bluuebunny/crossref_metadata_2025 huggingface dataset:
Introducing an Islamic equity-based microfinance models for MSMEs in the State of Libya
Authors: Lawhaishy Zainab Belal , Othman Anwar Hasan Abdullah
Published: April 2022

Purpose

This study aims to propose and verify the suitability and applicability of Islamic equity-based microfinance models for financing micro, small and medium enterprises (MSMEs) in the State of Libya. The proposed models combine the unique features of social solidarity, cooperation “Ta’awan,” meeting religious requirements and providing financing more fairly and equitably.

Design/methodology/approach

A qualitative approach is applied in this study through semi-structured interviews with several Libyan experts, including Islamic bankers,Shariahscholars, MSMEs experts, Islamic microfinance experts and academicians. The data collected from 2019 to 2021 and thematic analysis by computer-based software NVivo is used to analyze the data.

Findings

The results indicate that the proposed Islamic equity-based microfinance models are suitable and applicable in Libya. This study also reveals that the proposed models have numerous potential benefits not only in meeting the financial needs of MSMEs but also in meeting the government objectives in economic divarication and socioeconomic development.

Research limitations/implications

First, the study proposes the applicability and suitability of Islamic equity-based models in financing MSMEs only, while large firms are excluded from the study. Second, the study only proposes and tests the applicability of Islamic equity-modes of financing contracts, namely,MusharakahandMudarabah, while Islamic debt-based financing models are not included. Finally, as there is no practical evidence of using those models for financing MSMEs in Libya, this study lacks empirical evaluations of equity models’ real benefits on income, employment generation, living standards improvement and business growth and sustainability.

Practical implications

Given the importance of the MSMEs sector for the State of Libya’s economic growth, it is expected that the findings of this study can be of assistance in formulating guidelines and implementing Islamic equity-based microfinance programs. Besides, it can be a valuable source of information for policymakers for improving the functions of the current microfinance programs in the country. Additionally, as studies concerning Islamic alternative models for financing MSMEs are scarce, the current study can also be a reference point for researchers, academicians, practitioners and other stakeholders.

Social implications

Providing capital support for the underfunded economy segment, attracting small savings, increasing investments and developing entrepreneurial skills could lead to improved economic productivity and growth.

Originality/value

The present study proposes the structure of Islamic equity-based microfinance models for MSMEs in Libya and verifies the suitability of those proposed models among Libyan experts. To the best of the authors’ knowledge, no study has been conducted on uncovering and exploring the potentials of Islamic equity-based microfinance models for financing MSMEs in Libya.
Partnering with Agents: How the Covid‐19 Pandemic changed Relations between the UK Government and Public Service Contractors
Authors: Meggitt‐Smith Benjamin
Published: April 2022

The contracting out of public goods and services has become a central feature of the UK's state machinery, with more than £350 billion spent annually on services ranging from rubbish collection to building submarines. In response to the Covid‐19 pandemic, the UK government took the unprecedented step of incorporating private providers at a national scale to deliver emergency services which were previously the purview of the state. To achieve this, the government used emergency legislation temporarily to remove competitive tenders and reduced reporting processes. In doing so, it substantially re‐orientated its relationship with private providers, moving from a position of a principal granting its authority to deliver services to something more akin to a partner organisation leveraging private resources. This shift in power dynamics, coupled with an ongoing government ambition to expand the UK's public service markets, risks a permanent change in government‐provider relations, to the detriment of the UK's contracting out framework.
Caught in the eye of the perfect storm: Lebanese women human resource managers coping with macro‐level turbulence
Authors: Tlaiss Hayfaa A.
Published: April 2022

This paper advances research on the nexus between macro‐level turbulence and workers' experience through the empirical analysis of the coping strategies of women human resource managers in the context of Lebanon. Theoretically grounded in the transactional theory of stress and coping, the findings reveal how the multidimensional coping strategies of human resource managers unfold at the juncture of macro‐level turbulence, emotion‐focussed and problem‐solving strategies, doing/re‐doing of gender, and the deployment of various types of silence.
A huge Ewing's sarcoma of the rib presenting with superior vena cava syndrome and dysphagia
Authors: Lin Dan , Zhu Xiaomu , Tian Long , Qin Changlong , Dong Jingsi , Zhou Qinghua
Published: April 2022

A 24‐year‐old male patient was admitted to our center complaining of dizziness (superior vena cava syndrome [SVCS]), dysphagia and pain in the right chest wall. At the initial diagnosis, the patient had been found to have an irregular shaped 35 × 30 × 27 cm mass in the right side of his chest. On November 12, 2019, this patient received surgery in our center. The right sixth rib and the tumor were completely removed (R0), while preserving all the lung tissue and other organs in the chest. The patient recovered well after surgery, and his right lung was fully expanded.
Acute echocardiographic and hemodynamic response to his‐bundle pacing in patients with first‐degree atrioventricular block
Authors: Loring Zak , Holmqvist Fredrik , Sze Edward , Alenezi Fawaz , Campbell Kristen , Koontz Jason I. , Velazquez Eric J. , Atwater Brett D. , Bahnson Tristram D. , Daubert James P.
Published: April 2022

Background

Atrial pacing and right ventricular (RV) pacing are both associated with adverse outcomes among patients with first‐degree atrioventricular block (1°AVB). His‐bundle pacing (HBP) provides physiological activation of the ventricle and may be able to improve both atrioventricular (AV) and inter‐ventricular synchrony in 1°AVB patients. This study evaluates the acute echocardiographic and hemodynamic effects of atrial, atrial‐His‐bundle sequential (AH), and atrial‐ventricular (AV) sequential pacing in 1°AVB patients.

