optimal single-arm two-stage designs with consideration of dependency on efficacy and safety
Authors: Yin Huan , Wang Weizhen , Zhang Zhongzhan
Published: July 2022

In phase II clinical trials on cancer, it is of great interest to establish the efficacy and safety of a new treatment simultaneously. Existing hypotheses may not achieve this goal effectively. We introduce two new sets of hypotheses that consider the association between the two factors, then construct the optimal two-stage designs for the hypotheses. The proposed designs strictly control the maximum type I error rate at the given nominal level [Formula: see text], maintain the minimum power at least the given [Formula: see text], and have the smallest expected total sample size under the null hypothesis. Furthermore, an algorithm is provided to compute these designs. R-codes are given in the Supplemental Material.
Digital Transformation Taking Centre Stage: How Is Digital Transformation Reshaping Entrepreneurial Innovation?
Authors: Mukesh Hasirumane Venkatesh
Published: July 2022

The digital transformation has a profound implication for entrepreneurial innovation. In contrast, scholarly attention is mainly towards entre­preneurial innovation in pure digital businesses at the organisational and individual levels. However, our understanding of its implication at a higher level of aggregation, like the regional and national levels, is limited. Drawing on the national systems of innovation, I conceptualise digital transformation as changes in digital institutional and digitally relevant individual factors and examine its implication for digital business model innovation and entrepreneurial innovation at the country level. Using fuzzy-set qualitative comparative analysis for a sample of 55 countries, I explore the causal configurations explaining the implication of digital transformation. The result indicates that digital transformation fuels digital business model innovation in specific and entrepreneurial innovation in general at the country level. This study contributes to understanding the broader implication of digital transformation and extends the boundary condition of the national systems of innovation in the digital context.
Determinants and Consequences of Customer Satisfaction in Indian Retail Banks: Moderation of Bank Reputation
Authors: Biswas Abhijeet , Jaiswal Deepak , Kant Rishi
Published: July 2022

The entry of private sector banks in the Indian market has compelled all the banks to determine the drivers of customer satisfaction (CS). This research aims to assess the drivers of CS and its implications in the Indian retail banking (IRB) sector. The top six Indian private sector banks were chosen according to market capitalization. A standardized questionnaire was used to gather responses from IRB customers and then evaluated using structural equation modelling (SEM). Five factors of CS are identified in the study, viz. effective complaint handling (ECH), service convenience (SC), perceived fairness (PF), perceived market performance (PMP) and relationship commitment (RC). The results unveil that SC and RC have a strong positive influence on CS, which further augments customer word of mouth (WoM) and repurchase intention (RI). In addition, bank reputation (BR) moderates the model’s relationship between CS and its consequences. Considering only private sector banks may limit the generalization of findings to a certain extent. The study presents vital enablers that escalate CS and might help bank professionals to identify thrust areas. There is a shortage of research on ‘BR’ and ‘RC’ in India’s context of the banking sector. Therefore, the research adds to the current literature by including the components mentioned above and other essential determinants and consequences. Furthermore, the study accentuates the complexities of relationships among the determinants and consequences of CS through a meticulous conceptual model of an IRB sector.
Enabling Comparability of Responses in International Sales Force Surveys: Evidence from a Cross-National Survey of Salespeople and Sales Managers
Authors: Pourmasoudi Mohsen , Wiseman Phillip , Ahearne Michael , Hall Zachary
Published: July 2022

