bluuebunny/crossref_metadata_2025 huggingface dataset:
Fly-casting with ligand–sliding and orientational selection to support the complex formation of a GPCR and a middle-sized flexible molecule
Authors: Higo Junichi , Kasahara Kota , Bekker Gert-Jan , Ma Benson , Sakuraba Shun , Iida Shinji , Kamiya Narutoshi , Fukuda Ikuo , Kono Hidetoshi , Fukunishi Yoshifumi , Nakamura Haruki
Published: March 2022

To elucidate computationally a binding mechanism of a middle-sized flexible molecule, bosentan, to a GPCR protein, human endothelin receptor type B (hETB), a GA-guided multidimensional virtual-system coupled molecular dynamics (GA-mD-VcMD) simulation was performed. This method is one of generalized ensemble methods and produces a free-energy landscape of the ligand-receptor binding by searching large-scale motions accompanied with stably keeping the fragile cell-membrane structure. All molecular components (bosentan, hETB, membrane, and solvent) were represented with an all-atom model, and sampling was carried out from conformations where bosentan was distant from the binding site in the hETB’s binding pocket. The deepest basin in the resultant free-energy landscape was assigned to the native-like complex conformation. The obtained binding mechanism is as follows. First, bosentan fluctuating randomly in solution is captured by a tip region of the flexible N-terminal tail of hETB via nonspecific attractive interactions (fly-casting). Bosentan then occasionally slides from the tip to root of the N-terminal tail (ligand–sliding). In this sliding, bosentan passes the gate of the binding pocket from outside to inside of the pocket with accompanying a quick reduction of the molecular orientational variety of bosentan (orientational selection). Last, in the pocket, ligand–receptor attractive native contacts are formed, and eventually the native-like complex is completed. The bosentan-captured conformations by the tip- and root-regions of the N-terminal tail correspond to two basins in the free-energy landscape, and the ligand–sliding corresponds to overcoming a free-energy barrier between the basins.
Turning the head while biking makes older people lose cycling direction and balance
Authors: Afschrift Maarten , Matthijs Anouck , De Ryck Theresa , De Groote Friedl , De Xivry Jean-Jacques Orban
Published: March 2022

Background

Bike safety in older subjects is a major concern in multiple countries given the strong increase in the number of cyclists that are admitted to the hospital due to single-sided bicycle accidents in older populations. The increase in single-sided accident rate in older subjects suggests that older adults have more difficulty controlling balance while bicycling in traffic, which has been related to various age-related changes in the sensorimotor system. Yet, the impact of these age-related sensorimotor deficits on the ability of older people to remain stable on their bike during traffic situations such as turning their upper body to check on potential road users, remains unknown.

Methods

We instructed a group of 40 young (22.86 ± 1.53 years) and 41 older participants (62.73 ± 1.57 years) to bike in a straight line while performing a shoulder check movement in order to identify the color of an object presented behind them. We recorded the task-errors (lost balance, errors in identifying the color, cycling outside the lane) and computed the steering angle and rotation of the frame, pelvis and torso from IMU recordings.

Results

We observed that older adults made task-errors (one third of the older participants failed at the task by making errors such as cone-identification errors, loss of balance and cycling outside the lane). In the successful trials, we observed an increase in steering angle and rotation of the pelvis with respect to the frame in the older subjects compared to the young subjects.

Significance

Older cyclists lose balance while turning their head, which might contribute to the increased number of single sided bike accidents in older subjects. The use of simple devices, such as using a mirror, should be encouraged in older subjects to replace the shoulder check maneuver.
TUNNELING NANOTUBES CONNECT BLOOD-BRAIN BARRIER CELLS: ROLE OF PERICYTES IN BARRIER PRESERVATION DURING ISCHEMIA
Authors: Pisani Francesco , Castagnola Valentina , Simone Laura , Loiacono Fabrizio , Svelto Maria , Benfenati Fabio
Published: March 2022

Crosstalk mechanisms between pericytes, endothelial cells, and astrocytes preserve integrity and function of the blood-brain-barrier (BBB) under physiological conditions. Long intercellular channels allowing the transfer of small molecules and organelles between distant cells called tunneling nanotubes (TNT) represent a potential substrate for energy and matter exchanges between the tripartite cellular compartments of the BBB. However, the role of TNT across BBB cells under physiological conditions and in the course of BBB dysfunction is unknown.

In this work, we analyzed the TNT’s role in the functional dialogue between human brain endothelial cells, and brain pericytes co-cultured with human astrocytes under normal conditions or after exposure to ischemia/reperfusion, a condition in which BBB breakdown occurs, and pericytes participate in the BBB repair. Using live time-lapse fluorescence microscopy and laser-scanning confocal microscopy, we found that astrocytes form long TNT with pericytes and endothelial cells and receive functional mitochondria from both cell types through this mechanism. The mitochondrial transfer also occurred in multicellular assembloids of human BBB that reproduce the three-dimensional architecture of the BBB. Under conditions of ischemia/reperfusion, TNT formation is upregulated, and astrocytes exposed to oxygen-glucose deprivation were rescued from apoptosis by healthy pericytes through TNT-mediated transfer of functional mitochondria, an effect that was virtually abolished in the presence of TNT-destroying drugs. The results establish a functional role of TNT in the crosstalk between BBB cells and demonstrate that TNT-mediated mitochondrial transfer from pericytes rescues astrocytes from ischemia/reperfusion-induced apoptosis. Our data confirm that the pericytes might play a pivotal role in preserving the structural and functional integrity of BBB under physiological conditions and participate in BBB repair in brain diseases.
Remdesivir, Zidovudine (AZT) and Nevirapine inhibit Chandipura virus replication through high energy interactions with the RdRp domain of the polymerase protein L
Authors: Mandal Dibyakanti , Pandey Deeksha , Sarkar Debi P. , Kumar Manish
Published: March 2022

