bluuebunny/crossref_metadata_2025 huggingface dataset:
Mergers and acquisitions: does performance depend on managerial ability?
Authors: Suryaningrum Diah Hari , Abdul Rahman Abdul Aziz , Meero Abdelrhman , Cakranegara Pandu Adi
Published: May 2023

Companies in difficult financial situations may seek to survive through mergers and acquisitions. Managers must be able to use company resources efficiently to maintain and improve competitiveness and sustainable advantages. Managers' ability to make strategic decisions may determine whether a merger and acquisition is successful. This study aims to reveal the role of the acquirer's managerial ability in mergers and acquisitions based on short- and long-term performance as well as the type of M&A. Two metrics are used to assess short- and long-term performance: the market-to-book ratio (MTBR) as an indicator of operating performance and the buy-and-hold abnormal return (BHAR) as an indicator of stock return performance. The research sample consists of 153 M&A cases conducted by companies registered with the Business Competition Supervisory Commission in Indonesia between 2010 and 2017, and the performance till 2020. We used regression and difference analysis to analyze the data. We find that managerial ability has a positive impact on MTBR operating and BHAR stock performance. This result confirms that the higher ability of the acquirer's manager will ensure a successful M&A in the long run. Investors and potential investors might consider managerial ability in choosing investments in companies after an M&A. This study contributes to the M&A literature by examining the role of MA in the short- and long-term performance of acquiring firms following M&As in Indonesia.
Intraoperative pleth variability index-based fluid management therapy and gastrointestinal surgical outcomes in elderly patients: a randomised controlled trial
Authors: Wang Yu , Zhang Yue , Zheng Jin , Dong Xue , Wu Caineng , Guo Zhijia , Wu Xinhai
Published: May 2023

Background

Intraoperative goal-directed fluid therapy (GDFT) has been reported to reduce postoperative complications of patients undergoing major abdominal surgery. The clinical benefits of pleth variability index (PVI)-directed fluid management for gastrointestinal (GI) surgical patients remain unclear. Therefore, this study aimed to evaluate the impact of PVI-directed GDFT on GI surgical outcomes in elderly patients.

Methods

This randomised controlled trial was conducted in two university teaching hospitals from November 2017 to December 2020. In total, 220 older adults undergoing GI surgery were randomised to the GDFT or conventional fluid therapy (CFT) group (n = 110 each). The primary outcome was a composite of complications within 30 postoperative days. The secondary outcomes were cardiopulmonary complications, time to first flatus, postoperative nausea and vomiting, and postoperative length of stay.

Results

The total volumes of fluid administered were less in the GDFT group than in the CFT group (2.075 L versus [vs.] 2.5 L, P = 0.008). In intention-to-treat analysis, there was no difference in overall complications between the CFT group (41.3%) and GDFT group (43.0%) (odds ratio [OR] = 0.935; 95% confidence interval [CI], 0.541–1.615; P = 0.809). The proportion of cardiopulmonary complications was higher in the CFT group than in the GDFT group (19.2% vs. 8.4%; OR = 2.593, 95% CI, 1.120–5.999; P = 0.022). No other differences were identified between the two groups.

Conclusions

Among elderly patients undergoing GI surgery, intraoperative GDFT based on the simple and non-invasive PVI did not reduce the occurrence of composite postoperative complications but was associated with a lower cardiopulmonary complication rate than usual fluid management.

Trial registration

This trial was registered with the Chinese Clinical Trial Registry (ChiCTR-TRC-17012220) on 1 August 2017.
Epidemiology of community origin of major multidrug-resistant ESKAPE uropathogens in a paediatric population in South-East Gabon
Authors: Mouanga-Ndzime Yann , Onanga Richard , Longo-Pendy Neil-Michel , Bignoumba Michelle , Bisseye Cyrille
Published: May 2023

Background

Urinary tract infections (UTIs) in children are very common. They are often associated with a high risk of sepsis and death. In recent years, antibiotic-resistant uropathogens ESKAPE (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacteriaceae) are increasingly encountered in UTIs. These bacteria, usually multidrug-resistance (MDR), extensive drug-resistance (XDR), pandrug-resistance (PDR), Extended-spectrum cephalosporin-resistance (ESC), Usual Drug Resistance (UDR), Difficult-to-Treat Resistance (DTR) and Carbapenem-resistance Enterobacteriales (CRE), represent a global threat for the management of paediatric UTIs. The aim of this study was to determine the epidemiology of community origin and antibiotic sensitivity of major ESKAPE uropathogens in paediatric UTIs in South-East Gabon.

Methods

The study involved 508 children aged 0–17 years. Identification of bacterial isolates was carried out using Vitek-2 compact automated system and the antibiogram with the disk diffusion and microdilution methods according to the European Committee on Antimicrobial Susceptibility Testing recommendations. Logistic regression analysis was used to assess the impact of patients' socio-clinical characteristics on uropathogens phenotype in both univariate and multivariate analysis.

