bluuebunny/crossref_metadata_2025 huggingface dataset:
Developing human capital 4.0 in emerging economies: an industry 4.0 perspective
Authors: Singh Rohit Kumar , Agrawal Soni , Modgil Sachin
Published: September 2021

Purpose

The present study is an attempt of identifying the human capital skills and HR-related challenges faced by top management in the perspective of industry 4.0 in emerging economies. In addition, the importance or key resources related to human assets that help in attaining competitive advantages while adopting newer digital technologies are also identified.

Design/methodology/approach

For identifying the dimensions of human capital skills in the perspective of industry 4.0, an extensive review of literature was performed. Along with that, feedback from the expert was used to conceptualize the importance and relationship of the skills in the context of industry 4.0. After that, a qualitative survey was launched and triangulate method was applied for identifying the skills. AHP and DEMATEL was used to analyze the relationship among the skills and subskills and to rank them based on their importance.

Findings

The qualitative survey resulted in skills such as “Cognitive, Emotional and Behavioural skills” and subskills of them. AHP results indicated that “Cognitive skills” was found as the most important skill followed by “Emotional skills” and “Behavioural skills”. In addition to this, DEMATEL was applied for seeking the inter-relationship and identifying the “Cause” and “Effect” relationship of skills and sub-skills.

Originality/value

This study prioritizes factors in a coordinated manner and also finds the relative importance in the context of industry 4.0. It will help further in identifying and deploying human capital with the right skills and will play a significant role at the time of formulating organizational and HR level strategies.
Factors associated with depression among prisoners in Mizan prison institute, southwest Ethiopia
Authors: Girma Bethelehem , Taye Abonesh , Wondimu Wondimagegn , Sinaga Melese
Published: September 2021

Purpose

In spite of the vulnerability of prisoners to depression and their increased number, the issue has not been thoroughly investigated in Ethiopia. In particular, the determining factors of depression have not been exhaustively identified. Thus, the purpose of this study is to assess the prevalence of depression and associated factors among prisoners in Mizan prison institute, southwest Ethiopia.

Design/methodology/approach

An institution-based cross-sectional study was conducted from April 6–27, 2020. A total of 340 randomly selected prisoners were included. Depression was assessed using the Patient Health Questionnaire-nine and participants were considered to be in a state of depression if they scored five and above. Binary logistic regression was used to assess the association between the outcome variable (depression) and the independent variables (factors). The odds ratio with a 95% confidence interval (CI) was used to measure the strength of association. The final significance was decided using a p-value < 0.05.

Findings

The prevalence of depression was 29.9% (95% CI: 25%, 34.8%). Prisoners whowere not participating in the duty work of the prison had 55% (adjusted odds ratio [AOR] = 0.45; 95% CI: 0.22, 0.93) less odds of depression compared to those who were participating in the duty work. Similarly, physically active respondents had 81% (AOR = 0.19; 95% CI: 0.10, 0.35) less odds of depression than physically inactive respondents. Moreover, undernourished participants had two times (AOR = 2.03; 95% CI: 1.08, 3.82) higher odds of depression than normal participants.

Research limitations/implications

Considering their risk of exposure compared to the general population and the limitations of cross-sectional study design, special care should be provided to the prisoners’ mental health. Moreover, priority attention should be given to the undernourished, physically inactive and those who are participating in duty work in the prison.

Originality/value

This study demonstrated important and modifiable factors associated with prisoners’ depression. It also evaluated the contribution of new variables (such as participation in the duty work, nutritional status and physical activity) that were not considered in previous local studies.
Sustainable lubrication: low molecular weight PTFE micro-particles as extreme pressure additives for heavy duty grease applications
Authors: Gupta TCSM , Kumar Ajay , Prasad Babu
Published: September 2021

Purpose

The purpose of this paper is to formulate heavy-duty lithium complex grease using low molecular weight poly tetra fluoro ethylene (PTFE) micro-particles as extreme pressure (EP) additive manufactured by E-beam scissoring and ultra-high speed grinding process of pre-sintered PTFE scrap.

Design/methodology/approach

Lithium complex grease is formulated with PTFE micro-particles, and optimum treat rate was studied by standard bench tests by ASTM D 2266 and IP-239 for tribological properties and compared with commercially available Molybdenum Di sulphide (Moly)-based lithium complex grease. The performance of the grease was further evaluated by a cyclic load test at varying speeds and loads to simulate the operational field conditions.

Findings

The lithium complex PTFE grease was manufactured using PTFE micro-particles as EP additive. The PTFE micro-particles dispersed in the lithium complex grease significantly improve the anti-wear performance and load bearing properties. Further, when the product was tested under a cyclic load conditions on standard tribological bench test against commercially available Moly lithium complex grease, shows stable anti-wear properties and reduced coefficient of friction.

