bluuebunny/crossref_metadata_2025 huggingface dataset:
Incidence and Risk Factors of Postoperative Complications After Rhinoplasty: A Multi-Institutional ACS-NSQIP Analysis
Authors: Knoedler Samuel , Knoedler Leonard , Wu Mengfan , Haug Valentin , Broer P. Niclas , Kauke-Navarro Martin , Hundeshagen Gabriel , Prantl Lukas , Orgill Dennis P. , Panayi Adriana C.
Published: July 2023

Objective:

Despite the popularity of rhinoplasty, outcome research has been mainly limited to single-surgeon or single-institution reports. Therefore, we performed a multi-institutional analysis to present a broader portrait of the postoperative outcomes and risk factors for adverse events after rhinoplasty surgery.

Methods:

We reviewed the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database (2009–2019) to identify patients who underwent rhinoplasty. The postoperative outcomes of interest included 30-day mortality, reoperation, readmission, and surgical and medical complications. We also analyzed risk factors for complication occurrence, including patient comorbidities and preoperative laboratory values.

Results:

We identified 835 patients, 72% (n=602) of whom underwent a primary, 21% (n=175) a secondary, and 6.7% (n=58) a cleft nasal deformity procedure. The average patient age was 41±17 years, with most patients being female (n=472; 57%) and white (n=643; 77%). Complications rates were generally low, with reoperation (n=19; 2.3%) and superficial incisional infection (n=9; 1.1%) account for the most common general and surgical adverse event, respectively. Multivariable analysis revealed male sex (P=0.04) and higher ASA scores (P<0.0001) as risk factors for complications. Low serum albumin (P=0.04) and hematocrit (P=0.003) levels were associated with the occurrence of any complication, whereas low serum albumin (P=0.02) also correlated with the incidence of surgical adverse events.

Conclusion:

Complication rates after rhinoplasty were overall low and seemed to correlate with male sex and ASA scores. We identified preoperative albumin and hematocrit as predictive biomarkers of adverse events. Preoperative nutritional optimization and management of low hematocrit may improve postoperative outcomes.
Implementation of a New Surgeon Onboarding Program in an Academic-Affiliated Community Hospital
Authors: Etheridge James C. , Goldstone Robert N. , Harrington Bryanne , Calcaterra Michael J. , Tomczyk Eleanor G. , Parangi Sareh , Haas Susan
Published: July 2023

Best practices in onboarding are well-established, but surgeons frequently receive suboptimal introductions to new practice settings. At the same time, increasing regionalization of surgical programs and strategic alignments between academic and community hospitals have increased the demand for surgeons to practice at multiple sites with variable resources and institutional cultures. In response to this growing problem, we developed and implemented a surgeon onboarding program in an academic-affiliated community hospital. This pilot demonstrated excellent process adherence, user satisfaction, and significant improvements in preparedness to practice. We therefore conclude that robust onboarding is feasible and can be readily implemented by a local team to promote safe transitions in practice settings for surgeons.
Energy homeostasis from Lavoisier to control theory
Authors: Geary Nori
Published: July 2023

The intellectual history of energy homeostasis, focusing on food intake and energy storage, is briefly reviewed. Physiological energetics was founded by Lavoisier, who in the late eighteenth century invented direct and indirect calorimetry and discovered the role of oxygen in combustion and respiration. Energy was understood well enough by the mid-nineteenth century to realize the physiological energy-balance equation, that energy intake – energy expenditure = energy storage, but this did not greatly influence physiological research for another century. Homeostasis, the concept that many vital physiological variables are actively regulated in narrow envelopes, was developed by Bernard and Cannon between approximately 1870–1940 and remains a central principle of physiology. Kennedy coined the term lipostasis in 1953 to refer to the constancy of fat mass, which Mayer argued was the mechanism regulating body weight. A parameterized control-theory model suggests that a proportional negative-feedback control system incompletely compensates weight loss during persistent negative energy balance, suggesting that Cannon's idea of constancy within a narrow envelope may not fit body-weight regulation well. This modelling encourages further application of control theory to issues in energy homeostasis, including to the development of obesity. It also sets the stage for understanding the underlying neuroendocrine mechanisms.

This article is part of a discussion meeting issue ‘Causes of obesity: theories, conjectures and evidence (Part I)’.
Breaking down silos: the multifaceted nature of obesity and the future of weight management
Authors: Heeren Faith Anne N. , Darcey Valerie L. , Deemer Sarah E. , Menon Sarada , Tobias Deirdre , Cardel Michelle I.
Published: July 2023

The continued global increase in the prevalence of obesity prompted a meeting at the Royal Society of London investigating causal mechanisms of the disease, ‘Causes of obesity: theories, conjectures, and evidence’ in October 2022. Evidence presented indicates areas of obesity science where there have been advancements, including an increased understanding of biological and physiological processes of weight gain and maintenance, yet it is clear there is still debate on the relative contribution of plausible causes of the modern obesity epidemic. Consensus was reached that obesity is not a reflection of diminished willpower, but rather the confluence of multiple, complex factors. As such, addressing obesity requires multifactorial prevention and treatment strategies. The accumulated evidence suggests that a continued focus primarily on individual-level contributors will be suboptimal in promoting weight management at the population level. Here, we consider individual biological and physiological processes within the broader context of sociodemographic and sociocultural exposures as well as environmental changes to optimize research priorities and public health efforts. This requires a consideration of a systems-level approach that efficiently addresses both systemic and group-specific environmental determinants, including psychosocial factors, that often serve as a barrier to otherwise efficacious prevention and treatment options.