Chandipura Virus (CHPV), a rhabdovirus belonging to mononegavirales, is an emerging pathogen in Indian subcontinent. The virus infection causes fever, brain encephalitis among the young children below 14 yrs of age. In recent past, several outbreaks and deaths among children were reported from in India. There are no targeted drugs or vaccines available against CHPV and symptomatic treatments are the only option. In this background, we aimed to investigate the inhibitory effects of some priviously known viral RNA polymerase inhibitor drugs on CHPV replication. First, we examined remdesivir, which is known to inhibit HCV, Ebola and SARS-CoV-2 replication and close structural similarity along with conserved residues in the finger region of RNA dependent RNA polymerase (RdRp) domain is the basis of replication inhibition. Our results showed that remdesivir inhibits CHPV replication in vero E6 cells to a significant level. In this study we have also included non-nucleoside anti-retroviral inhibitor (NNRTI) drug nevirapine, and nucleoside inhibitor (NRTI) drug AZT (Zidovudine) to determine if these are also able to inhibit CHPV replication. Interestingly, we observed inhibition of CHPV replication by both nevirapine and AZT (in the order nevirapine>AZT), albeit to a lesser extent compared to remdesivir. We next performed molecular docking and modeling study to get an insight about the interactions of these drugs with CHPV polymerase protein. Modeling study predicts that remdesivir has most favourable CHPV polymerase binding energy among these three drugs. Both remdesivor and AZT binds near the polymerase active site through interctions with residues in finger and palm regions of RdRp. In contrast, nevirapine binds to the N-terminal domain (NTD) of the RdRp. In summary, we found remdesivir as a potent inhibitor of CHPV. A combination therapy including remdesivir, nevirapine and AZT may be a better drug cocktail to treat CHPV disease. Our findings warrant further studies of these drugs against CHPV in animal models for clinical use in near future.
4-Amidinopyridinium hexachloridostannate(IV) dihydrate
Authors: Ghallab Rochdi , Bougueria Hassiba , Merazig Hocine
Published: March 2022

In the title hydrated molecular salt {systematic name: 4-[amino(iminiumyl)methyl]pyridin-1-ium hexachloridostannate(IV) dihydrate}, (C6H9N3)[SnCl6]·2H2O, the tin atom lies on a crystallographic inversion centre and the organic cation shows whole-molecule disorder. Numerous N—H...O, N—H...Cl and O—H...Cl hydrogen bonds link the components in the crystal.
Effect of stator height change on bearing life in aircraft autopilot servos
Authors: Ortamevzi Gurkan , Sahin Yalcin
Published: March 2022

Purpose

The purpose of this paper is to make a more precise prediction of the life of servo motors used in aircraft. The variation of the axial load created by the wave washer for bearing, which is one of the factors affecting the bearing life of the electric motors and servo motors used in aircraft, was analyzed.

Design/methodology/approach

In electric motors and servo motors that body as stator, the height of the stator stack affects the compression amount of the wave washer spring. Working with electric motor and servo manufacturers, production-related variations in stator height were determined by making multiple measurements. The reaction forces resulting from these compression amounts were simulated by mathematical modeling with the finite element method, and also experimentally measured on real parts.

Findings

Results obtained with finite element method and real experiments were compared. By adding the force differences to the general operating conditions, the effect on the bearing life was theoretically determined. In a servo motor with this type of construction, the difference in stator height created different axial loads on the motor shaft. The difference of these loads affected the motor bearing life.

Research limitations/implications

The results implicated in terms of flight safety, maintenance operation and resource efficiency.

Practical implications

The results of this study are effective in determining the maintenance intervals more clearly. This study can be used for the design criteria of aircraft servo motors. These servos, which are especially used to move the flight control surfaces, contribute to flight safety as the life expectancy will be clearer.

Social implications

This study may be effective in preventing aviation accidents caused by servo motors. It can make maintenance management more efficient.

Originality/value

This study investigated the effect of aircraft servo motor design inputs on servo motor life, considering the production.
Experimental analysis of friction stir welded aviation grade AA8090 joints using Taguchi orthogonal array
Authors: Panwar Raghuraj , Chandna Pankaj
Published: March 2022

Purpose

This paper aims to predict the performance of friction stir welded AA8090 joint.

