bluuebunny/crossref_metadata_2025 huggingface dataset:
Shared and distinct abnormalities of brain magnetization transfer ratio in schizophrenia and major depressive disorder: a comparative voxel-based meta-analysis
Authors: Lan Huan , Suo Xueling , Zuo Chao , Ni Weishi , Wang Song , Kemp Graham J. , Gong Qiyong
Published: September 2023

Background:

Patients with schizophrenia (SCZ) and major depressive disorder (MDD) share significant clinical overlap, although it remains unknown to what extent this overlap reflects shared neural profiles. To identify the shared and specific abnormalities in SCZ and MDD, we performed a whole-brain voxel-based meta-analysis using magnetization transfer imaging, a technique that characterizes the macromolecular structural integrity of brain tissue in terms of the magnetization transfer ratio (MTR).

Methods:

A systematic search based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was conducted in PubMed, EMBASE, International Scientific Index (ISI) Web of Science, and MEDLINE for relevant studies up to March 2022. Two researchers independently screened the articles. Rigorous scrutiny and data extraction were performed for the studies that met the inclusion criteria. Voxel-wise meta-analyses were conducted using anisotropic effect size-signed differential mapping with a unified template. Meta-regression was used to explore the potential effects of demographic and clinical characteristics.

Results:

A total of 15 studies with 17 datasets describing 365 SCZ patients, 224 MDD patients, and 550 healthy controls (HC) were identified. The conjunction analysis showed that both disorders shared higher MTR than HC in the left cerebellum (P=0.0006) and left fusiform gyrus (P=0.0004). Additionally, SCZ patients showed disorder-specific lower MTR in the anterior cingulate/paracingulate gyrus, right superior temporal gyrus, and right superior frontal gyrus, and higher MTR in the left thalamus, precuneus/cuneus, posterior cingulate gyrus, and paracentral lobule; and MDD patients showed higher MTR in the left middle occipital region. Meta-regression showed no statistical significance in either group.

Conclusions:

The results revealed a structural neural basis shared between SCZ and MDD patients, emphasizing the importance of shared neural substrates across psychopathology. Meanwhile, distinct disease-specific characteristics could have implications for future differential diagnosis and targeted treatment.
Global, regional, and national burden of hypertensive heart disease among older adults in 204 countries and territories between 1990 and 2019: a trend analysis
Authors: Yang Ruixue , Zhang Xun , Bai Jingjing , Wang Lu , Wang Wenjie , Cai Jun
Published: September 2023

Background:

Hypertensive heart disease (HHD) poses a public health challenge, but data on its burden and trends among older adults are scarce. This study aimed to identify trends in the burden of HHD among older adults between 1990 and 2019 at the global, regional, and national levels.

Methods:

Using the Global Burden of Diseases study 2019 data, we assessed HHD prevalence, death, and disability-adjusted life-year (DALY) rates for individuals aged 60–89 years at the global, regional, and national levels and estimated their average annual percentage changes (AAPCs) between 1990 and 2019 using joinpoint regression analysis.

Results:

In 2019, there were 14.35 million HHD prevalent cases, 0.85 million deaths, and 14.56 million DALYs in older adults. Between 1990 and 2019, the prevalence of HHD increased globally {AAPC, 0.38 (95% confidence interval [CI], 0.36, 0.41)} with decreases observed in mortality (AAPC, –0.83 [95% CI, –0.99, –0.66]) and the DALY rate (AAPC, –1.03 [95% CI, –1.19, –0.87]). This overall global trend pattern was essentially maintained for sex, age group, and sociodemographic index (SDI) quintile except for non-significant changes in the prevalence of HHD in those aged 70–74 years and in the middle SDI quintile. Notably, males had a higher HHD prevalence rate. However, HHD-related mortality and the DALY rate were higher in females. The middle SDI quintile experienced the largest decreases in mortality and the DALY rate, with a non-significant decline in prevalence between 1990 and 2019. There were significant discrepancies in the HHD burden and its trends across regions and countries.

Conclusions:

In the past three decades, there has been an overall increasing trend in the prevalence of HHD among older adults worldwide despite decreasing trends in mortality and the DALY rate. Better management of hypertension, and prevention and control of HHD are needed in older adults.
Diagnostic Accuracy of a Trauma Risk Assessment Tool Among Geriatric Patients With Crash Injuries
Authors: Adeyemi Oluwaseun John , Gibbons Kester , Schwartz Luke B. , Meltzer-Bruhn Ariana T. , Esper Garrett W. , Grudzen Corita , DiMaggio Charles , Chodosh Joshua , Egol Kenneth A. , Konda Sanjit R.
Published: September 2023

