bluuebunny/crossref_metadata_2025 huggingface dataset:
Leveraging on technology and sustainability to innovate the supply chain: a proposal of agri-food value chain model
Authors: Corallo Angelo , De Giovanni Martina , Latino Maria Elena , Menegoli Marta
Published: June 2023

Purpose

Nowadays, the agri-food industry is called to face several sustainability challenges that require the development of new sustainable models. The adoption of new technological assets from Industry 4.0 supports the companies during the implementation of sustainability practices. Several models design the operation management of the food supply chains (FSCs). Because none extant models resulted complete in technological and sustainability elements, this paper aims to propose an innovative and sustainable agri-food value chain model, contributing to extend understating of how supply chains can become more sustainable through the Industry 4.0 technologies.

Design/methodology/approach

Thanks to a well-structured and replicable systematic literature review and sequent content analysis, this work recognized and compared the extant FSC models, focusing on the interaction of five key elements: activities, flows, stakeholders, technologies and sustainability. The output of the comparison leading in the definition of the proposed model is discussed in a focus group of 10 experts and tested in a case study.

Findings

Fifteen extant models were recognized in literature and analysed to discover their features and to putt in light peculiarities and differences among them. This analysis provided useful insights to design and propose a new innovative and sustainable agri-food value chain model; an example for the olive oil business case is provided.

Originality/value

The adding value of the work is the proposed model which regards innovative elements such as recirculation flows, external stakeholders and Industry 4.0 technologies usage which allows enhancing the agri-FSCs operational efficiency and sustainability.
Re‐recognition of innate immune memory as an integrated multidimensional concept
Authors: Tang Chang , Kurata Shoichiro , Fuse Naoyuki
Published: June 2023

In the past decade, the concept of immunological memory, which has long been considered a phenomenon observed in the adaptive immunity of vertebrates, has been extended to the innate immune system of various organisms. This de novo immunological memory is mainly called “innate immune memory”, “immune priming”, or “trained immunity” and has received increased attention because of its potential for clinical and agricultural applications. However, research on different species, especially invertebrates and vertebrates, has caused controversy regarding this concept. Here we discuss the current studies focusing on this immunological memory and summarize several mechanisms underlying it. We propose “innate immune memory” as a multidimensional concept as an integration between the seemingly different immunological phenomena.
Effect of renal denervation on cardiac remodelling and function in rats with chronic intermittent hypoxia
Authors: Lu Dasheng , Wang Kai , Jiang Wanying , Zhang Hao , Zhang Hongxiang
Published: June 2023

Chronic intermittent hypoxia (CIH) mimicking obstructive sleep apnea elicits divergent outcomes in the cardiovascular systems. The effect of renal denervation (RDN) on the heart during CIH remains unclear. We aimed to explore the effect of RDN on cardiac remodelling in rats exposed to CIH and to discuss the underlying mechanisms. Adult Sprague Dawley rats were divided into four groups: control, control+RDN, CIH (CIH exposure for 6 weeks, nadir of 5%–7% to peak of 21% O2, 20 cycles/h, 8 h/day) and CIH+ RDN group. Echocardiography, cardiac fibrosis, left ventricle (LV) expressions of nuclear factor‐E2‐related factor 2 (Nrf2)/heme oxygenase‐1 (HO‐1) pathway and inflammatory factors were tested at the end of the study. Cardiac structural remodelling and dysfunction were induced by CIH and attenuated by RDN. Myocardial fibrosis was more severe in the CIH group than in the control group and improved in the CIH + RDN group. Sympathetic activity reflected by tyrosine hydroxylase (TH) expression and noradrenaline were significantly elevated after CIH but blunted by RDN. CIH downregulated LV protein expressions of Nrf2 and HO‐1, which was activated by RDN. The downstream of Nrf2/HO‐1, such as NQO1 and SOD expression, elevated following RDN. RDN also decreased the mRNA expression of IL‐1β and IL‐6. Notably, control+RDN did not affect cardiac remodelling and Nrf2/HO‐1 compared with the control. Taken together, we found that RDN exerted cardio‐protective effects in a rat model of CIH involving Nrf2/HO‐1 pathway and inflammation.
Choosing Wisely audit: Blood gas ordering in the emergency department
Authors: Kumarakurusingham Evan , Yousif Fahad
Published: June 2023

Objective

Our aim was to reduce unnecessary blood gases to improve patient flow, reduce false positives and reduce unnecessary treatments.

Methods

This was a retrospective, single‐centre audit of 100 patients in June 2022.

Results

There were approximately 45 blood gases per 100 ED presentations. Following education and poster reminders, a re‐audit was undertaken in October 2022, resulting in a reduction of 33% of blood gases ordered.

