bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessments of Effectiveness of Technologies Utilizations in VIHSCM Among Selected Health Facilities in Tanzania Mainland
Authors: Mollel Henry A. , Mushi Lawrencia D. , Nkwera Richard V.
Published: November 2023

Introduction

Tanzania has adopted various technologies for Vaccine and Immunization Health Supply Chain Management to improve the availability, access, and utilization of immunization programs. However, questions remain regarding the effectiveness of the technologies in Vaccine and Immunization Health Supply Chain Management. This study assesses the effectiveness of technology on vaccine and immunization supply chain management in selected health facilities in Tanzania.

Methods

This study adopted an exploratory descriptive cross-sectional design. The study collected data using structured questionnaires from health facilities that adopted VIHSCM technologies in Arusha, Mwanza, and Mbeya regions, Tanzania. Data were analyzed using descriptive statistics and cross-tabulations with the aid of the Statistical Package of Social Sciences 23rdEdition (SPSS).

Results

The study findings showed that 56.7% of the surveyed Health facilities had either TiMR, DHIS2, or GOTHOMIS technology used for vaccine and immunization supply chain management. The study shows that 51.4% of respondents at health facilities agreed that the adopted technologies were very effective, 45.9% were moderately effective and 2.7% said the technologies were less effective. The results asserted that 18.9 % of the adopted technologies were effective in the Management of immunization services, 37.8 % asserted that technology utilizations have Increased access to the vaccine, 2.7% said that technology utilizations assisted in monitoring vaccine temperature, 24.3% said that technologies utilizations assisted in vaccines at their respective health facilities, 5.4 % said that technologies utilizations assisted in the Maintaining the quality of Vaccines.

Conclusion

This study concluded that technology plays a substantial role in improving the availability and quality of vaccines and immunization services in health facilities. Also, the study suggested that increase the use of technologies to capitalize the VIHSCM effectiveness.
Optimal referral rewards for poverty-alleviating products based on the structural equation interpretation
Authors: Zou Fei , Zhou Yanju
Published: November 2023

Purpose

The goal of this study is to investigate the mediating effect of referral rewards on consumer willingness to recommend poverty-alleviating products and to identify the most effective referral rewards for incentivizing consumers to recommend poverty-alleviating products.

Design/methodology/approach

Tournament rewards and piece-rate rewards are designed based on the theory of indebtedness, the related literature and the actual background. SPSS 26.0 and AMOS 17.0 are used to analyze the structural equation model.

Findings

According to the structural equation analysis, the following findings were found: under the tournament reward condition, social image, feelings of indebtedness and perceived reward value negatively affect consumer willingness to recommend. Under the piece-rate reward condition, social image and feelings of indebtedness significantly negatively affect consumer recommendation willingness, while perceived reward value significantly positively affects consumer recommendation willingness. The mean recommendation willingness of the tournament reward group is significantly lower than that of the control group. In contrast, the mean recommendation willingness of the piece-rate rewards group is significantly higher than that of the control group.

Originality/value

Based on the study findings, the authors propose that enterprises apply piece-rate rewards to incentivize consumers to recommend poverty-alleviating products when designing such rewards. In this way, the sale of poverty-alleviating products can be improved.
Time-varying connectedness and causality between oil prices and G7 economies exchange rates. Evidence from the COVID-19 and Russia-Ukraine crises
Authors: Thai Hung Ngo
Published: November 2023

Purpose

This study aims to attempt to investigate the time-varying causality and price spillover effects between crude oil and exchange rate markets in G7 economies during the COVID-19 and Russia–Ukraine crises.

Design/methodology/approach

This study uses time-varying Granger causality test and spillover index.

Findings

This study finds a time-varying causality between exchange rate returns and oil prices, implying that crude oil prices have the predictive power of the foreign exchange rate markets in G7 economies in their domain. Furthermore, the total spillover index is estimated to fall significantly around COVID-19 and war events. However, this index is relatively high – more than 57% during the first wave of COVID-19 and decreasing slightly during the Russia–Ukraine conflict.

Practical implications

This outcome supports the hypothesis that the majority of the time-varying interaction between exchange rates and oil prices takes place in the short term. As a result, the time-varying characteristics provide straightforward insight for investors and policymakers to fully understand the intercorrelation between oil prices and the G7 exchange rate markets.

Originality/value

First, this study has reexamined the oil–exchange rate nexus to highlight new evidence using novel time-varying Granger causality model recently proposed by Shi et al. (2018) and the spillover index proposed by Diebold and Yilmaz (2012). These approaches allow the author to improve understanding of time-varying causal associations and return transmission between exchange rates and oil prices. Second, compared to past papers, this paper has used data from December 31, 2019, to October 31, 2022, to offer a fresh and accurate structure between the markets, which indicates the unique experience of the COVID-19 outbreak and Russia–Ukraine war episodes. Third, this study analyzes a data set of seven advanced economies (G7) exhibiting significant variations in their economic situations and responding to global stress times.
Moving towards a comprehensive view of the spatial processes in seed dispersal networks: Embracing metacommunities
Authors: Vidal Mariana Morais
Published: November 2023

