bluuebunny/crossref_metadata_2025 huggingface dataset:
Content analysis of American consumers’ credit card fraud complaints filed with the Consumer Financial Protection Bureau
Authors: Estelami Hooman , Liu Kevin
Published: May 2023

Purpose

Every year, millions of consumers around the world become victims of credit card fraud. These individuals have to appeal to their credit card companies to reverse unauthorized charges. This study aims to profile the American consumers’ experience when complaints to their credit card companies about unauthorized charges fail to produce a resolution. Using a large database of consumer complaint filings with the Consumer Financial Protection Bureau (CFPB), the characteristics of these consumer complaints are identified, and the drivers of consumer financial hardship resulting from credit card fraud are determined.

Design/methodology/approach

A random sample of consumer complaints about their credit card companies’ perceived mishandling of cases, filed with the CFPB, is used to conduct content analysis. The resulting content analysis categories are used in a predictive model to determine the drivers of consumer hardship.

Findings

In nearly one-quarter of all complaint filings, the credit card company had blamed the complainant as the party responsible for the fraudulent charges or refused to open a fraud investigation altogether. Nearly 60% of complaint reports contain expressions of emotional distress and many mention financial hardship. Nearly half of all complainants consider the fraud department operations of their credit card company as lacking in service quality, many reporting inability to reach the department or to receive a returned call. Even after CFPB intermediation, only 15% of complainants receive some form of financial relief from their credit card company. The majority of the complainants report a lack of willingness by the credit card company to reverse unauathorized charges, leaving the complainant financially responsible for them.

Research limitations/implications

This study focused on data collected from consumers. Future research can expand the scope of inquiry by surveying the staff and executives in the fraud investigation departments of credit card companies to determine the norms of fraud investigation used within the industry.

Social implications

This study sheds light on the financial hardship and emotional pains that consumers victimized by credit card fraud experience in dealing with their credit card companies.

Originality/value

To the best of the authors’ knowledge, this is the first study to empirically examine American consumers’ complaints about the fraud investigation operations of their credit card companies. Using data captured through the complaint filing system of a federal bureau (CFPB), the findings have implications for policymakers, regulators and credit card companies.
Employee engagement in nonprofit organizations: the role of perception of HR and organizational culture
Authors: Akingbola Kunle , Kerekou Sephora , Tohon Aurelas
Published: May 2023

Purpose

The study draws on social exchange theory and theoretical perspectives on engagement to examine the multidimensional relationship between employee perception of HR practices (PHRP), organizational culture (POC) and engagement in nonprofit organizations (NPOs) in a sample of nonprofits in Canada.

Design/methodology/approach

This study examines the relationship between PHRP, POC and engagement in NPOs. The authors employed a quantitative research design (Creswell, 1998) involving data from a sample of NPOs in Ontario, Canada.

Findings

The findings suggest that PHRP has a direct effect on the level of both job and organization engagement. Employee perception of the value, relevance and importance of the job and membership in the organization induce the investment of physical, cognitive and emotional energy. The study emphasizes the importance of PHRP at individual and organizational levels as antecedents of engagement.

Research limitations/implications

The findings highlight the need to examine the contextual drivers of HR practices and engagement to better understand the multidimensional context of NPOs (Borzaga and Tortia, 2006).

Practical implications

The evidence reiterates the need for nonprofit managers to develop and implement HR practices that advance engagement.

Originality/value

Although what is known about nonprofit employee engagement is limited but growing (Park, Kim, Park, and Lim, 2018), the question of engagement and perception of HR in NPOs is yet to be examined.
Community knowledge and attitudes toward recovering citizenship and mental illness: a telephone survey approach
Authors: Wong Fiona Yan-yan , Wong Keith Kin-lung , Lam Paul Chi-wai , Chin Lok-yan , Fung Cheung-tim
Published: May 2023

Purpose

This study aims to assess the knowledge and attitudes toward recovering citizenship (RC)/5 Rs and mental illness of people aged ≥18 years in Hong Kong using a telephone survey approach.

Design/methodology/approach

A questionnaire comprised the Mental Health Knowledge Schedule (MAKS), Short Form-Community Attitudes Toward Mental Illness (SF-CAMI) and questions on attitudes toward RC/5 Rs, was administered on the phone.

Findings

A total of 1,009 respondents completed the telephone survey. A high mean score of MAKS (4.37 ± 1.08) was found with 68%–94% answering the knowledge items correctly. The mean score of SF-CAMI was 46.50 ± 8.74 with the most positive attitude toward fear and exclusion. Approximately half had heard about a similar concept of RC and 79%–94.3% agreed with people in recovery to possess the 5 Rs. Those with greater knowledge or more positive toward mental illness, or knowing someone in recovery were more supportive toward 5 Rs. Those aged 18–44 years, attained a post-secondary education, were employed, and received a monthly income of US$3,861–6,434 were significantly more positive toward 5 Rs.

Originality/value

To the best of the authors’ knowledge, this is the first study assessing the views of RC of people in the community. The sample had a good knowledge of mental illness but recognition of recovery from mental illness and a sympathetic view toward people in recovery can be further improved. Besides promotion programs, dissemination of the concept of RC and having people in recovery take up valued roles in the community could potentially facilitate the acceptance of social inclusion and acceptance in the community.
Learning from errors in digital patient communication: professionals’ enactment of negative knowledge and digital ignorance in the workplace
Authors: Jensen Rikke Amalie Agergaard , Jonasson Charlotte , Gartmeier Martin , Parviainen Jaana
Published: May 2023

Purpose

The purpose of this study is to investigate how professionals learn from varying experiences with errors in health-care digitalization and develop and use negative knowledge and digital ignorance in efforts to improve digitalized health care.

