bluuebunny/crossref_metadata_2025 huggingface dataset:
An empirical study on the leadership traits that enable successful six sigma implementation
Authors: Bagherian Anthony , Gershon Mark , Kumar Sunil
Published: September 2023

Purpose

Some Six Sigma (SS) efforts have not been entirely successful. This research paper aims to investigate the leadership style and the elements of it that positively influence the attainment of Six Sigma programs within the automobile industry.

Design/methodology/approach

The study used a Likert-scale questionnaire and a simple random sampling method. 2,325 potential participants were approached, resulting in 573 responses, primarily from Germany, the United Kingdom and Sweden. 260 completed questionnaires were included in the analysis, utilizing an exploratory and mixed-methods research design to examine the impact of leadership style on Six Sigma success. Statistical methods such as SEM, EFA and CFA were used for data analysis.

Findings

The study utilized numerous SEM methods, including Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) and identified three key elements of leadership traits: (1) leadership support for long-term improvement strategies; (2) leadership commit to the supplier's organization to maintain quality and supply defect-free products.

Research limitations/implications

Due to limited participants, the outcome of the research could lead to inadequacies in data interpretation regarding the contextual predispostions, and the research could develop weaknesses in the form of cross-sectional instead of longitudinal data and design.

Practical implications

The practical implications of this study suggest that institutions, practitioners and researchers can incorporate these two identified factors into leadership traits to promote the sustainable implementation of Six Sigma (SS) initiatives.

Originality/value

This study makes an original contribution to the assessment of leadership style and its elements in the European automobile industry, utilizing a mixed-methods research design along with descriptive statistics to provide valuable insights.
Ownership concentration and R&D investment: the moderating role of stock options
Authors: Qian Furong , Yuan Xiaoyong
Published: September 2023

Purpose

This study aims to elaborate on how firms manage research and development (R&D) activities by examining the relationship between ownership concentration and corporate R&D investment, as well as the moderating role of stock options in this relationship.

Design/methodology/approach

The study sample comprised 354 Chinese listed firms from 2011 to 2019, and the Tobit model and the system GMM test are used to check robustness.

Findings

The results reveal that ownership concentration and R&D investment have an inverted U-shaped relationship. In the presence of stock options, this inverted U-shaped relationship is significantly weaker.

Originality/value

The results have important managerial implications for firms that aim to grant stock options and improve the impact of ownership concentration on R&D investment strategies.
Remaking critical care: Place, body work and the materialities of care in the COVID intensive care unit
Authors: Montgomery Catherine M. , Docherty Annemarie B. , Humphreys Sally , McCulloch Corrienne , Pattison Natalie , Sturdy Steve
Published: September 2023

In this article, we take forward sociological ways of knowing care‐in‐practice, in particular work in critical care. To do so, we analyse the experiences of staff working in critical care during the first wave of the COVID‐19 pandemic in the UK. This moment of exception throws into sharp relief the ways in which work and place were reconfigured during conditions of pandemic surge, and shows how critical care depends at all times on the co‐constitution of place, practices and relations. Our analysis draws on sociological and anthropological work on the material culture of health care and its sensory instantiations. Pursuing this through a study of the experiences of 40 staff across four intensive care units (ICUs) in 2020, we provide an empirical and theoretical elaboration of how place, body work and care are mutually co‐constitutive. We argue that the ICU does not exist independently of the constant embodied work of care and place‐making which iteratively constitute critical care as a total system of relations.
Resolving phylogenetic relationships and taxonomic revision in the Pseudogastromyzon (Cypriniformes, Gastromyzonidae) genus: molecular and morphological evidence for a new genus, Labigastromyzon
Authors: CHEN Jingchen , CHEN Yiyu , TANG Wenqiao , LEI Haotian , YANG Jinquan , SONG Xiaojing
Published: September 2023

The Pseudogastromyzon genus, consisting of species predominantly distributed throughout southeastern China, has garnered increasing market attention in recent years due to its ornamental appeal. However, the overlapping diagnostic attributes render the commonly accepted criteria for interspecific identification unreliable, leaving the phylogenetic relationships among Pseudogastromyzon species unexplored. In the present study, we undertake molecular phylogenetic and morphological examinations of the Pseudogastromyzon genus. Our phylogenetic analysis of mitochondrial genes distinctly segregated Pseudogastromyzon species into two clades: the Pseudogastromyzon clade and the Labigastromyzon clade. A subsequent morphological assessment revealed that the primary dermal ridge (specifically, the second ridge) within the labial adhesive apparatus serves as an effective and precise interspecific diagnostic characteristic. Moreover, the distributional ranges of Pseudogastromyzon and Labigastromyzon are markedly distinct, exhibiting only a narrow area of overlap. Considering the morphological heterogeneity of the labial adhesive apparatus and the substantial division within the molecular phylogeny, we advocate for the elevation of the Labigastromyzon subgenus to the status of a separate genus. Consequently, we have ascertained the validity of the Pseudogastromyzon and Labigastromyzon species, yielding a total of six valid species. To facilitate future research, we present comprehensive descriptions of the redefined species and introduce novel identification keys.
SPdel: A pipeline to compare and visualize species delimitation methods for single‐locus datasets
Authors: Ramirez Jorge L. , Valdivia Paola , Rosas‐Puchuri Ulises , Valdivia Nereida L.
Published: September 2023

