bluuebunny/crossref_metadata_2025 huggingface dataset:
After-sales services, brand equity and purchasing intention to buy second-hand product
Authors: Habib Muhammad Danish , Sarwar Muhammad Arslan
Published: March 2021

Purpose

This study aims to examine the concept of brand equity and willingness to buy second-hand products in the automobile context. The customer-based brand equity model is used as a theoretical lens to examine after-sales services, brand credibility and brand loyalty as drivers of brand equity and willingness to buy the second-hand product.

Design/methodology/approach

A survey questionnaire based on convenience sampling is used to collect the data from the car owners. A total of 433 survey responses were used to empirically test the measures and propositions by using structural equation modeling (SEM).

Findings

The findings suggest that after-sales services are a key factor in developing brand credibility and brand loyalty. Results are also in support of the positive and significant impact of brand credibility and brand loyalty on brand equity and willingness to buy second-hand products.

Originality/value

Brand equity represents a differential response and preference to marketing efforts that a product obtains as a result of its brand identification. Although practitioners are actively engaged to position themselves as a unique, attractive and strong brand, little is known about the equity of the brand in the case of second-hand products. This study provides an alternate branding view to the academic scholars and to the marketing manager as this study explicitly probes into the effect of after-sales services in developing brand credibility, brand loyalty, brand equity and wiliness to buy second-hand product as an outcome.
The impact of using proportional representation system on the fragmentation of the party system in Algeria. Applied to the elections of the National People’s Assembly (1997–2017)
Authors: Mahgoub Ali Mahmoud
Published: March 2021

Purpose

The purpose of this study is to examine the impact of using proportional representation system on the fragmentation of the party system in the Algerian political system within the period from 1997 to 2017, in which Algeria has experienced five legislative elections regularly every five years by testing a hypothesis about adopting the proportional representation system on the basis of the closed list during the foregoing legislative elections has obviously influenced the exacerbation of the Algerian party system’s fragmentation, compared to other factors.

Design/methodology/approach

The essence of the theoretical framework of this study is to address the effect of the electoral system as an independent variable on the party system as a dependent variable. The starting point for that framework is to reassess the “Duverger’s law,” which appeared since the early 1950s and has influenced the foregoing relationship, and then to review the literature on a new phase that tried to provide a more accurate mechanism for determining the number of parties and their relative weight, whether in terms of electoral votes or parliamentary seats. This means that researchers began to use a measure called the effective number of parties (ENP) for Laakso and Taagepera since 1979. The study elaborates the general concepts of the electoral system and the party system. It used Laakso, Taagepera index of the “ENP” to measure the phenomenon of fragmentation party during the five legislative elections from 1997 to 2017 in Algeria.

Findings

The results of the study reveal that the proportional representation electoral system – beside other factors – had clear impacts on the fragmentation of the Algerian party system by all standards, whether on the level of the apparent rise in the number of the parties represented in the Algerian parliament from 10 parties in 1997 election to 36 parties in 2017 election or according to the index of Laakso and Taagepera (ENP). The average number of effective number of electoral parties in the five elections was around 7.66, and the average number of effective number of parliamentary parties in the five elections was around 4.39, which puts Algeria in an advanced degree of the fragmentation of the party system.

Originality/value

This study about the phenomenon of the fragmentation of the party system, which is one of the new subjects in the field of comparative politics – globally and in the Arab world. Hence, the value of this study aims to shed light on this mysterious area of science, the fragmentation of the party system in the Algerian political system during the period from 1997 to 2017.
Energy pathways modulate the resilience of stream invertebrate communities to drought
Authors: Nelson Daniel , Busch Michelle H. , Kopp Darin A. , Allen Daniel C.
Published: March 2021

While climate change is altering ecosystems on a global scale, not all ecosystems are responding in the same way. The resilience of ecological communities may depend on whether food webs are producer‐ or detritus‐based (i.e. ‘green’ or ‘brown’ food webs, respectively), or both (i.e. ‘multi‐channel’ food web).

Food web theory suggests that the presence of multiple energy pathways can enhance community stability and resilience and may modulate the responses of ecological communities to disturbances such as climate change. Despite important advances in food web theory, few studies have empirically investigated the resilience of ecological communities to climate change stressors in ecosystems with different primary energy channels.

We conducted a factorial experiment using outdoor stream mesocosms to investigate the independent and interactive effects of warming and drought on invertebrate communities in food webs with different energy channel configurations. Warming had little effect on invertebrates, but stream drying negatively impacted total invertebrate abundance, biomass, richness and diversity.

Although resistance to drying did not differ among energy channel treatments, recovery and overall resilience were higher in green mesocosms than in mixed and brown mesocosms. Resilience to drying also varied widely among taxa, with larger predatory taxa exhibiting lower resilience.

