bluuebunny/crossref_metadata_2025 huggingface dataset:
Consumers’ preferences for endoscopes: a discrete choice experiment
Authors: Chuah Teik-Leong , Hong Meenchee , Foroughi Behzad
Published: November 2023

Purpose

Infection and cross-contamination have been massive concerns in the medical field. This study aims to investigate consumers’ awareness and their choices of endoscopes, which may deter them from the cross-contamination problem.

Design/methodology/approach

A discrete choice experiment survey was administered to 166 respondents in Penang, Malaysia. Participants were asked to make hypothetical choices and estimate their preference for endoscopes. The multinomial logit model was used to estimate the assumptions based on the stated preference data collected.

Findings

Only two-fifths of respondents are aware of their rights regarding endoscope selection. The findings are consistent with utility theory, where choices are made to maximise personal satisfaction. If given the choice, consumers preferred the single-use endoscope over the reusable or the doctor’s preferred endoscope. Price, insurance coverage and personal income are significant determinants of the consumer’s choice of endoscopes.

Research limitations/implications

This study only investigates subjects living in Penang. Other possible important attributes to endoscope choices, such as environmental and device availability may be considered in future study.

Practical implications

The findings may create awareness among consumers about their rights when choosing medical devices. It may also improve health-care institutions’ (users’) and device manufacturers’ (industry players’) understanding of consumer needs and demands from socioeconomic perspectives.

Social implications

The research offers insights into consumer rights and awareness of health-care services. Ultimately leading to better policy to protect consumers’ rights and safety.

Originality/value

This study contributes to the rare literature on consumer rights toward medical devices, in particular, the consumer’s awareness of the choice of endoscopes.
A probit-based analysis of the deep stock market drawdowns
Authors: Tokic Damir , Jackson Dave
Published: November 2023

Purpose

This study is motivated in part by the fact that the unfolding 2022 bear market, which has reached the −25% drawdown, has not been preceded by the inverted 10Y-3 m spread or an inverted near-term forward spread.

Design/methodology/approach

The authors develop a three-factor probit model to predict/explain the deep stock market drawdowns, which the authors define as the drawdowns in excess of 20%.

Findings

The study results show that (1) the rising credit risk predicts a deep drawdown about a year in advance and (2) the monetary policy easing precedes an imminent drawdown below the 20% threshold.

Originality/value

This study three-factor probit model shows adaptability beyond the typical recessionary bear market and predicts/explains the liquidity-based selloffs, like the 2022 and possibly the 1987 deep drawdowns.
Exploring national digital transformation and Industry 4.0 policies through text mining: a comparative analysis including the Turkish case
Authors: Yildirim Nihan , Gultekin Derya , Hürses Cansu , Akman Abdullah Mert
Published: November 2023

Purpose

This paper aims to use text mining methods to explore the similarities and differences between countries’ national digital transformation (DT) and Industry 4.0 (I4.0) policies. The study examines the applicability of text mining as an alternative for comprehensive clustering of national I4.0 and DT strategies, encouraging policy researchers toward data science that can offer rapid policy analysis and benchmarking.

Design/methodology/approach

With an exploratory research approach, topic modeling, principal component analysis and unsupervised machine learning algorithms (k-means and hierarchical clustering) are used for clustering national I4.0 and DT strategies. This paper uses a corpus of policy documents and related scientific publications from several countries and integrate their science and technology performance. The paper also presents the positioning of Türkiye’s I4.0 and DT national policy as a case from a developing country context.

Findings

Text mining provides meaningful clustering results on similarities and differences between countries regarding their national I4.0 and DT policies, aligned with their geographic, economic and political circumstances. Findings also shed light on the DT strategic landscape and the key themes spanning various policy dimensions. Drawing from the Turkish case, political options are discussed in the context of developing (follower) countries’ I4.0 and DT.

Practical implications

The paper reveals meaningful clustering results on similarities and differences between countries regarding their national I4.0 and DT policies, reflecting political proximities aligned with their geographic, economic and political circumstances. This can help policymakers to comparatively understand national DT and I4.0 policies and use this knowledge to reflect collaborative and competitive measures to their policies.

Originality/value

This paper provides a unique combined methodology for text mining-based policy analysis in the DT context, which has not been adopted. In an era where computational social science and machine learning have gained importance and adaptability to political and social science fields, and in the technology and innovation management discipline, clustering applications showed similar and different policy patterns in a timely and unbiased manner.
Development of rail technology for high speed railway in China
Authors: Liu FengShou , Yang Guang , Chen Zhaoyang , Zhang Yinhua , Zhou Qingyue
Published: November 2023

Purpose

The purpose of this paper is to summarize the status and characteristics of rail technology of high-speed railway in China, and point out the development direction of rail technology of high-speed railway.

Design/methodology/approach

This study reviews the evolution of high-speed rail standards in China, comparing their chemical composition, mechanical attributes and geometric specifications with EN standards. It delves into the status of rail production technology, shifts in key performance indicators and the quality characteristics of rails. The analysis further examines the interplay between wheels and rails, the implementation of grinding technology and the techniques for inspecting rail service conditions. It encapsulates the salient features of rail operation and maintenance within the high-speed railway ecosystem. The paper concludes with an insightful prognosis of high-speed railway technology development in China.

