bluuebunny/crossref_metadata_2025 huggingface dataset:
Nonlinear feedforward controller design of gasoline engine air-path system for reducing engine torque overshoot
Authors: Shiraishi Tatsuya , Hirata Mitsuo , Suzuki Masayasu
Published: February 2024

In gasoline engines, the amount of fresh air in the cylinder becomes temporarily excessive owing to the slow response in exhaust gas recirculation (EGR) gas under a high EGR ratio. This phenomenon should be avoided, as it causes an engine torque overshoot because the amount of fuel also increases to follow the stoichiometric ratio, and can cause discomfort to the driver. In this study, we investigate reducing torque overshoot using a feedforward controller, which is a simple and effective method for improving the response of a control system. The feedforward controller is typically designed based on the inverse of the plant model. However, designing a feedforward controller for a high-order and nonlinear plant, such as an engine air-path system, can be challenging. Therefore, we exploit the fact that if a given nonlinear system satisfies the flatness property, a feedforward controller based on the inverse model can be easily obtained. The effectiveness of the proposed feedforward controller is evaluated through simulations.
A refined mode superposition method for dynamical responses of an underwater cylindrical shell with substructures
Authors: Zhang Dechun , Li Peng , Chen Haoran , Yin Hong , Yang Yiren
Published: February 2024

To overcome the difficulties of time-consuming and inefficient in the response calculations of the submerged cylindrical shell with internal substructures, this paper firstly presents a refined mode superposition method. In view of the necessity and difficulties of directly and quickly obtaining the frequencies and modes of structures submerged in fluid (named the wet modes), the wet modes are expanded by the modes in vacuum (dry modes) and solved by the energy method. The added kinetic energy of the fluid is calculated via boundary integration, and the Lagrange equations of the second kind is applied to the fluid-structure coupling equations. Then the wet modes are solved by eigenvalue calculation and the modal mass and stiffness of each order wet mode are obtained. Finally, they are used for establishing a mode superposition approach for response calculations. The accuracy of the present method is verified by ANSYS software. In this method, all the required data are obtained from the structural analysis and the traditional complicated fluid force modeling is no longer required. Thus it has the advantages of high computational efficiency and applicability. Compared to the traditional semi-analytic model, this modeling methodology has broad application potential for vibration problems of complex underwater structures since the structural dry modes can be solved efficiently by commercial software. It also has practical value as a theoretical reference for developing mode-superposition-based calculations for fluid-structure problems using commercial software.
Janus-faced discourse in contemporary Norwegian policy framing for tackling educational inequality? A critical analysis of contemporary tensions and contradictions
Authors: Jensen Joakim , Skrobanek Jan , Jobst Solvejg
Published: February 2024

This paper focuses on contemporary tensions and contradictions in current Norwegian educational policy discourse. Based on critical discourse analysis (CDA) of Norwegian governmental white papers our analysis reveals that contemporary Norwegian policy formulation is torn between an egalitarian and a selection discourse about how to tackle educational inequality in the Norwegian comprehensive school system. The egalitarian discourse is characterised by principles like inclusion, equity and recognising diversity in the education system with a stated aim to balance educational outcomes. The selection discourse advertises greater selection, competition, and outcome control in the light of international competition and calls for better correspondence between schooling, higher education, and labour market needs. Paradoxically, both discourses are advertising themselves as proper solutions for tackling and reducing educational inequality in Norway. Taking indications of growing social inequality in Norway into consideration we conclude that growing importance of selection and competition arguments in contemporary Norwegian educational policy have increased dissonance and inconsistency in discourse and have started to overpower egalitarian values. We conclude that this will, against egalitarian creed and rhetorical claim in Norwegian educational policy, rather foster than reduce educational inequality.
A case report of pancreatic exocrine insufficiency in a patient with Parkinson’s disease: A coincidence or is there more to it than meets the eye?
Authors: Edwards David , Krishnan Babu , Jalal Mustafa
Published: February 2024

Pancreatic exocrine insufficiency (PEI) is an under-diagnosed condition. Untreated PEI can result in developing gastrointestinal symptoms and long-term complications including weight loss, nutrient deficiencies, sarcopenia and osteoporosis. Current best practice recommends testing for PEI in certain disorders including chronic pancreatitis, cystic fibrosis, pancreatic cancer and post-pancreatic surgery. However, there is increasing evidence that PEI is associated with a number of conditions in addition to the aforementioned diseases. These ‘at-risk’ conditions are a heterogeneous group of diseases, for example, diabetes mellitus, people living with human immunodeficiency virus, high alcohol intake, and coeliac disease. The pathophysiology of some of ‘at-risk’ conditions is becoming increasingly recognised; therefore, the list of associated conditions are in evolving process. We present a case of a 60-year-old male with Parkinson’s disease and persistent abdominal pain who was found to have low faecal elastase levels indicative of severe PEI. His past medical history included none of the known risk factors for PEI. After examining the literature, we report a similar pathophysiological process underlying the development of pancreatitis and Parkinson’s disease which is dysfunction of the Unfolded Protein Response. We suggest further research to assess the prevalence of PEI in the population of patients with Parkinson’s disease.
Why Violence Cannot be Prevented in Healthcare Settings in Türkiye?: A Retrospective Policy Analysis
Authors: Sevim Ferit , Akbulut Yasemin
Published: February 2024