Design/methodology/approach

In the present study, Al-Li AA8090 plates are butt joined using friction stir welding (FSW). The experiments are designed and optimized using a Taguchi-orthogonal array. The experiments are conducted at three different process parameters, i.e. tool rotational speed (TRS), tool transverse speed (TTS) and dwell time (DT). The ultimate tensile strength (UTS) and microhardness (MH) are considered as response parameters. In addition, a statistical tool (ANOVA) is used to check the adequacy of experiment results.

Findings

The maximum UTS of 220 MPa is obtained at a TRS of 1,400 rpm, tool TTS of 40 mm/min and DT of 15 s. The maximum microhardness is obtained for 1,400 rpm, 25 mm/min and 8 s, i.e. 108.6 HV. The microstructural showed that the minimum grain is observed at the nugget zone. Fractography analysis revealed the ductile behaviour of fractured surfaces.

Originality/value

From the reported literature, it has been observed that very limited work is reported on the FSW of AA8090 alloy. Further, the thermal behaviour of welded joint is also observed in this experimental work.
Profiling the online premium brand consumers based on their fashion orientation
Authors: Sondhi Neena , Basu Rituparna
Published: March 2022

Purpose

This paper attempts to explore and identify the growing segments of online buyers of premium brands in the context of the post-pandemic market in India. The multi-dimensional trait of fashion orientation has been used as the psychographic construct for segmenting young urban consumers who shop on e-commerce platforms.

Design/methodology/approach

An online study across major cities resulted in a sample of 555 urban consumers of premium apparel and accessories brands. Hierarchical, two-step and k-means cluster analysis were conducted to identify diverse consumer segments and arrive at a demographic and usage-based profiling of the clusters. Furthermore, one-way analysis of variance was conducted to assess the key drivers for an online purchase among the obtained segments.

Findings

The pioneering use of fashion orientation as a base for segmentation helped identify three distinct clusters of socially conscious fashionistas, fashion involved and fashion indifferent buyers. The study identified significant differences in the demographic composition as well as their usage patterns and purchase motivations to shop online.

Originality/value

The study looks at an extremely important but neglected category of premium brands. The distinct clusters of premium brand buyers highlighted by the study adds theoretical value as well as managerial insights for the premium brand marketer as they seek to target consumers in Asian economies.
Temporary and permanent agency workers. A study of perceived organizational support and dual commitment
Authors: Cicellin Mariavittoria , Tomo Andrea , Consiglio Stefano , Moschera Luigi , Aria Massimo
Published: March 2022

Purpose

This study aims to analyze the effects of the type of agency contract on the relationship between agency workers' organizational commitment and perceived organizational support.

Design/methodology/approach

The authors extend a previously developed model considering organizational support and affective commitment by including also continuance commitment in the Italian employment agency industry. The authors use a probabilistic stratified sampling method on a sample of 8,283 agency workers. Data were analyzed with structural equation modelling (SEM) and multiple group analyses.

Findings

The findings confirm the positive relationship between perceived organizational support from both the agency and the client organization and agency workers' affective commitment to them. The authors also find that agency workers develop a mutually related dual commitment in response to the support they receive from both organizations.

Originality/value

The paper contributes to the literature on agency workers and suggests useful managerial and policy makers interventions for both temporary work agencies and client organizations for the development of the agency industry as well as the well-being of workers.
Intellectual property and the African continental free trade area: lessons and recommendations for the IP protocol
Authors: Ncube Caroline B.
Published: March 2022

Purpose

This paper aims to explore the contours of the future intellectual property (IP) protocol of the African Continental Free Trade Area (AfCFTA) Agreement.

Design/methodology/approach

This paper frames the IP protocol within the architecture of the AfCFTA Agreement, meaning that it will follow the structure of other protocols and will be guided by the Agreement’s foundational principles and objectives. With the place, shape and form of the protocol so established, the paper considers the substantive aspects that ought to be addressed. It also considers provisions on technical assistance, capacity building and cooperation.

Findings

The paper finds that the Tripartite Free Trade Phase 2 IP agenda is a credible starting place, which must be broadened to better meet gendered challenges and the continent’s developmental priorities. This will entail including provisions on specific aspects enumerated in the paper, which must be aligned with provisions on technical assistance, capacity building and cooperation to enhance implementation. The best outcomes in the negotiation, adoption and implementation of the IP protocol will be achieved by an inclusive approach incorporating all national, sub-regional and regional institutions guided by coherent policy and coordinated to ensure efficiency in resources and capacity mobilisation.

Originality/value

To the best of the author’s knowledge, this is the first paper to formally consider both the architecture and substantive provisions of the future AfCFTA IP protocol with specific focus on gendered dimensions.
Signing networks of audit partners and accruals quality: evidence from Taiwan
Authors: Shiue Min-Jeng , Chiu Peng-Chia , Kuo Li-Chun , Yeh Shu-Ling
Published: March 2022

Purpose

The purpose of this study is to examine the association between audit partners’ signing networks and accruals quality, using the sample of Taiwanese publicly traded companies.

Design/methodology/approach

This study uses four centrality measures as proxies in this study for the strength of the audit partners’ relationship networks and the absolute value of discretionary accruals to measure accruals quality.