Findings

The rail standards of high-speed railway in China are scientific and advanced, highly operational and in line with international standards. The quality and performance of rail in China have reached the world’s advanced level. The 60N profile guarantees the operation quality of wheel–rail interaction effectively. The rail grinding technology system scientifically guarantees the long-term good service performance of the rail. The rail service state detection technology is scientific and efficient. The rail technology will take “more intelligent” and “higher speed” as the development direction to meet the future needs of high-speed railway in China.

Originality/value

The development direction of rail technology for high-speed railway in China is defined, which will promote the continuous innovation and breakthrough of rail technology.
Pre‐Manichaean Beliefs of the Uyghurs II: Other Religious Elements
Authors: Erkoç Hayrettin İhsan
Published: November 2023

The original beliefs of the Uyghurs, which have been overshadowed by their conversion to Manichaeism and Buddhism, have not been thoroughly studied until recently. However, Uyghur inscriptions as well as Chinese and Islamic sources provide us with some information regarding their beliefs. In the first part of this article series, the Uyghurs' belief in various cults related to celestial and natural beings was explored. In this second part, other religious elements will be analysed. The Uyghurs possessed a cult of ancestors, in which souls were believed to fly away. Funeral ceremonies called yoγ are noted to contain animal and human sacrifices as well as self‐harming activities. Worship included animal sacrifice and idol worship. Qam (shamans) performed rituals, including fortune telling and weather magic. Religious terminology included qut (divine fortune), ülüg (destiny), yol (luck), and yazuq (sin). They held the numbers seven and nine in high esteem as sacred numbers, while sacred lights descending from the sky and the sacred consort of a mythological ruler were important motifs. Although some scholars have written that Buddhism was practiced by the Uyghurs before their conversion to Manichaeism in the 760s, further research has shown that this was not the case. This article also reveals how their ancient beliefs survived even after their conversions to major religions.
Transcultural adaptation in translating measurement instruments: Challenges and learned lessons
Authors: Abu Khait Abdallah , Shellman Juliette
Published: November 2023

Purpose

In cross‐cultural research, there is a need for standard rules for translating research measurement instruments. This article describes the Reminiscence Functions Scale (RFS) translation process from English into Arabic and the rigorous process followed in translating the scale. The process described can serve as a blueprint for translating research instruments for cross‐cultural studies and clinical practice.

Method

Six integrated steps were used to establish content and semantic equivalences. Six bilingual professional translators participated in the translation project and utilized the Flaherty 3‐point scale to assess and rate the translated RFS.

Findings

The difficulties encountered during the study were finding nuanced translation equivalences for Likert scale responses, the translation of phrases and idioms, and logistical issues.

Conclusions

Combining translation methods is the ideal choice to achieve robust translation.

Implication for Nursing Practice

The proposed translation method for research instruments would assist nurses in appraising prior research's findings, delineating potential effective nursing interventions, and facilitating comparisons of individuals from various cultures and contexts.
Indications for root canal treatment following traumatic dental injuries to permanent teeth
Authors: Abbott PV
Published: November 2023

The dental pulp may respond favourably or unfavourably to traumatic dental injuries. The most serious unfavourable responses are pulp necrosis and infection of the root canal system. These cause apical periodontitis and/or external inflammatory resorption of the tooth. The following injuries require root canal treatment as part of their emergency management—(A) complicated crown fractures (but some may be suitable for conservative pulp treatments, such as pulp capping, partial pulpotomy or pulpotomy), (B) complicated crown‐root fractures, (C) supra‐crestal coronal third root fractures and (D) injuries where pulp necrosis is predictable or highly likely to occur AND where there has been damage to the root surface and/or periodontal ligament with the aim of preventing external inflammatory resorption. This latter group of injuries are avulsion, intrusion, lateral luxation with a crown fracture, extrusion with a crown fracture (all in fully developed teeth) plus avulsion with a crown fracture and intrusion with a crown fracture (both in incompletely developed teeth). All other injuries should not have root canal treatment commenced as part of the emergency management, but they must be reviewed regularly to monitor the pulp for any adverse changes to its status, particularly pulp necrosis and infection of the root canal system.
Breaking bad: A model of expatriate managerial misbehavior
Authors: Ljubica Jasenko , Shaffer Margaret , Baker Colleen
Published: November 2023

The purpose of this paper is to develop a model to explain why and how some expatriate managers engage in misbehavior in host countries, a notoriously elusive phenomenon in the academe. Integrating social cognitive and fraud triangle theories, we conceptualize this phenomenon as an externally driven, cognitive decision‐making process. Specifically, we theorize that discrepancies between both home and host country environments and expatriate managerial and parent‐company performance expectations and on the ground realities that expatriates face trigger expatriate managerial cognitive self‐regulatory dynamics. Consequently, extrinsic reputation and intrinsic self‐esteem threats provide motivation for managers to learn vicariously from the host social environment about the effectiveness of misbehavior for achieving their goals. Expatriate self‐efficacy and the propensity to morally disengage moderate this process. Parent company controls also impact the influence of vicarious learning on expatriate managers' development of motivation, justification, and opportunities for misbehavior. Our model contributes to the misbehavior and expatriate literatures and extends social cognitive and fraud triangle theories.
Evolution of characteristics and biologic treatment effectiveness in patients of the Austrian psoriasis registry from 2004–2022
Authors: Graier Thomas , Salmhofer Wolfgang , Jonak Constanze , Weger Wolfgang , Zikeli Claudia , Gruber Barbara , Sator Paul , Prillinger Knut , Mlynek Alexander , Schütz‐Bergmayr Martina , Richter Leo , Ratzinger Gudrun , Sassmann Christoph , Painsi Clemens , Häring Nina , Wippel‐Slupetzky Katharina , Skvara Hans , Trattner Hannes , Inzinger Martin , Bangert Christina , Ellersdorfer Christina , Falkensteiner Katharina , Sadoghi Birgit , Gruber‐Wackernagel Alexandra , Hofer Angelika , Legat Franz , Lange‐Asschenfeldt Bernhard , Schmuth Matthias , Vujic Igor , Hötzenecker Wolfram , Saxinger Werner , Müllegger Robert , Quehenberger Franz , Wolf Peter
Published: November 2023