Design/methodology/approach

A two-year qualitative field study was conducted in the context of a public health-care organization working with digital patient communication. The data consisted of participant observation, semistructured interviews and document data. Inductive coding and a theoretically informed generation of themes were applied.

Findings

The findings show that both health-care and digital communication professionals learn through experiences with digital “rule-” and “knowledge-based” errors in patient communication and develop negative knowledge and awareness of digital ignorance. In their joint efforts, they use negative knowledge to “bend the rules” and to explore digital ignorance in efforts to improve patient communication.

Originality/value

This study provides insight into the importance of collaboration between professionals with varying experience of errors in digitalizing patient communication. Such collaboration is required to acknowledge own shortcomings and create complementary negative knowledge to improve digital patient communication. This is particularly important when working with innovative digitalization in health care.
Some observations on generative text artificial intelligence’s impact on libraries part 2
Authors: Fernandez Peter
Published: May 2023

Purpose

The purpose of this study is to provide a series of observations to help information professionals understand and anticipate the future developments.

Design/methodology/approach

This column delves into artificial intelligence (AI)-powered search and its implications for the open Web to show how multifaceted the impact of generative text AI might be in a single arena.

Findings

This framework includes the following observations: future applications are unpredictable, interdependent and will require flexibility, AI’s ability to create the feeling of intelligence combined with the power of language are key to its future; the technology is not neutral, it has biases and significant limitations; its widespread adoption will come with trade-offs that matter; and that libraries should develop a positive vision for how to use it.

Originality/value

For libraries to serve their patrons or embody their values, they must be prepared to grapple with a rapidly evolving technology by understanding the technologies possibilities, what makes it compelling, as well as its limitations and dangers.
Religious tourism: a bibliometric and network analysis
Authors: Das Anirban , Kondasani Rama Koteswara Rao , Deb Rupam
Published: May 2023

Purpose

This study aims to highlight the theoretical foundations and future research directions in religious tourism and related topics from 2003 to 2023.

Design/methodology/approach

A total of 4,143 documents from Web of Science and Scopus databases related to religious tourism and pilgrimage were analysed using VOSviewer software.

Findings

The analysis illuminates a steady rise in religious tourism research. The most influential countries are the USA, the UK and Israel. Gendered studies, tourists’ perceptions and technology in religious tourism will be research hotspots, as predicted with keyword co-occurrence analysis.

Originality/value

This study thoroughly evaluates two decades of religious tourism literature through bibliometric and network analysis. It can help researchers comprehend religious tourism study more thoroughly and determine where to focus in future research.
Hotels, second homes and destination planning policies: a sequential game model
Authors: Posadas Valeria , Brida Juan Gabriel , Alonsopérez María José
Published: May 2023

Purpose

This paper develops a theoretical model that analyzes the decision problem the landowner has to face between the construction of second homes and hotels. The starting point implies verifying that for a given tourist destination, the land available for the construction of accommodation is limited. For this reason, when choosing between building second homes or building hotels, many factors influence the decision model. The theoretical mechanism generalizes the model introduced in Brida and Boffa (2010) and is based on a four-stage sequential game with four players. From the results of the model, the authors conclude that it is optimal from the social point of view both to build a hotel and to build a second home because both generate added value during the year. For this reason, the construction of second homes should be taken into account in the planning policy of the tourist destination. This arises from considering that second homes, as they remain occupied all year like hotels, in certain tourist destinations, do not generate seasonality.
Ghar ki tension: domesticity and distress in India's aspiring middle class
Authors: Simpson Nikita
Published: May 2023

Tensionis a polysemic term used across South Asia to describe the strains and scrapes of life, like ‘worry’ or ‘stress’ in Euro‐American discourse. Yet in the formerly agro‐pastoralist and upwardly mobile Gaddi community of Himalayan India, it is used by women with the qualifyingghar ki – ‘household’ – to indicate a deeper disruption to bodily humours, intimate relations, and household materiality. This article takesghar ki tension, with a particular focus on the layered qualifierghar, as a window into the precarity of middle‐class domestic life as it is experienced in the bodies of the women who pursue it. Rather than focusing on the communicative functions of women's distress within the household, this article looks to the relational, affective, and material ways in which women see their bodies and houses as mutually constituted and disrupted. This approach reveals how women's domestic labour is both a source of dignity and a burden. This burden is experienced inghar ki tension, in bodily symptoms of overheating, and visits from supernatural beings. This article suggests thatghar ki tensionmight offer a novel way of looking at distress as the psychic and embodied cost of upward social mobility beyond the Gaddi context.
Intubation for patients with overdose: Time to move on from the Glasgow Coma Scale
Authors: Pellatt Richard AF , Isoardi Katherine , Keijzers Gerben
Published: May 2023

