bluuebunny/crossref_metadata_2025 huggingface dataset:
Empathy and clarity in GPT-4-Generated Emergency Department Discharge Letters
Authors: Ben Haim Gal , Livne Adva , Manor Uri , Hochstein David , Saban Mor , Blaier Orly , Iram Yael Abramov , Balzam Moran Gigi , Lutenberg Ariel , Eyade Rowand , Qassem Roula , Trabelsi Dan , Dahari Yarden , Eisenmann Ben Zion , Shechtman Yelena , Nadkarni Girish N , Glicksberg Benjamin S , Zimlichman Eyal , Perry Anat , Klang Eyal
Published: October 2024

Background and Aim

The potential of large language models (LLMs) like GPT-4 to generate clear and empathetic medical documentation is becoming increasingly relevant. This study evaluates these constructs in discharge letters generated by GPT-4 compared to those written by emergency department (ED) physicians.

Methods

In this retrospective, blinded study, 72 discharge letters written by ED physicians were compared to GPT-4-generated versions, which were based on the physicians’ follow-up notes in the electronic medical record (EMR). Seventeen evaluators, 7 physicians, 5 nurses, and 5 patients, were asked to select their preferred letter (human or LLM) for each patient and rate empathy, clarity, and overall quality using a 5-point Likert scale (1 = Poor, 5 = Excellent). A secondary analysis by 3 ED attending physicians assessed the medical accuracy of both sets of letters.

Results

Across the 72 comparisons, evaluators preferred GPT-4-generated letters in 1,009 out of 1,206 evaluations (83.7%). GPT-4 letters were rated significantly higher for empathy, clarity, and overall quality (p < 0.001). Additionally, GPT-4-generated letters demonstrated superior medical accuracy, with a median score of 5.0 compared to 4.0 for physician-written letters (p = 0.025).

Conclusion

GPT-4 shows strong potential in generating ED discharge letters that are empathetic and clear, preferable by healthcare professionals and patients, offering a promising tool to reduce the workload of ED physicians. However, further research is necessary to explore patient perceptions and best practices for leveraging the advantages of AI together with physicians in clinical practice.
Suppressive interactions between nearby stimuli in visual cortex reflect crowding
Authors: Soo Leili , Antonov Plamen , Chakravarthi Ramakrishna , Andersen Soren Krogh
Published: October 2024

Crowding is a phenomenon in which visual object identification is impaired by the close proximity of other stimuli. The neural processes leading to object recognition and its breakdown as seen in crowding are still debated. To assess how crowding affects the processing of stimuli in the visual cortex, we recorded steady-state visual evoked potentials (SSVEPs) elicited by flickering target and flanker stimuli while manipulating the spacing of these stimuli (Experiment 1) as well as target similarity (Experiment 2). Participants performed an orientation discrimination task while accuracy and speed of behavioural responses, along with frequency-tagged SSVEPs elicited by target and flanker stimuli, were recorded. Decreasing target-flanker distance reduced both behavioural performance and target-elicited SSVEP amplitudes. Estimates of the critical spacing, a measure of the spatial extent of crowding, from both behavioural data and SSVEP amplitudes were similar. Additionally, manipulating target similarity affected both measures in the same way. These findings establish a clear connection between the suppression of stimulus processing by nearby flankers in the visual cortex and crowding, and demonstrate the usefulness of SSVEPs in studying the cortical mechanisms of visual crowding.
Early alterations of motor learning and corticostriatal network activity in a Huntington’s disease mouse model
Authors: Badreddine N , Appaix F , Becq G , Achard S , Saudou F , Fino E
Published: October 2024

Huntington’s disease (HD) is a neurodegenerative disorder that presents motor, cognitive and psychiatric symptoms as it progresses. Prior to motor symptoms onset, alterations and dysfunctions in the corticostriatal projections have been described along with cognitive deficits, but the sequence of early defects of brain circuits is largely unknown. There is thus a crucial need to identify early alterations that precede symptoms and that could be used as potential early disease markers. Using an HD knock-In mouse model (HdhCAG140/+) that recapitulates the human genetic alterations and that show a late and progressive appearance of anatomical and behavior deficits, we identified early alterations in the motor learning abilities of young mice, long before any motor coordination defects. In parallel, ex vivotwo-photon calcium recordings revealed that young HD mice have altered basal activity patterns in both dorsomedial and dorsolateral parts of the striatum. In addition, while wild-type mice display specific reorganization of the activity upon motor training, network alterations present in the basal state of non-trained mice are not affected by motor training of HD mice. Our results thus identify early behavioral deficits and network alterations that could serve as early markers of the disease.
Animal acoustic communication maintains a universal optimum rhythm
Authors: Piette T. , Cathcart C. , Barbieri C. , Ming K. M. , Grandjean D. , Bickel B. , Déaux E.C , Giraud A-L.
Published: October 2024

