bluuebunny/crossref_metadata_2025 huggingface dataset:
Instability, crisis, and statecraft in Conservative Britain, 2010–24
Authors: Hayton Richard
Published: July 2024

This article examines how the Conservative Party dominated British politics from 2010 to 2024 despite this period being one of instability and crisis. It argues that a key source of this turmoil was the Conservative Party itself, which under a succession of Prime Ministers struggled to formulate an effective statecraft strategy. While these leadership failings have been well documented the underlying difficulties run deeper, reflecting tensions for the self-proclaimed natural party of government in adapting its statecraft to the rise of populist and anti-politics pressures. The article exposes these through the lens of statecraft theory, which is applied to the largely overlooked constitutional dimension of Conservative statecraft. This reveals a persistent willingness to prioritize partisan statecraft strategy over adherence to constitutional norms, which portends a slide into populism now the party has returned to opposition.
The Crystallization of Continental Flood Basalt Lavas: Insights from Textural Studies
Authors: Monteiro Aristle , Mittal Tushar , Duraiswami Raymond , Self Stephen
Published: July 2024

Continental flood basalt (CFB) provinces are products of the largest known volumetric eruptions on Earth (~104 km3), with individual flow fields commonly covering well over 10 000 km2 with a mean lava thickness of over 5 m. Studies focusing on the emplacement style of such lava flows have relied extensively on morphological observations and comparisons with modern lava flows and experimental analogs. In the present study, we compare the textures of flood basalt lavas with those from different eruption settings all over the world using data collected from pre-existing literature to gain detailed insights into the style of eruption. Comparison of crystal size distribution data indicates that the eruption style of CFBs is similar to those of modern-day fissure eruptions (e.g. Iceland). This matches inferences based on observations of morphology. We also use a 1D thermal model to estimate the depth-dependent cooling rates within a single lava lobe and test the validity of assumptions built into the formulation of these models for large scale flood basalt lavas. The results reveal that, on average, flood basalt lavas need to conductively cool much faster than we would expect (up to order of ~102 times faster) to match the textural observations. The model is also frequently unable to replicate the observed depth-wise relative variations in length with depth for CFB lavas. Furthermore, the calculated cooling rates from crystal shapes also do not match those calculated from crystal lengths, indicating the assumptions in cooling flow models need to be modified for large CFB flow fields. Given the large areas of CFB flow fields and the relatively long eruption times inferred for the emplacement of individual flow fields, we hypothesize that inflation of lobes and formation of new lobes via breakouts combined with variable eruption rates are key processes that are missing when modeling the cooling of these flow fields. Accounting for these processes is essential to derive accurate cooling rates, which is important to better understand the environmental impact CFBs have at the time of emplacement.
Subclinical aortic inflammation in patients with polymyalgia rheumatica
Authors: Kaymakci Mahmut S , Berry Gerald J , Langenfeld Hannah E , Hanson Andrew C , Crowson Cynthia S , Bois Melanie C , Schaff Hartzell V , Sato Yuki , Le Kevin-Phu C , Koster Matthew J , Weyand Cornelia M , Warrington Kenneth J
Published: July 2024

Objectives

To examine the clinicopathologic features of patients with polymyalgia rheumatica (PMR) who had thoracic aorta repair surgery. Findings were compared with those of a cohort of patients with giant cell arteritis (GCA) requiring thoracic aorta repair.

Methods

All patients evaluated at Mayo Clinic in Rochester, MN, with Current Procedural Terminology (CPT) codes for thoracic aorta repair surgery between 2000–2021 were identified. All patients were screened for prior PMR diagnosis. Patients with PMR and no signs of GCA were categorized as clinically isolated PMR. The medical records of all patients were manually reviewed, and pathologists re-examined all the aortic tissues.

Results

Of the 4621 patients with at least one CPT code for thoracic aorta repair surgery, 43 patients were diagnosed with clinically isolated PMR before the surgery. Detailed histopathological examination of the aortic tissues revealed active inflammation in 30/43 (70%) patients after a median (IQR) of 10.0 (4.7–13.3) years from the PMR diagnosis. When compared with aortic tissue from patients with a prior diagnosis of GCA, the aorta of patients with PMR had more severe inflammation (Grade 3: 15/30 [50%] vs 5/34 [15%], P = 0.002). Patients with PMR and thoracic aorta repair may experience a 40% increased risk of mortality compared with the general population, but this did not reach statistical significance (standardized mortality ratio: 1.40; 95% CI: 0.91–2.07).

Conclusions

Some patients with PMR have subclinical aortic inflammation that is detectable many years after initial diagnosis and may contribute to the development of aortic aneurysm.
Adaptation of stomatal conductance, photosynthesis and water-use efficiency at shoot and canopy scales in adjacent stands of Dacrycarpus dacrydioides and Podocarpus totara
Authors: Bown Horacio E , Hunt John E , Barbour Margaret M , Rogers Graeme N D , Whitehead David
Published: July 2024

