bluuebunny/crossref_metadata_2025 huggingface dataset:
Health System Expansion and Changes in Medicare Beneficiary Utilization of Safety Net Providers
Authors: Li Kun , Escarce José J. , Zhang Shiyuan , Agniel Denis , DeYoreo Maria , Timbie Justin W.
Published: December 2024

Background:

Evidence is limited on insured patients’ use of safety net providers as vertically integrated health systems spread throughout the United States.

Objectives:

To examine whether market-level health system penetration is associated with: (1) switches in Medicare beneficiaries’ usual source of primary care from federally qualified health centers (FQHCs) to health systems; and (2) FQHCs’ overall Medicare patient and visit volume.

Research Design:

Beneficiary-level discrete-time survival analysis and market-level linear regression analysis using Medicare fee-for-service claims data from 2013 to 2018.

Subjects:

A total of 659,652 Medicare fee-for-service beneficiaries aged 65 and older lived in one of 27,386 empirically derived primary care markets whose usual source of care in 2013 was an FQHC or a non-FQHC–independent physician organization that predominantly served low-income patients.

Measures:

Beneficiary-year measure of the probability of switching to health system-affiliated physician organizations and market-year measures of the number of FQHC visits by Medicare beneficiaries, number of beneficiaries attributed to FQHCs, and FQHC Medicare market shares.

Results:

During 2013–2018, 16.5% of beneficiaries who sought care from FQHCs switched to health systems. When health system penetration increases from the 25th to 75th percentile, the probability of Medicare FQHC patient switching increases by 4.6 percentage points, with 22 fewer Medicare FQHC visits and 4 fewer beneficiaries attributed to FQHCs per market year. Complex patients and patients who sought care from non-FQHC, independent physician organizations exhibited higher rates of switching to health systems.

Conclusions:

Health system expansion was associated with the loss of Medicare patients by FQHCs, suggesting potential negative spillovers of vertical integration on independent safety net providers.
Overcoming resistance in HER2-positive gastric cancer: a case report on the synergistic effect of pembrolizumab and trastuzumab
Authors: Gong Ting , Ma Qing , Ren Yaoyao , Gu Liyan , Lv Hui , Zhong Diansheng
Published: December 2024

Introduction:

The first-line standard therapy for advanced HER2-positive gastric cancer is chemotherapy combined with trastuzumab and pembrolizumab, while pembrolizumab alone does not benefit as a monotherapy in patients with mismatch repair proficiency (pMMR). This case explores the therapeutic potential of adding pembrolizumab to patients who were resistant to trastuzumab, focusing on the synergistic effect of an immune checkmate inhibitor, combined with HER2 antibody.

Case Presentation:

An 87-year-old metastatic gastric cancer patient, whose medical history was significant for intolerance to chemotherapy and had a poor status of performance. Immunohistochemical staining was presented as HER2 (3+), pMMR, and PD-L1 was 4. Initially treated with trastuzumab monotherapy, the patient showed no response and experienced progressive disease. Subsequently, a combined regimen of trastuzumab and a half-dose of pembrolizumab was administered every 3 weeks. Remarkably, it led to a significant reduction in tumor size, achieving partial remission (PR) after two cycles. This response was sustained over 21 months, as evidenced by the latest CT scans.

Clinical Discussion:

The concurrent administration of trastuzumab and pembrolizumab has demonstrated synergistic antitumor activity, achieving clinical efficacy in cases where each agent alone proved ineffective. Preclinical studies illustrated that tumor regression induced by HER2 antibodies requires T cell involvement, and the combination of immune checkpoint inhibitors with trastuzumab augments HER2-specific T cell responses, promotes immune cell recruitment, and induces the expansion of peripheral memory T cells, which showed synergistic rationales for a combination of pembrolizumab and trastuzumab.

Conclusion:

The observed synergy between pembrolizumab and trastuzumab highlights a promising treatment avenue that warrants further investigation.
The Petri dish under the ice: permafrost pathogens and their impact on global healthcare and antibiotic resistance
Authors: Saleem Muhammad M. , Elahi Naz , Athar Roha , Gul Areeba , Adil Mariam , Ellahi Aayat , Kashif Haider , Hojeij Moussa
Published: December 2024

Background:

A shallow active layer of soil above the permafrost thaws during the summer months which promotes microbial growth and releases previously confined pathogens which result in bacterial epidemics in circumpolar regions. Furthermore, these permafrost sources harbor several antibiotic resistance genes (ARGs) which may disseminate and pose a challenge for pharmacologists worldwide.

Aims:

The authors examined the potential association between climate change-induced permafrost thawing, and the resulting release of antibiotic-resistant pathogens, as well as the potential impact this can have on global healthcare systems in the long run.

Methodology:

A cursory abstract screening was done to rule out any articles that did not have to do with viral pathogens caused by melting permafrost. Articles that were not available in English or that our institutions library did not have full-text access were weeded out by a secondary screen.