The current biodiversity crisis requires efficient approaches to address the ongoing impoverishment of natural communities and the depletion of ecosystem services and functions. In this sense, identifying key species that promote the functioning of ecological processes can be strategic to guide actions aiming at the conservation and restoration of biodiversity. Node‐level metrics in interaction networks can be helpful to identify those key species, as they measure the role each species plays in organizing the interactions. Moreover, ecological correlates of species structural roles may vary between local and global networks of interactions, reflecting distinct mechanisms acting at different spatial scales. By studying local seed dispersal networks and one global meta‐network combining those local networks, Moulatlet et al. identified the most important traits explaining bird species centrality at varying spatial scales. They found that body mass was the main trait explaining centrality at the local scale, whereas range size was the main predictor of species centrality at the global scale. In this contribution, besides assessing local interaction networks, Moulatlet et al. adopt a biogeographical perspective to seed dispersal systems, extending our knowledge about the possible mechanisms that underlie the organization of interacting assemblages when changing the spatial scale of observation. Future efforts on this field could include an intermediate scale, comprising the level of metacommunities, shedding light on the interplay between local and spatial processes, both embedded in biogeographical realms, when determining the organization of interactions and the ecological correlates of species roles.
Impact of low pharyngeal/esophageal pressure associated with sarcopenia on postendoscopic submucosal dissection pneumonia in patients with superficial esophageal cancer
Authors: Taniguchi Yasuhiro , Ono Junki , Haraguchi Masafumi , Tabuchi Maiko , Hisamatsu Noriko , Takahata Hideaki , Kondo Hisayoshi , Yamaguchi Naoyuki , Kumai Yoshihiko , Nakao Kazuhiko
Published: November 2023

Objectives

The aging population, including patients with superficial esophageal cancer, encounters critical dysphagia‐ and postoperative pneumonia‐related issues. Although endoscopic submucosal dissection (ESD) provides advantages over other modalities, older patients are at higher risk of postoperative pneumonia. Furthermore, the etiologies of pneumonia are complex and include patient‐ (such as sarcopenia) and treatment‐ (including ESD) related factors. Therefore, this study evaluated swallowing function in patients with superficial esophageal cancer and identified post‐ESD pneumonia‐associated factors.

Methods

Comprehensive swallowing function and sarcopenia were evaluated in patients pre‐ESD and 2 months post‐ESD using high‐resolution manometry and several swallowing studies by multiple experts. The effects of mucosal resection and sarcopenia on swallowing function changes post‐ESD, the relationship between preoperative swallowing function and sarcopenia, and the factors influencing postoperative pneumonia were investigated.

Results

Twenty patients were included in the study. Patients with preoperative sarcopenia had significantly lower pharyngeal/upper esophageal sphincter and tongue pressures than those without sarcopenia. However, ESD did not worsen pharyngeal or upper esophageal pressure. Post‐ESD pneumonia incidence tended to be higher in patients with sarcopenia than in those without sarcopenia. The lower upper esophageal sphincter‐integrated relaxation pressure (UES‐IRP) was a significant factor in pneumonia development. Furthermore, the receiver operating characteristic curve for UES‐IRP in pneumonia yielded an area under the curve of 0.82.

Conclusions

Sarcopenia is associated with preoperative dysphagia, which increases post‐ESD pneumonia risk. Therefore, postoperative pneumonia incidence is expected to increase with an aging population, making preoperative sarcopenia and swallowing function evaluation crucial.
Enhancing reproducibility of machine learning‐based studies in clinical journals through model cards
Authors: Dan Jonathan , Seeuws Nick
Published: November 2023

This commentary is on the original articles by Chari et al. and Schafmeyer et al. on pages 216–225 and 226–232 of this issue.
Contrasting impacts of short‐ and long‐term large herbivore exclusion on understory net CO2 exchange in a boreal forest
Authors: Kantola Noora , Väisänen Maria , Joshua Leffler Alan , Welker Jeffrey M.
Published: November 2023

Across boreal forests, trees are the main living biomass carbon (C) stock, but the understory vegetation can contribute significantly to the C cycling and net forest carbon dioxide (CO2) balance. The patchy understory vegetation, which consists of sunlit (i.e. lichen‐like) and shaded habitats (i.e. dwarf shrub‐like), is often altered by ungulate grazers. Grazers may influence understory CO2 exchange and, consequently, the forest CO2 balance. Grazing affects differently the biomass of slow‐growing lichens compared to the faster‐growing mosses and dwarf shrubs, and therefore the effects of grazing on CO2 exchange in the patchy understory vegetation may vary temporally. We studied how excluding grazing for short and long periods affects the CO2 exchange and vegetation biomass in the understory of an oligotrophic Scots pine forest. We measured growing season (2019, 2020) CO2 exchange across sunlit and shaded habitats inside fences that had excluded large grazers for 0–1 and 25–26 years and in the adjacent grazed area. In addition, we measured the height of understory vegetation. We found that short‐term grazer exclusion increased ecosystem CO2 source fluxes only in the shaded habitats. However, long‐term exclusion of grazing decreased CO2 net release regardless of the habitat type. Furthermore, grazer exclusion increased moss depth immediately, which coincided with an abrupt intensification of CO2 net release. Considering the impacts of grazing over both short‐ and long‐term periods may help to forecast C fluxes more accurately, which may be relevant for informed climate solutions regionally and even on a larger scale.
Preclinical motor chunking and fine motor skill learning in fixed prosthodontics: Contribution of3Dprinting and satisfaction of dental students
Authors: Galibourg Antoine , Vergnes Jean‐Noel , Rattier Robin , Hourset Mathilde , Broutin Margaux , Dusseau Xavier , Bataille Coralie , Nabet Catherine , Esclassan Rémi
Published: November 2023

Introduction

In fixed prosthodontics, simulators are essential to students for a progressive transition from preclinical to clinical condition. With the 3D printing technology, we developed resin bars allowing students to better visualise by motor chunking technique. Main objectives of this work were to describe this teaching methodology used in preclinic among different promotions of second, third and fourth dental years and to evaluate students' feedback.

