bluuebunny/crossref_metadata_2025 huggingface dataset:
Arrayed waveguide gratings (AWGs) in ZBLAN fibers for switchable dual-wavelength fiber lasers in the O- and S-band regions
Authors: Ahmad Harith , Nizamani Bilal , Samion Muhamad Zharif , Radzi Zamri , Sun Shufeng
Published: September 2024

In this work, the potential of arrayed waveguide gratings (AWGs) in ZrF4-BaF2-LaF3-AlF3-NaF (ZBLAN) fibers to produce a dual-wavelength fiber laser (DWFL) is presented, covering the O- and S- communication bands. These DWFLs are rarely reported, and this is the first demonstration in these bands using AWGs and ZBLAN fibers with dopants such as praseodymium and thulium. The O-band DWFL was achieved in a praseodymium-doped fluoride fiber laser (PDFFL), and the S-band DWFL was obtained in thulium-doped fluoride fiber lasers (TDFFLs). The dual wavelength with a wavelength spacing of 2.7 nm was generated at operating wavelengths of 1307.4 and 1310.1 nm in the O-band. Meanwhile, the S-band DWFL was generated at operating wavelengths of 1503.6 and 1505.9 nm, with a wavelength spacing of 2.3 nm. The two DWFLs were switched by changing AWG channels within the PDFFL and TDFFL cavities. The O-band and S-band DWFLs were switchable at wavelength spacings of 2.7–22.8 nm and 2.3–20.8 nm, respectively. These DWFLs in communication bands provide opportunities for possible applications in dense wavelength division multiplexing high-speed optical networks.
The effect of afforestation on a regional carbon sink: a case study in the Yangtze River Delta, China
Authors: Zhao Yuan , Yue Xu , Zhou Hao , Yu Zhen , Yuan Wenping
Published: September 2024

As one of the most densely populated and economically developed regions in China, Yangtze River Delta (YRD) has confronted with substantial land cover change (LCC) over the past several decades. This study investigates the impact of climate change and LCC on carbon dynamics in the YRD region for 1990–2019, taking advantage of a high-resolution vegetation model and two well-established LCC data in China. Simulated gross primary productivity increases from 0.52 ± 0.02 Pg[C] yr−1 in the 1990s to 0.57 ± 0.01 Pg[C] yr−1 in the 2010s with the major contribution by CO2 fertilization effect. The regional carbon sink, measured as net biospheric productivity (NBP), peaks at 0.03 Pg[C] yr−1 in the 2000s but remains stable or slightly decreases in the 2010s depending on the LCC datasets. Forests act as the main contributors to the enhancement of the regional carbon sink, with negative contributions from the loss of shrubland and grassland. The stable NBP during 2000–2019 suggests a potential slowdown in the efficacy of carbon sink as forests mature. While forest expansion significantly promotes NBP, the carbon released during the replacement of other vegetation types suggests that afforestation efforts need to be complemented with associated supportive measures to prevent newly forested areas from becoming net carbon sources.
Distributions of Hook lengths in integer partitions
Authors: Griffin Michael , Ono Ken , Tsai Wei-Lun
Published: September 2024

Motivated by the many roles that hook lengths play in mathematics, we study the distribution of the number of

t
t

-hooks in the partitions of

n
n

. We prove that the limiting distribution is normal with mean
\[

μ
t

(
n
)
∼

6
n

π

−

t
2

\mu _t(n)\sim \frac {\sqrt {6n}}{\pi }-\frac {t}{2}

\]
and variance
\[

σ
t
2

(
n
)
∼

(

π
2

−
6
)

6
n

2

π
3

.

\sigma _t^2(n)\sim \frac {(\pi ^2-6)\sqrt {6n}}{2\pi ^3}.

\]
Furthermore, we prove that the distribution of the number of hook lengths that are multiples of a fixed

t
≥
4

t\geq 4

in partitions of

n
n

converge to a shifted Gamma distribution with parameter

k
=
(
t
−
1
)

/

2

k=(t-1)/2

and scale

θ
=

2

/

(
t
−
1
)

\theta =\sqrt {2/(t-1)}

.
On eigenvalue gaps of integer matrices
Authors: Abrams Aaron , Landau Zeph , Pommersheim Jamie , Srivastava Nikhil
Published: September 2024

Given an

n
×
n

n\times n

matrix with integer entries in the range

[
−
h
,
h
]

[-h,h]

, how close can two of its distinct eigenvalues be?

The best previously known examples (Lu [Minimum eigenvalue separation, ProQuest LLC, Ann Arbor, MI, 1992. Thesis (Ph.D.)–University of California, Berkeley; Wilkinson [The algebraic eigenvalue problem, Monographs on Numerical Analysis, The Clarendon Press, Oxford University Press, New York, 1988]) have a minimum gap of

h

−
O
(
n
)

h^{-O(n)}

. Here we give an explicit construction of matrices with entries in

[
0
,
h
]

[0,h]

with two eigenvalues separated by at most

h

−

n
2

/

16
+
o
(

n
2

)

h^{-n^2/16+o(n^2)}

. Up to a constant in the exponent, this agrees with the known lower bound of

Ω
(
(
2

n

)

−

n
2

h

−

n
2

)

\Omega ((2\sqrt {n})^{-n^2}h^{-n^2})

(Mahler [Michigan Math. J. 11 (1964), pp. 257–262]). Bounds on the minimum gap are relevant to the worst case analysis of algorithms for diagonalization and computing canonical forms of integer matrices (e.g. Dey et al. [Bit complexity of Jordan normal form and polynomial spectral factorization, Schloss Dagstuhl. Leibniz-Zent. Inform., Wadern, 2023, pp. Art. No. 42]).