Most animals interact with conspecifics through acoustic signals that are modulated in frequency and rhythm. While small animals vocalize at higher pitch than large ones due to the smaller size of their vocal apparatus, the rules governing vocalization rhythms throughout the animal kingdom remain unknown. Vocal rhythms serve as a natural information parser, and one possibility is that they are constrained by the neural rhythms of transmitter and receiver, known to be relatively conserved across species and independent of their size. In this study, we quantified acoustic rhythms across taxa and investigated their evolutionary history with regard to phylogeny and selective pressure. In 98 species from six classes, we tested the main factors likely to influence their communication rhythms: morphology, physiology, social complexity, mastication and detectability. Phylogenetic modeling did not confirm the influence of these species-specific factors, but rather point to a scenario where acoustic communication rhythms have been maintained around an optimum at around 3Hz in the biological (neuronal) delta range (1-4Hz) well before the mammals split. These results suggest that the rhythm of acoustic communication signals, unlike their pitch, has a universal neural determinant that has been conserved throughout evolution, allowing for intra- and cross-species signaling.
Local cytokine changes in response to mesenchymal stem cell-derived extracellular vesicles-based therapy in rat spinal cord injury
Authors: Kabdesh Ilyas , Garanina Ekaterina , Kostennikov Alexander , Rizvanov Albert , Mukhamedshina Yana
Published: October 2024

Aim

To investigate the effects of mesenchymal stem cell-derived extracellular vesicles (MSC-EVs), encapsulated in a fibrin matrix (FM), on pro-inflammatory and anti-inflammatory cytokine levels in a rat model of spinal cord injury (SCI) 60 days post-injury.

Methods

MSCs were isolated from rat adipose tissue and cultured to obtain MSC-EVs using cytochalasin B. MSC-EVs encapsulated in the FM were applied to the injury site at doses of 5 and 10 µg. Four experimental groups included SCI without treatment, SCI with FM application, and SCI with FM+EVs at 5 and 10 µg doses. A multiplex assay was conducted to measure 23 cytokines in spinal cord tissue homogenates.

Results

FM application to the injury site exhibited both pro- and anti-inflammatory cytokine shifts, with the most pronounced effect for G-CSF (2.8-fold) potentially due to the hemostatic properties of the FM. MSC-EVs led to significant modulation of cytokine levels. In the SCI FM+EVs10 group, concentrations of IL-10, IL-1b, IL-5, and IL-17A were significantly lower compared to the SCI and SCI FM groups. Here the most pronounced change was observed for IL-10, which decreased by 2.4-fold.

Conclusion

Combined treatment with MSC-EVs and FM significantly influenced pro- and anti-inflammatory cytokine levels, demonstrating a dose-dependent effect. These findings highlight the potential of EVs to modulate inflammatory responses and promote regeneration in the chronic phase of spinal cord injury.
Distinct proliferative and neuronal programmes of chromatin binding and gene activation by ASCL1 are cell cycle stage-specific
Authors: Beckman William F. , Parkinson Lydia M. , Chaytor Lewis , Philpott Anna
Published: October 2024

ASCL1 is a potent proneural factor with paradoxical functions during development, promoting both progenitor pool expansion and neuronal differentiation. How a single factor executes and switches between these potentially opposing functions remain to be understood. Using neuroblastoma cells as a model system, we show that ASCL1 exhibits cell cycle phase-dependent chromatin binding patterns. In cycling cells, S/G2/M phase-enriched binding occurs at promoters of transcribed pro-mitotic genes, while G1 phase-enriched binding of ASCL1 is associated with the priming of pro-neuronal enhancer loci. Prolonged G1 arrest is further required to activate these ASCL1-bound and primed neuronal enhancers to drive neuronal differentiation. Thus, we reveal that the same transcription factor can control distinct transcriptional programmes at different cell cycle stages, and demonstrate how lengthening of G1 allows engagement of a differentiation programme by turning unproductive factor binding into productive interactions.
Empowering commitment: unraveling the impact of motivating language and the mediating role of trust
Authors: Talukder Md Farid , Atinc Guclu
Published: October 2024

Purpose

The purpose of this study is to examine the direct and indirect effects of motivating language on organizational commitment, as this phenomenon has drawn the attention of researchers.

Design/methodology/approach

This study employs social exchange theory and motivating language theory to examine data collected from 217 full-time employees across various US-based companies. The proposed hypotheses were analyzed using the PLS-SEM method.

Findings

This study’s findings demonstrate that motivating language positively affects employees’ organizational commitment and affective trust but not cognitive trust, which mediates the relationship between motivating language and organizational commitment.

Research limitations/implications

There are some limitations of our study that need to be mentioned. First, there are concerns about survey data collection via M-Turk (Shapiro et al., 2013). We attempted to overcome some of these problems by including questions to identify careless respondents. Also, we eliminated many respondents who completed the surveys in unreasonably short periods of time. Hence, we believe we accounted for response bias with these check points. Also, while we believe our final sample is a representative sample due to the significant amount of data elimination during the data collection, we believe that checking for non-response bias, as Armstrong and Overton (1977) suggest, is imperative. Unfortunately, due to the nature of M-Turk, that is impossible. However, M-Turk recruits respondents based on the parameters provided by the researchers, so we expect the non-respondents to be not significantly different from the respondents. In parallel to that, we acknowledge the limitations of our study sample. Due to that reason, our findings must be considered within the context of our sample parameters. We urge future researchers of this area to further validate our findings in different types of samples.

