bluuebunny/crossref_metadata_2025 huggingface dataset:
Low-intensity shockwave therapy improves baseline erectile function: a randomized sham-controlled crossover trial
Authors: Kennady Emmett H , Bryk Darren J , Ali Marwan M , Ratcliffe Sarah J , Mallawaarachchi Indika V , Ostad Bahrom J , Beano Hamza M , Ballantyne Christopher C , Krzastek Sarah C , Clements Matthew B , Gray Mikel L , Rapp David E , Ortiz Nicolas M , Smith Ryan P
Published: November 2023

Background

Low-intensity shockwave therapy for erectile dysfunction is emerging as a promising treatment option.

Aim

This randomized sham-controlled crossover trial assessed the efficacy of low-intensity shockwave therapy in the treatment of erectile dysfunction.

Methods

Thirty-three participants with organic erectile dysfunction were enrolled and randomized to shockwave therapy (n = 17) or sham (n = 16). The sham group was allowed to cross over to receive shockwave therapy after 1 month.

Outcomes

Primary outcomes were the changes in Sexual Health Inventory for Men (SHIM) score and Erection Hardness Score at 1 month following shockwave therapy vs sham, and secondary outcomes were erectile function measurements at 1, 3, and 6 months following shockwave therapy.

Results

At 1 month, mean SHIM scores were significantly increased in the shockwave therapy arm as compared with the sham arm (+3.0 vs −0.7, P = .024). Participants at 6 months posttreatment (n = 33) showed a mean increase of 5.5 points vs baseline (P < .001), with 20 (54.6%) having an increase ≥5. Of the 25 men with an initial Erection Hardness Score <3, 68% improved to a score ≥3 at 6 months. When compared with baseline, the entire cohort demonstrated significant increases in erectile function outcomes at 1, 3, and 6 months after treatment.

Clinical Implications

In this randomized sham-controlled crossover trial, we showed that 54.6% of participants with organic erectile dysfunction met the minimal clinically important difference in SHIM scores after treatment with low-intensity shockwave therapy.

Strengths and Limitations

Strengths of this study include a sham-controlled group that crossed over to treatment. Limitations include a modest sample size at a single institution.

Conclusions

Low-intensity shockwave therapy improves erectile function in men with erectile dysfunction as compared with sham treatment, which persists even 6 months after treatment.

Clinical Trial Registration

ClinicalTrials.gov NCT04434352.
The unified patent court
Authors: Ullrich Hanns
Published: November 2023

On 1 June 2023, the Unified Patent Court (UPC) for the settlement of disputes relating to European patents and European patents with unitary effect opened its doors as a common court of those European Union (EU) Member States that, in 2012, had joined in an enhanced cooperation in the area of unitary patent protection, and then, in 2013, entered into an ‘Agreement on a Unified Patent Court’ (UPCA) that complements their cooperation and expands it to non-unitary European patents. Although the Court’s jurisdiction is strictly limited to the two main forms of actions that may be brought in the special field of patent protection—infringement and revocation—its establishment deserves an analytical evaluation from the perspective of general European Union law because it is the first time that Member States create a common court aside of the EU’s judicial system not only for the settlement of disputes arising under their own—national or internationally uniform—legal regimes, but also for a legal regime of Union law, the unitary protection of patents. In this regard, it is not so much the sheer size of the new court that attracts attention or the economic importance of the subject matter that comes under its exclusive jurisdiction, but the many fundamental issues and controversies that accompanied its creation and that are still extensively discussed in literature. Leaving aside doctrinal problems of a proper qualification of the UPC as a common court of Member States, the main concerns relate to (i) the need for and the risks of the (over-)specialization of the UPC as a technical expert court; (ii) the legitimacy and democratic deficits of the UPC as a jurisdiction the rules and operation of which are essentially determined through self-regulation by the patent law community; (iii) the difficulties of properly qualifying the nature of the rules of substantive law of both the EU’s Regulation on unitary patent protection and of the UPCA, the ambivalence of which seemingly allowing much room for interpretation and for curtailing the reach and primacy of Union law; (iv) the related problems of adequately defining the relationship between the UPC and the Court of Justice of the EU as regards safeguarding the autonomous and uniform interpretation of Union law; and (v), more generally, the structural imbalances within the EU’s judicial system that may result from the establishment of common courts of Member States the jurisdiction of which covers the very substance of a legal regime of the Union.
Integrating evolutionary theory and social–ecological systems research to address the sustainability challenges of the Anthropocene
Authors: Currie Thomas E. , Borgerhoff Mulder Monique , Fogarty Laurel , Schlüter Maja , Folke Carl , Haider L. Jamila , Caniglia Guido , Tavoni Alessandro , Jansen Raf E. V. , Jørgensen Peter Søgaard , Waring Timothy M.
Published: November 2023

The rapid, human-induced changes in the Earth system during the Anthropocene present humanity with critical sustainability challenges. Social–ecological systems (SES) research provides multiple approaches for understanding the complex interactions between humans, social systems, and environments and how we might direct them towards healthier and more resilient futures. However, general theories of SES change have yet to be fully developed. Formal evolutionary theory has been applied as a dynamic theory of change of complex phenomena in biology and the social sciences, but rarely in SES research. In this paper, we explore the connections between both fields, hoping to foster collaboration. After sketching out the distinct intellectual traditions of SES research and evolutionary theory, we map some of their terminological and theoretical connections. We then provide examples of how evolutionary theory might be incorporated into SES research through the use of systems mapping to identify evolutionary processes in SES, the application of concepts from evolutionary developmental biology to understand the connections between systems changes and evolutionary changes, and how evolutionary thinking may help design interventions for beneficial change. Integrating evolutionary theory and SES research can lead to a better understanding of SES changes and positive interventions for a more sustainable Anthropocene.