Methods

Patients with 1°AVB undergoing atrial fibrillation ablation were included. Following left atrial (LA) catheterization, patients underwent atrial, AH‐ and AV‐sequential pacing. LA/left ventricular (LV) pressure and echocardiographic measurements during the pacing protocols were compared.

Results

Thirteen patients with 1°AVB (mean PR 221 ± 26 ms) were included. The PR interval was prolonged with atrial pacing compared to baseline (275 ± 73 ms, p = .005). LV ejection fraction (LVEF) was highest during atrial pacing (62 ± 11%), intermediate with AH‐sequential pacing (59 ± 7%), and lowest with AV‐sequential pacing (57 ± 12%) though these differences were not statistically significant. No significant differences were found in LA or LV mean pressures or LV dP/dT. LA and LV volumes, isovolumetric times, electromechanical delays, and global longitudinal strains were similar across pacing protocols.

Conclusion

Despite pronounced PR prolongation, the acute effects of atrial pacing were not significantly different than AH‐ or AV‐sequential pacing. Normalizing atrioventricular and/or inter‐ventricular dyssynchrony did not result in acute improvements in cardiac output or loading conditions.
Combined T4 + T3 therapy versus T4 monotherapy effect on psychological health in hypothyroidism: A systematic review and meta‐analysis
Authors: Lan Huiyu , Wen Junping , Mao Yaqian , Huang Huibin , Chen Gang , Lin Wei
Published: April 2022

Purpose

To evaluate whether T4 + T3 combination therapy had advantages in improving psychological health compared with T4 monotherapy.

Methods

We searched PubMed, Embase, Cochrane Library, and Web of Science from January 2000 to March 2021, and updated in September 2021. The inclusion criteria (prospective study, published in English, had a T4 + T3 combination therapy test group and a T4 monotherapy control group, patients aged ≥18 years and with overt primary hypothyroidism, and published after January 2000) were applied by two reviewers; any disagreement was resolved by a third reviewer. The two reviewers independently extracted data using a standard data form and assessed the risk of bias using the Cochrane risk of bias tool. Coprimary outcomes included the psychological health measures of depression, fatigue, pain, anxiety and anger, measured using validated and reliable instruments.

Results

Eighteen of 2029 studies (883 patients) were included in the meta‐analysis. No significant difference was found between T4 + T3 combination therapy and T4 monotherapy with regard to depression (standardized mean difference [SMD]: −0.06, 95% confidence interval [CI]: −0.18; 0.07), fatigue (SMD: 0.06, 95% CI: −0.13; 0.26), pain (SMD: −0.01, 95% CI: −0.24; 0.22), anxiety (SMD: 0.01, 95% CI: −0.15; 0.17) and anger (SMD: 0.05, 95% CI: −0.15; 0.24). Methodological heterogeneity had no influence on the results. The patients preferred combination therapy significantly.

Conclusions

Compared with T4 monotherapy, T4 + T3 combination therapy had no significant advantage in improving psychological health. For patients who are unsatisfied with LT4 monotherapy, the patient and the physician should make a joint decision concerning therapy.
Clinical, imaging and biochemical presentation of cystic pheochromocytomas
Authors: Dogra Prerna , Navin Patrick J. , McKenzie Travis J. , Foster Trenton , Dy Benzon , Lyden Melanie , Young William F. , Bancos Irina
Published: April 2022

Objective

Cystic adrenal mass is a rare imaging presentation of pheochromocytoma. We aimed to describe the clinical, biochemical and imaging characteristics of patients with cystic pheochromocytoma.

Design

Single‐centre, retrospective study, 2000−2020.

Patients

Consecutive patients with cystic pheochromocytoma were identified from our institutional pathology and adrenal tumour database.

Results

Of the 638 patients with pheochromocytomas, 21 (3.2%) had cystic pheochromocytomas (median age: 57 years, 57% women). Most pheochromocytomas were discovered incidentally (57%) or due to symptoms of catecholamine excess (24%). The median tumour size was 6.4 cm. On imaging, cystic pheochromocytomas were round or oval (90%), heterogeneous lesions (86%) with a thick solid rim (median rim thickness 13.9 mm, unenhanced computed tomography (CT) attenuation 40 Hounsfield units (HU), venous‐phase CT attenuation 83 HU), and a median cystic component of 40% (unenhanced CT attenuation 17.6 HU, venous‐phase CT attenuation 20.4 HU), and rarely with calcifications (15%). All 20 patients with biochemical testing had functioning tumours (adrenergic in 80%, noradrenergic in 20%). Total urinary metanephrine excretion correlated with the volume of the solid component (R2 = .75, p < .0001) but not the cystic component (R2 = .04, p = .4386). All patients underwent adrenalectomy (48% laparoscopic, 52% open), and the median duration of hospital stay was 4 days.