Preventive policies have been devised with the aim of curbing health-related violence, and their efficacy is believed to furnish evidence for their continued implementation, thereby enhancing their effectiveness. This study undertakes a retrospective analysis of these policies in the context of Türkiye. A comprehensive examination involved the review of 26 documents, employing a progressive scanning approach for data collection. This methodology encompassed the utilization of gray literature databases (OECD iLibrary and WHO Iris), extensive Google searches, thorough website scans, and consultations with subject-matter experts. Data analysis was meticulously conducted within the framework of the Health Policy Triangle. The findings reveal active participation from diverse stakeholders, including governmental bodies, political entities, professional organizations, and trade unions, in various preventive initiatives aimed at mitigating health-related violence. Notably, the adoption of legislation for health violence prevention, perceived as a paramount achievement, can be attributed to persistent efforts by both the media and other influential actors and stakeholders. These endeavors have sustained the topic's prominence on the policy agenda, positioning it as a promising source for the development of novel violence prevention and management strategies. This study underscores the necessity for a comprehensive investigation into the working conditions, personal rights, and wage policies of healthcare workers, in light of documented factors that frequently precipitate violence. Concomitantly, it advocates for the development of effective mechanisms to address these issues.
Variable-fidelity sensors and observer uncertainty using touring multi-body periodic orbits to conduct cislunar SSA: preliminary study
Authors: Block Joshua M , Wilmer Adam P , Bettinger Robert A , Curtis David H , Johnis Benjamin J
Published: February 2024

An accelerating interest in cislunar space and lunar orbit for civilian, commercial, and scientific missions requires a space situational awareness (SSA) architecture extending beyond geosynchronous orbit to promote space traffic management and safety. Space-based SSA in cislunar space is challenging due to difficulties associated with accurately estimating the position of the surveillance satellite, which is a foundational requirement for effectively performing the general SSA mission. Using multiple surveillance satellites with lower-fidelity sensors helps alleviate these concerns by aggregating multiple data sets with higher variance to achieve the same level or potentially improved accuracy as compared to fewer higher-quality sensors. A subset of Earth–Moon periodic orbits, herein identified as “touring” orbits, are used for an optical surveillance constellation with a target resident space object (RSO) in a L1 Halo orbit. Angles-only measurement data are processed utilizing an extended Kalman filter to estimate the position of the RSO. The analysis focuses on assessing the effectiveness of different numbers of surveillance satellites using touring cislunar periodic orbits for conducting the SSA mission relative to L1. Overall, this study finds that the use of an SSA constellation with low-fidelity sensors can match the performance achieved by a constellation featuring higher-fidelity sensors and reduced observer uncertainty for the observer orbits examined.
Peripherally inserted central-related upper extremity deep vein thrombosis and machine learning
Authors: Hu Hankui , Wu Zhoupeng , Zhao Jichun
Published: February 2024

Objective

To establish a prediction model of upper extremity deep vein thrombosis (UEDVT) associated with peripherally inserted central catheter (PICC) based on machine learning (ML), and evaluate the effect.

Methods

452 patients with malignant tumors who underwent PICC implantation in West China Hospital from April 2021 to December 2021 were selected through convenient sampling. UEDVT was detected by ultrasound. Machine learning models were established using the least absolute contraction and selection operator (LASSO) regression algorithm: Seeley scale model (ML-Seeley-LASSO) and ML model. The information of patients with and without UEDVT was randomly allocated to the training set and test set of the two models, and the prediction effect of machine learning and existing prediction tools was compared.

Results

Machine learning training set and test set were better than Seeley evaluation results, and ML-Seeley-LASSO performance in training set was better than ML-LASSO. The performance of ML-LASSO in the test set is better than that of ML-Seeley-LASSO. The use of ML model (ML-LASSO and ML-Seeley-LASSO) in PICC-related UEDVT shows good effectiveness (the area under the subject’s working characteristic curve is 0.856, 0.799), which is superior to the currently used Seeley assessment tool.

Conclusion

The risk of PICC-related UEDVT can be estimated and predicted relatively accurately by using the method of ML modeling, so as to effectively reduce the incidence of PICC-related UEDVT in the future.
Reshaping consent so we might improve participant choice (III) – How is the research participant’s understanding currently checked and how might we improve this process?
Authors: Davies Hugh , Kolstoe Simon E , Lockett Anthony
Published: February 2024

Valid consent requires the potential research participant understands the information provided. We examined current practice in 50 proposed Clinical Trials of Investigational Medicinal Products to determine how this understanding is checked. The majority of the proposals ( n = 44) indicated confirmation of understanding would take place during an interactive conversation between the researcher and potential participant, containing questions to assess and establish understanding. Yet up until now, research design and review have not focussed upon this, concentrating more on written material. We propose ways this interactive conversation can be documented, and the process of checking understanding improved.
Preexposure to running attenuates rats’ running-based flavour avoidance: Testing associative blocking with a cover cues or context change
Authors: Nakajima Sadahiko
Published: February 2024