Results:

A comprehensive analysis of 13 relevant studies successfully revealed a wide variety of bacterial genera, including Staphylococcus spp., Pseudomonas spp., Acinetobacter spp., and Achromobacter spp., along with a total of 1043 antibiotic resistance genes (ARGs), with most pertaining to aminoglycosides and beta-lactams, offering resistance via diverse mechanisms such as efflux pumps and enzymatic modifications, within the permafrost isolates. Additionally, mobile genetic elements (MGEs) housing antibiotic resistance genes (ARGs) and virulence factor genes (VFGs), including plasmids and transposons, were also discovered.

Conclusion:

Permafrost thawing is an underrated healthcare challenge warranting the need for further articles to highlight it alongside concerted efforts for effective mitigation.
Linking Gaps and Outcomes
Authors: Dickerson Pamela S.
Published: December 2024

This article explores the importance of connecting gaps and outcomes to ensure delivery of quality professional development activities. Designing and implementing activities to close or narrow gaps and produce measurable outcomes supports the value of nursing professional development in advancing goals of departments, organizations, and consumer health. Implications for professional development associates as well as novice, competent, and advanced nursing professional development practitioners are addressed.
External Validation of the Surgical Intervention for Traumatic Injuries Scale in Children
Authors: Jonsson Bergthor , Madhok Manu , Lammers Shea , Reimche Paige , McClure Meghan , Kiragu Andrew W. , Kebriaei Meysam A. , Bergmann Kelly R.
Published: December 2024

Objectives:

The Surgical Intervention for Traumatic Injuries (SITI) scale is intended to predict the likelihood of needing surgical decompression among patients with traumatic brain injury (TBI). We sought to examine the performance of the SITI score to predict likelihood of acute neurosurgical intervention for children with TBI.

Methods:

We conducted a cross-sectional, retrospective, observational study of children diagnosed with TBI as determined by International Classification of Diseases codes, presenting to a single level 1 pediatric trauma center, between June 1, 2003, and May 31, 2018. The main outcome was decompressive craniotomy or craniectomy within 24 hours of arrival. Data for SITI scoring were abstracted by research assistants, and all cases were scored by a physician who was blinded to the outcome. The SITI scale performance was evaluated using receiver operating characteristic curve and by calculating the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).

Results:

There were 656 encounters with TBI, of which 39 (5.9%) underwent surgical decompression. The mean SITI scores were 4.15 for the operative group and 0.40 for the nonoperative group (P < 0.001). A cutoff of 2 or greater for a positive score gave the best performance with a sensitivity of 0.79, specificity of 0.90, PPV of 0.34, and NPV of 0.99. The area under the receiver operating characteristic curve was 0.89 (95% confidence interval, 0.83–0.96). In sensitivity analysis excluding 75 cases with depressed skull fractures, a score of 2 or greater had a sensitivity of 0.96, specificity of 0.91, PPV of 0.31, and NPV of 1.00. The area under the receiver operating characteristic curve was 0.98 (95% confidence interval, 0.97–1.00).

Conclusions:

A SITI score of less than 2 is associated with nonoperative management. However, clinicians should not be falsely reassured by a low score in patients with depressed skull fractures.
The Effects of Robot-Asssissted Gait Training on Balance and Fear of Falling in Patients with Stroke: A Randomized Controlled Clinical Trial
Authors: GUNDUZ Merve SEVINC , MUSTAFAOGLU Rustem , URAL Ibrahim Halil
Published: December 2024

Objective

The aim of this study was compare the effects of Combined Training (CombT), which included Robot-Assisted Gait Training in addition to Traditional Balance Training (TBT), and TBT alone on balance and fear of falling (FoF) in patients with stroke based on objective assessment methods.

Design

Patients were randomized into CombT Group (CombTG) (n = 21) and TBT Group (TBTG) (n = 21) for duration of 5-weeks. Balance were assessed with EncephaLog App recorded stand-up time (SUT), sit-down time (SDT), and directional sways during walking, Berg Balance Scale (BBS) and Timed Up and Go Test (TUG). International Fall Efficacy Scale (FES-I) measured fear of falling (FoF). Fugl Meyer Assessment-Lower Extremity (FMA-LE) assessed limb impairment. Foot posture were assessed with Foot Posture Index (FPI-6).

Results

After the treatments, EncephaLog sways (anterior, medial, lateral: P = 0.04, P = 0.01, P = 0.02), SUT (P = 0.006), SDT (P = 0.002); BBS (P < 0.001); FES-I (P = 0.002) improved in CombTG. TUG (P = 0.01) and FMA-LE (P < 0.001) improved in TBTG. SUT (P = 0.01) and SDT (P = 0.04) showed statistically significant improvement in CombTG compared to TBTG; FMA-LE (P = 0.002) demonstrated statistically significant improvement in TBTG compared to CombTG.

Conclusion

Objective assessment indicated that combined treatments in subacute and chronic stroke rehabilitation enhance balance and reduce FoF more effectively than isolated approaches.
The relationship between HIV and reading performance for children in Tanzania
Authors: Bonacina Silvia , Lichtenstein Jonathan D. , Niemczak Christopher , Magohe Albert , Fellows Abigail , Nicol Trent , Massawe Enica , Kraus Nina , Buckey Jay C.
Published: December 2024

Objective:

Children living with HIV (CLWH) are at increased risk for cognitive and developmental delays, although HIV's influence on reading development remains unclear. Research using internationally validated reading measures with control for factors known to influence literacy outcomes is needed. The Early Grade Reading Assessment (EGRA) is a tool for assessing students’ progress toward reading that has been validated across countries. It was administered to a cohort of children living with and without HIV (CLWH/CLWOH) and data on other factors that might affect literacy were also measured.

