bluuebunny/crossref_metadata_2025 huggingface dataset:
Local Versus General Anesthesia in Pediatric Otoplasty: A Cost and Efficiency Analysis
Authors: Iyer Hari , Bouhadana Gabriel , Cugno Sabrina
Published: July 2023

Objective

Quantify the cost benefits of otoplasty under local as opposed to general anaesthesia.

Design

A cost analysis of all components of otoplasty surgery under local anaesthesia (LA) in a minor operating room (OR) and general anaesthesia in a main OR was performed.

Setting

Our institution, compared to provincial/federal data, with costs converted into 2022 Canadian dollars.

Patients, Participants

Patients undergoing otoplasty under LA in the last year.

Interventions

An efficiency analysis was performed by means of an opportunity cost, and the cost of failure was added to the overall LA costs.

Main Outcome Measure

Expenses for infrastructure, surgical and anaesthetic material, salaries, and personnel costs were derived from the literature, our hospital OR catalog and federal/provincial salary data, respectively. The cost of failure to tolerate local anaesthesia for such cases was also tabulated.

Results

The true cost of LA otoplasty was computed as the absolute cost ($611.73) added to the cost of failure ($10.80), resulting in a total of $622.53/procedure. The true cost of GA otoplasty was calculated as the absolute cost ($2033.05) added to the opportunity cost ($1108.94), representing 3141.99$/procedure. The total savings when performing LA otoplasty to GA otoplasty are thus 2519.44$/case, with 1 GA otoplasty costing 5.05 LA otoplasties.

Conclusion

Otoplasty under local anaesthesia offers significant cost savings when compared with the same procedure under general anaesthesia. Economic considerations must be given particular attention given the elective nature of this procedure, which is often publicly funded.
Navigating the Moral-Economic Paradox of Diversity Management: Plurality of Stakeholder Perceptions and Coping Strategies
Authors: Jaeck Mélanie , Marais Magalie , Joly Cédrine , Preuss Lutz
Published: July 2023

Managing diversity is a challenge for many organizations and their diversity initiatives are often criticized for an inability to produce tangible outcomes. One reason for such mixed results is the fact that espoused diversity policies are often implemented in multi-objective contexts in which various stakeholders perceive of diversity and its place in the organization in different ways, thus affecting organizational outcomes. To shed new light on these challenges, we apply paradox theory to diversity management. Based on a series of interviews with all key stakeholder groups of one organization that successfully implemented a diversity initiative in a challenging context, we are able to provide a systematic account of differences between stakeholder groups in terms of both the tensions they perceive in diversity management and the solutions they prefer. Our data show that stakeholders perceive of tensions in a nested fashion, where some only see one or two categories of tensions, whereas others perceive a much wider range. This nested fashion re-appears in the coping strategies which different stakeholders prefer. Here, we found that ‘observers’ and ‘makers’ – that is, the two groups who are, respectively, least and most involved with the policy – favour strategies that accept the paradoxical tensions, whereas ‘beneficiaries’ tend to emphasize strategies to resolve them. We conclude our paper by discussing managerial implications of our findings, as well as avenues for future research.
Incidental Detection of TFEB-Amplified Renal Cell Carcinoma by Colocated Gene Amplification of CCND3 (6p21): A Case Report and Review of the Literature
Authors: Repetto Federico , Sirohi Deepika , Greipp Patricia , Mahlow Jonathon
Published: July 2023

TFEB-amplified renal cell carcinoma (RCC), which belongs to the MITF family of RCC, is characterized by genomic amplification at the 6p21.1 locus where the TFEB gene is located. The vascular endothelial growth factor A and cyclin D3 genes are also located at this same locus. When tumors lack classic morphologic features, they may be classified as “RCC not otherwise specified (NOS).” However, it is increasingly important to accurately diagnose the RCC subtype to define the patient's individual prognosis and select the subsequent therapeutic modalities, which now include targeted agents. Therefore, knowledge of the diagnostic features of TFEB-altered RCCs, such as t(6;11) RCCs and TFEB-amplified RCCs, is critical for identifying these tumors. Herein, we present an interesting case of TFEB-amplified RCC that was initially diagnosed as RCC NOS on biopsy of a renal tumor in a community practice setting with available molecular findings demonstrating CCND3 amplification. The genetic abnormality was “accidentally” detected due to the amplification of the colocated CCND3 gene at the 6p21 locus of the TFEB gene on a limited genetic sequencing panel. This case highlights the importance of molecular tests in accurately diagnosing RCC and carefully interpreting molecular findings in the context of histomorphologic features.
Chronic liver disease is not associated with statin prescription in a primary care cohort
Authors: Moore Joseph A , Schreiner Andrew D , Zhang Jingwen , Mauldin Patrick , Moran William P , Koch David G
Published: July 2023

