bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of software promotion strategies in product-service integrated supply chains
Authors: Li Kai , Xia Lulu , Zhao Nenggui , Zhou Tao
Published: November 2023

Purpose

The purpose of this paper is to compare the pricing decisions and earning potential of the software supplier and the smart device manufacturer in different software promotion strategies.

Design/methodology/approach

Based on game theory, the authors formulate two promotion models, that is, the supplier implements software promotion activities individually (SP model) or outsources the promotion activity to the manufacturer under profit-sharing contract (MP model) when taking different channel power structures into consideration. Besides, in order to test the robustness of the conclusions, the authors also extend the basic model to the following situations: (1) the customers have different price elasticity toward service fee and product price; (2) the revenue sharing contract is employed by the supply chain members; and (3) the manufacturer's product promotion practice is taken into consideration.

Findings

The optimal service fee (product price) of the supplier (manufacturer) under SP model is always lower (higher) than that under MP model. Surprisingly, if the supplier is the channel leader and the profit sharing ratio exceeds certain threshold, the manufacturer's profit decreases in profit sharing ratio, which remains robust in three extension models. Moreover, the supply chain's profit in supplier-led game is always lower than that in Nash game irrespective of the promotion strategy in profit sharing context. When revenue sharing contract is adopted, the result holds only when the revenue sharing ratio is relatively low.

Originality/value

The authors originally explore two promotion strategies of the software supplier when taking the channel power structures into considerations, which has not been explored in the literature to the best of the authors' knowledge.
CEO overconfidence and financial reporting complexity: evidence from textual analysis
Authors: Rajabalizadeh Javad
Published: November 2023

Purpose

This study investigates the relationship between the Chief Executive Officer's (CEO) overconfidence and financial reporting complexity in Iran, a context characterized by weak corporate governance and heightened managerial discretion.

Design/methodology/approach

The sample consists of 1,445 firm-year observations from 2010 to 2021. CEO overconfidence (CEOOC) is evaluated using an investment-based index, specifically capital expenditures. Financial reporting complexity (Complexity) is measured through textual features, particularly three readability measures (Fog, SMOG and ARI) extracted from annual financial statements. The ordinary least squares (OLS) regression is employed to test the research hypothesis.

Findings

Results suggest that CEOOC is positively related to Complexity, leading to reduced readability. Additionally, robustness analyses demonstrate that the relationship between CEOOC and Complexity is more distinct and significant for firms with lower profitability than those with higher profitability. This implies that overconfident CEOs in underperforming firms tend to increase complexity. Also, firms with better financial performance present a more positive tone in their annual financial statements, reflecting their superior performance. The findings remain robust to alternative measures of CEOOC and Complexity and are consistent after accounting for endogeneity issues using firm fixed-effects, propensity score matching (PSM), entropy balancing approach and instrumental variables method.

Research limitations/implications

This study adds to the literature by delving into the effect of CEOs' overconfidence on financial reporting complexity, a facet not thoroughly investigated in prior studies. The paper pioneers the use of textual analysis techniques on Persian texts, marking a unique approach in financial reporting and a first for the Persian language. However, due to the inherent challenges of text mining and feature extraction, the results should be approached with caution.

Practical implications

The insights from this study can guide investors in understanding the potential repercussions of CEOOC on financial reporting complexity. This will assist them in making informed investment decisions and monitoring the financial reporting practices of their invested companies. Policymakers and regulators can also reference this research when formulating policies to enhance financial reporting quality and ensure capital market transparency. The innovative application of textual analysis in this study might spur further research in other languages and contexts.

Originality/value

This research stands as the inaugural study to explore the relationship between CEOs' overconfidence and financial reporting complexity in both developed and developing capital markets. It thereby broadens the extant literature to include diverse capital market environments.
Wheel/rail-force–based maintenance interval extension of the C80 series wagon
Authors: Xiao Qi , Yu Weidong , Tian Guangrong , Li Fangxuan
Published: November 2023

Purpose

This study aims to introduce the achievements and benefits of applying wheel/rail-force–based maintenance interval extension of the C80 series wagon in China.

Design/methodology/approach

Chinese wagons' existing maintenance strategy had left a certain safety margin for the characteristics of widely running range, unstable service environment and submission to transportation organization requirements. To reduce maintenance costs, China railway (CR) has attempted to extend the maintenance interval since 2020. The maintenance cycle of C80 series heavy haul wagons is extended by three months (no stable routing) or 50,000 km (regular routing). However, in the meantime, the alarming rate of the running state, a key index to reflect the severe degree of hunting stability, by the train performance detection system (TPDS) for the C80 series heavy haul wagons has increased significantly.

Findings

The present paper addresses a big data statistical way to evaluate the risk of allowing the C80 series heavy haul wagons to remain in operation longer than stipulated by the maintenance interval initial set. Through the maintenance and wayside-detector data, which is divided into three stages, the extension period (three months), the current maintenance period and the previous maintenance period, this method reveals the alarming rate of hunting was correlated with maintenance interval. The maintainability of wagons will be achieved by utilizing wagon performance degradation modeling with the state of the wheelset and the often-contact side bearing. This paper also proposes a statistical model to return to the average safety level of the previous maintenance period's baseline through correct alarming thresholds for unplanned corrective maintenance.