Originality/value

The low molecular weight PTFE micro-particles, manufactured in the in-house electron beam (E-beam) and ultra-high speed micronizer facility from a pre-sintered PTFE scrap has been used as EP additive for grease applications for the first time. The results on the cyclic load tests indicate significant performance improvement in retaining the anti-wear and friction properties. Thus, value addition is done in formulating superior performance grease and evaluating under cyclic load conditions similar to field operating conditions and also in creating value added additives by converting the pre-sintered PTFE scarp which is environmental hazard due to poor biodegradability, creating a cyclic economy and a sustainable concept.
Selected macroeconomic determinants and economic growth in Cameroon (1970–2018) “dead or alive” an ARDL approach
Authors: Thaddeus Kesuh Jude , Ngong Chi Aloysius , Nebong Njimukala Moses , Akume Akume Daniel , Eleazar Jumbo Urie , Onwumere Josaphat Uchechukwu Joe
Published: September 2021

Purpose

The purpose of this paper is to examine key macroeconomic determinants on Cameroon's economic growth from 1970 to 2018.

Design/methodology/approach

Data were obtained from the World Development Indicators and applied on time series data econometric techniques. The auto-regressive distributed lag (ARDL) bounds model analyzed the data since the variables had different order of integration.

Findings

The results showed long and short runs’ positive and significant connection between economic growth in Cameroon and government expenditure; trade openness, gross capital formation and exchange rate. Human capital development, foreign aid, money supply, inflation and foreign direct investment negatively and significantly affected economic growth in the short and long-runs. Hence, the macroeconomic indicators are not death.

Research limitations/implications

The present research paper has tried to capture the impact of nine macroeconomic determinants on economic growth such as the government expenditure (LNGOVEXP), human capital development (LNHCD), foreign aids (AID), trade openness (LNTOP), foreign direct investment (LNFDI), gross capital formation (INVEST), broad money (LNM2), official exchange rate (LNEXHRATE) and Inflation (LNINFLA). However, these variables have the tendency to affect each other in a unidirectional or bidirectional manner. Further, the present research paper is unable to capture the impact of other macroeconomic variable due to the unavailability of data.

Practical implications

The study recommends that Cameroon should use proper planning and strategic policy interventions to achieve higher sustainable economic growth with human capital development, foreign aid, money supply, foreign direct investment and moderate inflation.

Social implications

Macroeconomic indicators, if managed well, increase economic growth.

Originality/value

This paper to the best of the researcher's knowledge presents new background information to both policymakers and researchers on the main macroeconomic determinants using econometric analysis.
Aspects of ICT connectivity among older adults living in rural subsidized housing: reassessing the digital divide
Authors: Golomski Casey , Corvini Marguerite , Kim BoRin , Wilcox John , Valcourt Scott
Published: September 2021

Purpose

This article examines aspects of information communication technology (ICT) connectivity among the understudied population of low-income older adults living in rural and peri-urban subsidized housing. We aim to investigate if variations exist in access and connectivity when economic and housing conditions are constant and use data from northern New England.

Design/methodology/approach

The multidisciplinary, mixed-methods approach involved administering structured surveys using iPads with senior residents (n = 91) from five housing sites, qualitative observations by field researchers and an ecological assessment of ICT resources at housing, community and state levels.

Findings

All subsidized housing sites were broadband accessible and nearby libraries. Fewer sites had Wi-Fi freely available to residents, and individual residents disparately accessed the Internet. Age and education demonstrably influenced ICT use of social media and email. Technology in the form of iPads used for surveys posed functional challenges for some older adults, but these technology-mediated interactions were also perceived as important sites of sociability.

Originality/value

Older adults disparately access and use ICT relative to socioeconomic status even as housing conditions remain constant, and access and use influences frequency of social connections with friends and family. The findings reveal factors that contribute to the existing digital divide facing older adults and broader lack of digital equity.
Exploring the indirect role of green business practices in transmitting eco-market orientation into positive organizational outcomes: an empirical study
Authors: Asamoah George Kwabena , Afum Ebenezer , Kusi Lawrence Yaw , Agyabeng-Mensah Yaw , Baah Charles
Published: September 2021

Purpose

This study aims to examine whether the types of eco-market orientation (eco-proactive market orientation and eco-responsive market orientation) result in green knowledge acquisition and positive organizational outcomes (green customer satisfaction [GCS], green brand image [GBI] and green value-based competitiveness [GVC]). The study further aims to explore the mediation role of green business practices in the relationship between the types of eco-market orientation and organizational outcomes.

Design/methodology/approach

Questionnaire was used to garner data from managers from Ghanaian hospitality firms. The hypothesized relationships were tested using partial least square structural equation modeling.

Findings

The result confirms the notion that although both eco-proactive market orientation and eco-responsive market orientation contribute significantly to enhancing the acquisition of green knowledge, eco-responsive market orientation has a strong effect on green knowledge acquisition. Also, the outcome of the mediation analysis proves that green business practices (GBPs) play an important indirect role in the relationship between eco-market orientation (eco-proactive market orientation and eco-responsive market orientation), GCS, GBI and GVC.

