bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of barriers of mHealth adoption in the context of sustainable operational practices in health care supply chains
Authors: Swain Suchismita , Muduli Kamalakanta , Kumar Anil , Luthra Sunil
Published: May 2023

Purpose

The goal of this research is to analyse the obstacles to the implementation of mobile health (mHealth) in India and to gain an understanding of the contextual inter-relationships that exist amongst those obstacles.

Design/methodology/approach

Potential barriers and their interrelationships in their respective contexts have been uncovered. Using MICMAC analysis, the categorization of these barriers was done based on their degree of reliance and driving power (DP). Furthermore, an interpretive structural modeling (ISM) framework for the barriers to mHealth activities in India has been proposed.

Findings

The study explores a total of 15 factors that reduce the efficiency of mHealth adoption in India. The findings of the Matrix Cross-Reference Multiplication Applied to a Classification (MICMAC) investigation show that the economic situation of the government, concerns regarding the safety of intellectual technologies and privacy issues are the primary obstacles because of the significant driving power they have in mHealth applications.

Practical implications

Promoters of mHealth practices may be able to make better plans if they understand the social barriers and how they affect each other; this leads to easier adoption of these practices. The findings of this study might be helpful for governments of developing nations to produce standards relating to the deployment of mHealth; this will increase the efficiency with which it is adopted.

Originality/value

At this time, there is no comprehensive analysis of the factors that influence the adoption of mobile health care with social cognitive theory in developing nations like India. In addition, there is a lack of research in investigating how each of these elements affects the success of mHealth activities and how the others interact with them. Because developed nations learnt the value of mHealth practices during the recent pandemic, this study, by investigating the obstacles to the adoption of mHealth and their inter-relationships, makes an important addition to both theory and practice.
Managing government commissioning and philanthropic expectations: earnings management in Australian nonprofit disability service providers
Authors: Gilchrist David John , Etheridge Dane , Liu Zhangxin (Frank)
Published: May 2023

Purpose

The purpose of this study is to investigate the prevalence of earnings management in the Australian not-for-profit (NFP) disability service providers sector, as well as to understand the motivations for and implications of such practices. This research is important for stakeholders, such as members and funders, as well as the broader Australian community, considering the significant financial resources allocated to these organizations from the public purse.

Design/methodology/approach

The authors employ a longitudinal dataset containing financial data from 154 Australian NFP disability service providers, collected over a two-year period (2015–2016). Through the analysis of detailed balance sheets and income statements, the authors seek to uncover evidence of earnings management practices in this sector. The study’s results provide valuable insights into the behaviour of the charitable human services sector.

Findings

The findings reveal that Australian NFP disability service providers engage in earnings management practices, primarily aimed at reducing reported profits to meet the normative financial expectations of stakeholders, such as public sector funders and philanthropists. The executives of these organizations strive to report profits close to zero, being cautious not to report a loss, which might raise concerns about their sustainability.

Originality/value

The authors contribute to the existing literature on earnings management in the NFP sector by focussing on Australian disability service providers, an area that has been under-researched due to a lack of suitable data. The results offer insights into the incentives and implications of earnings management practices in this sector and highlight the need for a revaluation of accounting standards, reporting requirements and audit arrangements applicable to the NFP sector.
Alpha-Stim AID cranial electrotherapy stimulation (CES) anxiety treatment: anxiety, depression and health-related quality-of-life outcomes in primary health-care social prescribing services
Authors: Griffiths Chris , da Silva Ksenija , Jiang Harmony , Walker Kate , Smart David , Zafar Azhar , Deeks Sarah , Galvin Sinead , Shah Taz
Published: May 2023

Purpose

This study aims to evaluate the effect of Alpha-Stim Anxiety, Insomnia and Depression (AID) cranial electrotherapy stimulation (CES) on anxiety, depression and health-related quality of life for primary care social prescribing service patients with anxiety symptoms.

Design/methodology/approach

Open-label patient cohort design with no control group. A total of 33 adult patients (average age 42 years) completed six weeks of Alpha-Stim AID use. Pre- and post-intervention assessment with participant self-report measures: Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder (GAD-7) and European Quality of Life Five Dimension (EQ-5D-5L).

Findings

Reliable improvement and remission rates, respectively, were 53.39% and 33.3% for GAD-7; 46.7% and 29.5% for PHQ-9. There was a significant improvement in GAD-7 and PHQ-9 with large effect sizes. EQ-5D-5L results showed significant improvements in health-related quality of life. Perceived quality of life increased by 0.17 on the health index score, with the intervention adding 1.68 quality-adjusted life years (QALYs).

Practical implications

Alpha-Stim AID can be delivered through a primary health-care social prescribing service and most patients will use as prescribed and complete treatment course. Alpha-Stim AID CES may be an effective anxiety and depression treatment for people with anxiety symptoms. The widespread roll-out of Alpha-Stim AID in health-care systems should be considered.

