bluuebunny/crossref_metadata_2025 huggingface dataset:
Towards quality 4.0 in home appliances: definitions, deployment scenarios, and future perspectives
Authors: Talaie Hamidreza , Ziaeian Mehran , Malekinejad Pooria
Published: July 2024

Purpose

Recent research has garnered increasing attention to Quality 4.0, yet its implementation poses significant challenges across various industries. This study aims to identify and analyze the factors influencing Quality 4.0 implementation, considering their types and interactions. It offers solutions to facilitate the adoption of Quality 4.0 within Iran’s home appliance industry.

Design/methodology/approach

This research involved identifying the factors impacting Quality 4.0 implementation through a comprehensive review of relevant literature and the evolution of Quality 4.0. To evaluate the present status of these factors, data were gathered from the top ten manufacturing companies in Iran’s home appliance industry.

Findings

The study revealed that Perceived Saving Time emerged as the primary factor influencing changes in one of the backward scenarios of Perceived Saving Cost. Additionally, the research findings indicate that enhancements in the Vision and Strategy factor trigger a cascade effect across multiple factors, ultimately resulting in improvements in Knowledge and Awareness of Quality 4.0.

Originality/value

This research’s outcomes offer valuable insights for implementing Quality 4.0 and provide a novel perspective for researchers engaged in quality management.
Mapping and prospective of additive manufacturing in the context of Industry 4.0 and 5.0
Authors: Rodríguez-Martín Manuel , Domingo Rosario , Ribeiro João
Published: July 2024

Purpose

This study aims to investigate the scientific impact of additive manufacturing in recent years, considering its evolution as an Industry 4.0 technology and also in the current context of Industry 5.0. For this aim, advanced statistics and scientometric tools have been used.

Design/methodology/approach

This study aims to explore the trends and impacts of additive manufacturing, focusing on its evolution and its relationship with Industry 4.0 and 5.0. For this purpose, a scientometric study and a meta-analysis of data extracted from the scientific Scopus database have been carried out. R programming and specific bibliometric software have been used to conduct the research. Initially, the data were evaluated from various perspectives, including sources, topics and impact indexes, to assess trends derived from the volume of publications, the impact of sources and affiliations, as well as the production segmented by country and the relationships between authors from different countries. Subsequently, a meta-analysis on keywords has been carried out using two distinct clustering methodologies: link strength and fractionalization. The results obtained were compared to establish a specific taxonomy of the AM subtopics, considering AM as a single body of knowledge related to Industries 4.0 and 5.0 paradigms. The analyses carried out have shown the impact and strong evolution of additive manufacturing as a field of knowledge at the world level, both from the point of view of manufacturing processes and from the point of view of materials science. In addition, some differences have been detected depending on the country. As a result of the meta-analysis, four different subtopics have been detected, some of which are highly related to other technologies and approaches in Industries 4.0 and 5.0 paradigms. Additionally, it establishes a comprehensive taxonomy for AM research, serving as a foundational reference for future studies aimed at exploring the evolution and transformative impact of this technology.

Findings

The analyses carried out have shown the impact and strong evolution of additive manufacturing as a field of knowledge at the world level, both from the point of view of manufacturing processes and from the point of view of materials science. In addition, some differences have been detected depending on the country. As a result of the meta-analysis, four different subtopics have been detected: one of them directly related to the use of recently developed Industry 4.0 technologies in additive manufacturing. The results provide a starting point for prospective studies to understand the evolution and disruption of this technology.

Originality/value

The paper is original and is based on data systematically extracted from scientific databases. Then, a specific methodology based on different advanced tools was applied for scientometric evaluation and meta-analysis.
Identifying as lesbian, gay, and bisexual at work: atemporal associations between sexual identity disclosure and work team experiences
Authors: Caylor Jesse , Wildman Jessica L. , Warren Catherine
Published: July 2024

Purpose

Although sexual identity disclosure in the workplace can be related to heightened adversity for lesbian, gay or bisexual (LGB) employees, disclosure can also serve as an avenue for LGB employees to attain additional resources. Much of the work done in today’s organizations is done in team-based structures, making it likely that LGB individuals disclose to members of their work teams. However, very limited prior research has examined the associations of sexual identity disclosure within work team experiences. This paper aims to take a first step in addressing this gap in research on the experiences of LGB employees in the workplace.

Design/methodology/approach

This study takes a first step toward addressing this gap by examining the associations between LGB identity disclosure and critical team-specific attitudes and behaviors (i.e., trust in team, commitment to team, conflict with team, withdrawal from team) and the atemporal indirect role of perceived LGB identity support from the team through a cross-sectional survey of 159 employees.

Findings

Results demonstrated that perceptions of a supportive LGB team climate atemporally mediated the association between disclosure and relevant workplace variables. Specifically, disclosure of sexual identity to one’s work team is directly and indirectly, through perceived identity support, positively associated with trust and commitment toward the team. Furthermore, disclosure was indirectly, through perceived identity support, negatively associated with conflict and withdrawal from the team. Theoretical and practical implications of these findings are discussed.

Originality/value

The results of this study highlight the importance of perceived identity support when individuals disclosure their sexual orientation in a team context.
Predicting Indian SME financial distress: an ex-ante approach
Authors: Rao Sushma , Satya Nandini A. , Zachariah Minu
Published: July 2024

Purpose

The purpose of this study is to propose a financial distress prediction (FDP) model and method suitable for listed Indian small and medium enterprises (SMEs).