Originality/value

Anchored on the resource advantage theory and natural resource-based view theory, this study offers a fresh contribution to marketing and environmental management literature by developing a unified research model that explores the mediation roles of GBPs between the types of eco-market orientation (eco-proactive market orientation and eco-responsive market orientation), GCS, GBI and GVC.
Removal of Congo red from aqueous solution in single and binary mixture systems using Argan nutshell wood
Authors: El Khomri Mohammed , El Messaoudi Noureddine , Dbik Abdellah , Bentahar Safae , Lacherai Abdellah , Chegini Zahra Goodarzvand , Bouich Amal
Published: September 2021

Purpose

Argan nutshell wood (ANW) has been used in this study as an agricultural solid waste to remove Congo red (CR) from an aqueous solution in single and mixture binary in the presence of methylene blue (MB) or crystal violet (CV).

Design/methodology/approach

The ANW was characterized by Fourier transform infrared and scanning electron microscope analysis. The effect of ANW dose (8–40 gL−1), contact time (0–180 min), pH of the solution (4–11) and CR dye concentration (100–500 mgL−1) on CR adsorption was studied in batch mode and evaluated by kinetic and isotherm models in a single system. In the binary system, the CR removal was studied from a CR + MB and CR + CV mixture with different percentages of dyes, ranging from 0% to 100%.

Findings

The pseudo-second-order and the Langmuir models could best describe the CR sorption onto ANW in a single system. In addition, in the case of the binary system, there is the appearance of a synergistic phenomenon between the CR and the other cationic dyes and the CR adsorption capacity increased until 12.24 mg g-1 and 12.06 mg g-1 in the presence of the MB and CV in the mixture, respectively.

Practical implications

This study demonstrated that ANW prepared can be suggested as an excellent potential adsorbent to remove dyes from wastewaters from single and mixture systems.

Originality/value

This study is original.
A new combined transient extraction method coupled with WO3 gas sensors for polluting gases classification
Authors: Faleh Rabeb , Gomri Sami , Aguir Khalifa , Kachouri Abdennaceur
Published: September 2021

Purpose

The purpose of this paper is to deal with the classification improvement of pollutant using WO3 gases sensors. To evaluate the discrimination capacity, some experiments were achieved using three gases: ozone, ethanol, acetone and a mixture of ozone and ethanol via four WO3 sensors.

Design/methodology/approach

To improve the classification accuracy and enhance selectivity, some combined features that were configured through the principal component analysis were used. First, evaluate the discrimination capacity; some experiments were performed using three gases: ozone, ethanol, acetone and a mixture of ozone and ethanol, via four WO3 sensors. To this end, three features that are derivate, integral and the time corresponding to the peak derivate have been extracted from each transient sensor response according to four WO3 gas sensors used. Then these extracted parameters were used in a combined array.

Findings

The results show that the proposed feature extraction method could extract robust information. The Extreme Learning Machine (ELM) was used to identify the studied gases. In addition, ELM was compared with the Support Vector Machine (SVM). The experimental results prove the superiority of the combined features method in our E-nose application, as this method achieves the highest classification rate of 90% using the ELM and 93.03% using the SVM based on Radial Basis Kernel Function SVM-RBF.

Originality/value

Combined features have been configured from transient response to improve the classification accuracy. The achieved results show that the proposed feature extraction method could extract robust information. The ELM and SVM were used to identify the studied gases.
The catabolic pathways of in situ rhizosphere PAH degraders and the main factors driving PAH rhizoremediation in oil‐contaminated soil
Authors: Li Jibing , Luo Chunling , Zhang Dayi , Zhao Xuan , Dai Yeliang , Cai Xixi , Zhang Gan
Published: September 2021

Rhizoremediation is a potential technique for polycyclic aromatic hydrocarbon (PAH) remediation; however, the catabolic pathways of in situ rhizosphere PAH degraders and the main factors driving PAH rhizoremediation remain unclear. To address these issues, stable‐isotope‐probing coupled with metagenomics and molecular ecological network analyses were first used to investigate the phenanthrene rhizoremediation by three different prairie grasses in this study. All rhizospheres exhibited a significant increase in phenanthrene removal and markedly modified the diversity of phenanthrene degraders by increasing their populations and interactions with other microbes. Of all the active phenanthrene degraders, Marinobacter and Enterobacteriaceae dominated in the bare and switchgrass rhizosphere respectively; Achromobacter was markedly enriched in ryegrass and tall fescue rhizospheres. Metagenomes of 13C‐DNA illustrated several complete pathways of phenanthrene degradation for each rhizosphere, which clearly explained their unique rhizoremediation mechanisms. Additionally, propanoate and inositol phosphate of carbohydrates were identified as the dominant factors that drove PAH rhizoremediation by strengthening the ecological networks of soil microbial communities. This was verified by the results of rhizospheric and non‐rhizospheric treatments supplemented with these two substances, further confirming their key roles in PAH removal and in situ PAH rhizoremediation. Our study offers novel insights into the mechanisms of in situ rhizoremediation at PAH‐contaminated sites.
Dynamic evolution of eukaryotic mitochondrial and nuclear genomes: a case study in the gourmet pine mushroom Tricholoma matsutake
Authors: Zhang Shu , Bai Xue , Ren Li‐Yuan , Sun Hui‐Hui , Tang Hui‐Ping , Vaario Lu‐Min , Xu Jianping , Zhang Yong‐Jie
Published: September 2021