Findings

Using the sample of publicly traded firms audited by the Big 4 accounting firms in Taiwan during the 2011–2017 period, this study finds that the centrality of an audit partner’s signing network is negatively associated with the absolute value of discretionary accruals. The result is robust to various discretionary accruals measures and survives the alternative explanation related to the endogenous matching between audit partners and their clients.

Originality/value

This study contributes to the understanding of the effect of the relationship network within an accounting firm on accruals quality. This is one of the few studies to empirically examine the strength of the audit partners’ relationship network as a factor in firms’ financial reporting quality, especially by using the sample from an emerging market. This study shows that the strength of the audit partners’ signing networks contains incremental information when assessing firms’ earnings quality. High-quality audit work is important to ensure high-quality financial reporting and the results of this study highlight that audit partners’ network linkages affect the quality of their work.
The carbon emission and life expectancy nexus: mediating roles of agriculture and foreign direct investment in Nigeria
Authors: Nwani Stanley Emife , Imhanzenobe Japhet Osazefua
Published: March 2022

Purpose

This study evaluates the impact of carbon emission on life expectancy in Nigeria. The study also investigates the mediating role of agricultural output and foreign direct investment as suggested by the environmental Kuznets curve (EKC) and the pollution haven hypothesis (PHH), respectively.

Design/methodology/approach

The hypotheses and theories were tested using structural equation modeling (SEM). Primary data were collected using cross-sectional survey design. Questionnaires were distributed and responses were used to measure the latent variables of the study. A confirmatory factor analysis (CFA) was used to evaluate the measurement models, while path analysis was used to estimate the coefficients of the structural equations.

Findings

Carbon emission was found to have a negative and significant impact on life expectancy. This impact constituted both direct and indirect effects that were mediated by both foreign direct investment and agricultural output. Carbon emission and agricultural output were found to play significant roles that lead to a further negative- and significant-mediated relationship of carbon emission with life expectancy.

Originality/value

Unlike many previous studies on air pollution, this study investigates carbon emission in particular as well as the mediating role of agricultural output and foreign direct investment in the carbon emission and life expectancy relationship. The use of SEM also fills a methodological gap as it computes coefficients of mediation and controls for measurement bias and multicollinearity.
Divergent perspectives: autistic adults' perceptions of the police
Authors: Parry Megan M. , Huff Jessica
Published: March 2022

Purpose

Much of the current criminological research regarding police and the autistic community focuses on police training for interacting with autistic individuals or the experiences, fears and perceptions of parents or caregivers. Largely absent from the criminological research are the opinions and perceptions of autistic adults. The purpose of the paper is to examine perceptions of the police and police-led initiatives among these individuals.

Design/methodology/approach

The authors analyze data from 121 autistic adults regarding their perceptions of the police and police-led autism awareness efforts using ordinary least squares (OLS) regression. Variables of interest include perceptions of procedural justice, police treatment of autistic individuals, fear of interacting with police and perceptions of police autism awareness campaigns.

Findings

Findings indicate that autistic respondents vary in perceptions of the police. Prior negative experiences with police have a stronger influence on perceptions than do positive experiences. Support for awareness campaigns is also varied.

Originality/value

Despite high-profile police incidents involving autistic individuals, there have been no empirical examinations of autistic adults' global perceptions of the police or police-led autism awareness campaigns. The current study addresses that oversight by directly examining autistic adults' perceptions. The approach is particularly salient given the ongoing police public scrutiny surrounding officer interactions with individuals from special populations, which is largely uninformed by research centering the voices of impacted individuals.
New Approaches to Economic History
Authors: Lloyd Peter
Published: March 2022

This note reviews new approaches to topics in economic history that have come into practice in the last 20 years or so. The three main approaches are cliodynamics, big history and deep history. All three extend the time scale of economic history investigations to beyond that of written history and involve a variety of disciplines other than economics and history. Cliodynamics and big history are essentially quantitative. They use models to interpret historical phenomena and test hypotheses derived from the models. An example of a research topic is provided for each of the three new approaches. These new areas offer many opportunities for the student of economic history.
Ten to Men: The Australian Longitudinal Study on Male Health: Waves 1–3
Authors: Swami Neha , Prattley Jennifer , Bandara Dinusha , Howell Leanne , Silbert Michelle , Renda Jennifer , Rowland Bosco , Quinn Brendan
Published: March 2022

This article presents an overview of the first three waves of data collection for Ten to Men: The Australian Longitudinal Study on Male Health (TTM). TTM is Australia's first national and representative longitudinal study of men aged 10–55 years who resided in private dwellings at recruitment. Findings address knowledge gaps and build the evidence base on male health to inform policy and program development. This article provides an update on the study's progress; it details the study's broad methodology and provides a brief overview of the measures available, potential uses and how data can be accessed.
The Australian Economy in 2021–2022: The Virus Strikes Back
Authors: Nguyen Viet H. , Robinson Tim , Tsiaplias Sarantis
Published: March 2022

This article summarises developments in the Australian economy in 2021. The recovery that was underway from the COVID‐19 recession was interrupted by the second wave of the pandemic and the associated policy responses, particularly in Victoria and New South Wales. We discuss the challenges facing the Australian economy as it once again re‐opens.
Taste knowledge: couscous and the cook's six senses
Authors: Graf Katharina
Published: March 2022