Results

The prevalence of UTIs was 59%. E. coli (35%) and K. pneumoniae (34%) were the main ESKAPE involved in UTIs followed by Enterococcus spp. (8%) and S. aureus (6%). Among major ESKAPE, DTR-E. coli (p = 0.01), CRE-E. coli (p = 0.02) and XDR-E. coli (p = 0.03), Trimethoprim-sulfamethoxazole-resistant bacteria (p = 0.03) were associated with abdomino-pelvic pain. While MDR-E. coli (p < 0.001), UDR-E. coli (p = 0.02), ESC-E. coli (p < 0.001), MDR- Enterococcus (p = 0.04), UDR- Enterococcus (p = 0.02), bacteria resistant to Ampicillin (p < 0.01), Cefotaxime (p = 0.04), Ciprofloxacin (p < 0.001), Benzylpenicillin (p = 0.03) and Amikacin (p = 0.04) were more frequent among male children. MDR-Enterococcus (p < 0.01), bacteria resistant to Amoxicillin-clavulanic acid (p = 0.03), Cefalotin (p = 0.01), Ampicillin (p = 0.02) and Gentamicin (p = 0.03) were associated with treatment failure. In addition, Trimethoprim-sulfamethoxazole-resistant bacteria (p = 0.03) was associated with recurrent UTIs while those resistant to Ciprofloxacin was associated with pollakiuria (p = 0.01) and urinary burning (p = 0.04). Furthermore, UDR-K. pneumoniae (p = 0.02) was more frequent in neonates and infants.

Conclusion

This study determined the epidemiology of ESKAPE uropathogens in paediatric UTIs. It found a high prevalence of paediatric UTIs associated with children’s socio-clinical characteristics and diverse bacterial antibiotic resistance phenotypes.
A risk score to predict 30-day hospital readmission rate in cirrhotic patients with spontaneous bacterial peritonitis
Authors: Mousa Nasser , Abdel-Razik Ahmed , Elbaz Sherif , Salah Mohamed , Abdelaziz Mohammed , Habib Alaa , Deib Ahmed , Gadallah Abdel-Naser , El-wakeel Niveen , Eldars Waleed , effat Narmin , El-Emam Ola , Taha Khaled , Elmetwalli Alaa , Mousa Eman , Elhammady Dina
Published: May 2023

Background and aim

There is lack of 30-day hospital readmission prediction score in patients with liver cirrhosis and SBP. The aim of this study is to recognize factors capable of predicting 30-day readmission and to develop a readmission risk score in patients with SBP.

Methods

This study prospectively examined the 30-day hospital readmission for patients previously discharged with a diagnosis of SBP. Based on index hospitalization variables, a multivariable logistic regression model was implemented to recognize predictors of patient hospital readmission within 30 days. Consequently, Mousa readmission risk score was established to predict 30-day hospital readmission.

Results

Of 475 patients hospitalized with SBP, 400 patients were included in this study. The 30-day readmission rate was 26.5%, with 16.03% of patients readmitted with SBP. Age ≥ 60, MELD > 15, serum bilirubin > 1.5 mg/dL, creatinine > 1.2 mg/dL, INR > 1.4, albumin < 2.5 g/dL, platelets count ≤ 74 (103/dL) were found to be independent predictors of 30-day readmission. Incorporating these predictors, Mousa readmission score was established to predict 30-day patient readmissions. ROC curve analysis demonstrated that at a cutoff value ≥ 4, Mousa score had optimum discriminative power for predicting the readmission in SBP with sensitivity 90.6% and specificity 92.9%. However, at cutoff value ≥ 6 the sensitivity and specificity were 77.4% and 99.7%, respectively, while a cutoff value ≥ 2 had sensitivity of 99.1% and specificity of 31.6%.

Conclusions

The 30-day readmission rate of SBP was 25.6%. With the suggested simple risk assessment Mousa score, patients at high risk for early readmission can be easily identified so as to possibly prevent poorer outcomes.
Is agricultural digitization a reality among smallholder farmers in Africa? Unpacking farmers' lived realities of engagement with digital tools and services in rural Northern Ghana
Authors: Abdulai Abdul-Rahim , Tetteh Quarshie Philip , Duncan Emily , Fraser Evan
Published: May 2023

Background

Digital technologies are promoted as transformational for smallholders in Africa through the potential to enhance access to knowledge, increase productivity and food security. Despite the anticipations for agricultural digitalization in Africa, smallholders' engagement with digitalization is empirically underexplored. Hence, we surveyed 1565 rural farmers in Northern Ghana to explore how farmers interact with digital tools and services, and the variations in their engagements.

Results

We found that despite the growing array of digital opportunities (with diverse tools and services available to farmers), farmers are mainly confined to simple devices (mobile phones, radio, and TV) as access to digital resources, including the internet remains limited. Meanwhile, the main sources of digitalization services for smallholders remain largely the highly subisidized, development-orieted. NGOs and private-sector projects, which generally leverage SMS, Interactive Voice Response (IVR), radio, or field agents to reach farmers. Nonetheless, participation in digitalization services remains limited, unimpressive at best, and often fades over time because of weak building blocks evident in low literacies, lack of digital competencies and the limited access to digital resources.

Conclusions

Thus, full-scale digitalization remains a distant goal, and transformation claims are disconnected from smallholders' lived realities. However, opportunities exist to create a ‘digitalization for smallholders’ that is sensitive to the current and future structural limitations of smallholder agriculture, including low literacy and limited access to digital tools, to make agriculture digitalization reach its full potential in Africa.
Feelings toward lying flatism and attitudes toward singlehood: the mediating role of happiness belief
Authors: Heng Zeng-Qing , Chin Joey , Tan Chee-Seng
Published: May 2023

Background

Lying flatism, a new emerging lifestyle by refusing to participate in consumerist lifestyles, is anticipated to be related to singlehood. Based on the Theory of Reasoned Action, we proposed a mediation model to examine the indirect relationship between feelings towards lying flatism and attitudes toward singlehood via individuals’ belief in that happiness can be achieved without romantic relationships (happiness belief).

Methods

Using purposive and snowball sampling methods, 232 single Malaysian young adults participated in an online experiment consisting of a writing task (to manipulate feelings toward lying flatism), single-item measures of manipulation checking and happiness belief, Attitudes toward Singlehood Scale, Negative Stereotyping of Single Persons Scale (a measure of singlism) and Fear of Being Single Scale.

Results

T-Test results support the writing task that successfully induced positive feelings toward lying flatism. Mediation analysis showed that the feelings toward lying flatism measured before the writing task, but not the manipulation of lying flatism, has an indirect relationship with attitudes toward singlehood via happiness belief, after controlling for gender, singlism, and fear of being single.

Conclusions

The findings offer preliminary support to the hypothetical relationships among feelings towards lying flatism, happiness belief, and attitudes toward singlehood. Implications of the findings are discussed.
Evaluating the psychometric properties of the fatigue severity scale using item response theory
Authors: Muranaka Seiji , Fujino Haruo , Imura Osamu
Published: May 2023

Background

Fatigue is a common daily experience and a symptom of various disorders. While scholars have discussed the use of the Fatigue Severity Scale (FSS) using item response theory (IRT), the characteristics of the Japanese version are not yet examined. This study evaluated the psychometric properties of the FSS using IRT and assessed its reliability and concurrent validity with a general sample in Japan.

Methods and measures

A total of 1,007 Japanese individuals participated in an online survey, with 692 of them providing valid data. Of these, 125 participants partook in a re-test after approximately 18 days and had their longitudinal data analyzed. In addition, the graded response model (GRM) was used to assess the FSS items’ characteristics.

Results

The GRM’s results recommended using seven items and a 6-point scale. The FSS’s reliability was acceptable. Furthermore, the validity was adequate from the results of correlation and regression analyses. The synchronous effects models demonstrated that the Multidimensional Fatigue Inventory (MFI) enhanced depression, and depression enhanced FSS.

Conclusion

This study suggested that the Japanese version of the FSS should be a 7-item scale with a 6-point response scale. Further investigations may reveal the different aspects of fatigue assessed by the analyzed fatigue measures.
Engagement in On-line Language Assessment: are test-taking skills, self-assessment, resilience, and autonomy critical?
Authors: Ritonga Mahyudin , Shaban Ahmad Abdulkareem , Al-Rashidi Anwar Hammad , Chilani Noam
Published: May 2023

Every decision made in the classroom has the potential to either help or hurt a student’s development as a learner. When students’ mental and emotional well-being are taken into account, effective instruction and assessment are possible, despite the importance of learners’ engagement in assessment (LEA), test-taking skills (TTS), self-assessment (SA), learner resilience (LR), and learner autonomy (LA). As a result, this study attempted to illustrate the dynamic between LEA, TTS, SA, LR, and LA. To this end, 435 English as a foreign language (EFL) students at intermediate levels in Afghanistan were given copies of the Test-taking Skills Scale (TTSS), the core of self‑assessments questionnaire (CSAQ), The Academic Resilience Scale (ARS), the learner autonomy questionnaire (LAQ), and the learner engagement in on-line assessment (LEOA). Confirmatory factor analysis (CFA) and structural equation modeling (SEM) screening of the data revealed that resilient EFL students feel better at on-line assessment and in pursuing their objectives. The mediating effects of TTS and SA on LR and LA and consequently Engagement in On-line Assessment were specifically identified. The survey’s ramifications, which may improve language learning and assessment, are reviewed at length.
Late chronic local inflammation, synaptic alterations, vascular remodeling and arteriovenous malformations in the brains of male rats exposed to repetitive low-level blast overpressures
Authors: Gama Sosa Miguel A. , De Gasperi Rita , Pryor Dylan , Perez Garcia Georgina S. , Perez Gissel M. , Abutarboush Rania , Kawoos Usmah , Hogg Seth , Ache Benjamin , Sowa Allison , Tetreault Timothy , Varghese Merina , Cook David G. , Zhu Carolyn W. , Tappan Susan J. , Janssen William G. M. , Hof Patrick R. , Ahlers Stephen T. , Elder Gregory A.
Published: May 2023

In the course of military operations in modern war theaters, blast exposures are associated with the development of a variety of mental health disorders associated with a post-traumatic stress disorder-related features, including anxiety, impulsivity, insomnia, suicidality, depression, and cognitive decline. Several lines of evidence indicate that acute and chronic cerebral vascular alterations are involved in the development of these blast-induced neuropsychiatric changes. In the present study, we investigated late occurring neuropathological events associated with cerebrovascular alterations in a rat model of repetitive low-level blast-exposures (3 × 74.5 kPa). The observed events included hippocampal hypoperfusion associated with late-onset inflammation, vascular extracellular matrix degeneration, synaptic structural changes and neuronal loss. We also demonstrate that arteriovenous malformations in exposed animals are a direct consequence of blast-induced tissue tears. Overall, our results further identify the cerebral vasculature as a main target for blast-induced damage and support the urgent need to develop early therapeutic approaches for the prevention of blast-induced late-onset neurovascular degenerative processes.
Analyzing the associations between motivation and academic performance via the mediator variables of specific mathematic cognitive learning strategies in different subject domains of higher education
Authors: Wild Steffen , Neef Christoph
Published: May 2023

