bluuebunny/crossref_metadata_2025 huggingface dataset:
Overcoming resistance to change in a big data analytics implementation case study
Authors: Farouk Firdous Mohd , Siew Eu-Gene , Yusof Siti Hawa
Published: January 2024

BigBank is a large commercial bank in Malaysia. The bank aims to implement big data analytics to enhance decision-making and improve customer services. Integrating big data analytics into the bank’s existing information systems not only requires specialized hardware, software, and data processing techniques but also a restructuring of the organization structure and processes. It is currently confronting challenges, particularly in terms of employee resistance. To tackle this issue, BigBank has introduced a new role known as “Translators,” who serve as intermediaries between the analytics IT team and operating business departments. In this case study, students will take on the role of Translators and analyze these obstacles while proposing strategic solutions.
Digital therapeutics-based lumbar core exercise for patients with low back pain: A prospective exploratory pilot study
Authors: Son Seong , Yoo Byung Rhae , Jeong Yu Mi
Published: January 2024

Objective

This study aimed to implement a digital therapeutics-based approach based on motion detection technology and analyze the clinical results for patients with chronic low back pain (LBP).

Methods

A prospective, single-arm clinical trial was conducted with 22 patients who performed mobile app-based sitting core twist exercise for 12 weeks. Clinical outcomes were assessed using the visual analog scale (VAS) for LBP, Oswestry Disability Index-Korean version (K-ODI), and EuroQol-5 dimension 5-level version (EQ-5D-5L) every 4 weeks after the initiation of treatment. Laboratory tests for factors associated with muscle metabolism, plain X-ray for evaluating sagittal balance, and magnetic resonance imaging for calculating cross-sectional area (CSA) of back muscles were performed at pretreatment and 12 weeks post-treatment.

Results

The study population included 20 female patients with an average age of 45.77 ± 15.45 years. The clinical outcomes gradually improved throughout the study period in the VAS for LBP (from 6.05 ± 2.27 to 2.86 ± 1.86), K-ODI (from 16.18 ± 6.19 to 8.64 ± 5.58), and EQ-5D-5L (from 11.09 ± 3.24 to 7.23 ± 3.89) ( p < 0.001, respectively). The laboratory test results did not show significant changes. Pelvic incidence (from 53.99 ± 9.70° to 50.80 ± 9.20°, p = 0.002) and the mismatch between pelvic incidence and lumbar lordosis (from 8.97± .67° to 5.28 ± 8.57°, p = 0.027) decreased significantly. Additionally, CSA of erector spinae and total back muscles increased by 5.20% ( p < 0.001) and 3.08% ( p = 0.013), respectively.

Conclusions

The results of this study suggest that the efficacy of digital therapy-based lumbar core exercise for LBP is favorable. However, further large-scale randomized controlled studies are necessary.
Providing compassionate care in a virtual context: Qualitative exploration of Canadian primary care nurses’ experiences
Authors: Rouleau Geneviève , Wu Kelly , Parry Monica , Richard Lauralie , Desveaux Laura
Published: January 2024

Objective

Virtual care presents a promising opportunity to create new communication channels and increase access to healthcare. However, concerns have been raised around the potential for unintended emotional distances created through virtual care environments that could strain patient–provider relationships. While compassionate care is an enabler of emotional connectivity and a core tenant of nursing, little is known about whether or how nurses have adapted their compassion skills into virtual interactions. These concerns are particularly relevant in primary care, where there is a focus on relational continuity (i.e. relationship-based, longitudinal care) and a broad uptake of virtual care. The aim of this study was to explore the meaning of compassionate virtual care and to uncover how nurses operationalized compassionate care through virtual interactions in primary care.

Methods

We used a qualitative interpretive descriptive lens to conduct semistructured interviews with primary care nurses (Ontario, Canada) who had provided virtual care (i.e. video visits, remote patient monitoring, or asynchronous messaging). We used a thematic approach to analyze the data.

Results

We interviewed 18 nurse practitioners and two registered nurses. Participants described how: (1) compassionate care was central to nursing practice, (2) compassionate care was evolving through virtual nurse–patient interaction, and (3) nurses balanced practice with patients’ expectations while providing virtual compassionate care.

Conclusions

There is an opportunity to better align nurses’ understanding and operationalization of compassionate care in virtual primary care contexts. Exploring how compassionate care is operationalized in primary care settings is a necessary first step to building compassionate competencies across the nursing profession to support the continued virtual evolution of health service delivery.
Algorithmic Ventriloquism: The Contested State of Voice in AI Speech Generators
Authors: Ramati Ido
Published: January 2024

This article explores the vocal human–machine relations embedded in text-to-speech (TTS) generators. Retracing the human sources behind the synthetic speech and tracking the remediation of the voice by the machine-learning algorithm, it argues that artificial intelligence (AI) speaking agents such as Siri and Alexa, as well as other TTS acts such as TikTok’s, are performing algorithmic ventriloquism. Speaking mechanically with the voices of professional voiceover artists, AI speech technologies algorithmically manipulate these voices, thus generating personas that hold an interconnected chain of tensions between the embodied and the virtual, the particular and the general, the human and the non-human, as well as between speech and writing. Algorithmic ventriloquism serves as an analytical framework to tie the techno-vocalic operation of the TTS system with its cultural, economic, philosophical, and sociolinguistic predicaments. The last section discusses the implications of algorithmic ventriloquism beyond the realm of the voice.
State-led embeddedness: Analyzing the discursive construction of platforms and social good in Beijing, Hangzhou, Shanghai, and Shenzhen
Authors: Chan Ngai Keung , Kwok Chi
Published: January 2024