We tested an approach to estimate daily canopy net photosynthesis, A, based on estimates of transpiration, E, using measurements of sap flow and water-use efficiency, ω, by measuring δ13C in CO2 respired from shoots in the canopies of two conifers (Podocarpaceae) native to New Zealand. The trees were planted in adjacent 20-year-old stands with the same soil and environmental conditions. Leaf area index was lower for Dacrycarpus dacrydioides D.Don in Lamb (1.34 m2 m−2) than for Podocarpus totara G.Benn. ex D.Don var. totara (2.01 m2 m−2), but mean (± standard error) stem diameters were the same at 152 ± 21 mm for D. dacrydioides and 154 ± 25 mm for P. totara. Over a 28-day period, daily A (per unit ground area) ranged almost five-fold but there were no significant differences between species (mean 2.73 ± 1.02 gC m−2 day−1). This was attributable to higher daily values of E (2.63 ± 0.83 mm day−1) and lower ω (1.35 ± 0.53 gC kg H2O−1) for D. dacrydioides compared with lower E (1.82 ± 0.72 mm day−1) and higher ω (1.90 ± 0.77 gC kg H2O−1) for P. totara. We attributed this to higher nitrogen availability and nitrogen concentration per unit foliage area, Na, and greater exposure to irradiance in the D. dacrydioides canopy compared with P. totara. Our findings support earlier observations that D. dacrydioides is more adapted to sites with poor drainage. In contrast, the high retention of leaf area and maintaining low rates of transpiration by P. totara, resulting in higher water-use efficiency, is an adaptive response to survival in dry conditions. Our findings show that physiological adjustments for two species adapted to different environments led to similar canopy photosynthesis rates when the trees were grown in the same conditions. We demonstrated consistency between whole-tree and more intensive shoot-scale measurements, confirming that integrated approaches are appropriate for comparative estimates of carbon uptake in stands with different species.
Immediate Nipple Reconstruction in Skin-sparing Mastectomy with A Modified Wise-pattern Design
Authors: Stead Thor S. , Francalancia Stephanie , Laspro Matteo , Tanney Kelly , Larson Blair , Mitra Amitabha
Published: July 2024

This article discusses a novel approach to immediate nipple reconstruction during skin-sparing mastectomy with Wise-pattern design, a common procedure in direct-to-implant breast reconstruction. Traditionally, nipple reconstruction is performed as a second procedure, incurring additional costs and potential complications. This novel technique involves a simple modification to the Wise-pattern flap during the initial mastectomy, allowing for one-step reconstruction. The procedure includes preoperative markings of the Wise-pattern design, with a U-shaped flap added at the top angle to create the nipple position. This U-shaped flap, containing both skin and subcutaneous tissue, is then folded over itself and sutured, resulting in an inverted T-shaped incision with the reconstructed nipple at the apex. This article emphasizes the avoidance of a secondary operation for nipple reconstruction, avoiding additional costs and potential complications associated with flap loss, especially in postradiation patients. The technique was applied to five consecutive cases, with patient satisfaction reported as very high. Follow-up at 6 months showed no venous congestion or flap loss, and in patients without adjuvant radiation, the reconstructed nipple maintained almost all its initial postoperative height. Minor loss of nipple protrusion over time was comparable to traditional nipple reconstruction (eg, skate flap), and the construction of the new nipple required only an average of 10 extra minutes. Although larger-scale studies are needed for a comprehensive evaluation, the preliminary results suggest promising outcomes and encourage larger-scale safety and outcomes studies of this technique in Wise-pattern skin-sparing reconstructions.
Granular Cell Tumor Initially Masquerading as Cellulitis
Authors: Berger Ori , Arnon Ofer , Lomeli Bernardo A. , Ofek Nona , Talisman Ran
Published: July 2024

Granular cell tumor (GCT), a rare Schwann cell–derived lesion, typically manifests as a benign skin or soft tissue growth. We report a case of GCT mimicking cellulitis on a woman’s foot at first presentation. Despite initial misdiagnosis, histological examination confirmed GCT, guiding successful excision and reconstruction. Our case underscores the importance of considering granular cell tumors in atypical presentations and highlights the role of histological evaluation in accurate diagnosis and management.
Composite Anterolateral Thigh–Tensor Fascia Lata–Vastus Lateralis Flap with Synthetic Mesh Reconstruction for Giant Ventral Hernia Repair
Authors: Winaikosol Kengkart , Punchai Suriya
Published: July 2024

Dealing with a giant ventral hernia can be a complex situation because it involves a considerable loss of space within the body. Although various surgical techniques are available for treating this condition, the recurrence rate remains high, making it challenging. This article presents a surgical treatment for a giant ventral hernia using synthetic mesh and a composite anterolateral thigh–tensor fasciae latae–vastus lateralis free flap. The average size of the hernia ring was 375.83 cm2, and all procedures were successful with minimal complications. After a follow-up period of 28 months, there have been no reports of recurrence. The technique is an effective option for treating patients with giant ventral hernias, particularly in cases where the component separation technique is not feasible.
A Survey of ECT Anesthesia Practice Variation in Finland
Authors: Huoponen Saara H. , Sisa Katrin , Taittonen Markku , Saari Tom , Ahlmén-Laiho Ulla
Published: July 2024

Objective

This study examines the extent of variation in anesthesia practices among Finnish neuromodulation units providing electroconvulsive therapy (ECT) and investigates recent changes within individual units.

Methods

An electronic survey was carried out among Finnish neuromodulation units exploring staff demographics, anesthesia practices (including agents and adjuvants), patient physiology monitoring, observed adverse effects, patient follow-up times, and recent anesthesia protocol changes.

