bluuebunny/crossref_metadata_2025 huggingface dataset:
Implications of placentation type on species-specific colostrum properties in mammals
Authors: Bigler Naomi A , Bruckmaier Rupert M , Gross Josef J
Published: September 2022

Maternal care is essential to optimally support survival of the offspring. During evolution of mammalian species, different phenotypes have evolved in relation to gestation length, number, size, and maturation stage of the offspring at parturition, as well as colostrum and milk composition. The aim of the present review is to describe relationships between placental function and colostrum and milk composition in different mammalian species. Species covered in this article include humans, rabbits, rodents (rat and mouse), carnivores (cats and dogs), and a variety of ungulate species (cattle, sheep, goats, pigs, and horses). Species-specific aspects are elucidated with a special focus on the transfer of passive immunity. In this regard, the structure and thus the capability of the placenta to transport immunoglobulins from maternal to fetal circulation in utero dictates the necessity of the passive transfer of immunity via colostrum. Consequently, species with exclusive postpartal transfer of immunity such as in all ungulate species have greater immunoglobulin G concentrations in colostrum than species with a prepartal transfer in utero, where especially immunoglobulin A with its local immune function in the gastrointestinal tract is present in colostrum (e.g., rabbit and human). In terms of the nutritional purpose, suckling frequency is an important factor determining the gross composition of colostrum as well as in the mature milk of these species. Milk of nidicolous animals with long intervals in-between suckling events contains more fat than milk of nidifugous animals with constant access to their mother. However, the importance of colostrum and milk consumption for newborn animals and human babies goes beyond nutrition and the transfer of immunity. Numerous bioactive components such as growth factors, hormones, and oligosaccharides are enriched in colostrum and transition milk, which support the development of the intestinal tract and local immune system.
Rabbit Immunity to the Rabbit Tick, Haemaphysalis Leporispalustris (Agari: Ixodidae): I. The development of resistance
Authors: Boese Jack L.
Published: September 2022

Resistance to ticks, manifested as a reduction in the number of nymphs supported through engorgement, was developed in rabbits subjected to a series of nymphal tick infestations. Resistance appeared in rabbits receiving their initial exposure to nymphal ticks approximately 6 to 10 days after ticks were paced on them. It increased to become maximal between about 10 and 16 days, and then declined if a 2nd group of nymphs was not placed on the rabbits during this time. Although a single infestation of nymphs usually produced resistance, its detection by means of a 2nd infestation thus depended upon the time elapsed between the 2 feedings. The development of the immunity appeared to depend less on the number of ticks per infestation than on the frequency of infestation. A homocytotropic antibody was found in the sera of immune rabbits.
A Collection of Reptilian Chiggers from Thailand with Descriptions of three New Species (Acari: Prostigmata, Trombiculidae) and Preliminary Notes on their Biologies
Authors: Nadchatram M. , Kethley John
Published: September 2022

Three new species of chiggers from Thailand are described and illustrated: Herpetacarus leptochaeta and Microtrombicula chamlongi, both from the skink, Riopa bowringi, and H. cadigani from the gecko, Phyllodactylus siamensis. Preliminary analysis of host-parasite relationships suggests site preferences for 3 species, H. leprochaeta, M. chamlongi and Babiangia parmifera (Womersley) on Riopa bowringi and an ecological separation of these species with respect to the host macrohabitat.
Using a Cloud-Based Machine Learning Classification Tree Analysis to Understand the Demographic Characteristics Associated With COVID-19 Booster Vaccination Among Adults in the United States
Authors: Meng Lu , Fast Hannah E , Saelee Ryan , Zell Elizabeth , Murthy Bhavini Patel , Murthy Neil Chandra , Lu Peng-Jun , Shaw Lauren , Harris LaTreace , Gibbs-Scharf Lynn , Chorba Terence
Published: September 2022

A tree model identified adults age ≤34 years, Johnson & Johnson primary series recipients, people from racial/ethnic minority groups, residents of nonlarge metro areas, and those living in socially vulnerable communities in the South as less likely to be boosted. These findings can guide clinical/public health outreach toward specific subpopulations.
Introduction
Authors: Baumgartner Michael
Published: September 2022

The introduction establishes Jean-Luc Godard’s predilection for experimenting with recorded music from the time of his early short films in the late 1950s until his last feature films in the 2010s. The introduction first theorizes Godard’s film music aesthetic, which closely correlates with his understanding of all other filmic devices. Godard practices a hands-on approach to filmmaking by exploring self-reflexively cinematic possibilities through experimenting with the visual and sonic material in postproduction, not unlike a bricoleur, as defined by Claude Lévi-Strauss. By questioning with sustained skepticism the established automatism in cinema, as outlined by Stanley Cavell, Godard introduced new strategies of cinematic expressions which have eventually become automatisms themselves (e.g., the jump cut). The self-reflexive foregrounding of the arbitrariness of all filmic devices encompasses in Godard’s work all artistic levels, from scenario to montage. Godard approaches film music through the same self-reflexive lens. His theoretical understanding and practical use of film music is synonymous with the concept of metafilm music. A comprehensive discussion defines metafilm music as film music (self-)consciously referring to other film music and also to its own role as film music. Metafilm music further invites the audience to think with film music about film music. The introduction concludes with a brief overview of the book’s chapters, discussing Godard’s various self-reflexive approaches to music in his copious filmic and videographic oeuvre encompassing a period of more than sixty years.
Leitmotif Technique Revisited
Authors: Baumgartner Michael
Published: September 2022