Background and Objectives

This study analyzed the extent to which the recent introduction of more effective treatments has led to an improvement in real‐world psoriasis patients.

Patients and Methods

Patient characteristics and the first‐year treatment effectiveness in biologic‐naive patients have been analyzed since 2004 until now, irrespective of treatment switches.

Results

Data from 2,729 patients were eligible for this analysis. The proportion of female patients increased significantly over the years from 29.9% to 36.2% (p < 0.028), while the number of patients with psoriatic arthritis declined from 36.6% to 30.0% (p < 0.001). Moreover, the duration of psoriatic disease and PASI at the start of the treatment significantly decreased. Last observation carrief forward (LOCF) analysis indicated that PASI 90 response increased from 18.9 to 44.6% at 3 months and from 32.9 to 66.8% at 12 months after treatment started. Similary, the PASI ≤ 3 rates increased from 33.2% to 66.0% at 3 months and from 41.9% to 78.9% at 12 months after the treatment started.

Conclusions

The continuous introduction of more efficient biologics has led to significant improvements in patient care and clinical outcomes. Though one out of three to five patients, depending on the endpoint selected, nowadays still does not achieve an entirely satisfactory treatment response (i.e., PASI 90 or PASI ≤ 3).
Functional connectivity in Lewy body disease with visual hallucinations
Authors: Firbank Michael J. , Collerton Daniel , Morgan Katrina daSilva , Schumacher Julia , Donaghy Paul C. , O'Brien John T. , Thomas Alan , Taylor John‐Paul
Published: November 2023

Background and purpose

Visual hallucinations are a common, potentially distressing experience of people with Lewy body disease (LBD). The underlying brain changes giving rise to visual hallucinations are not fully understood, although previous models have posited that alterations in the connectivity between brain regions involved in attention and visual processing are critical.

Methods

Data from 41 people with LBD and visual hallucinations, 48 with LBD without visual hallucinations and 60 similarly aged healthy comparator participants were used. Connections were investigated between regions in the visual cortex and ventral attention, dorsal attention and default mode networks.

Results

Participants with visual hallucinations had worse cognition and motor function than those without visual hallucinations. In those with visual hallucinations, reduced functional connectivity within the ventral attention network and from the visual to default mode network was found. Connectivity strength between the visual and default mode network correlated with the number of correct responses on a pareidolia task, and connectivity within the ventral attention network with visuospatial performance.

Conclusions

Our results add to evidence of dysfunctional connectivity in the visual and attentional networks in those with LBD and visual hallucinations.
Identification of gut microbiota dysbiosis in bullous pemphigoid under different disease activity
Authors: Hu Xiaomin , Wu Qingyang , Fan Yue , Guo Feng , Li Sizhe , Zhang Shuyang , Zuo Ya‐Gang
Published: November 2023

Bullous pemphigoid (BP) is a severe autoimmune blistering disease affecting patients' quality of life. Gut microbiota (GM) dysbiosis have been investigated to be associated with multiple autoimmune diseases. However, the relationship between GM and BP onset and remission remains to be established by a systematic study. We conducted a study that enrolled 24 patients with BP onset (BP group), 24 patients under remission stage (BP‐R group) and 24 healthy controls (HC group). We applied 16S rRNA sequencing on faecal samples and revealed a separation of the microbiota structure. At the family level, Lachnospiraceae, Prevotellaceae and Veillonellaceae were more abundant in the HC and BP‐R groups, while Bacteroidaceae, Ruminococcaceae and Enterobacteriaceae were more abundant in the BP group. Bugbase analysis revealed the potentially pathogenic bacteria had an increasing trend in the BP group compared with the HC group and this variation vanished in the BP‐R group. At the amplicon sequence variants (ASV) level, Bacteroides ovatus (ASV40) and Veillonella dispar (ASV140) significantly decreased, while Prevotella copri (ASV54) increased in the BP group compared to the HC and BP‐R groups. The HC group and BP‐R group shared similar abundance. Furthermore, by correlation analysis, we investigated key ASVs correlated with clinical parameters and found some discriminate biomarkers between the BP and BP‐R groups. Our study established a dynamic GM profile in BP patients under different disease activity, providing a new direction to understand the role of GM in BP pathogenesis and therapeutic effects.
A novel Ca2+ double cone vector system to treat compromised skin
Authors: Baumann Julia , Wandrey Franziska , Sacher Riikka , Zülli Fred
Published: November 2023

Background

Stressed, damaged or very aged skin is predominantly characterized by a malfunctioning skin barrier. Underlying skin barrier malfunction is a reduced or defective calcium gradient in the epidermis. Consequently, replenishing the compromised skin's calcium stores with topical calcium could be a potential therapeutic approach.

