bluuebunny/crossref_metadata_2025 huggingface dataset:
Importance of Quality of Medical Record: Differences in Patient Safety Incident Inquiry Results According to Assessment for Quality of Medical Record
Authors: Jeong Hyeran , Choi Eun Young , Lee Won , Jang Seung Gyeong , Pyo Jeehee , Ock Minsu
Published: March 2024

Background

Medical record review is the gold standard method of identifying adverse events. However, the quality of medical records is a critical factor that can affect the accuracy of adverse event detection. Few studies have examined the impact of medical record quality on the identification of adverse events.

Objectives

In this study, we analyze whether there were differences in screening criteria and characteristics of adverse events according to the quality of medical records evaluated in the patient safety incident inquiry in Korea.

Methods

Patient safety incident inquiry was conducted in 2019 on 7500 patients in Korea to evaluate their screening criteria, adverse events, and preventability. Furthermore, medical records quality judged by reviewers was evaluated on a 4-point scale. The χ2 test was used to examine differences in patient safety incident inquiry results according to medical record quality.

Results

Cases with inadequate medical records had higher rates of identified screening criteria than those with adequate records (88.8% versus 55.7%). Medical records judged inadequate had a higher rate of confirmed adverse events than those judged adequate. “Drugs, fluids, and blood-related events,” “diagnosis-related events,” and “patient care–related events” were more frequently identified in cases with inadequate medical records. There was no statistically significant difference in the preventability of adverse events according to the medical record quality.

Conclusions

Lower medical record quality was associated with higher rates of identified screening criteria and confirmed adverse events. Patient safety incident inquiry should specify medical record quality evaluation questions more accurately to more clearly estimate the impact of medical record quality.
The Relationship Between Anti–SSA-52 and Interstitial Lung Disease
Authors: Saunders Hollie , Baig Hassan , Li Yan , White Launia , Hodge David , Lesser Elizabeth , Stowell Justin T. , Rojas Carlos A. , Mira-Avendano Isabel
Published: March 2024

Objective

The aims of this study were to assess whether a relationship between anti–SSA-52 and interstitial lung disease (ILD) can be further defined, and to enhance screening, detection, and potentially guide treatment.

Methods

A historical cohort study of 201 patients was conducted at a single tertiary care center between January 1, 2016 and December 31, 2020. All included patients were anti–SSA-52 antibody positive. Chart review was performed for laboratory values, symptoms, pulmonary function tests, treatment, and imaging. Chest computed tomographies were reviewed by chest radiologists.

Results

Among anti–SSA-52 antibody–positive patients, ILD was found in 125 (62.2%) compared with 76 (37.8%) with no ILD (p = 0.001). For those with ILD, 78 (62.4%) were diagnosed with connective tissue disease (CTD)–associated ILD, 28 (22.4%) were diagnosed ILD only, and 19 (15.2%) met the criteria for interstitial pneumonia with autoimmune features. In patients with CTD-ILD, 18 (23.0%) had their ILD diagnosis made over 6 months before a CTD diagnosis, and an additional 43 (55.1%) had their ILD and CTD diagnosed within 6 months of each other (p < 0.001). Common computed tomography patterns were nonspecific interstitial pneumonia/organizing pneumonia overlap in 44 (35.2%), 25 (20.0%) nonspecific interstitial pneumonia, and 15 (12%) usual interstitial pneumonia. Twenty-eight (35.9%) had antisynthetase syndrome, followed by 16 (20.5%) with dermatomyositis, 10 (12.8%) with CTD overlap, and 6 (7.7%) with systemic scleroderma.

Conclusions

There was a significant association between anti–SSA-52 antibodies and ILD across a wide spectrum of rheumatological diagnoses. A significant portion of patients were diagnosed with ILD either at the same time or before their CTD diagnosis. Further study will be needed to assess effective treatment and response.
Translational analysis of data science and causal learning in real-world clinical evaluation of traditional Chinese medicine
Authors: Yang Wei , Yi Danhui , Zhou XiaoHua , Leng Yuanming
Published: March 2024

Real-world clinical evaluation of traditional Chinese medicine (RWCE-TCM) is a method for comprehensively evaluating the clinical effects of TCM, with the aim of delving into the causality between TCM intervention and clinical outcomes. The study explored data science and causal learning methods to transform RWD into reliable real-world evidence, aiming to provide an innovative approach for RWCE-TCM. This study proposes a 10-step data science methodology to address the challenges posed by diverse and complex data in RWCE-TCM. The methodology involves several key steps, including data integration and warehouse building, high-dimensional feature selection, the use of interpretable statistical machine learning algorithms, complex networks, and graph network analysis, knowledge mining techniques such as natural language processing and machine learning, observational study design, and the application of artificial intelligence tools to build an intelligent engine for translational analysis. The goal is to establish a method for clinical positioning, applicable population screening, and mining the structural association of TCM characteristic therapies. In addition, the study adopts the principle of real-world research and a causal learning method for TCM clinical data. We constructed a multidimensional clinical knowledge map of “disease-syndrome-symptom-prescription-medicine” to enhance our understanding of the diagnosis and treatment laws of TCM, clarify the unique therapies, and explore information conducive to individualized treatment. The causal inference process of observational data can address confounding bias and reduce individual heterogeneity, promoting the transformation of TCM RWD into reliable clinical evidence. Intelligent data science improves efficiency and accuracy for implementing RWCE-TCM. The proposed data science methodology for TCM can handle complex data, ensure high-quality RWD acquisition and analysis, and provide in-depth insights into clinical benefits of TCM. This method supports the intelligent translation and demonstration of RWD in TCM, leads the data-driven translational analysis of causal learning, and innovates the path of RWCE-TCM.
Behavioural consequences of intraspecific variability in a mate recognition signal
Authors: Steurer Maximilian , Ruther Joachim , Pokorny Tamara
Published: March 2024