This research addresses a challenge within cross-national surveys of salespeople and sales managers: systematic differences between respondents from different countries in their interpretation of response categories associated with survey items measuring a construct of interest. As a result of these discrepancies in interpretation, analyses based on uncorrected survey responses may yield misleading results. The authors mathematically demonstrate the issue and then, drawing on the literature in education and political science, demonstrate a potential solution, the use of anchoring vignettes, which possesses substantial appeal in contexts where a researcher is interested in comparing construct means across contexts where intergroup differences would otherwise make such comparisons problematic. The authors use the proposed method on data from a cross-national survey of 1,051 salespeople and 163 sales managers across three countries (Brazil, Japan, and the United Kingdom) to evaluate self-assessments and upward assessments of a sales manager's drive. The findings highlight the importance of correcting for systematic differences in survey responses driven by cross-national differences, especially when the goal is to compare construct means. Further, the authors demonstrate the value of anchoring vignettes concerning several analytical goals relevant to academics and practitioners.
Numerical modeling of residual stresses in additive manufacturing products using the theory of repeatedly superimposed finite strains
Authors: Levin Vladimir A , Zingerman Konstantin M , Vershinin Anatoly V , Konovalov Dmitry A
Published: July 2022

An approach to the residual stress analysis of parts made by powder bed additive manufacturing is proposed. The approach is based on the theory of repeatedly superimposed finite strains. The problem statement is formulated within the framework of nonlinear thermoelasticity. The method of problem solving is developed on the base of finite and spectral element methods. The numerical modeling of a full-sized experiment is performed. In this experiment, the additive manufactured part is notched in order to estimate residual stresses in it. The obtained numerical results are in good agreement with the experimental results. It is concluded from the results that the developed approach is correct and the nonlinear effects are substantial.
Sex-specific differences in 30-day outcomes following primary total hip replacement in 86,684 patients
Authors: Chaudhry Harman , Ekhtiari Seper , Ravi Bheeshma , Wadey Veronica , Tomescu Sebastian , Murnaghan John , Mundi Raman
Published: July 2022

Introduction:

Although differential outcomes based on sex are widespread in medicine and surgery, evaluation of sex-specific differences in the field of orthopaedic surgery in general – and arthroplasty in particular – are lacking. We hypothesised that morbidly obese male and female patients would have differing risks of surgical complications following primary total hip replacement.

Methods:

We reviewed data contained within the American College of Surgeons National Quality Improvement Program (ACS-NSQIP) database from 2015 through 2018, inclusive. A multivariable binary logistic regression model was used to determine the adjusted odds ratios (OR) of relevant variables on primary and secondary outcomes.

Results:

A total of 86,684 patients undergoing THR were identified, of whom 9972 patients (4095 male and 5877 female) were morbidly obese. Among morbidly obese patients, odds of surgical site infection were higher in females than males within 30 days of surgery (adjusted OR 1.40; 95% CI, 1.10–1.79; p = 0.007). This comprised the odds of both superficial infection (1.8% vs. 1.1%, adjusted OR 1.67; 95% CI, 1.16–2.40; p = 0.006) and deep infection (1.9% vs. 1.4%, adjusted OR 1.22; 95% CI, 0.88–1.68; p = 0.24). Unexpected return to the operating room (i.e., reoperation) within 30 days of the surgical procedure was also higher among females than males (4.2% vs. 3.1%, adjusted OR 1.38, 95% CI, 1.10–1.71, p = 0.005). There were no differences between male and female patients in the non-obese cohort.

Conclusions:

Among patients with morbid obesity, the risk of surgical site infection and reoperation within the first 30 days is greater in women as compared to men. Future research must address whether this early increased risk among morbidly obese women persists in the longer term, and whether it results in compromised function or quality of life.
The psychological impact on perioperative healthcare workers during Victoria’s second COVID-19 wave: A prospective longitudinal thematic analysis
Authors: Ku Michelle , Ng Irene , Barson Elizabeth , Fisher Caroline , Segal Reny , Williams Daryl Lindsay , Krieser Roni Benjamin , Mezzavia Paul Mario , Lee Keat , Chen Yinwei , Sindoni Teresa , Withiel Toni
Published: July 2022