An accurate species delimitation is critical for biological studies. In this context, the use of molecular techniques along with species delimitation methods would help to a rapid and accurate biodiversity assessment. The species delimitation methods cluster data sets of orthologous sequences in molecular operational taxonomic units (MOTU). In particular, the methods based on a single gene are easily integrated with the widely used DNA barcoding approach. We developed SPdel a user‐friendly pipeline to integrate different single‐gene species delimitation methods. SPdel is designed to calculate and compare MOTUs obtained by different species delimitation approaches. SPdel also outputs diverse ready‐to‐publish quality figures, that facilitate the interpretation of results. SPdel aims to help researchers use species delimitation methods that would improve biodiversity studies.
Monitoring environmental microbiomes: Alignment of microbiology and computational biology competencies within a culturally integrated curriculum and research framework
Authors: Lee J. S. , Lowell J. L. , Whitewater K. , Roane T. M. , Miller C. S. , Chan A. P. , Sylvester A. W. , Jackson D. , Hunter L. E.
Published: September 2023

We have developed a flexible undergraduate curriculum that leverages the place‐based research of environmental microbiomes to increase the number of Indigenous researchers in microbiology, data science and scientific computing. Monitoring Environmental Microbiomes (MEM) provides a curriculum and research framework designed to integrate an Indigenous approach when conducting authentic scientific research and to build interest and confidence at the undergraduate level. MEM has been successfully implemented as a short summer workshop to introduce computing practices in microbiome analysis. Based on self‐assessed student knowledge of topics and skills, increased scientific confidence and interest in genomics careers were observed. We propose MEM be incorporated in a scalable course‐based research experience for undergraduate institutions, including tribal colleges and universities, community colleges and other minority serving institutions. This coupled curricular and research framework explicitly considers cultural perspectives, access and equity to train a diverse future workforce that is more informed to engage in microbiome research and to translate microbiome science to benefit community and environmental health.
Nivolumab as maintenance therapy following platinum‐based chemotherapy in EGFR‐mutant lung cancer patients after tyrosine kinase inhibitor failure: A single‐arm, open‐label, phase 2 trial
Authors: Kim Jiwon , Choi Chang‐Min , Ji Wonjun , Lee Jae Cheol
Published: September 2023

Background

As the outcome of immunotherapy can be improved when concurrently or sequentially combined with cytotoxic chemotherapy or radiotherapy, we investigated the efficacy of immunotherapy maintenance following platinum‐based chemotherapy in epidermal growth factor receptor (EGFR)‐mutant non‐small cell lung cancer (NSCLC) after EGFR‐tyrosine kinase inhibitor (EGFR‐TKI) failure.

Methods

In this prospective, open‐label, single arm phase 2 trial, we enrolled patients aged 18 years or older with EGFR‐mutant NSCLC, which progressed after first‐ or second‐line EGFR‐TKI. Patients received platinum‐based chemotherapy followed by nivolumab maintenance therapy. They were intravenously administered 240 mg of nivolumab every 2 weeks for 3 months followed by 480 mg every 4 weeks until disease progression or unacceptable toxic effects occurred. The primary endpoint was progression‐free survival (PFS). Secondary outcomes were overall survival (OS) and incidence of grade 3–4 treatment‐related adverse events (AEs).

Results

We enrolled 26 patients between May 2020 and July 2021. The median PFS was 1.7 months (95% CI: 0.401–2.999 months). The median OS was 21.4 months (95% CI: 18.790–24.010 months) with 6‐ and 12‐month OS rates of 96.2% and 76.9%, respectively. The objective response rate was 7.7% (2/26) and disease control rate, 11.5% (3/26). The tumor mutational burden by next‐generation sequencing in blood was not related to the treatment outcomes. Grade 3–4 treatment‐related AEs occurred in four (15.4%) patients; the most frequent AE was increased alanine aminotransferase (7.7%).

Conclusion

Nivolumab maintenance following platinum‐based chemotherapy did not show clinical benefits after EGFR‐TKI failure in patients with EGFR‐mutant NSCLC.
Intrapartum fetal heart rate monitoring: Rationalise, refine or replace?
Authors: Crouch Catherine , Seeho Sean , Morris Jonathan
Published: September 2023

Monitoring the fetal heartbeat underpins assessment of fetal wellbeing in labour. Although commonly employed in clinical practice, shortcomings remain. A recent review of clinical practice guidelines highlights the variation in definitions of the fetal heart rate that will lead to differences in interpretation. Will intrapartum care be improved by greater consensus around clinical practice guidelines through rationalisation or refinement of guidelines, or will the future see this technique replaced by more accurate forms of fetal monitoring?
Letter: Safety after cessation of nucleos(t)ide analogue therapy in patients with chronic hepatitis B infection—Authors' reply
Authors: Hsu Yao‐Chun , Nguyen Mindie H. , Wu Chun‐Ying
Published: September 2023

LINKED CONTENT

This article is linked to Hsu et al papers. To view these articles, visit https://doi.org/10.1111/apt.17614 and https://doi.org/10.1111/apt.17657
Low and very low lithium levels: Thyroid effects are small but still require monitoring
Authors: Phelps James , Coskey Olivia Pipitone
Published: September 2023

Aim

Low doses of lithium, as might be used for mood or dementia prevention, do not carry the same renal, toxicity, and tolerability problems of doses used for prophylaxis or treatment of mania. However, thyroid effects of low doses have not been investigated. Our goal in this study was to assess the changes in thyroid‐stimulating hormone (TSH) associated with a broad range of lithium levels, including those well below the therapeutic range for bipolar disorders.