Methods

We investigated the effect of our novel Ca2+ double cone vector system on improving the differentiation and barrier function of reconstructed human epidermis (RHE), cultured at low basal calcium (0.3 mM) to represent very aged skin. Furthermore, in a randomized placebo‐controlled clinical study the skin barrier of 20 healthy volunteers was challenged with 2% sodium lauryl sulphate (SLS) for 24 h under occlusion, following and/or prior to treatment with a gel containing 2% of our calcium vector system.

Results

Culture in reduced basal calcium conditions (0.3 mM) strongly impeded the formation of a dense stratified epidermis. The apical treatment with 1.1 mM CaCl2 was not able to restore a functional differentiation. Treatment with 0.1% of the Ca2+ delivery system rescued the differentiation process and resulted in a normal stratified epidermis. Clinically, application of the Ca2+ vector system prior to and following SLS stress prevented increases in skin irritation and transepidermal water loss (TEWL) compared to placebo controls. Importantly, the treatment also significantly accelerated the recovery time following SLS stress.

Conclusion

With our novel Ca2+ vector system, we highlight the delivery of bioavailable Ca2+ ions into the skin as a new and successful approach to treat a damaged barrier present in stressed, aged or atopic skin.
Co‐expression pattern of SLC transporter genes associated with the immune landscape and clinical outcomes in gastric cancer
Authors: Zhang Yue , Liu Zhihong , Li Lingbo , Zeng Dongqiang , Sun Huiying , Wu Jianhua , Zhou Rui , Liao Wangjun
Published: November 2023

Solute carrier (SLC) transporters play a dual role in the occurrence and progression of tumours by acting as both suppressors and promoters. However, the overall impact of SLC transcriptome signatures on the tumour microenvironment, biological behaviour and clinical stratification of gastric cancer has not been thoroughly investigated. Therefore, we comprehensively analysed the expression profiles of the SLC transporter family members to identify novel molecular subtypes in gastric cancer. We identified two distinct SLC subtypes, SLC‐S1 and SLC‐S2, using non‐negative matrix factorization. These subtypes were markedly linked with the tumour microenvironment landscape, biological pathway activation and distinct clinical features of gastric cancer. Furthermore, a new scoring model, the SLC score, was developed to quantify the SLC subtypes. High SLC scores indicated a pattern of ‘SLC‐S2’, characterized by stromal infiltration and activation, poor prognosis and insensitivity to chemotherapy and immunotherapy, but high sensitivity to imatinib. The SLC score could serve as a supplement to the Tumour Node Metastasis (TNM) staging system to guide personalized treatment strategies and predict prognosis for patients with gastric cancer.
KIRREL promotes the proliferation of gastric cancer cells and angiogenesis through the PI3K/AKT/mTOR pathway
Authors: Wang Tao , Chen Shuo , Wang Ziliang , Li Siyu , Fei Xichang , Wang Tong , Zhang Mingjun
Published: November 2023

Anti‐angiogenesis is a promising therapeutic strategy for delaying tumour progression that offers, new hope for gastric cancer targeted therapy. The purpose of this study was to investigate the precise mechanism by which Kin of IRRE‐like protein 1 (KIRREL) contributes to the development of gastric cancer, particularly in terms of tumour angiogenesis. Differential expression of KIRREL in tissues and cells was detected using quantitative real‐time polymerase chain reaction, western blotting and immunohistochemistry. A bioinformatics analysis was conducted to screen for the function and pathway enrichment of KIRREL in gastric cancer. Lentivirus‐induced KIRREL silencing in SNU‐5 cells and lentivirus‐induced KIRREL overexpression in AGS cells were used to study the effect of KIRREL on the proliferation, cell cycle and angiogenesis of gastric cancer cells. Moreover, the expressions of PI3K, P‐PI3K, AKT, P‐AKT, mTOR, P‐mTOR, HIF‐1α and VEGF were also detected. Gastric cancer tissues and cells had high levels of KIRREL expression, which is associated with the proliferation, cell cycle and angiogenesis of gastric cancer cells. After silencing and overexpressing KIRREL in SNU‐5 and AGS cells, respectively, the proliferation and angiogenesis of SNU‐5 cells were inhibited, while the proliferation and angiogenesis of AGS cells were promoted. According to a bioinformatics analysis of the KIRREL gene, angiogenesis regulation and the PI3K/AKT pathway were highly connected. The PI3K/AKT/mTOR pathway was repressed and stimulated by KIRREL silencing and overexpression, respectively. IGF‐1, an AKT agonist, and LY294002, an inhibitor, reversed the effects of KIRREL silencing and overexpression on the PI3K/AKT/mTOR pathway and on gastric cancer cell proliferation and angiogenesis. KIRREL may mediate the proliferation and angiogenesis of gastric cancer cells through the PI3K/AKT/mTOR signalling pathway. These findings could help in the further development of potential anti‐angiogenesis targets.
A comparison of the cost effectiveness of property‐level adaptation and community‐scale flood defences in reducing flood risk
Authors: Rehan Balqis M. , Hall Jim W. , Penning‐Rowsell Edmund C. , Tan Vance Zong Hao
Published: November 2023