Originality/value

The paper proposes an approach to reduce safety risk due to maintenance interval extension by effective maintenance program. The results are expected to help the railway company make the optimal solution to balance safety and the economy.
Burning questions: Exploring the limits of microbial electrochemical technology for industrial biotechnological applications
Authors: Lai Bin
Published: November 2023

Microbial electrochemical technology (MET) has proven to be a promising solution to overcome the redox and energy metabolic constraints, enabling high yields of biosynthesis beyond stoichiometric limits. While there is room for improvement in extracellular electron transfer rates and productivity of the target compounds, it is crucial to think in advance about which bioprocess could be electrified and what would face major challenges. In this opinion paper, I presented and addressed interfacial electron transfer capacity of MET, whether built on biofilm or planktonic cells, and also discussed the upper limits of the MET system for biosynthesis of chemicals accordingly. Potential future application scenarios of different MET were also briefly addressed. This opinion paper aims to encourage the community to rethink the design and development of microbial electrochemical technologies for potential future applications in industrial biotechnology.
Low‐risk gestational trophoblastic neoplasia – 20 years experience of a state registry
Authors: McInerney Carmel , McNally Orla , Cade Thomas James , Jones Antonia , Neesham Deborah , Naaman Yael
Published: November 2023

Background

Gestational trophoblastic disease (GTD) is an uncommon but highly treatable condition. There is limited local evidence to guide therapy.

Aims

To report the experience of a statewide registry in the treatment of low‐risk gestational trophoblastic neoplasia (GTN) over a 20‐year period.

Materials and Methods

A retrospective review of the prospectively maintained GTD registry database was conducted. There were 144 patients identified with low‐risk GTN, of which 115 were analysed. Patient demographics, treatment details and outcomes, including development of resistance, toxicity or relapse were reviewed.

Results

The incidence of GTD was 2.6/1000 live births. There was 100% survival. The mean time from diagnosis to commencing treatment was 1.9 days (range 0–29 days). Seventy‐seven percent of patients treated with methotrexate achieved complete response. Thirteen patients (11.3%) required multi‐agent chemotherapy, for the treatment of resistant or relapsed disease. There was a higher rate of treatment resistance in those with World Health Organization (WHO) risk scores 5–6 (odds ratio (OR) 6.56, 95% CI 1.73–24.27, P = 0.005) and those with pre‐treatment human chorionic gonadotropin >10 000 (OR 4.00 95% CI 1.73–24.27 P = 0.007). Four patients (3.5%) were diagnosed with choriocarcinoma after commencing treatment. Nine patients (7.8%) had successful surgical treatment for GTN, both alone and in combination with chemotherapy. The relapse rate was 4.3%; all were treated successfully with a combination of chemotherapy and surgery, and 93.9% of patients completed follow up through the registry.

Conclusions

Methotrexate is a highly effective treatment for low‐risk GTN, especially with WHO risk score ≤4. The optimal treatment for those with risk scores of 5–6 requires further investigation.
I help, therefore, I am?—longitudinal interrelations of the three‐dimensional moral self‐concept and prosocial behaviours in 4–6‐year‐old children
Authors: Söldner Lena , Paulus Markus
Published: November 2023

Children's moral self‐concept (MSC) has been proposed to relate to prosocial behaviour. However, systematic assessments of their interrelations are scarce. The current study examines the early development, structure, stability and interrelation of three key prosocial behaviours and the corresponding dimensions of the moral self‐concept. To this end, we use a longitudinal approach with three measurement points during the preschool years at ages 4, 5 and 6 years. We assess three prosocial dimensions of children's MSC through a puppet‐interview. In addition, behavioural measures of children's helping, sharing and comforting were administered in a laboratory setting. By examining the longitudinal associations between MSC and prosocial behaviours, this study will provide valuable insights into the complex nature of prosocial development in early childhood.
Identification of novel targets for immunotherapies in subsets of patients with diffuse large B‐cell lymphoma (DLBCL)
Authors: Heini Alexander D. , Bacher Ulrike , Pabst Thomas
Published: November 2023

Personalized treatment options for subsets of patients with DLBCL are beginning to emerge. Caracciolo et al. explore UMG1, an epitope of CD43 as a potential target for certain patients with DLBCL, and demonstrate promising preclinical activity of an Anti‐UMG1‐antibody.

Commentary on: Caracciolo et al. UMG1/CD3ε‐bispecific T‐cell engager (BTCE) redirects T‐cell cytotoxicity against diffuse large B‐cell lymphoma (DLBCL). Br J Haematol 2024;204:555‐560.
Keratoconus in Down syndrome: Prevalence, risk factors, severity and corneal tomographic characteristics
Authors: Mathan Joyce J. , Gokul Akilesh , Simkin Samantha K. , Meyer Jay J. , McGhee Charles N. J.
Published: November 2023

Background

This study investigated the prevalence, risk factors and severity of corneal tomographic features of keratoconus in Down syndrome (DS). Additionally, previous studies indicate anomalous corneal features in DS, without keratoconus, this study characterised corneal features in DS without keratoconus.