Originality/value

To the best of the authors’ knowledge, they are the first to analyze the impact of motivating language on organizational commitment and the mediating role of trust (cognitive and affective) in this relationship.
Construction 4.0 implementation for performance improvement: an innovation management perspective
Authors: Murguia Danny , Soetanto Robby , Szczygiel Michael , Goodier Chris Ian , Kavuri Anil
Published: October 2024

Purpose

The emergence of Construction 4.0 technologies provides an impetus for radical change and rejuvenates the interest of stakeholders in addressing long-standing performance issues in the construction sector. However, construction firms struggle to implement Construction 4.0 technologies for performance measurement and improvement. Therefore, the purpose of this research is to develop a conceptual model of innovation management for implementing Construction 4.0 that guides and facilitates the strategic transformation of construction firms.

Design/methodology/approach

A conceptual model of innovation management is presented, and the findings are synthesised based on a literature review, 20 semi-structured interviews, two focus group discussions, three workshops, expert consultation and observations on three digitally-enabled projects. Data were inductively analysed using thematic analysis.

Findings

The analysis of empirical data revealed: (i) Four scenarios that could lead the industry to different futures, based on the extent of research and development, and the extent of integration/collaboration; (ii) Construction 4.0 capability stages for a sustained implementation route; (iii) Possible business model configurations derived from servitisation strategies; and (iv) Skills management challenges for organisations.

Research limitations/implications

First, the empirical data was only collected in the UK with its unique industry context, which may limit the applicability of the results. Second, most of the research data comes from the private sector, without the views of public sector organisations. Third, the model needs to be further validated with specific data-driven use cases to address productivity and sustainability issues.

Practical implications

Successful Construction 4.0 transformation requires a concerted effort of stakeholders, including those in the supply chain, technology companies, innovation networks and government. Although a stakeholder’s action would depend on others’ actions, each stakeholder should undertake action that can influence the factors within their control (such as the extent of collaboration and investment) and the outcomes.

Originality/value

The conceptual model brings together and establishes the relationships between the scenarios, Construction 4.0 capability stages, business models and skills management. It provides the first step that guides the fuzzy front-end of Construction 4.0 implementation, underpins the transformation to the desired future and builds long-term innovation capabilities.
A maturity assessment methodology for ISO 13485 implementation in the medical devices industry
Authors: Linck William , Tinoco Maria Auxiliadora Cannarozzo , Bonato Samuel Vinícius , Grochau Ines Hexsel , Pacheco Diego A. de J. , Ten Caten Carla Schwengber
Published: October 2024

Purpose

This study aims to develop a novel diagnostic methodology for implementing ISO13485:2016 and test its applicability to improve quality management systems (QMS) in the medical devices industry context.

Design/methodology/approach

First, a literature review on the topic was conducted. Second, insights gained from the literature and expert interviews were employed to develop the new maturity assessment methodology. Subsequently, the methodology was tested on a medical device manufacturer. Next, based on the evaluation of the intervention, actions were recommended to improve the QMS.

Findings

Research findings have developed a maturity assessment methodology comprising 52 certifiable requirements structured into four macro-requirements derived from ISO 13485:2016. Findings show that the methodology is valuable for aiding QMS implementation, and the diagnosed maturity levels corresponded with the company’s empirical perceptions of the requirement’s maturity.

Practical implications

Empirical evidence validates the significance and practical utility of the proposed methodology, as evidenced by the company’s attainment of FDA (US Food and Drug Administration) approval after the intervention. Findings suggest that the methodology could be replicated within the medical products industry or adapted to assess other QMS, leveraging the organizational alignment with the international regulations of the sector and the ISO 9000 requirements.

Originality/value

The developed methodology fills existing gaps in both literature and practice within the medical devices industry, providing a valuable contribution by addressing the limited research on diagnostic methodologies designed for ISO 13485:2016 implementation. The article assists medical device enterprises in addressing QMS maturity levels as a metric for evaluating QMS requirements, which is an underexplored avenue in existing QMS evaluation approaches.
Organisational cyber resilience: a heuristic for bridging foundations and applications
Authors: Sallos Mark-Paul , Garcia Perez Alexeis , Bocanet Anca
Published: October 2024

Purpose

The drive for digitalisation has increased the scope of cyber threats which can exploit the growing footprint of information and communication technology infrastructure supporting modern societies. Despite substantial interest and efforts in researching and building organisational cyber resilience, the resulting body of work is heterogeneous and has yet to reach maturity. This paper aims to address the gap in the conceptualisation of cyber resilience in academic and practice-oriented grey literature.