Materials and Methods

Two hundred seventy resin strips were digitally designed and printed in resin. All participants from second, third and fourth had to fulfil a User Experience Questionnaire (UEQ) after the preclinical work. The scales of this questionnaire covered the complete impression of the user experience. Both classical aspects of usability (efficiency, insight and reliability) and aspects of user experience (originality, stimulation) were measured.

Results

For the second dental years, ‘Attractiveness’, ‘Stimulation’ and ‘Novelty’ were considered ‘Excellent’. For the third dental year, novelty average was considered as ‘Excellent’. For the fourth dental year, ‘novelty’ was considered as ‘Good’.

Discussion

The resin plates used in this study are original and stimulating for the students, especially for the second‐year dental students who found the exercises useful for their learning. This method can also be used by creating scenarios close to the clinical situations encountered in dentistry departments (more dilapidated teeth, preparation of inlays, post and core, etc.). This 3D printed simulation model is not intended to replace the Frasaco® models but is a complement to the learning process.
What motivates young Arab Muslim women to choose nursing as a profession: A cross‐sectional study
Authors: Ben Natan Merav , Abd El Hadi Miriam , Zoubi Fardus
Published: November 2023

Aim

This study examines the impact of nurse uniforms, the coronavirus pandemic, and the image of nurses and the nursing profession on the career choice of young Muslim Arab women in nursing, with a focus on policy implications.

Background

The global nursing shortage poses significant challenges, including in Israel. Attracting young Muslim Arab women to nursing careers is vital. Understanding how nurse uniforms, the pandemic, and perceptions of nurses and the nursing profession shape their career decisions can inform policy interventions.

Methods

A cross‐sectional study utilized digital questionnaires administered to 200 Muslim Arab women aged 20–30 in Israel. The study adhered to the EQUATOR checklist for cross‐sectional studies.

Results

Only 29.2% of participants expressed interest in studying nursing. Findings revealed a positive correlation between the pandemic's impact and intention to pursue nursing. A linear regression analysis shows the impact of the white uniform, the image of nurses, and the image of the profession on the choice of a career in nursing.

Discussion

The study emphasizes the significance of nurse uniforms, the image of nurses, and the image of the nursing profession in shaping young Muslim Arab women's career choices in nursing. Policy interventions should raise awareness about nursing roles, expand responsibilities, and highlight nurses' contributions to society.

Conclusion

Strategies to attract young Muslim Arab women to nursing careers should address nurse uniforms, the image of nurses, and the image of the nursing profession.

Implications for policy

Policy interventions should prioritize diversity, promote positive images of nurses and the nursing profession, and raise awareness of nursing roles and contributions among young Muslim Arab women.
The impact of job burnout on nurses' caring behaviors: Exploring the mediating role of work engagement and job motivation
Authors: Labrague Leodoro J.
Published: November 2023

Aim

To investigate the influence of job burnout on nurses' caring behaviors, with a specific focus on the serial mediating role of work engagement and job motivation.

Background

Job burnout is a prevalent issue among nurses and poses significant challenges to their ability to deliver compassionate care. However, the underlying mechanisms that explain the relationship between job burnout and nurses' caring behaviors, which could provide valuable insights for developing targeted interventions and strategies to support nurse well‐being and ensure the consistent provision of compassionate care, remain underexplored.

Methods

A cross‐sectional design was used to gather data from 520 clinical nurses working in various acute healthcare settings in the Philippines. Mediation analyses were conducted using the PROCESS Macro with Model 6.

Results

Nurses exhibited high levels of caring behaviors (M = 4.219); however, they experienced moderate levels of job burnout (M = 2.342). Job burnout had a negative effect (β = −0.0603, p = 0.0482) on nurses’ caring behaviors. Work engagement and job motivation sequentially mediated the relationship between job burnout and nurse caring behaviors (β = −0.0126, p < 0.05).

Conclusions

Higher levels of job burnout were associated with a decreased demonstration of nurses' caring behaviors. Job burnout among nurses led to a decrease in their level of work engagement and job motivation, ultimately impacting their ability to provide caring behaviors to patients.