Methods

This prospective observational study included participants with DS ≥10 years old. Keratoconus diagnosis, risk factors and corneal tomographic characteristics were recorded. Participants underwent slit‐lamp biomicroscopy, Scheimpflug corneal tomography, corneal topography and autorefraction. A diagnosis of keratoconus (DS‐KC), suspect keratoconus (DS‐SK) and non‐keratoconus (DS‐NK) was made based on expert review of scans by three fellowship trained anterior segment ophthalmologists. Corneal tomography parameters from one eye of each participant were analysed.

Results

Keratoconus affected 50 (26.3%) of 190 participants, diagnosed by corneal tomography, topography or slit‐lamp signs. Corneal hydrops affected 14.0% of DS‐KC participants. Eye rubbing was a significant risk factor for keratoconus (p = 0.036). 175 (92%) participants could undertake corneal tomography of which tomography assessment alone identified 47 (26.9%) DS‐KC participants, 64 (36.6%) DS‐SK participants and 64 (36.6%) DS‐NK participants. Significant differences (p < 0.001) were identified when the DS‐KC, DS‐SK and DS‐NK groups were compared in maximum keratometry and posterior elevation at the thinnest point respectively: median (interquartile range) 50.20 (10.30D), 47.60 (1.95D), 46.50 (2.40D); 24.0 (38.00 μm), 10.00 (13.75 μm), 8.00 (6.00 μm). The DS‐SK and DS‐NK cohorts had similar minimum pachymetry, however, had several significantly different parameters among which included greater maximum keratometry, posterior elevation at the thinnest point in the DS‐SK group.

Conclusions

Keratoconus is common in DS. Keratoconus screening with corneal tomography is recommended for early detection.
Asymmetric local adaptation to host plants (Cirsium spp.) by the phytophagous ladybird beetle Henosepilachna niponica and its implications
Authors: Nakasone Daiki , Matsubayashi Kei W. , Fujiyama Naoyuki
Published: November 2023

Divergent host specialization by phytophagous insects is often detected as local adaptation and is thought to have played an important role in their diversification even within an ecological specialist. The phytophagous ladybird beetle Henosepilachna niponica Lewis (Coleoptera: Coccinellidae) predominantly depends on thistles (Cirsium spp., Asteraceae). The distribution of H. niponica occupies multiple areas dominated by different thistle species. This implies the possibility of the occurrence of host‐associated divergent specialization of H. niponica. In this study, we investigated the pattern of host‐use ability of three allopatric H. niponica populations (Aomori, Iwate, and Yamagata) on three thistle species – Cirsium alpicola Nakai, Cirsium nipponicum (Maxim.) Makino, and Cirsium tonense Nakai – under laboratory conditions. The results displayed asymmetric local adaptation by the beetles. The adults and larvae of the Aomori population showed sufficient acceptance and performance on C. nipponicum and C. tonense, the hosts of the Iwate and Yamagata populations, respectively. On the other hand, the Iwate and Yamagata populations fed small amounts of and performed poorly on C. alpicola, the host of the Aomori population. In contrast, the adults from all the populations clearly preferred feeding on C. nipponicum or C. tonense to C. alpicola. We concluded that the small but significant population differentiation and asymmetric local adaptation by beetles to congeneric host plant species could be a sign of the earliest stage of population divergence by divergent natural selection, given that these divergences will act as ‘immigrant inviability’ and ‘habitat isolation’ at least asymmetrically when these populations come into contact.
Antagonistic interactions between native fungi of Minnesota and the root rot pathogen Heterobasidion irregulare
Authors: Otto Eric C. , Blanchette Robert A.
Published: November 2023

The forest pathogen, Heterobasidion irregulare, is a serious threat to conifers in North America including Minnesota. Fungi native to Minnesota were isolated and tested in laboratory and field assays to evaluate their antagonism towards H. irregulare. One management strategy for plant pathogens, and especially H. irregulare, is to use fungi as biological control agents. A successful biological control agent used to manage root rot disease caused by H. irregulare is the fungus Phlebiopsis gigantea. The goal of this research was to screen different native fungi, including P. gigantea, against H. irregulare and examine and quantify their interactions in vitro and ex vitro. A set of four different antagonism assays were conducted. These assays served as a screening process involving both the laboratory and the field. Interactions were first examined with dual inoculation studies on media and wood discs of red pine (Pinus resinosa). These assays demonstrated strong inhibition and limited growth of H. irregulare by select fungi, including Phanerochaete livescens and P. gigantea. Another assay involved using soil microcosms and wood wedges of red pine. This allowed for a different examination, as wood wedges were inoculated with a candidate antagonistic fungus and placed in soil microcosms with H. irregulare. The opposite interaction was also examined with wedges inoculated with H. irregulare and then placed in soil microcosms containing different candidate fungi. In the field, large wood discs were placed around stumps and inoculated with candidate fungi in a red pine plantation infected with H. irregulare. Certain fungi performed well in different assays, but across all assays, P. gigantea performed the best. The antagonism of P. gigantea was most noticeable on wood discs and wood wedges used in vitro, as H. irregulare was not able to be reisolated from these substrates. Overall, these results provide more information on the fungi that appear to be acting as antagonists in forests to prevent H. irregulare from colonizing and provide new information on potential candidate fungi that could be used as a new biological control agent.
Assessment of an online open‐book examination in postgraduate dentistry
Authors: Millar Brian , Hussain Fariha
Published: November 2023

Aim

To investigate the impact of changing from in‐person written assessments to open‐book online assessments and assess grade inflation, student preferences and potential cheating.