This article is part of a discussion meeting issue ‘Causes of obesity: theories, conjectures and evidence (Part I)’.
Diagnostic and therapeutic challenges of isolated genital tuberculosis and drug resistant urogenital tuberculosis- case series
Authors: Bala Kiran , Xess Ashit , Das Rojaleen , Singla Neeta , Seth Amlesh , Singh Urvashi B
Published: July 2023

Genito-urinary tuberculosis (GUTB) has varied presentation such as recurrent urinary tract infection, sterile pyuria with/without hematuria, irritating voiding symptoms, infertility, hydronephrosis and renal failure. Genital tuberculosis usually associated with renal TB. Very few case reports of isolated tuberculous epididymo-orchitis have been published in literature. Epididymal TB may be the only clinically evident location of infection in rare cases of GUTB. Epididymal TB presents with non-specific local insidious  and  progressive symptoms   which are difficult to differentiate with cysts, tumours and other infections. Suspicion of tubercular etiology becomes stronger with bilateral epididymal involvement along with testicular lesion and  resistant to multiple courses of antibiotics. Tuberculous epididymo-orchitis    has    significant impact on fertility, as sperm count and motility may be reduced by blockage of the vas and/or secondary atrophy. Timely diagnosis and treatment will prevent late sequel of disease such as non-functioning kidney and thimble bladder and infertility. We are presenting three cases of GUTB, two cases (Case 1 & 3) were isolated case of tuberculous epididymo-orchitis in a 20 year old male and a 35 year old male and one case (case 2) of complicated drug resistant genitourinary tuberculosis in a 29 year old male. These rare cases were managed successfully with diagnostic and therapeutic challenges.
One year experience of Achromobacter bacteremia at a tertiary care hospital in Northern India
Authors: Kar Mitra , Singh Romya , Tejan Nidhi , Jamwal Ashima , Dubey Akanksha , Chaudhary Radhika , Sahu Chinmoy , Patel Sangram Singh , Kumari Pooja , Ghar Malay
Published: July 2023

Introduction: Achromobacter is a Gram-negative, motile, obligate aerobic, and non-fermentative bacterium. It is an emerging pathogen in the hospital environment as it is frequently found in various solutions.
Hypothesis/Gap Statement: Information about the incidence and risk factors of Achromobacter bacteremia from India is limited.
Aim: We conducted this study to identify the risk factors and underlying conditions predisposing to bacteremia by Achromobacter spp and analyze the antibiotic resistance pattern of the isolates.
Methodology: We performed a retrospective observational study where automated blood cultures positive for Achromobacter spp were assessed for clinical characteristics and antibiotic susceptibility patterns from January 2022 to December 2022 in the microbiology laboratory of a tertiary care center in Northern India.
Results: A total of fourteen cases of Achromobacter spp were identified from bloodstream infections in one year. The mean age of the patients was 37.59 ± 23.17 years with a male predominance (8/14, 57.1%). All patients were managed on intravenous antibiotics and intravenous access as peripheral line catheters and only 5 (5/14, 35.7%) patients were managed on central line catheters. The most common antibiotic found to be susceptible against Achromobacter spp was Ticarcillin- clavulanic acid (14/14, 100.0%) followed by Fluoroquinolones (12/14, 85.72%) and Trimethoprim- sulphamethoxazole (12/14, 85.72%). The all-cause 40-day mortality was observed in 35.7% (5/14, 35.7%) with two death that was directly attributable to sepsis.
Conclusion: This study provides insight into the incidence of Achromobacter bacteremia at our center and the necessary antibiotic therapy to combat it.
Williamsia muralis bacteremia in a patient with Fanconi anemia after hematopoietic cell transplantation
Authors: Sonoda Motoshi , Motomura Yoshitomo , Ishimura Masataka , Kanno Shunsuke , Kiyosuke Makiko , Ohga Shouichi
Published: July 2023

Williamsia muralis is an environmental bacterium first detected in 1999. We present a case of facial cellulitis and bacteremia caused by W. muralis following hematopoietic cell transplantation (HCT).
Case presentation:
A 10-year-old Japanese boy presented with fever and the left cheek swelling 8 days after HCT for the treatment of Fanconi anemia. Gram-positive, rod-shaped bacteria were isolated from the blood cultures after five day’s incubation. The 16S ribosomal RNA sequencing but not mass spectrometry identified the strain of W. muralis (1,414 bp, %ID: 100%). The phlegmon did not respond to antimicrobial therapy but remitted with defervescence after a successful engraftment with teicoplanin and meropenem therapy on day 16 after HCT. The same strain was isolated from the cultured tip of central venous catheter that was later removed to control recurrent bacteremia. The isolated infection with W. muralis has been reported in two elderly patients with surgical intervention. The first case of W. muralis bacteremia was determined to arise from the catheter-related bloodstream infection after HCT.
Conclusion:
W. muralis bacteremia developed in an immunocompromised child. Introduction of artificial objects into the body raises a risk of rare infection with the slowly growing environmental bacteria.
Hanseniaspora menglaensis f.a., sp. nov., a novel apiculate yeast species isolated from rotting wood
Authors: Chen Xue , Qiao Ya-Zhuo , Hui Feng-Li
Published: July 2023