Originality/value

To the best of the authors’ knowledge, this is the first study to respond to the UK’s National Institute for Health and Care (NICE) request for the collection of real-world data to understand better Alpha-Stim AID in relation to people’s treatment uptake, response rates and treatment completion rates (NICE, 2021).
Economic ideas and policy outcomes: applications to climate and energy
Authors: Garnaut Ross
Published: May 2023

This paper presents a revised version of the FH Gruen lecture by Professor Ross Garnaut at the Australian National University on 29 June 2022.
Cumulative exposure to immunomodulators increases risk of cervical neoplasia in women with inflammatory bowel disease
Authors: Kreijne J. E. , Goetgebuer R. L. , Erler N. S. , De Boer N. K. , Siebers A. G. , Dijkstra G. , van Kemenade F. A. , Hoentjen F. , Oldenburg B. , van der Meulen A. E. , Ponsioen C. I. J. , Pierik M. J. , van der Woude C. J. , de Vries A. C. ,   the Dutch Initiative on Crohn and Colitis (ICC)
Published: May 2023

Background

Women with inflammatory bowel disease (IBD) are at increased risk of high‐grade cervical intraepithelial neoplasia and cervical cancer (CIN2+).

Aim

To assess the association between cumulative exposure to immunomodulators (IM) and biologic agents (BIO) for IBD and CIN2+

Methods

Adult women diagnosed with IBD before December 31st 2016 in the Dutch IBD biobank with available cervical records in the nationwide cytopathology database were identified. CIN2+ incidence rates in IM‐ (i.e., thiopurines, methotrexate, tacrolimus and cyclosporine) and BIO‐ (anti‐tumour necrosis factor, vedolizumab and ustekinumab) exposed patients were compared to unexposed patients and risk factors were assessed. Cumulative exposure to immunosuppressive drugs was evaluated in extended time‐dependent Cox‐regression models.

Results

The study cohort comprised 1981 women with IBD: 99 (5%) developed CIN2+ during median follow‐up of 17.2 years [IQR 14.6]. In total, 1305 (66%) women were exposed to immunosuppressive drugs (IM 58%, BIO 40%, IM and BIO 33%). CIN2+ risk increased per year of exposure to IM (HR 1.16, 95% CI 1.08–1.25). No association was observed between cumulative exposure to BIO or both BIO and IM and CIN2+. In multivariate analysis, smoking (HR 2.73, 95%CI 1.77–4.37) and 5‐yearly screening frequency (HR 1.74, 95% CI 1.33–2.27) were also risk factors for CIN2+ detection.

Conclusion

Cumulative exposure to IM is associated with increased risk of CIN2+ in women with IBD. In addition to active counselling of women with IBD to participate in cervical screening programs, further assessment of the benefit of intensified screening of women with IBD on long‐term IM exposure is warranted.
Accelerated death of megakaryocytes from Wiskott–Aldrich syndrome patients
Authors: Obydennyi Sergei I. , Kuznetsova Sofya A. , Fedyanina Olga S. , Khoreva Anna , Voronin Kirill , Mazurov Alexey V. , Glukhova Anna A. , Artemenko Elena O. , Ataullakhanov Fazoil I. , Maschan Alexey A. , Novichkova Galina A. , Shcherbina Anna , Panteleev Mikhail A.
Published: May 2023

Wiskott–Aldrich syndrome (WAS) is an X‐linked recessive disorder caused by WAS gene mutations resulting in haematopoietic/immune cell defects. Recent studies report accelerated death of WAS platelets and lymphocytes. Data on megakaryocyte (MK) maturation, viability and their possible role in thrombocytopenia development in WAS are limited. In this study we evaluate the MK viability and morphology in untreated, romiplostim‐treated WAS patients compared with normal controls. The study included 32 WAS patients and 17 healthy donors. MKs were captured from bone marrow aspirates by surface‐immobilized anti‐GPIIb‐IIIa antibody. Viability (by phosphatidylserine [PS] externalization), distribution by maturation stages and size of MK were determined by light microscopy. MK distribution by maturation stages in patients differed from controls. 40 ± 22% of WAS MKs versus 23 ± 11% of normal MKs were at maturation stage 3 (p = 0.02), whereas 24 ± 20% in WAS and 39 ± 14% in controls had megakaryoblast morphology (p = 0.05). Romiplostim treatment changed the MK maturation stages distribution close to normal. PS‐positive (PS+) MK in WAS was significantly higher (21 ± 21%) than in healthy controls (2 ± 4%, p < 0.01). WAS patients with more damaging truncating mutations and higher disease score had higher PS+ MK fraction (Spearman r = 0.6, p < 0.003). We conclude that WAS MKs have increased cell death tendency and changes in maturation pattern. Both could contribute to thrombocytopenia in WAS patients.
Diffusion tensor imaging‐based machine learning for IDH wild‐type glioblastoma stratification to reveal the biological underpinning of radiomic features
Authors: Wang Zilong , Guan Fangzhan , Duan Wenchao , Guo Yu , Pei Dongling , Qiu Yuning , Wang Minkai , Xing Aoqi , Liu Zhongyi , Yu Bin , Zheng Hongwei , Liu Xianzhi , Yan Dongming , Ji Yuchen , Cheng Jingliang , Yan Jing , Zhang Zhenyu
Published: May 2023

Introduction

This study addresses the lack of systematic investigation into the prognostic value of hand‐crafted radiomic features derived from diffusion tensor imaging (DTI) in isocitrate dehydrogenase (IDH) wild‐type glioblastoma (GBM), as well as the limited understanding of the biological interpretation of individual DTI radiomic features and metrics.

Aims

To develop and validate a DTI‐based radiomic model for predicting prognosis in patients with IDH wild‐type GBM and reveal the biological underpinning of individual DTI radiomic features and metrics.