Voluntary running in activity wheels by rats leads to a Pavlovian conditioned aversion to the flavour consumed immediately before the running, causing the rats to avoid that flavour. This learning process, known as running-based flavour avoidance learning (FAL), is weakened when the rats have had repeated exposure to the wheels before. According to the associative account, the association between the background context and running established during the preexposure phase blocks the conditioning of the target flavour because the running is highly predictable by the background context from the outset of the FAL phase. Experiments 1 and 2 examined this account by introducing another flavour as a cue signalling wheel access during the preexposure phase. In the framework of the associative account, the introduction of this cue should impede the formation of the context-running association during the preexposure phase, thereby hindering the contextual blocking of aversive conditioning for the target flavour in the FAL phase. This would result in unweakened FAL. Although the results of Experiment 1 align with this prediction, in Experiment 2, when highly distinct flavours were used as the target and second cues, the preexposure effect was not eliminated. This contradicts the predictions of the associative account, indicating that Experiment 1 may have been influenced by stimulus generalisation. In Experiment 3, changing background contexts between the preexposure and FAL phases had no impact on the preexposure effect, contrary to the predictions of the associative account. In general, the associative account was not supported.
Subcutaneous vedolizumab interval extension in inflammatory bowel disease patients: a case series
Authors: Anjie Suzanne I. , Gecse Krisztina B. , Ponsioen Cyriel Y. , Löwenberg Mark , D’Haens Geert R.
Published: February 2024

Subcutaneous vedolizumab has demonstrated efficacy as a maintenance therapy in inflammatory bowel disease (IBD). However, data on the extension of subcutaneous vedolizumab injection intervals are lacking. Here, we present the first real-world data on subcutaneous vedolizumab interval extension in IBD patients. Nine patients (eight Crohn’s disease patients and one ulcerative colitis patient) were included in the study. At interval extension (at baseline), all patients were in clinical and biochemical remission and requested an extension of their 2-weekly injection intervals due to side effects potentially related to subcutaneous vedolizumab. Patients increased their intervals to 3, 4, or 5 weeks. During a median follow-up of 10.0 months (IQR 6.5–19.5), no flare-ups were observed. After 6 months, median biochemical parameters remained stable compared to baseline levels (fecal calprotectin 24.0 µg/g [IQR 10.0–43.0] versus 28.0 µg/g [IQR 15.0–54.0], p = 0.553; C-reactive protein 3.4 mg/L [IQR 1.4–4.2] versus 3.1 mg/L [IQR 0.7–4.9], p = 0.172), while vedolizumab serum concentrations significantly decreased (22.0 µg/mL [IQR 20.0–33.0] versus 40.0 µg/mL [IQR 28.3–45.0], p = 0.018). After interval extension, almost all suspected vedolizumab-induced side effects disappeared within 6 months. Lengthening subcutaneous vedolizumab intervals in IBD patients in clinical and biochemical remission appears to be both effective and safe, potentially leading to substantial reductions in healthcare expenses.
Attitudes, perceptions and barriers in implementing therapeutic drug monitoring for anti-TNFs in inflammatory bowel disease: a survey from the Middle East
Authors: Nigam Gaurav B. , Chatten Kelly , Sharara Ala , Al-Taweel Talal , Alharbi Othman , Elamin Hussein , Al Awadhi Sameer , Annese Vito , Limdi Jimmy K.
Published: February 2024

Background:

A growing body of evidence underscores the beneficial impact of therapeutic drug monitoring (TDM) on the efficacy and cost-effectiveness of anti-tumour necrosis factor (TNF) therapy in patients with inflammatory bowel disease (IBD).

Objectives:

We surveyed clinician attitudes, perceptions and barriers related to TDM in IBD in the Middle East.

Design:

A 15-question survey was distributed through national gastroenterological societies in five Middle Eastern countries (UAE, Saudi Arabia, Kuwait, Lebanon and Egypt).

Methods:

Data on clinician characteristics, demographics, utilization patterns and obstacles related to the adoption of TDM with anti-TNFs were gathered. Logistic regression analysis was used to predict factors influencing the utilization of TDM.

Results:

Among 211 respondents (82% male), 82% were consultants, 8% were physicians with an interest in gastroenterology (GI), and 6% were GI trainees. Of these, 152 met inclusion criteria, treating >5 IBD patients per month and ⩾1 with an anti-TNF per month. TDM was used in clinical practice by 78% (95% CI: 71–85) of respondents. TDM was utilized following the loss of response (LOR) in 93%, for primary non-response (PNR) in 40% and before restarting anti-TNF therapy after a drug holiday in 33% of respondents, while 34% used TDM proactively. No specific factors were associated with the use of TDM. Barriers to TDM use included cost (85%), time lag to results (71%) and lack of insurance reimbursement (65%). Overall knowledge of TDM (70%), interpretation and actioning of results (76%) or awareness of clinical guidelines (57%) were not perceived as barriers. If barriers were removed, 95% would use TDM more frequently; 93% for LOR, 60% for PNR, 50% when restarting after a drug holiday, and 54% would use TDM proactively.