Methods

This study was conducted in a small healthcare system with 19 associated primary care clinics served by a Collaborative Care program of psychiatric consultation. In this retrospective review of electronic records, we searched for patients who had received a lithium prescription and both pre‐ and post‐lithium thyroid‐stimulating hormone (TSH) levels.

Results

Patients with low lithium levels (<0.5 mEq/L, N = 197) had a mean thyroid‐stimulating hormone (TSH) increase of 0.52 mIU/L. Patients with maintenance lithium levels (0.5–0.8 mEq/L; N = 123) had a mean TSH increase of 1.01 mIU/L; and patients with antimanic lithium levels (>0.8 mEq/L; N = 79) had a mean TSH increase of 2.16 mIU/L. The probability of TSH exceeding the upper limit of normal in our laboratory (>4.2 mIU/L) was positively associated with pre‐lithium TSH.

Conclusion

These results suggest that the risk of lithium‐induced hypothyroidism is dose‐related, and relatively small with very low doses, but thyroid monitoring, including a pre‐lithium TSH, is still warranted.
Trends in postpartum hemorrhage and manual removal of the placenta and the association with childbirth interventions: A Dutch nationwide cohort study
Authors: Seijmonsbergen‐Schermers Anna E. , Rooswinkel Ellen T. C. , Peters Lilian L. , Verhoeven Corine J. , Jans Suze , Bloemenkamp Kitty , de Jonge Ank
Published: September 2023

Background

Because the cause of increasing rates of postpartum hemorrhage (PPH) and manual placental removal (MROP) is still unknown, we described trends in PPH, MROP, and childbirth interventions and examined factors associated with changes in rates of PPH and MROP.

Methods

This nationwide cohort study used national perinatal registry data from 2000 to 2014 (n = 2,332,005). We included births of women who gave birth to a term singleton child in obstetrician‐led care or midwife‐led care. Multivariable logistic regression analyses were used to examine associations between characteristics and interventions, and PPH ≥ 1000 mL and MROP.

Results

PPH rates increased from 4.3% to 6.6% in obstetrician‐led care and from 2.5% to 4.8% in midwife‐led care. MROP rates increased from 2.4% to 3.4% and from 1.0% to 1.4%, respectively. A rising trend was found for rates of induction and augmentation of labor, pain medication, and cesarean section, while rates of episiotomy and assisted vaginal birth declined. Adjustments for characteristics and childbirth interventions did not result in large changes in the trends of PPH and MROP. After adjustments for childbirth interventions, in obstetrician‐led care, the odds ratio (OR) of PPH in 2014 compared with the reference year 2000 changed from 1.66 (95% CI 1.57–1.76) to 1.64 (1.55–1.73) among nulliparous women and from 1.56 (1.47–1.66) to 1.52 (1.44–1.62) among multiparous women. For MROP, the ORs changed from 1.51 (1.38–1.64) to 1.36 (1.25–1.49) and from 1.56 (1.42–1.71) to 1.45 (1.33–1.59), respectively.

Conclusions

Rising PPH trends were not associated with changes in population characteristics and rising childbirth intervention rates. The rising MROP was to some extent associated with rising intervention rates.
Natural products modulating epigenetic mechanisms by affecting histone methylation/demethylation: Targeting cancer cells
Authors: Dorna Dawid , Grabowska Adriana , Paluszczak Jarosław
Published: September 2023

Many natural products can exert anticancer or chemopreventive activity by interfering with the cellular epigenetic machinery. Many studies indicate the relevance of affecting DNA methylation and histone acetylation, however the influence on the mechanisms related to histone methylation are often overlooked. This may be associated with the lagging evidence that changes in the action of histone methylation writers and erasers, and subsequent alterations in the profile of histone methylation are causally related with carcinogenesis. Recent animal studies have shown that targeting histone methylation/demethylation affects the course of experimentally induced carcinogenesis. Existing data suggest that numerous natural compounds from different chemical groups, including green tea polyphenols and other flavonoids, curcuminoids, stilbene derivatives, phenolic acids, isothiocyanates, alkaloids and terpenes, can affect the expression and activity of crucial enzymes involved in the methylation and demethylation of histone lysine and arginine residues. These activities have been associated with the modulation of cancer‐related gene expression and functional changes, including reduced cell proliferation and migration, and enhanced apoptosis in various cancer models. Most studies focused on the modulation of the expression and/or activity of two proteins ‐ EZH2 (a H3K27 methyltransferase) and LSD1 (lysine demethylase 1A ‐ a H3K4/9 demethylase), or the effects on the global levels of histone methylation caused by the phytochemicals, but data regarding other histone methyltransferases or demethylases are scarce. While the field remains relatively unexplored, this review aims to explore the impact of natural products on the enzymes related to histone methylation/demethylation, showing their relevance to carcinogenesis and cancer progression.
ZNF500 abolishes breast cancer proliferation and sensitizes chemotherapy by stabilizing P53 via competing with MDM2
Authors: Ma Xiaowen , Fan Mingwei , Yang Kaibo , Wang Yuanyuan , Hu Ran , Guan Mengyao , Hou Yuekang , Ying Jiao , Deng Ning , Li Qingchang , Jiang Guiyang , Zhang Yong , Zhang Xiupeng
Published: September 2023