Results

Finland has 26 neuromodulation units providing ECT, of which 18 (69%) responded to our study. The research uncovered significant differences in anesthesia practices, including induction agent choice, convulsion motor component monitoring, staff educational backgrounds, and reported adverse effects. Propofol was the most commonly used anesthetic in 14 units (78%). Three units (17%) reported using methohexital in 80%–100% of their patients, whereas in contrast, methohexital was not used at all in 10 units (56%). Electromyography seizure activity was quantitatively measured in 6 units (33%), whereas 10 units (56%) did not measure electromyography seizure activity at all. The remaining 2 units assessed seizure activity through visual observation. Headache requiring medication was the most commonly reported adverse effect, and it was reported as a frequent problem in 3 units (18%).

Conclusions

Based on the variation in anesthesia practices identified in the study, we suggest there may be benefits to developing a national guideline for standardizing treatment.
Biobased, Biodegradable but not bio-neutral: about the effects of polylactic acid nanoparticles on macrophages
Authors: Collin-Faure Véronique , Vitipon Marianne , Diemer Hélène , Cianférani Sarah , Darrouzet Elisabeth , Rabilloud Thierry
Published: July 2024

Plastics are persistent pollutants, because of their slow degradation, which suggests that they may lead to cumulative and/or delayed adverse effects due to their progressive accumulation over time. Macroplastics produced by human activity are released in the environment, where they degrade into micro and nanoplastics that are very easily uptaken by a wide variety of organisms, including humans. Microplastics and nanoplastics being particulates, they are handled in the body by specialized cells such as macrophages (or their evolutionary counterparts), where they can elicit a variety of responses. One solution to alleviate the problems due to biopersistence, such as accumulation over life, would be to use biodegradable plastics. One of the emerging biodegradable plastics being polylactide, we decided to test the responses of macrophages to polylactide nanoparticles, using a combination of untargeted proteomics and targeted validation experiments. Proteomics showed important adaptive changes in the proteome in response to exposure to polylactide nanoparticles. These changes affected for example mitochondrial, cytoskeletal and lysosomal proteins, but also proteins implicated in immune functions or redox homeostasis. Validation experiments showed that many of these changes were homeostatic, with no induced oxidative stress and no gross perturbation of the mitochondrial function. However, polylactide particles altered the immune functions such as phagocytosis (−20%) or cytokine production (2-fold increase for TNF production), which may translate into a decreased ability to macrophages to respond to bacterial infections. Furthermore, polylactide particles also induced moderate cross-toxicity with some quinones such as phenanthrene quinone, a combustion by-product that is a suspected carcinogen.
Expanded Genome and Proteome Reallocation in a Novel, Robust Bacillus coagulans Capable of Utilizing Pentose and Hexose Sugars
Authors: Dooley David , Ryu Seunghyun , Giannone Richard J , Edwards Jackson , Dien Bruce S , Slininger Patricia , Trinh Cong T.
Published: July 2024

Bacillus coagulans is recognized for its probiotic properties and recent development as a cell factory. Despite its importance for biotechnological applications, current understanding of B. coagulans’ robustness is limited. To fill this knowledge gap, we characterized metabolic capability and performed functional genomics and systems analysis of a novel, robust strain, B. coagulans B-768. Genome sequencing revealed that B-768 has the largest B. coagulans genome (3.94 Mbp), about 0.63 Mbp larger than the average genome of sequenced B. coagulans strains, with expanded carbohydrate metabolism and mobilome. Functional genomics identified a well-equipped genetic portfolio for utilizing a wide range of C5 (xylose, arabinose), C6 (glucose, mannose, galactose), and C12 (cellobiose) sugars present in biomass hydrolysates. For growth on individual xylose and glucose, the dominant sugars in biomass hydrolysates, B-768 exhibited distinct phenotypes and proteome profiles. Faster growth and glucose uptake rates resulted in lactate overflow metabolism, which makes B. coagulans a lactate overproducer; however, slower growth and xylose uptake diminished overflow metabolism due to the high energy demand for sugar assimilation. Carbohydrate Transport and Metabolism (COG-G), Translation (COG-J), and Energy Conversion and Production (COG-C) made up 60–65% of the measured proteomes but were allocated differently when growing on xylose and glucose. The trade-off in proteome reallocation, with high investment in COG-C over COG-G, explains the xylose growth phenotype with significant upregulation of xylose metabolism, pyruvate metabolism, and TCA cycle. Strain B-768 tolerates and effectively utilizes inhibitory biomass hydrolysates containing mixed sugars and exhibits hierarchical sugar utilization with glucose as the preferential substrate.
Integration of MRI radiomics and germline genetics to predict the IDH mutation status of gliomas
Authors: Nakase Taishi , Francis Stephen S. , Guerra Geno , Zhao Qingyu , Kachuri Linda
Published: July 2024