Conclusion:

Most gastroenterologists use TDM for LOR, with cost, time lag and insurance reimbursement being significant barriers. Addressing these barriers would increase the judicious use of reactive and proactive TDM to optimize anti-TNF therapy in IBD.
Legal and ownership unbundling in the Turkish natural gas market: A comparative analysis
Authors: Gürler Yunus Emre , Ertemel Sinan , Finger Matthias , Eroğlu Muzaffer
Published: February 2024

This study introduces a theoretical framework for the Turkish natural gas market based on the principles of game theory and industrial organization. It investigates the effects of the legal and ownership unbundling on consumer surplus, social welfare, and competition. The model considers a mixed oligopoly with a transmission system operator (TSO), a state-owned incumbent, and a private firm. The state-owned incumbent is assumed to maximize consumer surplus and its own profit, while the private firm is assumed to be profit-maximizing. Additionally, the state-owned incumbent is assumed to be less efficient than the private firm. The game consists of three stages. In the first two stages, the state-owned incumbent and the private firm sequentially choose contract sizes in the upstream market. In the last stage, a contract size-restricted Cournot game is played. The findings of the study suggest that legal unbundling appears to offer greater advantages for consumer surplus and social welfare compared to ownership unbundling, particularly when considering key factors such as third-party access, non-tariff discrimination, and import liberalization. The results indicate that adopting the role of a Stackelberg follower by the state-owned incumbent in the upstream market is advantageous in terms of consumer surplus, social welfare, and competition under both unbundling approaches.
Determinants of Bluetooth-Enabled Self-Measured Blood Pressure Monitoring in Federally Qualified Health Centers
Authors: Hellem Abby , Whitfield Candace , Mansour Maria , Curran Yvonne , Dinh Mackenzie , Warden Kimberly , Skolarus Lesli E
Published: February 2024

Background:

In 2021, the Health Resources and Services Administration (HRSA) launched the National Hypertension Control Initiative (HTN Initiative) with the goal to enhance HTN control through Bluetooth-enabled self-measured blood pressure (BT-SMBP) monitoring and use this data to inform clinical decisions in Federally Qualified Health Centers (FQHCs) with a large proportion of their population with uncontrolled blood pressure (BP). We sought to understand the experience of Michigan-based FQHCs in implementing the HTN initiative.

Methods:

Staff from three Michigan-based FQHCs were invited to participate in semi-structured interviews from September to November 2022. Interviews were conducted in-person and were based on the Tailored Implementation in Chronic Diseases framework. Content analysis was performed by three coders.

Results:

Ten staff participated in interviews (FQHC 1: n = 6, FQHC 2: n = 1, FQHC 3: n = 3). The FQHCs differed in their stage of implementation and their approach. FQHC 1 created a large-scale, community health worker driven program, FQHC 2 created a small-scale, short term, BP device loan program, and FQHC 3 created a primarily outsourced, large-scale program through a contracted partner. Positive staff attitudes and outcome expectations, previous experience with SMBP grants, supportive clinic leadership, social support, and free BP cuff resources were identified as facilitators to implementation. Patients’ high social needs, SMBP-related Technology, and insufficient workforce and staff capacity were identified as barriers.

Conclusion:

BT-SMBP among FQHC patients is promising but challenges in integrating SMBP data into clinic workflow, workforce capacity to support the high social needs of participants, and to assist in reacting to the more frequent BP data remain to be overcome.
Identifying High-Cost, High-Need Patients in a Network of Community Hospitals
Authors: Zdrale Gabriel , Essary Alison , Bremer Stephan , Peng Wesley , Chen Weiqi , Kalpas Edward
Published: February 2024

We examined healthcare costs at HonorHealth, a community-based academic health center comprised of 5 hospitals and numerous ambulatory care facilities. Patient encounters that resulted in admission in 2019 were included in the study. Mean costs in 2019 for high costs and high needs (HCHN) patients were compared with all remaining patients using a framework developed by the National Academy of Medicine. HCHN patients were older (71 vs 52 years), with a lower percentage of females (41.7% vs 59.8%), more frequently White (90.1% vs 87.5%), less frequently married (52.4% vs 54.5%), with a longer length of stay (6.5 vs 3.0 days) and higher mean charges ($134 743 vs $16 414). The mean cost per patient in the HCHN group decreased by age group ($192, 963, $165 200, $144 584, $134 795, and $108 356) for 0 to 18, 19 to 44, 45 to 64, 65 to 84, and 85+ years, respectively. HCHN patients were more publicly insured (49% vs 38%). Targeted interventions to treat HCHN may lead to lower healthcare costs and improved health outcomes within this system.
Missed Healthcare Visits During the COVID-19 Pandemic: A Longitudinal Study
Authors: Hernandez Jethel , Batio Stephanie , Lovett Rebecca Mullen , Wolf Michael S. , Bailey Stacy C.
Published: February 2024

Introduction:

Missed visits have been estimated to cost the U.S. healthcare system $50 billion annually and have been linked to healthcare inefficiency, higher rates of emergency department visits, and worse outcomes. COVID-19 disrupted existing outpatient healthcare utilization patterns. In our study, we sought to examine the frequency of missed outpatient visits over the course of the COVID-19 pandemic and to examine patient-level characteristics associated with non-attendance.

