bluuebunny/crossref_metadata_2025 huggingface dataset:
Duration of Surgery and Intraoperative Blood Pressure Management Are Modifiable Risk Factors for Postoperative Neurocognitive Disorders After Spine Surgery
Authors: Müller Jonas , Nowak Stephan , Weidemeier Martin , Vogelgesang Antje , Ruhnau Johanna , von Sarnowski Bettina , Saar Angelika , Veser Yannick , Behr Frederik , Gross Stefan , Rathmann Eiko , Schmidt Sein , Rehberg Sebastian , Usichenko Taras , Hahnenkamp Klaus , Ehler Johannes , Flöel Agnes , Schroeder Henry W.S. , Müller Jan-Uwe , Fleischmann Robert
Published: May 2023

Study Design.

Prospective quasi-experimental observational study.

Objective.

The objective of this study was to evaluate whether duration of surgery is a modifiable risk factor for postoperative delirium (POD) after spine surgery and explore further modifiable risk factors. In addition, we sought to investigate the association between POD and postoperative cognitive dysfunction and persistent neurocognitive disorders.

Summary of Background Data.

Advances in spine surgery enable technically safe interventions in elderly patients with disabling spine disease. The occurrence of POD and delayed neurocognitive complications (e.g. postoperative cognitive dysfunction/persistent neurocognitive disorder) remain a concern since these contribute to inferior functional outcomes and long-term care dependency after spine surgery.

Materials and Methods.

This prospective single-center study recruited patients aged 60 years or above and scheduled for elective spine surgery between February 2018 and March 2020. Functional (Barthel Index, BI) and cognitive outcomes [Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) test battery; telephone Montréal Cognitive Assessment] were assessed at baseline, three (V3), and 12 months postoperatively. The primary hypothesis was that the duration of surgery predicts POD. Multivariable predictive models of POD included surgical and anesthesiological parameters.

Results.

Twenty-two percent of patients developed POD (n=22/99). In a multivariable model, duration of surgery [ORadj=1.61/h (95% CI, 1.20–2.30)], age [ORadj=1.22/yr (95% CI, 1.10–1.36)], and baseline deviations of intraoperative systolic blood pressure [25th percentile: ORadj=0.94/mm Hg (95% CI, 0.89–0.99); 90th percentile: ORadj=1.07/mm Hg (95% CI, 1.01–1.14)] were significantly associated with POD. Postoperative cognitive scores generally improved (V3, ΔCERAD total z-score: 0.22±0.63). However, this positive group effect was counteracted by POD [beta: −0.87 (95% CI, −1.31 to 0.42)], older age [beta: −0.03/yr (95% CI, −0.05 to 0.01)], and lack of functional improvement [ΔBI; beta: −0.04/point (95% CI, −0.06 to 0.02)]. Cognitive scores at twelve months remained inferior in the POD group, adjusted for baseline cognition/age.

Conclusions.

This study identified distinct neurocognitive effects after spine surgery, which are influenced by perioperative risk factors. Potential cognitive benefits are counteracted by POD, rendering its prevention critical in an aging population.
The Prevalent New-user Design for Studies With no Active Comparator: The Example of Statins and Cancer
Authors: Suissa Samy , Dell’Aniello Sophie , Renoux Christel
Published: May 2023

Background:

Observational studies evaluating the effect of a drug versus “non-use” are challenging, mainly when defining cohort entry for non-users. The approach using successive monthly cohorts to emulate the randomized trial can be perceived as somewhat opaque and complex. Alternatively, the prevalent new-user design can provide a potentially simpler more transparent emulation. This design is illustrated in the context of statins and cancer incidence.

Methods:

We used the Clinical Practice Research Datalink to identify a cohort of subjects with low-density lipoprotein cholesterol level <5 mmol/L. We used a prevalent new-user design, matching each statin initiator to a non-user from the same time-based exposure set on time-conditional propensity scores with all subjects followed for 10 years for cancer incidence. We estimated the hazard ratio and 95% confidence interval (CI) of cancer incidence with statin use versus non-use using a Cox proportional hazards model, and the results were compared with those using the method of successive monthly cohorts.

Results:

The study cohort included 182,073 statin initiators and 182,073 matched non-users. The hazard ratio of any cancer after statin initiation versus non-use was 1.01 (95% CI = 0.98, 1.04), compared with 1.04 (95% CI = 1.02, 1.06) under the successive monthly cohorts approach. We estimated similar effects for specific cancers.

Conclusion:

Using the prevalent new-user design to emulate a randomized trial when compared to “non-use” led to results comparable with the more complex successive monthly cohorts approach. The prevalent new-user design emulates the trial in a potentially more intuitive and palpable manner, providing simpler data presentations in line with those portrayed in a classical trial while producing comparable results.
Differential Employment Quality and Educational Inequities in Mental Health: A Causal Mediation Analysis
Authors: Blaikie Kieran , Eisenberg-Guyot Jerzy , Andrea Sarah B. , Owens Shanise , Minh Anita , Keil Alexander P. , Hajat Anjum
Published: May 2023

Background:

In the United States, inequities in mental distress between those more and less educated have widened over recent years. Employment quality, a multidimensional construct reflecting the relational and contractual features of employer–employee relationships, may mediate this inequity throughout adulthood, yet no study has examined the extent of this mediation in the United States, or how it varies across racialized and gendered populations.