In addition to our explicit construction, we show there are many matrices with a slightly larger gap of roughly

h

−

n
2

/

32

h^{-n^2/32}

. We also construct 0-1 matrices which have two eigenvalues separated by at most

2

−

n
2

/

64
+
o
(

n
2

)

2^{-n^2/64+o(n^2)}

.
Do we have our FACTTs straight about cor pulmonale in acute respiratory distress syndrome?
Authors: Hockstein Maxwell A , Duggal Abhijit , Siuba Matthew T
Published: September 2024

Aims

The incidence of cor pulmonale in acute respiratory distress syndrome is roughly 20–25% and is associated with nearly 50% increase in mortality risk. Our primary aim was to quantify the association of traditional cor pulmonale risk factors {pH, PaO2:FiO2 ratio, PaCO2, and driving pressure [plateau pressure minus the positive end-expiratory pressure (PEEP)]} and PEEP with the mentioned cor pulmonale parameters.

Methods and results

Using data from the FACTT trial, we examined four cor pulmonale parameters. In addition to pulmonary arterial compliance (Cpa) and pulmonary vascular resistance index (PVRi), we assessed pulmonary artery pulsatility index (PAPi) and effective arterial elastance (Ea) of the pulmonary circulation. Median [interquartile range (IQR)] Cpa on study day 1 was 4.28 mL/mmHg (3.14, 6.08). Increasing pH and P:F were associated with an increase in Cpa. Median (IQR) Ea on Day 1 was 0.48 mmHg/mL (0.36, 0.66). Increase of pH, PaCO2, and P:F were associated with a decrease in Ea, while an increase in PEEP was associated with an increase in Ea. Median (IQR) PAPi on Day 1 was 1.58 (1.13, 2.38). Increase in pH was associated with an increase in PAPi, while increase in PEEP was associated with a decrease in PAPi. Median (IQR) PVRi on Day 1 was 3.86 WU*m2 (2.45, 4.79). Increases in PaCO2 and P:F were associated with a decrease in PVRi, while increasing driving pressure and PEEP were associated with an increase in PVRi.

Conclusion

While the FACTT data demonstrate neither a clear nor a consistent relationship between right ventricular-pulmonary arterial function and traditional risk factors, this does not indicate their unimportance.
Bone-targeting engineered milk-derived extracellular vesicles for MRI-assisted therapy of osteoporosis
Authors: Huang Qing , Jiang Yang , Cao Yang , Ding Yunchuan , Cai Jinghui , Yang Tingqian , Zhou Xin , Wu Qiang , Li Danyang , Liu Qingyu , Li Fangping
Published: September 2024

The imbalance between osteoblasts and osteoclasts is the cause of osteoporosis. Milk-derived extracellular vesicles (mEVs), excellent drug delivery nanocarriers, can promote bone formation and inhibit bone resorption. In this study, we conjugated bone-targeting peptide (AspSerSer, DSS)6 to mEVs by click chemistry and then loaded with SRT2104, a SIRT1 (silent mating-type information regulation 2 homolog 1) agonist that was proofed to help reduce bone loss. The engineered (DSS)6-mEV-SRT2104 had the intrinsic anti-osteoporosis function of mEVs and SRT2104 to reverse the imbalance in bone homeostasis by simultaneously regulating osteogenesis and osteoclastogenesis. Furthermore, we labelled mEVs with MnB nanoparticles that can be used for the in vivo magnetic resonance imaging (MRI) visualization. The obtained nanocomposites significantly prevented bone loss in osteoporosis mice and increased bone mineral density, exhibiting superior bone accumulation under MRI. We believe the proposed (DSS)6-mEV-SRT2104/MnB provides a novel paradigm for osteoporosis treatment and monitoring.
Management of Vulvovaginal Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis
Authors: Ross Erin E. , Knapp Rachel C. , Ciccone Marcia A. , Garner Warren L. , Gillenwater T. Justin , Yenikomshian Haig A.
Published: September 2024

Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) is an autoimmune process resulting in painful epidermal sloughing that can involve the vulva and vagina. Current guideline recommendations are based on expert opinion and may not reflect modern management of SJS/TEN in burn centers. We performed a retrospective chart review of 34 female patients treated for SJS/TEN at our burn center from 2015 to 2023. Cases frequently involved the vulva (83.3%) and vagina (56.0%), though pelvic examination often was limited. For eight patients with confirmed vulvovaginal lesions, there were no direct sequelae of SJS/TEN requiring intervention. In the modern era of SJS/TEN management in burn centers, interventions such as steroids may not be needed.
Optimizing e-Learning in CPD: Preferences and Perceptions of Health Professionals
Authors: Samuel Anita , Cervero Ronald M. , King Beth , Durning Steven J.
Published: September 2024

Introduction:

Continuing professional development for health professionals increasingly relies on e-learning. However, there is insufficient research into the instructional strategies health professionals prefer to engage with in e-learning. An empirical study was undertaken to answer the research question: What instructional strategies do learners prefer in e-learning modules to improve their learning experience?