Conclusions

Cystic pheochromocytomas are rare, large tumours with a phenotypic appearance that can masquerade as other adrenal cystic lesions. The degree of biochemical abnormality in cystic pheochromocytomas is associated with the volume of the solid component. All patients with adrenal cysts that have a solid component or an unenhanced attenuation >10 HU should undergo biochemical testing for pheochromocytoma.
The attenuation effect of potassium 2‐(1‐hydroxypentyl)‐benzoate in a mouse model of diabetes‐associated cognitive decline: The protein expression in the brain
Authors: Yu Wenwen , Yin Huajing , Sun Yingni , Shi Si , Li Jiang , Wang Xiaoliang
Published: April 2022

Aims

dl‐PHPB (potassium 2‐(1‐hydroxypentyl)‐benzoate) has been shown to have neuroprotective effects against acute cerebral ischemia, vascular dementia, and Alzheimer's disease. The aim of this study was to investigate the effects of dl‐PHPB on memory deficits and preliminarily explore the underlying molecular mechanism.

Methods

Blood glucose and behavioral performance were evaluated in the KK‐Ay diabetic mouse model before and after dl‐PHPB administration. Two‐dimensional difference gel electrophoresis (2D‐DIGE)‐based proteomics was used to identify differentially expressed proteins in brain tissue. Western blotting was used to study the molecular mechanism of the related signaling pathways.

Results

Three‐month‐old KK‐Ay mice were given 150 mg/kg dl‐PHPB by oral gavage for 2 months, which produced no effect on the level of serum glucose. In the Morris water maze test, KK‐Ay mice treated with dl‐PHPB showed significant improvements in spatial learning and memory deficits compared with vehicle‐treated KK‐Ay mice. Additionally, we performed 2D‐DIGE to compare brain proteomes of 5‐month KK‐Ay mice treated with and without dl‐PHPB. We found 14 altered proteins in the cortex and 11 in the hippocampus; two of the 25 altered proteins and another four proteins that were identified in a previous study on KK‐Ay mice were then validated by western blot to further confirm whether dl‐PHPB can reverse the expression levels of these proteins. The phosphoinositide 3‐kinase/protein kinase B/glycogen synthase kinase‐3β (PI3K/Akt/GSK‐3β) signaling pathway was also changed in KK‐Ay mice and dl‐PHPB treatment could reverse it.

Conclusions

These results indicate that dl‐PHPB may play a potential role in diabetes‐associated cognitive impairment through PI3K/Akt/GSK‐3β signaling pathway and the differentially expressed proteins may become putative therapeutic targets.
Application of the current diagnostic algorithm for early mycosis fungoides to a single center cohort: Identification of challenges and suggestions for modification
Authors: Krishnasamy Shalini , Correia Emily , Kartan Saritha , Wang Xuejun , Porcu Pierluigi , Cha Jisun , Nikbakht Neda
Published: April 2022

Background

Diagnosing early‐stage mycosis fungoides (MF) remains a significant challenge. The International Society for Cutaneous Lymphomas (ISCL) proposed an algorithm for diagnosing early MF incorporating clinical and histopathologic characteristics, as well as immunohistochemistry and molecular studies. Here we aim to examine the diagnostic utility of the ISCL algorithm.

Methods

In this single‐center retrospective review, the ISCL algorithm was applied to 28 patients diagnosed with early‐stage MF. Immunohistochemistry and molecular studies were not performed for all patients, so a subgroup analysis was conducted including 18 patients in whom both studies had been performed. We calculated the diagnostic sensitivity of the algorithm. Subsequently, we examined how modifying the algorithm's histopathologic criterion from epidermotropism without spongiosis to epidermotropism influenced its sensitivity.

Results

Forty‐three percent (12/28) of the cohort and 50% (9/18) of the subgroup met the algorithm's diagnostic threshold. When the algorithm was modified, 71% of the cohort and 89% of the subgroup met the algorithm's threshold.

Conclusion

While the ISCL algorithm is useful in diagnosing early‐stage MF, its sensitivity remains suboptimal. Further refinement of the algorithm to capture spongiotic subtypes of MF may improve its diagnostic value.
Kutane Angiosarkome: molekulare Pathogenese und neue therapeutische Ansätze
Authors: Goerdt Lea V. , Schneider Stefan W. , Booken Nina
Published: April 2022

Das kutane Angiosarkom (CAS) ist ein hochaggressiver maligner Tumor mit schlechter Prognose. Das primäre, spontane CAS (pCAS) und das sekundäre, mit einer Bestrahlung oder einem Lymphödem assoziierte CAS (sCAS) unterscheiden sich klinisch sowie molekular. Die Amplifikation/Überexpression von Myc ist ein charakteristisches, wenn auch nicht ausschließliches Merkmal von sCAS, während der Verlust von TP53 selektiv bei pCAS vorkommt. Detaillierte molekulare Analysen mit modernen Multi‐Omics‐Ansätzen haben gezeigt, dass sowohl pCAS als auch sCAS eine erhebliche molekulare Heterogenität aufweisen. Die betroffenen Gene und ihre molekularen Regulatoren sind mögliche therapeutische Zielstrukturen. Darüber hinaus kann das pCAS in Cluster mit hoher Mutationsrate und/oder ausgeprägten Entzündungssignaturen eingeteilt werden, die als Grundlage für die künftige Stratifizierung von pCAS‐Patienten in immuntherapeutischen klinischen Studien dienen können. Während die Aufklärung der der Erkrankung zugrunde liegenden molekularen Veränderungen zügig voranschreitet, verläuft die Entwicklung daraus abgeleiteter neuer Therapien für das CAS jedoch bisher eher langsam. Dennoch wurden einige über die Standardtherapien wie Operation und Radiochemotherapie hinausgehende klinische Studien zu neuen Behandlungsmöglichkeiten initiiert. Dazu gehören zielgerichtete Therapien gegen VEGF und VEGFR1–3 wie Bevacizumab und Pazopanib, sowie β‐Adrenozeptorenblocker wie Propranolol. Derzeit werden auch Immuntherapien entwickelt, unter anderem unter Verwendung der Immuncheckpoint‐Inhibitoren Pembrolizumab und Nivolumab sowie des Anti‐RANKL‐Antikörper Denosumab.
Research on dead human bodies: African perspectives on moral status
Authors: Matisonn Heidi , Muade Ndivhoniswani Elphus
Published: April 2022