The Score for Trauma Triage in the Geriatric and Middle-Aged (STTGMA) is a risk stratification tool. We evaluated the STTGMA's accuracy in predicting 30-day mortality and the odds of unfavorable clinical trajectories among crash-related trauma patients. This retrospective cohort study (n = 912) pooled adults aged 55 years and older from a single institutional trauma database. The data were split into training and test data sets (70:30 ratio) for the receiver operating curve analysis and internal validation, respectively. The outcome variables were 30-day mortality and measures of clinical trajectory. The predictor variable was the high-energy STTGMA score (STTGMAHE). We adjusted for the American Society of Anesthesiologists Physical Status. Using the training and test data sets, STTGMAHE exhibited 82% (95% CI: 65.5–98.3) and 96% (90.7–100.0) accuracies in predicting 30-day mortality, respectively. The STTGMA risk categories significantly stratified the proportions of orthopedic trauma patients who required intensive care unit (ICU) admissions, major and minor complications, and the length of stay (LOS). The odds of ICU admissions, major and minor complications, and the median difference in the LOS increased across the risk categories in a dose–response pattern. STTGMAHE exhibited an excellent level of accuracy in identifying middle-aged and geriatric trauma patients at risk of 30-day mortality and unfavorable clinical trajectories.
A Study on Vascular Regulators as Early Biomarkers of Hand Arm Vibration Syndrome
Authors: Yang Hongyu , Chen Ziyu , Hu Xiuwen , Wei Nuoyan , Li Jiajie , Wei Yuan , Chen Qingsong
Published: September 2023

Objectives

Purposes of this study are to study the changes in expression of vascular regulators after vibration exposure and during the onset of vibration-induced white finger (VWF) and to screen for vascular regulatory factors that could be used as early biomarkers of HAVS.

Methods

Using judgmental sampling from a Chinese factory, workers with VWF and hand-transmitted vibration exposure but without VWF were selected for research. Blood samples were taken from all subjects, and the levels of nine of the vascular regulators were measured using ELISA.

Results

Receiver operating characteristic curve analysis was performed on nine vascular regulators to assess their diagnostic sensitivity for VWF with the following area under the curve results: PGI2 = 0.861, ANP = 0.840.

Conclusions

Collectively, PGI2 and ANP exhibited the most potential for the early diagnosis of HAVS.
Antimitochondrial antibody-negative primary biliary cirrhosis with secondary Sjogren syndrome: a case report
Authors: Acharya Suman , Shrestha Suraj , Poddar Elisha , Neupane Ashru , Khadayat Ramesh , Magar Sagar R. , Lamsal Manoj , Pathak Rahul
Published: September 2023

Introduction and importance:

Primary biliary cholangitis (PBC) is a rare immune-mediated liver disease characterized by the destruction of intrahepatic bile ducts and a positive antimitochondrial antibody (AMA), which is considered a serological hallmark for the diagnosis. Rarely, AMA can be absent/nondetectable in a few cases and is referred to as ‘AMA-negative’.

Case presentation:

The authors present such an uncommon case of AMA-negative PBC in a 39-year-female with Sjogren’s syndrome who presented with fatigue, pruritus, and dry eyes.

Clinical discussion:

Previously published studies state that approximately only about 5% of patients with PBC are ‘AMA-negative’. For patients negative for AMA, the diagnosis has to be based on typical pathological features of this disease. Once a diagnosis of PBC is established, regardless of whether it is positive or negative for AMAs, ursodeoxycholic acid is a widely accepted treatment.

Conclusion:

The presence/absence of AMAs is associated with similar clinical, biochemical, and histopathological characteristics in PBC. The identification of AMAs alone should not impact the diagnosis or treatment of PBC.
Disseminated adrenal histoplasmosis in an immunocompetent adult from Nepal: a case report
Authors: Oli Aadhar , Poudel Shila , Ranabhat Abirodh
Published: September 2023

Introduction:

Histoplasmosis is caused by the environmental fungus Histoplasma capsulatum. In immunocompromised patients, histoplasmosis can present as a disseminated infection that can involve the liver, lymph nodes, lungs, and adrenal glands. Disseminated histoplasmosis affecting the adrenal glands in an immunocompetent individual is a rare infection.

Case presentation:

A 53-year-old male without HIV complained of weight loss of 15 kg in 6 months. Computed tomography (CT) scan of the abdomen was done, which showed bilateral adrenal gland hyperplasia with hepatosplenomegaly. Endoscopic ultrasound fine needle aspiration of the adrenal gland revealed numerous budding yeast forms of Histoplasma intracellularly within the macrophages. A diagnosis of disseminated adrenal histoplasmosis was made. Liposomal amphotericin B and itraconazole therapy was started.

Discussion:

Disseminated histoplasmosis is commonly present in immunocompromised individuals. Immunocompetent individuals may also present with the disseminated form of the disease, which typically involves the adrenal glands. CT scan of the abdomen shows bulky adrenal glands with normal configuration, peripheral enhancement, and central hypodensities due to necrosis and/or hemorrhage. This might be a common presentation in other disseminated infections. Therefore, a definitive visualization of H. capsulatum in tissue specimens is the best method to confirm the diagnosis in a patient.

Conclusion:

Physicians must be suspicious of disseminated adrenal histoplasmosis in patients presenting with enlarged adrenal glands, even in immunocompetent individuals who are from endemic regions. Histopathological or cytological evaluation is the best method to establish a diagnosis.
Characteristics and factors associated with hypertensive crisis: a cross-sectional study in patients with hypertension receiving care in a tertiary hospital
Authors: Chootong Rattanaporn , Pethyabarn Wasuntaraporn , Sono Supinya , Choosong Thitiworn , Choomalee Kittisakdi , Ayae Maimoonah , Wisan Punnisa , Kantalak Phappim
Published: September 2023

Background:

The hypertensive crisis is characterized by poorly controlled hypertension, which can lead to unfavorable outcomes and high utilization. The purpose of this study was to examine the prevalence, clinical characteristics, and factors associated with hypertensive emergency.