Fungi, as eukaryotic organisms, contain two genomes, the mitochondrial genome and the nuclear genome, in their cells. How the two genomes evolve and correlate to each other is debated. Herein, taking the gourmet pine mushroom Tricholoma matsutake as an example, we performed comparative mitogenomic analysis using samples collected from diverse locations and compared the evolution of the two genomes. The T. matsutake mitogenome encodes 49 genes and is rich of repetitive and non‐coding DNAs. Six genes were invaded by up to 11 group I introns, with one cox1 intron cox1P372 showing presence/absence dynamics among different samples. Bioinformatic analyses suggested limited or no evidence of mitochondrial heteroplasmy. Interestingly, hundreds of mitochondrial DNA fragments were found in the nuclear genome, with several larger than 500 nt confirmed by PCR assays and read count comparisons, indicating clear evidence of transfer of mitochondrial DNA into the nuclear genome. Nuclear DNA of T. matsutake showed a higher mutation rate than mitochondrial DNA. Furthermore, we found evidence of incongruence between phylogenetic trees derived from mitogenome and nuclear DNA sequences. Together, our results reveal the dynamic genome evolution of the gourmet pine mushroom.
A novel method for cyanide quantification in human whole blood using ion chromatography with amperometric detection and its application to cyanide intoxication cases
Authors: Sim Juhyun , Kim Minyoul , Kim Suncheun , Yang Wonkyung
Published: September 2021

Cyanide is a highly toxic agent that has been frequently used for suicide in South Korea. It is also used in various industrial fields, such as metal plating, in which many accidental cyanide intoxications have occurred. To overcome the disadvantages of conventional cyanide analysis methods, a simple and fast method for the analysis of cyanide in whole blood using ion chromatography (IC) with amperometric detection was developed in this study. Whole blood samples were deproteinized, diluted, and analyzed using an IC–amperometric detection system. The limits of detection and quantitation were 0.1 and 0.2 mg/L, respectively. The method showed good linearity in the range of 0.2 to 50 mg/L with R2 > 0.99. The intra‐ and inter‐assay precision and accuracy values were <10%. The established method was successfully applied to analyze whole blood samples from three cyanide intoxication cases.
Tooth hop variability in human and nonhuman bone: Effect on the estimation of saw blade TPI
Authors: Grosso Alicia R.
Published: September 2021

Forensic research has demonstrated that tooth hop (TH) is a valuable measurement from saw‐cut bones as it can be used to estimate teeth‐per‐inch (TPI) of a saw used in postmortem dismemberment cases. However, error rates for TPI estimation are still under development and knowledge of how bone tissue affects TH measurements remains unclear. The purpose of this research was to investigate the effects of tissue variability through the use of different taxa on the accuracy and precision of TH measurements in the bone to estimate TPI of the blade. A total of 1766 TH measurements were analyzed from human, pig, and deer long bones cut by two 7 TPI saw blades of different tooth type. Fifty distance‐between‐teeth measurements before and after sawing were collected directly from each blade for comparison to bone‐measured TH to assess potential effects of tooth wear on TH variability. ANOVA and F tests were used to compare mean TH and variance, respectively, by saw‐species (i.e., crosscut‐deer, rip‐deer) and species groups (i.e., all deer, all pig), with significance determined at the p < 0.05 level. TH measurements were converted to usable TPI ranges, which would typically be presented in a forensic report. It is concluded that significant differences in TH (mm) do not necessarily reflect significant differences in associated TPI ranges of suspect blades. Forensic reports should report mean TPI ± 1.5–2.5 TPI while providing a sample size indicating number of TH measured rather than just number of cuts or cut surfaces examined.
Optimising sampling designs for habitat fragmentation studies
Authors: Bowler Ellen , Lefebvre Veronique , Pfeifer Marion , Ewers Robert M.
Published: September 2021

Habitat fragmentation has become one of the largest areas of research in conservation biology. Empirical studies into habitat fragmentation impacts typically measure ecological responses to metrics describing fragmentation processes, for example ‘distance to the nearest forest edge’, ‘forest fragment area’ and ‘landscape habitat amount’. However, these studies often fail to sample across representative ranges of fragmentation metrics characterising the study region. They therefore lack the data to account for correlation among multiple fragmentation metrics and for spatial autocorrelation among sample sites, which reduces the strength of derived predictive models.

Here, we draw on approaches used in the mining and soil science industry to develop standardised and repeatable protocols for designing optimised sampling schemes of biodiversity in fragmented landscapes that meet three criteria: the distance between sample sites is maximised to reduce spatial autocorrelation, the full range of values of the metrics of interest are sampled and the confounding effects of correlated metrics are minimised.

We show that our computational methods can optimise the placement of sample sites in fragmented landscapes to minimise, and in some cases to entirely avoid, over‐ or under‐sampling of fragmentation metrics. Our method is flexible enough to cater for any continuous (e.g. maps of percentage tree cover) or categorical (e.g. habitat and land use types) fragmentation metric, and to simultaneously handle combinations of multiple fragmentation metrics and habitat types. We implement our methods as open‐source code which includes options to mask invalid or inaccessible regions, update designs to adapt to unforeseen constraints in the field and suggest optimal numbers of sample sites for given design criteria.