Conclusion

We have found that many blood gases are ordered for patients who are not critically unwell, and whose disposition was not affected by their result.
Hydro‐economic modeling of managed aquifer recharge in the lower Mississippi
Authors: Ali Ahmed A. , Tran Dat Q. , Kovacs Kent F. , Dahlke Helen E.
Published: June 2023

The Mississippi Embayment aquifer is one of the largest alluvial groundwater aquifers in the United States. It is being excessively used, located along the lower Mississippi River covering approximately 202,019 km2 (78,000 square miles). Annual average groundwater depletion in the aquifer has been estimated at 5.18 billion cubic meters (Gm3) (4.2 million acre‐feet) in 1981–2000. However, since 2000, annual groundwater depletion has increased abruptly to 8 Gm3 (2001–2008). In recent years, multi‐state efforts have been initiated to improve the Mississippi Embayment aquifer sustainability. One management strategy of interest for preserving groundwater resources is managed aquifer recharge (MAR). In this study, we evaluate the impact of different MAR scenarios on land and water use decisions and the overall groundwater system using an economic model able to assess profitability of crop and land use decisions coupled to the Mississippi Embayment Regional Aquifer Study (MERAS) hydrogeologic model. We run the coupled model for 60 years by considering the hydrologic conditions from the MERAS model for the years 2002–2007 and repeating them 10 times. We find MAR is not economically attractive when the water cost is greater than $0.05/m3. Groundwater storage is unlikely to improve when relying solely on MAR as groundwater management strategy but rather should be implemented jointly with other groundwater conservation policies.
What can Nabataean Aramaic tell us about Pre‐Islamic Arabic?
Authors: Suchard Benjamin D.
Published: June 2023

Nabataean Aramaic contains a large number of loanwords from Arabic. Together with other evidence, this has been taken as an indication that the Nabataeans used Aramaic as a written language only, while a Pre‐Islamic variety of Arabic was their spoken language. Based on a comprehensive review of the evidence, however, this article concludes that both Arabic and Aramaic were in spoken use in the Nabataean Kingdom and Late Antique Northwest Arabia. Departing from this modified understanding of the linguistic status of Nabataean Aramaic, various features of Pre‐Islamic Arabic are then examined based on the Nabataean evidence: the realisation of the voiceless sibilant /s/, nominal morphology, the reflexes of stem‐final *y, verbal syntax, and the lexicon.
A review of the biology of the pincer wasps (Hymenoptera: Dryinidae)
Authors: Virla Eduardo G. , Moya‐Raygoza Gustavo , Guglielmino Adalgisa
Published: June 2023

Because of their frequency, abundance, and unique morphological and biological traits, the Dryinidae (pincer wasps) are among the most important parasitoids of nymphs and adults of Hemiptera: Auchenorrhyncha. This contribution offers a summary of the knowledge about the main biological characteristics of the Dryinidae gained over more than 130 years. Among other topics, the information provided covers the interactions with their hosts and other organisms, as well as their development, behaviour, natural enemies and economic importance.
Hydroxychloroquine improves pregnancy outcomes in patients undergoing frozen embryo transfer with positive serum autoantibodies
Authors: Guo Yaping , Su Yan , Zhang Mianqiu , Ji Hui , Zhao Chun , Ling Xiufeng , Shen Rong
Published: June 2023

Problem

Does hydroxychloroquine (HCQ) improve pregnancy outcomes after frozen embryo transfer (FET) cycles in patients who are positive for autoantibodies？

Method of study

This was a retrospective clinical study involving 128 patients who were positive for autoantibodies undergoing FET cycles between October 2017 and December 2022. Subjects were divided into two groups: a study group of 65 cycles with HCQ (HCQ was administered orally over 2 months before transplantation and continued during the first trimester) and a control group consisting of 63 cycles without HCQ (no HCQ was used throughout the FET cycle). Each patient was enrolled in the cohort only once. Then, we analyzed the clinical pregnancy outcomes between the two groups.

Results

Analysis showed that HCQ was a factor that independently associated with clinical pregnancy rate (CPR) OR (Odds Ratio): 3.106; 95% confidence interval (CI): 1.458‐6.616; p = .003. Furthermore, the implantation rate (IR), CPR and ongoing pregnancy rate (OPR) of the treatment group were significantly higher than those in the control group. The biochemical pregnancy rate (BPR) and early miscarriage rate (EMR) were significantly lower than that in the control group (p = .029, p < .001).

Conclusion

We found that HCQ improved clinical pregnancy outcomes and reduced the rate of first‐trimester abortion in patients who were positive for autoantibodies during FET cycles.
Robust PCA for high‐dimensional data based on characteristic transformation
Authors: He Lingyu , Yang Yanrong , Zhang Bo
Published: June 2023

In this paper, we propose a novel robust principal component analysis (PCA) for high‐dimensional data in the presence of various heterogeneities, in particular strong tailing and outliers. A transformation motivated by the characteristic function is constructed to improve the robustness of the classical PCA. The suggested method has the distinct advantage of dealing with heavy‐tail‐distributed data, whose covariances may be non‐existent (positively infinite, for instance), in addition to the usual outliers. The proposed approach is also a case of kernel principal component analysis (KPCA) and employs the robust and non‐linear properties via a bounded and non‐linear kernel function. The merits of the new method are illustrated by some statistical properties, including the upper bound of the excess error and the behaviour of the large eigenvalues under a spiked covariance model. Additionally, using a variety of simulations, we demonstrate the benefits of our approach over the classical PCA. Finally, using data on protein expression in mice of various genotypes in a biological study, we apply the novel robust PCA to categorise the mice and find that our approach is more effective at identifying abnormal mice than the classical PCA.
‘I guess I really survived many crises’: On the benefits of longitudinal ethnographic research
Authors: Di Feliciantonio Cesare
Published: June 2023