Drawing on Polanyi’s concept of embeddedness, this article introduces the concept of “state-led embeddedness” to theorize non-competitive and subordinating state-platform relations in China. Under state-led embeddedness, platforms are not conceived first and foremost as private economic actors but as instruments for providing social good and resolving social problems. This article presents a qualitative thematic analysis of the official discourses about platforms for and against social good in four major cities that represent key technology and innovation hubs in China: Beijing, Hangzhou, Shanghai, and Shenzhen. The analysis reveals how platforms are discursively portrayed as emerging providers of social good, both nationally and locally. This discursive construction of platforms in conjunction with social good, in turn, encourages the state to legitimize collaborative governance and surveillance practices in cities like Beijing, Hangzhou, Shanghai, and Shenzhen. Finally, this study affords opportunities to regionalize platform studies in China by considering how diverse forms of intergovernmental relationships might result in diverse interpretations of a “platform for social good” in practical scenarios.
Questioning Sports Journalists: Stereotypes, Work Routines, and Color-Blind Racism in Sports Press Conferences
Authors: Peña Vincent , Bock Mary Angela
Published: January 2024

Sports scholars have long studied how stereotypes pervade sports. However, little if any of this research has examined the origins of these stereotypes and how they influence journalistic practice. This study explores sports journalists’ work routines, their perception of stereotypes in sports, and whether there is a connection between the two. The authors conduct a critical discourse analysis of in-depth interviews with 13 sports journalists from across the U.S. Results show that journalists are (sometimes) aware of stereotypes, downplay their role in perpetuating them, and engage in color-blind rhetoric about the prevalence of stereotypes in sports media coverage of college sports. Additionally, the sports journalists interviewed as part of this study outlined the various constraints on their jobs that might impact their ability to establish rapport with athletes, which might result in an increased likelihood of the perpetuation of stereotypes. The findings underscore the need for more scholarly inquiry about sports press conferences and the connection between journalistic practice and ideology, particularly as it relates to race.
Sequential Depth Stimulation Within the Psoas Offers No Benefit for Localization of the Lumbar Plexus During Lateral Lumbar Fusion Surgery
Authors: Barkay Gal , Oshtori Rayshad , Reto Javier , Gan Wenqi , Moss Isaac
Published: January 2024

Study Design

Prospective cohort study.

Objectives

In this study we aim to assess the difference in triggered EMG readings throughout different depths in the psoas muscle during the lateral approach to the lumbar spine and their effect on surgeon decision making.

Methods

Three surgeons, practicing at different institutions, assessed triggered EMG readings during the trans psoas approach at the level of the disc and 5,10 and 15 millimeters into the psoas muscle with sequential dilators. Measurement of distance into the psoas muscle was done with a specially designed instrument. Results of anterior and posterior directed stimulation as well as the delta value between these were recorded and underwent statistical analysis. Patients who had partial readings were excluded from the study.

Results

A total of 40 levels in 35 patients were included in the study. There was no significant difference found between means of anterior or posterior threshold readings along the different distance groups. A significant difference was found ( P = .024) in the mean difference between the distance groups with a decrease in the difference between anterior and posterior threshold values found as the distance from the disc space increased. None of the surgeons reported a decision to abort the fusion of a spinal level.

Conclusions

In the trans-psoas approach to the lumbar spine, the assessment of the location of the femoral nerve using directional neuromonitoring when advancing in the psoas muscle shows no clear benefit as opposed to stimulating solely when adjacent to the disc space.
Association of the Coronal Lateral Collateral Ligament Sign in ACL-Deficient Knees With Greater Anterior Tibial Translation and Femorotibial Rotation in Adults and Adolescents
Authors: Lin Yu-Ju , Cheng Ting-An , Hsu Kai-Lan , Kuan Fa-Chuan , Su Wei-Ren , Hong Chih-Kai
Published: January 2024

Background:

The coronal lateral collateral ligament (LCL) sign (the entire LCL being seen in 1 coronal slice on a magnetic resonance imaging [MRI] scan), is a new secondary sign of anterior cruciate ligament (ACL) tear.

Purpose:

To (1) evaluate the coronal LCL sign in adults with ACL tears and (2) compare the magnitude of the MRI scan parameters between adolescent and adult ACL-deficient knees with positive coronal LCL signs.

Study Design:

Cross-sectional study; Level of evidence: 3.

Methods:

We retrospectively reviewed patients who underwent ACL reconstruction between February 1, 2013, and May 31, 2021, and divided them into adolescent (10-18 years) and adult (>18 years) groups. Tibial translation, femorotibial rotation, and presence of the coronal LCL sign were evaluated using MRI. The static femorotibial position parameters were also compared between positive and negative coronal LCL sign groups. Independent Student t tests were used to identify statistically significant differences for continuous variables, whereas the categorical variables were compared using the chi-square test.

Results:

A total of 65 adolescents and 300 adults with ACL tears were identified. The coronal LCL sign was present in a similar percentage of adolescents and adults with ACL tears (57% vs 58%; P = .873). The anterior tibial translation (ATT) in patients with positive coronal LCL signs (adolescents, 7.9 ± 3.4 mm; adults, 6.6 ± 3.5 mm) was significantly greater compared with those with negative signs (adolescents, 1.5 ± 2.6 mm, P < .001; adults, 2.3 ± 4.2 mm, P < .001). Femorotibial rotation was also statistically greater in positive coronal LCL sign groups (adolescents, 6.4°± 5.6°; adults, 7.0°± 5.0°) compared with negative sign groups (adolescents, 0.7°± 4.7°, P < .001; adults, 3.5°± 4.2°, P < .001).

Conclusion:

The occurrence of the coronal LCL sign on MRI scans was comparable between adolescents and adults with ACL-deficient knees. The presence of the LCL sign was associated with a greater ATT and femorotibial rotation in both adolescents and adults with ACL tears.
Preoperative Patient Education: Perceptions and Actual Practice among Nurses Working in Surgical Units
Authors: Almutary Hayfa , Almashi Ashwaq
Published: January 2024

Introduction

Preoperative education is an essential nursing task that can be affected by the nurses’ perception. Patients may be receiving insufficient vital information before surgery. However, the essential information that should be provided to patients undergoing surgery is not fully addressed.

Objective

To assess the essential elements of preoperative information as perceived by the surgical nurses.

Methods

This was a cross-sectional study. A convenience sample of 224 registered nurses who were working at surgical units was recruited from two hospitals. A preoperative teaching questionnaire was used.

Results

Details about the operation (4.39 ± 0.61) and preoperative preparation (4.36 ± 0.61) were the most important domains of preoperative education as perceived by nurses. The results show significant differences between the perceived and actual preoperative educational practice across all domains except the preoperative preparation.

Conclusions

The delivery of preoperative education could be affected by nurses’ perceptions. Efforts to facilitate the implementation of effective education as perceived by nurses should be conducted by minimizing potential barriers.
Framing Welfare Expansion: Citizenship, Collective Memory, and Fiscal Dilemmas in Mexico and Peru
Authors: Campos Ugaz Daniela
Published: January 2024

One of the most significant innovations in welfare policies in the past three decades has been the adoption of conditional cash transfers in dozens of countries in the Global South. The policies are puzzling, as they deviate from contributory social policy that privileges formal workers and were implemented during democratization and Washington Consensus reforms. How did policy makers justify welfare expansion? The author conducts an analysis of the parliamentary debates that resulted in the implementation of these programs in Mexico (1997) and Peru (2005). By examining the policy makers’ reasoning behind these programs, the author aims to explore the relationship between new forms of social rights and citizenship. The findings show that state actors mobilized narratives of nation-building to justify the historical debt to specific segments of the population, shared an ambivalence regarding the meaning of cash transfers between entitlements or investments, and acknowledged the precarity of the funding scheme.
Opioid Overdose Recognition: A Survey of Perceived Preparedness and Desire for Curricular Integration Among Current US Medical Students
Authors: Walsh Lindsay , Chapman Brittany , Carey Jennifer , Loycano Kayla , Carreiro Stephanie
Published: January 2024

OBJECTIVES

Opioid overdose deaths remain a major health issue in the United States (US). As future physicians, medical students must receive comprehensive training to recognize and manage opioid overdoses. This study aimed to highlight training gaps at the medical student level and understand students’ attitudes toward patients with opioid use disorder (OUD).

METHODS

We assessed baseline knowledge of and attitudes toward the management of opioid overdoses and naloxone administration among medical students in the US. Two validated survey tools (Opioid Overdose Knowledge Scale and Opioid Overdose Attitude Scale) were administered to medical students training at accredited institutions along with supplemental questions measuring knowledge and attitudes towards opioid overdose management, naloxone administration, and prior training.

RESULTS

The final sample had N = 73 participants from US medical schools with a mean age of 25.3 (range of 22–37): 72.6% of respondents were female. Although most respondents reported personal/professional experience with OUD before medical school, they expressed interest in additional training. Knowledge surrounding opioid overdoses increased insignificantly over the 4 years of medical school. However, there was a significant increase in both perceived competence in overdose recognition/management and in concerns about intervening from the first to fourth year of medical school. Female respondents had significantly lower perceived competence and readiness to intervene sub-scores than male counterparts; however, there was no significant difference in overall attitude and knowledge scores when stratified by sex. Incorporating opioid overdose prevention training (OOPT) into early medical education was favorable among respondents, who expressed an overwhelming interest in learning and supporting patients with OUD.