The COVID-19 pandemic has had a profound psychological impact on our frontline healthcare workers. Throughout the entire second COVID-19 wave at one major tertiary hospital in Melbourne Australia, longitudinal qualitative data between perioperative staff members, and analyses of intrapersonal changes were reported. Inductive analysis of three open-ended questions generated four major themes: Organisational Response to the Pandemic, Psychological Impact, Changes in Feelings of Support Over Time and Suggestions for Changes. Understanding the challenges, perception and suggestions from this longitudinal study allows us to provide a range of support services and interventions to minimise the long-term negative psychological impact and be better prepared should another similar situation arises again.
The Influence of Dementia Beliefs and Knowledge on Perceived Dementia Worry: An Empirical Study Among Adults in Rural China
Authors: Liu Meng , Sun Fei , Lu Chuntian , Xie Jinchen
Published: July 2022

Alzheimer’s disease and related dementias are more prevalent in rural areas than in urban areas in China. This study aims to examine the role of dementia beliefs and knowledge in influencing dementia worry among rural adults in China. Data were generated in a cross-sectional survey of 577 participants. Hierarchical regression analyses found that both the beliefs and knowledge of dementia contributed to higher levels of dementia worry. The propensity score matching method affirmed the robustness of regression results. In addition, those aged 45-64 reported higher worry about dementia than those aged 65 or older, while being married was related to lower dementia worry. As one of the first kind studies that examined dementia worry in rural Chinese population, our findings suggest that policy and practice efforts should address cultural beliefs of dementia as they contributed to higher worry about dementia in rural areas.
Transradial access for cerebral angiography and neurointerventional procedures: A meta-analysis and systematic review
Authors: Rentiya Zubir S. , Kuhn Anna Luisa , Hutnik Robert , Shazeeb Mohammed Salman , De Leacy Reade A. , Goldman Daryl , Singh Jasmeet , Puri Ajit S.
Published: July 2022

Purpose:

Transradial access (TRA) for diagnostic and interventional neurointerventional procedures has recently gained traction over transfemoral access (TFA) in the neurointerventional community. This meta-analysis aims to assess and summarize the utility of TRA in cerebral angiography and neurointerventional procedures.

Methods:

A systematic literature review was performed utilizing Pubmed, Embase, and Scopus databases. Using PRISMA guidelines, records were extracted with the following search terms: transradial approach, transradial access, radial access, cerebral angiogram, cerebral angiography, neurointervention, and neuroendovascular. The primary outcomes assessed were case success rate, complication rate, and crossover rate from TRA to TFA. Secondary analysis was performed on procedure time, fluoroscopy time, fluoroscopy time per vessel (diagnostic procedures only), contrast dose, radial artery diameter, distal radial artery diameter, and patient preference for TRA over TFA.

Results:

Sixty-two full-text articles were analyzed for this meta-analysis, representing 12,927 diagnostic and interventional TRA access patients. Our analysis revealed a combined diagnostic and interventional case success rate of 95.9% and complication rate of 3.5%, with crossover to TFA occurring in 4.9% of cases.

Conclusion:

This meta-analysis demonstrates that TRA access for diagnostic angiography and neurointerventional procedures is a safe and effective approach, though determining a true complication rate is challenging as the definition of TRA complications has changed in various publications over time.
Extensive exploration of the conformational landscapes of neutral and terminally blocked prolines in the gas phase: A density functional theory study
Authors: Yang Yizhou , Lin Zijing
Published: July 2022

Proline is an important amino acid that plays unique roles in the structures of peptides and proteins. The conformations of proline are searched by a thorough method, generating 3888 trial structures optimized at the B97D/6-311++G** level. A total of 23 conformations are found and their structural and energetic data are presented. All the proline conformers exhibit a coplanar feature for four of the five pyrrolidine ring atoms. The coplanar rule reduces the cost of the conformational search by a factor of 40. The theoretical composition-weighted infrared spectrum provides a good explanation of the experimental results. A conformational search of capped proline yields seven unique conformers, all with trans C-termini peptide planes. The trans C-termini rule further cuts by half the cost of the conformational search of proline-containing peptides. The theoretical composition of the cis N-termini peptide bonds at room temperature is 5.5%, agreeing with the experimental estimations of 3%–10%.
Motherhood and Child Healthcare Experiences Among a Unique PVTG of West Bengal, India: A Case of Tradition, Transition and Transformation for the Sake of Existence
Authors: Tarafdar Pinak
Published: July 2022