This article is part of the theme issue ‘Evolution and sustainability: gathering the strands for an Anthropocene synthesis’.
Continuities and discontinuities in the cultural evolution of global consciousness
Authors: Zhang Robert Jiqi , Liu James H. , Lee Michelle , Lin Mei-hua , Xie Tian , Chen Sylvia Xiaohua , Leung Angela K.-y. , Lee I-Ching , Hodgetts Darrin , Valdes Evan A. , Choi Sarah Y.
Published: November 2023

Global consciousness (GC), encompassing cosmopolitan orientation, global orientations (i.e. openness to multicultural experiences) and identification with all humanity, is a relatively stable individual difference that is strongly associated with pro-environmental attitudes and behaviours, less ingroup favouritism and prejudice, and greater pandemic prevention safety behaviours. Little is known about how it is socialized in everyday life. Using stratified samples from six societies, socializing institution factors correlating positively with GC were education, white collar work (and its higher income) and religiosity. However, GC also decreased with increasing age, contradicting a ‘wisdom of elders’ transmission of social learning, and not replicating typical findings that general prosociality increases with age. Longitudinal findings were that empathy-building, network-enhancing elements like getting married or welcoming a new infant, increased GC the most across a three-month interval. Instrumental gains like receiving a promotion (or getting a better job) also showed positive effects. Less intuitively, death of a close-other enhanced rather than reduced GC. Perhaps this was achieved through the ritualized management of meaning where a sense of the smallness of self is associated with growth of empathy for the human condition, as a more discontinuous or opportunistic form of culture-based learning.

This article is part of the theme issue ‘Evolution and sustainability: gathering the strands for an Anthropocene synthesis’.
Effectiveness of controlled atmosphere container on the freshness
of exported PMRsupia melon
Authors: Yang Haejo , Chang Min-Sun , Park Puehee , Eum Hyang Lan , Cho Jae-Han , Choi Ji Weon , Lim Sooyeon , Yun Yeo Eun , Choi Han Ryul , Park Me-Hea , Hong Yoonpyo , Lee Ji Hyun
Published: November 2023

This study investigates the effectiveness of CA (controlled atmosphere)
containers in maintaining the freshness of exported melons. The melons were
harvested on June 5, 2023, in the Yeongam area of Jeollanam-do, Korea. The CA
container was loaded with melon samples packed in an export box. The temperature
inside the container was set at 4°C, while the gas composition was set at
5% oxygen, 12% carbon dioxide, and 83% nintrogen. Following
two weeks of simulated transportation, quality analysis was conducted at
10°C. The melons were inoculated with spore suspensions, and the decay
rate was determined to investigate the effect of the gas composition inside the
CA container on suppressing the occurrence of Penicillium
oxalicum in melons. The results were compared with a Reefer
container set at the same temperature. The samples transported in the CA
container exhibited lower weight loss. The melon pulp softening, respiration
rate, and ethylene production were slower using the CA container. Moreover, the
decay rate during the distribution period in the CA container was lower than in
the Reefer container. In contrast, the firmness of melons transported in the
Reefer container decreased significantly (from 9.03N to 5.18N) immediately after
transportation. The soluble solid content (SSC) of melons transported in the
Reefer container also decreased rapidly. The results suggested that the CA
container is the optimal export container for maintaining the freshness of
melons.
Nutritional and functional constituents and antioxidant activity in
whole onion (Allium cepa L.) by growth stage
Authors: Lee Sun-Kyung , Lee You-Seok , Ji Soo-Hyun , Kim Pyo-Hyeon , Kim Ju-Hyun , Kim Seong-Jun , Ma Kyung-Cheol , Lee Jin-Woo
Published: November 2023

Onions are essential vegetables for Koreans’ diet and have various physiological
activities. However, problems arise every year due to the imbalance between
production and demand. Therefore, in this study, nutritional and functional
components, and antioxidant activity were analyzed for each growth period in
order to utilize onions at the disposal period. Whole onions harvested before
June showed higher values of general ingredients, inorganic ingredients, organic
acids, spiraeoside, quercetin, total chlorophyll, and antioxidant activity than
bulbs harvested in June. On the other hand, the free sugar content was higher in
the bulb of the harvest season in June than in whole onions. The total
thiosulfinate content was similar to that of whole onions and bulbs in the early
stages of growth. In addition, as a result of comparing the flavonoid compound
and antioxidant activity of each onion variety, whole onions harvested at 25
weeks were higher in content than onion bulbs harvested in June. In conclusion,
onions before the harvest season in June had excellent utilization value as
food. Harvesting before 21 weeks is desirable for growing onions with excellent
nutritional value, while harvesting after 23 weeks is recommended for excellent
functional components and antioxidant activity in onions.
Enzymatic preparation and antioxidant activities of protein
hydrolysates derived from tuna byproducts
Authors: Park Gyu-Hyeon , Lee Jeong-Min , Lim Na-Young , Lee Syng-Ook
Published: November 2023

This study aims to investigate the production and characteristics of protein
hydrolysates derived from tuna byproducts (TP) using various proteolytic enzymes
and to compare the antioxidant activity of the resulting hydrolysates. The TP
were subjected to enzymatic hydrolysis using five different proteases: alcalase,
bromelain, flavourzyme, neutrase, and papain, and the antioxidant activities of
the hydrolysates were evaluated. Subsequent analysis of the available amino
group contents and sodium dodecyl sulfate-polyacrylamide gel electrophoresis
patterns indicated a high degree of hydrolysis in TP after treatment with all
the enzymes, except for papain. Based on the RC50 values obtained
from four different antioxidant analyses, all the hydrolysates exhibited similar
antioxidant activity, except for the flavourzyme hydrolysate, which showed
significantly higher scavenging activity against ABTS radicals and hydrogen
peroxide than the other hydrolysates. These findings suggest that protein
hydrolysates derived from TP hold promise as potential sources of natural
antioxidants.
Applying machine learning to identify ionizable lipids for nanoparticle-mediated delivery of mRNA
Authors: Lewis Mae M. , Beck Travis J. , Ghosh Debadyuti
Published: November 2023

mRNA lipid nanoparticles (LNPs) have a tremendous potential to treat, cure, or prevent many diseases. To identify promising candidates for each application, most studies screen dozens to hundreds of formulations with ionizable lipids synthesized using a single type of chemistry. However, this technique leaves the ionizable lipids synthesized through multi-step chemistries underexplored. This gap in the repertoire of structures is of particular significance because it affects the screening of analogs that are structurally similar to SM-102 and ALC-0315, the ionizable lipids used to formulate the clinically approved mRNA LNP COVID-19 vaccines. Herein, we address this by employing LightGBM, a machine learning algorithm, to reduce the burden of screening these types of ionizable lipids by learning from the breadth and diversity of lipids that have already been tested. We first evaluate the ability of LightGBM to predict LNP potency across heterogeneous chemistries from different studies to achieve an R2of 0.94. After establishing the predictive capacity of the model, we then identify the number of outside carbons in the ionizable lipid as the most important factor contributing to transfection efficiency. From this finding, we subsequently apply the algorithm to predict the effect of formulating nanoluciferase mRNA LNPs using analogs of SM-102 and ALC-0315 with small changes in the number of outside carbons on luciferase activity in HEK293T cells and achieve an R2of 0.83. Importantly, this correlation encompasses novel lipids not included within the database used to train the algorithm. Overall, this study demonstrates the potential of machine learning to accelerate the development of new ionizable lipids by simplifying the screening process.
Three-dimensional electro-neural interfaces electroplated on subretinal prostheses
Authors: Butt Emma , Wang Bing-Yi , Shin Andrew , Chen Zhijie Charles , Bhuckory Mohajeet , Shah Sarthak , Galambos Ludwig , Kamins Theodore , Palanker Daniel , Mathieson Keith
Published: November 2023

Objective

High-resolution retinal prosthetics offer partial restoration of sight to patients blinded by retinal degenerative diseases through electrical stimulation of the remaining neurons. Decreasing the pixel size enables an increase in prosthetic visual acuity, as demonstrated in animal models of retinal degeneration. However, scaling down the size of planar pixels is limited by the reduced penetration depth of the electric field in tissue. We investigate 3-dimensional structures on top of the photovoltaic arrays for enhanced penetration of electric field to permit higher-resolution implants.

Approach

We developed 3D COMSOL models of subretinal photovoltaic arrays that accurately quantify the device electrodynamics during stimulation and verified it experimentally through comparison with the standard (flat) photovoltaic arrays. The models were then applied to optimise the design of 3D electrode structures (pillars and honeycombs) to efficiently stimulate the inner retinal neurons. The return electrodes elevated on top of the honeycomb walls surrounding each pixel orient the electric field inside the cavities vertically, aligning it with bipolar cells for optimal stimulation. Alternatively, pillars elevate the active electrode into the inner nuclear layer, improving proximity to the target neurons. Modelling results informed a microfabrication process of electroplating the 3D electrode structures on top of the existing flat subretinal prosthesis.

Main results

Simulations demonstrate that despite the conductive sidewalls of the 3D electrodes being exposed to electrolyte, most of the charge flows via the high-capacitance sputtered Iridium Oxide film that caps the top of the 3D structures. The 24 µm height of the electroplated honeycomb structures was optimised for integration with the inner nuclear layer cells in rat retina, while 35 µm height of the pillars was optimized for penetrating the debris layer in human patients. Release from the wafer and implantation of the 3D arrays demonstrated that they are mechanically robust to withstand the associated forces. Histology demonstrated successful integration of the 3D structures with the rat retina in-vivo.

Significance

Electroplated 3D honeycomb structures produce a vertically oriented electric field that offers low stimulation threshold, high spatial resolution and high contrast for the retinal implants with pixel sizes down to 20µm in width. Pillar electrodes offer an alternative configuration for extending the stimulation past the debris layers. Electroplating of the 3D structures is compatible with the fabrication process of the flat photovoltaic arrays, thereby enabling much more efficient stimulation than in their original flat configuration.
The influence of internal pressure and neuromuscular agents onC. elegansbiomechanics: an empirical and multi-compartmentalin silicomodelling study
Authors: Essmann Clara L. , Elmi Muna , Rekatsinas Christoforos , Chrysochoidis Nikolaos , Shaw Michael , Pawar Vijay , Srinivasan Mandayam A. , Vavourakis Vasileios
Published: November 2023

The function of a specific tissue and its biomechanics are interdepended, with pathologies or ageing often being intertwined with structural decline. The biomechanics of Caenorhabditis elegans (C. elegans), a model organism widely used in pharmacological and ageing research, has been established as biomarker for healthy ageing, though the mechanics of individual tissues have remained elusive. In this study we investigated the biomechanics of healthyC. eleganscuticle, muscle tissue, and pseudocoelom using a combination of indentation experiments andin silicomodelling. Nematode stiffness measurements were performed using an atomic force microscope. The worm’s cylindrical body was approximated using a novel three-compartmental nonlinear finite element model, enabling analysis of how changes in the elasticity of individual compartments affect the bulk stiffness ofC. elegans. The parameters of the model were then fine-tuned to match the simulation force-indentation output to the experimental data. To test the finite element model, distinct compartments were modified experimentally. Ourin silicoresults, in agreement with previous studies, suggest that hyperosmotic shock reduced stiffness by decreasing theC. elegans’ internal pressure. Unexpectedly, treatment with the neuromuscular agent aldicarb, traditionally associated with muscle contraction, reduced stiffness by decreasing the internal pressure. It challenges previous assumptions about the effects of aldicarb. Furthermore, our finite element model can offer insights into how drugs, mutations or processes like ageing target individual tissues.
Olanzapine, Risperidone and Clozapine prescribing is associated with increased risk for Alzheimer’s Disease reflecting antipsychotic-specific effects on microglial phagocytosis
Authors: Mondal Mrityunjoy , Solomon Shiden , Sun Jiangwei , Sampathkumar Nirmal Kumar , Carre Ivo , Cotel Marie-Caroline , Mehta Puja R. , Rajendran Lawrence , Vernon Anthony C. , Fang Fang , Mitchell Jacqueline
Published: November 2023

Epidemiological data provides evidence for a positive correlation between schizophrenia diagnosis and an increased risk to develop dementia. Whether and how use of antipsychotic medication may contribute to this association is however unknown. We therefore conducted a pharmaco-epidemiological study based on Swedish Patient and Prescribed Drug Registers to investigate the effect of three antipsychotics, Olanzapine, Risperidone, and Clozapine, on dementia risk. Our data suggest that prescription of all three antipsychotics is significantly associated with increased risk of Alzheimer’s disease (AD) and other dementias including vascular dementia. To provide a nexus of causality to this association, we explored the impact of these drugs on microglia and neurons using cells derived from human induced pluripotent stem cells (hiPSCs). Acute exposure to Olanzapine and Risperidone did not significantly alter amyloid-β (Aβ) production in hiPSC-derived cortical neurons, but suppressed hiPSC-derived microglial-mediated Aβ clearance, leading to Aβ accumulation. Neither Olanzapine nor Risperidone had any significant effect on hiPSC-derived microglial synaptosome phagocytosis. Conversely, Clozapine significantly reduced Aβ production in neurons, and increased microglial uptake of Aβ but also synaptosomes, consistent with higher lysosomal levels in Clozapine-exposed hiPSC-derived microglia. These data provide the first evidence that antipsychotics prescribed to individuals with schizophrenia are associated with increased risk for dementia and suggest potential cellular bases for this effect via the modulation of microglia uptake of Aβ and synapses in a drug specific manner.
Misclassification of yellow fever vaccination status revealed through hierarchical Bayesian modeling
Authors: Tran Quan Minh , Perkins T. Alex
Published: November 2023

Vaccination coverage estimates are crucial inputs to decisions about investments in vaccination, yet they can be prone to inaccuracies. At the individual level, inaccuracies can be described in terms of the sensitivity and specificity of vaccination status. We estimated these quantities using a hierarchical Bayesian analysis of data from a test-negative study design with reported yellow fever vaccination status as the exposure. Our analysis accounted for the possibility of misclassification of both the exposure and the test at the country level. Across all countries, our median estimates of the sensitivity and specificity of vaccination status were 0.69 (95% credible interval [CrI]: 0.21-0.98) and 0.70 (95% CrI: 0.21-0.98), respectively. Median estimates at the country level ranged from 0.06 (95% CrI: 0.04-0.09) to 0.96 (95% CrI: 0.94-0.98) for sensitivity, and from 0.15 (95% CrI: 0.09-0.23) to 0.98 (95% CrI: 0.90-1.00) for specificity. This suggests that there is substantial misclassification of yellow fever vaccination status in general and extensive variation in misclassification across countries. Taking into account misclassification in vaccination status, we made adjustments to reported vaccination coverage and showed that reported coverage may be significantly underestimated in 10 out of 20 countries and significantly overestimated in 5 out of 20.
Endonucleosis mediates internalization of cytoplasm into the nucleus in senescent cells
Authors: Galanopoulou Ourania , Tachmatzidi Evangelia C. , Deligianni Elena , Botskaris Dimitris , Nikolaou Kostas C. , Gargani Sofia , Dalezios Yannis , Chalepakis Georges , Talianidis Iannis
Published: November 2023

Cellular senescence is driven by diverse effector programs, leading to irreversible growth arrest, DNA damage and complex secretomes. Here we show that, in liver-specific Setd8-KO mice, after mitogen treatment, a significant number of hepatocytes become senescent and display unusual features such as enlarged nuclei, chromosomal hyperploidy and nuclear engulfments progressing to the formation of intranuclear vesicles. These vesicles contain glycogen, cytoplasmic proteins and even entire organelles. We term this process “endonucleosis”. Experiments with Setd8/Atg5 double knockout mice, demonstrated that endonucleosis requires the function of the autophagy machinery. Endonucleosis and hyperploidization are temporary, early features of senescence. Larger vesicles brake down into microvesicles over time and are eventually eliminated. The results reveal a senescence phenotype, which function as part of survival mechanisms to prevent necrotic death.
Quantity or quality? The effect of green finance on enterprise green technology innovation
Authors: Li Xin , Wang Siwei , Lu Xue , Guo Fei
Published: November 2023

Purpose

This paper aims to explore the impact of green finance on the heterogeneity of enterprise green technology innovation and the underlying mechanism between them.

Design/methodology/approach

Using the data of China's A-share listed enterprises from 2008 to 2020 and the fixed effect model, the authors empirically explore the relationship and mechanism between green finance and green technology innovation by constructing the green finance index while considering both the quality and quantity of innovation.

Findings

The study suggests that green finance is positively related to the quality and quantity of enterprise green technology innovation, while green finance is more effective in stimulating the quality of green technology innovation than quantity. In addition, alleviating financial mismatch and improving the quality of environmental information disclosure are core mechanisms during the process of green finance facilitating green technology innovation. Furthermore, green finance exerts a more positive effect on the quality and quantity of green technology innovation with large-size enterprises, heavily polluting industries and enterprises in the eastern region.

Originality/value

This paper enriches the literature on green finance and green technology innovation and provides practical significance for green finance implementation.
Does prior trust work as a buffer? Examining the impact of perceived betrayal on customer responses to a double deviation
Authors: Temessek Behi Azza , Ben Dahmane Mouelhi Norchene , Chaouali Walid
Published: November 2023

Purpose

This study aims to explain customer reactions to a double deviation by examining the moderating role of prior trust in peer-to-peer (P2P) accommodation platforms on the relationship between perceived betrayal and negative outcomes such as negative word-of-mouth (NWOM), vindictive complaining and patronage reduction.

Design/methodology/approach

An online survey was used to obtain a sample of 246 respondents familiar with P2P accommodation platforms. The model was tested using SmartPLS.

Findings

The results showed a positive correlation between perceived betrayal and NWOM, vindictive complaining and patronage reduction. Unexpectedly, prior trust had positive moderating effects. High levels of prior trust caused more negative customer reactions than low levels of prior trust.

Practical implications

The findings of this study caution firms about the potential risks to rely on the forgiveness and tolerance of highly trusted customers who may retaliate fiercely to double deviations.

Originality/value

This research unveils the prior trust paradox. Customers' prior trust magnified the negative impact of double-deviation experiences. This study contributes to the service-recovery literature by questioning the buffer effect of prior trust in the context of a double deviation.
Further investigations into performance variance on the Multiple Errands Test
Authors: Scarff Shannon , Gullo Hannah L. , Nalder Emily J. , Fleming Jennifer
Published: November 2023

Introduction

The Multiple Errands Test (MET) is a complex, performance‐based assessment that is useful for characterising the impact of impairments of executive function on everyday activities. However, performance variance amongst those without neurological pathology, and the impact of non‐cognitive factors on this, requires further investigation.

Methods

This was a cross‐sectional analytic study, conducted with a convenience sample of 40 neurologically intact community‐dwelling Australian adults. Participants completed a hospital or shopping centre version of the MET, where their Performance Efficiency, Task Completions and Rule Breaks were recorded. Non‐cognitive factors of interest were demographic (age, sex and education), psychological (measured with the Hospital Anxiety and Depression Scale and self‐ratings of test anxiety) and assessment‐related (assessment site, self‐reported site familiarity and observed strategy use). MET performance was analysed using descriptive statistics. A series of standard multiple and binary logistic regression analyses examined the relationships between MET performance and non‐cognitive factors.

Results

Most participants (n = 35, 87.5%) completed at least 10 of the 12 prescribed tasks and broke an average of four rules (SD = 2.36). They achieved an average performance efficiency rating of 0.75/1 (SD = 0.15), suggesting variability in the extent to which participants made non‐essential location stops and/or failed to complete tasks whilst at an essential location. The assessment site and participant site familiarity had a statistically significant (p < 0.05) impact on Performance Efficiency and Task Completion scores, and psychological factors had a statistically significant (p < 0.05) relationship with Rule Breaks.