Design and methods:

388 children (217 children living without HIV (CLWOH) and 171 CLWH; ages 3–8) drawn from a longitudinal study in Dar es Salaam, Tanzania completed the EGRA. EGRA performance between CLWH and CLWOH was compared adjusting for age socioeconomic status, years of education, English learning, and type of school (public or private).

Results:

Despite the biological and environmental confounders, CLWH performed significantly worse than CLWOH on the Letter Name Knowledge subtest, the Syllable subtest, the Non-Word subtest, and the Reading Comprehension subtest. The difference approached significance for the Oral Reading Fluency subtest.

Conclusions:

CLWH performed worse than CLWOH on the EGRA, indicating literacy skill development in CLWH needs early intervention. Longitudinal analyses, including electrophysiological and behavioral data, are needed to find the factors associated with poor reading and literacy performance in CLWH.
“Modified String Test to Improve and Confirm by Molecular Characterization for Bacterial Identification”
Authors: Mian Muhammad Dawood , Khan Saadullah Jan , Rani Rehana , Sadiq Sara , Jafri Laila , Jamil Bushra
Published: December 2024

Rapid and precise identification of bacteria is crucial in both clinical and environmental microbiology. Traditional Gram staining methods, while foundational in bacterial classification, often suffer from delays and require additional confirmatory tests, raising concerns about the potential for misidentification. To address these limitations, we present a modified KOH string test enhanced with Methylene Blue, aimed at improving the visualization and differentiation of Gram-positive and Gram-negative bacteria. In our study, we analyzed approximately 185 samples collected from hospitals, soil, salt mines, and honeycombs. Initially, we employed conventional Gram staining for preliminary bacterial identification, followed by our modified KOH string test. This innovative procedure involved mixing a drop of 3% KOH with a bacterial colony on a slide. After one minute, the addition of a dye significantly enhanced the visibility of string formation, facilitating the distinction between bacterial types. The results were compelling: 100% of Gram-negative bacteria displayed a visible string, while all Gram-positive bacteria exhibited no string formation. To further validate our findings, selected environmental samples were analyzed using 16S rRNA PCR, reinforcing the effectiveness of our modified KOH string test. This enhanced method is not only cost-effective and straightforward but also reliable, positioning it as an excellent supplementary or alternative approach for bacterial identification. By improving diagnostic accuracy and efficiency, our innovative technique represents a valuable advancement in microbiological applications.
High-Throughput Quantification of miRNA-3′-Untranslated-Region Regulatory Effects
Authors: Mastriano Stephen , Kanoria Shaveta , Rennie William , Liu Chaochun , Li Dan , Cheng Jijun , Ding Ye , Lu Jun
Published: December 2024

MicroRNAs (miRNAs) regulate gene expression post-transcriptionally, primarily through binding sites in 3′ untranslated regions (3′ UTRs). While computational and biochemical approaches have been developed to predict miRNA binding sites on target messenger RNAs, reliable and high-throughput assessment of the regulatory effects of miRNAs on full-length 3′ UTRs can still be challenging. Utilizing a miniaturized and high-throughput reporter assay, we present a ‘pilot miRNA-targeting map’, containing 4,994 successfully measured miRNA:3′ UTR regulatory outputs by pairwise assays between 461 miRNAs and eleven 3′ UTRs. This collection represents a large experimental miRNA:3′ UTR dataset to date on a single platform. The methodology can be generally applied to studies of miRNA-mediated regulation of critical genes. We found that seedless sites can lead to substantial downregulation. We utilized this dataset in the development of a quantitative total score for modeling the total regulatory effects by both seed and seedless sites on a full-length 3′ UTR. To assess the predictive value of the total score, we analyzed data from mRNA expression and proteomics studies. We found that the score can discriminate the potent miRNA inhibition from the weak inhibition and is thus useful for quantitative prediction of miRNA regulation. The score has been added to the STarMir program of the Sfold package now available via GitHub athttps://github.com/Ding-RNA-Lab/Sfold.
Development and testing of a dual-frequency real-time hardware feedback system for the hard X-ray nanoprobe beamline of the SSRF
Authors: Jiang Zhisen , Jiang Hui , He Yinghua , He Yan , Liang Dongxu , Yu Huaina , Li Aiguo , Signorato Riccardo
Published: December 2024

A novel dual-frequency real-time feedback system has been developed to simultaneously optimize and stabilize beam position and energy at the hard X-ray nanoprobe beamline of the Shanghai Synchrotron Radiation Facility. A user-selected cut-off frequency is used to separate the beam position signal obtained from an X-ray beam position monitor into two parts, i.e. high-frequency and low-frequency components. They can be real-time corrected and optimized by two different optical components, one chromatic and the other achromatic, of very different inertial mass, such as Bragg monochromator dispersive elements and a pre-focusing total external reflection mirror. The experimental results shown in this article demonstrate a significant improvement in position and energy stabilities. The long-term beam angular stability clearly improved from 2.21 to 0.92 µrad RMS in the horizontal direction and from 0.72 to 0.10 µrad RMS in the vertical direction.
Cylindrically bent Laue analyzer in an X-ray Raman/emission spectrometer: performance tests and a comparison with spherically bent Bragg analyzers
Authors: Hiraoka Nozomu
Published: December 2024