Implications for nursing and health policy

Organizations should prioritize creating a positive work environment and implementing theory‐driven strategies to address job burnout, which can foster work engagement and job motivation among nurses, thereby providing crucial support for them in delivering high‐quality, compassionate care to patients.
Optimal pricing strategies of e‐commerce supply chain considering consumers’ anticipated regrets under the background of blockchain anti‐counterfeiting technology
Authors: Yu Tianyang , Guan Zhimin , Li Jin , Zhang Jun , Dong Jingyang
Published: November 2023

In this study, we investigate pricing decisions with different decision sequences in an e‐commerce supply chain. The e‐commerce platform sells blockchain‐compatible products through a self‐operated model, while the retailer operating on the platform sells general products. Furthermore, we take into account the impact of counterfeits infiltrating the general product market. This can trigger consumers’ anticipated regrets, including high‐price regret and fake purchase regret. We design three scenarios: Scenario ES (the e‐commerce platform makes the decision first), Scenario RS (the retailer makes the decision first), and Scenario VN (they make decisions simultaneously). We study the impact of consumers’ anticipated regrets and the decision sequence on pricing strategies, as well as the profits of the e‐commerce platform and the retailer. Our results show that the optimal retail prices of the two versions of the products and the profits of the e‐commerce platform and the retailer are negatively correlated with the relative regret intensity. The profits of the e‐commerce platform and the retailer are the lowest under Scenario VN due to the fiercest competition. The e‐commerce platform prefers Scenario RS to Scenario ES. If the counterfeit penetration rate is small and the commission rate is large, the retailer prefers Scenario RS to Scenario ES. However, if the counterfeit penetration rate is high, or if both the counterfeit penetration rate and the commission rate are low, the retailer prefers Scenario ES to Scenario RS. Furthermore, if government penalties (or consumer claims) exist, the retailer should combat counterfeiting appropriately for better financial performance.
Epigenetic patterns in Atlantic herring (Clupea harengus): Temperature and photoperiod as environmental stressors during larval development
Authors: Kho J. , Delgado M. L. , McCracken G. R. , Munden J. , Ruzzante D. E.
Published: November 2023

Understanding the molecular mechanisms underlying individual responses to environmental changes is crucial for species conservation and management. Pelagic fishes including Atlantic herring (Clupea harengus) are of particular interest because of their key ecological and economic roles and their susceptibility to a changing ocean from global warming. Temperature and photoperiod have been linked with spawning time and location in adult herring, but no study has thus far investigated the role of environmental factors on gene regulation during the vulnerable early developmental stages. Here, we examine DNA methylation patterns of larval herring bred under two temperatures (11°C and 13°C) and photoperiod (6 and 12 h) regimes in a 2 × 2 factorial design. We found consistently high levels of global methylation across all individuals and a decline in global methylation with increased developmental stage that was more pronounced at 13°C (p ≤ 0.007) than at 11°C (p ≥ 0.21). Most of the differentially methylated sites were in exon and promoter regions for genes linked to metabolism and development, some of which were hypermethylated at higher temperature. These results demonstrate the important role of DNA methylation during larval development and suggest that this molecular mechanism might be key in regulating early‐stage responses to environmental stressors in Atlantic herring.
Dos Crisis En Diez Años
Authors: Baylos Antonio
Published: November 2023

El articulo contribuye a la cartografía de los debates sobre las reformas y contrarreformas laborales, teniendo en cuenta la reforma laboral española estructurada en torno al RDL 32/2021, y en general al proceso de cambios normativos a partir de marzo del 2020, en plena crisis del COVID, hasta el momento actual en el que se ha producido un desplazamiento del momento post crisis tras la pandemia a la policrisis en la que está inmerso el espacio europeo a partir de febrero del 2022 con el inicio de la guerra en Ucrania y la crisis energética y de suministros consiguiente, que ha provocado el dispararse de la inflación y, hasta el momento, el inicio de una nueva crisis financiera que por el momento no ha repercutido en el espacio monetario del euro. Estudia los dos ciclos de reformas contrapuestas en la regulación de las relaciones laborales. Problematiza los temas referentes a necesidad y excepcionalidad en los dos ciclos de reformas. Y examina la interpretación de la reforma y la mediación de los sujetos que la aplican.

PALABRAS CLAVE: Derecho laboral; Reforma laboral; Reformas laborales españolas.
Digitalización Y Poder De Dirección En La Empresa: Entre La Distopía Y La Acción Sindical
Authors: Gómes Gordillo Rafael
Published: November 2023

El impacto de la digitalización en el sistema de relaciones laborales está siendo objeto de una intensa atención por estudios de distintas disciplinas y desde ópticas diversas. La mayoría de estos trabajos parten de una premisa globalmente aceptada: los notables avances en las técnicas de recogida, tratamiento y análisis de datos mediante fórmulas algorítmicas o desarrollos de inteligencia artificial permiten facilitar la adopción automatizada de decisiones de gestión empresarial, tanto en las empresas que se organizan en forma de plataformas digitales como en las que se estructuran mediante fórmulas más tradicionales. Si, hace algunos años, la distopía laboral se anunciaba en forma de empresa megadescentralizada, que no necesita contratar directamente a ninguna persona porque todas sus actividades han sido externalizadas, en la actualidad, las amenazas futuristas tienen que ver con la posibilidad de eliminar también el concurso de personas trabajadoras en la empresa mediante la robotización de todas las tareas. Esta tendencia alcanza también a las labores de gestión de recursos humanos. El artículo estudia y propone fórmulas de control sindical del uso de estas tecnologías en el ejercicio de los poderes empresariales, con el objetivo de garantizar el goce de los derechos reconocidos a las personas trabajadoras.