Mate recognition is paramount for sexually reproducing animals, and many insects rely on cuticular hydrocarbons (CHCs) for close-range sexual communication. To ensure reliable mate recognition, intraspecific sex pheromone variability should be low. However, CHCs can be influenced by several factors, with the resulting variability potentially impacting sexual communication. While intraspecific CHC variability is a common phenomenon, the consequences thereof for mate recognition remain largely unknown. We investigated the effect of CHC variability on male responses in a parasitoid wasp showing a clear-cut within-population CHC polymorphism (three distinct female chemotypes, one thereof similar to male profiles). Males clearly discriminated between female and male CHCs, but not between female chemotypes in no-choice assays. When given a choice, a preference hierarchy emerged. Interestingly, the most attractive chemotype was the one most similar to male profiles. Mixtures of female CHCs were as attractive as chemotype-pure ones, while a female–male mixture negatively impacted male responses, indicating assessment of the entire, complex CHC profile composition. Our study reveals that the evaluation of CHC profiles can be strict towards ‘undesirable' features, but simultaneously tolerant enough to cover a range of variants. This reconciles reliable mate recognition with naturally occurring variability.
Advances in understanding bat infection dynamics across biological scales
Authors: Sánchez Cecilia A. , Phelps Kendra L. , Frank Hannah K. , Geldenhuys Marike , Griffiths Megan E. , Jones Devin N. , Kettenburg Gwenddolen , Lunn Tamika J. , Moreno Kelsey R. , Mortlock Marinda , Vicente-Santos Amanda , Víquez-R Luis R. , Kading Rebekah C. , Markotter Wanda , Reeder DeeAnn M. , Olival Kevin J.
Published: March 2024

Over the past two decades, research on bat-associated microbes such as viruses, bacteria and fungi has dramatically increased. Here, we synthesize themes from a conference symposium focused on advances in the research of bats and their microbes, including physiological, immunological, ecological and epidemiological research that has improved our understanding of bat infection dynamics at multiple biological scales. We first present metrics for measuring individual bat responses to infection and challenges associated with using these metrics. We next discuss infection dynamics within bat populations of the same species, before introducing complexities that arise in multi-species communities of bats, humans and/or livestock. Finally, we outline critical gaps and opportunities for future interdisciplinary work on topics involving bats and their microbes.
Leveraging Single-Cell Sequencing to Classify and Characterize Tumor Subgroups in Bulk RNA-Sequencing Data
Authors: Shetty Arya , Wang Su , Khan A. Basit , English Collin W. , Nouri Shervin Hosseingholi , Magill Stephen T. , Raleigh David R. , Klisch Tiemo J. , Harmanci Arif O. , Patel Akash J. , Harmanci Akdes Serin
Published: March 2024

Accurate classification of cancer subgroups is essential for precision medicine, tailoring treatments to individual patients based on their cancer subtypes. In recent years, advances in high-throughput sequencing technologies have enabled the generation of large-scale transcriptomic data from cancer samples. These data have provided opportunities for developing computational methods that can improve cancer subtyping and enable better personalized treatment strategies. Here in this study, we evaluated different feature selection schemes in the context of meningioma classification. While the scheme relying solely on bulk transcriptomic data showed good classification accuracy, it exhibited confusion between malignant and benign molecular classes in approximately ~8% of meningioma samples. In contrast, models trained on features learned from meningioma single-cell data accurately resolved the sub-groups confused by bulk-transcriptomic data but showed limited overall accuracy. To integrate interpretable features from the bulk (n=78 samples) and single-cell profiling (~10K cells), we developed an algorithm named CLIPPR which combines the top-performing single-cell models with RNA-inferred copy number variation (CNV) signals and the initial bulk model to create a meta-model, which exhibited the strongest performance in meningioma classification. CLIPPR showed superior overall accuracy and resolved benign-malignant confusion as validated on n=792 bulk meningioma samples gathered from multiple institutions. Finally, we showed the generalizability of our algorithm using our in-house single-cell (~200K cells) and bulk TCGA glioma data (n=711 samples). Overall, our algorithm CLIPPR synergizes the resolution of single-cell data with the depth of bulk sequencing and enables improved cancer sub-group diagnoses and insights into their biology.
Comparative analysis ofWolbachiamaternal transmission and localization in host ovaries
Authors: Hague Michael T.J. , Wheeler Timothy B. , Cooper Brandon S.
Published: March 2024

