bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of COVID-19 on first responders in the United States of America
Authors: Headley Andrea M. , Remington Christa , Witkowski Kaila , Contreras Santina L. , Ganapati Nazife Emel
Published: January 2023

Purpose

This project specifically aims to examine (1) the individual impact of coronavirus disease 2019 (COVID-19) on first responders, (2) the organizational impact of COVID-19 on first response agencies and (3) policy and organizational response and support efforts to mitigate potentially harmful effects of the pandemic.

Design/methodology/approach

The authors' conducted a mixed-methods analysis, including a review of secondary sources (e.g. government documents, organizational policies and news pieces), state-level policies, encompassing surveys, in-depth semi-structured interviews and PhotoVoice focus groups.

Findings

COVID-19 compounded many of the inherent risks facing first responders and added new stressors. First responders assumed added responsibilities during the pandemic which increased workloads, job-related stress, burnout, distance from the community and first responders' feelings of frustration. Even with personal protective equipment (PPE), first responders faced greater exposure to individuals with COVID-19 and were primarily concerned with transmitting the virus to family members, or other members of the first responders' support networks. State-level COVID-19 policies that were geared toward first responders aimed to improve the first responders' personal lives outside of work and mitigate burnout within the profession. First response agencies adapted to the pandemic by implementing a wide range of measures.

Practical implications

First responders also identified several weaknesses in the first responders' agencies' approach to the pandemic. To prepare for the next public health emergency, first response agencies should proactively train employees, build up the first responders' supplies of equipment and PPE, implement policies to strengthen their workforce (e.g. increase hiring for understaffed positions, reduce turnover and mitigate role abandonment), allow for greater employee autonomy, improve communication between leaders and employees and prioritize employees' mental health, as well as other factors relating to departments' informal culture.

Originality/value

This is one of the largest studies conducted on three types of first responders (police officers, fire firefighters, emergency medical technicians (EMTs) and paramedics) across the United States of America during a public health crisis.
Thinking differently about supply chain resilience: what we can learn from social-ecological systems thinking
Authors: Wieland Andreas , Stevenson Mark , Melnyk Steven A. , Davoudi Simin , Schultz Lisen
Published: January 2023

Purpose

This article seeks to broaden how researchers in supply chain management view supply chain resilience by drawing on and integrating insights from other disciplines – in particular, the literature on the resilience of social-ecological systems.

Design/methodology/approach

Before the authors import new notions of resilience from outside the discipline, the current state of the art in supply chain resilience research is first briefly reviewed and summarized. Drawing on five practical examples of disruptive events and challenges to supply chain practice, the authors assess how these examples expose gaps in the current theoretical lenses. These examples are used to motivate and justify the need to expand our theoretical frameworks by drawing on insights from the literature on social-ecological systems.

Findings

The supply chain resilience literature has predominantly focused on minimizing the consequences of a disruption and on returning to some form of steady state (often assumed to be identical to the state that existed prior to the disruption) implicitly assuming the supply chain behaves like an engineered system. This article broadens the debate around supply chain resilience using literature on social-ecological systems that puts forward three manifestations of resilience: (1) persistence, which is akin to an engineering-based view, (2) adaptation and (3) transformation. Furthermore, it introduces seven principles of resilience thinking that can be readily applied to supply chains.

Research limitations/implications

A social-ecological interpretation of supply chains presents many new avenues of research, which may rely on the use of innovative research methods to further our understanding of supply chain resilience.

Practical implications

The article encourages managers to think differently about supply chains and to consider what this means for their resilience. The three manifestations of resilience are not mutually exclusive. For example, while persistence may be needed in the initial aftermath of a disruption, adaptation and transformation may be required in the longer term.

Originality/value

The article challenges traditional assumptions about supply chains behaving like engineered systems and puts forward an alternative perspective of supply chains as being dynamic and complex social-ecological systems that are impossible to entirely control.
Child benefits and child tax allowances in the Czech Republic, Slovak Republic and Sweden
Authors: Hájek Jan , Olexová Cecília
Published: January 2023

Purpose

The paper deals with the child benefits system in the Czech Republic, Slovak Republic and Sweden.

Design/methodology/approach

The authors describe the systems as the key baseline for subsequent qualitative and quantitative comparison. An essential element is the quantitative comparison of child benefits using their statistically stationarised values.

Findings

The Czech and Slovak systems provide a comparable rate of coverage as the Swedish system regarding the payment of both types of benefits, i.e. child benefits and tax allowances, for the first and second child; however, from the third child, the individual differences are considerable. Albeit the concepts of Czech and Slovak systems are framed by the same historical origins and conceptual approach, they differ significantly, with Slovakia providing the lowest aggregate level of child benefits.