CONCLUSIONS

Given the ongoing opioid crisis, medical students are ideally placed to identify and manage opioid overdoses. Medical students are ready to receive this training, thus strengthening the argument for OOPT integration into early medical student curricula.
Early tirofiban administration after intravenous thrombolysis in acute ischemic stroke (ADVENT): Study protocol of a multicenter, randomized, double-blind, placebo-controlled clinical trial
Authors: Guo Zhen-Ni , Zhang Ke-Jia , Zhang Peng , Qu Yang , Abuduxukuer Reziya , Nguyen Thanh N , Chen Hui-Sheng , Yang Yi
Published: January 2024

Background:

Nearly half of patients with acute ischemic stroke who undergo intravenous thrombolysis (IVT) fail to achieve excellent functional outcomes. Early administration of tirofiban after IVT may improve patient outcomes.

Objective:

To evaluate the efficacy and safety of early tirofiban administration after intravenous tenecteplase in patients with acute ischemic stroke.

Methods and design:

The ADVENT trial is a multicenter, randomized, parallel-controlled, double-blind clinical trial. A total of 1084 patients undergoing IVT without subsequent endovascular treatment will be recruited from multiple hospitals in China. Subjects will be randomized in a 1:1 ratio to receive tirofiban or placebo, which will be infused within 6 h after IVT until 24 h after IVT, at 0.4 μg/kg/min for 30 min and then at 0.1 μg/kg/min. The primary efficacy outcome is the proportion of patients with excellent functional outcomes (modified Rankin Scale (mRS) ⩽ 1) at 90 days. Secondary outcomes include the proportion of patients with favorable functional outcomes (mRS ⩽ 2) at 90 days and neurological functional assessments evaluated during hospitalization. Symptomatic intracranial hemorrhage will be the primary safety outcome. Mortality and other adverse events will be recorded.

Discussion:

This pivotal trial will provide important data on the early administration of antiplatelet therapy after IVT and may promote progress in treatment standards.

Trial registry:

ClinicalTrials.gov (NCT06045156)
Food and Nutrition Insecurity and Farming Household Resilience to COVID-19 Shocks in Ghana
Authors: Suh Neville N. , Nyiawung Richard A. , Abay Canan F.
Published: January 2024

The COVID-19 pandemic affected farming households in Sub-Saharan Africa. As a case in point, we examine farming households’ resilience to food and nutrition insecurity in Ghana under the COVID-19 shocks. Focus group discussions were initially conducted with farming household heads to identify households’ sources of resilience and the different COVID-19 shocks. A multi-stage random sampling technique was then used to survey 252 farming households. We used different econometric modelling techniques, that is, the multiple indicators multiple causes modelling procedure, ordinary least square, and multinomial probit model, for data analysis. Our results provide supportive evidence affirming that COVID-19 shocks undermine farming households’ resilience and food and nutrition security. Urban and male-headed households experience more food and nutrition insecurity than rural and female-headed households. Farming households’ adaptive capacity significantly contributed to household resilience and food and nutrition security. The findings suggest that lessons learned from the current pandemic can help policymakers, governments, and international organisations build adequate responses and interventions that strengthen and support farming households’ resilience to food and nutrition security and systemic shocks such as COVID-19 in Ghana.
Global Uncertainty, Climate Change and the Unemployment-Economic Growth Relationship in Nigeria
Authors: Edeme Richardson Kojo , Emeka Ekene ThankGod , Ogbuabor Jonathan Emenike
Published: January 2024

This study investigates global uncertainty, climate change and the unemployment-economic growth relationship in Nigeria. The study utilised the autoregressive distributed lag (ARDL) estimation technique using quarterly data, 1990–2020. Findings indicate that global uncertainty and unemployment impact negatively economic growth both in the short run and long run. Also, climatic change variables employed in this study such as temperature and level of rainfall have a negative impact on economic growth both in the long-run and short-run. The moderating effects of global uncertainty and climatic variables on the unemployment-economic growth relationship were positive, though insignificant. The policy implication underlying the finding is that tackling economic uncertainty and climate change is necessary for solving unemployment problem and the attainment of sustainable growth in Nigeria.

JEL Codes: C22, D80, Q25, E24, O40
The Political Economy Puzzle of Indian Agriculture: A Political Settlement Analysis
Authors: Gautam Hritic
Published: January 2024

In their influential paper for the National Council of Applied Economic Research, Chatterjee and Kapur raised some fundamental questions about Indian agriculture and why it has not transformed with economic development. They identify six important ‘puzzles’ in Indian agriculture, one of which is the political economy puzzle. This puzzle refers to the fact that farmers have not been able to leverage their power of land and numbers to economically benefit themselves. The essay utilizes the political settlements framework to understand the underlying causes of this puzzle. Such analysis is important as it recognizes the historical and sociocultural traditions to explain the economic phenomenon of the backwardness of Indian agriculture.
Caste Wise Earning Discrimination among Rural Non-farm Sector Workers in India
Authors: Pattayat Shiba Shankar
Published: January 2024