All over the world and, moreover, in the developing countries like India, women experience threats to their lives, health and well-being are also overburdened with work and lack power and influence; further, the situation is vulnerable among the marginalized segment. A unique PVTG of the northern part of West Bengal is struggling for its very existence through the life experiences of motherhood and childcare practices. It is noticed that most often they follow the age-old traditions while not completely unaware of the modern biomedical procedures. The lack of accessibility makes them less confident towards the latter. A typical state of transition is evident, although their conceptions regarding the pregnancy, delivery and childcare practices are not significantly hyper-medicalized. Rather a continuous existence of humanization of birth process is being practised. The article explores the conspicuous women participation and significant roles in the entire health-seeking behaviour in connection to pregnancy, childbirth and related health care issues. Furthermore, the entire discourse also elucidates the state of motherhood and its intrinsic decision-making behaviour in order to retain the economic viability of the population.
‘You can’t un-see what you’ve seen’: An ex-prison officer's autoethnographic account of suicide and self-harm in a UK male adult prison
Authors: Nixon Sarah
Published: July 2022

Internationally, prisons are challenging environments for officers and prisoners, and suicide and self-harm have ramifications for both parties. Suicide and self-harm in prison far exceed prevalence in the general population and officers experience many psychological and emotional impacts including distress, bereavement, guilt, shame, accountability, desensitisation and PTSD. This article explores relational and institutional dynamics and cultural expectations placed upon officers when dealing with suicide/self-harm. Prison officer culture can be limited in supporting officers around trauma and it can be perceived as stigmatising and a weakness to seek help. This article explores a former prison officer's experience of dealing with trauma around self-harm and suicide including the first experience of suicide, moral conflict and the impact of losing a colleague to suicide. I worked as a prison officer at a category ‘B’ local prison in the (UK) between 2003 and 2009 and kept a reflective journal during service. Drawing upon Autoethnography (AE), I seek to explore the lived experience of trauma from an ‘insider perspective’ using prison research to interpret retrospective accounts. Concepts around emotional labour, occupational morality and prison officer occupational culture/ socialisation are used to highlight the complexities of prison officer work around suicide/self-harm. The prison service (UK) needs to reduce stigma in officers who need help and support around mental health and coping with trauma, with strategies like peer support programmes, regular supervision/mandatory counselling and extensive debriefs to support officers in the aftermath of traumatic critical incidents.
Designing togetherness: Mediating digital social touch through footwear
Authors: Cohrt Emilie B.
Published: July 2022

This article investigates the significance of digital social touch in creating and maintaining our relationships to intimate others. It presents ‘Project Re:Connect’ – a speculative design project centred around mediating digital social touch through footwear. The primary objective of the project was to use diegetic props to instigate debate and deliberate decision making regarding the design futures of technologically mediated communication.
Flavaspidic acid BB combined with mupirocin improves its anti-bacterial and anti-biofilm activities against Staphylococcus epidermidis
Authors: Cai Zhiling , Mo Zitong , Zheng Shiqian , Lan Shihua , Xie Shengjun , Lu Jinghui , Tang Chunping , Shen Zhibin
Published: July 2022

Background

The increase in drug-resistant opportunistic pathogenic bacteria, especially of antibiotic-resistant Staphylococcus epidermidis (S. epidermidis), has led to difficulties in the treatment of skin and soft tissue infections (SSTI). The major reason for bacterial resistance is the formation of bacterial biofilm. Here, we report a promising combination therapy of flavaspidic acid BB (BB) and mupirocin, which can effectively eradicate the biofilm of S. epidermidis and eliminate its drug resistance.