Materials and Methods

Data from the Master of Clinical Dentistry in Fixed and Removable Prosthodontics (MClinDent FRP) postgraduate programme in dentistry was analysed. A comparison was made between the results from 3 years of traditional format written examinations (2017–2019) and the same examinations in an open‐book online format over 2 years (2020 and 2021).

Results

A comparison of assignment grades (all in open‐book online format) over the 5 years 2017–2021 showed no significant difference in mean grades, suggesting the academic ability of each cohort was similar. The examination results increased by 2.5% (2020) and 1.9% (2021) compared with the equivalent data from 2017 to 2019. This shows modest grade inflation, which was highly significant (t 4.73, df 937, p < .00001) due to the change in format but suggests that no widespread collusion was taking place to raise the grades. Student feedback strongly endorsed the open‐book online format and was of the opinion that it was less stressful.

Conclusions

The move to open‐book examinations was supported by student feedback, and the comparison of results, while showing an expected grade inflation, did not provide evidence that cheating was taking place through enhanced examination grades.
Fashion as embodied resistance: The case of Jewish ultraorthodox female entrepreneurs
Authors: Wasserman Varda , Baikovich Avital
Published: November 2023

Drawing on the qualitative research of Jewish ultraorthodox female fashion entrepreneurs (JUFFE) in Israel, we examine how women's body regulations are collectively negotiated, challenged, and resisted. Our paper shows that, through the disruption of religious clothing and hairstyling, JUFFEs have challenged the patriarchal expectations of women's ideal type in their authoritative society and triggered various changes that allowed for the construction of alternative forms of femininity. Our contributions are twofold: First, we advance the understanding of the body as a site of resistance by exposing the analytical constituents of embodied resistance, namely, the forms of femininity constructed through embodied resistance, which demands are challenged, which types of modesty are resisted, which bodily means are used in women's resistance acts, and the implications of the resistance. By deepening our understanding of the constitutive resources of embodied resistance, we offer a more nuanced and detailed analysis of the various embodied ways and means through which women of religious communities may prompt changes regarding women's visibility and economic status. Second, we broaden the conceptualization of resistance's outcomes in authoritarian regimes by demonstrating how alternative religious femininities are constructed through the collective power of fashion. We present two manifestations of femininity: femininity as a marker of diversity (individualized femininity) and femininity as a marker of economic status (affluent femininity)—both deviate from the one prescribed by their leadership and community. We demonstrate how entrepreneurs' subversive messages are diffused through their clientele's bodies as the carriers of their subversive messages.
Experience of primary care nurses applying nurse‐led management of patients with acute minor illnesses
Authors: Vara‐Ortiz María Ángeles , Marcos‐Alonso Susana , Fabrellas‐Padrés Núria
Published: November 2023

Aim

The aim of this study is to determine the experience of primary health care nurses regarding the application of nurse‐led management in patients with acute minor illnesses.

Background

Nursing leadership of care for acute minor illnesses is a new challenge faced by nurses in Spain.

Design

Qualitative, hermeneutical, interpretive phenomenological approach is used. The Consolidated criteria for reporting qualitative research guidelines were applied.

Methods

Twenty primary care nurses participated; three focus group discussions and nine semi‐structured interviews were conducted between November 2019 and October 2020. All the focus group discussions and interviews were recorded, transcribed verbatim and analysed using content analysis.

Results

Seven main themes emerged from the focus group discussions and interviews: concept, perception of the other actors, practice, history and social context, competencies, training, and legality.

Conclusion

The study shows the diversity and complexity of nurses' experience when applying nurse‐led management in acute minor illnesses. This work has helped to show the gaps perceived by nurses, including the lack of training in the treatment of conditions historically attended by physicians, the lack of definition of the legal framework and the limitations on nurse prescribing. It also highlighted the power of the nursing profession in terms of autonomy, competencies and role expansion.
Evolution of advanced practice nursing in acute care in Germany: A cross‐sectional study of nurses’ scope of practice
Authors: von der Lühe Verena , Roos Marcelina , Adams Anne , Scholten Nadine , Köpke Sascha , Dichter Martin Nikolaus
Published: November 2023

Aim

To describe activities and professional characteristics of nurses in expanded roles in acute care in Germany and achieve a greater understanding of the current situation of advanced practice nursing.

Background

Advanced practice nursing plays an important role in meeting increased demands in healthcare and promoting high‐quality care.

Introduction

In Germany, advanced practice nursing is still at an early stage with a lack of studies describing the scope of practice of nurses in expanded roles.

Methods

We conducted a cross‐sectional‐study using a paper‐and‐pencil questionnaire. In a nationwide convenience sample, we surveyed nurses with an academic degree, who work in an acute care hospital and take over expanded roles in direct patient care. Reporting followed the STROBE checklist.

Results

Of 108 eligible nurses, 84 (77%) completed the survey. The majority had a Master's degree (63.1%) and the average work experience was 18.2 years. Participants carried out activities in all the domains that were queried (direct clinical practice, guidance and coaching, consultation, leadership and research) with differences within and between domains. Foci were on direct clinical practice and coaching and guidance.