Design/methodology/approach

A three-part screening criteria similar to Platt and Platt (2006) was tested independently and jointly on Indian SMEs using statistically significant financial variables. Five stepwise multiple discriminant analysis (MDA) models were developed and the best-performing model was further compared against seminal models to check for robustness.

Findings

Model C2 developed under Criterion C which stated “if net income before special items is negative in any given year the firm is considered as ‘unwell’” proved robust and effective.

Originality/value

The proposed model identifies the importance of profitability and efficiency ratios over leverage ratios in determining financial distress and therefore, has implications for SME owners/managers and shareholders.
Forest growth resistance and resilience to the 2018–2020 drought depend on tree diversity and mycorrhizal type
Authors: Sachsenmaier Lena , Schnabel Florian , Dietrich Peter , Eisenhauer Nico , Ferlian Olga , Quosh Julius , Richter Ronny , Wirth Christian
Published: July 2024

The frequency of consecutive drought years is predicted to increase due to climate change. These droughts have strong negative impacts on forest ecosystems. Mixing tree species is proposed to increase the drought resistance and resilience of tree communities. However, this promising diversity effect has not yet been investigated under extreme drought conditions and in the context of complementary mycorrhizal associations and their potential role in improving water uptake.

Here, we investigate whether tree diversity promotes growth resistance and resilience to extreme drought and whether drought responses are modulated by mycorrhizal associations. We used inventory data (2015–2021) from a young tree diversity experiment in Germany, manipulating tree species richness (1, 2 and 4 species) and mycorrhizal type (communities containing arbuscular mycorrhizal [AM] or ectomycorrhizal [EM] tree species, or both). For all tree communities, we calculated basal area increment in the periods before, during and after drought and used the concepts of resistance and resilience to quantify growth responses to drought.

We found strong growth declines during the extreme 2018–2020 drought for most tree communities. Contrary to our hypothesis, we did not find that tree species richness per se can buffer the negative impacts of extreme drought on tree growth. However, while for EM communities, drought resistance and resilience decreased with tree species richness, they increased for AM communities and communities comprising both mycorrhizal types. We highlight that among various mixtures of tree species, only those with mixed mycorrhizal types outperformed their respective monocultures during and after drought. Furthermore, under extreme drought, the community tends to segregate into ‘winner’ and ‘loser’ tree species in terms of diversity, indicating a possible intensification of competition.

While we cannot disentangle the underlying mechanisms or clarify the role of mycorrhiza during drought, our findings suggest that mixtures of mycorrhizal types within tree communities could help safeguard forests against increasing drought frequency.

Synthesis. Drought resistance and resilience of tree communities depend on tree diversity and mycorrhizal association types. Mixing tree species with diverse mycorrhizal types holds promise for forest restoration in the face of climate change.
Phytocannabinoid profile and potency of cannabis resin (hashish) of northwest Himalayas of India
Authors: Chauhan Jyotsnessh , Bastia Binaya Kumar , Kohli Kanchan , Chaudhary Babulal , Chikara Gaurav , Gupta Annie , Kumar Ankit
Published: July 2024

Cannabis is one of the most consumed illicit drugs and the potency of cannabis products is of note due to health‐related concerns. Hand‐rubbed hashish is the ancient technique of extracting psychoactive resin from cannabis plants and is practiced in the Indian Himalayas. This study establishes the cannabinoid profile and potency of hand‐rubbed hashish collected from 20 regions of the northwest Himalayas. Fifty‐eight hashish samples were analyzed using a validated high‐performance liquid chromatography‐diode array detection (HPLC‐DAD) method. Ten cannabinoids were quantified including acidic (THCA & CBDA), and neutral compounds (CBDV, THCV, CBD, CBG, CBN, Δ9‐THC, Δ8‐THC, and CBC). The mean concentration (w/w%) of Δ9‐THC is 26%; THCA is 15% and THCTotal is 40% is observed in the studied hashish samples. The majority (70%) of the hashish samples were categorized in chemotype I with the THC:CBD:CBN ratio of 91:3:4, and the remaining 30% were categorized under chemotype II with the ratio of 76:15:8. Diverse qualities of hashish are produced in the studied regions as per the seed, plant selection, and skills of manual rubbing, which results in potency variations. The average difference between the least and highest potent hand‐rubbed hashish of a region is 27 w/w% (THCTotal). The other studied non‐psychoactive cannabinoids have a mean w/w% of <5%, followed by 6% of CBDA. It is concluded that the cultivated and wild cannabis fields in the northwest Himalayas belong to the drug‐type cannabis subspecies. Hand‐rubbed hashish holds traditional significance and impacts the current policies of legislation.
Osteon shape variation in the femoral diaphysis: A geometric‐morphometric approach on human cortical bone microstructure in an elderly sample
Authors: Leiss Luisa , Ramphaleng Tshegofatso , Bacci Nicholas , Houlton Tobias M. R. , García‐Donas Julieta G.
Published: July 2024