The performances of a spherically bent Bragg analyzer and a cylindrically bent Laue analyzer in an X-ray Raman/emission spectrometer are compared. The reflectivity and energy resolution are evaluated from the intensity of the elastic scattering and the width of the energy distribution on a SiO2 glass sample. Widely used, Bragg analyzers display excellent performance at the photon energy E ≤ 10 keV. However, at higher E, the reflectivity and the resolution gradually deteriorate as E increases, showing poor performance above 20 keV. On the other hand, the reflectivity of the Laue analyzer gradually increases at E > 10 keV, displaying excellent reflectivity and good resolution around 20 keV. The Laue analyzer is suitable for X-ray absorption spectroscopy in high-energy-resolution fluorescence-detection mode or X-ray emission spectroscopy on 4d transition metal compounds. Furthermore, the X-ray Raman features of the lithium K-edge in LiF and the oxygen K-edge feature in H2O, measured by nine Bragg analyzers (2 m radius) at E ≃ 9.9 keV and by five Laue analyzers (1.4 m radius) at E ≃ 19.5 keV, have been compared. Similar count rates and resolutions are observed.
Rayleigh waves in thermoelastic medium based on a novel nonlocal three-phase-lag diffusion model with double porosity
Authors: Mahato Chandra Sekhar , Biswas Siddhartha
Published: December 2024

Purpose

This paper is concerned with the study of the propagation of Rayleigh waves in a homogeneous isotropic, generalized thermoelastic medium with mass diffusion and double porosity structure using the theoretical framework of three-phase-lag model of thermoelasticity.

Design/methodology/approach

Using Eringen’s nonlocal elasticity theory and normal mode analysis technique, this paper solves the problem. The medium is subjected to isothermal, thermally insulated stress-free, and chemical potential boundary conditions.

Findings

The frequency equation of Rayleigh waves for isothermal and thermally insulated surfaces is derived. Propagation speed, attenuation coefficient, penetration depth and specific loss of the Rayleigh waves are computed numerically. The impact of nonlocal, void and diffusion parameters on different physical characteristics of Rayleigh waves like propagation speed, attenuation coefficient, penetration depth and specific loss with respect to wave number for isothermal and thermally insulated surfaces is depicted graphically.

Originality/value

Some limiting and particular cases are also deduced from the present investigation and compared with the existing literature. During Rayleigh wave propagation, the path of the surface particle is found to be elliptical. This study can be extended to fields like earthquake engineering, geophysics and the degradation of old building materials.
Peering into the mechanism: uncovering critical drivers of green entrepreneurial orientation through total interpretive structural modelling
Authors: Shivani Shivani , Datta Manisankar , Sharma Seema , Singh Shveta
Published: December 2024

Purpose

The growing pressure on businesses to balance environmental sustainability with profit maximisation has led to the development of green entrepreneurial orientation (GEO), which proactively integrates green practices into core business operations. Grounded in the ecological modernisation theory, GEO acts as a green management practice which helps in achieving competitiveness through environmental innovation. However, despite the growing emphasis on GEO, there remains a gap in understanding how specific drivers influence the organisational structures and processes that lead to GEO. Therefore, the study addresses this gap by analysing the key drivers of GEO using an integrated approach.

Design/methodology/approach

In this study, total interpretive structural modelling (TISM) and cross-impact matrix multiplication applied to classification (MICMAC) were used to identify and interpret the interrelationship between key drivers of GEO. Here, TISM technique aided in constructing a contextual relationship-based structural model of drivers, whereas MICMAC assisted in categorising the drivers based on their driving and dependence power. A case evaluation was also carried out in the Indian textile industry to validate the TISM model.

Findings

The result indicates that institutional pressure, managerial environment concern, organisational resilience and big data analytical capabilities are the most influential drivers of GEO at organisational level, and other drivers act as secondary and linked variables in this process. The MICMAC analysis further supports the results of TISM. In addition, the overall TISM model is validated in the Indian textile sector.

Practical implications

The study findings will assist researchers and policymakers in adopting a systematic approach to prioritise GEO in pollution intensive industries. Moreover, it will help managers in leveraging GEO to achieve strategic advantages amid environmental challenges.

Originality/value

This study is amongst the first to employ an integrated qualitative approach to analyse drivers of GEO.
Learning mechanisms and firms’ performance in the global south: reflections from Ludhiana’s manufacturing firms
Authors: Kaur Manpreet , Mehta Swati
Published: December 2024

Purpose

This study examines the impact of doing, using and interacting (DUI) and science, technology and innovation (STI) learning mechanisms on firm performance, investigating their influence on financial performance through innovative performance in machine tools and textile manufacturing firms in Ludhiana, Punjab, India.

Design/methodology/approach

Primary data was collected through a survey of 202 manufacturing firms across two industries, as secondary data inadequately captures learning mechanisms, particularly for DUI mode. The study employed structural equation modelling (SEM) alongside descriptive analysis to examine the impact of STI–DUI learning mechanisms on performance.