Results

The DTI‐based radiomic signature was an independent prognostic factor (p < 0.001). Incorporating the radiomic signature into a clinical model resulted in a radiomic‐clinical nomogram that predicted survival better than either the radiomic model or clinical model alone, with a better calibration and classification accuracy. Four categories of pathways (synapse, proliferation, DNA damage response, and complex cellular functions) were significantly correlated with the DTI‐based radiomic features and DTI metrics.

Conclusion

The prognostic radiomic features derived from DTI are driven by distinct pathways involved in synapse, proliferation, DNA damage response, and complex cellular functions of GBM.
Drainage pattern of the splenic flexure vein and its accompanying arteries using three‐dimensional computed tomography angiography: a single‐centre study of 600 patients
Authors: Sakamoto Kyoko , Okabayashi Koji , Matsumoto Shunsuke , Matsui Shimpei , Seishima Ryo , Shigeta Kohei , Kitagawa Yuko
Published: May 2023

Aim

The splenic flexure has variable vascular anatomy, and the details of the venous forms are not known. In this study, we report the flow pattern of the splenic flexure vein (SFV) and the positional relationship between the SFV and arteries such as the accessory middle colic artery (AMCA).

Methods

This was a single‐centre study using preoperative enhanced CT colonography images of 600 colorectal surgery patients. CT images were reconstructed into 3D angiography. SFV was defined as a vein flowing centrally from the marginal vein of the splenic flexure visible on CT. AMCA was defined as the artery feeding the left side of the transverse colon, separate from the left branch of the middle colic artery.

Results

The SFV returned to the inferior mesenteric vein (IMV) in 494 cases (82.3%), the superior mesenteric vein in 51 cases (8.5%) and the splenic vein in seven cases (1.2%). The AMCA was present in 244 cases (40.7%). The AMCA branched from the superior mesenteric artery or its branches in 227 cases (93.0% of cases with existing AMCA). In the 552 cases in which the SFV returned to the IMV, superior mesenteric vein or splenic vein, the left colic artery was the most frequent artery accompanying the SFV (42.2%), followed by the AMCA (38.1%) and the left branch of the middle colic artery (14.3%).

Conclusions

The most common flow pattern of the vein in the splenic flexure is from the SFV to IMV. The SFV is frequently accompanied by the left colic artery or AMCA.
The Gospel according to civic engagement
Authors: Peñaranda Nicolette Marie
Published: May 2023

The author of this passage suggests that hospitality is at the heart of both Christianity and politics. They draw on the writing of Martin Luther, who argues that Christians do not live in themselves but in Christ and their neighbor. This paper invites us to consider that Christian relationships should not be individualistic, as this removes them from the community and movement that Jesus established. Rather, Christians must act collectively to combat societal issues and oppression. By choosing to get involved civically, whether through elections, community organizing, or advocacy, individuals can choose to side with either self‐interest or radical hospitality. The author suggests that choosing radical hospitality is the way to live in Christ and our neighbor, and to truly demonstrate authentic love for those around us. The author is reflecting on their decision to engage in local politics after witnessing civil unrest and racial injustices in their community. They highlight the importance of public witness as a prophetic act, grounded in faith and a desire for justice. The author draws on the teachings of Martin Luther and the tradition of the Black church as inspiration for their political engagement, which they see as a way to serve their neighbors and demonstrate their love and teachings. They also acknowledge the challenges and complexities of political leadership, especially in the face of corruption and unethical practices. Overall, the author's message is one of hope and a commitment to working towards a more equitable and hospitable community for all.
Association between COVID‐19 vaccination and 28‐day all‐cause mortality in SARS‐CoV‐2–infected older people living in residential aged care facilities
Authors: Yap Sok Shin , Low Zi Yi , Kovaleva Natalia , Tacey Mark , Hurley Kate , Harvey Penelope , Brown Sandra
Published: May 2023

This retrospective cross‐sectional study reviewed the association between COVID‐19 vaccination and the 28‐day all‐cause mortality amongst SARS‐CoV‐2–infected older people living in residential aged care facilities. A lower mortality rate was observed in fully vaccinated residents compared with not fully vaccinated residents. Further research is required to investigate the optimal timing of vaccination boosters and vaccine efficacy as variants evolve.
Morphology and dynamic behavior of anal pores during defecation in the ctenophore Pleurobrachia pileus
Authors: Tamm Sidney L.
Published: May 2023

Defecation in the lobate ctenophore Mnemiopsis leidyi was recently shown to occur periodically with an ultradian rhythm through a single transient anal pore which suddenly appeared, expelled waste, and disappeared afterward. To discover whether this novel method of defecation occurs in other kinds of ctenophores, I examined individuals of Pleurobrachia pileus and Beroe cucumis. Both ctenophores were found to have two identical and permanent anal pores as described in the scientific literature and textbooks. In P. pileus, both anal pores commonly participated in a defecation, but they did so asynchronously with independent and irregular opening and closing kinetics. Individuals of P. pileus defecated with an ultradian rhythm. Closed anal pores in P. pileus and B. cucumis consisted of a continuous ectodermal epithelium overlying a continuous endodermal epithelium with a cup‐shaped group of thickened endodermal cells bearing a tuft of cilia which beats into the anal cavity. The rims of opening or closing pores were smooth and uniform without encircling muscles or fibers. This morphology and the continuity of the epithelial layers between defecations suggest that anal pores may not operate by a contractile sphincter, but by a reversible ring of tissue fusion between apposed ectodermal and endodermal epithelia to create an adjustable hole to expel waste.
"The Council," Artist Adelita Husni‐Bey and Young Adults Envision the Future Museum
Authors: Lee Eunji J.
Published: May 2023