Adaptations to flood‐proof individual properties (referred to here as property‐level adaptation, PLA) provide a potential means of reducing flood risk at isolated properties, whilst conventional community‐scale flood protection (CSFP) is usually more economical in protecting high‐density urban spaces. This paper develops a risk‐based framework to identify the tipping point when PLA measures become more cost‐beneficial when compared to CSFP in different urban densities. The framework was demonstrated using a hypothetical case study based on a residential area in Teddington, London. Sensitivity analysis was performed by varying the building densities in the urban space. Results show that PLA can have a role to supplement CSFP even in dense urban areas if the CSFP standard of protection is low. However, adding some element of CSFP to PLA can be more cost‐effective than implementing a single higher protection standard of PLA. Given the unique flood risk condition of most urban spaces, and the sensitivity of cost‐effectiveness of flood adaptation measures such as those demonstrated in this work, this approach can provide additional information to assist decisions in finding a sensible portfolio of measures that match that risk condition.
Nutritional risk predicts postoperative complications and length of stay, whereas sarcopenia risk predicts need for step‐down care in a mixed elective surgery population
Authors: Power Siobhán , Maarof Asryaf , Power Aoibheann , Feehan Sinéad , Whelan Maria
Published: November 2023

Background

Malnutrition and poor functional reserves place patients at risk for negative surgical outcomes. In this prospective study we aimed to measure preoperative nutritional and sarcopenia risk and evaluate their impact on postoperative outcomes.

Methods

Adults scheduled to undergo elective general and gastrointestinal surgery were screened for nutrition risk using the Malnutrition Universal Screening Tool screening tool. Sarcopenia risk was measured using the SARC‐F tool and hand‐grip strength. Patients were followed postoperatively. Incidence of complications, length of stay (LOS), readmission rates, and need for step‐down care were recorded.

Results

One hundred and twenty‐two patients were included. Mean age was 53.8 years (standard deviation [SD] 16.44). Sixty‐six (54%) were scheduled for day‐case procedures, and 56 (46%) for nonday‐case procedures. About 18.9% (n = 23) were at nutritional risk preoperatively. Ten patients (8.2%) had probable sarcopenia based on SARC‐F, whereas seven (5.7%) had measurably reduced HG. Incidence of postoperative complications was 23.8% (n = 29). Nutrition risk was associated with the development of complications (p = 0.018). In the nonday‐case group, nutritional risk was associated with greater LOS (p = 0.013). Older age was associated with need for step‐down care (p = 0.002) as was SARC‐F (p = 0.003).

Conclusions

Preoperative nutritional screening can predict postoperative complications and LOS, whereas sarcopenia screening is predictive of the need for step‐down care after discharge. Screening tools are quick and inexpensive and could provide valuable information to clinicians and allow patients the opportunity to enhance their physical preparedness for surgery thereby mitigating their risk for negative surgical outcomes.
Radiofrequency and pulsed electromagnetic field application following liposuction—Clinical evaluation of performance and safety
Authors: Kaye Kai O. , Paprottka Felix , Moellhoff Nicholas , Fertsch Sonia , Frank Konstantin , Casabona Gabriela
Published: November 2023

Objective

With more than 1.5 million performed procedures, liposuction was the second most performed esthetic surgical procedure all over the world in males and in females in the year 2020. The objective of this open‐label, evaluator‐blinded study was to assess the efficacy and safety of an energy‐based device that combines multipolar radiofrequency with pulsed electromagnetic field (PEMF) in patients that underwent liposuction.

Materials and Methods

A total of 30 subjects, of whom 24 were females (80%), with a mean age of 48.4 ± 11.0 years (range: 27–69 years) and a mean weight of 69.5 ± 11.7 kg underwent unilateral treatment with radiofrequency and application of PEMF after bilateral liposuction. One month after the last of a total of six weekly treatments, skin elasticity, visco‐elasticity and net elasticity, as well as subject reported satisfaction on a 5‐point scale ranging from −1 (worse) to 3 (very much improved) and esthetic improvement ranging from 0 (very unsatisfied) to 4 (very satisfied) rated by three independent reviewers were assessed.

Results

Three independent and blinded reviewers rated the improvement of the treated side on average as 1.17 + 0.07 compared with baseline. Subjects were very satisfied with their treatment, with a mean score of 3.24 (0.03) out of 4 at the 1‐month follow‐up visit. Cutometer measurements showed no significant changes.

