bluuebunny/crossref_metadata_2025 huggingface dataset:
Towards an understanding of consumers’ FinTech adoption: the case of Open Banking
Authors: Chan Rebecca , Troshani Indrit , Rao Hill Sally , Hoffmann Arvid
Published: April 2022

Purpose

This study aims to identify key factors driving consumers' adoption of Open Banking. It extends the Unified Theory of Acceptance and Use of Technology (UTAUT) by integrating perceived risk, initial trust and financial literacy into an overarching conceptual model.

Design/methodology/approach

Measurement items of the theoretical constructs included in the conceptual model were adapted from related literature and a set of hypotheses was developed. The hypotheses of the conceptual model were subsequently assessed with partial least squares structural equation modeling using a dataset of 456 Australian survey respondents.

Findings

The model has strong explanatory power with anR2of 69.5%. Performance expectancy, effort expectancy, social influence and perceived risk are direct antecedents of consumers' usage intention of Open Banking. Social influence has a strong mediating effect on usage intention through performance expectancy. The effect of perceived risk is alleviated by effort expectancy and initial trust, while initial trust positively affects the effects of performance expectancy and effort expectancy on consumers' usage intention of Open Banking. Finally, financial literacy lowers initial trust towards Open Banking, possibly inducing consumer skepticism.

Practical implications

The results suggest that practitioners should focus on performance expectancy as a primary driver of Open Banking adoption, while understanding the role of other drivers, such as social influence and perceived risk in developing marketing strategies. Policy makers are recommended to adopt a governance approach to build initial trust amongst consumers.

Originality/value

This research contributes by providing an integrated and comprehensive model for explaining consumers' FinTech adoptions by extending the existing technology adoption model UTAUT to the Open Banking domain and integrating perceived risk, initial trust and financial literacy, thereby advancing and enriching the conceptual horizon of the extant literature.
Internet penetration, financial access and new business formation: evidence from developing economies
Authors: Haini Hazwan , Pang Wei Loon
Published: April 2022

Purpose

This study examines whether Internet penetration has a complementary effect on the relationship between financial access and new business formation in 57 developing economies from 2006 to 2018.

Design/methodology/approach

Using the generalised least squares estimator, the authors employ a framework that allows us to distinguish between the marginal impact of financial access on new business formation in developing economies with high and low levels of Internet penetration rates. Furthermore, the authors distinguish between financial institutions and financial markets.

Findings

The authors find that increased accessibility for financial institutions promotes entrepreneurial activity, while financial market access has a negative relationship with new business formation. Furthermore, the authors find that the marginal impact of financial institution access increases in magnitude as Internet penetration increases. The effect does not hold for financial markets.

Research limitations/implications

The major limitation lies in the measurement of new business formation, as it focuses on the formal entrepreneurial sector and overlooks the informal economy and entrepreneurs operating as sole proprietors.

Practical implications

Policymakers should continue to promote the development of the information communication and technology sector and digitalisation policy while increasing financial accessibility in the financial system.

Originality/value

This study provides new empirical evidence on the greasing role of technology to leverage the impact of financial access on new business formation. Furthermore, the study distinguishes this effect by differentiating between financial institutions and markets.
Looking beyond violence prevention climate – exploring line managers' violence preventive practices in two high-risk sectors
Authors: Jaspers Sofie Østergaard , Raaby Andersen Dorte , Karlsen Iben Louise , Sønderbo Andersen Lars Peter , Conway Paul Maurice , Dyreborg Johnny , Aust Birgit
Published: April 2022

Purpose

Work-related violence is a major occupational safety and health (OSH) issue. According to the concept of violence prevention climate, managers play a pivotal role in preventing the risk of violence at work. However, research on this is scarce. The objective of this study was, therefore, to examine line managers' use of violence preventive practices in high-risk sectors.

Design/methodology/approach

The authors employed three different sources of data (semi-structured interviews and field notes from both leadership seminars and coaching sessions) that were collected in the context of an intervention study in Denmark aimed at improving violence prevention. The authors conducted a thematic analysis of violence prevention experiences among 16 line managers – eight from the prison and probation services and eight from psychiatric hospitals.

Findings

Using an existing prevention framework, the authors categorized the descriptions into three types of violence preventive practices used by the line managers across the two sectors: “preventing violence”, “managing episodes of violence” and “promoting the positive”. Especially the category “promoting the positive” is often neglected in the intervention literature.

Originality/value

The study identified new aspects of managers' violence preventive practices than those included in the violence prevention climate concept. Such knowledge may help organizations devise improved systems for violence prevention in high-risk sectors.
An empirical assessment of the sustainable development goals compass based on consumer sentiment
Authors: Anwar Abdou Yasmin , El-Bassiouny Noha , Becker-Ritterspach Florian
Published: April 2022

Purpose

This research aims to provide an empirical assessment of consumer sentiment towards corporate sustainability practices in the context of developing countries, specifically Egypt.

Design/methodology/approach

A survey was deployed to measure the importance of corporate sustainability activities to consumers.