Using a case study landscape, we demonstrate how the approach improves on manually generated sampling designs. We also show that the methods are flexible enough to be applied to landscape studies beyond the field of habitat fragmentation. We introduce our package as a novel research tool that is able to streamline the experimental design process for biodiversity sampling and monitoring at landscape scales, leading to improved data quality and representativeness.
Effects of sex and genotype in human APOE‐targeted replacement mice on alcohol self‐administration measured with the automated IntelliCage system before and after repeated mild traumatic brain injury
Authors: Simmons Kathryn E. , Healey Kati L. , Li Qiang , Moore Scott D. , Klein Rebecca C.
Published: September 2021

Background

Few studies have examined the association between APOE genotype and alcohol use. Although some of these studies have reported outcomes associated with a history of drinking, none have examined alcohol‐seeking behavior. In addition, no preclinical studies have examined alcohol use as a function of APOE genotype with or without traumatic brain injury.

Methods

Male and female human APOE3‐ and APOE4‐targeted replacement (TR) mice were used to assess voluntary alcohol seeking longitudinally using a 2‐bottle choice paradigm conducted within the automated IntelliCage system prior to and following repeated mild TBI (rmTBI). Following an acquisition phase in which the concentration of ethanol (EtOH) was increased to 12%, a variety of drinking paradigms that included extended alcohol access (EAA1 and EAA2), alcohol deprivation effect (ADE), limited access drinking in the dark (DID), and progressive ratio (PR) were used to assess alcohol‐seeking behavior. Additional behavioral tasks were performed to measure cognitive function and anxiety‐like behavior.

Results

All groups readily consumed increasing concentrations of EtOH (4–12%) during the acquisition phase. During the EAA1 period (12% EtOH), there was a significant genotype effect in both males and females for EtOH preference. Following a 3‐week abstinence period, mice received sham or rmTBI resulting in a genotype‐ and sex‐independent main effect of rmTBI on the recovery of righting reflex and a main effect of rmTBI on spontaneous home‐cage activity in females only. Reintroduction of 12% EtOH (EAA2) resulted in a significant effect genotype for alcohol preference in males with APOE4 mice displaying increased preference and motivation for alcohol compared with APOE3 mice independent of TBI while in females, there was a significant genotype × TBI interaction under the ADE and DID paradigms. Finally, there was a main effect of rmTBI on increased risk‐seeking behavior in both sexes, but no effect on spatial learning or cognitive flexibility.

Conclusion

These results suggest that sex and APOE genotype play a significant role in alcohol consumption and may subsequently influence long‐term recovery following traumatic brain insults.
CEO inside debt and the acquisition of private targets
Authors: Bhabra Gurmeet S. , Bhabra Harjeet S. , Hossain Ashrafee T.
Published: September 2021

We find a strong positive association between the inside debt holdings (pension benefits and deferred compensation) of CEOs and announcement‐period abnormal returns (CARs) of acquiring firms bidding for private targets. In addition, gains to acquirers with high inside debt persist for at least 3 years post‐acquisition. Further analyses suggest that our results are largely driven by firms with lower levels of manager‐shareholder agency conflicts as proxied by higher transparency in firm activities, presence of a less powerful CEO, or presence of stronger monitoring. Our results are robust to an array of sensitivity tests.
Digital financial inclusion development, investment diversification, and household extreme portfolio risk
Authors: Lu Xiaomeng , Guo Jiaojiao , Zhou Hailing
Published: September 2021

Most Chinese households are exposed to extreme portfolio risks; the findings show that digital financial inclusion significantly mitigates this phenomenon. Using a panel of nation‐wide data from the China Household Finance Survey, we find digital financial inclusion significantly reduces the probability of households taking extreme portfolio risks by promoting diversification. It also plays a greater role among households with low levels of wealth and financial literacy, located in areas where traditional finance has been slow to develop. These findings suggest that Internet‐based financial products are needed that are better suited to households with low levels of wealth and financial literacy.
Migration of Jewish “Displaced Persons” from Europe to Australia after the Second World War: Revisiting the Question of Discrimination and Numbers1
Authors: Fitzpatrick Sheila
Published: September 2021

Post‐war Jewish immigration from Europe to Australia has been much discussed in the scholarship, primarily with reference to the question of discriminatory (anti‐semitic) intention on the part of the Australian government and the Department of Immigration bureaucracy. The assumption has often been made that the existence of discriminatory policy and practices necessarily led to a reduction in the number of Jewish migrants entering Australia. Using new data on Jewish entrants under the Mass Resettlement programme (1947–51) and under individual sponsorship on landing permits, as well as material from the archives of the International Refugee Organization which administered the Mass Resettlement programme, this article revisits the related questions of discriminatory intentions and quantitative outcomes, concluding that discriminatory intent, while stimulating evasive strategies of resistance on the part of individuals and institutions, does not necessarily result in significant reduction in the rate of entry of the migrants who are the object of discrimination.
Design, development and implementation of the virtual, coordination, access, referral and escalation service in western New South Wales
Authors: Parks James , Hunter Amanda , Taylor Anne , Addis Bridget , Setterfield Madeline , Dean Kimberley , Nott Shannon
Published: September 2021

Problem

People in rural and remote New South Wales experience avoidable admissions, limited access to skilled clinicians and commonly travel >400 km to access specialist services within the district and >700 km for tertiary services outside.