Material and Methods:

This cross-sectional study collected data from the hospital information system that included patients greater than or equal to 18 years who were diagnosed with hypertensive crisis (blood pressure ≥180 and/or 120 mmHg) and receiving care from the primary care unit and emergency department from 2020 to 2022. The prevalence and clinical characteristics of these patients were examined. Multiple logistic regression analysis was used to analyze factors associated with hypertensive emergency.

Results:

Among 3329 patients with hypertension, 17.33% had a hypertensive crisis (16.64 vs. 0.69%, urgency and emergency types). Most patients were female (63.6%), with a median age of 66 years. Almost half the patients (42.2%) with hypertensive crisis presented without specific symptoms, and the most common presenting symptom was vertigo/dizziness (27.7%). The initial and after treatment blood pressures were 203/98 and 174/91 mmHg. In the hypertensive emergency, the most common end-organ damage was ischemic stroke (33.3%), hemorrhagic stroke (25%), and acute heart failure (20.8%). An oral angiotensin-converting enzyme (57.5%) was the most commonly administered medication. Multiple logistic regression was performed but did not reveal any statistically significant.

Conclusion:

Our result revealed a high prevalence of hypertensive crises; most were of hypertensive urgency. The most common presenting symptom was vertigo/dizziness. There was no factor significantly associated with the hypertensive emergency in this study. Further studies should explore the cause of the hypertensive crisis to improve care delivery to patients with hypertension.
Short-term recurrence rate of male urethral stricture and its predictors after treatment with optical internal urethrotomy: Prospective Cohort Study at a tertiary center in Ethiopia
Authors: Issack Feysel H. , Hassen Seid M. , Tefera Alemayehu T. , Teshome Henok , Gebreselassie Kaleab H. , Mummed Ferid O.
Published: September 2023

Background:

Although optical internal urethrotomy is popular among the urologists due to its simplicity and safety, urethroplasty is considered the gold standard treatment for urethral strictures. This study aims to determine the 1-year recurrence rate of urethral strictures after optical urethrotomy and identify predictors of recurrence in a tertiary center in Ethiopia.

Methods:

A prospective observational cohort study was conducted on 80 male patients who underwent optical urethrotomy from November 2019 to August 2020 in a tertiary center in Ethiopia. Logistic regression was used to analyze the association between dependent and independent variables, with a P-value of <0.05 considered statistically significant.

Results:

The mean and median age (±SD) of patients at the time of the procedure were 54.76 (±14.74) and 58 years with a range [20–78], respectively. Urethral discharge was the most common etiology identified in 39 (48.75%) of patients. Eleven (13.75%) patients had no identifiable etiology for their urethral stricture disease.

The majority of patients presented with at least one voiding lower urinary tract symptoms.

Sixty-eight (85%) patients out of the total had a single stricture and 12 (15%) had multiple strictures. The location of the stricture was in the bulbar urethra on cystourethrography in 83% of the patients. The 1-year recurrence rate of urethral stricture after optical urethrotomy was 35% in our study.

The number of strictures and the presence of hypertension were independent predictors of recurrence of urethral stricture within 1-year after treatment with optical urethrotomy (AOR=15.35, 95% CI: 2.92–80.61, P=0.00; AOR=19.47, 95% CI: 2.11–178.98, P=0.01, respectively).

Conclusions:

Our study identified that multiple strictures, and the presence of hypertension are associated with an increased recurrence rate in the first postoperative year.
Posterior reversible encephalopathy syndrome in a child following hypovolemic shock: a case report
Authors: Adhikari Yuvraj , Bista Satkirti , Karmacharya Sammridhi , Upadhaya Regmi Binit , Marasini Anupama , Basukala Anisha , Bhandari Shakar , Ghimire Krishna , Subedi Ram Chandra
Published: September 2023

Introduction and importance:

Posterior reversible encephalopathy syndrome (PRES) is a condition that causes a wide range of clinical neurological manifestations like headache, seizures, visual changes, and altered mental sensations. It is diagnosed with the help of sequential neuroimaging findings. Manifestations may occur a few hours to months after the initial precipitating cause. In the pediatric population, the most common cause is hypertension caused by renal disease or different drugs.

Case presentation:

Here, the authors present the case of a 4-year-old boy with a significant medical history of acute gastroenteritis following hypovolemic shock that later developed white matter edema of the brain on T2-weighted MRI scans along with symptoms such as headache and vomiting. Here, the patient was managed symptomatically with antiepileptic medication as prophylaxis.

Clinical discussion:

PRES is a rare neurological diagnosis made in the child that presents with headache, vomiting, blurring of vision, and abnormal body movements, which have several etiology like hypertension, glomerulonephritis, organ transplant, drugs, and very rarely with hypovolemic shock. It is an acute reversible condition in which a person presents with visual disturbances, headaches, and seizures. Seizures present as a life-threatening situation, so antiepileptic drugs are used as early prophylaxis.

