bluuebunny/crossref_metadata_2025 huggingface dataset:
Microbial dispersion in the human gut through the lens of fecal transplant
Authors: Algavi Yadid M. , Borenstein Elhanan
Published: August 2023

Microorganisms frequently migrate from one ecosystem to another, influencing and shaping their new environment. Yet, despite the potential importance of this process in modulating the environment and the microbial ecosystem, our understanding of the fundamental forces that govern microbial migration and dispersion is still lacking. Moreover, while theoretical studies and in-vitro experimental work have highlighted the contribution of biotic interactions to the assembly of the community, identifying such interactions in vivo, specifically in communities as complex as the human gut, remains challenging. To this end, we developed a new, robust, and compositionally invariant approach, and leveraged data from well-characterized translocation experiments, namely, clinical fecal microbiota transplant (FMT) trials, to rigorously pinpoint dependencies between taxa during the colonization of human gastrointestinal habitat. Our analysis identified numerous pairwise dependencies between co-colonizing microbes during migration between gastrointestinal environments. We further demonstrated that identified dependencies agree with previously reported findings from in-vitro experiments and population-wide distribution patterns. Finally, we characterized the web of metabolic dependencies between these taxa and explored the functional properties that may promote better dispersion. Combined, our findings provide insights into the principles and determinants of community dynamics following ecological translocation, informing potential opportunities for precise community design.
The digital literacy of first-year students and its function in an online method of delivery
Authors: Budiman Rahmat , Syafrony Andre Iman
Published: August 2023

Purpose

This study aimed to acquire a comprehensive understanding of the digital literacy skills possessed by first-year students and how they impact students' participation in online classes.

Design/methodology/approach

This research was conducted using a quantitative method to investigate first-year students' digital literacy and its effect on their interaction in online learning. Nine hundred and two students from 19 online English writing classes were invited to complete an online survey questionnaire. The sampling approach was conducted by a nonrandom method. Prior to the data collection, the instrument was reviewed by researchers and peers with quantitative and Indonesian language backgrounds. The procedure was conducted to ensure that the instrument covered the objective of the research.

Findings

The results showed that students digital literacy in the first semester, in general, is still in the low category. The average score for each competency area still varies. The average score on information and data literacy competence was low. The average score for communication and collaboration competence was in the medium category. The average score for the digital content creation competence area is low.

Practical implications

The authors suggest that educational institutions should consider organizing primary student digital literacy training or optimizing the lecture process to improve students' digital literacy and further research could usefully explore how information and communication technology (ICT) skills affect student performance.

Social implications

The study reveals the importance of digital literacy of students for online teaching learning. In order to achieve quality teaching in online methods, the digital literacy is a must for students. The study highlights the limitations of the study and indicates the necessity for further research in this area. The findings have immense implications for practice in a distance learning university, where online teaching learning has become a new normal post-Covid-19.

Originality/value

The authors present new findings on the digital literacy of first-year students and their effect on their interaction in online learning. The authors also make connections between digital literacy and student engagement in online classes, which is a significant contribution to the field. This paper also provides a comprehensive review of the literature on digital literacy and e-learning, which adds to the scholarship in the field.
The “fight” for adaptations: exploring the drivers and barriers to implementing home and environment modifications that support healthy ageing
Authors: McCall Vikki , Gibb Kenneth , Wang Yang
Published: August 2023

Purpose

The ageing and disabled population is fast growing, which emphasises the need to effectively modify current homes and environments to support healthy ageing and increasingly diverse health needs. This paper aims to bring together findings and analyses from three adaptations-focussed projects, drawing on perspectives from key stakeholders alongside the lived experiences of service users acquiring adaptations.

Design/methodology/approach

Following an Adaptations Framework developed from interviews and focus groups with older people and key stakeholders, the paper discusses barriers experienced by older people and front-line workers in receiving and delivering adaptations through all stages of the process.

Findings

This paper reveals how experiences around adaptations might diverge with unseen, hidden investment and need amongst individuals, and how conceptual and cost-focussed evidence gaps impact wider understandings of adaptations delivery. In so doing, this paper highlights how the adaptations process is perceived as a “fight” that does not work smoothly for either those delivering or receiving adaptations services.

Research limitations/implications

The paper suggests a systematic failure such that the adaptations process needs to be rehauled, reset and prioritised within social and public policy if the housing, health and social care sectors are to support healthy ageing and prepare for the future ageing population.

Originality/value

The paper brings together insights from key stakeholders alongside service users' experiences of adaptations to highlight key policy drivers and barriers to accessing and delivering adaptations.
Pay for performance at a crossroads: lessons from taking a global perspective
Authors: Kristensen Søren Rud , Anselmi Laura , Brown Garrett Wallace , Fichera Eleonora , Kovacs Roxanne , Loewenson Rene , Singh Neha , Midzi Nicholas , Mustapha Fatimah , White Lee , Borghi Josephine
Published: August 2023

Purpose

The use of pay for performance (P4P) as an instrument to incentivise quality improvements in health care is at a crossroads in high-income countries but has remained a commonly used tool in low- and middle-income countries. The authors aimed to take stock of the evidence on effectiveness and design from across income settings to reveal insights for the future design of performance payment across income contexts.

