bluuebunny/crossref_metadata_2025 huggingface dataset:
Hygiene Aspects of Premature Nutrition
Authors: Fischer Matthias , Buschulte Anja
Published: October 2022

The very low birth weight and the not fully developed immune system make preterm infants especially susceptible to infections. Therefore microbiological food safety of preterm nutrition is a particular challenge. This is also due to the fact that breastfeeding is often not possible in these infants. There are several obstacles to breastfeeding, such as intensive care conditions and individual nutritional requirements of the newborn. The chapter covers the microbiological aspects of preterm nutrition, including quality requirements for commercial infant formulas, breastmilk fortifiers and extracted breast milk. The main pathogens of concern (e.g. Cronobacter spp. Salmonella spp. and Clostridium botulinum) are discussed in detail, including related food safety indicators. An important part of the chapter is devoted to the hygienic aspects of preterm formula preparation techniques, storage conditions and microbiological risks linked to certain feeding techniques (e.g. tube feeding). The risks associated with microorganisms found in commercial infant formula and in the prepared environment, as well as the risk of biofilm formation, are described. Options and requirements for risk mitigation are discussed in detail.
Acid-Induced Gelation of Milk: Formation Mechanism, Gel Characterization, and Influence of Different Techniques
Authors: Wang Xiuju , Zhao Zhengtao
Published: October 2022

Understanding the acid coagulation of milk is the core of producing different fermented dairy products. The formation of the gelled structure includes the decreased stability of casein micelles, aggregation, and the gradual development of the bonding between proteins during acidification and cold storage. The coagulation behavior of casein micelles and the physical properties of the final gels can be modified by processing techniques. Exopolysaccharides (EPS) produced by starter culture during fermentation also contribute significantly to the microstructure and texture of acid gels. This chapter discusses the mechanisms of acid-induced gelation of milk based on the modified nanocluster model of casein micelles. The recent findings of heating, high-pressure treatment, ultrasonication, and enzymatic modification on the acid gelation behavior of milk are described. The influence of different ingredients such as polysaccharides (endogenous and exogenous) and phenolic compounds on the physical properties of acid gels are also summarized.
Microplastics in the Marine Environment: A Review of Their Sources, Formation, Fate, and Ecotoxicological Impact
Authors: Haque Fatima , Fan Chihhao
Published: October 2022

Global plastic production is on the rise, and improper plastic management leads to the disposal of plastic in the environment, wherein it enters the environment, after degradation, as microplastics (size < 5 mm) and nanoplastics (size < 1 μm). The most common sink for the microplastics is the marine environment, including the sediment, deep sea, shorelines, and oceans. The objective of this study is to collate the environmental impact assessment of the microplastics in the marine habitat, focusing on the following main elements: (a) source and type of microplastics, specifically leading to the marine sink; (b) degradation pathways; (c) ecotoxicological impact on marine biota, since the smaller-sized microplastics can be digested by the marine biota and cause threats to them; (d) fate of microplastic in the marine environment, including the modes of transport and deposition. This chapter aims to provide a deeper insight into the fate of microplastics once it enters the marine environment, and the information could be a useful reference for the development of microplastic risk management strategies.
Outer Membrane Vesicles: A Challenging Yet Promising Platform for COVID-19 Vaccines
Authors: Izeli Portilho Amanda , De Gaspari Elizabeth
Published: October 2022

The outer membrane vesicles (OMVs) are vesicles released from Gram-negative bacteria, which present a range of biological applications, such as vaccine adjuvants. OMVs present several pathogen-associated molecular patterns, being immunogenic and capable of triggering different arms of the immune response. Thus, they are suitable for mucosal and parenteral delivery, feasible to obtain and have been used in licensed-vaccines previously. However, the extraction protocols and manipulations can modify OMVs cargo and, consequentially, the immunization results. Therefore, this chapter will review OMVs use as adjuvant and discuss results from COVID-19 vaccines which employed this technique.
Patient Safety in the Critical Care Setting: Common Risks and Review of Evidence-Based Mitigation Strategies
Authors: M. Arteaga Grace , Bacu Lilia , Moreno Franco Pablo
Published: October 2022