Methods:

The Department of Health Professions Education at the Uniformed Services University of Health Sciences developed six, stand-alone, self-paced modules for health professionals focusing on education and leadership. The module evaluation survey consisted of six Likert scale questions and two open-ended questions. Responses from these anonymized module evaluations from 2019 to 2022 were analyzed. Descriptive statistics for the Likert scale questions were calculated. Responses to the two open-ended questions were compiled and analyzed thematically.

Results:

All survey respondents found the content of the modules helpful and met their stated learning objectives. A majority (94%) agreed or strongly agreed that readings and videos increased their knowledge in the topic area and that quizzes effectively strengthened their understanding of the topics. Four themes emerged from the qualitative data: pedagogical strategies, technology issues, feedback and interaction, and transfer of learning.

Conclusions:

This study foregrounds the voice of the learner, which emphasizes health professionals' preference for instructional strategies that align with their needs as adult learners. The findings highlight the value of content relevance, expert creation, and authentic examples in enhancing learner satisfaction.
Developing and Validating a Bundle for Safe Intra-Hospital Transporting of the Critically Ill Patients
Authors: Mahran Ghada Shalaby Khalaf , Mekawy Mimi M. , Abd El-Aziz Wafaa W. , Ali Aida F. A. , El Demerdash Doaa A. , Sayed Magdy M. M.
Published: September 2024

The aim of this study was to develop a bundle to increase safety of intra-hospital transport in critically ill patients. A qualitative design with Delphi approach was conducted for creation of an intra-hospital transport bundle in 3 steps. First, doctors and nurses were questioned about their encounters with intra-hospital transport incidents. Second, several databases were looked through to find published checklists and recommendations for intra-hospital transport. Third, using this strategy, a bundle was created and reviewed with subject matter experts. The content validity index (CVI), which assesses the degree of expert agreement, was utilized to evaluate each item in the generated bundle.

Two evaluation cycles were required before a minimal index could be reached. We looked at the content validity and important weighting of the items. The scale-CVI was calculated using the average of all the elements, and it was 1. The created bundle serves as a framework for directing doctors and nurses during intra-hospital transportation and offers continuity of care to improve patient safety. The techniques suggested in this study can be used to adapt this bundle to the needs of other hospitals.
Effectiveness of the ABCDEF Bundle to Manage and Prevent Delirium
Authors: Nagy Nagm Eldean Tahany , Hassan Bakri Mohamed , Anwar Abdel Aziz Mervet , Shalaby Khalaf Ghada
Published: September 2024

Purpose:

To investigate effectiveness of the ABCDEF bundle to manage and prevent delirium. Background: ICU delirium is a common hospital problem that 80% of critically ill patients in the ICU experience. The ABCDEF bundle is one of the tools that included in Delirium guidelines to manage critically ill patients. Research design: Pre- and post intervention a quasi-experimental design was utilized in the present study. Setting: This study was conducted in the intensive care units of Assiut University Hospital. Methods: A total of 60 mechanically ventilated patients were recruited using inclusion and exclusion criteria. The ABCDEF bundle was implemented every day for the first 7 days of ICU admission, and patient sedation and delirium status were assessed using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Sedation instrument measures were utilized in data collection. Results: Significant differences were found in the incidence of delirium: 20% in the study group versus 70% in the control group. The increased mean of days without delirium ICU stay was 4.6333 in the study group and 1.1000 in the control group, with P value = .001. Conclusion: The mechanically ventilated patients exposed to the implementation of the ABCDE bundle experienced fewer delirium signs than before the ABCDE bundle was implemented.
Effect of the “aSSKINg” Model in Reducing Pressure Ulcer Risk
Authors: Khalaf Mahran Ghada Shalaby , Mohamed Ahmed Nada Ahmed , Bakri Mohamed Hassan , Abdel Aziz Mervet Anwar
Published: September 2024

Pressure ulcer is considered a common and costly problem in the care of patients. Prevention and management of pressure ulcer are very important due to the high cost of treatment and the adverse consequences of pressure ulcer. This study aimed to evaluate the effect of implementing “aSSKINg” model in reducing pressure ulcer risk. This study used a before- and after-intervention quasi-experimental design. This study was performed on 60 patients who were not randomly selected and assigned in to control and study group. The data collection tool was a 3-part sheet (Braden scale, skin health assessment, and Pressure ulcer assessment). The incidence of pressure ulcer was 19 (60.0%) in the control group versus 9 (30.0%) in the study group with statistical significant differences. The most common site of pressure ulcer was coccyx (6 [31.6%]) in the control group and Heel (3 [33.3%]) in the study group. The application of “aSSKINg” model in the patients with pressure ulcers is effective in reducing the incidence and severity of pressure ulcers.
Significance of a Simulation for the Relocation of an Intensive Care Unit
Authors: Yanagawa Youichi , Nagasawa Hiroki , Tada Shinya , Nakamura Saori , Onitsuka Mika , Suzuki Eiko , Sasaki Shino
Published: September 2024