Methods:

Using the information on working-age adults from the 2001 to 2019 Panel Study of Income Dynamics, we construct a composite measure of employment quality via principal component analysis. Using this measure and the parametric mediational g-formula, we then estimate randomized interventional analogs for natural direct and indirect effects of low baseline educational attainment (≤high school: no/yes) on the end-of-follow-up prevalence of moderate mental distress (Kessler-6 Score ≥5: no/yes) overall and within subgroups by race and gender.

Results:

We estimate that low educational attainment would result in a 5.3% greater absolute prevalence of moderate mental distress at the end of follow-up (randomized total effect: 5.3%, 95% CI = 2.2%, 8.4%), with approximately 32% of this effect mediated by differences in employment quality (indirect effect: 1.7%, 95% CI = 1.0%, 2.5%). The results of subgroup analyses across race and gender are consistent with the hypothesis of mediation by employment quality, though not when selecting on full employment (indirect effect: 0.6%, 95% CI = −1.0%, 2.6%).

Conclusions:

We estimate that approximately one-third of US educational inequities in mental distress may be mediated by differences in employment quality.
The Role of Dedicated Research Training in Promoting Academic Success in Plastic Surgery: Analysis of 949 Faculty Career Outcomes
Authors: McGraw J. Reed , Amro Chris , Niu Ellen F. , Honig Stephanie E. , Broach Robyn B. , Fischer John P. , Kovach Stephen J. , Azoury Saïd C.
Published: May 2023

Background:

This study aimed to analyze the association between completion of research training and career success in American plastic surgery faculty to aid trainees in their decisions to perform research fellowships.

Methods:

A cross-sectional analysis of attending academic plastic surgeons in the United States was conducted. Outcomes were compared between faculty who completed research training (research fellowship, PhD, or MPH) and those who did not. Outcomes included promotion to full professor and/or department chair, h-index, and attainment of National Institutes of Health funding. Outcomes were analyzed using chi-squared tests, t tests, and multivariable regressions.

Results:

A total of 949 plastic surgery faculty members were included, and of those, 185 (19.5%) completed dedicated research training, including 13.7% (n = 130) who completed a research fellowship. Surgeons who completed dedicated research training were significantly more likely to achieve full professorship (31.4% versus 24.1%, P = 0.01), obtain National Institutes of Health funding (18.4% versus 6.5%, P < 0.001), and have a higher mean h-index (15.6 versus 11.6, P < 0.001). Dedicated research fellowships were independently predictive of achieving full professorship (OR = 2.12, P = 0.002), increased h-index (β = 4.86, P < 0.001), and attainment of National Institutes of Health funding (OR = 5.06, P = 0.01). Completion of dedicated research training did not predict an increased likelihood of becoming department chair.

Conclusion:

The performance of dedicated research training was predictive of improved markers of career success in plastic surgery and should be considered beneficial in both the short and long term.
Use of autologous adipose-derived mesenchymal stem cells for ovarian rejuvenation in poor responder IVF patients: a phase 1 randomized placebo-controlled double-blind crossover study
Authors: Cassim Mohamed Iqbal , Mohamed Tasneem , Adam Jamila Kathoon , Niesler Carola , Chikandiwa Admire
Published: May 2023

Background:

Despite the application of various methods to augment ovarian responsiveness, the management of poor ovarian responders remains challenging and pregnancy rates following in vitro fertilization are poor. Advances in adult stem cell research and their clinical application has prompted interest in their use in assisted reproduction. We report the first double-blind, randomized, placebo-controlled clinical study using autologous human stromal vascular fraction (SVF) containing adipose-derived stem cells (ADSCs) for ovarian rejuvenation.

Materials and methods:

Thirty patients were recruited. Twenty-one had lower-than-expected reserves for their age and 9 had premature ovarian insufficiency. Patients were randomized into a placebo group (10) and an intervention group (20). SVF was obtained from adipose tissue following abdominal liposuction; the ADSC component was characterized using flow cytometry. Three equal insertions, adjusted based on ovarian volume, were performed at monthly intervals via an ultrasound-guided transvaginal needle puncture. The SVF was not cultured before transplantation. Those in the placebo group were then crossed over to the intervention group and received a single SVF (maximally concentrated) insertion (crossover group).