Geometric morphometrics (GMM) have been applied to understand morphological variation in biological structures. However, research studying cortical bone through geometric histomorphometrics (GHMM) is scarce. This research aims to develop a landmark‐based GHMM protocol to depict osteonal shape variation in the femoral diaphysis, exploring the role of age and biomechanics in bone microstructure. Proximal, midshaft, and distal anatomical segments from the femoral diaphysis of six individuals were assessed, with 864 secondary intact osteons from eight periosteal sampling areas being manually landmarked. Observer error was tested using Procrustes ANOVA. Average osteonal shape and anatomical segment‐specific variation were explored using principal component analysis. Osteon shape differences between segments were examined using canonical variate analysis (CVA). Sex differences were assessed through Procrustes ANOVA and discriminant function analysis (DFA). The impact of osteonal size on osteonal shape was investigated. High repeatability and reproducibility in osteon shape landmarking were reported. The average osteon shape captured was an elliptical structure, with PC1 reflecting more circular osteons. Significant differences in osteon shape were observed between proximal and distal segments according to CVA. Osteon shape differed between males and females, with DFA showing 52% cross‐validation accuracies. No effect of size on shape was reported. Osteonal shape variation observed in this study might be explained by the elderly nature of the sample as well as biomechanical and physiological mechanisms playing different roles along the femoral diaphysis. Although a larger sample is needed to corroborate these findings, this study contributes to the best of our knowledge on human microanatomy, proposing a novel GHMM approach.
Survey of physicians' knowledge about pediatric nonalcoholic fatty liver disease in China
Authors: Gao Xiang Yang , Yang Yi Fan , Li Li , Xing Yun Fei , Wang You Xin , Li Xue Ying , Yang Shu Han , Wang Ming Yue , Fan Jian Gao , Wang Hui
Published: July 2024

Objectives

To evaluate physicians’ awareness and knowledge towards pediatric nonalcoholic fatty liver disease (NAFLD) and their attitude toward change in nomenclature from NAFLD to metabolic dysfunction‐associated fatty liver disease (MAFLD) or metabolic dysfunction‐associated steatotic liver disease (MASLD) in China.

Methods

The questionnaire survey contained five parts (characteristics of the participants, epidemiology, diagnosis, management of NAFLD, and attitudes toward the nomenclature of MAFLD/MASLD). The participants included 53 hepatologists, 88 gastroenterologists (GEs), 74 endocrinologists (ENDOs), 61 primary care physicians (PCPs), and 157 pediatricians across 31 municipalities, provinces and autonomous regions of China's mainland.

Results

Hepatologists saw the largest number of pediatric NAFLD patients annually (median 9 [range 1–20]), with the lowest number by PCPs (even notwithstanding one patient annually). The primary sources of pediatric NAFLD knowledge were acquired via guidelines. Hepatologists had the highest total knowledge score among all five types of physicians. Approximately one‐third of nonspecialists (ENDOs and PCPs) considered liver biopsy necessary for pediatric NAFLD patients, and this percentage increased to half in specialists (hepatologists and GEs). For nonspecialists, the major barriers to the management of pediatric NAFLD were poor patient adherence to lifestyle modifications and lacking confidence in managing NAFLD. Above 90% physicians agreed to change the nomenclature NAFLD to MAFLD; however, they were not sure whether it could reduce the economic burden.

Conclusions

Despite the epidemic of pediatric NAFLD in China, a significant knowledge gap remains in the identification, diagnosis, and treatment of pediatric NAFLD, particularly among frontline workers such as pediatricians and PCPs. More education programs should be carried out in the future.
A target trial emulation comparing the antidepressant effectiveness of selective serotonin reuptake inhibitors (SSRIs) highlighting the importance of patent‐related confounding by indication
Authors: Rohde Christopher , Hieronymus Fredrik , Østergaard Søren Dinesen
Published: July 2024

Background

The comparative effectiveness of selective serotonin reuptake inhibitors (SSRIs) has been subjected to relatively little research. However, a recent study based on target trial emulation suggested that sertraline may be more effective than escitalopram.

Aims

To investigate whether sertraline, citalopram, and escitalopram differ in their effectiveness—assessed via the risk of psychiatric hospital admission and suicide following treatment initiation. The choice to focus on sertraline, citalopram, and escitalopram was made to limit confounding by indication, as the Danish depression treatment guideline from 2007 specifically listed these three SSRIs as first choice.

Method

We conducted a target trial emulation based on data from Danish registers. We identified all individuals that initiated treatment for depression with sertraline, citalopram, or escitalopram in the period from January 1, 2007, to March 1, 2019. These individuals were followed until psychiatric hospital admission or suicide (separate analyses), death, 1 year after treatment initiation or end of data. Cox proportional hazards regression adjusted for relevant baseline covariates was performed to emulate randomized treatment allocation, comparing the rate of psychiatric hospital admission and suicide for individuals treated with sertraline (used as reference), citalopram or escitalopram, respectively. For escitalopram, we conducted a sensitivity analysis excluding data from the period during which the drug was sold under patent, as the price of the drug during that time likely entailed a different prescription pattern, increasing the risk of (“patent‐related”) confounding by indication.

Results

We identified 56,865, 118,145, and 31,083 individuals initiating treatment with sertraline, citalopram, and escitalopram, respectively. Using sertraline as reference, the adjusted hazard rate ratio (aHRR) for psychiatric admission was 0.98 (95% CI = 0.91–1.05) for citalopram and 1.21 (95% CI = 1.10–1.32) for escitalopram. Notably, in the sensitivity analysis only including patients initiating treatment after the escitalopram patent had expired, the increased risk of psychiatric hospital admission associated with escitalopram treatment was no longer present (aHRR = 0.98, 95% CI = 0.82–1.18). The results of the analyses of suicide were inconclusive, due to few outcome events.