This study investigates wage discrimination among non-farm workers, including both regular and casual workers, in rural India between the forward caste (FC) and backward caste (BC). Using data from NSSO unit-level employment and unemployment surveys from 2004–2005 and 2011–2012, as well as periodic labour force surveys from 2017–2018 to 2019–2020, the study found that the wage differential between FC and BC non-farm employees increased over time, with BC workers being paid less than FC workers. To determine the factors contributing to the wage difference, a linear regression model was used, and the decomposition method was employed to examine whether the difference was due to endowment or discrimination effects. Overall, the study highlights the persistence of caste-based wage discrimination in rural non-farm employment in India. For the betterment of BC workers and to reduce discrimination, the policies and programmes which are implemented by the government need to be revived.
Spatial political economy: The ideology of Nature, State–space and the oil commodity frontier
Authors: Avilés David
Published: January 2024

In this article, a spatial political economy approach is used to examine the development of global capitalism through an analysis of the expansionary movement of commodity frontiers. It surveys the early history of oil exploitation in Chile and offers a close analysis of Patagonia’s constitution of its oil commodity frontier as Cheap Energy. It is argued that focusing on the internal relation of space and Nature can enhance our understanding of capitalism as an emergent and dynamic totality grounded in particular places where value is extracted. The article sheds new light on the spatialities of Import Substitution Industrialisation in Latin America using the case of Chile and its development agency, Corfo, and reveals how the capitalist ideology of Nature was wrought as a state project. The political economy of scale in this context is examined by analysing the central role of state and class relations in the environment-making process of capital accumulation. The article advances a new understanding of State–space within uneven and combined capitalist development. The spatial political economy lens allows for a fresh understanding of past history, which may help us understand the current ‘green’ energy transition by means of the production of space and Nature.
Scoping Review of Healthcare Disparities in Treatment of Craniosynostosis: Assessing Impacts of Race, Insurance, and Socioeconomic Status
Authors: Amin Sharmi C. , Tursak Hailey R. , Ulma Raquel M. , Vercler Christian J.
Published: January 2024

Background:

Racial and socioeconomic factors persist as barriers to timely diagnosis and treatment for children with craniosynostosis, contributing to inequitable care. This scoping review aims to better understand how disparities influence differences in services, approach, and outcomes for patients undergoing surgical corrections for craniosynostosis.

Methods:

We conducted a PRISMA systematic review of all articles published between 2003 and 2023 within PubMed/Medline, Embase, and a Scopus cited review. Variables of interest included sociodemographic factors such as race, socioeconomic status (SES), and insurance status, and measurements of treatment access or outcomes within craniosynostosis surgical repair.

Results:

The final analysis included 28 studies, of which 21 studies examined race, 13 examined insurance status, and 5 examined household income or other socioeconomic factors. Overall, non-White, minority patients, patients with Medicaid or government-funded insurance, and patients from lower SES were more likely to experience delays in diagnosis and presentation for surgery compared to White and privately-insured patients. Black and Hispanic patients and patients with public insurance were more likely to undergo open cranial vault reconstruction (CVR) at an older age and experience longer total surgery time, increasing perioperative complication risk, compared to patients who underwent endoscopic procedures. Sociodemographic factors including non-White race, lower SES, and being underinsured or uninsured predisposed patients to the more expensive CVR procedure, increased hospital length of stay (LOS), and a higher rate of readmission, accumulating to greater total cost of care.

Conclusion:

Significant disparities continue to exist in craniosynostosis management. It is still unknown whether these discrepancies in the type of operation lead to significant clinical differences in neurocognitive outcomes, revision operations, or patient/parent satisfaction with appearance. This study highlights gaps in the current body of knowledge to better inform future aeas of investigation to ensure the best outcomes for all children born with craniosynostosis regardless of patient demographic.
Conceptual Framework – Sustainability Actions, Global Crises and Justice in the Future of Tourism and Hospitality
Authors: Amoako George Kofi , Sedalo Genevive , Asiedu Emelia Amoako , Oppong Appiagyei Ampong George
Published: January 2024

The coronavirus disease 2019 pandemic posed a big obstacle for nations as it affected the anticipated cash flows from the tourism and hospitality industry. Many tourist destinations have suffered as a result of the coronavirus disease 2019 crisis. Tourism and hospitality have been major source of revenue, and nations depend on them to augment their budgetary issues and support the provision of basic public services. Ethical tourism, responsible tourism, social justice, and sustainable tourism promise to be effective tools to execute this reputation agenda, which scholars have ignored. This paper proposes a conceptual framework that shows the effect of sustainability actions and justice on stakeholders in the tourism and hospitality industries, presently and for future generations. An in-depth literature review was employed using papers on sustainability actions. Using Scopus-indexed journals, 88 articles from several databases were sourced using key words. The conceptual framework provides insights into how global crises such as coronavirus disease in 2019 can be used as a gate to launch social justice in the tourism and hospitality space for employees, local tourism communities, tourists, and stakeholders globally. It provides academics and practitioners in the tourism and hospitality sectors with a fairer perspective on the development of strategies to attract tourists and better investment initiatives.
Severe and nonuniform liquefaction damage of reclaimed ground contributed by interference between body waves and stratigraphic irregularity-induced surface waves
Authors: Nakai Kentaro , Noda Toshihiro , Asaoka Akira
Published: January 2024