Methods:

This study utilized data from a longitudinal cohort study (the Chicago COVID-19 Comorbidities (C3) study). C3 participants were enrollees in 1 of 4 active, “parent” studies; they were rapidly enrolled in C3 at the onset of the pandemic. Multiple waves of telephone-based interviews were conducted to collect experiences with the pandemic, as well as socio-demographic and health characteristics, health literacy, patient activation, and depressive and anxiety symptoms. For the current analysis, data from waves 3 to 8 (05/01/20-05/19/22) were analyzed. Participants included 845 English or Spanish-speaking adults with 1 or more chronic conditions.

Results:

The percentage of participants reporting missed visits due to COVID-19 across study waves ranged from 3.1 to 22.4%. Overall, there was a decline in missed visits over time. No participant sociodemographic or health characteristic was consistently associated with missed visits across the study waves. In bivariate and multivariate analysis, only patient-reported anxiety was significantly associated with missed visits across all study waves.

Conclusion:

Findings reveal that anxiety was consistently associated with missed visits during the COVID-19 pandemic, but not sociodemographic or health characteristics. Results can inform future public health initiatives to reduce absenteeism by considering patients’ emotional state during times of uncertainty.
Unlocking the Power of Entrepreneurship Activity in Vietnam’s Regions: The Role of Formal Institution
Authors: Tran My-Linh , Lo Shihmin
Published: February 2024

While entrepreneurship has been extensively studied worldwide, scant empirical research evidence has been found in Vietnam. Building upon the institutional economics perspective, this study empirically investigates the tripartite relationship between formal institutions, entrepreneurial activity, and socio-economic outcomes. A fixed effects model is employed to test the proposed hypotheses using a 5-year strong balanced panel data. The findings indicate that provinces are heterogeneous along multiple dimensions of institutional quality, leading to different entrepreneurial rates. Concurrently, it highlights the vital role of entrepreneurial activity in explaining the differences in economic performance, unemployment rate, and living standards across Vietnam’s regions. The results also confirm that the entrepreneurial rate exerts a mediating effect on the relationship between institutional quality and socio-economic outcomes. This study contributes to the entrepreneurial literature in Vietnam and provides practical implications for Vietnamese policymakers.
The Effect of Supportive Mentoring Style on Innovative Behavior of Master’s Degree Students: Evidence from China
Authors: Yang Pengcheng , Gao Yudong , Li Xiaoyu
Published: February 2024

The rapid growth of postgraduate education in China necessitates the imperative to augment the innovative behaviors of postgraduates. The purpose of this study was to explore whether a supportive mentoring style affects the innovative behavior of master’s degree students and the potential role that academic aspiration may play in the relationship between the two. A time-lag questionnaire was given to 911 master’s degree students in central China for Study 1. The results revealed that a supportive mentoring style positively predicted innovative behavior. Furthermore, the connection between a supportive mentoring style and innovative behaviors was mediated by academic aspirations. Study 2 matched five pairs of students with mentors to administer the survey using semi-structured interviews. The results confirmed the mechanisms through which supportive mentoring styles impact innovative behavior and provided more evidence for them. This study examines the development path of master’s degree students’ innovative behavior, reveals how internal (academic aspiration) and external (mentoring) factors impact such behavior, and offers insights into graduate students’ educational practices.
Spatial Impact of Digital Economy on the Upgrading of Industrial Structure: Evidence From Chinese Cities
Authors: Lu Yang , Hu JunJie
Published: February 2024

To study the impact of the digital economy on industrial structure upgrading, this paper constructs the dynamic spatial Durbin model, dynamic spatial intermediary model, and spatial threshold model based on the panel data of 155 prefecture-level cities in China from 2011 to 2021. It is found that: (a) the improvement of the digital economy in the region can directly promote the upgrading of local industrial structure, but there is a significant “siphon effect,” which makes the spatial spillover effect negative and significant. (b) The digital transformation of enterprises plays a mediating role in the path of digital economy-driven industrial structure upgrading, with a short-term mediating effect size of about 17.18%. (c) The digital economy has a threshold effect on the path of enterprise digital transformation for industrial structure upgrading. These findings provide suggestions for policy.
Do Store and Brand Attachments Influence Customer Loyalty? Evidence From Migrant Workers in Taiwan
Authors: Wu Ju-Chuan , Tsai Pei-Hsuan , Tang Jia-Wei , Chen Chih-Jou
Published: February 2024

The number of migrant workers in Taiwan has been increasing annually. Over the past decade, migrant workers have contributed to the nation’s economic growth, particularly in the construction, fishing, nursing, and public service sectors. Although many practitioners and scholars have articulated the significance of managing and understanding the migrant workers’ work and living conditions, research on the complex influences targeting their shopping behavior, attachment, and customer loyalty has not been steady. This study aimed to develop and empirically test a framework to examine the effects of store image, service quality, product attributes, and sales promotion on store and brand attachments, affecting customers’ loyalty to stores among migrant workers. The study employed the Mehrabian-Russell Model and attachment theory as theoretical bases. Empirical data was collected from 504 migrant workers in Taiwan through the purposive sampling technique using a questionnaire survey. Data analysis, hypotheses testing, and model validation were performed through SmartPLS 3.2.8 statistical software. The findings showed that store image and service quality were positively related to store attachment. Product attributes and sales promotion were positively related to brand attachment. Additionally, store and brand attachments are positively related to customer loyalty. Therefore, store and brand attachment were mediators linking store image, service quality, product attributes, and sales promotion to customer loyalty. According to the findings, the study offers implications and suggestions for researchers and practitioners in the retail sector, especially for retail stores related to migrant workers.
Does a High-Performance Human Resource Practice Stimulate Employee Creativity: A Moderated Mediation Model
Authors: Iram Tahira , Ashfaq Bilal , Bilal Ahmad Raza , Mian Tariq Saeed
Published: February 2024