Conclusion

Findings suggest that the impact of factors other than cognition should be considered when interpreting MET performance. The assessment site and participant site familiarity may contribute to significant variability in Performance Efficiency scores. Clinicians should also be aware of the potential impact of these assessment‐related factors on Task Completions and psychological distress on Rule Breaks.
‘Selective historians’: The construction of cisness in Byzantine and Byzantinist texts
Authors: Maude Ilya
Published: November 2023

Far from being a natural, prelapsarian state, cisness is a hegemonic ideal of gender performance demanded of all people. This article explores the construction of cisness in the field of Byzantine studies, and the historiographical tropes through which it is maintained, naturalised and made invisible. It uses analysis of hegemonic cisness in Byzantine studies to suggest new avenues of investigation for Byzantine gender history. It proposes ‘cisness’ as method; a focal point for historical and historiographical investigation. It asks, was there cisness in Byzantium? If so, did it resemble ours?
Studies in children with obesity in two European treatment centres show a high prevalence of impaired glucose metabolism in the Swedish cohort
Authors: Ciba Iris , Dahlbom Marie , Manell Hannes , Mörwald Katharina , Roomp Kirsten , Weghuber Daniel , Bergsten Peter , Forslund Anders
Published: November 2023

Aim

To investigate the prevalence and possible risk factors for the development of impaired glucose metabolism in children and adolescents with obesity.

Methods

This was a cross‐sectional retrospective cohort study, including 634 patients with obesity and 98 normal weight controls aged 4–18 years from the Beta‐cell function in Juvenile Diabetes and Obesity (Beta‐JUDO) cohort, a dual‐centre study at Uppsala University Hospital (Sweden) and Paracelsus Medical University Hospital (Salzburg, Austria) conducted between 2012 and 2021. A longitudinal subgroup analysis, including 188 of these subjects was performed. Impaired glucose metabolism was diagnosed by oral glucose tolerance tests according to American Diabetes Association criteria.

Results

The prevalence of impaired glucose metabolism was 72% in Uppsala patients, 24% in Salzburg patients, 30% in Uppsala controls and 13% in Salzburg controls. The prevalence was lower at the follow‐up visits compared with baseline both in Uppsala and Salzburg patients. A family history of type 2 diabetes showed the strongest association with impaired glucose metabolism at the follow‐up visits besides belonging to the Uppsala cohort.

Conclusion

The prevalence of impaired glucose metabolism was extraordinarily high in Swedish children and adolescents with obesity, but decreased during the follow‐up period.
Predictors of response and adherence to enuresis alarm therapy—a confirmatory study
Authors: Bergsten Amadeus , Larsson Jens , Borgström Malin , Karanikas Birgitta , Nevéus Tryggve
Published: November 2023

Aim

To look for predictors to response and adherence to the enuresis alarm while exploring the possibility of families managing therapy independently.

Methods

We used a body‐worn alarm linked to a smartphone app. Subjects with enuresis were recruited both via paediatric nurses and independently as families bought the alarm and downloaded the app on their own.

Results

We recruited 385 nurse‐supported and 1125 independent subjects. Many (79.9%) dropped out before 8 weeks, but among adherent subjects 48.2% had a full or partial response. Age was a predictor of non‐response (p = 0.019). Daytime incontinence did not influence response. If enuresis frequency did not decrease during the first 4 weeks of therapy the chance of response was very small (p < 0.001). Adherence was higher among subjects supported by a nurse (p < 0.001), but for adherent subjects the outcome was similar regardless of nurse support (p = 0.554).

Conclusions

Daytime incontinence is no contraindication to enuresis alarm therapy. Treatment can be managed independently by the families, but adherence is enhanced by nurse support. Alarm treatment should be reassessed after 4 weeks. Enuresis alarm treatment guidelines need to be updated.
Asymmetric response of domestic production to exchange rate changes: Evidence from southeast Asian countries
Authors: Nosheen Misbah , Chohan Beenish , Iqbal Javed , Wohar Mark
Published: November 2023

This study explores the asymmetric effects of real effective exchange rate variation on domestic output in nine South East Asian nations. The study is the first thorough study on this issue for these countries. The results show that exchange rate fluctuations have asymmetric long‐run and short‐run effects on production in most nations. However, the findings vary across nations. Appreciation has a contractionary effect on production in most countries, while depreciation has an expansionary effect. In certain economies, an appreciation boosts domestic output whereas a depreciation diminishes it. Such conclusions can only be reached if appreciations and depreciations are separated, using non‐linear models.
Survival outcomes in patients with acute myeloid leukaemia who received subsequent therapy for relapse in QUAZAR AML‐001
Authors: Ravandi Farhad , Döhner Hartmut , Wei Andrew H. , Montesinos Pau , Pfeilstöcker Michael , Papayannidis Cristina , Lai Yinzhi , Wang Kefeng , See Wendy L. , de Menezes Daniel Lopes , Petrlik Erica , Prebet Thomas , Roboz Gail J.
Published: November 2023