Statins have historically been underutilized in patients with chronic liver disease (CLD). We sought to investigate the association between CLD and statin prescription in a primary care setting. Our retrospective cohort study identified primary care patients with a low-density lipoprotein value and more than one office visit from 2012 through 2018. Indication for statin therapy was determined using the Third Adult Treatment Panel criteria prior to November 2016 and the American College of Cardiology and American Heart Association guidelines thereafter. Indication for statin prescription and statin therapy by year was determined. Patients with CLD were identified using ICD-9/10 diagnosis codes. In total, 2119 individuals with an indication for statin therapy were identified. Of these individuals, 354 (16.7%) had CLD. Alcoholic and nonalcoholic fatty liver disease comprised 44.9% and 28.5% of the CLD population, respectively; 27.7% had cirrhosis. There was no difference in the prevalence of statin prescriptions when comparing patients with a CLD diagnosis to those without one (57.9 vs 59.9%, p = 0.48). A diagnosis of CLD was also not significantly associated with statin prescription when adjusting for other covariates (odds ratio (OR) 1.02; 95% confidence interval (CI) 0.78–1.33). An alanine aminotransferase level greater than 45 U/L significantly reduced the odds of a statin prescription (OR 0.62; 95% CI 0.44–0.87). Overall, the presence of a CLD diagnosis was not associated with attenuated statin utilization compared to those without a CLD diagnosis. Nevertheless, adherence to guideline indicated statin therapy remains suboptimal and efforts to increase statin utilization in this high-risk population remain prudent.
How Chatbot Language Shapes Consumer Perceptions: The Role of Concreteness and Shared Competence
Authors: Jiménez-Barreto Jano , Rubio Natalia , Molinillo Sebastian
Published: July 2023

In service settings, chatbots frequently are associated with substandard care, depersonalization, and linguistic misunderstandings. Drawing on assemblage theory (i.e., the examination of how heterogeneous parts, through their ongoing interaction, create an emergent whole with new capacities that the parts themselves do not have), the authors investigate how chatbots’ language concreteness—the specificity of words used during interactions with consumers—can help improve satisfaction, willingness to use the chatbot, and perceived shopping efficiency. Across three experiments, the findings reveal a psychological mechanism driven by concrete chatbot language that makes chatbots seem competent and reinforces consumer self-competence, in turn boosting satisfaction, willingness to use the chatbot, and perceived shopping efficiency. This pattern of results contributes to consumer behavior by providing evidence of the chatbot language concreteness effect on consumer–chatbot interactions. For practitioners, the authors outline conversational designs that could help optimize implementation of chatbots in customer service.
Integrated design and analysis of a high-precision aerostatic spindle for internal grinding machines and its implementation perspectives
Authors: Yue Songjie , Cheng Kai , Bai Qingshun , Ding Hui
Published: July 2023

Aerostatic spindles are commonly employed in ultra-precision machines. The aerostatic spindle, as a critical key component for the development of industrial ultra-precision grinding machines, requires an industrial feasible precision engineering approach to robust design and optimization in order to render the high-precision spindle system. This paper presents such an approach to the design and development of aerostatic spindles and the associated digital virtual spindle systems based on multiscale modelling and analysis. Multiscale modelling and analysis combined with the virtual spindle simulation are used as the kernel of the virtual spindle system, including innovative design on the spindle system structure, fluid dynamics modelling, drive and control system, and the integration of the spindle electromechanical system, which can be used to systematically model and simulate both the static and dynamic performances of the aerostatic spindle system. Experiments are carried out to evaluate and validate the above approach and the virtual spindle simulations, which can be further utilized for the development of next-generation high-precision aerostatic spindle systems.
Not all language tourists take language courses – the determinants of formal and informal language tourism
Authors: Carvalho Inês , Ramires Ana , Iglesias Montserrat , Fidalgo Alexandra
Published: July 2023

Language tourism is characterized by language learning being a primary or secondary motivation for the trip. Although language tourists typically take language courses in the destination, many also choose to develop their language skills autonomously through immersion. However, the mechanisms underlying this choice are ignored, particularly in a context where informal language tourists are still largely neglected in the literature. This study seeks to identify the main factors that predict language tourists’ decision to take language lessons in the destination, using a binary logistic regression model. A sample of 964 language tourists is used, which comprises both formal ( N = 409) and informal ( N = 555) language tourists. It is concluded that the decision to take language lessons in the destination is positively influenced by trip length, greater formality of pre-trip learning strategies, having a scholarship, traveling without relatives, being motivated to learn a language due to instrumental reasons, and purposeful choice of language travel destination for language-related reasons, among other variables. Informal language tourism is positively influenced by having acquaintances in the destination, traveling with relatives, investing more in self-directed language learning strategies, and having shorter stays, among other variables. This study sheds light on a group of travellers that has been neglected by both academia and the tourism industry.
Strain signal denoising based on adaptive Variation Mode Decomposition (VMD) algorithm
Authors: Yu Ning , Yang Xuyuan , Feng Renjian , Wu Yinfeng
Published: July 2023