The molecular profiling of gliomas for isocitrate dehydrogenase (IDH) mutations currently relies on resected tumor samples, highlighting the need for non-invasive, preoperative biomarkers. We investigated the integration of glioma polygenic risk scores (PRS) and radiomic features for prediction ofIDHmutation status. The elastic net classifier used 256 radiomic features, a glioma PRS and demographic information in 159 glioma cases. The integration of glioma PRS with radiomics increased the area under the receiver operating characteristic curve (AUC) for distinguishing IDH-wildtype vs. IDH-mutant glioma from 0.824 to 0.890 (PΔAUC=0.0016). Incorporating age at diagnosis and sex further improved the classifier (AUC=0.920). Patients predicted to have IDH-mutant vs. IDH-wildtype tumors had significantly lower mortality risk (hazard ratio (HR)=0.27, 95% CI: 0.14-0.51, P=6.3×10-5), comparable to prognostic trajectories for biopsy-confirmedIDHstatus. The augmentation imaging-based classifiers with genetic risk profiles may help delineate molecular subtypes and improve the timely, non-invasive clinical assessment of glioma patients.
Cancer as a novel Risk Factor for Major Adverse Cardiovascular Events in Secondary Prevention
Authors: Melchiori Renzo , Diaz Saravia Sara , Rubio Pablo , Szlaien Lucas , Mouriño Romina , O’Flaherty Martin , Rizzo Miguel , Hita Alejandro
Published: July 2024

Introduction

The inflammatory mechanisms of cancer can be associated with atherosclerosis development and progression. Although there is an incidence rate of cardiovascular events in secondary prevention following a first acute coronary syndrome (ACS).

Methods

A retrospective study cohort study including patients who underwent a PCI for first Acute Coronary Syndrome (ACS), and without prior history of Major Cardiovascular Events (MACE) from 2008 to 2022 was analyzed. Included patients were grouped according to the absence or presence of cancer: G1 non-oncologic, and G2 oncologic (either prior or actual history). We compared the incidence rate ratio of MACE within 3 years after STEMI between groups Time-to-event analysis was conducted through proportional Cox regression analysis, estimating hazard ratio, and corresponding 95% confidence intervals (95% CI)

Results

Out of 937 patients who underwent a PCI, 787 patients were included of which 88.7% (n=698) presented without cancer. Over a median follow-up time of 45 months [IQR= 14-72], the incidence rate of MACE was 4.4 cases per 1000 patients/months of follow-up (n=173 MACE events). When comparing both groups, the incidence rate ratio of MACE was 1.9 (95% CI 1.24-2.99), significantly increased in the cancer group (P=0.0032) without showing differences in median follow-up times. Cancer was an independent predictor of MACE HR 1.84 (95% CI 1.19-2.85; P=0.006), adjusted for hypertension, dyslipidemia, diabetes, smoking history, sedentary lifestyle, obesity, age, male gender, and family history of cardiovascular disease.

Conclusions

Patients with cancer represent a novel independent risk factor for MACE, even following secondary preventive therapies. These results highlight future endpoints for cardiovascular prevention and further public health interventions on this population.
Proteomic evidence for amyloidogenic cross-seeding in fibrinaloid microclots
Authors: Kell Douglas B , Pretorius Etheresia
Published: July 2024

In classical amyloidoses, amyloid fibres form through the nucleation and accretion of protein monomers, with protofibrils and fibrils exhibiting a cross-β motif of parallel or antiparallel β-sheets oriented perpendicular to the fibre direction. These protofibrils and fibrils can intertwine to form mature amyloid fibres. Similar phenomena occur in blood from individuals with circulating inflammatory molecules (also those originating from viruses and bacteria). In the presence of inflammagens, pathological clotting can occur, that results in an anomalous amyloid form termed fibrinaloid microclots. Previous proteomic analyses of these microclots have shown the presence of non-fibrin(ogen) proteins, suggesting a more complex mechanism than simple entrapment. We provide evidence against a simple entrapment model, noting that clot pores are too large and centrifugation would have removed weakly bound proteins. Instead, we explore whether co-aggregation into amyloid fibres may involve axial (multiple proteins within the same fibril), lateral (single-protein fibrils contributing to a fibre), or both types of integration. Our analysis of proteomic data from fibrinaloid microclots in different diseases shows no significant overlap with the normal plasma proteome and no correlation between plasma protein abundance and presence in microclots. Notably, abundant plasma proteins like α-2-macroglobulin, fibronectin, and transthyretin are absent from microclots, while less abundant proteins such as adiponectin, periostin, and von Willebrand Factor are well represented. Using bioinformatic tools including AmyloGram and AnuPP, we found that proteins entrapped in fibrinaloid microclots exhibit high amyloidogenic tendencies, suggesting their integration as cross-β elements into amyloid structures. This integration likely contributes to the microclots’ resistance to proteolysis. Our findings underscore the role of cross-seeding in fibrinaloid microclot formation and highlight the need for further investigation into their structural properties and implications in thrombotic and amyloid diseases. These insights provide a foundation for developing novel diagnostic and therapeutic strategies targeting amyloidogenic cross-seeding in blood clotting disorders.
Geranylgeraniol supplementation leads to an improvement in inflammatory parameters and reversal of the disease specific protein signature in patients with hyper-IgD syndrome
Authors: Sediva Anna , Orlicky Martin , Vrabcova Petra , Klocperk Adam , Kalina Tomas , Fujiwara Hideji , Hsu Fong-Fu , Bambouskova Monika
Published: July 2024