In this article, I explore how cooking knowledge is constituted and show that a sense of taste is central to it. Drawing on the thick description of domestic couscous preparation in Marrakech, Morocco, I treat taste both as a multisensory form of knowing that includes a sixth sense, temporality, and as a broader set of values that inform everyday food preparation. The notion of taste knowledge highlights that there is much more to a cook's knowledge than the act of cooking, and that food and the broader environment play an active part in it. Importantly, taste knowledge only fully emerges as an activity in which past, present, and future experiences are evaluated against material and social changes. Finally, taste knowledge shows that phenomenologically inspired research allows an understanding of broader cultural, economic, and political processes and how these shape, and are shaped by, the work of low‐income, yet highly knowledgeable, women.
Fragile halos: Comparing organisational reputation across sectors
Authors: Ruddle Travis B. , Robinson Scott E. , Fister Aaron
Published: March 2022

Non‐profit organisations operate with the advantage of a generally positive social image. Workers and managerial employees of nonprofits are commonly thought of as altruistic, trustworthy and respectable actors who assist their communities. However, the non‐profit sector has faced several notable scandals and crises that have tested this positive social image. This paper reports on an analysis of the positive social image, which we call a sector ‘halo’ and its durability in the face of organisational crisis. Based on a sample from Amazon's Mechanical Turk, the analysis confirms the general positive social image of non‐profit organisations when compared to their private for‐profit and government sector peers, who possess lower levels of trust. However, a survey experiment reveals that given a crisis scenario regarding a data breach incident, the ‘halo’ entirely disappears. Our study improves on the literature regarding trust and organisational reputation and highlights the importance of sector ownership and perceived differences pre‐ and postcrisis.
Stakeholder perspectives on sustainment of Housing First in a VA permanent supportive housing program
Authors: Fletcher Erica Hua , Gabrielian Sonya , Flynn Anthony W. P. , Greenberg Jared M. , Hovsepian Sona , Oberman Rebecca S. , Young Alexander S.
Published: March 2022

Objective

To evaluate the sustainment of Housing First (HF) implementation in a permanent supportive housing program for homeless‐experienced veterans, 5 years after practice implementation.

Study setting

From 2016 to 2017, primary data were collected from providers and veterans in the Department of Housing and Urban Development–VA Supportive Housing (HUD‐VASH) program at Los Angeles.

Study design

Guided by the integrated sustainability framework, we performed a mixed‐methods study to evaluate the sustainment of HF, an evidence‐based practice implemented to improve housing outcomes. To assess sustainment, we measured fidelity to HF in six of seven HUD‐VASH teams. These data were integrated with qualitative interviews with providers and veterans who described perceived sustainment to HF and contextual factors that supported or impeded sustainment.

Data collection

Fidelity to HF at 5 years after practice implementation, as a proxy for sustainment, was quantified via surveys with HUD‐VASH teams. HUD‐VASH providers (n = 51) and 31 veterans participated in semi‐structured interviews. Team‐based template analyses were used to develop an emergent understanding of stakeholder perspectives on HF sustainment.

Principal findings

Overall, HUD‐VASH teams reported HF sustainment. The lowest fidelity scores were found in the domains of client‐to‐staff ratios, frequency of client–provider contact, and time to housing. Qualitative findings indicated that outer contextual factors (e.g., housing scarcity) and organizational factors (e.g., staff turnover) impacted HF sustainment. Providers identified changes in leadership and unmet resource needs as impediments to practice sustainment. All stakeholders identified positively with the HF practice and believed that the approach benefited veterans.

Conclusions

This snapshot of HF sustainment demonstrates that this practice can be sustained over time. However, strong leadership, organizational resources, and community partnerships are needed. Adaptations to HF in response to outer contextual factors and organizational capacity may result in practice sustainment while allowing for flexibility in service provision.
Analysis of a national response to a White House directive for ending veteran suicide
Authors: Kalvesmaki Andrea F. , Chapman Alec B. , Peterson Kelly S. , Pugh Mary Jo , Jones Makoto , Gleason Theresa C.
Published: March 2022

Objective

Analyze responses to a national request for information (RFI) to uncover gaps in policy, practice, and understanding of veteran suicide to inform federal research strategy.

Data source

An RFI with 21 open‐ended questions generated from Presidential Executive Order #1386, administered nationally from July 3 to August 5, 2019.

Study design

Semi‐structured, open‐ended responses analyzed using a collaborative qualitative and text‐mining data process.

Data extraction methods

We aligned traditional qualitative methods with natural language processing (NLP) text‐mining techniques to analyze 9040 open‐ended question responses from 722 respondents to provide results within 3 months. Narrative inquiry and the medical explanatory model guided the data extraction and analytic process.

Results

Five major themes were identified: risk factors, risk assessment, prevention and intervention, barriers to care, and data/research. Individuals and organizations mentioned different concepts within the same themes. In responses about risk factors, individuals frequently mentioned generic terms like “illness” while organizations mentioned specific terms like “traumatic brain injury.” Organizations and individuals described unique barriers to care and emphasized ways to integrate data and research to improve points of care. Organizations often identified lack of funding as barriers while individuals often identified key moments for prevention such as military transitions and ensuring care providers have military cultural understanding.