Patients frequently present to the ED with drug overdose and reduced conscious level leading to coma. There is considerable practice variation around which patients require intubation. Indications include: (i) respiratory failure (including airway obstruction); (ii) to facilitate specific therapies or intubation as a therapy in itself; and (iii) for airway protection in the unprotected airway. We argue that intubating a patient purely for (iii) is outdated and that most patients can be safely observed. There is a paucity of good quality research in the area of drug overdose with reduced consciousness. Teaching may be outdated and based on the use of the Glasgow Coma Scale in head trauma. Current low quality research suggests observation is safe. We recommend that patients undergo an individualised risk assessment of the need for intubation. We propose a flow diagram to aid clinicians in safely observing comatose overdose patients. This can be applied if the drug is unknown, or there are multiple drugs involved.
Frequency changes in HLA‐I alleles: A marker to guide immunotherapy in lung adenocarcinoma patients and its relationship with tumor mutational burden and PD‐L1 expression
Authors: Wu Xuanpeng , Wang Hao , Xue Fei , Jiang Tao , Chen Nanzheng , Wang Tianju , Zhang Yong , Zhang Guangjian , Fu Junke , Wu Qifei
Published: May 2023

Background

The aim of the study was to investigate differences in HLA‐I alleles between lung adenocarcinoma patients and healthy controls and determine their association with PD‐L1 expression and tumor mutational burden (TMB) to understand the mechanism underlying lung adenocarcinoma susceptibility.

Methods

Differences in HLA allele frequencies between the two groups were analyzed in a case–control study. PD‐L1 expression and TMB in lung adenocarcinoma patients were determined and their relationships with HLA‐I were analyzed.

Results

The lung adenocarcinoma group showed significantly higher HLA‐A*30:01 (p = 0.0067, odds ratio [OR], 1.834; 95% confidence interval [CI]: 1.176–2.860), B*13:02 (p = 0.0050, OR, 1.855; 95% CI: 1.217–2.829), and C*06:02 (p = 0.0260, OR, 1.478; 95% CI: 1.060–2.060) and significantly lower B*51:01 (p = 0.0290, OR, 0.6019; 95% CI: 0.3827–0.9467), and C*14:02 (p = 0.0255, OR, 0.5089; 95% CI: 0.2781–0.9312) than the control group. Haplotype analysis results showed that HLA‐A*30:01–B*13:02 (p = 0.0100, OR, 1.909; 95% CI: 1.182–3.085), A*11:01–C*01:02 (p = 0.0056, OR, 1.909; 95% CI: 1.182–3.085), A*30:01–C*06:02 (p = 0.0111, OR, 1.846; 95% CI: 1.147–2.969), and B*13:02–C*06:02 (p = 0.0067, OR, 1.846; 95% CI: 1.147–2.969) frequencies significantly increased and B*51:01–C*14:02 (p = 0.0219, OR, 0.490; 95% CI: 0.263–0.914) frequency significantly decreased in lung adenocarcinoma patients. Three‐locus haplotype analysis showed that HLA‐A*30:01‐B*13:02‐C*06:02 frequency (p = 0.0100, OR, 1.909; 95% CI: 1.182–3.085) significantly increased in patients.

Conclusion

HLA‐A*30:01, B*13:02, and C*06:02 may be the susceptibility genes and HLA‐B*51:01 and C*14:01 act as the resistance genes of lung adenocarcinoma. The changes in HLA‐I allele frequencies had no association with PD‐L1 expression and TMB among these patients.
Exposure to alcohol outlets and risk of suicidal behavior in a Swedish cohort of young adults
Authors: Edwards Alexis C. , Ohlsson Henrik , Lannoy Séverine , Stephenson Mallory , Crump Casey , Sundquist Jan , Kendler Kenneth S. , Sundquist Kristina
Published: May 2023

Background

Greater alcohol accessibility, for example in the form of a high density of alcohol outlets or low alcohol taxation rates, may be associated with increased risk of suicidal behavior. However, most studies have been conducted at the aggregate level, and some have not accounted for potential confounders such as socioeconomic position or neighborhood quality.

Methods

In a Swedish cohort of young adults aged 18 to 25, we used logistic regressions to evaluate whether living in a neighborhood that included bars, nightclubs, and/or government alcohol outlets was associated with risk of suicide attempt (SA) or suicide death (SD) during four separate 2‐year observation periods. Neighborhoods were defined using pre‐established nationwide designations. We conducted combined‐sex and sex‐stratified analyses, and included as covariates indicators of socioeconomic position, neighborhood deprivation, and aggregate genetic liability to suicidal behavior.

Results

Risk of SA was increased in some subsamples of individuals living in a neighborhood with a bar or government alcohol outlet (odds ratios [ORs] = 1.05 to 1.15). Risk of SD was also higher among certain subsamples living in a neighborhood with a government outlet (ORs = 1.47 to 1.56), but lower for those living near a bar (ORs = 0.89 to 0.91). Significant results were driven by, but not exclusive to, the male subsample. Individuals with higher aggregate genetic risk for SA were more sensitive to the effects of a neighborhood government alcohol outlet, pooled across observation periods, in analyses of the sexes combined (relative excess risk due to interaction [RERI] = 0.05; 95% confidence intervals [CI] 0.01; 0.09) and in the male subsample (RERI = 0.06; 95% CI 0.001; 0.12).