Design/methodology/approach

In this conceptual paper, we firstly seek to explore the available foundations of resilience as a construct and consider how these can be applied to organisational cybersecurity. To that aim, this study employs a targeted literature review approach, incorporating systematic elements to ensure rigour. Literature was identified through comprehensive searches in key academic databases, reference chaining and expert recommendations. Articles were selected based on relevance and contribution to the field, resulting in a thematic analysis to identify gaps and propose a heuristic model for cyber resilience. With this approach, we aim to position the emerging view of cyber resilience relative to risk analysis, while highlighting its domain of “conceptual comparative advantage” – the types of applications it is best suited to address. Finally, a high-level heuristic model for cyber resilience is proposed, which functions across the relevant policy, strategy and operational dimensions while also considering its relationship with cyber risk management.

Findings

A conceptual model for organisational cyber resilience is proposed which helps position and frame research contributions in this domain relative to risk analysis, highlighting its domain of comparative advantage. The model integrates policy, strategy and operational dimensions, in a manner conducive to bridging foundations and applications of the concept of cyber risk management. The proposed model provides a critical point of reference to evaluate individual models, frameworks and tools.

Originality/value

This paper is a pioneering effort to overcome the current gaps between conceptual and practical views of cyber resilience. It proposes a new, risk-aligned view of the concept of cyber resilience and provides a structural foundation for further research and practice in the field.
Adverse childhood experiences, economic challenges and suicide risk under COVID-19 pandemic: results from U-CORONA study
Authors: Doi Satomi Kato , Nawa Nobutoshi , Yamaoka Yui , Nishimura Hisaaki , Koyama Yuna , Kuramochi Jin , Fujiwara Takeo
Published: October 2024

Purpose

The purpose of this study is to examine the synergistic effect of adverse childhood experiences (ACEs) and economic challenges on suicide risk, under the coronavirus disease 2019 (COVID-19) pandemic, using a prospective population-based cohort study.

Design/methodology/approach

Participants included 435 adults (aged from 18 to 92 years, mean = 53.8) from the Utsunomiya COVID-19 seROprevalence Neighborhood Association (U-CORONA) study, a population-based longitudinal study in Utsunomiya city, Japan. The baseline survey was conducted in June 2020, between the first and the second wave of the COVID-19 pandemic in Japan. ACEs were assessed using 13 items, and economic challenges due to the COVID-19 were assessed using one item. In the follow-up study, conducted in October 2020 between the second and the third wave of the COVID-19 pandemic in Japan, suicide risk was assessed using six items from the Mini-International Neuropsychiatric Interview via a self-reported questionnaire.

Findings

This study found positive independent association between ACEs and economic challenges due to COVID-19 and suicide risk. Synergistic effects were also found: the participants with one ACE and economic challenges and those with 2+ ACEs and economic challenges were more likely to be at higher risk of suicide compared to those without ACEs and economic challenges.

Originality/value

The findings suggest that adults with a higher number of ACEs, in addition to severe economic challenges, were more likely to be at risk for suicide during the COVID-19 pandemic.
Exploring the socioeconomic factors affecting green cities development
Authors: Dzramado Emmanuel Doe , Asiedu Richard Ohene , Owusu-Manu De-Graft , Edwards David J. , Adesi Michael , Acheampong Alex
Published: October 2024

Purpose

This paper explored the socioeconomic factors affecting green cities development. Extant literature have highlighted green cities as a major path towards sustainability in the construction industry but very little is known on the socioeconomic aspect of green cities and its bid in promoting sustainability in the construction industry; hence, the premise of this study which highlights the socioeconomic factors affecting green cities development in Ghana.

Design/methodology/approach

A comprehensive literature review was conducted to identify the socioeconomic factors affecting green cities. A quantitative research strategy was adopted to collect primary data from respondents who have the requisite understanding and knowledge in green cities using questionnaires. The data gathered was then analysed using descriptive statistics and exploratory factor analysis viz principal component analysis.

Findings

The socioeconomic factors affecting green city development comprised: Green support mechanisms (i.e. innovation and technology, green city planning (urban planning), stakeholder engagement, awareness, city planning (transportation) and environmental regulations); green inhibitors (i.e. population, culture, housing and policy implementation); green market and finance (i.e. digital finance, green market mechanism, green investment finance, risks and uncertainties, income levels of clients). It was evident that socioeconomic factors are significant to the development of green cities in Ghana and hence policy makers and various stakeholders should prioritize socioeconomic factors in the bid to achieve sustainability through green cities in the construction industry.

Originality/value

This paper presents a foremost and comprehensive study on the socioeconomic factors affecting green cities in Ghana. The study results showed that even though the path to sustainability in green cities has pivoted mainly on environmental factors, socioeconomic factors are also significant to green city development, hence, policy makers and the construction industry should keenly consider the socioeconomic factors affecting green city development in the bid towards sustainability for cities.
Does applying inductive methods based on system thinking improve EFL grammar learning?
Authors: Alfares Nurah
Published: October 2024

Purpose

This study examined the effect of incorporating an inductive method based on system thinking to enhance grammar learning in the English language at a secondary school in Saudi Arabia.