Our results suggest that the effects of drought on stream communities may vary regionally and depend on whether food webs are fuelled by autochthonous or allochthonous basal resources. Communities inhabiting streams with large amounts of organic matter and more complex substrates that provide refugia may be more resilient to the loss of surface water than communities inhabiting streams with simpler, more homogeneous substrates.
Contrast‐enhanced ultrasound assessed renal microvascular perfusion may predict postoperative renal complications following colorectal surgery
Authors: Read David J. , Doleman Brett , Heinink Tom , Selby Nicholas M. , Lund Jonathan N. , Phillips Bethan E. , Williams John P.
Published: March 2021

Colorectal surgery is associated with an above‐average mortality rate of approximately 15%. During surgery, maintenance of vital organ perfusion is essential in order to reduce postoperative mortality and morbidity, with renal perfusion of particular importance. Oesophageal Doppler monitors (ODM) are commonly used to try and provide accurate measures of fluid depletion during surgery; however, it is unclear to what extent they reflect organ perfusion. In addition, it is not known whether macro‐ and/ or microvascular perfusion indices are associated with renal complications following colorectal surgery. Thirty‐two participants scheduled for colorectal surgery had three measures of macro‐ and microvascular renal blood flow via contrast enhanced ultrasound (CEUS), and simultaneous measures of cardiac output indices via ODM: (i) pre‐operatively; (ii) intra‐operatively at the mid‐point of operation, and (iii) after the conclusion of surgery. The Postoperative Morbidity Survey (POMS) was used to assess postoperative complications. Intra‐operatively, there was a significant correlation between renal microvascular flow (RT) and renal macrovascular flow (TTI) (ρ = 0.52; p = 0.003). Intra‐operative TTI, but not RT, was associated with cardiac index (ρ = −0.50; p=0.0003). Intra‐operative RT predicted increases in renal complications (OR 1.46; 95% CI 1.03–2.09) with good discrimination (C‐statistic, 0.85). Complications were not predicted by TTI or ODM‐derived indices. There was no relationship between RT and TTI before or after surgery. ODM measures of haemodynamic status do not correlate with renal microvascular blood flow, and as such are likely not suitable to determine vital organ perfusion. Only CEUS‐derived measures of microvascular perfusion were predictive of postoperative renal complications.
Time‐course in attractiveness of pheromone lure on the smaller tea tortrix moth: A generalized additive mixed model approach
Authors: Sudo Masaaki , Sato Yasushi , Yorozuya Hiroshi
Published: March 2021

Long‐term pest insect monitoring in agriculture and forestry has advanced population ecology. However, the discontinuation of research materials such as pheromone lure products jeopardizes data collection continuity, which constrains the utilization of the industrial datasets in ecology. Three pheromone lures against the smaller tea tortrix moth Adoxophyes honmai Yasuda (Lepidoptera; Tortricidae) were available but one was recently discontinued. Hence, a statistical method is required to convert data among records of moths captured with different lures. We developed several generalized additive mixed models (GAMM) separating temporal fluctuation in the background male density during trapping and attenuation of lure attractiveness due to aging or air exposure after settlement. We collected multisite trap data over four moth generations. The lures in each of these were unsealed at different times before trap settlement. We used cross‐validation to select the model with the best generalization performance. The preferred GAMM had nonlinear density fluctuation terms and lure attractiveness decreased exponentially after unsealing. The attenuation rates varied among lures. A light trap dataset near the pheromone traps was a candidate for a male density predictor. Nevertheless, there was only a weak correlation between trap yields, suggesting the difficulty of data conversion between the traps differing in attraction mechanisms.
The health effects of wage setting institutions: How collective bargaining improves health but not because it reduces inequality
Authors: Reeves Aaron
Published: March 2021

Do wage‐setting institutions, such as collective bargaining, improve health and, if so, is this because they reduce income inequality? Wage‐setting institutions are often assumed to improve health because they increase earnings and reduce inequality and yet, while individual‐level studies suggest higher earnings improve well being, the direct effects of these institutions on mortality remains unclear. This paper explores both the relationship between wage‐setting institutions and mortality rates whether income inequality mediates this relationship. Using 50 years of data from 22 high‐income countries (n ~ 825), I find mortality rates are lower in countries with collective bargaining compared to places with little or no wage protection. While wage‐setting institutions may reduce economic inequality, these institutions do not appear to improve health because they reduce inequality. Instead, collective bargaining improves health, in part, because they increase average wage growth. The political and economic drivers of inequality may not, then, be correlated with health outcomes, and, as a result, health scholars need to develop more nuanced theories of the political economy of health that are separate from but in dialogue with the political economy of inequality.
The Information Externality of Public Firms’ Financial Information in the State‐Bond Secondary Market
Authors: CHENG STEPHANIE F.
Published: March 2021

This study provides evidence on the role of public firms’ financial reports in the state‐bond secondary market. I investigate the informational role of corporate earnings announcements and find that public firms’ monthly earnings signals aggregated to the state level are positively associated with contemporaneous state‐bond returns. Further analyses reveal that public firms’ earnings announcements predict traditional economic indicators and contain incremental information that is independent of the traditional economic indicators. In cross‐sectional analyses, I show that the earnings–returns relation is especially pronounced when bondholders face longer investment horizons and higher credit risks. Taken together, the evidence indicates a positive externality of corporate financial reports in alleviating the opacity in the municipal bond secondary market.
Navigating sticky floors and glass ceilings: Barriers and opportunities for women's employment in natural resources industries in Canada
Authors: Baruah Bipasha , Biskupski‐Mujanovic Sandra
Published: March 2021