There have been few reports concerning simulation drills for the relocation of severely ill or injured patients treated in intensive care units (ICUs). We herein report our experience of one such simulation drill. It is a Narrative method. A simulation drill was performed on a weekday 2 weeks prior to the actual relocation. We selected 3 mock patients. The first one was a severely ill and unstable patient, the second had severe stroke, and the third had severe trauma. After the simulation, the average transportation time was 15 minutes. The simulation revealed that mock patients with a percutaneous cardiopulmonary support system and intra-aortic balloon pumping in a standard ICU bed could not be accommodated in the elevator. Furthermore, working the elevator controls resulted in wasted time while transferring the patients. As a result, the number of people, who controlled the elevator, was therefore increased during the actual relocation. During the actual relocation, all patients were transported safely and more quickly than predicted based on the results of the simulation drill. Most physicians and paramedical staff have little experience with relocating ICUs, so a simulation drill was necessary to ensure the safe and prompt transport of patients.
Machine Learning Approaches for Automated Diagnosis of Cardiovascular Diseases: A Review of Electrocardiogram Data Applications
Authors: Elmassaoudi Abdelhakim , Douzi Samira , Abik Mounia
Published: September 2024

Cardiovascular diseases (CVDs) have been identified as the leading cause of mortality worldwide. Electrocardiogram (ECG) is a fundamental diagnostic tool used for the diagnosis and detection of these diseases. The new technological tools can help enhance the effectiveness of ECGs. Machine learning (ML) is widely acknowledged as a highly effective approach in the realm of computer-aided diagnostics. This article presents a review of the effectiveness of ML algorithms and deep-learning algorithms in diagnosing, identifying, and classifying CVDs using ECG data. The review identified relevant studies published in the 5 major databases: PubMed, Web of Science (WoS), Scopus, Springer, and IEEE Xplore; between 2021 and 2023, a total of 30 were chosen for the comprehensive quantitative and qualitative. The study demonstrated that different datasets are available online with data related to CVDs. The various ML techniques are employed for the purpose of classification. Based on our investigation, it has been observed that deep learning-based neural network algorithms, such as convolutional neural networks and deep neural networks, have demonstrated superior performance in the detection of entire record data. Furthermore, deep learning showcases its efficacy even when confronted with a scarcity of data. ML approaches utilizing ECG data exhibit a notable proficiency in the realm of diagnosis, hence holding the potential to mitigate the occurrence of disease-related consequences at advanced stages.
Implementation and Evaluation Strategies for Pharmacogenetic Testing in Hospital Settings: A Scoping Review
Authors: Wu Angela , Raack Edward J. , Ross Colin J. D. , Carleton Bruce C.
Published: September 2024

Background:

Pharmacogenetic testing in clinical settings has improved the safety and efficacy of drug treatment. There is a growing number of studies evaluating pharmacogenetic implementation and identifying barriers and facilitators. However, no review has focused on bridging the gap between identifying barriers and facilitators of testing and the clinical strategies adopted in response. This review was conducted to understand the implementation and evaluation strategies of pharmacogenetic testing programs.

Methods:

A PRISMA-compliant scoping review was conducted. The included studies discussed pharmacogenetic testing programs implemented in a hospital setting. Quantitative, qualitative, and mixed design methods were included.

Results:

A total of 232 of the 7043 articles that described clinical pharmacogenetic programs were included. The most common specialties that described pharmacogenetic implementation were psychiatry (26%) and oncology (16%), although many studies described institutional programs implemented across multiple specialties (19%). Different specialties reported different clinical outcomes, but all reported similar program performance indicators, such as test uptake and the number of times the test recommendations were followed. There were benefits and drawbacks to delivering test results through research personnel, pharmacists, and electronic alerts, but active engagement of physicians was necessary for the incorporation of pharmacogenetic results into clinical decision making.

Conclusions:

Further research is required on the maintenance and sustainability of pharmacogenetic testing initiatives. These findings provide an overview of the implementation and evaluation strategies of different specialties that can be used to improve pharmacogenetic testing.
Efficacy, Safety, and Longevity of Hyaluronic Acid Filler Injection in Treating Temple Hollowness by Sonographic Identifying 17 Soft Tissue Layers
Authors: Kim Jong-Seo
Published: September 2024

Background:

Successful aesthetic interventions in upper-face aging require a profound understanding of the intricate anatomy of temporal. This study aimed to comprehensively evaluate the effect of hyaluronic acid (HA) injection in temple areas by combining quantitative analysis with detailed anatomical insights.

Methods:

Twenty-five women received HA injections for temple hollowness. The injections targeted the interfacial layer between superficial and deep temporal fascia. Three-dimensional scanning, hollowness examination, and sonographic measurements were conducted 3 and 6 months postprocedure.

Results:

Sonography identified 17 soft tissue layers in the temple, each with distinct characteristics. The notable layers include the epidermis, dermis, superficial and deep temporal fasciae, innominate fasciae, and superficial and deep temporal fat compartments. Three-dimensional volume was 0.86 mL at 3 months and 0.72 mL at 6 months. The average thickness of HA was 3.82 mm (immediately), 3.00 mm (3 mo), and 2.51 mm (6 mo). The depression on the temple was 4.33 mm (preprocedure), 0.71 mm (3 mo), and 1.62 mm (6 mo). The grade improved by 2.41 and 1.74 levels at 3 and 6 months.