Mevalonate kinase (MVK) deficiency, a rare autosomal recessive disease, significantly impacts metabolism and immunity, leading to mevalonic aciduria in severe cases and hyper-IgD syndrome (HIDS) in partial deficiency. These conditions arise due to disruptions in the mevalonate pathway, which is essential metabolic pathway responsible for the synthesis of non-sterol isoprenoids and other molecules. The resulting metabolic blockade triggers autoinflammatory responses, primarily due to deficient isoprenoid intermediates such as geranylgeranyl pyrophosphate (GGPP). This first reported pilot study evaluates the safety and efficacy of dietary geranylgeraniol supplementation (GG) in three patients with HIDS. Over three months, GG supplementation showed no liver toxicity and did not alter lipid profiles. Although GG did not rise the plasma levels of GGPP, the plasma proteomics showed significant changes induced by GG. Proteomic analysis further revealed that GG supplementation can reverse some of the features of HIDS-specific plasma protein signature, highlighting its potential to modulate inflammation and protein prenylation pathways. These findings suggest that GG supplementation could be a promising metabolic intervention to mitigate inflammation in HIDS, warranting further, more targeted investigation in larger clinical trials.
Baseline characteristics among 101,407 people with myocardial infarction over nine-year time period: a population-based study using primary care data
Authors: Arsene Corneliu T
Published: July 2024

CardioVascular (CV) Disease (CVD) accounts for 25% of all UK deaths [1-4]. Before developing and applying new or existing CV risk prediction tools [5-22] for prediction of incident CVD events, it is important to have a description of the baseline characteristics of the patients who experienced a myocardial Infarction (MI) event. This paper presents the baseline characteristics of a cohort of patients who experienced a first MI between 1st of January 2006 and 31st of December 2014 in England, UK, age equal or greater than 35 years
AD plasma biomarkers are stable for an extended period at –20°C: implications for resource-constrained environments
Authors: Ayele Biniyam A. , Whitehead Patrice L. , Pascual Julianna , Gu Tianjie , Arvizu Jamie , Golightly Charles G. , Adams Larry D. , Pericak-Vance Margaret A. , Vance Jeffery M. , Griswold Anthony J.
Published: July 2024

Standard procedures for measuring Alzheimer’s disease (AD) plasma biomarkers include storage at -80°C. This is challenging in countries lacking research infrastructure, such -80°C freezer. To investigate stability of AD biomarkers from plasma stored at -20°C, we compared aliquots stored at -80°C and others at -20°C for two, four, six, fifteen, and thirty-five weeks. pTau181, Aβ42, Aβ40, NfL, and GFAP were measured for each timepoint. pTau181 and Aβ42/Aβ40 ratios showed minimal variation for up to 15 weeks. NfL and GFAP had higher variability. This finding of 15-week stability at -20°C enables greater participation in AD biomarker studies in resource constrained environments.
Trends and patterns of dual use of combustible tobacco and e-cigarettes among adults in England: a population study, 2016-2024
Authors: Jackson Sarah E , Cox Sharon , Shahab Lion , Brown Jamie
Published: July 2024

Background/Aims: E-cigarettes are frequently used by people who smoke. This study examined how the prevalence and patterns of smoking and vaping ('dual use') in England have changed as the vaping market has rapidly evolved. Design: Representative monthly cross-sectional survey, July 2016 to April 2024. Setting: England. Participants: 128,588 adults (≥18y). Measurements: Logistic regression estimated associations between survey wave and dual use. Descriptive statistics were used to analyse patterns of smoking and vaping, overall and by sociodemographic, smoking, and vaping characteristics and harm perceptions of e-cigarettes vs. cigarettes. Results: Across the period, the overall prevalence of dual use increased non-linearly from 3.5% to 5.3% of adults (prevalence ratio [PR]=1.49 [1.25-1.76]). Among adults who smoked, the proportion who also vaped was relatively stable up to mid-2021, at an average of 18.6% between July-2016 and May-2021, then increased rapidly to 34.2% by April 2024 (PR=1.76 [1.48-2.09]). This increase was greatest at younger ages (e.g., from 19.6% to 59.4% among 18-24-year-olds; PR=3.04 [2.28-4.23]). The most common pattern of dual use across the period was daily cigarette smoking with daily vaping (49.0% [47.3-50.8%]). Over time, the proportion of dual users reporting daily cigarette smoking with non-daily vaping decreased (from 35.2% to 15.0%; PR=0.43 [0.29-0.63]), offset primarily by an increase in the proportion reporting non-daily cigarette smoking with daily vaping (from 7.6% to 21.5%; PR=2.84 [1.71-4.72]). Daily cigarette smoking with daily vaping was more common (and non-daily cigarette smoking with daily vaping less common) among dual users who were older, less advantaged, mainly smoked hand-rolled cigarettes, had stronger urges to smoke, and had been vaping for ≤6 months. Daily vaping was more common among dual users who thought e-cigarettes were less/equally harmful as cigarettes, or were unsure. Conclusions: The proportion of smokers in England who vape has increased rapidly since 2021, which was when disposable e-cigarettes started to become popular. Since 2016, patterns of dual use have shifted away from more frequent smoking towards more frequent vaping. This may be the result of increasing prevalence of dual use among younger adults, who are more likely than older dual users to smoke non-daily and vape daily.
Stroke rates, risk factors, and aspirin prescribing trends in the Canadian Fabry Disease Initiative cohort
Authors: Théberge Emilie T. , Selvage Caroline , Thomas Anita , LeMoine Kaye M. , Robichaud Rebecca , Zhou Lily , Yeung Darwin F. , West Michael L. ,   the CFDI investigators group, Sirrs Sandra , Lehman Anna
Published: July 2024

Background

Fabry disease (FD) is an X-linked disorder caused by deleterious variants inGLA.Cardiovascular disease (CVD) causes premature mortality in FD. Hope for aspirin (acetylsalicylic acid, ASA) to reduce CVD risks in FD as primary prevention may have been tempered by the 2018 ARRIVE, ASCEND, and ASPREE clinical trials. It is unclear how new ASA guidance applies to FD patients, who have a high rate of young-onset, small vessel stroke compared with the general population.

