bluuebunny/crossref_metadata_2025 huggingface dataset:
Public spending and sustainable economic development
Authors: Sama Molem C. , Oumar Saidou Baba , Ndam Nembo Leslie
Published: October 2024

Purpose

Despite the increase in public spending by Sub-Saharan African (SSA) Governments in a bid to foster the growth of human capital and sustainable development, they continue to experience a very slow rate of progress. This study aims to investigate the impacts of public spending on sustainable economic development in SSA.

Design/methodology/approach

The study adopts the system generalized method of moments to account for cross-sectional dependence and endogeneity for 38 SSA countries from 1996 to 2019.

Findings

The findings indicate that public spending inhibits sustainable economic development while human capital enhances sustainable economic development in SSA. Furthermore, the study equally reveals that the development-inhibiting role of public spending is modulated through human capital and governance quality. Public spending interacts with human capital and governance quality to produce negative net effects and positive synergy effects, respectively.

Originality/value

Based on these findings, the study suggests that governments in SSA countries should discourage heavy dependence on public spending. Policies that provide a framework for financial incentives in the domain of health and education should be encouraged to increase investment in human capital.
Ways to wellbeing in postgraduate research students: interactions with positive perceptions of relationships with university staff
Authors: Gooding Patricia , Crook Rebecca , Westwood Melissa , Peters Sarah
Published: September 2024

Purpose

Understanding ways to foster wellbeing in postgraduate-research students (PGRs) requires focus especially with respect to positive relationship formation with supervisory teams. Hence, the purpose of this study was to explore six different ways of nurturing wellbeing; perceptions of positive relationships with supervisory teams; and interactions between these factors.

Design/methodology/approach

In total, 155 PGRs completed questionnaires at baseline and six months. The predictor variables were six ways of nurturing wellbeing; the outcome variable was psychological wellbeing appraisals overall; and the moderator variables were positive perceptions of relationships with key staff.

Findings

The most effective ways of nurturing wellbeing were Noticing and Being Aware; Discovering and Learning; Connecting with Others; and Being Healthy and Safe. Over time, Noticing and Being Aware predicted psychological wellbeing appraisals overall. Positive relationships with supervisors, co-supervisors and work peers were associated with wellbeing appraisals. Furthermore, positive relationships with co-supervisors most convincingly strengthened the relationships between wellbeing appraisals and Noticing and Being Healthy cross-sectionally, and Giving longitudinally.

Research limitations/implications

It is concerning that PGRs are often overlooked when developing policies and strategies to combat mental health problems. Rather than simply focusing on diminishing mental health problems, the current work evidences ways of optimizing positive aspects of PGR experiences by actively nurturing wellbeing in tandem with enhancing relationships with supervisory team members. However, such initiatives have to be an investment at institutional, as well as individual levels.

Originality/value

Examining the interactions between nurturing positive wellbeing in PGRs and positive relationships with supervisory team members is under-researched.
Identifying control intensities to overcome aquatic invader resilience across a range of ecosystem sizes
Authors: Wallace Ellie , Walsworth Timothy E.
Published: September 2024

Populations of invasive species continue to expand globally, causing extensive ecological and economic damages and are thus frequently the focus of control efforts. To effectively control invasive species populations, management agencies need to apply efforts that will overcome the population's resistance and resilience to disturbance. For aquatic invasive species, initial control efforts often use mechanical removals, which are frequently challenged by size‐selectivity of gears used. Consequently, successful control often requires additional or alternative strategies. Identifying the scale at which alternative strategies need to be applied to benefit control efforts is critical to effective allocation of limited resources.

Here, we use a simulation modelling approach to characterize the effect of ecosystem size (as an index of resistance) and population productivity (as an index of resilience) on the effectiveness of a non‐size‐selective method, targeted poison bait, for invader control. We examine the population‐level response to a range of control effort intensities across a range of ecosystem sizes and population productivities. Further, we use our approach to address a case study of ongoing common carp (Cyprinus carpio) control in a very large, shallow lake (Utah Lake, UT, USA), where mechanical removal has been challenged by compensatory recruitment, gear limitations and dynamic lake conditions.

Poison bait quantities required annually to meet population reduction targets increased linearly with increasing ecosystem size and population productivity. Critically, we identify the presence of minimum effort levels below which management has no impact on long‐term invader biomass, and these minimum effort levels increase with ecosystem size and population productivity.

In our case study at Utah Lake, successful carp control would require long‐term application of >11 t of poison bait annually and would require a 65–485× increase in historic annual budget, depending on acceptable level of risk and timeline to success.