Conclusions

This study provides an example of a rapid, adaptive analysis of a large body of qualitative, public response data about veteran suicide to support a federal strategy for an important public health topic. Combining qualitative and text‐mining methods allowed a representation of voices and perspectives including the lived experiences of individuals who described stories of military transition, treatments that worked or did not, and the perspective of organizations treating veterans for suicide. The results supported the development of a national strategy to reduce suicide risks for veterans as well as civilians.
Microbial analysis of endodontic infections in teeth with post‐treatment apical periodontitis before and after medication
Authors: Ersahan Seyda , Hepsenoglu Yelda Erdem
Published: March 2022

This study aimed to determine the intraradicular microbiota of previously root canal‐treated teeth with apical periodontitis and to investigate the antibacterial effectiveness of different intracanal medicaments. Sixteen patients with post‐treatment apical periodontitis were allocated into two groups according to the intracanal medicament used: calcium hydroxide (CH) and 2% chlorhexidine gluconate gel (CHX) group. Total bacterial loads, as well as the amount of Enterococcus faecalis (E. faecalis) were determined before (S1) and after (S2) chemomechanical preparation and finally, after intracanal medication (S3) by means of ddPCR. The unpaired t test was used to compare parametric. S3‐total bacteria copy number of the CH group was lower than the CHX group (p < 0.05). There was no statistical difference between the CHX‐ and the CH groups in terms of E.faecalis copy number (p > 0.05). But in terms of total bacteria, CH is better than CHX. Consequently, CH can be used to optimise the antibacterial efficiency of chemomechanical preparation in previously root canal‐treated teeth with apical periodontitis.
Time to medical fitness for discharge following surgical evacuation of chronic subdural haematoma with general or regional anaesthesia: a prospective randomised trial
Authors: Hestin R. , Kamga Totouom H. , Gaberel T. , Parienti J. J. , Hanouz J. L.
Published: March 2022

General or regional anaesthesia can be used for chronic subdural haematoma evacuation, but no study has compared these types of anaesthesia in terms of peri‐operative outcomes. This single‐centre, prospective, randomised study included adult patients (age ≥ 18 years) undergoing surgical chronic subdural haematoma evacuation. Patients were randomly allocated to general (target‐controlled total intravenous anaesthesia with propofol and remifentanil) or regional anaesthesia (bilateral scalp block with remifentanil sedation if required). The primary outcome measure was duration of hospital stay, based on the day patients were judged by an investigator blinded from the allocation group to be medically fit for discharge. Secondary outcomes included: rate of regional anaesthesia failure; rate of intra‐operative and postoperative adverse events at 24 hours; and pain scores at 24 hours. Data from 60 patients were analysed (30 general anaesthesia and 30 regional anaesthesia). Median (IQR [range]) time until patients were judged medically fit for discharge was 3 (3–3 [2–10]) days and 3 (2–5 [2–15]) days for general and regional anaesthesia, respectively (p = 0.700). Regional anaesthesia failed in two patients. There were more intra‐operative adverse events in patients who received general anaesthesia (25 vs. 11, respectively; p = 0.001). The occurrence of postoperative adverse events was similar for general and regional anaesthesia (16 vs. 13 patients, respectively; p = 0.605). In patients requiring chronic subdural haematoma evacuation, general and regional anaesthesia are comparable in terms of duration of time until medically fit for discharge and occurrence of postoperative complications. The rate of intra‐operative adverse events (mainly arterial hypotension) is greater with general anaesthesia.
Comparative study of photoplethysmographic waveforms with application of antihypertensive medication in hypertensive patients
Authors: Hu Yanchun , Hu Anming , Song Shenju
Published: March 2022

Background

Multiple studies have been published using a pulse oximeter's photoplethysmographic (PPG) capability to detect tissue perfusion. However, the origin of the PPG signal is still debatable.

Aim

A comparative study was performed of PPG waveforms in hypertensive patients before and after treatment with antihypertensive medication. The aim of this study was to observe the changes of PPG waveforms before and after lowering blood pressure in hypertensive patients and then to detect the relationship between blood pressure and PPG waveforms.

Methods

The PPG waveforms of 60 patients with hypertension were collected. After administration of the antihypertensive medication nitroglycerin, PPG waveforms were collected again. The changes of the T3 (time3): This phase occurred between Marker 3 and Marker 4 (this phase occurs mid‐diastolic) angle, before and after the antihypertensive medication treatment, were compared. The statistical analyses of two related groups were performed using the Paired t‐test.

Results

The blood perfusion waveforms of hypertensive patients before and after antihypertensive medication administration were differently indicated with the tilt angle T3. The slope angle of the T3 phase waveform increased significantly when the blood pressure dropped to normal (−41.9 ± 16.2° vs. −25.6 ± 21.9°, p < .0001), and the tilt angle of some patients was similar to that of adults with normal blood pressure.