Conclusion:

PRES is a reversible neurological condition, and prognosis is typically favorable if recognized and treated early, with symptom improvement or resolution in a few days to several weeks. Complications of PRES develop if the disease is not treated promptly. Complications include focal neurologic deficits from ischemic injury and epilepsy.
Plasma cell leukemia in a 34-year-old male: rare scenario case report
Authors: Issa Muhsen , Hannouneh Zein Alabdin , Alabbas Zeina , Hussein Firas , Issa Rana
Published: September 2023

Introduction:

Plasma cell leukaemia is an uncommon plasma cell dyscrasia with a very poor prognosis. It is more common among males and usually presents between 55 and 65 years of age.

Case presentation:

A 34-year-old male presented to Al-Assad hospital with unremitting back pain. He was given analgesics but his pain was unresponsive to treatment, and due to the COVID-19 pandemic, he refused a computed tomography scan in the hospital. Later that year, he presented again with weight loss, nausea, abdominal pain, melena, and ascites. He was pale with a moderately distended abdomen. Laboratory tests revealed anaemia, thrombocytopenia, hypercalcemia, increased total proteins, and elevated lactate dehydrogenase. Flow cytometry findings of the bone marrow aspirate showed the presence of 30% of plasma cells, positive for CD38, CD56, and kappa light chains. He was diagnosed with secondary plasma cell leukaemia and started on chemotherapy; however, he could not continue his treatment due to myeloid inhibition. He passed away 5 months later.

Clinical discussion:

Multiple myeloma was not suspected in the patient due to his young age. The diagnosis was delayed even further due to the COVID-19 pandemic. His multiple myeloma progressed into secondary plasma cell leukaemia and had uncommon features like small intestinal polyps. Even though there has been groundbreaking advancements in chemotherapy, plasma cell leukaemia still possesses a fatal prognosis.

Conclusion:

This report showcases a rare age presentation with unique manifestations of secondary plasma cell leukaemia. Multiple myeloma should be a differential diagnosis for cases with unexplained back pain despite an unclassical age.
2 days versus 5 days of Postoperative Antibiotics for Complex Appendicitis
Authors: de Wijkerslooth Elisabeth M.L. , Boerma Evert-Jan G. , van Rossem Charles C. , Koopmanschap Marc A. , Baeten Coen I.M. , Beverdam Frédérique H. , Bosmans Joanna W.A.M. , Consten Esther C.J. , Dekker Jan Willem T. , Emous Marloes , van Geloven Anna A.W. , Gijsen Anton F. , Heijnen Luc A. , Jairam An P. , van der Ploeg Augustinus P.T. , Steenvoorde Pascal , Toorenvliet Boudewijn R. , Vermaas Maarten , Wiering Bas , Wijnhoven Bas P.L. , van den Boom Anne Loes ,   for the APPIC Study Group
Published: September 2023

Objective:

To compare costs for 2 days versus 5 days of postoperative antibiotics within the Antibiotics following aPPendectomy In Complex appendicitis (APPIC) trial.

Summary Background Data:

Recent studies suggest that restrictive antibiotic use leads to a significant reduction in hospital stay without compromising patient safety. Its potential effect on societal costs remains underexplored.

Methods:

This was a pragmatic, open-label, multicenter clinical trial powered for non-inferiority. Patients with complex appendicitis (age ≥ 8 y) were randomly allocated to 2 days or 5 days of intravenous antibiotics after appendectomy. Patient inclusion lasted from June 2017 to June 2021 in 15 Dutch hospitals. Final follow-up was on September 1, 2021. The primary trial endpoint was a composite endpoint of infectious complications and mortality within 90 days. In the present study, main outcome measures were overall societal costs (comprising direct healthcare costs and costs related to productivity loss) and cost-effectiveness. Direct healthcare costs were recorded based on data in the electronic patient files, complemented by a telephone follow-up at 90 days. In addition, data on loss of productivity were acquired through the validated Productivity-Cost-Questionnaire at four weeks after surgery. Cost estimates were based on prices for the year 2019.

Results:

In total, 1005 patients were evaluated in the Intention-to-Treat analysis: 502 patients allocated to the 2-day group and 503 to the 5-day group. The mean difference in overall societal costs was – € 625 (95% confidence interval – € 958 to – € 278) to the advantage of the 2-day group. This difference was largely explained by reduced hospital stay. Productivity losses were similar between the study groups. Restricting postoperative antibiotics to two days was cost-effective, with estimated cost savings of € 31,117 per additional infectious complication.

Conclusions:

2 days of postoperative antibiotics for complex appendicitis results in a statistically significant and relevant cost reduction, as compared with 5 days. Findings apply to laparoscopic appendectomy in a well-resourced healthcare setting.