Conclusions

Sertraline, citalopram, and escitalopram do not seem to have differential effectiveness in the treatment of depression. Taking potential patent‐related, time varying, confounding by indication (via severity) into account is critical for pharmacoepidemiological studies, including those employing target trial emulation.
Understanding the role of cannabis use on cigarette dependence severity among individuals with e‐cigarette and combustible tobacco dual use
Authors: Buckner Julia D. , Vargo Luke A. , Zvolensky Michael J.
Published: July 2024

Background and Objectives

The use of both electronic and combustible cigarettes is related to greater rates of cannabis use. Further, cannabis use is associated with worse combustible smoking‐related outcomes, yet little research has identified mechanisms underlying such relations. It may be that negative‐affect‐related transdiagnostic factors such as emotion dysregulation, anxiety sensitivity, and/or distress intolerance play a mechanistic role in the cannabis–tobacco interrelations.

Methods

The current study tested this hypothesis among 400 adults who endorsed dual use, 33% of whom endorsed current (past 3 months) cannabis use. We conducted analyses of variance and indirect effects model using the PROCESS v4.1 macro in SPSS version 29.

Results

Results indicated that participants who use cannabis reported greater difficulty with emotion regulation, anxiety sensitivity, and cigarette dependence severity. Cannabis use was related to cigarette dependence severity indirectly via difficulty with emotion regulation and anxiety sensitivity.

Discussion and Conclusions

These results indicate that specific transdiagnostic negative‐affect‐related factors of difficulty with emotion regulation and anxiety sensitivity are associated with cannabis use among adults who smoke combustible and electronic cigarettes.

Scientific Significance

Given that these transdiagnostic factors are malleable, these findings suggest targeting and engaging such mechanisms may offer novel behavioral change strategies for this high‐risk population.
Association Between Influenza Vaccination and SARS‐CoV‐2 Infection
Authors: Ma'ayeh Marwan , de Voest Jessica A. , Hughes Brenna L. , Grobman William A. , Saade George R. , Manuck Tracy A. , Longo Monica , Simhan Hyagriv N. , Rouse Dwight J. , Mendez‐Figueroa Hector , Gyamfi‐Bannerman Cynthia , Bailit Jennifer L. , Costantine Maged M. , Sehdev Harish M. , Tita Alan T. N. , Metz Torri D. ,   for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal‐Fetal Medicine Units (MFMU) Network
Published: July 2024

Background

Recent data in nonpregnant individuals suggest a protective effect of influenza vaccination against SARS‐CoV‐2 infection and its severity.

Objectives

Our primary objective was to evaluate whether influenza vaccination was associated with COVID‐19 severity and pregnancy and neonatal outcomes among those infected with SARS‐CoV‐2. The secondary objective was to examine the association between influenza vaccination and SARS‐CoV‐2 infection.

Study Design

Secondary analysis of a multicenter retrospective cohort of pregnant people who tested positive for SARS‐CoV‐2 between March and August 2020, and a cohort of random deliveries during the same time period. The associations between 2019 influenza vaccination and the primary outcome of moderate‐to‐critical COVID‐19 as well as maternal and perinatal outcomes were examined among all people who tested positive for SARS‐CoV‐2 between March and August 2020. The association between 2019 influenza vaccination and having a positive SARS‐CoV‐2 test was examined among a cohort of individuals who delivered on randomly selected dates between March and August 2020. Univariable and multivariable analyses were performed.

Results

Of 2325 people who tested positive for SARS‐CoV‐2, 1068 (45.9%) were vaccinated against influenza in 2019. Those who received the influenza vaccine were older, leaner, more likely to have private insurance, and identify as White or Hispanic. They were less likely to smoke tobacco and identify as Black. Overall, 419 (18.0%) had moderate, 193 (8.3%) severe, and 52 (2.2%) critical COVID‐19. There was no association between influenza vaccination and moderate‐to‐critical COVID‐19 (29.2% vs. 28.0%, adjusted OR 1.10, 95% CI 0.90–1.34) or adverse maternal and perinatal outcomes among those who tested positive. Of 8152 people who delivered in 2020, 4658 (57.1%) received the influenza vaccine. Prior vaccination was not associated with a difference in the odds of SARS‐CoV‐2 infection (3.8% vs. 4.2%, adjusted OR 0.94, 95% CI 0.74–1.19).