Artmaking, when used as a form of pedagogy and approached in a socially‐conscious manner, has the potential to promote agency and create a democratic learning environment for students. This study examines one such project, "The Council," created by artist Adelita Husni‐Bey in collaboration with former Teen Program attendees of the Museum of Modern Art. The Council is a collection of large‐scale photographs created from a series of workshops in which 13 young adults imagined themselves reshaping the museum's societal role after a major global crisis. The final photographs were exhibited in the museum's main galleries, representing a participatory, socially‐engaged artwork produced from a pedagogical process. While there is a prevalence of these types of pedagogy‐based artworks, contemporary art literature tends to focus mainly on the artist, disregarding the participants. Therefore, from the stance of an art educator, I examined the learning experiences of the participants as well as the pedagogical framework of the artist. The reviews from the participants were overwhelmingly positive, with many noting a significant increase in their confidence and a greater sense of agency. A liberating experience of collaboration was also stated as a common experience. These outcomes were attributed to the artist's innovative use of multimodal learning and effective facilitation grounded in Francesc Ferrer's philosophy of anarcho‐collectivism and integral education, as well as critical pedagogy. This study suggests that creative methodologies can significantly enhance intrinsically motivated learning and emphasises the importance of nurturing the next generation as they envision a more equitable and just society.
Cover Image
Authors: Zehner Fabian , Hahnel Carolin
Published: May 2023

The cover image is based on the Editorial Artificial Intelligence on the Advance to Enhance Educational Assessment: Scientific Clickbait or Genuine Gamechanger? by Fabian Zehner and Carolin Hahnel, https://doi.org/10.1111/jcal.12810.

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Diagnostic testing in children: A qualitative study of pediatricians' considerations
Authors: Ropers Fabienne G. , Rietveld Sophie , Rings Edmond H. H. M. , Bossuyt Patrick M. M. , van Bodegom‐ Vos Leti , Hillen Marij A.
Published: May 2023

Aims and Objectives

Studies in adult medicine have shown that physicians base testing decisions on the patient's clinical condition but also consider other factors, including local practice or patient expectations. In pediatrics, physicians and parents jointly decide on behalf of a (young) child. This might demand more explicit and more complex deliberations, with sometimes conflicting interests. We explored pediatricians' considerations in diagnostic test ordering and the factors that influence their deliberation.

Method

We performed in‐depth, semistructured interviews with a purposively selected heterogeneous sample of 20 Dutch pediatricians. We analyzed transcribed interviews inductively using a constant comparative approach, and clustered data across interviews to derive common themes.

Results

Pediatricians perceived test‐related burden in children higher compared with adults, and reported that avoiding an unjustified burden causes them to be more restrictive and deliberate in test ordering. They felt conflicted when parents desired testing or when guidelines recommended diagnostic tests pediatricians perceived as unnecessary. When parents demanded testing, they would explore parental concern, educate parents about harms and alternative explanations of symptoms, and advocate watchful waiting. Yet they reported sometimes performing tests to appease parents or to comply with guidelines, because of feared personal consequences in the case of adverse outcomes.

Conclusion

We obtained an overview of the considerations that are weighed in pediatric test decisions. The comparatively strong focus on prevention of harm motivates pediatricians to critically appraise the added value of testing and drivers of low‐value testing. Pediatricians' relatively restrictive approach to testing could provide an example for other disciplines. Improved guidelines and physician and patient education could help to withstand the perceived pressure to test.
Fatty acid composition and energy allocation in muscle and gonad tissues indicate that the female mackerel icefish Champsocephalus gunnari is an income breeder
Authors: Huang Kai , Zhu Guoping
Published: May 2023

The energy density and fatty acid composition profiles of the muscle and gonad tissues of female mackerel icefish Champsocephalus gunnari from the South Orkney Islands in Antarctica were investigated throughout ovarian development to better understand the reproductive allocation strategy and the role of specific fatty acids in the reproductive process. Energy density in gonads increased from resting to spawning stages as the ovaries developed (19.60–25.10 kJ g−1 dry mass [DM]). In contrast, energy density in muscles remained constant throughout ovarian development (20.13–22.87 kJ g−1 DM), suggesting that the spawning events of the C. gunnari rely on energy income from feeding rather than on the energy stored in body. In addition, the variation in fatty acid composition between muscle and gonad tissues may reflect the role of main FAs as energy source. These results suggest that C. gunnari may utilize an income breeding strategy.
Rheological modeling of marjoram fortified rice dough: Empirical and machine learning approach
Authors: Vishwakarma Siddharth , Mandliya Shubham , Dalbhagat Chandrakant Genu , Singh Pallavi Kumari , Mishra Hari Niwas
Published: May 2023