Discussion

In Germany, qualifications are nearing the international standard of advanced practice nursing. Results suggest that participants partly undertake activities within the scope of registered nurses' practice that do not correspond fully to their formal qualifications.

Conclusion and implications for nursing and/or health policy

In order to foster the role development of expanded practice nurses in Germany, political efforts are needed in terms of training (e.g. specific Master's programmes), funding of corresponding positions in practice and control mechanisms (e.g. professional registration).
Extracellular vesicle features are associated with COVID‐19 severity
Authors: Caponnetto Federica , De Martino Maria , Stefanizzi Daniele , Del Sal Riccardo , Manini Ivana , Kharrat Feras , D'Aurizio Federica , Fabris Martina , Visentini Daniela , Poz Donatella , Sozio Emanuela , Tascini Carlo , Cesselli Daniela , Isola Miriam , Beltrami Antonio Paolo , Curcio Francesco
Published: November 2023

COVID‐19 is heterogeneous; therefore, it is crucial to identify early biomarkers for adverse outcomes. Extracellular vesicles (EV) are involved in the pathophysiology of COVID‐19 and have both negative and positive effects. The objective of this study was to identify the potential role of EV in the prognostic stratification of COVID‐19 patients. A total of 146 patients with severe or critical COVID‐19 were enrolled. Demographic and comorbidity characteristics were collected, together with routine haematology, blood chemistry and lymphocyte subpopulation data. Flow cytometric characterization of the dimensional and antigenic properties of COVID‐19 patients' plasma EVs was conducted. Elastic net logistic regression with cross‐validation was employed to identify the best model for classifying critically ill patients. Features of smaller EVs (i.e. the fraction of EVs smaller than 200 nm expressing either cluster of differentiation [CD] 31, CD 140b or CD 42b), albuminemia and the percentage of monocytes expressing human leukocyte antigen DR (HLA‐DR) were associated with a better outcome. Conversely, the proportion of larger EVs expressing N‐cadherin, CD 34, CD 56, CD31 or CD 45, interleukin 6, red cell width distribution (RDW), N‐terminal pro‐brain natriuretic peptide (NT‐proBNP), age, procalcitonin, Charlson Comorbidity Index and pro‐adrenomedullin were associated with disease severity. Therefore, the simultaneous assessment of EV dimensions and their antigenic properties complements laboratory workup and helps in patient stratification.
Non‐invasive in vivo measurements of metabolic alterations in the type 2 diabetic brain by 1H magnetic resonance spectroscopy
Authors: Choi In‐Young , Wang Wen‐Tung , Kim Bhumsoo , Hur Junguk , Robbins David C. , Jang Dae‐Gyu , Savelieff Masha G. , Feldman Eva L. , Lee Phil
Published: November 2023

Type 2 diabetes (T2D) is a complex chronic metabolic disorder characterized by hyperglycemia because of insulin resistance. Diabetes with chronic hyperglycemia may alter brain metabolism, including brain glucose and neurotransmitter levels; however, detailed, longitudinal studies of metabolic alterations in T2D are lacking. To shed insight, here, we characterized the consequences of poorly controlled hyperglycemia on neurochemical profiles that reflect metabolic alterations of the brain in both humans and animal models of T2D. Using in vivo 1H magnetic resonance spectroscopy, we quantified 12 metabolites cross‐sectionally in T2D patients and 20 metabolites longitudinally in T2D db/db mice versus db+ controls. We found significantly elevated brain glucose (91%, p < 0.001), taurine (22%, p = 0.02), glucose+taurine (56%, p < 0.001), myo‐inositol (12%, p = 0.02), and choline‐containing compounds (10%, p = 0.01) in T2D patients versus age‐ and sex‐matched controls, findings consistent with measures in T2D db/db versus control db+ littermates. In mice, hippocampal and striatal neurochemical alterations in brain glucose, ascorbate, creatine, phosphocreatine, γ‐aminobutyric acid, glutamate, glutamine, glutathione, glycerophosphoryl‐choline, lactate, myo‐inositol, and taurine persisted in db/db mice with chronic disease progression from 16 to 48 weeks of age, which were distinct from control db+ mice. Overall, our study demonstrates the utility of 1H magnetic resonance spectroscopy as a non‐invasive tool for characterizing and monitoring brain metabolic changes with T2D progression.

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Axillary arch (of Langer): A large‐scale dissection and simulation study based on unembalmed cadavers of body donors
Authors: Weninger Jeremias T. , Pruidze Paata , Didava Giorgi , Rossmann Tobias , Geyer Stefan H. , Meng Stefan , Weninger Wolfgang J.
Published: November 2023