Synthesis and applications. Our analysis highlights the challenges presented by highly productive invasive species occupying large ecosystems, and the critical need to appropriately scale control efforts to produce the desired impact on target populations. Failure to appropriately scale control efforts can result in expensive long‐term control programs which produce no long‐term impact on target populations.
A policy and quantitative analysis of U.S. climate policy from a global perspective
Authors: Suárez‐Cuesta David , Latorre Maria C. , Yonezawa Hidemichi
Published: September 2024

We analyze a recent significant shift in United States (US) climate policy focusing on a landmark law: the Inflation Reduction Act (IRA). To put the IRA in context, we adopt a three‐pronged approach. First, we describe the portfolio of economic policies available to address climate change, highlighting their advantages and disadvantages in an intuitive manner. Second, we reflect on US climate policies prior to the IRA and compare them to those of other major players, such as the European Union and China. Third, we offer a quantitative estimation of the IRA's impact on the US economy. We compare the IRA's green subsidies with the effects of a potential carbon pricing policy that achieves the same reduction in CO2 emissions. Our Computable General Equilibrium simulations account for various channels affecting the efficiency of climate policies, indicating that carbon pricing would be a more efficient approach. There are good reasons why both the EU and China and have opted for this mechanism. We highlight the challenges faced by the US and other countries, including those stemming from political feasibility, which hinder quicker advances in the green transition.
Feasible sampling plan for the whitefly Bemisia tabaci in bell pepper crops
Authors: da Silva Lima Mikaelison , Pancieri Guilherme Pratissoli , das Graças do Carmo Daiane , de Araújo Tamíris Alves , da Silva Paes Jhersyka , Ramos Rodrigo Soares , Picanço Marcelo Coutinho
Published: September 2024

Bell peppers (Capsicum annuum) play a key role in food production, commerce, and society, with smallholder farmers being the 36 primary cultivators. However, the whitefly Bemisia tabaci (Hemiptera: Aleyrodidae) poses a significant threat to bell pepper crops. Traditional control methods rely heavily on the application of insecticides, resulting in increased production costs and ecological concerns. To address this issue, the establishment of decision‐making systems, starting with effective sampling plans, is crucial.

This study aimed to develop a practical sampling strategy for assessing B. tabaci populations at different growth stages of bell pepper crops, including vegetative, flowering, and fruiting stages.

Over a 4‐year period, commercial bell pepper fields were monitored to determine the optimal sampling technique and sample size.

Results indicated that sampling the apical third of the plant's leaves and shaking the plants onto a white plastic tray yielded the most accurate samples. Pest densities followed a negative binomial distribution pattern, with a consistent aggregation parameter (Kc = 0.3339) across all fields. Therefore, assessing 78 plants per field was deemed necessary. The sampling procedure incurred a cost of up to $1.12 per hectare and required approximately 24 min.

The simplicity, ease of execution, and low cost of the developed sampling strategy make it suitable for integration into comprehensive pest management programs.
Care pathways for reduced fetal movements: A cost‐consequence analysis
Authors: Mcknoulty Matthew J. , Martin Elizabeth K.
Published: September 2024

Objective

This study aimed to evaluate the costs and consequences of a new midwife‐navigator‐facilitated care pathway for reduced fetal movements.

Materials and Methods

This study was conducted at a tertiary obstetric centre in Queensland, Australia and modelling occurred for this and smaller services. Two months of data from pre (n = 112 in 2019) and post (n = 141 in 2020) implementation of the care pathway were analysed with T‐tests and logistic regression models to evaluate maternal and neonatal outcomes. A Markov model was built to estimate the costs and consequences of the intervention. Sensitivity analysis was conducted to test various scenarios including modelling for smaller centres.

Results

There were no statistically significant differences in clinical outcome between the intervention and usual care groups. Intervention patients spent one hour and eight minutes less time in hospital (P < 0.001). This resulted in a saving to the centre of AU$135 per patient (AU$159 083 annually). One‐way sensitivity analysis suggested that cost savings would be found in all scenarios except for smaller units providing services for less than 1900 births per annum.

Conclusion(s)

To our knowledge, no other care pathway involving acute obstetric care has been economically evaluated to date. Our model based on real‐world presentations for reduced fetal movements confirms that midwife‐navigators may be an economically beneficial implementation strategy for dealing with common obstetric conditions.
Epicutaneous immunotherapy for the treatment of peanut allergy
Authors: Ravindran Mayuran , Sampson Hugh A. , Kim Edwin H. , Bee Katharine J. , Green Todd D. , Burks A. Wesley
Published: September 2024

Peanut allergy treatment options remain limited, but novel approaches are being studied, including epicutaneous immunotherapy (EPIT). EPIT uses the cutaneous immune system to promote tolerance to food allergens. Viaskin™ Peanut, an approach to EPIT in late‐stage clinical development uses an occlusive patch with a condensation chamber that enables natural epidermal water loss to solubilize dry antigen on the patch, which is then absorbed and captured by skin Langerhans cells. This form of EPIT does not require disruption of the skin barrier, thus avoiding a proinflammatory cytokine response by targeting the nonvascularized epidermis and limiting systemic allergen exposure. Extensive preclinical research suggests that Viaskin Peanut has a distinct mechanism of desensitization, including the potential for disease modification, driven by a unique population of regulatory T cells. Numerous clinical studies of Viaskin Peanut have demonstrated desensitization and reductions in reaction severity, particularly in children aged 1 through 11 years, as well as a favorable safety profile with mostly mild‐to‐moderate skin reactions that were observed to decrease over time. EPIT with Viaskin Peanut may be a potential therapeutic option for peanut allergy that is clinically practical with long‐term efficacy and tolerability.
Comparison of distal extremity magnetic resonance imaging findings in Australian racing Standardbreds and Thoroughbreds
Authors: Stutsel M , Jordan L , Smith C , Lee WY , Symonds N , Bell RJW , Young A
Published: September 2024

Introduction

Foot‐related lameness is common in Standardbred and Thoroughbred racehorses. Magnetic resonance imaging (MRI) provides information on both the soft tissue and osseous structures of the distal extremity. The aim of this study was to determine whether abnormalities identified on distal limb MRI differed between these two racehorse populations.

Materials and Methods

The records of Standardbred and Thoroughbred racehorse distal extremity MRI examinations conducted at Camden Equine Centre and Ballarat Veterinary Practice between 2013 and 2023 were retrieved. Horses were included if pain causing lameness had been localised to the foot using perineural or intra‐articular analgesia. MRI abnormalities of the structures within the distal extremity were recorded and comparisons made between the two groups.

Results

There was a significant difference in the rate of occurrence of certain MRI abnormalities between the Thoroughbred and Standardbred racehorse populations, including distal phalangeal fractures, proximal phalangeal short tau inversion recovery (STIR) hyperintensity (distal aspect), the presence and severity of ungular cartilage ossification, abnormalities of the navicular bone distal border synovial invaginations/vascular channels and navicular bone distal border fragments. The presence of distal extremity STIR hyperintensity and fractures was significantly higher in Standardbred compared to Thoroughbred racehorses when these findings were grouped and considered in combination.

Conclusion

There were many similarities in the distal extremity MRI abnormalities identified in lame Australian Standardbred and Thoroughbred racehorses. However, distal phalangeal fractures, ungular cartilage ossification and distal extremity STIR hyperintensity were identified in significantly more in Standardbred than Thoroughbred racehorses.
Leveraging non‐coding regions to guarantee the accuracy of small‐sized panel‐based tumor mutational burden estimates
Authors: Nishino Takahiro , Yumura Mio , Sunami Kuniko , Kubo Takashi , Ichikawa Hitoshi , Yasuda Tomoyo , Furukawa Eisaku , Nagai Momoko , Yatabe Yasushi , Kato Mamoru , Kohno Takashi
Published: October 2024

Accurate estimation of tumor mutational burden (TMB) as a predictor of responsiveness to immune checkpoint inhibitors in gene panel assays requires an adequate panel size. The current calculations of TMB only consider coding regions, while most of gene panel assays interrogate non‐coding regions. Leveraging the non‐coding regions is a potential solution to address this panel size limitation. However, the impact of including non‐coding regions on the accuracy of TMB estimates remains unclear. This study investigated the validity of leveraging non‐coding regions to supplement panel size using the OncoGuide NCC Oncopanel System (NOP). The aim of this study was to evaluate test performance against orthogonal assays and the association with responsiveness to immune checkpoint inhibitors was not included in the evaluation. We compared TMB status and values between TMB calculated only from coding regions (NOP‐coding) and from both coding and non‐coding regions (NOP‐overall) using whole exome sequencing (WES) and FoundationOne®CDx (F1CDx) assay. Our findings revealed that NOP‐overall significantly improved the overall percent agreement (OPA) with TMB status compared with NOP‐coding for both WES (OPA: 96.7% vs. 73.3%, n = 30) and F1CDx (OPA: 90.0% vs. 73.3%). Additionally, the mean difference in TMB values compared with WES was lower for NOP‐overall (3.55 [95% CI: 0.98–6.13]) than for NOP‐coding (6.22 [95% CI: 3.73–8.70]). These results exemplify the utility of incorporating non‐coding regions to maintain accurate TMB estimates in small‐sized panels.
Rethinking spatial history: envisioning a mechanistic historical biogeography
Authors: Schultz Eduardo D. , Cracraft Joel
Published: September 2024

Historical biogeography is the study of geographic distributions of taxa through space and time. Over the last 50 years, several methods have been proposed to reconstruct these histories. However, despite their particularities, conceptually they have been most often derived from the reconstruction of area relationships. Here we advocate that area cladograms lack explanatory power and that biogeography needs to move towards a more mechanistic approach. We discuss the ontological problems related to areas of endemism and their validity as biogeographic units. Specifically, we propose that areas of endemism are not discrete historical entities and that area‐based analyses are inappropriate for analytical biogeography. Instead, we suggest that biogeographic analyses should focus on those spatial–geographic elements that cause diversification, namely barriers. We discuss how barriers have more discrete boundaries in space and time than do areas of endemism, which allows the identification of homologous units and the recovery of vicariant events. Reconstructing the history of vicariant events results in a better understanding of spatial evolution within a biota because barrier formation is the relevant causal mechanism of diversification. We end by acknowledging the largely ignored views of Peter Hovenkamp and his conceptual contributions to developing a mechanistic biogeography.
Functional Brain Adaptations During Speech Processing in 4‐Month‐Old Bilingual Infants
Authors: Blanco Borja , Molnar Monika , Arrieta Irene , Caballero‐Gaudes César , Carreiras Manuel
Published: September 2024