Findings

The results demonstrate that consumers are concerned with all the measured dimensions of corporate sustainability practices, yet some of the dimensions are more critical to them than others.

Originality/value

By providing an overview of how consumers' purchase behavior is affected by corporate sustainability practices, this research contributes to knowledge on understanding more about sustainable consumer behavior in developing countries, which is scarce. Moreover, this research goes further by segmenting sustainable consumers into groups based on their sustainability concerns.
A trust model for consumer conversion in community-based group buying: the dual roles of group leaders
Authors: Ying Huajing , Ji Huanhuan , Shi Xiaoran , Wang Xinyue
Published: April 2022

Purpose

In the presence of coronavirus disease 2019 (COVID-19), due to the social distance restriction, consumers' regular consumption behaviors and patterns have been changing fundamentally. Thereafter, an innovative group buying model has emerged and developed explosively with a specific focus on consumer's location, known as community-based group buying (CGB). The purpose of this paper is to investigate the transfer mechanism of user's trust in dyadic contexts of social and commercial role-playing in the CGB program.

Design/methodology/approach

This study adopts an empirical research method, with an online and offline questionnaire survey, a total of 382 responses have been obtained. Then, both descriptive analysis and hierarchical regression analysis are conducted to explore the dual roles of group leader and its corresponding effects on consumers' trust (i.e. emotional trust and behavioral trust) and engagement actions (i.e. purchase and share) in the CGB program.

Findings

Results indicate that resident's trust and their perception of group leader's friend role can positively enhance their engagement actions in the CGB programs. Meanwhile, for the purpose of profit maximization, the group leader is more willing to play a friend role in transactions no matter whether the role conflict exists.

Originality/value

Research findings provide some managerial insights for CGB platform on the selection and training of group leaders and the incentive mechanism design.
Histopathological analysis of skin reactions after coronavirus disease 2019 vaccination: Increment in number of infiltrated plasmacytoid dendritic cell
Authors: Watanabe Hanako , Ashida Miwa , Satomi Naoyoshi , Koike Yuta , Kuwatsuka Sayaka , Murota Hiroyuki
Published: April 2022

Skin disorders are frequent adverse events after coronavirus disease 2019 (COVID‐19) vaccination. However, the pathogenesis of these disorders is not fully understood. Here, we report a case series of cutaneous adverse events following COVID‐19 vaccination, and the results of our investigation reveal the underlying mechanism. Case 1: a 47‐year‐old female developed a wheal, confined to the COVID‐19 vaccination site, 2 days after her first injection. She was treated with topical steroids and oral antihistamines. Case 2: a 51‐year‐old female showed generalized petechial erythema accompanied by fever, genital bleeding, thrombocytopenia, liver dysfunction, and disseminated intravascular coagulation, 2 days after her second injection. She was diagnosed with vaccine‐induced macrophage activation syndrome and treated with anti‐inflammatory therapy. Immunohistological analysis of the skin eruption, in both these cases, showed infiltration of CD123+ BDCA2+ plasmacytoid dendritic cells (p‐DC). Despite the distinctive clinical features in these two cases, this finding suggests that p‐DC might be involved in different cutaneous adverse events after COVID‐19 vaccination.
The ecological drivers of growth form evolution in flowering plants
Authors: Klimeš Adam , Šímová Irena , Zizka Alexander , Antonelli Alexandre , Herben Tomáš
Published: April 2022

In flowering plants (angiosperms), the herbaceous habit has evolved repeatedly from the ancestral woody state and herbs evolved repeatedly back to woody plants. Yet, how common these transitions were and which ecological conditions promote the herbaceous habit is poorly known. Several hypotheses exist, postulating an advantage of the herbaceous growth form to better cope with frost, drought, fire and shade and in allowing a fast life strategy, but their evaluation has been hitherto limited and support equivocal. We aim to evaluate these hypotheses by testing the difference between woody plants and herbs for a set of variables related to these hypotheses.

We compiled and integrated data for up to 21,581 species representing 359 families from public databases. We estimated the minimum number of evolutionary transitions between both growth forms. We assembled data on frost, drought, fire and shade tolerances, clonality and specific leaf area and we tested individual hypotheses by comparing herbaceous and woody angiosperm growth forms globally and within selected biomes and clades using phylogenetic comparative analyses.

We found 1656 evolutionary transitions from woody towards herbaceous growth form and 2111 transitions in the opposite direction. In agreement with our expectations, herbs were more tolerant to frost and shade than woody plants and had higher specific leaf area. However, the growth forms did not differ in their fire tolerance and clonality. Furthermore, contrary to our expectation, woody plants were more drought tolerant than herbs. The majority of the differences were robust to the choice of biome or clade.