This chapter investigates film music made up of the same short musical fragment repeated several times throughout a film. As a self-reflexive device, these identical fragments attract the attention of the spectator, for they are identically repeated multiple times, and they often begin and end in the middle of a musical phrase, harshly disrupting the cinematic flow. These succinct musical cues, often mixed unusually loudly into the soundtrack, break with the tradition of classical Hollywood and conventional European mainstream film music and challenge the dramaturgical function of music in cinema altogether. Godard critically questions one of the core concepts of film music: the leitmotif technique. In his early 1960s films, the identical musical fragment correlates the same narrowly defined signified with each repetition. Godard limits the interpretation of the music’s function by having the same musical fragment adhering to one specific visual or aural component. The fragments represent in Vivre sa vie and Pierrot le fou mnemonic signs that are indices—in Charles Sanders Pierce’s sense—for, respectively, love or death. The fact that these themes appear multiple times unchanged in the course of the same film and that they explicitly correlate to always the same extra-musical trope signals that Godard not only questions the usefulness of the leitmotif technique but altogether denounces it as a viable approach to film scoring. Since he thinks with the leitmotif technique about the function of film music, the scores in Pierrot le fou and Vivre sa vie can thus be interpreted as metafilm music.
The Undoing of the Leitmotif Technique
Authors: Baumgartner Michael
Published: September 2022

This chapter examines the last step of Godard’s systematic dismantling of the leitmotif technique. Meaning to demythologize cinematic illusion, Godard revokes all narrative agency from Georges Delerue’s memorable Camille theme in Le mépris, which is repeated verbatim several times during the apartment sequence with Paul and Camille quarreling. The Camille theme acts as a leitmotif but is emptied of any identifiable narrative significance and only attracts attention to itself as metafilm music. In Made in U.S.A., Godard treats several fragments from a Beethoven piano sonata and a Schumann symphony in an even more radical fashion. They become objets trouvés in the sense of surrealist art. By arbitrarily repeating these concise quotations several times throughout the film, Godard does not treat them as memorable leitmotifs but uses them instead as building blocks for a sound collage. Without preparing the spectator for their entrances, these musical quotations have no dramaturgical function and are thus relegated to the level of mere sound effects. Godard erases the last hints of the leitmotif technique in Deux ou trois choses que je sais d’elle. Due to the extreme ephemerality of several extremely short fragments from Beethoven’s late String Quartet, Op. 135, the music completely loses its function as film music and, therefore, also as metafilm music. These musical micro-shards no longer express anything discernible; evaporate amid the dense soundscape, dialogue, and voice-overs; and ultimately cease supporting the film’s narrative.
Referencing Film Music as a Genre
Authors: Baumgartner Michael
Published: September 2022

Based on the assumption that film music is responsible for conjuring up the audience’s emotions, this chapter explores Antoine Duhamel’s score for Pierrot le fou and Georges Delerue’s score for Le mépris as archetypical, self-conscious music referencing specific film genres. With his critical approach to film music as metafilm music in his 1960s films, Godard frequently alludes to overused paradigms of film music that are modeled after the prerogatives of Hollywood cinema. Such genre-typical music in Godard’s films is reminiscent of scores used in romantic comedies, suspense thrillers, and melodramas. The clichéd use of genre-specific music draws attention to itself and questions the efficacy of music as an integral part of the cinematic narrative influencing the viewing experience. Godard reduces Duhamel’s Pierrot score to the four most basic film musical articulations which are intended to evoke appropriate emotions in the spectator. This reduction to one function raises the question of whether film music can be defined as its own musical genre, similar to opera or symphony. A closer look at Delerue’s Le mépris score demonstrates that such a reduction to genre-specific musical denominators suggests Claudia Gorbman’s experiment of commutation. One score that expresses a specific mood can be easily exchanged with another one conceived in a similar mood without substantially altering the filmic message. Le mépris’s main-title theme, resembling a 1950s Hollywood melodrama score, assumes the role of a placeholder for generic melodramatic music and can thus be effortlessly replaced by any similar score written in an inherently melodramatic idiom.
Music Making as Metaphor for Filmmaking I
Authors: Baumgartner Michael
Published: September 2022