Conclusions:

Identifying detailed superficial and deep layers of the deep temporal fascia challenged traditional descriptions, with detailed dividing of superficial and deep temporal fascia in sonography. Innominate fascia was also distinguished. This study provided a comprehensive evaluation of the effects of HA injections in temple areas. Precise anatomical insights and quantitative assessments contribute to a deeper understanding of the structural changes induced by this procedure. Sonography is valuable for delineating distinct layers and guiding aesthetic interventions in the temporal region.
Netherton Syndrome
Authors: Brown Riley H. , Morrissette Summer V. , McClees Sarah F. , Huynh Thy N.
Published: September 2024

This case describes a 9-day-old female infant who presented with severe skin peeling and diffuse erythema. As the patient was refractory to standard treatment, a working differential diagnosis was built and included infectious, inflammatory, and inherited etiologies. The patient’s workup pointed toward Netherton syndrome, a rare autosomal recessive condition that presents at birth or within the first few weeks of life and is characterized by widespread erythroderma with ichthyosis.
Survey of Clinical Knowledge and Procedural Readiness of Pulmonary Fellows to Start Interventional Pulmonary Fellowship
Authors: DeMarco Benjamin , Ibanez Harold , Pai Cheryl , Batra Hitesh , Argento Angela Christine , Thiboutot Jeffrey , Akulian Jason , Yarmus Lonny , Lee Hans
Published: September 2024

Background:

Entry into the interventional pulmonary (IP) fellowship requires prerequisite training in pulmonary and critical care medicine (PCCM) fellowship in the United States. IP fellowship has become standardized, but the prerequisite training may be quite variable depending on the learner’s exposure to IP during their PCCM fellowship. A survey study was conducted to identify potential foundational knowledge and/or skills gaps of new fellows entering IP fellowships. This may help both PCCM and IP fellowship directors to identify common knowledge gaps within PCCM training specific to IP.

Methods:

Based on components of the ACGME’s common program requirements for PCCM fellowships, a survey was developed and categorized into 5 domains: nonprocedural skills, didactic knowledge, diagnostic bronchoscopy, pleural procedures, and airway/percutaneous procedures. The survey was then sent to 42 IP fellowship directors after the content validity review and approval by the Association of Interventional Pulmonary Program Directors.

Results:

The survey response rate was 88.1% (37/42). The overall mean scores in all 5 domains were perceived as below competent (<3). The highest mean domain was nonprocedural skills, and the lowest was airway/percutaneous procedures. Within the domains, there were 4/ 30 topics that were considered competent with a score of ≥3 as competent or higher; bronchoscopy lavage (mean: 3.5/5, SD: 0.87), interpersonal skills (mean: 3.03/5, SD: 0.76), thoracentesis (mean: 3.14/5, SD: 0.89), and ultrasound for pleural effusion (mean: 3.19/5, SD: 0.84).

Conclusion:

There are perceived gaps in PCCM training pertaining to IP fellowship readiness.
Informing Decision-making for Transected Margin Reresection in Intraductal Papillary Mucinous Neoplasm-derived PDAC
Authors: Habib Joseph R. , Rompen Ingmar F. , Kinny-Köster Benedict , Campbell Brady A. , Andel Paul C.M. , Sacks Greg D. , Billeter Adrian T. , van Santvoort Hjalmar C. , Daamen Lois A. , Javed Ammar A. , Müller-Stich Beat P. , Besselink Marc G. , Büchler Markus W. , He Jin , Wolfgang Christopher L. , Molenaar I. Quintus , Loos Martin
Published: September 2024

Objective:

To assess the prognostic impact of margin status in patients with resected intraductal papillary mucinous neoplasms (IPMN)-derived pancreatic ductal adenocarcinoma (PDAC) and to inform future intraoperative decision-making on handling differing degrees of dysplasia on frozen section.

Summary Background Data:

The ideal oncologic surgical outcome is a negative transection margin with normal pancreatic epithelium left behind. However, the prognostic significance of reresecting certain degrees of dysplasia or invasive cancer at the pancreatic neck margin during pancreatectomy for IPMN-derived PDAC is debatable.

Methods:

Consecutive patients with resected and histologically confirmed IPMN-derived PDAC (2002-2022) from six international high-volume centers were included. The prognostic relevance of a positive resection margin (R1) and degrees of dysplasia at the pancreatic neck margin were assessed by log-rank test and multivariable Cox-regression for overall survival (OS) and recurrence-free survival (RFS).

Results:

Overall, 832 patients with IPMN-derived PDAC were included with 322 patients (39%) having an R1-resection on final pathology. Median OS (mOS) was significantly longer in patients with an R0 status compared to those with an R1 status (65.8 vs. 26.3 mo P<0.001). Patients without dysplasia at the pancreatic neck margin had similar OS compared to those with low-grade dysplasia (mOS: 78.8 vs. 66.8 months, P=0.344). However, high-grade dysplasia (mOS: 26.1 mo, P=0.001) and invasive cancer (mOS: 25.0 mo, P<0.001) were associated with significantly worse OS compared to no or low-grade dysplasia. Patients who underwent conversion of high-risk margins (high-grade or invasive cancer) to a low-risk margin (low-grade or no dysplasia) after intraoperative frozen section had significantly superior OS compared to those with a high-risk neck margin on final pathology (mOS: 76.9 vs. 26.1 mo P<0.001).