Design/methodology/approach

The researcher developed pre- and post-grammar tests for this study. Two EFL teachers participated; one taught the experimental group using inductive methods based on system thinking, while the other taught the control group using the traditional deductive approach to grammar instruction. Around 52 students participated in both the experimental group (26) and the control group (26). At the beginning of the term, all students completed pre-tests, and after eight weeks they completed the post-tests.

Findings

The results demonstrated significant differences between the experimental and control groups. The findings revealed that using inductive methods based on system thinking was highly effective in improving students’ grammar performance.

Research limitations/implications

This study could benefit EFL teachers, encouraging them to use inductive materials based on system thinking to create a more meaningful, interactive and engaging learning environment.

Originality/value

This study fills a gap in the EFL literature since it examines the impact of an inductive approach based on system thinking in grammar learning. System thinking activities encourage deep reflection, helping learners deduce grammatical rules. This study could benefit EFL teachers, encouraging them to use inductive materials based on system thinking to create a more meaningful, interactive and engaging learning environment.
Museum specimens shedding light on the evolutionary history and cryptic diversity of the hedgehog family Erinaceidae
Authors: ZENG Ying , HE Kai , CHEN Xing , BAI Weipeng , LIN Hongzhou , CHEN Jianhai , NEDYALKOV Nedko , YAMAGUCHI Nobuyuki , VIJAYAN Keerthy , SUGANTHASAKTHIVEL Ramamoorthy , KUMAR Brawin , HAN Yuqing , CHEN Zhongzheng , WANG Wenzhi , LIU Yang
Published: October 2024

The family Erinaceidae encompasses 27 extant species in two subfamilies: Erinaceinae, which includes spiny hedgehogs, and Galericinae, which comprises silky‐furred gymnures and moonrats. Although they are commonly recognized by the general public, their phylogenetic history remains incompletely understood, and several species have never been included in any molecular analyses. Additionally, previous research suggested that the species diversity of Erinaceidae might be underestimated. In this study, we sequenced the mitochondrial genomes of 29 individuals representing 18 erinaceid species using 18 freshly collected tissue and 11 historical museum specimens. We also integrated previously published data for a concatenated analysis. We aimed to elucidate the evolutionary relationships within Erinaceidae, estimate divergence times, and uncover potential underestimated species diversity. Our data finely resolved intergeneric and interspecific relationships and presented the first molecular evidence for the phylogenetic position of Mesechinus wangi, Paraechinus micropus, and P. nudiventris. Our results revealed a sister relationship between Neotetracus and Neohylomys gymnures, as well as a sister relationship between Hemiechinus and Mesechinus, supporting previous hypotheses. Additionally, our findings provided a novel phylogenetic position for Paraechinus aethiopicus, placing it in a basal position within the genus. Furthermore, our study uncovered cryptic species diversity within Hylomys suillus as well as in Neotetracus sinensis, Atelerix albiventris, P. aethiopicus, and Hemiechinus auratus, most of which have been previously overlooked.
Preparation and characterization of ovomucin self‐assembly nanoparticles under glycerol compression for astaxanthin delivery: Sustained release and antioxidant activity
Authors: Zhang Zhenqing , Li Xuanchen , Teng Haoye , Han Yumeng , Jin Yongguo , Xu Qi
Published: October 2024

Astaxanthin (AST) is a natural hydrophobic nutrient with various biological activities, but its low solubility limits its application. In this study, self‐assembly nanoparticles were prepared by ovomucin (OVM) and Ca2+ with the enhancement of glycerol to deliver AST. Glycerol compressed the particle size of nanoparticles from 175.7 ± 1.8 to 142.9 ± 0.6 nm, and the nanoparticles had a strong negative charge (−28.9 ± 0.6 mV). Ultraviolet–visible spectroscopy and X‐ray diffraction (XRD) confirmed the successful encapsulation of AST in an amorphous form with a high encapsulation efficiency (82.9% ± 2.1%). Fourier transform infrared and circular dichroism analyses demonstrated that nanoparticles formation mainly involved electrostatic interactions and hydrophobic interactions. AST in nanoparticles presented excellent gastric juice resistance and sustained release ability, whereas free radical scavenging efficiency reached up to 75%. In addition, the nanoparticles had no apparent toxicity to cell viability. This study is expected to provide a new insight into the safe and efficient delivery of AST, while demonstrating the potential of OVM as a delivery carrier in the food and health industries.
Detection and characterization of HIV‐1 group O and HIV‐2 in the Central African Republic
Authors: Moussa Sandrine , Tagnouokam‐Ngoupo Paul Alain , Tombette Fabienne , Manirakiza Alexandre , Boum Yap , Vernet Guy , Njouom Richard , Belec Laurent , Plantier Jean‐Christophe , Kfutwah Anfumbom
Published: October 2024

