bluuebunny/crossref_metadata_2025 huggingface dataset:
Business model innovations amidst adverse economic conditions: the role of CEO values
Authors: Artamoshina Polina , Shirokova Galina , Bodolica Virginia
Published: July 2024

Purpose

The current business environment is characterized by high levels of uncertainty that affect the global economic system and have the greatest impact on small and medium-sized enterprises (SMEs). With an elevated degree of perceived uncertainty, Chief executive officers' (CEOs) of SMEs find themselves in a situation where the old approaches to decision-making are irrelevant and the time to create new ones is limited. The purpose of this study is to examine whether appealing to personal values helps CEOs cope with a high level of perceived uncertainty and make decisions about the further development of the firm by undertaking business model innovations (BMI).

Design/methodology/approach

This study follows a multiple case study research design drawing on data collected from 10 Russian SMEs.

Findings

The authors show that CEOs’ communion values lead to innovations in the revenue model and value architecture dimensions of the business model. CEOs who are inclined to agentic values introduce innovations in the revenue model and value offering dimensions. Those executives who balance between the two types of values tend to also balance between different types of innovations in the elements of the business model.

Originality/value

The results indicate that personal values of CEOs play an important role in managerial processes and the strategic choice of a BMI type. Moreover, personal temporal focus orientation serves as a translation mechanism in the relationship between CEO values and BMI in SME settings.
Collaborative vehicle routing for equitable and effective food allocation in nonprofit settings
Authors: Bonku Rabiatu , Alkaabneh Faisal , Davis Lauren Berrings
Published: July 2024

Purpose

Inspired by a food bank distribution operation, this paper aims to study synchronized vehicle routing for equitable and effective food allocation. The primary goal is to improve operational efficiency while ensuring equitable and effective food distribution among the partner agencies.

Design/methodology/approach

This study introduces a multiobjective Mixed Integer Programming (MIP) model aimed at addressing the complex challenge of effectively distributing food, particularly for food banks serving vulnerable populations in low-income urban and rural areas. The optimization approach described in this paper places a significant emphasis on social and economic considerations by fairly allocating food to food bank partner agencies while minimizing routing distance and waste. To assess the performance of the approach, this paper evaluates three distinct models, focusing on key performance measures such as effectiveness, equity and efficiency. The paper conducts a comprehensive numerical analysis using randomly generated data to gain insights into the trade-offs that arise and provide valuable managerial insights for food bank managers.

Findings

The results of the analysis highlight the models that perform better in terms of equity and effectiveness. Additionally, the results show that restocking the vehicles through the concept of synchronization improves the overall quantity of food allocation to partner agencies, thereby increasing accessibility.

Research limitations/implications

This paper contributes significantly to the literature on optimization approaches in the field of humanitarian logistics.

Practical implications

This study provides food bank managers with three different models, each with a multifaceted nature of trade-offs, to better address the complex challenges of food insecurity.

Social implications

This paper contributes significantly to social responsibility by enhancing the operational efficiency of food banks, ultimately improving their ability to serve communities in need.

Originality/value

To the best of the authors’ knowledge, this paper is the first to propose and analyze this new variant of vehicle routing problems in nonprofit settings.
Influencer storefronts: impact of social media advertising disclosures on purchases
Authors: Al-Hasan Abrar
Published: July 2024

Purpose

The purpose of this study is to address the surging reliance on influencer marketing in evolving business models, focusing on a novel approach – the influencer e-commerce storefront. This study investigates various influencer advertising disclosures, social media activities and their impact on consumer engagement and sales within the influencer e-commerce storefront.

Design/methodology/approach

Secondary data was collected on 734 influencers from an e-commerce website based on “influencer” storefronts, and the influencer’s social media activity and content were collected from Instagram. Two-stage seemingly unrelated regression model was used to examine the research model.

Findings

Influencer social media use, encompassing daily posts, story posts and average comments, positively influences consumer engagement and sales on influencer e-commerce storefronts. Notably, the study reveals that different advertising disclosure languages yield varying effects. Unclear disclosures (e.g. branded Highlights) positively impact engagement and sales, while obvious disclosures (e.g. “Sponsored Ad”) negatively affect both.

Originality/value

The study contributes to Persuasion Knowledge Theory, examining influencer e-commerce storefronts and revealing the persuasive impact of undisclosed language in advertising. This study innovatively explores the effects of obvious and undisclosed sponsorship on coping mechanisms, offering insights into consumer reactions. The recommended use of undisclosed language suggests that ambiguity can enhance ad persuasion, guiding practitioners in crafting more effective messages. Moreover, the study extends co-creation theory and service-dominant logic by underscoring the significance of influencers’ social media engagement in co-creating value for consumers. Influencers’ active engagement on social media fosters co-creation, strengthening connections and boosting consumer loyalty.
Service-informed marketing reform
Authors: Grönroos Christian
Published: July 2024

Purpose

This paper aims to develop an alternative perspective on marketing informed by service scholarship to resolve marketing’s challenges as a discipline and practice.