Conclusions

Although effect sizes are small, living in a neighborhood with bars and/or government alcohol outlets may increase suicidal behavior among young adults. Individuals with higher genetic liability for SA are slightly more susceptible to these exposures.
Mutation spectrum of FLT3 and significance of non‐canonical FLT3 mutations in haematological malignancy
Authors: Ge Shuai‐Shuai , Qiu Qiao‐Cheng , Dai Hai‐Ping , Shen Xiang‐Dong , Wu Tian‐Mei , Du Jia‐Hui , Wan Chao‐Ling , Shen Hong‐Jie , Wu De‐Pei , Xue Sheng‐Li , Liu Song‐Bai
Published: May 2023

Fms‐like tyrosine kinase 3 (FLT3) is frequently mutated in haematological malignancies. Although canonical FLT3 mutations including internal tandem duplications (ITDs) and tyrosine kinase domains (TKDs) have been extensively studied, little is known about the clinical significance of non‐canonical FLT3 mutations. Here, we first profiled the spectrum of FLT3 mutations in 869 consecutively newly diagnosed acute myeloid leukaemia (AML), myelodysplastic syndrome and acute lymphoblastic leukaemia patients. Our results showed four types of non‐canonical FLT3 mutations depending on the affected protein structure: namely non‐canonical point mutations (NCPMs) (19.2%), deletion (0.7%), frameshift (0.8%) and ITD outside the juxtamembrane domain (JMD) and TKD1 regions (0.5%). Furthermore, we found that the survival of patients with high‐frequency (>1%) FLT3‐NCPM in AML was comparable to those with canonical TKD. In vitro studies using seven representative FLT3‐deletion or frameshift mutant constructs showed that the deletion mutants of TKD1 and the FLT3‐ITD mutant of TKD2 had significantly higher kinase activity than wild‐type FLT3, whereas the deletion mutants of JMD had phosphorylation levels comparable with wild‐type FLT3. All tested deletion mutations and ITD were sensitive to AC220 and sorafenib. Collectively, these data enrich our understanding of FLT3 non‐canonical mutations in haematological malignancies. Our results may also facilitate prognostic stratification and targeted therapy of AML with FLT3 non‐canonical mutations.
Is there an acceptable surrogate for caries clinical trials? Evidence from a systematic review of primary studies
Authors: Gimenez Thais , Estevam Luana Rodrigues , de Oliveira Ponte Yohana , Dalboni Adriana , Calvo Ana Flávia Bissoto , Tedesco Tamara Kerber , Pontes Laura Regina Antunes , Moro Bruna Lorena Pereira , Raggio Daniela Prócida , Braga Mariana Minatel , Mendes Fausto Medeiros
Published: May 2023

Background

There is currently a lack of evidence supporting the use of valid surrogates in caries clinical trials. This study aimed at examining the validity of two surrogate outcomes used in randomized clinical trials for caries prevention, pit and fissure sealants and fluoridated dentifrices, according to the Prentice criteria.

Methods

A systematic review was conducted in MEDLINE (PubMed), LILACS and Scopus databases up to 05 October 2022. The grey literature and the list of eligible studies' references were also screened. The search was conducted, selecting randomized clinical trials focussed on dental caries prevention using pit and fissure sealants or fluoridated dentifrices and with at least one surrogate endpoint for cavitated caries lesions. The risk of each surrogate endpoint and for the occurrence of cavitated caries lesions was calculated and compared. The association between each surrogate and the presence of cavitation was quantified, and each outcome was assessed graphically for validity according to the Prentice criteria.

Results

For pit and fissure sealants, from 1696 potentially eligible studies, 51 were included; while for fluoridated dentifrices, of 3887 potentially eligible studies, four were included. Possible surrogates assessed were retention of sealants, presence of white spot lesions, presence of plaque or marginal discoloration around the sealants, oral hygiene index, radiographic and fluorescence caries lesion assessments. However, only the retention of sealants and the presence of white spot lesions could be evaluated for their validity according to the Prentice criteria.

Conclusion

Loss of retention of sealants and the presence of white spot lesions do not fulfil all of the Prentice criteria. Therefore, they cannot be considered valid surrogates for caries prevention.
Red‐list status and extinction risk of the world's whales, dolphins, and porpoises
Authors: Braulik Gill T. , Taylor Barbara L. , Minton Gianna , Notarbartolo di Sciara Giuseppe , Collins Tim , Rojas‐Bracho Lorenzo , Crespo Enrique A. , Ponnampalam Louisa S. , Double Michael C. , Reeves Randall R.
Published: May 2023

To understand the scope and scale of the loss of biodiversity, tools are required that can be applied in a standardized manner to all species globally, spanning realms from land to the open ocean. We used data from the International Union for the Conservation of Nature Red List to provide a synthesis of the conservation status and extinction risk of cetaceans. One in 4 cetacean species (26% of 92 species) was threatened with extinction (i.e., critically endangered, endangered, or vulnerable) and 11% were near threatened. Ten percent of cetacean species were data deficient, and we predicted that 2–3 of these species may also be threatened. The proportion of threatened cetaceans has increased: 15% in 1991, 19% in 2008, and 26% in 2021. The assessed conservation status of 20% of species has worsened from 2008 to 2021, and only 3 moved into categories of lesser threat. Cetacean species with small geographic ranges were more likely to be listed as threatened than those with large ranges, and those that occur in freshwater (100% of species) and coastal (60% of species) habitats were under the greatest threat. Analysis of odontocete species distributions revealed a global hotspot of threatened small cetaceans in Southeast Asia, in an area encompassing the Coral Triangle and extending through nearshore waters of the Bay of Bengal, northern Australia, and Papua New Guinea and into the coastal waters of China. Improved management of fisheries to limit overfishing and reduce bycatch is urgently needed to avoid extinctions or further declines, especially in coastal areas of Asia, Africa, and South America.
Effects of temperature and heat waves on embryonic development of annual fishes from Neotropical wetlands: Implications for climate change scenarios
Authors: Godoy Robson Souza , Weber Vinicius , Lanés Luis Esteban Krause , Pires Mateus Marques , Stenert Cristina , Maltchik Leonardo
Published: May 2023