The Intensive Care Unit (ICU) has evolved in the last 50 years. This evolution’s main drivers include equipment and software improvements, the patient safety movement, and a better pathophysiological understanding of critical illness. There is mounting pressure from accreditation agencies, governmental regulation, financial challenges, operational dynamics, staffing changes, and increased acuity affecting-ICU care delivery and impacting patient safety. There are higher than ever expectations to improve clinical outcomes after an intensive care stay, to enhance patient safety, to increase family involvement in decision making, and merge the multidisciplinary medical experience into an effective teamwork. Leadership focus is directed towards increasing diversity and inclusion in the workforce while enhancing psychological safety. This review addresses the common risks for patient safety in the intensive care setting and describes the changes in mindset and application of evidence-based mitigation strategies.
Insights into the Wnt Signaling Pathway Evolution
Authors: Rismani Elham , Haghighi-Najafabadi Nasrin , Elyasi Far Babak , Shahbazi Behzad , Mafakher Ladan
Published: October 2022

Animals’ Wnt signaling pathways are highly preserved signal transduction pathways, which play a crucial role in embryogenesis and adult tissue homeostasis. This chapter reviews the three major Wnt pathways, focusing on some critical proteins in the Wnt/β-catenin path in terms of their evolution and role in homeostasis. Wnt proteins act as a gateway between extracellular, cytoplasmic, and nuclear components to transmit signaling pathways. The Frizzled (FZD) family as G-protein-coupled receptors activates the signaling pathways by binding to Wnt ligands. LRP5/6, members of the family of low-density lipoprotein receptors (LDLR), associate with FZD receptor and Wnt ligands as co-receptors to initiate the Wnt/β-catenin pathway. The Wnt/β-catenin pathway is regulated by antagonists such as the Dickkopf and secreted Frizzled-related protein (SFRP) families.
The Role of NGOs in Protecting and Preserving Cultural Heritage in the EU: The Case of Slovenia-Austria Cross-Border Program
Authors: Bobek Vito , Slanovc Manuela , Horvat Tatjana
Published: October 2022

The core part of this chapter is an analysis of how is the cultural heritage present in the EU Policies and in the Slovenia-Austria Interreg V Program in the previous and present multi-annual financial framework (2014–2020 and 2021–2027). The special focus is on the role of NGOs in protecting and preserving cultural heritage at the level of Slovenia. The final section identifies an example of a project idea titled HEGIRA-Heritage in Your Hands where NGOs in the field of cultural heritage are accepted as project partners. A historic forge in Bad Eisenkappel (Austria) serves as an authentic location to establish a “Centre for Forgotten Arts” where NGOs could play a distinctive role. Due to its strategically beneficial position, the center will serve as a gateway to Slovenia and bundle cross-border intangible cultural heritage offers. The implementation of the “Craftsmen in Residence” workshop series—aimed at schools, tourists, and interested citizens—will facilitate knowledge transfer and contribute to safeguarding traditional craftsmanship. HEGIRA builds capacity by connecting actors and institutions to develop an integrated cross-border tourist product, which will serve as a role model and can be transferred to other regions with similar territorial challenges and opportunities.
Indigenous Autonomy and Self-Determination in International Forest Financing Strategy: A Case Study from the Indigenous Bribri People of Costa Rica
Authors: Villhauer Britney
Published: October 2022