Design/methodology/approach

This paper is conceptual and builds on the ongoing debate regarding marketing’s challenges and on service research to develop a new alternative marketing perspective and model, which could contribute to reforming marketing.

Findings

An analysis of the current understanding of marketing showed that the discipline’s myopic focus on activities, which disregards what marketing is as a phenomenon, is the primary reason for the prevailing problems and failure to reform marketing. Based on research into service logic (SL), the paper demonstrates that a higher level view of service can be characterized as the provision of help to the users of goods and services to ensure that these goods and services deliver meaningful assistance in their lives and work. This suggests that the ultimate objective for marketing is to make firms meaningful to the users of their goods and services.

Research limitations/implications

To the best of the author’s knowledge, since this paper is the first to conceptually develop a perspective on marketing and a corresponding model informed by service scholarship, more conceptual and empirical research is necessary. Developing the new meaningfulness-based perspective and model for marketing brings a new approach to the process of resolving marketing’s current troubled situation.

Practical implications

The meaningfulness approach to marketing enables customer-centered marketing strategies to be implemented. Such strategies include both demand-stimulating and demand-satisfying programs.

Originality/value

To the best of the author’s knowledge, this paper is the first to examine marketing’s troubled situation from a service research and SL perspective.
Literacy and illiteracy in Morocco and the multifaceted role of public libraries
Authors: Bouaamri Asmaa , Barátné Hajdu Ágnes
Published: July 2024

Purpose

This paper aims to present Morocco's main situation in terms of literacy and illiteracy rates and how public libraries can assist in the development of literacy and education.

Design/methodology/approach

The research collected data and statistics available on the Ministry of Education's website, as well as a literature review of the existing research in this regard.

Findings

Data shows a lack of support in the field of education and adult literacy and limited access to library services.

Originality/value

The current study is the first and unique one to provide data and analyses on the literacy situation in Morocco.
Extreme roughness reduction and ultrafine quality of innovative dual function material extrusion 3D printer
Authors: Rashyid Muhammad Ibnu , Jaya Mahendra , Muflikhun Muhammad Akhsin
Published: July 2024

Purpose

This paper aims to use hybrid manufacturing (HM) to overcome several drawbacks of material extrusion three-dimensional (3D) printers, such as low dimension ranging from 0.2 to 0.5 µm, resulting in a noticeable staircase effect and elevated surface roughness.

Design/methodology/approach

Subtractive manufacturing (SM) through computer numerical control milling is renowned for its precision and superior surface finish. This study integrates additive manufacturing (AM) and SM into a single material extrusion 3D printer platform, creating a HM system. Two sets of specimens, one exclusively printed and the other subjected to both printing and milling, were assessed for dimension accuracy and surface roughness.

Findings

The outcomes were promising, with postmilling accuracy reaching 99.94%. Significant reductions in surface roughness were observed at 90° (93.4% decrease from 15.598 to 1.030 µm), 45° (89% decrease from 26.727 to 2.946 µm) and the face plane (71% decrease from 12.176 to 3.535 µm).

Practical implications

The 3D printer was custom-built based on material extrusion and modified with an additional milling tool on the same gantry. An economic evaluation based on cost-manufacturing demonstrated that constructing this dual-function 3D printer costs less than US$560 in materials, offering valuable insights for researchers looking to replicate a similar machine.

Originality/value

The modified general 3D printer platform offered an easy way to postprocessing without removing the workpiece from the bed. This mechanism can reduce the downtime of changing the machine. The proven increased dimension accuracy and reduced surface roughness value increase the value of 3D-printed specimens.
Uncovering corporate greenwashing: a predictive model based on Chinese heavy-pollution industries
Authors: Li Qiang , He Zichun , Li Huaxia
Published: July 2024

Purpose

As the global emphasis on environmental consciousness intensifies, many corporations claim to be environmentally responsible. However, some merely partake in “greenwashing” – a facade of eco-responsibility. Such deceptive behavior is especially prevalent in Chinese heavy-pollution industries. To counter these deceptive practices, this study aims to use machine learning (ML) techniques to develop predictive models against corporate greenwashing, thus facilitating the sustainable development of corporations.

Design/methodology/approach

This study develops effective predictive models for greenwashing by integrating multifaceted data sets, which include corporate external, organizational and managerial characteristics, and using a range of ML algorithms, namely, linear regression, random forest, K-nearest neighbors, support vector machines and artificial neural network.

Findings

The proposed predictive models register an improvement of over 20% in prediction accuracy compared to the benchmark value, furnishing stakeholders with a robust tool to challenge corporate greenwashing behaviors. Further analysis of feature importance, industry-specific predictions and real-world validation enhances the model’s interpretability and its practical applications across different domains.

Practical implications

This research introduces an innovative ML-based model designed to predict greenwashing activities within Chinese heavy-pollution sectors. It holds potential for application in other emerging economies, serving as a practical tool for both academics and practitioners.

Social implications

The findings offer insights for crafting informed, data-driven policies to curb greenwashing and promote corporate responsibility, transparency and sustainable development.