The 2011 off the Pacific Coast of Tohoku earthquake caused extensive liquefaction damage to reclaimed land along the Tokyo Bay coast, even though it was approximately 400 km from the epicenter. The characteristics of the liquefaction damage include the fact that liquefaction occurred in soils with a high percentage of fine particles and that the distribution of liquefied and nonliquefied areas was nonuniform. The factors contributing to such nonuniform liquefaction damage included the heterogeneity of the ground materials and their depositional conditions, and the effects of the long earthquake duration. Although these points are certainly valid as reasons for the occurrence of severe liquefaction damage, they do not fully explain the mechanisms of the liquefaction of the fine-grained soils, or the localized extent of the liquefaction. To elucidate the severe and nonuniform damage, seismic response analyses of a multi-layered ground were conducted focusing on the stratigraphic irregularities in the ground beneath Urayasu city. The results showed that the thicker and softer sedimentary layers amplify the slightly long-period component of the seismic motion and increase the shaking at the ground surface. Moreover, the wave propagation in the ground became very complicated owing to the focal effect caused by the refractions and reflections of body waves at the stratum boundary, surface wave excitation at the base of the slope, and amplified interference between body and surface waves. This complex wave propagation contributed to nonuniform surface ground shaking and severe liquefaction damage. In addition, surface waves, which consist primarily of slightly long-period components, can propagate far and wide; as such, they triggered extensive damage owing to delayed shaking phenomena that continue even after the earthquake. The analysis results suggested that multidimensional elasto-plastic seismic response analyses considering stratigraphic irregularities are important for detailed seismic evaluation.
Sfrp1 inhibits lung fibroblast invasion during transition to injury-induced myofibroblasts
Authors: Mayr Christoph H. , Sengupta Arunima , Asgharpour Sara , Ansari Meshal , Pestoni Jeanine C. , Ogar Paulina , Angelidis Ilias , Liontos Andreas , Rodriguez-Castillo José Alberto , Lang Niklas J. , Strunz Maximilian , Porras-Gonzalez Diana , Gerckens Michael , De Sadeleer Laurens J. , Oehrle Bettina , Viteri-Alvarez Valeria , Fernandez Isis E. , Tallquist Michelle , Irmler Martin , Beckers Johannes , Eickelberg Oliver , Stoleriu Gabriel Mircea , Behr Jürgen , Kneidinger Nikolaus , Wuyts Wim A. , Wasnick Roxana Maria , Yildirim Ali Önder , Ahlbrecht Katrin , Morty Rory E. , Samakovlis Christos , Theis Fabian J. , Burgstaller Gerald , Schiller Herbert B.
Published: January 2024

Background

Fibroblast-to-myofibroblast conversion is a major driver of tissue remodelling in organ fibrosis. Distinct lineages of fibroblasts support homeostatic tissue niche functions, yet their specific activation states and phenotypic trajectories during injury and repair have remained unclear.

Methods

We combined spatial transcriptomics, multiplexed immunostainings, longitudinal single-cell RNA-sequencing and genetic lineage tracing to study fibroblast fates during mouse lung regeneration. Our findings were validated in idiopathic pulmonary fibrosis patient tissuesin situas well as in cell differentiation and invasion assays using patient lung fibroblasts. Cell differentiation and invasion assays established a function of SFRP1 in regulating human lung fibroblast invasion in response to transforming growth factor (TGF)β1.

Measurements and main results

We discovered a transitional fibroblast state characterised by highSfrp1expression, derived from bothTcf21-Cre lineage positive and negative cells.Sfrp1+cells appeared early after injury in peribronchiolar, adventitial and alveolar locations and preceded the emergence of myofibroblasts. We identified lineage-specific paracrine signals and inferred converging transcriptional trajectories towardsSfrp1+transitional fibroblasts andCthrc1+myofibroblasts. TGFβ1 downregulated SFRP1 in noninvasive transitional cells and induced their switch to an invasive CTHRC1+myofibroblast identity. Finally, using loss-of-function studies we showed that SFRP1 modulates TGFβ1-induced fibroblast invasion and RHOA pathway activity.

Conclusions

Our study reveals the convergence of spatially and transcriptionally distinct fibroblast lineages into transcriptionally uniform myofibroblasts and identifies SFRP1 as a modulator of TGFβ1-driven fibroblast phenotypes in fibrogenesis. These findings are relevant in the context of therapeutic interventions that aim at limiting or reversing fibroblast foci formation.
Prognostic value of deep echocardiographic phenotyping in pulmonary arterial hypertension
Authors: Ghio Stefano , Badagliacca Roberto , Acquaro Mauro , Filomena Domenico , Recchioni Tommaso , Papa Silvia , Colombo Davide , Ditali Valentina , Carrozzi Chiara , Greco Alessandra , Turco Annalisa , Breviario Federico , Benza Raymond , Vizza Dario , Scelsi Laura
Published: January 2024

Background

A novel approach to derive prognostic information from echocardiography in pulmonary arterial hypertension (PAH) is to define a phenotype of right heart function combining standard echocardiographic parameters which describe right ventricular pump function and systemic venous congestion. We tested the hypothesis that the combination of advanced strain imaging parameters could yield high prognostic accuracy.