Addressing the problem of vulnerability of the directly measured signal in the field of strain weighing to the high-energy noise of similar frequency bands, an adaptive VMD algorithm is proposed from the perspective of signal separation for the decomposition and denoising of strain signal in the field of strain weighing. In this paper, the adaptive VMD algorithm is used to determine the optimal values of two key parameters, namely, the number of decomposition layers and the penalty factor, to avoid the blindness of parameter selection. The separation results are tested by parameters such as sample entropy, and then the original measurement signal is adaptively decomposed into multiple optimal intrinsic mode function components, and the effective components after extraction are reconstructed into new observation signals. The analysis results of the strain data collected at the weighing site show that the adaptive VMD algorithm can separate and extract the effective strain signal in line with the actual situation from the original strain signal mixed with noise and achieve the purpose of avoiding the interference of high-energy environmental noise with close frequency bands.
Intravascular Ultrasound Guidance During Peripheral Vascular Interventions: Long-term Clinical Outcomes and Costs From the Japanese Perspective
Authors: Soga Yoshimitsu , Ariyaratne Thathya V. , Secemsky Eric , Leboucher Claire , Blein Cecile , Jaff Michael R. , Priest Virginia
Published: July 2023

Purpose:

The value of intravascular ultrasound (IVUS) guidance during peripheral vascular revascularization procedures is incompletely understood. Moreover, data on long-term clinical outcomes and costs are limited. The objective of this study was to compare outcomes and costs between IVUS and contrast angiography alone in patients undergoing peripheral revascularization procedures in Japan.

Materials and Methods:

This retrospective comparative analysis was performed using the Japanese Medical Data Vision insurance claims database. All patients undergoing revascularization for peripheral artery disease (PAD) between April 2009 and July 2019 were included. Patients were followed until July 2020, death, or a subsequent revascularization procedure for PAD. Two patient groups were compared: one undergoing IVUS imaging or the other contrast angiography alone. The primary end point was major adverse cardiac and limb events, including all-cause-mortality, endovascular thrombolysis, subsequent revascularization procedures for PAD, stroke, acute myocardial infarction, and major amputations. Total health care costs were documented over the follow-up and compared between groups, using a bootstrap method.

Results:

The study included 3956 patients in the IVUS group and 5889 in the angiography alone group. Intravascular ultrasound was significantly associated with reduced risk of a subsequent revascularization procedure (adjusted hazard ratio: 0.25 [0.22–0.28]) and major adverse cardiac and limb events (0.69 [0.65–0.73]). The total costs were significantly lower in the IVUS group, with a mean cost saving over follow-up of $18 173 [$7 695–$28 595] per patient.

Conclusion:

The use of IVUS during peripheral revascularization provides superior long-term clinical outcomes at lower costs compared with contrast angiography alone, warranting wider adoption and fewer barriers to IVUS reimbursement for patients with PAD undergoing routine revascularization.

Clinical Impact

Intravascular ultrasound (IVUS) guidance during peripheral vascular revascularization has been introduced to improve the precision of the procedure. However, questions over the benefit of IVUS in terms of long-term clinical outcome and over cost have limited its use in everyday clinical practice. This study, performed in a Japanese health insurance claims database, demonstrates that use of IVUS provides a superior clinical outcome over the long term at a lower cost compared to angiography alone. These findings should encourage clinicians to use IVUS in routine peripheral vascular revascularization procedures and encourage providers to reduce barriers to use.
Comprehensive Mutation Profiling of Colorectal Cancer Patients With Lung or Liver Metastasis by Targeted Next-Generation Sequencing
Authors: Hu Chun-Ting , Wang Jing-Long , Hou Ting , Yan Zhao-Wen , Zu Li-Dong , Fu Guo-Hui , Shen Wei-Wei
Published: July 2023

Objectives

Primary tumor tissue is often analyzed to search for predictive biomarkers and DNA-guided personalized therapies, but there is an incomplete understanding of the discrepancies in the genomic profiles between primary tumors and metastases, such as liver and lung metastases.

Methods

We performed in-depth targeted next-generation sequencing of 520 key cancer-associated genes for 47 matched primary and metastatic tumor samples which were retrospectively collected.

Results

A total of 699 mutations were detected in the 47 samples. The coincidence rate of primary tumors and metastases was 51.8% (n = 362), and compared to patients with liver metastases, patients with lung metastases had a significantly greater coincidence rate ( P = .021). The number of specific mutations for the primary tumors and liver and lung metastases was 186 (26.6%), 122 (17.5%), and 29 (4.1%), respectively. Analysis of a patient with all three occurrences, including a primary tumor, liver metastasis, and lung metastasis, indicated a possible polyclonal seeding mechanism for liver metastases. Remarkably, multiple samples from patients with primary and metastatic tumors supported a mechanism of synchronous parallel dissemination from primary tumors to metastatic tumors that were not mediated through pre-metastatic tumors. We also found that the PI3K-Akt signaling pathway significantly altered lung metastases compared to matched primary tumors ( P = .001). In addition, patients with mutations in CTCF, PIK3CA, or TP53 and LRP1B, AURKA, FGFR1, ATRX, DNMT3B, or GNAS had larger primary tumor sizes and metastases, especially patients with both LRP1B and AURKA mutations. Interestingly, CRC patients with TP53-disruptive mutations were more likely to have liver metastases ( P = .016).