Design/methodology/approach

The authors identified Cochrane literature reviews of the use of P4P in health care in any income setting, tracked the development in the quantity and quality of evidence over time, and compared the incentive design features used across high-income countries compared to low- and middle-income countries.

Findings

The quantity and quality of the evidence base have grown over time but can still be improved. Scheme design varies across income settings, and although some design choices may reflect differences in context, the authors find that incentive designers in both income settings can learn from practices used in the other setting.

Originality/value

The research and literature on P4P in high-, low- and middle-income countries largely operate in silos. By taking stock of the evidence on P4P from across income settings, the authors are able to draw out key insights between these settings, which remain underexplored in the literature.
Emotional intelligence as a predictor of workgroup fit among police leaders
Authors: White David R. , Schafer Joseph
Published: August 2023

Purpose

Policing scholars have largely ignored the workgroup dynamics of police command staffs. These officers work closely at the top of police organizations, promoting strategic objectives and overseeing significant changes. As leaders, emotional regulation is critical to the maintenance of internal and external relationships. Only a few research studies address emotional intelligence (EI) among police leaders. The current study combines these two issues to examine whether emotionally intelligent leaders report better perceptions of workgroup fit with their respective command staffs.

Design/methodology/approach

Using a survey of 304 United States (US) command staff officers attending the Federal Bureau of Investigation (FBI) National Academy (NA), the authors apply person-environment fit theory and test several hypotheses using structural equation modeling.

Findings

Command staff officers with better EI report significantly better perceptions of workgroup fit, suggesting that they may be better equipped to navigate the command staff workgroup dynamics in this complex environment that demands high emotional regulation. Workgroup fit was also significantly higher among higher ranking officers and among officers racialized as White.

Originality/value

Few studies have addressed perceptions of workgroup fit among command staff officers, and little attention has been given to the concept of EI. The authors add to these two important areas of research and provide evidence that emotional intelligence is an important characteristic for leaders when considering how well command staffs work together. This finding may have implications for the efficacy of agencies to facilitate change efforts or to carry out daily operations.
Testing for sign and size symmetry between futures prices and spot prices in the markets of energy commodities: risk diversification and policy implications
Authors: Panagiotou Dimitrios , Naka Filio
Published: August 2023

Purpose

The purpose of this paper is to investigate for symmetries – in sign and size – between spot and futures prices in the markets of energy commodities.

Design/methodology/approach

The aforementioned objective is pursued using daily observations of spot and futures prices for the commodities of crude oil, Brent, heating oil, gasoline and natural gas, along with local nonlinear regression.

Findings

Symmetry in sign and size cannot be rejected. This means that, shocks of the same absolute magnitude, but of different sign, are transmitted from futures prices to spot prices with the same intensity. In addition, larger absolute value price shocks in the futures are transmitted to the spot markets with the same intensity compared with smaller ones. The findings of symmetry in the comovements among prices reveal a lack of those commodities on diversifying the investors’ investment risk.

Originality/value

To the best of the authors’ knowledge, this is the first study to use local nonlinear regression to test for sign and size symmetry between futures and spot prices in the energy commodities markets.
Does guests-perceived value for money affect WOM and eWOM? The impact of consumer engagement on SNS on eWOM
Authors: Souki Gustavo Quiroga , Oliveira Alessandro Silva de , Barcelos Marco Túlio Correa , Guerreiro Maria Manuela Martins , Mendes Júlio da Costa , Moura Luiz Rodrigo Cunha
Published: August 2023

Purpose

Hotels provide high-quality guest experiences to generate perceived value for money (PVM), positively influencing word-of-mouth (WOM) and electronic word-of-mouth (eWOM) communication. This study aims to (1) verify the impacts of the perceived quality by the guests about their experiences in hotels on their PVM; (2) inspect the influence of guests' perception of hotel prices on PVM; (3) examine the impacts of guest PVM on their hotel experiences on WOM and eWOM and (4) investigate the consequences of the hotel guests' behavioural engagement on social networking sites (HGBE-SNS) on eWOM.

Design/methodology/approach

This quantitative and descriptive study consists of a survey with 371 guests who evaluated their experiences at three hotels in Brazil. PLS-SEM tested the hypothetical model that resorted to the stimulus-organism-response theory (S-O-R), proposed by Mehrabian and Russell (1974). Cluster Analysis compared the PVM, WOM and eWOM of groups of hotel guests with different levels of social media engagement.

Findings

Perceived quality by hotel guests positively impacts PVM. Perceived price negatively influences PVM. PVM had a positive and robust impact on WOM. PVM impacts and explains weakly eWOM. In contrast, HGBE-SNS affects and better explains eWOM than PVM.