Many insects and other animals carry microbial endosymbionts that influence their reproduction and fitness. These relationships only persist if endosymbionts are reliably transmitted from one host generation to the next.Wolbachiaare maternally transmitted endosymbionts found in most insect species, but transmission rates can vary across environments. Maternal transmission ofwMelWolbachiadepends on temperature in naturalDrosophila melanogasterhosts and in transinfectedAedes aegypti, wherewMel is used to block pathogens that cause human disease. InD. melanogaster,wMel transmission declines in the cold asWolbachiabecome less abundant in host ovaries and at the posterior pole plasm (the site of germline formation) in mature oocytes. Here, we assess how temperature affects maternal transmission and underlying patterns ofWolbachialocalization across 10Wolbachiastrains diverged up to 50 million years—including strains closely related towMel—and their naturalDrosophilahosts. ManyWolbachiamaintain high transmission rates across temperatures, despite highly variable (and sometimes low) levels ofWolbachiain the ovaries and at the developing germline in late-stage oocytes. Identifying strains like closely relatedwMel-likeWolbachiawith stable transmission across variable environmental conditions may improve the efficacy ofWolbachia-based biocontrol efforts as they expand into globally diverse environments.
Multi-trait Analysis of GWAS for circulating FGF23 Identifies Novel Network Interactions Between HRG-HMGB1 and Cardiac Disease in CKD
Authors: Perwad Farzana , Akwo Elvis A. , Vartanian Nicholas , Suva Larrry J , Friedman Peter A , Robinson-Cohen Cassianne
Published: March 2024

Background

Genome-wide association studies (GWAS) have identified numerous genetic loci associated with mineral metabolism (MM) markers but have exclusively focused on single-trait analysis. In this study, we performed a multi-trait analysis of GWAS (MTAG) of MM, exploring overlapping genetic architecture between traits, to identify novel genetic associations for fibroblast growth factor 23 (FGF23).

Methods

We applied MTAG to genetic variants common to GWAS of 5 genetically correlated MM markers (calcium, phosphorus, FGF23, 25-hydroxyvitamin D (25(OH)D) and parathyroid hormone (PTH)) in European-ancestry subjects. We integrated information from UKBioBank GWAS for blood levels for phosphate, 25(OH)D and calcium (n=366,484), and CHARGE GWAS for PTH (n=29,155) and FGF23 (n=16,624). We then used functional genomics to model interactive and dynamic networks to identify novel associations between genetic traits and circulating FGF23.

Results

MTAG increased the effective sample size for all MM markers to n=50,325 for FGF23. After clumping, MTAG identified independent genome-wide significant SNPs for all traits, including 62 loci for FGF23. Many of these loci have not been previously reported in single-trait analyses. Through functional genomics we identified Histidine-rich glycoprotein (HRG) and high mobility group box 1(HMGB1) genes as master regulators of downstream canonical pathways associated with FGF23. HRG-HMGB1 network interactions were also highly enriched in left ventricular heart tissue of a cohort of deceased hemodialysis patients.

Conclusion

Our findings highlight the importance of MTAG analysis of MM markers to boost the number of genome-wide significant loci for FGF23 to identify novel genetic traits. Functional genomics revealed novel networks that inform unique cellular functions and identifiedHRG-HMGB1as key master regulators of FGF23 and cardiovascular disease in CKD. Future studies will provide a deeper understanding of genetic signatures associated with FGF23 and its role in health and disease.
Reconstitution of the uterine immune milieu after transplantation
Authors: Strunz Benedikt , Ivarsson Martin A. , Sun Dan , Ziegenhain Christoph , Crona-Guterstam Ylva , Solders Martin , Björklund Andreas , Marquardt Nicole , Kaipe Helen , Flöter-Rådestad Angelique , Gidlöf Sebastian , Brännström Mats , Björkström Niklas K.
Published: March 2024

Maintenance of tissue-specific immunity is important for immunological fitness, but its establishment have been difficult to assess in humans. Here, we investigated reconstitution of the human uterine immune system by studying women undergoing uterus solid organ transplantation (UTX) or hematopoietic stem cell transplantation (HSCT). Through single-cell identification based on SNPs and disparate HLA expression using single-cell RNA sequencing or high-parameter flow cytometry, donor vs recipient cell origin was determined, and features of these cells were studied. A full uterine immune cell reconstitution occurred after both UTX and HSCT, both at transcriptomic and phenotypic level. This occurred despite tacrolimus-induced calcineurin-mediated NFAT pathway inhibition, which affected de novo induction of tissue-residency featuresin vitro. Intriguingly, after HSCT, immune cells of male origin could reconstitute the uterine immune milieu. Collectively, our results proved insights into tissue immune system persistence and reconstitution capabilities in an organ undergoing continuous regeneration.
Engineering a wolf spider A-family toxin towards increased antimicrobial activity but low toxicity
Authors: Dersch Ludwig , Stahlhut Antonia , Eichberg Johanna , Paas Anne , Hardes Kornelia , Vilcinskas Andreas , Lüddecke Tim
Published: March 2024