Conclusion

In this study, we demonstrate significant differences in the genomic landscapes of colorectal cancer patients based on the site of metastasis. Notably, we observe a larger genomic variation between primary tumors and liver metastasis compared to primary tumors and lung metastasis. These findings can be used for tailoring treatments based on the specific metastatic site.
Gendered Prison and Reentry Experiences: Perspectives From Rural People on Parole
Authors: Oroz Ruben , Dewey Susan , VandeBerg Brittany , Longoria Elisha
Published: July 2023

The present study unites and builds on existing research about gendered reentry experiences and gender-responsive approaches in prison through its analysis of 74 in-depth, semi-structured interviews with people on parole. Taking a gender-responsive approach, the project’s twofold research question asked how rural people conceptualized men’s and women’s prisons as gendered institutions and the various ways in which they understand their individual experiences in prison as gendered. Analysis resulted in three primary themes: [1] structural and institutional gender discrimination; [2] solidarity as supportive for women versus solidarity as protective for men; and [3] emotional regulation in peer relationships. Taken together, our findings add nuance to understandings of the profound impact of gender on incarceration and reentry and offer support for the expansion of gender-responsive approaches to both men’s and women’s institutions.
Sexual and Gender Minorities Inclusion and Uptake of Sexual and Reproductive Health Services: A Scoping Review of Literature
Authors: Khozah Methembe Yotamu , Nunu Wilfred Njabulo
Published: July 2023

Despite the efforts to ensure that sexual and reproductive health services are integrated into global, regional, and national initiatives, a significant number of countries are overwhelmed by frames of exclusion and violations of fundamental human rights, particularly for sexual and gender minority groups such as lesbians, gays, bisexuals, and transgender people. This study sought to review the literature on access and barriers faced by sexual and gender minorities. A scoping literature review was conducted on literature that focused on sexual and gender minorities and sexual and reproductive health services and published in the English language. Studies were independently screened and coded, categorizing themes such as policies, uptake of services, barriers to sexual and reproductive health access, and strategies to aid the uptake of services. The search yielded 1,148 literature sources, of which 39 met the inclusion criteria and were reviewed. The average sexual and reproductive health service uptake was generally low overall and was influenced by factors such as clinical settings, punitive laws, and availability of services specific to sexual and gender minorities. Noted strategies to aid sexual and reproductive health uptake include education, friendly health care facilities, availability of specific services, and legislative reform. The sexual and reproductive health program is an important component of short-term and long-term sexual and reproductive health needs. Health intervention initiatives targeted at improving or increasing sexual and reproductive health uptake must be supported by suitable legal and regulatory framework contexts and based on context-specific evidence.
Linking transformational leadership to teacher commitment and alienation: Do motivational climate profiles moderate?
Authors: Kılınç Ali Çağatay , Özdemir Nedim , Polatcan Mahmut , Savaş Gökhan , Dolapcı Erhan
Published: July 2023

This study aimed to identify schools’ motivational climate profiles and tested how each profile moderates the linkage of transformational leadership with teacher commitment and alienation. Gathering data from 1193 teachers working in 103 schools in Türkiye, we employed multilevel moderation with a latent class variable to estimate the structural links between our variables. The study offered nuanced evidence to the literature by suggesting that sampled schools were categorised under two profiles as high performance and high mastery school climate in terms of their prevalent motivational climate. Our results also provided evidence of the significant moderator role of the school-level profiles on the effect of transformational leadership. Our study suggests that transformational leaders might be more effective in promoting teachers’ collective sense of commitment and eliminating their sense of alienation in schools where a performance-oriented climate is fostered. Key implications for policy and practice around the contextualised nature of school leadership are discussed in this study.
Risk assessment-based optimal safety measure for dust explosion in wooden products processing enterprises
Authors: Pang Lei , Mao Tingting , Cao Jiaojiao , Chen Zikun , Sun Siheng
Published: July 2023

A risk assessment method of dust explosion applicable to wood product processing enterprises was studied to effectively control the occurrence of dust explosion accidents. First, considering the explosive attributes of dust and the technical attributes of wood product processing, a risk assessment index system for dust explosion was constructed from the human, machine, environment, and management perspectives. It comprises 3 first-level indices (namely: accident possibility, accident severity, and safety management system), 6 second-level indices, and 28 third-level indices. The weight of each index was calculated using the structural entropy weight method (SEWM). Second, combined with an association degree matrix, a theoretical model for dust explosion risk assessment was established using a three-dimensional matrix method. Finally, an empirical analysis was conducted on a wood product processing plant using the established model. It was concluded that the overall risk level of the plant was level IV, indicating a relatively high risk. This conclusion is consistent with the actual operation status of the plant, showing that the model has a certain degree of applicability and effectiveness.
How other countries can improve Canada's maternal mortality statistics
Authors: Aflaki Kayvan , Ray Joel G
Published: July 2023