Building on my ongoing ethnographic research with people living with HIV in different European countries, the paper focuses on RD, a Catalan man I have interviewed three times since 2014. In RD's life narrative, ‘crisis’ is a recurring theme including both the most blatant forms, like the severe housing crisis in Spain that followed the global financial crisis, and the most ordinary ones like domestic violence. Analysing the impact of crises in RD's perception and experience of the present, interwoven with the past(s) and the future(s), the paper discusses two main benefits of longitudinal ethnographic research. First, it allows to capture how crisis is not just a moment or a phase in RD's life, but acts as context generating a recurring experience of an ‘uncanny present’ shaped by logics of return and repetition of the past, and anticipation of the future. Second, it supports RD's self‐awareness around his ability to navigate the unknown when experiencing the ‘uncanny present’; this highlights the ethical care dimension entailed by such methodology.
Comparison of acute phase response in mice after inhalation and intratracheal instillation of molybdenum disulphide and tungsten particles
Authors: Gutierrez Claudia Torero , Loizides Charis , Hafez Iosif , Biskos George , Loeschner Katrin , Brostrøm Anders , Roursgaard Martin , Saber Anne Thoustrup , Møller Peter , Sørli Jorid Birkelund , Hadrup Niels , Vogel Ulla
Published: June 2023

Inhalation studies are the gold standard for assessing the toxicity of airborne materials. They require considerable time, special equipment, and large amounts of test material. Intratracheal instillation is considered a screening and hazard assessment tool as it is simple, quick, allows control of the applied dose, and requires less test material. The particle‐induced pulmonary inflammation and acute phase response in mice caused by intratracheal instillation or inhalation of molybdenum disulphide or tungsten particles were compared. End points included neutrophil numbers in bronchoalveolar lavage fluid, Saa3 mRNA levels in lung tissue and Saa1 mRNA levels in liver tissue, and SAA3 plasma protein. Acute phase response was used as a biomarker for the risk of cardiovascular disease. Intratracheal instillation of molybdenum disulphide or tungsten particles did not produce pulmonary inflammation, while molybdenum disulphide particles induced pulmonary acute phase response with both exposure methods and systemic acute phase response after intratracheal instillation. Inhalation and intratracheal instillation showed similar dose–response relationships for pulmonary and systemic acute phase response when molybdenum disulphide was expressed as dosed surface area. Both exposure methods showed similar responses for molybdenum disulphide and tungsten, suggesting that intratracheal instillation can be used for screening particle‐induced acute phase response and thereby particle‐induced cardiovascular disease.
Cognitive dysfunction and impaired neuroplasticity following repeated exposure to the synthetic cannabinoid JWH‐018 in male mice
Authors: Bilel Sabrine , Zamberletti Erica , Caffino Lucia , Tirri Micaela , Mottarlini Francesca , Arfè Raffaella , Barbieri Mario , Beggiato Sarah , Boccuto Federica , Bernardi Tatiana , Casati Sara , Brini Anna T. , Parolaro Daniela , Rubino Tiziana , Ferraro Luca , Fumagalli Fabio , Marti Matteo
Published: June 2023

Background and Purpose

Psychotic disorders have been reported in long‐term users of synthetic cannabinoids. This study aims at investigating the long‐lasting effects of repeated JWH‐018 exposure.

Experimental Approach

Male CD‐1 mice were injected with vehicle, JWH‐018 (6 mg·kg−1), the CB1‐antagonist NESS‐0327 (1 mg·kg−1) or co‐administration of NESS‐0327 and JWH‐018, every day for 7 days. After 15 or 16 days washout, we investigated the effects of JWH‐018 on motor function, memory, social dominance and prepulse inhibition (PPI). We also evaluated glutamate levels in dialysates from dorsal striatum, striatal dopamine content and striatal/hippocampal neuroplasticity focusing on the NMDA receptor complex and the neurotrophin BDNF. These measurements were accompanied by in vitro electrophysiological evaluations in hippocampal preparations. Finally, we investigated the density of CB1 receptors and levels of the endocannabinoid anandamide (AEA) and 2‐arachidonoylglycerol (2‐AG) and their main synthetic and degrading enzymes in the striatum and hippocampus.

Key Results

The repeated treatment with JWH‐018 induced psychomotor agitation while reducing social dominance, recognition memory and PPI in mice. JWH‐018 disrupted hippocampal LTP and decreased BDNF expression, reduced the synaptic levels of NMDA receptor subunits and decreased the expression of PSD95. Repeated exposure to JWH‐018, reduced hippocampal CB1 receptor density and induced a long‐term alteration in AEA and 2‐AG levels and their degrading enzymes, FAAH and MAGL, in the striatum.

Conclusion and Implications

Our findings suggest that repeated administration of a high dose of JWH‐018 leads to the manifestation of psychotic‐like symptoms accompanied by alterations in neuroplasticity and change in the endocannabinoid system.
Associations of father absence and limited access to books and toys with early childhood development among children aged 0–6 years in a rural county lifted out of poverty in China
Authors: Chang Rui , Li Chunan , Wei Mengna , Jiang Yanfen , Zhang Jianduan
Published: June 2023

Objectives

This study aimed to understand the early development and nurturing care environment of children aged 0–6 years in rural China and to evaluate the sex‐ and age‐specific associations of nurturing care environment with child developmental outcomes.

Methods

A cross‐sectional survey involving 2078 children aged 0–6 years was conducted using a stratified cluster sampling strategy. We used face‐to‐face interviews to collect information on child, family and nurturing care. The Ages & Stages Questionnaires‐Chinese version and ASQ: Social‐Emotional were applied to assess children's neuro‐ and social–emotional development, respectively. Lower neurodevelopmental scores indicate an increased risk for neurodevelopmental delay, and higher social–emotional scores are indicative to a risk of social–emotional problems. The multiple linear regression model examined the associations of nurturing care environments with childhood development.