Language learning is influenced by both neural development and environmental experiences. This work investigates the influence of early bilingual experience on the neural mechanisms underlying speech processing in 4‐month‐old infants. We study how an early environmental factor such as bilingualism interacts with neural development by comparing monolingual and bilingual infants’ brain responses to speech. We used functional near‐infrared spectroscopy (fNIRS) to measure 4‐month‐old Spanish‐Basque bilingual and Spanish monolingual infants’ brain responses while they listened to forward (FW) and backward (BW) speech stimuli in Spanish. We reveal distinct neural signatures associated with bilingual adaptations, including increased engagement of bilateral inferior frontal and temporal regions during speech processing in bilingual infants, as opposed to left hemispheric functional specialization observed in monolingual infants. This study provides compelling evidence of bilingualism‐induced brain adaptations during speech processing in infants as young as 4 months. These findings emphasize the role of early language experience in shaping neural plasticity during infancy suggesting that bilingual exposure at this young age profoundly influences the neural mechanisms underlying speech processing.
Prospective Interrelation Between Sensory Sensitivity and Fine Motor Skills During the First 18 Months Predicts Later Autistic Features
Authors: Capelli Elena , Crippa Alessandro , Riboldi Elena Maria , Beretta Carolina , Siri Eleonora , Cassa Maddalena , Molteni Massimo , Riva Valentina
Published: September 2024

Sensory features are included in the diagnostic criteria of autism and atypical sensory responsiveness may produce “cascading effects” on later development. Similarly, autistic individuals often struggle with motor coordination and early delays in the motor domain appear to be linked to later development. However, the longitudinal interrelation between early sensory profiles and motor features on later socio‐communicative skills remains to be defined. This study aimed to investigate whether sensory sensitivity impacts fine motor abilities and vice versa from 12 to 18 months of age and to examine how sensory‐motor interplay would be associated with later autistic traits at 24–36 months of age. The sample included 118 infant siblings of autistic children recruited at 12 months of age. Sensory sensitivity and eye–hand coordination were assessed at 12 and 18 months of age and autistic traits were evaluated at 24–36 months of age. Cross‐lagged panel analysis revealed significant within‐domain effects for sensory sensitivity and eye–hand coordination from 12 to 18 months. Furthermore, a significant association between these two domains on later autistic traits was found. In analyzing the longitudinal bidirectional relationship, we found that lower eye–hand coordination skills at 12 months predicted later sensory sensitivity at 18 months, and in turn, social communication skills at 24–36 months. The present study offers new empirical evidence supporting the potential clinical value of including sensory and motor measures besides social communication skills within early autism surveillance programs.
Lamotrigine for cognitive deficits associated with neurofibromatosis type 1: A phase II randomized placebo‐controlled trial
Authors: Ottenhoff Myrthe J. , Mous Sabine E. , Castricum Jesminne , Rietman André B. , Oostenbrink Rianne , van der Vaart Thijs , Tulen Joke H. M. , Parra Alba , Ramos Federico J. , Legius Eric , Moll Henriette A. , Elgersma Ype , de Wit Marie‐Claire Y. ,   ENCORE Expertise Center for NF1
Published: September 2024

Aim

To find proof‐of‐principle evidence for short‐term treatment with lamotrigine to improve cognitive functioning of adolescents with neurofibromatosis type 1 (NF1).

Method

This was a double‐blind, parallel‐group, randomized, placebo‐controlled clinical trial (the NF1‐EXCEL trial: Examining the Cognitive and Electrophysiological benefit of Lamotrigine in Neurofibromatosis type 1; Clinicaltrials.gov identifier NCT02256124), with the aim of enrolling 60 adolescents with NF1 aged 12 to 17  years 6 months. The short‐term study intervention was 200 mg of lamotrigine taken orally for 26 weeks. The primary outcome was performance IQ tested with the Wechsler Intelligence Scale for Children, Third Edition, complemented with secondary outcomes for visuospatial learning efficacy, visual perception, visual sustained attention, fine motor coordination, attention‐deficit/hyperactivity problems, and executive functioning.

Results

We screened 402 adolescents with NF1, of whom 31 (eight females) entered the study. Complete‐case analysis showed no effect of lamotrigine on either performance IQ (−0.23, 95% CI −6.90 to 6.44) or most secondary outcomes. Visual sustained attention showed a trend towards better performance in the lamotrigine group (−0.81, 95% CI −1.67 to 0.04).

Interpretation

Lamotrigine did not improve cognitive functioning in adolescents with NF1. The small treatment effects make it unlikely that a larger sample size could have changed this conclusion.
External validation of the DIAFORA system to predict lower‐extremity amputations in a prospective Danish cohort
Authors: Røikjer Johan , Monteiro‐Soares Matilde , Walton Daina , Iacopi Elisabetta , Jirkovska Jarmila , Edmonds Michael , Trocha Anna , Jeffocate William , Bus Sicco ,   the Diabetic Foot Study Group (DFSG) prevention of the first ulcer research group
Published: September 2024

Aim

A diabetes‐related foot ulcer (DFU) is a major risk factor for lower‐extremity amputation (LEA). To help clinicians predict the risk of LEA in people with DFU, the Diabetic Foot Risk Assessment (DIAFORA) system was developed but has never been externally validated.

Methods

In this study, 317 people presenting with a new DFU were included. At baseline, participants were grouped into three groups based on their DIAFORA score: low‐risk (<15), medium‐risk (15–25), and high‐risk (>25). Participants were followed until healing, LEA, death, or at least 3 months. Discriminative accuracy was evaluated using sensitivity, specificity, likelihood ratios (LRs) and the area under the curve (AUC).