The Central African Republic (CAR) is characterized by widespread HIV epidemic with notable prevalence and genetic diversity. We herein analysed the genetic diversity of atypical non‐M HIV‐1 strains. In‐house serotyping assays for variants of HIV‐1 (M, N, O, P) and HIV‐2 were used to test a biological collection of 6092 HIV‐seropositive blood samples collected between 2003 and 2014 at the Institut Pasteur de Bangui. Samples indicative of recombinant M/O groups, HIV‐2, or those that yield doubtful/negative results underwent further PCR tests and sequencing. We found six atypical HIV strains: specifically, three (0.05%) HIV‐1 group O strains (subtype H) detected in samples from 2005, 2008 and 2009, alongside three (0.05%) HIV‐2 strains (two group A and one group B) identified in samples from 2007 and 2009. HIV‐1/O strains showed a genetic link to Cameroon and Gabon strains. This study highlights the dominance of HIV‐1/M in the CAR's HIV epidemic over time and underscores the infrequent occurrence of HIV‐1 group O and HIV‐2 strains. These findings validate the efficacy of WHO‐recommended HIV testing protocols and emphasize the need for adaptive surveillance and management strategies to confront the complexities introduced by the genetic diversity of HIV strains.
The evolution of Japanese real GDP components in the time–frequency domain: The disappearance of the investment accelerator effect?
Authors: Crowley Patrick M. , Hudgins David
Published: October 2024

Understanding the interaction between national income GDP expenditure components is a key part of the study of the macroeconomics of any country. The general aim of this study is to explore this interaction between the GDP expenditure components in the time–frequency domain for the country of Japan, obtain some stylized facts and then compare them with those of the United States. The main result shows that the cyclical interactions between consumption and investment are typical of an “accelerator” effect and operate at several different frequencies, but that the several different cycles evident in the data phase out in the 1990s, once secular stagnation started to take hold. We hypothesize that Japan's investment drivers then changed to be dependent on the external sector by the 2000s. A secondary result is that Japanese fiscal policy appears to have been largely ineffective in terms of creating cyclical interactions with other GDP components.
Antecedents of Lead Director Selection
Authors: Li Yajing
Published: October 2024

Research Question/Issue

This paper investigates the antecedents of lead director selection in the US context. Specifically, how do rational and social factors influence the likelihood of being selected as the lead director?

Research Findings/Insights

Results for independent directors in S&P 1500 firms from 2000 to 2021 support the positive effect of both board capital (human capital and social capital) and social embeddedness with the CEO (university ties and demographic similarity) as factors in the selection of lead directors. Results also show that among late adopters, the effect of human capital (board experience) on selection is strengthened, and the effect of demographic similarity to the CEO on selection is weakened.

Theoretical/Academic Implications

First, building on the director selection model, this paper further differentiates the rational and socialized perspectives by integrating the diffusion model. Specifically, among late adopters, rational factors play a larger role, and socialized factors play a smaller role in the lead director selection. Second, for the literature on the boards of directors, this paper provides unique individual‐level insights about directors' attributes and their interactions with firm‐level timing of practice adoption.

Practitioner/Policy Implications

The new governance practice of having a lead director, a leader of independent directors, has emerged and spread in the United States since 2000. As attention to the lead director governance practice increases, this paper focuses on the complexity of its adoption. Specifically, both rational (board capital) and socialized (social embeddedness with the CEO) factors can play a role in the lead director selection. Related stakeholder groups such as directors, investors, and policymakers should be aware of the potential symbolic adoption of this new governance practice.
Clinical Efficacy of Isatuximab Plus Carfilzomib and Dexamethasone in Relapsed/Refractory Multiple Myeloma Patients
Authors: De Novellis Danilo , Derudas Daniele , Vincelli Donatella , Fontana Raffaele , Della Pepa Roberta , Palmieri Salvatore , Accardi Fabrizio , Rotondo Francesco , Morelli Emanuela , Gigliotta Emilia , Roccotelli Daniela , Marano Luana , Barone Maria Lucia , Cetani Giusy , Esposito Daniela , Lazzaro Antonio , Delle Cave Giuseppe , Serio Bianca , Morini Denise , Porrazzo Marika , Urciuoli Eleonora , Masucci Chiara , Fanelli Fulvia , Rizzo Michela , Arcamone Manuela , Trastulli Fabio , Rocco Stefano , Leone Aldo , Bianco Rosario , Salvatore Flavia , Idato Aurora , Sicari Maria , Tosi Patrizia , Rascato Maria Gabriella , Di Perna Maria , Falcone Antonietta Pia , Morello Lucia , Carlisi Melania , Svanera Gino , Annunziata Mario , Frigeri Ferdinando , Califano Catello , Carella Angelo Michele , Marcacci Gianpaolo , Pane Fabrizio , Risitano Antonio Maria , Giudice Valentina , Botta Ciro , Selleri Carmine
Published: October 2024