 

PALABRAS CLAVE: Poder de dirección en la empresa; gestión automatizada; inteligencia artificial; algoritmos; participación sindical en el centro de trabajo.
Anticyclotomic Euler systems for unitary groups
Authors: Graham Andrew , Shah Syed Waqar Ali
Published: November 2023

Let be an odd integer. We construct an anticyclotomic Euler system for certain cuspidal automorphic representations of unitary groups with signature .
Electron-enhanced atomic layer deposition of Ru thin films using Ru(DMBD)(CO)3 and effect of forming gas anneal
Authors: Collings Michael A. , Junige Marcel , Cavanagh Andrew S. , Wang Victor , Kummel Andrew C. , George Steven M.
Published: November 2023

Ruthenium (Ru) thin films were deposited utilizing electron-enhanced atomic layer deposition (EE-ALD). Sequential exposures of Ru(DMBD)(CO)3 (DMBD = 2,3-dimethylbutadiene) and low-energy electrons at ∼125 eV were used to grow the Ru films at temperatures ≤160 °C. The electrons were obtained from a hollow cathode plasma electron source that provided an electron current of ∼200 mA over a surface area of ∼4 cm2. Low-energy electrons can desorb surface ligands derived from Ru(DMBD)(CO)3, such as CO, through electron-stimulated desorption. The desorbed surface ligands leave chemically reactive sites for subsequent Ru(DMBD)(CO)3 precursor absorption. Ru EE-ALD film growth was monitored utilizing in situ spectroscopic ellipsometry (SE). The electron exposures resulted in rapid Ru film nucleation and growth. Under saturation conditions at 160 °C, the growth rate for Ru EE-ALD was 0.2 Å/cycle. The electron efficiency factor for Ru EE-ALD was ∼21 500 electrons/deposited Ru atom. There was no film growth without electron exposures. Ru growth was observed on various substrates including silicon with native oxide and titanium. Ru growth was also obtained on insulating substrates such as 400 nm thick thermal SiO2 substrates. XPS analysis measured <1 at. % oxygen in the deposited Ru films. XRD, x-ray reflectivity, and SE were used to characterize the Ru films before and after forming gas anneal (FGA). FGA successfully removed carbon impurities from the as-deposited Ru films. The resistivity of the Ru EE-ALD films after FGA was determined to be as low as 17 μΩ cm for a film thickness of 6.7 nm. SE measurements of the imaginary part of the pseudodielectric function, 〈ɛ2〉, were utilized to characterize the as-deposited Ru films and the high purity Ru films after FGA. The low resistivity of the Ru films after FGA was consistent with a prominent Drude absorption in the ⟨ε2⟩ spectrum at ≤1 eV. Various reactive background gases such as H2, NH3, and H2O were utilized during EE-ALD to attempt to remove the carbon from the as-deposited Ru EE-ALD films.
The CALIPR framework for highly accelerated myelin water imaging with improved precision and sensitivity
Authors: Dvorak Adam V. , Kumar Dushyant , Zhang Jing , Gilbert Guillaume , Balaji Sharada , Wiley Neale , Laule Cornelia , Moore G.R. Wayne , MacKay Alex L. , Kolind Shannon H.
Published: November 2023

Quantitative magnetic resonance imaging (MRI) techniques are powerful tools for the study of human tissue, but, in practice, their utility has been limited by lengthy acquisition times. Here, we introduce the Constrained, Adaptive, Low-dimensional, Intrinsically Precise Reconstruction (CALIPR) framework in the context of myelin water imaging (MWI); a quantitative MRI technique generally regarded as the most rigorous approach for noninvasive, in vivo measurement of myelin content. The CALIPR framework exploits data redundancy to recover high-quality images from a small fraction of an imaging dataset, which allowed MWI to be acquired with a previously unattainable sequence (fully sampled acquisition 2 hours:57 min:20 s) in 7 min:26 s (4.2% of the dataset, acceleration factor 23.9). CALIPR quantitative metrics had excellent precision (myelin water fraction mean coefficient of variation 3.2% for the brain and 3.0% for the spinal cord) and markedly increased sensitivity to demyelinating disease pathology compared to a current, widely used technique. The CALIPR framework facilitates drastically improved MWI and could be similarly transformative for other quantitative MRI applications.
Acoustic diffraction–resistant adaptive profile technology (ADAPT) for elasticity imaging
Authors: Gu Yuyang , Kumar Viksit , Dayavansha E. G. Sunethra K. , Schoen Scott , Feleppa Ernest , Tadross Rimon , Wang Michael H. , Washburn Michael J. , Thomenius Kai , Samir Anthony E.
Published: November 2023

Acoustic beam shaping with high degrees of freedom is critical for applications such as ultrasound imaging, acoustic manipulation, and stimulation. However, the ability to fully control the acoustic pressure profile over its propagation path has not yet been achieved. Here, we demonstrate an acoustic diffraction–resistant adaptive profile technology (ADAPT) that can generate a propagation-invariant beam with an arbitrarily desired profile. By leveraging wave number modulation and beam multiplexing, we develop a general framework for creating a highly flexible acoustic beam with a linear array ultrasonic transducer. The designed acoustic beam can also maintain the beam profile in lossy material by compensating for attenuation. We show that shear wave elasticity imaging is an important modality that can benefit from ADAPT for evaluating tissue mechanical properties. Together, ADAPT overcomes the existing limitation of acoustic beam shaping and can be applied to various fields, such as medicine, biology, and material science.
Sequence and epigenetic landscapes of active and silent nucleolus organizer regions in
Arabidopsis
Authors: Fultz Dalen , McKinlay Anastasia , Enganti Ramya , Pikaard Craig S.
Published: November 2023