Results

All 317 participants completed at least 3 months of follow‐up for a median duration of 146 days, during which 12.6% underwent minor amputation and 2.5% major amputation. People in the low‐ and medium‐risk categories had major amputation rates of 0.9% and 2.1%, respectively, and negative LR of major LEA of 0.10 and 0.38, respectively, while the people in the high‐risk category had an amputation rate of 25.0% and a positive LR of 12.9. The DIAFORA risk groups had a sensitivity of 75.0% and a specificity of 65.7%, with a corresponding AUC of 0.78 (95% CI 0.68–0.87) for the prediction of major LEA.

Conclusion

The DIAFORA score is a useful tool for risk stratification of people presenting with a newly occurred DFU, with the external validation presenting results similar to those presented in the original study. The DIAFORA score may guide clinicians towards more individualized DFU treatment regimens.
Dose‐dependent association between estimated glomerular filtration rate and the subsequent risk of depression: An analysis of a nationwide epidemiological dataset
Authors: Ko Toshiyuki , Kaneko Hidehiro , Suzuki Yuta , Okada Akira , Azegami Tatsuhiko , Fujiu Katsuhito , Takeda Norifumi , Morita Hiroyuki , Yokoo Takashi , Hayashi Kaori , Komuro Issei , Yasunaga Hideo , Nangaku Masaomi , Takeda Norihiko
Published: September 2024

Background

Although the risk of depression is well‐known in the patients with kidney dysfunction, especially at the late stages, little is known about the exact point at which the decline in estimated glomerular filtration rate (eGFR) begins to significantly increase the risk of depression. In the present study, we analysed a nationwide epidemiological dataset to investigate the dose‐dependent association between baseline eGFR and a future risk of developing depression in a general population.

Methods

We retrospectively analysed 1,518,885 individuals (male: 46.3%) without a history of depression identified between April 2014 and November 2022 within a nationwide epidemiological database, provided by DeSC Healthcare (Tokyo, Japan). We investigated the association of eGFR with the incidence of depression using Cox regression analyses and also conducted cubic spline analysis to investigate the dose‐dependent association between eGFR and depression.

Results

In the mean follow‐up of 1218 ± 693 days, 45,878 cases (3.0% for total participants, 2.6% for men and 3.3% for women) of depression were recorded. The risk of depression increased with the eGFR decline as well as the presence of proteinuria. Multivariable Cox regression analysis showed the hazard ratio (95% CI) of depression in each kidney function category (eGFR ≥90, 60–89, 45–59, 30–44, 15–29, and < 15 mL/min/1.73 m2) was 1.14 (1.11–1.17), 1 (reference), 1.11 (1.08–1.14), 1.51 (1.43–1.59), 1.77 (1.57–1.99) and 1.77 (1.26–2.50), respectively. In the cubic spline analysis, the risk of depression continued to increase monotonically as the eGFR declined when the eGFR fell below approximately 65 mL/min/1.73 m2.

Conclusions

Our analysis using a large‐scale epidemiological dataset presented the dose‐dependent association between eGFR decline and the risk of depression, which highlights the importance of incorporating mental health assessments into the routine care of patients with kidney dysfunction, regardless of the stage of their disease.
Association of first antiseizure medication with acute health care utilization in a cohort of adults with newly diagnosed epilepsy
Authors: Blank Leah J. , Agarwal Parul , Kwon Churl‐Su , Boockvar Kenneth , Jetté Nathalie
Published: September 2024

Objective

Epilepsy is primarily treated with antiseizure medications (ASMs). The recommendations for first ASM in newly diagnosed epilepsy are inconsistently followed, and we sought to examine whether nonrecommended first ASM was associated with acute care utilization.

Methods

We conducted a retrospective cohort study of adults (≥18 years old) with newly diagnosed epilepsy (identified using validated epilepsy/convulsion International Classification of Diseases, Clinical Modification codes) in 2015–2019, sampled from Marketscan's Commercial and Medicare Databases. Exposure of interest was receipt of a non‐guideline‐recommended ASM, and the primary outcome was acute care utilization (an emergency department visit or hospitalization after the first ASM claim). Descriptive statistics characterized covariates, and multivariable negative binominal regression models were built adjusting for age, sex, Elixhauser Comorbidity Index, comorbid neurologic disease (e.g., stroke), and ASM polypharmacy.

Results

Approximately 14 681 people with new epilepsy were prescribed an ASM within 1 year. The three most prescribed medications were levetiracetam (54%, n = 7912), gabapentin (10%, n = 1462), and topiramate (7%, n = 1022). Approximately 4% (n = 648) were prescribed an ASM that should be avoided, and ~74% of people with new epilepsy had an acute care visit during the follow‐up period. Mean number of acute care visits during follow‐up was 3.34 for “recommended” ASMs and 4.42 for ASMs that “should be avoided.” Prescription of a recommended/neutral ASM as compared to an ASM that should be avoided was associated with reduced likelihood of acute care utilization (incidence rate ratio [IRR] = .85, 95% confidence interval [CI] = .77–.94). The recommended/neutral category of ASMs was not statistically significantly associated with seizure‐ or epilepsy‐specific acute care utilization (IRR = .93, 95% CI = .79–1.09).

