bluuebunny/crossref_metadata_2025 huggingface dataset:
Parasitic, bacterial, viral, immune-mediated, metabolic and nutritional factors associated with nodding syndrome
Authors: Edridge Arthur W D , Abd-Elfarag Gasim , Deijs Martin , Broeks Melissa H , Cristella Cosimo , Sie Brandon , Vaz Frédéric M , Jans Judith J M , Calis Job , Verhoef Hans , Demir Ayse , Poppert Sven , Nickel Beatrice , van Dam Alje , Sebit Boy , Titulaer Maarten J , Verweij Jaco J , de Jong Menno D , van Gool Tom , Faragher Brian , Verhoeven-Duif Nanda M , Elledge Stephen J , van der Hoek Lia , Boele van Hensbroek Michael
Published: August 2023

Nodding syndrome is a neglected, disabling and potentially fatal epileptic disorder of unknown aetiology affecting thousands of individuals mostly confined to Eastern sub-Saharan Africa. Previous studies have identified multiple associations—including Onchocerca volvulus, antileiomodin-1 antibodies, vitamin B6 deficiency and measles virus infection—yet, none is proven causal. We conducted a case-control study of children with early-stage nodding syndrome (symptom onset <1 year). Cases and controls were identified through a household survey in the Greater Mundri area in South Sudan. A wide range of parasitic, bacterial, viral, immune-mediated, metabolic and nutritional risk factors was investigated using conventional and state-of-the-art untargeted assays. Associations were examined by multiple logistic regression analysis, and a hypothetical causal model was constructed using structural equation modelling. Of 607 children with nodding syndrome, 72 with early-stage disease were included as cases and matched to 65 household- and 44 community controls. Mansonella perstans infection (odds ratio 7.04, 95% confidence interval 2.28–21.7), Necator americanus infection (odds ratio 2.33, 95% confidence interval 1.02–5.3), higher antimalarial seroreactivity (odds ratio 1.75, 95% confidence interval 1.20–2.57), higher vitamin E concentration (odds ratio 1.53 per standard deviation increase, 95% confidence interval 1.07–2.19) and lower vitamin B12 concentration (odds ratio 0.56 per standard deviation increase, 95% confidence interval 0.36–0.87) were associated with higher odds of nodding syndrome. In a structural equation model, we hypothesized that Mansonella perstans infection, higher vitamin E concentration and fewer viral exposures increased the risk of nodding syndrome while lower vitamin B12 concentration, Necator americanus and malaria infections resulted from having nodding syndrome. We found no evidence that Onchocerca volvulus, antileiomodin-1 antibodies, vitamin B6 and other factors were associated with nodding syndrome. Our results argue against several previous causal hypotheses including Onchocerca volvulus. Instead, nodding syndrome may be caused by a complex interplay between multiple pathogens and nutrient levels. Further studies need to confirm these associations and determine the direction of effect.
2B4: A potential target in Staphylococcus aureus associated allergic inflammation
Authors: Gaur Pratibha , Seaf Mansour , Trabelsi Nirit , Marcu Orly , Gafarov Daria , Schueler-Furman Ora , Mandelboim Ofer , Ben-Zimra Micha , Levi-Schaffer Francesca
Published: August 2023

Staphylococcus aureus (SA) and its exotoxins activate eosinophils (Eos) and mast cells (MCs) via CD48, a GPI-anchored receptor belonging to the signaling lymphocytes activation molecules (SLAM) family. 2B4 (CD244), an immuno-regulatory transmembrane receptor also belonging to the SLAM family, is the high-affinity ligand for CD48. 2B4 is expressed on several leukocytes including NK cells, T cells, basophils, monocytes, dendritic cells (DCs), and Eos. In the Eos and MCs crosstalk carried out by physical and soluble interactions (named the ‘allergic effector unit’, AEU), 2B4–CD48 binding plays a central role. As CD48 and 2B4 share some structural characteristics and SA colonization accompanies most of the allergic diseases, we hypothesized that SA exotoxins (e.g. Staphylococcus enterotoxin B, SEB) can also bind and activate 2B4 and thereby possibly further aggravate inflammation. To check our hypothesis, we used in vitro, in silico, and in vivo methods. By enzyme-linked immunosorbent assay (ELISA), flow cytometry (FC), fluorescence microscopy, and microscale thermophoresis, we have shown that SEB can bind specifically to 2B4. By Eos short- and long-term activation assays, we confirmed the functionality of the SEB–2B4 interaction. Using computational modeling, we identified possible SEB-binding sites on human and mouse 2B4. Finally, in vivo, in an SEB-induced peritonitis model, 2B4-KO mice showed a significant reduction of inflammatory features compared with WT mice. Altogether, the results of this study confirm that 2B4 is an important receptor in SEB-mediated inflammation, and therefore a role is suggested for 2B4 in SA associated inflammatory conditions.
Tissue-Resident Memory T Cell: Ontogenetic Cellular Mechanism and Clinical Translation
Authors: Xu Haoran , Zhou Runhong , Chen Zhiwei
Published: August 2023