This study explores entrepreneurial leadership as a moderator between employee work engagement and perceptions of high-performance human resource management (HRM) practices. Additionally, it delves into the mediating role of employee work engagement between employee creativity and these perceptions. Utilizing a quantitative research strategy, the study includes a sample of 396 members from the banking sector in Pakistan. The study employs PLS-SEM to test hypotheses. Findings indicate that employee work engagement serves as a mediator between employees’ perceptions of high-performance HRM practices and creativity, while entrepreneurial leadership moderates this association. Entrepreneurial leadership enhances the employee–organization relationship and strengthens the impact of high-performance HRM practices on positive work-related behaviours. The study contributes to the body of knowledge by examining the strong role of employee work engagement in the relationship between employee perceptions of high-performance HRM practices and creativity as mediator, as well as the significance of entrepreneurial leadership as a moderator in that relationship to optimize the working of organization stimulating through the demand resource theory.
Incremental value of serum neurofilament light chain and glial fibrillary acidic protein as blood-based biomarkers for predicting functional outcome in severe acute ischemic stroke
Authors: Vollmuth Christoph , Fiessler Cornelia , Montellano Felipe A , Kollikowski Alexander M , Essig Fabian , Oeckl Patrick , Barba Lorenzo , Steinacker Petra , Schulz Cara , Ungethüm Kathrin , Wolf Judith , Pham Mirko , Schuhmann Michael K , Heuschmann Peter U , Haeusler Karl Georg , Stoll Guido , Otto Markus , Neugebauer Hermann
Published: February 2024

Introduction:

Blood-based biomarkers may improve prediction of functional outcome in patients with acute ischemic stroke. The role of neurofilament light chain (NfL) and glial fibrillary acidic (GFAP) as potential biomarkers especially in severe stroke patients is unknown.

Patients and Methods:

Prospective, monocenter, cohort study including consecutive patients with severe ischemic stroke in the anterior circulation on admission (NIHSS score ⩾ 6 points or indication for mechanical thrombectomy). Outcome was assessed 3 months after the index stroke by the modified Rankin Scale (mRS). Serum biomarkers levels of NfL and GFAP were determined by ultrasensitive ELISA. Univariate and multivariate logistic regression models were performed to determine the association of biomarker levels and functional disability. Discrimination, calibration, and overall performance were analyzed in different models via AUROC, calibration plots (with Emax and Eavg), Brier-score and R2 using variables, identified as important covariates for functional outcome in previous studies.

Results:

Between 06/2020 and 08/2021, 213 patients were included [47% female, mean age 76 (SD ± 12) years, median NIHSS score 13 (interquartile range, IQR 9; 17)]. Biomarker serum levels were measured at a median of 1 [IQR, 1; 2] day after admission. Compared to patients with mRS 0–2 at 3 months, patients with mRS 3–6 had higher serum levels of NfL (median: 136 pg/ml vs 41 pg/ml; p < 0.0001) and GFAP (700 ng/ml vs 9.6 ng/ml; p < 0.0001). Both biomarkers were significantly associated with functional outcome [adjusted logistic regression, odds ratio (95% CI) for NfL: 2.63 (1.62; 4.56), GFAP: 2.16 (1.58; 3.09)]. In all models the addition of serum NfL led to a significant improvement in the AUROC, as did the addition of serum GFAP. Calibration plots showed high agreement between the predicted and observed outcomes and after addition of the two blood-based biomarkers there was an improvement of the overall performance.

Conclusion:

Prediction of functional outcome after severe acute ischemic stroke was improved by the blood-based biomarkers serum NfL and GFAP, measured in the acute phase of stroke. These findings have to be replicated in independent external cohorts. Study registration: DRKS00022064
Escherichia coli and their potential transmission of carbapenem and colistin-resistant genes in camels
Authors: youseef Marwa , Karam Fatma , Kadry Mona , Elhariri Mahmoud , Elhelw Rehab
Published: February 2024

Background

Camels harbouring multidrug-resistant Gram-negative bacteria are capable of transmitting various microorganisms to humans. This study aimed to determine the distribution of anti-microbial resistance among Escherichia coli (E. coli) isolated from the feces of apparently healthy camels in Egyptian abattoirs. Additionally, we sought to characterize Shiga toxin-producing E. coli (STEC) strains, assess their virulence potential, and investigate the possibility of camels spreading carbapenem- and colistin-resistant E. coli.