Peptides with insecticidal, antimicrobial and/or cytolytic activities, also known as spider venom antimicrobial peptides (AMPs), can be found in the venoms of RTA-clade spiders. They show translational potential as therapeutic leads. A set of 52 AMPs has been described in the Chinese wolf spider (Lycosa shansia), and many have been shown to exhibit antibacterial effects. Here we explored the potential to enhance their antimicrobial activity using bioengineering. We generated a panel of artificial derivatives of an A-family peptide and screened their activity against selected microbial pathogens, vertebrate cells and insects. In several cases, we increased the antimicrobial activity of the derivatives while retaining the low cytotoxicity of the parental molecule. Furthermore, we injected the peptides into adultDrosophila suzukiiand found no evidence of insecticidal effects, confirming the low levels of toxicity. Our data therefore suggest that spider venom linear peptides can be modified into more potent antimicrobial agents that could help to battle infectious diseases in the future.
Biological modifications of the immune response to COVID-19 vaccine in patients treated with rituximab and immune-checkpoint inhibitors
Authors: Ravera Francesco , Dameri Martina , Lombardo Isabella , Stabile Mario , Fallani Neri , Scarsi Camilla , Cigolini Benedetta , Gentilcore Giusy , Domnich Alexander , Zullo Lodovica , Cella Eugenia , Francia Giulia , Montanari Eugenia , Orsi Andrea , Bellodi Andrea , Ferrando Fabio , Rinchai Darawan , Ballerini Filippo , Bruzzone Bianca , Chaussabel Damien , Grivel Jean-Charles , Genova Carlo , Lemoli Roberto Massimo , Bedognetti Davide , Ballestrero Alberto , Ferrando Lorenzo , Zoppoli Gabriele
Published: March 2024

Investigating the impact of immune-modulating therapies on mRNA vaccine efficacy transcends the immediate context of the COVID-19 pandemic. This study focuses on the differential immune responses to the third dose of COVID-19 mRNA vaccine among healthy volunteers, cancer patients treated with immune-checkpoint inhibitors (ICIs), and those treated with the anti-CD20 antibody rituximab. Utilizing RNA sequencing, serology, and interferon-γ release assessment, we charted the temporal dynamics of the immune response in such cohorts. Our findings indicate that ICIs maintain an immune profile similar to that of healthy individuals, whereas treatment with rituximab is associated with impairment of type I interferon response and the upregulation of transcripts pertaining to regulatory T cells, with a global dysfunction of both humoral and cellular immunity. This research deepens our understanding of the sophisticated interplay within the immune system in health and disease states, potentially informing therapeutic strategies across a spectrum of immunological conditions.

Significance statement

Our study examines how cancer treatments that modify the immune system affect transcriptional, serological, and cellular responses to a model for repeated antigenic stimulation in humans, represented by the SARS-CoV-2 booster vaccine. Specifically, we investigated patients treated with rituximab (RTX), which impairs antibody production, and immune checkpoint inhibitors (ICI), which can trigger autoimmune disorders. We discovered that RTX-treated patients not only exhibit a reduced antibody response but actually show a diminished interferon-mediated immune response, indicating a broader immune disruption than anticipated. Conversely, ICI-treated patients responded to the vaccine similarly to healthy individuals, suggesting that fears of adverse vaccine reactions in these patients may be unfounded. This research highlights important considerations for the clinical management of cancer patients receiving these treatments.
Mapping the knowledge structure of artificial neural network research in the stock market: a bibliometric analysis and future research pathways
Authors: Kaur Manpreet , Kumar Amit , Mittal Anil Kumar
Published: March 2024

Purpose

In past decades, artificial neural network (ANN) models have revolutionised various stock market operations due to their superior ability to deal with nonlinear data and garnered considerable attention from researchers worldwide. The present study aims to synthesize the research field concerning ANN applications in the stock market to a) systematically map the research trends, key contributors, scientific collaborations, and knowledge structure, and b) uncover the challenges and future research areas in the field.

Design/methodology/approach

To provide a comprehensive appraisal of the extant literature, the study adopted the mixed approach of quantitative (bibliometric analysis) and qualitative (intensive review of influential articles) assessment to analyse 1,483 articles published in the Scopus and Web of Science indexed journals during 1992–2022. The bibliographic data was processed and analysed using VOSviewer and R software.

Findings

The results revealed the proliferation of articles since 2018, with China as the dominant country, Wang J as the most prolific author, “Expert Systems with Applications” as the leading journal, “computer science” as the dominant subject area, and “stock price forecasting” as the predominantly explored research theme in the field. Furthermore, “portfolio optimization”, “sentiment analysis”, “algorithmic trading”, and “crisis prediction” are found as recently emerged research areas.

Originality/value

To the best of the authors’ knowledge, the current study is a novel attempt that holistically assesses the existing literature on ANN applications throughout the entire domain of stock market. The main contribution of the current study lies in discussing the challenges along with the viable methodological solutions and providing application area-wise knowledge gaps for future studies.
Fostering sustainability performance in the Malaysian manufacturing companies: the role of green technology innovation and innovation capabilities
Authors: Mukhtar Bilal , Shad Muhammad Kashif , Lai Fong Woon
Published: March 2024

Purpose

The purpose of this study is to examine the influence of green technology innovation on sustainability performance with the moderating effect of innovation capabilities in the Malaysian manufacturing listed companies.