Zinc finger protein 500 (ZNF500) has an unknown expression pattern and biological function in human tissues. Our study revealed that the ZNF500 mRNA and protein levels were higher in breast cancer tissues than those in their normal counterparts. However, ZNF500 expression was negatively correlated with advanced TNM stage (p = 0.018), positive lymph node metastasis (p = 0.014), and a poor prognosis (p < 0.001). ZNF500 overexpression abolished in vivo and in vitro breast cancer cell proliferation by activating the p53‐p21‐E2F4 signaling axis and directly interacting with p53 via its C2H2 domain. This may prevent ubiquitination of p53 in a manner that is competitive to MDM2, thus stabilizing p53. When ZNF500‐∆C2H2 was overexpressed, the suppressed proliferation of breast cancer cells was neutralized in vitro and in vivo. In human breast cancer tissues, ZNF500 expression was positively correlated with p53 (p = 0.022) and E2F4 (p = 0.004) expression. ZNF500 expression was significantly lower in patients with Miller/Payne Grade 1–2 than in those with Miller/Payne Grade 3–5 (p = 0.012). ZNF500 suppresses breast cancer cell proliferation and sensitizes cells to chemotherapy.
Parents' food choice for their preschool‐aged children: A means‐end investigation
Authors: Kielb Elizabeth I. , Moding Kameron J. , Kimiecik Carlyn , Klenosky David B.
Published: September 2023

Background

Despite the growing literature on the importance of parental feeding practices, the factors that influence how parents make decisions regarding the foods they offer to their young children are not fully understood. Means‐end theory and its associated methodology known as laddering provide a useful framework for characterizing the relationships between the attributes of a choice option (e.g., a food item), the consequences (i.e., the benefits or costs/risks) associated with those attributes and the personal values (i.e., enduring beliefs) those consequences help reinforce. The present research uses this means‐end perspective to enrich our understanding of how parents make food choices for their preschool‐aged children.

Methods

Interviews were conducted with parents (N = 33) of 3‐ to 5‐year‐old children to explore the factors underlying parents' decisions regarding the foods they recently offered, prefer to offer and avoid offering to their preschooler. The resulting data were transcribed, content analysed and summarized in a series of summary diagrams known as hierarchical value maps (HVMs).

Results

Study results indicate that although most parents reported trying to make food decisions because they want their child to be healthy, factors such as avoiding fights/battles and low perceived likelihood their child would eat a food may be barriers to offering certain foods.

Conclusions

Taken together, these study findings enhance our understanding of the range of meanings underlying parents' food choice decisions and suggest opportunities for interventions to improve the quality of foods that parents offer to their children at home.
Bottom‐up global biodiversity metrics needed for businesses to assess and manage their impact
Authors: Hawkins Frank , Beatty Craig R. , Brooks Thomas M. , Church Rebekah , Elliott Wendy , Kiss Edit , Macfarlane Nicholas B. W. , Pugliesi Juliette , Schipper Aafke M. , Walsh Maria
Published: September 2023

Ensuring that companies can assess and manage their impacts on biodiversity will be crucial to solving the current biodiversity crisis, and regulatory and public pressure to disclose these impacts is increasing. Top‐down intactness metrics (e.g., Mean Species Abundance) can be valuable for generating high‐level or first‐tier assessments of impact risk but do not provide sufficient precision or guidance for companies, regulators, or third‐party assessors. New metrics based on bottom‐up assessments of biodiversity (e.g., the Species Threat Abatement and Restoration metric) can accommodate spatial variation of biodiversity and provide more specific guidance for actions to avoid, reduce, remediate, and compensate for impacts and to identify positive opportunities.
Safety and efficacy of intraperitoneal drain placement after emergency colorectal surgery: An international, prospective cohort study
Authors:   EuroSurg Collaborative†
Published: September 2023

Aim

Intraperitoneal drains are often placed during emergency colorectal surgery. However, there is a lack of evidence supporting their use. This study aimed to describe the efficacy and safety of intraperitoneal drain placement after emergency colorectal surgery.

Method

COMPlicAted intra‐abdominal collectionS after colorectal Surgery (COMPASS) is a prospective, international, cohort study into which consecutive adult patients undergoing emergency colorectal surgery were enrolled (from 3 February 2020 to 8 March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included rate and time‐to‐diagnosis of postoperative intraperitoneal collections, rate of surgical site infections (SSIs), time to discharge and 30‐day major postoperative complications (Clavien–Dindo III–V). Multivariable logistic and Cox proportional hazards regressions were used to estimate the independent association of the outcomes with drain placement.

Results

Some 725 patients (median age 68.0 years; 349 [48.1%] women) from 22 countries were included. The drain insertion rate was 53.7% (389 patients). Following multivariable adjustment, drains were not significantly associated with reduced rates (odds ratio [OR] = 1.56, 95% CI: 0.48–5.02, p = 0.457) or earlier detection (hazard ratio [HR] = 1.07, 95% CI: 0.61–1.90, p = 0.805) of collections. Drains were not significantly associated with worse major postoperative complications (OR = 1.26, 95% CI: 0.67–2.36, p = 0.478), delayed hospital discharge (HR = 1.11, 95% CI: 0.91–1.36, p = 0.303) or increased risk of SSIs (OR = 1.61, 95% CI: 0.87–2.99, p = 0.128).