Mounting evidence has indicated the essential role of tissue-resident memory T (TRM) cells for frontline protection against viral infection and for cancer immune surveillance (Mueller SN, Mackay LK. Tissue-resident memory T cells: local specialists in immune defense. Nat Rev Immunol 2016, 16, 79–89. doi:10.1038/nri.2015.3.). TRM cells are transcriptionally, phenotypically, and functionally distinct from circulating memory T (Tcirm) cells. It is necessary to understand the unique ontogenetic mechanism, migratory regulation, and biological function of TRM cells. In this review, we discuss recent insights into cellular mechanisms and discrete responsiveness in different tissue microenvironments underlying TRM cell development. We also emphasize the translational potential of TRM cells by focusing on their establishment in association with improved protection in mucosal tissues against various types of diseases and effective strategies for eliciting TRM cells in both pre-clinical and clinical studies.
Comparison of Two High-Dose Versus Two Standard-Dose Influenza Vaccines in Adult Allogeneic Hematopoietic Cell Transplant Recipients
Authors: Thomas Lora D , Batarseh Einas , Hamdan Lubna , Haddadin Zaid , Dulek Daniel , Kalams Spyros , Stewart Laura S , Stahl Anna L , Rahman Herdi , Amarin Justin Z , Hayek Haya , Ison Michael , Overton Edgar T , Pergam Steven A , Spieker Andrew J , Halasa Natasha B ,   the Adult HCT Flu Study, Savani B , Kassim  , Logue M , Barto S , McHenry R , Tanna S , Bezler L , Al-Saden P , Marshall M , Salzman D , Greenstein A , Jackson A , Wright S , Flowers M , Loeffelholz M , Marquis S , Nguyen E
Published: August 2023

Background

Adult hematopoietic cell transplant (HCT) recipients are at high risk for influenza-related morbidity and mortality and have suboptimal influenza vaccine immune responses compared to healthy adults, particularly within 2 years of transplant.

Methods

This phase II, double-blind, multicenter randomized controlled trial compared 2 doses of high-dose trivalent (HD-TIV) to 2 doses of standard-dose quadrivalent (SD-QIV) influenza vaccine administered 1 month apart in adults 3–23 months post-allogeneic HCT. Hemagglutinin antibody inhibition (HAI) titers were measured at baseline, 4 weeks following each vaccine dose, and approximately 7 months post-second vaccination. Injection-site and systemic reactions were assessed for 7 days post-vaccination. The primary immunogenicity comparison was geometric mean HAI titer (GMT) at visit 3 (4 weeks after the second dose); we used linear mixed models to estimate adjusted GMT ratios (aGMRs) comparing HD-TIV/SD-QIV for each antigen.

Results

We randomized 124 adults; 64 received SD-QIV and 60 received HD-TIV. Following the second vaccination, HD-TIV was associated with higher GMTs compared to SD-QIV for A/H3N2 (aGMR = 2.09; 95% confidence interval [CI]: [1.19, 3.68]) and B/Victoria (aGMR = 1.61; 95% CI: [1.00, 2.58]). The increase was not statistically significant for A/H1N1 (aGMR = 1.16; 95% CI: [0.67, 2.02]). There was a trend to more injection-site reactions for HD-TIV after the second vaccination compared to SD-QIV (50% vs 33%; adjusted odds ratio [aOR] = 4.53; 95% CI: [0.71, 28.9]), whereas systemic reactions were similar between groups with both injections.

Conclusions

Adult allogeneic HCT recipients who received 2 doses of HD-TIV produced higher HAI antibody responses for A/H3N2 and B/Victoria compared with 2 doses of SD-QIV, with comparable injection-site or systemic reactions.
Platelet inhibition with orodispersible ticagrelor in acute coronary syndromes according to morphine use: the TASTER study final results
Authors: Parodi Guido , Dossi Filippo , Raccis Mario , Talanas Giuseppe , Mura Enrico , Siciliano Roberta , Guarino Simona , Marini Alessandro , Franca Paolo , Saba Pier Sergio , Sanna Giuseppe D , Canonico Mario E
Published: August 2023

Aim

To date, it is still unknown whether orodispersible tablet (ODT) ticagrelor might represent a suitable way to reach a proper antiaggregation in acute coronary syndrome (ACS) patients receiving morphine. Aim of the present study was to evaluate platelet inhibition with 180 mg ticagrelor loading dose (LD) administered as ODT compared with standard coated tablet ticagrelor formulation in ACS patients undergoing percutaneous coronary intervention (PCI) according to morphine use.

Methods and Results

One-hundred and 30 patients presenting with STEMI or very high-risk NSTE-ACS were randomly assigned to receive ODT or standard ticagrelor LD. Potential morphine-ticagrelor interaction was assessed by stratified randomization according to morphine use. Platelet reactivity was evaluated by Platelet Reactivity Units (PRU) VerifyNow™ 1, 2, 4, and 6 h after ticagrelor LD. The primary endpoint was residual platelet reactivity 1 h after LD across the two ticagrelor formulation and according to morphine use. Safety endpoints were major bleedings and other in-hospital ticagrelor administration-related adverse events. One hour after LD, PRU median value was higher in morphine-treated patients (N = 32) as compared with patients not receiving morphine (N = 98; PRU = 187 [70–217]) vs. 73 [7–187]; P = 0.012). In patients with morphine, 1-h PRU values were similar between study groups (192 [114–236] vs. 173 [16–215] in ODT and standard tablet ticagrelor, respectively). Similarly, in patients without morphine, 1-h PRU values were not significantly different between study groups (69 [8–152] vs. 110 [6—193] in ODT and standard tablet ticagrelor, respectively). Platelet reactivity appeared similar in the 2 study arms at 2, 4, and 6 h after LD. No significant difference was observed among patients with or without morphine regarding in-hospital adverse events or drug side-effects, even if a reinfarction due to acute stent thrombosis was observed in a patient treated with morphine.

Conclusions

There was no difference between ODT and standard ticagrelor tablets in terms of post-LD residual platelet reactivity, percentage of platelet inhibition or safety regardless to morphine use.
Association of radiation dose to cardiac substructures with major ischaemic events following breast cancer radiotherapy
Authors: Lai Tzu-Yu , Hu Yu-Wen , Wang Ti-Hao , Chen Jui-Pin , Shiau Cheng-Ying , Huang Pin-I , Lai I Chun , Tseng Ling-Ming , Huang Nicole , Liu Chia-Jen
Published: August 2023

Background and Aims

Patients with left-sided breast cancer receive a higher mean heart dose (MHD) after radiotherapy, with subsequent risk of ischaemic heart disease. However, the optimum dosimetric predictor among cardiac substructures has not yet been determined.

Methods and results

This study retrospectively reviewed 2158 women with breast cancer receiving adjuvant radiotherapy. The primary endpoint was a major ischaemic event. The dose–volume parameters of each delineated cardiac substructure were calculated. The risk factors for major ischaemic events and the association between MHD and major ischaemic events were analysed by Cox regression. The optimum dose–volume predictors among cardiac substructures were explored in multivariable models by comparing performance metrics of each model. At a median follow-up of 7.9 years (interquartile range 5.6–10.8 years), 89 patients developed major ischaemic events. The cumulative incidence rate of major ischaemic events was significantly higher in left-sided disease (P = 0.044). Overall, MHD increased the risk of major ischaemic events by 6.2% per Gy (hazard ratio 1.062, 95% confidence interval 1.01–1.12; P = 0.012). The model containing the volume of the left ventricle receiving 25 Gy (LV V25) with the cut-point of 4% presented with the best goodness of fit and discrimination performance in left-sided breast cancer. Age, chronic kidney disease, and hyperlipidaemia were also significant risk factors.

Conclusion

Risk of major ischaemic events exist in the era of modern radiotherapy. LV V25 ≥ 4% appeared to be the optimum parameter and was superior to MHD in predicting major ischaemic events. This dose constraint could aid in achieving better heart protection in breast cancer radiotherapy, though a further validation study is warranted.
EUIPO v KaiKai—filling an ‘EU legislative gap’ with an international treaty gap? On the interpretative effect of the international agreement at issue and consideration of other decisions on its interpretation
Authors: Hartman Gerben
Published: August 2023

This case concerns, in essence, the question whether it is possible, in view of Article 4 of the Paris Convention for the Protection of Industrial Property (‘Paris Convention’), to claim priority from an earlier international application for a patent, filed under the Patent Cooperation Treaty (PCT), for the purpose of filing a Community design application.
Planning strategies for robust carbon-ion scanning radiotherapy for stage I esophageal cancer: a retrospective study
Authors: Suga Makito , Kusano Yohsuke , Takakusagi Yosuke , Oosawa Yukio , Minohara Shinichi , Yoshida Daisaku , Katoh Hiroyuki , Kamada Tadashi , Komori Masataka
Published: August 2023

This study aimed to establish a treatment planning strategy with carbon-ion scanning radiotherapy (CIRTs) for stage I esophageal cancer. The clinical data of seven patients treated with CIRTs were used. The setup error and interfractional and intrafractional motion error were analyzed using in-room computed tomography (CT) images for each treatment day. Finally, the planning target volume (PTV) margin was identified according to the accuracy of the treatment system. To ensure robustness against the positional displacements of the target and organs at risk (OAR), the replacement areas were placed as a contour adjacent to the tumor or OAR on the CT-image. The CT values of these areas were replaced by those of the target or OAR. Further, the dose distributions were optimized. Moreover, the variations in the target coverage from the initial plan for each treatment day (ΔV95%) were evaluated. By contrast, the risk of OAR was not evaluated in this study. The setup error was within 1.0 mm. The interfractional and intrafractional target motion errors were 2.8 and 5.0 mm, respectively. The PTV margins were 6.5 and 6.8 mm in the axial and depth directions, respectively. The robustness to target and OAR displacement was evaluated. The results showed that the target coverage with replacement could suppress decreased target coverage more than that without replacement. The PTV determination and replacement methods used in this study improved the target coverage in CIRTs for stage I esophageal cancer. Despite the need for a clinical follow-up, this method may help to improve clinical outcomes.
Line-of-sight optical Dome Turbulence Monitor
Authors: Osborn James , Alaluf David
Published: August 2023

Optical turbulence in the enclosure of a ground-based telescope can be a major contributor to the total optical turbulence strength and can therefore limit the precision of astronomical observations, in terms of angular resolution, or signal to noise ratio, depending on the instrumentation used. Here we propose a new Dome Turbulence Monitor (DTM) technique. This DTM is based on the well known Scintillation Detection And Ranging (SCIDAR) concept with a few major differences. By designing the instrument specifically for the dome turbulence, we can use a small (<0.2 m telescope), and observe single bright stars (as opposed to the SCIDAR using double stars). This enables a dedicated instrument with enough targets to operate continuously. Operationally, the DTM could be mounted somewhere on the main astronomical telescope and track stars that are visible through the dome aperture. By measuring through the dome aperture we obtain an optical measure of the strength of the turbulence along a similar line of sight as the main telescope itself. We demonstrate the new technique through numerical Monte Carlo modelling and present results from a proof-of-concept demonstration at the European Space Agency Optical Ground Station on Tenerife, Spain.
Dust dynamics in AGN winds: a new mechanism for multiwavelength AGN variability
Authors: Soliman Nadine H , Hopkins Philip F
Published: August 2023