Women make up almost half the Canadian labour force and more than 50% of post‐secondary students. However, in natural resources (NR) industries (energy, mining, forestry), they represent less than 20% of the workforce, face persistent wage gaps, hold traditionally gendered roles (in sales, administrative and support services) instead of technical or managerial positions, and are persistently absent from leadership roles. Retention of women is also a big challenge in these industries: many tend to leave their jobs within the first five years of employment, and/or after one or more maternity leaves. Women are very poorly represented in leadership positions (as senior executives and board members) despite significant evidence that gender diversity in leadership is good for business. Findings from our study of the status of women in NR employment in Canada produced concrete policy recommendations for recruiting, retaining, and promoting women in energy, mining, and forestry. Although these are intended specifically for Canadian organisations, they may also be relevant for other countries where women are underrepresented in NR industries.
Building a new social contract in the United States: the task at hand
Authors: Kochan Thomas A
Published: March 2021

This paper argues for a new social contract in the United States which will establish the mutual expectations and obligations that workers, employers and their communities have regarding work and employment relationships. It reports suggestions by participants in a recent online MITx course on ‘Shaping the Future of Work’. The participants in the course assigned high priority to business leaders working collaboratively with employees to improve organizational performance and provide workers with a significant voice in corporate governance. They urged unions to be effective in representing workers’ interests, not in an adversarial but in a partnership manner. They advocated that government should balance power in society and reform labor laws to provide workers with a wider range of voice and representation. The paper suggests steps which the new Administration should take to achieve these goals, in order to establish a new social contract and heal deep divisions in American society.
Defensive behavior of the invasive alien hornet Vespa velutina nigrithorax against potential human aggressors
Authors: Choi Moon Bo
Published: March 2021

In areas where wasps are common, many wasp sting incidents occur. However, guidance on the correct response to wasp attacks remains lacking. In this study, behavioral response experiments were conducted with the aim of minimizing damage from group wasp attacks. The study species was Vespa velutina, which frequently causes wasp sting injuries in the southern regions of South Korea. Results demonstrated that worker wasps showed defensive behavior when a person approached within 3 m of the nest, and the attack rate was higher when the person conducted a large arm swing. When a person walked away after touching a nest, the number of workers attacking did not significantly decrease until they reached 5 m, this reduced to less than half when the person reached 10 m. Approximately 1.3 workers attacked even up to 300 m. However, when the person ran, the number of workers attacking was almost one or less after 10 m. Therefore, it is best to escape quickly to at least 10 m to reduce injury from group attacks. When wasps attacked, even if the person crouched, the attack did not decrease. Our recommended defensive behavior when wasps attack unexpectedly is that victims should turn their face in the opposite direction to the nest or the wasps, protect their face with their hands and arms, lean forward and run away rapidly to minimize injury. Wearing a wide brim hat was very effective, preventing about 75% of stings to the head, so this is also recommended.
Implementation of a Petrographical and Petrophysical Workflow Protocol for Studying the Impact of Heterogeneity on the Rock Typing and Reservoir Quality of Reefal Limestone: A Case Study on the Nullipore Carbonates in the Gulf of Suez
Authors: SAFA Mona G. , NABAWY Bassem S. , BASAL Ahmed M.K. , OMRAN Mohammad A. , LASHIN Aref
Published: March 2021

This study focuses on the heterogeneity of the middle Miocene syn‐rift Belayim nullipore (reefal) marine sequences in the Gulf of Suez and its impacts on reservoir quality. The sequences consist of coralline algal reef limestones with a highly complex dual‐porosity system of primary and secondary porosities of widely varying percentages. To achieve a precise mathematical modeling of these reservoir sequences, a workflow protocol was applied to separate these sequences into a number of hydraulic flow units (HFUs) and reservoir rock types (RRTs). This has been achieved by conducting a conventional core analysis on the nullipore marine sequence. To illustrate the heterogeneity of the nullipore reservoir, the Dykstra‐Parsons coefficient (V) has been estimated (V = 0.91), indicating an extremely heterogeneous reservoir. A slight to high anisotropy (λk) has been assigned for the studied nullipore sequences. A stratigraphic modified Lorenz plot (SMLP) was applied to define the optimum number of HFUs and barriers/baffles in each of the studied wells. Integrating the permeability‐porosity, reservoir quality index‐normalized porosity index (RQI‐NPI) and the RQI‐flow zone indicator (RQI‐FZI) plots, the discrete rock types (DRT) and the R35 techniques enable the discrimination of the reservoir sequences into 4 RRTs/HFUs. The RRT4 packstone samples are characterized by the best reservoir properties (moderate permeability anisotropy, with a good‐to‐fair reservoir quality index), whereas the RRT1 mudstone samples have the lowest flow and storage capacities, as well as the tightest reservoir quality.
A Juvenile Specimen of Sauropodomorpha from the Lower Jurassic of China and a Brief Review of the Lufeng Sauropodomorph Fauna
Authors: PEYRE DE FABRÈGUES Claire , BI Shundong , AI Tianyu , XU Xing
Published: March 2021

An incomplete dinosaur skeleton, including a partial skull, recently discovered from the Lower Jurassic Lufeng Formation of Yunnan, China, is here reported. Apart from its small size, little anatomical evidence supports, a priori, the non‐adult status of this new sauropodomorph specimen but osteohistological analyses suggest that it is a fast‐growing juvenile. This specimen represents only the second occurrence of a juvenile non‐sauropodan sauropodomorph in the Lufeng Basin. The anatomy of the new specimen does not match that of other Lower Jurassic immature specimens; although cranial material is preserved, it does not display the diagnostic characters of early sauropodomorphs from the same horizon, namely Lufengosaurus, Yizhousaurus and Yunnanosaurus. Our phylogenetic analysis places the new specimen in a position relatively distant from other Chinese sauropodomorphs, and corroborates the anatomical evidence showing it is not referable to any known species already excavated in Yunnan. This result is interpreted with caution considering that ontogeny affects phylogenetic reconstruction. A thorough comparison with adult forms, taking into account ontogeny‐related characters, suggests that this Lufeng juvenile might represent a previously unknown species of early sauropodomorph.
Management of chyle leakage after general thoracic surgery: Impact of thoracic duct embolization
Authors: Jeon Yeong Jeong , Cho Jong Ho , Hyun Dongho , Shin Sumin , Kim Hong Kwan , Choi Yong Soo , Kim Jhingook , Zo Jae Ill , Shim Young Mog
Published: March 2021

Background

The aim of this study was to investigate the impact of thoracic duct embolization (TDE) on the management of postoperative chyle leakage.

Methods

We retrospectively reviewed the electronic medical record database of 4171 patients who underwent curative resection for lung or esophageal cancer between January 2015 and June 2017. We classified the period before the introduction of TDE as the first period and the period after the introduction of TDE as the second period.

Results

A total of 105 patients who developed chyle leakage after surgery were included. In the first period, 49 patients who underwent lung surgery developed chylothorax. Of those, two patients (4.1%) underwent surgical ligation of the thoracic duct (TD). Of eight patients with chyle leakage after esophagectomy, four patients (50%) underwent TD ligation. In the second period, 30 patients developed postoperative chyle leakage after pulmonary resection. Only one (3.3%) of them required surgical ligation. Of eight patients with chyle leakage after esophagectomy, only two (11.1%) patients underwent TD ligation. Five patients (16.7%) received TDE after lung surgery and five patients (27.7%) after esophageal surgery. Also, in the second period, the hospital stay of patients who underwent lung cancer surgery was shorter than the first period (12.6 ± 4.6 days vs. 16.3 ± 9.7 days; p = 0.026).

Conclusions

TDE is an effective method for the management of chyle leakage and might help to avoid invasive surgery.
Genomic analysis between idiopathic pulmonary fibrosis and associated lung cancer using laser‐assisted microdissection: A case report
Authors: Iida Yuko , Gon Yasuhiro , Nakanishi Yoko , Kurosawa Yusuke , Nakagawa Yoshiko , Mizumura Kenji , Shimizu Tetsuo , Takahashi Noriaki , Masuda Shinobu
Published: March 2021

Lung cancer (LC) is the most fatal complication of idiopathic pulmonary fibrosis (IPF). However, the molecular pathogenesis of the development of LC from IPF is still unclear. Here, we report a case of IPF‐associated LC for which we investigated the genetic alterations between IPF and LC. We extracted formalin‐fixed paraffin‐embedded DNA from each part of the surgical lung tissue using a laser‐assisted microdissection technique. The mutations in each part were detected by next‐generation sequencing (NGS) using 72 lung cancer‐related mutation panels. Five mutations were found in IPF and four in LC. Almost all somatic mutations did not overlap between the IPF and LC regions. These findings suggest that IPF‐associated LC may not be a result of the accumulation of somatic mutations in the regenerated epithelium of the honeycomb lung in the IPF region.
Two cases of lung cancer with hemophagocytic lymphohistiocytosis caused by immune checkpoint inhibitors
Authors: Kurozumi Atsumasa , Takahashi Hidenori , Watanabe Takayasu , Iwasaki Yoshinobu
Published: March 2021

We report the cases of two patients with secondary hemophagocytic lymphohistiocytosis caused by immune checkpoint inhibitors, who were diagnosed using the recently developed HScore. The first patient presented with fever, cytopenia, and elevated liver enzyme levels at 46 days post‐pembrolizumab administration. The HScore was 175. The second patient developed an immune‐related adverse event at 30 days after the final pembrolizumab dose. The HScore was 185. Hemophagocytic lymphohistiocytosis was confirmed in both patients, and corticotherapy improved their condition. It is challenging to diagnose hemophagocytic lymphohistiocytosis, particularly after development at a late stage. Our patients developed hemophagocytic lymphohistiocytosis late after immune checkpoint inhibitor administration. However, the HScore enabled us to diagnose both cases precisely and in a timely manner.
Failaka Island in the Late Islamic Period. Investigations at the fishing village of Kharaib al‐Dasht
Authors: Pieńkowska Agnieszka , Truszkowski Marek
Published: March 2021

The aim of the paper is to present the architectural remains and spatial organisation of the site of Kharaib al‐Dasht, a Late Islamic fishing village dating from the late seventeenth to the nineteenth century. In the course of six seasons of excavation, which started in 2013, there was uncovered a part of this extensive site, revealing remnants of a fish processing area, residential architecture and a mosque. The findings from Kharaib al‐Dasht serve here as a starting point for a discussion on the character of settlement activity on Failaka in the Late Islamic period, which was a time of dynamic change in the political and economic landscape of the region as evidenced by the available written sources.
β‐Arrestin 2 (ARRB2) Polymorphism is Associated With Adverse Consequences of Chronic Heroin Use
Authors: Karavidha Klevis K. , Burmeister Margit , Greenwald Mark K.
Published: March 2021

Background and Objectives

β‐arrestin 2 is an intracellular protein recruited during the activation of G‐protein‐coupled receptors. In preclinical studies, β‐arrestin 2 has been implicated in µ‐opioid receptor desensitization and internalization and the development of opioid tolerance and dependence. The present study investigated relationships between variants in the gene encoding β‐arrestin 2 (ARRB2) and clinically relevant phenotypes among individuals with opioid use disorder (OUD). We hypothesized that ARRB2 variants would be associated with the negative effects of long‐term heroin use.

Methods

Chronic heroin users (N = 201; n = 103 African American; n = 98 Caucasian) were genotyped for ARRB2 r1045280 (synonymous, also affecting binding motif of transcription factor GTF2IRD1), rs2036657 (3'UTR) and rs3786047 (intron) and assessed for the past‐month frequency of use, injection use, and lifetime duration of heroin use, number of heroin quit‐attempts, and heroin use‐related consequences.

Results

Lifetime heroin‐use consequences (especially occupational and health‐related) were significantly lower for African American ARRB2 r1045280 C‐allele carriers compared with the TT genotype. There was no significant genotype difference in the Caucasian group. ARRB2 rs2036657 was in strong linkage disequilibrium with rs1045280.

Discussion and Conclusions

These results, consistent with extant data, illustrate a role for ancestry‐dependent allelic variation in ARRB2 r1045280 on heroin‐use consequences. The ARRB2 r1045280 C‐allele played a protective role in African‐descent participants.

Scientific Significance

These first‐in‐human findings, which should be replicated, provide support for mechanistic investigations of ARRB2 and related intracellular signaling molecules in OUD etiology, treatment, and relapse prevention. (Am J Addict 2021;00:00–00)
Managing social support needs in older age for childless Malaysians living in poverty
Authors: Ng Yin Mei , Tilse Cheryl , Wilson Jill
Published: March 2021

Objective

To explore how older people manage social support needs when they are childless and living in poverty in the Malaysian context where social policy emphasises family as the primary provider of social support.

Methods

Semi‐structured interviews were completed with a purposive sample of 34 childless and older Malaysians living in poverty in Kuala Lumpur, Malaysia. A thematic content analysis focused on their reports of managing social support needs.

Results

Key strategies were using existing resources, developing new networks and adjusting expectations. Agency played a vital role in avoiding institutional care.

Conclusions

This paper adds to research on childlessness in older age in varied policy and cultural contexts. It challenges assumptions about families providing social support and argues for policies to recognise older people as an individual unit rather than as part of a family to prolong independent living in the community.
Efficacy of topical versus intradermal injection of Tranexamic Acid In Egyptian melasma Patients: A randomised clinical trial
Authors: Badran Aya Y. , Ali Ahmed U. , Gomaa Ahmed S.
Published: March 2021

Background

Melasma is one of the common pigmentary problems affecting females in our community, owing to the frequent use of hormonal contraceptives as well as our sunny climate. A lot of treatment options are available but none of them is completely satisfactory. Many patients prefer the use of topical preparations and minimally invasive methods. Tranexamic acid (TA) is a potential treatment option for hyperpigmentation with different delivery routes.

Aim

We designed the study in order to evaluate the efficacy of TA in melasma using 2 different routes of delivery.

Patients and methods

A randomised clinical trial was performed on 60 female patients with melasma, they randomly divided into three groups; A, B and C. Group (A) patients received TA (4 mg/mL) intradermal injections every 2 weeks with, group B received TA (10 mg/mL) intradermal injections every 2 weeks, group C received TA cream (10% concentration) twice daily, treatment continued for 12 weeks in all groups. Melasma Area and Severity Index (MASI) scores were measured for each patient before and after completion of treatment.

Results

The percentage of MASI score reduction was highest in group B (62.7%) versus (39.1%) in group A, while the percentage of MASI reduction was the lowest in group C (4.2%).

Conclusion

Tranexamic acid is a safe effective and well‐tolerated treatment option for melasma patients. Intradermal injection of TA leads to better results than the topical application. Topical TA cream (even in a high concentration) produce fair improvement of melasma.
Intra‐cavernous injection of BOTOX® (50 and 100 Units) for treatment of vasculogenic erectile dysfunction: Randomized controlled trial
Authors: El‐Shaer Waleed , Ghanem Hussein , Diab Tamer , Abo‐Taleb Ahmed , kandeel Wael
Published: March 2021

Background

Erectile dysfunction (ED) is a socioeconomic problem.There are several options for its management including intra‐cavernosal injection (ICI).