Originality/value

The paper provides insight into the child benefit systems in the respective countries. These systems are at the centre of attention of policymakers who are attempting to maintain birth rates and reduce child poverty. The Czech Republic has the lowest level of at-risk-of-poverty rates for persons under 16 years of age, while natality rates are comparable.
The moderating role of terrorism on the insurance–growth nexus: empirical evidence from the 14 MENA countries
Authors: Alam Md Badrul , Tahir Muhammad , Omar Ali Norulazidah , Naveed Jan Muhammad , Sayal Aziz Ullah
Published: January 2023

Purpose

This paper empirically examines the impact of terrorism on the insurance–growth relationship in the context of Middle East and North Africa (MENA) region, thereby attempting to address the unexplored area in the relevant literature.

Design/methodology/approach

The study considered MENA as it has been one of the terribly affected zones in the world during the study period. Panel data for the period (2002–2017) are sourced from reliable sources for 14 member economies of the MENA region.

Findings

After employing the suitable econometric procedures on the panel data, the results indicate that terrorism appears to have detrimental impact on the observed positive relationship between insurance and economic growth. In addition, trade openness seems to be the main driving force behind economic growth of the selected MENA countries. Surprisingly, the study suggests a negative association between the growth of physical capital and economic growth. Human capital has played a positive but insignificant role in improving economic growth as it is insignificant in majority of the specifications. The growth of labor force has although positively but insignificantly influenced economic growth. Finally, the results demonstrate that government expenditures and high inflation are harmful for growth.

Originality/value

The study investigated the impact of terrorism on the insurance–growth relationship for the first time, and hence policymakers of the MENA region are expected to be benefited enormously from the findings of the study.
How are financial institutions enabling online fraud? A developmental online financial fraud policy review
Authors: Cole Tessa
Published: January 2023

Purpose

The criminalization of online financial fraud is examined by analyzing the existing literature, policies and state statutes within the context of the cybercrime ecosystem. Therefore, this paper aims to investigate online fraud policies within the USA and the prevalence of such incidents to explore the effectiveness of current fraud policies.

Design/methodology/approach

This examination explores policies related to online fraud within the USA by defining online financial fraud incidents within the context of the cybercrime ecosystem and analyzing such incidents with routine activities theory to emphasize the current legislative inadequacies with provisional policy recommendations.

Findings

This research suggests online financial fraud is not unanimously conceptualized among regulating or criminal institutions. Although federal regulators have governed financial institutions, federal institutions have failed to account for the capabilities of computer-mediated and technological device use (12 USC §1829).

Research limitations/implications

The limited research analyzing the effectiveness of guardianship that prevents or deters internet-mitigated or dependent financial fraud crimes.

Practical implications

Policy recommendations include but are not limited to mandating federal and privatized financial institutions to disclose all fraudulent activity to all stakeholders (e.g. customers and local and federal criminal justice agencies).

Originality/value

This paper provides an innovative approach using a criminological theory and policy framework to examine the prevalence of online fraud and the regulations enacted to counteract such violations.
Understanding employees’ voluntary pro-environmental behavior in public organizations – an integrative theory approach
Authors: Al Zaidi Sameera Mohamed , Iyanna Shilpa , Jabeen Fauzia , Mehmood Khalid
Published: January 2023

Purpose

This paper aims to investigate the impact of situational factors and internal psychological states on employees’ decisions to perform voluntary pro-environmental behavior. This study used a model combining the theory of planned behavior, norm activation model and comprehensive action determination model. This stud also explored the moderating role of habit (HAB) on the relationship between intention and actual voluntary pro-environmental behavior.

Design/methodology/approach

Data were collected through three waves of time-lagged survey questionnaires from 519 employees of public organizations in Abu Dhabi, United Arab Emirates.

Findings

Employees’ perceptions of corporate social responsibility (CSR) had a significant impact on intention to perform voluntary pro-environmental behavior, as did all other variables except perceived behavioral control. HABs related to pro-environmental behavior enhanced the relationship between intention and actual behavior.

Practical implications

The main factors influencing employees’ voluntary pro-environmental behavioral intentions were perceived CSR, personal moral norms, organizational citizenship behaviors toward the environment and attitude. Public organization planners, managers and practitioners can use these findings to improve their organization’s environmental performance, leveraging nonmandated actions.

Social implications

Employees can achieve a better work–life balance in organizations with flexible CSR policies and which sponsor social activities to improve public well-being and individuals’ life quality. Positive sense-making of corporate social activity helps employees develop social interactions with stakeholders, increasing their involvement in society and decreasing work stress.

Originality/value

This study sheds light on the factors influencing employees’ voluntary pro-environmental behavior. To the best of the authors’ knowledge, this is the first study of its kind to combine these three models to explain the variables affecting intent to perform voluntary pro-environmental behavior in the workplace.
Seed dormancy revisited: Dormancy‐release pathways and environmental interactions
Authors: Lamont Byron B. , Pausas Juli G.
Published: January 2023

Many internal (inherent) and environmental (imposed) factors control seed dormancy and germination that we divide into three basic dormancy‐release pathways: Maternal structures and embryo physiology control inherent dormancy that is broken by various types of scarification and physiological changes, followed by imposed‐dormancy release when the prevailing environment is replaced by certain ‘standard’ conditions that stimulate germination (Pathway 1); imposed dormancy prevails even if inherent dormancy is broken or not applicable that is released when replaced by certain ‘standard’ environmental conditions which stimulate germination (Pathway 2); and release from inherent dormancy by light/dark or cold stratification is contingent on the pre‐existence of certain environmental conditions that stimulate germination (Pathway 3).