Connective or muscular tissue crossing the axilla is named axillary arch (of Langer). It is known to complicate axillary surgery and to compress nerves and vessels transiting from the axilla to the arm. Our study aims at systematically researching the frequency, insertions, tissue composition and dimension of axillary arches in a large cohort of individuals with regard to gender and bilaterality. In addition, it aims at evaluating the ability of axillary arches to cause compression of the axillary neurovascular bundle. Four hundred axillae from 200 unembalmed and previously unharmed cadavers were investigated by careful anatomical dissection. Identified axillary arches were examined for tissue composition and insertion. Length, width and thickness were measured. The relation of the axillary arch and the neurovascular axillary bundle was recorded after passive arm movements. Twenty‐seven axillae of 18 cadavers featured axillary arches. Macroscopically, 15 solely comprised muscular tissue, six connective tissue and six both. Their average length was 79.56 mm, width 7.44 mm and thickness 2.30 mm. One to three distinct insertions were observed. After passive abduction and external rotation of the arm, 17 arches (63%) touched the neurovascular axillary bundle. According to our results, 9% of the Central European population feature an axillary arch. Approximately 50% of it bilaterally. A total of 40.74% of the arches have a thickness of 3 mm or more and 63% bear the potential of touching or compressing the neuromuscular axillary bundle upon arm movement.
Vertical Contracts and Downstream Entry*
Authors: Milliou Chrysovalantou , Petrakis Emmanuel
Published: November 2023

We study the implications of different contractual forms in a market with an incumbent upstream monopolist and free downstream entry. We show that traditional conclusions regarding the desirability of linear contracts radically change when entry in the downstream market is endogenous rather than exogenous. By triggering more entry than two‐part tariffs, wholesale price contracts can generate higher aggregate output, consumer surplus, and welfare. In light of this, the upstream monopolist may prefer to trade with wholesale price contracts as well as to give up part of its bargaining power when it is high.
Perceived social status, socioeconomic status, and preventive dental utilization among a low‐income Medicaid adult population
Authors: Sukalski Jennifer M. C. , Askelson Natoshia M. , Reynolds Julie C. , Damiano Peter C. , Shi Wei , Xie Xian Jin , McKernan Susan C.
Published: November 2023

Objectives

Perceived Social Status (PSS) is a measure of cumulative socioeconomic circumstances that takes perceived self‐control into account. It is hypothesized to better capture social class compared to socioeconomic status (SES) measures (i.e., education, occupation, and income). This study examined the association between PSS and dental utilization, comparing the strength of associations between dental utilization and PSS and SES measures among a low‐income adult Medicaid population.

Methods

A cross‐sectional survey was administered to a random sample of low‐income adults in Iowa, United States with Medicaid dental insurance (N = 18,000) in the spring of 2018. Respondents were asked about PSS, dental utilization, and demographics. A set of multivariable logistic regression models examined the relative effects of PSS and SES measures on dental utilization, controlling for age, sex, health literacy, whether the respondent was aware they had dental insurance, transportation, and perceived need of dental care.

Results

The adjusted response rate was 25%, with a final sample size of 2252. Mean PSS (range 1–10) was 5.3 (SD 1.9). PSS was significantly associated with dental utilization (OR = 1.11; CI = 1.05, 1.18) when adjusting for control variables, whereas other SES measures—education, employment, and income—were not.

Conclusions

PSS demonstrated a small positive association with dental utilization. Results support the relative importance of PSS, in addition to SES measures, as PSS may capture aspects of social class that SES measures do not. Results suggest the need for future research to consider the effects of PSS on oral health outcomes and behaviors.
The impact of single‐dose trazodone administration on plasma endogenous adrenocorticotropic hormone and serum cortisol concentrations in healthy dogs
Authors: Brown Morgan , Lee‐Fowler Tekla , Behrend Ellen N. , Grobman Megan
Published: November 2023

Background

Conditions affecting the hypothalamic‐pituitary‐adrenal (HPA) axis are common in dogs. Testing the function of the HPA axis includes measurement of endogenous adrenocorticotropic hormone (eACTH) and performance of an adrenocorticotropic hormone (ACTH) stimulation test. Trazodone is commonly administered to dogs to decrease stress. In humans, trazodone significantly decreases plasma cortisol concentration via alpha‐1 adrenergic activity.

Objectives

Determine the influence of trazodone on eACTH and serum cortisol concentrations in healthy dogs.

Animals

Fourteen healthy, adult, companion dogs.

Methods

Prospective, randomized placebo‐controlled study. Trazodone (8‐10 mg/kg) or placebo was administered PO 1 hour before eACTH measurement and ACTH stimulation testing. After a ≥7‐day wash‐out period, dogs received the opposite treatment. Differences in eACTH, pre‐ and post‐ACTH stimulation cortisol concentrations, and delta (difference between pre‐ and post‐ACTH) cortisol concentrations were analyzed using a paired t or signed‐rank test with a P < .05 significance level.

Results

The eACTH concentrations were not significantly different (P = .23) between treatments. Similarly, no significant differences were found in the pre‐ACTH cortisol concentrations between treatments (P = .40). Post‐ACTH cortisol concentrations (P = .05) and delta cortisol concentrations (P = .04) were significantly lower when the dogs were treated with trazodone.

Conclusions

Preliminary data suggest trazodone administration dampens the adrenocortical response to stimulation in healthy dogs. If similar effects are found in dogs with adrenal disease, the use of trazodone may affect diagnosis and clinical decision making in these populations.
Onychoscopic characteristics of Trichophyton rubrum and Trichophyton interdigitalis fungal infections: A multicentric study
Authors: Starace Michela , Milan Elisa , Summa Giovanni , Alessandrini Aurora Maria , Sechi Andrea , Iorizzo Matilde , Di Chiacchio Nilton Gioia , Di Chiacchio Nilton , Piraccini Bianca Maria
Published: November 2023

Background

Trichophyton rubrum and Trichophyton mentagrophytes variant interdigitalis are the most frequent etiologic agents of onychomycosis. Diagnosis of certainty requires mycological examination, which often results unfeasible.