Objective

To compare the safety, efficacy, and durability of ICI of onabotulinum toxin‐A (BTX) in different doses (50 and 100 U) against placebo (saline) in the management of vasculogenic ED non‐responding to pharmacological therapy (phosphodiesterase type 5 inhibitors or/and ICI of trimix).

Materials and Methods

A prospective randomized double‐blind placebo‐controlled trial was conducted between July 2016 and February 2019. A total of 176 patients were randomly assigned (1:1:1) to one of the treatment sequences: Botox 100 U group (BTX‐100; 62 patients), Botox 50 U group (BTX‐50; 59 patients), or placebo group (55 patients). All patients were followed up for 6 months.

Results

Significant improvement in all parameters, that is, SHIM score & Erection Hardness Score (EHS), Sexual Encounter Profile (SEP), Global Assessment Score (GAS), and Doppler parameters (p < 0.001) was observed in patients of BTX‐100 and BTX‐50 groups with maximum improvement at 3rd month of treatment. Around 40% of patients were responders and were able to engage in sexual intercourse. Patients in placebo group did not experience significant improvement (p = 0.264). It was noted that at the 2nd week and 3rd months after treatment, there was no statistically significant difference in the improvement of these parameters in BTX‐100 and BTX‐50 groups (p > 0.05). In the 6th month, there was a statistically significant difference between the aforementioned groups in favor of BTX‐100 (p < 0.01).

Conclusions

Only one‐time ICI of BTX (50 U and 100 U) is effective and safe for the treatment of refractory ED. This agent has a considerable long duration of action, particularly BTX‐100U seems to be more durable.
Optical coherence tomography angiography changes in cardiovascular systemic diseases and risk factors: A Review
Authors: Monteiro‐Henriques Inês , Rocha‐Sousa Amândio , Barbosa‐Breda João
Published: March 2021

Cardiovascular (CV) disease (CVD) is the main cause of death around the world, and assessing a patient’s CV risk factors (CVRF) can play a major role in its prevention. Since it has been shown that retinal vascular alterations may reflect several systemic processes such as CVRF, we conducted a systematic review in order to summarize which ocular microvasculature changes can be found using Optical Coherence Tomography Angiography (OCTA) in patients without ocular diseases and with systemic pathologies/conditions that affect the CV system when compared to healthy subjects. We searched on online databases, namely PubMed, Scopus, Cochrane and Web of Science, and obtained additional studies through citation tracking. Case reports and review articles were excluded. A total of 47 articles were included in our review. We describe that patients with hypertension, diabetes mellitus, kidney disease, preeclampsia, coronary artery disease, carotid artery stenosis and obstructive sleep apnoea syndrome have, in general, lower retinal and choroidal Vessel Density (VD) and Length (VL), as well as an increased foveal avascular zone area and perimeter. Additionally, several characteristics and/or conditions in healthy subjects, such as smoking status, hyper or hypoxia conditions, race, among others, are also related to ocular vascular changes and should be accounted for. We concluded that OCTA could be a useful tool to assess a patient’s CV risk profile in a non‐invasive way, possibly integrating the diagnostic and prognostic algorithms of the most prevalent CV diseases in the future.
Chromogranin A regulates gut permeability via the antagonistic actions of its proteolytic peptides
Authors: Muntjewerff Elke M. , Tang Kechun , Lutter Lisanne , Christoffersson Gustaf , Nicolasen Mara J. T. , Gao Hong , Katkar Gajanan D. , Das Soumita , ter Beest Martin , Ying Wei , Ghosh Pradipta , El Aidy Sahar , Oldenburg Bas , van den Bogaart Geert , Mahata Sushil K.
Published: March 2021

Aim

A “leaky” gut barrier has been implicated in the initiation and progression of a multitude of diseases, for example, inflammatory bowel disease (IBD), irritable bowel syndrome and celiac disease. Here we show how pro‐hormone Chromogranin A (CgA), produced by the enteroendocrine cells, and Catestatin (CST: hCgA352‐372), the most abundant CgA‐derived proteolytic peptide, affect the gut barrier.

Methods

Colon tissues from region‐specific CST‐knockout (CST‐KO) mice, CgA‐knockout (CgA‐KO) and WT mice were analysed by immunohistochemistry, western blot, ultrastructural and flowcytometry studies. FITC‐dextran assays were used to measure intestinal barrier function. Mice were supplemented with CST or CgA fragment pancreastatin (PST: CgA250‐301). The microbial composition of cecum was determined. CgA and CST levels were measured in blood of IBD patients.

Results

Plasma levels of CST were elevated in IBD patients. CST‐KO mice displayed (a) elongated tight, adherens junctions and desmosomes similar to IBD patients, (b) elevated expression of Claudin 2, and (c) gut inflammation. Plasma FITC‐dextran measurements showed increased intestinal paracellular permeability in the CST‐KO mice. This correlated with a higher ratio of Firmicutes to Bacteroidetes, a dysbiotic pattern commonly encountered in various diseases. Supplementation of CST‐KO mice with recombinant CST restored paracellular permeability and reversed inflammation, whereas CgA‐KO mice supplementation with CST and/or PST in CgA‐KO mice showed that intestinal paracellular permeability is regulated by the antagonistic roles of these two peptides: CST reduces and PST increases permeability.