Results

Among the investigated children, the average age was (42.9 ± 19.8) months and 55.8% were boys; 67.9% of the children had absent fathers because of labour migration and 54.0% had limited access to books and toys. Overall, boys had a lower total neurodevelopmental score than girls; similar gender patterns were also found in the domains of communication, fine motor, problem‐solving and person‐social. Concurrent absent fathers and limited access to books and toys were significantly associated with reduced neurodevelopmental scores [β − 11.44, 95% CI (−18.20, −4.68)] and increased social–emotional developmental scores [β 5.88, 95%CI (1.35, 10.41)] after controlling for confounding factors. Sex‐specific analysis only echoed the results in boys. Additionally, having an absent father and limited access to books and toys was associated with lower neurodevelopmental scores [β − 14.58, 95%CI (−25.41, −3.75)] in children under 3 years of age and higher social–emotional developmental scores among children aged 3–6 years [β 10.66, 95%CI (5.09, 16.24)].

Conclusions

Children, especially boys, with absent fathers due to labour migration have poorer neuro‐ and social–emotional development. Limited access to books and toys and father absence are linked to the children's developmental delay, especially for those under 3 years of age. Our findings suggest that intervention programs in resource‐constrained rural areas are desirable; more importantly, such programs should begin before 3 years of age to achieve a benefit–cost outcome.
Intergroup resource allocation among children from minority and majority groups in three settings of former conflict
Authors: Corbett B. , Dautel J. , Tomašić Humer J. , Tomovska Misoska A. , Taylor L. K.
Published: June 2023

Intergroup resource allocation was examined among 333 children aged 7–11 (51.9% female) within three settings of former intergroup conflict (January–June 2021). Children represented both ethno‐religious minority and majority groups (Republic of North Macedonia: Albanians, Macedonians; Croatia: Serbs, Croats; Northern Ireland: Catholics, Protestants), from predominantly White and middle‐class families. Ingroup bias in average resource allocation amounts was demonstrated by both minority and majority children, across settings, in the context of novel targets (historic conflict rivals). Majority children were also more likely to give equally (which maintains the status quo) than minority children. Giving equally increased with age for both minority and majority children, despite being in “zero‐sum,” conflict settings. Equitable intergroup resource allocation in such settings has implications for conflict transformation.
Stability of guided bone regeneration with two ratios of biphasic calcium phosphate at implant sites in the esthetic zone: A randomized controlled clinical trial
Authors: Arunjaroensuk Sirida , Thunyakitpisal Pasutha , Nampuksa Katanchalee , Monmaturapoj Naruporn , Mattheos Nikos , Pimkhaokham Atiphan
Published: June 2023

Aims

The aim of this randomized, double‐blind, clinical trial was to compare the stability of the horizontal dimensions (facial bone thickness) of augmented bone using biphasic calcium phosphate (BCP) with hydroxyapatite/β‐tricalcium phosphate ratio of either 60/40 or 70/30.

Materials and Methods

Sixty dental implants placed with contour augmentation in the esthetic zone were randomized to 60/40 BCP (n = 30) or 70/30 BCP (n = 30). Cone‐beam computed tomographic was used to assess facial bone thickness post‐implantation and 6 months later at implant platform and 2, 4, and 6 mm apical to it.

Results

The percentage of horizontal dimension reduction was 23.64%, 12.83%, 9.62%, and 8.21% in 70/30 BCP group, while 44.26%, 31.91%, 25.88%, and 21.49% in 60/40 BCP group at the level of the implant platform and 2, 4, and 6 mm apical, respectively. Statistically significant difference was found at 6 months at all levels of measurement (p‐value < .05).

Conclusions

BCP bone grafts with HA/β‐TCP ratio of 60/40 and 70/30 showed comparable outcomes for contour augmentation simultaneously with implant placement. Interestingly, the 70/30 ratio was significantly superior in maintaining facial thickness and showed more stable horizontal dimensions of the augmented site.
Automatic detection of microaneurysms using a novel segmentation algorithm based on deep learning techniques
Authors: Monisha Birlin T. , Divya C. , John Livingston J.
Published: June 2023

Microaneurysms is the first stage of diabetic retinopathy (DR) and it plays a vital role in the computerized diagnosis. However, it is difficult to automatically detect microaneurysms in fundus images due to the complicated background and various illumination reasons. The motivation behind this, is the number of increases in diabetic patients is very large when compared with the number of ophthalmologists. The FSCA‐UNET (Frequency Spatial Channel Attention UNET) segmentation model, is proposed and it is an improvement over UNET. We first use the frequency channel attention mechanism to analyze the features that were extracted from the first stage of the convolution layer, and we obtain good results. Then, we included a spatial attention map with frequency attention, also known as FSCA‐UNET, which makes use of inter‐spatial connections between features. Our deep neural model with an encoder‐decoder structure termed FSCA‐UNET produced more accurate results. Our novel algorithm outdated the performance measures of the existing segmentation algorithms. The proposed segmentation algorithm was trained and tested on Indian Diabetic Retinopathy Image Dataset (IDRiD), and E‐ophtha Dataset and we got promising results in terms of sensitivity, specificity, dice coefficient, precision, F1 score, and accuracy.
Rapid vision improvement by using icotinib in a patient with bilateral choroidal metastases symmetrically from lung cancer
Authors: Li Chaoran , Wang Xue E , Yan Lei , Zhao Yani , Zhu Yun Kui
Published: June 2023

Introduction

The metastases of lung cancer to bilateral choroids symmetrically and simultaneously are very rare. Almost all patients with choroid metastasis can be treated with external beam radiotherapy in order to increase quality of life and preserve vision.