Significance

Adults with new epilepsy are frequent users of acute care. There remain a proportion of persons with epilepsy prescribed ASMs that guidelines suggest avoiding, and these ASMs are associated with increased likelihood of emergency department visit or hospitalization. These findings reinforce the importance of optimizing the choice of first ASM in epilepsy.
Generative artificial intelligence and adversarial network for fraud detections in current evolutional systems
Authors: Selvarajan Shitharth , Manoharan Hariprasath , Khadidos Adil O. , Khadidos Alaa O. , Shankar Achyut , Maple Carsten , Singh Suresh
Published: September 2024

This article examines the impact of utilizing generative artificial intelligence optimizations in automating the content generation process. This instance involves the identification of fraudulent content, which is often characterized by dynamic patterns, in addition to content production. The generated contents are constrained, which limits their dimensionality. In this scenario, duplicated contents are eliminated from the automatic creations. Furthermore, the generated ratios are utilized to discover current patterns with minimized losses and errors, hence enhancing the accuracy of generative contents. Furthermore, while analysing the created patterns, we detect a significant discrepancy in lead durations, resulting in the generation of high scores for relevant information. In order to test the results using generative tools, the adversarial network codes are employed in four scenarios. These scenarios involve generating large patterns and reducing the dynamic patterns with an enhanced accuracy of 97% in the projected model. This is in contrast to the existing approach, which only provides a content accuracy of 77% after detecting fraud.
Formalization in Health Care: The Role of Hybrid Professionals
Authors: Ahlgren Per Christian , Mo Idun Garmo , Nyland Kari
Published: September 2024

This article explores the introduction of a new formalized management control system (MCS) in a Norwegian municipal emergency care unit where formal control had previously been limited. We seek to understand how and why the formalized MCS came to be perceived as enabling by organizational members. In the process of formalization key, individuals emerge, as hybrid professionals, engaging in specific choices and actions in the design, implementation, and use of the formal MCS, founded in their efforts to balance the complexities of multiple logics. A key contribution is how hybrid professionals, through their practices of hybridization, become important mediators of the outcome of formalization. Beyond the design characteristics of MCS, the question of whether the system is perceived as enabling or coercive is, also, dependent upon the efforts of key individuals in balancing the complexity of multiple logics. Moreover, we observe how hybrids at different levels of the organization mutually engage in enabling hybrid practices throughout the process of formalization that appears critical for the outcome, suggesting that practices of hybridization in formalization are a collective endeavor rather than exclusively individual.
Parents' anti‐Black messages, empathic reactions toward racism, fear of Black individuals, and perceived ability to engage in anti‐racism advocacy among Asian American emerging adults
Authors: Keum Brian TaeHyuk , Wong Lianne Jean , Tran Emma , Nguyen Mary Minh Giao , Zhu Cathy
Published: September 2024

Asian Americans, historically oppressed and influenced by White supremacist norms, may internalize anti‐Blackness (beliefs of behaviors that minimize, marginalize, or devalue Black individuals) as they navigate White‐dominated environments to survive and seek acceptance. However, there is limited research addressing the intergenerational socialization of anti‐Blackness within Asian American communities and its impact as a barrier to cross‐racial solidarity and involvement in anti‐racism efforts. Thus, we tested whether parents' anti‐Black messages were associated with fear of Black individuals and lack of empathic reactions to anti‐Black racism, and in turn, related to hindrance in the perceived ability to engage in anti‐racism advocacy among Asian American emerging adults. With data from 205 participants (Mage = 19.92, SD = 2.64, online convenience sample), we conducted a path analysis of parents' anti‐Black messages indirectly associated with perceived ability in advocacy against anti‐Black racism through fear of Black individuals and empathic reactions to anti‐Black racism. Parents' anti‐Black messages were associated with greater fear of Black individuals, which was associated with lower empathic reactions to racism, and in turn, ultimately associated with a lower perceived ability to engage in advocacy against anti‐Black racism. This pathway was the best‐fitting model compared with an alternative parallel model (fear and empathy as separate mediators) and a model with empathy as the first mediator. Our study suggests that clinicians, educators, and researchers should target parents' anti‐Black messages and Asian American emerging adults' emotional responses (fear, empathy) to anti‐Black racism in disrupting anti‐Blackness at parental/family and individual levels.
Fatigue Limit Estimation for Post‐Peened Induction‐Hardened and Tempered Steel Considering Changes in Surface Properties
Authors: Takesue Shogo , Ono Keisuke , Nambu Koichiro , Kikuchi Shoichi
Published: September 2024

Shot peening (SP) and fine particle peening (FPP) were performed as post‐treatments on induction‐hardened and tempered AISI 4140 steels. Furthermore, the combined effects of surface characteristics including changes in surface morphology, compressive residual stress, and hardness on the fatigue limit were quantitatively examined. The surface characteristics of the prepared specimens were investigated using a laser and stereomicroscope, a micro‐Vickers hardness tester, and an X‐ray device for residual stress measurements. The rotating bending fatigue properties were also examined. FPP increased the fatigue limit of induction‐hardened and tempered steel samples by introducing compressive residual stress and increasing their surface hardness. Conversely, the fatigue limit of the steel treated with SP was lower than that of the electrochemically polished sample owing to the formation of large dents. The fatigue limits of post‐peened induction‐hardened and tempered steels can be estimated using a modified Goodman diagram considering changes in surface properties.
Motivations and Views on State Support for Refugees: Distinguishing Between Politically and Socially Engaged
Authors: Frederiksen Sifka Etlar , Haller Liam , Uhr Theresa
Published: September 2024