Maternal mortality is the death of a woman while pregnant or within 42 days of the end of pregnancy. Late maternal deaths are from 42 to 365 days thereafter. Maternal mortality is an important surrogate indicator of a woman's overall health, social and economic status, and the provision of antenatal and emergency obstetric care at regional and national levels. Canada does not have a national system to report on maternal mortality; rather, maternal death investigations fall under the legal purview of coroners and medical examiners within each individual province or territory. Furthermore, the Canadian Perinatal Surveillance System is limited by its access to a comprehensive dataset. Hence, there is no accurate national picture of mortality prevalence or trends. The implementation of a national confidential enquiry system is a crucial step toward detailing pregnancy and post-pregnancy maternal mortality in Canada and should be organized in accordance with existing successful international systems.
Estimating the adoption of electric vehicles: A case study of four Indian states
Authors: Saw Krishna , Kedia Ashu
Published: July 2023

Rapid growth in petrol and diesel-powered vehicles has resulted in significant increases in tailpipe greenhouse gas emissions and air pollution, both of which harm public health in Indian cities. Furthermore, India’s dependence on imported fuel to transport people and goods threatens its fuel security. Therefore, electric mobility has been sought to deal with these issues. The governments have framed several plans and policies to promote electric vehicles (EVs) and achieve the target of EV30@30. However, EV adoption in Indian states has been slow. Therefore, this paper aims to estimate the number of EVs needed to be registered to achieve the desired target by 2030 by taking a case study of four states: Delhi, Uttar Pradesh, Karnataka, and Gujarat. The vehicular registration data used in this paper has been obtained from the government database. The study looks at the EV adoption rates of passenger vehicles such as two-wheelers, cars, auto-rickshaws (including e-rickshaws), and buses. According to the findings, the average annual share of passenger EVs is less than 2% in Delhi, less than 1% in Uttar Pradesh, and less than 0.5% in Karnataka and Gujarat during the study period. According to the models’ estimates, Delhi, Uttar Pradesh, Gujarat, and Karnataka will need to register 0.31 million, 1.51 million, 0.88 million, and 0.79 million passenger EVs, respectively, in FY 2030–2031 to achieve a 30% EV share of total registrations.
Autoimmune diseases of the spine and spinal cord
Authors: Biddle Garrick , Beck Ryan T , Raslan Osama , Ebinu Julius , Jenner Zach , Hamer John , Hacein-Bey Lotfi , Apperson Michelle , Ivanovic Vladimir
Published: July 2023

Magnetic resonance imaging (MRI) and clinicopathological tools have led to the identification of a wide spectrum of autoimmune entities that involve the spine. A clearer understanding of the unique imaging features of these disorders, along with their clinical presentations, will prove invaluable to clinicians and potentially limit the need for more invasive procedures such as tissue biopsies. Here, we review various autoimmune diseases affecting the spine and highlight salient imaging features that distinguish them radiologically from other disease entities.
Superior mesenteric artery syndrome treatment strategies: A case report
Authors: Danushka P G Nadun , Jayasinghe Ravindri , Wijemanne Asoka
Published: July 2023

Superior mesenteric artery syndrome is a rare manifestation of small bowel obstruction caused by the compressed third part of the duodenum between the superior mesenteric artery and the abdominal aorta. We present the case of an 18-year-old female and presented with symptoms of duodenal outflow obstruction. Upon investigation, her cross-sectional imaging revealed partial obstruction of the distal duodenum at the crossing of superior mesenteric artery forming an acute angle between the superior mesenteric artery and aorta. Failing initial attempts at conservative management, the patient underwent laparotomy and duodenojejunostomy with complete relief of symptoms. Superior mesenteric artery syndrome is a rare but a sinister diagnosis in patients presenting with features of duodenal outflow obstruction. Cross-sectional imaging plays an important role in diagnosis.
A pilot project investigating the use of ONCOpatient®—An electronic patient-reported outcomes app for oncology patients
Authors: Macanovic Bojan , O’Reilly David , Harvey Harry , Hadi Danial , Cloherty Maeve , O’Dea Pauline , Power Derek G. , Collins Dearbhaile C. , Connolly Roisin M. , Bambury Richard M. , O’Reilly Seamus
Published: July 2023

Purpose

To investigate the feasibility of implementing a remote patient monitoring system using an electronic patient-reported outcomes (ePROs) platform in a tertiary cancer center in the Republic of Ireland.

Methods

Patients receiving oral chemotherapy and oncology clinicians were invited to participate in the study. Patients were asked to submit weekly symptom questionnaires through an ePRO mobile phone application (app)—ONCOpatient®. Clinical staff were invited to use the ONCOpatient® clinician interface. After 8 weeks all participants submitted evaluation questionnaires.

Results

Thirteen patients and five staff were enrolled in the study. The majority of patients were female (85%) with a median age of 48 years (range 22–73). Most (92%) were enrolled over telephone requiring on average 16 minutes. Compliance with the weekly assessments was 91%. Alerts were triggered by 40% of patients who then required phone calls to aid with symptom management. At the end of study, 87% of patients reported they would use the app frequently, 75% reported that the platform met their expectations, and 25% that it exceeded their expectations. Similarly, 100% of staff reported they would use the app frequently, 60% reported that it met their expectations, and 40% that it exceeded their expectations.