A useful concept that can be invoked to resolve complex bioethical issues is that of moral status (or, human dignity). In this article, we apply this concept to dead human bodies in order to support our view that research on such bodies is permissible. Instead of drawing from salient Western theories of human dignity that account for it by appeals to autonomy or rationality, we will base our investigation on emerging conceptions in African theories of moral status as articulated by Thaddeus Metz and Munamato Chemhuru. Our conclusion is that neither of these theories of moral status, one secular, and the other religious, can accommodate the intuition that we have direct duties of respect towards such bodies because, in relation to Metz's conception, they lack the capacity to enter into social relationships while on Chemhuru's conception, dead bodies appear not to have any meaningful purpose within the hierarchy that captures the ontological systems that determine such status. Consequently, we argue that our analysis provides support for the use of unclaimed cadavers in training and research in medical institutions.
Robustness of individualized inferences from longitudinal resting state EEG dynamics
Authors: Hommelsen Maximilian , Viswanathan Shivakumar , Daun Silvia
Published: April 2022

Tracking how individual human brains change over extended timescales is crucial to clinical scenarios ranging from stroke recovery to healthy aging. The use of resting state (RS) activity for tracking is a promising possibility. However, it is unresolved how a person's RS activity over time can be decoded to distinguish neurophysiological changes from confounding cognitive variability. Here, we develop a method to screen RS activity changes for these confounding effects by formulating it as a problem of change classification. We demonstrate a novel solution to change classification by linking individual‐specific change to inter‐individual differences. Individual RS‐electroencephalography (EEG) was acquired over 5 consecutive days including task states devised to simulate the effects of inter‐day cognitive variation. As inter‐individual differences are shaped by neurophysiological differences, the inter‐individual differences in RS activity on 1 day were analysed (using machine learning) to identify distinctive configurations in each individual's RS activity. Using this configuration as a decision rule, an individual could be re‐identified from 2‐s samples of the instantaneous oscillatory power spectrum acquired on a different day both from RS and confounded RS with a limited loss in accuracy. Importantly, the low loss in accuracy in cross‐day versus same‐day classification was achieved with classifiers that combined information from multiple frequency bands at channels across the scalp (with a concentration at characteristic fronto‐central and occipital zones). Taken together, these findings support the technical feasibility of screening RS activity for confounding effects and the suitability of longitudinal RS for robust individualized inferences about neurophysiological change in health and disease.
Role of uroguanylin's signalling pathway in the development of ischaemic stroke
Authors: Ratko Martina , Habek Nikola , Dobrivojević Radmilović Marina , Škokić Siniša , Justić Helena , Barić Anja , Dugandžić Aleksandra
Published: April 2022

Stroke is one of the leading causes of mortality and disability worldwide. By affecting bradykinin function, activation of guanylate cyclase (GC)‐A has been shown to have a neuroprotective effect after ischaemic stroke, whereas the same has not been confirmed for GC‐B; therefore, we aimed to determine the possible role of GC‐C and its agonist, uroguanylin (UGN), in the development of stroke. In this study, middle cerebral artery occlusion (MCAO) was performed on wild‐type (WT), GC‐C KO and UGN KO mice. MR images were acquired before and 24 h after MCAO. On brain slices 48 h after MCAO, the Ca2+ response to UGN stimulation was recorded. Our results showed that the absence of GC‐C in GC‐C KO mice resulted in the development of smaller ischaemic lesions compared with WT littermates, which is an opposite effect compared with the effects of GC‐A agonists on brain lesions. WT and UGN KO animals showed a stronger Ca2+ response upon UGN stimulation in astrocytes of the peri‐ischaemic cerebral cortex compared with the same cortical region of the unaffected contralateral hemisphere. This stronger activation was not observed in GC‐C KO animals, which may be the reason for smaller lesion development in GC‐C KO mice. The reason why GC‐C might affect Ca2+ signalling in peri‐ischaemic astrocytes is that GC‐C is expressed in these cells after MCAO, whereas under normoxic conditions, it is expressed mainly in cortical neurons. Stronger activation of the Ca2+‐dependent signalling pathway could lead to the stronger activation of the Na+/H+ exchanger, tissue acidification and neuronal death.
Oral care, loss of personal identity and dignity in residential care homes
Authors: Johnson Ilona G. , Morgan Maria Z. , Jones Rhiannon J.
Published: April 2022

Objective

The UK National Institute of Clinical Excellence (NICE) guidelines recommend that care staff who provide daily personal care to residents: “Understand the importance of residents' oral health and the potential effect on their general health, well‐being and dignity.” The aim of this study was to explore residents' views and perspectives of dental care in care homes in order to understand how to deliver this care.