Conclusion

This is the first study investigating placement of intraperitoneal drains following emergency colorectal surgery. The safety and clinical benefit of drains remain uncertain. Equipoise exists for randomized trials to define the safety and efficacy of drains in emergency colorectal surgery.
High flow nasal cannula versus noninvasive ventilation in the treatment of acute hypercapnic respiratory failure: A systematic review and meta‐analysis
Authors: Fahey Aisling C. , O'Connell Martina , Cornally Nicola , Saab Mohamad M.
Published: September 2023

Chronic obstructive pulmonary disease can lead to acute hypercapnic respiratory failure (AHRF), often treated using noninvasive ventilation (NIV). Emerging research suggests the potential utility of high flow nasal cannula (HFNC) for AHRF. This systematic review and meta‐analysis aimed to determine the effect of HFNC versus NIV on AHRF management. A search of electronic databases (CINAHL, MEDLINE, and Academic Search Complete), web sources, and trial registries was last conducted on 9 February 2023. Quality and risk of bias assessments were conducted. Meta‐analyses were used to synthesise data. Seven randomised controlled trials were included. No statistically significant differences between HFNC and NIV were found within the following outcomes of interest: (i) correction of pCO2: standardised mean difference (SMD) = −0.16, 95% confidence interval (CI) (−0.34 to 0.02), p = 0.08; (ii) correction of pH: SMD = −0.05, 95% CI (−0.25 to 0.14), p = 0.59; (iii) correction of pO2: SMD = −0.15, 95% CI (−0.40 to 0.09), p = 0.22; (iv) intubation rates: risk ratio (RR) = 0.87, 95% CI (0.41 to 1.82), p = 0.71; (v) mortality rates: RR = 0.85, 95% CI (0.47 to 1.56), p = 0.61; and (vi) treatment switch: RR = 1.30, 95% CI (0.43 to 3.94), p = 0.64. More controlled trials with large sample sizes are required to investigate the management of AHRF of various aetiologies. HFNC may be used as a final exhaustive measure for COPD‐related AHRF where NIV is not tolerated, and when it is not clinically indicated to extend to endotracheal intubation.
International Patent Cooperation, Patent Prosecution Highway Agreements, and Export Product Quality
Authors: Duan Fan , Li Yifei , Zhong Tenglong
Published: September 2023

This paper investigates how international cooperation for patent examination using Patent Prosecution Highway (PPH) agreements has affected the quality of firms' exports. Taking the PPH agreements signed between China and the export destinations as a quasi‐natural experiment, we established a difference‐in‐difference‐in‐differences model. We found that international cooperation for patent examination caused firms to increase export quality to PPH partners in patent‐intensive industries to a greater extent. This effect was more profound among PPH partners with stronger intellectual property protection, differentiated products and core products, and agreements along with the Patent Cooperation Treaty. We also found that PPH agreements increased the number of Chinese patent applications filed in PPH partners, patent applications by PPH partners in China, and the level of innovation, all of which constitute the major channels through which export quality to PPH partners increases. Our findings demonstrate that international patent cooperation has played an important role in promoting international trade quality.
First report from the International Evaluation of Endoscopic classification Japan NBI Expert Team: International multicenter web trial
Authors: Saito Yutaka , Sakamoto Taku , Dekker Evelien , Pioche Mathieu , Probst Andreas , Ponchon Thierry , Messmann Helmut , Dinis‐Ribeiro Mario , Matsuda Takahisa , Ikematsu Hiroaki , Saito Shoichi , Wada Yoshiki , Oka Shiro , Sano Yasushi , Fujishiro Mitsuhiro , Murakami Yoshitaka , Ishikawa Hideki , Inoue Haruhiro , Tanaka Shinji , Tajiri Hisao ,   IEE‐JNET Group
Published: September 2023

Objectives

Narrow‐band imaging (NBI) contributes to real‐time optical diagnosis and classification of colorectal lesions. The Japan NBI Expert Team (JNET) was introduced in 2011. The aim of this study was to explore the diagnostic accuracy of JNET when applied by European and Japanese endoscopists not familiar with this classification.

Methods

This study was conducted by 36 European Society of Gastrointestinal Endoscopy (ESGE) and 49 Japan Gastroenterological Endoscopy Society (JGES) non‐JNET endoscopists using still images of 150 lesions. For each lesion, nonmagnified white‐light, nonmagnified NBI, and magnified NBI images were presented. In the magnified NBI, the evaluation area was designated by region of interest (ROI). The endoscopists scored histological prediction for each lesion.

Results

In ESGE members, the sensitivity, specificity, and accuracy were respectively 73.3%, 94.7%, and 93.0% for JNET Type 1; 53.0%, 64.9%, and 62.1% for Type 2A; 43.9%, 67.7%, and 55.1% for Type 2B; and 38.1%, 93.7%, and 85.1% for Type 3.

When Type 2B and 3 were considered as one category of cancer, the sensitivity, specificity, and accuracy for differentiating high‐grade dysplasia and cancer from the others were 59.9%, 72.5%, and 63.8%, respectively. These trends were the same for JGES endoscopists.