This research investigates engagement for refugees within the German socio‐political landscape. Following the arrival of one million forced migrants from Ukraine to Germany in 2022, we conducted two surveys on those who volunteered in support. The first was on general engagement (N = 2000) and the second was on individuals who provided homestay accommodation (N = 3682). Our analysis explores the driving motivations for different types of engagement, comparing individuals involved in political activities with those engaged in social‐humanitarian activities. We find that value‐based motivations impact both political and social‐humanitarian engagement, with universalism driving political engagement and benevolence linked to social‐humanitarian involvement. Further, differing motivations and types of engagement align with varying beliefs about the role of the state, suggesting that individuals engaged politically believe in increased state responsibility, contrasting with views held by socially engaged individuals. These findings are contextualized within the broader literature on engagement and migration regimes.
Value contribution of etranacogene dezaparvovec gene therapy in moderately severe and severe haemophilia B through multi‐criteria decision analysis
Authors: García‐Diego Daniel‐Aníbal , Badia Xavier , Benítez‐Hidalgo Olga , Jiménez Víctor , Juárez Juan Carlos , Núñez Ramiro , Poveda José Luis , Trillo José Luis , Vallés Joan‐Antoni
Published: September 2024

Introduction

The value of gene therapies for haemophilia needs to be assessed holistically.

Aim

To determine the value of etranacogene dezaparvovec (ED) compared to current extended half‐life (EHL) recombinant factors (rFIX), using multi‐criteria decision analysis (MCDA).

Method

MCDA EVIDEM methodology adapted to orphan drugs was used, with nine quantitative criteria and four contextual criteria. The MCDA framework was rated by 28 multidisciplinary experts. Descriptive statistics were performed for quantitative and qualitative criteria.

Results

Haemophilia B (HB) was considered a severe disease (mean ± SD: 4.3 ± 0.7) with some unmet needs (mean ± SD 3.3 ± 0.9). Experts found ED more effective (mean ± SD 2.0 ± 2.3) and provide better quality of life (QoL) (mean ± SD: 1.8 ± 1.5) than the comparative HB treatments but with safety uncertainties (mean ± SD ‐1.2 ± 1.8). ED could lead to medical cost and non‐medical cost savings over time (mean ± SD: 1.6 ± 2.0 and 2.0 ± 1.5, respectively). The quality of the evidence was high (mean ± SD: 3.9 ± 0.9). ED was considered aligned with the priorities of the National Health System (NHS) and the specific interests of patients. ED's value contribution was 0.45 (+1 = highest value).

Conclusions

ED brings added value in the treatment of moderately severe and severe HB (sHB) compared to current EHL rFIX, addressing the severity of the disease and increasing efficacy and patients’ QoL especially related to the single dose and low bleeding rate. Concerns about long‐term safety need to be addressed.
Substance use in Guyana: Echoes of the colonial past
Authors: Ayres Tammy C. , Moss Kellie , Cameron Queenela
Published: September 2024

The impact of intoxicating substances both licit and illicit has been integral to expressions of colonial power and the control of colonised populations, including in Caribbean societies. Historically, licensing laws and carceral institutions were used to discipline workers, and the ongoing criminalisation of certain drugs illustrates the transhistorical legacies that continue to haunt former British colonies like Guyana. Focusing on prisons and prisoners to explore the histories and lingering legacies of colonial drug policies in the country, despite a much‐changed international context, this article documents experiences of, and approaches to, the management and prohibition of psychoactive substances. It reveals connections and continuities between substance use, enslavement, labour, and incarceration, and their relationship both to what we conceptualise as ‘the colonial imaginary’ and ‘booty capitalism’ of the modern age. The article will show how now and in the past, the colonisers partook in extractive booty capitalism (Weber, 1930), while in order to survive, the colonised partook in booty capitalism of the streets (Wacquant, 2003).
Toward a low‐temperature sintering of carbon fiber toughened high entropy boride composite with Co addition
Authors: Huang Feilong , Wang Hailong , Fang Cheng , Li Mingliang , Xie Wei , Hu Zhangfan , Wang Hailiang , Chen Yongqiang , Shao Gang
Published: September 2024

Dense Cf/(ZrHfNbTaCr)B2–SiC (CBS‐Co) composite is successfully prepared at a low temperature of 1500°C by adding 5 vol.% Co. Liquid Co accelerates the particle rearrangement and significantly enhances the relative density of CBS‐Co (95.2%). In situ formed Co2B phase by diffusion reaction bonds tightly with high entropy diboride (HEB) and SiC grains in CBS‐Co. Due to the promotion of relative density and interfacial bonding strength, CBS‐Co exhibits a high flexural strength (283 ± 23 MPa). Structural damages of carbon fibers are effectively prevented by compact fiber coating. The well‐preserved fibers play dominant roles to increase the fracture toughness of CBS‐Co (4.77 ± .5 MPa·m1/2). Moreover, SiO2‐rich oxide layer can effectively heal flaws and inhibit oxygen diffusion, achieving relatively high flexural strength after oxidation at 1300°C of CBS‐Co composite. This work provides a stepping stone for developing high‐performance carbon fiber toughened HEB composites based on low temperature liquid‐phase sintering technology.
Protective role of antibodies in enteric virus infections: Lessons from primary and secondary immune deficiencies
Authors: Riller Quentin , Schmutz Muriel , Fourgeaud Jacques , Fischer Alain , Neven Bénédicte
Published: September 2024