Conclusion

This study revealed that the subjective satisfaction with the results of the application of RF and PEMF after liposuction is high, while at the same time the esthetic appearance as rated by independent raters improved on the treated side.
Effects of forest roads on vegetation biodiversity and soil characteristics in Hyrcanian forests
Authors: Arjmand Afshin , Kiadaliri Hadi , Kazemnezhad Farid , Eshagh Nimvari Majid
Published: November 2023

As one of the main components of forest operations and sustainable management, forest roads affect the vegetation communities around the road. In this study, the effects of the edge of forest roads were investigated to understand the changes caused by the network of forest roads on the Hyrcanian forest ecosystem in northern Iran. In order to investigate the impact of forest roads on the biodiversity of herbaceous species, tree regeneration and lichen, sampling was used at different distances from the road in two controlled and harvested areas. The effects of roads on vegetation diversity in relation to soil characteristics were also investigated. The results showed that harvesting caused the destruction and reduction of tree, herbaceous and lichen regeneration, but the physical and chemical properties of the soil were not affected. The distance from the road has affected the diversity and richness of herbaceous and lichen, tree regeneration and all physical and chemical characteristics of the soil (except C). There was a significant correlation between most of the physical and chemical properties of the soil with the regeneration of trees and herbaceous species. Also, most of the physical and chemical properties of soil have increased with increasing distance from the road. Results showed that the buffering effect of the roadside in these forests up to a distance of 45 m had an effect on diversity and richness. Also, the results of this study are consistent with the fact that the road affects the biodiversity and properties of the forest soil.
Viral specific T cell therapy in kidney transplant recipients – A single‐center experience
Authors: Anand Manish , Nysather Jake , McGraw Gregory , Apewokin Senu , Khoury Ruby , Grimley Michael S , Bumb Shalini , Govil Amit
Published: November 2023

Background

Viral infections such as adenovirus (ADV), BK virus (BKV), and cytomegalovirus (CMV) after kidney transplantation negatively impact outcomes in transplant recipients despite advancements in screening and antiviral therapy. We describe our experience of using the virus‐specific T cell therapy (VSTs) in kidney transplant recipients (KTR) at our transplant center.

Methods

This is a retrospective, single center review of KTR with ADV, BKV and CMV infections between June 2021 and December 2022. These patients received third party VSTs as part of the management of infections. The immunosuppression, details of infection and outcome data were obtained from electronic medical records.

Results

Two cases of ADV infection resolved after one infusion of VSTs. The response rate of BKV and CMV infection was not as robust with close to 50% reduction in median viral load after VSTs. Out of 23 patients, two patients developed chronic allograft nephropathy from membranoproliferative glomerulonephritis and acute rejection.

Conclusion

Patients that are resistant to antivirals or who have worsening viremia despite conventional management may benefit from VSTs therapy to treat underlying viral infection. Additional studies are needed to ascertain efficacy and short‐ and long‐term risks secondary to VSTs.

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How I approach diarrhea in hematological transplant patients: A practical tool
Authors: Castillo Almeida Natalia E. , Cichon Catherine J. , Gomez Carlos A.
Published: November 2023

Diarrhea in hematopoietic stem‐cell transplantation (HSCT) remains a multifactorial challenge that demands a nuanced diagnostic approach. The causes of infectious diarrhea in HSCT recipients are diverse and influenced by patient‐specific risk factors, the post‐transplant timeline, and local epidemiology. During the past decade, our understanding of diarrhea in HSCT has witnessed a transformative shift through the incorporation of gastrointestinal (GI) multiplex polymerase chain reaction (PCR) panels. However, the judicious application of these panels is imperative to avoid overtesting and prevent adverse outcomes. The challenge lies in distinguishing between the diverse causes of diarrhea, ascertaining the clinical significance of detected pathogens, and navigating the diagnostic uncertainty presented by several non‐infectious conditions such as mucositis, intestinal dysbiosis, and acute graft‐versus‐host disease (aGvHD), all of which mimic infection. This review examines the landscape of infectious diarrhea in the HSCT population, encompassing both established (e.g., Cytomegalovirus, Clostridioides difficile, and norovirus) and emerging pathogens (e.g., sapoviruses, astroviruses). We propose a multifaceted diagnostic algorithm that combines clinical assessment, risk stratification, and tailored utilization of molecular platforms. While multiplex GI panels present invaluable opportunities for rapid and comprehensive pathogen detection, their judicious use is pivotal in preserving diagnostic stewardship. Customization of diagnostic algorithms tailored to local epidemiology ensures optimal patient care and resource utilization.
Uncertainty and the effectiveness of fiscal policy in the United States and Brazil: SVAR approach
Authors: Rodrigues Eduardo de Sá Fortes Leitão
Published: November 2023

The article analyses the interference of uncertainty on the effectiveness of fiscal policy. This issue is investigated through the lens of a Structural Vector Auto Regressive (SVAR) model for the United States and Brazil. Imposing government spending shocks, the models highlight a positive effect on economic activity. The results suggest Keynesian effects on consumption and GDP. To assess the effects of uncertainty, the models use two indices: the Economic Policy Uncertainty Index (EPU) and the World Uncertainty Index (WUI). The findings indicate that the fiscal effects are considerably less intense when uncertainty reaches high levels, consistent with the Real Options approach. The results suggest that agents are more cautious when the high‐uncertainty overshadows the outline of the economic scenario. In this sense, uncertainty disturbs agents' decisions and decreases consumption, investment and economic activity.
Identification of a pharyngeal mucosal lymphoid organ in zebrafish and other teleosts: Tonsils in fish?
Authors: Resseguier Julien , Nguyen-Chi Mai , Wohlmann Jens , Rigaudeau Dimitri , Salinas Irene , Oehlers Stefan H. , Wiegertjes Geert F. , Johansen Finn-Eirik , Qiao Shuo-Wang , Koppang Erling O. , Verrier Bernard , Boudinot Pierre , Griffiths Gareth
Published: November 2023

The constant exposure of the fish branchial cavity to aquatic pathogens causes local mucosal immune responses to be extremely important for their survival. Here, we used a marker for T lymphocytes/natural killer (NK) cells (ZAP70) and advanced imaging techniques to investigate the lymphoid architecture of the zebrafish branchial cavity. We identified a sub-pharyngeal lymphoid organ, which we tentatively named “Nemausean lymphoid organ” (NELO). NELO is enriched in T/NK cells, plasma/B cells, and antigen-presenting cells embedded in a network of reticulated epithelial cells. The presence of activated T cells and lymphocyte proliferation, but not V(D)J recombination or hematopoiesis, suggests that NELO is a secondary lymphoid organ. In response to infection, NELO displays structural changes including the formation of T/NK cell clusters. NELO and gill lymphoid tissues form a cohesive unit within a large mucosal lymphoid network. Collectively, we reveal an unreported mucosal lymphoid organ reminiscent of mammalian tonsils that evolved in multiple teleost fish families.
Tumor-specific GPX4 degradation enhances ferroptosis-initiated antitumor immune response in mouse models of pancreatic cancer
Authors: Li Jingbo , Liu Jiao , Zhou Zhuan , Wu Runliu , Chen Xin , Yu Chunhua , Stockwell Brent , Kroemer Guido , Kang Rui , Tang Daolin
Published: November 2023

Lipid peroxidation–dependent ferroptosis has become an emerging strategy for tumor therapy. However, current strategies not only selectively induce ferroptosis in malignant cells but also trigger ferroptosis in immune cells simultaneously, which can compromise anti-tumor immunity. Here, we used In-Cell Western assays combined with an unbiased drug screening to identify the compound N6F11 as a ferroptosis inducer that triggered the degradation of glutathione peroxidase 4 (GPX4), a key ferroptosis repressor, specifically in cancer cells. N6F11 did not cause the degradation of GPX4 in immune cells, including dendritic, T, natural killer, and neutrophil cells. Mechanistically, N6F11 bound to the RING domain of E3 ubiquitin ligase tripartite motif containing 25 (TRIM25) in cancer cells to trigger TRIM25-mediated K48-linked ubiquitination of GPX4, resulting in its proteasomal degradation. Functionally, N6F11 treatment caused ferroptotic cancer cell death that initiated HMGB1-dependent antitumor immunity mediated by CD8
+
T cells. N6F11 also sensitized immune checkpoint blockade that targeted CD274/PD-L1 in advanced cancer models, including genetically engineered mouse models of pancreatic cancer driven by
KRAS
and
TP53
mutations. These findings may establish a safe and efficient strategy to boost ferroptosis-driven antitumor immunity.
Functional potential and evolutionary response to long-term heat selection of bacterial associates of coral photosymbionts
Authors: Maire Justin , Philip Gayle K. , Livingston Jadzia , Judd Louise M. , Blackall Linda L. , van Oppen Madeleine J. H.
Published: November 2023

Corals rely on a wide range of microorganisms for their functioning, including intracellular dinoflagellates (Symbiodiniaceae) and bacteria. Marine heatwaves trigger the loss of Symbiodiniaceae from coral tissues–coral bleaching–often leading to death. While coral-bacteria interactions are widely studied, Symbiodiniaceae-bacteria interactions have remained largely uninvestigated. Here, we provide a genomic analysis of 49 bacteria, spanning 16 genera, that are closely associated with six cultured Symbiodiniaceae species. We analyzed bacterial functional potential by focusing on potentially beneficial functions for the Symbiodiniaceae host, including B vitamin synthesis and antioxidant abilities, which may be crucial for Symbiodiniaceae heat tolerance and, in turn, coral resistance to thermal bleaching. These analyses suggest a wide potential for B vitamin synthesis and the scavenging of reactive oxygen species (through the production of carotenoids or antioxidant enzymes), and possibly the transfer of organic carbon to host cells. Single nucleotide polymorphism analysis between bacteria isolated from wild-type and heat-evolved Symbiodiniaceae cultures revealed that exposure to long-term elevated temperature has resulted in mutations in genes known to be involved in host-symbiont interactions, such as secretion systems. Climate change may therefore modify how Symbiodiniaceae and bacteria interact. This study provides an overview of the possible roles of Symbiodiniaceae-associated bacteria in Symbiodiniaceae functioning and heat tolerance, reinforcing the need for further studies of such interactions to fully understand coral biology and climate resilience.

IMPORTANCE

Symbiotic microorganisms are crucial for the survival of corals and their resistance to coral bleaching in the face of climate change. However, the impact of microbe-microbe interactions on coral functioning is mostly unknown but could be essential factors for coral adaption to future climates. Here, we investigated interactions between cultured dinoflagellates of the Symbiodiniaceae family, essential photosymbionts of corals, and associated bacteria. By assessing the genomic potential of 49 bacteria, we found that they are likely beneficial for Symbiodiniaceae, through the production of B vitamins and antioxidants. Additionally, bacterial genes involved in host-symbiont interactions, such as secretion systems, accumulated mutations following long-term exposure to heat, suggesting symbiotic interactions may change under climate change. This highlights the importance of microbe-microbe interactions in coral functioning.
Different lanthanide elements induce strong gene expression changes in a lanthanide-accumulating methylotroph
Authors: Gorniak Linda , Bechwar Julia , Westermann Martin , Steiniger Frank , Wegner Carl-Eric
Published: November 2023

Lanthanides (Ln) are the most recently described life metals and are central to methylotrophy (type of metabolism in which organic substrates without carbon-carbon bonds serve as carbon and energy source) in diverse taxa. We recently characterized a novel, Ln-dependent, and Ln-accumulating methylotroph, Beijerinckiaceae bacterium RH AL1, which requires lighter Ln (La, Ce, Nd) for methanol oxidation. Starting from two sets of incubations, one with different La concentrations (50 nM and 1 µM) and one with different Ln elements [La, Nd, or an Ln cocktail (containing Ce, Nd, Dy, Ho, Er, Yb)], we could show that La concentration and different Ln elements strongly affect gene expression and intracellular Ln accumulation. Differential gene expression analysis revealed that up to 41% of the encoded genes were differentially expressed. The effects of La concentration and Ln elements were not limited to Ln-dependent methanol oxidation but reached into many aspects of metabolism. We observed that Ln influence the flagellar and chemotactic machinery and that they affect polyhydroxyalkanoate biosynthesis. The most differentially expressed genes includedlanM, coding for the well-characterized lanthanide-binding protein lanmodulin, and a glucose dehydrogenase gene linked to the conversion of β-D-glucose to D-glucono-1,5-lactone, a known potential metal chelator. Electron microscopy, together with RNAseq, suggested that Beijerinckiaceae bacterium RH AL1 can discriminate between Ln elements and that they are differently taken up and accumulated. The discrimination of Ln and links between Ln and various aspects of metabolism underline a broader physiological role for Ln in Beijerinckiaceae bacterium RH AL1.

IMPORTANCE

Since its discovery, Ln-dependent metabolism in bacteria attracted a lot of attention due to its bio-metallurgical application potential regarding Ln recycling and circular economy. The physiological role of Ln is mostly studied dependent on presence and absence. Comparisons of how different (utilizable) Ln affect metabolism have rarely been done. We noticed unexpectedly pronounced changes in gene expression caused by different Ln supplementation. Our research suggests that strain RH AL1 distinguishes different Ln elements and that the effect of Ln reaches into many aspects of metabolism, for instance, chemotaxis, motility, and polyhydroxyalkanoate metabolism. Our findings regarding Ln accumulation suggest a distinction between individual Ln elements and provide insights relating to intracellular Ln homeostasis. Understanding comprehensively how microbes distinguish and handle different Ln elements is key for turning knowledge into application regarding Ln-centered biometallurgy.
First report of environmental
bla
PAC-1
-carrying
Aeromonas enteropelogenes
Authors: Zhong Yang , Guo Siyao , Thong Shuhua , Schlundt Joergen , Kwa Andrea L.
Published: November 2023

The
bla
PAC-1
has been reported in Central Asia and Europe countries like Afghanistan and France in
Aeromonas caviae
and
Pseudomonas aeruginosa
strains from animals and patients, respectively. However, there is no record of
bla
PAC-1
-carrying strain from the natural environment, and
bla
PAC-1
-carrying
Aeromonas
has not been reported in the Asia Pacific. Here, we report the first known enviromental
bla
PAC-1
-carrying
Aeromonas enteropelogenes
in the world from reservoir water in Singapore. We have performed a comprehensive genetic environment alignment and comparison of
bla
PAC-1
between our strain and other strains from different countries and sources and found the
bla
PAC-1
located on a highly conserved gene cluster. We suggest that environmental
Aeromonas
strains may act as a hidden reservoir involved in the circulating of
bla
PAC-1
. The finding of conserved
bla
PAC-1
cluster also suggested the existence of multiple transmission pathways of
bla
PAC-1
in the Asia-Pacific region, involving multiple sources and different species.
Incarcerated hernia with ileal perforation in an extreme preterm infant
Authors: Lim Alicia May , Yap Te-Lu , Kong Juin Yee
Published: November 2023

We describe a case of a premature 24 weeks gestation infant who presented with clinical lability and abdominal distention with initial concerns of necrotising enterocolitis. On further examination, a right inguinal hernia was noted and serial abdominal X-rays showed bowel loop dilatation with intramural air and no perforation. However, the hernia was recurrent and later found to be not reducible. He underwent right groin exploration. Intraoperatively, distal ileal perforation was noted and he was found to have an additional five sites of perforation. He had a stoma sited at the left iliac fossa as well as primary anastomosis at the site of the second to fifth perforations. He had a stormy postoperative period but is currently doing well. Although obstructed hernias are rare in the initial course of an extreme preterm infant, it should not be missed as a cause of intestinal obstruction and early surgical opinion should be sought.
Sign-changing solutions for a weighted Schrödinger–Kirchhoff equation with double exponential nonlinearities growth
Authors: Baraket Sami , Chetouane Rima , Jaidane Rached , Mtaouaa Wafa
Published: November 2023

This work is devoted to the existence of least energy nodal solutions for a nonlocal weighted Schrödinger–Kirchhoff problem, under boundary Dirichlet condition in the unit ball [Formula: see text] of [Formula: see text]. The nonlinearity of the equation is assumed to have double exponential growth in view of Trudinger–Moser type inequalities. By using the constrained minimization in Nehari set, the quantitative deformation Lemma and degree theory results, we prove our existence result.