Conclusion

In patients with hypertension, the tilt angle of the PPG waveform in the T3 phase increased significantly after administration of the antihypertensive medication nitroglycerin. It is worth to conduct deeper research about the relationship between hypertension and the blood perfusion of microcirculation in the diastolic period.
Relationship between creatinine clearance and clinical outcomes in Chinese emergency patients with atrial fibrillation
Authors: Wang Juan , Zhang Tao , Yang Yan‐min , Zhu Jun , Zhang Han , Shao Xing‐hui
Published: March 2022

Background

Few real‐world data on the relation between creatinine clearance (CrCl) and adverse clinical outcomes in Chinese emergency department (ED) patients with nonvalvular atrial fibrillation (AF).

Methods

In this prospective, observational, multicenter AF study, enrolled AF patients presenting to an ED at 20 hospitals in China from November 2008 to October 2011, with a follow‐up of 12 month. A total of 863 AF patients with CrCl data were analyzed, and patients were categorized as CrCl ≥ 80, 50 ≤ CrCl < 80, 30 ≤ CrCl < 50, and CrCl < 30(ml/min). Outcomes of analyses were all‐cause death, cardiovascular death, thromboembolism (TE), and major bleeding.

Results

Among the whole patients, 126(14.6%) patients died during 12‐month follow‐up, 53(40.2%) among CrCl < 30 ml/min group, and 48(16.2%), 22(6.5%), and 3(3.2%) among 30 ≤ CrCl50, 50 ≤ Crl < 80, and CrCl ≥ 80 ml/min groups, respectively (p < 0.001). Cardiovascular death and TE rates also increased with decreasing CrCl. On multivariate analysis, patients with CrCl < 30 ml/min were associated with higher risks of all‐cause death (HR 5.567; 95%CI1.618–19.876; p = .007) and higher cardiovascular death (HR11.939; 95%CI1.439–99.031; p = .022) as compared with CrCl≥80 ml/min category. Nevertheless, for TE and major bleeding risk, CrCl groups showed no significant difference after adjustment for variables in CHA2DS2‐VASc score and status of warfarin prescription in our cohort.

Conclusions

In Chinese ED nonvalvular AF patients, incidence rates of death increased with reducing CrCl across the whole range of renal function. CrCl < 30 ml/min was associated with all‐cause death, cardiovascular death, but not for TE and major bleeding.
Particulate Matters: Trump EPA Deregulatory Science, Fossil Fuels, and Racist Regimes of Breathing
Authors: Mansfield Becky
Published: March 2022

Particulate matter (a key contributor to poor air quality) was central to the most far‐reaching deregulatory actions of the Trump EPA and as such became a key mechanism through which fossil fuels saturate and racialise deregulatory knowledge. This article introduces particulate matter as a problem of fossil fuel combustion and leading cause of death that—given well‐known racial disparities in exposure—is at the heart of today’s racist politics of breathing. It then traces particulate matter through the Trump EPA’s efforts to remake regulatory science, including through expansive measures not directly about air quality. It is not just that particulate matter is an effect of deregulation but that it served as a mechanism for a wider deregulatory apparatus. The article then elaborates on the significance of particulate matter in the suffocating nature of racism to argue that these actions entrench racist calculations of whose lives matter within the EPA’s regulatory apparatus.
Nationwide confidential enquiries into maternal deaths because of obstetric hemorrhage in the Netherlands between 2006 and 2019
Authors: Ramler Paul I. , Beenakkers Ingrid C. M. , Bloemenkamp Kitty W. M. , Van der Bom Johanna G. , Braams‐Lisman Babette A. M. , Cornette Jérôme M. J. , Kallianidis Athanasios F. , Kuppens Simone M. I. , Rietveld Anna L. , Schaap Timme P. , Schutte Joke M. , Stekelenburg Jelle , Zwart Joost J. , Van den Akker Thomas
Published: March 2022

Introduction

Obstetric hemorrhage‐related deaths are rare in high income countries. Yet, with increasing incidences of obstetric hemorrhage in these countries, it is of utmost importance to learn lessons from each obstetric hemorrhage‐related death to improve maternity care. Our objective was to calculate the obstetric hemorrhage‐related maternal mortality ratio (MMR), assess causes of obstetric hemorrhage‐related deaths, and identify lessons learned.

Material and methods

Nationwide mixed‐methods prospective case‐series with confidential enquiries into maternal deaths due to obstetric hemorrhage in the Netherlands from January 1, 2006 to December 31, 2019.

Results

The obstetric hemorrhage‐related MMR in the Netherlands in 2006–2019 was 0.7 per 100 000 livebirths and was not statistically significantly different compared with the previous MMR of 1.0 per 100 000 livebirths in 1993–2005 (odds ratio 0.70, 95% confidence interval 0.38–1.30). Leading underlying cause of hemorrhage was retained placenta. Early recognition of persistent bleeding, prompt involvement of a senior clinician and timely management tailored to the cause of hemorrhage with attention to coagulopathy were prominent lessons learned. Also, timely recourse to surgical interventions, including hysterectomy, in case other management options fail to stop bleeding came up as an important lesson in several obstetric hemorrhage‐related deaths.