Synthesis. Both herbaceous and woody habits evolved many times making the evolution of growth forms a well‐replicated event and suggesting that conditions favourable for either of the growth forms emerge often and plants respond to them. Apart from standard explanation by low temperatures, the success of herbs was likely enabled also by biotic interactions—by their fast life strategy, which is beneficial in seasonal and early successional habitats, and by their ability to tolerate shade.
Reproductive biology of Myrtillocactus geometrizans (Cactaceae) flowers with contrasting orientation
Authors: Aguilar‐García Sandra Aracely , Figueroa‐Castro Dulce María , Valverde Pedro Luis , Vite Fernando , López‐Ortega Gerardo , Pérez‐Hernández Marco Aurelio
Published: April 2022

In columnar cacti, a higher production of reproductive structures on branches oriented towards the Equator has been explained by their higher interception of photosynthetic active radiation (PAR) as well as resource availability. The goal of this study was to evaluate the effect of orientation on diverse aspects of the reproductive biology of Myrtillocactus geometrizans. Phenology was studied in north‐ and south‐facing branches. Floral cycle events, floral visitors, reproductive traits associated with sexual and attraction functions, and reproductive success were estimated from reproductive structures with contrasting orientation. Pollination experiments were conducted to evaluate the effect of orientation on mating system. Our results showed that south‐facing branches had a longer duration of the mature fruit phenophase. Moreover, flower synchrony, production of reproductive structures, and floral traits associated with the male (number of anthers and pollen grains per floral bud), female (number and size of ovules and dimensions of both ovary and ovary cavity), and attraction (petal size) functions had higher values in south‐facing flowers. The beginning and ending of the male function and the end of flower anthesis occurred earlier in south‐facing flowers. Diversity of floral visitors was similar between orientations, except for beetles whose abundance was greater in flowers oriented towards the south. North‐ and south‐facing flowers had a mixed mating system, with similar reproductive success. Our results showed strong differences in the reproductive biology of an intertropical columnar cactus, probably in response to the uneven PAR interception and resource availability in branches and flowers with contrasting orientation.
Intrahepatic cholestasis of pregnancy – Time to redefine the reference range of total serum bile acids: A cross‐sectional study
Authors: Huri Mor , Seravalli Viola , Lippi Camilla , Tofani Lorenzo , Galli Andrea , Petraglia Felice , Di Tommaso Mariarosaria
Published: April 2022

Objective

To establish pregnancy‐specific reference ranges for fasting and postprandial total serum bile acid (TSBA) concentrations.

Design

Cross‐sectional study.

Setting

Tertiary‐care university hospital.

Population

Healthy pregnant women at term admitted to the Obstetrics Department over a period of 1 year. Exclusion criteria were an established diagnosis of intrahepatic cholestasis of pregnancy (ICP) or any coexisting condition of increased risk for ICP.

Methods

Both fasting (after 8–14 h of fasting) and postprandial (2 h after meal) TSBA concentrations were measured in 612 women (with 528 fasting samples and 377 postprandial samples) by automated enzymatic spectrophotometric assay.

Main outcome measures

Fasting and postprandial TSBA concentrations in 612 women.

Results

Reference intervals of 4.4–14.1 μmol/L for fasting TSBA and 4.7–20.2 μmol/L for postprandial TSBA were established. The postprandial values were significantly higher than the fasting values, with a median increase of 1.0 μmol/L (p < 0.0001). A correlation between fasting TSBA concentrations and postprandial concentrations was found, as well as correlations with fetal sex, parity and assisted reproductive technologies. A seasonal pattern was noticed for both fasting and postprandial TSBA, with the highest values measured in the winter season (p < 0.01 and 0.02, respectively)

Conclusions

Normal pregnancy is associated with mild hypercholanaemia, and therefore a higher threshold should be considered for the diagnosis of ICP. We suggest using the upper reference limits observed in our healthy pregnant population (14 μmol/L for fasting TSBA and 20 μmol/L for postprandial TSBA). As the fasting measurement is more specific for the diagnosis, and the postprandial measurement is essential for the assessment of severity, it is recommended to measure both values rather than use random sampling.

Tweetable abstract

Normal pregnancy is associated with mild hypercholanaemia, a higher threshold should be considered for the diagnosis of ICP.
Ride the trend: Is there spread momentum profit in the US commodity markets?
Authors: Shang Quanbiao , Serra Teresa , Garcia Philip
Published: April 2022

Some previous researchers have argued that trading strategies based on calendar spread time series momentum (STSM) can deliver significant returns (Szymanowska et al. 2014; Boons and Prado 2019), which, if true, is at odds with the efficient market hypothesis. These arguments however, do not exclude the unrealisable futures contract roll yield and are also affected by other empirical and statistical issues that may lead to misleading results. With more than 30 years of data, we investigate STSM in 22 US commodity futures markets. First, we assess whether past spread returns can predict future returns, a necessary condition for the existence of momentum. We find predictability to be very weak after correcting for the issues affecting prior research. Second, we implement STSM‐based investment strategies. We compare STSM profits for individual markets and portfolios to profits generated by a simple long‐only benchmark strategy that does not require any predictability. STSM does not generate returns statistically different from the benchmark trading strategy, with both strategies generating very low or negative returns. For the momentum to outperform the benchmark strategy, predictability should be three times larger than observed from real data, but would entail substantial downside risk. In sum, the empirical evidence indicates that returns from STSM‐type strategies are illusive for the commodities and period studied. Our results strongly suggest that inclusion of unrealisable roll yield generates the illusion of profitable STSM trading strategies in previous research.
Safety and efficacy of prophylactic gastric open peroral endoscopic myotomy for prevention of post‐ESD stenosis: A case series (with video)
Authors: Lee Won Dong , Song Jae Sun , Kim Byung Sun , Yang Min A. , Lee Young Jae , Jung Gum Mo , Kim Ji Woong , Cho Yong Keun , Cho Jin Woong
Published: April 2022