Conclusion

Prior influenza vaccination was not associated with decreased severity of COVID‐19 or lower odds of SARS‐CoV‐2 infection in pregnancy.
Unveiling deception: An approach of the Shroud of Turin's anatomical anomalies and artistic liberties
Authors: Rodríguez Elio Quiroga
Published: July 2024

The authenticity of the Shroud of Turin, also known as the ‘Síndone’ or ‘Holy Shroud’, faces significant doubt based on scientific evidence. Carbon‐14 testing conducted decades ago placed its origin in the Middle Ages, raising questions about its connection to Jesus Christ. This article highlights an anatomical anomaly: the hand placement covering the genitals appears inconsistent with human proportions, suggesting a possible artistic intervention.
The economic aftermath of Thailand's 2014 military coup: Evidence from the synthetic control method
Authors: Suwanprasert Wisarut
Published: July 2024

In this paper, I study the effects of Thailand’s 2014 military coup on Thailand’s economy. I use the synthetic control method to create synthetic Thailand, which represents hypothetical Thailand had the 2014 coup not occurred. The empirical findings reveal no statistically significant effects on key economic variables such as gross domestic product, unemployment, military expenditure, and income inequality. Contrary to previous research, military expenditures did not increase following the coup. Supporters of the coup may interpret these results as evidence that the coup had no negative effects on the economy. At the same time, critics may argue that the coup did not lead to improved economic outcomes compared with the politically unstable precoup period, thus perpetuating a state of national stagnation.
Protocol of a drug–drug interaction study between bictegravir/emtricitabine/tenofovir alafenamide and feminizing hormones in trans women living with HIV
Authors: Lacombe‐Duncan Ashley , Tseng Alice , Scarsi Kimberly K. , Senneker Tessa , Kluger Hadas , Persad Yasmeen , Underhill Angela , Kennedy V. Logan , Armstrong Ian , Fung Raymond , Bourns Amy , Nguyen Quang , Hranilovic Susan , Weisdorf Thea , Chan Louie , Kia Hannah , Halpenny Roberta , Iyer Harshita , Jeyarajah Nirubini , Kovchazov George , Tharao Wangari , Loutfy Mona
Published: July 2024

Aims

Trans/transfeminine women are disproportionally affected by HIV. Concerns regarding negative drug–drug interactions (DDIs) between ART drugs and gender‐affirming hormone therapy (GAHT), specifically feminizing hormone therapy (FHT), may contribute to the lower ART uptake by trans women with HIV compared with their cis counterparts. The aim of this study is to investigate the bidirectional pharmacokinetic effects of components of FHT regimens (oral oestradiol and androgen‐suppressing medications) with the ART regimen (bictegravir/emtricitabine/tenofovir alafenamide [B/F/TAF)].

Methods

We present a protocol for a three‐armed, parallel‐group, longitudinal (6‐month), DDI study. Group 1 includes 15 3trans women with HIV taking FHT and ART; group 2 includes 15 premenopausal cis women with HIV taking ART; group 3 includes 15 trans women without HIV taking FHT. Women with HIV must be on or switch to B/F/TAF at baseline and be virally suppressed for ≥3 months. Trans women must be taking a stable regimen of ≥2 mg daily oral oestradiol and an anti‐androgen (pharmaceutical, and/or surgical, and/or medical) for ≥3 months. Plasma ART drug concentrations will be sampled at Month 2 and compared between groups 1 and 2. Serum oestradiol concentrations will be sampled at baseline and Month 2 visits and compared between groups 1 and 3. The primary outcomes are B/F/TAF pharmacokinetic parameters (Cmin, Cmax and AUC) and oestradiol concentrations (Cmin, C4h, Cmax and AUC) at month 2.

Discussion

This study is of global importance as it provides critical information regarding safe coadministration of B/F/TAF and FHT, both of which are life‐saving therapies for trans women with HIV.
Estimation of self‐funded human papillomavirus vaccine recipients from Japan's previously assumed “unvaccinated generation”
Authors: Kobayashi Mariya , Nakagawa Satoshi , Ueda Yutaka , Yagi Asami , Kakuda Mamoru , Hiramatsu Kosuke , Kimura Tadashi
Published: July 2024

Precise vaccination data is essential to accurately estimate the effectiveness of the human papillomavirus (HPV) vaccine against HPV‐related cancers. In Japan, the number of subsidized HPV vaccinations can be tracked through registries, but the number of self‐funded vaccinations has not been tracked. The number of individuals who chose to receive the vaccine at their own expense, despite being ineligible for public subsidies due to their age, is unknown and has been nominally considered to be zero. Our aim is to produce a more accurate estimate of this number using recently released proprietary data. First, we estimated the total number of self‐funded HPV vaccinations occurring from 2010 to 2012 using public data from the Ministry of Health, Labour and Welfare and our previously reported data on the number of HPV vaccinations eligible for public subsidy. Second, using proprietary data from the vaccine manufacturer, we calculated the distribution of self‐funded vaccination shots by age. Finally, we combined these data to estimate the number of self‐funded HPV vaccinations by birth fiscal year (FY) relative to a yearly reference population. We found that 78,264 individuals born in FY1993 and 58,190 born in FY1992 self‐funded their vaccinations, representing 13.6% and 10.0% of the reference population, respectively. Additionally, we found that 5%–10% of individuals born from FY1986 to FY1991 self‐funded their vaccinations. Our study revealed for the first time that a certain number of individuals from the “HPV unvaccinated generation,” ineligible for subsidies due to age restrictions, chose to self‐fund their vaccinations.
‘There was nothing, just absolute darkness’: Understanding the needs of those caring for children and young people with complex neurodisability in a diverse UK context: A qualitative exploration in the ENCOMPASS study
Authors: Prest Kirsten , Wilson Emma , Vassiliadou Io , Ali Sayeeda , Lakhanpaul Monica , Morris Christopher , Tann Cally , Harniess Phillip , Lewis‐Jackson Sasha , Kuper Hannah , Heys Michelle
Published: July 2024

Background

Children and young people (CYP) with complex neurodisability experience multiple physical, communication, educational and social challenges, which require complex packages of multidisciplinary care. Part of the holistic care required includes supporting the families and parents/caregivers. The aim of the wider study was to introduce a new programme (‘Ubuntu’) to parents/caregivers and healthcare professionals (HCPs) in order to test the feasibility and acceptability of the concept and content, with the goal of potential adaptation for the UK in mind. Data collection and analysis uncovered rich data on caregiving journeys, navigation of health services, and perceived service gaps. This paper focuses solely on these topics. Further papers will report on the feasibility and adaptation data.