Methods

121 fecal swaps were collected from camels in different abattoirs in Egypt. Isolation and identification of E. coli were performed using conventional culture techniques and biochemical identification. All isolates obtained from the examined samples underwent genotyping through polymerase chain reaction (PCR) of the Shiga toxin-encoding genes (Stx1 and Stx2), the carbapenemase-encoding genes (blaKPC, blaOXA−48, blaNDM, and blaVIM), and the mcr genes for mcr-1 to mcr-5.

Result

Bacteriological examination revealed 75 E. coli isolates. PCR results revealed that one strain (1.3%) tested positive for Stx1, and five (6.6%) were positive for Stx2. Among the total 75 strains of E. coli, the overall prevalence of carbapenemase-producing E. coli was 27, with 7 carrying blaOXA48, 14 carrying blaNDM, and 6 carrying blaVIM. Notably, no strains were positive for blaKPC but a high prevalence rate of mcr genes were detected. mcr-1, mcr-2, mcr-3, and mcr-4 genes were detected among 3, 2, 21, and 3 strains, respectively.

Conclusion

The results indicate that camels in Egypt may be a primary source of anti-microbial resistance (AMR) E. coli, which could potentially be transmitted directly to humans or through the food chain.
Integrated analysis and validation of ferroptosis-related genes and immune infiltration in acute myocardial infarction
Authors: Wu Xinyu , Li Jingru , Chai Shengjie , Li Chaguo , Lu Si , Bao Suli , Yu Shuai , Guo Hao , He Jie , Peng Yunzhu , Sun Huang , Wang Luqiao
Published: February 2024

Background

Acute myocardial infarction (AMI) is indeed a significant cause of mortality and morbidity in individuals with coronary heart disease. Ferroptosis, an iron-dependent cell death, is characterized by the accumulation of intracellular lipid peroxides, which is implicated in cardiomyocyte injury. This study aims to identify biomarkers that are indicative of ferroptosis in the context of AMI, and to examine their potential roles in immune infiltration.

Methods

Firstly, the GSE59867 dataset was used to identify differentially expressed ferroptosis-related genes (DE-FRGs) in AMI. We then performed gene ontology (GO) and functional enrichment analysis on these DE-FRGs. Secondly, we analyzed the GSE76591 dataset and used bioinformatic methods to build ceRNA networks. Thirdly, we identified hub genes in protein–protein interaction (PPI) network. After obtaining the key DE-FRGs through the junction of hub genes with ceRNA and least absolute shrinkage and selection operator (LASSO). ImmucellAI was applied to estimate the immune cell infiltration in each sample and examine the relationship between key DE-FRGs and 24 immunocyte subsets. The diagnostic performance of these genes was further evaluated using the receiver operating characteristic (ROC) curve analysis. Ultimately, we identified an immune-related ceRNA regulatory axis linked to ferroptosis in AMI.

Results

Among 56 DE-FRGs identified in AMI, 41 of them were integrated into the construction of competitive endogenous RNA (ceRNA) networks. TLR4 and PIK3CA were identified as key DE-FRGs and PIK3CA was confirmed as a diagnostic biomarker for AMI. Moreover, CD4_native cells, nTreg cells, Th2 cells, Th17 cells, central-memory cells, effector-memory cells, and CD8_T cells had higher infiltrates in AMI samples compared to control samples. In contrast, exhausted cells, iTreg cells, and Tfh cells had lower infiltrates in AMI samples. Spearman analysis confirmed the correlation between 24 immune cells and PIK3CA/TLR4. Ultimately, we constructed an immune-related regulatory axis involving XIST and OIP5-AS1/miR-216a/PIK3CA.

Conclusion

Our comprehensive analysis has identified PIK3CA as a robust and promising biomarker for this condition. Moreover, we have also identified an immune-related regulatory axis involving XIST and OIP5-AS1/miR-216a/PIK3CA, which may play a key role in regulating ferroptosis during AMI progression.
Advanced gastrointestinal stromal tumor: reliable classification of imatinib plasma trough concentration via machine learning
Authors: Ran Pan , Tan Tao , Li Jinjin , Yang Hao , Li Juan , Zhang Jun
Published: February 2024

Aim

Patients with advanced gastrointestinal stromal tumors (GISTs) exhibiting an imatinib plasma trough concentration (IM Cmin) under 1100 ng/ml may show a reduced drug response rate, leading to the suggestion of monitoring for IM Cmin. Consequently, the objective of this research was to create a customized IM Cmin classification model for patients with advanced GISTs from China.

Methods

Initial data and laboratory indicators from patients with advanced GISTs were gathered, and the above information was segmented into a training set, validation set, and testing set in a 6:2:2 ratio. Key variables associated with IM Cmin were identified to construct the classification model using the least absolute shrinkage and selection operator (LASSO) regression and forward stepwise binary logistic regression. Within the training and validation sets, nine ML classification models were constructed via the resampling method and underwent comparison through the Brier scores, the areas under the receiver-operating characteristic curve (AUROC), the decision curve, and the precision-recall (AUPR) curve to determine the most suitable model for this dataset. Two methods of internal validation were used to assess the most suitable model's classification performance: tenfold cross-validation and random split-sample validation (test set), and the value of the test set AUROC was used to evaluate the model's classification performance.