The rheological properties (viscosity) of marjoram fortified rice dough (MFRD) inside extruder are helpful for product development, process control, and product quality. This study aims to predict viscosity of MFRD through regression analysis of existing empirical models and machine learning (ML) techniques. At first, MFRD was subjected to steady shear analysis (SSA) at various temperatures (60–100°C) and shear rates (1–50 s−1). The SSA data was split into training and validation sets in 70:30 ratio. Rheological modeling was conducted using various empirical models. Hyperparameter tuning was performed using existing MATLAB functions to develop ML models. The SSA revealed that MFRD exhibited pseudoplastic behavior, with viscosity decreasing with increasing temperature up to 70°C and then increasing again, most probably due to starch gelatinization. The regression analysis indicated satisfactory results for Power Law, Carreau, Cross, Sisko, Carreau‐Yasuda model (R2: 0.9849–0.9992) was deemed the best based on Akaike information criterion. A dual variable model (DVM) was then developed using this model, and its coefficient was calculated more efficiently through prepareSurfaceData (R2: 0.8865) MATLAB function than lsqcurvefit (R2: 0.8280) function. In ML model development, Levenberg–Marquardt was the most effective for artificial neural networks (ANNs), grid search for support vector, and Bayesian optimization for decision tree, ensemble, and gaussian process regression (GPR). Only ANN and GPR models had R2(testing) of 1 during training, but GPR model (Nash‐Sutcliffe efficiency: 0.9995) outperformed others during validation. Therefore, GPR model can be used to accurately predict MFRD viscosity and DVM for simulation study.

Practical applications

Shear profile and temperature within the extruder change frequently, affecting the viscosity of MFRD and the extrudate quality. The present study develops a dual variable viscosity prediction model using regression, which can be utilized in simulating extrusion process of MFRD. Using ML approach, the GPR model was found to be better than other models in accurately predicting MFRD viscosity at a range of shear and temperature conditions between 60–100°C and 3–50 s−1, respectively.
Influence of wearing complete dentures on control of head position during walking in edentulous older adults
Authors: Shimizu Kento , Suzuki Hiroyuki , Isoyama Naoya , Yanagihara Yuiko , Minakuchi Shunsuke
Published: May 2023

Background

Coordination between the trunk and head is considered important for walking stability. Recent studies have reported that wearing complete dentures could improve trunk stability during walking; however, its effect on the head has not been clarified.

Objective

This study aimed to clarify the effect of complete dentures on head stability during walking in edentulous older adults.

Methods

Twenty edentulous older adults (11 men and 9 women; mean age, 78.6 ± 5.8 years) who used complete dentures were included in the study. Acceleration and angle rate sensors were placed on the participants' brow, chin and waist, and they were asked to walk a 20‐m passage under two conditions: with and without dentures. The outcomes used to assess head stability were the variance values of acceleration and angle rate, the peak‐to‐peak values, harmonic ratio, root mean square, integrated values of the difference and dynamic time warping data obtained from the sensors. The variance values of the brow acceleration were compared using a paired t‐test, and other outcomes were compared using a Wilcoxon signed‐rank test. All significance levels were set at 5%.

Results

In acceleration without dentures, the variance values of the chin and the peak‐to‐peak values of the brow and chin were significantly larger than with dentures. Angle rate without dentures, the variance values and the peak‐to‐peak values of the brow and chin were also significantly larger than with dentures.

Conclusion

Wearing complete dentures while walking might improve head stability and contribute to walking stability in edentulous older adults.
Lysosomal acid lipase deficiency manifestations in children and adults: Baseline data from an international registry
Authors: Balwani Manisha , Balistreri William , D'Antiga Lorenzo , Evans Jennifer , Ros Emilio , Abel Florian , Wilson Don P.
Published: May 2023

Background and Aims

Lysosomal acid lipase deficiency (LAL‐D) is a rare, autosomal recessive disease involving lysosomal accumulation of cholesteryl esters and triglycerides. The International Lysosomal Acid Lipase Deficiency Registry (NCT01633489), established in 2013 to understand LAL‐D natural history and long‐term outcomes, is accessible to centres caring for patients diagnosed by deficient LAL activity and/or biallelic pathogenic LIPA variants. We describe the registry population enrolled through 2 May 2022.

Methods

In this prospective observational study, we analysed demographic and baseline clinical characteristics of children (ages ≥6 months to <18 years) and adults diagnosed with LAL‐D.

Results

Of 228 patients with confirmed disease, 61% were children; 202/220 (92%) with data on race were white. Median age was 5.5 years at sign/symptom onset and 10.5 years at diagnosis; median time from sign/symptom onset to diagnostic testing was 3.3 years. The most common manifestations raising suspicion of disease were elevated alanine (70%) and aspartate aminotransferase levels (67%) and hepatomegaly (63%). Among 157 with reported LIPA mutations, 70 were homozygous and 45 were compound heterozygous for the common exon 8 splice junction pathogenic variant (E8SJM‐1). Seventy percent (159/228) of patients had dyslipidaemia. Among 118 with liver biopsies, 63% had microvesicular steatosis exclusively, 23% had mixed micro‐ and macrovesicular steatosis and 47% had lobular inflammation. Of 78 patients with fibrosis‐stage data, 37% had bridging fibrosis and 14% had cirrhosis.

Conclusions

Although LAL‐D signs/symptoms occur early, diagnosis is often delayed. Abnormal transaminase levels associated with hepatomegaly and dyslipidaemia should raise suspicion and prompt earlier diagnosis of LAL‐D.

Trial registration number

NCT01633489.
Predictors and management of post‐banding ulcer bleeding in cirrhosis: A systematic review and meta‐analysis
Authors: de Brito Nunes Maria , Knecht Matthias , Wiest Reiner , Bosch Jaume , Berzigotti Annalisa
Published: May 2023

Background and Aims

Post‐banding ulcer bleeding (PBUB) is an understudied complication of oesophageal varices endoscopic band ligation (EBL). This systematic review with meta‐analysis aimed at: (a) evaluating the incidence of PBUB in patients with cirrhosis treated with EBL in primary or secondary prophylaxis or urgent treatment for acute variceal bleeding and (b) identifying predictors of PBUB.