This and the following chapter are concerned with Godard’s objective of adding a philosophical underpinning to his innovative and singular film music aesthetics in the 1980s. Based on his observation that music making acts as a guide to understanding the creative process of filmmaking, Godard establishes an aesthetical concept of film music that corresponds to his complex cinematic language of the 1980s. As part of a profound investigation involving both the image and the soundtrack, he approached film music as metafilm music in Prénom: Carmen and Soigne ta droite (Une place sur la terre) as an equally important component of these films to storytelling itself. He thus established an aesthetical concept of film music that corresponds to his intricate cinematic language of the 1980s. Similar explorations had begun already in the late 1960s, when he captured the Rolling Stones on film in One Plus One during the recording of their song “Sympathy for the Devil.” As in Prénom: Carmen, in which he depicts the Quatuor Prat rehearsing Beethoven’s string quartets, Godard intertwines the rehearsal footage with fictional and quasi-documentary material. The objective of this chapter is thus to investigate how Godard self-reflexively emulates the process of music making for the sphere of cinema by utilizing the rehearsal sequences in the two discussed films as a metaphor for the act of filmmaking itself.
Music Making as Metaphor for Filmmaking II
Authors: Baumgartner Michael
Published: September 2022

This chapter continues the discussion of Godard’s self-reflexive understanding of music making as a model for filmmaking. After One Plus One and Prénom: Carmen, Godard returned once more to the metaphor of rehearsing music as viable guidance for filmmaking. In Soigne ta droite (Une place sur la terre), the sequences with the eclectic French techno-pop duo Les Rita Mitsouko rehearsing in their home studio displays an intimate and productive relationship between the two musicians. The rehearsal sequences are frequently interrupted by non-congruent sketches with comedian Jacques Villeret and a second side story with Godard as “the Idiot” finishing a film within twenty-four hours. With an intricate montage of the three disparate storylines supported by frequent text quotations from evocative Austrian author Hermann Broch, André Malraux, and Samuel Beckett, Godard investigates the crisis of the (post)modernist artist and the notion of the ever-unfinished artwork which itself is based on a never-ending string of quotations. Music, as metafilm music assuming a transcendental role, is involved—with the other filmic devices—in searching for the truth of artistic creation. In this thought-provoking yet underrated film, Godard’s intertwined, multilayered use of music and sound as part of a complex audiovisual web confirms the increasingly more complex function of music in his films from the late 1980s up to the late 2010s.
Emergency and essential surgical capacity assessment in Gimbichu district: cross-sectional study
Authors: Gebregzi Amare H. , Meshesha Berhane R. , Chekol Tadesse S. , Bereded Eyobed K. , Adem Getachew Y. , Beshir Hassen M. , Taye Desalegn B. , Negash Fitsum T. , Andarie Netsanet B.
Published: September 2022

Introduction:

Effectively integrating surgical and anesthesia care through bottom-up approach to fulfill universal health coverage is a crucial step to avail essential surgical and emergency service in low and middle-income countries.

Objective:

The study aims to assess the surgical and anesthesia service delivery capacity of Gimbichu district, East Shao Zone of Oromia Regional State, Ethiopia, using WHO’s emergency and essential surgical care situational analysis assessment tool.

Methods:

A cross-sectional survey design is conducted in Gimbichu district health facilities and linked referral hospitals to assess the surgical capacity. Direct observation and interview using WHO surgical capacity assessment, is used to collect data. All surgical patients managed from January to December 2021 are included in the study. Descriptive statistics were used to describe and present the finding.

Result:

The total amount of surgical procedures performed in a year in the health centers and nearby referral hospitals is 2838 procedures. Two health facilities that receive referrals from the district have a combined surgical workforce of 23 people serving a population of >1.5 million people in the catchment area. Gimbichu district health institutions execute 18.32% of the interventions/procedures recommended by the WHO emergency and essential surgical list. Nearby health facilities affiliated to Gimbichu district health institutions refer surgical patients for 56% of procedures classified as an emergency and necessary surgical services. Referred patients travel 5.6 km on average to access essential and emergency surgical services.

Conclusion and recommendation:

Building the capacity of health extension professionals on utilization of health facility service directory, community-level surgical condition assessment, referral, and linkage need to be priority activity to cement responsive primary health system to community surgical demand. Further improvement areas includes surgical workforce deployment and expanding the surgical capacity of health facilities in the Gimbichu district and nearby referral hospitals.
Preoperative Evaluation of Otosclerosis: A National Survey of Otologists
Authors: Doerfer Karl W. , Tu Nathan C. , Sioshansi Pedrom C. , Luryi Alex L. , Schutt Christopher A. , Babu Seilesh C.
Published: September 2022

Objective

Describe practice patterns in preoperative assessment for stapedectomy.

Study Design

Survey.

Setting

Tertiary referral center.

Subjects

Active members of the American Neurotologic Society and American Otologic Society.

Intervention

Survey.

Main Outcome Measures

Percent of respondents performing preoperative testing with acoustic reflexes (ARs), electrocochleography, vestibular evoked myogenic potentials, and computed tomography (CT). Further analysis of those not ordering routine CT to determine whether imaging would be ordered for previous ear surgery, vestibular complaints, childhood hearing loss, AR inconsistent with otosclerosis, possible advanced otosclerosis, or atypical complaints, including autophony. Further subgroup analysis based on years in practice and practice setting (private versus academic).

Results

Most respondents (56.5%) had practiced more than 15 years and worked in academic settings (69.4%). Rates of routine use of preoperative AR, vestibular evoked myogenic potential, and electrocochleography were 80, 4.7, and 0%, respectively. There were no significant differences based on time in practice or practice settings. For CT, 35.3% reported routine use with a statistically significant difference between academic and private practice respondents (42.4% versus 19.2%, p = 0.040). For CT contingent on specific clinical factors, only AR inconsistent with otosclerosis showed a statistically significant difference between academic and private practice providers (85.3% versus 57.1%, p = 0.020).