Trial Registration:

Trialregister.nl number NL5946.
Neopolyploidy increases stress tolerance and reduces fitness plasticity across multiple urban pollutants: support for the ‘general purpose’ genotype hypothesis
Authors: Turcotte Martin M. , Kaufmann Nancy , Wagner Katie L. , Zallek Taylor A. , Ashman Tia-Lynn
Published: September 2023

Whole genome duplication is a common macromutation with extensive impacts from gene expression, to cellular function, and whole organism phenotype. As a result, it has been proposed that polyploids have ‘general purpose’ genotypes that perform better than their diploid progenitors under stressful conditions. Here we test this hypothesis in the context of stresses presented by anthropogenic pollutants. Specifically, we tested how multiple neotetraploid genetic lineages of the Greater Duckweed (Spirodela polyrhiza) perform across a favorable control environment and five urban pollutants (iron, salt, manganese, copper, and aluminum). By quantifying the population growth rate of duckweed over multiple generations we found that across most pollutants, but not all, polyploidy decreased the growth rate of actively growing propagules but increased that of dormant ones. Yet, when considering total propagule production, polyploidy increased tolerance to most pollutants and polyploids maintained population-level fitness across pollutants better than diploids. Furthermore, broad-sense genetic correlations in growth rate among pollutants were all positive in neopolyploids but not so for diploids. Our results provide a rare test and support for the hypotheses that polyploids are more tolerant of stressful conditions and can maintain fitness better than diploids across heterogenous stresses. These results may help predict the distribution of polyploids across stress gradients such as those caused by urbanization and other human activities.
Differential outcomes of infection by wild-type SARS-CoV-2 and the B.1.617.2 and B.1.1.529 variants of concern in K18-hACE2 transgenic mice
Authors: He Yicheng , Henley Jill , Sell Philip , Comai Lucio
Published: September 2023

Background

SARS-CoV-2 is a respiratory virus with neurological complications including loss of smell and taste, headache, and confusion that can persist for months or longer. Severe neuronal cell damage has also been reported in some cases. The objective of this study was to compare the infectivity of Wild-type virus, Delta and Omicron variants in transgenic mice that express the human angiotensin-converting enzyme 2 (hACE2) receptor under the control of the keratin 18 promoter (K18) and characterize the progression of infection and inflammatory response in the lung, brain medulla oblongata and olfactory bulbs of these animals. We hypothesized that Wild-type, Delta and Omicron differentially infect K18-hACE2 mice, thereby inducing distinct cellular responses.

Methods

K18-hACE2 female mice were intranasally infected with Wild-type, Delta, or Omicron variants and euthanized either at 3 days post-infection (dpi) or at the humane endpoint. None of the animals infected with the Omicron variant reached the humane endpoint and were euthanized at day 8 dpi. Virological and immunological analyses were performed in the lungs, olfactory bulbs, medulla oblongata, and brains.

Results

Mice infected with Wild-type and Delta display higher levels of viral RNA in the lungs than mice infected with Omicron at 3dpi. Viral RNA levels in the brains of mice infected with the Wild-type virus were however significantly lower than those observed in mice infected with either Delta or Omicron at 3dpi. Viral RNA was also detected in the medulla oblongata of mice infected by all these virus strains at 3dpi. At this time point, mice infected with the Delta virus display a marked upregulation of inflammatory makers both in the lungs and brains. Upregulation of inflammatory markers was also observed in the brains of mice infected with Omicron but not in mice infected with the Wild-type virus, suggesting that during the initial phase of the infection only the Delta and Omicron variants induce strong inflammatory response in the brain. At the humane endpoint/8dpi, mice infected by any of these strains display elevated levels of viral RNA and upregulation of a subset of inflammatory markers in the lungs. There was also a significant increase in viral RNA in the brains of mice infected with Wild-type and Delta, as compared to 3dpi. This was accompanied by an increase in the expression of most cytokines and chemokines. In contrast, mice infected with the Omicron variant showed low levels of viral RNA and downregulation of cytokines and chemokines expression at 8dpi, suggesting that brain inflammation by this variant is attenuated. Reduced RNA levels and downregulation of inflammatory markers was also observed in the medulla oblongata and olfactory bulbs of mice infected with Omicron, while infection by Wild-type and Delta resulted in high levels of viral RNA and increased expression of inflammatory makers in these organs.
Multiplexed single-cell lineage tracing of mitotic kinesin inhibitor resistance in glioblastoma
Authors: Cheng Yim Ling , Banu Matei A. , Zhao Wenting , Rosenfeld Steven S. , Canoll Peter , Sims Peter A.
Published: September 2023

Glioblastoma (GBM) is a deadly brain tumor, and the kinesin motor KIF11 is an attractive therapeutic target because of its dual roles in proliferation and invasion. The clinical utility of KIF11 inhibitors has been limited by drug resistance, which has mainly been studied in animal models. We used multiplexed lineage tracing barcodes and scRNA-seq to analyze drug resistance time courses for patient-derived GBM neurospheres treated with ispinesib, a potent KIF11 inhibitor. Similar to GBM progression in patients, untreated cells lost their neural lineage identity and transitioned to a mesenchymal phenotype, which is associated with poor prognosis. In contrast, cells subjected to long-term ispinesib treatment exhibited a proneural phenotype. We generated patient-derived xenografts to show that ispinesib-resistant cells form less aggressive tumorsin vivo, even in the absence of drug. Finally, we used lineage barcodes to nominate drug combination targets by retrospective analysis of ispinesib-resistant clones in the drug-naïve setting and identified drugs that are synergistic with ispinesib.
Automated Identification of Heart Failure with Reduced Ejection Fraction using Deep Learning-based Natural Language Processing
Authors: Nargesi Arash A. , Adejumo Philip , Dhingra Lovedeep , Rosand Benjamin , Hengartner Astrid , Coppi Andreas , Benigeri Simon , Sen Sounok , Ahmad Tariq , Nadkarni Girish N , Lin Zhenqiu , Ahmad Faraz S. , Krumholz Harlan M , Khera Rohan
Published: September 2023