Two apiculate strains (NYNU 181072 and NYNU 181083) of a bipolar budding yeast species were isolated from rotting wood samples collected in Xishuangbanna Tropical Rainforest in Yunnan Province, southwest PR China. On the basis of phenotypic characteristics and the results of phylogenetic analysis of the D1/D2 domain of the large subunit (LSU) rRNA, internal transcribed spacer (ITS) region and the actin (ACT1) gene, the two strains were found to represent a single novel species of the genusHanseniaspora, for which the nameHanseniaspora menglaensisf.a., sp. nov. (holotype CICC 33364T; MycoBank MB 847437) is proposed. In the phylogenetic tree,H. menglaensissp. nov. showed a close relationship withHanseniaspora lindneri,Hanseniaspora mollemarum,Hanseniaspora smithiaeandHanseniaspora valbyensis.H. menglaensissp. nov. differed fromH. lindneri, the most closely related known species, by 1.2 % substitutions in the D1/D2 domain, 2.5 % substitutions in the ITS region and 5.4 % substitutions in theACT1gene, respectively. Physiologically,H. menglaensissp. nov. can also be distinguished fromH. lindneriby its ability to assimilated-gluconate.
Whole-genome sequencing of Chlamydia psittaci from Australasian avian hosts: A genomics approach to a pathogen that still ruffles feathers
Authors: Kasimov Vasilli , White Rhys T. , Foxwell Jonathan , Jenkins Cheryl , Gedye Kristene , Pannekoek Yvonne , Jelocnik Martina
Published: July 2023

Chlamydia psittaci

is a globally distributed veterinary pathogen with zoonotic potential. Although

C. psittaci

infections have been reported in various hosts, isolation and culture of

Chlamydia

is challenging, hampering efforts to produce contemporary global

C. psittaci

genomes. This is particularly evident in the lack of avian

C. psittaci

genomes from Australia and New Zealand. In this study, we used culture-independent probe-based whole-genome sequencing to expand the global

C. psittaci

genome catalogue. Here, we provide new

C. psittaci

genomes from two pigeons, six psittacines, and novel hosts such as the Australian bustard (Ardeotis australis) and sooty shearwater (Ardenna grisea) from Australia and New Zealand. We also evaluated

C. psittaci

genetic diversity using multilocus sequence typing (MLST) and major outer membrane protein (ompA) genotyping on additional

C. psittaci

-positive samples from various captive avian hosts and field isolates from Australasia. We showed that the first

C. psittaci

genomes sequenced from New Zealand parrots and pigeons belong to the clonal sequence type (ST)24 and diverse ‘pigeon-type’ ST27 clade, respectively. Australian parrot-derived strains also clustered in the ST24 group, whereas the novel ST332 strain from the Australian bustard clustered in a genetically diverse clade of strains from a fulmar, parrot, and livestock. MLST and ompA genotyping revealed ST24/ompA genotype A in wild and captive parrots and a sooty shearwater, whilst ‘pigeon-types’ (ST27/35 and ompA genotypes B/E) were found in pigeons and other atypical hosts, such as captive parrots, a little blue penguin/Kororā (Eudyptula minor) and a zebra finch (Taeniopygia guttata castanotis) from Australia and New Zealand. This study provides new insights into the global phylogenomic diversity of

C. psittaci

and further demonstrates the multi-host generalist capacity of this pathogen.
Impact of Genetic Background as a Risk Factor for Atherosclerotic Cardiovascular Disease: A Protocol for a Nationwide Genetic Case-Control (CV-GENES) study in Brazil
Authors: Mattos Antônio José Cordeiro , de Menezes Neves Precil Diego Miranda , de Figueiredo Oliveira Gustavo Bernardes , Moreira Frederico Rafael , Pintão Maria Carolina , Rocha Viviane Zorzanelli , de Souza Rocha Cristiane , Katz Viviane Nakano , Ferreira Elisa Napolitano , Rojas-Málaga Diana , Viana Celso Ferraz , da Silva Fabiula Fagundes , Vidotti Juliete Jorge , Felicio Natalia Mariana , de Araujo Vitor Leticia , Cesar Karina Gimenez , da Silva Camila Araújo , de Oliveira Alves Lucas Bassolli , de Oliveira Junior Haliton Alves , Avezum Álvaro
Published: July 2023

Atherosclerotic Cardiovascular Disease (ASCVD) represents the leading cause of death worldwide, and individual screening should be based on behavioral, metabolic, and genetic profile derived from data collected in large population-based studies. Due to a polygenic nature of ASCVD, we aimed to assess the association of genomics to ASCVD risk and its impact on the occurrence of acute myocardial infarction, stroke, or peripheral artery thrombotic-ischemic events on a population level. CV-GENES is a multicenter, Brazilian nationwide, 1:1 case-control study of 3,734 patients. Inclusion criteria for cases are the first occurrence of one of the cardiovascular events. Individuals without known ASCVD, and age- and sex-matched will be eligible for the control group. A genetics core lab analysis will be performed through the association of low-pass whole genome sequencing and whole exome sequencing. A polygenic risk score will be built in a multiethnic population to estimate the association between genetic polymorphisms and risk of ASCVD. In addition, the presence of pathogenic or likely pathogenic variants will be screened in 8 genes (ABCG5,ABCG8,APOB,APOE, LDLR,LDLRAP1,LIPA, PCSK9) associated with atherosclerosis. Multiple logistic regression will be applied to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs), and population attributable risks will be calculated. This study is registered inclinicaltrials.gov(NCT05515653.)
Spatiotemporal precise optical manipulation of intracellular molecular activities
Authors: Dong Bin , Mahapatra Shivam , Clark Matthew G. , Carlsen Mark , Mohn Karsten J. , Ma Seohee , Brasseale Kent , Crim Grace , Zhang Chi
Published: July 2023