Conclusion

The pro‐hormone CgA regulates the intestinal paracellular permeability. CST is both necessary and sufficient to reduce permeability and primarily acts by antagonizing PST.
Model‐based recursive partitioning of extended redundancy analysis with an application to nicotine dependence among US adults
Authors: Kim Sunmee , Hwang Heungsun
Published: March 2021

Extended redundancy analysis (ERA) is used to reduce multiple sets of predictors to a smaller number of components and examine the effects of these components on a response variable. In various social and behavioural studies, auxiliary covariates (e.g., gender, ethnicity) can often lead to heterogeneous subgroups of observations, each of which involves distinctive relationships between predictor and response variables. ERA is currently unable to consider such covariate‐dependent heterogeneity to examine whether the model parameters vary across subgroups differentiated by covariates. To address this issue, we combine ERA with model‐based recursive partitioning in a single framework. This combined method, MOB‐ERA, aims to partition observations into heterogeneous subgroups recursively based on a set of covariates while fitting a specified ERA model to data. Upon the completion of the partitioning procedure, one can easily examine the difference in the estimated ERA parameters across covariate‐dependent subgroups. Moreover, it produces a tree diagram that aids in visualizing a hierarchy of partitioning covariates, as well as interpreting their interactions. In the analysis of public data concerning nicotine dependence among US adults, the method uncovered heterogeneous subgroups characterized by several sociodemographic covariates, each of which yielded different directional relationships between three predictor sets and nicotine dependence.
In vitro profiling of orphan G protein coupled receptor (GPCR) constitutive activity
Authors: Watkins Lyndsay R. , Orlandi Cesare
Published: March 2021

Background and Purpose

Members of the GPCR family are targeted by a significant fraction of the available FDA‐approved drugs. However, the physiological role and pharmacological properties of many GPCRs remain unknown, representing untapped potential in drug design. Of particular interest are ~100 less‐studied GPCRs known as orphans because their endogenous ligands are unknown. Intriguingly, disease‐causing mutations identified in patients, together with animal studies, have demonstrated that many orphan receptors play crucial physiological roles and, thus, represent attractive drug targets.

Experimental Approach

The majority of deorphanized GPCRs demonstrate coupling to Gi/o. However, a limited number of techniques allow the detection of intrinsically small constitutive activity associated with Gi/o protein activation, which represents a significant barrier in our ability to study orphan GPCR signalling. Using luciferase reporter assays, we effectively detected constitutive Gs, Gq and G12/13 protein signalling by unliganded receptors and introducing various G protein chimeras, we provide a novel, highly sensitive tool capable of identifying Gi/o coupling in unliganded orphan GPCRs.

Key Results

Using this approach, we measured the constitutive activity of the entire class C GPCR family that includes eight orphan receptors and a subset of 20 prototypical class A GPCR members, including 11 orphans. Excitingly, this approach illuminated the G protein coupling profile of eight orphan GPCRs (GPR22, GPR137b, GPR88, GPR156, GPR158, GPR179, GPRC5D and GPRC6A) previously linked to pathophysiological processes.

Conclusion and Implications

We provide a new platform that could be utilized in ongoing studies in orphan receptor signalling and de‐orphanization efforts.
The enigma of persistent symptoms in hypothyroid patients treated with levothyroxine: A narrative review
Authors: Perros Petros , Van Der Feltz‐Cornelis Christina , Papini Enrico , Nagy Endre V. , Weetman Anthony P. , Hegedüs Laszlo
Published: March 2021

A significant minority of patients with hypothyroidism report persistent symptoms despite achieving normal thyroid biochemistry after levothyroxine (L‐T4) replacement. Four principal lines of thinking, which are not mutually exclusive, may explain this enigma. The ‘low tissue liothyronine hypothesis’ emphasizes the potential imperfections of L‐T4 replacement therapy that may lead to hypothyroidism in some tissues such as the brain, while others (eg hypothalamus) are euthyroid. The ‘Somatic Symptom and Related Disorders hypothesis’ draws attention to an incidental coexistence of a diagnosis of Somatic Symptom and Related Disorders in patients with treated hypothyroidism. The ‘autoimmune neuroinflammation hypothesis’ highlights the potential consequences of inflammatory mediators due to thyroid autoimmunity (the commonest cause of hypothyroidism) on the brain. The ‘comorbidities and psychosocial hypothesis’ implicates a variety of physical and psychosocial factors that have been noted to be associated with a diagnosis of hypothyroidism, which may be primarily the cause of persistent complaints. Over the past twenty years, a great deal of time and effort has been expended pursuing the ‘low tissue liothyronine hypothesis’, which has failed to yield results that translate to patient benefits. This has skewed the balance in clinical practice, in favour of pursuing answers relating to L‐T4 and liothyronine combination treatment, while the alternative explanations have been downplayed and potentially useful interventions have been given insufficient attention.
Visualization of Tensor Fields in Mechanics
Authors: Hergl Chiara , Blecha Christian , Kretzschmar Vanessa , Raith Felix , Günther Fabian , Stommel Markus , Jankowai Jochen , Hotz Ingrid , Nagel Thomas , Scheuermann Gerik
Published: March 2021