Methods

This was a prospective observational study with a single centre derivation cohort and a second centre validation cohort. The derivation cohort included 49 naive PAH patients who underwent right heart catheterisation and echocardiographic evaluation at baseline and 4–12 months after diagnosis. The validation cohort included 83 prevalent PAH patients who underwent the same examinations at 12 months after diagnosis. We stratified the risk of the derivation cohort according to three models: Model 1, based on haemodynamic parameters; Model 2, based on standard echocardiographic parameters; and Model 3, based on advanced echocardiographic parameters. The median follow-up period was 21 months; the end point of the analysis was clinical worsening.

Results

In the derivation cohort, haemodynamic and echocardiographic parameters obtained at diagnosis were not associated with outcome, whereas a significant association was observed at first reassessment. Model 3 yielded a better predictive accuracy (Harrell's C index 0.832) as compared to Model 2 (Harrell's C index 0.667), and to Model 1 (Harrell's C index 0.713). The validation cohort confirmed the accuracy of Model 3.

Conclusions

A comprehensive assessment of right heart function using right ventricular strain, right atrial reservoir strain and degree of tricuspid regurgitation provides accurate prognostic information in prevalent PAH patients.
Aberrant characteristics of peripheral blood innate lymphoid cells in COPD, independent of smoking history
Authors: van Zelst Cathelijne M. , in ’t Veen Johannes C.C.M. , Krabbendam Lisette , de Boer Geertje M. , de Bruijn Marjolein J.W. , van Nimwegen Menno , van der Ploeg Esmee K. , van Uden Denise , Stadhouders Ralph , Tramper-Stranders Gerdien A. , Hendriks Rudi W. , Braunstahl Gert-Jan
Published: January 2024

Background

Distinguishing asthma and COPD can pose challenges in clinical practice. Increased group 1 innate lymphoid cells (ILC1s) have been found in the lungs and peripheral blood of COPD patients, while asthma is associated with elevated levels of ILC2s. However, it is unclear whether the inflammatory characteristics of ILC1s and ILC2s differ between COPD and asthma. This study aims to compare peripheral blood ILC subsets and their expression of inflammatory markers in COPD patients, asthma patients and controls.

Methods

The study utilised multi-colour flow cytometry to analyse peripheral blood ILC populations in clinically stable COPD patients (n=38), asthma patients (n=37), and smoking (n=19) and non-smoking (n=16) controls.

Results

Proportions of peripheral blood inflammatory CD4+ILC1s were significantly higher in COPD patients than in asthma. Proportions of CD4−ILC1s were increased in COPD patients compared to asthma patients and smoking controls. Frequencies of CD117−ILC2s were significantly reduced in COPD patients compared with asthma patients. In contrast, the fraction of inflammatory CD45RO+cells within the CD117−ILC2 population was significantly increased. Principal component analyses showed that combined features of the circulating ILC compartment separated COPD patients from asthma patients and both control groups.

Conclusion

Our in-depth characterisation of ILC1 and ILC2 populations in peripheral blood revealed significant differences in their phenotypes between COPD and asthma patients and smoking or non-smoking controls. These findings suggest a role for both ILC subsets in COPD disease pathology, independent of smoking history, and may have implications for patient stratification and therapy development.
Anticancer platinum-drug delivered by mesenchymal stromal cells improves its activity on glioblastoma
Authors: Coccè Valentina , Martegani Eleonora , Doneda Luisa , Rimoldi Isabella , Facchetti Giorgio , Giulia Coffetti , Lucchini Giorgio , Roncoroni Leda , Giannì Aldo , Corradini Costantino , Alessandri Giulio , Ciusani Emilio , Cilurzo Francesco , Franzè Silvia , Paino Francesca , Pessina Augusto
Published: January 2024

Background

Glioblastoma multiforme (GBM) is nowadays the most aggressive tumor affecting brain in adults with a very poor prognosis due to the limited therapies and the systemic cytotoxicity. Among the different new drugs, recently has been reported the in vitro anti-glioma activity of a new cationic platinum(II) complex bearing 8-aminoquinoline as chelating ligand (Pt-8AQ). The purpose of this research work was to confirm the activity of Pt-8AQ on U87-GM spheroid and to investigate the ability of Mesenchymal Stromal Cells (MSCs) to incorporate and release Pt-8AQ in its active form. The MSCs were primed with Pt-8AQ under optimized conditions and the secretome was analyzed for evaluating the cytotoxic activity of Pt-8AQ and the presence of Extracellular Vesicles (Evs).

Results

The principal results showed that Pt-8AQ incorporated by MSCs was released in the secretome and exerted a significant higher anticancer activity with respect to the free drug. The release of Pt-8AQ did not occur in Evs, as demonstrated for other drugs, but it could be delivered bound to some specific carriers able to enhance its bioavailability and efficacy. Some hypotheses are discussed to explain this surprisingly finding out that, however, it needs more investigations.