On‐plant seed storage (serotiny) and frugivorous seeds are recognized here as representing special types of physical dormancy, as their properties are consistent with those of hard diaspores. Warm stratification does not require seeds to be moist as it is just a physical response. Heat may promote germination of non‐hard, as well as hard, seeds as it may increase their permeability further.

Levels of germination gauge the net effect of inherent‐ and imposed‐dormancy release so that it is only possible to identify the extent of inherent‐dormancy release when conditions for germination are optimal (imposed dormancy has been annulled). While imposed dormancy may be protracted after inherent dormancy is broken by heat or chilling during the dry or cold seasons, release from both states may effectively coincide if smoke chemicals or light are received during the (wet) growing season.

We suggest reserving the term secondary dormancy for seeds that return to (inherent or imposed) dormancy due to changed environmental conditions. Under seasonal climates, fluctuations in environmental conditions can lead to secondary dormancy and even dormancy cycling.

We recognize four types of functional interactions between any two environmental factors that induce inherent‐dormancy release: binary interactions are ineffective, only one stimulus is effective, both are effective but non‐additive, or both are additive/synergistic. Two environmental stimuli that individually break dormancy but have no additive effect must be affecting the same process; this was demonstrated here for some interactions between heat and smoke.

The three dormancy‐release pathways, together with internal, seasonal and stochastic interactions, are coordinated by the non‐dormant seed to ensure maximum germination under optimal conditions. To ignore any aspect outlined here leads to an impoverished understanding of the disparate seed ecology of species adapted to different stressful and disturbance‐prone habitats.

Read the free Plain Language Summary for this article on the Journal blog.
Undersowing oats with clovers supports pollinators and suppresses arable weeds without reducing yields
Authors: Boetzl Fabian A. , Douhan Sundahl Anna , Friberg Hanna , Viketoft Maria , Bergkvist Göran , Lundin Ola
Published: January 2023

Sustainable food production requires agriculture to conserve biodiversity and facilitate ecosystem services to maintain productivity levels while reducing inputs detrimental to ecosystem functioning. Increasing within‐field vegetation diversity by legume intercropping seems promising to facilitate cropping system multi‐functionality. Effects of intercropping with legumes on biodiversity‐mediated ecosystem services such as pollination or natural pest control are, however, not sufficiently understood.

Using 26 observation plots in a paired field design, we studied the effects of undersowing oats with a mixture of three annual clovers across different aspects of cropping system multi‐functionality. We investigated 16 below‐ and above‐ground ecosystem service indicators related to soil mineral nitrogen, arable weed control, pollination, disease and pest pressures, natural pest control and crop yield.

We found lower arable weed cover, higher flower cover and pollinator densities as well as decreased root‐feeding nematode densities in intercropped observation plots compared with the non‐intercropped controls. However, intercropping decreased spider activity densities and oat yield nitrogen content. Root diseases, pest damages, natural pest control and crop yield were not affected by intercropping.

The biomass of undersown clovers was positively related with the differences in flower cover and pollinator densities, and negatively related with the differences in arable weed cover between the intercropped and the control treatment.

Synthesis and applications: We demonstrate that undersowing annual clovers suppresses arable weeds and simultaneously support pollinators without reducing crop yields or taking land out of arable production. Undersown plant mixtures should, however, be tailored to support a wider spectrum of pollinators and benefit natural pest control to support a higher level of overall cropping system multi‐functionality.
Climatic and vegetational controls of Holocene wildfire regimes in the boreal forest of northern Fennoscandia
Authors: Remy Cécile C. , Magne Gwenaël , Stivrins Normunds , Aakala Tuomas , Asselin Hugo , Seppä Heikki , Luoto Tomi , Jasiunas Nauris , Ali Adam A.
Published: January 2023

Climate change is expected to increase wildfire activity in boreal ecosystems, thus threatening the carbon stocks of these forests, which are currently the largest terrestrial carbon sink in the world. Describing the ecological processes involved in fire regimes in terms of frequency, size, type (surface vs. crown) and severity (biomass burned) would allow better anticipation of the impact of climate change on these forests. In Fennoscandia, this objective is currently difficult to achieve due to the lack of knowledge of long‐term (centuries to millennia) relationships between climate, fire and vegetation.

We investigated the causes and consequences of changes in fire regimes during the Holocene (last ~11,000 years) on vegetation trajectories in the boreal forest of northern Finland. We reconstructed fire histories from sedimentary charcoal at three sites, as well as vegetation dynamics from pollen, moisture changes from Sphagnum spore abundance at two sites, and complemented these analyses with published regional chironomid‐inferred July temperature reconstructions.

Low‐frequency, large fires were recorded during the warm and dry mid‐Holocene period (8500–4500 cal. year BP), whereas high‐frequency, small fires were more characteristic of the cool and wet Neoglacial period (4500 cal. year BP onward). A higher proportion of charcoal particles with a woody aspect—characterizing crown fires—was recorded at one of the two sites at times of significant climatic and vegetational changes, when the abundance of Picea abies was higher.

Synthesis. Our results show both a direct and an indirect effect of climate on fire regimes in northern Fennoscandia. Warm and dry periods are conducive to large surface fires, whereas cool and moist periods are associated with small fires, either crown or surface. Climate‐induced shifts in forest composition also affect fire regimes. Climatic instability can alter vegetation composition and structure and lead to fuel accumulation favouring stand‐replacing crown fires. Considering the ongoing climate warming and the projected increase in extreme climatic events, Fennoscandian forests could experience a return to a regime of large surface fires, but stand‐replacing crown fires will likely remain a key ecosystem process in areas affected by climatic and/or vegetational instability.
The need for an integrated multi‐OMICs approach in microbiome science in the food system
Authors: Ferrocino Ilario , Rantsiou Kalliopi , McClure Ryan , Kostic Tanja , de Souza Rafael Soares Correa , Lange Lene , FitzGerald Jamie , Kriaa Aicha , Cotter Paul , Maguin Emmanuelle , Schelkle Bettina , Schloter Michael , Berg Gabriele , Sessitsch Angela , Cocolin Luca ,   The MicrobiomeSupport Consortium
Published: January 2023

Microbiome science as an interdisciplinary research field has evolved rapidly over the past two decades, becoming a popular topic not only in the scientific community and among the general public, but also in the food industry due to the growing demand for microbiome‐based technologies that provide added‐value solutions. Microbiome research has expanded in the context of food systems, strongly driven by methodological advances in different ‐omics fields that leverage our understanding of microbial diversity and function. However, managing and integrating different complex ‐omics layers are still challenging. Within the Coordinated Support Action MicrobiomeSupport (https://www.microbiomesupport.eu/), a project supported by the European Commission, the workshop “Metagenomics, Metaproteomics and Metabolomics: the need for data integration in microbiome research” gathered 70 participants from different microbiome research fields relevant to food systems, to discuss challenges in microbiome research and to promote a switch from microbiome‐based descriptive studies to functional studies, elucidating the biology and interactive roles of microbiomes in food systems. A combination of technologies is proposed. This will reduce the biases resulting from each individual technology and result in a more comprehensive view of the biological system as a whole. Although combinations of different datasets are still rare, advanced bioinformatics tools and artificial intelligence approaches can contribute to understanding, prediction, and management of the microbiome, thereby providing the basis for the improvement of food quality and safety.
Quorum‐quenching enzymes: Promising bioresources and their opportunities and challenges as alternative bacteriostatic agents in food industry
Authors: Wang Dangfeng , Cui Fangchao , Ren Likun , Li Jianrong , Li Tingting
Published: January 2023

The problems of spoilage, disease, and biofilm caused by bacterial quorum‐sensing (QS) systems have posed a significant challenge to the development of the food industry. Quorum‐quenching (QQ) enzymes can block QS by hydrolyzing or modifying the signal molecule, making these enzymes promising new candidates for use as antimicrobials. With many recent studies of QQ enzymes and their potential to target foodborne bacteria, an updated and systematic review is necessary. Thus, the goals of this review were to summarize what is known about the effects of bacterial QS on the food industry; discuss the current understanding of the catalytic mechanisms of QQ enzymes, including lactonase, acylase, and oxidoreductase; and describe strategies for the engineering and evolution of QQ enzymes for practical use. In particular, this review focuses on the latest progress in the application of QQ enzymes in the field of food. Finally, the current challenges limiting the systematic application of QQ enzymes in the food industry are discussed to help guide the future development of these important enzymes.
Development and validation of a LC–MS/MS method for analysis of vortioxetine in postmortem specimens. First data from an authentic case
Authors: Zuccarello Pietro , Carnazza Giulia , Barbera Nunziata
Published: January 2023

Vortioxetine is an antidepressant recently licensed in USA and EU for the treatment of major depressive disorder. Neither fatal case due to overdose nor data about postmortem concentrations on blood or other specimens have been reported. The aims of this study were the development and validation of a method for vortioxetine analysis by Liquid Chromatography Tandem Mass Spectrometry (LC–MS/MS) in postmortem samples and its application in an authentic case. The method was validated and applied on blood, vitreous humor, bile, brain, liver, kidney, and gastric content. After protein precipitation, the supernatant was directly injected into LC–MS/MS. Analysis was carried out by Multiple Reaction Monitoring (MRM) mode. The authentic case concerned a 38 years‐old woman, affected by depression, who was found hanged at home. The method determined an acceptable sensitivity, selectivity, linearity, precision, and accuracy for all matrices. No interference was shown for all matrices. The matrices do not significantly reduce the peak intensity of vortioxetine. No carryover was shown. Toxicological analysis of the authentic case showed vortioxetine in blood (234 ng/ml), vitreous humor (10.5 ng/ml), brain (490 ng/g), lung (479 ng/g), liver (3751 ng/g), kidney (798 ng/g), bile (2267 ng/ml) and gastric content (253 ng/ml). Our case suggests that even at blood concentrations of vortioxetine equal to 234 ng/ml, the subject was able to stage and carry out the hanging. Vortioxetine concentrations found in the other cadaveric samples (biological fluids, organs, and gastric content) may be helpful to evaluate further similar comparable cases.
Early prediction of hospital admission of emergency department patients
Authors: Kishore Kartik , Braitberg George , Holmes Natasha E , Bellomo Rinaldo
Published: January 2023

Objective

The early prediction of hospital admission is important to ED patient management. Using available electronic data, we aimed to develop a predictive model for hospital admission.