Methods

Two rounds of semi‐structured interviews were conducted with 12 caregivers of CYP with complex neurodisability and six HCPs from a variety of disciplines, recruited from a community child health service in London Borough of Newham, UK in 2020. The interviews included open‐ended questions to explore caregiving journeys, experiences of navigating health services and perceived service gaps. Transcripts were analysed using a data‐driven inductive thematic analysis.

Results

Three themes were identified that related to the aim of understanding caregivers' experiences and unmet needs relating to current service provision. These were (1) Caregiver Mental Health, (2) The Information Gap and (3) The Need for Holistic Support. Mental health difficulties were reported, particularly around the period of diagnosis. Priority needs included the provision of clear information about the diagnosis and services offered, opportunities to forge peer support networks and for services across the community to collaborate.

Conclusions

The delivery of health services for CYP with neurodisability should encompass the broad needs of the family as well as meeting the clinical needs of the CYP.
Monitoring levetiracetam concentration in saliva during pregnancy is stable and feasible
Authors: Li Wanling , Yang Ximeng , Chen Qian , Wang Zhenlei , Duan Yifei , Chen Lei
Published: July 2024

Aims

This multicenter prospective cohort study (registration no. ChiCTR2000032089) aimed to investigate the relationship between saliva and plasma levetiracetam concentrations to determine whether saliva could be used for routine monitoring of levetiracetam during pregnancy.

Methods

The slot concentrations of levetiracetam in simultaneously obtained saliva and plasma samples were measured using UPLC–MS/MS. The correlations between saliva and plasma levetiracetam concentrations and the dose‐normalized concentrations were compared among pregnant women in different stages and nonpregnant control participants with epilepsy.

Results

In total, 231 patients with 407 plasma and saliva sample pairs were enrolled from 39 centers. Linear relationships between salivary and plasma levetiracetam concentrations were reported in the enrolled population (r = 0.898, p < 0.001), including pregnant (r = 0.935, p < 0.001) and nonpregnant participants (r = 0.882, p < 0.001). Plasma concentrations were moderately higher than saliva concentrations, with ratios of saliva to plasma concentrations of 0.98 for nonpregnant women, 0.98, 1, and 1.12 for pregnant women during the first trimester, the second trimester, the and third trimester, respectively. The effective range of saliva levetiracetam concentration was found to be 9.98 μg/mL (lower limit) with an area under the curve (AUC) of 0.937 (95% confidence intervals, 0.915–0.959), sensitivity of 88.9%, specificity of 86.8%, and p < 0.001, to 24.05 μg/mL (upper limit) with an AUC of 0.952 (0.914–0.99), sensitivity of 100%, specificity of 92.3%, and p = 0.007.

Conclusion

The saliva/plasma concentration ratio of levetiracetam remains constant during pregnancy and is similar to that in non‐pregnant individuals. Monitoring levetiracetam concentration in saliva during pregnancy should be widely promoted.
Activation of GPER1 by G1 prevents PTSD‐like behaviors in mice: Illustrating the mechanisms from BDNF/TrkB to mitochondria and synaptic connection
Authors: Chen Lixia , Zhang Yang , Wang Zisheng , Zhang Zhengrong , Wang Jingji , Zhu Guoqi , Yang Shaojie
Published: July 2024

Background

G1 is a specific agonist of G protein‐coupled estrogen receptor 1 (GPER1), which binds and activates GPER1 to exert various neurological functions. However, the preventive effect of G1 on post‐traumatic stress disorder (PTSD) and its mechanisms are unclear.

Objective

To evaluate the protective effect of G1 against synaptic and mitochondrial impairments and to investigate the mechanism of G1 to improve PTSD from brain‐derived neurotrophic factor (BDNF)/tyrosine kinase receptor B (TrkB) signaling.

Methods

This study initially detected GPER1 expression in the hippocampus of single prolonged stress (SPS) mice, utilizing both Western blot and immunofluorescence staining. Subsequently, the effects of G1 on PTSD‐like behaviors, synaptic, and mitochondrial functions in SPS mice were investigated. Additionally, the involvement of BDNF/TrkB signaling involved in the protection was further confirmed using GPER1 antagonist and TrkB inhibitor, respectively.

Results

The expression of GPER1 was reduced in the hippocampus of SPS mice, and G1 treatment given for 14 consecutive days significantly improved PTSD‐like behaviors in SPS mice compared with model group. Electrophysiological local field potential (LFP) results showed that G1 administration for 14 consecutive days could reverse the abnormal changes in the gamma oscillation in the CA1 region of SPS mice. Meanwhile, G1 administration for 14 consecutive days could significantly improve the abnormal expression of synaptic proteins, increase the expression of mitochondria‐related proteins, increase the number of synapses in the hippocampus, and ameliorate the damage of hippocampal mitochondrial structure in SPS mice. In addition, G15 (GPER1 inhibitor) and ANA‐12 (TrkB inhibitor) blocked the ameliorative effects of G1 on PTSD‐like behaviors and aberrant expression of hippocampal synaptic and mitochondrial proteins in SPS mice and inhibited the reparative effects of G1 on structural damage to hippocampal mitochondria, respectively.

Conclusion

G1 improved PTSD‐like behaviors in SPS mice, possibly by increasing hippocampal GPER1 expression and promoting BDNF/TrkB signaling to repair synaptic and mitochondrial functional impairments. This study would provide critical mechanism for the prevention and treatment of PTSD.
Efficacy and Safety of Azvudine in Patients With COVID‐19 in China: A Meta‐Analysis of Observational Studies
Authors: Dong Tao , Zhang Wentao , Wu Tingting , Ge Yongxiang , Yang Qi , Xu Jia , Liu Yuna
Published: July 2024

Background

Azvudine (FNC) is a novel small molecule antiviral drug for treating COVID‐19 that is available only on the Chinese market. Despite being recommended for treating COVID‐19 by the Chinese guidelines, its efficacy and safety are still unclear. This study aimed to evaluate the protective effect of FNC on COVID‐19 outcomes and its safety.

Methods

We followed the PRISMA 2020 guidelines and searched the PubMed, Embase, Web of Science, Scopus, and China National Knowledge Infrastructure (CNKI) databases to evaluate studies on the effectiveness of FNC in treating COVID‐19 in China, focusing on mortality and overall outcomes. Additionally, its impact on the length of hospital stay (LOHS), time to first nucleic acid negative conversion (T‐FNANC), and adverse events was evaluated. The inclusion criterion was that the studies were published from July 2021 to April 10, 2024. This study uses the ROBINS‐I tool to assess bias risk and employs the GRADE approach to evaluate the certainty of the evidence.

Results

The meta‐analysis included 24 retrospective studies involving a total of 11 830 patients. Low‐certainty evidence revealed no significant difference in mortality (OR = 0.91, 95% CI: 0.76–1.08) or LOHS (WMD = −0.24, 95% CI: −0.83 to 0.35) between FNC and Paxlovid in COVID‐19 patients. Low‐certainty evidence shows that the T‐FNANC was longer (WMD = 1.95, 95% CI: 0.36–3.53). Compared with the Paxlovid group, low‐certainty evidence shows the FNC group exhibited a worse composite outcome (OR = 0.77, 95% CI: 0.63–0.95) and fewer adverse events (OR = 0.63, 95% CI: 0.46–0.85). Compared with supportive treatment, low certainty shows FNC significantly reduced the mortality rate in COVID‐19 patients (OR = 0.61, 95% CI: 0.51–0.74) and decreased the composite outcome (OR = 0.67, 95% CI: 0.50–0.91), and very low certainty evidence shows significantly decreased the T‐FNANC (WMD = −4.62, 95% CI: −8.08 to −1.15). However, in very low certainty, there was no significant difference in LOHS (WMD = −0.70, 95% CI: −3.32 to 1.91) or adverse events (OR = 1.97, 95% CI: 0.48–8.17).

Conclusions

FNC appears to be a safe and potentially effective treatment for COVID‐19 in China, but further research with larger, high‐quality studies is necessary to confirm these findings. Due to the certainty of the evidence and the specific context of the studies conducted in China, caution should be exercised when considering whether the results are applicable worldwide.

Trial Registration

PROSPERO number: CRD42024520565
Placental Transmogrification of the Lung Presenting as Cystic‐Solid Mass: A Case Report
Authors: Liu Chen , Zhang Yunhui , Li Dengyuan , Sun Danxiong
Published: July 2024

The gradually progressive solitary cystic‐solid mass of chest CT scans is highly suggestive of lung cancer. We report a case of a 29‐year‐old woman with a persistent cystic‐solid lesion in the right upper lobe. A chest CT scan showed a 35 mm × 44 mm × 51 mm focal cystic‐solid mass in the anterior segment of the right upper lobe. The size of lesion had increased over 3 years, especially for the solid component. The right upper lobe pneumonectomy was performed. Postoperative pathological examination showed placental transmogrification of the lung, which is a rare cause of pulmonary cystic lesion.
Myelodysplasia cutis and VEXAS syndrome initially diagnosed as histiocytoid Sweet syndrome: A diagnostic pitfall
Authors: Shimshak Serena J. , Jasmine Sion , Davis Mark D. P. , Johnson Emma F. , Peters Margot S. , Zheng Gang , Sokumbi Olayemi , Comfere Nneka I.
Published: July 2024

Histiocytoid Sweet syndrome (H‐SS) is a histopathological variant of Sweet syndrome (SS) defined by cutaneous infiltration of immature myeloid cells morphologically resembling histiocytes. The association of H‐SS with underlying malignancy, particularly myelodysplastic syndromes, is well‐established. Myelodysplasia cutis (MDS‐cutis) has been proposed to describe cases historically diagnosed as H‐SS but characterized by shared clonality of the myeloid infiltrate in skin and bone marrow. Therefore, identifying patients who might have MDS‐cutis is critical for the management of the associated hematologic malignancy. VEXAS syndrome, an adult‐onset autoinflammatory disease, should also be included in the histopathologic differential diagnosis of H‐SS, as it shares clinical and pathologic features with MDS‐cutis. Through the presentation of two cases, we aim to highlight the defining features and key clinical implications of MDS‐cutis and VEXAS syndrome.
A cross‐sectional time series of cardiometabolic health education format preferences across sociodemographic groups
Authors: Woolley Angharad , Hadjiconstantinou Michelle , Bodicoat Danielle H. , Khunti Kamlesh , Davies Melanie J. , Seidu Samuel
Published: July 2024

Aims

Health education is integral to cardiometabolic disease (CMD) management. This study aimed to assess whether and how education preferences have changed over time, and whether trends differ by sociodemographic characteristics (education status, age, ethnicity, and sex).