Objectives

The aim of our study is to describe pathogen specific dermoscopic features, allowing a differential diagnosis without the need for cultural examination, in order to prescribe the most appropriate treatment anyway.

Patients and methods

We conducted an observational retrospective study on 54 patients with a culture proven diagnosis of distal subungual onychomycosis of the toenail, caused by Trichophyton rubrum or Trichophyton mentagrophytes variant interdigitalis. Using a videodermatoscope we collected data on nail colour (white, yellow, orange, brown, dark) and on dermoscopic patterns (aurora, spikes, jagged, ruin, linear edge, dots, striae).

Results

Fifty‐four patients, with a total of 72 nails, were eligible for this study. Analysing the association between discoloration of the nail plate and type of infection (T. rubrum or T. interdigitalis), no correlation turned out to be statistically significant. Instead, significant associations between spikes and T. rubrum infection and striae and infection from T. interdigitalis were identified. Finally, a 100% specificity was identified for white colour and ruin pattern for T. rubrum infection, and brown colour, jagged border and aurora pattern for T. interdigitalis.

Conclusions

Trying to find relationships between specific pathogens and dermoscopic patterns, we found out an association between spikes and striae and T. rubrum and T. interdigitalis respectively. Further larger studies are however necessary to evaluate our preliminary findings.
Chronic kidney disease prevalence and clinical outcomes in anterior circulation acute ischemic stroke patients with reperfusion therapy: A meta‐analysis
Authors: Rajesh Kruthajn , Spring Kevin J. , Beran Roy G. , Bhaskar Sonu M. M.
Published: November 2023

Aim

Chronic Kidney Disease (CKD) is a common comorbidity among acute ischaemic stroke (AIS) patients undergoing reperfusion therapies, including intravenous thrombolysis (IVT) and endovascular thrombectomy (EVT). Acknowledging CKD's prevalence in this cohort and understanding its influence on outcomes is crucial for prognosis and optimizing care. This study aims to determine the prevalence of CKD among anterior circulation AIS (acAIS) patients undergoing reperfusion therapies and to analyse the role of CKD in mediating outcomes.

Methods

A random‐effects meta‐analysis was conducted to pool and examine prevalence data. A total of 263 633 patients were included in the meta‐analysis. The study assessed CKD's association with functional outcomes, symptomatic intracranial haemorrhage (sICH) and mortality.

Results

The overall pooled prevalence of CKD among acAIS ranged from 30% to 56% in IVT‐treated patients and 16%–42% for EVT‐treated patients. CKD was associated with increased odds of unfavourable functional outcome at 90 days in both IVT (OR 1.837; 95% CI: [1.599; 2.110]; p < .001) and EVT (OR 1.804; 95% CI: [1.525; 2.133]; p < .001) groups. In IVT‐treated patients, CKD was associated with increased odds of 30‐day mortality (OR 6.211; 95% CI: [1.105; 34.909]; p = .038). CKD in IVT‐treated patients exhibited increased odds of sICH, albeit statistically non‐significant (OR 1.595; 95% CI: [0.567; 3.275]).

Conclusions

The high prevalence of CKD and its significant impact on outcomes in acAIS patients treated with reperfusion therapies underscore its clinical significance. This insight can guide personalised care strategies and potentially improve the prognosis in the management of acAIS.

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Arthroscopic Bone Grafting and Robot‐assisted Fixation for Scaphoid Nonunion
Authors: Yi Zhe , Lim Rebecca Qian Ru , Chen Wei , Zhu Jin , Chen Shanlin , Liu Bo
Published: November 2023

Objectives

Scaphoid nonunion remains a challenging problem to manage with no general consensus on its treatment recommendations. We propose a novel minimally invasive (MIS) technique of arthroscopic bone grafting (ABG) with robot‐assisted fixation for the treatment of scaphoid nonunions.

Methods

Patients with radiographically proven scaphoid nonunion treated by this novel surgical technique were included. Following arthroscopic debridement and iliac crest bone grafting, the scaphoid was fixed percutaneously using either multiple Kirschner (K)‐wires or a headless compression screw using a robotic navigation system.

Results

Six male patients with an average age of 29.2 years were enrolled. Four patients had scaphoid waist fractures, and the other two were proximal pole fractures. During wrist arthroscopy, punctate bleeding of the proximal scaphoid fragment was observed in four out of the six patients. Half of the patients were fixed using a headless compression screw and the other half using multiple K‐wires. All the guidewires were placed with a single‐attempt using the robotic navigation system. Postoperatively, all the scaphoid fractures had complete radiographic union by 16 weeks. At a mean follow‐up of 18.3 months, there were significant improvements in wrist range of motion, grip strength, and patient‐rated outcomes. No intraoperative or early postoperative complications were encountered in any of our patients.