Methods

We analysed all presentations to the ED of a tertiary referral centre over 7 years. To our knowledge, our data set of nearly 600 000 presentations is the largest reported. Using demographic, clinical, socioeconomic, triage, vital signs, pathology data and keywords in electronic notes, we trained a machine learning (ML) model with presentations from 2015 to 2020 and evaluated it on a held‐out data set from 2021 to mid‐2022. We assessed electronic medical records (EMRs) data at patient arrival (baseline), 30, 60, 120 and 240 min after ED presentation.

Results

The training data set included 424 354 data points and the validation data set 53 403. We developed and trained a binary classifier to predict inpatient admission. On a held‐out test data set of 121 258 data points, we predicted admission with 86% accuracy within 30 min of ED presentation with 94% discrimination. All models for different time points from ED presentation produced an area under the receiver operating characteristic curve (AUC) ≥0.93 for admission overall, with sensitivity/specificity/F1‐scores of 0.83/0.90/0.84 for any inpatient admission at 30 min after presentation and 0.81/0.92/0.84 at baseline. The models retained lower but still high AUC levels when separated for short stay units or inpatient admissions.

Conclusion

We combined available electronic data and ML technology to achieve excellent predictive performance for subsequent hospital admission. Such prediction may assist with patient flow.
Solitary extramedullary plasmacytoma of the left main bronchus: A case report and literature review
Authors: Gao Limin , Li Huifang , Shen Wang , Wang Xinyun , Ai Cheng , Li Xuebing
Published: January 2023

Tracheal tumors are rare, accounting for 0.1% of all malignancies. Squamous cell carcinoma and adenoid cystic carcinoma are the two most prevalent tracheal cancers. Less than 20 cases of extramedullary plasmacytoma in the trachea and main bronchus have ever been documented in the literature, making it extremely uncommon. Although the origin of these lesions is unclear, viral pathogenesis and persistent inflammation are thought to be the main causes. Clinically, these individuals exhibit vague symptoms such as stridor, a persistent cough, dyspnea, or wheezing, making a correct diagnosis difficult.
Associations between enteral nutrition and outcomes in the SUP‐ICU trial: Protocol for exploratory post hoc analyses
Authors: Borthwick Mark , Granholm Anders , Marker Søren , Krag Mette , Lange Theis , Wise Matt P. , Bendel Stepani , Keus Frederik , Guttormsen Anne Berit , Schefold Joerg C. , Wetterslev Jørn , Perner Anders , Møller Morten Hylander ,   for the SUP‐ICU investigators
Published: January 2023

Critically ill patients are at risk of gastrointestinal (GI) bleeding. Counter measures to minimise this risk include the use of pharmacological stress ulcer prophylaxis (SUP). The effect of enteral nutrition as SUP on GI bleeding event rates is unknown. There are conflicting data describing the effect of co‐administration of enteral nutrition with pharmacological SUP, and there is substantial variation in practice. We aim to conduct an exploratory post hoc analysis to evaluate the association of enteral nutrition with clinically important GI bleed rates in ICU patients included in the SUP‐ICU trial, and to explore any interactions between enteral nutrition and pharmacologic SUP on patient outcomes. The SUP‐ICU trial dataset will be used to assess if enteral nutrition is associated with the outcomes of interest. Extended Cox models will be used considering relevant competing events, including treatment allocation (SUP or placebo) and enteral nutrition as a daily time‐varying covariate, with additional adjustment for severity of illness (SAPS II). Results will be presented as adjusted hazard ratios for treatment allocation and enteral nutrition, and for treatment allocation and enteral nutrition considering potential interactions with the other variable, all with 95% confidence intervals and p‐values for the tests of interaction. All results will be considered as exploratory only. This post hoc analysis may yield important insights to guide practice and inform the design of future randomised clinical trial investigating the effect of enteral nutrition on GI bleeding.
Anatomical and pathological characteristics of ribs in the Atlantic salmon (Salmo salar L.) and its relevance to soft tissue changes
Authors: Brimsholm Malin , Fjelldal Per Gunnar , Hansen Tom , Trangerud Cathrine , Knutsen Geir Magne , Asserson Charlotte Finstad , Koppang Erling Olaf , Bjørgen Håvard
Published: January 2023