Material and Methods

We documented a case and studied the effect of icotinib on choroidal metastases in bilateral eyes simultaneously from pulmonary adenocarcinoma.

Results

A 49‐year‐old Chinese man presented with bilateral vision losing simultaneously for 4 weeks, it was as an initial presentation in the clinical. The examinations with ophthalmofundoscopy, ultrasonography, and fluorescein angiography showed the lesions in bilateral choroids, two solitary juxtapapillary yellow‐white choroidal metastases inferior to the optic discs with bleeding. Positron emission tomography confirmed the choroidal metastases and further proved that it was from lung cancer with lymph nodes and multiple bone metastasis. The biopsy taken from the lung by bronchoscopy and needle biopsy from supraclavicular lymph nodes revealed the pulmonary adenocarcinoma with epithelial growth factor receptor mutation (exon 21). The patient was treated with oral icotinib (125 mg, three times a day, TID). Five days after starting icotinib therapy, the patient's visions were rapidly recovered. Two months after the treatment with icotinib, the choroidal metastases regressed to small lesions, and the visions were preserved to before. The lung tumor and other metastatic lesions were partly regressive. There was no evidence of recurrence for eye lesions at 15‐months follow‐up. After 17 months treating by icotinib, the patient presented headache and dizzy with multiple brain metastases determined by magnetic resonance imaging; however, the lesions of the choroidal metastases remained progressing‐free. Almonertinib with radiotherapy were used to treat the brain metastases, and he is surviving with progress‐free more than 2 years until now.

Conclusion

Bilateral choroidal metastases from lung cancer symmetrically are very rare. Icotinib following by almonertinib was an alternative therapy for choroidal metastasis from non‐small cell lung cancer with epithelial growth factor receptor mutation.
Risk of breakthrough SARS‐CoV‐2 infection and clinical outcomes among vaccinated patients with type 2 diabetes
Authors: Bea Sungho , Choi Ahhyung , Kim Jae Hyeon , Cho Young Min , Choi Won Suk , Jung Jaehun , Shin Ju‐Young
Published: June 2023

Aim

To explore the risk of breakthrough infection among patients with type 2 diabetes (T2D) and risk of severe clinical outcomes after SARS‐CoV‐2 infection according to vaccination status.

Materials and Methods

We conducted a population‐based cohort study using South Korea's linked database of nationwide COVID‐19 registry and claims data between 2018 and 2021. Hazard ratios (HRs) and 95% confidence intervals (CIs) for breakthrough infections were measured in 1:1 propensity‐score (PS)‐matched fully vaccinated patients with versus without T2D (full–vaccination cohort), and HRs for all‐cause mortality, intensive care unit (ICU) admission/mechanical ventilation (MV) use, and hospitalizations after SARS‐CoV‐2 infection were measured in 1:1 PS‐matched T2D patients with versus without full–vaccination (T2D cohort).

Results

After 1:1 PS matching, 2 109 970 patients with and without T2D were identified (age 63.5 years; 50.9% male). Patients with T2D showed an increased risk of breakthrough infections compared to those without T2D (HR 1.10, 95% CI 1.06‐1.14). The increased risk of breakthrough infections was more notable among T2D patients receiving insulin treatment. However, the risk of severe COVID‐19 outcomes was lower in fully vaccinated T2D patients compared with unvaccinated T2D patients (all‐cause mortality: HR 0.54, 95% CI 0.43‐0.67; ICU admission/MV use: HR 0.31, 95% CI 0.23‐0.41; hospitalization: HR 0.73, 95% CI 0.68‐0.78).

Conclusions

While patients with T2D remain a vulnerable population to SARS‐CoV‐2 infection even after full‐vaccination, full‐vaccination was associated with a lower risk of adverse clinical outcomes after SARS‐CoV‐2 infection. These findings support the guidelines recommending patients with T2D as a priority vaccination group.
Tolerability, safety and pharmacodynamics of oral, small‐molecule glucagon‐like peptide‐1 receptor agonist danuglipron for type 2 diabetes: A 12‐week, randomized, placebo‐controlled, Phase 2 study comparing different dose‐escalation schemes
Authors: Saxena Aditi R. , Frias Juan P. , Gorman Donal N. , Lopez Rene N. , Andrawis Nabil , Tsamandouras Nikolaos , Birnbaum Morris J.
Published: June 2023

Aim

To evaluate the tolerability, safety and pharmacodynamics of different dose‐escalation schemes of the oral small‐molecule glucagon‐like peptide‐1 receptor (GLP‐1R) agonist danuglipron.

Materials and Methods

This Phase 2a, double‐blind, placebo‐controlled, parallel‐group study randomly assigned adults with type 2 diabetes (T2D) treated with metformin to placebo or danuglipron (low [5‐mg] or high [10‐mg] starting dose, with 1‐ or 2‐week dose‐escalation steps, to target doses of 80, 120 or 200 mg twice daily [BID]) and adults with obesity without diabetes to placebo or danuglipron 200 mg BID.