Objective

Endoscopic resection of over 3/4 of the lumen of the antrum or pylorus is a known risk factor for post‐endoscopic submucosal dissection (ESD) stenosis. Local or systemic steroids may reduce the risk of stenosis, but their overall role in stenosis prevention remains controversial. We aimed to evaluate the efficacy and safety of prophylactic gastric open peroral endoscopic myotomy (GO‐POEM) in preventing post‐ESD stenosis.

Methods

Ten patients who underwent GO‐POEM during or immediately after ESD in the Presbyterian Medical Center between June 2017 and November 2020 were included. All patients underwent excision of over 3/4 of the lumen of the antrum or pylorus. GO‐POEM was performed without submucosal tunneling.

Results

Well‐differentiated tubular adenocarcinoma, tubulovillous adenoma with high‐grade dysplasia, and tubular adenoma with low‐grade dysplasia were diagnosed in three, one, and six patients, respectively. GO‐POEM was performed successfully in all the 10 patients. Stenosis could not be evaluated in one patient, whereas one of the remaining nine patients developed post‐ESD stenosis. GO‐POEM decreased the risk of post‐ESD stenosis in the other eight patients. Two patients presented with intraprocedural bleeding, both of whom were managed endoscopically successfully.

Conclusions

Prophylactic GO‐POEM may be a novel, effective and safe treatment modality for preventing post‐ESD stenosis in the stomach. Well‐designed, multicenter studies with large sample sizes are needed to confirm our results.
Endoscopic detection of esophageallow‐gradesquamous dysplasia: How to predict pathologic upgrades before treatment?
Authors: Chen Han , Zhou Xiao Ying , Li Shuo , Jiang Liu Qin , Hua Jie , Si Xin Min , Zhang Guo Xin
Published: April 2022

Objective

In this study we aimed to predict the risk factors related to histopathologic upgrade after endoscopic submucosal dissection (ESD) in patients with pre‐ESD esophageal squamous low‐grade intraepithelial neoplasm (LGIN).

Methods

A training cohort of 201 patients with biopsy‐confirmed esophageal squamous LGIN and underwent ESD at a tertiary medical center between January 2017 and July 2019 were included. Risk factors for histological upgrade were identified using the least absolute shrinkage and selection operator (LASSO) regression. A nomogram was then established. Internal validation was evaluated by discrimination, calibration plot, and decision‐curve analysis. Another cohort of 48 patients were prospectively collected from July 2019 to June 2021 for external validation of the nomogram.

Results

The rate of histological upgrade was 34.8% (70/201) and 27.1% (13/48) in the training and validation sets, respectively. LASSO regression identified that tumor area (mm2) per biopsy, Lugol's staining pattern, background coloration, and the circumferential range of the lesion were significantly associated with histological upgrade. The final nomogram attained favorable prediction efficacy in the training cohort (area under the receiver operating curve [AUROC] 0.96, 95% confidence interval [CI] 0.94–0.98) and validation cohort (AUROC 0.92, 95% CI 0.79 –0.99). This model generated well‐fitted calibration and clinical‐decision curves in both cohorts.

Conclusions

The nomogram may better guide clinical decision on whether performing EDS or follow‐up for suspicious lesions in patients with biopsy‐confirmed esophageal squamous LGIN.
Precision glycerine jelly swab for removing pollen from small and fragile insect specimens
Authors: Donald Marion L. , Bolstridge Nic , Ridden Johnathon D.
Published: April 2022

Historical datasets can establish a critical baseline of plant–animal interactions for understanding contemporary interactions in the context of global change. Pollen is often incidentally preserved on animals in natural history collections. Techniques for removing pollen from insects have largely been developed for fresh insect specimens or historical specimens with large amounts of pollen on specialized structures. However, many key pollinating insects do not have these specialized structures and thus, there is a need for a method to extract pollen from these small and fragile insects.

Here, we propose a precision glycerine jelly swab tool to allow for the precise removal of pollen from old, small and fragile insect specimens. We use this tool to remove pollen from five families of insects collected in the late 1970s. Additionally, we compare our method with four previously published techniques for removing pollen from pinned contemporary specimens.

We show the functionality of the precision glycerine jelly swab for removing small quantities of pollen across insect families. We found that across the five methods, all removed pollen; yet, it was clear that some are better suited for fragile specimens. In particular, the traditional glycerine jelly swab and the precision glycerine jelly swabs both performed well for removing pollen from bee faces. The shaking wash resulted in specimen fracture and residue left behind, the ethanol rinses left setae matted, and the glycerol swabbing left residue on the specimen. Additionally, we present photographs documenting the effects of these methods on pinned honey bee specimens.