Enteric viruses are the main cause of acute gastroenteritis worldwide with a significant morbidity and mortality, especially among children and aged adults. Some enteric viruses also cause disseminated infections and severe neurological manifestations such as poliomyelitis. Protective immunity against these viruses is not well understood in humans, with most knowledge coming from animal models, although the development of poliovirus and rotavirus vaccines has extended our knowledge. In a classical view, innate immunity involves the recognition of foreign DNA or RNA by pathogen recognition receptors leading to the production of interferons and other inflammatory cytokines. Antigen uptake and presentation to T cells and B cells then activate adaptive immunity and, in the case of the mucosal immunity, induce the secretion of dimeric IgA, the more potent immunoglobulins in viral neutralization. The study of Inborn errors of immunity (IEIs) offers a natural opportunity to study nonredundant immunity toward pathogens. In the case of enteric viruses, patients with a defective production of antibodies are at risk of developing neurological complications. Moreover, a recent description of patients with low or absent antibody production with protracted enteric viral infections associated with hepatitis reinforces the prominent role of B cells and immunoglobulins in the control of enteric virus.
Meso‐portal graft for thrombosed portal vein in liver transplantation
Authors: Sheil A. G. Ross , Thompson John F. , Stephen Michael S. , Eyers Anthony A. , Graham John C. , Bookallil Michael J.
Published: September 2024

A hepatic transplantation operation is described in a recipient in whom the portal and splenic veins were found unexpectedly at operation to be thrombosed. Previously described techniques for short grafts from the origin of the recipient portal vein to the donor portal vein and thrombophlebectomy could not be used. A 12 cm graft of donor inferior vena cava and iliac vein was inserted between the superior mesenteric vein of the recipient below the pancreas and the donor portal vein. Satisfactory inflow into the donor portal vein and decompression of the intestinal circulation was achieved. This method does not, however, decompress the splenic circulation when the splenic vein is thrombosed or inadequate. The recipient experienced gastrointestinal hemorrhage which required operation in the post‐transplantation period and continues with “left‐sided portal hypertension”. However, liver function remains good and the patient is well 8 months following transplantation.
The importance of prolonged post‐transplant dialysis requirement in cyclosporine‐treated renal allograft recipients
Authors: Rocher Leslie L. , Landis Claudia , Dafoe Donald C. , Swartz Richard D. , Keyserling Connie , Campbell Darrell A.
Published: September 2024

Eighty‐six consecutive cyclosporine‐treated recipients of cadaver donor renal allografts were studied to examine the long‐term effect of prolonged posttransplantation dialysis requirement. Overall, 1‐yr actuarial patient survival was 93% and 1‐yr actuarial graft survival was 71%. Group I patients (0 or 1 dialysis, n = 44) had a 1‐yr actuarial graft survival of 88% compared to Group 3 patients (>5 dialyses, n = 25) who had a 38% actuarial 1‐yr graft surival (p = 0.0004). Group 3 patients who eventually became dialysis‐independent (n = 18) had a 1‐yr actuarial graft survival of 53%, (p=0.0125 compared to Group 1). Furthermore, Group 3 patients retaining allograft function 1 yr after transplantation had a significantly higher mean serum creatinine, 2.70 ± 0.25 mg/dl, compared to 1.66 ± 0.12 mg/dl in Group I patients (p=0.001), despite similar cyclosporine levels. One‐year actuarial patient survival was 98% in Group I, 100% in Group 2 (2–5 dialysis treatments, n = 17), and 79% in Group 3 (p = 0.01). Multivariate analysis revealed that cold storage of allografts (compared to machine perfusion) and a history of prior renal transplants were the main risk factors for prolonged post‐transplant dialysis requirement. When controlled for multiple immunologic risk factors such as prior transplants, ATG therapy, pulse steroid therapy and high cytotoxic antibody levels, prolonged postoperative dialysis therapy did not emerge as an independent predictor of graft loss. We conclude that delayed graft function imparts a poorer prognosis principally because of its association with immunologic risk factors for graft loss.
Two‐and‐a‐half year experience with heart transplantation in Norway
Authors: Frøysaker Tor , Geiran Odd , Lindberg Harald , Bvrum Eivind , Simonsen Svein , Forfang Kolbjørn , Amlie Jan , Ihlen Halvdan , Thorsby Erik , Foerster Arnold , Åm‐Holen Einfrid
Published: September 2024

We report 2½ yr experience with orthotopic heart transplantation in Norway (population 4.1 million). All donor hearts have been procured within the country. Twenty‐five patients (6 females and 19 males), mean age 44 yr (range 19–56) have been treated with 26 grafts. In 1985, 11 patients were transplanted, giving a transplantation rate of 3‐million‐yr. In the first 9 patients the immunosuppressive regimen consisted of cyclosporine A and prednisolone, and in the last 16 patients azathioprine was added (triple medication). There was no operative mortality, but in the first group 4 patients died from other causes: 3 acute irreversible rejections and 1 toxoplasma myocarditis. In the last group 1 died due to early graft failure. Twenty patients are alive and clinically in good condition. Since our main problem has been rejection, it is concluded that careful clinical supervision and liberal indications for myocardial biopsy is decisive for the prognosis.