Controlling chemical processes in live cells is a challenging task. The spatial heterogeneity of biochemical reactions in cells is often overlooked by conventional means of incubating cells with desired chemicals. A comprehensive understanding of spatially diverse biochemical processes requires precise control over molecular activities at the subcellular level. Herein, we develop a closed-loop optoelectronic control system that allows the manipulation of biomolecular activities in live cells at high spatiotemporal precision. Chemical-selective fluorescence signals are utilized to command lasers that trigger specific chemical reactions or control the activation of photoswitchable inhibitors at desired targets. We demonstrate the capability to selectively produce reactive oxygen species (ROS) solely at targeted organelles using blue light. Notably, the induction of ROS in the endoplasmic reticulum leads to a more pronounced disruption of tubulin polymerization and a reduction in green fluorescent protein signals, in comparison to that in lipid droplets. Moreover, when combined with a photoswitchable inhibitor, we selectively inhibit tubulin polymerization within subcellular compartments. This technology enables spatiotemporal control over chemical processes and drug activities, exclusively at desired targets, while minimizing undesired effects on non-targeted locations.
Association study of human leukocyte antigen (HLA) variants and idiopathic pulmonary fibrosis
Authors: Guillen-Guio Beatriz , Paynton Megan L. , Allen Richard J. , Chin Daniel P.W. , Donoghue Lauren J. , Stockwell Amy , Leavy Olivia C. , Hernandez-Beeftink Tamara , Reynolds Carl , Cullinan Paul , Martinez Fernando ,   CleanUP-IPF Investigators of the Pulmonary Trials Cooperative, Booth Helen L. , Fahy William A. , Hall Ian P. , Hart Simon P. , Hill Mike R. , Hirani Nik , Hubbard Richard B. , McAnulty Robin J. , Millar Ann B. , Navaratnam Vidya , Oballa Eunice , Parfrey Helen , Saini Gauri , Sayers Ian , Tobin Martin D. , Whyte Moira K. B. , Adegunsoye Ayodeji , Kaminski Naftali , Ma Shwu-Fan , Strek Mary E. , Zhang Yingze , Fingerlin Tasha E. , Molina-Molina Maria , Neighbors Margaret , Sheng X. Rebecca , Oldham Justin M. , Maher Toby M. , Molyneaux Philip L. , Flores Carlos , Noth Imre , Schwartz David A. , Yaspan Brian L. , Jenkins R. Gisli , Wain Louise V. , Hollox Edward J.
Published: July 2023

Introduction

Idiopathic pulmonary fibrosis (IPF) is a chronic interstitial pneumonia marked by progressive lung fibrosis and a poor prognosis. Recent studies have highlighted the potential role of infection in the pathogenesis of IPF and a prior association of theHLA-DQB1gene with idiopathic fibrotic interstitial pneumonia (including IPF) has been reported. Due to the important role that the Human Leukocyte Antigen (HLA) region plays in the immune response, here we evaluated if HLA genetic variation was associated specifically with IPF risk.

Methods

We performed a meta-analysis of associations of the HLA region with IPF risk in individuals of European ancestry from seven independent case-control studies of IPF (comprising a total of 5,159 cases and 27,459 controls, including the prior study of fibrotic interstitial pneumonia). Single nucleotide polymorphisms, classical HLA alleles and amino acids were analysed and signals meeting a region-wide association thresholdp<4.5×10−4and a posterior probability of replication >90% were considered significant. We sought to replicate the previously reportedHLA-DQB1association in the subset of studies independent of the original report.

Results

The meta-analysis of all seven studies identified four significant independent single nucleotide polymorphisms associated with IPF risk. However, none met the posterior probability for replication criterion. TheHLA-DQB1association was not replicated in the independent IPF studies.

Conclusion

Variation in the HLA region was not consistently associated with risk in studies of IPF. However, this does not preclude the possibility that other genomic regions linked to the immune response may be involved in the aetiology of IPF.
Blood epigenome-wide association studies of suicide attempt in adults with bipolar disorder
Authors: Mirza Salahudeen , de Carvalho Lima Camila N. , Del Favero-Campbell Alexandra , Rubinstein Alexandre , Topolski Natasha , Cabrera-Mendoza Brenda , Kovács Emese H.C. , Blumberg Hilary P. , Richards Jenny Gringer , Williams Aislinn J. , Wemmie John A. , Magnotta Vincent A. , Fiedorowicz Jess G. , Gaine Marie E. , Walss-Bass Consuelo , Quevedo Joao , Soares Jair C. , Fries Gabriel R.
Published: July 2023