Conclusions:

In IPMN-derived PDAC, normal epithelium or low-grade dysplasia at the neck have similar outcomes while pancreatic neck margins with high-grade dysplasia or invasive cancer are associated with poorer outcomes. Conversion of a high-risk to low-risk margin after intraoperative frozen section is associated with survival benefit and should be performed when feasible.
Human metapneumovirus (hMPV): an associated etiology of severe acute respiratory infection in children of Eastern Uttar Pradesh, India
Authors: Deval Hirawati , Kumar Niraj , Srivastava Mitali , Potdar Varsha , Mehta Anita , Verma Ayushi , Singh Rajeev , Kavathekar Asif , Kant Rajni , Murhekar Manoj
Published: September 2024

Acute respiratory infections (ARIs) are a serious public health concern across the world, causing considerable morbidity and mortality. Every year, around 13 million children under the age of five die. Approximately 95% of them are from developing nations, and ARIs are responsible for one-third of all deaths. Human Metapneumovirus (hMPV) is one of the causative agents associated with respiratory tract infections. There is lack of information about hMPV from the eastern region of Uttar Pradesh. At Indian Council of Medical Research- Regional Medical Research Centre, Gorakhpur (ICMR‐RMRC, Gorakhpur) in Uttar Pradesh, India; we tested respiratory pathogens in under-five patients presenting with ARI and severe acute respiratory illness (SARI) through semi nested PCR. A total of 100 nasal and throat specimens were collected from the outdoor and indoor patient Departments (OPD) and (IPD) of Department of Paediatrics, BRD Medical College, Gorakhpur during February to April 2022. Out of 100 enrolled paediatric patients, 4(4%) were found to be hMPV positive. Among the patients who tested positive for hMPV, 25%(1/4) unfortunately died. The phylogenetic analysis of hMPV showed the close resemblance with the clade of Singapore and USA hMPV isolates. The study underlines the importance of hMPV as the cause of acute respiratory infections in children and the highlight the need for routine testing for this virus in laboratories. Further more comprehensive detailed study on various aspects of hMPV in this area is needed.
Streptomyces castrisilvae sp. nov. and Streptomyces glycanivorans sp. nov., novel soil streptomycetes metabolizing mutan and alternan
Authors: Widén Tove , Rangel Albert Tafur , Lombard Vincent , Drula Elodie , Mazurkewich Scott , Terrapon Nicolas , Kerkhoven Eduard J. , Larsbrink Johan
Published: September 2024

Six bacterial strains, Mut1T, Mut2, Alt1, Alt2, Alt3T, and Alt4, were isolated from soil samples collected in parks in Gothenburg, Sweden, based on their ability to utilize the insoluble polysaccharides α−1,3-glucan (mutan; Mut strains) or the mixed-linkage α−1,3/α−1,6-glucan (alternan; Alt strains). Analysis of 16S rRNA gene sequences identified all strains as members of the genus Streptomyces. The genomes of the strains were sequenced and subsequent phylogenetic analyses identified Mut2 as a strain of Streptomyces laculatispora and Alt1, Alt2 and Alt4 as strains of Streptomyces poriferorum, while Mut1T and Alt3T were most closely related to the type strains Streptomyces drozdowiczii NBRC 101007T and Streptomyces atroolivaceus NRRL ISP-5137T, respectively. Comprehensive genomic and biochemical characterizations were conducted, highlighting typical features of Streptomyces, such as large genomes (8.0–9.6 Mb) with high G+C content (70.5–72.0%). All six strains also encode a wide repertoire of putative carbohydrate-active enzymes, indicating a capability to utilize various complex polysaccharides as carbon sources such as starch, mutan, and cellulose, which was confirmed experimentally. Based on phylogenetic and phenotypic characterization, our study suggests that strains Mut1T and Alt3T represent novel species in the genus Streptomyces for which the names Streptomyces castrisilvae sp. nov. and Streptomyces glycanivorans sp. nov. are proposed, with strains Mut1T (=DSM 117248T=CCUG 77596T) and Alt3T (=DSM 117252T=CCUG 77600T) representing the respective type strains.
Towards quantifying plasmid similarity
Authors: Matlock William , Shaw Liam P. , Sheppard Samuel K. , Feil Edward
Published: September 2024

Plasmids are extrachromosomal replicons which can quickly spread resistance and virulence genes between clinical pathogens. From the tens of thousands of currently available plasmid sequences we know that overall plasmid diversity is structured, with related plasmids sharing a largely conserved ‘backbone’ of genes while being able to carry very different genetic cargo. Moreover, plasmid genomes can be structurally plastic and undergo frequent rearrangements. So, how can we quantify plasmid similarity? Answering this question requires practical efforts to sample natural variation as well as theoretical considerations of what defines a group of related plasmids. Here we consider the challenges of analysing and rationalising the current plasmid data deluge to define appropriate similarity thresholds.
Deep Learning-Based Detection of Reticular Pseudodrusen in Age-Related Macular Degeneration on Optical Coherence Tomography
Authors: Kumar Himeesh , Bagdasarova Yelena , Song Scott , Hickey Doron G. , Cohn Amy C. , Okada Mali , Finger Robert P. , Terheyden Jan H. , Hogg Ruth E. , Gabrielle Pierre-Henry , Arnould Louis , Jannaud Maxime , Hadoux Xavier , van Wijngaarden Peter , Abbott Carla J. , Hodgson Lauren A.B. , Schwartz Roy , Tufail Adnan , Chew Emily Y. , Lee Cecilia S. , Fletcher Erica L. , Bahlo Melanie , Ansell Brendan R.E. , Pébay Alice , Guymer Robyn H. , Lee Aaron Y. , Wu Zhichao
Published: September 2024