Conclusions

Our pilot study showed that it is feasible to implement ePRO platforms in the Irish clinical setting. Small sample bias was recognized as a limitation, and we plan to confirm our findings on a larger cohort of patients. In the next phase we will integrate wearables including remote blood pressure monitoring.
Analysis of the effect of glutamyltransferase on hyperlipidemia based on decision tree
Authors: Zhang Tingting , Ouyang Dantong , Sun Chenglin , Bi Yaru , He Lili , Bai Hongtao
Published: July 2023

Objectives

This study is designed to analyze the potential influencing factors of hyperlipidemia, and to explore the relationship between liver function indicators such as gamma-glutamyltransferase (GGT) and hyperlipidemia.

Methods

Data were derived from 7599 outpatients who visited the Department of Endocrinology of the First Hospital of Jilin University (2017–2019). A multinomial regression model is used to identify related factors of hyperlipidemia and the decision tree method is used to explore the general rules in hyperlipidemia patients and non-hyperlipidemia patients on these factors.

Results

The average of age, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure, aspartate aminotransferase, alanine aminotransferase (ALT), GGT and glycosylated hemoglobin (HbA1c) in the hyperlipidemia group are higher than those in the non-hyperlipidemia group. In multiple regression analysis, SBP, BMI, fasting plasma glucose, 2-h postprandial blood glucose, HbA1c, ALT, GGT are associated with triglyceride. For people with HbA1c less than 6.0%, controlling GGT within 30 IU/L reduces the prevalence of hypertriglyceridemia by 4%, and for people with metabolic syndrome with impaired glucose tolerance controlling GGT within 20 IU/L reduces the prevalence of hypertriglyceridemia by 11%.

Conclusions

Even when GGT is in the normal range, the prevalence of hypertriglyceridemia increases with its gradual increase. Controlling GGT in people with normoglycemia and impaired glucose tolerance can reduce the risk of hyperlipidemia.
Learning Chemistry, Connecting Ecological Citizenship and Environmental Sustainability: “A Plate of Food” as a Learning Medium
Authors: Simanjuntak Familia Novita , Utomo Suyud Warno , Sika Ery Seda Francisia Saveria , Budhi Soesilo Tri Edhi , Sumiyati Sumiyati
Published: July 2023

Highlights

Using a new concept of “a plate of food” (aPoF), a symbol of meaningful chemical reaction products, this article addresses the Grade 10 students’ chemistry anxiety in Indonesia. In line with the ecological citizenship and pro-environmental behavior perspectives, the aPoF is conceptualized based on environmental concerns such as food sustainability, food-critical consciousness, and the earth's carrying capacity. This means that the aPoF is beneficial to support Sustainable Development Goals #2 Zero Hunger, #4 Quality Education, and #12 Responsible Consumption and Production. Based on our results, we suggest that chemistry teachers can give more space for students to express their difficulties in learning chemistry. The space can be delivered by giving assignments focusing on the students’ feelings and experiences related to a certain chemistry topic.
The Cause of Institutionalized Private Tutoring in Korea: Defective Public Schooling or a Universal Desire for Family Reproduction?
Authors: Bae (배상훈) Sang Hoon , Choi (최기호) Kee Ho
Published: July 2023

Purpose

In Korea, private tutoring is considered a social evil that damages the capacity of public schooling and undermines social justice. Although the government has implemented various policies to reduce private tutoring, ranging from improving the quality of education to providing “quasi-private tutoring” programs and regulating the shadow education market, total spending on private tutoring has continued to increase. This study examines a little noticed but important cause of institutionalized private tutoring in Korea.

Design/Approach/Methods

The study employed a socio-ecological perspective to analyze both education and socio-structural factors. An extensive review of the government's private tutoring reduction policies and related literature was conducted.

Findings

Private tutoring functions as a means by which parents can help their children compete for admission to prestigious universities and pass on wealth and social status to their children. Participation in private tutoring has become a social norm that is taken for granted. The root causes of institutionalized private tutoring lie in both educational and socio-structural factors.

Originality/Value

The study suggests that government policies, when ignoring the long-established “grammar” of parents about children's education, may either end in failure or produce unintended consequences.
When Those With Privacy Concerns Show Stronger In-Group Favoritism: Using Personal Information From In-Group and Out-Group Members to Identify Terrorist Threats
Authors: Reimer Torsten , Johnson Nathanael
Published: July 2023

Terrorist threats and attacks provide major risks and sources of public crises in the 21st century. New probabilistic computing technologies possess the capability of increasing the success of identifying terrorist threats and solving cybersecurity and encryption problems more efficiently. However, to identify terrorist threats, these technologies would require the use of a large amount of personal data, which cause potential concerns for privacy. We offer a social-identity explanation of public support for the detection of terrorist threats through the use of online personal data. A survey study ( N = 1,204) revealed strong support for the provided social-identity explanation of public perceptions. As expected, respondents displayed in-group favoritism by more strongly supporting the use of private personal information from out-group members (non-U.S. citizens) than from in-group members (U.S. citizens). The observed in-group favoritism was most pronounced when respondents had both a strong national identity and a strong sense of general privacy concern. The observed differences were independent of respondents’ political orientation and age.
The Impact of Social Media on Preventive Behavior During the COVID-19 Outbreak in South Korea: The Roles of Social Norms and Self-Efficacy
Authors: Choi Doo-Hun , Noh Ghee-Young
Published: July 2023