Findings

The study reveals that firms, despite minimal investment in formal R&D, effectively learn through networking and imitation (DUI mechanisms). They also benefit from local industrial training institutions. Notably, innovative performance mediates the relationship between learning mechanisms (imitation, networking and industry institutions) and firms' financial performance.

Originality/value

The literature was found to be scant in terms of understanding the nature of firms learning mechanism, especially for the firms undertaken for the analysis. Although having distinguished nature of knowledge and learning required to compete for the products manufactured in machine tools and textiles industries, local conditions, domestic national institutions and regional aspects makes the industries unique case to understand the challenges amidst unique features of these industries. The study is expected to fill-in the gap in the literature of manufacturing industries belonging to developing countries in the era of increasing technological competition in the integrated world economies.
Monitoring by a single banker and accounting conservatism: evidence from India
Authors: Pradeep Kavitha , Baag Pankaj Kumar
Published: December 2024

Purpose

This paper aims to investigate the effect of bank monitoring on conditional conservative accounting of Indian listed firms. Drawing on bank monitoring and relationship lending literature, the study hypothesizes that monitoring by a single bank reduces the bank’s demand for conservatism-facilitated control transfers.

Design/methodology/approach

The empirical design is composed of three steps. In the first step, using data on Indian firms listed in NSE and BSE for the period 2000–2019, market-based firm-year measure and accrual cash flow-based firm-year measure of conditional conservatism is estimated. In the second step, we test the hypothesis using multivariate panel regression corrected for heteroskedasticity and incorporating firm and year-fixed effects. In the third step, we test for the robustness of the results using Heckman’s correction approach.

Findings

Results indicate that firms which are monitored by a single bank tend to be less conservative. Also, the negative association between single bank monitoring and conservatism is stronger when the firm’s debt structure is dominated by bank debt.

Research limitations/implications

The study’s scope does not include analyzing the influence of characteristics of the single banker monitoring the firm. Future research could investigate attributes like ownership of the banker as a possible source of variation in the relationship documented in this study.

Practical implications

Accounting standard-setting boards are now discouraging implementation of conservatism to avoid bias in financial reporting. This paper finds that a strong bank–firm relationship can be a possible substitute for conservatism.

Originality/value

The study sheds new light on the debt structure–conservatism relationship. Bank’s availability of inside information through the transaction account and its impact on lending relationships is established in the literature. However, the literature on the determinants of conservatism has not examined how the benefit enjoyed by the firm’s single banker, possessing all the information in the transaction account can lead to bank’s reduced dependence on financial statements and subsequently reduced accounting conservatism of borrowing firms.
Beyond the transaction: exploring resources stewardship, relational connectedness and co-creation in B2B marketing
Authors: Saragih Harriman Samuel
Published: December 2024

Purpose

This study aims to explore the interplay between resource stewardship, relational connectedness and value co-creation in business-to-business (B2B) marketing, addressing gaps in understanding how these elements collectively influence stakeholder relationships and organizational outcomes. Drawing on stewardship theory, social exchange theory and service-dominant logic, the study develops a model that highlights the synergies between ethical resource management, strategic relational engagement and co-creative value processes.

Design/methodology/approach

Using an abductive qualitative approach, the study focuses on the B2B service sector in an emerging economy. Data were collected through in-depth interviews with 30 management professionals and analyzed thematically, supported by a network view to visualize the interconnected dynamics.

Findings

Resource stewardship emerges as a key driver of trust and relational connectedness, which facilitates collaborative innovation and value co-creation. Relational connectedness enhances loyalty and cooperative problem-solving, while active participation in co-creation fosters shared ownership, satisfaction and long-term engagement.

Research limitations/implications

The study’s context-specific focus on an emerging economy limits broader applicability, suggesting future cross-industry, cross-cultural approach and quantitative validation.

Originality/value

This study presents an empirically grounded framework that advances theoretical understanding and offers practical insights for optimizing B2B marketing strategies through resource stewardship, relational connectedness and co-creative practices.
Development of the new machine-learning approach in pipeline condition assessment prediction and optimizing rehabilitation strategies
Authors: Sabamehr Ardalan , Amani Nima , Boateng Solomon , Sommer Adam
Published: December 2024

Purpose

This paper aims to outlines a model for water main rehabilitation in Kitchener, Ontario, using a machine-learning approach. Water main networks are vital infrastructure, requiring regular condition assessments to ensure consistent service. Budgets are often allocated for nondestructive testing methods, but using machine learning to predict network conditions offers cost benefits.

Design/methodology/approach

The study focuses on a prediction approach that includes the rehabilitation requirement model. The Decision Tree machine learning method was applied to predict water main pipe breaks in 2024. Based on the predictions, 24 pipes were identified for rehabilitation, and the appropriate Trenchless Rehabilitation Method was selected accordingly.

Findings

The model, applied to data from Kitchener, successfully predicted 24 water main pipe breaks for 2024. The largest pipe diameter was 1200 mm, and the longest length was 6977 m. A cost comparison, factoring in Environmental and Social (E&S) costs, showed that open-cut methods were 25% more expensive than Cured-in-Place Pipe (CIPP). When E&S costs were included, the total cost of the open-cut method increased by approximately 300% compared to sliplining.