Conclusion

The diagnostic accuracy of the JNET classification was similar between ESGE and JGES and considered to be sufficient for JNET Type 1. On the other hand, the accuracy for Types 2 and 3 is not sufficient; however, JNET 2B lesions should be resected en bloc due to the risk of cancers and JNET 3 can be treated by surgery due to its high specificity.
Risk factors for adverse outcomes at various phases of endoscopic ultrasound‐guided treatment of pancreatic fluid collections: Data from a multi‐institutional consortium
Authors: Saito Tomotaka , Omoto Shunsuke , Takenaka Mamoru , Tsujimae Masahiro , Masuda Atsuhiro , Sato Tatsuya , Hamada Tsuyoshi , Ota Shogo , Shiomi Hideyuki , Takahashi Sho , Fujisawa Toshio , Nakagawa Keito , Matsubara Saburo , Uemura Shinya , Iwashita Takuji , Yoshida Kensaku , Maruta Akinori , Okuno Mitsuru , Iwata Keisuke , Hayashi Nobuhiko , Mukai Tsuyoshi , Isayama Hiroyuki , Yasuda Ichiro , Nakai Yousuke ,   for the WONDERFUL study group in Japan
Published: September 2023

Objectives

No comprehensive study has examined short‐ and long‐term adverse outcomes of endoscopic ultrasound (EUS)‐guided treatment of pancreatic fluid collections (PFCs) including walled‐off necrosis (WON) and pseudocysts.

Methods

In a multi‐institutional cohort of 357 patients receiving EUS‐guided treatment of PFCs (228 with WON and 129 with pseudocysts), we examined PFC type‐specific risk factors for procedure‐related adverse events (AEs), clinical failure, and recurrence. Odds ratios (ORs) and hazard ratios (HRs) with 95% confidence intervals (CIs) were computed using the logistic and Cox regression models, respectively, adjusting for potential confounders.

Results

Adverse events were observed predominantly in WON, and risk factors were WON extension to the pelvis (OR 2.49; 95% CI 1.00–6.19) and endoscopic necrosectomy (OR 5.15; 95% CI 1.61–16.5). Risk factors for clinical failure in WON treatment included higher Charlson Comorbidity Index (OR for ≥3 vs. ≤2, 2.58; 95% CI 1.05–6.35), extension to the pelvis (OR 3.63; 95% CI 1.57–8.43), nonuse of a lumen‐apposing metal stent (OR 2.88; 95% CI 1.10–7.54), and percutaneous drainage (OR 3.73; 95% CI 1.27–10.9). Patients with pseudocysts extending to the paracolic gutter and the need for more than two endoscopic/percutaneous procedures had ORs for clinical failure of 5.28 (95% CI 1.10–25.3) and 5.52 (95% CI 1.61–18.9), respectively. Pseudocysts requiring the multigateway approach were associated with a high risk of recurrence (HR 4.00; 95% CI 1.11–11.6).

Conclusion

The adverse outcomes at various phases of EUS‐guided PFC treatment may be predictable based on clinical parameters. Further research is warranted to optimize treatment strategies for high‐risk patients.
Severe (level 3) hypoglycaemia occurrence in a real‐world cohort of adults with type 1 or 2 diabetes mellitus (iNPHORM, United States)
Authors: Ratzki‐Leewing Alexandria , Black Jason E. , Kahkoska Anna R. , Ryan Bridget L. , Zou Guangyong , Klar Neil , Timcevska Kristina , Harris Stewart B.
Published: September 2023

Aims

Among adults with insulin‐ and/or secretagogue‐treated diabetes in the United States, very little is known about the real‐world descriptive epidemiology of iatrogenic severe (level 3) hypoglycaemia. Addressing this gap, we collected primary, longitudinal data to quantify the absolute frequency of events as well as incidence rates and proportions.

Materials and Methods

iNPHORM is a US‐wide, 12‐month ambidirectional panel survey (2020‐2021). Adults with type 1 diabetes mellitus (T1DM) or insulin‐ and/or secretagogue‐treated type 2 diabetes mellitus (T2DM) were recruited from a probability‐based internet panel. Participants completing ≥1 follow‐up questionnaire(s) were analysed.

Results

Among 978 respondents [T1DM 17%; mean age 51 (SD 14.3) years; male: 49.6%], 63% of level 3 events were treated outside the health care system (e.g. by family/friend/colleague), and <5% required hospitalization. Following the 12‐month prospective period, one‐third of individuals reported ≥1 event(s) [T1DM 44.2% (95% CI 36.8%‐51.8%); T2DM 30.8% (95% CI 28.7%‐35.1%), p = .0404, α = 0.0007]; and the incidence rate was 5.01 (95% CI 4.15‐6.05) events per person‐year (EPPY) [T1DM 3.57 (95% CI 2.49‐5.11) EPPY; T2DM 5.29 (95% CI 4.26‐6.57) EPPY, p = .1352, α = 0.0007]. Level 3 hypoglycaemia requiring non‐transport emergency medical services was more common in T2DM than T1DM (p < .0001, α = 0.0016). In total, >90% of events were experienced by <15% of participants.

Conclusions

iNPHORM is one of the first long‐term, prospective US‐based investigations on level 3 hypoglycaemia epidemiology. Our results underscore the importance of participant‐reported data to ascertain its burden. Events were alarmingly frequent, irrespective of diabetes type, and concentrated in a small subsample.
The prevalence of vitamin D deficiency and associated factors in first‐episode psychosis
Authors: Tsiglopoulos Jonathan , Pearson Nicholas , Mifsud Nathan , Castagnini Emily , Allott Kelly , Thompson Andrew , Killackey Eoin , McGorry Patrick , O'Donoghue Brian
Published: September 2023

Aim

Vitamin D deficiency is prevalent in people with established psychotic disorders, but less is known about vitamin D levels in people with first‐episode psychosis (FEP). This study aimed to determine the prevalence of vitamin D deficiency in people with FEP and identify the factors associated with vitamin D status.

Methods

This was a prospective cohort study nested within a randomized controlled trial, which included 37 young people with an FEP with minimal antipsychotic medication exposure.