Social media are important channels to propagate health information and influence preventive behavior during a public health crisis, as witnessed during the coronavirus pandemic (COVID-19). This study explored the association between social media use and preventive behavior during the outbreak of COVID-19 in South Korea. Using the national survey data ( N = 1,500), the study examined the mediating role of social norms in the association between social media use for news and information about COVID-19 and preventive behavior. In addition, the study tested the moderating effect of self-efficacy on the mediating path of social media use for preventive behavior via social norms. Conducting a moderated mediation analysis method, this study found that social norms mediated the relationship between social media use and preventive behavior ( b = 0.046). Moreover, the study revealed that the indirect relationship between social media use and preventive behavior through social norms becomes stronger as an individual’s level of self-efficacy decreases (low: b = 0.044, middle: b = 0.036, and high: b = 0.030). The study provides empirical evidence of the beneficial impact of social media use on preventive behavior. The findings of the study recommend promoting messages on social norms through social media for facilitating preventive behavior.
Senior High School Teachers’ Preference for Professional Development: A Case Study in the Central Region of Ghana Under the Current Free Senior High School Policy
Authors: Ma Zhiqiang , Oteng Agyeman Fredrick , Kwasi Sampene Agyemang , Li Mingxing , Botchway Stephen
Published: July 2023

The critical role of the educational sector in improving and reforming society and the world has aroused the interest of governments and agencies to exert substantial financial resources to reduce the financial burden of parents in educating children and attaining a holistic approach to national development. This paper evaluates the impact of variables such as professional needs, form of training, duration period, perceived impact, and feedback effect on teacher professional development (PD) in Ghana. To facilitate the study objective, we used a survey design approach to collect data from 400 teachers in the Central region of Ghana. This paper adopted PLS-SEM for analysis. The study concludes that: (1) The duration period of PD training significantly affects teacher feedback effect and professional needs. (2) Feedback effect from teachers has a significant effect on PD. (3) The form of training that teachers receive has a direct effect on PD. (4) Perceived impact influences feedback effect and PD. (5) Teachers’ professional needs impact their feedback effect. To achieve the target goals, stakeholders, teachers, and PD planners for SHS, must ask more specifically from teachers about what knowledge or content they would like to learn and their prioritized mode of training and duration period needed.
Impacts of COVID-19 Pandemic on the Price Volatility of Listed Commercial Bank Stocks in Vietnam
Authors: Lan Le Phuong , Phuong Dong Khanh
Published: July 2023

This article aims to estimate the relationship between COVID-19 and the price volatility of listed commercial bank stocks in Vietnam during the two most severely affected years of the pandemic (2020–2021), and measuring the impacts of macroeconomic factors on those stocks’ returns and their price volatility (measured by standard deviation of returns) with previous studies’ results before the pandemic. Using the data from 16 listed commercial banks’ stock returns on Ho Chi Minh Stock Exchange (HOSE) and Hanoi Stock Exchange (HNX) during the study period, we used OLS to find the effect, with important findings: (1) COVID-19 daily reported cases had a weak negative effect on Vietnam listed banks’ stock returns and hardly any relation with stock returns’ standard deviation. (2) GDP influenced commercial bank stock returns positively, while CPI, number of COVID-19 cases, and businesses closed had a negative effect. Also, listed commercial bank stock returns were insignificantly impacted by the interest rate. (3) Macroeconomic factors’ impact on the standard deviation of returns were weak, during the pandemic. GDPs and CPIs effect turned out to be insignificant while interest rate had a negative effect on the volatility rate, and was only significant in two out of the three models, implying potential negative impacts of COVID-19 on the macroeconomy.

JELClassification: G21, F62, F65, G18, G28
Clinical utility of lipid ratios as potential predictors of metabolic syndrome among the elderly population: Birjand Longitudinal Aging Study (BLAS)
Authors: Saeedi Farhad , Baqeri Elnaz , Bidokhti Ali , Moodi Mitra , Sharifi Farshad , Riahi Seyed Mohammad
Published: July 2023

Background

Elderly adults are at higher risk of developing metabolic syndrome (MetS). The present study aims to investigate the relationship between lipid ratios and MetS in the elderly population.

Methods

This study was conducted on elderly population of Birjand during 2018–2019. The data of this study was driven from Birjand Longitudinal Aging Study (BLAS). The participants were selected based on multistage stratified cluster sampling. Patients were categorized into quartiles according to the lipid ratios (TG/HDL-C, LDL-C/HDL-C, non-HDL/HDL-C), and the relationship between lipid ratio quartiles and MetS was determined by Logistic Regression using Odds Ratio. Finally, the optimal cut-off for each lipid ratio in MetS diagnosis was calculated according to the Area Under the Curve (AUC).