Methods

Longitudinal data spanning 2007-2023 from patients in the Canadian Fabry Disease Initiative (CFDI) were analyzed retrospectively. Incident stroke and transient ischemic attack (TIA), other CVD events, FD-specific risk factors, and ASA/antiplatelet (“ASA/AP”) prescription before and after 2018 were compared between groups who never had an event (“primary prevention group”) to those who had incident stroke/TIA during the study. Stroke/TIA rates were compared between the sexes, byGLAvariant severity, and between the CFDI to Canadian statistics. 10-year atherosclerotic CVD (ASCVD) risk was calculated using the 2013 ACC/AHA risk calculator. ASA/AP prescription rate was compared before and after 2018.

Results

Out of 641 patients, 57 had an incident stroke/TIA during the study, and 193 with complete data remained in the primary prevention group. Stroke/TIA rates were significantly higher among male patients (0.026/year) than females (0.0098/year), and higher among patients with severeGLAvariants (males: 0.031, females: 0.0096) compared to those with attenuated variants (males: 0.011, females: 0.0088). No patients under 60 years at their incident stroke/TIA had high (≥10%) calculated 10-year ASCVD risk. Fewer patients were prescribed ASA/AP for primary prevention after 2018.

Conclusions

There was a high incidence of stroke/TIA in the younger CFDI cohort compared to the general Canadian population, despite low levels of traditional vascular risk factors as represented in 10-year estimated ASCVD risk. Primary prevention use of ASA has declined.
Identifying Artifacts from Large Library Docking
Authors: Wu Yujin , Liu Fangyu , Glenn Isabella , Fonseca-Valencia Karla , Paris Lu , Xiong Yuyue , Jerome Steven V. , Brooks Charles L. , Shoichet Brian K.
Published: July 2024

While large library docking has discovered potent ligands for multiple targets, as the libraries have grown, the very top of the hit-lists can become populated with artifacts that cheat our scoring functions. Though these cheating molecules are rare, they become ever-more dominant with library growth. Here, we investigate rescoring top-ranked molecules from docking screens with orthogonal methods to identify these artifacts, exploring implicit solvent models and absolute binding free energy perturbation (AB-FEP) as cross-filters. In retrospective studies, this approach deprioritized high-ranking non-binders for nine targets while leaving true ligands relatively unaffected. We tested the method prospectively against results from large library docking AmpC β-lactamase. From the very top of the docking hit lists, we prioritized 128 molecules for synthesis and experimental testing, a mixture of 39 molecules that rescoring flagged as likely cheaters and another 89 that were plausible true actives. None of the 39 predicted cheating compounds inhibited AmpC up to 200µM in enzyme assays, while 57% of the 89 plausible true actives did do so, with 19 of them inhibiting the enzyme with apparent Kivalues better than 50µM. As our libraries continue to grow, a strategy of catching docking artifacts by rescoring with orthogonal methods may find wide use in the field.

Graphical TOC Entry
Evidence-based XAI of clinical decision support systems for differential diagnosis: Design, implementation, and evaluation
Authors: Miyachi Yasuhiko , Ishii Osamu , Torigoe Keijiro
Published: July 2024

Introduction

We propose the Explainable AI (XAI) model for Clinical Decision Support Systems (CDSSs). It supports physician’s Differential Diagnosis (DDx) with Evidence-based Medicine (EBM). It identifies instances of the case data contributing to predicted diseases. Each case data is linked to the sourced medical literature. Therefore, this model can provide medical professionals with evidence of predicted diseases.

Methods

The source of the case data (training data) is medical literature. The prediction model (the main model) uses Neural Network (NN) + Learning To Rank (LTR). Physicians’ DDx and machines’ LTR are remarkably similar. The XAI model (the surrogate model) uses k-Nearest Neighbors Surrogate model (k-NN Surrogate model). The k-NN Surrogate model is a symphony of Example-based explanations, Local surrogate model, and k-Nearest Neighbors (k-NN). Requirements of the XAI for CDSS and features of the XAI model are remarkably adaptable. To improve the surrogate model’s performance, it performs “Selecting its data closest to the main model.” We evaluated the prediction and XAI performance of the models.

Results

With the effect of “Selecting,” the surrogate model’s prediction and XAI performances are higher than those of the “standalone” surrogate model.

Conclusions

The k-NN Surrogate model is a useful XAI model for CDSS. For CDSSs with similar aims and features, the k-NN Surrogate model is helpful and easy to implement. The k-NN Surrogate model is an Evidence-based XAI for CDSSs.

Unlike current commercial Large Language Models (LLMs), Our CDSS shows evidence of predicted diseases to medical professionals.
The adoption and implementation of local government planning regulations to manage hot food takeaways near schools in England: A qualitative process evaluation
Authors: Hassan S , Thompson C , Adams J , Chang M , Derbyshire D , Keeble M , Liu B , Mytton OT , Rahilly J , Savory B , Smith R , White M , Burgoine T , Cummins S
Published: July 2024

Introduction

Access to hot food takeaways, particularly near schools, is of growing concern for policymakers seeking to reduce childhood obesity globally. In England, United Kingdom (UK), local government jurisdictions are implementing planning policies to reduce access by restricting or denying planning permission for new takeaway outlets near schools. We used a qualitative approach to explore local government officers’ perspectives on the barriers to and facilitators of the adoption, implementation, and perceived effectiveness of these policies.