Results

Twenty‐four percent of participants were vitamin D deficient, and a further 30% were vitamin D insufficient. There was no association between vitamin D and demographic factors or clinical symptoms (positive, negative, general psychopathology and depressive symptoms) or cognition and functioning. However, vitamin D levels were associated with season of sampling.

Conclusions

Considering the longer‐term adverse effects associated with vitamin D deficiency, it is warranted to ensure this clinical population receives supplementation if indicated.
Set in motion. Paradoxical narratives of becoming Swedish digital media influencers
Authors: Nilsson Gabriella
Published: September 2023

This article analyzes how Swedish digital media influencers make sense of their careers in print media interviews and autobiographical books. I explore how influencers use metaphors involving motion, speed and acceleration to describe, explain and legitimate the various circumstances and phases of their career development, and how these metaphors may be viewed in the wider context of social acceleration and conflicting gender norms. I show that the valorization of neoliberal ideals that promote individuality, flexibility, entrepreneurship, and passion as the basis for career choices is facilitated by the rapidly changing technology that influencers use. This does not imply, however, that female influencers are empowered or breaking norms. Instead, their narratives reflect traditional gender norms, such as assigning themselves passive roles in their career development. This analysis illustrates a paradox in the work of influencers: it is fast‐paced and ever‐changing, dependent on algorithms and platforms run by multinational companies, but at the same time, it must be slow, static, and authentic, organically growing through listening, sensing and the building of relationships. I show that neoliberal ideals around work are intertwined with traditional notions of femininity, and that these ideals reinforce a normative view of women's work—including notions of never‐idle hands and a perpetual availability to serve the needs of others—as “non‐work.”
Labour disputes in contexts of trade union fragmentation and pluralism: An empirical analysis of the case of Chile
Authors: PÉREZ AHUMADA Pablo , OCAMPO Gino
Published: September 2023

The number of strikes in Chile has increased substantially since the late 2000s. This article analyses this development from the point of view of a key aspect of the Chilean model of industrial relations: trade union pluralism. Drawing on a representative survey of private sector companies, the authors estimate logistic regression models indicating that trade union pluralism significantly increases the probability of strike action. The analysis does not, however, indicate that the positive effect of trade union pluralism can be explained by inter‐union competition, as is suggested in some of the international literature.
Oxide semiconductors for thermoelectric: The challenges and future
Authors: Ge Bangzhi , Li Ruoyan , Wang Guohao , Zhu Menghua , Zhou Chongjian
Published: September 2023

The oxide thermoelectric (TE) ceramics have continued to attract the focus due to their high stability and low cost. However, their TE performance falls obviously backward with the typical TE compounds such as PbTe. Here, we revealed the reason for the difficulty of optimized performance is the large electronegativity difference between the metal and O ions in oxide, which results in strong electron localization and bond energy. The former leads to unfavorable electrical properties and the latter results in a high lattice thermal conductivity. Focusing on these issues, we briefly reviewed the strategies for electrical optimization including carrier concentration optimization, band gap tuning, and the density of state resonance, as well as the lattice thermal suppression strategies involving weakened bond, high entropy, grain size engineering, hierarchical architecture, textured polycrystal, and composite strategies for oxide TE ceramics. Finally, we proposed several possible perspectives for n‐type oxide TE ceramics, strategies for bond anisotropy, and predicted new TE oxides for further breakthroughs in oxide TE properties.
Multiscale understanding the effect of K/Na ratio on electrical properties of high‐performance KNN‐based ceramics
Authors: Huang Yifeng , Wang Xin , Ma Yinchang , Lv Xiang , Wu Jiagang
Published: September 2023

Although certain efforts were paid to the effect of K/Na ratio on the phase structure and piezoelectric properties of potassium sodium niobate {(K, Na)NbO3, KNN}‐based ceramics, insufficient attention was given to the local structure and ferroelectric domains, hindering the further understanding of physical mechanisms. Herein, we studied the effect of the K/Na ratio on KNN‐based ceramics with multi‐phase coexistence from multiscale structure. High Na+ content leads to local stress heterogeneity and retains large ferroelectric domains, while high K+ content rotates the NbO6 octahedron and results in local polarity heterogeneity and distinct dielectric relaxational behavior, consequently fragmenting ferroelectric domains. The improved piezoelectricity is obtained at the equal K/Na ratio and originates from the balanced local polarity and stress heterogeneities. Therefore, an appropriate K/Na ratio should be fully considered when designing compositions with the purpose of improving performance of KNN‐based ceramics in the future.
Research on wheat flour‐making technology based on discrete elements
Authors: Wang Xuefeng , Wu Wenbin , Jia Huapo
Published: September 2023

The operating characteristics of a mill's rolling distance and roller speed during wheat‐milling were studied to provide a reference for optimizing the operating parameters of the mill. The high‐performance discrete element method software (EDEM) was used to establish a roller‐crushing system for wheat flour production. Numerical simulations of wheat flour production were performed using this system. It was found that increasing the roller distance of the flour mill machine could reduce the wear of the grinding rolls and the power of the grinding roll system, which reduced the crushing rate of wheat during the milling process. Increasing the grinding roll speed can reduce the wear of the grinding rolls but will increase the wheat‐crushing rate. At a constant fast roller speed, increasing the speed ratio increased the wheat‐crushing rate which reduced the power of the grinding roller system. During the grinding roll wear process, the obtuse and sharp angles gradually disappear. A comparison of the simulation and experimental results shows that the discrete element method can accurately predict the wear of the grinding roll.