Methods

We conducted a systematic review of articles in English published in 2006–2022 using the Preferred Reporting Items for Systematic Reviews and Meta‐analyses guidelines. Searches were made in eight databases including Embase, PubMed and Cochrane Library. Random‐effects meta‐analysis was used to determine the incidence, mean interval and predictors of PBUB.

Results

Eighteen studies (9034 patients) were included. The incidence of PBUB was 5.5% (95% CI 4.3–7.1). The mean time for it to occur was 11 days (95% CI 9.94–11.97). Model for End‐stage Liver Disease (MELD) score (OR 1.162, 95% CI 1.047–1.291) and EBL done in emergency setting (OR 4.902, 95% CI 2.99–8.05) independently predicted post‐ligation ulcer bleeding. Treatment included drugs, endoscopic procedures and transjugular intrahepatic portosystemic shunt. Refractory bleeding was treated with self‐expandable metallic stents or balloon tamponade. Mortality was on average 22.3% (95% CI 14.1–33.6).

Conclusions

Patients with high MELD score and receiving EBL in an emergency setting are more prone to develop PBUB. Prognosis is still poor and the best therapeutic strategy to address remains to be ascertained.
Photosynthetic capacity in seagrass seeds and early‐stage seedlings of Zostera marina
Authors: Brodersen Kasper Elgetti , Kühl Michael
Published: May 2023

In many terrestrial seeds, photosynthetic activity supplies O2 to the developing plant embryo to sustain aerobic metabolism and enhance biosynthetic activity. However, whether seagrass seeds possess similar photosynthetic capacity to alleviate intra‐seed hypoxic stress conditions is unknown.

We used a novel combination of microscale variable chlorophyll fluorescence imaging, a custom‐made O2 optode microrespirometry system and planar optode O2 imaging, to determine the O2 microenvironment and photosynthetic activity in developing seeds and seedlings of seagrass (Zostera marina).

Developing, sheath‐covered seeds exhibited high O2 concentrations in the photosynthetic active seed sheath and low O2 concentrations in the centre of the seed at the position of the embryo. In light, photosynthesis in the seed sheath increased O2 availability in central parts of the seed enabling enhanced respiratory energy generation for biosynthetic activity. Early‐stage seedlings also displayed photosynthetic capacity in hypocotyl and cotyledonary tissues, which may be beneficial for seedling establishment.

Sheath O2 production is important for alleviating intra‐seed hypoxic stress, which might increase endosperm storage activity, improving the conditions for successful seed maturation and germination.
Predictors of pacemaker implantation within three months after catheter ablation of atrial fibrillation
Authors: Guo Yi , Chen Hongwu , Yang Shu , Gu Kai , Shen Youmei , Ju Weizhu , Yang Gang , Shi Jiaojiao , Wang Zidun , Liu Hailei , Jiang Xiaohong , Chen Minglong , Li Mingfang
Published: May 2023

Background

It is inevitable for patients to have a temporary or permanent pacemaker implanted during or after radiofrequency catheter ablation (RFCA) for treatment of atrial fibrillation (AF) in some cases. The aim of our study was to evaluate the incidence of pacemaker implantation (PMI) during or within 3 months of RFCA for AF and to identify the risk factors that were associated with PMI.

Methods

We performed a retrospective analysis of consecutive AF patients who underwent RFCA between August 2018 and October 2020 at our center. The incidence of PMI within 3 months during or after RFCA were assessed. A multivariate logistic regression model was performed to identify predictors of PMI.

Results

One thousand and five patients (mean age, 60.2 ± 10.3 years; 37.6% women) were included in this analysis. PVI was performed in all patients. A total of 23 (2.3%) patients had a pacemaker implanted within 3 months during or after ablation. Multivariable logistic regression analysis revealed that older age (OR: 1.08 [95% CI 1.03‐1.13], p = .003), female sex (OR: 3.08 [95% CI 1.28‐7.45], p = .012), paroxysmal AF (OR: 4.71 [95% CI 1.09‐20.45], p = .038) and repeated ablation (OR: 2.78 [95% CI 1.04‐7.40], p = .041) were the independent predictors for PMI.

Conclusions

Older age, female sex, paroxysmal AF and repeated ablation were identified as predictive risk factors for PMI after RFCA in patients with AF. A "watch and wait" strategy could be taken for patients with temporary PMI after ablation, especially for those with prolonged sinus pause after AF termination.
Analyzing the philosophy of travel with Schopenhauerian argument maps
Authors: Lemanski Jens
Published: May 2023

Emily Thomas's seminal book The Meaning of Travel has brought the philosophy of travel back into the public eye in recent years. Thomas has shown that the topic of travel can be approached from numerous different perspectives, ranging from the historical to the conceptual‐analytical, to the political or even social‐philosophical perspectives. This article introduces another perspective, which Thomas only indirectly addresses, namely the argumentation‐theoretical perspective. It is notable that contemporary philosophy of travel lacks the nineteenth‐century approach of using diagrams and maps to examine arguments for and against travel. Since this approach starts with Schopenhauer, we first introduce his argument maps, discuss their advantages and disadvantages, and argue that a modified version is suitable to visualize and analyze arguments for and against traveling as presented in Thomas's work.
Impact of climate change on paddy crop failure under different water regimes in Sri Lanka
Authors: Chandrasiri Chamila Kumari , Tsusaka Takuji W. , Zulfiqar Farhad , Datta Avishek
Published: May 2023