Results:

The median viable SVF cell number inserted per patient over 3 months, and the percentage of mesenchymal stem cells (MSC) thereof, was 1.6×106 and 13.2%, respectively. Resulting anti-Mullerian hormone (AMH) changes were variable over the treatment course with a notable placebo effect. Patients with premature ovarian insufficiency showed no change in AMH, both to intervention and placebo. Despite this, a temporary return of menses was noted in a third of patients while on treatment. Patients with low reserves for age showed an increase in AMH, although not statistically significant when compared to placebo. In the crossover group, insertions were limited to one intervention comprising all cells; here a significantly higher median of 3.4×106 SVF cells were injected containing an average of 16.9% MSCs. No significant change in AMH was noted. To date 12 patients have undergone ovarian stimulation and in vitro fertilization after stem cell therapy; of these 9 have had embryo transfers with a resulting pregnancy rate of 33%. There were also 2 spontaneous pregnancies.

Conclusion:

Although the application of SVF-derived ADSCs for ovarian rejuvenation remains experimental, the current study provides further support for the safety of this approach and presents encouraging results as to its efficacy in assisted reproduction.
Onychomycosis
Authors: Weber Isaac , Martin Kari L.
Published: May 2023

Onychomycosis is a commonly encountered fungal infection of the nail that is increasing in prevalence worldwide. Diagnosis and treatment of onychomycosis is essential for any dermatologic practice, and the options available for both are numerous. The subtypes of this infection can help guide diagnostic techniques and determine the route and type of treatment that should be pursued. This article reviews the pathogenic organisms, epidemiology, clinical presentation and subtypes, and diagnostic and current treatment options available to treat this condition.
Long-Term Outcomes of Antegrade Continence Enemas to Treat Constipation and Fecal Incontinence in Children
Authors: Baaleman Desiree F. , Vriesman Mana H. , Lu Peter L. , Benninga Marc A. , Levitt Marc A. , Wood Richard J. , Yacob Desale , Di Lorenzo Carlo , Koppen Ilan J.N.
Published: May 2023

Objectives:

The objective of this study is to investigate long-term outcomes of antegrade continence enema (ACE) treatment in children with constipation or fecal incontinence.

Methods:

Prospective cohort study including pediatric patients with organic or functional defecation disorders who started ACE treatment. Data were collected at baseline and at follow-up (FU) from 6 weeks until 60 months. We assessed parent and patient-reported gastrointestinal health-related quality of life (HRQoL) using the Pediatric Quality of Life Inventory Gastrointestinal Symptoms Module (PedsQL-GI), gastrointestinal symptoms, adverse events, and patient satisfaction.

Results:

Thirty-eight children were included (61% male, median age 7.7 years, interquartile range 5.5–12.2). Twenty-two children (58%) were diagnosed with functional constipation (FC), 10 (26%) with an anorectal malformation, and 6 (16%) with Hirschsprung disease. FU questionnaires were completed by 22 children (58%) at 6 months, 16 children (42%) at 12 months, 20 children (53%) at 24 months, and 10 children (26%) at 36 months. PedsQL-GI scores improved overall with a significant increase at 12- and 24-month FU for children with FC and a significant increase in parent reported PedsQL-GI score at 36-month FU for children with organic causes. Minor adverse events, such as granulation tissue, were reported in one-third of children, and 10% of children needed a surgical revision of their ACE. The majority of all parents and children reported that they would “probably” or “definitely” choose ACE again.

Conclusion:

ACE treatment is perceived positively by patients and parents and can lead to long-term improvement in gastrointestinal HRQoL in children with organic or functional defecation disorders.
Communication Strategies to Improve Antibiotic Prescribing in Pediatric Urgent Care Centers
Authors: Nedved Amanda , Bizune Destani , Fung Melody , Liu Cindy M. , Tsay Sharon , Hamdy Rana F. , Montalbano Amanda
Published: May 2023

Objective

Urgent care (UC) clinicians frequently prescribe inappropriate antibiotics for upper respiratory illnesses. In a national survey, pediatric UC clinicians reported family expectations as a primary driver for prescribing inappropriate antibiotics. Communication strategies effectively reduce unnecessary antibiotics while increasing family satisfaction. We aimed to reduce inappropriate prescribing practices in otitis media with effusion (OME), acute otitis media (AOM), and pharyngitis in pediatric UC clinics by a relative 20% within 6 months using evidence-based communication strategies.

Methods

We recruited participants via e-mails, newsletters, and Webinars from pediatric and UC national societies. We defined antibiotic-prescribing appropriateness based on consensus guidelines. Family advisors and UC pediatricians developed script templates based on an evidence-based strategy. Participants submitted data electronically. We reported data using line graphs and shared deidentified data during monthly Webinars. We used χ2 tests to evaluate change in appropriateness at the beginning and end of the study period.

Results

The 104 participants from 14 institutions submitted 1183 encounters for analysis in the intervention cycles. Using a strict definition of inappropriateness, overall inappropriate antibiotic prescriptions for all diagnoses trended downward from 26.4% to 16.6% (P = 0.13). Inappropriate prescriptions trended upward in OME from 30.8% to 46.7% (P = 0.34) with clinicians' increased use of “watch and wait” for this diagnosis. Inappropriate prescribing for AOM and pharyngitis improved from 38.6% to 26.5% (P = 0.03) and 14.5% to 8.8% (P = 0.44), respectively.