Originality/value

While prior research mainly concentrated on the factors influencing greenwashing behavior, this study takes a proactive approach. It aims to forecast the extent of corporate greenwashing by using a range of multi-dimensional variables, thus providing enhanced value to stakeholders. To the best of the authors’ knowledge, this is the first study introducing ML-based models designed to predict a company’s level of greenwashing.
The evolution of sensitive periods beyond early ontogeny: Bridging theory and data
Authors: Walasek Nicole , Panchanathan Karthik , Frankenhuis Willem E.
Published: July 2024

Sensitive periods, in which experiences have a large impact on phenotypic development, are most common early in ontogeny. Yet, they may also occur at later ontogenetic stages, such as adolescence. At present, however, we know little about why natural selection favours sensitive periods for some traits early in ontogeny and for others later in ontogeny. This article synthesizes recent mathematical models and empirical studies that explore sensitive periods beyond early ontogeny.

Across mathematical models, we observe two general patterns. First, sensitive periods emerge beyond early ontogeny when an organism's uncertainty about the environment‐phenotype fit increases at later developmental stages. Second, sensitive periods emerge beyond early ontogeny when cues at later stages reduce this uncertainty more than earlier cues do.

In the empirical literature, we observe that traits showing sensitive periods beyond early ontogeny tend to be social traits, particularly among mammals. Connecting theory to data, we hypothesize that mammals have evolved to expect reliable information from peers in adolescence to reduce uncertainty about the current and future social environment (e.g. social dominance, mate value).

Finally, we highlight current gaps in our understanding and suggest future directions for strengthening bridges between empirical and theoretical studies of sensitive periods. Ultimately, we hope our synthesis will contribute towards an integrative science of sensitive periods across the biological and the social sciences.

Read the free Plain Language Summary for this article on the Journal blog.
Reconciling 22,000 years of landscape openness in a renowned wilderness
Authors: Fletcher Michael‐Shawn , Romano Anthony , Lisé‐Pronovost Agathe , Mariani Michela , Henriquez William , Gadd Patricia , Heijnis Hendrik , Hodgson Dominic , Blaauw Maarten , Sculthorpe Andry
Published: July 2024

Here, we explore the profound impact of the Tasmanian Aboriginal (Palawa) people on Tasmanian landscapes by examining a 22,000‐year record of landscape change from Lake Selina in western Tasmania, Australia. We analysed a sediment core for palaeoecological proxies, namely, pollen (vegetation), charcoal (fire), and geochemical data (landscape weathering). This study reveals that the contemporary landscape is a product of Palawa people’s intentional and strategic fire management practices characterised by fire‐dependent buttongrass moorland and the absence of climax rainforest. Specifically, our data show that rainforest failed to re‐establish a dominance at Lake Selina following the end of the Last Glacial Maximum, as temperature and moisture increased as a result of Palawa cultural fire for at least 18,000 years. This finding challenges the long‐held notion that Tasmania’s wilderness is a product of the absence of human activity. Rather, archaeological sites across western and central Tasmania demonstrate long term presence, with some of the highest artefact and faunal bone densities in the world. The study contributes to the recognition of Tasmania’s west as a cultural landscape shaped by generations of Aboriginal care for Country and fire practices.
Regulatory decentralization and food safety: evidence from China
Authors: Lin Wen , Liang Jiangyuan
Published: July 2024

It is not clear, a priori, whether a centralized or decentralized institutional arrangement is better at providing public goods. This study investigates how decentralization of regulatory authority affects public good provision, focusing on food safety. Using a natural experiment that transfers food safety regulatory authority over the food processing and manufacturing sector from provincial to city‐level governments, we find a 51% decrease in the average number of food safety incidents within cities that experienced the decentralization reform. Decentralization reduces food safety incidents by rectifying information asymmetry in food safety regulations and by increasing local food safety laws and regulations. Additional analyses show that decentralization primarily improves the food safety of larger and more experienced firms, and it has not harmed the total revenue of large‐scale food processing and manufacturing firms. Our study demonstrates the importance of information available to regulatory authorities in food safety regulation and highlights the role of local information in the decentralized provision of public goods.
Mortality following admission to the paediatric intensive care unit: A Swedish longitudinal cohort study
Authors: Daham Shanay , Larsson Emma , Eksborg Staffan , Hamrin Tova Hannegård
Published: July 2024

Aim

This study aimed to compare outcomes post‐admission to a Swedish paediatric intensive care unit (PICU) in children with complex chronic conditions (CCC) and without CCC.

Methods

In this observational registry‐based study, consecutive admissions to the Astrid Lindgren Children's Hospital PICU from 1 January 2008 to 31 December 2016 were analysed. Data on demographics, predicted death rates (PDR), admission diagnoses and causes of death were collected. Mortality was recorded up to 15 years after admission and compared between groups.

Results

Patients with CCC constituted 64.6% (n = 3026) of PICU admissions and 83.5% (n = 111) of PICU deaths. The crude mortality rate in PICU was 2.84% overall. CCC‐patients were 2.83 times more likely to die in PICU compared to non‐CCC (OR 2.83; 95% CI: 1.78–4.49). Mortality increased in the CCC‐cohort up to 5 years after PICU discharge, while non‐CCC patients generally survived if they survived in PICU. Of the patients who died in PICU, the median PDR was 22.9% for CCC‐patients and 66.5% in the non‐CCC cohort.