Studies on the anatomical and pathological characteristics of ribs in farmed Atlantic salmon (Salmo salar L.) are warranted due to their possible association with red and melanized focal changes (RFC and MFC) in the fillet, a major quality and animal welfare concern. In this work, we provide an anatomical description of ribs based on radiographical and histological analyses. We also address various pathological rib changes and their association to RFC and MFC. In total, 129 fish were investigated; captured wild (n = 10) and hatchery reared (n = 119) Atlantic salmon (3.5–6.1 kg). The fish were selected based on the macroscopic presence of RFC, MFC or no changes (controls). Radiographic results revealed costal abnormalities in all fish groups. By histological investigations of the variations herein, our results provide new insight into the anatomical characteristics including vascularization within the ribs; a potential site for haemorrhage following costal fractures. Costal fractures were detected by radiology in 40 of 129 samples (RFC: 38.4%, MFC: 47.2%, controls: 9.5 %). A statistically significant association was found between costal fractures and red (p = 0.007) and melanized changes (p = 0.000). However, red and melanized changes were also observed in samples with no costal fractures (n = 45), indicating that also other factors influence the development of RFC/MFC.
Struggle for coalition‐building: Japan, South Korea, and the Indo‐Pacific
Authors: Koga Kei
Published: January 2023

One of the most important defining features of Japan's “Free and Open Indo‐Pacific” (FOIP) vision is coalition‐building. Given the Yoon administration's strong political will to commit to the Indo‐Pacific affairs and improve its ties with Japan, can Japan and South Korea finally forge cooperation in the Indo‐Pacific region? I argue that Japan has not incorporated South Korea in its FOIP vision because of four main factors: timing, leadership transition, commitment to regional and global strategic affairs, and differing perspectives on China. Particularly, the negative impact of South Korea's leadership change and its fluctuating commitment to regional and global affairs have nurtured Japan's skepticism toward South Korea's potential role in the Indo‐Pacific region. In this context, the key to overcoming such difficulties and incorporating South Korea into the Indo‐Pacific network depends on the Yoon administration's conceptualization and institutionalization of its Indo‐Pacific strategy and Japan's support for South Korea's current diplomatic activism
Patient preferences for pilonidal sinus treatments: A discrete choice experiment survey
Authors: Wickramasekera Nyantara , Strong Emily , Shackley Philip , Callaghan Tia , Lee Matthew , Hind Daniel , Brown Steven ,   PITSTOP Project Management Group and PITSTOP Collaborators,    
Published: January 2023

Aim

A range of treatments are available for pilonidal sinus disease (PSD), each of which has a different risk/benefit profile. The aim of this study was to collect patient views on which interventions they would rather avoid and which outcomes they most value for PSD.

Method

We conducted an online survey using the discrete choice experiment (DCE) method. The DCE task involved participants choosing the best treatment option when presented with a set of competing hypothetical treatment profiles. Participants with symptomatic PSD referred for elective surgery were recruited from 33 National Health Service trusts between 2020 and 2022. Collected DCE data were analysed using regression analyses.

Results

In all, 111 participants completed the survey. In the overall group, low risk of infection/persistence was the most important characteristic when making a treatment decision (attribute importance score 70%), followed by treatments with shorter recovery time with an attribute importance score of 30%. The results demonstrated that patients are willing to accept trade‐offs between treatment recovery time and risk of infection/persistence. Patients above 30 years old are willing to accept a higher chance of treatment failure in exchange for rapid treatment recovery (risk tolerance between 22.35 and 34.67 percentage points). Conversely, patients in the younger age groups were risk averse and were only willing to accept a small risk of 1.51–2.15 in exchange for a treatment with faster recovery time. All patient groups appear to the reject the excision and leave open technique due to the need for protracted nursing care.

Conclusion

This study highlights the need for shared decision making when it comes to surgery for PSD.
Effect of compliance to continuous positive airway pressure on exacerbations, lung function and symptoms in patients with chronic obstructive pulmonary disease and obstructive sleep apnea (overlap syndrome)
Authors: Voulgaris Athanasios , Archontogeorgis Kostas , Anevlavis Stavros , Fanaridis Michail , Froudarakis Marios E. , Schiza Sofia , Steiropoulos Paschalis
Published: January 2023

Introduction

Patients with overlap syndrome (OS), that is obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD), are at increased risk of acute exacerbations related to COPD (AECOPD). We assessed the effect of CPAP compliance on AECOPD, symptoms and pulmonary function in OS patients.

Methods

Consecutive OS patients underwent assessment at baseline and at 12 months under treatment with CPAP of: AECOPD and hospitalizations, COPD Assessment Test (CAT) and modified British Medical Research Council (mMRC) questionnaires, pulmonary function testing and 6‐min walking test (6MWT).

Results

In total, 59 patients (54 males) with OS were followed for 12 months and divided post hoc according to CPAP compliance into: group A with good (≥4 h CPAP use/night, n = 29) and group B with poor (<4 h CPAP use/night, n = 30) CPAP compliance. At 12 months, group A showed improvements in FEV1 (p = 0.024), total lung capacity (p = 0.024), RV/TLC (p = 0.003), 6MWT (p < 0.001) and CAT (p < 0.001). COPD exacerbations decreased in patients with good CPAP compliance from baseline to 12 months (17 before vs. 5 after, p = 0.001), but not in those with poor compliance (15 before vs. 15 after, p = 1). At multivariate regression analysis, COPD exacerbations were associated with poor CPAP compliance (β = 0.362, 95% CI: 0.075–0.649, p = 0.015).