Design

Iterative use of New South Wales Health redesign methodology in the period 2015‐2020.

Setting

Western New South Wales Local Health District is geographically the largest Health District within New South Wales and includes disadvantaged communities. Virtual Coordination Access Referral Escalation is an audio‐visually enabled transport, patient flow and clinical advice unit established in 2006 to support patients and clinicians at 35 small, rural and remote hospitals.

Key measures for improvement

Right care, right place and right time by the right team the first time. Care delivery close to home and ‘on country’. Safe and cost‐effective transport. Performance measures to support quality, safety and clinical outcomes. Improving the human experience.

Strategies for change

Cycles of strategic planning, innovation, productive partnerships, change management and human systems development.

Effects of change

Virtual Coordination Access Referral Escalation critical care telehealth more effectively supports rural and remote health care across large distances.

Lessons learnt

Improvements include expanded/redefined management and nursing roles, integration of dedicated critical care emergency medicine specialists within the service, delegated authority to accept transfers, upgraded technology, 24‐hour service provision and a central ‘Virtual Support’ proactive outreach model.
The effect of prenatal lithium exposure on the neuropsychological development of the child
Authors: Poels Eline M. P. , Schrijver Lisanne , White Tonya J. H. , Roza Sabine J. , Zarchev Milan G. , Bijma Hilmar , Honig Adriaan , van Kamp Inge L. , Hoogendijk Witte J. G. , Kamperman Astrid M. , Bergink Veerle
Published: September 2021

Objectives

Lithium is an effective treatment for bipolar disorder, also during pregnancy to prevent the recurrence of episodes in the perinatal period. Little is known about the neuropsychological development of lithium‐exposed offspring. The current study was designed to investigate neuropsychological functioning in lithium‐exposed children with the aim to provide further knowledge on the long‐term effects of lithium use during pregnancy.

Methods

Participants were offspring of women with a diagnosis of bipolar spectrum disorder, aged 6–14 years. In total, 99 children participated in the study, 56 were exposed to lithiumin uteroand 43 were not exposed to lithium. Neuropsychological tests were administered, including the Snijders‐Oomen Nonverbal Intelligence Test and the NEPSY‐II‐NL assessment. Linear and negative binomial regression models were used to investigate the association between prenatal lithium exposure and neuropsychological functioning. In secondary analyses, the association between lithium blood level during pregnancy and neuropsychological functioning was assessed. Additionally, norm scores and percentiles for task outcomes were calculated.

Results

Lithium use during pregnancy was associated with the total number of mistakes made on the Auditory Attention task, but not statistically significant after full adjustment for potential confounding factors. No association between prenatal lithium exposure and IQ was found. Also, no relationship between lithium blood level during pregnancy and neuropsychological functioning was found after adjustment for potential confounders. Task outcomes in both groups were comparable to the general population.

Conclusion

In this study, we found no evidence for significantly altered neuropsychological functioning of lithium‐exposed children at the age of 6–14 years, when compared to non‐lithium‐exposed controls.
Generalized case‐control sampling under generalized linear models
Authors: Maronge Jacob M. , Tao Ran , Schildcrout Jonathan S. , Rathouz Paul J.
Published: September 2021

A generalized case‐control (GCC) study, like the standard case‐control study, leverages outcome‐dependent sampling (ODS) to extend to nonbinary responses. We develop a novel, unifying approach for analyzing GCC study data using the recently developed semiparametric extension of the generalized linear model (GLM), which is substantially more robust to model misspecification than existing approaches based on parametric GLMs. For valid estimation and inference, we use a conditional likelihood to account for the biased sampling design. We describe analysis procedures for estimation and inference for the semiparametric GLM under a conditional likelihood, and we discuss problems with estimation and inference under a conditional likelihood when the response distribution is misspecified. We demonstrate the flexibility of our approach over existing ones through extensive simulation studies, and we apply the methodology to an analysis of the Asset and Health Dynamics Among the Oldest Old study, which motives our research. The proposed approach yields a simple yet versatile solution for handling ODS in a wide variety of possible response distributions and sampling schemes encountered in practice.
A case of COVID-19 vaccination-associated forme fruste purpura fulminans
Authors: Griss J. , Eichinger S. , Winkler S. , Weninger W. , Petzelbauer P.
Published: September 2021

We report the case of a female, 77 year old patient with multi-localized skin infarctions following vaccination with mRNA-1273 (Moderna). This phenomenon is to our knowledge otherwise only seen in infection-associated purpura fulminans - which was thoroughly ruled out in our patient. This report demonstrates that we need to be vigilant of a wider array of vascular phenomena related to Covid vaccinations.
Augmented reality for preschool children: An experience with educational contents
Authors: Aydoğdu Fatih
Published: September 2021

This study was conducted to test the effect of the augmented reality‐based program on the motivation, attention and conceptual skills of preschool children. The research was conducted according to the pretest‐posttest control group quasi‐experimental design: 13 participants (6 girls, 7 boys) in the experimental group and 13 (5 girls, 8 boys) in the control group, a total of 26 children (4–5 age group) were included in the study. While the children in the experimental group participated in the applications prepared with augmented reality, the children in the control group were practised upon with the traditional teaching method. In the research, measurement tools were applied to the working groups (experiment‐control) both before and after the application. As a result, it was determined that the motivation, attention and concept skills of the children in the experimental group increased significantly compared to the children in the control group. The results show that augmented reality applications can be used in learning activities in preschool education.

Practitioner notes

What is already known about this topic

Augmented reality applications can be adapted for preschool children.

Augmented reality applications are new in pre‐school education.

Augmented reality applications are interesting for preschool children.

What this paper adds

Augmented reality applications improve the motivational skills of preschool children.

Augmented reality applications improve the attention skills of preschool children.

Augmented reality applications improve the concept skills of preschool children.

Implications for practice and/or policy

Technology‐based classroom environments should be created in pre‐school education institutions.

Augmented reality applications in pre‐school education should be expanded in line with the gains.

Teachers should receive training on augmented reality applications.
BSACI 2021 guideline for the management of egg allergy
Authors: Leech Susan C. , Ewan Pamela W. , Skypala Isabel J. , Brathwaite Nicola , Erlewyn‐ Lajeunesse Mich , Heath Sarah , Ball Heidi , James Polly , Murphy Karen , Clark Andrew T.
Published: September 2021

This guideline advises on the management of patients with egg allergy. Most commonly egg allergy presents in infancy, with a prevalence of approximately 2% in children and 0.1% in adults. A clear clinical history will confirm the diagnosis in most cases. Investigation by measuring egg‐specific IgE (by skin prick testing or specific IgE assay) is useful in moderate‐severe cases or where there is diagnostic uncertainty. Following an acute allergic reaction, egg avoidance advice should be provided. Egg allergy usually resolves, and reintroduction can be achieved at home if reactions have been mild and there is no asthma. Patients with a history of severe reactions or asthma should have reintroduction guided by a specialist. All children with egg allergy should receive the MMR vaccine. Most adults and children with egg allergy can receive the influenza vaccine in primary care, unless they have had anaphylaxis to egg requiring intensive care support. Yellow Fever vaccines should only be considered in egg‐allergic patients under the guidance of an allergy specialist. This guideline was prepared by the Standards of Care Committee (SOCC) of the British Society for Allergy and Clinical Immunology (BSACI) and is intended for allergists and others with a special interest in allergy. The recommendations are evidence based. Where evidence was lacking, consensus was reached by the panel of specialists on the committee. The document encompasses epidemiology, risk factors, diagnosis, treatment, prognosis and co‐morbid associations.
Age‐specific thyrotropin references decrease over‐diagnosis of hypothyroidism in elderly patients in iodine‐excessive areas
Authors: Zhang Yingchai , Sun Yu , He Zhiwei , Xu Shuhang , Liu Chao , Li Yongze , Shan Zhongyan , Teng Weiping
Published: September 2021

Objective

Acute or chronic exposure to excess iodine has detrimental effects on thyroid physiology; therefore, this study aimed to determine the prevalence of overt hypothyroidism (OH) and subclinical hypothyroidism (SCH) in an elderly population residing in geographical areas with chronic exposure to excess iodine intake and to analyse contributing risk factors.

Design

This cross‐sectional study was conducted from 2016 to 2017 in areas of Jiangsu Province that have documented chronic exposure to high iodine intake.

Patients

We enroled 2559 adult participants using a multistage, stratified sampling method.

Measurements

Urinary iodine concentration (UIC), serum thyroid‐stimulating hormone (TSH) level and other relevant parameters were measured. Demographic information was recorded using a standardized questionnaire. The age‐specific TSH references were determined by the National Academy of Clinical Biochemistry guidelines. Univariate and multivariate logistic regression analyses were performed to identify risk factors for hypothyroidism in the study population.

Results

The median UIC of participants was 307.3 µg/L (interquartile range: 200.7, 469.8 μg/L). The prevalence of OH in subjects ≥70 years using laboratory reference ranges was 2.37%; however, it decreased to 1.78% with the use of an age‐specific reference range. Similarly, the prevalence of SCH also declined drastically from 29.59% to 2.96% with the application of an age‐specific reference range. In both univariate and multivariate models, advanced age, female gender and high UIC were identified as risk factors for hypothyroidism.

Conclusions

Usage of age‐specific TSH reference ranges led to a significantly lower prevalence of OH and SCH in the study population, thus preventing unnecessary over‐diagnosis and over‐treatment.
Conditioned medium derived from 3D tooth germs: A novel cocktail for stem cell priming and early in vivo pulp regeneration
Authors: Zhou Tengfei , Rong Mingdeng , Wang Zijie , Chu Hongxing , Chen Chuying , Zhang Jiayi , Tian Zhihui
Published: September 2021

Objectives

Conditioned medium (CM) from 2D cell culture can mitigate the weakened regenerative capacity of the implanted stem cells. However, the capacity of 3D CM to prime dental pulp stem cells (DPSCs) for pulp regeneration and its protein profile are still elusive. We aim to investigate the protein profile of CM derived from 3D tooth germs, and to unveil its potential for DPSCs‐based pulp regeneration.