Conclusion

Children with CCC accounted for most admissions and deaths in PICU. Despite lower severity of illness scores upon admission, CCC patients were nearly three times more likely to die in PICU compared to non‐CCC patients.
Should high‐dose N‐acetylcysteine be given in cases of massive paracetamol overdoses: A narrative review
Authors: Erichsen Philip Ahle , Dalhoff Kim , Andersen Michael Asger
Published: July 2024

N‐acetylcysteine (NAC) is regarded as an effective treatment of paracetamol overdoses. However, in cases of “massive” paracetamol overdoses, recent studies indicate that patients may not be sufficiently treated with the standard dose of NAC (300 mg/kg over 20–21 h). The subject is further complicated because “massive overdoses” and “high‐risk” are defined differently; some studies use the ingested amount (e.g., >40 g), and some studies use blood concentrations of paracetamol and transaminases. This narrative review investigates whether high‐dose NAC significantly decreases the risk of hepatotoxicity in patients with massive paracetamol overdoses. Three observational studies were analysed; one study with 373 patients found no significant difference (odds ratio [OR]: 1.27, 95% confidence interval [CI]: 0.49–3.29). One study with 79 patients found a significant difference (OR: 0.27, 95% CI: 0.08–0.94). The third study with 89 patients found a significant difference in hepatoxicity between the groups (p = 0.043). There are no solid evidence to support that treatment with high‐dose NAC significantly reduces the rate of hepatotoxicity in patients presenting with massive paracetamol overdoses. Differences in inclusion criteria in the included studies make the studies incomparable. This paper shows that standardized inclusion is needed to determine whether a high‐dose NAC regimen should be included in clinical practice.
How rising housing prices affect labor costs in China: Heterogeneity and lagging
Authors: Yuan Pengfei , Cao Yunhui
Published: July 2024

The impact of house prices rising on urban labor costs has typical heterogeneity and lag effects, but there is little literature on it. Based on the panel data of 283 prefecture level cities from 2001 to 2017, we constructed panel model considering lag effect and threshold effect. The results show that lag one period of housing price has significant positive impact on urban labor costs, with the increase of housing prices, the effect of pushing up the current labor costs is gradually increasing. So, this impact has obvious lag effect and threshold effect. Through grouped regression to test heterogeneity effect, at the regional level, the heterogeneity of the impact is more significant. The more developed the economy is, the greater the pushing effect of house prices on labor costs.
Genetics of 67 patients of suspected primary ciliary dyskinesia from India
Authors: Jat Kana Ram , Faruq Mohammed , Jindal Shishir , Bari Shreya , Soni Akshita , Sharma Pooja , Mathews Susi , Shamim Uzma , Ahuja Vanshika , Uppilli Bharathram , Yadav Subhash C. , Lodha Rakesh , Arava Sudheer K. , Kabra Sushil K.
Published: July 2024

Data are limited on the genetic profile of primary ciliary dyskinesia (PCD) from developing countries. Here, we report one of the first study on genetic profile of patients with suspected PCD from India. In this prospective cross‐sectional study, we enrolled 162 children with suspected PCD. We recorded clinical features, relevant laboratory tests for PCD and performed whole exome sequencing (WES). We are reporting 67 patients here who had positive variant/s on WES. We had 117 variants in 40 genes among 67 patients. Among the 108 unique variants, 33 were categorized as pathogenic or likely pathogenic (P/LP). We had nine novel variants in out cohort. The 29 definite PCD cases, diagnosed by composite reference standards, had variants in 16 genes namely LRRC6/DNAAF11 (5), DNAH5 (3), CCDC39 (3), HYDIN (3), DNAH11 (2), CCDC40 (2), CCDC65 (2) and one each DNAAF3, DNAAF2, CFAP300, RPGR, CCDC103, CCDC114, SPAG1, DNAI1, and DNAH14. To conclude, we identified 108 unique variants in 40 genes among 67 patients. The common genes involved in definite cases of PCD in Indian patients were LRRC6, DNAH5, CCDC39, and HYDIN. Our findings suggest a need to develop a separate genetic panel for PCD in the Indian population.
Global scoping review of behavioral interventions to reduce plastic pollution with recommendations for key sectors
Authors: Nuojua Sohvi , Cracknell Deborah , Heske Anja , Pahl Sabine , Wyles Kayleigh J. , Thompson Richard C.
Published: July 2024