The efforts to protect the global environment, in principle, reflect Indigenous priorities through an appropriate cosmological perspective. However, international forest financing strategies through the United Nations Framework Convention on Climate Change are solely negotiated and agreed upon through state powers and governments, with nothing more than a symbolic gesture toward the essentiality of the Traditional Ecological Knowledge of Indigenous Peoples. The autonomy of Indigenous Peoples to negotiate their own financing models and forest conservation strategies are neglected in these international conventions, and are consequently relegated to the impulse of national governments. Despite Costa Rica’s adoption of the United Nations Declaration on the Rights of Indigenous Peoples, the ratification of the International Labor Organization’s Convention 169, and the passing of the 1977 Indigenous Law legally demarcating Indigenous territories in Costa Rica, the failure to recognize Indigenous autonomy and self-determination is a blight on Costa Rica’s record. My research in one of the Indigenous Bribri territories in Costa Rica demonstrates that while international forest financing strategies are a contemporary hot topic and pertinent issue of international diplomacy, it is essential that Costa Rica and other nations codify Indigenous autonomy and self-determination within these strategy developments for climate change mitigation.
Covalent Organic Frameworks for Ion Conduction
Authors: Lu Fei , Gao Yanan
Published: October 2022

Covalent organic frameworks (COFs) are an emerging class of crystalline porous materials constructed by the precise reticulation of organic building blocks through dynamic covalent bonds. Due to their facile preparation, easy modulation and functionalization, COFs have been considered as a powerful platform for engineering molecular devices in various fields, such as catalysis, energy storage and conversion, sensing, and bioengineering. Particularly, the highly ordered pores in the backbones with controlled pore size, topology, and interface property provide ideal pathways for the long-term ion conduction. Herein, we summarized the latest progress of COFs as solid ion conductors in energy devices, especially lithium-based batteries and fuel cells. The design strategies and performance in terms of transporting lithium ions, protons, and hydroxide anions are systematically illustrated. Finally, the current challenges and future research directions on COFs in energy devices are proposed, laying the groundwork for greater achievements for this emerging material.
How Should (and Shouldn’t) We Think About Profound Intellectual Disability?
Authors: Peabody Smith Ally ,   Philosophy Documentation Center
Published: October 2022

Many accounts of the grounds for human moral standing rely on the possession of higher-order capacities of mind that serve as status-conferring attributes, to the exclusion of those with significant intellectual impairments. Interconnectedly, our relationships with those with profound intellectual disability (PID) remain beneath their potential. Taking as a starting point Peter Singer’s graduated account of moral status, its assumptions about PID, and its implications for what we owe those with PID, I argue that rather than conceptualizing PIDs as severe cognitive deficit, we should characterize them as disabilities marked by the impossibility of successful, mutual linguistic communication. Considering existing relationships between non-PID and PID pairs, I center the potential for atypical forms of communication. I close with the beginnings of a more extensionally adequate grounds for moral status, where moral standing is a product of one’s being able to participate in the shared activity of developing and deepening relationships.
First records of the spider wasps Ctenocerus Dahlbom and Paraclavelia Haupt from Asia, with discussions on the systematics of Ctenocerinae (Hymenoptera: Pompilidae)
Authors: Shimizu Akira , Broad Gavin , Yoshimura Jin , Pitts James P.
Published: October 2022

We describe two new species of Ctenocerinae (Pompilidae) from Asia, i.e., Ctenocerus srilankae Shimizu sp. nov. from Sri Lanka and Paraclavelia arabiae Shimizu sp. nov. from Oman. These represent the first records of Ctenocerus Dahlbom, 1845 and Paraclavelia Haupt, 1930 in Asia. Two new combinations and a new synonymy are proposed: Ctenocerus fasciatus (Smith, 1851) (= Micropteryx fasciata Smith, 1851); Paraclavelia decipiens (Arnold, 1932) (= Clavelia decipiens Arnold, 1932); and Ctenocerus Dahlbom, 1845 (= Euclavelia Arnold, 1932). We discuss the difficulty of systematics of Ctenocerinae at generic level. The head and pronotal structures of Ctenocerus and Paraclavelia are presumably specialized for preying on trapdoor spiders. These structures are considered to have evolved independently of other unrelated parasitoid Pompilidae that have been confirmed or proposed to prey on trapdoor spiders. We also discuss the biogeographical distribution of these genera.
Evaluation of a Multilevel Laboratory Stewardship Intervention Targeted to Cardiac and Thoracic Surgical Services at an Academic Medical Center
Authors: Mathias Patrick C. , Khor Sara , Harris Kathryn , Wood Suzanne J. , Farjah Farhood
Published: October 2022

Context.—

Unnecessary laboratory tests are ordered because of factors such as preselected orders on order sets, clinician habits, and trainee concerns. Excessive use of laboratory testing increases patient discomfort via unnecessary phlebotomy, contributes to iatrogenic anemia, increases risk of bloodstream infections, and increases the cost of care.

Objective.—

To address these concerns, we implemented a multilevel laboratory stewardship intervention to decrease unnecessary laboratory testing, measured by laboratory tests per day attributed to service, across 2 surgical divisions with high laboratory use.

Design.—

The multilevel intervention included 5 components: stakeholder engagement, provider education, computerized provider order entry modification, performance feedback, and culture change supported by leadership. The primary outcome of the study was laboratory tests ordered per patient-day. Secondary outcomes included the number of blood draws per patient-day, total lab-associated costs, length of stay, discharge to a nursing facility, 30-day readmissions, and deaths. A difference-in-differences analytic approach assessed the outcome measures in the intervention period, with other surgical services as controls.

Results.—

The primary outcome of laboratory tests per patient-day showed a significant decrease across both thoracic and cardiac surgery services, with between 1.5 and 2 fewer tests ordered per patient-day for both services and an estimated 20 000 fewer tests performed during the intervention period. Blood draws per patient-day were also significantly decreased on the thoracic surgery service but not for cardiac surgery.

Conclusions.—

A multilevel laboratory stewardship intervention targeted to 2 surgical services resulted in a significant decrease in laboratory test use without negatively impacting length of stay, readmissions, or mortality.
Pharmaceutical Science in a post-COVID-19 world: The 13th APS PharmSci International Conference
Authors: Batchelor Hannah
Published: October 2022

The 13th APS PharmSciInternational Conference was held in Belfast between the 7th and 9th September 2022 at the city’s landmark Europa Hotel. The event, the first face-to-face APS meeting since Greenwich in 2019, attracted 365 delegates of more than 20 nationalities. A key theme running through the conference was how innovation and teamwork in the pharmaceutical sciences, often across international boundaries, continue to drive the recovery of patients, healthcare organizations, the economy, and society to overcome the deleterious effects of the COVID-19pandemic.
“I feel it in my gut:” Epistemic motivations, political beliefs, and misperceptions of COVID-19 and the 2020 U.S. presidential election
Authors: Young Dannagal G. , Maloney Erin K. , Bleakley Amy , Langbaum Jessica B.
Published: October 2022

This project examines the intersection of political constructs and epistemic motivations as they relate to belief in misinformation. How we value the origins of knowledge – through feelings and intuition or evidence and data – has important implications for our susceptibility to misinformation. This project explores how these epistemic motivations correlate with political ideology, party identification, and favorability towards President Trump, and how epistemic and political constructs predict belief in misinformation about COVID and the 2020 election. Results from a US national survey from Nov-Dec 2020 illustrate that Republicans, conservatives, and those favorable towards President Trump held greater misperceptions about COVID and the 2020 election. Additionally, epistemic motivations were associated with political preferences; Republicans and conservatives were more likely to reject evidence, and Trump supporters more likely to value feelings and intuition. Mediation analyses support the proposition that Trump favorability, Republicanism, and conservatism may help account for the relationships between epistemic motivations and misperceptions. Results are discussed in terms of the messaging strategies of right-wing populist movements, and the implications for democracy and public health.
EFFECT OF VARIABLE MAGNETIC FIELDS ON CHROMIUM (VI) REMOVAL CAPACITY FROM WATER BY WATERCRESS (NASTURTIUM OFFICINALE): A MODEL PROPOSED
Authors: Contreras García Octavio , Carreño  Aguilera Gilberto , Baltazar  Vera Juan Carlos , VALTIERRA OLIVARES JOEL EVERARDO , Morales  Martínez Jorge Luis , Rodriguez Rodriguez Carolina de Jesús , Abraham  Juarez Maria del Rosario , HORTA RANGEL FRANCISCO ANTONIO
Published: October 2022

This study presents the effect of a variable magnetic field on chromium (VI) absorption typical of a hydroponic system for Phytoabsorption using watercress (Nasturtium officinale) plants in a batch system. The experimentation was carried out applying magnetic fields of 12 and 44 mT and comparing it with the system without field; the field was generated by arrangement of coils and specific conditions for each system, for this work solutions with concentrations of 1, 10, and 20 ppm of chromium (VI) were used during a four-week process with the objective of evaluating the effect of the magnetic field in bioaccumulation in the system. The results indicate that the absorption of chromium increased per week, having that in most of the study cases (0 mT, 12 mT, 44 mT) the highest absorption was achieved in week 4, having that for all cases between week 3 and 4 the difference is minimal, likewise the results indicate that when implementing a magnetic field bioaccumulation is favored showing similar results for both magnetic fields studied in this work. The highest removal efficiency for the study cases corresponding to 1 ppm and 10 ppm was achieved when a field of 12 mT was applied, reporting values of 0.83 and 0.85 respectively, with respect to the case of 20 ppm, the highest efficiency was 0.83 applying a field of 44 mT. Statistical correlation models were found using multiple linear regression model finding significant variables (the magnetic field, concentration of chromium (VI), exposure time). With the interaction model we found significant interactions (concentration*week and field*concentration), and with the model of quadratic terms and interactions (non-significant field*week), which presented adequate adjustments description of the phenomenon, r^2=0.965 using coefficient analysis.

Keywords: Chromium (VI), Removal capacity, Watercress plants, Magnetic field, Hydroponic system
Rendering Research
Authors: Cox Geoff , Andersen Christian Ulrik
Published: October 2022

To render is to give something “cause to be” or “hand over” (from the Latin reddere “give back”) and enter into an obligation to do or make something like a decision. More familiar perhaps in computing, to render is to take an image or file and convert it into another format or apply a modification of some kind, or in the case of 3D animation or scanning. To render is to animate it or give it volume. In this issue, we ask, what it means to render research? How does the rendering of research typically reinforce certain limitations of thought and action? We ask these questions in the context of more and more demands on researchers to produce academic outputs in standardised forms, in peer-reviewed journals and such like that are legitimised by normative values. So, then, how to render research otherwise?
Re:searching Together (in Two Acts)
Authors: Hill Clareese , Clarke Elly
Published: October 2022

Here are the visual scriptal remains of – and for – two performances presented by artist-researchers Clareese Hill and Elly Clarke at Transmediale Festival On Refusal and at ERG in Brussels in January and March 2022 respectively:
- Mixtape / Shuffle Play (USA/UK 27.1.22)
- Meditational Drag/gy Sales Pitch (BEL 24 & 26.3.22)
Featuring:
● research fragments: dis:mantled & re:assembled● wormholes: conjured & cared-for● extracts: from past & not yet realised performances● quotes: from artists & scholars we imagine ourselves to be in dialogue with ● requests: to unmute, to turn on video● co-host(ess)ing● a spanning: of time, of the western geographical terrains we reside in, ● like-minded, differently em:bodied resistance: to the drag/gy performance of academic positioning, placing, posing and posturing for the sake of legibility
The two Acts may be read consecutively or separately, or else watched as they were performed, by following the QR codes embedded within this text.
Un funeral lleno de ceremonial (II)
Authors:   Universitat Oberta de Catalunya, Estanyol i Casals Elisenda
Published: October 2022

Tal y como vimos en la primera entrega de este artículo, el funeral de la Reina Isabel II del Reino Unido reunió a más de 500 mandatarios de todo el mundo, 2.000 invitados dentro de la abadía de Westminster y una audiencia de millones de personas que siguieron la retransmisión en directo. El acto, que duró menos de una hora, fue un ejemplo de ceremonial, etiqueta y protocolo. En esta última entrega, analizamos los símbolos, la parte musical, la etiqueta y la ornamentación floral.
Islamic Middle East: Characteristics and Some Features of Modern Transformations of Political Identity
Authors: Alekseev Nikolai Nikolaevich
Published: October 2022

The subject of the study is the modern transformation of political identity in the Middle Eastern states and communities that profess Islam. The author examines in detail the complex of identifications that exist in the Middle East region. Particular attention is paid to the interaction and harmonization of religious, imperial, national and ethno-cultural identities. Regional features of identification transformations are considered both in the context of transformations in the global system of international relations, and taking into account the regional specifics of political processes and the general originality of the socio-cultural space. The general tendencies typical for all communities of the region under consideration are analyzed, as well as particular features of identity transformations as a factor of state policy on the example of Turkey and Iran. The novelty of the study lies in the analysis of transnational identification transformations in the Middle East region in the context of global trends towards the growing role of transnational identity in international relations and world politics. The author's special contribution to the study of the topic is the combination of fundamental theoretical approaches to the study of identity with the methodology of system analysis, which allows to more accurately describe the complex multi-level structure of modern identities, based on the current works of Russian, Western and Middle Eastern researchers. The main results of the study are the determination of general and particular features of identification transformations in the Middle East region, as well as the definition of the functions of religious and imperial identities in the system of identifications.
Little skate genome provides insights into genetic programs essential for limb-based locomotion
Authors: Yoo DongAhn , Park Junhee , Lee Chul , Song Injun , Lee Young Ho , Yun Tery , Lee Hyemin , Heguy Adriana , Han Jae Yong , Dasen Jeremy S , Kim Heebal , Baek Myungin
Published: October 2022

The little skate Leucoraja erinacea, a cartilaginous fish, displays pelvic fin driven walking-like behavior using genetic programs and neuronal subtypes similar to those of land vertebrates. However, mechanistic studies on little skate motor circuit development have been limited, due to a lack of high-quality reference genome. Here, we generated an assembly of the little skate genome, with precise gene annotation and structures, which allowed post-genome analysis of spinal motor neurons (MNs) essential for locomotion. Through interspecies comparison of mouse, skate and chicken MN transcriptomes, shared and divergent gene expression profiles were identified. Comparison of accessible chromatin regions between mouse and skate MNs predicted shared transcription factor (TF) motifs with divergent ones, which could be used for achieving differential regulation of MN-expressed genes. A greater number of TF motif predictions were observed in MN-expressed genes in mouse than in little skate. These findings suggest conserved and divergent molecular mechanisms controlling MN development of vertebrates during evolution, which might contribute to intricate gene regulatory networks in the emergence of a more sophisticated motor system in tetrapods.
Evolutionary shaping of human brain dynamics
Authors: Pang James C , Rilling James K , Roberts James A , van den Heuvel Martijn P , Cocchi Luca
Published: October 2022

The human brain is distinct from those of other species in terms of size, organization, and connectivity. How do structural evolutionary differences drive patterns of neural activity enabling brain function? Here, we combine brain imaging and biophysical modeling to show that the anatomical wiring of the human brain distinctly shapes neural dynamics. This shaping is characterized by a narrower distribution of dynamic ranges across brain regions compared with that of chimpanzees, our closest living primate relatives. We find that such a narrow dynamic range distribution supports faster integration between regions, particularly in transmodal systems. Conversely, a broad dynamic range distribution as seen in chimpanzees facilitates brain processes relying more on neural interactions within specialized local brain systems. These findings suggest that human brain dynamics have evolved to foster rapid associative processes in service of complex cognitive functions and behavior.
Towards survival prediction of cancer patients using medical images
Authors: Ul Haq Nazeef , Tahir Bilal , Firdous Samar , Amir Mehmood Muhammad
Published: October 2022

Survival prediction of a patient is a critical task in clinical medicine for physicians and patients to make an informed decision. Several survival and risk scoring methods have been developed to estimate the survival score of patients using clinical information. For instance, the Global Registry of Acute Coronary Events (GRACE) and Thrombolysis in Myocardial Infarction (TIMI) risk scores are developed for the survival prediction of heart patients. Recently, state-of-the-art medical imaging and analysis techniques have paved the way for survival prediction of cancer patients by understanding key features extracted from Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) scanned images with the help of image processing and machine learning techniques. However, survival prediction is a challenging task due to the complexity in benchmarking of image features, feature selection methods, and machine learning models. In this article, we evaluate the performance of 156 visual features from radiomic and hand-crafted feature classes, six feature selection methods, and 10 machine learning models to benchmark their performance. In addition, MRI scanned Brain Tumor Segmentation (BraTS) and CT scanned non-small cell lung cancer (NSCLC) datasets are used to train classification and regression models. Our results highlight that logistic regression outperforms for the classification with 66 and 54% accuracy for BraTS and NSCLC datasets, respectively. Moreover, our analysis of best-performing features shows that age is a common and significant feature for survival prediction. Also, gray level and shape-based features play a vital role in regression. We believe that the study can be helpful for oncologists, radiologists, and medical imaging researchers to understand and automate the procedure of decision-making and prognosis of cancer patients.
Five-year LDL-cholesterol trend and its predictors among type 2 diabetes patients in an upper-middle-income country: a retrospective open cohort study
Authors: Wan Kim Sui , Hairi Noran Naqiah , Mustapha Feisul , Ismail Mastura , Mohd Yusoff Muhammad Fadhli , Moy Foong Ming
Published: October 2022

Background

Patients with diabetes have increased risks of cardiovascular diseases (CVD), and their LDL-cholesterol (LDL-C) has to be treated to target to prevent complications. We aim to determine the LDL-C trend and its predictors among patients with type 2 diabetes (T2D) in Malaysia.

Methods

This was a retrospective open cohort study from 2013 to 2017 among T2D patients in public primary health care clinics in Negeri Sembilan state, Malaysia. Linear mixed-effects modelling was conducted to determine the LDL-C trend and its predictors. The LDL-C target for patients without CVD was <2.6 mmol/L, whereas <1.8 mmol/L was targeted for those with CVD.

Results

Among 18,312 patients, there were more females (55.9%), adults ≥60 years (49.4%), Malays (64.7%), non-smokers (93.6%), and 45.3% had diabetes for <5 years. The overall LDL-C trend reduced by 6.8% from 2.96 to 2.76 mmol/L. In 2017, 16.8% (95% CI: 13.2–21.0) of patients without CVD and 45.8% (95% CI: 44.8–46.8) of patients with CVD achieved their respective LDL-C targets. The predictors for a higher LDL-C trend were younger adults, Malay and Indian ethnicities, females, dyslipidemia, and diabetes treatment with lifestyle modification and insulin. Longer diabetes duration, obesity, hypertension, retinopathy, statin therapy, achievement of HbA1c target and achievement of BP target were independent predictors for a lower LDL-C trend.

Conclusions

The LDL-C trend has improved, but there are still gaps between actual results and clinical targets. Interventions should be planned and targeted at the high-risk populations to control their LDL-C.
Optimal Working Capital Solutions for Companies in the Field of Environment
Authors: Hoan Nguyen The
Published: October 2022

The study aims to analyze the impact of working capital management on the profitability of companies in the environmental sector in Vietnam. The study sample was 68 companies doing business in the environmental sector, corresponding to 628 observations from 2010 to 2021. Using the Tobit regression model, the author identified the significant effect of the average collection period and average payment period on the profitability of companies. Based on the study, the author offers some discussions and assessments about the critical role of shortening the cash conversion cycle, shortening the receivables period, and financial solution recommendations to improve profitability for companies in the environmental sector in Vietnam.
Credit Risk and its Impact on Profit Quality (An Applied Study in a Sample of Commercial Banks Registered in the Iraq Stock Exchange 2011-2020)
Authors: Alnakee Mustafa Razzaq , Wadi Mohamed Hassan , