bluuebunny/crossref_metadata_2025 huggingface dataset:
Opening the black boxes: financial algorithms and multi-paradigmatic research in information technology
Authors: Schinckus Christophe , Gasparin Marta , Green William
Published: July 2022

Purpose

This paper aims to contribute to recent debates about financial knowledge by opening the black box of its algorithmization to understand how information systems can address the major challenges related to interactions between algorithmic trading and financial markets.

Design/methodology/approach

The paper analyses financial algorithms in three steps. First, the authors introduce the phenomenon of flash crash; second, the authors conduct an epistemological analysis of algorithmization and identify three epistemological regimes – epistemic, operational and authority – which differ in terms of how they deal with financial information. Third, the authors demonstrate that a flash crash emerges when there is a disconnection between these three regimes.

Findings

The authors open the black box of financial algorithms to understand why flash crashes occur and how information technology research can address the problem. A flash crash is a very rapid and deep fall in security prices in a very short time due to an algorithmic misunderstanding of the market. Thus, the authors investigate the problem and propose an interdisciplinary approach to clarify the scope of algorithmization of financial markets.

Originality/value

To manage the misalignment of information and potential disconnection between the three regimes, the authors suggest that information technology can embrace the complexity of the algorithmization of financial knowledge by diversifying its implementation through the development of a multi-sensorial platform. The authors propose sonification as a new mechanism for capturing and understanding financial information. This approach is then presented as a new research area that can contribute to the way financial innovations interact with information technology.
Low-carbon tourism: determining domestic tourist perception from Thailand: Tourism Agenda 2030
Authors: Fakfare Pipatpong , Wattanacharoensil Walanchalee
Published: July 2022

Purpose

Underpinned by three-factor theory, this study aims to: examine the dynamics (asymmetry) of multi-quality low-carbon attributes towards the Thai tourists’ perception and prioritise carbon-tourism attributes on the basis of impact-range performance and asymmetric analysis.

Design/methodology/approach

The study applies a multi-method approach to derive the low-carbon tourism (LCT) items before conducting exploratory factor analysis to identify the underlying dimensions. Impact range performance analysis and impact asymmetry analysis were carried out to explore the asymmetric or symmetric relationship associated with tourists’ perception of LCT.

Findings

Findings reveal the three dimensions of the LCT attributes. Out of the 29 attributes, nine are regarded as “must-have” categories, such that tourists will be disappointed at the efforts of a low-carbon destination if these attributes are missing, but they will feel neutral if the attributes are present. Six LCT attributes fall into the “hybrid” category, such that tourists will appreciate if they perceive these attributes to be available for LCT and feel disappointed if these attributes are not or poorly offered. Fourteen attributes are considered under the “value-added” category, meaning tourists will only appreciate if they encounter these attributes at the destination, and the lack thereof will not cause any dissatisfaction or negative perception from tourists.

Originality/value

Through the multi-quality asymmetric analysis, the study provides deep insights into the degree of perception of the 29 LCT attributes. The study offers tangible guidelines to destination authorities and pinpoints the necessity to provide attributes, especially in the “hybrid” and “must-have” categories, to avoid tourists’ negative perceptions when they visit a low-carbon destination.
Functional composition of plant communities mediates biomass effects on ecosystem service recovery across an experimental dryland restoration network
Authors: Balazs Kathleen R. , Munson Seth M. , Butterfield Bradley J.
Published: July 2022

Land degradation can result in a loss of critical ecosystem services that we often seek to restore through re‐establishment of desired plant communities. Trait‐based approaches have the potential to target specific ecosystem services based on associations between the functional composition of plant communities and ecosystem properties that serve as indicators of those services.

The effect of functional composition on ecosystem recovery may depend on the amount of restored plant biomass, itself a supporting service frequently targeted in restoration efforts. Yet, interactions between functional composition and biomass are not formally integrated into trait‐based analytical frameworks.

We tested the hypothesis that functional composition of plant communities both drives, and interacts with, biomass production to influence indicators of soil functioning and weed suppression across a network of degraded dryland restoration experiments. This networked approach allowed us to identify generalized effects of functional composition on ecosystem recovery across a range of dryland climate conditions.

Climate had a substantial effect on ecosystem indicators, with weed cover and soil surface stability increasing in more arid climates, water infiltration increasing with precipitation, and aggregate structure increasing with less freezing. After accounting for climate effects across study sites, we found significant effects of community‐weighted mean (CWM) trait values on biomass, particularly a positive effect of leaf carbon‐to‐nitrogen ratio, and of CWM‐biomass interactions on other ecosystem indicators. Cover of exotic species was reduced in restored communities with a combination of low leaf dry matter content and high biomass, soil water infiltration increased with lower specific root length and high biomass, and soil aggregate stability increased with higher root dry matter content and high biomass, among other effects. Functional diversity had no significant effects on any ecosystem indicators.

Synthesis: The influence of community functional composition on ecosystem properties increases with community biomass, particularly in disturbed or low productivity systems. This suggests that active management should not only focus on trait values that optimize individual ecosystem indicators but also how those functional strategies are complementary or counter to those that increase biomass.

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Predators minimize energy costs, rather than maximize energy gains under warming: Evidence from a microcosm feeding experiment
Authors: Meehan Matthew L. , Turnbull Kurtis F. , Sinclair Brent J. , Lindo Zoë
Published: July 2022

Climate warming may alter predator–prey interactions and predator feeding behaviour due to increased metabolic demands. How predators meet these increased demands may depend on trade‐offs in prey energy content and body size, handling time and other functional constraints.

We tested hypotheses associated with these trade‐offs with the predatory mite Stratiolaelaps scimitus, and three prey that differed in body size, energy content, and defenses (Folsomia candida, Oppia nitens, and Carpoglyphus lactis). We estimated metabolic rate, predation in choice and no choice feeding trials, movement rate, and lipid and protein content for all four species at 16°C and 24°C. We used these data to estimate the predator's energy demands and compared these to estimated energy intake in the choice feeding trials.

Predators had greater metabolic demands at 24°C than at 16°C, but temperature did not affect predator or prey movement rates. Warming decreased lipid content, but not protein content, of all three prey species, leading to lower energy content for C. lactis and O. nitens, but not F. candida. In both feeding trials at 24°C, predators increased their feeding on the smaller, energy‐poor C. lactis, but not the larger, energy‐rich F. candida, resulting in lower estimated energy intake. S. scimitus did not feed on O. nitens at either temperature.

Predators increasingly fed on small‐bodied prey under warming and not the large‐bodied prey despite the potential for greater energetic gains from larger prey. We posit that predators minimized energy lost during feeding through lower handling costs associated with C. lactis, rather than maximize energy gain. We conclude that selection of prey based on body size changes with temperature as a trade‐off for predators to balance increased metabolic demands. As predators provide top‐down control and regulate energy flow through the consumption of their prey, changes to predator feeding behaviour with climate warming may affect food web dynamics and ecosystem‐level processes.

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Review of United States laws pertaining to the recovery and analysis of human skeletal remains
Authors: Carter Melinda L. , Newman Justine L. , Seidemann Ryan M. , Reedy Edward A.
Published: July 2022

Human skeletal remains (HSR) are routinely excavated from archeological contexts and analyzed by experts in human osteology. Contrarily, HSR in medicolegal contexts are usually recovered by law enforcement officers and examined by pathologists with limited osteological training. To examine legal requirements for expertise, we reviewed laws in the United States regarding the recovery and analysis of HSR from archeological sites, unmarked graves, and medicolegal contexts. Of the 50 states, 19 (38%) have laws stating that an anthropologist with osteological training should be involved in the recovery or analysis of HSR from an archeological context. Fifteen of those 16 states have laws requiring a minimum level of education to be a qualified skeletal analyst. In contrast, only one state, Texas, requires an anthropologist who handles forensic cases to have a doctoral degree. Including Texas, only eight states (16%) have laws that encourage but do not mandate consultation with a forensic anthropologist for medicolegal skeletal cases. Louisiana and Washington have state‐funded laboratories, expert forensic anthropologists, and effective protocols for handling forensic cases. Due process and human rights concerns at stake in criminal cases require that those recovering and analyzing modern HSR have an equal or higher level of expertise than those working with archeological remains. Yet, legislators assume that law enforcement and pathologists are adequately trained. Because court standards demand expert testimony based on accepted methodologies and standard levels of competency, forensic anthropologists have a professional responsibility to engage with lawmakers to draft legislation to ensure proper handling of all skeletal cases.
New Frontiers in HR Practices and HR Processes: evidence from Asia
Authors: Sanders Karin , Song Lynda Jiwen , Wang Zhen , Bednall Timothy Colin
Published: July 2022

Research on the relationship between human resource management (HRM) and organizational outcomes has mainly been studied at the organizational level so far. However, HRM scholars acknowledge that employees are the foundation of organizations, and they play an important role in the effect of HRM on employee and organizational outcomes. While research on HR content focuses on the effects of HR practices, HR process research considers how employee perceptions and attributions of HR influence organizational outcomes. In the special issue of New Frontiers in HR Practices and HR Processes: Evidence from Asia, we focus on emerging research in the Asian region, especially China and Pakistan regarding the role of employees, also known as the micro‐foundations of HR research, in terms of both HR content and HR process. In this Introduction of the special issue, we review the current state‐of‐the‐art studies in both research streams and highlight further research questions. We outline how the papers in this special issue advance our knowledge for the Asian region and we also call for more Asian region HR practice and HR process studies in the future.
Understanding the Effects of Coronavirus on Australian Households: A Macro–Micro Analysis
Authors: Mariano Marc Jim , Verikios George
Published: July 2022

The coronavirus (COVID‐19) pandemic brought economic recession that affected nations, businesses, and households globally. The severity of this global economic crisis is large and the impact has been asymmetric across socioeconomic groups. We examine the distributional effects of the COVID‐19 pandemic across household types using a specially‐designed model that combines macro (computable general equilibrium) and micro (heterogenous households) approaches. Computable general equilibrium models are able to capture behavioural changes in macroeconomic and sectoral variables but they often lack the rich distributional detail found in microsimulation models. In this paper, we address this limitation by incorporating 10,046 actual households into a computable general equilibrium model to capture the heterogeneity through which the pandemic may influence household behaviour. We find that the income effects are asymmetric across income groups leading to a slight increase in income inequality. The distributional effects are more progressive for non‐wage income sources and uniform for wage income. For younger cohorts, income changes are dominated by employment effects whereas income changes for older cohorts are dominated by changes in capital rentals and government transfers. Spatially, the income effects follow a similar pattern for city and non‐city dwellers.
Metastatic lipoblastoma‐like tumour
Authors: Chia Misté (Rong Hui) , Windsor Morgan
Published: July 2022

Introduction

Lipoblastoma‐like tumours (LLT) are uncommon and their biologic nature is not well‐understood. Complete resection of the primary lesion is usually curative. This is the first reported case of metastatic LLT.

Case presentation and management

This patient originally had a large primary resected from the vulva. She subsequently developed tumours in multiple areas including her right pleura and lung. These were resected and pathology was consistent with LLT. On follow‐up imaging, there was evidence of metastatic disease.

Conclusion

The patient is currently undergoing detailed molecular analysis in the hope of detecting a molecular target. Given the infrequent occurrence of LLT, its behaviour is not well understood. Longer duration of follow up is required and prognostic markers need to be identified to better direct treatment.
Occurrence of complications in patients restored with implants
Authors: Cecchinato Denis , Marino Massimiliano , Håkansson Jan , Lindhe Jan , Derks Jan
Published: July 2022

Objectives

To determine the occurrence and clustering of complications in subjects restored with fixed implant‐supported prostheses.

Methods

In the present retrospective case series, 241 subjects treated at one clinical centre and provided with 729 implants were included. A clinical and radiographic examination was performed after a mean follow‐up period of 4.8 ± 2.0 years. Additional information on occurrence of technical (chipping, loss of retention, fracture of components) and biological complications (marginal bone loss, implant loss) during follow‐up was extracted from patient records. For each type of complication and complications overall, regression analyses were performed to identify potential risk factors. Cox regression analyses were used to evaluate time to event for implant loss and technical complications.

Results

In all, 30% of the 241 patients presented with at least one complication of technical and/or biological character during the follow‐up period. Technical complications affected 19.5% of subjects, while 14.1% presented with marginal bone loss >2 mm. Implant loss occurred in 4.6% of subjects. While technical complications were noted already early during the maintenance period (<1200 days), implant loss typically occurred during a later phase. A small subgroup of subjects (7.9%) experienced more than one type of complication.

Conclusions

Complications occurred frequently and the most common type of complication was of technical character. Technical and biological complications occurred independently of each other.
Framing co‐productive conservation in partnership with Arctic Indigenous peoples
Authors: Buschman Victoria Qutuuq
Published: July 2022

Indigenous communities at the front lines of climate change and biodiversity loss are increasingly shaping the conservation of lands, waters, and species. The Arctic is a hotbed for emerging local, national, and international conservation efforts, and researchers, managers, and communities alike will benefit from a framework that improves approaches to Indigenous partnerships. Co‐productive conservation is a framework that encompasses both the co‐production of knowledge and the co‐production of public services to pursue ethically conscious, culturally relevant, and fully knowledge‐based approaches to biodiversity concerns. Co‐productive conservation recognizes that conservation can be practiced in a way that embodies Indigenous perspectives, knowledge, rights, priorities, and livelihoods. Six iterative and reflexive co‐production processes (i.e., co‐planning, co‐prioritizing, co‐learning, co‐managing, co‐delivering, and co‐assessing) focus on the human dimensions that allow research, management, and conservation to affect change. By opening discussions on how to structure conservation efforts in partnership with Indigenous communities, the conservation community can move away from narratives that perceive Indigenous participation as an obligation or part of an ethical narrative and instead embrace a process that broadens the evidence base and situates conservation within Indigenous contexts.
Longitudinal nonlinear mixed effects modeling of EGFR mutations in ctDNA as predictor of disease progression in treatment of EGFR‐mutant non‐small cell lung cancer
Authors: Janssen Julie M. , Verheijen Remy B. , van Duijl Tirsa T. , Lin Lishi , van den Heuvel Michel M. , Beijnen Jos H. , Steeghs Neeltje , van den Broek Daan , Huitema Alwin D. R. , Dorlo Thomas P. C.
Published: July 2022

Correlations between increasing concentrations of circulating tumor DNA (ctDNA) in plasma and disease progression have been shown. A nonlinear mixed effects model to describe the dynamics of epidermal growth factor receptor (EGFR) ctDNA data from patients with non‐small cell lung cancer (NSCLC) combined with a parametric survival model were developed to evaluate the ability of these modeling techniques to describe ctDNA data. Repeated ctDNA measurements on L858R, exon19del, and T790M mutants were available from 54 patients with EGFR mutated NSCLC treated with erlotinib or gefitinib. Different dynamic models were tested to describe the longitudinal ctDNA concentrations of the driver and resistance mutations. Subsequently, a parametric time‐to‐event model for progression‐free survival (PFS) was developed. Predicted L858R, exon19del, and T790M concentrations were used to evaluate their value as predictor for disease progression. The ctDNA dynamics were best described by a model consisting of a zero‐order increase and first‐order elimination (19.7/day, 95% confidence interval [CI] 14.9–23.6/day) of ctDNA concentrations. In addition, time‐dependent development of resistance (5.0 × 10−4, 95% CI 2.0 × 10−4–7.0 × 10−4/day) was included in the final model. Relative change in L858R and exon19del concentrations from baseline was identified as most significant predictor of disease progression (p = 0.001). The dynamic model for L858R, exon19del, and T790M concentrations in ctDNA and time‐to‐event model adequately described the observed concentrations and PFS data in our clinical cohort. In addition, it was shown that nonlinear mixed effects modeling is a valuable method for the analysis of longitudinal and heterogeneous biomarker datasets obtained from clinical practice.
Sjögren’s syndrome
Authors: André Fiona , Böckle Barbara C.
Published: July 2022

Sjögren’s syndrome (SjS) is an autoimmune disease characterized by the triad of sicca symptoms, fatigue and pain. This diagnosis is usually made in women at the average age of 60 years. Diagnosis is made when sicca symptoms persist for more than three months, after the exclusion of possible differential diagnoses, and using the ACR/EULAR 2016 classification criteria for SjS. Many organs can be affected in the course of this disease. Xerosis cutis and pruritus are the most common skin manifestations, followed by leukocytoclastic vasculitis and subacute cutaneous lupus erythematosus. In addition, SjS patients often have myoarthralgia and neuropsychiatric symptoms. In the long term, attention must be paid to the increased risk of cardiovascular disease and lymphoma. Due to the multiorgan involvement in SjS patients, interdisciplinary care is required.
Novel predictors of daily fluctuations in glycemia and self‐management in adolescents and young adults with type 1 diabetes
Authors: Messer Laurel H. , Vigers Tim , Pyle Laura , Fivekiller Emily , Wadwa R. Paul , Hernandez Teri L. , Cook Paul F.
Published: July 2022

Aims

To understand morning biopsychosocial factors that predict glycemia, adherence, and goal attainment in adolescents and young adults (AYA) with type 1 diabetes (T1D) on a daily basis.

Methods

Eight‐eight AYA (mean 17.6 ± 2.6 years, 54% female, HbA1c 7.9 ± 1.4%, diabetes duration 8.5 ± 4.5 years) with T1D who use Continuous Glucose Monitoring (CGM) completed a 2‐week prospective study. Participants chose a self‐management goal to focus on during participation. For six days, participants prospectively completed a 25‐item Engagement Prediction Survey to assess biopsychosocial factors to predict daily diabetes outcomes and an end‐of‐day Goal Survey. Lasso and mixed‐model regression were used to determine items in the Engagement Prediction Survey most predictive of perceived goal attainment, CGM Time‐in‐Range (TIR, 70–180 mg/dl), sensor mean glucose, number of insulin boluses and hyperglycemia response (bolus within 30 min of high alert or glucose <200 mg/dl within 2 hours).

Results

A 7‐item model (including current glucose, planning/wanting to manage diabetes, wanting to skip self‐management, feeling good about self, health perception and support needs) explained 16.7% of the daily variance in TIR, 18.6% of mean sensor glucose, 2.1% of the number of boluses, 14% of hyperglycemia response, and 28.7% of goal attainment perceptions. The mean absolute change in day‐to‐day TIR was 16%, sensor glucose was 30 mg/dl, and the number of boluses was 2. AYA reported more positive Engagement Prediction Survey responses on mornings when they awoke with lower glucose levels.

Conclusions

Morning biopsychosocial state factors predict glycemic and adherence outcomes in AYA with diabetes and could be a novel intervention target for future behavioural interventions.
Higher susceptibility to 6 Hz corneal kindling and lower responsiveness to antiseizure drugs in mouse models of Alzheimer's disease
Authors: Vande Vyver Maxime , Barker‐Haliski Melissa , Aourz Najat , Nagels Guy , Bjerke Maria , Engelborghs Sebastiaan , De Bundel Dimitri , Smolders Ilse
Published: July 2022

Objective

Epileptic spikes and seizures seem present early in the disease process of Alzheimer's disease (AD). However, it is unclear how soluble and insoluble amyloid beta (Aβ) and tau proteins affect seizure development in vivo. We aim to contribute to this field by assessing the vulnerability to 6 Hz corneal kindling of young female mice from two well‐characterized transgenic AD models and by testing their responsiveness to selected antiseizure drugs (ASDs).

Methods

We used 7‐week‐old triple transgenic (3xTg) mice that have both amyloid and tau mutations, and amyloid precursor protein Swedish/presenillin 1 dE9 (APP/PS1) mice, bearing only amyloid‐related mutations. We assessed the absence of plaques via immunohistochemistry and analyzed the concentrations of both soluble and insoluble forms of Aβ1–42 and total tau (t‐tau) in brain hippocampal and prefrontal cortical tissue. Seven‐week‐old mice of the different genotypes were subjected to the 6 Hz corneal kindling model. After kindling acquisition, we tested the anticonvulsant effects of three marketed ASDs (levetiracetam, brivaracetam, and lamotrigine) in fully kindled mice.

Results

No Aβ plaques were present in either genotype. Soluble Aβ1–42 levels were increased in both AD genotypes, whereas insoluble Aβ1–42 concentrations were only elevated in APP/PS1 mice compared with their respective controls. Soluble and insoluble forms of t‐tau were increased in 3xTg mice only. 3xTg and APP/PS1 mice displayed more severe seizures induced by 6 Hz corneal kindling from the first stimulation onward and were more rapidly kindled compared with control mice. In fully kindled AD mice, ASDs had less‐pronounced anticonvulsive effects compared with controls.

Significance

Mutations increasing Aβ only or both Aβ and tau in the brain enhance susceptibility for seizures and kindling in mice. The effect of ASDs on seizures measured by the Racine scale is less pronounced in both investigated AD models and suggests that seizures of young AD mice are more difficult to treat.
A slimmer and deeper approach to deep network structures for low‐level vision tasks
Authors: Xu Boyan , Yin Hujun
Published: July 2022

Deep network design is a fundamental challenge. A right trade‐off between depth and complexity of convolutional neural networks is of significant importance to applications in low‐level vision tasks. Wider feature maps could be beneficial to performance and generality but would increase computational complexity. In this paper, we rethink the balance between width of the feature maps and depth of the network especially for image restoration tasks including deblurring, dehazing, super‐resolution, and denoising. We explore a new approach to network structure by encouraging more depth to deal with restoration requirements while decreasing the width of some feature maps. Such a slimmer and deeper approach can enhance the performance while maintaining the same level of computational costs. We have experimentally evaluated the performances of the proposed approach on four image restoration tasks and obtained state‐of‐the‐art results on quantitative measures and qualitative assessments, demonstrating the effectiveness of the approach.
The agreement between measured HbA1c and optimized target HbA1c based on the Dementia Assessment Sheet for Community‐based Integrated Care System 8‐items (DASC‐8): A cross‐sectional study of elderly patients with diabetes
Authors: Miya Aika , Nakamura Akinobu , Yokota Isao , Cho Kyu Yong , Kameda Hiraku , Nomoto Hiroshi , Takase Takahiro , Omori Kazuno , Ono Mayuko , Nagai So , Taneda Shinji , Miyoshi Hideaki , Atsumi Tatsuya
Published: July 2022

Aim

To investigate the achievement of individualized target HbA1c based on the Japanese guideline after geriatric assessment with the Dementia Assessment Sheet for Community‐based Integrated Care System 8‐items (DASC‐8) and to evaluate patient characteristics acting as barriers to achieving the target HbA1c in elderly outpatients with diabetes.

Methods

This cross‐sectional study enrolled 303 Japanese outpatients aged ≥65 years with diabetes. Their health status was measured using the DASC‐8. The target HbA1c was optimized for each patient by the guideline based on the DASC‐8 score and use of drugs potentially associated with severe hypoglycemia. Patient characteristics related to the agreement between measured HbA1c and target HbA1c were extracted by multivariate logistic regression analysis.

Results

The mean age was 73.0 years and the mean body mass index (BMI) was 24.2 kg/m2. The agreement between measured HbA1c and target HbA1c was 43.9% (95% confidence interval: 38.4%–50.0%). In multivariate logistic regression analysis, the agreement in patients with drugs potentially associated with severe hypoglycemia was significantly lower than in those without these drugs (37.8% vs. 60.5%, P = 0.0004). In patients with these drugs, higher BMI (P = 0.0271) and higher fasting plasma glucose (P = 0.0034) were independent related factors for measured HbA1c being higher than target HbA1c. Vulnerable elderly patients (P = 0.0116) and not taking sodium glucose co‐transporter‐2 (SGLT2) inhibitor (P = 0.0186) were independent related factors for inappropriately lower HbA1c.

Conclusions

The agreement between measured HbA1c and target HbA1c was low in elderly patients with diabetes. Geriatr Gerontol Int 2022; 22: 560–567.
Association between care rehabilitation and the risk of fracture hospitalization in people with Parkinson's disease
Authors: Liu Ning , Babazono Akira , Ishihara Reiko , Li Yunfei , Jamal Aziz , Kim Sung‐A , Matsuda Shinya
Published: July 2022

Aim

This study examined whether there is an association between continuous care rehabilitation (CR) and the risk of fracture hospitalization among people with Parkinson's disease (PwP) aged >75 years with mild‐to‐moderate care needs level.

Methods

A retrospective study design based on the merging of medical claims and long‐term care insurance claims data was used. Before propensity score matching, of the 2177 participants, 222 received continuous CR, whereas 1955 did not. After matching using a 1:4 ratio, we identified 222 patients in the CR group and 888 patients in the non‐CR groups. We carried out a survival analysis to clarify the association between CR and the risk of fracture hospitalization.

Results

After matching, there was a significant difference between the CR and non‐CR groups in 3 years (stratified log‐rank test by age P = 0.036) and in 4 years (stratified log‐rank test by age P = 0.011). The CR group was significantly associated with delays of hospital admission due to fracture within 3 years (hazard ratio 0.54; 95% confidence interval 0.29–0.99; P = 0.047) and within 4 years (hazard ratio 0.52; 95% confidence interval 0.30–0.88; P = 0.010).

Conclusions

Our study showed that older people with Parkinson's disease who continuously received CR had a lower risk of fracture hospitalization in 3 and 4 years than those who did not receive CR or received interrupted CR. Considering our participants with a mild‐to‐moderate care needs level, a sustainable CR service might benefit people with Parkinson's disease from an early time when their activities of daily living are still intact and cognitive function has not deteriorated. Geriatr Gerontol Int 2022; 22: 628–634.
Exploring patient acceptability of a short‐stay care pathway in hospital post arthroplasty: A theory‐informed qualitative study
Authors: McDonald Cassie E. , Paynter Camille , Francis Jill J. , Rodda Daevyd , Bajwa Supreet , Jackson Dwane , Story David
Published: July 2022

Introduction

Arthroplasty is an effective, yet costly, surgical procedure for end‐stage osteoarthritis. Shorter stays in hospital are being piloted in Australia. In some countries, short stay is established practice, associated with improving perioperative care and enhanced recovery after surgery practices. Exploring the acceptability to patients of a short stay care pathway in hospital postarthroplasty is important for informing health policy, adoption and potential scalability of this model of care.

Methods

Consecutive patients at one site, at least 3 months post total joint arthroplasty, were invited to participate in theory‐informed semi‐structured qualitative interviews. The Theoretical Framework of Acceptability (TFA) informed development of the interview guide. Interview data were analysed using the Framework Method.

Results

Eighteen patients were invited. Fifteen consented to be contacted and were interviewed. Short‐stay post arthroplasty was highly acceptable to patients who had the supports necessary to recover safely at home. Key findings were as follows: flexibility of short‐stay care pathway was essential and valued; prior beliefs and expectations informed acceptability; and the absence of out‐of‐pocket expenses had an incentivizing effect, but was not the primary reason for patients choosing this care pathway. Further themes analysed within the TFA constructs highlighted nuances of acceptability relating to this model of care.

Conclusions

A short stay in hospital post arthroplasty appeared to be acceptable to patients who had experienced this care pathway. Our thematic findings identified aspects of the short‐stay care pathway that enhanced acceptability and some aspects that limited acceptability. These findings can inform refinement of the short‐stay care pathway.

Patient or Public Contribution

Patients/people with lived experience were not involved in the study design or conduct of this preliminary work; as this short‐stay model of care was recently introduced, only a small group of patients was eligible to participate in this study. This study is the first step towards understanding the experiences of patients about a short‐stay model of care post arthroplasty. The findings will help inform future patient and public involvement in expanding the programme.
Abductive Reasoning: A Design Thinking Experiment
Authors: Dreamson Neal , Khine Phyo Htet Htet
Published: July 2022

Design thinking fundamentally relies on abductive reasoning. Diverse thinking types such as divergent thinking, systems thinking, and empathetic thinking have been adopted in design thinking education. Yet, it is very rare to address abductive reasoning to be integrated in a design thinking course because of deductive validity and inductive strength. In practice, the quality of design thinking is judged from design outcomes in terms of creativity and innovation rather than the application of abductive reasoning in thinking that is necessary for educators to develop diverse instructional strategies for design thinking. Through a design thinking experiment where abductive reasoning was structured for groups of students to modify their chosen fairy stories by challenging identified lessons/values/beliefs, we articulated relevant strategies from case analysis. As a result, we discovered the following six strategies for abductive reasoning: questioning on socially given identity; restructuring a hierarchy of values; de‐ and re‐contextualisation; perspective‐taking; being intersubjective through body swapping; and developing imaginative empathy for compassion. The six strategies support pedagogical aspects of design thinking such as collaborative problem‐solving and analytic and empathetic engagement; and thus, design educators can use them in developing instructional strategies to facilitate abductive reasoning in design thinking.
Initial testing of components of the cultural determinants of trauma recovery (CDTR) theory amongst American Gender‐Based violence survivors: Structural equation modelling
Authors: Kita Sachiko , Zonp Zeynep , Saint Arnault Denise
Published: July 2022

Aim

We tested key hypotheses derived from the Cultural Determinants of Trauma Recovery Theory (CDTR) with an American sample.

Design

A cross‐sectional study using anonymous online surveys.

Methods

This study was conducted with 225 American survivors of gender‐based violence (GBV) between August to November 2019. Demographics, distress (depression: PHQ8; PTSD: PCL‐5), mental health service utilization (counselling and medication), sense of coherence (SOC), internal barriers to help‐seeking (shame, frozen and problem management subscales: BHS‐TR Internal) and the GBV healing (GBV‐Heal) were used. Structural equation modelling (SEM) was conducted to test the hypotheses.

Results

The final SEM model showed that the relationship between distress and mental health service utilization was not mediated by internal help‐seeking barriers; the relationship between distress and trauma healing was partially mediated by internal help‐seeking barriers; the relationship between internal help‐seeking barriers and trauma healing was partially mediated by SOC; mental health service utilization was not significantly associated with trauma healing. Overall, the relationship between distress and trauma healing was partially mediated by internal help‐seeking barriers and SOC.

Conclusions

This study confirmed some hypothetical pathways between distress and trauma healing. Further research with larger and international samples should be necessary to test the overall CDTR and compare groups.

Impact

This study can help us focus on psychological interventions that enhance meaning and mitigate internal help‐seeking barriers to promote holistic trauma recovery. Public and public contribution: The sample was gathered from a clinical population registry that alerts patients of potential research opportunities.
Defining competencies for nurse anaesthetists: A Delphi study
Authors: Sanclemente‐Dalmau Montse , Galbany‐Estragués Paola , Palomar‐Aumatell Xavier , Rubinat‐Arnaldo Esther
Published: July 2022

Aim

To define the competencies of nurse anaesthetists in the hospitals of Catalonia on the basis of their clinical practice through a consensus‐building process.

Design

We used the Delphi method to determine consensus among a group of 16 nurse anaesthetists.

Methods

Between February and June 2020, we administered a questionnaire of 142 questions distributed among seven domains: expert, communicator, collaborator, manager, health advocate, scholar and professional. Two rounds were conducted.

Results

In round 1, 18 competencies were discarded and nine had inconclusive results. Eighteen competencies were proposed by participants. The nine competencies with inconclusive results and the 18 newly proposed competencies were considered in round 2. In round 2, three of these 27 competencies tested were discarded, and consensus was reached on the other 24.

Conclusion

Health education and the empowerment of the patient and family are fundamental pillars in the practice of nurse anaesthetists in Spain, especially in pre‐anaesthetic assessment and pain care. These areas of practice can help define competencies in other countries where the profession of nurse anaesthetist is less developed.

Impact

The lack of regulation of the competencies of nurse anaesthetists leads to great variability in training and practice. The results can help in their standardization in Spain and in other countries lacking regulation. Our approach can also help policymakers and hospital administrators in health systems that are undergoing the process of regulation. The regulation of the competencies of nurse anaesthetists will allow them to contribute their expertise to the health‐illness continuum, increasing safety and improving the quality of care.
Distinct propagation patterns of right pulmonary veins through multiple epicardial connections during right atrial pacing and sinus rhythm
Authors: Kitamura Takeshi , Hayashi Kentaro , Ohta Masayuki , Izumi Chihiro , Masuda Naoki , Ogata Nobohiko , Isshiki Takaaki
Published: July 2022

A 47‐year‐old man with symptomatic paroxysmal atrial fibrillation (AF) underwent AF ablation. Activation maps during right atrial pacing and sinus rhythm before the ablation revealed distinctive left atrial (LA) propagations with multiple LA breakthrough sites via epicardial connections. A wide area circumferential ablation was not able to achieve a right pulmonary vein (RPV) isolation and required an inner PV ablation to isolate the RPV. Activation maps during different rhythms before the ablation may be helpful to unmask multiple epicardial connections between the RPV and right atrium.
Activation of adenosine A3 receptor attenuates progression of osteoarthritis through inhibiting the NLRP3/caspase‐1/GSDMD induced signalling
Authors: Bai Hui , Zhang Zhiheng , Liu Lin , Wang Xinyu , Song Xiaopeng , Gao Li
Published: July 2022

The specific adenosine A3 receptor (A3AR) agonist (CF101) has potential for inflammation and pain in various disease, such as arthritis, cancer and neuropathic pain, while the role of A3AR in post‐traumatic OA and the underlying mechanism is largely unknown. CF101 was orally administrated in OA rats induced by anterior cruciate ligament transection (ACLT) surgery, and the rat primary chondrocytes were stimulated by hydrogen peroxide (H2O2, 300 μM). Histologic grading system was performed for detecting cartilage degeneration and immunohistochemistry for determining pyroptosis. The moleculars associated with cartilage homeostasis and inflammatory cytokines were analysed; moreover, the activation of NLRP3 inflammasome was determined. CF101 treatment significantly attenuated OA cartilage damage, OA‐related pain and cartilage pyroptosis. Chondrocytes stimulated by H2O2 evoked ROS release, thereby promoting the activation of NLRP3 inflammasome and facilitating the cleavage of GSDMD, which ultimately resulted in the mass release of pro‐inflammatory cytokines including IL‐1β and IL‐18, and production of matrix hydrolase. The pre‐treatment with CF101 powerfully inhibited the above process both in vivo and in vitro. Our findings demonstrated that activation of A3AR attenuates OA progression and relieves pain perception through suppression of cartilage degradation and inhibition of ROS/NLRP3/GSDMD signalling, indicating pyroptosis is a potential candidate for OA treatment.
Malignancy risk stratification for solitary pulmonary nodule: A clinical practice guideline
Authors: Chen Bojiang , Li Qianrui , Hao Qiukui , Tan Jing , Yan Lan , Zhu Yuqi , Hu Chengping , Qian Guisheng , Zhang Guozhen , Chen Liangan , Zhou Chengzhi , Zhang Jian , Sun Jiayuan , Jiang Li , Zhang Li , Wang Qi , Zhang Xiaoju , Jin Yang , He Yong , Song Yong , Sun Xin , Li Weimin
Published: July 2022

Clinical question

The detection rate of the solitary pulmonary nodule (SPN) is increasing with the popularization of CT scanning. Malignancy risk stratification for SPN is a major clinical difficulty.

Current practice

There have been several guidelines for SPN assessment. Inconsistency of these guidelines makes the clinical application difficult and confusing.

Recommendations

In this Rapid Recommendation, solid and subsolid SPNs are recommended to be evaluated respectively. Six factors, namely the combination of age with sex, smoking history, history of malignancy, family history of malignancy, and nodule size, are recommended for malignancy risk stratification for both kinds of SPNs; the border of nodules (spiculation and lobulation) is recommended for evaluating solid SPNs and the density of nodules (pure or mixed ground‐glass nodule) is recommended for subsolid nodules. Among them, smoking history and radiologic features (nodule diameter, border, and density) are of relatively higher importance. A scoring system was proposed to assist malignancy risk stratification of SPNs, with a total score ranging from six points to 15 points (if solid) or 17 points (if subsolid). For each SPN, regardless of solid or subsolid in nature, a total score of ≤ 7 points suggested a low risk of being malignant, while 7 to 9 points suggested medium risk, and ≥ 9 points suggested high risk.

How this guideline was created

This rapid recommendation was developed using the MAGIC (Making GRADE the Irresistible Choice) methodological framework. First, a clinical subcommittee identified the topic of recommendation and requested evidence. Then, an independent evidence synthesis subcommittee performed a comprehensive literature review and evaluated the evidence. Finally, based on findings from the systematic review and use of real‐world data, the clinical subcommittee formulated recommendations, including the scoring system, through a consensus procedure.

The evidence

A total of 13857 patients with SPNs were included in the meta‐analysis and the association between 12 candidate factors and the risk of SPNs being malignant was studied. Eventually, seven factors were recommended for SPNs evaluation, and a scoring system was proposed.

Understanding the recommendation

The parameters included are objective. Therefore, this recommendation is feasible in clinical practice. However, there are several uncertainties, such as a lack of further verification. It might be misclassified by the scoring system. Clinicians could choose the most suitable scheme according to the recommendation, along with their own experience in specific situations.
Adoption of Consensus Guidelines for Safe Prevention of the Primary Cesarean Delivery by Freestanding Birth Centers
Authors: Niemczyk Nancy A. , Ren Dianxu , Jolles Diana R. , Wright Jennifer , Christy Ellen , Stapleton Susan R.
Published: July 2022

Introduction

Slow or arrested progress in labor is the most frequent (64%) indication for nonemergent transfer of laboring people from freestanding birth centers to the hospital. After the 2014 publication of the Consensus Statement on Safe Prevention of Primary Cesarean Delivery (Consensus Statement), many freestanding birth centers changed their clinical practice guidelines to allow more time for active labor in the birth center prior to hospital transfer. The result of these changes has not been evaluated in birth centers. Evaluation of adoption of guidelines based on the Consensus Statement in hospitals has shown inconsistent results.

Methods

Birth centers were contacted to determine whether they changed clinical practice guidelines in response to the Consensus Statement. A before‐after analysis compared outcomes for the 2 calendar years before and the 2 calendar years after adoption of new guidelines with a retrospective analysis of deidentified client‐level data collected in the American Association of Birth Centers Perinatal Data Registry.

Results

A third of responding birth centers (11 of 33) changed their clinical practice guidelines, mostly redefining the onset of active labor as beginning at 6 cm cervical dilatation and allowing 4 hours of arrest of dilatation in active labor before transfer to the hospital. These changes were associated with fewer diagnoses of prolonged first stage of labor (13.8% vs 8.0%, P < .01) but not with fewer intrapartum transfers (14.0% vs 14.7%, P = .55) or cesarean births (5.0 vs 4.1%, P = .26.)

Discussion

We found no evidence that making these practice changes was associated with better outcomes. Two hours of a lack of documented cervical change in active labor is likely long enough to diagnose arrested progress in labor. Research on proportion of morbidity and mortality associated with prolonged labor could inform practice guidelines for transfers.