Background

The lack of automated tools for measuring care quality has limited the implementation of a national program to assess and improve guideline-directed care in heart failure with reduced ejection fraction (HFrEF). A key challenge for constructing such a tool has been an accurate, accessible approach for identifying patients with HFrEF at hospital discharge, an opportunity to evaluate and improve the quality of care.

Methods

We developed a novel deep learning-based language model for identifying patients with HFrEF from discharge summaries using a semi-supervised learning framework. For this purpose, hospitalizations with heart failure at Yale New Haven Hospital (YNHH) between 2015 to 2019 were labeled as HFrEF if the left ventricular ejection fraction was under 40% on antecedent echocardiography. The model was internally validated with model-based net reclassification improvement (NRI) assessed against chart-based diagnosis codes. We externally validated the model on discharge summaries from hospitalizations with heart failure at Northwestern Medicine, community hospitals of Yale New Haven Health in Connecticut and Rhode Island, and the publicly accessible MIMIC-III database, confirmed with chart abstraction.

Results

A total of 13,251 notes from 5,392 unique individuals (mean age 73 ± 14 years, 48% female), including 2,487 patients with HFrEF (46.1%), were used for model development (train/held-out test: 70/30%). The deep learning model achieved an area under receiving operating characteristic (AUROC) of 0.97 and an area under precision- recall curve (AUPRC) of 0.97 in detecting HFrEF on the held-out set. In external validation, the model had high performance in identifying HFrEF from discharge summaries with AUROC 0.94 and AUPRC 0.91 on 19,242 notes from Northwestern Medicine, AUROC 0.95 and AUPRC 0.96 on 139 manually abstracted notes from Yale community hospitals, and AUROC 0.91 and AUPRC 0.92 on 146 manually reviewed notes at MIMIC-III. Model-based prediction of HFrEF corresponded to an overall NRI of 60.2 ± 1.9% compared with the chart diagnosis codes (p-value < 0.001) and an increase in AUROC from 0.61 [95% CI: 060-0.63] to 0.91 [95% CI 0.90-0.92].

Conclusions

We developed and externally validated a deep learning language model that automatically identifies HFrEF from clinical notes with high precision and accuracy, representing a key element in automating quality assessment and improvement for individuals with HFrEF.
Analyzing pharmaceutical industry risks under uncertainty for performance improvement: an Indian scenario
Authors: Sharma Astha , Kumar Dinesh , Arora Navneet
Published: September 2023

Purpose

The pharmaceutical industry faces multiple risks that adversely affect its performance. Within these risks, some dependencies have been observed, which help in streamlining the mitigation efforts. Therefore, the present work identifies and categorizes various risks/sub-risks in cause–effect groups, considering uncertainty in the decision-making process.

Design/methodology/approach

An extensive literature review and experts' opinions were utilized to identify and finalize the risks faced by the pharmaceutical industry. For further analysis, data collection was done using a questionnaire focusing on finalized risks. Based on the data, the causal relation under uncertainty between various risks/sub-risks was identified using a multi-criteria decision making (MCDM) technique, i.e. intuitionistic fuzzy DEMATEL, in a pairwise manner.

Findings

The results show that the three most prominent risk categories are operational, demand/customer/market and financial. Also, out of the seven main risks, only supplier and operational are categorized within the effect group and the rest, i.e. financial, demand, logistics, political and technology within the cause group. The sub-risks within each category have also been categorized into cause–effect groups. The mitigation of cause group risks will help in economize the financial resources and improve the performance and resilience of the industry.

Originality/value

There is insufficient research on identifying the causality among the pharmaceutical industry risks. Additionally, an extensive discussion on the identified cause–effect groups is also missing in the literature. Therefore, in this work, efforts have been made to determine the prominent risks for the Indian pharmaceutical industry that will be helpful for channelizing the resources to mitigate risks for a resilient industry.
Anti-racism in my pocket: mobilizing women, technology and privilege to support systemic equity
Authors: Grier Sonya A. , Porter Bea V.
Published: September 2023

Social implications

The “Anti-Racism in my Pocket” case illustrates how collaborative entrepreneurial leadership can build on personal experiences, expertise and a desire to change the status quo to support racial equity. The case will support students’ critical thinking skills and further heighten their understanding of the contributions of women in leadership, anti-racism and the role of technology. Moreover, the case is motivating for students with aspirations of using business skills and knowledge to contribute to social equity.