Background

There are different teaching methods and learning content in the academic field of mathematics between school and university. Many students fail in their studies when the proportion of mathematics is high. Additionally, dropout rates, due to mathematical performance, are high. However, there are different strategies used to improve mathematical skills. Based on the process model of self-regulated learning, an analysis of the association between motivational aspects in the pre-action phase as well as seven special cognitive learning strategies for mathematics in the action phase was conducted. The variables were compared with student performance. The study drew on data from 548 retrospective interviews of cooperative students, using a cross-sectional research design.

Results

The analysis via structural equation modeling shows a direct association between motivational aspects, such as academic self-concept and curiosity, and the seven learning strategies in mathematics. Furthermore, there is a direct effect of academic self-concept on performance. However, the learning strategy of practicing was the only variable with associations to performance. Additionally, the indirect effect of curiosity on performance via practicing is analyzed.

Conclusion

It can be seen, that curiosity on its own is not enough to ensure a good level of performance in mathematics. The findings suggest student learning strategies focusing on harnessing their curiosity and on practicing. A high academic self-concept is also relevant to the performance level achieved. Lecturers should create a learning environment to support such student behavior.
Predicted results of the velocity structure at the target site of the blind prediction exercise from microtremors and surface wave method as Step-1, Report for the experiments for the 6th international symposium on effects of surface geology on seismic motion
Authors: Chimoto Kosuke , Yamanaka Hiroaki , Tsuno Seiji , Matsushima Shinichi
Published: May 2023

1D velocity profiles at a strong motion station in the northern part of the Kumamoto plain, Japan, were submitted in Step-1 of the blind prediction exercise of strong ground motions in the sixth international symposium on effects of surface geology on seismic motion (ESG6). Individual participants were requested to estimate a 1D S-wave velocity profile of sedimentary layers from the given data obtained by microtremor array explorations and surface-wave explorations at the site. This paper reports the target site, methods used by the individual participants, and the submitted results. More than half of the participants estimated the phase velocities of the Rayleigh-wave in the frequency range from 0.53 to 29.8 Hz. The statistical analysis of the phase velocity dispersion curves indicates that the standard deviation was below 40 m/s at the frequencies above 3.4 Hz, and it was below 20 m/s above 20 Hz. The S-wave velocity profiles are also similar to a depth of 20 m. The standard deviation was below 45 m/s. The average S-wave velocity in the top 30 m from the surface is 207.3 ± 60.7 m/s for the submitted profiles. The large variation is related to the introduction of the near-surface low velocity layers. The large variation of the S-wave velocities was found in the deep part. The average S-wave velocity at a depth of 1500 m was 2674 m/s with the standard deviation of 786 m/s. We compared 1D amplifications for the submitted profiles. Common peaks can be identified at 0.3–0.4 Hz and 1–2 Hz, excluding two teams. However, the amplifications vary much in the frequency range higher than 4 Hz. Through the experiment, it was found that the dispersion curves and the shallow S-wave velocity structures are estimated with a low standard deviation among the participants. Further development of the techniques for deep S-wave velocity profiling was found to be required.

Graphical Abstract
Risk Factors for Sustaining a Second ACL Injury after Primary ACL Reconstruction in Female Football Players: A Study Investigating the Effects of Follow-Up Time and the Statistical Approach
Authors: Fältström Anne , Hägglund Martin , Kvist Joanna , Mendonça Luciana D.
Published: May 2023

Background

Studies evaluating risk factors for sustaining an anterior cruciate ligament (ACL) injury have different, sometimes contrasting, results. Different follow-up times and statistical approaches may be a reason for these differences. The aim of this study was to explore if different follow-up times and statistical approaches, classification and regression tree (CART) analysis and Cox regression, would impact on the association between various candidate risk factors and ACL injury in female football players. In total, 112 active female football players, 18 ± 8 months after ACL reconstruction (mean age ± SD, 20 ± 2 years), were included and followed for at least 36 months. At baseline, all players underwent assessment of range of motion of knee and ankle joints, functional tests, and answered questionnaires regarding knee function, psychological and personality traits. Nineteen independent variables were included for the CART analysis and for univariable Cox regression and compared using four different follow-up times: 0–12, 0–24, 0–36, and 0–>36 months.

Results

Forty-three (38%) players sustained a second ACL injury. The identified risk factors varied depending on follow-up time both with CART analysis and with Cox regression. CART identified 12 of the 19 independent variables and selected between 5 and 6 of the variables in the four different follow-up times associated with second ACL injury. The accuracy of the different follow-up times for the CART varied between 86 and 93% with 77–96% sensitivity and 70–81% specificity. Cox regression identified two risk factors: knee extension at 0–36 months and 0–>36 months, and time between primary injury and surgery at 0–>36 months. The accuracy varied between 54 and 64% with 44–88% sensitivity and 32–71% specificity.