Results

Six key variables (gender, daily IM dose, metastatic site, red blood cell count, platelet count, and percentage of neutrophils) were ultimately selected to construct the classification model. In the validation set, it is found by comparison that the Extreme Gradient Boosting (XGBoost) model has the largest AUROC, the lowest Brier score, the largest area under the decision curve, and the largest AUPR value. Furthermore, as evaluated via internal verification, it also performed well in the test set (AUROC = 0.725).

Conclusion

For patients with advanced GISTs who receive IM, initial data and laboratory indicators could be used to accurately estimate whether the IM Cmin is below 1100 ng/ml. The XGBoost model may stand a chance to assist clinicians in directing the administration of IM.
Does transanal drainage tubes placement have an impact on the incidence of anastomotic leakage after rectal cancer surgery? a systematic review and meta-analysis
Authors: Liu Yating , Hu Xuhua , Huang Yu , Yin Xu , Zhang Pengfei , Hao Yaoguang , Li Hongyan , Wang Guiying
Published: February 2024

Background

Whether Transanal drainage tubes (TDTs) placement reduces the occurrence of anastomotic leakage (AL) after rectal cancer (RC) surgery remains controversial. Most existing meta-analyses rely on retrospective studies, while the prospective studies present an inadequate level of evidence.

Methods

A systematic review and meta-analysis of prospective studies on TDTs placement in RC patients after surgery was conducted. The main analysis index was the incidence of AL, Grade B AL, and Grade C AL, while secondary analysis index was the incidence of anastomotic bleeding, incision infection, and anastomotic stenosis. A comprehensive literature search was performed utilizing the databases Cochrane Library, Embase, PubMed, and Web of Science. We recorded Risk ratios (RRs) and 95% confidence intervals (CI) for each included study, and a fixed-effect model or random-effect model was used to investigate the correlation between TDTs placement and four outcomes after RC surgery.

Results

Seven studies (1774 participants, TDT 890 vs non-TDT 884) were considered eligible for quantitative synthesis and meta-analysis. The meta-analysis revealed that the incidence of AL was 9.3% (83/890) in the TDT group and 10.2% (90/884) in the non-TDT group. These disparities were found to lack statistical significance (P = 0.58). A comprehensive meta-analysis, comprising four studies involving a cumulative sample size of 1259 participants, revealed no discernible disparity in the occurrence of Grade B AL or Grade C AL between the TDT group and the non-TDT group (Grade B AL: TDT 34/631 vs non-TDT 26/628, P = 0.30; Grade C AL: TDT 11/631 vs non-TDT 27/628, P = 0.30). Similarly, the incidences of anastomotic bleeding (4 studies, 876 participants), incision infection (3studies, 713 participants), and anastomotic stenosis (2studies, 561 participants) were 5.5% (24/440), 8.1% (29/360), and 2.9% (8/280), respectively, in the TDT group, and 3.0% (13/436), 6.5% (23/353), and 3.9% (11/281), respectively, in the non-TDT group. These differences were also determined to lack statistical significance (P = 0.08, P = 0.43, P = 0.48, respectively).

Conclusion

The placement of TDTs does not significantly affect the occurrence of AL, Grade B AL, and Grade C AL following surgery for rectal cancer. Additionally, TDTs placement does not be associated with increased complications such as anastomotic bleeding, incision infection, or anastomotic stenosis.

Trial registration

PROSPERO: CRD42023427914
Social isolation consequences: lessons from COVID-19 pandemic in a context of dynamic lock-down in Chile
Authors: Patrono Alessandra , Renzetti Stefano , Guerini Cristian , Macgowan Mark , Moncada Stefanny M , Placidi Donatella , Memo Maurizio , Lucchini Roberto G.
Published: February 2024

Background

Chile did not adopt general and unified lockdowns for the whole nation but organized itself with dynamic and sometimes irregular lockdowns. These dynamics and consequences of social isolation could be generalized to other contexts of isolation such as those affecting minorities such as immigrants, prisoners, refugees.

Methods

In this study, we investigated the physical and mental health symptoms associated with lifestyle changes due to lockdown among university students in Chile. We examined psychopathological variations in relation to mental health problems in a healthy young population. Our goal was to develop interventions to address these new psychosocial problems in potentially comparable post-pandemic contexts. From May 10th 2021 to June 2th 2021, 420 University students took part in an anonymous survey asking for information on habits and symptoms that emerged during the lockdown in response to the COVID-19 pandemic. Three health outcomes were assessed: digestive disorders; headache; fear of COVID-19. Covariates including conditions and lifestyle during the pandemic, SARS-CoV-2 infections in the family, financial situation and productivity were considered in the analysis.

Results

Participants experienced headache and fear of COVID-19 quite frequently during the lockdown period. More than half of the sample also experienced social isolation. Female gender, sleep quality, memory difficulties, and a change in eating habits resulted associated with an increased risk of health outcomes such as headaches and digestive disorders.

Conclusions

The results of this study fit within an original pandemic context: The results of this study can help identify needs and promote solutions applicable to different contexts. Future interventions should focus on the promotion and implementation of healthy habits focused on sleep hygiene, psychoeducation on the use of mobile devices and gender medicine with the support of healthcare organizations and University.