Design/methodology/approach

This was a quantitative study and carried out by applying a research survey. The questionnaire was used to collect the data from 204 Malaysian manufacturing companies of the “consumer products and services” sector listed at Bursa Malaysia, incorporating a five-point Likert scale. All the hypothesized relationships were tested by using the partial least square structural equation modeling (PLS-SEM).

Findings

The empirical results showed that the comprehensive adoption of green technology innovation significantly promotes sustainability performance including economic, environmental and social performance. In addition, innovation capabilities significantly and positively moderate the relationship between green technology innovation and sustainability performance.

Research limitations/implications

The scope of this study is specifically confined to the Malaysian manufacturing listed companies, operating within the consumer products and services sector listed at Bursa Malaysia. Consequently, the findings of this study may not be generalized to manufacturing companies of the different geographical contexts.

Practical implications

The findings of this study may help the top management and policymakers of the Malaysian manufacturing listed companies to scrutinize green technology innovation and innovation capabilities to achieve higher sustainability performance.

Originality/value

This study magnifies and provides new insights into the extant literature by developing a comprehensive research model that concurrently tests the direct and moderation effects between green technology innovation, innovation capabilities and sustainability performance. Additionally, this is the first study to examine the influence of green technology innovation on sustainability performance with the moderating effect of innovation capabilities in the Malaysian manufacturing listed companies. This distinct approach significantly bolsters the originality of this study.
Synergistic lubrication effects of Sn–Ag–Cu and MXene–Ti3C2 to improve tribological properties of M50 bearing steel with microporous channels
Authors: Huang Yuchun , Ma Haishu , Meng Yubo , Mao Yazhou
Published: March 2024

Purpose

This paper aims to study the synergistic lubrication effects of Sn–Ag–Cu and MXene–Ti3C2 to improve the tribological properties of M50 bearing steel with microporous channels.

Design/methodology/approach

M50 matrix self-lubricating composites (MMSC) were designed and prepared by filling Sn–Ag–Cu and MXene–Ti3C2 in the microporous channels of M50 bearing steel. The tribology performance testing of as-prepared samples was executed with a multifunction tribometer. The optimum hole size and lubricant content, as well as self-lubricating mechanism of MMSC, were studied.

Findings

The tribological properties of MMSC are strongly dependent on the synergistic lubrication effect of MXene–Ti3C2 and Sn–Ag–Cu. When the hole size of microchannel is 1 mm and the content of MXene–Ti3C2 in mixed lubricant is 4 wt.%, MMSC shows the lowest friction coefficient and wear rate. The Sn–Ag–Cu and MXene–Ti3C2 are extruded from the microporous channels and spread to the friction interface, and a relatively complete lubricating film is formed at the friction interface. Meanwhile, the synergistic lubrication of Sn–Ag–Cu and MXene–Ti3C2 can improve the stability of the lubricating film, thus the excellent tribological property of MMSC is obtained.

Originality/value

The results help in deep understanding of the synergistic lubrication effects of Sn–Ag–Cu and MXene–Ti3C2 on the tribological properties of M50 bearing steel. This work also provides a useful reference for the tribological design of mechanical components by combining surface texture with solid lubrication.

Peer review

The peer review history for this article is available at: https://publons.com/publon/10.1108/ILT-12-2023-0381/
‘Work locally but think globally’: The Alliance Against Women's Oppression and transnational multiracial grassroots activism in the 1980s
Authors: Toscano Bruno Walter Renato
Published: March 2024

This article examines the transnational history of the Alliance Against Women's Oppression (AAWO), a multiracial and Marxist US women's organisation founded in California in 1979. By focusing on the political connection between the AAWO, the so‐called ‘Third World’ and other international organisations such as the Women International Democratic Federation, the article intends to delve into the relationship between global far‐left, non‐White women's organisations in the United States and the Global South. Using extensive archival sources internal to the organisation, this work highlights the 1980s as a central period for anti‐imperialist women's activism against the Reagan administration and for the formation of international grassroots connections.
Unveiling the criticality of digitalization, eco‐innovation, carbon tax, and environmental regulation in G7 quest for carbon footprint mitigation: Insights for sustainable development
Authors: Wang Yu , Chen Xudong , Ibrahim Ridwan Lanre , Al‐Faryan Mamdouh Abdulaziz Saleh
Published: March 2024

A great deal of empirical research has been conducted to find effective solutions to global warming, which is widely recognized as a major cause of environmental degradation and overall decline in well‐being. It should be noted that international coalitions such as the G7 countries (Canada, France, Germany, Italy, Japan, the United Kingdom, and the United) are not left of the ravaging adverse effects of environmental pollution. Consequently, this study contributes to the literature by examining the role of digitalization on carbon footprint amidst environmental‐related technologies, renewable energy, environmental policy stringency, carbon tax, and financial development in G7 countries from 1996 to 2019. The study relies on cross‐sectional autoregressive distributed lag, common correlated effects mean group, augmented mean group, and method of moment quantile regression (MMQR). Results from the analyses show that digitalization is an essential mitigating tool for the surging carbon footprint in G7 countries. Besides, the imperatives of other covariates in subduing the adverse environmental effects of carbon footprint are empirically supported except for financial development. Remarkably, the distributional effects of the exogenous variables on carbon footprint based on MMQR are found robust for the primary analyses. The direction of cause standing between bidirectional and unidirectional heightens the novelties of this study. Based on the findings, sustainable footprint policies in G7 economies are suggested.
The role of digitalization, infrastructure, and economic stability in tourism growth: A pathway towards smart tourism destinations
Authors: Sun Dongling , Zhou Yang , Ali Qamar , Khan Muhammad Tariq Iqbal
Published: March 2024