Arabidopsis thaliana
has two ribosomal RNA (rRNA) gene loci, nucleolus organizer regions
NOR2
and
NOR4
, whose complete sequences are missing in current genome assemblies. Ultralong DNA sequences assembled using an unconventional approach yielded ~5.5- and 3.9-Mbp sequences for
NOR2
and
NOR4
in the reference strain, Col-0. The distinct rRNA gene subtype compositions of the NORs enabled the positional mapping of their active and inactive regions, using RNA sequencing to identify subtype-specific transcripts and DNA sequencing to identify subtypes associated with flow-sorted nucleoli. Comparisons of wild-type and silencing-defective plants revealed that most rRNA gene activity occurs in the central region of
NOR4
, whereas most, but not all, genes of
NOR2
are epigenetically silenced. Intervals of low CG and CHG methylation overlap regions where gene activity and gene subtype homogenization are high. Collectively, the data reveal the genetic and epigenetic landscapes underlying nucleolar dominance (differential NOR activity) and implicate transcription as a driver of rRNA gene concerted evolution.
Cold-blooded vertebrates evolved organized germinal center–like structures
Authors: Shibasaki Yasuhiro , Afanasyev Sergei , Fernández-Montero Alvaro , Ding Yang , Watanabe Shota , Takizawa Fumio , Lamas Jesús , Fontenla-Iglesias Francisco , Leiro José Manuel , Krasnov Aleksei , Boudinot Pierre , Sunyer J. Oriol
Published: November 2023

Germinal centers (GCs) or analogous secondary lymphoid microstructures (SLMs) are thought to have evolved in endothermic species. However, living representatives of their ectothermic ancestors can mount potent secondary antibody responses upon infection or immunization, despite the apparent lack of SLMs in these cold-blooded vertebrates. How and where adaptive immune responses are induced in ectothermic species in the absence of GCs or analogous SLMs remain poorly understood. Here, we infected a teleost fish (trout) with the parasite
Ichthyophthirius multifiliis
(Ich) and identified the formation of large aggregates of highly proliferating IgM
+
B cells and CD4
+
T cells, contiguous to splenic melanomacrophage centers (MMCs). Most of these MMC-associated lymphoid aggregates (M-LAs) contained numerous antigen (Ag)–specific B cells. Analysis of the IgM heavy chain CDR3 repertoire of microdissected splenic M-LAs and non–M-LA areas revealed that the most frequent B cell clones induced after Ich infection were highly shared only within the M-LAs of infected animals. These M-LAs represented highly polyclonal SLMs in which Ag-specific B cell clonal expansion occurred. M-LA–associated B cells expressed high levels of activation-induced cytidine deaminase and underwent significant apoptosis, and somatic hypermutation of Igμ genes occurred prevalently in these cells. Our findings demonstrate that ectotherms evolved organized SLMs with GC-like roles. Moreover, our results also point to primordially conserved mechanisms by which M-LAs and mammalian polyclonal GCs develop and function.
Fecal microbiota transplantation promotes reduction of antimicrobial resistance by strain replacement
Authors: Woodworth Michael H. , Conrad Roth E. , Haldopoulos Marina , Pouch Stephanie M. , Babiker Ahmed , Mehta Aneesh K. , Sitchenko Kaitlin L. , Wang Charlotte H. , Strudwick Amanda , Ingersoll Jessica M. , Philippe Cécile , Lohsen Sarah , Kocaman Kumru , Lindner Blake G. , Hatt Janet K. , Jones Rheinallt M. , Miller Candace , Neish Andrew S. , Friedman-Moraco Rachel , Karadkhele Geeta , Liu Ken H. , Jones Dean P. , Mehta C. Christina , Ziegler Thomas R. , Weiss David S. , Larsen Christian P. , Konstantinidis Konstantinos T. , Kraft Colleen S.
Published: November 2023

Multidrug-resistant organism (MDRO) colonization is a fundamental challenge in antimicrobial resistance. Limited studies have shown that fecal microbiota transplantation (FMT) can reduce MDRO colonization, but its mechanisms are poorly understood. We conducted a randomized, controlled trial of FMT for MDRO decolonization in renal transplant recipients called PREMIX (NCT02922816). Eleven participants were enrolled and randomized 1:1 to FMT or an observation period followed by delayed FMT if stool cultures were MDRO positive at day 36. Participants who were MDRO positive after one FMT were treated with a second FMT. At last visit, eight of nine patients who completed all treatments were MDRO culture negative. FMT-treated participants had longer time to recurrent MDRO infection versus PREMIX-eligible controls who were not treated with FMT. Key taxa (
Akkermansia muciniphila
,
Alistipes putredinis
,
Phocaeicola dorei
,
Phascolarctobacterium faecium
,
Alistipes
species,
Mesosutterella massiliensis
,
Barnesiella intestinihominis
, and
Faecalibacterium prausnitzii
) from the single feces donor used in the study that engrafted in recipients and metabolites such as short-chain fatty acids and bile acids in FMT-responding participants uncovered leads for rational microbiome therapeutic and diagnostic development. Metagenomic analyses revealed a previously unobserved mechanism of MDRO eradication by conspecific strain competition in an FMT-treated subset. Susceptible
Enterobacterales
strains that replaced baseline extended-spectrum β-lactamase–producing strains were not detectable in donor microbiota manufactured as FMT doses but in one case were detectable in the recipient before FMT. These data suggest that FMT may provide a path to exploit strain competition to reduce MDRO colonization.
Heterologous expression of a fully active
Azotobacter vinelandii
nitrogenase Fe protein in
Escherichia coli
Authors: Solomon Joseph B. , Liu Yiling A. , Górecki Kamil , Quechol Robert , Lee Chi Chung , Jasniewski Andrew J. , Hu Yilin , Ribbe Markus W.
Published: November 2023

The functional versatility of the Fe protein, the reductase component of nitrogenase, makes it an appealing target for heterologous expression, which could facilitate future biotechnological adaptations of nitrogenase-based production of valuable chemical commodities. Yet, the heterologous synthesis of a fully active Fe protein of
Azotobacter vinelandii
(
Av
NifH) in
Escherichia coli
has proven to be a challenging task. Here, we report the successful synthesis of a fully active
Av
NifH protein upon co-expression of this protein with
Av
IscS/U and
Av
NifM in
E. coli
. Our metal, activity, electron paramagnetic resonance, and X-ray absorption spectroscopy/extended X-ray absorption fine structure (EXAFS) data demonstrate that the heterologously expressed
Av
NifH protein has a high [Fe
4
S
4
] cluster content and is fully functional in nitrogenase catalysis and assembly. Moreover, our phylogenetic analyses and structural predictions suggest that
Av
NifM could serve as a chaperone and assist the maturation of a cluster-replete
Av
NifH protein. Given the crucial importance of the Fe protein for the functionality of nitrogenase, this work establishes an effective framework for developing a heterologous expression system of the complete, two-component nitrogenase system; additionally, it provides a useful tool for further exploring the intricate biosynthetic mechanism of this structurally unique and functionally important metalloenzyme.

IMPORTANCE

The heterologous expression of a fully active
Azotobacter vinelandii
Fe protein (AvNifH) has never been accomplished. Given the functional importance of this protein in nitrogenase catalysis and assembly, the successful expression of AvNifH in
Escherichia coli
as reported herein supplies a key element for the further development of heterologous expression systems that explore the catalytic versatility of the Fe protein, either on its own or as a key component of nitrogenase, for nitrogenase-based biotechnological applications in the future. Moreover, the “clean” genetic background of the heterologous expression host allows for an unambiguous assessment of the effect of certain nif-encoded protein factors, such as AvNifM described in this work, in the maturation of AvNifH, highlighting the utility of this heterologous expression system in further advancing our understanding of the complex biosynthetic mechanism of nitrogenase.
Medical expenditure trajectory and HbA1c progression prior to and after clinical diagnosis of type 2 diabetes in a commercially insured population in the USA
Authors: Pagán Lorissa , Yang Wenya , Shao Hui , Wang Yu , Zhang Ping
Published: November 2023

Introduction

Medical expenditures of individuals with type 2 diabetes escalate before clinical diagnosis. How increases in medical expenditures are related to glucose levels remains unclear. We examined changes in HbA1c and medical expenditures in years prior to and shortly after type 2 diabetes diagnosis.

Research design and methods

Using insurance claims and laboratory test results from a commercially insured population in the USA, we built three (2014, 2015, 2016) longitudinal cohorts with type 2 diabetes up to 10 years before and 2 years after the diagnosis (index year). We identified diabetes diagnosis using International Classification of Diseases, Ninth Revision and Tenth Revision codes and antidiabetic medication use. We ran two individual fixed regression models with annual total medical expenditures and average HbA1c values as dependent variables and number of years from diagnosis as the main independent variable and examined the risk-adjusted movement of the outcomes.

Results

Our study included 9847 individuals (83 526 person-years). Medical expenditures and HbA1c levels increased before and peaked at the diagnosis year. Medical expenditures were $8644 lower 10 years and $5781 lower 1 year before diagnosis compared with the index year. HbA1c was 12.18 mmol/mol (1.11 percentage points) and 3.49 mmol/mol (0.32 percentage points) lower, respectively. Average annual increases in medical expenditures and HbA1c values over the prediagnosis period were $318 and 0.97 mmol/mol (0.09 percentage points), respectively.

Conclusions

Medical expenditures and HbA1c values followed similar trajectories before and after diabetes diagnosis. Our results can inform economic evaluations of programs and policies aimed at preventing type 2 diabetes.
Early parenting interventions to prevent internalising problems in children and adolescents: a global systematic review and network meta-analysis
Authors: Costantini Ilaria , López‐López José A , Caldwell Deborah , Campbell Amy , Hadjipanayi Veronica , Cantrell Sarah J , Thomas Tallulah , Badmann Nathan , Paul Elise , James Deborah M , Cordero Miguel , Jewell Tom , Evans Jonathan , Pearson Rebecca M
Published: November 2023

Question

We compared the effectiveness of different types of parenting interventions based on an a priori taxonomy, and the impact of waitlists versus treatment as usual (TAU), in reducing child internalising problems.