Originality/value

This unprecedented investigation concomitantly exhibits the relationships between perceived quality, price, PVM, WOM, eWOM and HGBE-SNS. Hotels must offer high perceived quality experiences to influence PVM and WOM positively. PVM is unable to stimulate eWOM strongly. HGBE-SNS is pivotal for guests to share their hotel experiences through eWOM. This study suggests marketing strategies for hospitality companies to amplify customer engagement on SNS.
Trade‐Related Aspects of Intellectual Property Rights Flexibilities and Public Health: Implementation of Compulsory Licensing Provisions into National Patent Legislation
Authors: McGIVERN LAUREN
Published: August 2023

Policy Points

Given the challenges associated with negotiating the COVID‐19 Trade‐Related Aspects of Intellectual Property Rights (TRIPS) Waiver, there are questions as to whether the World Trade Organization is able to effectively address pandemics and global crises under the current architecture.

Although the framework set out by the TRIPS Agreement does not view intellectual property (IP) rights as a means to foster public health and development, IP rights should nonetheless be interpreted through a public health lens.

Countries should implement compulsory licensing provisions into their patent legislation, which increase access to medicines and allow governments (especially in developing and least‐developed countries) to better protect public health.

Context

The protection of intellectual property (IP) rights, given international legal effect through the World Trade Organization (WTO) Trade‐Related Aspects of IP Rights (TRIPS) Agreement, has long been a contentious issue. In recent years, the long‐standing debate on IP rights as a barrier to the access of affordable medicines has been heightened by the global vaccine inequity evidenced during the COVID‐19 pandemic. The TRIPS Agreement contains a number of flexibilities that WTO members can exploit in order to accommodate their policy needs. Among these is the mechanism of compulsory licensing, whereby patent licenses may be granted without consent of the patent holder in certain circumstances. TRIPS Article 31bis created a special mechanism for compulsory licenses specifically for the export of pharmaceutical products to countries with insufficient manufacturing capacity.

Methods

We analyzed domestic patent legislation for 195 countries (193 UN members and two observers) and three customs territories. We analyzed patent legislation for provisions on compulsory licenses, including those defined in Article 31bis of the TRIPS Agreement.

Findings

We identified 11 countries with no patent legislation. Of the 187 countries with domestic or regional patent laws, 176 (94.1%) had provisions on compulsory licensing and 72 (38.5%) had provisions implementing TRIPS Article 31bis.

Conclusions

The results of this study have highlighted the gap in the implementation of TRIPS flexibilities in countries’ national patent legislation, especially in least‐developed countries. Although it will not fully solve patent barriers to the access of medicines, implementation of compulsory licensing (and specifically those for the import and export of pharmaceutical products) will provide governments with another tool to safeguard their population's public health. Further discussions are needed to determine whether the WTO can provide effective responses to future pandemics or global crises.
The role of plasmapheresis in severe acute disseminated encephalomyelitis with clinical findings of transverse myelitis
Authors: Fjellbirkeland Olivia W. , Szpirt Wladimir M. , Børresen Malene L.
Published: August 2023

Introduction

Acute disseminated encephalomyelitis is a rare acute demyelinating disease of the central nervous system (CNS). The pathogenesis remains unclear but is suspected to be autoimmune. High doses of methylprednisolone (HDMP) are currently considered standard of treatment. Plasmapheresis (PE) is typically given in steroid refractory cases. There is currently limited evidence supporting its use in ADEM.

Materials and Methods

We report a 16‐year‐old girl with ADEM who improved rapidly after initiating PE.

Results

The patient presented with acute onset of multifocal CNS symptoms, including encephalopathy, requiring intensive care unit management. Despite HDMP administration, her clinical condition continued to deteriorate. PE was therefore initiated on the same day as HDMP. Her clinical condition improved significantly following the first session. She was extubated and discharged from the intensive care unit the following day.

Conclusion

HDMP combined with PE may be an effective first‐line treatment in patients with fulminant ADEM.
IFN‐γ enhances the therapeutic efficacy of MSCs‐derived exosome via miR‐126‐3p in diabetic wound healing by targeting SPRED1
Authors: Lu Wen , Du Xuan , Zou Shengyi , Fang Qionglei , Wu Mengjiao , Li Huijuan , Shi Bimin
Published: August 2023

Background and Aims

The traditional treatment of diabetic wounds is unsatisfactory. Exosomes isolated from bone marrow mesenchymal stem cells (BMSCs) promote the healing of diabetic wounds. However, whether the exosomes secreted by interferon (IFN)‐γ‐pretreated BMSCs have an enhanced therapeutic effect on diabetic wound healing and the relevant mechanisms remain unclear.

Methods

In this study, we isolated exosomes from the corresponding supernatants of BMSCs with (IExos) or without IFN‐γ treatment (NExos). Human umbilical vein endothelial cells (HUVECs) were used to investigate the proliferation, migration, and tube formation under different treatments in vitro. Diabetic mice were induced by intraperitoneal administration of streptozotocin, and a circular full‐thickness dermal defect was then made on the back of each mouse, followed by a multisite subcutaneous injection of phosphate buffered saline or exosomes. Hematoxylin–eosin (H&E) staining, Masson's trichrome staining, and histological analysis were performed to assess the speed and quality of wound healing.