Conclusions

When compared to poorly compliant patients, OS patients with good CPAP compliance had a lower number of AECOPD and showed improved lung function and COPD related symptoms.
The butterfly effect: Restoring the tricuspid coaptation after clipping the antero‐septal commissure
Authors: Cammalleri Valeria , Neri Giuseppe , Carpenito Myriam , Nusca Annunziata , Grigioni Francesco , Ussia Gian Paolo
Published: January 2023

Edge‐to‐edge tricuspid transcatheter repair requires extensive echocardiographic planning before the procedure. Sometimes, anatomic features may anticipate a suboptimal result. For this reason, a tailored strategy is the key to the procedural success. We report a case of massive tricuspid regurgitation due to multiple complex mechanisms that was successfully treated by clipping the antero‐septal commissure to restore functional coaptation of the valve leaflets at multiple sites.
Enhanced neutrophil extracellular traps formation in AF patients with dilated left atrium
Authors: Mołek Patrycja , Ząbczyk Michał , Malinowski Krzysztof P. , Natorska Joanna , Undas Anetta
Published: January 2023

Background

Atrial fibrillation (AF) is associated with cardiac remodelling and prothrombotic state. Enhanced neutrophil extracellular traps (NETs) formation has been reported in AF, contributing to thromboembolism.

Purpose

We investigated whether increased left atrium (LA) diameter and reduced left ventricular ejection fraction (LVEF) affect NETs formation and prothrombotic state in AF patients.

Methods

In 243 AF patients (median CHA2DS2‐VASc = 4) we measured LA diameter and LVEF, 123 of them with LVEF<50%. Moreover, we determined 3 markers of NETosis: circulating citrullinated histone H3 (H3cit), myeloperoxidase (MPO) and peptidylarginine deiminase 4 (PAD4), along with prothrombotic markers, including endogenous thrombin potential, plasma fibrin clot permeability (Ks) and clot lysis time (CLT). Ischaemic cerebrovascular events, major bleeding and death were recorded during a median follow‐up of 53 months, on anticoagulation.

Results

LA diameter correlated positively with H3cit, MPO and PAD4, while LVEF was inversely associated with the same NETosis markers. After adjustment for age and body mass index, concentrations of MPO (per 10 units; β = −1.9, 95%CI −3.40;−0.42) and H3cit (per 10 units; β = 2.02, 95%CI 0.61–3.42) were independently associated with LVEF and LA diameter. LA diameter, but not LVEF, correlated inversely with Ks and positively with CLT. The Cox regression analysis revealed that H3cit >6.16 ng/mL (HR = 21.76, 95%CI 2.85–166.28, p = .003) and LA diameter > 46 mm (HR = 2.89, 95%CI 1.04–8.03, p = .043) independently predicted cerebrovascular ischaemic events (1.9%/year).

Conclusions

This hypothesis‐generating study suggests that in AF enlarged LA diameter and reduced LVEF are associated with enhanced NETs formation, which might have clinical importance and contribute to thromboembolic events despite anticoagulation.
TREM2 signalling as a multifaceted player in brain homoeostasis and a potential target for Alzheimer's disease treatment
Authors: Ayyubova Gunel
Published: January 2023

Triggering receptor expressed on myeloid cells‐2 (TREM2) has crucial roles in microglial physiology, differentiation, metabolism and survival. Genome‐wide association studies (GWAS) show that genetic mutations of the TREM2 increase the risk of late‐onset Alzheimer's disease (AD) by two to four times, disrupting the microglial function in reducing the progression of the disease. Accumulating data show that TREM2 function in AD is related primarily to the clearance of soluble and insoluble amyloid beta (Aβ42) aggregates from the brain. TREM2 also ameliorates the pathological effects of activated microglia on neuronal tau pathology, demonstrating its protective anti‐inflammatory effects. However, since the excessive activation of TREM2 signalling can inhibit pro‐inflammatory reactions and suppress the role of microglia in immune surveillance, at the late stages of the disease, it might promote immune tolerance, which is detrimental. The contradictory effects of TREM2 mutations on brain amyloidopathy and tauopathy in multiple mouse models, as well as studies revealing various effects of TREM2 overexpression, complicate the understanding of the role that TREM2 plays in AD aetiopathogenesis. In this review, we summarize the latest developments regarding the significance of TREM2 signalling in the stability of microglial pro‐ and anti‐inflammatory activations and propose the mechanisms that should be targeted in the future to treat AD.
Levetiracetam as a first‐line antiseizure medication in WHO grade 2 glioma: Time to seizure freedom and rates of treatment failure
Authors: Fairclough Sam , Goodden John , Chumas Paul , Mathew Ryan , Maguire Melissa
Published: January 2023

Objective

The high seizure burden seen in World Health Association (WHO) grade 2 gliomas is well documented. This study aims to identify factors that influence the probability of seizure freedom (12 months of seizure remission) and treatment failure (antiseizure medication [ASM] cessation or introduction of an alternative) in patients with WHO grade 2 glioma.