Climate change projections predict warmer temperatures and increased frequency of heat waves in many regions across the globe. These scenarios are expected to strongly impact temperature‐dependent life‐history traits of aquatic species, such as the embryonic stage of annual fishes inhabiting temporary freshwater wetlands. Here, we assessed the effects of different incubation temperatures (18, 24, 27 and 30°C) and exposure to heat waves (18–30°C for 6 h) on aspects of the embryonic development: mortality and trajectory (direct development or diapause entry) of two Neotropical species of annual fishes from high‐ (Austrolebias nubium) and low‐altitude (A. cyaneus) areas. Temperatures of 30°C resulted in 100% embryo mortality in both species, and development trajectory differed between species across temperatures. Embryo mortality in the high‐altitude species was higher at 27°C, while a higher number of embryos of the low‐altitude species entered diapause II at 18°C. Embryo mortality and development trajectory after exposure to heat waves were similar between species. In terms of implications for climate change scenarios, temperatures above 27°C seem critical for the embryo survival of both species studied, although they seem capable to endure short‐term events of heat waves. In summary, our results indicate that the persistence of populations of high‐altitude annual fish species may be subject to higher threat under warming scenarios, since embryos from this species were more sensitive to increasing temperatures than the low‐altitude species.
Increased fishing quality of Chicago's waterways following the Clean Water Act
Authors: Happel A. , Kennedy P. J.
Published: May 2023

As conditions of Chicago's (Illinois, USA) waterways improved following implementation of the Clean Water Act, interest in recreational use of the waterways continued to grow, but the ability of this system to support quality recreational fishing opportunities remained unclear. We analyzed historical electrofishing data (1985–2020) to determine the status and trends in body‐size metrics of fish populations throughout Chicago's waterways. Many species exhibited increases in abundance, size, and diversity of lengths. Despite these increases, the number of quality‐sized or larger fish was sparse. While many species increased in abundance, Common Carp (Cyprinus carpio) and Gizzard Shad (Dorosoma cepedianum) declined in abundance during 2001–2020. Improvements to the availability and diversity of key habitats within Chicago's waterways would likely improve target fish demographics further and resultant recreational fishery opportunities.
Validity and reliability of the Integrated Palliative Care Outcome Scale for non‐cancer patients
Authors: Ishii Yoko , Ito Nao , Matsumura Yuko , Aoyama Maho , Kohara Izumi , Murai Kunihiko , Takeuchi Kazuhisa , Yokoyama Takako , Miyashita Masako , Miyashita Mitsunori
Published: May 2023

Aim

This study assessed the validity and reliability of the Integrated Palliative Care Outcome Scale for non‐cancer patients.

Methods

We recruited 223 non‐cancer patients receiving palliative care and their healthcare providers (222) across two home care facilities and two hospitals for a cross‐sectional study. We assessed the construct validity and known‐group validity of the Integrated Palliative Care Outcome Scale. The weighted kappa and interclass correlation coefficients were assessed to ascertain reliability.

Results

The scale scores were significantly higher for the ‘non‐stable’ group (worsening condition group) measured in the palliative care phase than for the ‘stable’ group (P < 0.001). Regarding validity, Spearman's correlations between similar items on the Integrated Palliative Care Outcome Scale and Edmonton Symptom Assessment System ranged from 0.61 to 0.94. Regarding reliability, the weighted kappa coefficients ranged from 0.53 to 0.81 for patients and from 0.58 to 0.90 for healthcare providers. For inter‐rater reliability between patients and healthcare providers, the weighted kappa coefficients for each item ranged from 0.03 to 0.42.

Conclusion

This study confirmed the validity and reliability of the Integrated Palliative Care Outcome Scale for non‐cancer patients requiring palliative care. However, the inter‐rater reliability indicates poor agreement between the assessments of patients and healthcare providers. This highlights the discrepancies between both their assessments and the importance of the patient's assessment. Geriatr Gerontol Int 2023; 23: 517–523.
Establishment and validation of a nomogram to predict the neck contracture after skin grafting in burn patients: A multicentre cohort study
Authors: Li Rui , Zheng Yangyang , Fan Xijuan , Cao Zilong , Yue Qiang , Fan Jincai , Gan Cheng , Jiao Hu , Liu Liqiang
Published: May 2023