Conclusion

Most otologists routinely obtain AR before stapedectomy. Academic providers more commonly order CT routinely and for AR inconsistent with otosclerosis. Most respondents not ordering routine CT ordered imaging in specific clinical scenarios. Overall, there is a high level of consistency in preoperative testing regardless of practice setting or time in practice.
Hearing Aid Usage and Reported Hearing Difficulty in Americans With Subclinical Hearing Loss
Authors: Dragon Jacqueline M. , Grewal Maeher R. , Irace Alexandria L. , Golub Justin S.
Published: September 2022

Objective

Subclinical hearing loss (SCHL) (previously defined by our group as a four-frequency pure tone average [PTA4] >0 to ≤25 dB) has recently been associated with depressive symptoms and cognitive decline. This suggests that the common 25 dB adult cutpoint in the United States for normal hearing may not be sensitive enough. We aim to characterize real-world hearing difficulties, as measured by hearing aid use and self-reported hearing difficulty, among individuals with SCHL.

Study Design

Analysis of biennial cross-sectional epidemiologic survey (National Health and Nutrition Examination Survey, 1999–2012, 2015–2016).

Setting

Community, multicentered, national.

Subjects

Noninstitutionalized US citizens ≥12 years old, n = 19,246.

Measures

PTA4 (500, 1,000, 2,000, 4,000 Hz), high-frequency pure tone average (PTAhf) (6,000, 8,000 Hz), reported hearing aid use, subjective difficulty hearing.

Results

There were 806,705 Americans with SCHL who wore hearing aids (or 0.35% of the 227,324,096 Americans with SCHL; 95% confidence interval = 0.23%–0.54%). Among those with SCHL, 14.6% (33.1 million Americans) perceived a little trouble hearing and 2.29% (5.21 million Americans) perceived moderate/a lot of trouble hearing. When restricted to the borderline subcategory (>20 to ≤25 dB), 42.43% (6.64 million Americans) had at least a little trouble hearing. Among those with SCHL who wore hearing aids, 81% had a PTAhf >25 dB.

Conclusion

Despite hearing loss traditionally being defined by PTA4 ≤ 25 dB in the United States, nearly 1 million adults and adolescents with SCHL wore hearing aids, and nearly half with borderline HL had subjective difficulty hearing. To better reflect real-world difficulties, stricter definitions of hearing loss should be explored, including a lower cutpoint for the PTA4 or by using the more sensitive PTAhf.
Optimized Infliximab Induction Predicts Better Long‐Term Clinical and Biomarker Outcomes Compared to Standard Induction Dosing
Authors: Lawrence Sally , Faytrouni Farah , Harris Rachel E. , Irvine Mike , Carrion Estefania , Scott Gregor , Clarke Benjamin , Garrick Vikki , Curtis Lee , Gervais Lisa , Tayler Rachel , Riou Marliss , Hansen Richard , Jacobson Kevan , Russell Richard K.
Published: September 2022

Objectives:

To evaluate the efficacy of standard and optimized infliximab induction dosing in attaining corticosteroid (CS) free clinical remission at week 52 and the effect that post‐induction trough levels have on long‐term outcome.

Methods:

Inflammatory bowel disease (IBD) patients ≤18 years commenced on infliximab between August 1, 2016, and August 1, 2018, from Vancouver, Canada, and Glasgow, Scotland, were included. The Glasgow cohort followed standard induction while the Vancouver cohort undertook induction optimization based on clinical, biomarker, and proactive infliximab trough levels. Baseline characteristics and laboratory values were documented.

Results:

In total, 140 children were included [median age 14.1 years (interquartile range (IQR) 12.0–16.0)]; 54% male. CS‐free clinical remission at week 52 was higher in the optimized group compared to the standard cohort [65/78 (83%) vs. 32/62 (52%), P < 0.001]. Combined CS‐free clinical and biomarker remission (CRP < 5 mg/L) was also higher in the optimized compared to the standard cohort [65/78 (83%) vs 25/62 (40%), P < 0.001]. The median post‐induction trough level was higher in children who were in CS‐free clinical remission at week 52 [3.6 mg/L (1.5‐7.1)] vs. those who were not [2.0 mg/L (0.8–4.1), P = 0.04]. The odds of attaining a therapeutic post‐induction trough level were almost 4‐fold higher in the optimized group than the standard cohort (OR 3.97, 95% CI: 1.89–8.68, P < 0.001).