Suicide attempt (SA) risk is elevated in individuals with bipolar disorder (BD), and DNA methylation patterns may serve as possible biomarkers of SA. We conducted epigenome-wide association studies (EWAS) of blood DNA methylation associated with BD and SA. DNA methylation was measured at > 700,000 positions in a discovery cohort of n = 84 adults with BD with a history of SA (BD/SA), n = 79 adults with BD without history of SA (BD/non-SA), and n = 76 non-psychiatric controls (CON). EWAS revealed six differentially methylated positions (DMPs) and seven differentially methylated regions (DMRs) between BD/SA and BD/non-SA, with multiple immune-related genes implicated. There were no epigenome-wide significant differences when BD/SA and BD/non-SA were each compared to CON, and patterns suggested that epigenetics differentiating BD/SA from BD/non-SA do not differentiate BD/non-SA from CON. Weighted gene co-methylation network analysis and trait enrichment analysis of the BD/SA vs. BD/non-SA contrast further corroborated immune system involvement, while gene ontology analysis implicated calcium signalling. In an independent replication cohort of n = 48 BD/SA and n = 47 BD/non-SA, fold-changes at the discovery cohort’s significant sites showed moderate correlation across cohorts and agreement on direction. In both cohorts, classification accuracy for SA history among individuals with BD was highest when methylation at the significant CpG sites as well as information from clinical interviews were combined, with an AUC of 88.8% (CI = 83.8-93.8%) and 82.1% (CI = 73.6-90.5%) for the combined epigenetic-clinical predictor in the discovery and replication cohorts, respectively. Our results provide novel insight to the role of immune system functioning in SA and BD and also suggest that integrating information from multiple levels of analysis holds promise to improve risk assessment for SA in adults with BD.
Protocol and statistical analysis plan for the Mode of Ventilation During Critical IllnEss (MODE) trial
Authors: Seitz Kevin P. , Lloyd Bradley D. , Wang Li , Shotwell Matthew S. , Qian Edward T. , Richardson Roger K. , Rooks Jeffery C. , Hennings-Williams Vanessa , Sandoval Claire E. , Richardson Whitney D. , Morgan Tracy , Thompson Amber N. , Hastings Pamela G. , Ring Terry P. , Stollings Joanna L. , Talbot Erica M. , Krasinski David J. , Decoursey Bailey , Gibbs Kevin W. , Self Wesley H. , Mixon Amanda S. , Rice Todd W. , Semler Matthew W. , Casey Jonathan D.
Published: July 2023

Introduction:

For every critically ill adult receiving invasive mechanical ventilation, clinicians must select a mode of ventilation. The mode of ventilation determines whether the ventilator directly controls the tidal volume or the inspiratory pressure. Newer hybrid modes allow clinicians to set a target tidal volume, for which the ventilator controls and adjusts the inspiratory pressure. A strategy of low tidal volumes and low plateau pressure improves outcomes, but the optimal mode to achieve these targets is not known.

Methods and analysis:

The Mode of Ventilation During Critical Illness (MODE) trial is a cluster-randomized, multiple-crossover pilot trial being conducted in the medical intensive care unit (ICU) at an academic center. The MODE trial compares the use of volume control, pressure control, and adaptive pressure control. The study ICU is assigned to a single ventilator mode (volume control versus pressure control versus adaptive pressure control) for continuous mandatory ventilation during each 1-month study block. The assigned mode switches every month in a randomly generated sequence. The primary outcome is ventilator-free days (VFDs) to study day 28, defined as the number of days alive and free of invasive mechanical ventilation from the final receipt of mechanical ventilation to 28 days after enrollment. Enrollment began November 1, 2022 and will end on July 31, 2023.

Ethics and dissemination:

The trial was approved by the Vanderbilt University Medical Center institutional review board (IRB# 220446). Results of this study will be submitted to a peer-reviewed journal and presented at scientific conferences.

Trial registration number:

The trial was registered withclinicaltrials.govon October 3, 2022, prior to initiation of patient enrollment on November 1, 2022 (ClinicalTrials.govidentifier:NCT05563779)
Uncertainty in serious illness: A national interdisciplinary consensus exercise to identify clinical research priorities
Authors: Etkind Simon N , Barclay Stephen , Spathis Anna , Hopkins Sarah A , Bowers Ben , Koffman Jonathan
Published: July 2023

Background

Serious illness is characterised by uncertainty, particularly in older age groups. Uncertainty may be experienced by patients, family carers, and health professionals about a broad variety of issues. There are many evidence gaps regarding the experience and management of uncertainty.

Aim

We aimed to identify priority research areas concerning uncertainty in serious illness, to ensure that future research better meets the needs of those affected by uncertainty and reduce research inefficiencies.

Methods

Rapid prioritisation workshop comprising five focus groups to identify research areas, followed by a ranking exercise to prioritise them. Participants were healthcare professionals caring for those with serious illnesses including geriatrics, palliative care, intensive care; researchers; patient/carer representatives, and policymakers. Descriptive analysis of ranking data and qualitative framework analysis of focus group transcripts was undertaken.

Results

Thirty-four participants took part; 67% female, mean age 47 (range 33 – 67). The highest priority was communication of uncertainty, ranked first by 15 participants (overall ranking score 1.59/3). Subsequent priorities were: 2) How to cope with uncertainty; 3) healthcare professional education/training; 4) Optimising clinical approaches to uncertainty; and 5) exploring in-depth experiences of uncertainty. Research related to optimally managing uncertainty was given higher priority than research focusing on experiences of uncertainty and its impact.

Conclusions

These co-produced, clinically-focused research priorities map out key evidence gaps concerning uncertainty in serious illness. Managing uncertainty is the most pressing issue, and researchers should prioritise how to optimally manage uncertainty in order to reduce distress, unlock decision paralysis and improve illness and care experience.

Key points

Uncertainty is ubiquitous and distressing in serious illness, and can paralyse decision making

In this consensus exercise, stakeholders identified research priorities for uncertainty in serious illness

Communication of uncertainty was the highest priority

Participants prioritised research concerning managing uncertainty above research to understand experiences of uncertainty
Genomic Analysis and Surveillance of Respiratory Syncytial Virus (RSV) Using Wastewater-Based Epidemiology (WBE)
Authors: Allen Danielle M. , Reyne Marina I. , Allingham Pearce , Levickas Ashley , Bell Stephen H. , Lock Jonathan , Coey Jonathon D. , Carson Stephen , Lee Andrew J. , McSparron Cormac , Nejad Behnam Firoozi , McKenna James , Shannon Mark , Li Kathy , Curran Tanya , Broadbent Lindsay J. , Downey Damian G. , Power Ultan F. , Groves Helen E. , McKinley Jennifer M. , McGrath John W. , Bamford Connor G. G. , Gilpin Deirdre F.
Published: July 2023

Respiratory syncytial virus (RSV) causes severe infections in infants, immunocompromised or elderly individuals resulting in annual epidemics of respiratory disease. Currently, limited clinical RSV surveillance and the lack of predictable RSV seasonal dynamics and limits the public health response. Wastewater-based epidemiology (WBE) has the capacity to determine levels of health-associated biomarkers and has recently been used globally as a key metric in determining prevalence of SARS-CoV-2 in the community. However, the application of genomic WBE for the surveillance of other respiratory viruses is limited.

In this study, we present an integrated genomic WBE approach, using RT-qPCR and partial sequencing of the G gene to monitor RSV levels and variants in the community across 2 years encompassing two periods of high RSV clinical positivity in Northern Ireland.

We report increasing detection of RSV in wastewater concomitant with increasing numbers of RSV positive clinical cases. Furthermore, analysis of wastewater-derived RSV sequences permitted subtyping, genotyping, and identification of distinct circulating lineages within and between seasons.

Altogether, our genomic WBE platform has the potential to complement ongoing global surveillance efforts and aid the management of RSV by informing the timely deployment of pharmaceutical and non-pharmaceutical interventions.
Genomic epidemiology of EuropeanAspergillus fumigatuscausing COVID-19-associated pulmonary aspergillosis in Europe
Authors: Simmons B.C. , Rhodes J. , Rogers T.R. , Talento A.F. , Griffin A. , Mansfield M , Sheehan D. , Abdolrasouli A. , Verweij P.E. , Bosch T. , Schelenz S. , Hemmings S. , Fisher M.C.
Published: July 2023

The opportunistic fungusAspergillus fumigatushas been found to cause coinfections in patients with severe SARS-CoV-2 virus infection, leading to COVID-19-associated pulmonary aspergillosis (CAPA). The CAPA all-cause mortality rate is approximately 50% and may be complicated by azole-resistance. Genomic epidemiology can help shed light on the genetics ofA. fumigatuscausing CAPA including the prevalence of alleles that are associated with azole-resistance. Here, a population genomic analysis of 21 CAPA isolates from four European countries is presented. The CAPA isolates were compared withA. fumigatusfrom a wider population of 167 non-CAPA clinical isolates and 73 environmental isolates. Bioinformatic analysis and antifungal susceptibility testing were performed to quantify resistance and identify possible genetically-encoded azole-resistant mechanisms. Phylogenetic analysis of the 21 CAPA isolates showed a lack of genetic distinction from the widerA. fumigatuspopulation, with isolates distributed within two distinct clades (A and B), with the majority of the CAPA isolates in clade B (71.4%). The prevalence of phenotypic azole-resistance in CAPA was 14.3% (n=3/21); all three CAPA isolates contained a known resistance-associatedcyp51Apolymorphism. CAPA isolates are drawn from the widerA. fumigatuspopulation rather than forming a unique genetic background showing that COVID-19 patients are susceptible to the entireA. fumigatuspopulation. However, the relatively high prevalence of azole-resistance alleles that we document poses a threat to treatment success rates, warranting enhanced detection and surveillance ofA. fumigatusgenotypes in these patients. Furthermore, potential changes to antifungal first-line treatment guidelines may be needed to improve patient outcomes.
Comparison of the analytical and clinical sensitivity of thirty-four rapid antigen tests with the most prevalent SARS-CoV-2 variants of concern during the COVID-19 pandemic in the UK
Authors: Byrne Rachel L. , Aljayyoussi Ghaith , Greenland-Bews Caitlin , Kontogianni Konstantina , Wooding Dominic , Williams Christopher T. ,   LSTM Diagnostics group,   Falcon Steering group, de Vos Margaretha , Body Richard , Adams Emily R. , Escadafal Camille , Edwards Thomas , Cubas-Atienzar Ana I.
Published: July 2023

Background

The continued emergence of SARS-CoV-2 variants of concern (VOC) requires timely analytical and clinical evaluation of antigen-based rapid diagnostic tests (Ag-RDTs) especially those that are recommended for at home use.

Methods

The limit of detection (LOD) of 34 Ag-RDTs was evaluated using the most encountered SARS-CoV-2 VOC viral isolates (Alpha, Delta, Gamma, Omicron BA.1, Omicron BA.5) and the wild type (WT). Clinical sensitivity was further evaluated for five Ag-RDT utilising retrospective samples (Alpha, Delta, Omicron BA.1) and one Ag-RDT utilising prospective clinical samples (Delta and Omicron BA.1).

Findings

For the WT, Alpha, Delta, Gamma and Omicron (BA.1) variants 22, 32, 29, 31 and 32 of the 34 Ag-RDTs evaluated met the World Health Organisations (WHO) target product profile (TPP), respectively. Of the 31 Ag-RDTs included for Omicron BA.5 evaluation 29 met the WHO TPP. Additionally, the LODs for samples spiked with Omicron BA.5 were significantly lower than all other VOCs included (p<0.001). In the retrospective clinical evaluation when comparing RNA copies/mL, the Ag-RDTs detected Alpha and Omicron (BA.1) more sensitively than the Delta VOC. Samples with high RT-qPCR Cts (Ct>25) resulted in reduced test sensitivities across all variants. We used linear regression to model the 50% and 95% LOD of clinical samples and observed statistically similar results for all tests. In the prospective clinical samples, the sensitivity was statistically similar for the Delta VOC 71.9% (CI 95% 53.3-86.6%) and Omicron VOC 84.4% (CI95% 75.3-91.2%).