Methods

In 2021-2022, we conducted semi-structured interviews with 29 local planning (‘planners’) and public health government officers from 15 different local authorities across England who adopted a policy to restrict new takeaways. Data were analysed thematically.

Results

Participants explained that they mostly thought the policies facilitated the refusal of applications for new takeaways near schools. However, participants speculated that businesses identified alternative opportunities to operate including functioning as ‘restaurants’ or within other locations. Effective working relationships between planners and public health officers were important for adoption and implementation, although planning and public health agendas did not always align and there were tensions between economic development and health improvement goals. The policy was adapted to suit local needs and priorities; in some cases, the policy was not used in areas where economic growth was prioritised. Clarity in policy wording and establishing a formal process for implementing policies including a designated individual responsible for checking and reviewing takeaway applications helped ensure consistency and confidence in policy implementation.

Conclusion

Although sometimes challenging, the policies were commonly described as feasible to implement. However, they may not completely prevent new takeaways opening, particularly where takeaways are relied upon to enhance local economies or where takeaway businesses find alternative ways to operate. Nevertheless, the policies can serve to shift the balance of power that currently favours commercial interests over public health priorities.

Highlights

Planning and public health officers struggled to align economic and health agendas

Policy champions helped align agendas and push takeaway management policies forward

Policies were adapted to avoid use where they negatively impacted economic growth

Established processes and clearly worded policies facilitated policy implementation

The polices made it easier to deny planning permission for new takeaways
DASH diet, Reduced Rank Regression Dietary Patterns and relations with kidney function in the CHRIS general population study
Authors: Barbieri Giulia , Garcia-Larsen Vanessa , Lundin Rebecca , Fujii Ryosuke , Ferraro Pietro Manuel , Gambaro Giovanni , Melotti Roberto , Gögele Martin , Cazzoletti Lucia , Pramstaller Peter P , Zanolin Maria Elisabetta , Pattaro Cristian , Hantikainen Essi
Published: July 2024

Objective

We assessed dietary patterns (DPs) using the pre-defined Dietary Approaches to Stop Hypertension (DASH) score and reduced rank regression (RRR) to evaluate their association with estimated glomerular filtration rate (eGFR) in a general population sample.

Methods

We analysed cross-sectional data from 6,133 healthy adult participants of the Cooperative Health Research In South Tyrol (CHRIS) study. Using self-reported food frequency questionnaire data, we derived the DASH-score and two RRR-based sex-specific DP-scores based on nine cardio-renal-metabolic parameters. We fitted sex-stratified linear and non-linear models to assess associations with creatininebased eGFR.

Results

Males with higher intake of cereals, whole grains, sugar, fruits, and legumes, and lower intake of beer, and red and processed meat (MDP1), exhibited higher eGFR levels. Coherently, high adherence to the DASH-style diet was associated with higher eGFR. In females, the associations varied by menstrual status. Among those with ceased menstruation, a low intake of meat, spirits, refined grains, beer, and fish, and a high intake of whole grains and dairy products was associated with higher eGFR. In females still experiencing regular menstruation, a high intake of beef, nuts, beer, legumes, fish, and coffee, and low intake of refined grains, (FDP2) was associated with lower eGFR. No association was observed with the DASH score in females.

Conclusion

Our findings confirm the DASH-style diet is associated with better kidney function in males, but not in females. By identifying sex-specific kidney function-oriented DPs, the RRR approach provides new insights into the diet-eGFR relation, highlighting in addition potential effect modification by menstrual status.
Optimizing telework in an epidemic context: contrasting the infectious and non-communicable diseases perspectives
Authors: Moutet Leo , Leclerc Quentin , Layan Maylis , Ait Bouziad Karim , Dab William , Henriot Paul , Hodbert Elise , Louati Narimene , Maurin Aurelie , thonon Frederique , Znaty Sylvie , Benhalima Mohamed , Jean Kevin , Temime Laura
Published: July 2024

1.

Objectives

In a global context of increasing telework, this study explores its health effects, to determine if there is an optimal teleworking frequency during an epidemic. We aim to quantify the relationship between teleworking frequency and both infectious disease (ID) transmission and non-communicable disease (NCD) risk.

Methods

We developed a mathematical model simulating ID transmission and NCD acquisition in a medium-sized company, analysing how different teleworking levels impact workers health. We conducted a rapid literature review to identify potential exposure-response relationships between teleworking and NCD risk and inform this model. We then simulated infection dynamics over a three-month epidemic wave to contrast ID and NCD risks in relation to the extent of telework engagement.

Results

Evidence from the literature showed varying patterns of NCD risk across different teleworking frequencies. Depending on these relationships, we observed that risk may peak at low, intermediate, or high teleworking levels. We demonstrated the existence of a benefit-risk balance between reducing ID transmission and potentially increasing NCD burden.