Result

The susceptibility test showed that the combination of BB and mupirocin has good antibacterial and antibiofilm activities, and the fractional inhibitory concentration index (FICI) of BB combined with mupirocin was 0.51 ± 0.00 ~ 0.75 ± 0.05, showing synergistic effect. Moreover, the time-kill curve assay results indicated that the combination of drugs can effectively inhibit the planktonic S. epidermidis. After drugs treatment, the drug-combination showed significantly inhibitory effects on the metabolic activity and total biomass in each stage of biofilm formation. The synergistic effect is likely related to the adhesion between bacteria, which is confirmed by field emission scanning electron microscope. And the expression level of aap, sarA and agrA genes were detected by real-time quantitative PCR (qRT-PCR).

Conclusion

Our study provides the experimental data for the use of BB for the clinical treatment of skin infections and further demonstrate the potential of BB as a novel biofilm inhibitor.
Effect of bilateral paravertebral nerve block on cognitive function in elderly patients undergoing radical gastrectomy for gastric cancer: a prospective randomized double-blind controlled trial
Authors: Shang Yanhong , Qi Fuwei , Zheng Zhong , Yang Guangyu , Fei Fan , Guo Qiang , Zhu Kangle
Published: July 2022

Objective

To investigate the effect of a bilateral paravertebral block (PVB) on cognitive function in elderly patients undergoing radical gastrectomy for gastric cancer.

Methods

Sixty patients (40 men and 20 women) aged 65–80 undergoing radical gastrectomy surgery under general anaesthesia were included and randomly assigned to either the PVB group or the control group. Patients in the PVB group had before incision a single-shot ultrasound-guided bilateral PVB at the T8 level with 20 mL of ropivacaine 0.375%, while patients in the control group had no block. Patients in both groups had a BIS-guided total intravenous anaesthesia with propofol and remifentanil infusions. Postoperative cognitive function assessed by the mini-mental state examination (MMSE) and NSE (neuron-specific enolase) was the primary outcome.

Results

The awareness time in group PVB was shorter than that in the group C, and the propofol and remifentanil dosages were less than that in group C (P<0.001, P = 0.007, respectively). Furthermore, the change of the MMSE score and the NSE concentration was significant from day0 to day1 and day1 to day2. (P<0.001).

Conclusion

A single-shot bilateral PVB active throughout radical gastrectomy for gastric cancer reduces the needs for general anaesthetic agents and improve postoperative recovery, along with a surrogate evidence for neuroprotective effects.

Trial registration

ChiCTR2200060088. Registered 18 May 2022.
Clinical assessment and molecular mechanism of the upregulation of Toll-like receptor 2 (TLR2) in myocardial infarction
Authors: Li Ming-Jie , Yan Shi-Bai , Dong Hao , Huang Zhi-Guang , Li Dong-Ming , Tang Yu-lu , Pan Yan-Fang , Yang Zhen , Pan Hong-Bo , Chen Gang
Published: July 2022

Objective

The prevalence and mortality of cardiovascular diseases remain ranked first worldwide. Myocardial infarction (MI) is the central cause of death from cardiovascular diseases, seriously endangering human health. The clinical implication of toll-like receptor 2 (TLR2) remains contradictory, and its mechanism is still unknown. Hence, the objective of this study was to elucidate the clinical value and molecular mechanism of TLR2 in MI.

Methods

All high-throughput datasets and eligible literature were screened, and the expression levels of TLR2 were collected from the MI. The integrated expression level of TLR2 was displayed by calculating the standardized mean difference (SMD) and the area under the curve (AUC) of the summary receiver operating characteristic curve (sROC). The related TLR2 genes were sent for pathway analyses by gene ontology (GO), Kyoto encyclopedia of genes and genome (KEGG), and disease ontology (DO). Single-cell RNA-seq was applied to ascertain the molecular mechanism of TLR2 in MI.

Results

Nine microarrays and four reported data were available to calculate the comprehensive expression level of TLR2 in MI, including 325 cases of MI and 306 cases of controls. The SMD was 2.55 (95% CI = 1.35–3.75), and the AUC was 0.76 (95% CI = 0.72–0.79), indicating the upregulation of TLR2 in MI. The related TLR2 genes were primarily enriched in the pathways of atherosclerosis, arteriosclerotic cardiovascular disease, and arteriosclerosis, suggesting the clinical role of TLR2 in the progression of MI. Afterward, TLR2 was upregulated in myeloid cells in MI.