Cervical burn contracture is one of the burn contractures with the highest incidence and severity, and there is no effective method to predict the risk of neck contracture. This study aimed to investigate the effect of combined cervicothoracic skin grafting on the risk of neck contracture in burn patients and to develop a nomogram to predict the risk of neck contracture after skin grafting in burn patients. Data from 212 patients with burns who underwent neck skin grafting were collected from three hospitals, and the patients were randomly divided into training and validation sets. Independent predictors were identified through univariate and multivariate logistic regression analyses and incorporated into a prognostic nomogram. Its performance was assessed using the receiver operating characteristic area under the curve, calibration curve, and decision curve analysis. Burn depth, combined cervicothoracic skin grafting, graft thickness, and neck graft size were significantly associated with neck contractures. In the training cohort, the nomogram had an area under the curve of 0.894. The calibration curve and decision curve analysis indicated good clinical applicability of the nomogram. The results were tested using a validation dataset. Combined cervicothoracic skin grafting is an independent risk factor for neck contracture. Our nomogram demonstrated excellent performance in predicting neck contracture risk.
Hypoxic preconditioned mesenchymal stem cells ameliorate rat brain injury after cardiopulmonary resuscitation by suppressing neuronal pyroptosis
Authors: Tang Xiahong , Ke Jun , Chen Falu , Lin Qingming , You Yan , Zheng Nan , Gong Zheng , Han Xu , Zhuang Yangping , Chen Feng
Published: May 2023

Cardiac arrest (CA) can result in cerebral ischaemia–reperfusion injury and poor neurological outcomes. While bone marrow‐derived mesenchymal stem cells (BMSCs) have been shown to have protective effects in brain ischaemic disease, their efficacy can be reduced by the poor oxygen environment. In this study, we investigated the neuroprotective effects of hypoxic preconditioned BMSCs (HP‐BMSCs) and normoxic BMSCs (N‐BMSCs) in a cardiac arrest rat model by examining their ability to ameliorate cell pyroptosis. The mechanism underlying the process was also explored. Cardiac arrest was induced in rats for 8 min and surviving rats received 1 × 106 normoxic/hypoxic BMSCs or PBS via intracerebroventricular (ICV) transplantation. Neurological function of rats was evaluated using neurological deficit scores (NDSs) and examined for brain pathology. Serum S100B and neuron‐specific enolase (NSE) levels and cortical proinflammatory cytokines were measured to evaluate brain injury. Pyroptosis‐related proteins in the cortex after cardiopulmonary resuscitation (CPR) were measured using western blotting and immunofluorescent staining. Transplanted BMSCs were tracked using bioluminescence imaging. Results showed significantly better neurological function and neuropathological damage after transplantation with HP‐BMSCs. In addition, HP‐BMSCs reduced levels of pyroptosis‐related proteins in the rat cortex after CPR and significantly reduced levels of biomarkers for brain injury. Mechanistically, HP‐BMSCs alleviated brain injury by reducing the expressions of HMGB1, TLR4, NF‐κB p65, p38 MAPK and JNK in the cortex. Our study demonstrated that hypoxic preconditioning could enhance the efficacy of BMSCs in alleviating post‐resuscitation cortical pyroptosis. This effect may be related to the regulation of the HMGB1/TLR4/NF‐κB, MAPK signalling pathways.
Free sugars and gingival inflammation: A systematic review and meta‐analysis
Authors: Woelber J. P. , Gebhardt D. , Hujoel P. P.
Published: May 2023

Aim

Consumption of free sugars has been associated with chronic non‐communicable diseases. The aim of the study was to investigate the effect of free‐sugar consumption on gingival inflammation using a systematic review and meta‐analysis based on the PICO question ‘What impact does the restriction of free sugars have on the inflammation of gingival tissue?’

Materials and Methods

Literature review and analyses were based on the Cochrane Handbook for Systematic Reviews of Interventions. Controlled clinical studies reporting on free‐sugar interventions and gingival inflammation were included. Risk of bias was performed with ROBINS‐I and ROB‐2, and effect sizes were estimated with robust variance meta‐regressions.

Results

Of the 1777 primarily identified studies, 1768 were excluded, and 9 studies with 209 participants with gingival inflammation measures were included. Six of these studies reported on the dental plaque scores of 113 participants. Restriction of free sugars, when compared with no such restriction, was associated with statistically significantly improved gingival health scores (standard mean difference [SMD] = −0.92; 95% confidence interval [CI]: −1.43 to −0.42, p < .004; I2 [heterogeneity] = 46.8) and a trend towards lower dental plaque scores (SMD = −0.61; 95% CI: −1.28 to 0.05, p < .07; I2 = 41.3). The observed improvement of gingival inflammation scores with restricted consumption of free sugar was robust against various statistical imputations. No meta‐regression models were feasible because of the limited number of studies. The median publication year was 1982. Risk‐of‐bias analysis showed a moderate risk in all studies.

Conclusion

Restriction of free sugar was shown to be associated with reduced gingival inflammation. The systematic review was registered at PROSPERO (CRD 42020157914).
Recombinant Treponema pallidum protein Tp47 promoted the phagocytosis of macrophages by activating NLRP3 inflammasome induced by PKM2‐dependent glycolysis
Authors: Zheng Y.‐W. , Wang M. , Xie J.‐W. , Chen R. , Wang X.‐T. , He Y. , Yang T.‐C. , Liu L.‐L. , Lin L.‐R.
Published: May 2023

Background

Glycolysis is a critical pathway in cellular glucose metabolism that provides energy and participates in immune responses. However, whether glycolysis is involved in NOD‐like receptor family protein 3 (NLRP3) inflammasome activation and phagocytosis of macrophages in response to Treponema pallidum infection remains unclear.