The precision glycerine jelly swab opens up opportunities to sample pollen from a variety of insects in natural history collections. These pollen samples can be incorporated into downstream analyses for pollen identification either via microscopy or DNA sequencing, and the resulting plant–insect interaction data can establish historical baselines for contemporary comparison. Beyond our application of this method to pollen on insects, this precision glycerine jelly swab tool could be used to explore pollen placement specialization or to sample bryophyte, fungal and tree fern spores dispersing on animals.
Does social support predict increased use of dental services in older men?
Authors: Shu C‐C , Wright FAC , Naganathan V , Blyth FM , Le Couteur DG , Handelsman DJ , Stanaway FF
Published: April 2022

Background

Past research on social support and dental visits in older people has been limited by cross‐sectional design, limited social support dimensions and non‐representative samples.

Methods

Data came from men with natural teeth completing Waves 3 and 4 of the Concord Health and Ageing in Men Project in Sydney, Australia. The relationship between social support at Wave 3 (2011–2012) and at least one dental visit per year at Wave 4 (2014–2016) was examined by Poisson regression. Social support was measured by structural (marital status, living arrangements, family support and social interaction) and functional (social support satisfaction) domains.

Results

About 673 men were analysed. Structural and functional social support were not associated with the pattern of usual dental visits 5 years later in univariable or multivariable analyses. The only consistent significant factor was income source, with older men who had other sources of income more likely to regularly visit the dentist than older men solely reliant on the pension for income (prevalence ratio: 1.31, 95% CI: 1.13–1.52).

Conclusions

We found no differences in the pattern of usual dental visits between older men with different levels and types of social support. For older Australian men, income source seems to be the most important determinant of regular dental visits. © 2022 Australian Dental Association
Eating pizza in prison
Authors: DENYER WILLIS GRAHAM
Published: April 2022

Police work is obviously a question of pursuing subjects. In postslave societies, one figure dominates; police are always after the young Black man. Meanwhile, another distinctive subject of policing exists. In São Paulo, Brazil, police detectives are also worried about the failing White father. He represents a crucial kind of problem: he weakens whiteness by subjecting White children to the indignities that Black children face. His punishment is not incarceration, however. Instead, his punishment is a question of civility and reparation, of being “pedagogical.” Attention to police officers’ decision‐making about these two subjects of everyday policing shows how the long‐standing fallacy of the idealized White family is produced by extracting from the Black family. It reveals the logic of differentiated punishment—civil and reparative punishment for White men, life in prison or death for Black men and boys—as a mechanism in the constant remediation of whiteness as property and accumulation. [whiteness, policing, punishment, men, family, child support, race, São Paulo, Brazil]
Management of oesophageal impaction of button batteries in Queensland
Authors: Chandran Dhina , Park Sooji , Barker Ruth , Burns Hannah
Published: April 2022

Background

Oesophageal button battery impaction (OBBI) is a medical emergency requiring timely removal due to rapid oesophageal tissue injury. The aim of this study was to characterize circumstances of OBBI and identify potential barriers to timely removal of button batteries (BB) in the paediatric population.

Methods

This is a retrospective review of OBBI cases between January 2018 to June 2019. Medical records were used to obtain patient demographics, battery size and type, battery source, location of initial presentation and outcomes. Time to obtaining x‐ray, transfer to tertiary centre and to removal of button battery were recorded.

Results

Eight cases of OBBI were recorded during the 18 months study timeframe. Six patients were male and two were female, aged 0.97 to 2.8 years. Six were from an English‐speaking background and two were from families of non‐English speaking background. Battery removal occurred at Queensland Children's Hospital (QCH) in seven of eight cases. Time from ingestion to initial presentation to hospital ranged from 39 min to 123 h with a mean time of 2 h and 13 min. Overall, the total time from ingestion of BB to removal ranged from 2 h 54 min to 126 h 51 min.

Conclusion

Despite being recognized as a time critical emergency, diagnostic, geographic and logistic challenges in Queensland make optimal care a challenge. Primary prevention strategies coupled with an expanded network for safe battery removal, and novel management strategies such as honey and acetic acid could improve care and reduce morbidity.
Novel vision restoration techniques: 3D bioprinting, gene and stem cell therapy, optogenetics, and the bionic eye
Authors: Menon Abhay , Vijayavenkataraman Sanjairaj
Published: April 2022

Background

Vision restoration has been one of the most sought‐after goals of ophthalmology because of its inception. Despite these problems being tackled from numerous different perspectives, a concrete solution has not yet been achieved. An optimal solution will have significant implications on the patient's quality of life, socioeconomic status, and mental health.

Methods

This article will explore new and innovative approaches with one common aim—to restore functional vision for the visually impaired. These novel techniques include 3D bioprinting, stem cell therapy, gene therapy, implantable devices, and optogenetics.

Results

While the techniques mentioned above show significant promise, they are currently in various stages of development ranging from clinical trials to commercial availability. Restoration of minimal vision in specific cases has already been achieved by the different methods but optimization of different parameters like biocompatibility, spatiotemporal resolution, and minimizing the costs are essential for widespread use.