Conclusions

TLR2 may have a crucial role in progressing from coronary atherosclerosis to MI. The upregulation of TLR2 may have a favorable screening value for MI.
Cognitive-motor multitasking in older adults: a randomized controlled study on the effects of individual differences on training success
Authors: Mack Melanie , Stojan Robert , Bock Otmar , Voelcker-Rehage Claudia
Published: July 2022

Background

Multitasking is an essential part of our everyday life, but performance declines typically in older age. Many studies have investigated the beneficial effects of cognitive, motor and combined cognitive-motor training on multitasking performance in older adults. Previous work, however, has not regarded interindividual differences in cognitive functioning and motor fitness that may affect training benefits. The current study aims to identify whether different training programs may have differential effects on multitasking performance depending on the initial level of cognitive functioning and motor fitness.

Methods

We conduct a 12-week single-blinded randomized controlled trial. A total ofN = 150 healthy older adults are assigned to either a single cognitive, a single motor, or a simultaneous cognitive-motor training. Participants are trained twice per week for 45 min. A comprehensive test battery assesses cognitive functions, motor and cardiovascular fitness, and realistic multitasking during walking and driving in two virtual environments. We evaluate how multitasking performance is related not only to the training program, but also to participants’ initial levels of cognitive functioning and motor fitness.

Discussion

We expect that multitasking performance in participants with lower initial competence in either one or both domains (cognitive functioning, motor fitness) benefits more from single-task training (cognitive training and/or motor training). In contrast, multitasking performance in participants with higher competence in both domains should benefit more from multitask training (simultaneous cognitive-motor training). The results may help to identify whether tailored training is favorable over standardized one-size-fits all training approaches to improve multitasking in older adults. In addition, our findings will advance the understanding of factors that influence training effects on multitasking.

Trial registration

DRKS (German Clinical Trials Register), DRKS00022407. Registered 26/08/2020 - Retrospectively registered athttps://www.drks.de/drks_web/setLocale_EN.do
Protocol for a mixed-methods and multi-site assessment of the implementation process and outcomes of a new community-based frailty programme
Authors: Tan Woan Shin , Nai Ze Ling , Tan Hwee Teng Robyn , Nicholas Sean , Choo Robin , Ginting Mimaika Luluina , Tan Edward , Teng Poh Hoon June , Lim Wee Shiong , Wong Chek Hooi , Ding Yew Yoong ,   the Geriatric Services Hub Programme Group, Seetharaman Santhosh Kumar , Lien Christopher Tsung Chien , Rosario Barbara Helen , Low Shou Lin , Ang Arron Seng Hock , Yap Mei Foon , Nurjono Milawaty , Au Lydia , Low Lian Leng , Lim Su Fee , Lim Esther Li Ping , Tay Laura Bee Gek , Chng Germaine Hwui San , Chua Melvin Peng Wei , Ng Yee Sien
Published: July 2022

Background

Frailty is increasing in prevalence internationally with population ageing. Frailty can be managed or even reversed through community-based interventions delivered by a multi-disciplinary team of professionals, but to varying degrees of success. However, many of these care models’ implementation insights are contextual and may not be applicable in different cultural contexts. The Geriatric Service Hub (GSH) is a novel frailty care model in Singapore that focuses on identifying and managing frailty in the community. It includes key components of frailty care such as comprehensive geriatric assessments, care coordination and the assembly of a multi-disciplinary team. This study aims to gain insights into the factors influencing the development and implementation of the GSH. We also aim to determine the programme’s effectiveness through patient-reported health-related outcomes. Finally, we will conduct a healthcare utilisation and cost analysis using a propensity score-matched comparator group.