Conclusion

Arthroscopic bone grafting with robot‐assisted fixation is a feasible and promising therapeutic option for scaphoid nonunions, regardless of the vascularity of the proximal pole fragment. This novel technique allows for anatomic restoration of the scaphoid alignment and accurate, targeted placement of implants into the scaphoid nonunion site within a single‐attempt using a robotic navigation system.
Assessment of thin film gradient diffusion technique for precise analysis of soil cadmium passivation and uptake inhibition by different amendments
Authors: Fan Beibei , Ding Shuai , Wang Yuqian , Li Xue , Yang Xiao , Yin Junhui , Chen Hao , Chen Qing , Peng Yutao
Published: November 2023

The utilization of the thin film gradient diffusion technique has been on the rise for appraising the efficacy of soil cadmium (Cd). Nonetheless, in contrast to conventional methodologies employed to gauge the efficacy of soil Cd, there exists a dearth of adequate research concerning whether the technique of diffusive gradients in thin films (DGT) can furnish a more precise and all‐encompassing evaluation of soil Cd effectiveness in soil passivation and remediation procedures. Herein, this study selects four popular amendments (i.e. oyster shells, red mud, hydroxyapatite and biochar) and analyses the correlations among soil Cd availability, Cd uptake amount and spinach biomass. Results showed that the following concentration ranges: DGT‐Cd (1.78–21.1 μg L−1), HAc‐Cd (1.84–2.22 mg kg−1), DTPA‐Cd (0.62–1.22 mg kg−1) and CaCl2‐Cd (0.0489–0.103 mg kg−1). Among the methods, CaCl2 extraction had a lower capacity to extract soil Cd compared with the other methods. These amendments improved soil environment, promoted spinach growth and decreased plant Cd concentrations. Oyster shells and red mud treatments significantly reduced DGT‐Cd levels (by 90.4% and 82.2%, respectively), which led to a reduction in plant Cd concentrations (by 77.1% and 72.4%) and bioconcentration factor (by 75.8% and 68.8%). Furthermore, oyster shells were found to be most effective in reducing soil‐available Cd and inhibiting Cd uptake by spinach. Based on correlation analysis, the DGT method showed the largest measurement range and provided the best prediction of Cd accumulation in spinach compared with chemical extraction methods (R2 = .88, p <.001). Overall, the use of DGT in combination with plant uptake and chemical extraction data can provide a comprehensive assessment of soil Cd bioavailability. These findings facilitate an accurate and comprehensive evaluation of the bioavailability of Cd after applying amendments. These results also showed that oyster shells can be regarded as a promising eco‐friendly and low‐cost amendment for large‐scale immobilizing Cd and producing plants with lesser Cd concentrations.
Effect of different red cell transfusion thresholds on quality of life: An important question with no clear answer yet
Authors: Jiang Helen , Hare Gregory M. T. , Mazer C. David
Published: November 2023

See article on page 2032–2039, in this issue
Analysis of the Dynamics of Vegetation Cover and Land Use in Forest Management Unit 00-004 and its Surroundings on the Coast of Cameroon
Authors: Lacatuce Kenne Tene , Momo Solefack Marie Caroline , Tanougong Delanot Armand , Dong Etchike Alex Bruno , Monthe Serge Rodrigue , Tchokomeni Arnaud
Published: November 2023

In Cameroon, the government gives serious attention to protect Forest Management Units (FMU). Unfortunately, vegetation cover of FMU 00-004 decreases in the area as years ago due to anthropogenic pressures. The present study aimed to analyse the dynamics of the vegetation cover and land use of the FMU 00-004 and its surroundings in Cameroon, in the period between 1988-2020. Landsat images (1988, 2001 and 2020) and field investigations were used and processed by ENVI 5.3 software. 175 people around the forest were interviewed to obtain their perceptions on the causes of forest landscape degradation. In 1988, the FMU 00-004 and its surroundings consisted of seven types of land cover, the most important being dense forest, open forest and woody savannah. Cropland, building area, water area and eroded soil were less than 2%. In 2020, building area and croplands surface areas increased while dense and open forests cover decreased. Change in vegetation was more pronounced between 1988 and 2020 and the deforestation rate was 2.55%. The degradation main causes were settlements of the forest exploitation companies and agricultural practices. For sustainable production systems, landscape planning should be put in place by logging company to reduce Land use / Land cover challenges.
Co-Optimization of Distributed Energy Resources Under Time-of-Use Pricing Frame
Authors: Maharjan Krisha , Zhang Jian , Cho Heejin , Chen Yang
Published: November 2023

Distributed energy resources (DERs) have been considered as a promising solution due to the benefits on efficiency and environmental sides. However, despite the rapid development of distributed energy resources and technologies, the share of distributed energy generation is still small in comparison to that of traditional generation. Time-of-use (TOU) pricing can be an important incentive strategy to encourage the penetration of distributed energy resources. In this paper, a multi-objective optimization considering the time-of-use pricing impacts is proposed to determine the optimal configuration and capacity of distributed energy resources involving different technologies, including solar photovoltaic (PV), solar thermal collector (STC), combined heating and power system (CHP), and integrated energy storage (ES). The distributed energy resources are designed to satisfy the electric and thermal load of commercial buildings (large hotels and medium offices) partially or entirely. The proposed multi-objective optimization is utilized to configure the optimal combination of distributed energy technologies as well as the system capacity to reduce both the cost and environmental impact of the system in different locations. Results show that the proposed optimization method can achieve a trade-off between system cost and environmental impact based on the existing time-of-use pricing structure.