Study selection and analysis

We conducted a systematic review and network meta-analysis of published and unpublished randomised controlled trials (RCTs) until 1 October 2022 that investigated parenting interventions with children younger than 4 years. Exclusion criteria: studies with children born preterm, with intellectual disabilities, or families receiving support for current abuse, neglect, and substance misuse. We assessed the certainty of evidence using the Confidence in Network Meta-Analysis framework. We used random-effects network meta-analysis to estimate standardised mean differences (SMDs) with 95% credible intervals (CrIs).

Findings

Of 20 520 citations identified, 59 RCTs (18 349 participants) were eligible for the network meta-analysis. Parenting interventions focusing on the dyadic relationship (SMD: −0.26, 95% CrI: −0.43 to −0.08) and those with mixed focus (−0.09, –0.17 to −0.02) were more effective in reducing internalising problems than TAU at the first time point available. All interventions were more effective than waitlist, which increased the risk of internalising problems compared with TAU (0.36, 0.19 to 0.52). All effects attenuated at later follow-ups. Most studies were rated as with ‘high risk’ or ‘some concerns’ using the Risk of Bias Assessment Tool V.2. There was no strong evidence of effect modification by theoretically informed components or modifiers.

Conclusions

We found preliminary evidence that relationship-focused and mixed parenting interventions were effective in reducing child internalising problems, and the waitlist comparator increased internalising problems with implications for waiting times between referral and support. Considering the high risk of bias of most studies included, the findings from this meta-analysis should be interpreted with caution.

PROSPERO registration numberCRD42020172251.
Quantifying the potential epidemiological impact of a 2-year active case finding for tuberculosis in rural Nepal: a model-based analysis
Authors: Shrestha Sourya , Mishra Gokul , Hamal Mukesh , Dhital Raghu , Shrestha Suvesh , Shrestha Ashish , Shah Naveen Prakash , Khanal Mukti , Gurung Suman , Caws Maxine
Published: November 2023

Objectives

Active case finding (ACF) is an important tuberculosis (TB) intervention in high-burden settings. However, empirical evidence garnered from field data has been equivocal about the long-term community-level impact, and more data at a finer geographic scale and data-informed methods to quantify their impact are necessary.

Methods

Using village development committee (VDC)-level data on TB notification and demography between 2016 and 2017 in four southern districts of Nepal, where ACF activities were implemented as a part of the IMPACT-TB study between 2017 and 2019, we developed VDC-level transmission models of TB and ACF. Using these models and ACF yield data collected in the study, we estimated the potential epidemiological impact of IMPACT-TB ACF and compared its efficiency across VDCs in each district.

Results

Cases were found in the majority of VDCs during IMPACT-TB ACF, but the number of cases detected within VDCs correlated weakly with historic case notification rates. We projected that this ACF intervention would reduce the TB incidence rate by 14% (12–16) in Chitwan, 8.6% (7.3–9.7) in Dhanusha, 8.3% (7.3–9.2) in Mahottari and 3% (2.5–3.2) in Makwanpur. Over the next 10 years, we projected that this intervention would avert 987 (746–1282), 422 (304–571), 598 (450–782) and 197 (172–240) cases in Chitwan, Dhanusha, Mahottari and Makwanpur, respectively. There was substantial variation in the efficiency of ACF across VDCs: there was up to twofold difference in the number of cases averted in the 10 years per case detected.

Conclusion

ACF data confirm that TB is widely prevalent, including in VDCs with relatively low reporting rates. Although ACF is a highly efficient component of TB control, its impact can vary substantially at local levels and must be combined with other interventions to alter TB epidemiology significantly.
Organ donation decision-making in ICU patients: from the perspectives of organ coordinators and physicians in China – a qualitative study
Authors: Yang Xi , Chen ChaoQun , Geng Kun , Jia Xuedong , Si FangYing , Lu XiaoJing , Zhang Wan , Du Shuzhang , Zhang Xiaojian , Guo Wenzhi , Yin Zhao
Published: November 2023

Objectives

Intensive care unit (ICU) dying patients are the most important source of organ donation. This study explores the reasons affecting organ donation in the Chinese sociocultural context from the perspectives of coordinators and physicians, and further seeks countermeasures to alleviate the shortage of organs.

Design and setting

Semistructured interviews conducted in a large tertiary hospital in China.

Participants and method

15 respondents (including 8 organ coordinators and 7 ICU physicians) were interviewed. Participants were invited to describe the factors that influence organ donation and the underlying reasons behind it. Bronfenbrenner’s socioecological system model was used as theoretical support to construct a theoretical model of the factors influencing organ donation. Respondents participated in semistructured qualitative interviews that were audio-recorded and transcribed. The relevant data were analysed using thematic analysis.

Results

Four themes that influenced organ donation were identified including the influence of the deceased person’s attributes, immediate family members, surrounding people and the environment, and the social-level factors. In addition, we obtained four strategies from the interviews to improve the organ shortage to ameliorate the current supply–demand imbalance in organ donation. These include multilevel publicity, relevant policy support, increasing other forms of supply and reducing organ demand.

Conclusions

Factors affecting organ donation after the death of a Chinese citizen include the personal characteristics of the donor, the decisions of family members such as immediate family members and the indirect influence of surrounding people such as collateral family members, in addition to factors related to the humanistic environment, religious beliefs and social opinion.