End users of single‐use plastics can help minimize their contribution to plastic pollution via mindful purchasing and waste management. These behaviors can be impacted via behavior change interventions in various key sectors of society. This review set out to summarize recent (2015–2023) peer‐reviewed evidence on interventions aimed at changing the plastic consumption, recycling, and/or littering behaviors of individuals across four sectors: business and retail, tourism and leisure, schools and education, and communities. Systematic literature searches were conducted across multiple databases and resulted in the inclusion of 92 intervention studies. Information on intervention strategy and effectiveness was extracted, and the studies were assessed for risk of bias. Intervention descriptions and outcomes were coded into five intervention categories (informational, contextual, prompts, social, and personal strategies) and synthesized qualitatively to inform future practice in an accessible manner. Although nearly half of the reviewed studies were assessed as having moderate‐to‐high risk of bias (e.g., lacked reliability assessment of outcome measures), limiting confidence in the documented findings, the review concludes that different strategies work in different sectors. For example, informational strategies showed mostly promising results in most sectors, but had mixed effectiveness in the education sector, while contextual modifications were effective across sectors.
Dermatomyositis‐like skin eruptions under hydroxyurea therapy conceal TP53‐mutated atypical keratinocytes: A histopathologic and molecular pathologic case series
Authors: Pruessmann Wiebke , Kirfel Jutta , Sailer Verena‐Wilbeth , Rose Christian
Published: July 2024

Hydroxyurea is an antimetabolite that inhibits DNA synthesis and is used as a treatment option in chronic myeloproliferative disorders. Rarely, “dermatomyositis (DM)‐like” skin lesions are observed after long‐term therapy. In this case series, five skin biopsies of four patients were evaluated by histology, immunohistochemistry, and next‐generation sequencing of the TP53 gene locus. All biopsies showed focal basal pleomorphic keratinocytes and suprabasal aberrant p53 expression as well as sparse to severe vacuolar interface dermatitis. Histopathologically, “DM‐like” skin lesions can be clearly distinguished from DM by marked subepidermal fibrosis, vascular proliferation, and the absence of dermal mucin deposits. In 75% of the specimens multiple, partly inactivating and/or pathogenic point mutations of TP53 were found in low frequencies. “DM‐like” skin eruptions as a long‐term consequence of hydroxyurea therapy are possibly not chemotherapy‐associated benign toxic changes, but rather inflammatory reactions to complex keratinocyte alterations that clinically mimic the picture of DM. Synergistic mutagenic effects of hydroxyurea and sunlight might be responsible for this unique drug side effect and could provide a pathogenic link to the known increased risk of skin cancer in these patients.
Sharing is caring: Designing incentive rebate strategies for information‐sharing alliances
Authors: Zhuo Yueran , Solak Senay , Zou Yi , Hu Bingyan
Published: July 2024

Information security plays a crucial role in organizational governance and management, and information‐sharing alliances (ISAs) have emerged as effective platforms for the secure and controlled sharing of information security knowledge. Despite their potential, many ISAs face financial and operational challenges, including inadequate pricing policies and insufficient incentives for information sharing. This study addresses these challenges by proposing a modeling framework for the fee rebate strategies that ISAs can deploy to motivate effective information sharing. Taking into account the economic implications of both information sharing and information security technology investment, we propose two ISA‐based pricing rebate strategies for information sharing: the split‐return rebate strategy and the swap‐return rebate strategy. Analytical and numerical analyses are conducted to demonstrate the dynamics in different ISA settings under these pricing rebate strategies. The results suggest that in addition to firm size, the price for participating in sharing should be adjusted based on each participating firm's technology investment level, its information‐sharing level, and the marginal cost of information sharing. Also, by focusing on various information‐sharing environments, the study identifies specific conditions under which unfair sharing practices are likely to occur.
Current type 2 diabetes guidelines: Individualized treatment and how to make the most of metformin
Authors: Chan Juliana C. N. , Yang Aimin , Chu Natural , Chow Elaine
Published: July 2024

Evidence‐based guidelines provide the premise for the delivery of quality care to preserve health and prevent disabilities and premature death. The systematic gathering of observational, mechanistic and experimental data contributes to the hierarchy of evidence used to guide clinical practice. In the field of diabetes, metformin was discovered more than 100 years ago, and with 60 years of clinical use, it has stood the test of time regarding its value in the prevention and management of type 2 diabetes. Although some guidelines have challenged the role of metformin as the first‐line glucose‐lowering drug, it is important to point out that the cardiovascular‐renal protective effects of sodium‐glucose co‐transporter‐2 inhibitors and glucagon‐like peptide‐1 receptor agonists were gathered from patients with type 2 diabetes, the majority of whom were treated with metformin. Most national, regional and international guidelines recommend metformin as a foundation therapy with emphasis on avoidance of therapeutic inertia and early attainment of multiple treatment goals. Moreover, real‐world evidence has confirmed the glucose‐lowering and cardiovascular‐renal benefits of metformin accompanied by an extremely low risk of lactic acidosis. In patients with type 2 diabetes and advanced chronic kidney disease (estimated glomerular filtration rate 15‐30 mL/min/1.73m2), metformin discontinuation was associated with an increased risk of cardiovascular‐renal events compared with metformin persistence. Meanwhile, it is understood that microbiota, nutrients and metformin can interact through the gut‐brain‐kidney axis to modulate homeostasis of bioactive molecules, systemic inflammation and energy metabolism. While these biological changes contribute to the multisystem effects of metformin, they may also explain the gastrointestinal side effects and vitamin B12 deficiency associated with metformin intolerance. By understanding the interactions between metformin, foods and microbiota, healthcare professionals are in a better position to optimize the use of metformin and mitigate potential side effects. The United Kingdom Prospective Diabetes Study and the Da Qing Diabetes Prevention Program commenced 40 years ago provided the first evidence that type 2 diabetes is preventable and treatable. To drive real‐world impact from this evidence, payors, practitioners and planners need to co‐design and implement an integrated, data‐driven, metformin‐based programme to detect people with undiagnosed diabetes and prediabetes (intermediate hyperglycaemia), notably impaired glucose tolerance, for early intervention. The systematic data collection will create real‐world evidence to bring out the best of metformin and make healthcare sustainable, affordable and accessible.
Clinical skills examination as part of the Swedish proficiency test of dentists educated outside of the EU/EEA
Authors: Dalum Jesper , Christidis Nikolaos , Häbel Henrike , Karlgren Klas , Leanderson Charlotte , Englund Gunilla Sandborgh
Published: July 2024