Isatuximab, a novel anti‐CD38 monoclonal antibody, is approved in combination with carfilzomib and dexamethasone (Isa‐Kd) in relapsed/refractory multiple myeloma (RRMM) patients. Because of its recent introduction, real‐world efficacy and safety are poorly reported. In this Italian multicenter real‐life observational retrospective study, efficacy and safety of the Isa‐Kd regimen were evaluated in a cohort of 103 RRMM patients. Overall response rate (ORR) was 85%, with stringent (sCR) or complete response (CR) in 18% of cases and very good partial response (VGPR) in 39%. Median PFS and OS were not reached within the study period, while 1‐year PFS and OS were 72% and 77%, respectively. Hematological toxicities were observed in 42% of subjects, and cardiac toxicities occurred in 24% of cases. Moreover, we conducted a subanalysis on patients (N = 69) treated with Isa‐Kd after one prior line of therapy, showing an ORR of 88%, with sCR + CR in 20% of subjects, VGPR in 46%, and PR in 22% of patients. In this group, median PFS and OS were not reached, while 1‐year PFS and OS were 92% and 95%, respectively. In conclusions, our study confirmed Isa‐Kd as an effective treatment option for RRMM with a manageable safety profile even in real‐life settings.
Kenyan Female Immigrants’ Creation of a Virtual Enclave: The Influence of Age and Immigration Status
Authors: Chenane Joselyne L. , Gonzales Teresa Irene , Pryce Daniel K.
Published: October 2024

Much of the research on ethnic enclaves in the United States has focussed on physical, geographic spaces or brick‐and‐mortar establishments that foster community building and provide shared resources for immigrant groups, such as those from Latin America, Asia and Europe. These studies often highlight the benefits and challenges enclaves provide, with only a limited discussion of how immigrant women use these spaces. Using survey data drawn from Kenyan women residing in the United States, this study aimed to answer two research questions: (1) Does membership in social media groups comprised of Kenyan female immigrants vary (e.g. by age, immigration status)? (2) Do age and immigration/citizenship status influence Kenyan female immigrants' reasons for joining social media groups? The bivariate results show that older women and those who migrated to the United States for school or through the Green Card lottery programme were likelier to join Tumaini and other immigrant‐specific social media groups. Regarding factors influencing their reasons for joining these groups, the regression results revealed that US citizens and permanent residents were less likely to join the group for solidarity/support. Furthermore, those who migrated for school or to join family members were likelier to join the Tumaini group for support/solidarity. This finding suggests that older women, being more likely to belong to physical social groups, have a relatively stronger attachment to such groups. Consequently, their willingness to join the Tumaini group, despite it being an online community, may be stronger than that of their younger counterparts.
Microstructure and mechanical properties of 3D‐printed zirconia bone scaffold: Experimental and computational analysis
Authors: Barui Srimanta , Lebert Austin , Jauregui Francisco , Munjuluri Krishna Sai Aparna , Kate Kunal
Published: October 2024

Microextrusion‐based additive manufacturing of zirconia‐based bioceramics is capable of fabricating design‐specific architectures with high mechanical strength properties and relative density. We developed a novel organic residue‐free binder system for zirconia paste printing (ZP2) with the shear‐thinning properties apropos to microextrusion‐based 3D printing. Based on thermogravimetric analysis, debinding protocol was established followed by high‐temperature heat treatment under four sintering conditions. Quantitative linear shrinkage (32.3%–42.7% ranging from in‐plane to vertical direction), density (83.3%–87.5%), and surface roughness (7.7–13.8 µm from the parallel to the perpendicular to the infill direction) as a factor of sintering conditions (1400°C–1500°C for 3–4 h) were analyzed. Whereas qualitative phase assemblage demonstrated “sintering condition independent” phase stability; grain growth and reduction in porosity were observed in the microstructure with increment in sintering temperature and hold time. Interestingly, at higher temperature and hold time, the compressive (46–72.4 MPa) and tensile strength (16.2–23.1 MPa) properties experienced a trade‐off between grain growth and reduction in porosity. The ZP2 scaffolds sintered at lower temperature and hold time qualified for the bone scaffold applications having interconnected porosities, biologically relevant surface roughness, and human bone mimicking mechanical properties. With a unique finite element analysis recipe, the mechanical behavior of the “life‐like” reconstructed computer aided design (CAD) geometries identical to real 3D‐printed‐sintered ZP2 scaffolds was quantitatively predicted.
What is the State of Organisational Compassion‐Based Interventions Targeting to Improve Health Professionals' Well‐Being? Results of a Systematic Review
Authors: Nielsen Camilla Littau , Lindhardt Christina Louise , Näslund‐Koch Lui , Frandsen Tove Faber , Clemensen Jane , Timmermann Connie
Published: October 2024

Aim

To identify and assess the state of knowledge regarding compassion‐based interventions and outcomes, targeted to the organisational level, that aim to improve health professionals' well‐being.

Design

Systematic review.

Data Sources

Using the PICO model, the clinical question and search strategy were structured. The searches were performed on 20 September 2022 and 26 December 2023 in the Scopus, CINAHL, EMBASE, PsycINFO and ProQuest Dissertations & Theses Global databases. Content analysis was applied to analyse data, and the PRISMA and SWiM guidelines were followed for reporting.