Methods

We will adopt a mixed-methods approach that includes a qualitative evaluation among key stakeholders and participants in the programme, through in-depth interviews and focus group discussions. The main topics covered include factors that affected the development and implementation of each programme, operations and other contextual factors that influenced implementation outcomes. The quantitative evaluation monitors each programme’s care process through quality indicators. It also includes a multiple-time point survey study to compare programme participants’ pre- and post- outcomes on patient engagement, healthcare services experiences, health status and quality of life, caregiver burden and societal costs. A retrospective cohort study will compare healthcare and cost utilisation between participants of the programme and a propensity score-matched comparator group.

Discussion

The GSH sites share a common goal to increase the accessibility of essential services to frail older adults and provide comprehensive care. This evaluation study will provide invaluable insights into both the process and outcomes of the GSH and inform the design of similar programmes targeting frail older adults.

Trial Registration

ClinicalTrials.gov Identifier NCT04866316. Date of Registration April 26, 2021. Retrospectively registered.
The tryptophan catabolite or kynurenine pathway in COVID-19 and critical COVID-19: a systematic review and meta-analysis
Authors: Almulla Abbas F. , Supasitthumrong Thitiporn , Tunvirachaisakul Chavit , Algon Ali Abbas Abo , Al-Hakeim Hussein K. , Maes Michael
Published: July 2022

Background

Coronavirus disease 2019 (COVID-19) is accompanied by activated immune-inflammatory pathways and oxidative stress, which both induce indoleamine-2,3-dioxygenase (IDO), a key enzyme of the tryptophan (TRP) catabolite (TRYCAT) pathway. The aim of this study was to systematically review and meta-analyze the status of the TRYCAT pathway, including the levels of TRP and kynurenine (KYN) and the activity of IDO, as measured by the ratio of KYN/TRP.

Methods

This systematic review searched PubMed, Google Scholar, and Web of Sciences and included 14 articles that compared TRP and tryptophan catabolites (TRYCATs) in COVID-19 patients versus non-COVID-19 controls, as well as severe/critical versus mild/moderate COVID-19. The analysis was done on a total of 1269 people, including 794 COVID-19 patients and 475 controls.

Results

The results show a significant (p < 0.0001) increase in the KYN/TRP ratio (standardized mean difference, SMD = 1.099, 95% confidence interval, CI: 0.714; 1.484) and KYN (SMD = 1.123, 95% CI: 0.730; 1.516) and significantly lower TRP (SMD = − 1.002, 95%CI: − 1.738; − 0.266) in COVID-19 versus controls. The KYN/TRP ratio (SMD = 0.945, 95%CI: 0.629; 1.262) and KYN (SMD = 0.806, 95%CI: 0.462; 1.149) were also significantly (p < 0.0001) higher and TRP lower (SMD = − 0.909, 95% CI: − 1.569; − 0.249) in severe/critical versus mild/moderate COVID-19. No significant difference was detected in kynurenic acid (KA) and the KA/KYN ratio between COVID-19 patients and controls.

Conclusions

Our results indicate increased activity of the IDO enzyme in COVID-19 and severe/critical patients. The TRYCAT pathway is implicated in the pathophysiology and progression of COVID-19 and may signal a worsening outcome of the disease.
A case report of Klebsiella aerogenes-caused lumbar spine infection identified by metagenome next-generation sequencing
Authors: Gu Huajie , Cai Qingqing , Dai Xiaoyong , Wang Huanhuan , Xu Wenying , Cao Xuejie , Ye Youwen
Published: July 2022

Background

The early clinical diagnosis of spinal infections in elderly patients with recessive or atypical symptoms is difficult. Klebsiella aerogenes is a common opportunistic bacterium that can infect the respiratory tract, urinary tract, and even the central nervous system. However, whether it can infect the lumbar spine has not been previously described.

Case presentation

In this paper, we report the case of a 69-year-old female patient with osteoporosis who was initially diagnosed with hemolytic anemia. Later, she was diagnosed with K. aerogenes infection of the lumbar spine based on imaging combined with blood culture and metagenome next-generation sequencing (mNGS) detection. After precise medication, the lumbar degeneration was improved.

Conclusions

Bacterial infection should therefore be considered in cases of lumbar degenerative disease in middle-aged and elderly patients.