Results

Participants with T2D (n = 123, mean glycated haemoglobin [HbA1c] 8.19%) or obesity without diabetes (n = 28, mean body mass index 37.3 kg/m2) were randomly assigned and treated. Discontinuation from study medication occurred in 27.3% to 72.7% of participants across danuglipron groups versus 16.7% to 18.8% for placebo, most often due to adverse events. Nausea (20.0%‐47.6% of participants across danuglipron groups vs. 12.5% for placebo) and vomiting (18.2%‐40.9% danuglipron vs. 12.5% placebo, respectively) were most commonly reported in participants with T2D. Gastrointestinal adverse events were generally related to danuglipron target dose and were not substantially affected by starting dose. In participants with T2D, least squares mean changes from baseline in HbA1c (−1.04% to −1.57% across danuglipron groups vs. −0.32% for placebo), fasting plasma glucose (−23.34 mg/dL to −53.94 mg/dL danuglipron vs. −13.09 mg/dL placebo) and body weight (−1.93 to −5.38 kg danuglipron vs. −0.42 kg placebo) at Week 12 were generally statistically significant for danuglipron compared with placebo (P < 0.05).

Conclusions

Danuglipron resulted in statistically significant reductions in HbA1c, FPG and body weight over 12 weeks, in the setting of higher discontinuation rates and incidence of gastrointestinal adverse events with higher target doses.

Clinicaltrials.gov identifier: NCT04617275.
Neighbourhood‐level social deprivation and the risk of recurrent heart failure hospitalizations in type 2 diabetes
Authors: Deo Salil V. , Al‐Kindi Sadeer , Motairek Issam , Elgudin Yakov E. , Gorodeski Eiran , Nasir Khurram , Rajagopalan Sanjay , Petrie Mark C. , Sattar Naveed
Published: June 2023

Background

The importance of type 2 diabetes mellitus (T2D) in heart failure hospitalizations (HFH) is acknowledged. As information on the prevalence and influence of social deprivation on HFH is limited, we studied this issue in a racially diverse cohort.

Methods

Linking data from US Veterans with stable T2D (without prevalent HF) with a zip‐code derived population‐level social deprivation index (SDI), we grouped them according to increasing SDI as follows: SDI: group I: ≤20; II: 21‐40; III: 41‐60; IV: 61‐80; and V (most deprived) 81‐100. Over a 10‐year follow‐up period, we identified the total (first and recurrent) number of HFH episodes for each patient and calculated the age‐adjusted HFH rate [per 1000 patient‐years (PY)]. We analysed the incident rate ratio between SDI groups and HFH using adjusted analyses.

Results

In 1 012 351 patients with T2D (mean age 67.5 years, 75.7% White), the cumulative incidence of first HFH was 9.4% and 14.2% in SDI groups I and V respectively. The 10‐year total HFH rate was 54.8 (95% CI: 54.5, 55.2)/1000 PY. Total HFH increased incrementally from SDI group I [43.3 (95% CI: 42.4, 44.2)/1000 PY] to group V [68.6 (95% CI: 67.8, 69.9)/1000 PY]. Compared with group I, group V patients had a 53% higher relative risk of HFH. The negative association between SDI and HFH was stronger in Black patients (SDI × Race pinteraction < .001).

Conclusions

Social deprivation is associated with increased HFH in T2D with a disproportionate influence in Black patients. Strategies to reduce social disparity and equalize racial differences may help to bridge this gap.
Dewey, Experience, and Education for Democracy: A Reconstructive Discussion
Authors: Lind Andreas Reichelt
Published: June 2023

In this article, Andreas Reichelt Lind explores the possibilities of a Deweyan account of education for democracy. To that end, an account emphasizing democratic habit formation, direct experience of democracy as a way of life, and the distinction between being and becoming is explicated and discussed. Lind shows how these elements together point to the issue of designing educational environments and then discusses in a preliminary way the implications of this insight from the perspective of education for democracy. The article's contribution is twofold. First, it explicitly contributes to a reconstruction of Dewey in relation to the issue of educating for democracy. This represents a reframing of his writings. Second, it highlights and discusses some theoretical implications of the possibilities inherent in the Deweyan account of education for democracy.
Four ways to define the growing season
Authors: Körner Christian , Möhl Patrick , Hiltbrunner Erika
Published: June 2023

What is addressed asgrowing seasonin terrestrial ecosystems is one of the main determinants of annual plant biomass production globally. However, there is no well‐defined concept behind. Here, we show different facets of what might be termed growing season, each with a distinct meaning: (1) the time period during which a plant or a part of it actually grows and produces new tissue, irrespective of net carbon gain (growing season sensu stricto). (2) The period defined by developmental, that is, phenological markers (phenological season). (3) The period during which vegetation as a whole achieves its annual net primary production (NPP) or a net ecosystem production (NEP), expressed as net carbon gain (productive season) and (4) the period during which plants could potentially grow based on meteorological criteria (meteorological season). We hypothesize that the duration of such a ‘window of opportunity’ is a strong predictor for NPP at a global scale, especially for forests. These different definitions have implications for the understanding and modelling of plant growth and biomass production. The common view that variation in phenology is a proxy for variation in productivity is misleading, often resulting in unfounded statements on potential consequences of climatic warming such as carbon sequestration.
Angiogenesis and flap‐related research: A bibliometric analysis
Authors: Tong Xiao‐Fei , Xiao Zhen‐Yang , Li Pei‐Ting , Liu Xin , Wang Ming‐Zhu , Wen Shi‐Yi , Wang Na , Liao Shenghui , Zhou Jian‐Da
Published: June 2023