Conclusion

The developments over the past decade have resulted in multiple milestones in each of the techniques with many solutions getting approved by the FDA. This article will compare these novel techniques and highlight the major advantages and drawbacks of each of them.
Non‐invasive phrenic nerve stimulation to avoid ventilator‐induced diaphragm dysfunction in critical care
Authors: Keogh Conor , Saavedra Francisco , Dubo Sebastian , Aqueveque Pablo , Ortega Paulina , Gomez Britam , Germany Enrique , Pinto Daniela , Osorio Rodrigo , Pastene Francisco , Poulton Adrian , Jarvis Jonathan , Andrews Brian , FitzGerald James J.
Published: April 2022

Background

Diaphragm muscle atrophy during mechanical ventilation begins within 24 h and progresses rapidly with significant clinical consequences. Electrical stimulation of the phrenic nerves using invasive electrodes has shown promise in maintaining diaphragm condition by inducing intermittent diaphragm muscle contraction. However, the widespread application of these methods may be limited by their risks as well as the technical and environmental requirements of placement and care. Non‐invasive stimulation would offer a valuable alternative method to maintain diaphragm health while overcoming these limitations.

Methods

We applied non‐invasive electrical stimulation to the phrenic nerve in the neck in healthy volunteers. Respiratory pressure and flow, diaphragm electromyography and mechanomyography, and ultrasound visualization were used to assess the diaphragmatic response to stimulation. The electrode positions and stimulation parameters were systematically varied in order to investigate the influence of these parameters on the ability to induce diaphragm contraction with non‐invasive stimulation.

Results

We demonstrate that non‐invasive capture of the phrenic nerve is feasible using surface electrodes without the application of pressure, and characterize the stimulation parameters required to achieve therapeutic diaphragm contractions in healthy volunteers. We show that an optimal electrode position for phrenic nerve capture can be identified and that this position does not vary as head orientation is changed. The stimulation parameters required to produce a diaphragm response at this site are characterized and we show that burst stimulation above the activation threshold reliably produces diaphragm contractions sufficient to drive an inspired volume of over 600 ml, indicating the ability to produce significant diaphragmatic work using non‐invasive stimulation.

Conclusion

This opens the possibility of non‐invasive systems, requiring minimal specialist skills to set up, for maintaining diaphragm function in the intensive care setting.
Risk factors of pediatric venoarterial extracorporeal membrane oxygenation‐related gastrointestinal bleeding after open‐heart surgeries
Authors: Yang Yinyu , Yu Xindi , Guo Zheng , Zhang Wei , Shen Jia , Wang Wei
Published: April 2022

Objective

To analyze the risk factors for gastrointestinal (GI) bleeding in congenital heart disease (CHD) patients supported with venoarterial extracorporeal membrane oxygenation (V‐A ECMO) after open‐heart surgery.

Methods

A retrospective analysis was performed on children with (GI group: 26 cases) and without (control group: 122 cases) GI bleeding during ECMO at Shanghai Children's Medical Center from 2017 to 2020. Clinical data were analyzed and compared between groups to search for risk factors for GI bleeding.

Results

A total of 148 cases were included in the study. The overall incidence of GI bleeding was 17.6% (26/148). The in‐hospital mortality rate in the GI group was 61.5% (16/26) versus 45.9% (56/122) in the control group. Twenty‐six patients suffered cardiac arrest before ECMO support. The GI bleeding incidence among extracorporeal cardiopulmonary resuscitation (ECPR) patients was 50.0% (13/26) versus 28.7 (35/122) among non‐ECPR patients, p = 0.035. The activated clotting time (ACT) was 201.40 s (180.47 to 247.27) in the GI group versus 177.63 s (167.79 to 203.13) (p = 0.050) in the control group. The lowest antithrombin level (Min AT) was 27.00 ± 13.07% versus 37.62 ± 15.18 (p = 0.001). The pH and lactate levels before ECMO (Pre PH and Pre Lac) were lower in the GI group than in the control group. (7.31 ± 0.23 vs. 7.35 ± 0.17, p = 0.035 and 12.2 ± 6.11 vs. 7.78 ± 6.67, p = 0.003). Liver function during ECMO support was statistically worse in the GI group than in the control group. Multivariate analysis showed that Pre Lac (OR = 1.106 [1.018–1.202], p = 0.0016) was an independent risk factor for GI bleeding. ROC analysis of Pre Lac and GI bleeding showed an area under the curve (AUC) of 0.700 (95% CI: 0.600–0.800, p = 0.002) and a cutoff value of 9.30 mmol/L (sensitivity, 73.1%; specificity, 62.7%).