Method

Care homes were identified using care home inspection reports for Wales, the UK. Care homes for older people with residents having mental capacity to consent were invited to participate. Data were collected using semi‐structured one‐to‐one interviews with care home residents, care home managers and oral healthcare leads. Interviews were audio recorded, transcribed and analysed using a thematic approach to data. Analysis was assisted by NVivo 10 software. Data collection was completed when no new themes emerged.

Results

This analysis presents findings from 26 interviews with residents, across five care homes. Going into care was associated with a loss of identity. Having teeth and looking after teeth (natural teeth or dentures) was part of keeping that identity. All prioritised privacy, pride and independence above effective oral hygiene. Oral hygiene was viewed as a very private event. Carers adapted oral care, to balance time constraints, care, privacy and dignity. Teeth were a part of personal pride to the extent that two residents said they did not want to die without dentures in their mouths.

Conclusion

Whilst oral care is important to residents, dignity and privacy are often more important; care routines and practices are adapted around this. Carers need to adopt an individualised, pragmatic and sensitive approach to oral care to account for personal dignity when looking after residents to be able to provide appropriate oral care in accordance with guidance. Members of the dental team need to support carers to provide effective oral care, which allows dignified and effective care.
Volatilisation of Trace Elements During Evaporation to Dryness of HF‐Dissolved Silicates (BHVO‐2, AGV‐1, BIR‐1, UB‐N): Open‐ Versus Closed‐System Conditions
Authors: Vlastelic Ivan , Piro Jean‐Luc
Published: April 2022

This work characterises the volatilisation of trace elements during evaporation to dryness of HF‐dissolved silicate rock reference materials (BHVO‐2, AGV‐1, BIR‐1, UB‐N). In open‐system conditions, sublimation at 80 °C remained small (≤ 3%) for most elements with the exception of boron. Conversely, during closed‐system evaporation in a PTFE elbow, volatilisation loss could exceed 3% for Te, Au, Se, Ru, B, Re, As, V and Ge; 100 μg g−1 for Pt, Cd, Ag, Mo and Ti; and 10 μg g−1 for many refractory elements including Nb, Hf, U and Yb. Higher volatilisation loss in the closed‐system results from the higher vapour pressure of HF that allows for the formation of highly fluorinated species with lower sublimation temperature, or unstable species such as rare earth tetrafluorides for which sublimation competes with thermal decomposition. Increasing the temperature from 50 to 100 °C promotes the formation and sublimation of highly fluorinated species (VF5, GeF4, SeF6). Conversely, some refractory elements (Hf, Zr, Yb, U, Cu, Zn, Rb, Ba and Sr) seem to preferentially sublimate at 50 °C possibly through the formation of hydrated fluorides. Our results indicate that closed‐system evaporation must be used with caution for quantitative analyses.
Coding the negative emotions of family members and patients among the high‐risk preoperative conversations with the Chinese version of VR‐CoDES
Authors: Qian Liru , Liu Xinchun , Yin Meng , Zhao Ya , Tie Bingyu , Wang Qingyan , Zhang Yi , Yuan Siyang
Published: April 2022

Background

Little is known about family members' and patients' expression of negative emotions among high‐risk preoperative conversations.

Objectives

This study aimed to identify the occurrence and patterns of the negative emotions of family members and patients in preoperative conversations, to investigate the conversation themes and to explore the correlation between the negative emotions and the conversation themes.

Methods

A retrospective study was conducted using the Chinese version of Verona Coding Definitions of Emotional Sequences (VR‐CoDES‐C) to code 297 conversations on high‐risk procedures. Inductive content analysis was used to analyse the topics in which negative emotions nested. The χ2 Test was used to test the association between the cues and the conversation themes.

Results

The occurrence rate of family members' and patients' negative emotions was very high (85.9%), much higher when compared to most conversations under other medical settings. The negative emotions were mainly expressed by cues (96.4%), and cue‐b (67.4%) was the most frequent category. Cues and concerns were mostly elicited by family members and patients (71.6%). Negative emotions were observed among seven themes, in which ‘Psychological stress relating to illness severity, family's care and financial burden’ (30.3%) ranked the top. Cue‐b, cue‐c and cue‐d had a significant correlation (p < .001) with certain themes.

Conclusions

Family members and patients conveyed significantly more negative emotions in the high‐risk preoperative conversations than in other medical communications. Certain categories of cues were induced by specific emotional conversation contents.

Patient Contribution

Family members and patients contributed to data.
Oral health issues in children and adolescents with vision impairment: A systematic review and meta‐analysis
Authors: Costa Silva‐Freire Luiza , Guimaraes Mariana Oliveira , Abreu Lucas Guimaraes , Vargas‐Ferreira Fabiana , Vieira‐Andrade Raquel Gonçalves
Published: April 2022

Background

Children and adolescents with vision impairment (VI) may be at increased risk of oral health issues, such as periodontal inflammation, poor oral hygiene, dental caries, and dental trauma, but this is inconclusive in the literature.

Aim

To systematically review the literature to determine the main oral health issues of children and adolescents with VI compared to those without VI.

Design

Electronic and manual searches were performed to identify observational studies involving children and adolescents with and without VI, to determine and compare their oral health issues. The methodological quality was assessed using the Joanna Briggs Institute critical appraisal tool. Studies that had homogeneity of methods were incorporated into meta‐analyses.

Results

Fifteen cross‐sectional studies were included. Overall, most studies presented methodological flaws and high risk of bias. The meta‐analysis showed that children and adolescents with VI were 3.86 times as likely to exhibit dental trauma (OR = 3.86, 95% CI = 2.63–5.68, I2 = 0%) and had higher/poorer values for plaque (MD = 0.80, 95% CI = 0.58–1.02, I2 = 96%), gingivitis (MD = 0.69, 95% CI = 0.02–1.37, I2 = 100%), calculus (MD = 0.04, 95% CI = 0.03–0.06, I2 = 0%), and oral hygiene indices (MD = 0.71, 95% CI = 0.24–1.18, I2 = 97%), as well as DMFS (MD = 0.90, 95% CI = 0.68–1.13, I2 = 26%).

Conclusion

Across a wide array of assessments, children and adolescents with vision impairment had worse oral health outcomes than those without VI.
Optimal pricing of online products based on customer anchoring‐adjustment psychology
Authors: Liu Xuwang , Zhang Yujie , Qi Wei , Wang Junwei
Published: April 2022

Online product pricing is an important factor that affects the purchase of customers and the earnings of e‐commerce platform enterprises. It has an increasingly prominent influence on consumers’ purchasing decisions. To study the influence of customers’ anchoring psychology and product pricing on customers’ purchasing behaviors, this paper proposes a pricing model that considers online consumers to be anchored by the product price and sales. The cognitive bias of online consumers is described by a utility function based on an anchoring‐adjustment heuristic, and consumer choice behavior and an online product pricing strategy are studied with a multinomial logit model. Then, it studies the influence of the anchoring point and anchoring degree on optimal pricing, sales and profit. In particular, when consumers are anchored only by sales of goods, the optimal solution is monotonic with respect to the anchoring degree. However, when consumers are anchored by both price and sales, both factors affect consumer behaviors and produce more complex results. This paper provides a flexible pricing mechanism for platform enterprises, and it can provide a theoretical basis and decision support for dynamic pricing of platform enterprises based on historical consumption data.
Interventions for health‐related physical fitness and overweight and obesity in children with intellectual disability: Systematic review and meta‐analysis
Authors: Wang Aiwei , Gao Yang , Wang Jingjing , Brown Tamara J. , Sun Yan , Yu Siyue , Tong Tomas K. , Zhong Linda L. D. , Fong Shirley Siu Ming , Dutheil Frédéric , Baker Julien S.
Published: April 2022

Background

Poor health‐related physical fitness (HRPF) and overweight and obesity are common health problems for children with intellectual disability. This study aimed to review existing lifestyle intervention studies, and identify effective strategies for this population.

Methods

A systematic search was undertaken in three databases. The random‐effects model was used to pool the weighted results by inverse variance methods, and the I2 statistic was applied to assess heterogeneity among the included studies.

Results

Most of the identified interventions (27/29) adopted physical activity (PA). For obesity‐related outcomes, the results showed no significant effect of PA studies on reducing obesity. For HRPF outcomes, significant effects were found on 6‐min walk distance (51.86 m, 95% CI [16.49, 87.22], p < .05).

Conclusions

PA is the predominant intervention component adopted and may contribute to improving cardiopulmonary fitness; but the lack of research limits our ability to draw any confirmed conclusion on obesity‐related outcomes and other HRPF outcomes.
Impaired odor identification ability and olfactory hedonic capacity in children with elevated autistic traits
Authors: Huang Gao‐jie , Qiu Yi‐qi , Tan Shao‐zhen , Ma Qian‐wen , Zou Lai‐quan
Published: April 2022

Atypical olfactory function in autism spectrum disorder has been documented in numerous studies, but little is known about its occurrence in individuals with autistic traits. The aim of the current study was to investigate odor identification ability and olfactory hedonic capacity in children with autistic traits. We recruited 415 children and measured their autistic traits by the Short Autism Spectrum Quotient. The Universal Sniff (U‐Sniff) test was used to measure odor identification ability and olfactory hedonic capacity. Olfactory hedonic capacity was also measured using the children's version of the Chemosensory Pleasure Scale (CPS‐C). Odor identification and olfactory hedonic capacity measured by CPS‐C were negatively correlated with autistic traits. Children with higher autistic traits exhibited poorer odor identification ability and olfactory trait hedonic capacity measured by CPS‐C but intact olfactory state hedonic capacity measured by odor pleasantness. These results pertaining to odor identification and olfactory hedonic capacity may be the endophenotypic markers for autism spectrum disorder.