Conclusions

Our study highlights that the definition of an “optimal” teleworking frequency to maximise health benefits is inconsistent, and depends on the NCD considered. Effective teleworking strategies must consider both ID prevention and the risk of NCDs, and weigh these health impacts accordingly to optimise societal health outcomes.
Apathy under the surface: Theorizing quiet quitting’s impact on organizational learning
Authors: Srivastava Ayushi , Pandey Agrata , Sharma Dheeraj , Ghosh Koustab
Published: July 2024

Purpose

This paper integrates research on quiet quitting (a mindset where employees restrict their efforts to their job description) and organizational learning (OL) to illustrate how quiet quitting challenges the sub-processes of OL.

Design/methodology/approach

By integrating the existing literature on quiet quitting and OL, this paper identifies and maps the challenges of quiet quitting to the sub-processes of OL, namely, intuiting, interpreting, integrating, and institutionalizing within the 4I framework of Crossan et al. (1999).

Findings

This paper conceptually establishes that quiet quitting undermines employees’ cognitive efforts and weakens employees’ contribution to team discussions. Further, quiet quitting undermines suggestion sharing and creates a reluctance to share knowledge, undermining OL.

Practical implications

The paper provides actionable strategies for managers to tackle the challenges of quiet quitting on OL.

Originality/value

To the best of the authors' knowledge, this study is amongst the first to illustrate the challenges of quiet quitting on OL.
Purchase intent in social media for healthcare services: the influence of value co-creation, brand equity and engagement
Authors: de Assis Walter Macêdo , Vilela Bruno
Published: July 2024

Purpose

This study aims to analyze the effect of social media marketing (SMM), generated by doctors and dentists, on consumers’ purchase intention, via the influence of the value co-creation perception, brand equity and consumer brand engagement. Additionally, this study analyzes the moderating role of purchase frequency.

Design/methodology/approach

A sample of 110 respondents was surveyed using a self-administered questionnaire. The partial least squares structural equation modeling (PLS-SEM) was used to test the research hypothesis.

Findings

The findings reveal that SMM positively influences value co-creation perception. Value co-creation perception positively influences brand equity and consumer brand engagement. Brand equity positively influences purchase intention. The moderating role of frequency was confirmed. However, the effects of consumer brand engagement on purchase intention were not confirmed.

Practical implications

The study findings enable healthcare marketers to develop social media marketing and branding strategies to engage consumers and increase perceived value, brand equity and purchase intention of healthcare services.

Originality/value

To the best of the authors’ knowledge, this study is the first to introduce SMM as an antecedent of the relationship between value co-creation and brand equity. This study is also the first to test the relationship between value co-creation and brand equity in the healthcare sector. A new integrated model was proposed to understand the effects of SMM on the intention to purchase healthcare services.
Handicrafts as cultural creative clusters: a spatial-cultural planning approach for the regeneration of the urban historical fabrics
Authors: Taheri Shima , Khalilpour Farnaz , Ashayeri Mehdi , Shabani Amirhosein
Published: July 2024

Purpose

The purpose of this paper is to evaluate the role of handicraft production units within creative cultural clusters (CCCs) and their impact on urban regeneration, particularly within the historical fabric of Isfahan. It aims to identify the key factors contributing to the development of CCCs and how these clusters, in turn, influence tourism development.

Design/methodology/approach

The research method of this study is based on a quantitative approach, using a researcher-devised questionnaire as the primary data collection instrument. The statistical population included 227 units of handicraft makers in the historical fabric of Isfahan. The data processing and analysis were performed using SPSS software.

Findings

Statistical analysis confirms the creative industries, spatial and socio-cultural indices significantly impact tourism, with means of 14.19, 19.07 and 15.11. Clustering, cultural resources and tourism are key to CCCs growth, while innovation and cultural identity have less effect. CCCs enhance Isfahan’s historical fabric, improving urban space attractiveness and fostering social ties. Handicraft clusters around Naqsh-e Jahan square notably influence the economy and cultural identity, with shop placement reflecting the city’s character.

Originality/value

The originality of this research lies in its analysis of how handicraft production within CCCs contributes to urban regeneration and tourism in Isfahan, with a novel focus on the socio-cultural and economic impacts of these clusters in a historical context.
Work ethic, cultural impact and perceived performance – innovative insights from three countries
Authors: Runić-Ristić Marija , Savić Tot Tijana , Ljepava Nikolina , Tot Vilmoš
Published: July 2024

Purpose

This study aims to examine the relationship between work ethics and organizational performance and investigate the influence of respondents’ career stages on their work ethic among British, United Arab Emirates (UAE) and Serbian nations.

Design/methodology/approach

This research is based on a survey of British, UAE and Serbian managers, whose task was to assess the dimensions of the multidimensional work ethic profile (MWEP) and organizational performance. Since the MWEP does not analyze work ethics in the context of religion, it is deemed the most suitable instrument for this study because it analyzes work ethics among the three cultures that practice different religions.

Findings

The results revealed that national culture impacts work ethics. British managers place greater value on the wasted time, self-reliance and morality dimensions of work ethics. Serbian managers prefer the leisure and delay of gratification dimensions, while UAE managers value hard work ethics more than the other two groups of managers. The study also shows that respondents’ career stage influences their work ethic, and a significant relationship exists between different dimensions of work ethics and organizational performance in all three nations.

Originality/value

This study contributes to the theory by analyzing work ethic and its relationship with organizational performance and respondents’ career stages in three nations that share business interests. It addresses a research gap by comparing work ethics in developed, developing and a country in socio-economic transition.