Reticular pseudodrusen (RPD) signify a critical phenotype driving vision loss in age-related macular degeneration (AMD). Their detection is paramount in the clinical management of those with AMD, yet they remain challenging to reliably identify. We thus developed a deep learning (DL) model to segment RPD from 9,800 optical coherence tomography B-scans, and this model produced RPD segmentations that had higher agreement with four retinal specialists (Dice similarity coefficient [DSC]=0·76 [95% confidence interval [CI] 0·71–0·81]) than the agreement amongst the specialists (DSC=0·68, 95% CI=0·63–0·73;p<0·001). In five external test datasets consisting of 1,017 eyes from 812 individuals, the DL model detected RPD with a similar level of performance as two retinal specialists (area-under-the-curve of 0·94 [95% CI=0·92–0·97], 0·95 [95% CI=0·92–0·97] and 0·96 [95% CI=0·94–0·98] respectively;p≥0·32). This DL model enables the automatic detection and quantification of RPD with expert-level performance, which we have made publicly available.
Adjusting for specificity of symptoms reveals higher prevalence of asymptomatic SARS-CoV-2 infections than previously estimated
Authors: Tiwari Akshay , Chowdhury Shreya , James Ananthu , Chatterjee Budhaditya , Dixit Narendra M.
Published: September 2024

Accurate estimates of the prevalence of asymptomatic SARS-CoV-2 infections,ψ, have been important for understanding and forecasting the trajectory of the COVID-19 pandemic. Two-part population-based surveys, which test the infection status and also assess symptoms, have been used to estimateψ. Here, we identified a widely prevalent confounding effect that compromises these estimates and devised a formalism to adjust for it. The symptoms associated with SARS-CoV-2 infection are not all specific to SARS-CoV-2. They can be triggered by a host of other conditions, such as influenza virus infection. By not accounting for the source of the symptoms, the surveys may misclassify individuals experiencing symptoms from other conditions as symptomatic for SARS-CoV-2, thus underestimatingψ. We developed a rigorous formalism to adjust for this confounding effect and derived a facile formula for the adjusted prevalence,ψadj. We applied it to data from 50 published serosurveys, conducted on the general populations from 28 nations. We found thatψadjwas significantly higher than the reported prevalence,ψc(P=3×10−8). The medianψadjwas ∼60%, whereas the medianψcwas ∼40%. In several instances,ψadjexceededψcby >100%. These findings suggest that asymptomatic infections have been far more prevalent than previously estimated. Our formalism can be readily deployed to obtain more accurate estimates ofψfrom standard population-based surveys, without additional data collection. The findings have implications for understanding COVID-19 epidemiology and devising more effective interventions.
Gendered resistances and emotions to neo-liberalism in a post-1992 university in England
Authors: Tsouroufli Maria , Walton Anita , Thompson David
Published: September 2024

Purpose

In this paper we explore the gendered ways in which academic staff resistance and compliance is configured in a post-1992 University in England, including the emotions implicated in the navigation of neo-liberalisation and research intensification of their academic institution and its associated disciplinarian mechanisms.

Design/methodology/approach

We draw on data from an interview study of a diverse sample of 32 academics of different gender, discipline and academic grade. Analysis informed by a feminist post-structuralist framework of power and discourse explored different forms of academic resistance and compliance; how the embodied academic subject was (re)negotiated within gendered discourses of neo-liberal research excellence and managerialism and the gendered emotions generated in processes of resistance and compliance.

Findings

Institutional change and expectations to engage with research performativity generated fear, anxiety and anger. Female staff appeared to actively resist the masculinized research subject performing all hours work and individualism in the context of private and institutional gendered relations and labour. Male staff though actively resisted the feminization of higher education and the neo-liberal instrumentalization of caring and therapeutic cultures and ideologically resisted the surveillance mechanisms of higher education including the REF.

Research limitations/implications

Our work contributes to scholarship problematizing the assumed neutrality of resistance and compliance and highlighting women’s symbolic struggle to (dis)identify with a masculine professional norm. In terms of theorising academic resistance to neo-liberalism and identity construction, further attention should be given to the mobilization and symbolic capital of academics and emotions positioned differently due to their gender and intersecting differences.

Originality/value

Our study addresses a gap in the scholarship of academic resistance and compliance by advancing the understanding of gender inequalities and emotions implicated in the process of resistance and compliance against neo-liberalism.
The impact of superstition on corporate tax avoidance: how do CEOs trade off risks associated with tax avoidance?
Authors: He Guanming , Shen Dongxiao
Published: September 2024

Purpose

We examine how superstition shapes corporate tax avoidance and do so by taking a risk perspective and focusing on the zodiac-year belief prevalent in China.

Design/methodology/approach

We adopt a difference-in-differences research design to compare the degree of corporate tax avoidance in the CEOs’ zodiac year with that in the adjacent years. We do propensity-score matching to form a sample of Chinese listed firms for the regression analysis.

Findings

We find causal evidence that firms exhibit a greater magnitude of tax avoidance in the CEOs’ zodiac years, a result attributable to relatively weak tax enforcement in the Chinese context. We also find that the zodiac-year effect on corporate tax avoidance is more pronounced for firms with tight financial constraints, firms with high business risk, firms headquartered in regions with a high degree of superstition and non-state-owned firms.