Practical Applications

The milling machine is a key piece of equipment used for making wheat flour. The rolling distance, speed, and speed ratio of grinding rolls are important operating parameters during mill operation. Selecting specific parameters will directly affect the quality of wheat‐milling and the economic efficiency of the milling enterprise. This study adopted a discrete element method to study the effects of these parameters on wheat milling, providing a good reference for the technical personnel of milling enterprises.
Mathematical modeling for investigating the effect of single‐sided flipping on moisture, fat content, and safety of hamburger patty
Authors: Dalvi‐Isfahan Mohsen
Published: September 2023

The aim of this research was to investigate the impact of the number of hamburger flips on cooking loss and the safety of hamburger patties during contact heating. To achieve this, a kinetic model describing the thermal inactivation of Salmonella serotypes during the cooking of hamburger patties was developed and coupled with heat and mass transfer equations (moisture and fat loss). The model also incorporated the effect of shrinkage during cooking. The results showed that while increasing the number of flips helps to distribute heat more evenly and decrease the temperature difference across the patty, which can increase safety, it can also lead to greater loss of moisture and fat during cooking. In addition, although shrinkage has a significant effect on cooking loss in the model, its inclusion did not improve the accuracy of the model in predicting experimental data.

Practical Applications

The research highlights the importance of not only conveying the risks of consuming undercooked hamburgers, but also providing guidance on how to cook hamburgers thoroughly while retaining their juiciness and flavor. This information is crucial for hamburger producers to promote best practices for cooking hamburgers that meet both safety and taste criteria. The study also emphasizes the role of the effects of consecutive flipping and product shrinkage on cooking loss, as well as temperature changes during single‐sided contact heating of frozen hamburger patties. By understanding these factors, hamburger producers can develop cooking protocols that minimize cooking loss while ensuring product safety and taste. Overall, this research has practical applications for the hamburger industry, as it provides a scientific basis for optimizing cooking processes that can improve product safety, quality, and taste.
Should Researchers Conceptualize Differently the Dimensions of Parenting for Fathers and Mothers?
Authors: Fagan Jay , Day Randal , Lamb Michael E. , Cabrera Natasha J.
Published: September 2023

This article asks whether researchers should seek separate conceptualizations of fathers' and mothers' parenting behaviors. We posit that there is not sufficient evidence to conclude that the constructs of fathering and mothering are unique. Our argument is based on 3 sets of findings. First, there have been a number of studies showing that fathering and mothering constructs are the same. Second, there is evidence that fathers' parenting behaviors affect children's outcomes in ways that are similar to the effects of mothers' parenting behaviors. Third, fathers and mothers are becoming more similar in terms of their roles, the types of behaviors with which they engage children, and the amount of time they spend with children.
Neglected Risks in the Communication of Residential Mortgage‐Backed Securities Offerings
Authors: ZHANG HAROLD H. , ZHAO FENG , ZHAO XIAOFEI
Published: September 2023

Examining the contractual disclosures during the sale of private‐label residential mortgage‐backed securities before the 2008 financial crisis, we find that textual contents in the risk‐factor section predict subsequent losses and yet were not reflected in pricing. Insurance companies, especially life insurers and insurers with low regulatory capital ratios, are more exposed to textual risks. Consistent with issuers hedging litigation risks with disclosure, we find that textual contents are associated with second‐lien underreporting and preissuance written communications. Overall, we find that investors neglected risks in the purportedly safe assets before the crisis.
Time‐calibrated phylogeny of Daphne (Thymelaeaceae): Pre‐mediterranean temporal origin of the sclerophyllous Daphne gnidium
Authors: Ramos‐Capón Cristina , Vargas Pablo , Pomeda‐Gutiérrez Fernando , Martín‐Hernanz Sara
Published: September 2023

The sclerophyllous syndrome is characterized by well‐defined traits (evergreen coriaceous leaves, inconspicuous flowers, and fleshy fruits). It has been hypothesized that lineages displaying the sclerophyllous syndrome show lower speciation rates than non‐sclerophyllous lineages after the establishment of the mediterranean climate. Daphne gnidium displays sclerophyllous traits and some differentiation into three subspecies (gnidium, mauritanica, maritima), but the spatio‐temporal origin of this taxonomic group is unknown due to the lack of a time‐calibrated phylogeny of the whole genus. Here, we inferred phylogenetic relationships and divergence times of Daphne (32 species, 238 samples) and other genera of Thymelaeaceae (16 genera, 38 species, 34 samples) using the internal transcribed spacer (ITS), which revealed that the current circumscription of Daphne is profoundly polyphyletic because some species are nested within the genera Wikstroemia and Edgeworthia. In contrast, D. gnidium formed a well‐supported clade as recognized in taxonomic accounts (subgenus Spachia). We found morphological and phylogenetic support for Daphne mauritanica as a monophyletic lineage sister to D. gnidium. Divergence between D. gnidium and D. mauritanica appears to have predated the establishment of seasonally dry conditions, which supports a pre‐mediterranean temporal origin of the lineage. A phylogeographical analysis within D. gnidium based on 66 nrDNA (ITS) and 84 cpDNA (rps16, trnV) sequences agreed with the low differentiation of the species in the Pleistocene despite its large distribution range. Altogether, D. gnidium illustrates one more example of the sclerophyllous syndrome with no speciation after the onset of the mediterranean climate.