Learning outcomes

After completing this case, students should be able to identify the role of marketing in the development, implementation and evaluation of a behavior change initiative, the Anti-Racism Action Nuggets anti-racism training program; analyze qualitative and quantitative data to assess the impact of the Anti-Racism Action Nuggets Pilot using a logic model; identify marketing opportunities, challenges and strategies to scale the Anti-Racism Action Nuggets series for a broader impact; and discuss the relationship of gender in strategic positioning and marketing leadership to the development of the Anti-Racism Action Nuggets (Optional).

Case overview/synopsis

This case charts the development of an anti-racism training series by two friends, Allison Plyer (she/her) and Valerie (Val) Uccellani (she/her), called Anti-Racism Action Nuggets. The two protagonists aimed to change individual behaviors to reduce structural racism through lessons that were delivered in text messages to participants. Once the course is completed, they conduct a test pilot with members of NOW, LOVE, a women’s organization in New Orleans, Louisiana. At the end of the case, students are provided with the qualitative and quantitative pilot data for their analysis to recommend next steps and important marketing considerations for the Anti-Racism Action Nuggets series.

Complexity academic level

Undergraduate, graduate and executive education

Supplementary materials

Teaching notes are available for educators only.

Subject code

CCS 8: Marketing
Optimal coalition splitting with heterogenous strategies
Authors: Boucekkine Raouf , Camacho Carmen , Ruan Weihua , Zou Benteng
Published: September 2023

Purpose

The authors characterize the conditions under which a country may eventually split and when it splits within an infinite horizon multi-stage differential game.

Design/methodology/approach

In contrast to the existing literature, the authors do not assume that after splitting, players will adopt Markovian strategies. Instead, the authors assume that while the splitting country plays Markovian, the remaining coalition remains committed to the collective control of pollution and plays open-loop.

Findings

Within a full linear-quadratic model, the authors characterize the optimal strategies. The authors later compare with the outcomes of the case where the splitting country and the remaining coalition play both Markovian. The authors highlight several interesting results in terms of the implications for long-term pollution levels and the duration of coalitions under heterogenous strategies as compared to Markovian behavior.

Originality/value

In this paper, the authors have illustrated the richness of the simplications of enlarging the set of strategies in terms of the emergence of coalitions, their duration and the implied welfare levels per player. Varying only three parameters (the technological gap, pollution damage and coalition payoff share distribution across players), the authors have been able to generate, among other findings, quite different rankings of welfare per player depending on whether the remaining coalitions after split play Markovian or stay precommited to the pre-splitting period decisions.
Sustainable energy for all: the link between financial inclusion, renewable energy and environmental sustainability in developing economies
Authors: Ofosu-Mensah Ababio Josephine , Yiadom Eric B. , Mawutor John K.M. , Tuffour Joseph K. , Attah‐Botchwey Edward
Published: September 2023

Purpose

This study aims to use 67 developing countries to examine the role of financial inclusion as an “empowering tool” for renewable energy uptake and to improve environmental sustainability in developing countries.

Design/methodology/approach

Using a battery of econometric models, including the generalized method of moment-panel vector autoregression (GMM-PVAR), impulse response function, Granger causality, fully modified ordinary least squares and dynamic ordinary least squares, the study proposed and tested three hypotheses.

Findings

The results from various estimations indicate that financial inclusion has a positive effect on renewable energy consumption and environmental sustainability improvement in developing countries. The findings suggest that financial inclusion can improve environmental sustainability by increasing access to financing to fund renewable energy projects, support sustainable businesses and promote sustainable practices.

Originality/value

This study suggests that policymakers prioritize financial inclusion to promote renewable energy consumption and environmental sustainability. Policies should enhance access to financial services, offer financial incentives and subsidies, provide affordable loans through microfinance institutions and fintech companies and promote sustainable businesses and green technologies.
The differential effects of human resource management on organizational innovation: a meta-analytic examination
Authors: Chen Mengsang , Wu Mengdi , Wang Xiaohui , Wang Haibo
Published: September 2023

Purpose

This meta-analytical review aims to clarify the relationships between three bundles of human resource management (HRM) practices—competency-enhancing, motivation-enhancing and opportunity-enhancing—and organizational innovation by addressing two questions: (a) Which types of HRM bundles are most strongly related to different forms of innovation (i.e. process and product innovation)? And (b) Which mechanism provides a stronger explanation for the positive effects of HRM bundles on innovation?

Design/methodology/approach

Based on data from 103 studies, a meta-analysis was conducted to quantitatively summarize existing HRM–innovation studies at the organizational level.

Findings

The results showed that the competency-enhancing bundle was more positively related to product innovation than the motivation-enhancing and opportunity-enhancing bundles. The opportunity-enhancing bundle was most strongly associated with process innovation. The authors further found that knowledge management capability (KMC) and employee motivation mediated the positive relationship between the three HRM bundles and innovation outcomes. In comparing the two mechanisms, this review suggests that KMC better explains both the impact of the competency-enhancing HRM bundle on product innovation and the effect of the opportunity-enhancing bundle on process innovation.