Results

NExos treatment accelerated the healing of diabetic wounds by promoting angiogenesis in vivo and in vitro, and IExos exhibited superior therapeutic efficiency. MicroRNA (miR)‐126‐3p was significantly increased in IExos, and exosomal miR‐126‐3p promoted angiogenesis and diabetic wound healing via its transfer to HUVECs. miR‐126‐3p regulates SPRED1 by directly targeting the 3′‐UTR. Mechanistically, IFN‐γ‐pretreated BMSCs secreted miR‐126‐3p‐enriched exosomes, which enhanced the function of HUVECs and promoted angiogenesis via the SPRED1/Ras/Erk pathway.

Conclusion

Exosomal miR‐126‐3p secreted from IFN‐γ‐pretreated BMSCs exhibited higher therapeutic efficacy than NExos in diabetic wound healing by promoting angiogenesis via the SPRED1/Ras/Erk axis.
Parental openness and communication regarding cannabis and alcohol use with their children
Authors: Dopke Campbell , Romm Katelyn F. , Berg Carla J.
Published: August 2023

Background and Objectives

Given increases in youth cannabis and alcohol use and changes in the cannabis market, we examined parental openness and communication about cannabis and alcohol.

Methods

Among 197 participants who had children ≤18 years old and lived in six US metropolitan areas (Atlanta, Boston, Minneapolis, Oklahoma City, San Diego, Seattle), we examined sociodemographic and use correlates of parental openness (i.e., acceptability of child use, rules regarding use in the home or around children, communication) about cannabis and alcohol, as well as being more open about cannabis versus alcohol.

Results

In this sample (Mage = 32.30, 70.1% female, 30.5% sexual minority, 33.0% racial/ethnic minority, 41.6% in recreational cannabis state), 33.5% reported past‐month cannabis use, and 59.9% alcohol (22.8% used both, 29.4% used neither). Multivariable regression indicated that cannabis users (vs. nonusers) and sexual minority (vs. heterosexual) individuals were more open about cannabis use; alcohol users (vs. nonusers) were more open about alcohol use. Additionally, older parental and child age correlated with greater cannabis‐ and alcohol‐related communication, and females (vs. males) reported greater cannabis‐related communication. Those married/cohabitating and reporting past‐month alcohol use were less likely to allow cannabis versus alcohol in the home or near children. Parents in legalized recreational (vs. nonlegalized) states, females, and heterosexual individuals reported greater cannabis‐ versus alcohol‐related communication.

Discussion and Conclusions

Interventions are needed to support parental communication regarding substance use, particularly cannabis.

Scientific Significance

This study addressed parenting and youth substance use during evolving cannabis legislation and can inform youth substance use prevention interventions targeting parent‐child communication.
Differences in the prevalence and clinical correlates of depressive symptoms in male patients with methamphetamine and heroin use disorder in a Chinese Han population
Authors: Zhu Rongrong , Wang Dongmei , Fan Fusheng , Fu Fabing , Wei Dejun , Tang Shanshan , Tian Yang , Chen Jiajing , Li Yuqing , Zhou Huixia , Wang Li , Zhang Xiangyang
Published: August 2023

Background and Objectives

Comorbidity of substance use disorders and depression is a common phenomenon. It is well known that opioid addiction is neurobiologically distinct from psychostimulant addiction. However, direct comparisons of comorbid depressive symptoms in patients with methamphetamine (METH) use disorder (MAUD) and heroin use disorders (HUD) have been lacking until now.

Methods

A total of 353 patients with methamphetamine use disorder, 76 patients with HUD, and 203 healthy controls were recruited. The Beck Depression Inventory (BDI‐SF), the Desires for Drug Questionnaire (DDQ) and the short form of the Childhood Trauma Questionnaire (CTQ‐SF) were used to measure participants' depressive symptoms, drug craving, and childhood abuse or neglect, respectively.

Results

The prevalence of depressive symptoms was 35.41% (125/353) in MAUD and 56.57% (43/76) in MAUD, significantly higher than the 22.66% (46/203) in healthy controls. Furthermore, there was a significant difference in the total BDI score between the MAUD and HUD groups (F = 5.02, df = 1, 372, p = .026). Among MAUD, years of education, history of incarceration, month of abstinence and negative reinforcement scores were associated with depressive symptoms (all p < .05). Among HUD, duration of drug use, childhood emotional abuse and sexual abuse were associated with depressive symptoms (all p < .05).

Conclusions and Scientific Significance

The prevalence and correlates of depressive symptoms differ between MAUD and HUD, adding to the existing literature. Therefore, treatment and intervention programs should be designed to address these unique correlates in HUD and MAUD patients.
Association between acculturation, dental floss use, dental visits and unmet dental needs among Asians in the United States: Findings from National Health and Nutrition Examination Survey (NHANES) 2011–2018
Authors: Luo Ting , Beiter Kaylin , Tseng Tung‐Sung
Published: August 2023

Objectives

The objectives of this study were to examine the associations between acculturation and dental floss, regular dental visits and unmet dental care needs among Asian Americans, as well as the moderating effects of these associations.

Methods

This study analysed national representative samples from the National Health and Nutrition Examination Survey (NHANES) 2011–2018. A total of 2763 Asian Americans aged 20 and older were included in this analysis. The primary predictor, acculturation score, was determined by three questions: (i) language spoken at home (higher score for English), (ii) country of birth (higher score for United States) and (iii) length of time in the United States. Dental floss use, dental visits and unmet dental care needs were included as outcomes in this study. Descriptive statistics and logistic regressions were used to analyse the samples.

Results

Acculturation was significantly associated with dental health behaviours: Individuals with higher levels of acculturation were more likely than less acculturated individuals to use dental floss (81.0% vs. 63.9%, respectively) and visit the dentist regularly (76.7% vs. 66.9% respectively). Insurance status moderated the association between acculturation and dental visits: Acculturation was significantly associated with dental visits in the past year among insured individuals (OR = 1.70, 95% CI: 1.29–2.23), but not among uninsured individuals. Unmet dental care needs were present in 11.1% of participants. While costs and insurance were the top two determinants of access to care, individuals with and without insurance differed with regard to their third major reason for unmet dental care needs: Being ‘too busy’ and not wanting to spend money on dental care.

Conclusions

Among the Asian population in the United States, those with high acculturation scores were more likely to engage in dental flossing and visit the dentist regularly compared to those Asians with lower acculturation scores. To encourage dental flossing and regular dental visits among Asians with lower acculturation scores, cultural adaptation and language accessibility suggests being considered. Future research is necessary to confirm the moderating effect of insurance status on the association between acculturation and regular dental visits. Additionally, our findings emphasize the impact of costs and insurance on access to dental care among Asians in the United States, highlighting the importance of future public health programmes in addressing these barriers.
Relationship‐based practice and contextual safeguarding: Approaches to working with young people experiencing extra‐familial risk and harm
Authors: Lloyd Jenny , Hickle Kristine , Owens Rachael , Peace Delphine
Published: August 2023

This article explores the synergies between relationship‐based practice and contextual safeguarding when working with young people experiencing extra‐familial risk and harm (EFRH). The article draws on data from interviews, observations, policy reviews and case files from two sites in England who are testing contextual safeguarding approaches to EFRH, including a children and families social work department and a voluntary and community sector organisation. The findings evidence how relationship‐based practice in contextual safeguarding facilitates practitioners' understanding of places and their peers. The discussion draws on the theory of social defences to evidence that despite willingness and commitment to relationship‐based practice, without systemic and cultural organisational support to respond to EFRH, efforts to do so may undermine and cause harm to practitioners engaging in this work.
Amicrobial pustulosis of the folds: A case report of a rare variant of neutrophilic dermatosis associated with systemic lupus erythematosus
Authors: Varano Alison T. , McKinley Timothy D. , Junkins‐Hopkins Jacqueline M.
Published: August 2023

Amicrobial pustulosis of the folds (APF) is a rare neutrophilic dermatosis found in association with autoimmune diseases. We present a 49‐year‐old woman with a history of systemic lupus erythematosus and a recurrent pustular eruption in the cutaneous folds. Histologic examination revealed spongiform pustulosis and dermal neutrophilic infiltrate. The Gram and periodic acid–Schiff stains were negative for bacteria and fungi. A diagnosis of amicrobial pustulosis of the folds was given. While there is no standard treatment, our patient's symptoms resolved following an oral prednisone taper and have not recurred since starting colchicine. The presence of pustules and erosive plaques in skin folds in young women with autoimmune conditions should raise suspicion for APF. The combination of localized neutrophilic spongiosis with intraepidermal or subcorneal pustules in conjunction with dermal changes of a neutrophilic dermatosis is a helpful clue to the diagnosis. If the patient does not already have a diagnosis of an underlying autoimmune condition, a presentation of APF should prompt further screening consisting of a relevant review of symptoms and appropriate assessment for autoimmune antibodies, since APF may precede the diagnosis of autoimmune disorders.
Body mass index vs. waist‐to‐height‐ratio in patients with lipohyperplasia dolorosa (vulgo lipedema)
Authors: Brenner Erich , Forner‐Cordero Isabel , Faerber Gabriele , Rapprich Stefan , Cornely Manuel
Published: August 2023

Background

Lipedema, also known as lipohyperplasia dolorosa (LiDo), is a painful condition affecting women, causing a disproportionate accumulation of subcutaneous adipose tissue in the extremities. It carries a lower risk of diabetes and cardio‐metabolic dysfunctions compared to obesity, but coincident obesity can complicate diagnosis and treatment.

Patients and Methods

This retrospective study included 607 female LiDo patients, ≥ 18 years, stage 1–3, from Germany, the UK, and Spain. Data were collected as part of the standard initial assessment for LiDo patients.

Results

Based on waist‐to‐height‐ratio (WHtR), 15.2% of patients were underweight, 45.5% normal weight, 22.1% overweight and 17.3% obese. There was a significant association between WHtR category and age group. Body mass index (BMI) is often overestimated, leading to misdiagnosis of obesity.