Conclusions

Using templates to standardize communication with caregivers, a national collaborative decreased inappropriate antibiotic prescriptions for AOM and had downward trend in inappropriate antibiotic prescriptions for pharyngitis. Clinicians increased the inappropriate use of “watch and wait” antibiotics for OME. Future studies should evaluate barriers to the appropriate use of delayed antibiotic prescriptions.
Novel Therapies in Myelodysplastic Syndrome
Authors: Abaza Yasmin , Patel Anand Ashwin
Published: May 2023

Myelodysplastic syndromes (MDSs) are a heterogeneous group of clonal hematopoietic stem cell disorders with treatment approaches tailored to the presence of cytopenias, disease risk, and molecular mutation profile. In higher-risk MDSs, the standard of care are DNA methyltransferase inhibitors, otherwise referred to as hypomethylating agents (HMAs), with consideration for allogeneic hematopoietic stem cell transplantation in appropriate candidates. Given modest complete remission rates (15%–20%) with HMA monotherapy and median overall survival of approximately 18 months, there is much interest in the investigation of combination and targeted treatment approaches. Furthermore, there is no standard treatment approach in patients with progression of disease after HMA therapy. In this review, we aim to summarize the current evidence for the B-cell lymphoma-2 inhibitor, venetoclax, and a variety of isocitrate dehydrogenase inhibitors in the treatment of MDSs along with discussing their potential role in the treatment paradigm of this disease.
Novel Approaches and Future Directions in Myelodysplastic Syndrome Treatment
Authors: Bewersdorf Jan Philipp , Xie Zhuoer , Zeidan Amer M.
Published: May 2023

Myelodysplastic syndromes/neoplasms (MDSs) constitute a heterogeneous group of clonal disorders that are clinically characterized by dysplastic changes in multiple hematopoietic lineages, cytopenias, and a variable risk of progression to acute myeloid leukemia. Patients with MDS are classified as either lower- or higher-risk based on risk stratification tools such as the International Prognostic Scoring System and its revised version, which continue to be the basis for prognosis and treatment selection. Although anemic patients with lower-risk MDS are currently treated with an erythropoiesis-stimulating agent, luspatercept, and transfusions, the telomerase inhibitor imetelstat and the hypoxia-inducible factor α inhibitor roxadustat have shown encouraging early results and are now in phase III clinical trials. For higher-risk MDS patients, hypomethylating agent monotherapy continues to be the standard of care. However, with various novel hypomethylating agent–based combination therapies in advanced clinical testing and an increased emphasis on individualized biomarker-driven treatment decisions, the standard therapy paradigms might change in the future.
Overview of the Management of Higher-Risk Myelodysplastic Syndromes
Authors: Singh Abhay , Carraway Hetty E.
Published: May 2023

Myelodysplastic syndromes or myelodysplastic neoplasms (both abbreviated MDSs) (Leukemia 2022;36:1703–1719) have historically been challenging diseases to treat owing to their complex biology, molecular diversity, and a patient population that is elderly with comorbidities. As the patients are living longer, incidence of MDSs is rising, and challenges in selecting MDS treatments or lack thereof have been becoming more apparent. Fortunately, with better understanding of molecular underpinnings of this heterogeneous syndrome, numerous clinical trials reflecting the biology of disease and catering to the advanced age of MDS patients are in development to maximize the likelihood of identifying active drugs. Addressing this diverse nature of genetic abnormalities, novel agents, and combinations are in development to formulate personalized treatment approaches for MDS patients. Myelodysplastic syndrome is categorized into subtypes that are associated with lower or higher risk for leukemic evolution, and that knowledge helps with therapy selection. Currently, as it stands, for those with higher-risk MDSs, hypomethylating agents are the first-line therapy. Allogenic stem cell transplantation represents the only potential cure for our patients with MDSs and should be considered for all eligible patients with higher-risk MDSs at the time of diagnosis. This review discusses current MDS treatment landscape, as well as new approaches in development.
Epidemiology and Pathogenesis of Myelodysplastic Syndrome
Authors: Rotter Lara K. , Shimony Shai , Ling Kelly , Chen Evan , Shallis Rory M. , Zeidan Amer M. , Stahl Maximilian
Published: May 2023

Myelodysplastic syndrome (MDS) is a clonal disorder characterized by ineffective hematopoiesis and variable cytopenias with a considerable risk of progression to acute myeloid leukemia. Epidemiological assessment of MDS remains challenging because of evolving classification systems, but the overall incidence in the United States is estimated to be approximately 4 per 100,000 and increases with age. The sequential accumulation of mutations drives disease evolution from asymptomatic clonal hematopoiesis (CH) to CH of indeterminate potential, clonal cytopenia of unknown significance, to frank MDS. The molecular heterogeneity seen in MDS is highly complex and includes mutations of genes involved in splicing machinery, epigenetic regulation, differentiation, and cell signaling. Recent advances in the understanding of the molecular landscape of MDS have led to the development of improved risk assessment tools and novel therapies. Therapies targeting the underlying pathophysiology will hopefully further expand the armamentarium of MDS therapeutics, bringing us closer to a more individualized therapeutic approach based on the unique molecular profile of each patient and eventually improving the outcomes of patients with MDS. We review the epidemiology of MDS and the newly described MDS precursor conditions CH, CH of indeterminate potential, and CCUS. We then discuss central aspects of MDS pathophysiology and outline specific strategies targeting hallmarks of MDS pathophysiology, including ongoing clinical trials examining the efficacy of these therapeutic modalities.
Long-Term Patient-Reported Symptom Improvement and Quality of Life after Transthoracic Diaphragm Plication in Adults
Authors: Hunt Amanda R , Stuart Christina M , Gergen Anna K , Bang Tami J , Reihman Anne E , Helmkamp Laura J , Lin Yihan , Mitchell John D , Meguid Robert A , Scott Christopher D , Wojcik Brandon M
Published: May 2023

BACKGROUND:

Open and robotic-assisted transthoracic approaches for diaphragm plication are accepted surgical interventions for diaphragm paralysis and eventration. However, long-term patient-reported symptom improvement and quality of life (QOL) remains unclear.

STUDY DESIGN:

A telephone-based survey was developed focusing on postoperative symptom improvement and QOL. Patients who underwent open or robotic-assisted transthoracic diaphragm plication (2008-2020) across three institutions were invited to participate. Patients who responded and provided consent were surveyed. Likert responses on symptom severity were dichotomized and rates before and after surgery were compared using McNemar’s test.

RESULTS:

Forty-one percent of patients participated (43 of 105 responded, mean age 61.0 years, 67.4% male, 37.2% robotic-assisted surgery), with an average time between surgery and survey of 4.1 ± 3.2 years. Patients reported significant improvement in dyspnea while lying flat (67.4% pre- vs 27.9% postoperative, p < 0.001), dyspnea at rest (55.8% pre- vs 11.6% postoperative, p < 0.001), dyspnea with activity (90.7% pre- vs 55.8% postoperative, p < 0.001), dyspnea while bending over (79.1% pre- vs 34.9% postoperative, p < 0.001), and fatigue (67.4% pre- vs 41.9% postoperative, p = 0.008). There was no statistical improvement in chronic cough. 86% of patients reported improved overall QOL, 79% had increased exercise capacity, and 86% would recommend surgery to a friend with a similar problem. Analysis comparing open and robotic-assisted approaches found no statistically significant differences in symptom improvement or QOL responses between the groups.

CONCLUSIONS:

Patients report significantly improved dyspneic and fatigue symptoms after transthoracic diaphragm plication, regardless of open or robotic-assisted approach. The majority of patients report improved QOL and exercise capacity.
Agitated ants: regulation and self-organization of incipient nest excavation via collisional cues
Authors: Avinery Ram , Aina Kehinde O. , Dyson Carl J. , Kuan Hui-Shun , Betterton Meredith D. , Goodisman Michael A. D. , Goldman Daniel I.
Published: May 2023

Ants are millimetres in scale yet collectively create metre-scale nests in diverse substrates. To discover principles by which ant collectives self-organize to excavate crowded, narrow tunnels, we studied incipient excavation in small groups of fire ants in quasi-two-dimensional arenas. Excavation rates displayed three stages: initially excavation occurred at a constant rate, followed by a rapid decay, and finally a slower decay scaling in time as
t
−1/2
. We used a cellular automata model to understand such scaling and motivate how rate modulation emerges without global control. In the model, ants estimated their collision frequency with other ants, but otherwise did not communicate. To capture early excavation rates, we introduced the concept of ‘agitation’—a tendency of individuals to avoid rest if collisions are frequent. The model reproduced the observed multi-stage excavation dynamics; analysis revealed how parameters affected features of multi-stage progression. Moreover, a scaling argument without ant–ant interactions captures tunnel growth power-law at long times. Our study demonstrates how individual ants may use local collisional cues to achieve functional global self-organization. Such contact-based decisions could be leveraged by other living and non-living collectives to perform tasks in confined and crowded environments.
Towards a leptospirosis early warning system in northeastern Argentina
Authors: Lotto Batista Martín , Rees Eleanor M. , Gómez Andrea , López Soledad , Castell Stefanie , Kucharski Adam J. , Ghozzi Stéphane , Müller Gabriela V. , Lowe Rachel
Published: May 2023

Leptospirosis is a zoonotic disease with a high burden in Latin America, including northeastern Argentina, where flooding events linked to El Niño are associated with leptospirosis outbreaks. The aim of this study was to evaluate the value of using hydrometeorological indicators to predict leptospirosis outbreaks in this region. We quantified the effects of El Niño, precipitation, and river height on leptospirosis risk in Santa Fe and Entre Ríos provinces between 2009 and 2020, using a Bayesian modelling framework. Based on several goodness of fit statistics, we selected candidate models using a long-lead El Niño 3.4 index and shorter lead local climate variables. We then tested predictive performance to detect leptospirosis outbreaks using a two-stage early warning approach. Three-month lagged Niño 3.4 index and one-month lagged precipitation and river height were positively associated with an increase in leptospirosis cases in both provinces. El Niño models correctly detected 89% of outbreaks, while short-lead local models gave similar detection rates with a lower number of false positives. Our results show that climatic events are strong drivers of leptospirosis incidence in northeastern Argentina. Therefore, a leptospirosis outbreak prediction tool driven by hydrometeorological indicators could form part of an early warning and response system in the region.
A synthetic delivery vector for mucosal vaccination
Authors: Billet Anne , Hadjerci Justine , Tran Thi , Kessler Pascal , Ulmer Jonathan , Mourier Gilles , Ghazarian Marine , Gonzalez Anthony , Thai Robert , Urquia Pauline , Van Baelen Anne-Cécile , Meola Annalisa , Fernandez Ignacio , Deville-Foillard Stéphanie , MacDonald Ewan , Paolini Léa , Schmidt Frédéric , Rey Félix A. , Kay Michael S. , Tartour Eric , Servent Denis , Johannes Ludger
Published: May 2023

The success of mRNA-based vaccines during the Covid-19 pandemic has highlighted the value of this new platform for vaccine development against infectious disease. However, the CD8+T cell response remains modest with mRNA vaccines, and these do not induce mucosal immunity, which would be needed to prevent viral spread in the healthy population. To address this drawback, we developed a dendritic cell targeting mucosal vaccination vector, the homopentameric STxB. Here, we describe the highly efficient chemical synthesis of the protein, and itsin vitrofolding. This straightforward preparation led to a synthetic delivery tool whose biophysical and intracellular trafficking characteristics were largely indistinguishable from recombinant STxB. The chemical approach allowed for the generation of new variants with bioorthogonal handles. Selected variants were chemically coupled to several types of antigens derived from the mucosal viruses SARS-CoV-2 and type 16 human papillomavirus. Upon intranasal administration in mice, mucosal immunity, including resident memory CD8+T cells and IgA antibodies was induced against these antigens. Our study thereby identifies a novel synthetic antigen delivery tool for mucosal vaccination with an unmatched potential to respond to an urgent medical need.
Factors associated with bacterial sexually transmitted infections amongst people of South Asian ethnicity in England
Authors: Dhairyawan R , Shah A , Bailey JV , Mohammed H
Published: May 2023

Objectives

Despite being the largest ethnic minority group in England, South Asians have historically had low levels of utilisation of sexual health services and sexually transmitted infection (STI) diagnoses, though recent data suggests this may be changing. This study aimed to investigate factors associated with a bacterial STI diagnosis amongst South Asians attending SHS in England.

Methods

Using data from the GUMCAD STI Surveillance system, a descriptive analysis of South Asians attending sexual health services in England in 2019 was carried out. Factors associated with a bacterial STI diagnosis were examined using univariate and multivariable logistic regression models adjusted for age, Asian ethnic subgroup, HIV status, patient region of residence and Index of Multiple Deprivation quintile. Analyses were stratified by gender and sexual orientation (heterosexual male vs. gay, bisexual, and other men who have sex with men [GBMSM] vs. women of any sexual orientation). Crude and adjusted associations were derived using binary logistic regression.

Results

There were 121,842 attendances by South Asians to SHS in England in 2019. Compared to heterosexual South Asian men, GBMSM had a higher odds of being diagnosed with a bacterial STI (aOR 2.32, 95% CI 2.19-2.44) and South Asian women had a lower odds (aOR 0.83, 95% CI 0.78-0.87). For women and heterosexual South Asian men, a diagnosis was associated with younger age, being of any other Asian background other than Bangladeshi, Indian or Pakistani and not being HIV positive. For heterosexual South Asian men, there was an association with increasing socioeconomic deprivation. For GBMSM, a bacterial STI diagnosis was associated with known HIV positive status and living in London.

Conclusions

People of South Asian ethnicity in England are heterogenous with regards to their sexual health needs, which should be explored further through focused research and policy.

Key Messages

What is already known on this topic: Historically South Asians in England have had low rates of sexually transmitted infections and sexual health service utilisation. Despite South Asians being the largest ethnic minority group in England, there has been a paucity of research investigating their sexual health needs.

What this study adds: To our knowledge, this is the first national epidemiological study focusing on people of South Asian ethnicity accessing sexual health services in England, finding variation in factors associated with bacterial STI diagnosis, particularly when stratified by gender and sexual orientation.

How this study might affect research, practice or policy: Our results reflect the heterogeneity of South Asian communities in England with regards to sexual health need, and we suggest that policy makers and researchers should prioritise this under-served group to improve their sexual health outcomes.
Leveraging family data to design Mendelian randomization that is provably robust to population stratification
Authors: LaPierre Nathan , Fu Boyang , Turnbull Steven , Eskin Eleazar , Sankararaman Sriram
Published: May 2023

Mendelian randomization (MR) has emerged as a powerful approach to leverage genetic instruments to infer causality between pairs of traits in observational studies. However, the results of such studies are susceptible to biases owing to weak instruments, as well as the confounding effects of population stratification and horizontal pleiotropy. Here, we show that family data can be leveraged to design MR tests that are provably robust to confounding from population stratification, assortative mating, and dynastic effects. We show in simulations that our approach, MR-Twin, is robust to confounding from population stratification and is not affected by weak instrument bias, whereas standard MR methods yield inflated false positive rates. We then conduct an exploratory analysis of MR-Twin and other MR methods applied to 121 trait pairs in the UK Biobank data set. Our results suggest that confounding from population stratification can lead to false positives for existing MR methods, whereas MR-Twin is immune to this type of confounding, and that MR-Twin can help assess whether traditional approaches may be inflated owing to confounding from population stratification.
On automatic determination of quasicrystal orientations by indexing of detected reflections
Authors: Morawiec Adam
Published: May 2023

Automatic crystal orientation determination and orientation mapping are important tools for research on polycrystalline materials. The most common methods of automatic orientation determination rely on detecting and indexing individual diffraction reflections, but these methods have not been used for orientation mapping of quasicrystalline materials. The paper describes the necessary changes to existing software designed for orientation determination of periodic crystals so that it can be applied to quasicrystals. The changes are implemented in one such program. The functioning of the modified program is illustrated by an example orientation map of an icosahedral polycrystal.
A literature review on the impact of the COVID-19 pandemic on consumer behaviour: implications for consumer-centric logistics
Authors: Cai Lanhui , Yuen Kum Fai , Fang Mingjie , Wang Xueqin
Published: May 2023

Purpose

The COVID-19 pandemic has resulted in significant changes in consumer behaviour, which has had a cascading effect on consumer-centric logistics. As a result, this study conducts a focused literature review of pandemic-related consumer behaviour research to address two research questions: 1) what are the pandemic's direct effects on consumer consumption behaviour, with an emphasis on changes in their basic and psychological needs? and 2) what are the consequences of behavioural changes on consumer-centric logistics?

Design/methodology/approach

The scientific procedure and rationales for systematic literature review (SPAR-4-SLR) protocol and the theory, context, characteristics and methodology (TCCM) framework were adopted as a guideline to map, refine, evaluate and synthesise the literature. A total of 53 research articles were identified for further analysis.

Findings

Using Maslow's hierarchy of human needs as a theoretical guide, this review synthesises the COVID-19 pandemic's effects on consumer behaviour into four categories: abnormal buying behaviour, changes in consumer preferences, digitalisation of shopping behaviour and technology-related behaviour. Furthermore, four consumer-centric logistics propositions are proposed based on the four aspects of consumer behavioural changes.

Originality/value

This study outlines the significant behavioural changes in consumers in the face of the COVID-19 pandemic and how these changes impact consumer-centric logistics, with implications for managing consumers' involvement in logistics and pointing out future research directions.
Risk assessment of infrastructure REITs projects based on cloud model: a case study of China
Authors: Wang Yousong , Gong Enqin , Zhang Yangbing , Yao Yao , Zhou Xiaowei
Published: May 2023

Purpose

The need for infrastructure is growing as urbanization picks up speed, and the infrastructure REITs financing model has been crucial in reviving the vast infrastructure stock, alleviating the pressure on government funds and diversifying investment entities. This study aims to propose a framework to better assess the risks of infrastructure REITs, which can serve for the researchers and the policy makers to propose risk mitigation strategies and policy recommendations more purposively to facilitate successful implementation and long-term development of infrastructure REITs.

Design/methodology/approach

The infrastructure REITs risk evaluation index system is established through literature review and factor analysis, and the optimal comprehensive weight of the index is calculated using the combination weight. Then, a risk evaluation cloud model of infrastructure REITs is constructed, and experts quantify the qualitative language of infrastructure REITs risks. This paper verifies the feasibility and effectiveness of the model by taking a basic REITs project in China as an example. This paper takes infrastructure REITs project in China as an example, to verify the feasibility and effectiveness of the cloud evaluation method.

Findings

The research outcome shows that infrastructure REITs risks manifest in the risk of policy and legal, underlying asset, market, operational and credit. The main influencing factors in terms of their weights are tax policy risk, operation and management risk, liquidity risk, termination risk and default risk. The financing project is at a higher risk, and the probability of risk is 64.2%.

Originality/value

This research contributes to the existing body of knowledge by supplementing a set of scientific and practical risk evaluation methods to assess the potential risks of infrastructure REITs project, which contributes the infrastructure financing risk management system. Identify key risk factors for infrastructure REITs with underlying assets, which contributes to infrastructure REITs project management. This research can help relevant stakeholders to control risks throughout the infrastructure investment and financing life cycle, provide them with reference for investment and financing decision-making and promote more sustainable and healthy development of infrastructure REITs in developing countries.
New perspective of learning objects in e-learning system
Authors: Amane Meryem , Aissaoui Karima , Berrada Mohammed
Published: May 2023

Purpose

Together, learning objects (LOs) and e-pedagogical practices have the potential to improve the performance of e-learning systems in several ways. They can make e-learning more personalised and adaptable, providing students with a more engaging and effective learning experience.

Design/methodology/approach

The development of LOs and e-pedagogical practices have significantly influenced and changed the performance of e-learning systems. LOs are self-contained, reusable units of instructional content that create instructional materials, such as online courses, tutorials and assessments. They provide a flexible and modular approach to designing and delivering e-learning content, allowing educators to easily customise and adapt their materials to the needs of their students. e-pedagogical practices refer to the use of technology to enhance and support the teaching and learning process. They include strategies such as online collaboration, gamification and adaptive learning to improve student engagement, motivation and achievement.

Findings

To achieve this objective, this study consists of two main phases. First, the authors extract metadata from LOs using latent semantic analysis algorithms, which are considered a strong tool in web-mining exploration techniques. Second, they identify LOs according to a particular form of similarity using fuzzy c-means (FCM) algorithms. To improve classification accuracy, the FCM is used as a clustering algorithm.

Originality/value

Finally, in order to assess the effectiveness of LOs with FCM, a series of experimental studies using a real-world dataset are conducted. The results of this study indicate that the proposed approach exceeds the traditional approach and produces good results.
Inclusive leadership and work-from-home engagement during the COVID-19 pandemic: a moderated mediation model
Authors: Nguyen Thi Vinh Tran , Tsang Seng-Su
Published: May 2023

Purpose

The current study proposes a moderated mediation model to predict work-from-home engagement during an emergency such as the coronavirus disease 2019 (COVID-19) pandemic based on the integration of well-known concepts, including inclusive leadership, organizational support and perceived risk theory.

Design/methodology/approach

An online questionnaire on the Google Forms platform was designed and distributed to Vietnamese employees using a convenience sampling method. A total of 794 valid questionnaires were used for data analysis. Partial least squares structural equation modeling (PLS-SEM) was employed to test the proposed model and hypotheses. The instrument's validity and reliability were tested and ensured.

Findings

The study found that inclusive leadership has direct and indirect effects on work-from-home engagement through the separate and serial mediating roles of perceived organizational support and employee motivation. The present study also revealed that the effects of perceived organizational support and employee motivation on work-from-home engagement are strengthened by employee risk perception. Moreover, the study showed that perceived organizational support and employee motivation performed the lowest of the four elements that were considered, while the importance of these two factors was the highest.

Practical implications

These findings suggest that in an emergency such as COVID-19, contextual factors should be given more attention. Based on these findings, several theoretical and practical implications for human resource management are highlighted.

Originality/value

By integrating inclusive leadership, organizational support and perceived risk theory to explore employees' engagement in working from home during an emergency, the present study demonstrated that in addition to traditional factors, leadership and contextual factors should be considered for studies on working from home in an emergency such as the COVID-19 pandemic. The present study established that these factors might encourage employees' work-from-home engagement.
Machine learning and artificial intelligence-induced technostress in organizations: a study on automation-augmentation paradox with socio-technical systems as coping mechanisms
Authors: Kumar Amit , Krishnamoorthy Bala , Bhattacharyya Som Sekhar
Published: May 2023

Purpose

This research study aims to inquire into the technostress phenomenon at an organizational level from machine learning (ML) and artificial intelligence (AI) deployment. The authors investigated the role of ML and AI automation-augmentation paradox and the socio-technical systems as coping mechanisms for technostress management amongst managers.

Design/methodology/approach

The authors applied an exploratory qualitative method and conducted in-depth interviews based on a semi-structured interview questionnaire. Data were collected from 26 subject matter experts. The data transcripts were analyzed using thematic content analysis.

Findings

The study results indicated that role ambiguity, job insecurity and the technology environment contributed to technostress because of ML and AI technologies deployment. Complexity, uncertainty, reliability and usefulness were primary technology environment-related stress. The novel integration of ML and AI automation-augmentation interdependence, along with socio-technical systems, could be effectively used for technostress management at the organizational level.

Research limitations/implications

This research study contributed to theoretical discourse regarding the technostress in organizations because of increased ML and AI technologies deployment. This study identified the main techno stressors and contributed critical and novel insights regarding the theorization of coping mechanisms for technostress management in organizations from ML and AI deployment.

Practical implications

The phenomenon of technostress because of ML and AI technologies could have restricting effects on organizational performance. Executives could follow the simultaneous deployment of ML and AI technologies-based automation-augmentation strategy along with socio-technical measures to cope with technostress. Managers could support the technical up-skilling of employees, the realization of ML and AI value, the implementation of technology-driven change management and strategic planning of ML and AI technologies deployment.

Originality/value

This research study was among the first few studies providing critical insights regarding the technostress at the organizational level because of ML and AI deployment. This research study integrated the novel theoretical paradigm of ML and AI automation-augmentation paradox and the socio-technical systems as coping mechanisms for technostress management.