Methods

This is a retrospective observational analysis of patients from a regional UK neurosurgical center with histologically proven (n = 146) WHO grade 2 glioma and brain tumor related epilepsy. Statistical analyses using both Kaplan‐Meier and Cox proportional hazards models were undertaken, with a particular focus on treatment outcomes when the commonly prescribed ASM levetiracetam (n = 101) is used as first line.

Results

Treatment with levetiracetam as a first‐line ASM resulted in a significant increase in the probability of seizure freedom (p < .05) at 2 years compared with treatment with an alternative ASM. Individuals presenting with focal seizures without bilateral tonic‐clonic progression were between 39% and 42% significantly less likely to reach seizure freedom within 10 years (p < .05) and 132% more likely to fail treatment by 5 years (p < .01) when compared to individuals who had seizures with progression to bilateral tonic‐clonic activity. ASM choice did not significantly affect treatment failure rates.

Significance

More than two‐thirds of patients with WHO grade 2 glioma related epilepsy treated with levetiracetam first line achieve seizure freedom within 2 years and it is a reasonable first‐choice agent. Experiencing mainly focal seizures without progression infers a significant long‐term reduction in the chance of seizure freedom. Further studies are needed to inform ASM selection.
Steps forward in biomonitoring 2.0: eDNA Metabarcoding and community‐level modelling allow the assessment of complex drivers of Neotropical fish diversity
Authors: Carvalho Daniel C. , Leal Cecília G.
Published: January 2023

The Neotropical realm still represents a great challenge to our understanding of species distribution patterns and the role played by different drivers of biodiversity. The paper by Coutant et al. (2022) is a great advance towards a holistic approach to quantifying the contribution of environmental and anthropogenic factors that drive community assembly in the Amazon, and how we can apply such knowledge to guide future monitoring programmes. Disentangling the relative roles played by multiple drivers of biodiversity allowed them to also highlight hotspot areas hosting unique freshwater fish diversity and to pinpoint conservation priorities.
Bodies in‐between: Religious women's‐only spaces and the construction of liminal identities
Authors: Frenkel Michal , Wasserman Varda
Published: January 2023

This paper examines the creation of women‐only organizational spaces as a diversity practice and assesses their potential to facilitate the workforce inclusion of religious women from gender‐conservative groups. Based on longitudinal fieldwork in two ultra‐Orthodox‐Jewish women‐only colleges in Israel and interviews with students and staff, we demonstrate how this practice constitutes three types of liminality—spatial, social, and epistemic—that enable ultra‐Orthodox women to move unimpeded between a familiar, religious environment and a secular one. In this protected and carefully curated environment, they feel safe and are able to develop new identities relevant to the secular labor market while maintaining or even enhancing their traditional, religious sense of self. The liminal space of the college reinforces their sense of belonging to a space of their own and serves as a bridge that helps them cope with the secular world.
Quality of life in Dutch patients with primary biliary cholangitis: Discrepancies between patients’ perspectives and objective disease parameters
Authors: de Veer Rozanne C. , van Hooff Maria C. , da Silva Geraldine , Harms Maren H. , Metselaar Herold J. , Willemse José , Utomo Elaine , van der Meer Adriaan J.
Published: January 2023

Aim

This study aims to assess the health‐related quality of life (HRQoL) in a Dutch population of patients with primary biliary cholangitis (PBC) in relation to the prognosis and need for second line‐therapy, based on both objective disease parameters and patients’ perspectives.

Methods

In this cross‐sectional multicenter study, HRQoL was assessed by using the Dutch PBC‐40 according to objective clinical parameters and patients’ perspectives on treatment and prognosis.

Results

In total, 178/269 (66%) patients responded; mean age 61.2 (SD 9.9) years and 165 (92.7%) women. The PBC‐40 domain scores did not differ according to the GLOBE score response (p > 0.05 for all) or according to the POISE criteria (p > 0.05), except for the domain itch (p = 0.031). Patients who considered their survival to be impaired scored higher on all domains as compared to those expecting a normal prognosis (p < 0.05). Similarly, PBC‐40 domain scores were higher among patients who considered that they were in need of additional therapy compared to those who did not (p < 0.05 for all, except for domain itch [p = 0.056]). However, 45/62 (72.6%) patients with a self‐expected impaired prognosis had a GLOBE score indicative of a normal prognosis. Twenty‐five of the 40 (62.5%) patients who believed they needed additional therapy were below POISE criteria.

Conclusion

The HRQoL of patients with PBC was impaired in terms of nonfavorable disease status according to the expectations of patients, but not according to objective disease parameters. Substantial discrepancies between patients’ perspectives and objective parameters were observed, which highlights the need for better patient guidance among patient with PBC.