Conclusions

The use of BMI also affects the recent decision of the German Federal Joint Committee on the reimbursement of liposuction costs by health insurance funds. Patients with BMI of more than 40 kg/m2 are excluded from cost coverage, and those with BMI between 35 kg/m2 and 40 kg/m2 must first receive conservative obesity therapy. In conclusion, the sole use of BMI in lipedema is unreliable and, in contrast to WHtR, leads to inaccurate diagnoses overestimating overweight and obesity.
Telemedicine in the treatment of gestational diabetes: An observational cohort study on pregnancy outcomes and maternal satisfaction
Authors: Montori Sara , Lugli Francesca , Monesi Marcello , Scutiero Gennaro , Forini Elena , Greco Pantaleo , Verteramo Rosita
Published: August 2023

Aims

Gestational diabetes treatment requires several outpatient consultations from diagnosis until delivery in order to prevent hyperglycaemia, which is associated with maternal and fetal complications. There is limited evidence in the literature about telemedicine superiority in improving pregnancy outcomes for women with gestational diabetes. The primary aim of the study was to evaluate maternal and fetal outcomes, while the secondary aim was to estimate the degree of satisfaction with gestational diabetes treatment, comparing telemedicine versus outpatient care.

Methods

This observational cohort study involved 60 consecutive women with gestational diabetes treated at the Diabetology Unit of Ferrara: 27 were followed up through a weekly remote control method (telemedicine group) and 33 in ambulatory clinics every 2 or 3 weeks (conventional group). After giving birth, 56 women responded to the modified Oxford Maternity Diabetes Treatment Satisfaction Questionnaire to assess their satisfaction with diabetes care.

Results

No statistically significant differences were found in most of the maternal and neonatal parameters evaluated in both groups. The questionnaire scores were positive in all areas investigated. Telemedicine follow‐up made women feel more controlled (p = 0.045) and fit better with their lifestyle (p = 0.005). It also emerged that almost all women treated with telemedicine would recommend this method to a relative or a friend.

Conclusions

Telemedicine follow‐up proved to be safe both in terms of metabolic control and pregnancy outcomes; furthermore, it significantly decreased the need for outpatient consultations and increased women's satisfaction. Studying the impact of telemedicine is also necessary, considering the current difficulties associated with the Sars‐COV‐2 pandemic.
Association between glycated haemoglobin and the risk of chronic obstructive pulmonary disease: A prospective cohort study in UK biobank
Authors: Li Mengyao , Wan Yanan , Zhu Zheng , Luo Pengfei , Yu Hao , Su Jian , Hang Dong , Lu Yan , Tao Ran , Wu Ming , Zhou Jinyi , Fan Xikang
Published: August 2023

Aims

To investigate the association between glycated haemoglobin (HbA1c) levels and chronic obstructive pulmonary disease (COPD) incidents in the general population, and the association between HbA1c levels and mortality in patients with COPD.

Materials and Methods

We investigated the association of HbA1c levels with COPD risk in the general population in the UK Biobank, using data from 420 065 participants. Survival analysis was conducted for 18 854 patients with COPD. We used restricted cubic spline analysis to assess the dose‐response relationship between HbA1c levels and COPD risk and survival. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs).

Results

During a median follow‐up of 12.3 years, 11 556 COPD cases were recorded. HbA1c had a non‐linear relationship with COPD risk (p for non‐linearity < .05). Compared with the quintile 2 (32.2‐<34.3 mmol/mol), those with HbA1c levels above 38.7 mmol/mol (quintile 5) had a 22% (HR, 1.22, 95% CI: 1.15‐1.30) higher risk of COPD. Compared with the HbA1c decile 2 (30.5‐<32.2 mmol/mol), the HRs (95% CI) of COPD risk were 1.16 (1.03‐1.30) and 1.36 (1.24‐1.50) in the lowest HbA1c decile (<30.5 mmol/mol) and highest decile (≥41.0 mmol/mol), respectively. The increased COPD risk associated with HbA1c was more pronounced in younger, current smokers, passive smokers, and participants with a higher Townsend deprivation index (all p for interaction < .05). Among patients with COPD, 4569 COPD cases died (488 because of COPD) during a median follow‐up of 5.4 years. Regarding COPD survival, HbA1c had a non‐linear relationship with all‐cause death (p for non‐linearity < .05). Those with HbA1c quintile 5 (≥38.7 mmol/mol) had a 23% (HR, 1.23, 95% CI: 1.10‐1.37) higher risk of all‐cause death compared with the quintile 2 (32.2‐<34.3 mmol/mol). Compared with the HbA1c decile 4 (33.3‐<34.3 mmol/mol), those in the lowest HbA1c decile (<30.5 mmol/mol) and highest HbA1c decile (≥41.0 mmol/mol) had 22% (HR, 1.22; 95% CI: 1.01‐1.47) and 28% (HR, 1.28; 95% CI: 1.11‐1.48) higher risk for overall death. However, no significant association was observed between HbA1c levels and the risk of COPD‐specific death.

Conclusions

Our findings indicated that lower and higher HbA1c levels were associated with a higher risk of COPD. In COPD cases, lower and higher HbA1c levels were associated with a higher COPD all‐cause death risk.
Leveraging the resting brain to predict memory decline after temporal lobectomy
Authors: Audrain Sam , Barnett Alexander , Mouseli Pedram , McAndrews Mary Pat
Published: August 2023

Objective

Predicting memory morbidity after temporal lobectomy in patients with temporal lobe epilepsy (TLE) relies on indices of preoperative temporal lobe structural and functional integrity. However, epilepsy is increasingly considered a network disorder, and memory a network phenomenon. We assessed the utility of functional network measures to predict postoperative memory changes.