Originality/value

Based on behavioral and knowledge management perspectives, this study takes a sub-bundle approach to providing an integrative review by comparing the direct effects and mediating paths of HRM bundles on product and process innovation.
Assessment of antecedents of financial literacy among young adults: hybrid BWM and ISM approach
Authors: Saharan Anamika , Saharan Akash , Pandey Krishan Kumar , Rao T. Joji
Published: September 2023

Purpose

The low level of financial literacy among young adults is a pressing concern at both individual and country levels. Therefore, there is a dire need to understand the best-worst antecedents of financial literacy and how they influence each other.

Design/methodology/approach

A two-phased multicriteria decision-making (MCDM) technique consisting of best-worst method and interpretive structural modeling (BWM-ISM) was employed for pair-wise comparison, assigning weights, ranking and establishing the relationship among antecedents of financial literacy.

Findings

Results suggest that use of Internet (SF1), role of financial advisors (SF3) and education level of individuals (DS7) are top ranked antecedents, whereas masculinity/feminity, language and power distance in society are the least ranked antecedents of financial literacy. Findings will help both academicians and practitioners focus on the key factors and make efforts to increase financial literacy by minimizing resource usage.

Originality/value

The current study provides clarity among antecedents of financial literacy by following BWM-ISM approach for the first time in the financial literacy context.

Peer review

The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-11-2022-0746
Stock price index prediction based on SSA-BiGRU-GSCV model from the perspective of long memory
Authors: Mao Zengli , Wu Chong
Published: September 2023

Purpose

Because the dynamic characteristics of the stock market are nonlinear, it is unclear whether stock prices can be predicted. This paper aims to explore the predictability of the stock price index from a long-memory perspective. The authors propose hybrid models to predict the next-day closing price index and explore the policy effects behind stock prices. The paper aims to discuss the aforementioned ideas.

Design/methodology/approach

The authors found a long memory in the stock price index series using modified R/S and GPH tests, and propose an improved bi-directional gated recurrent units (BiGRU) hybrid network framework to predict the next-day stock price index. The proposed framework integrates (1) A de-noising module—Singular Spectrum Analysis (SSA) algorithm, (2) a predictive module—BiGRU model, and (3) an optimization module—Grid Search Cross-validation (GSCV) algorithm.

Findings

Three critical findings are long memory, fit effectiveness and model optimization. There is long memory (predictability) in the stock price index series. The proposed framework yields predictions of optimum fit. Data de-noising and parameter optimization can improve the model fit.

Practical implications

The empirical data are obtained from the financial data of listed companies in the Wind Financial Terminal. The model can accurately predict stock price index series, guide investors to make reasonable investment decisions, and provide a basis for establishing individual industry stock investment strategies.

Social implications

If the index series in the stock market exhibits long-memory characteristics, the policy implication is that fractal markets, even in the nonlinear case, allow for a corresponding distribution pattern in the value of portfolio assets. The risk of stock price volatility in various sectors has expanded due to the effects of the COVID-19 pandemic and the R-U conflict on the stock market. Predicting future trends by forecasting stock prices is critical for minimizing financial risk. The ability to mitigate the epidemic’s impact and stop losses promptly is relevant to market regulators, companies and other relevant stakeholders.

Originality/value

Although long memory exists, the stock price index series can be predicted. However, price fluctuations are unstable and chaotic, and traditional mathematical and statistical methods cannot provide precise predictions. The network framework proposed in this paper has robust horizontal connections between units, strong memory capability and stronger generalization ability than traditional network structures. The authors demonstrate significant performance improvements of SSA-BiGRU-GSCV over comparison models on Chinese stocks.
An integrated optimization model for planning supply chains' resilience and business continuity under interrelated disruptions: a case study
Authors: Dehghani Sadrabadi Mohammad Hossein , Makui Ahmad , Ghousi Rouzbeh , Jabbarzadeh Armin
Published: September 2023

Purpose

The adverse interactions between disruptions can increase the supply chain's vulnerability. Accordingly, establishing supply chain resilience to deal with disruptions and employing business continuity planning to preserve risk management achievements is of considerable importance. The aforementioned idea is discussed in this study.

Design/methodology/approach

This study proposes a multi-objective optimization model for employing business continuity management and organizational resilience in a supply chain for responding to multiple interrelated disruptions. The improved augmented e-constraint and the scenario-based robust optimization methods are adopted for multi-objective programming and dealing with uncertainty, respectively. A case study of the automotive battery manufacturing industry is also considered to ensure real-world conformity of the model.

Findings

The results indicate that interactions between disruptions remarkably increase the supply chain's vulnerability. Choosing a higher fortification level for the supply chain and foreign suppliers reduces disruption impacts on resources and improves the supply chain's resilience and business continuity. Facilities dispersion, fortification of facilities, lateral transshipment, order deferral policy, dynamic capacity planning and direct transportation of products to markets are the most efficient resilience strategies in the under-study industry.

Originality/value

Applying resource allocation planning and portfolio selection to adopt preventive and reactive resilience strategies simultaneously to manage multiple interrelated disruptions in a real-world automotive battery manufacturing industry, maintaining the long-term achievements of supply chain resilience using business continuity management and dynamic capacity planning are the main contributions of the presented paper.