Conclusions

The obstetric hemorrhage‐related MMR in the Netherlands in 2006–2019 has not substantially changed compared to the MMR of the previous enquiry in 1993–2005. Although obstetric hemorrhage is commonly encountered by maternity care professionals, it is important to remain vigilant for possible adverse maternal outcomes and act upon an ongoing bleeding following birth in a more timely and adequate manner. Our confidential enquiries still led to important lessons learned with clinical advice to professionals as how to improve maternity care and avoid maternal deaths. Drawing lessons from maternal deaths should remain a qualitative and moral imperative.
Pharmacokinetics/pharmacodynamics of L‐ornithine phenylacetate in overt hepatic encephalopathy and the effect of plasma ammonia concentration reduction on clinical outcomes
Authors: Safadi Rifaat , Rahimi Robert S. , Thabut Dominique , Bajaj Jasmohan S. , Ram Bhamidimarri Kalyan , Pyrsopoulos Nikolaos , Potthoff Amy , Bukofzer Stan , Wang Laurene , Jamil Khurram , Devarakonda Krishna R.
Published: March 2022

Hepatic encephalopathy (HE) is a serious neurocognitive complication of liver dysfunction, often associated with elevated plasma ammonia. Ornithine phenylacetate (OP), a potent ammonia scavenger, is being evaluated for the treatment of acute/overt HE. The pharmacokinetics and pharmacodynamics of OP in patients with HE were characterized in this phase IIb study (NCT01966419). Adult patients hospitalized with an overt HE episode, cirrhosis, and plasma ammonia above the upper limit of normal (ULN) who failed to improve after 48 hours’ standard care were randomly assigned to continuous intravenous OP (10, 15, or 20 g/day, based on Child–Turcotte–Pugh score) or matching placebo for 5 days. Plasma levels of ornithine and phenylacetic acid (PAA) and plasma/urinary levels of phenylacetylglutamine (PAGN) (primary metabolite of PAA) were regularly assessed; plasma ammonia level was the primary pharmacodynamic variable. PAA demonstrated dose‐dependent pharmacokinetics; ornithine and PAGN levels increased with dose. PAGN urinary excretion represented ~50%–60% of administered PAA across all doses. Mean reduction in plasma ammonia with OP at 3 hours postinfusion was significantly greater versus placebo (p = 0.014); and time to achieve plasma ammonia less than or equal to the ULN was significantly reduced (p = 0.028). Achievement of clinical response based on HE stage was associated with a greater reduction in mean plasma ammonia level (p = 0.009). OP effects on plasma ammonia were consistent with its proposed mechanism of action as a primary ammonia scavenger, with a significant association between reduced plasma ammonia and improvement in HE stage. OP should be further evaluated as a promising treatment for hyperammonemia in patients with overt HE.
Acute changes in plasma glucose increases left ventricular systolic function in insulin‐treated patients with type 2 diabetes and controls
Authors: Andersen Andreas , Jørgensen Peter G. , Bagger Jonatan I. , Baldassarre Maria P. A. , Christensen Mikkel B. , Pedersen‐Bjergaard Ulrik , Lindhardt Tommi B. , Gislason Gunnar , Knop Filip K. , Vilsbøll Tina
Published: March 2022

Aims

We aimed to evaluate the effect of acute hyperglycaemia and hypoglycaemia on cardiac function in patients with type 2 diabetes (T2D) and a control group.

Materials and methods

In a nonrandomized interventional study, insulin‐treated patients with T2D (N = 21, mean ± SD age 62.8 ± 6.5 years, body mass index [BMI] 29.0 ± 4.2 kg/m2, glycated haemoglobin [HbA1c] 51.0 ± 5.4 mmol/mol [6.8 ± 0.5%]) and matched controls (N = 21, mean ± SD age 62.2 ± 8.3 years, BMI 29.2 ± 3.5 kg/m2, HbA1c 34.3 ± 3.3 mmol/L [5.3 ± 0.3%]) underwent one experimental day with plasma glucose (PG) clamped at three different 30‐minute steady‐state levels: (1) fasting plasma glucose (FPG); (2) hyperglycaemia (FPG + 10 mmol/L); and (3) hyperinsulinaemic hypoglycaemia (PG <3.0 mmol/L). Cardiac function was evaluated during each steady state by echocardiography.

Results

Acute hyperglycaemia increased left ventricular (LV) ejection fraction from baseline in patients with T2D (mean [95% confidence interval] 4.5 percentage points [1.1; 7.9]) but not in controls (2.0 percentage points [−1.4; 5.4]). Mitral annular peak systolic velocity (s′) increased during hyperglycaemia in both patients and controls (0.4 m/s [0.2;0.6] and 0.6 m/s [0.4; 0.8], respectively), whereas global longitudinal strain rate only increased in the controls (−0.05 s−1 [−0.12; 0.02] and −0.11 s−1 [−0.18; −0.03], respectively). All measures of LV systolic function increased markedly during hypoglycaemia (P <0.01 for all). No interaction between group and PG level on cardiac function was observed.

Conclusions

Acute hyperglycaemia and hypoglycaemia increase LV systolic function, with no difference between patients with T2D and controls. Standardization of PG may improve reproducibility when evaluating LV systolic function in patients with T2D.