Conclusions

As the first study in this field, the probability of GI bleeding and related mortality was found to be high in children supported with V‐A ECMO after open‐heart surgery. A higher lactate level before ECMO was an independent risk factor for GI bleeding.
An infrared image‐enhancement algorithm in simulated prosthetic vision: Enlarging working environment of future retinal prostheses
Authors: Liang Junling , Li Heng , Chen Jianpin , Zhai Zhenzhen , Wang Jing , Di Liqing , Chai Xinyu
Published: April 2022

Background

Most existing retinal prostheses contain a built‐in visible‐light camera module that captures images of the surrounding environment. Thus, in case of insufficient or lack of visible light, the camera fails to work, and the retinal prostheses enter a dormant or “OFF” state. A simple and effective solution is replacing the visible‐light camera with a dual‐mode camera. The present research aimed to achieve two main purposes: (1) to explore whether the dual‐mode camera in prosthesis recipients works under no visible‐light conditions and (2) to assess its performance.

Methods

To accomplish these aims, we enrolled subjects in a psychophysical experiment under simulated prosthetic vision conditions. We found that the subjects could complete some simple visual tasks, but the recognition performance under the infrared mode was significantly inferior to that under the visible‐light mode. These results inspired us to develop and propose a feasible infrared image‐enhancement processing algorithm. Another psychophysical experiment was performed to verify the feasibility of the algorithm.

Results

The obtained results showed that the average efficiency of the subjects completing visual tasks using our enhancement algorithm (0.014 ± 0.001) was significantly higher (p < 0.001) than that of subjects using direct pixelization (0.007 ± 0.001).

Conclusions

We concluded that a dual‐mode camera could be a feasible solution to improving the performance of retinal prostheses as the camera adapted better to the specific existing ambient light conditions. Dual‐mode cameras combined with this infrared image‐enhancement algorithm could provide a promising direction for the design of future retinal prostheses.
Short‐term preservation of porcine zygotes at ambient temperature using a chemically defined medium
Authors: Lin Qingyi , Le Quynh Anh , Takebayashi Koki , Hirata Maki , Tanihara Fuminori , Sawamoto Osamu , Kikuchi Takeshi , Otoi Takeshige
Published: April 2022

We aimed to develop a simple method for the short‐term preservation of in vitro‐produced porcine zygotes at 25°C for up to 2 days. Firstly, we evaluated the efficiency of three storage solutions to preserve porcine zygotes at 25°C for 24 h. Two of these were commercially available defined media for cell storage (Cell‐W and Cell‐S), and the third was fetal bovine serum (FBS). Thereafter, we examined the effects of storing the zygotes in the Cell‐W solution for 24–72 h at 25°C. The Cell‐W solution was the most efficient for 24 h storage of porcine zygotes at 25°C, with no apparent effects on blastocyst quality. However, short‐term storage of porcine zygotes for 24 h reduced the blastocyst formation rate compared with the fresh control group. As storage duration increased from 24 to 48 or 72 h, blastocyst formation rates were significantly decreased from 11.3% to 4.4% and 0%, respectively. In conclusion, during zygote storage, the developmental competence to the blastocyst stage decreased with time. Storage of zygotes in chemically defined media did not affect blastocyst quality, but the storage in 100% serum had an adverse effect on developing embryos causing apoptosis.
Development and validation of a life expectancy calculator for US patients with prostate cancer
Authors: Chase Elizabeth C. , Bryant Alex K. , Sun Yilun , Jackson William C. , Spratt Daniel E. , Dess Robert T. , Schipper Matthew J.
Published: April 2022

Objective

To develop and validate an accurate, usable prediction model for other‐cause mortality (OCM) in patients with prostate cancer diagnosed in the United States.

Materials and Methods

Model training was performed using the National Health and Nutrition Examination Survey 1999–2010 including men aged >40 years with follow‐up to the year 2014. The model was validated in the Prostate, Lung, Colon, and Ovarian Cancer Screening Trial prostate cancer cohort, which enrolled patients between 1993 and 2001 with follow‐up to the year 2015. Time‐dependent area under the curve (AUC) and calibration were assessed in the validation cohort. Analyses were performed to assess algorithmic bias.

Results

The 2420 patient training cohort had 459 deaths over a median follow‐up of 8.8 years among survivors. The final model included eight predictors: age; education; marital status; diabetes; hypertension; stroke; body mass index; and smoking. It had an AUC of 0.75 at 10 years for predicting OCM in the validation cohort of 8220 patients. The final model significantly outperformed the Social Security Administration life tables and showed adequate predictive performance across race, educational attainment, and marital status subgroups. There is evidence of major variability in life expectancy that is not captured by age, with life expectancy predictions differing by 10 or more years among patients of the same age.

Conclusion

Using two national cohorts, we have developed and validated a simple and useful prediction model for OCM for patients with prostate cancer treated in the United States, which will allow for more personalized treatment in accordance with guidelines.
Reconstructing subsurface sandbody connectivity from temporal evolution of surface networks
Authors: Steel Elisabeth , Paola Chris , Chadwick Austin J. , Hariharan Jayaram , Passalacqua Paola , Xu Zhongyuan , Michael Holly A. , Brommecker Hannah , Hajek Elizabeth A.
Published: April 2022