Introduction

The increase in the migration of dentists educated outside the EU/EEA calls for the sharing of information and evaluation of recognition processes within countries in the EU. In 2017, the Swedish National Board of Health and Welfare implemented the Proficiency test, a recognition process for dentists who have completed an education programme outside the EU/EEA. The Proficiency test consists of a theoretical and an integrated clinical skills examination, followed by a 6‐month clinical practice. The clinical skills examination is a two‐part examination that includes an OSCE and an operative test on a dental manikin. This paper presents data from proficiency tests between 2018 and 2022, and explores factors related to grade fail, that is, demographics, theoretical exam scores and language comprehension.

Materials and Methods

In a cohort study, demographics and factors associated with grade fail were explored using test results from theoretical and clinical skills examinations (n = 181) from 2018 to 2022. Pearson correlation coefficient and linear regression analysis were used for studying correlations and associations between exam results. Univariable linear and logistic regression models were used for background variable associations with clinical skills exam outcomes.

Results

Higher age was a significant risk factor for failing the clinical skills examination and the OSCE. Higher scores in the theoretical exam reduced the odds of failing the OSCE but were not associated with results in the operative test or the overall results of the clinical skills examination. Regarding the OSCE there was a statistically significant difference within all professional qualifications explored between participants who passed and participants who failed the OSCE.

Conclusions

Four years of data collection reveal that age and previous theoretical exam results influence the odds of failing the clinical examination. The study results also highlight the necessity of multiple assessment formats to assess clinical and communication skills of foreign‐trained dentists.
Casual, customized and contemptuous relationships with education: Social solvation and young people's strategies during multi‐crisis
Authors: Sarnowska Justyna , Pustulka Paula , Kajta Justyna
Published: July 2024

This paper focuses on individual responses to education in crisis, with the strategies of students contextualised and examined within a wider multi‐crisis reality. Offering a conceptual framework of social solvation, the proposed model explains how failures in the education system at the macro (state) and meso (institutional) levels translate into young people's behaviours at the individual (micro) level. Based on the analysis of 26 in‐depth interviews with young students, we identify and discuss three main micro‐rational strategies that the interviewees relied upon to navigate their learning during the pandemic: (1) casualisation (2) customisation and (3) contempt towards the broader system. We argue that the already weak Polish education system was further impaired by the COVID‐19 crisis. In response to growing social and educational risks, young people forge and employ highly individualised strategies. As micro‐rational social actions essentially bypass the unwieldy education system in a variety of ways, they have vital implications for educational futures.
The role of N6‐methyladenosine RNA methylation in the crosstalk of circadian clock and neuroinflammation in rodent suprachiasmatic nuclei
Authors: Filipovská Eva , Čočková Zuzana , Černá Barbora , Kubištová Aneta , Spišská Veronika , Telenský Petr , Bendová Zdeňka
Published: July 2024

N6‐methyladenosine (m6A) is the most abundant epitranscriptomic mark that regulates the fate of RNA molecules. Recent studies have revealed a bidirectional interaction between m6A modification and the circadian clock. However, the precise temporal dynamics of m6A global enrichment in the central circadian pacemaker have not been fully elucidated. Our study investigates the relationship between FTO demethylase and molecular clocks in primary cells of the suprachiasmatic nucleus (SCN). In addition, we examined the effects of lipopolysaccharide (LPS) on Fto expression and the role of FTO in LPS‐induced reactive oxygen species (ROS) production in primary SCN cell culture. We observed circadian rhythmicity in the global m6A levels, which mirrored the rhythmic expression of the Fto demethylase. Silencing FTO using siRNA reduced the mesor of Per2 rhythmicity in SCN primary cells and extended the period of the PER2 rhythm in SCN primary cell cultures from PER2::LUC mice. When examining the immune response, we discovered that exposure to LPS upregulated global m6A levels while downregulating Fto expression in SCN primary cell cultures. Interestingly, we found a loss of circadian rhythmicity in Fto expression following LPS treatment, indicating that the decrease of FTO levels may contribute to m6A upregulation without directly regulating its circadian rhythm. To explore potential protective mechanisms against neurotoxic inflammation, we examined ROS production following LPS treatment in SCN primary cell cultures pretreated with FTO siRNA. We observed a time‐dependent pattern of ROS induction, with significant peak at 32 h but not at 20 h after synchronization. Silencing the FTO demethylase abolished ROS induction following LPS exposure, supporting the hypothesis that FTO downregulation serves as a protective mechanism during LPS‐induced neuroinflammation in SCN primary cell cultures.
Childhood executive control and adolescent substance use: Mediation via parent–child relationship quality
Authors: Patwardhan Irina , Guo Ying , Fleming Charles B. , James Tiffany D. , Nelson Jennifer Mize , Espy Kimberly Andrews , Nelson Timothy D. , Mason W. Alex
Published: July 2024