Results

This study included 1356 individuals, of whom 655 were men and 701 were women. In our study, the crude prevalence of MetS was 792 (58%), including 543 (77.5%) women and 249 (38%) men. Increasing trends were observed in quartiles of all lipid ratios for TC, LDL-C, TG, and DBP. TG/HDL was also the best lipid ratio to diagnose the MetS, based on NCEP ATP III criteria. One unit increased in level of TG/HDL resulted in 3.94 (OR: 3.94; 95%CI: 2.48–6.6) and 11.56 (OR: 11.56; 95%CI: 6.93–19.29) increasing risk of having MetS in quartile 3 and 4 compared to quartile 1, respectively. In men and women, the cutoff for TG/HDL was 3.5 and 3.0, respectively.

Conclusions

Our results showed that the TG/HDL-C is superior to the LDL-C/HDL-C and the non-HDL /HDL-C to predict MetS among the elderly adults.
Hepatitis C Virus in people with experience of injection drug use following their displacement to Southern Ukraine before 2020
Authors: Yakovleva Anna , Kovalenko Ganna , Redlinger Matthew , Smyrnov Pavlo , Tymets Olga , Korobchuk Anna , Kotlyk Lyudmyla , Kolodiazieva Anna , Podolina Anna , Cherniavska Svitlana , Antonenko Petro , Strathdee Steffanie A. , Friedman Samuel R. , Goodfellow Ian , Wertheim Joel O. , Bortz Eric , Meredith Luke , Vasylyeva Tetyana I.
Published: July 2023

Background

Due to practical challenges associated with genetic sequencing in low-resource environments, the burden of hepatitis C virus (HCV) in forcibly displaced people is understudied. We examined the use of field applicable HCV sequencing methods and phylogenetic analysis to determine HCV transmission dynamics in internally displaced people who inject drugs (IDPWID) in Ukraine.

Methods

In this cross-sectional study, we used modified respondent-driven sampling to recruit IDPWID who were displaced to Odesa, Ukraine, before 2020. We generated partial and near full length genome (NFLG) HCV sequences using Oxford Nanopore Technology (ONT) MinION in a simulated field environment. Maximum likelihood and Bayesian methods were used to establish phylodynamic relationships.

Results

Between June and September 2020, we collected epidemiological data and whole blood samples from 164 IDPWID (PNAS Nexus.2023;2(3):pgad008). Rapid testing (Wondfo® One Step HCV; Wondfo® One Step HIV1/2) identified an anti-HCV seroprevalence of 67.7%, and 31.1% of participants tested positive for both anti-HCV and HIV. We generated 57 partial or NFLG HCV sequences and identified eight transmission clusters, of which at least two originated within a year and a half post-displacement.

Conclusions

Locally generated genomic data and phylogenetic analysis in rapidly changing low-resource environments, such as those faced by forcibly displaced people, can help inform effective public health strategies. For example, evidence of HCV transmission clusters originating soon after displacement highlights the importance of implementing urgent preventive interventions in ongoing situations of forced displacement.
Systematic discovery of gene fusions in pediatric cancer by integrating RNA-seq and WGS
Authors: van Belzen Ianthe A. E. M. , Cai Casey , van Tuil Marc , Badloe Shashi , Strengman Eric , Janse Alex , Verwiel Eugène T. P. , van der Leest Douwe F. M. , Kester Lennart , Molenaar Jan J. , Meijerink Jules , Drost Jarno , Peng Weng Chuan , Kerstens Hindrik H. D. , Tops Bastiaan B. J. , Holstege Frank C. P. , Kemmeren Patrick , Hehir-Kwa Jayne Y.
Published: July 2023

Background

Gene fusions are important cancer drivers in pediatric cancer and their accurate detection is essential for diagnosis and treatment. Clinical decision-making requires high confidence and precision of detection. Recent developments show RNA sequencing (RNA-seq) is promising for genome-wide detection of fusion products but hindered by many false positives that require extensive manual curation and impede discovery of pathogenic fusions.

Methods

We developed Fusion-sq to overcome existing disadvantages of detecting gene fusions. Fusion-sq integrates and “fuses” evidence from RNA-seq and whole genome sequencing (WGS) using intron–exon gene structure to identify tumor-specific protein coding gene fusions. Fusion-sq was then applied to the data generated from a pediatric pan-cancer cohort of 128 patients by WGS and RNA sequencing.

Results

In a pediatric pan-cancer cohort of 128 patients, we identified 155 high confidence tumor-specific gene fusions and their underlying structural variants (SVs). This includes all clinically relevant fusions known to be present in this cohort (30 patients). Fusion-sq distinguishes healthy-occurring from tumor-specific fusions and resolves fusions in amplified regions and copy number unstable genomes. A high gene fusion burden is associated with copy number instability. We identified 27 potentially pathogenic fusions involving oncogenes or tumor-suppressor genes characterized by underlying SVs, in some cases leading to expression changes indicative of activating or disruptive effects.

Conclusions

Our results indicate how clinically relevant and potentially pathogenic gene fusions can be identified and their functional effects investigated by combining WGS and RNA-seq. Integrating RNA fusion predictions with underlying SVs advances fusion detection beyond extensive manual filtering. Taken together, we developed a method for identifying candidate gene fusions that is suitable for precision oncology applications. Our method provides multi-omics evidence for assessing the pathogenicity of tumor-specific gene fusions for future clinical decision making.