Partial dust obscuration in active galactic nuclei (AGNs) has been proposed as a potential explanation for some cases of AGN variability. The dust–gas mixture present in AGN tori is accelerated by radiation pressure, leading to the launching of an AGN wind. Dust under these conditions has been shown to be unstable to a generic class of fast-growing resonant drag instabilities (RDIs). In this work, we present the first numerical simulations of radiation-driven outflows that explicitly include dust dynamics in conditions resembling AGN winds. We investigate the implications of RDIs on the torus morphology, AGN variability, and the ability of radiation to effectively launch a wind. We find that the RDIs rapidly develop, reaching saturation at times much shorter than the global time-scales of the outflows, resulting in the formation of filamentary structure on box-size scales with strong dust clumping and super-Alfvénic velocity dispersions. The instabilities lead to fluctuations in dust opacity and gas column density of 10–20  per cent when integrated along mock observed lines of sight to the quasar accretion disc. These fluctuations occur over year to decade time-scales and exhibit a red-noise power spectrum commonly observed for AGNs. Additionally, we find that the radiation effectively couples with the dust–gas mixture, launching highly supersonic winds that entrain 70–90  per cent of the gas, with a factor of ≲3 photon momentum loss relative to the predicted multiple-scattering momentum loading rate. Therefore, our findings suggest that RDIs play an important role in driving the clumpy nature of AGN tori and generating AGN variability consistent with observations.
Addressing Intergenerational Inequity in Tobacco-Harm: What Helps Children of Smokers to Remain Nonsmokers?
Authors: Ball Jude , Zhang Jane , Stanley James , Waa Andrew , Crengle Sue , Edwards Richard
Published: August 2023

Introduction

Children of people who smoke are more likely to take up smoking themselves. In Aotearoa New Zealand (NZ), adolescent smoking declined dramatically between 2000 and 2016 despite limited change in parental smoking, demonstrating that the cycle can be broken.

Aims and Methods

This study aimed to identify modifiable factors associated with never smoking in Year 10 students (14–15 years) who had at least one caregiver who smoked. We used data from the Youth Insights Survey (2016 and 2018, pooled, N = 5,422) and identified students with at least one caregiver (mother, father, grandparent, other caregiver) who smoked (N = 2,205). To investigate modifiable factors potentially associated with nonsmoking we used logistic regression with marginally adjusted prevalence estimates.

Results

Overall, 41% of students had at least one caregiver who smoked. In this group, the majority (65%) had never smoked themselves. After adjustment, never-smoking was more prevalent among students attending low-deprivation (more affluent) schools (73% had never smoked) compared to high-deprivation schools (44%); students not exposed to others’ smoking inside the home (72%) or in cars (70%) in the past week compared to those exposed (59% and 51%, respectively); and students whose parents would be upset if they were caught smoking (68% vs 49% for those whose parents would not be upset), or who had high self-esteem (69% vs 55% for those with low self-esteem).

Conclusions

Modifiable factors independently associated with non-smoking in adolescents with caregiver(s) who smoked were: nonexposure to smoking inside the home and in cars, parental expectations of nonsmoking, and high self-esteem.

Implications

Even in countries like NZ with relatively low adult smoking rates, children’s exposure to caregiver smoking may be prevalent, particularly in structurally disadvantaged populations. This study suggests that action to promote smokefree homes and cars, build high self-esteem in young people, and communicate expectations of non-smoking are likely to help children of people who smoke to remain nonsmokers. A comprehensive approach that also addresses “upstream” factors (eg, socioeconomic deprivation) and underlying causes of structural inequity (eg, institutional racism) is needed. Such policy and community action may help to break intergenerational cycles of tobacco use and health inequity.
Clinic-based Assessment and Support for Family Caregivers of Patients With Cancer: Results of a Feasibility Study
Authors: Suresh Madhuvanthi , Risbud Rashmi , Patel Manali I. , Lorenz Karl A. , Schapira Lidia , Gallagher-Thompson Dolores , Trivedi Ranak
Published: August 2023

Background:

Cancer caregiving is burdensome with unique needs, highlighting the importance of assessing caregivers’ distress. Caregivers often accompany patients to healthcare visits, presenting an opportunity to complete distress screening at patients’ point-of-care.

Objective:

To evaluate the feasibility of caregiver distress screening at the patients’ point-of-care and implementing a caregiver psychoeducational session.

Methods:

We approached caregivers in outpatient cancer clinic waiting rooms. Participants completed depression, burden, anxiety, quality of life, and stress measures. A psychoeducational session with a psychologist was offered to those meeting clinical cutoffs for depression and/or burden. Fifty caregivers completed 1+ measure; however, due to incomplete consent documentation, findings from 23 caregivers are reported.

Results:

A total of 22% of caregivers screened positive for depression, 30% for burden, and 70% for anxiety. More than half rated stress as moderate or higher. Mental wellbeing was slightly below that of the general population. More than 75% screened positive on 1+ distress measure. Of the 9 caregivers who met cutoffs for depression and/or burden, two (22%) accepted the psychoeducational session.

Conclusion:

Caregivers were moderately receptive to distress screening during patients’ visits, but were less receptive to engaging in the psychoeducational session due to time constraints and privacy concerns.