Practical Applications

Our study extends the knowledge on children with high autistic traits and provides a new perspective on olfactory identification ability and olfactory hedonic capacity in children with high autistic traits. In addition, our findings suggest olfactory testing may provide a new approach for detecting and understanding autism.
Detection, genotyping and virulence characterization of Fusarium wilt race 4 (VCG0114) causing cotton wilt in three Texas fields
Authors: Wagner Tanya A. , Bell Alois A. , Castles Zachary A. , Ali Akhtar , Flores Orlando , Liu Jinggao
Published: April 2022

Fusarium wilt of cotton, caused by the soilborne fungusFusarium oxysporumf.sp.vasinfectumrace 4 (Fov4, VCG0114), is a serious disease that has adversely affected cotton production in California since 2001 and in the Upper Rio Grande Region near El Paso in the border areas between Texas and New Mexico since 2017. Fov4 was isolated from cotton stem samples collected from wilted or asymptomatic plants adjacent to the wilting plants from the El Paso area. The MT genotype was the only Fov4 genotype found in two fields in the Lower Valley of El Paso and the T genotype was the only Fov4 genotype found in one field in the Upper Valley Region of El Paso. No N, MiT or mixed genotypes of Fov4 were detected in any of these fields. Furthermore, theF.oxysporumf.sp.vasinfectumisolates were exclusively Fov4. The results support the observation that the MT genotype of Fov4 is mainly distributed in the Lower Valley of El Paso and the T genotype of Fov4 is mainly distributed in the Upper Valley Region of El Paso. Virulence of the MT genotype of Fov4 was higher than that of the T genotype. PCR methods previously developed for Fov4 specific PCR detection and multiplex Fov4 genotyping were validated by VCG analyses of the newly obtained isolates. These PCR methods were adapted for thein plantadetection of Fov4, but Fov4 genotyping was limited to the detection of T, MT and MiT genotypes. It is important to continue to monitor dynamic population structure of Fov4 genotypes to prevent the spread of Fov4 and optimize disease control.
Religious Markets Under Heavy Regulation: Diversification as a Survival Strategy of the Catholic Church in Communist Countries
Authors: Minarik Pavol
Published: April 2022

The operation of a religious organization under an oppressive regime, such as in communist countries, differs from that in a free society. There is extensive literature on the effects of regulation on competition in religious markets and on the religiosity of a population. Less attention has been given to the effects of oppressive regulation that aims to control and possibly eliminate religion rather than to promote a particular religious group. This paper focuses on the specific question of how churches deal with oppressive regulation, particularly how they choose between legal and illegal operation. It proposes that both the official and the black‐market way of supplying religious services have some advantages and disadvantages, and that dual operation is advantageous where the regulation is severe. The paper examines the operation of the Catholic Church in Central European countries under communist rule, particularly Czechoslovakia, Poland, Hungary, and Ukraine, and the different strategies adopted by the Church concerning official and underground operation.
Timely completion of spinal fusion: A multidisciplinary quality improvement initiative to improve operating room efficiency
Authors: Du Trung , Chidambaran Vidya , Kara Setenay Tuncel , Frazier Matthew , Anadio Jennifer , Girten Sandra , Levi Stacy , Allen Donna , Kurth Charles Dean , Sturm Peter , Varughese Anna
Published: April 2022

Background

Failure to complete surgery within the scheduled timeframe impairs operating room efficiency leading to patient dissatisfaction and unplanned labor costs. We sought to improve timely completion (within 30 min of scheduled time) of first‐case spine fusion surgery (for idiopathic scoliosis) from a baseline of 25%–80% over 12 months. We also targeted timely completion of perioperative stages within predetermined target completion times.

Methods

The project was conducted in three overlapping phases over 16 months. A simplified process map outlining five sequential perioperative stages, preintervention baselines (N = 24) and time targets were defined. A multidisciplinary team conducted a series of tests of change addressing the aims. The key drivers included effective scheduling, team communications, family engagement, data collection veracity, standardized pathways, and situational awareness. Data collected by an independent data collector and from electronic medical records were analyzed using control charts and statistical process control methods.

Results

Post‐intervention, timely case completion increased from 25% to 68% (N = 49) (95% CI 15.1–62.7), (p = 0.003) and was sustained (N = 14). Implementation of prediction model for case‐scheduling decreased difference between scheduled and actual case end‐time (33 vs. 53 min [baseline]) and variance [lower/upper control limits ([−26, 51] vs. [−109, 216] min [baseline]). Average start time delay decreased from 6 to 2 min and on‐time surgical starts improved from 50% to 70% (95% CI 3.2–41.6%). Timely completion increased for anesthesia induction (60% to 85%), surgical procedure (26% to 48%) and emergence from anesthesia (44% to 80%) but not for intraoperative patient preparation (30% to 25%) perioperative stages. Families reported satisfaction with preoperative processes (N = 14), and no untoward intraoperative safety events occurred.

Conclusions

Application of QI methodology reduced time variation of several tasks and improved timely completion of spine surgery. Beyond the study period, sustained team behavior, adaptive changes, and vigilant monitoring are imperative for continued success.
Subjective machines: Probabilistic risk assessment based on deep learning of soft information
Authors: Brito Mario P. , Stevenson Matthew , Bravo Cristián
Published: April 2022

For several years machine learning methods have been proposed for risk classification. While machine learning methods have also been used for failure diagnosis and condition monitoring, to the best of our knowledge, these methods have not been used for probabilistic risk assessment. Probabilistic risk assessment is a subjective process. The problem of how well machine learning methods can emulate expert judgments is challenging. Expert judgments are based on mental shortcuts, heuristics, which are susceptible to biases. This paper presents a process for developing natural language‐based probabilistic risk assessment models, applying deep learning algorithms to emulate experts’ quantified risk estimates. This allows the risk analyst to obtain an a priori risk assessment when there is limited information in the form of text and numeric data. Universal sentence embedding (USE) with gradient boosting regression (GBR) trees trained over limited structured data presented the most promising results. When we apply these models’ outputs to generate survival distributions for autonomous systems’ likelihood of loss with distance, we observe that for open water and ice shelf operating environments, the differences between the survival distributions generated by the machine learning algorithm and those generated by the experts are not statistically significant.
Understanding Political News Media Consumption with Digital Trace Data and Natural Language Processing
Authors: Bach Ruben L. , Kern Christoph , Bonnay Denis , Kalaora Luc
Published: April 2022