Originality/value

Based on the pipe characteristics, CIPP lining and sliplining are recommended for rehabilitation by the City of Kitchener. This study presents a novel approach using Decision Tree machine learning techniques to predict pipe breaks, with a 97% prediction accuracy, making it a promising alternative to traditional models.
Structural equation modelling of the critical barriers influencing the adoption of green building concepts and technologies in Ghana
Authors: Anzagira Lee Felix , Duah Daniel Yaw Addai , Badu Edward , Simpeh Eric Kwame , Marful Alexander B. , Amos-Abanyie Samuel
Published: December 2024

Purpose

In Ghana, the adoption and application of green building concepts and technologies have not been fully explored. The study aimed to look into the key barriers and how they affect this.

Design/methodology/approach

Purposive and snowball sampling techniques were used to select a total of 292 construction industry stakeholders in Ghana who provided information via a questionnaire survey used for the data collection. Exploratory factor analysis and Partial least squares structural equation modelling (PLS-SEM) were used for computing the data analyses.

Findings

According to the study findings, the top five most critical barriers to the uptake of green building concepts and technologies (GBCs and Ts) in Ghana are: lack of government incentives/supports for implementing green building technologies (GBTs), lack of knowledge and awareness of GBTs and their benefits, lack of GBTs databases and information, Lack of green building (GB) expertise/skilled labour and Higher costs of GBTs. Principal Component Factor Analysis was used to further analyse the data, which allowed for the reduction of the 27 (27) factors to just four (4) underlying critical barriers: (1) government and knowledge-associated barriers, (2) technical barriers, (3) cost and finance barriers and (4) stakeholders’ attitude barriers. PLS-SEM techniques were used to analyse this collection of barriers, and the results showed that stakeholders’ attitude-associated barriers and cost and finance-related barriers have a significant negative influence on the uptake of GBCs and Ts in Ghana. This study’s findings have provided empirical evidence of the critical barriers to the uptake of GBCs and Ts from all stakeholders. Stakeholders desirous of implementing GBCs and Ts would work against the negative influences on the uptake of GBCs and TS.

Originality/value

Although there has been an abundance of research to examine the critical barriers to GB, however, the uniqueness of this study is nested in modelling the influence of the barriers on the adoption of GBCs and Ts using the PLS-SEM path modelling.
Endometriosis‐Related Genetic Factors and Their Role in Preterm Birth: A Two‐Sample Mendelian Randomisation Study
Authors: Flatley Christopher , Kristjansson Dana , Ytterberg Karin , Juodakis Julius , Sole‐Navais Pol , Jacobsson Bo
Published: December 2024

Objective

Endometriosis affects 10% of women worldwide and is linked to adverse pregnancy outcomes, including preterm birth. Recent epidemiological and genetic studies indicate that endometriosis may influence gestational duration and the likelihood of preterm birth. This study aimed to estimate the direct genetic causal effects of endometriosis on gestational duration and preterm birth using Mendelian randomisation (MR) analysis, leveraging genetic data from recent genome‐wide association studies (GWASs).

Design

A two‐sample MR study.

Setting

Summary statistics from published GWASs on European ancestry populations for endometriosis and gestational duration.

Population or Sample

Instrumental variables for endometriosis were derived from a meta‐analysis comprising 60 674 endometriosis cases and 701 926 controls.

Methods

Genetic correlations and heritability estimates were calculated using linkage disequilibrium score regression. Two‐sample MR with multiplicative random‐effects inverse variance weighting assessed the primary objectives, supplemented by sensitivity analyses to validate MR assumptions.

Main Outcome Measures

Primary outcomes were gestational duration and preterm birth, sourced from the latest GWAS data.

Results

LD score regression revealed no genetic correlation between endometriosis and either gestational duration or preterm birth. MR analysis showed no causal association between endometriosis and maternal effects on offspring gestational duration (β = 0.40, 95% CI: −0.39 to 1.19, p = 0.32) or preterm birth (OR = 0.94, 95% CI: 0.82–1.06, p = 0.36). Sensitivity analyses indicated pleiotropy but no violations of MR assumptions. Of the four loci overlapping between the gestational duration and endometriosis GWASs, three (EBF1, WNT4, and GDAP1) were identified as outliers using MR‐Presso.

Conclusions

Contrary to observational studies, MR analyses found no direct causal link between endometriosis and gestational duration or preterm birth. Overlaps in genomic regions suggest that the relationship may be mediated through different biological pathways.
The ecology of business environments and consequences for crime
Authors: Hipp John R. , Hodgen Cheyenne
Published: December 2024

Research has typically focused on how certain types of business establishments are associated with the location of crime on street blocks. Studies in this genre, however, often have not accounted for the general business context of the block on which a business is located. This study uses a large sample of blocks in Southern California to test whether the context of businesses matters. We assess whether a nonlinear relationship exists between the total businesses on a block and crime, whether differences exist based on broad categories of businesses—consumer‐facing businesses, blue‐collar businesses, and white‐collar businesses—and whether the mixing of businesses on a block impacts crime. The study finds strong evidence that blocks with more business mixing have higher levels of crime. A 1 standard deviation increase in business mixing is associated with 35%–95% more crime. The relationship between business mixing and crime is moderated by the size of the population on the block. Evidence also shows differences in relationships with crime between consumer‐facing and white‐ or blue‐collar businesses. Only modest evidence shows that specific business types are related to crime levels after accounting for this general business context.
Person‐Organization (Mis)fit: The Experience of Furlough as Career Shock
Authors: Simosi Maria , Conway Neil
Published: December 2024

This study examines employees' experience of being furloughed as a career shock drawing on person‐organization (P–O) fit theory. We focus on the UK's Covid‐19 furlough scheme and the experiences of 23 employees from different sectors following the scheme's termination. Findings from qualitative interviews support the value of misfit to understanding career shocks. Furloughed employees perceived change to their person‐organization fit, and more specifically misfit relating to personal needs (for security, growth and support) versus supplies, and demands (increased responsibilities, lack of retraining upon resuming work) versus skills, where such misfit was attributed to furlough being a career shock and triggering career‐related thoughts and behaviors. Organizational communication and topping‐up furloughed workers' lost monthly income buffered the extent furlough resulted in misfit. Tolerance threshold and perceived employability were found to explain the likelihood of career transitions for furloughed workers reporting misfit. Our findings contribute to the emerging career shocks literature by identifying P–O misfit as a mechanism explaining career transitions.
Associations of smoke‐free policies in multi‐unit housing with smoking behavior and second‐hand smoke exposure: A systematic review
Authors: Garritsen Heike H. , Khan Farzana , Rozema Andrea D. , Navas‐Acien Ana , Hernández Diana
Published: December 2024

Background and aim

Although considerable progress has been made regarding the implementation of smoke‐free policies (SFPs), many people continue to be exposed to second‐hand smoke (SHS) in the home environment. The aim of this study was to conduct a systematic review on the association of SFPs in multi‐unit housing (MUH) with smoking behavior and SHS exposure.

Methods

In August 2022, we searched five online databases: PubMed, Embase, Web of Science, PsycINFO and CENTRAL. Keywords included terms for SFPs, MUH, smoking behavior and exposure to SHS. We searched for studies that focused on regular combustible cigarettes. Due to the high heterogeneity in methodology and outcomes of the included studies, a meta‐analysis was not performed.

Results

Our search yielded 4750 articles. All of them were screened (24 based on full‐text), and 17 met the inclusion criteria. All studies were published between 2001 and 2022. Most studies were conducted in the United States (n = 16) and used a cross‐sectional design (n = 7) or a longitudinal design (n = 7). Seven studies evaluated smoking behavior. Five of them reported that SFPs in MUH were statistically significantly associated with decreases in either current smoking, smoking quantity, smoking frequency or smoking cessation. Fourteen studies evaluated exposure to SHS. Ten reported that SFPs in MUH were statistically significantly associated with decreases in self‐reported exposure to SHS, airborne nicotine levels and particulate matter levels.

Conclusions

Smoke‐free policies in multi‐unit housing appear to be associated with reduced smoking behavior and second‐hand smoke exposure. Successful implementation depends on accessible cessation support and effective enforcement.
Operative caseload of general surgeons working in a rural hospital in Central Australia
Authors: Kaur Harleen , Arayne Aisha Abdulmoeed , Paredes Steven , Barbaro Antonio , Elgindy Yara , Tran Steven , Senaratne Jayantha
Published: December 2024

Background

There is limited published data on the caseload of general surgeons in Central Australia. The region has a significant Indigenous population, who often face higher rates of chronic diseases and require more frequent surgical interventions compared to non‐Indigenous individuals. This study aims to outline the workload of surgeons at Alice Springs Hospital to determine the necessary skill set and surgical education for future surgeons.

Methods

A retrospective review of all general surgery operative cases performed in Central Australia, Alice Springs Hospital was conducted between January 2012 and December 2021. The RACS Morbidity Audit and Logbook Tool was used to classify surgical procedures along with Medicare Benefits Schedule item numbers. Tables were created to present the annual and specialty‐specific data on the types and volumes of procedures.

Results

From January 2012 to December 2021, 35 318 cases were performed, with 92.5% being general surgery, 3% plastics and reconstructive surgery and 2.8% vascular procedures. Indigenous patients received a higher proportion of procedures (50–60%) compared to non‐Indigenous patients (30–50%). Common procedures included incision and drainage of abscesses and debridement of wounds, while trends across specialties showed a decline in ENT and plastic surgeries, stable thoracic and vascular cases, and increased numbers of urology operations.

Conclusion

General surgeons in rural centres must possess a wide range of skills and be capable of performing a variety of procedures. Trainees should be encouraged to consider practicing in rural areas, and those interested should account for the specific needs of the communities they plan to serve.
Cancer‐associated fibroblast‐derived MMP11 promotes tumor progression in pancreatic cancer
Authors: Wang Zhuoyin , Guo Xu , Li Xinming , Wang Jing , Zhang Nengwei , Amin Buhe , Xu Guangzhong , Zhu Bin
Published: December 2024

Matrix metalloproteinase 11 (MMP11), a zinc‐dependent endopeptidase involved in extracellular matrix degradation and remodeling, has been identified as a tumor promoter in multiple cancer types. However, its expression pattern and role in pancreatic ductal adenocarcinoma (PDAC) remain unclear. In this study, elevated MMP11 expression was identified in PDAC tissues and was associated with diminished survival. Integrated single‐cell RNA sequencing and co‐immunofluorescence staining revealed that MMP11 was predominantly expressed in cancer‐associated fibroblasts (CAFs). Mechanistically, cancer cell‐derived TGF‐β1 mediated CAF activation via the pSmad2/3 pathway and accompanied by MMP11 production. Additionally, MMP11 knockdown in CAFs impaired the proliferative and invasive abilities of AsPC‐1 and BxPC‐3 cells in vitro; which could be rescued by adding recombinant MMP11. Similarly, co‐injection of AsPC‐1 cells with MMP11‐knockdown CAFs into nude mice significantly suppressed tumor growth and liver metastasis compared with tumors bearing unmodified CAFs. Furthermore, we confirmed that CAF‐derived MMP11 may drive the epithelial–mesenchymal transition process of PDAC cells to promote tumor invasion via the PI3K/AKT pathway rather than extracellular matrix remodeling. Collectively, we uncovered a crosstalk between cancer cells and CAFs mediated by TGF‐β1 and MMP11 that drives the progression of PDAC.
Combination of rs‐fMRI, QSM, and ASL Reveals the Cerebral Neurovascular Coupling Dysfunction Is Associated With Cognitive Decline in Patients With Chronic Kidney Disease
Authors: Song Lijun , Wang Hao , Yang Wenbo , Li Mingan , Xu Boyan , Li Min , Ding Heyu , Lv Han , Zhao Pengfei , Yang Zhenghan , Liu Wenhu , Wang Zhen‐chang , Liu Xu
Published: December 2024

Background

Neurovascular coupling (NVC) reflects the close connection between neural activity and cerebral blood flow (CBF) responses, providing new insights to explore the neuropathological mechanisms of various diseases. Non‐dialysis patients with chronic kidney disease (CKD) exhibit cognitive decline, but the underlying pathological mechanisms are unclear.

Methods

The prospective study involved 53 patients with stage 1–3a CKD (CKD1–3a), 78 patients with stage 3b–5 CKD (CKD3b–5), and 52 healthy controls (HC). Our investigation involved voxel‐based assessments of both global and regional BOLD signal characteristics. Additionally, we explored the correlations between neuroimaging indices, Montreal Cognitive Assessment (MoCA) scores, and clinical laboratory findings.

Results

Compared to HC, the CKD3b–5 and CKD1–3a groups exhibited lower ALLF and ReHo in the default mode network (DMN), higher CBF in bilateral hippocampus (HIP), higher susceptibility values in bilateral caudate nucleus (CAU) and putamen (PUT), and lower susceptibility values in bilateral HIP. At the global level, the coupling coefficients were lower in CKD1–3a and CKD3b–5 groups than in HC. At the ROI level, the CBF‐ALFF and CBF‐ReHo coupling in HIP and basal ganglia regions were lower in CKD3b–5 groups than in the CKD1–3a group. Most importantly, susceptibility‐ALFF in ANG.R may mediate the effects of phosphorus on cognitive decompensation in patients with CKD1‐3a.

Conclusions

Non‐dialysis patients with CKD exhibit abnormal NCV, which is associated with the cognitive decline. Specifically, the susceptibility‐ALFF may serve as a valuable biomarker for early assessment of cognitive decline in CKD, offering insights into the pathogenesis of cognitive decline in CKD.
Does giving tax debtors a break improve compliance and income? Evidence from quasi‐random assignment of IRS Revenue Officers
Authors: Boning William C. , Slemrod Joel , Stuart Ellen , Turk Alex
Published: December 2024

This paper uses the quasi‐random assignment of IRS Revenue Officers to tax debtors' cases as an instrumental variable to identify the causal effects of suspending debt collection on tax compliance and future income. In contrast to uninstrumented estimates, we find no statistically significant evidence that putting off attempts to collect debt reduces compliance with future tax obligations or future reported income. Among marginal hardship cases, pausing collection instead increases future income, specifically wage earnings by the taxpayer's spouse. In addition, we address concerns about potential non‐random assignment of Revenue Officers.
The quest for efficiency in higher education in England: lessons learned for developed economies
Authors: Johnes Jill , Perez‐Esparrells Carmen
Published: December 2024

Over recent decades, universities in England have transitioned from providing higher education (HE) for the elite to HE for the masses. Funding mechanisms have changed, cost‐sharing has shifted from public to private sources, and efficiency and productivity have been emphasized. Three excellence frameworks relating to research, teaching, and knowledge exchange have been introduced to assess performance. In this paper, we explore the systems of performance measurement and funding implemented in English HE and critically appraise these against the recommendations from the relevant literature. We conclude that these frameworks, by separately assessing performance in the three missions, inadequately account for synergies between activities, thereby ignoring the civic nature of universities and possibilities for economies of scale and scope. We conclude by highlighting some emerging areas for future research. While the focus of the paper is English HE, the themes and findings are relevant to all HE sectors around the world.