Conclusions:

Standard infliximab induction resulted in less favorable long‐term outcomes for pediatric IBD patients. Optimizing induction using clinical, biomarker, and proactive trough levels resulted in higher post‐induction trough levels and a greater odds of attaining long‐term clinical remission.
Back to the Basics
Authors: Berti-Hearn Linda
Published: September 2022

Due to the plethora of wound care products on the market and varying physician practices, it can be very confusing for home healthcare clinicians to recommend and provide the best wound care. As a result, many outdated or ritual practices are still being used to manage wounds. Assessment, management, and documentation are the basis of delivering evidence-based wound care. This article will highlight those essential areas and offer best practices for clinicians in the home care setting.
Addressing What Matters Aligning care with the priorities of older adults and their caregivers.
Authors: Carbonell Ellen , Zonsius Mary C. , Rodriguez-Morales Grisel , Newman Michelle , Emery-Tiburcio Erin E.
Published: September 2022

This article is the second in a series, Supporting Family Caregivers in the 4Ms of an Age-Friendly Health System, published in collaboration with the AARP Public Policy Institute and originally appearing in the American Journal of Nursing, Volume 122, issue 1, as part of the ongoing Supporting Family Caregivers: No Longer Home Alone series. The 4Ms of an Age-Friendly Health System (What Matters, Medication, Mentation, and Mobility) is an evidence-based framework for assessing and acting on critical issues in the care of older adults across settings and transitions of care. Engaging the health care team, including older adults and their family caregivers, with the 4Ms framework can help to ensure that every older adult gets the best care possible, is not harmed by health care, and is satisfied with the care they receive.

The articles in this series present considerations for implementing the 4Ms framework in the inpatient hospital setting and incorporating family caregivers in doing so. Resources for both nurses and family caregivers, including a series of accompanying videos developed by AARP and the Rush Center for Excellence in Aging and funded by The John A. Hartford Foundation, are also provided. Nurses should read the articles first, so they understand how best to help family caregivers. Then they can refer caregivers to the informational tear sheet—Information for Family Caregivers—and instructional videos, encouraging them to ask questions. For additional information, see Resources for Nurses. Cite this article as: Carbonell, E., et al. Addressing What Matters. Am J Nurs 2022; 122(1): 54-58.
A review of dengue and dengue haemorrhagic fever amidst the COVID-19 pandemic in Thailand: A raising concern and public health nested crises
Authors: Yodjan Naluepanat
Published: September 2022

Dengue and dengue haemorrhagic fever, caused by the dengue virus (DENV) belonging to the Flaviviridae family, has become a significant public health concern that has led to more than 1,000,000 cases and 1076 deaths in Thailand between 2009 and 2021. The patients infected with the dengue virus can be represented with severe headaches, eye pain, muscle and joint pains, nausea, vomiting, diarrhoea, swollen glands, and rash. Coexisting with the COVID-19 pandemic affects humans in morbidity and mortality in Thai individuals, including effects on the healthcare system. COVID-19 and Its impacts confirmed that cases of dengue fever in 2021 in Thailand had been reported to decrease irregularly compared with the previous year; however, trends have increased in dengue cases since early 2022. Therefore, to overcome current burdens and challenges caused by dengue and dengue haemorrhagic fever amidst COVID-19 in Thailand, exposing various perspectives on the dengue situation, recommendations for dengue fever control, and approaches to promote accurate understanding.
Predicting the response to Neoadjuvant Chemotherapy. Can the addition of tomosynthesis improve the accuracy of CESM? A comparison with breast MRI
Authors: Savaridas Sarah L , Vinnicombe Sarah , Warwick Violet , Evans Andrew J
Published: September 2022

Background

Neoadjuvant chemotherapy (NACT) is used to downstage breast cancer prior to surgery. Image monitoring is essential to guide treatment and to assess in vivo chemosensitivity. Breast MRI is considered the gold-standard imaging technique; however, it is contraindicated or poorly tolerated in some patients and may be hard to access. Evidence suggests contrast enhanced spectral mammography (CESM) may approach the accuracy of MRI. This novel pilot study investigates whether the addition of digital breast tomosynthesis (DBT) to CESM increases the accuracy of response prediction.

Results

Sixteen cancers in fourteen patients were imaged with CESM+DBT and MRI following completion of NACT. Ten cancers demonstrated pathological complete response (pCR) defined as absence of residual invasive disease. Greatest accuracy for predicting pCR was with CESM contrast-enhancement only (accuracy 81.3%, sensitivity 100%, specificity 57.1%), followed by MRI (accuracy 62.5%, sensitivity 44.4%, specificity 85.7%). Concordance with invasive tumour size was greater for CESM than MRI, concordance-coefficients 0.70 vs 0.66 respectively. MRI demonstrated greatest concordance with whole tumour size followed by CESM contrast-enhancement plus microcalcification, concordance-coefficients 0.86 vs 0.69. The addition of DBT did not improve accuracy for prediction of pCR or residual disease size. Whereas CESM+DBT tended to underestimate size of residual disease, MRI tended to overestimate but no significant differences were seen (p>0.05).

Conclusions

CESM contrast-enhancement plus microcalcification is similar to MRI for predicting residual disease post-NACT. Size of enhancement alone demonstrates best concordance with invasive disease. Inclusion of residual microcalcification improves concordance with DCIS. The addition of DBT to CESM does not improve accuracy.

Highlights

No benefit of adding DBT to CESM for NACT response prediction

CESM appears similar to MRI for predicting response to NACT

CESM has greatest accuracy for residual invasive tumour size.