This study shows the impact of information and communication technology (ICT), inflation, economic growth, foreign direct investment (FDI), infrastructural development, and financial development on the global tourism index across all income groups. We use a generalized method of moments technique, novel index of tourism, and ICT in 130 countries from 1995 to 2019. The empirical results infer an increase in tourism due to sustained growth in ICT (all panels), economic growth (all panels), FDI (all panels), financial development (all panels), and infrastructure development (all panels). This study highlights the importance of increasing 4G networking in remote areas and introducing reliable mobile applications to promote smart tourism, which involves setting up a Tourist Information Centre to guide tourists in terms of traveling, accommodation, food, shopping, parking, history of specific places, healthcare services, weather forecasting, and emergencies. The central bank could ensure price stability by using different tools of monetary and fiscal policy while encouraging FDI and ICT infrastructure in the tourism industry, especially in developing countries. Tourism is directly associated with foreign exchange earnings, which in turn increases the financial strength of an economy. Besides, prioritizing investment in infrastructure, particularly in sanitation and waste management, drinking water supply, clean fuel management, and generation of electricity, could bolster tourism. The contribution of this study employs multiple indicators in the form of a composite index (i.e., global tourism index, ICT index, and infrastructure index). In addition, we have developed a global ICT index using several related indicators.
Development and validation of a nomogram model for accurately predicting severe fatigue in maintenance hemodialysis patients: A multicenter cross‐sectional study in China
Authors: Zhou Xinyuan , Han Jiahui , Zhu Fuxiang
Published: March 2024

Introduction

This study aims to analyze the risk factors for severe fatigue in maintenance hemodialysis (MHD) patients and develop a clinical prediction model to help doctors and patients prevent severe fatigue.

Methods

Multicentre MHD patients were included in this study. The objective was to investigate the risk factors for severe fatigue in MHD patients and develop a prediction model.

Results

A total of 243 MHD patients were included in the study, and the incidence of severe fatigue was found to be 20.99%. Using age, body mass index, total cholesterol, and albumin levels, a predictive nomogram for fatigue was constructed. In the training set, the nomogram had an area under the curve of 0.851, sensitivity of 82.86%, specificity of 81.76%, and c‐index of 0.851. The nomogram was accurate in calibration and proved to be clinically useful.

Conclusion

The nomogram developed in this study is a practical and reliable tool for quickly identifying severe fatigue in MHD patients.
Setting a direction for continuing professional development in anesthesiology: A synthesis of the outcome from an Utstein style meeting
Authors: Petersen J. A. , Østergaard D. , Østergaard H. T. , Bray L. , Haug A. C.
Published: March 2024

Background

An Utstein style meeting of key stakeholders from the existing collaboration surrounding post‐graduate training was arranged to set a direction for continuing professional development (CPD) of anesthesiologists in Denmark. A 2‐day meeting was planned to guide discussions about competencies in anesthesiology, facilitate the development of a blueprint for a portfolio‐based CPD program and provide examples of how a portfolio can be used in practice.

Methods

The meeting agenda was based on an adaptation of Kern's six‐step approach to curriculum development. Twenty‐four participants from the university hospitals in Denmark were invited. Prior to the meeting participants were informed of the objectives and the Utstein style process.

Results

Participants acknowledged a need for a more structured approach to CPD, preferably within the current organizational set up at the departmental level, and with a portfolio‐based, individualized curriculum. It was recognized that CPD should contain an array of possibilities to accommodate needs and wants of both the individual and the department. It was emphasized that, while anesthesiologists are used to give feedback to trainees, many are less familiar in providing the same to peers, and psychological safety was identified as a prerequisite to support a culture where specialists can reflect openly on each other's performance.

Conclusion

The results provide an insight into the attitudes, opportunities, and challenges of anesthesiologists in relation to continuing professional development in Denmark. Generally, participant suggestions are in line with the shift in medical education toward workplace‐based learning, feedback and lifelong learning.
Generation of a virus‐like particles based vaccine against IgE
Authors: Gharailoo Zahra , Plattner Kevin , Augusto Gilles , Engeroff Paul , Vogel Monique , Bachmann Martin F.
Published: March 2024

Background

Anti‐IgE immunotherapy with monoclonal antibodies represents a breakthrough in treatment of severe allergic diseases. However, drawbacks such as short half‐life and high price are not negligible. Our objective is to develop an anti‐IgE vaccine based on virus‐like particles (VLPs) which can induce long‐lasting neutralizing IgG anti‐IgE antibodies reducing allergic responses without causing intrinsic mast cell activation due to IgE cross‐linking.