In the phase 3 QUAZAR AML‐001 trial (NCT01757535) of patients with acute myeloid leukaemia (AML) in remission following intensive chemotherapy (IC) and ineligible for haematopoietic stem cell transplant (HSCT), oral azacitidine (Oral‐AZA) maintenance significantly prolonged overall survival (OS) versus placebo. The impact of subsequent treatment following maintenance has not been evaluated. In this post hoc analysis, OS was estimated for patients who received subsequent AML therapy, and by regimen received (IC or lower‐intensity therapy). First subsequent therapy (FST) was administered after treatment discontinuation in 134/238 Oral‐AZA and 173/234 placebo patients. OS from randomization in patients who received FST after Oral‐AZA versus placebo was 17.8 versus 12.9 months (HR: 0.82 [95% CI: 0.64–1.04], median follow‐up: 56.7 months); OS from FST was similar between arms. Among patients who received injectable hypomethylating agents as FST, median OS was 8.2 versus 4.9 months in the Oral‐AZA versus placebo groups (HR: 0.66 [95% CI: 0.41–1.06]). Forty‐eight patients (16/238 Oral‐AZA, 32/234 placebo) received HSCT following treatment discontinuation, including six Oral‐AZA patients still in first remission; Oral‐AZA OS benefit persisted when censoring these patients. Oral‐AZA maintenance can prolong AML remission duration without negatively impacting survival outcomes after salvage therapies.
When pro‐poor microcredit institutions favour richer borrowers: A moral hazard story
Authors: Biancini Sara , Ettinger David , Venet Baptiste
Published: November 2023

We suggest an explanation for the existence of “mission drift,” the tendency for Microfinance Institutions (MFIs) to lend money to wealthier borrowers rather than to the very poor. We focus on the relationship between MFIs and external funding institutions. We assume that both the MFIs and the funding institutions are pro‐poor. However, asymmetric information on the effort chosen by the MFI to identify higher‐quality projects may increase the share of loans attributed to wealthier borrowers. This occurs because funding institutions have to build incentives for MFIs, creating a trade‐off between the quality of the funded projects and the attribution of loans to poorer borrowers.
Role of brain renin–angiotensin system in depression: A new perspective
Authors: Ali Naif H. , Al‐Kuraishy Hayder M. , Al‐Gareeb Ali I. , Albuhadily Ali K. , Hamad Rabab S. , Alexiou Athanasios , Papadakis Marios , Saad Hebatallah M. , Batiha Gaber El‐Saber
Published: November 2023

Depression is a mood disorder characterized by abnormal thoughts. The pathophysiology of depression is related to the deficiency of serotonin (5HT), which is derived from tryptophan (Trp). Mitochondrial dysfunction, oxidative stress, and neuroinflammation are involved in the pathogenesis of depression. Notably, the renin–angiotensin system (RAS) is involved in the pathogenesis of depression, and different findings revealed that angiotensin‐converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) may be effective in depression. However, the underlying mechanism for the role of dysregulated brain RAS‐induced depression remains speculative. Therefore, this review aimed to revise the conceivable role of ACEIs and ARBs and how these agents ameliorate the pathophysiology of depression. Dysregulation of brain RAS triggers the development and progression of depression through the reduction of brain 5HT and expression of brain‐derived neurotrophic factor (BDNF) and the induction of mitochondrial dysfunction, oxidative stress, and neuroinflammation. Therefore, inhibition of central classical RAS by ARBS and ACEIs and activation of non‐classical RAS prevent the development of depression by regulating 5HT, BDNF, mitochondrial dysfunction, oxidative stress, and neuroinflammation.
Fashionable protection gear: Understanding mask wearing practices through protection motivation theory
Authors: An Su Kyoung , Kumphai Pimpawan , Gam Hae Jin , Lee Dong Donald
Published: November 2023

Amid the COVID‐19 pandemic, face masks gained significance alongside handwashing and physical distancing, as recommended by the Center for Disease Control and Prevention (2020). Our study focused on consumers' willingness to purchase and wear specific masks, employing the protection motivation theory. We utilized the Functional, Expressive, and Aesthetic (FEA) framework to identify distinct mask types. The research revealed that the protection motivation theory effectively explains design‐oriented mask‐wearing practices identified by the FEA framework. The findings emphasize the importance of considering both protection and self‐expression aspects while developing fashionable masks, targeting specific consumer groups through tailored advertising strategies.
Baited remote underwater video stations as a potential tool for assessing coastal rocky fishes in Chile
Authors: Irigoyen Alejo J. , Flores Andrés , Gacitúa Santiago , Merlo Pablo , Wiff Rodrigo , Canales T. Mariella
Published: November 2023

Coastal rocky fish species support important fishing activities, but basic information is lacking for many before catches decline. Monitoring and management of coastal rocky fish species is urgently needed in Chile, but knowledge of these species is fragmentary at best. Performance of Baited Remote Underwater Video Stations (BRUVS) for assessing rocky fish assemblages was evaluated in south‐central Chile. Seven medium‐ to large‐sized exploited species dominated fish assemblages in the survey area, including five small cryptic rocky reef fishes, one agnathan and a catshark species. These seven species represented 78% of the species targeted by commercial fishing in the survey area. Furthermore, this tool provided new information on behaviour of rocky fish species. The simple, inexpensive and light nature of single‐camera BRUVS may be crucial for maintaining monitoring programs along remote areas of Chile.
Interactions among acute respiratory viruses in Beijing, Chongqing, Guangzhou, and Shanghai, China, 2009–2019
Authors: Madewell Zachary J. , Wang Li‐Ping , Dean Natalie E. , Zhang Hai‐Yang , Wang Yi‐Fei , Zhang Xiao‐Ai , Liu Wei , Yang Wei‐Zhong , Longini Ira M. , Gao George F. , Li Zhong‐Jie , Fang Li‐Qun , Yang Yang ,   The Chinese Centers for Disease Control and Prevention (CDC) Etiology of Respiratory Infection Surveillance Study Team
Published: November 2023