This study highlighted the severity of paddy harvest failure under various water regimes by elaborating on spatiotemporal variations, and estimating the influence of climatic variation on such crop failure in Sri Lanka. A panel data set obtained from 18 districts from 1981 to 2019 was analysed. The Unharvest Index (UI) (i.e., an index that was developed to measure the intensity of crop failure) was estimated according to seasonal water regimes for each district. The panel data regression method was used for analysis. On average, 5 per cent of areas planted for paddy was unharvested annually, fluctuating with the coefficient of variation at 60 per cent with remarkable spatial variation. Harvest failure was more prominent in rainfed production as compared to irrigated cultivation; in dry and intermediate zones as opposed to wet zones; and in the Maha season (October to March) rather than the Yala season (April to September). Climate variability during the crop season significantly altered UI, especially during the early growth phase (Growth Phase I) as compared to the later growth phase (Growth Phase II). Temperature variability increased UI in rainfed production; an increase in the number of days above optimum temperature in Growth Phase I affected UI in minor irrigation; higher rainfall during Growth Phase I reduced UI in rainfed production; and higher rainfall variation reduced UI under all water regimes. Our findings suggest the importance of formulating localized climate‐smart adaptation policies and specific crop insurance programs for rainfed paddy production.
EVKG: An interlinked and interoperable electric vehicle knowledge graph for smart transportation system
Authors: Qi Yanlin , Mai Gengchen , Zhu Rui , Zhang Michael
Published: May 2023

Over the past decade, the electric vehicle (EV) industry has experienced unprecedented growth and diversification, resulting in a complex ecosystem. To effectively manage this multifaceted field, we present an EV‐centric knowledge graph (EVKG) as a comprehensive, cross‐domain, extensible, and open geospatial knowledge management system. The EVKG encapsulates essential EV‐related knowledge, including EV adoption, EV supply equipment, and electricity transmission network, to support decision‐making related to EV technology development, infrastructure planning, and policy‐making by providing timely and accurate information and analysis. To enrich and contextualize the EVKG, we integrate the developed EV‐relevant ontology modules from existing well‐known knowledge graphs and ontologies. This integration enables interoperability with other knowledge graphs in the Linked Data Open Cloud, enhancing the EVKG's value as a knowledge hub for EV decision‐making. Using six competency questions, we demonstrate how the EVKG can be used to answer various types of EV‐related questions, providing critical insights into the EV ecosystem. Our EVKG provides an efficient and effective approach for managing the complex and diverse EV industry. By consolidating critical EV‐related knowledge into a single, easily accessible resource, the EVKG supports decision‐makers in making informed choices about EV technology development, infrastructure planning, and policy‐making. As a flexible and extensible platform, the EVKG is capable of accommodating a wide range of data sources, enabling it to evolve alongside the rapidly changing EV landscape.
Hábitat popular y organización comunitaria en barrios periféricos de Gran La Plata - Argentina ante COVID 19
Authors: Ursino Sandra Valeria , Vila Mariana Paola , Durante María Eugenia
Published: May 2023

En este artículo se presentan avances del proyecto de investigación “Atención primaria del hábitat en barrios populares del Gran La Plata”, cuyo objetivo es elaborar un diagnóstico de las condiciones de criticidad del hábitat popular durante la pandemia por Covid 19, fortaleciendo el nexo entre necesidades sociales y políticas públicas. Se utiliza una metodología basada en herramientas cualitativas y cuantitativas con estrategias de recolección de datos múltiples —datos oficiales, entrevistas y focus group— en dos barrios del Gran La Plata (Argentina): Las Palmeras y Villa Progreso, como casos ejemplificadores respecto de las dificultades y lógicas de organización que experimentaron ciertos sectores sociales signados por la precariedad habitacional y la vulnerabilidad socioeconómica. Los resultados del trabajo exponen cómo estas estrategias desplegadas interpelan las formas en que se planifican las ciudades desde el urbanismo tradicional, mostrando por medio de la organización territorial y comunitaria de estos barrios otras formas de habitar las periferias.
Novel Strategy for Thermal Evaluation of Film-Cooled Blades Using Thermographic Phosphors at Simulated Engine Conditions
Authors: Zhou Wenwu , Shao Hongyi , Zhang Xu , Peng Di , Liu Yingzheng , Li Yang , Yang Weihua , Zhao Xiaofeng
Published: May 2023

Practical strategy for the thermal evaluation of film-cooled blade is of great importance to the gas turbine community. Due to the physical or methodology limitations, it is difficult to evaluate the blade’s thermal performance at simulated engine conditions. The present study proposed novel focal-sweep-based phosphor thermometry for blade cooling inspection. While Mg4FGeO6:Mn (MFG) served as the temperature sensor to quantify the blade temperatures as well as simulated the thermal barrier coating (TBC) effect, the focal sweep method was adopted to overcome the optical constraints in cascade testing. The obtained MFG results of microstructures, jet impingement, and anti-erosion test demonstrated that the MFG phosphor is robust enough to simulate the thermal insulation effect of TBC and can withstand high-speed flow erosion. Furthermore, the proposed strategy clearly captured the blade temperature distributions (mainstream at T0,∞=∼850K) with high spatial resolution, which was then successfully remapped onto the three-dimensional twisted blade. Additional comparisons with the thermocouples demonstrated that the simulated TBC has a thermal insulation effect of about 68 K. This study addressed the common problems of phosphor thermometry in blade cooling evaluation, offering a practical strategy for future thermal diagnostics of the gas turbine.
Heart Rate–Blood Lactate Profiling in World-Class Biathletes During Cross-Country Skiing: The Difference Between Laboratory and Field Tests
Authors: Staunton Craig A. , Andersson Erik P. , Björklund Glenn , Laaksonen Marko S.
Published: May 2023

Purpose: To identify differences in heart rate (HR) and concentration of blood lactate ([La]) relationships between laboratory- and field-based skate-roller-skiing tests. Methods: Fourteen world-class biathletes (8 women, 6 men) completed a laboratory- and field-based roller-skiing test using the skate technique. The laboratory-based test comprised 5 to 7 submaximal steps at a fixed incline and speed on a roller-skiing treadmill. The field-based test comprised 5 steps on a course where the final hill was designed to mimic the conditions of the laboratory test. HR and [La] were measured for each step. The HR associated with 2 mmol·L−1 (HR@2 mmol) and 4 mmol·L−1 (HR@4 mmol) of [La] was calculated using an interpolation method. A 1-way analysis of variance and Bland–Altman analyses with 95% limits of agreement (LoA) were used to determine if test type influenced HR@2 mmol or HR@4 mmol. A second-order polynomial was fitted to group-level data to highlight the HR–[La] relationships for laboratory- and field-based tests. Results: HR@2 mmol was lower for field tests than for laboratory tests (mean bias: 1.9%HRmax; 95% LoA: −4.5 to +8.3%HRmax; P < .001). HR@4 mmol was also lower for field tests compared to laboratory tests (mean bias: 2.4%HRmax; 95% LoA: −1.2 to +6.0%HRmax; P < .001). On the group level, the lactate threshold occurred at a lower HR during roller skiing in the field compared to the laboratory. Conclusions: The findings from this study confirm that for a given HR, [La] was greater in field- compared with laboratory-based conditions. These results might have implications for how coaches define training-intensity “zones” during skate roller skiing based on laboratory tests.
Balancing economic and epidemiological interventions in the early stages of pathogen emergence
Authors: Dobson Andy , Ricci Cristiano , Boucekkine Raouf , Gozzi Fausto , Fabbri Giorgio , Loch-Temzelides Ted , Pascual Mercedes
Published: May 2023

The global pandemic of COVID-19 has underlined the need for more coordinated responses to emergent pathogens. These responses need to balance epidemic control in ways that concomitantly minimize hospitalizations and economic damages. We develop a hybrid economic-epidemiological modeling framework that allows us to examine the interaction between economic and health impacts over the first period of pathogen emergence when lockdown, testing, and isolation are the only means of containing the epidemic. This operational mathematical setting allows us to determine the optimal policy interventions under a variety of scenarios that might prevail in the first period of a large-scale epidemic outbreak. Combining testing with isolation emerges as a more effective policy than lockdowns, substantially reducing deaths and the number of infected hosts, at lower economic cost. If a lockdown is put in place early in the course of the epidemic, it always dominates the “laissez-faire” policy of doing nothing.
Osmotrophy of dissolved organic compounds by coccolithophore populations: Fixation into particulate organic and inorganic carbon
Authors: Balch William M. , Drapeau David T. , Poulton Nicole , Archer Stephen D. , Cartisano Carmen , Burnell Craig , Godrijan Jelena
Published: May 2023

Coccolithophores are typically thought of as photoautotrophs, yet a few genera inhabit sub-euphotic environments with insufficient light for photosynthesis, suggesting that other carbon acquisition strategies are likely. Field experiments were performed in the northwest Atlantic (a region with potentially abundant coccolithophores). Phytoplankton populations were incubated with
14
C-labeled dissolved organic carbon (DOC) compounds, acetate, mannitol, and glycerol. Coccolithophores were sorted from these populations 24 hours later using flow cytometry, and DOC uptake was measured. DOC uptake rates were as high as 10
−15
moles cell
−1
day
−1
, slow relative to photosynthesis rates (10
−12
moles cell
−1
day
−1
). Growth rates on the organic compounds were low, suggesting that osmotrophy plays more of a survival strategy in low-light situations. Assimilated DOC was found in both particulate organic carbon and calcite coccoliths (particulate inorganic carbon), suggesting that osmotrophic uptake of DOC into coccolithophore calcite is a small but notable part of the biological carbon pump and alkalinity pump paradigms.
Stratification of Nontuberculous Mycobacterial Disease Risk in Type 2 Diabetes Based on Metformin Use: a Population-Based Cohort Study in South Korea
Authors: Kim Hyeon Hwa , Kim Seonok , Kim Mi Ae , Jung Chang Hee , Chong Yong Pil , Shim Tae Sun , Kim Ye-Jee , Jo Kyung-Wook
Published: May 2023

In a 1:4 case-control matched analysis of data from a nationwide population-based cohort in South Korea, we evaluated whether metformin use mitigates the risk of nontuberculous mycobacterial disease in patients with type 2 diabetes. Multivariable analysis revealed no significant association of metformin use with a diminished risk for incident nontuberculous mycobacterial disease in patients with type 2 diabetes.