Materials and Methods

We prepared CM of 3D ex vivo cultured tooth germ organs (3D TGO‐CM) and CM of 2D cultured tooth germ cells (2D TGC‐CM) and applied them to prime DPSCs. Influences on cell behaviours and protein profiles of CMs were compared. In vivo pulp regeneration of CMs‐primed DPSCs was explored using a tooth root fragment model on nude mice.

Results

TGO‐CM enhanced DPSCs proliferation, migration, in vitro mineralization, odontogenic differentiation, and angiogenesis performances. The TGO‐CM group generated superior pulp structures, more odontogenic cells attachment, and enhanced vasculature at 4 weeks post‐surgery, compared with the TGC‐CM group. Secretome analysis revealed that TGO‐CM contained more odontogenic and angiogenic growth factors and fewer pro‐inflammatory cytokines. Mechanisms leading to the differential CM profiles may be attributed to the cytokine–cytokine receptor interaction and PI3K‐Akt signalling pathway.

Conclusions

The unique secretome profile of 3D TGO‐CM made it a successful priming cocktail to enhance DPSCs‐based early pulp regeneration.
Probing behavior of Neophilaenus campestris on various plant species
Authors: Cornara Daniele , Morente Marina , Lago Clara , Markheiser Anna , Garzo Elisa , Moreno Aranzazu , Fereres Alberto
Published: September 2021

The recent history of Xylella fastidiosa Wells et al. introduction in Europe illustrates how the lack of knowledge about the bacterium‐vector‐host interactions hinders the application of effective containment strategies, with the bacterial spread that currently appears relentless. Vector behavior is a key component in plant pathogen transmission; therefore, detailed knowledge of vector probing behavior on various host plants would furnish useful data for containing the bacterium. Aiming at this goal, we carried out electrical penetration graph (EPG)‐assisted probing behavior observations of the spittlebug, Neophilaenus campestris (Fallen) (Hemiptera: Aphrophoridae), a candidate vector widespread in all the areas where X. fastidiosa is currently established. Spittlebug probing was first characterized on one of its preferred host plants, Bromus madritensis L. (Poaceae), over short (6 h) and long (16 h) time spans. Thereafter, we performed comparative observations of the spittlebug probing on B. madritensis, olive, and grapevine. Overall, the probing behavior of N. campestris, that is, the main characteristic waveforms, did not differ substantially from that of Philaenus spumarius (L.) (Hemiptera: Aphrophoridae); however, here we report and describe a new kind of xylem activity interruption, provisionally termed N2, not previously observed in P. spumarius. Considering the time spent in xylem ingestion as a percentage of the total probing time (host‐suitability indicator used for spittlebugs), grapevine and B. madritensis are the preferred hosts for N. campestris, with olive as the least suitable among the plants tested. Successful probes, that is, probes during which xylem ingestion occurred, on grapevine were 2.5× greater than olive. Therefore, our data on N. campestris probing behavior suggest that the spittlebug role in X. fastidiosa epidemiology in European vineyards should be given more attention. In the present manuscript, we also discuss the current difficulties in interpreting and analyzing the outcomes of EPG studies on spittlebugs.
Prenatal exposure to valproate and risk of congenital malformations—Could we have known earlier?—A population‐based cohort study
Authors: Christensen Jakob , Trabjerg Betina B. , Sun Yuelian , Gilhus Nils Erik , Bjørk Marte‐Helene , Tomson Torbjörn , Dreier Julie Werenberg
Published: September 2021

Objective

Prenatal exposure to the antiseizure medication (ASM) valproate is associated with an increased risk of congenital malformations, but warnings against the use of valproate in pregnancy were not issued until 2009. The objective was to study how early administrative health registers could have identified the teratogenic risk associated with valproate.

Methods

This was a population‐based cohort study of individual‐linked data from Danish health care and socioeconomic registers including children born in Denmark between January 1, 1997 and December 31, 2014. Information on ASM use, including valproate, in pregnancy was obtained from the Danish National Prescription Registry. Children identified with major congenital malformations from the Danish National Patient Register and the Danish Register of Causes of Death were included. Using logistic regression models, we estimated odds ratios (ORs) and 95% confidence intervals (CIs) for major congenital malformations during the first year of life in children with and without prenatal exposure to ASMs adjusted for potential confounders.

Results

Among the 895 507 children (males, 51.3%), 31 790 (3.6%) were diagnosed with a major congenital malformation in the first year of life. In the analyses including children born in 1997, the risk of major congenital malformations among children prenatally exposed to valproate compared with children not exposed to ASMs was increased by a fully adjusted OR (aOR) of 3.95 (95% CI = 1.65–9.47). With the addition of data from the following years, the teratogenic effect of valproate was further substantiated, as the precision of the estimate improved (1997–2014: aOR = 2.44, 95% CI = 1.80–3.30).

Significance

Using Danish health care data, we were able to identify a teratogenic risk associated with prenatal valproate exposure in children born in 1997, which is much earlier than prospective clinical cohorts. Health registry data represent an important tool for early identification of risk associated with drugs in pregnancy.