CESM+calcification has greater accuracy for predicting residual in situ disease.
Evaluating the frequency and the impact of pharmacogenetic alleles in an ancestrally diverse Biobank population
Authors: Verma Shefali S. , Keat Karl , Li Binglan , Hoffecker Glenda , Risman Marjorie ,   Regeneron Genetics Center, Sangkuhl Katrin , Whirl-Carrillo Michelle , Dudek Scott , Verma Anurag , Klein Teri E. , Ritchie Marylyn D. , Tuteja Sony
Published: September 2022

Background

Pharmacogenomics (PGx) aims to utilize a patient’s genetic data to enable safer and more effective prescribing of medications. The Clinical Pharmacogenetics Implementation Consortium (CPIC) provides guidelines with strong evidence for 24 genes that affect 72 medications. Despite strong evidence linking PGx alleles to drug response, there is a large gap in the implementation and return of actionable pharmacogenetic findings to patients in standard clinical practice. In this study, we evaluated opportunities for genetically guided medication prescribing in a diverse health system and determined the frequencies of actionable PGx alleles in an ancestrally diverse biobank population.

Methods

A retrospective analysis of the Penn Medicine electronic health records (EHRs), which includes ∼3.3 million patients between 2012-2020, provides a snapshot of the trends in prescriptions for drugs with genotype-based prescribing guidelines (‘CPIC level A or B’) in the Penn Medicine health system. The Penn Medicine BioBank (PMBB) consists of a diverse group of 43,359 participants whose EHRs are linked to genome-wide SNP array and whole exome sequencing (WES) data. We used the Pharmacogenomics Clinical Annotation Tool (PharmCAT), to annotate PGx alleles from PMBB variant call format (VCF) files and identify samples with actionable PGx alleles.

Results

We identified ∼316,000 unique patients that were prescribed at least 2 drugs with CPIC Level A or B guidelines. Genetic analysis in PMBB identified that 98.9% of participants carry one or more PGx actionable alleles where treatment modification would be recommended. After linking the genetic data with prescription data from the EHR, 14.2% of participants (n=6157) were prescribed medications that could be impacted by their genotype (as indicated by their PharmCAT report). For example, 856 participants received clopidogrel who carriedCYP2C19reduced function alleles, placing them at increased risk for major adverse cardiovascular events. When we stratified by genetic ancestry, we found disparities in PGx allele frequencies and clinical burden. Clopidogrel users of Asian ancestry in PMBB had significantly higher rates ofCYP2C19actionable alleles than European ancestry users of clopidrogrel (p<0.0001, OR=3.68).

Conclusions

Clinically actionable PGx alleles are highly prevalent in our health system and many patients were prescribed medications that could be affected by PGx alleles. These results illustrate the potential utility of preemptive genotyping for tailoring of medications and implementation of PGx into routine clinical care.
The impact of WHO’s Treat All guideline on disease progression among people enrolled in HIV care in Central Africa: an observational cohort data by target trial design with multistate modeling
Authors: Zhu Jiaqi , Zhang Hongbin , Brazier Ellen , Tymejczyk Olga , Yotebieng Marcel , Kimmel April D. , Anastos Kathryn , Ross Jonathan , Hoover Donald R , Shi Qiuhu , Murenzi Gad , Nsonde Dominique , Dzudie Anastase , Lelo Patricia , Twizere Christella , Nash Denis
Published: September 2022

WHO’s Treat All guidelines, which eliminate eligibility thresholds for people living with HIV to receive antiretroviral therapy, have been implemented by most countries. However, the impact of Treat All on the process of HIV disease progression is unknown. We conducted a target trial to emulate a hypothetical RCT to evaluate the policy’s impact on HIV disease progression among people living with HIV. We included people enrolled in HIV care during 2013-2019 from the Central Africa International Epidemiology Databases to Evaluate AIDS. Multistate models inferred the transitional hazards of disease progression across the four WHO clinical stages (1: asymptomatic; 2: mild; 3: advanced; 4: severe) and death. We estimated hazard ratios (HR) between a cohort enrolling in HIV care after (n=4,607) and a cohort enrolling before (n=4,439) Treat All guideline implementation, with and without covariates adjustment. Treat All implementation was associated with decreased hazards of transition in most stage categories, with significant results from stage 1 to stage 2 (adjusted HR (aHR) 0.64, 95% CI 0.44-0.94) and from stage 1 to death (0.37, 0.17-0.81), and non-significant but low HR results from stage 2 to 3 (0.71, 0.50-1.01), from stage 2 to death (0.58, 0.18-1.80). Treat All implementation substantially reduced HIV disease progression.

Main Point Summary

We compared the HIV disease progression outcome between a pri- and post-Treat All periods, utilizing individual service delivery data from Central Africa International Epidemiology Databases to Evaluate AIDS. We concluded that Treat All implementation substantially reduced HIV disease progression.
Mosquito Electroantennography
Authors: Lahondère Chloé
Published: September 2022

Mosquitoes use multiple cues to locate food sources (animal and plants), mates, and oviposition sites. The sense of smell plays an important role in these behaviors, and olfactory cues are detected primarily by the appendages on the head—in particular, the antennae. Thus, mosquito olfaction can be studied by conducting electroantennogram (EAG) recordings. EAGs have emerged as a reliable technique to screen for bioactive compounds and are useful in the development of attractants and repellents for mosquito population control. Here, we focus on comparing the two main experimental approaches used in the literature (whole-body and whole-head mounting) and highlight key considerations for conducting EAGs in multiple species and for obtaining reliable and reproducible data.
Identification of Bioactive Volatile Organic Compounds Using Combined Gas Chromatography and Single Sensillum Recording
Authors: Ignell Rickard , Ghaninia Majid , Hill Sharon Rose
Published: September 2022

Most arthropods rely heavily on their sense of smell (i.e., olfaction) to locate and discriminate among mates, food, and egg laying sites. The odors emanating from these resources are composed of blends of volatile compounds that are detected by olfactory sensory neurons (OSNs) that are housed in hair-like structures, called sensilla, on the olfactory organs of arthropods. By inserting an electrode into a single sensillum and recording the activity of the OSNs while stimulating with volatile compounds eluting from a gas chromatograph, combined gas chromatography and single sensillum recording (GC-SSR) provides a high-resolution tool to identify bioactive compounds and to functionally characterize the peripheral olfactory system of arthropods.
Competitive analysis: a determinant in Freshood Express Store expansion strategy
Authors: Makumbe William , Tsikira Cuthbert
Published: September 2022

Learning outcomes

The learning outcomes of this study are as follows: 1) identifying challenges confronting small businesses in emerging markets using the SWOT framework; 2) the application of the Porter’s five forces model in analysing industry dynamics for small businesses; and 3) evaluating business expansion decisions using the force field analysis framework.

Case overview/synopsis

Freshood Express Store was a convenience store owned and managed by Mr Cuthbert Tsikira. Freshood Express Store operated grocery convenience stores in partnership with a government-owned fuel retailer in Zimbabwe. It operated two grocery convenience stores in Harare and Bindura. Its business environment was a complex and highly competitive industry with large retailers such as OK supermarkets and TM-Pick n Pay. These large retailers enjoyed massive discounts from powerful suppliers, which enabled them to charge low prices in the market. However, Freshood Express Store, as a small business, sourced their stock from the same suppliers on a cash basis. The playing field was thus uneven. In early 2021, Freshood Express Store was offered two sites to open new establishments. These two sites were more than 200 km out of Harare, the major supplier hub for Freshood Express. In addition, large retailers had existing operations in the two proposed sites, thus adding serious competition. The dilemma confronting Mr Tsikira was as follows: Could he direct limited resources to existing establishments or new markets? He wanted a sound business analysis of the attractiveness of the proposed two markets before making a management decision to invest resources. The case focuses on the need to perform industry analysis before making strategic decisions. The use of the Porter’s five forces model and the force field analysis model to validate decisions after an industry analysis is the high point of the case.

Complexity academic level

This case study can be used to teach the environmental analysis topic in emerging markets in the small business management course.

Supplementary materials

Teaching notes are available for educators only.

Subject code

CSS 11: Strategy.
Godrej commercial network contingency planning: in context COVID
Authors: Sharma Aasha Jayant , Samant Swapnil
Published: September 2022

Learning outcomes

This study aims to introduce students to uncontrolled and unprecedented business scenarios and strategies to deal with them, to make students understand the importance of contingency planning and create what-if scenarios, to step by step guide students how to build a network contingency planning tool and to enable students to use tools such as solver to build up a dashboard with given information.

Case overview/synopsis

The case is about Godrej Commercial, a vertical of Godrej and Boyce that handles warehousing and transportation support to five verticals under the banner of Godrej operating pan India. How Godrej is trying to deal with COVID pandemic, what were their coping strategies and how contingency planning is done is what this case is all about. The main focus of this case is understanding how network contingency planning is done and what parameters should be considered. How a dashboard can be developed that can be used as a base for taking strategic decisions related to networking given the uncertainties due to COVID. The case gives hands on to students to use solver and build a dash board, plus gives a peep into Godrej and its operations.

Complexity academic level

This study is suitable for students of undergraduate or first year MBA level. Specifically, the case can be used in business strategies, operations and supply chain management courses.

Supplementary materials

Teaching notes are available for educators only.

Subject code

CSS 9: Operations and Logistics.
Asymmetric determinants of Bitcoin's wild price movements
Authors: Benlagha Noureddine , Hemrit Wael
Published: September 2022

Purpose

The present work endeavors to explore the potential nonlinear and asymmetric effects of supply fundamental properties of Bitcoin mining process (velocity, size and stock of Bitcoins, cost of production and mining revenue), DJIA, VIX, economic policy uncertainty and Google Trend on the price of Bitcoin (PB).

Design/methodology/approach

The authors apply the Nonlinear Autoregressive Distributed lag (NARDL) approach for the period from November 31, 2013 to December 30, 2020.