Augmenting survey data with digital traces is a promising direction for combining the advantages of active and passive data collection. However, extracting interpretable measurements from digital traces for social science research is challenging. In this study, we demonstrate how to obtain measurements of news media consumption from survey respondents’ web browsing data using Bidirectional Encoder Representations from Transformers, a powerful natural language processing algorithm that estimates contextual word embeddings from text data. Our approach is particularly relevant for political scientists and communication researchers studying exposure to online news content but can easily be adapted to projects in other disciplines working with similar data sets.
Bayesian Inference for Risk Minimization via Exponentially Tilted Empirical Likelihood
Authors: Tang Rong , Yang Yun
Published: April 2022

The celebrated Bernstein von-Mises theorem ensures credible regions from a Bayesian posterior to be well-calibrated when the model is correctly-specified, in the frequentist sense that their coverage probabilities tend to the nominal values as data accrue. However, this conventional Bayesian framework is known to lack robustness when the model is misspecified or partly specified, for example, in quantile regression, risk minimization based supervised/unsupervised learning and robust estimation. To alleviate this limitation, we propose a new Bayesian inferential approach that substitutes the (misspecified or partly specified) likelihoods with proper exponentially tilted empirical likelihoods plus a regularization term. Our surrogate empirical likelihood is carefully constructed by using the first-order optimality condition of empirical risk minimization as the moment condition. We show that the Bayesian posterior obtained by combining this surrogate empirical likelihood and a prior is asymptotically close to a normal distribution centering at the empirical risk minimizer with an appropriate sandwich-form covariance matrix. Consequently, the resulting Bayesian credible regions are automatically calibrated to deliver valid uncertainty quantification. Computationally, the proposed method can be easily implemented by Markov Chain Monte Carlo sampling algorithms. Our numerical results show that the proposed method tends to be more accurate than existing state-of-the-art competitors.
Identifying sexual risk‐taking and ill health in the meeting with young people‐experiences of using an assessment tool
Authors: Kilander Helena , Alehagen Siw , Hammarström Sofia , Golsäter Marie
Published: April 2022

Background

Identifying young people exposed to sexual risk‐taking or violence is fundamental, when seeking to strengthen their health. However, young people seldom share sexual health concerns or experiences of violence with healthcare professionals (HCPs). Studies evaluating how use of a risk assessment tool influences the dialogue about sexual health and violence are sparse.

Aims

The aim of this study was to explore HCPs' experiences of using the SEXual health Identification Tool (SEXIT) in encounters with young people at Swedish youth clinics.

Method

Three focus group interviews were conducted with 21 HCPs from nine youth clinics, where SEXIT had been introduced. Data were analysed using thematic content analysis.

Results

Three themes were identified. The theme, Facilitates dialogue about sexuality and vulnerability, describes how the questionnaire pertaining to SEXIT helped to normalise and help both HCPs and young people to take part in the dialogue about sensitive issues. Need for a trustful encounter presents HCPs' ethical concerns regarding how the questionnaire affects the integrity of young people and trust‐making. Sensitive topics entail challenges describes HCPs' challenges when dealing with sensitive issues. Additionally, it describes needs for knowledge and collaboration when targeting vulnerable young people.

Conclusions

The HCPs stated that using SEXIT developed their ability to address sensitive issues and helped both them and young people to take part in the dialogue about sexuality and exposure to violence. SEXIT involves experiences of ethical concerns regarding integrity and trust‐making. It also entails challenges in having dialogues about sensitive issues, how to deal with risk assessment outcomes and in improvements regarding inter‐professional collaborations.
Characterization of Puncture Forces of the Human Trachea and Cricothyroid Membrane
Authors: DeSchmidt Aleah M. , Gong Alex T. , Batista Joaquin E. , Song Agnes Y. , Bidinger Sophia L. , Schul Alyssa L. , Wang Everet Y. , Norfleet Jack E. , Sweet Robert M.
Published: April 2022

Accurate human tissue biomechanical data represents a critical knowledge gap that will help facilitate the advancement of new medical devices, patient-specific predictive models, and training simulators. Tissues related to the human airway are a top priority, as airway medical procedures are common and critical. Placement of a surgical airway, though less common, is often done in an emergent (cricothyrotomy) or urgent (tracheotomy) fashion. This study is the first to report relevant puncture force data for the human cricothyroid membrane and tracheal annular ligaments. Puncture forces of the cricothyroid membrane and tracheal annular ligaments were collected from 39 and 42 excised human donor tracheas, respectively, with a mechanized load frame holding various surgical tools. The average puncture force of the cricothyroid membrane using an 11 blade scalpel was 1.01 ± 0.36 N, and the average puncture force of the tracheal annular ligaments using a 16 gauge needle was 0.98 ± 0.34 N. This data can be used to inform medical device and airway training simulator development as puncture data of these anatomies has not been previously reported.