Methods

The vaccines were made by chemically coupling three synthetic mouse IgE‐Fc fragments to plant‐derived immunologically optimized CuMVTT VLPs. The immunogenicity of the vaccines was tested by immunizing naive or allergic mice either with the coupled vaccines or the VLP control followed by systemic or local allergen challenge.

Results

Mice immunized with the vaccines exhibited high titers of anti‐IgE antibodies in the sera and high levels of anti‐IgE secreting plasma cells in lymphoid organs. Moreover, free IgE in serum were reduced by the induced anti‐IgE antibodies; therefore, less IgE was bound to FcεRI on the surface of basophils. In line with these reduced IgE levels on effector cells after vaccination, immunized mice were protected from challenge with allergens. Importantly, despite presence of anti‐IgE antibodies, no signs of acute or chronic allergic response were seen in immunized allergic mice.

Conclusion

The generated vaccines can effectively induce anti‐IgE antibodies that did not cause allergic responses in sensitized mice but were able to decrease the level of free and cell bound IgE and protected sensitized animals from allergic responses upon allergen challenge.
Pre‐admission virus detection during the COVID‐19 pandemic in children with and without symptoms of infection
Authors: Bennet Rutger , Rinder Malin Ryd , George Eric , Hertting Olof , Luthander Joachim , Åkefeldt Selma Olsson , Hammas Berit , Allander Tobias , Eriksson Margareta
Published: March 2024

Aim

Pre‐admission viral screening is used only in exceptional situations such as pandemics. We therefore evaluated pre‐admission screening for severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), respiratory syncytial virus (RSV) and influenza during the COVID‐19 pandemic, comparing epidemiology and clinical features of admitted children.

Methods

Children were screened at a paediatric emergency department from 1 March 2020 to 30 June 2022 by nasopharyngeal sampling and polymerase chain reaction kit. We retrospectively retrieved positive results from the laboratory and scrutinised charts of admitted children.

Results

Out of 15 927 screened children, 522, 127 and 572 were positive and admitted with RSV, influenza A or SARS‐CoV‐2, respectively. Of these, 29 (5.6%), 26 (24.1%) and 245 (44.8%) were incidental findings, lacking symptoms of infection. RSV and influenza A were initially absent but re‐emerged in the autumn of 2021. The rate of COVID‐19 rose when the Omicron variant emerged in December 2021. The median age of children with RSV was 0.3 years, of those with influenza A 6.7 years and of those with COVID‐19 1.6 years. Major complications were rare.

Conclusion

Frequent incidental detections of SARS‐CoV‐2 likely reflected widespread presence of a mild infection. Clinically, COVID‐19 was like other viral respiratory infections in children.
When and how many: Factors associated with campus sexual assault reforms
Authors: Nelson Abbie , Moylan Carrie A. , Allen Jennifer , Hammock Amy
Published: March 2024

Institutions of higher education have faced increasing pressure to comply with federal regulations and reform their response to campus sexual assault. This study explores institutions of higher education employees’ perceptions on whether decoupling, or organizational resistance to change, is associated with the number and timing of campus sexual assault reforms adopted. Early captured reforms instituted before the “Dear Colleague Letter” in 2011, mid included reforms instituted after the Dear Colleague Letter in 2011 but before the 2015–2016 academic year and during the period of heightened attention to campus sexual assault, and late which included reforms instituted during or after the 2015–2016 academic year. A web‐based survey of institutions of higher education employees familiar with sexual assault policy implementation on their campuses asked about types of reforms, timing, decoupling, and campus characteristics. Correlations and t‐tests were run to examine the types of reforms across time periods, and regression assessed the degree to which decoupling was associated with the number and timing of reforms. Higher decoupling was associated with fewer reforms in the early period and more in the late period, though not with the overall number of reforms adopted. Findings highlight the importance of understanding factors that influence change on campuses.
COVID‐19 infection in patients with history of pediatric heart transplant in Germany, Austria, and Switzerland
Authors: Ulrich Sarah , Balmer Christian , Becker Kolja , Bruhs Josefin , Danne Friederike , Debus Volker , Dewein Leonie , Di‐Bernardo Stefano , Doll Ulrike , Fleck Thilo , Tirilomis Theodor , Glöckler Martin , Grafmann Maria , Greil Sabine , Grosser Urte , Saur Patrick , Skrzypek Susanne , Steinmetz Michael ,   the Working group thoracic organ transplantation DGPK
Published: March 2024