Results

Thirty‐eight studies, mostly from the United Kingdom and the United States, met the inclusion criteria and were quality assessed and analysed. Compassion‐based interventions that target the organisational level are quite new, thus representing a burgeoning initiative. In this review, many included quantitative studies revealed significant methodological challenges in effectively measuring organisational compassion (interpersonal relationships, organisational culture and retention/turnover). However, the review findings overall indicate that interpersonal connections between colleagues that foster a sense of community, through shared experiences, mindfulness and (self‐)compassion practices and social activities, may be a protective factor for well‐being. Further, the review emphasises the crucial role of management support in catalysing organisational changes to improve health professionals' well‐being.

Conclusion

Evidence strongly suggests that fostering human interconnectedness among health professionals is associated with enhanced well‐being. Further rigorous studies are needed to validate these findings, clarify the organisational cultural aspects of compassion and develop an effective outcome measurement tool for organisational compassion.

Practice Implications

Organisational compassion‐based interventions may help foster a culture of compassion within organisations, enhance health professionals' capacity for compassion and benefit both their well‐being and the quality of care provided to patients and relatives.

Patient Contributions

This review is part of a larger project about compassion and includes two patient representatives (mothers of children with cancer) in the research team.
‘Balancing Challenges and Personal Resources’: A Qualitative Study of Women's Experiences of Arm Impairment After Axillary Surgery for Breast Cancer
Authors: Appelgren Matilda , Wengström Yvonne , de Boniface Jana , Sackey Helena
Published: October 2024

Aim

To explore how women previously treated for breast cancer experience living with arm impairment after axillary surgery.

Design

Descriptive qualitative study. The inductive starting point for the analysis was followed by a deductive approach as the categories were related to the components of the sense of coherence framework.

Methods

Twenty‐eight relapse‐free Swedish‐speaking females participated in six focus group discussions conducted between September and December 2022. All participants had undergone sentinel lymph node biopsy with or without completion axillary dissection 4 years earlier. Data were analysed using qualitative content analysis.

Results

Three categories and an overall theme were identified. The categories ‘Sense‐making’, ‘Daily life’ and ‘Driving force’ reflect actions to understand and prevent arm symptoms, adaptations made in daily life and the empowering resources adopted to meet challenges. The overall theme, ‘Balancing challenges and personal resources’, comprised a process that began at diagnosis and remained ongoing for some participants. Most participants considered their new life situations manageable. However, those with more pronounced arm impairment reported that they did not always receive adequate aid, and that their daily lives were negatively affected.

Conclusion

Returning to everyday life after axillary surgery for breast cancer is associated with varying degrees of challenges. Individuals with persistent arm impairment find returning to normal life more challenging. Therefore, further improvements in person‐centred care are of utmost importance.

Patient and Public Contribution

Members of the Swedish Breast Cancer Association were involved in the creation of the interview guide.

Impact

This study emphasises the requirement for providing further individualised support to those living with more severe arm impairment after axillary surgery.

Reporting Method

This study was reported in accordance with the Standards for Reporting Qualitative Research.
Understanding Older Persons' Experiences of Care Encounters in the Home Environment: A Hermeneutic Study
Authors: Larsson Gerdin Anna , Rönngren Ylva , Hellzén Ove , Kjällman Alm Annika , Holmström Rising Malin
Published: October 2024

Aim

To explore and gain a deeper understanding of older persons' experiences of care encounters when their home becomes a workplace.

Background

Worldwide healthcare services are increasingly being provided in older persons' homes by registered nurses. This presents new challenges as the home environment of older persons now doubles as a workplace for healthcare professionals. However, there is limited research available on how older persons experience care encounters when their homes serve as workplaces and how this influences their overall well‐being and quality of life.

Design

A qualitative hermeneutic study.

Methods

In‐depth face‐to‐face interviews were conducted in Sweden from October 2023 to January 2024 with 10 purposefully selected older persons (aged 65+). Each participant received regular visits from a home care nurse in their home to address specific care needs, such as wound care, medication administration, blood sampling and general supervision. The interviews were audiotaped, transcribed verbatim and analysed using a hermeneutic interpretation.

Findings

The hermeneutic analysis emerged with one main theme: ‘Experiencing care encounters at home as a lottery’, with two underlying themes: ‘Adapting to loss of control in the private sphere’ and ‘Striving for independence while navigating daily living’.

Conclusions

Older persons try to control their lives despite the challenges associated with ageing and receiving care at home. They strive to maintain their independence and autonomy, which reflects their desire for self‐determination. Supporting these efforts in an interdependent relationship can enhance their well‐being and quality of life.

Reporting Method

Findings were reported following the Consolidated Criteria for Reporting Qualitative Research guidelines.

Patient or Public Contribution

Data were collected by patient interviews.

Implications for the Profession and Patient Care

This study emphasises the importance of supporting older persons in maintaining control over their lives while being cared for in their homes. In the care encounters with home care nurses, their well‐being and quality of life can be improved by respecting their autonomy, involving them in decision‐making and offering tailored support.