Methods

A cross‐sectional questionnaire was deployed across five counties in the East Midlands, UK between 2017 and 2022 to adults with CMD (type 2 diabetes, cardiovascular disease or cerebrovascular disease). Respondent demographic data were collected alongside health education preferences. Statistical analyses ascertained whether demographic characteristics influenced preferences. The distribution of preferences over time was charted to identify trends.

Results

A total of 4301 eligible responses were collected. Face‐to‐face one‐to‐one education was preferred (first choice for 75.1% of participants) but popularity waned over the five‐year period. Trends were similar amongst demographic groups. Online education showed a U‐shaped trend: In 2017, 44% of respondents ranked it as acceptable, peaking at 53% in 2019, but declining again, to below base line, 43%, by 2022. This modality was more popular with participants aged younger than 65 years, but popularity in people older than 65 years increased over the study period. The popularity of printed information also declined over time across all demographic groups except those of South Asian ethnicity, for whom it remained static.

Conclusions

The overwhelming preference for face‐to‐face one‐to‐one health education from a doctor or nurse highlights the importance of preserving access to this modality, even in the face of current NHS pressures and trends towards digitalisation. Trends are changing, and should continue to be monitored, including between different sociodemographic groups.
Blood pressure response during exercise testing in individuals with and without hypertension: The value of the recovery phase
Authors: Ghidoni Céline , van der Stouwe Jan Gerrit , Würzburger Laura , Wiech Patrick , Vontobel Jan , Bohm Philipp , Moser Georg , Petrasch Gloria , Rossi Valentina A. , Schmied Christian M. , Caselli Stefano , Niederseer David
Published: July 2024

Background

Hypertension and exercise testing are essential for cardiovascular risk assessment. However, an exact description of blood pressure (BP) in patients with a hypertensive response during exercise (HRE), especially in the recovery phase is lacking. Herein, we aimed to analyse BP and heart rate during exercise testing and recovery in patients with an HRE.

Methods

800 patients aged 17–90 with an HRE during a standardized bicycle ergometry test were recruited. The BP behaviour during exercise testing was correlated with clinical data. Furthermore, data were analysed according to the presence of pre‐existent hypertension.

Results

Of the 800 patients included in this study 497 (62%) were previously diagnosed with hypertension. Analysis of covariance showed a significantly faster systolic (β [95% CI] 8.0 [4.9–11.1]) and diastolic (2.4 [0.4–4.4]) BP recovery 3 min after maximal exercise in patients without hypertension in univariable models. These results remained robust in fully adjusted models taking into account age, sex, body mass index, cardiovascular disease, and antihypertensive treatment for systolic (5.3 [1.2–9.4]) and diastolic BP (4.5 [1.9–7.0]). Furthermore, patients with hypertension displayed higher systolic BP during maximal exercise in univariable (3.8 [0.1–7.5]) and fully adjusted (5.5 [1.1–10.0]) models. There was no difference in maximum diastolic BP between groups.

Conclusion

In this large cohort study, patients without hypertension showed a faster systolic and diastolic BP recovery and lower maximal systolic BP compared to patients with hypertension. Overall, this study provides new insights into cardiovascular health during recovery phase.
Control and management ofPhytophthoradamage in forestry—A systematic mapping study
Authors: López‐García Noelia , Romeralo Carmen , Rönnberg Jonas , Witzell Johanna
Published: July 2024

Plant pathogens in the genusPhytophthoraare a severe threat to forest plantations, ecosystems and tree nurseries. Especially in forests and natural ecosystems, there is a lack of effective measures to control and manage these pathogens. In this study, we conducted a systematic mapping review to collate evidence regarding the control and management of forestPhytophthorain different production settings and ecosystems. The study aimed to reveal possible knowledge gaps, thus guiding future research priorities. We extracted information from nine databases, limiting the search to studies published during the time period from January 2010 to December 2022. The articles were shared between three reviewers who classified the reports using a set of inclusion/exclusion criteria. A total of 561 articles were included and mapped in a database using pre‐defined coding, and critically appraised for relevance and reliability. The analysis showed that biological or bio‐based measures were the most studied interventions, followed by genetics or breeding programmes, whereas chemical and silvicultural management approaches were less studied. Most of the studies were conducted in Europe, North America, Australia and New Zealand.Phytophthora cinnamomihas been the most studied species followed byP. ramorum. We discuss the current knowledge gaps in the implementation of existing research, likely due to a lack of holistic understanding of the processes over time and space, and suggest future research that is needed to managePhytophthorain forest ecosystems.