Tensors are used to describe complex physical processes in many applications. Examples include the distribution of stresses in technical materials, acting forces during seismic events, or remodeling of biological tissues. While tensors encode such complex information mathematically precisely, the semantic interpretation of a tensor is challenging. Visualization can be beneficial here and is frequently used by domain experts. Typical strategies include the use of glyphs, color plots, lines, and isosurfaces. However, data complexity is nowadays accompanied by the sheer amount of data produced by large‐scale simulations and adds another level of obstruction between user and data. Given the limitations of traditional methods, and the extra cognitive effort of simple methods, more advanced tensor field visualization approaches have been the focus of this work. This survey aims to provide an overview of recent research results with a strong application‐oriented focus, targeting applications based on continuum mechanics, namely the fields of structural, bio‐, and geomechanics. As such, the survey is complementing and extending previously published surveys. Its utility is twofold: (i) It serves as basis for the visualization community to get an overview of recent visualization techniques. (ii) It emphasizes and explains the necessity for further research for visualizations in this context.
Risks posed by SARS‐CoV‐2 to North American bats during winter fieldwork
Authors: Cook Jonathan D. , Grant Evan H. C. , Coleman Jeremy T. H. , Sleeman Jonathan M. , Runge Michael C.
Published: March 2021

The virus that causes COVID‐19 likely evolved in a mammalian host, possibly Old‐World bats, before adapting to humans, raising the question of whether reverse zoonotic transmission to bats is possible. Wildlife management agencies in North America are concerned that the activities they authorize could lead to transmission of SARS‐CoV‐2 to bats from humans. A rapid risk assessment conducted in April 2020 suggested that there was a small but significant possibility that SARS‐CoV‐2 could be transmitted from humans to bats during summer fieldwork, absent precautions. Subsequent challenge studies in a laboratory setting have shed new information on these risks, as has more detailed information on human epidemiology and transmission. This inquiry focuses on the risk to bats from winter fieldwork, specifically surveys of winter roosts and handling of bats to test for white‐nose syndrome or other research needs. We use an aerosol transmission model, with parameter estimates both from the literature and from formal expert judgment, to estimate the risk to three species of North American bats, as a function of several factors. We find that risks of transmission are lower than in the previous assessment and are notably affected by chamber volume and local prevalence of COVID‐19. Use of facemasks with high filtration efficiency or a negative COVID‐19 test before field surveys can reduce zoonotic risk by 65 to 88%.
Research trends in U.S. national parks, the world's “living laboratories”
Authors: Vukomanovic Jelena , Randall Joshua
Published: March 2021

U.S. national parks are essential public assets for preserving natural and cultural resources and for decades have provided natural laboratories for scholarly research. However, park research, and how it may be biased, has not been inventoried at a national scale. Such a synthesis is crucial for assessing research needs and planning for the future. Here, we present the first comprehensive summary of national park research using nearly 7,000 peer‐reviewed research articles published since 1970. We report when and where these studies occurred, what academic disciplines were most represented, and who funded the research. Our findings show that publication rates increased rapidly during the 1990s and 2000s, but since about 2013 have declined. Over half of the studies occurred in five parks, with Yellowstone representing over a third of all studies, followed by Everglades, Great Smoky Mountains, Glacier, and Yosemite. Nearly half of the studies occurred in the Northwestern Forested Mountains ecoregion. The life sciences, particularly ecological studies, contributed the majority of park research, although the earth sciences dominated several arid ecoregions of the West. Federal agencies funded the largest proportion of research, followed by U.S. universities, non‐profit organizations, federal programs (mainly the National Science Foundation), state agencies, and private industry. Over a quarter of the research was supported by international sources. Recent declines in scholarly output suggest that national park research directions and funding opportunities should be examined.
Feasibility and pilot efficacy of cognitive remediation for people in residential substance use treatment
Authors: Allan Julaine , Thompson Anna , Carlyle Molly , Thomas Matthew , Medalia Alice
Published: March 2021

Introduction

There are high rates of cognitive impairment among people seeking treatment for problematic substance use, which is rarely addressed in treatment programs. The aim of this pilot study was to evaluate the feasibility and outcomes of the neuropsychological and educational approach to cognitive remediation (NEAR) in a residential substance treatment setting.

Methods

A non‐randomised trial conducted between November 2018 and November 2019, compared outcomes for 34 residents who received cognitive remediation (CR) plus treatment as usual (TAU) to 31 residents who received TAU only. Number of groups and attendance, and a measure of client satisfaction assessed feasibility. Cognitive function was assessed at baseline (service admission), and at 2 and 6 months post‐admission.

Results

A total of 95 CR groups were delivered over a 36‐week time period with a high degree of treatment fidelity and acceptability to participants. Cognitive outcomes improved across both the CR+TAU and TAU groups by 2 months, which was maintained at 6 months for outcomes related to executive functioning. There were no significant differences between the CR+TAU and TAU groups at 2 or 6 months, although a large effect size and confidence intervals indicated a potentially larger change in cognitive flexibility after receiving CR.

Discussion and Conclusions

This study contributes to our understanding of the implementation of CR in the alcohol and other drug rehabilitation setting. It is feasible to incorporate the NEAR program in treatment. The small sample size and lower than expected treatment dose likely contributed to the lack of significant findings.