COVID‐19 is a heterogenous infection—asymptomatic to fatal. While the course of pediatric COVID‐19 infections is usually mild or even asymptomatic, individuals after adult heart transplantation are at high risk of a severe infection. We conducted a retrospective, multicenter survey of 16 pediatric heart transplant centers in Germany, Austria and Switzerland to evaluate the risk of a severe COVID‐19 infection after pediatric heart transplantation between 02/2020 and 06/2021. Twenty‐six subjects (11 male) with a median age of 9.77 years at time of transplantation and a median of 4.65 years after transplantation suffered from COVID‐19 infection. The median age at time of COVID‐10 infection was 17.20 years. Fourteen subjects had an asymptomatic COVID‐19 infection. The most frequent symptoms were myalgia/fatigue (n = 6), cough (n = 5), rhinitis (n = 5), and loss of taste (n = 5). Only one subject showed dyspnea. Eleven individuals needed therapy in an outpatient setting, four subjects were hospitalized. One person needed oxygen supply, none of the subjects needed non‐invasive or invasive mechanical ventilation. No specific signs for graft dysfunction were found by non‐invasive testing. In pediatric heart transplant subjects, COVID‐19 infection was mostly asymptomatic or mild. There were no SARS‐CoV‐2 associated myocardial dysfunction in heart transplant individuals.
Immunohistochemical p16 overexpression and Rb loss correlate with high‐risk human papillomavirus infection in endocervical adenocarcinomas
Authors: Yasutake Nobuko , Yamamoto Hidetaka , Kuga Ryosuke , Jiromaru Rina , Hongo Takahiro , Katayama Yoshihiro , Sonoda Kenzo , Yahata Hideaki , Kato Kiyoko , Oda Yoshinao
Published: March 2024

Aims

p16 is a sensitive surrogate marker for transcriptionally active high‐risk human papillomavirus (HR‐HPV) infection in endocervical adenocarcinoma (ECA); however, its specificity is not perfect.

Methods and results

We examined p16 and Rb expressions by immunohistochemistry (IHC) and the transcriptionally active HR‐HPV infection by mRNA in‐situ hybridisation (ISH) with histological review in 108 ECA cases. Thirteen adenocarcinomas of endometrial or equivocal origin (six endometrioid and seven serous carcinomas) were compared as the control group. HR‐HPV was detected in 83 of 108 ECA cases (77%), including five HPV‐associated adenocarcinomas in situ and 78 invasive HPV‐associated adenocarcinomas. All 83 HPV‐positive cases showed consistent morphology, p16 positivity and partial loss pattern of Rb. Among the 25 cases of HPV‐independent adenocarcinoma, four (16%) were positive for p16, and of these four cases, three of 14 (21%) were gastric type adenocarcinomas and one of 10 (10%) was a clear cell type adenocarcinoma. All 25 HPV‐independent adenocarcinomas showed preserved expression of Rb irrespective of the p16 status. Similarly, all 13 cases of the control group were negative for HR‐HPV with preserved expression of Rb, even though six of 13 (46%) cases were positive for p16. Compared with p16 alone, the combination of p16 overexpression and Rb partial loss pattern showed equally excellent sensitivity (each 100%) and improved specificity (100 versus 73.6%) and positive predictive values (100 versus 89.2%) in the ECA and control groups. Furthermore, HR‐HPV infection correlated with better prognosis among invasive ECAs.

Conclusions

The results suggest that the combined use of p16 and Rb IHC could be a reliable method to predict HR‐HPV infection in primary ECAs and mimics. This finding may contribute to prognostic prediction and therapeutic strategy.
Association between gastrointestinal symptoms and insomnia in patients with type 2 diabetes: The KAMOGAWA‐DM cohort study
Authors: Minamida Megumi , Okada Hiroshi , Hamaguchi Masahide , Hironaka Junya , Kondo Yuriko , Nakajima Hanako , Okamura Takuro , Sennmaru Takafumi , Nakanishi Naoko , Ushigome Emi , Fukui Michiaki
Published: March 2024

Aims/Introduction

Gastrointestinal disturbances and insomnia affect the quality of life of patients with diabetes. However, the relationship between gastrointestinal symptoms and insomnia in patients with diabetes has rarely been analyzed. Thus, aim of this study was to investigate the association between gastrointestinal symptoms and insomnia in patients with type 2 diabetes mellitus.

Materials and Methods

This cross‐sectional study of patients with type 2 diabetes was carried out from January 2014 to April 2022 using the database of the KAMOGAWA‐DM cohort study. Patient data were collected using a self‐administered questionnaire, and the Izumo Scale and the Athens Insomnia Scale were used to assess gastrointestinal symptoms and insomnia, respectively. Multivariate logistic regression analysis was carried out to determine the association between gastrointestinal symptoms and insomnia.

Results

A total of 175 patients with type 2 diabetes were included in this study. Patients with insomnia had higher Izumo scores than those without insomnia (P < 0.0001). Izumo scale score was significantly associated with insomnia in patients with type 2 diabetes, even after adjustment for age, body mass index, systolic blood pressure, glycated hemoglobin level, neuropathy, insulin therapy and nocturia (odds ratio 1.10, 95% confidence interval [CI] 1.06–1.16). Each gastrointestinal symptom assessed using the Izumo scale was associated with insomnia. The odds ratios of heartburn, stomach pain, lethargy, constipation and diarrhea for insomnia were 1.32 (95% CI 1.13–1.55), 1.38 (95% CI 1.16–1.63), 1.33 (95% CI 1.13–1.56), 1.21 (95% CI 1.08–1.36) and 1.29 (95% CI 1.12–1.47), respectively.

Conclusions

Gastrointestinal symptoms are strongly associated with sleep disturbances in patients with type 2 diabetes.