Conclusions

The identified risk factors associated with a second ACL injury varied depending on the follow-up time and statistical approach used. Thus, in future research on risk factors, the time athletes are followed up and the type of statistical methods used are important to discuss.
Intracranial pressure monitoring in neurosurgery: the present situation and prospects
Authors: He Chenqi , Teng Chubei , Xiong Zujian , Lin Xuelei , Li Hongbo , Li Xuejun
Published: May 2023

Intracranial pressure (ICP) is one of the most important indexes in neurosurgery. It is essential for doctors to determine the numeric value and changes of ICP, whether before or after an operation. Although external ventricular drainage (EVD) is the gold standard for monitoring ICP, more and more novel monitoring methods are being applied clinically.

Invasive wired ICP monitoring is still the most commonly used in practice. Meanwhile, with the rise and development of various novel technologies, non-invasive types and invasive wireless types are gradually being used clinically or in the testing phase, as a complimentary approach of ICP management. By choosing appropriate monitoring methods, clinical neurosurgeons are able to obtain ICP values safely and effectively under particular conditions.

This article introduces diverse monitoring methods and compares the advantages and disadvantages of different monitoring methods. Moreover, this review may enable clinical neurosurgeons to have a broader view of ICP monitoring.
The state of current research on COVID-19 and antibiotic use: global implications for antimicrobial resistance
Authors: Zyoud Sa’ed H.
Published: May 2023

Background

During the initial stages of the coronavirus disease 2019 (COVID-19) pandemic, the administration of antibiotics to patients was prevalent in numerous countries. Despite this, the rising threat of antimicrobial resistance (AMR) presents a significant public health concern. The escalation of AMR has been exacerbated by the ongoing COVID-19 pandemic. Against this backdrop, the primary aim of this study was to conduct a bibliometric and visual analysis of research pertaining to the use of antibiotics in COVID-19.

Methods

This study examined documents indexed in Scopus between 2020 and 2022. To visualize the trends and hotspots of research related to antibiotics and COVID-19, as well as collaborative networks, the researcher utilized version 1.6.18 of the VOSviewer software. Scopus data were analysed to extract information on the types of publications, annual research output, countries, institutions, funding agencies, journals, citations, and highly cited references. Microsoft Excel 2019 was used to process and organize the extracted data.

Results

This study analysed 1137 documents related to COVID-19 and antibiotics and found that the number of publications increased from 130 in 2020 to 527 in 2022. These publications included 777 (68.34%) articles and 205 (18.03%) reviews. The top five countries in terms of scientific production were the United States (n = 231; 20.32%), the United Kingdom (n = 156; 13.72%), China (n = 101; 8.88%), India (n = 100; 8.8%), and Italy (n = 63; 5.54%), and the leading institutions wereImperial College London(n = 21; 1.85%),University of Oxford(n = 20; 1.76%), andUniversity College London(n = 15; 1.32%). TheNational Natural Science Foundation of Chinaprovided funding for the highest number of articles (n = 48; 4.22%), followed by theNational Institutes of Health(n = 32; 2.81%). The most productive journals wereAntibiotics(n = 90; 7.92%),Journal of Antimicrobial Chemotherapy(n = 30; 2.64%), andInfection Control and Hospital Epidemiology(n = 26; 2.29%). Finally, the research hotspots identified in this study were ‘antimicrobial stewardship during the COVID-19 outbreak’ and ‘implicationsof the COVID-19 pandemic on the emergence of antimicrobial resistance.’

Conclusions

This is the first bibliometric analysis of COVID-19-related research on antibiotics. Research was carried out in response to global requests to increase the fight against AMR and awareness of the issue. More restrictions on the use of antibiotics are urgently needed from policy makers and authorities, more so than in the current situation.
The Ragulator complex: delving its multifunctional impact on metabolism and beyond
Authors: Tsujimoto Kohei , Takamatsu Hyota , Kumanogoh Atsushi
Published: May 2023

Our understanding of lysosomes has undergone a significant transformation in recent years, from the view that they are static organelles primarily responsible for the disposal and recycling of cellular waste to their recognition as highly dynamic structures. Current research posits that lysosomes function as a signaling hub that integrates both extracellular and intracellular stimuli, thereby regulating cellular homeostasis. The dysregulation of lysosomal function has been linked to a wide range of diseases. Of note, lysosomes contribute to the activation of mammalian target of rapamycin complex 1 (mTORC1), a key regulator of cellular metabolism. The Ragulator complex, a protein complex anchored on the lysosomal membrane, was initially shown to tether the mTORC1 complex to lysosomes. Recent research has substantially expanded our understanding of the roles of the Ragulator complex in lysosomes, including roles in the regulation of metabolism, inflammation, cell death, cell migration, and the maintenance of homeostasis, via interactions with various proteins. This review summarizes our current knowledge on the diverse functions of the Ragulator complex, highlighting important protein interactions.
Three-stage day-ahead scheduling strategy for regional thermostatically controlled load aggregators
Authors: Fan Dejin , Zhang Shu , Huang He , Zhou Liping , Wang Yang , Xiao Xianyong
Published: May 2023