Objective

The goal of the current study was to test prospective direct and indirect associations between preschool executive control (EC), parental affective quality and harsh discipline, and adolescent substance use (e‐cigarettes, cannabis, and alcohol) while accounting for participants' age, sex, family history of substance use, and family socioeconomic status.

Method

Participants were 313 youth (49% boys; 70.9% European American) and their parents who participated in a longitudinal cohort‐sequential study on the development of EC in preschool and its associations with subsequent health outcomes. Substance use initiation and frequency (e‐cigarettes, cannabis, and alcohol) were obtained via phone surveys from youth who participated in adolescent assessments. Parental affective quality and harsh discipline were obtained from parental questionnaires in adolescence.

Results

The direct effects from preschool EC on adolescent substance use were statistically nonsignificant for e‐cigarettes, cannabis, and alcohol. Mediation analyses revealed a statistically significant indirect effect from preschool EC to adolescent use of e‐cigarettes through harsh discipline (b = −0.07 [95% CI = −0.18; −0.01]; β = −0.04). The associations between preschool EC and any of the substance use outcomes in adolescence through parental affective quality were nonsignificant.

Conclusions

This study fills significant gaps in the emerging literature on longitudinal contributions of child characteristics to parenting behaviors, suggesting that early EC deficiencies may elicit more harsh discipline during adolescence, ultimately leading to higher adolescent engagement in e‐cigarette use.
The therapeutic effect of NRF2 activator, ezetimibe, in cardiac cachexia
Authors: Vashi Ruju , Joshi Mit , Patel Bhoomika M.
Published: July 2024

Introduction

Heart failure (HF) is caused by functional and structural irregularity leading to impaired ejection or filling capacity of the heart. HF leads to chronic inflammatory conditions in the heart leads to weight loss, anorexia, and muscle atrophy known as cachexia. The present study was carried out to investigate the role of Ezetimibe, an NRF2 activator, in cardiac cachexia and to develop a treatment strategy for cardiac cachexia.

Method

Balb/c mice of either sex at 6–8 weeks of age were given 2 mg/kg of doxorubicin in 0.9% sodium chloride solution intraperitoneally (i.p.) for the alternate days for the first week and then once a week for the next 4 weeks. After induction of cardiac atrophy, treatment with Ezetimibe (1.5 mg/kg, p.o) was given for the next 4 weeks.

Result

In the cardiac cachectic animals, a significant decrease in body weight, food, and water intake was observed. Cardiac cachectic animals showed a significant increase in serum glucose, total cholesterol, LDL, triglyceride, VLDL, CK‐MB, LDH, and CRP levels. Cardiac atrophic index, heart weight to body weight ratios (HW/BW), right ventricular weight to heart weight ratios (RV/HW), and left ventricular weight to heart weight ratios (LV/HW), were significantly decreased in cardiac cachectic animals. The weights of the skeletal muscles such as EDL, gastrocnemius, soleus, tibialis anterior, and quadriceps muscles, and the weight of adipose tissue such as subcutaneous, visceral, perirenal, and brown adipose tissue were significantly decreased in the cardiac cachectic group relative to the normal group. Treatment with ezetimibe improves body weight, food intake, and water intake. Ezetimibe decreases serum glucose, total cholesterol, LDL, triglyceride, VLDL, CK‐MB, LDH and CRP levels. Cardiac atrophic markers such as HW/BW, RV/HW, and LV/HW were improved. The weight of skeletal muscles and adipose tissue was increased after treatment with ezetimibe.

Conclusion

Our data showed that the NRF2 activator, Ezetimibe produces a beneficial effect on cardiac cachexia in the doxorubicin‐induced cardiac cachexia model. Ezetimibe was successful to reduce the levels of inflammatory cytokines, ameliorate the effects on cardiac muscle wasting, lipid levels, fat tissues, and skeletal muscles.
Densification, microstructure, mechanical, and thermionic properties of spark plasma sintered LaB6–HfB2 composite
Authors: Wang Ke , Yang Xinyu , Zhao Wei , Gu Zengjie , Luo Shifeng , Zhang Jiuxing
Published: July 2024