Adequate blood supply, a prerequisite for flap survival after grafting, makes angiogenesis of the flap the biggest problem to be solved. Researches have been conducted around vascularisation in correlation with flap grafting. However, bibliometric analyses systematically examining this research field are lacking. As such, we herein sought to conduct comprehensive comparative analyses of the contributions of different researchers, institutions, and countries to this research space in an effort to identify trends and hotspots in angiogenesis and vascularisation in the context of flap grafting. Publications pertaining to angiogenesis and vascularisation in the context of flap grafting were retrieved from the Web of Science Core Collection. References were then analysed and plotted using Microsoft Excel 2019, VOSviewer, and CiteSpace V. In total, 2234 papers that were cited 40 048 times (17.63 citations/paper) were included in this analysis. The greatest number of studies were from the United States, with these studies exhibiting both the highest number of citations (13 577) and the greatest overall H‐index (60). For The institutions that published the greatest number of studies were WENZHOU MEDICAL UNIVERSITY (681), while UNIVERSITY OF ERLANGEN NUREMBERG has the highest number of citations (1458), and SHANGHAI JIAO TONG UNIVERSITY holds the greatest overall H‐index (20). The greatest number of studies in this research space were published by Gao WY, while Horch RE was the most commonly cited researcher in the field. The VOS viewer software clustered relevant keywords into three clusters, with clusters 1, 2, 3, and 4 corresponding to studies in which the keywords ‘anatomy’, ‘survival’, ‘transplantation’, ‘therapy’ most frequently appeared. The most promising research hotspot‐related terms in this field included ‘autophagy’, ‘oxidative stress’, ‘ischemia/reperfusion injury’, which exhibited a most recent average appearing year (AAY) of 2017 and after. Generally speaking, the results of this analysis indicate that the number of articles exploring angiogenesis and flap‐related research has risen steadily, with the United States and China being the two countries publishing the greatest proportion of studies in this field. The overall focus of these studies has shifted away from ‘infratest and tissue engineering’ towards ‘mechanisms’. In the future, particular attention should be paid to emerging research hotspots, which include ‘ischemia/reperfusion injury’ and treatments for promoting vascularization, such as ‘platelet‐rich plasma’. In light of these findings, funding agencies should continue increasing their investment in the exploration of the concrete mechanisms and interventional therapeutic relevance of angiogenesis during flap transplantation.
Thermal conductivity of Ca α‐SiAlON ceramics with varying m and n values
Authors: Zhang Shijia , Zhang Jie , Li Fei , Du Songmo , Chen Zhanglin , Zhao Shuo , KL Smirnov , Chen Kexin , Liu Guanghua
Published: June 2023

α‐SiAlON is well known for its excellent mechanical properties, but its thermal properties are less investigated. In this work, we investigate the thermal conductivity of Ca α‐SiAlON ceramics with varying m and n values and prepared samples by spark plasma sintering (SPS) at 1600°C or gas pressure sintering (GPS) at 1800°C and 1900°C. The prepared Ca α‐SiAlON ceramics showed thermal conductivities ranging from 4.6 to 10.7 W/(mK) at 25°C. It was found that the thermal conductivity of the α‐SiAlON samples could be reduced by increasing either m or n or both. Besides, the samples prepared by SPS had lower thermal conductivity compared with those by GPS due to their smaller grain size, and the effect of m and n would be minor after m reached 2. These results provide basic knowledge for tuning α‐SiAlON's thermal conductivity for applications concerning thermal management.
Untangling a complex skein on ward round terminologies, purposes, and main features through a rapid review
Authors: Bayram Aysun , Chiappinotto Stefania , Mansutti Irene , Palese Alvisa
Published: June 2023

Aim(s)

To increase conceptual clarity in the field of nursing regarding terms, purposes, and main features of rounding as investigated to date.

Design

A Rapid Review according to the Cochrane Rapid Reviews Protocol.

Review Methods

These were: (a) set the research question; (b) establish the study eligibility criteria; (c) search the databases; (d) select the studies; (e) extract the data; (f) assess the risk of bias; and (g) provide a synthesis using three methodologies, namely a qualitative content analysis, a thematic and a framework synthesis.

Data Sources

MEDLINE (PubMed), Cumulative Index of Nursing and Allied Health databases and grey literature from 2014 to 2022.

Results

A total of 72 studies were included; 88 different terminologies are used to describe the rounding from one up to five words. “Preparing the care by ensuring an effective care plan, team and environment”, “Delivering tailored and timely nursing care” and “Promoting the quality of care” are the three main purposes of the rounding, including several specific aims. Regarding the main features, these emerged from highly structured/prescriptive to low structured/prescriptive approaches to rounding intervention.

Conclusion

The word “round” alone seems to be not sufficient to communicate and describe the intervention, suggesting that this field of research is entering within the complex intervention framework. The different aims of the rounding have been conceptually categorized into three main purposes whereas the intervention features may range from simple to very complex, where several options regarding who to involve, how and when to deliver are expressed.

Implications for the profession and/or patient care

This rapid review followed by three data analysis methodologies have resulted in three main frameworks that may be useful to address the research, the clinical practice and the education regarding the terminologies, the different purposes and the main features of the rounding.