Methods

Seventy‐two adults with TLE (37 left/35 right) underwent preoperative resting‐state functional magnetic resonance imaging and pre‐ and postoperative neuropsychological assessment. We compared functional connectivity throughout the memory network of each patient to a healthy control template (n = 19) to identify differences in global organization. A second metric indicated the degree of integration of the to‐be‐resected temporal lobe with the rest of the memory network. We included these measures in a linear regression model alongside standard clinical variables as predictors of memory change after surgery.

Results

Left TLE patients with more atypical memory networks, and with greater functional integration of the to‐be‐resected region with the rest of the memory network preoperatively, experienced the greatest decline in verbal memory after surgery. Together, these two measures explained 44% of variance in verbal memory change, outperforming standard clinical and demographic variables. None of the variables examined was associated with visuospatial memory change in patients with right TLE.

Significance

Resting‐state connectivity provides valuable information concerning both the integrity of to‐be‐resected tissue and functional reserve across memory‐relevant regions outside of the to‐be‐resected tissue. Intrinsic functional connectivity has the potential to be useful for clinical decision‐making regarding memory outcomes in left TLE, and more work is needed to identify the factors responsible for differences seen in right TLE.
Overselling corporate social responsibility
Authors: Attig Najah , Hu Wenyao , Rahaman Mohammad M. , Zaman Ashraf Al
Published: August 2023

We show that firms hype up their corporate social responsibility (CSR) narratives during the turn‐of‐the‐year earnings conference calls to project an overly responsible public image of their firms. This previously unexplored phenomenon does not appear to be related to past, current, and future CSR engagements and cannot be explained by observed time‐varying firm attributes and unobserved time‐invariant firm and CEO attributes. We find that the fourth‐quarter CSR narrative hike is more pronounced among firms that are (ex ante) expected to do more corporate good as well as firms embedded in dirty industries, but less prevalent among firms facing elevated product‐market threats. Although elevated CSR narrative is associated with positive short‐term market reaction and lower near‐term stock price crash risk, such behavior tends to reduce financial report readability and leads to lower equity valuation in the longer term. Our analyses suggest that CSR narrative hike at the turn‐of‐the‐year is a pervasive phenomenon in the corporate landscape and may have valuation and governance implications.
Segmentation in higher education in Chile: Massification without equality
Authors: Espinoza Oscar , Corradi Bruno , González Luis , Sandoval Luis , McGinn Noel , Vera Trinidad
Published: August 2023

Fifty years ago, the expansion of access to higher education was expected to result in greater socio‐economic equality. Instead, segmentation in mass higher education systems has called into question the effective democratization of access to higher education. This phenomenon appeared first in higher income countries, allowing the identification of some factors that contribute to segmentation. This article seeks to provide evidence from the Chilean case, evaluating how students' social backgrounds affect admission to different types of universities. Data for the study were taken from the applications of 57,780 students admitted in 2019. Multinomial logistic regression was employed. The results showed that, depending on their background, students of the same level of academic performance follow different paths. Students from families with a high level of income or graduated from private secondary school were more likely to be admitted to private universities. Some of the dynamics present in European countries and the United States are also observed in Chile, particularly those related to the segregation of the school system and private provision and funding at the tertiary level.
Factors associated with registered nurses' academic performance in advanced practice nursing preparatory education: A retrospective cohort study
Authors: Woo Brigitte Fong Yeong , Tam Wilson Wai San , Hartman Kevin , Zhou Wentao
Published: August 2023

Aim

To explore factors associated with academic performance in the Master of Nursing programme.

Background

Advanced practice nursing preparatory education generally involves completion of the Master of Nursing programme. While prior clinical experiences and on‐the‐job training are believed to underpin the preparation for such education, studies have suggested only weak or no associations between nurses’ academic success in graduate schools and their clinical experiences.

Methods

A retrospective cohort study was conducted in the nursing department of a university in Singapore. Academic and demographic data were extracted in February 2020 from a shared repository of anonymised teaching and learning data. R was used to select and merge data tables into a usable format for subsequent analysis. Students enrolled between 2010 and 2017 were included for the analysis (n = 246).

Results

Age was statistically significantly associated with overall cumulative academic performance (p < 0.001). Younger students on average academically outperformed older students. Unmarried students were associated with better cumulative academic performance in the Clinical Practicum 2 module (p = 0.018).

Conclusion

Younger students have historically outperformed their older counterparts in the Master of Nursing programme. There is a need to reassess the requirement of five years of clinical experience as an admission criterion for the Master of Nursing programme in Singapore.