Characterization of groundwater aquifers and hydrocarbon reservoirs requires an understanding of the distribution and connectivity of subsurface sandbodies. In deltaic environments, distributary channel networks serve as the primary conduits for water and sediment. Once these networks are buried and translated into the subsurface, the coarse‐grained channel fills serve as primary conduits for subsurface fluids such as water, oil or gas. The temporal evolution of channels on the surface therefore plays a first‐order role in the 3D permeability and connectivity of subsurface networks. Land surface imagery is more broadly available than topographic or subsurface data, and time‐series imagery of river networks can hold useful information for constraining the shallow subsurface. However, these reconstructions require an understanding of the degree to which channel bathymetry and river kinematics affect connectivity of subsurface sandbodies. Here, we present a novel method for building synthetic cross sections using overhead images of an experimental delta. We use principal components analysis to extract river networks from surface imagery, then couple this with an inverse‐CDF method to estimate channel bathymetry, to generate a time‐series of synthetic delta topography. This synthetic topography is then transformed, accounting for deposition and subsidence, to produce synthetic stratigraphy that differentiates coarse‐grained channel fill from overbank and offshore deposition. We find that large‐scale subsurface architecture is relatively insensitive to details of channel bathymetry, but instead is primarily controlled by channel location and kinematics. We analyse the connectivity of sand bodies and the geometries of barriers to flow and find that periods of rapid sea‐level rise have more variability in sand body connectivity. We also find that barrier width decreases downstream during all sea‐level phases. Our method generates synthetic stratigraphy that closely resembles the large‐scale architecture and 2‐dimensional connectivity of the real stratigraphy built during the experiment it was based on. We anticipate that it will be broadly applicable to other experimental and field‐scale scenarios.
Current status of first‐line treatment with pembrolizumab for non–small‐cell lung cancer with high PD‐L1 expression
Authors: Ikezawa Yasuyuki , Mizugaki Hidenori , Morita Ryo , Tateishi Kazunari , Yokoo Keiki , Sumi Toshiyuki , Kikuchi Hajime , Kitamura Yasuo , Nakamura Atsushi , Kobayashi Maki , Aso Mari , Kimura Nozomu , Yoshiike Fumiaki , Furuta Megumi , Tanaka Hisashi , Sekikawa Motoki , Hachiya Tsutomu , Nakamura Keiichi , Shimokawa Mototsugu , Oizumi Satoshi
Published: April 2022

It is not clear whether pembrolizumab monotherapy (MONO) or pembrolizumab plus platinum‐based chemotherapy (COMB) should be selected for patients with advanced non–small‐cell lung cancer (NSCLC) exhibiting high PD‐L1 expression (tumor proportion score ≥ 50%). We performed a retrospective, multicenter study of 300 patients with NSCLC exhibiting high PD‐L1 expression who received MONO or COMB as first‐line treatment between December 2018 and January 2020. We reviewed the medical records of all consecutive patients with no driver mutations, and assessed the patient characteristics, therapeutic regimens, treatment periods, and adverse events. In total, 166 (55%; median age: 74 years) and 134 (45%; median age: 68 years) patients received MONO and COMB, respectively. Patients were younger and had better performance status (0–1) in the COMB group (p < 0.01). With a median follow‐up time of 10.6 (range: 0.1–20.6) months, the median progression‐free survival was 7.1 months with MONO and 13.1 months with COMB. The objective response rate was 42.2% with MONO and 67.9% with COMB. With respect to treatment discontinuation, 36 out of 166 (21.7%) and 28 out of 134 (20.1%) patients discontinued MONO and COMB, respectively. In conclusion, COMB may be a promising option for first‐line treatment for NSCLC with high PD‐L1 expression and good performance status.
Linguistic Redundancy and its Effects on Younger and Older Adults’ Real‐Time Comprehension and Memory
Authors: Saryazdi Raheleh , Nuque Joanne , Chambers Craig G.
Published: April 2022

Redundant modifiers can facilitate referential interpretation by narrowing attention to intended referents. This is intriguing because, on traditional accounts, redundancy should impair comprehension. Little is known, however, about the effects of redundancy on older adults’ comprehension. Older adults may show different patterns due to age‐related decline (e.g., processing speed and memory) or their greater proclivity for linguistic redundancy, as suggested in language production studies. The present study explores the effects of linguistic redundancy on younger and older listeners’ incremental referential processing, judgments of informativity, and downstream memory performance. In an eye tracking task, gaze was monitored as listeners followed instructions from a social robot referring to a unique object within a multi‐object display. Critical trials were varied in terms of modifier type (“…closed/purple/[NONE] umbrella”) and whether displays contained another object matching target properties (closed purple notebook), making modifiers less effective at narrowing attention. Relative to unmodified descriptions, redundant color modifiers facilitated comprehension, particularly when they narrowed attention to a single referent. Descriptions with redundant state modifiers always impaired real‐time comprehension. In contrast, memory measures showed faster recognition of objects previously described with redundant state modifiers. Although color and state descriptions had different effects on referential processing and memory, informativity judgments showed participants perceived them as informationally redundant to the same extent relative to unmodified descriptions. Importantly, the patterns did not differ by listener age. Together, the results show that the effects of linguistic redundancy are stable across adulthood but vary as a function of modifier type, visual context, and the measured phenomenon.