Originality/value

This study is the first to show that superstition is a determinant factor of tax avoidance and contributes to the tax literature by shedding light on the behavioral risk factors that shape corporate tax avoidance. We take the perspective of CEOs’ risk appetite to analyze how tax avoidance is influenced by the CEOs’ trade-off between the costs and benefits of avoiding taxes. Our results suggest that, when CEOs are more risk-averse, they attach more importance to financial risk than the risk of reputational losses and litigation associated with corporate tax avoidance. The findings imply that tax avoidance can be curbed by increasing (or decreasing) the tax (financial) risk confronting the CEOs.
Unveiling iconic sounds as intangible cultural heritage of a tourist city
Authors: Mediastika Christina Eviutami , Sudarsono Anugrah Sabdono , Utami Sentagi Sesotya , Rachman Zulfi Aulia , Yanti Ressy Jaya , Ariyanto Yusuf , Setiawan Teguh
Published: September 2024

Purpose

This study is part of a series aimed at improving the city's environment, as fully restoring the past soundscape is hardly feasible. The initial study aims to uncover the city's sound characteristics, including iconic sounds that have shaped the city's environment for decades, contributing to its status as Indonesia's second most popular tourist destination. This stage is critical for informing policymaking to carefully manage and enhance the urban acoustic environment in alignment with the preserved culture.

Design/methodology/approach

The city's sound profile was examined using standard urban sound taxonomies. The study used quantitative methods, including (1) sound pressure level (SPL) measurements and sound recordings, (2) in situ surveys and (3) memory-based surveys. The first set of data were compared to current standards and standard urban sound taxonomies, while the second set was analysed to determine the median rating score for determining the soundscape dimensions. The third data set was used to identify the specific acoustic aspects inherent in Yogyakarta.

Findings

Yogyakarta's acoustic environment was bustling, with traffic noise and human activities dominating the soundscape, surpassing the standard levels. Many sounds not classified in standard urban sound taxonomies were present, showing the diverse nature of urban sound classification, particularly in a cultural and traditional city like Yogyakarta. The memory-based survey unveils Yogyakarta's two most remarkable soundmarks, “gamelan” and “andong”, which support the findings of prior studies. The in situ survey rated the city's acoustic environment as eventful, pleasurable and generally appropriate, emphasising the presence of cultural sounds unique to Yogyakarta, even though they are not fully audible in the current environment.

Originality/value

The standard sound taxonomies used in urban areas need to be adjusted to include the unique sounds produced by cultural and traditional activities in developing countries. The ordinates and subordinates of the taxonomies also need to be updated. When cultural and daily activities are massively seen in a particular city, the sounds they produce can be recalled exclusively as the city's signature. It is urgent to implement policies to safeguard the few remaining soundmarks before they disappear entirely.
Empowering dependent patients in self-care when returning home: scoping review
Authors: Melo Ricardo Manuel Da Costa , Lopes Eunice Cristina Ribeiro , Vilas Boas José Luis Coelho , Santos Lúcia Batista , Amaro Sandra Cristina Ferreira , Ventura-Silva João Miguel Almeida , Oliveira Isabel de Jesus
Published: September 2024

Purpose

The impact of dependence on self-care on people’s lives is very significant, with consequences for the person and their caregivers. The purpose of this study is to map the evidence on the factors that influence the empowerment of the person dependent on self-care on returning home.

Design/methodology/approach

Scoping review according to the criteria proposed by the Joanna Briggs Institute: population (people with a dependence on self-care), concept (factors that influence training) and context (return home after hospitalization in a medical-surgical context). The research was carried out from March 1 to April 30, 2022, in the databases CINAHL and MEDLINE (via EBSCO), Scielo, LILACS, Cuiden and MedicLatina; Gray literature searched RCAAP, DART-Europe and OpenGrey. Studies published in Portuguese, Spanish and English were included, with no time limit.

Findings

One hundred and eighty-one articles were obtained, which, after analysis according to the criteria, resulted in seven studies included for review, ranging from 2007 to 2021, with a level of evidence between 2. c and 4. a (according to Joanna Briggs Institute), and two thematic areas/four categories emerging.

Research limitations/implications

The need for information and training, the relationship and proximity with the health-care team, the design of nursing care targeted at the person’s level of dependence, education, gender, type of surgical intervention and postoperative period, physical space and lack of privacy and audiovisual media.

Originality/value

The perception of these factors proves to be important in the person’s training process, with the nurse’s role being highlighted due to their emphasis on the transition home.
Reflections on achieving anti‐racism in organisations: The role of human resource management scholars and practitioners
Authors: Ogbonna Emmanuel
Published: September 2024

In this article, I reflect on the role of human resource management (HRM [I acknowledge that HRM scholarship encompasses a wide range of researchers employing varying analytical and methodological lenses and that publish in an eclectic mix of journals within and outside the human resource management domain. However, although I draw from other journals and academies for illustrative purposes, this article focuses on the two journals that are most widely respected in the field (Human Resource Management Journal and Human Resource Management)] in the treatment of race and racism in organisations. I argue that the combined negative impacts of the brutal murder of George Floyd before a social media watching world and the strong evidence of negative racially disproportionate impacts of the coronavirus pandemic contributed to a collective moral outrage and provided an unprecedented catalyst and opportunity to tackle institutional racism. I provide a review of research interests to argue that HRM scholars and the business practitioners they commonly inform have not grasped this opportunity fully, in that the treatment of race remains inadequate and informed by an erroneous view of race as neutral and irrelevant in influencing organisational outcomes. I contend that this presents a danger that racism will continue to thrive. I argue that grasping this opportunity fully requires a rethinking of the approaches commonly adopted by HRM scholars and practitioners to acknowledge and embrace fully the significance of race (and anti‐racism) in influencing organisational outcomes. I call for a reconsideration of key constructs, especially those that are implicated in racism (such as organisational culture and culture change) so that anti‐racism is at the centre of HRM conceptualisations and organisational processes.