Conclusions

The major conclusions are that cell mediated drug delivery systems could provide a potential approach to facilitate the GBM therapy by intra-tumoral administration of cells loaded with Pt-8AQ, being MSCs able to integrate it into the tumor mass and exert high therapeutic efficacy in situ. The increased efficacy of Pt-8AQ delivered by MSCs even suggests to deeper investigate a possible direct use of MSCs secretome both in situ and/or by systemic administration, being secretome able to pass the blood–brain tumor.
Prevalence and correlates of disability in older adults, Ghana: evidence from the Ghana 2021 Population and Housing Census
Authors: Agyekum Martin Wiredu , Afrifa-Anane Grace Frempong , Kyei-Arthur Frank
Published: January 2024

Background

Although there are studies on disabilities in older persons, most of these studies have been carried out in developed countries. Hence, there are limited studies on disability in older adults in sub-Saharan Africa, including Ghana. The few studies that have examined the prevalence and correlates of disability in older adults used survey data for their analyses. To contribute to addressing this knowledge gap that has arisen, this study used a national census, the 2021 Ghana Population and Housing Census, to examine the prevalence and correlates of disability in older adults in Ghana.

Methods

The 2021 Ghana Population and Housing Census data was used for this study. A sample size of 197,057 Ghanaians aged 60 years and above was used for this study. The Washington Group questions on disability were used to measure disability by asking older adults about their difficulties in performing the six domains of disability (physical, sight, intellectual, hearing, self-care, and speech). A multinomial logistic regression housed in STATA was used to analyse the correlates of disability in older adults in Ghana. A p-value less than 0.05 was used for statistical significance.

Results

The results show that slightly more than one-third (38.4%) of the older adults were disabled. In terms of the number of disabilities in older adults, 16.9% had one disability condition, while 2.4% had six disability conditions. Also, 9.4% had two disability conditions. Older adults who were females, aged 70–79 years and 80 years and above, resided in rural areas, with primary, JHS/Middle, SHS, unaffiliated with religion, ever married and never married, unemployed, and belonged to the middle and rich households were more likely to have a disability condition. Also, older adults residing in the Middle and Northern zones, having no health insurance, and using clean cooking fuel were less likely to have a disability condition.

Conclusions

The results show that socio-demographic and household factors were associated with disability in older adults in Ghana. Hence, policymakers and researchers should target these factors when designing appropriate policies, programmes, and interventions to improve the wellbeing of older adults.
Disentangling drug contributions: anticholinergic burden in older adults linked to individual medications: a cross-sectional population-based study
Authors: Bhatkhande Gauri , Choudhry Niteesh K. , Mahesri Mufaddal , Haff Nancy , Lauffenburger Julie C.
Published: January 2024

Background

Medications with potent anticholinergic properties have well-documented adverse effects. A high cumulative anticholinergic burden may arise from the concurrent use of multiple medications with weaker anticholinergic effects. We sought to identify patterns of high anticholinergic burden and associated patient characteristics.

Methods

We identified patients aged ≥ 65 who filled ≥ 1 medication with anticholinergic adverse effects in 2019 and had a cumulative Anticholinergic Burden score (ACB) ≥ 4 (i.e., high anticholinergic burden) in a large US health insurer. We classified patients based on how they attained high burden, as follows: 1) only filling strong or moderate anticholinergic medications (i.e., ACB = 2 or 3, “moderate/strong”), 2) only filling lightly anticholinergic medications (i.e., ACB = 1, “light/possible”), and 3) filling any combination (“mix”). We used multinomial logistic regression to assess the association between measured patient characteristics and membership in the three anticholinergic burden classifications, using the moderate/strong group as the referent.

Results

In total, 83,286 eligible patients with high anticholinergic burden were identified (mean age: 74.3 years (SD:7.1), 72.9% female). Of these, 4.5% filled only strong/moderate anticholinergics, 4.3% filled only light/possible anticholinergics, and the rest filled a mix (91.2%). Within patients in the mixed group, 64.3% of medication fills were for light/possible anticholinergics, while 35.7% were for moderate/strong anticholinergics. Compared with patients in the moderate/strong anticholinergics group, patients filling only light/possible anticholinergics were more likely to be older (adjusted Odds Ratio [aOR] per 1-unit of age: 1.06, 95%CI: 1.05–1.07), less likely to be female (aOR: 0.56, 95%CI: 0.50–0.62 vs. male), more likely to have comorbidities (e.g., heart failure aOR: 3.18, 95%CI: 2.70–3.74 or depression aOR: 1.20, 95%CI: 1.09–1.33 vs. no comorbidity), and visited fewer physicians (aOR per 1-unit of change: 0.98, 95%CI: 0.97–0.98). Patients in the mixed group were older (aOR per 1-unit of age: 1.02, 95%CI: 1.02–1.03) and less likely to be female (aOR: 0.89, 95%CI: 0.82–0.97 vs. male) compared with those filling moderate/strong anticholinergics.

Conclusion

Most older adults accumulated high anticholinergic burden through a combination of light/possible and moderate/strong anticholinergics rather than moderate/strong anticholinergics, with light/possible anticholinergics being the major drivers of overall anticholinergic burden. These insights may inform interventions to improve prescribing in older adults.