Background

A viral infection can modify the risk to subsequent viral infections via cross‐protective immunity, increased immunopathology, or disease‐driven behavioral change. There is limited understanding of virus–virus interactions due to lack of long‐term population‐level data.

Methods

Our study leverages passive surveillance data of 10 human acute respiratory viruses from Beijing, Chongqing, Guangzhou, and Shanghai collected during 2009 to 2019: influenza A and B viruses; respiratory syncytial virus A and B; human parainfluenza virus (HPIV), adenovirus, metapneumovirus (HMPV), coronavirus, bocavirus (HBoV), and rhinovirus (HRV). We used a multivariate Bayesian hierarchical model to evaluate correlations in monthly prevalence of test‐positive samples between virus pairs, adjusting for potential confounders.

Results

Of 101,643 lab‐tested patients, 33,650 tested positive for any acute respiratory virus, and 4,113 were co‐infected with multiple viruses. After adjusting for intrinsic seasonality, long‐term trends and multiple comparisons, Bayesian multivariate modeling found positive correlations for HPIV/HRV in all cities and for HBoV/HRV and HBoV/HMPV in three cities. Models restricted to children further revealed statistically significant associations for another ten pairs in three of the four cities. In contrast, no consistent correlation across cities was found among adults. Most virus–virus interactions exhibited substantial spatial heterogeneity.

Conclusions

There was strong evidence for interactions among common respiratory viruses in highly populated urban settings. Consistent positive interactions across multiple cities were observed in viruses known to typically infect children. Future intervention programs such as development of combination vaccines may consider spatially consistent virus–virus interactions for more effective control.
Antibiotic prescription for outpatients with influenza and subsequent hospitalisation: A cohort study using insurance data
Authors: Yokomichi Hiroshi , Mochizuki Mie , Lee Joseph Jonathan , Kojima Reiji , Horiuchi Sayaka , Ooka Tadao , Yamagata Zentaro
Published: November 2023

Background

Whether prophylactic administration of antibiotics to patients with influenza reduces the hospitalisation risk is unknown. We aimed to examine the association between antibiotic prescription in outpatients with influenza infection and subsequent hospitalisation.

Methods

We conducted a cohort study using health insurance records of Japanese clinic and hospital visits between 2012 and 2016. Participants were outpatients (age, 0–74 years) with confirmed influenza infection who were prescribed anti‐influenza medicine. The primary outcomes were the hospitalisation risk from all causes and pneumonia and the duration of hospitalisation due to pneumonia.

Results

We analysed 903,104 outpatient records with 2469 hospitalisations. The risk of hospitalisation was greater in outpatients prescribed anti‐influenza medicine plus antibiotics (0.31% for all causes and 0.18% for pneumonia) than in those prescribed anti‐influenza medicine only (0.27% and 0.17%, respectively). However, the risk of hospitalisation was significantly lower in patients prescribed peramivir and antibiotics than in those prescribed peramivir only. Patients who received add‐on antibiotics had a significantly longer hospital stay (4.12 days) than those who received anti‐influenza medicine only (3.77 days). In all age groups, the hospitalisation risk from pneumonia tended to be greater in those who received antibiotics than in those prescribed anti‐influenza medicine only. However, among older patients (65–74 years), those provided add‐on antibiotics had an average 5.24‐day shorter hospitalisation due to pneumonia than those provided anti‐influenza medicine only (not significant).

Conclusions

In outpatient cases of influenza, patients who are prescribed antibiotics added to antiviral medicines have a higher risk of hospitalisation and longer duration of hospitalisation due to pneumonia.
Governance, tourism and inclusive growth in Africa
Authors: Dossou Toyo A. M. , Asongu Simplice A. , Kambaye Emmanuelle N. , Dossou Kouessi P. , Alinsato Alastaire S.
Published: November 2023

The use of Gross Domestic Product (GDP) per capita as a measure of economic growth has been recently subject to wide criticism by many economists. It has been observed that although some countries have experienced economic growth in recent years, income inequality and poverty continue to be exacerbated. Recently, sustainable development goal 8 has been geared to promote inclusive growth. Considering this fact, this study expands the literature by examining the relationship between tourism development and inclusive growth for a panel of 44 African countries over the period 2000–2020. Further, the study also adds to the literature by examining the moderation of governance quality on the tourism‐inclusive growth nexus. The investigation is made using the generalized method of moments as an estimation technique. The result indicates that tourism and governance quality appear to promote inclusive growth. Moreover, the results indicate that good quality of institutions or governance could complement tourism development to promote inclusive growth, as positive synergies are apparent from the role of governance in moderating the incidence of tourism on inclusive growth. Policy implications are discussed.