Objectives

To investigate the role of glycolysis in activating the NLRP3 inflammasome for regulating phagocytosis in macrophages in response to T. pallidum protein Tp47 and its associated mechanisms.

Methods

Interactions between activation of the NLRP3 inflammasome and phagocytosis and the role of glycolysis in Tp47‐treated macrophages were investigated through experiments on peritoneal macrophages and human monocytic cell line‐derived macrophages.

Results

Activation of phagocytosis and NLRP3 inflammasome were observed in Tp47‐treated macrophages. Treatment with NLRP3 inhibitor MCC950 or si‐NLRP3 attenuated Tp47‐induced phagocytosis. Glycolysis and glycolytic capacity were enhanced by Tp47 stimulation in macrophages, and a change in the levels of glycolytic metabolites (phosphoenolpyruvate, citrate and lactate) was induced by Tp47 in macrophages. Inhibition of glycolysis with 2‐deoxy‐D‐glucose, a glycolysis inhibitor, decreased the activation of NLRP3. Expression of M2 isoform of pyruvate kinase (PKM2), an enzyme catalysing a rate‐limiting reaction in the glycolytic pathway, was upregulated in Tp47‐stimulated macrophages. Inhibition of PKM2 with shikonin or si‐PKM2 decreased glycolysis and NLRP3 activation.

Conclusion

Tp47 promotes phagocytosis in macrophages by activating the NLRP3 inflammasome, which is induced by the enhancement of PKM2‐dependent glycolysis.
Health system approaches and experiences implementing the 4Ms: Insights from 3 early adopter health systems
Authors: Adler‐Milstein Julia R. , Krueger Grace N. , Rosenthal Sarah W. , Rogers Stephanie E. , Lyles Courtney R.
Published: May 2023

Background

Redesigning the healthcare system to consistently provide effective and tailored care to older adults is needed. The 4Ms (What Matters, Mobility, Medication, and Mentation) offer a framework to guide health systems' efforts to deliver Age‐Friendly care. We use an implementation science framework to characterize and assess real‐world implementation experiences with the 4Ms across varied health systems.

Methods

With expert input, we selected three health systems that were early adopters of the 4Ms and engaged in different implementation support models through the Institute for Healthcare Improvement. We conducted 29 semi‐structured interviews with diverse stakeholders from each site. Stakeholders ranged from hospital leadership to frontline clinicians. Interviews covered each site's approach to and experiences with implementation, including facilitators and barriers. Interviews were recorded, transcribed, and deductively coded using the Consolidated Framework for Implementation Research. We characterized each site's implementation decisions and then inductively identified overarching themes and subthemes with supporting quotes.

Results

Health systems varied in their implementation approach, including the implementation order of each of the 4Ms. We identified three overarching themes: (1) the 4Ms offered a compelling conceptual framework for advancing Age‐Friendly care, but implementation was complex and fragmented; (2) complete and sustained implementation of the 4Ms required multidisciplinary and multilevel leadership and engagement; (3) strategies that facilitate implementation success and support frontline culture change included top‐down communication and infrastructure alongside hands‐on clinical education and support. Common barriers are siloed implementation efforts across settings that impeded synergies and scaling; disengaged physicians; and difficulty implementing What Matters in a meaningful way.

Conclusions

Similar to other implementation studies, we identified multifactorial domains impacting 4Ms implementation. To achieve Age‐Friendly transformation, health systems must plan for and attend to multiple phases of implementation while ensuring that the work coheres under a unified vision that spans disciplines and settings.
Methionine‐PET to differentiate between brain lesions appearing similar on conventional CT/MRI scans
Authors: Ohmura Kazufumi , Ikegame Yuka , Yano Hirohito , Shinoda Jun , Iwama Toru
Published: May 2023

Background and Purpose

11C‐Methionine (MET)‐PET is a useful tool in neuro‐oncology. This study aimed to examine whether a combination of diagnostic variables associated with MET uptake could help distinguish between brain lesions that are often difficult to discriminate in conventional CT and MRI.

Methods

MET‐PET was assessed in 129 patients with glioblastoma multiforme, primary central nervous lymphoma, metastatic brain tumor, tumefactive multiple sclerosis, or radiation necrosis. The accuracy of the differential diagnosis was analyzed using five diagnostic characteristics in combination: higher maximum standardized uptake value (SUV) of MET in the lesion/the mean normal cortical SUV of MET ratio, overextension beyond gadolinium, peripheral pattern indicating abundant MET accumulation in the peripheral region, central pattern denoting abundant MET accumulation in the central region, and dynamic‐up suggesting increased MET accumulation during dynamic study. The analysis was conducted on sets of two of the five brain lesions.

Results

Significant differences in the five diagnostic traits were observed among the five brain lesions, and differential diagnosis could be achieved by combining these diagnostic features. The area under the curve between each set of two of the five brain lesions using MET‐PET features ranged from .85 to 1.0.