LaB6–HfB2 composites with the different HfB2 contents (10 wt.%, 30 wt.%, 50 wt.%, 70 wt.%, and 90 wt.%) were densified by spark plasma sintering (SPS). Results showed that the densification mechanism of the composite transformed from the grain boundary diffusion into the dislocation climbing mechanism as the holding time was extended from 0 to 15 min under temperature range of 1750–1900°C. The HfB2 phase could effectively limit the grain growth of LaB6 phase, and the dynamic growth of the grain was governed by grain boundary diffusion. Both the Berkovich hardness and Vickers hardness obeyed the normal indentation size effect. LaB6–70 wt.% HfB2 composite had the highest fracture toughness of 3.98 ± .43 MPa m.5, whereas the highest current density of 18.34 A/cm2 belonged to LaB6–30 wt.% HfB2 composite. All the results demonstrated that LaB6–HfB2 composite was a promising material with the excellent structural and functional performance.
Age‐related impairment in testosterone elevation after anterior fibromuscular stroma preserved enucleation
Authors: Chang Ruei‐Je , Tsai Chih‐Yiu , Tsai Han‐Yu , Tsao Shu‐Han , Hou Chen‐Pang , Juang Horng‐Heng , Lin Yu‐Hsiang
Published: July 2024

Objectives

This study aims to evaluate the impact of anterior fibromuscular stroma preserved enucleation (AFSPE) of the prostate on serum testosterone levels in patients with benign prostatic obstruction (BPO) and to explore age‐related differences in postoperative testosterone elevation.

Methods

In a retrospective analysis, 304 patients from a pool of 560 who underwent AFSPE at Linkou Chang Gung Memorial Hospital between January 2018 and December 2021 were evaluated. Patients were stratified based on preoperative testosterone levels into low (<3.5 ng/mL) and normal (≥3.5 ng/mL) groups. Serum testosterone levels were measured preoperatively, at 1.5 and 3–6 months postoperatively. Age and other demographic data were analyzed as potential factors influencing testosterone changes.

Results

The low‐testosterone group (n = 90) showed significant testosterone increases, from an average of 2.61 ng/mL preoperatively to 3.3 ng/mL at 1.5 months and 3.59 ng/mL at 3–6 months postoperatively (p < 0.0001). The normal‐testosterone group (n = 214) maintained stable testosterone levels at 1.5 months but exhibited a significant rise to 6.06 ng/mL by 3–6 months (p = 0.0079). Older age was inversely associated with postoperative testosterone elevation in both groups. Improvements in nocturia were notable in both groups.

Conclusions

AFSPE of the prostate significantly elevates serum testosterone levels in men with BPO, particularly benefiting those initially with low levels. Age is a crucial factor influencing postoperative testosterone changes, indicating that younger patients may benefit more from this intervention. AFSPE offers a promising approach for improving hormonal health in BPO patients, alongside alleviating urinary symptoms.
‘They must know their rights’– reflecting on privacy, informed consent and the digital agency of asylum seekers and refugees in border contexts
Authors: Lintner Claudia
Published: July 2024

The article questions digital agency as a subjective experience of refugees when crossing Europe's external and internal borders. More concretely, the article asks how refugees experience digital agency, and how this concrete experience is constituted in specific border practices. In doing so, it examines the contradictions that arise between European laws and human rights in the context of border practices. The analysis of the data of this paper reflects two important components of digital agency: the sense of ownership and control of one's body and actions, and the capacity to think independently and thus make considered choices. This study is based on a qualitative research approach based on narrative interviews. The data was imported to MAXQDA, a software package that allows data to be efficiently collected, organised, analysed and visualised electronically. The article shows how refugees and asylum seekers, when crossing the border to Europe, do not simply enter another country, but a (powerful) institutional system. In having their biometric and digital data collected, they are confronted with several practices of border and risk management that have become routinised and thus ‘normalised’ on an institutional level. Thus, their digital agency must be understood as precarious, underscored by an installed coercive environment.
VARIPULSE: A step‐by‐step guide to pulmonary vein isolation
Authors: Nair Devi G. , Gomez Tara , De Potter Tom
Published: July 2024

Introduction

The VARIPULSE™ variable‐loop circular catheter (VLCC) is a bidirectional, multielectrode catheter that can perform electrophysiological mapping and deliver pulsed field energy through the TRUPULSE™ Generator for the treatment of atrial fibrillation. This ablation system, including the CARTO 3™ three‐dimensional electroanatomical mapping system, represents a fully integrated system.

Methods

Pulsed field ablation (PFA) is a novel, primarily cardiac tissue–selective ablation technology with a minimal thermal effect, potentially eliminating the collateral tissue damage associated with radiofrequency ablation or cryoablation. Integration of a mapping system may lead to shorter fluoroscopy times and improve the usability of the system, allowing tracking of energy density and placement to confirm no areas around the vein are left untreated.

Results

This step‐by‐step review covers patient selection, mapping, the step‐by‐step ablation workflow, details on catheter repositioning and ensuring contact, considerations for ablation of specific anatomical variations, and discussion of ablation without fluoroscopy based on our initial clinical experience.

Conclusions

The VLCC is part of the fully integrated PFA system designed for pulmonary vein isolation, using mapping to guide catheter placement and lesion set creation. The current workflow, which is based on our initial clinical experience, may be further refined as the PFA system is used in real‐world settings.