Findings

The asymmetric effects of inflation, the size of Bitcoin economy, reveal a positive impact on the PB in the short and long run. In the short run, Bitcoin price shows negative statistically significant sensitivity to positive (negative) changes in DJIA (VIX) index. In addition, Google Trends have an impact on Bitcoin prices indicating that the Bitcoin market is also driven by investors' sentiments. In the long run, negative policy uncertainty shocks increase the PB while in the short run, negative shocks decrease it.

Originality/value

The authors give credence to the best ways of understanding the existence of asymmetries in the link between the PB and a number of influential macro-finance variables to improve the appropriate asset allocation and portfolio management.
Aiming for diversity of thought – a business view
Authors: Despierre Arnaud , Wang Kaifeng
Published: September 2022

Purpose

The purpose of this study is to provide a practical framework for business and human resources (HR) practitioners to drive diversity in their organizations in a manner that can promote better business results.

Design/methodology/approach

The authors’ team led personal one-on-one interviews with 31 global and regional chief executive officers (CEOs) of Asia-based businesses across a wide range of sectors. The authors distilled the qualitative content of these individual conversations into an overall framework, supported by anecdotal evidence and key lessons learned from the majority of respondents. It is also highlighted in this study where a common view could not be obtained on certain topics, though cases have been rare.

Findings

The authors found an overwhelming alignment on how CEOs think about how to promote diversity of thought in their organizations. At a high level, the authors agreed that this is a complex issue which cannot be easily measured and needs to be tackled by using a holistic approach across several dimensions. These include the need to use a context-based definition of diversity, the pitfalls of measuring diversity by using an overly narrow lens (e.g. gender or ethnic), the requirement to create a bias-free culture where diverse opinions can flourish and be listened to and the need for supporting HR systems and processes.

Originality/value

This study provides a comprehensive framework for companies to drive diversity of thought in their organizations. This approach goes beyond the commonly used methods of using targets and quotas to push for diversity and takes a holistic look at the issue including the roles that individual business leaders and company culture can play in the process.
Conclusion: what innovations would enable the tourism and hospitality industry to re-build?
Authors: Jayawardena Chandi
Published: September 2022

Purpose

This paper aims to provide answers to the question: “What innovations would enable the tourism and hospitality industry to re-build?”.

Design/methodology/approach

At the outset, it redefines the concept of ‘Innovation” in the context of the hospitality and tourism industry. It then focuses on post-pandemic re-building best practices in tourism and hospitality. It captures the essence of the articles in this theme issue collection on innovative actions from around the world and presents concluding remarks.

Findings

This article summarises the key findings of this theme issue and it draws generalized conclusions about re-building the tourism and hospitality industry. In conclusion, 14 key learning outcomes are presented. These include topics such as: rethinking tourism and hospitality products and services, sustaining resilience, collaboration between the government, academia and industry, special interest tourism, domestic tourism, crisis management, digital transformation, the health and safety of all stakeholders, operational efficiencies and environmental sustainability.

Research limitations/implications

This research contributes to the emerging research theme of tourism and hospitality post-pandemic re-building.

Practical implications

There are a number of practical implications in terms of industry approaches to the adoption of innovative strategies to re-build tourism and hospitality operations around the world.

Originality/value

Readers who are interested in international best practices of hospitality and tourism should find this concluding article of interest.
Quality of life among post-stroke Jordanian survivors: a prospective study
Authors: Alhalabi Marwa N. , Bani Hani Salam H.
Published: September 2022

Purpose

This study aims to assess the quality of life (QOL) and the related factors in patients post-stroke in Jordan.

Design/methodology/approach

Prospective, the cross-sectional study recruited 100 participants with stroke from three public hospitals from December 1, 2021 to February 1, 2022. Patients with stroke were interviewed to fill the stroke-specific quality of life questionnaire.

Findings

Forty-five per cent of the participants were male. More than half of the participants (53%) were married, and the average age of the participants was 63.6 (SD =3.8). Most of the participants had an ischemic stroke (86%) with an affected left side (65%). The overall QOL of the participants was leveling at (M = 123.5, SD = 45.2), which is a moderate level. It was found statistical significance differences among participants according to gender, type of stroke, affected side and presence of comorbidities (Table 1).

Research limitations/implications

There were some limitations in this study. First, this study was based on mild to moderate Jordanian stroke survivors and did not include critically ill stroke survivors; the QOL critically ill stroke survivors may differ, which could affect the generalizability of data among all stroke survivors. Second, this study is prospective, and this type of study is prone to bias that could influence the reliability of the results. It is recommended to conduct a mixed-method study to reveal an in-depth understanding of the associated factors with QOL, to ensure reliability and to reflect a better view of the Jordanian population.

Practical implications

To sum up, there is a reduction in the level of QOL among stroke survivors; hence, it is crucial to focus on detecting factors contributing to reducing the QOL and taking individual differences between sexes, type and location of the stroke, and comorbidities into consideration to develop a treatment plan that enhances the QOL and well-being for survivors of stroke.

Social implications

Taking individual differences between sexes, type and location of the stroke and comorbidities into consideration to develop a treatment plan that enhances the QOL and well-being of survivors of stroke.

Originality/value

The findings of this study bring a strong insight toward assessing the main factors indicating a decrease QOL among stroke survivors.