Interpretation

Test performance differs between SARS-CoV-2 VOCs, and high sensitivity was achieved when testing the Omicron BA.5 VOC compared to the WHO Ag-RDT requirements. Continuous evaluations must be performed to monitor test performance.

Funding

This work was funded as part of FIND’s work as a co-convener of the diagnostics pillar of the Access to COVID-19 Tools (ACT) Accelerator, including support from Unitaid (grant number 2019-32-FIND MDR), the government of the Netherlands (grant number MINBUZA-2020.961444), and the UK Department for International Development (grant number 300341-102). Funding was also obtained from the MRC for RLB and CGB. The Facilitating Accelerated Clinical Evaluation of Clinical Diagnostics for COVID-19 (FALCON C-19) study was funded by the UK National Institute of Health and Care Research (NIHR).
MiniBAR/KIAA0355 is a dual Rac and Rab effector required for ciliogenesis
Authors: Shaughnessy Ronan , Serres Murielle , Escot Sophie , Hammich Hussein , Cuvelier Frédérique , Salles Audrey , Rocancourt Murielle , Verdon Quentin , Gaffuri Anne-Lise , Sourigues Yannick , Malherbe Gilles , Velikovsky Leonid , Chardon Florian , Tinevez Jean-Yves , Callebaut Isabelle , Formstecher Etienne , Houdusse Anne , David Nicolas , Pylypenko Olena , Echard Arnaud
Published: July 2023

Cilia protrude from the cell surface and play critical roles in in-tracellular signaling, environmental sensing and development. Actin-dependent contractility and intracellular trafficking are both required for ciliogenesis, but little is known about how these processes are coordinated. Here, we identified a Rac1-and Rab35-binding protein with a truncated BAR domain that we named MiniBAR (aka KIAA0355/GARRE) which plays a key role in ciliogenesis. MiniBAR colocalizes with Rac1 and Rab35 at the plasma membrane and on intracellular vesicles traffick-ing to the ciliary base and exhibits remarkable fast pulses at the ciliary membrane. MiniBAR depletion leads to short cilia resulting from abnormal Rac-GTP/Rho-GTP levels, increased acto-myosin-II-dependent contractility together with defective trafficking of IFT88 and ARL13B into cilia. MiniBAR-depleted zebrafish embryos display dysfunctional short cilia and hall-marks of ciliopathies including left-right asymmetry defects. Thus, MiniBAR is a unique dual Rac and Rab effector that con-trols both actin cytoskeleton and membrane trafficking for cili-ogenesis.
Voluntary and enforced tax compliance determinants and impact among agrochemical businesses in Ghana
Authors: Kumi Richmond , Bannor Richard Kwasi , Oppong-Kyeremeh Helena , Adaletey Jennifer Ellah
Published: July 2023

Purpose

This paper examined tax compliance and its impact on agrochemical traders in Ghana.

Design/methodology/approach

Based on the registered agrochemical lists obtained from the Plant Protection and Regulatory Service Department, 92 agrochemical traders were sampled for data collection. Probit regression was used to estimate determinants of tax compliance, whereas the Inverse Probability Weighted Regression Adjustment Model was employed to evaluate the impact of tax compliance on business performance.

Findings

The results revealed that age and gender relate positively to enforced tax compliance, while education positively impacts voluntary tax compliance. Nonetheless, tax rate, trust and monthly sales positively affect voluntary tax compliance but negatively impact enforced tax compliance. Inversely, while authorities’ power negatively impacted voluntary compliance, it positively influenced enforced tax compliance confirming the Slippery Slope Framework.

Originality/value

To the best knowledge of the authors, this paper is the first to investigate tax compliance determinants and impact among agrochemical traders, despite the tremendous growth of the agrochemical sub-sector in Africa and Ghana. Therefore, this study makes a modest contribution to empirical studies that validate the Slippery Slope Framework in promoting tax compliance in the agricultural and agribusiness sectors of a developing country. Similarly, it also unearths the impact of tax compliance on agribusiness growth which has yet to be highlighted in the extant literature.
Changing the boundaries of public sector auditing
Authors: Grossi Giuseppe , Hay David C. , Kuruppu Chamara , Neely Daniel
Published: July 2023

Purpose

This paper aims at reflecting on the changing boundaries of public sector auditing. In particular the paper focusses on the opportunities and challenges for performance auditing, for sustainable development auditing and digitalised public sector auditing.

Design/methodology/approach

Building from the papers in this special issue, the authors draw on the literature on current development of public sector auditing (such as public sector auditing performance auditing, sustainable development auditing and digitalised public sector auditing) and propose a future research agenda.

Findings

The “changing boundaries” of public sector auditing may influence the difficulty for public sector organisations to manage the uncertainties and risks not only associated to corruption but also the public governance development (collaborative, digital and emergency governance). The authors speculate on the role that the “changing boundaries” of public sector auditing can play.