Thermostatically controlled loads (TCLs) are regarded as having potential to participate in power grid regulation. This paper proposes a scheduling strategy with three-stage optimization for regional aggregators jointly participating in day-ahead scheduling to support demand response. The first stage is on the profit of aggregators and peak load of the grid. The line loss and voltage deviation of regulation are considered to ensure stable operation of the power grid at the second stage, which guarantees the fairness of the regulation and the comfort of users. A single temperature adjustment strategy is used to control TCLs to maximize the response potential in the third stage. Finally, digital simulation based on the IEEE 33-bus distribution network system proves that the proposed three-stage scheduling strategy can keep the voltage deviation within ± 5% in different situations. In addition, the Gini coefficient of distribution increases by 20% and the predicted percentage of dissatisfied is 48% lower than those without distribution.
Outpatient physical therapy bundled payment models are feasible for total hip arthroplasty patients: an evaluation of utilization, cost and outcomes
Authors: Stock Laura A. , Johnson Andrea H. , Brennan Jane C. , Turcotte Justin J. , King Paul J. , MacDonald James H.
Published: May 2023

Background

Various episode-of-care bundled payment models for patients undergoing total joint arthroplasty have been implemented. However, participation in bundled payment programs has dropped given the challenges of meeting continually lower target prices. The purpose of our study is to investigate the cost of outpatient physical therapy (PT) and the potential for stand-alone outpatient PT bundled payments for patients undergoing total hip arthroplasty (THA).

Methods

A retrospective review of 501 patients who underwent primary unilateral THA from November 2017 to February 2020 was performed. All patients included in this study received postoperative PT care at a single hospital-affiliated PT practice. Patients above the 75th percentile of therapy visits were then classified as high-PT utilizers and compared with the rest of the population using univariate statistics. Stepwise multivariate logistic regression was used to assess the predictors of high therapy utilization.

Results

Patients averaged 65 ± 10 years of age and a BMI of 29 ± 5 kg/m2. Overall, 80% of patients were white and 53% were female. The average patient had 11 ± 8 total therapy sessions in 42 days: one initial evaluation, one re-evaluation and 9 standard sessions. High-PT utilizers incurred estimated average costs of $1934 ± 431 per patient, compared to $783 ± 432 (P < 0.001) in the rest of the population. Further, no significant differences in 90-day outcomes including lower extremity functional scale scores, emergency department returns, readmissions, or returns to the operating room were observed between high utilizers and the rest of the population (all P > 0.08). In the multivariate analysis, women (OR = 1.68, P = 0.017) and those with sleep apnea (OR = 2.02, P = 0.012) were nearly twice as likely to be high utilizers, while white patients were 42% less likely to be high utilizers than patients of other races (OR = 0.58, P = 0.028).

Conclusions

Outpatient PT utilization is highly variable in patients undergoing THA. However, despite using more services and incurring increased cost, patients in the top quartile of utilization experienced similar outcomes to the rest of the population. If outpatient therapy bundles are to be developed, 16 visits appear to be a reasonable target for pricing, given this provides adequate coverage for 75% of THA patients.
The Echo of Voices after the Fall of the Aztec Empire
Authors: Hidalgo Alex
Published: May 2023

The recent quincentennial of the Mexica forces' defeat at the hands of a Spanish-led coalition invites us to reflect on the changes in the region's acoustic ecology, the layers of sound that reverberated across geographic spaces. Expressions of sound allow us to consider the actions of past actors in relation to their physical surroundings, the stimulation of the senses, and patterns of religious conversion that guided social behavior. Vocal sounds produced by people of various ethnic and racial backgrounds formed part of this aural environment, and they carried meaning that has often escaped the attention of scholars. An analysis of routines of indoctrination centered on vocal modulations reveals that authorities hierarchized different forms of sounds, from singing and praying—which they encouraged—to screams and muffled noises such as murmur and chatter—which they attempted to silence. These routines took shape during daily masses, theater presentations, civic and religious rituals, confession, and, in some cases, formal training.
Family Norms and Declining First-Marriage Rates: The Role of Sibship Position in the Japanese Marriage Market
Authors: Uchikoshi Fumiya , Raymo James M. , Yoda Shohei
Published: May 2023

This study explores how changes in sibship composition associated with fertility decline may, in conjunction with entrenched family norms and expectations associated with specific sibship positions, impact marriage rates and further reduce fertility. We evaluate this possibility by focusing on Japan, a society characterized by half a century of below-replacement fertility and widely shared family norms that associate eldest (male) children with specific family obligations. Harmonic mean models allow us to quantify the contribution of changes in both marriage market composition with respect to sibship position and sibship-specific pairing propensities to the observed decline in marriage rates between 1980 and 2010. One important finding is that marriage propensities are lower for those pairings involving men and women whose sibship position signals a higher potential of caregiving obligations, especially only-children. Another is that changes in marriage propensities, rather than changing sibship composition, explain most of the observed decline in marriage rates. We also found that marriage propensity changes mitigate the impact of the changing sibship composition to some extent. However, the limited contribution of changing sibship composition to the decline in first-marriage rates provides little support for a self-reinforcing fertility decline via the relationship between changing sibship composition and marriage behavior.
Archaeology of the Eyeball: Lu Xun, Eye-Gouging Myth, and Ocular Anatomy
Authors: Teng Tim Shao-Hung
Published: May 2023