Implications for Practice:

Assessing caregivers’ distress can facilitate referrals for supportive services. Offering caregivers psychoeducational intervention outside of patient care may not be acceptable. Future research may evaluate the integration of routine caregiver screening within patient care to promote engagement with mental health services.

What is Foundational:

This research offers a unique method of assessing cance caregivers’ distress.
Efficacy and Safety of Sutureless Deep Sclerectomy in Juvenile and Adult Open Angle Glaucoma: 2-Year Outcomes
Authors: Abdelrahman Ahmed Mostafa , Eltanamly Rasha Mounir , Kotb Mohamed Sabry
Published: August 2023

Précis:

Sutureless deep sclerectomy (SDS) achieved significant reduction in primary open angle glaucoma (POAG) and juvenile open angle glaucoma (JOAG).

Purpose:

To assess long-term results of SDS in cases with POAG and JOAG.

Patients and Methods:

A prospective interventional study included 84 eyes of 54 patients underwent SDS with the superficial scleral flap left un-sutured. Changes in intraocular pressure (IOP) were recorded over 2 years. Success was defined according to the world glaucoma association criteria: Criterion A: IOP ≤18 mmHg and IOP reduction ≥30% from the preoperative status without medications [complete success (A1)], with and without medications [qualified success (A2)]. Criterion B: IOP ≤15 mmHg and IOP reduction ≥40% from the preoperative status without medications [complete success (B1)], with and without medications [qualified success (B2)].

Results:

There was statistically significant reduction in IOP compared with the preoperative IOP (mean IOP = 26.21± 10.46 mmHg) starting from 1st postoperative day (mean IOP = 7.18 ± 1.8 mmHg) till the end of follow-up period at 2 years (mean IOP = 15.85± 4.46) (P < 0.001). Also, number of medications dropped significantly from 3.27 ± 1.14 to 0.82 ± 0.97 at the end of follow up period. At 2 years complete success (A1) was achieved in 57.1% and qualified success (A2) was achieved in 91.6% of cases. Subgroup analysis into males and females, POAG and JOAG showed no statistically significant difference between subgroups regarding IOP reduction.

Conclusion:

SDS is an effective and safe modification to deep sclerectomy in cases with POAG and JOAG.
Characteristics and Mechanism of Acute Ischemic Stroke in NAVF Patients With Prior Oral Anticoagulant Therapy
Authors: Xue Sufang , Na Risu , Dong Jing , Wei Min , Kong Qi , Wang Qiujia , Qiu Xue , Li Fangyu , Song Haiqing
Published: August 2023

Objectives:

We aimed to analyze the characteristics and mechanisms of acute ischemic stroke (AIS) in patients with nonvalvular atrial fibrillation (NVAF) who received prior anticoagulant therapy.

Methods:

We retrospectively analyzed the data of patients with NVAF and AIS between January 2016 and December 2021. Patients were divided into non-anticoagulant, adequate anticoagulant, and insufficient anticoagulant groups according to their prior anticoagulant status. Patients with prior anticoagulant therapy were further divided into warfarin and direct oral anticoagulant groups.

Results:

A total of 749 patients (661 without anticoagulants, 33 with adequate anticoagulants, and 55 with insufficient anticoagulants) were included. Patients with adequate anticoagulant had a milder National Institute of Health Stroke Scale at presentation (P=0.001) and discharge (P=0.003), a higher proportion of Modified Rankin Scale (mRS) ≤2 at discharge (P=0.011), and lower rates of massive infarction (P=0.008) than patients without anticoagulant. Compared with the non-anticoagulant group, the proportion of intravenous thrombolysis was significantly lower in the adequate anticoagulant (P<0.001) and insufficient anticoagulant (P=0.009) groups. Patients in the adequate anticoagulant group had higher rates of responsible cerebral atherosclerotic stenosis (P=0.001 and 0.006, respectively) and competing large artery atherosclerotic mechanisms (P=0.006 and 0.009, respectively) than those in the other 2 groups. Compared with warfarin, direct oral anticoagulant was associated with higher rates of Modified Rankin Scale ≤2 at discharge (P=0.003).

Conclusions:

Adequate anticoagulant therapy may be associated with milder stroke severity and better outcomes at discharge in patients with NVAF. Competing large artery atherosclerotic mechanisms may be associated with anticoagulant failure in patients with NAVF with prior adequate anticoagulant therapy.
Randomized Trial of a Social Support Intervention to Improve Home Blood Pressure Monitoring in Patients With Cerebrovascular Disease
Authors: Mullen Michael T. , Cucchiara Brett L. , Messé Steven R. , Zamzam Ahmad , Kasner Scott E.
Published: August 2023

Background:

A pilot randomized trial evaluating whether a social support intervention improves adherence to home blood pressure (BP) monitoring among patients with cerebrovascular disease.

Methods:

Subjects with ischemic stroke, intracerebral hemorrhage, or transient ischemic attack within 5 years with BP >140/90, were given a centrally monitored home BP cuff and asked to check their BP twice a day for 90 ± 7 days. Subjects received text and/or email reminders for missed measurements and weekly reports on adherence/BP control. Subjects were randomized 1:1 to a social support intervention, in which close personal contact also received all study-related education and communications. The primary outcome was the proportion of requested measurements completed. A secondary outcome was a change in BP over time.