Conclusions

According to the findings, combining the five diagnostic criteria could help with the differential diagnosis of the five brain lesions. MET‐PET is an auxiliary diagnostic technique that could help in distinguishing these five brain lesions.
Network analysis of sleep bruxism in the EPISONO adult general population
Authors: Chattrattrai Thiprawee , Aarab Ghizlane , Blanken Tessa F. , Pires Gabriel N. , Herrero Babiloni Alberto , Dal Fabbro Cibele , van Someren Eus , Lavigne Gilles , Maluly Milton , Andersen Monica L. , Tufik Sergio , Lobbezoo Frank
Published: May 2023

Sleep bruxism (SB) has been associated with biological and psychosocial factors. The assessment of SB includes self‐report, clinical evaluation, and polysomnography. This study aimed to investigate the associations of self‐reported SB with other sleep disorders and demographic, psychological, and lifestyle factors in the adult general population, and to investigate whether self‐reported SB and polysomnographically (PSG) confirmed SB provide similar outcomes in terms of their associated factors. We recruited 915 adults from the general population in Sao Paulo, Brazil. All participants underwent a one‐night PSG recording and answered questions about sex, age, BMI, insomnia, OSA risk, anxiety, depression, average caffeine consumption, smoking frequency, and alcohol consumption frequency. We investigated the link between SB and the other variables in univariate, multivariate, and network models, and we repeated each model once with self‐reported SB and once with PSG‐confirmed SB. Self‐reported SB was only significantly associated with sex (p = 0.042), anxiety (p = 0.002), and depression (p = 0.03) in the univariate analysis, and was associated with insomnia in the univariate (p < 0.001) and multivariate (β = 1.054, 95%CI 1.018–1.092, p = 0.003) analyses. Network analysis showed that self‐reported SB had a direct positive edge to insomnia, while PSG‐confirmed SB was not significantly associated with any of the other variables. Thus, sleep bruxism was positively associated with insomnia only when self‐reported, while PSG‐confirmed SB was not associated with any of the included factors.
Prospective evaluation of a telmisartan suppression test as a diagnostic tool for primary hyperaldosteronism in cats
Authors: Kurtz Maxime , Fabrès Virginie , Dumont Renaud , Chetboul Valérie , Chahory Sabine , Saponaro Vittorio , Trehiou Emilie , Poissonnier Camille , Passavin Peggy , Jondeau Coline , Bott Matthieu , Buronfosse Thierry , Benchekroun Ghita
Published: May 2023

Background

In a previous study, telmisartan suppressed aldosterone secretion in healthy cats but not in cats with primary hyperaldosteronism (PHA).

Hypotheses

Telmisartan suppresses aldosterone secretion in middle‐aged healthy cat and cats with diseases that may result in secondary hyperaldosteronism, but not in those with PHA.

Animals

Thirty‐eight cats: 5 with PHA; 16 with chronic kidney disease (CKD), subclassified as hypertensive (CKD‐H) or non‐hypertensive (CKD‐NH); 9 with hyperthyroidism (HTH); 2 with idiopathic systemic arterial hypertension (ISH); and 6 healthy middle‐aged cats.

Methods

Prospective, cross‐sectional study. Serum aldosterone concentration, potassium concentration, and systolic blood pressure were measured before and 1 and 1.5 hours after PO administration of 2 mg/kg of telmisartan. The aldosterone variation rate (AVR) was calculated for each cat.

Results

No significant difference in the minimum AVR was observed among groups (median [quartile 1 (Q1); quartile 3 (Q3)]: 25 [0; 30]; 5 [−27; −75]; 10 [−6; −95]; 53 [19; 86]; 29 [5; 78]) for PHA, CKD, HTH, ISH, and healthy cats, respectively (P = .05). Basal serum aldosterone concentration (pmol/L) was significantly higher in PHA cats (median [Q1; Q3]: 2914 [2789; 4600]) than in CKD‐H cats (median [Q1; Q3]: 239 [189; 577], correctedPvalue = .003) and CKD‐NH cats (median [Q1; Q3]: 353 [136; 1371], correctedPvalue = .004).

Conclusions and Clinical Importance

The oral telmisartan suppression test using a single dose of 2 mg/kg telmisartan did not discriminate cats with PHA from healthy middle‐aged cats or cats with diseases that may result in secondary hyperaldosteronism.
Putative adaptive loci show parallel clinal variation in a California‐endemic wildflower
Authors: Hernández Adriana I. , Specht Chelsea D.
Published: May 2023

As the global climate crisis continues, predictions concerning how wild populations will respond to changing climate conditions are informed by an understanding of how populations have responded and/or adapted to climate variables in the past. Changes in the local biotic and abiotic environment can drive differences in phenology, physiology, morphology and demography between populations leading to local adaptation, yet the molecular basis of adaptive evolution in wild non‐model organisms is poorly understood. We leverage comparisons between two lineages of Calochortus venustus occurring along parallel transects that allow us to identify loci under selection and measure clinal variation in allele frequencies as evidence of population‐specific responses to selection along climatic gradients. We identify targets of selection by distinguishing loci that are outliers to population structure and by using genotype–environment associations across transects to detect loci under selection from each of nine climatic variables. Despite gene flow between individuals of different floral phenotypes and between populations, we find evidence of ecological specialization at the molecular level, including genes associated with key plant functions linked to plant adaptation to California's Mediterranean climate. Single‐nucleotide polymorphisms (SNPs) present in both transects show similar trends in allelic similarity across latitudes indicating parallel adaptation to northern climates. Comparisons between eastern and western populations across latitudes indicate divergent genetic evolution between transects, suggesting local adaptation to either coastal or inland habitats. Our study is among the first to show repeated allelic variation across climatic clines in a non‐model organism.