This article situates Lu Xun at the intersection of late-Qing folkloric discourse and medical science by studying his 1925 essay “Lun zhaoxiang zhilei” (“On Photography”). “On Photography” is a rich yet enigmatic piece of writing that has yet to receive critical attention on its own terms in the scholarship of either Lu Xun or Chinese visual culture. Lu Xun's essay includes a folklore account of “foreign devils” plucking out locals’ eyes and pickling them in a jar. Bracketing the magic lantern incident held by many as the primal scene of modern Chinese literature, this article suggests that Lu Xun's account of the eyeball offers a no less significant example of how an alternate optical device can be employed to reflect China's encounter with colonial modernity. Adopting the method of media archaeology, this article argues that Lu Xun's essay holds the key to tracing a genealogy of the eyeball from its embedment in feudal superstition to its embodiment of antimissionary sentiments, from figurative representation in Chinese medical classics to physiological simulation in anatomical treatises, and from anatomical visualization to optical abstraction and modulation. This genealogy constructs the eye as a historically valid subject that morphs from the eye to the eyeball and then to the eye again, a genealogy that is revealing of how China grappled through a crucial period of political, cultural, and scientific sea changes.
Nalanda Rising
Authors: Marston John , Geary David
Published: May 2023

While the memory of the ancient Nalanda University has often been invoked in recent years as a symbol of educational excellence and pan-Asian unity, particularly with reference to the creation of a new international university in Bihar, India, these discourses often overlook and erase the significance of Nava Nalanda Mahviahra that was created in India's postindependence period as an institute devoted to the study of Buddhist texts and languages near the archeological site of the ancient university. This article looks at the Indian Buddhist scholar Jagdish Kashyap and his role in creating the state-sponsored institute, the symbolism of cultural revival it represented, and the excitement it generated in international Buddhism, attracting monks and lay students from around the Buddhist world. The article also discusses the institute's links to China and its sensitive relation to the dynamics of the Cold War in the 1950s and ’60s. It then discusses how these two Nalanda insitutions speak to issues of heritage diplomacy and the politics of revival in contemporary India and beyond.
Perceived Utility of Intracranial Pressure Monitoring in Traumatic Brain Injury: A Seattle International Brain Injury Consensus Conference Consensus-Based Analysis and Recommendations
Authors: Chesnut Randall M. , Aguilera Sergio , Buki Andras , Bulger Eileen M. , Citerio Giuseppe , Cooper D. Jamie , Arrastia Ramon Diaz , Diringer Michael , Figaji Anthony , Gao Guoyi , Geocadin Romergryko G. , Ghajar Jamshid , Harris Odette , Hawryluk Gregory W. J. , Hoffer Alan , Hutchinson Peter , Joseph Mathew , Kitagawa Ryan , Manley Geoffrey , Mayer Stephan , Menon David K , Meyfroidt Geert , Michael Daniel B. , Oddo Mauro , Okonkwo David O. , Patel Mayur B. , Robertson Claudia , Rosenfeld Jeffrey V. , Rubiano Andres M. , Sahuquillo Juain , Servadei Franco , Shutter Lori , Stein Deborah M. , Stocchetti Nino , Taccone Fabio Silvio , Timmons Shelly D. , Tsai Eve C. , Ullman Jamie S. , Videtta Walter , Wright David W. , Zammit Christopher
Published: May 2023

BACKGROUND:

Intracranial pressure (ICP) monitoring is widely practiced, but the indications are incompletely developed, and guidelines are poorly followed.

OBJECTIVE:

To study the monitoring practices of an established expert panel (the clinical working group from the Seattle International Brain Injury Consensus Conference effort) to examine the match between monitoring guidelines and their clinical decision-making and offer guidance for clinicians considering monitor insertion.

METHODS:

We polled the 42 Seattle International Brain Injury Consensus Conference panel members' ICP monitoring decisions for virtual patients, using matrices of presenting signs (Glasgow Coma Scale [GCS] total or GCS motor, pupillary examination, and computed tomography diagnosis). Monitor insertion decisions were yes, no, or unsure (traffic light approach). We analyzed their responses for weighting of the presenting signs in decision-making using univariate regression.

RESULTS:

Heatmaps constructed from the choices of 41 panel members revealed wider ICP monitor use than predicted by guidelines. Clinical examination (GCS) was by far the most important characteristic and differed from guidelines in being nonlinear. The modified Marshall computed tomography classification was second and pupils third. We constructed a heatmap and listed the main clinical determinants representing 80% ICP monitor insertion consensus for our recommendations.

CONCLUSION:

Candidacy for ICP monitoring exceeds published indicators for monitor insertion, suggesting the clinical perception that the value of ICP data is greater than simply detecting and monitoring severe intracranial hypertension. Monitor insertion heatmaps are offered as potential guidance for ICP monitor insertion and to stimulate research into what actually drives monitor insertion in unconstrained, real-world conditions.
Συγκριτική μελέτη της δράσης αντιδιαβητικών φαρμάκων στην παθογένεια της οστεοπόρωσης
Authors: Αμπντί Αρεζού
Published: May 2023