Results:

Thirty-three subjects were enrolled, 15 in the control arm and 18 in the social support arm. The social support arm completed a greater proportion of BP measurements at day 30 (88% vs 78%), day 60 (72% vs 54%), and day 83 (60% vs 40%), but none of these differences were statistically significant (P > 0.05). Comparing the first 7 days of BP readings to the last 7 days across subjects, there was a nonsignificant decrease in BP over time (systolic BP = −2.8 mm Hg, P = 0.29 and diastolic BP = −1.7, P = 0.36). The social support intervention did not modify the change in BP over time.

Conclusion:

A social support intervention may increase adherence to home BP monitoring. This pilot study provides important preliminary data to inform the design of larger more definitive trials utilizing self-monitoring of BP in patients with cerebrovascular disease.
Safety and Efficacy of Aspiration Catheter CAT6 and 5 Fr Navien in the Endovascular Treatment of Acute Ischemic Stroke
Authors: Chen Zhongjun , Fan Tieping , Zhao Xusheng , Hu Teng , Qi Hengxu , Li Di
Published: August 2023

Background:

Mechanical thrombectomy has become a key treatment option for acute ischemic stroke. This study compared the safety and efficacy of aspiration catheter CAT6 and 5 Fr Navien.

Methods:

Thrombectomy was performed in103 patients with the acute internal carotid artery, middle cerebral artery M1 or M2 occlusions, including the CAT6 group (n=53 with stent retriever and CAT6 aspiration) and the 5 Fr Navien group (n=50 with stent retriever and 5 Fr Navien aspiration) at the Advanced Stroke Center.

Results:

Overall, an aspiration catheter placement success rate was achieved in 93.2% of cases, 52 (98.11%) for CAT6, and 44 (88.00%) for 5 Fr Navien (P=0.042). Overall, 17 cases (16.51%) required additional guidewire rates, 5.66% for CAT6, and 13.592% for 5 Fr Navien (P=0.002). First-pass success rate (FPSR) was achieved in 38.84% of cases overall, a rate that did not differ significantly between catheters: 45.28% for CAT6; 32.00% for 5 Fr Navien (P=0.167). Final thrombolysis in cerebral infarction 2b or 3 reperfusion was achieved in 91.26% of cases overall, 51 (96.23%) for CAT6, and 43 (86%) for 5 Fr Navien (P=0.066). The participants had a mean number of passes for the index thrombus of 1.956 and a median procedure time of 65.82±21.8 minutes. There was no significant difference found in 90-day good outcome (mean 42.7%, modified Rankin Score 0 to 2) and 90-day mortality (17%) between CAT6 and 5 Fr Navien.

Conclusion:

Aspiration catheter placement success rate and first-pass success rate seemed to be higher for CAT6 and, moreover, the rate of additional guidewires was lower.
Defining Sentinel Injuries of Suspected Child Abuse by Age Using International Classification of Diseases-10
Authors: Kim Han Bit , Noh Hyun
Published: August 2023

Objective

To address child abuse effectively requires accurate assessment of the magnitude of the problem. Although it is difficult to assess the scale of child abuse cases nationwide, it can be estimated through the incidence of sentinel injuries, which are defined as minor but unusual injuries such as bruises or wounds in children of precruising age. Therefore, this study aimed to define disease codes for sentinel injuries by age as a preliminary study to elucidate the incidence of sentinel injuries among patients who visited hospitals nationwide.

Method

This study was designed using the Delphi method with a structured questionnaire. An extensive literature review was conducted to develop the questionnaire. The 9 participants selected as experts in child abuse were all experienced pediatric emergency medicine specialists working at pediatric emergency medicine training hospitals in South Korea, and 8 participants responded to the first survey. The Delphi method comprised 3 rounds of online surveys using Google Forms and Excel sheet questionnaire via e-mail. Only questions that achieved consensus were selected and assigned a sentinel injury disease code.

Results

In total, 105 questions regarding the definition of sentinel injury disease codes were surveyed as to whether they should be included as sentinel injuries, categorized by type (bruises, burns, open wounds/lacerations, and others) and anatomical location. Among them, 5 (62.5%) or more participants agreed on 92 items.

Conclusions

Using the Delphi method, we defined disease codes for sentinel injuries in children aged younger than 12 months, possibly enabling assessment of the incidence of child abuse based on national data. Future research is needed to validate this result and investigate the incidence of sentinel injuries using the defined disease codes and to determine their association with actual cases of child abuse.
18F-FDG PET/CT to Spare Malignancy in a Rare Case of Lung Endometriosis
Authors: Padilla Bermejo Amanda , García Zoghby Laura , Pena Pardo Francisco José , del Prado Talavera Rubio María , Poblete García Víctor Manuel
Published: August 2023

Lung endometriosis is a rare condition. A 44-year-old woman with known lung endometriosis and radiological follow-up showed progression of bilateral lung affection at control CT, with an enlarged solid nodule with respect to previous control. 18F-FDG PET/CT was performed to assess that lesion and to guide biopsy. PET images showed the multiple known nodules with pathological tracer uptake.
Transcription factor expression levels and environmental signals constrain transcription factor innovation
Authors: Shepherd Matthew J. , Reynolds Mitchell , Pierce Aidan P. , Rice Alan M. , Taylor Tiffany B.
Published: August 2023

Evolutionary innovation of transcription factors frequently drives phenotypic diversification and adaptation to environmental change. Transcription factors can gain or lose connections to target genes, resulting in novel regulatory responses and phenotypes. However the frequency of functional adaptation varies between different regulators, even when they are closely related. To identify factors influencing propensity for innovation, we utilise a

Pseudomonas fluorescens

SBW25 strain rendered incapable of flagellar mediated motility in soft-agar plates via deletion of the flagellar master regulator (fleQ). This bacterium can evolve to rescue flagellar motility via gene regulatory network rewiring of an alternative transcription factor to rescue activity of FleQ. Previously, we have identified two members (out of 22) of the RpoN-dependent enhancer binding protein (RpoN-EBP) family of transcription factors (NtrC and PFLU1132) that are capable of innovating in this way. These two transcription factors rescue motility repeatably and reliably in a strict hierarchy – with NtrC the only route in a ∆fleQ background, and PFLU1132 the only route in a ∆fleQ∆ntrC background. However, why other members in the same transcription factor family have not been observed to rescue flagellar activity is unclear. Previous work shows that protein homology cannot explain this pattern within the protein family (RpoN-EBPs), and mutations in strains that rescued motility suggested high levels of transcription factor expression and activation drive innovation. We predict that mutations that increase expression of the transcription factor are vital to unlock evolutionary potential for innovation. Here, we construct titratable expression mutant lines for 11 of the RpoN-EBPs in

P. fluorescens

. We show that in five additional RpoN-EBPs (FleR, HbcR, GcsR, DctD, AauR and PFLU2209), high expression levels result in different mutations conferring motility rescue, suggesting alternative rewiring pathways. Our results indicate that expression levels (and not protein homology) of RpoN-EBPs are a key constraining factor in determining evolutionary potential for innovation. This suggests that transcription factors that can achieve high expression through few mutational changes, or transcription factors that are active in the selective environment, are more likely to innovate and contribute to adaptive gene regulatory network evolution.
A Novel Model of Sacral Obliquity, Iliac Obliquity, and Hip Obliquity in Adolescent Idiopathic Scoliosis
Authors: Chi Pengfei , Cheng Junyao , Song Kai , Wu Bing , Yu Wen , Yu Yang , Cui Geng , Wang Zheng
Published: August 2023

Objective

To propose and validate a novel model to explore the potential compensatory mechanism of sacral obliquity and pelvic obliquity in coronal balance.

Summary of Background Data

Sacral obliquity and pelvic obliquity are common phenomena in adolescent idiopathic scoliosis (AIS). However, their compensatory mechanisms in coronal balance remain unclear.

Methods

A total of 569 AIS patients were recruited. Coronal pelvic and lower limb parameters, including sacral obliquity (SO), iliac obliquity (IO), and hip obliquity (HO), were measured. Coronal spinal parameters, such as coronal distance (CD), clavicle angle (CA), thoracic curve (T), thoracolumbar/lumbar curve (TL/L), and tilt angle of L2∼L5, were measured. Correlation analysis was performed.

Results

The mean values of SO, IO, and HO were 3.34±2.81°, 1.40±2.04°, and 0.82±1.79°, respectively. The largest correlation coefficients with SO were L5 and IO (r=0.725, 0.701). The largest correlation coefficients with IO were SO and HO (r=0.701, 0.801). The largest correlation coefficients with HO were SO and IO (r=0.566, 0.801).

Conclusion

SO, IO, and HO have different implications for coronal balance, and their magnitude and direction can be deduced from the novel model. These parameters could be used to evaluate the compensation of the pelvis and lower limbs in AIS. In the coronal position, the pelvis and lower limbs extend the spinal sequence, similar to vertebrae and intervertebral discs.
The influence of feedback on employees’ goal setting and performance in online corporate training: a moderation effect
Authors: Duan Lian , Song Hongbo , Huang Xiaoshan , Lin Weihan , Jiang Yan , Wang Xingheng , Wu Yihua
Published: August 2023

Purpose

The study examined the impact of feedback types through a learning management system (LMS) on employees’ training performance. The purpose of this study is to establish effective feedback on advanced technologies for promoting corporate training.

Design/methodology/approach

A total of 148 trainees were recruited from a multinational medical company. Employees were randomly assigned to receive feedback from shallow to more constructive details on their learning performance with LMS. Data sources included are employees’ goal setting (GS) performance evaluated by the experts and their posttest scores obtained from the LMS. A series of statistical analyses were performed to investigate the impact of feedback intervention on employees’ GS and their impacts on corporate training results.

Findings

GS has a significant impact on learning outcomes. Employees who set greater specific goals attained higher scores. Furthermore, feedback with more formative evaluation and constructive developmental advice resulted in the most significant positive influence on the relationship between participants’ GS and learning outcomes.

Practical implications

Organizations can benefit from delivering appropriate feedback using LMS to enhance employees’ GS and learning efficacy in corporate training.

Originality/value

This study is one of the first to examine the moderating effect of feedback provided by LMS on GS and online learning performance in corporate training. This study contributes to GS theory for practical application and proposes a viable method for remote learning. The current study’s findings can be used to provide educational psychological insights for training and learning in industrial contexts.
Dynamics modeling and simulation analysis of wet clutch considering spline pair
Authors: Niu Yinkai , Bao Heyun , Huang Wei , Tan Wuzhong , Zhu Rupeng
Published: August 2023

Purpose

During the operation of a wet clutch, there are fluctuations in speed and torque, which have an impact on the stability of the clutch and the strength of the friction plate and the spline pair of the dual steel plate. The purpose of this study is to investigate the vibration characteristics of the wet clutch and the dynamic load characteristics of the spline pairs.

Design/methodology/approach

The spline pair model is established by the piecewise linear function method, and on this basis, dynamic equations considering the spline pair of dual steel plates and friction plates are established. Considering that the wet clutch has multiple spline pairs, an equivalent model of the number of teeth and the equivalent model of the tooth width were proposed, and the Runge-Kutta numerical method was used for the wet clutch for these two models.

Findings

The research results show that the equal tooth number model has greater meshing stiffness and smaller fluctuation than the constant tooth width model, which shows that increasing the meshing stiffness of the system is beneficial to reduce system fluctuation and improve system stability.

Research limitations/implications

The friction plate has the system that multiple splines are independent of each other, which is relatively complicated. Therefore, an equivalent calculation is performed on multiple pairs of steel plates (friction plates) to simplify the calculation of the spline pairs.

Social implications

This paper provides a theoretical basis for further dynamic characteristics analysis of wet clutch and reducing fluctuation of speed and torque.

Originality/value

Dynamic equation considering the spline pair of the dual steel plates and the friction plates is established to study the vibration characteristics of the wet clutch and the dynamic load characteristics of the spline pair, etc.

Peer review

The peer review history for this article is available at: https://publons.com/publon/10.1108/ILT-03-2023-0078/
Are returns from adoption of soil conservation practices heterogeneous? Evidence from Indian agriculture
Authors: Akber Nusrat , Paltasingh Kirtti Ranjan
Published: August 2023

Purpose

This paper finds the returns from soil conservation practices and examines whether the welfare implications of adopting the conservation practices are heterogeneous across the farming groups in Indian agriculture.

Design/methodology/approach

The study uses an endogenous switching regression (ESR) method on the data collected from the 77th round of National Sample Survey (2019–21) to quantify the returns from adopting soil conservation practices.

Findings

It finds that farmers adopting soil health conservation practices would have reduced their crop yield by 13% if they did not implement them. Similarly, smallholders who have not adopted soil health management practices would have increased crop yield by 16% if they had adopted the practices. The authors also observed that the returns from adopting soil health management practices vary across farming groups, where marginal and large farms tend to gain higher yields. Finally, the authors find that regardless of farm size, smallholders who did not adopt soil health management practices would benefit from adopting these with increased crop yields of 29%–31%.

Research limitations/implications

More data could have been better for drawing policy implications, since the number of soil card users are relatively less.

Originality/value

This research work uses nationally representative data, which is first in nature on this very aspect.
Effects of dietary restraint on perceived healthfulness and purchase intention: the moderating effects of food type and product label
Authors: Rodriguez Anita G. , Madadi Rozbeh , Blaugrund Erin Baca , Acharya Ram N. , Idowu O. John , Zúñiga Miguel Ángel , Torres Ivonne M.
Published: August 2023

Purpose

The purpose of this study is to investigate genetically modified food labeling effects on dietary restrained consumers’ perception and purchase intention based upon various labels and food type – whole versus processed.

Design/methodology/approach

A 2 (food type: whole vs processed) × 2 (product label: genetically modified organism [GMO] vs nongenetically modified organism [non-GMO]) research design was used in two steps. In the first step, the authors distributed 1,000 surveys, of which 858 surveys were used, and in the second step, the authors distributed 1,000 surveys and were able to use 891 surveys.

Findings

Results show that respondents with higher levels of dietary restraint have higher levels of perceived healthfulness. In addition, respondents with higher perceived healthfulness levels have a higher level of purchase intention for whole/GMO products, whole/non-GMO products, processed/GMO products and processed/non-GMO products. Moreover, the results show that individuals have higher purchase intention for whole/non-GMO than the whole/GMO products, whole/GMO than the processed/non-GMO products and processed/non-GMO than the processed/GMO products.

Research limitations/implications

A future longitudinal study with assigned tracking numbers is suggested. Given that four different blocks were randomized, comparing data among individual participants would be interesting, as the ability to compare responses would be feasible among the four separate blocks.

Originality/value

The results of this study may assist the government in policy development, food manufacturers in labeling techniques used and consumers by increasing transparency and information availability.
Green product consumption behaviour, green economic growth and sustainable development: unveiling the main determinants
Authors: Armutcu Barış , Zuferi Rasim , Tan Ahmet
Published: August 2023

Purpose

The purpose of the current study is to help remove the obstacles to sustainable production and consumption by revealing the determinants of green consumption behaviour, which is one of the precursors of sustainable economic growth. This study aims to expand the theory of planned behaviour (TPB) model and contribute to the relevant literature by investigating the factors of social media usage, social media marketing and digital marketing interactions that have not been investigated before in relation to green product purchasing behaviour.

Design/methodology/approach

This study examines the effect of the extended TPB model on consumers’ intention to buy green products in Turkey, which has a Middle Eastern culture and is a developing economy. In the study, data collected from 409 participants with the questionnaire method were analysed using SmartPLS 4.0 and IBM SPSS 26 statistical programs.

Findings

The study findings revealed that all the structural elements of TPB (attitude, subjective norms, personal behaviour controls) and social media marketing and digital marketing interactions contribute to consumers’ green product purchasing behaviour. The study findings also demonstrated that the use of social media is not effective in the purchasing of green products.

Originality/value

Understanding consumers’ perspective on purchasing green products is crucial for policymakers, businesses and marketers, as it helps formulate appropriate strategies to support sustainable economic growth. In this respect, this study has important implications for sustainable consumption and production. In addition, to the best of the authors’ knowledge, the study is the first to examine consumers’ green product purchasing behaviour in the context of sustainable economy.