Implications for nursing policy

There is a need to re‐evaluate the admission criteria to better engage and retain younger nurses interested in advanced nursing practice. Nursing educators and leaders can partner with academics to develop advanced practice‐specific education for pre‐master nurses with the aptitude and interest in pursuing this track.
Severe necrotizing soft tissue infections—Is wound microbiology a prognostic factor for clinical outcome?
Authors: Friederichs Jan , Gerl Benedikt , Schneidmüller D. , Hungerer Sven
Published: August 2023

Necrotizing soft tissue infections (NSTIs) represent similar pathophysiological features, but the clinical course might range from subacute to a rapidly progressive, fulminant sepsis. Initial wound microbiology is the base for the Guiliano classification. The timeline of microbiological colonization has not been described during the clinical course. The role of the different microbiological pathogens on the outcome and mortality is unclear. One hundred eighty patients were included with septic inflammation response syndrome on admission. Initial wound microbiology and the changes in wound microbiology were analysed during the clinical course and correlated with outcome and risk indicators. Overall mortality was 35%. Higher age, a high Charlson Comorbidity Index or ASA score and truncal infections were highly prognostic for a lethal outcome. Microbiological findings revealed significant differences in the persistence of bacteria during the course of disease. Streptococci were only detectable within the first 5 days, whereas other bacteria persisted over a longer period of time. Initial microbiological findings correlated with better prognosis when no causative agent was identified and for gram‐negative rods. Varying survival rates were observed for different Streptococci, Staphylococci, Enterococci and other bacteria. The highest odds ratio for a lethal outcome was observed for Enterococci and fungi. Microbiological colonization changes during the clinical course of NSTIs and some microbiologic pathogens are predictive for worsening the outcome and survival. Streptococcus pyogenes is only detectable in the very early phase of NSTI and after 6 days not anymore detectable. Later Enterococci and fungi showed the highest odds ratios for a lethal outcome. Enterococci bacteria and fungi have yet not been considered of clinical relevance in NSTI or even as indicator for worsening the outcome.
Influence of endoscopists' expertise level on clinical outcomes after bridge‐to‐surgery stenting in obstructive colorectal cancer
Authors: Park Suhyun , Lee Jae Yong , Hong Seung Wook , Hwang Sung Wook , Park Sang Hyoung , Yang Dong‐Hoon , Ye Byong Duk , Myung Seung‐Jae , Yang Suk‐Kyun , Byeon Jeong‐Sik
Published: August 2023

Background and Aim

This study aimed to investigate the effect of stenting‐related factors, including endoscopists' expertise, on clinical outcomes after bridge‐to‐surgery (BTS) stenting for obstructive colorectal cancer (CRC).

Methods

We analyzed BTS stenting‐related factors, including stenting expertise and the interval between stenting and surgery, in 233 patients (63 [13] years, 137 male) who underwent BTS stenting for obstructive CRC. We evaluated the influence of these factors on post‐BTS stenting clinical outcomes such as stent‐related complications and cancer recurrence.

Results

The interval between stenting and surgery was ≤ 7 days in 79 patients (33.9%) and > 7 days in 154 patients (66.1%). BTS stenting was performed by endoscopists with ≤ 50, 51–100, and > 100 prior stenting experiences in 94, 43, and, 96 patients, respectively. The clinical success rate of BTS stenting was 93.1%. Stent‐related and postoperative complications developed in 19 (8.2%) and 20 (8.6%) patients, respectively. Cancer recurrence occurred in 76 patients (32.6%). Short BTS interval of ≤ 7 days increased the risk of postoperative complications (odds ratio [OR], 2.61 [1.03–6.75]; P = 0.043). Endoscopists' stenting experience > 100 showed greater clinical success of stenting (OR, 5.50 [1.45–28.39]; P = 0.021) and fewer stent‐related complications (OR, 0.26 [0.07–0.80]; P = 0.028) compared with stenting experience ≤ 50. BTS stenting‐related factors did not affect long‐term oncological outcomes.

Conclusion

Greater expertise of endoscopists was associated with better short‐term outcomes, including high stenting success rate and low rate of stent‐related complications after BTS stenting for obstructive CRC. An interval of > 7 days between BTS stenting and surgery was required to decrease postoperative complications.
Experimental investigation of biostimulatory effects after polydioxanone thread insertion in a pig model
Authors: Su Diya , Wang Shiwei , He Tong , Wang Jieqing
Published: August 2023

Background

Polydioxanone (PDO) threads have been widely used to tighten and lift the facial soft tissue.

Objective

This research aims to determine the collagenation and inflammation changes that occur in the adipose tissue over time when different types of threads are implanted.

Methods & Materials

Three threads types, PDO, poly glycolic‐co‐lactic acid (PGLA), and nylon, were inserted in the subcutaneous fat of 12‐month‐old Bama miniature pigs. Collagen production and inflammatory response were evaluated by hematoxylin and eosin and Masson trichrome staining at 1, 4, 12, 24, and 48 weeks.

Results

The integrity of the PDO thread lasted up to 24 weeks with mild inflammation and collagen production. The PGLA thread integrity lasted until 12 weeks and had a strong inflammatory response. The nylon thread's integrity was maintained for 48 weeks and showed minor inflammation and collagen production.

Conclusion

Our data suggest that PDO thread is the best choice for clinicians, as it has a mild action process with minimal irritation, moderate collagen production, a reasonable explanation time, with obvious bridging fibrous tissue, and thickening action for the superficial fascia.