Σκοπός: Σκοπός της μελέτης είναι να αποσαφηνίσει τη συσχέτιση του μονοπατιού των ινκρετινών με την παθογένεση της οστεοπόρωσης. Στην παρούσα μελέτη συγκρίνουμε δυο διαφορετικά αντιδιαβητικά φάρμακα βασισμένα στο μονοπάτι των ινκρετινών.Υλικά και μέθοδοι: Χρησιμοποιήθηκαν 40 επίμυες Wistar, οι οποίοι χωρίστηκαν μετά από τυχαιοποίηση σε 4 ομάδες. Η ομάδα 1 ήταν ομάδα control, η ομάδα 2 ήταν διαβητικά ζώα που δεν έλαβαν αγωγή, η ομάδα 3 ήταν διαβητικά ζώα στα οποία χορηγήθηκε αναστολέας του dpp4 (10 mg/kg/day) ενώ στην ομάδα 4 χορηγήθηκε αγωνιστής του glp-1 (10 μg/kg/day). Το μοντέλο του διαβήτη τύπου 2 που χρησιμοποιήθηκε για τα 30 διαβητικά ζώα βασίστηκε στη χορήγηση φρουκτόζης σε συνδυασμό με χαμηλή δόση στρεπτοζοτοκίνης. Μετά από 5 εβδομάδες θεραπείας έγινε αιμοληψία και κατόπιν θυσία των πειραματοζώων. Τα μηριαία των πειραματοζώων χρησιμοποιήθηκαν για μελέτες μηχανικής αντοχής και φασματοσκοπίας Ραμαν, ενώ το αίμα τους μελετήθηκε με μέθοδο ELISA για δείκτες οστικού σχηματισμού και απορρόφησης. Τα αριστερά μηριαία χρησιμοποιήθηκαν για παθολογανατομική μελέτη.Αποτελέσματα: Και τα δυο φάρμακα μείωσαν την οστεοκλαστική λειτουργία, ωστόσο δεν μπόρεσαν να επαναφέρουν τον οστικό επανασχηματισμό. Η συνολική επίδραση στην αντοχή του οστού ήταν απρόσμενη, καθώς η ελαστικότητα του οστού επανήλθε χάρη στην αντιδιαβητική αγωγή αλλά η οστική αντοχή μειώθηκε. Η εξενατίδη είχε πιο έντονη δράση σε σχέση με τη σιταγλιπτίνη, επιβεβαιώνοντας πως η DPP4 συνδέει τη μειωμένη οστεοκλαστική δραστηριότητα με τη μειωμένη οστική παραγωγή. Συμπεράσματα: Οι DPP4 υποδοχείς είναι ένας από τους συνδετικούς κρίκους μεταξύ της μειωμένης οστικής απορρόφησης και της μειωμένης οστικής ανακατασκευής. Το συμπέρασμα που μπορεί να εξαχθεί είναι πως η αναστολή του υποδοχέα DPP4 είναι πιο βλαβερή για το οστό σε σχέση με τους αγωνιστές του GLP-1.
Small studies in systematic reviews: To include or not to include?
Authors: El Alayli Abdallah , Thomas Preston , Jdiaa Sara , Mansour Razan , Gautam Archana , Phadnis Millind A. , El Mikati Ibrahim K. , Mustafa Reem A.
Published: May 2023

Background: COVID-19 provided a real challenge for evidence synthesis due to the rapid growth of evidence. We aim to assess the impact of including all studies versus including larger studies only in systematic reviews when there is plethora of evidence. We use a case study of COVID-19 and chronic kidney disease (CKD).

Methods: The review team conducted a systematic review of multiple databases. The review assessed the effect of CKD on mortality in patients with COVID-19. We performed a sensitivity analysis to assess the effect of study size on the robustness of the results based on cutoffs of 500, 1000 and 2000 patients.

Results: We included 75 studies. Out of which there were 40 studies with a sample size of >2,000 patients, seven studies with 1,000-2,000 patients, 11 studies with 500-1,000 patients, and 17 studies with <500 patients. CKD increased the risk of mortality with a pooled hazard ratio (HR) 1.57 (95% confidence interval (CI) 1.42 - 1.73), odds ratio (OR) 1.86 (95%CI 1.64 - 2.11), and risk ratio (RR) 1.74 (95%CI 1.13 - 2.69). Across the three cutoffs, excluding the smaller studies resulted in no statistical significance difference in the results with an overlapping confidence interval.

Conclusions: These findings suggested that, in prognosis reviews, it could be acceptable to limit meta-analyses to larger studies when there is abundance of evidence. Specific thresholds to determine which studies are considered large will depend on the context, clinical setting and number of studies and participants included in the review and meta-analysis.
Exploring Ghanaian medical students’ learning experiences during the COVID-19 lockdown: a case study of the University for Development Studies Medical School
Authors: Amalba Anthony , Amoore Bright Yammaha , Kpebu Sophia Ewuenye Adwoa , Abugri Bruce Ayabilla , Mogre Victor
Published: May 2023

Background: Coronavirus disease (COVID-19) continues to affect health professions education, especially in developing and middle-income countries, even though alternative educational measures have been sanctioned to continue educating students in their homes while observing physical distancing.

Methods: A qualitative cross-sectional study design was adopted for the study. Participants among the four departments of a Ghanaian medical school were treated as clusters, and a voluntary response sampling approach was used to recruit students across the clusters to respond to self-administered online Google interview questions on students’ learning experiences during the COVID-19 pandemic.

Results: The study found that lack of supervision, lack of access to school library resources, overload of syllabi and the interference of household chores were major factors that made online learning difficult and ineffective during the COVID-19 lockdown. Most participants (n=133, 67%) described online learning as completely inadequate, ineffective and an expensive mode of learning which may not develop the necessary competence and skills required for effective clinical practice.

Conclusions: Notwithstanding this, almost all students believed that combining face-to-face and online learning will significantly improve medical education. The COVID-19 pandemic brought about the increased use of online learning in the health professions that was accompanied with significant challenges for students.