Originality/value

The paper contributes by setting new research avenues for future studies on public sector auditing in a post-new public management context.
Let virtual creatures stay virtual: tactics to increase trust in virtual influencers
Authors: Qu Ying , Baek Eunsoo
Published: July 2023

Purpose

Advances in technology and the popularity of social media influencers have sparked a rise of “virtual influencers (VIs).” This study examines consumer attitudes toward VIs in social networking services and explores factors that enhance or dampen these attitudes. In three experiments, it was explored how contextual factors (background and companion) interact with human (HIs) and VIs, influencing attitudes through trustworthiness.

Design/methodology/approach

Three experiments were conducted using an online panel (N = 894). All experiments were based on the comparison between HIs and VI with mediating role of trustworthiness. In Studies 2 and 3, moderated mediation analyses were conducted to test hypotheses.

Findings

The results revealed that human-like VI was less trusted than animi-like VI or HIs. However, the perceived trustworthiness toward VI was enhanced when the VI was in a virtual (vs. real) environment (Study 2) or accompanied by a virtual (vs. human) companion (Study 3), leading to positive attitudes.

Originality/value

This research not only enriches relevant literature (avatars and SMIs) but also provides actionable insight for practitioners who design and utilize VIs. This paper proposes novel and handy tactics to enhance consumers' trustworthiness in and attitudes toward VIs.
Opening up their values: how CEOs conservation and openness to change impact downsizing decisions
Authors: Kremer Rico
Published: July 2023

Purpose

Based on the theory of basic human values, this study aims to examine the impact of CEO conservation (i.e. security, conformity and tradition) and openness to change (i.e. self-direction, stimulation and hedonism) values on one of the most conflictual decisions inside a firm: workforce downsizing.

Design/methodology/approach

The hypothesis testing was done in the context of all workforce downsizing decisions made by German companies (and their CEOs) listed on the German Prime-Index between 2005 and 2019. A software-based psycholinguistic assessment of various sources of CEO communications was conducted to tap into their underlying values.

Findings

Tobit regression analysis confirms that CEO conservation and openness-to-change values impact the severity of workforce downsizing. Namely, the higher the CEO conservation values, the lower the downsizing severity (i.e. employees dismissed in relation to overall workforce). In contrast, the higher the CEO openness to change values, the higher the downsizing severity.

Originality/value

Against prior research that has centered around political ideology as a proxy to understand the mechanisms through which values impact strategic decisions, the present study employs advanced measurement approaches to assess the general impact of CEO values on critical firm decisions. As such, the study contributes to upper echelons research by offering a new perspective on how CEO values impact critical firms' decisions.
Effects of financial inclusion on tax revenue mobilization: Evidence from WAEMU countries
Authors: Chebochok Milly Chepkorir , Bayale Nimonka
Published: July 2023

Financial inclusion remains at the heart of governments concerns. By creating favorable conditions for access to a diversified range of adapted financial products and services at affordable costs for the populations, financial inclusion generates important opportunities that could lead to increased tax revenue mobilization. This paper analyzes the effects of financial inclusion on tax revenue mobilization, using panel data from West African Economic and Monetary Union (WAEMU) countries over the period 2006–2019. The findings suggest that financial inclusion positively and significantly influences government's tax revenue. Moreover, by looking at the effects of disaggregated financial inclusion dimensions (access, use, and affordability) on various components of tax revenue, we find that the estimated coefficients on the subcomponents of financial inclusion are statistically significant. Results also indicate that the magnitude of effect of financial inclusion is higher on indirect taxes compared to direct tax revenues. This research recommends that policy‐makers should prioritize financial inclusion in their policies and development agenda through National Financial Inclusion Strategies (NFIS) because it can increase countries' resource mobilization and help them to build fiscal resilience.
Research trends towards crisis management in social sciences: A bibliometric analysis
Authors: Polat Hıdır , Seyfi Murat
Published: July 2023

This research aims to reveal the main trends, gaps and paradigm shifts in crisis management. Data from research dealing with crisis/crisis management in the social sciences literature were examined in this context. The Web of Science database was used to collect research data. The data were analyzed using bibliometric analysis, a quantitative research method. The findings show that crisis management, crisis planning, crisis actions, strategic management and crisis management in public relations were the most intensively studied topics until 2018. But after 2018, research, tourism, Covid‐19 pandemic have shown a trend towards social media. In general, there is an increase in empirical research on crisis management. In this body of research, the United States of America has the greatest weight numerically, however, European countries are better positioned in terms of interest levels and international cooperation. All in all, this research provides a good conceptual framework for future crisis management research.
Capturing high‐resolution digital images for use in forensic document examination
Authors: Riley Paige , Eisenhart Linda , Stephens Joseph C. , Abonamah Jocelyn V. , Ryman Colbey , Eckenrode Brian A.
Published: July 2023

In the past, pattern disciplines within forensic science have periodically faced criticism due to their subjective and qualitative nature and the perceived absence of research evaluating and supporting the foundations of their practices. Recently, however, forensic scientists and researchers in the field of pattern evidence analysis have developed and published approaches that are more quantitative, objective, and data driven. This effort includes automation, algorithms, and measurement sciences, with the end goal of enabling conclusions to be informed by quantitative models. Before employing these tools, forensic evidence must be digitized in a way that adequately balances high‐quality detail and content capture with minimal background noise imparted by the selected technique. While the current work describes the process of optimizing a method to digitize physical documentary evidence for use in semi‐automated trash mark examinations, it could be applied to assist other disciplines where the digitization of physical items of evidence is prevalent. For trash mark examinations specifically, it was found that high‐resolution photography provided optimal digital versions of evidentiary items when compared to high‐resolution scanning.