No Patient or Public Contribution.

No Patient or Public Contribution

There was no patient or public contribution in the conduct of this study.
‘Everything's adaptable’: A qualitative study of how nurses make decisions in sustained home‐visiting care with mothers and children experiencing adversity
Authors: Kanda Kie , Blythe Stacy , Grace Rebekah , Elcombe Emma , Rodgers Kim , Kemp Lynn
Published: June 2023

Aims

To explore nurse decision‐making processes in the delivery of sustained home‐visiting care for mothers of young children who are experiencing adversity.

Design

Qualitative descriptive research design using focus group interviews.

Methods

Thirty‐two home‐visiting nurses participated in four focus group interviews exploring their decision‐making in the care they provide to families. The data were analysed using a reflexive thematic analysis approach.

Results

Four steps of a recurring stepwise decision‐making process were identified: (1) information gathering; (2) exploring; (3) implementing; (4) checking. The facilitators and barriers to effective decision‐making processes were also identified and included elements relating to good relationship skills, a good attitude, high quality training and mentoring and resources.

Conclusion

The findings indicate that a recurring stepwise process of decision‐making requires both analytical and intuitive approaches. The intuition required by home‐visiting nurses is to sense unvoiced client needs and identify the right time and way to intervene. The nurses were engaged in adapting the care in response to the client's unique needs while ensuring the fidelity of the programme scope and standards. We recommend creating an enabling working environment with cross‐disciplinary team members and having well‐developed structures, particularly the feedback systems such as clinical supervision and case reviews. Enhanced skills to establish trusting relationships with clients can help home‐visiting nurses make effective decisions with mothers and families, particularly in the face of significant risk.

Impact

This study explored nurse decision‐making processes in the context of sustained home‐visiting care, which has been largely unexplored in the research literature. Understanding the effective decision‐making processes, particularly when nurses customize or individualize the care in response to the client's unique needs, assists with the development of strategies for precision home‐visiting care. The identification of facilitators and barriers informs approaches designed to support nurses in effective decision‐making.
Examining the validity of the Delis–Kaplan Executive Function System (D‐KEFS) in traumatic brain injury
Authors: Hacker David , Jones Christopher A. , Chan Yin Ming , Yasin Eyrsa , Clowes Zoe , Belli Antonio , Cooper Julian , Bose Deepa , Hawkins Andrew , Davies Holly , Paton Emily
Published: June 2023

This study examines the validity of the Delis–Kaplan Executive Function System (D‐KEFS) in a traumatic brain injury (TBI) population compared to participants with orthopaedic injuries and normative controls. The utility of the D‐KEFS was examined using a between groups design. One hundred patients with mild uncomplicated to severe TBI were recruited from a consecutive cohort of patients admitted as inpatients to a UK Major Trauma Centre and compared to 823 participants from the D‐KEFS normative sample and 26 participants with orthopaedic injuries. Data were filtered for performance validity. Sample discrimination was calculated from D‐KEFS subtest scores and derived index scores. Sensitivity to TBI severity was established. The TBI participants performed significantly lower on the D‐KEFS Trail Making Test, Colour Word Interference, Colour Word Switching, Letter Fluency and Verbal Fluency Category Switching Total Words Correct. The D‐KEFS index scores discriminated between TBI, orthopaedic and normative participants with large and moderate effect sizes, respectively. The D‐KEFS demonstrated a dose–response relationship with TBI severity. These effects were robust to differences in premorbid intellectual functioning; however, D‐KEFS performance was sensitive to performance on tests of mental processing speed. The use of a D‐KEFS index score provides a robust and reliable discrimination of TBI patients from healthy control participants. This discrimination is not accounted for by premorbid intellect or the non‐specific effects of trauma. The clinical and conceptual implications of these findings are considered.
Imbalance and lower limb tremor in chronic inflammatory demyelinating polyradiculoneuropathy
Authors: Silsby Matthew , Yiannikas Con , Fois Alessandro F. , Ng Karl , Kiernan Matthew C. , Fung Victor S. C. , Vucic Steve
Published: June 2023

Background and Aims

Imbalance is a prominent symptom of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Although upper limb tremor in CIDP is described, lower limb tremor has not been assessed. The aim of this study was to determine whether lower limb tremor was present in CIDP and assess potential relationships with imbalance.

Methods

This was a cross‐sectional observational study of prospectively recruited consecutive patients with typical CIDP (N = 25). Clinical phenotyping, lower limb nerve conduction and tremor studies, and posturography analyses were performed. The Berg Balance Scale (BBS) divided CIDP patients into those with “good” and “poor” balance.

Results

Lower limb tremor was evident in 32% of CIDP patients and associated with poor balance (BBSTremor 35 [23–46], BBSNo Tremor 52 [44–55], p = .035). Tremor frequency was 10.2–12.5 Hz with legs outstretched and on standing, apart from four patients with a lower frequency tremor (3.8–4.6 Hz) while standing. Posturography analysis revealed a high‐frequency spectral peak in the vertical axis in 44% of CIDP patients (16.0 ± 0.4 Hz). This was more likely in those with “good” balance (40% vs. 4%, p = .013).

Interpretation

Lower limb tremor is present in one third of CIDP patients and is associated with poor balance. A high‐frequency peak on posturography is associated with better balance in CIDP. Lower limb tremor and posturography assessments could serve as important biomarkers of balance in a clinical setting.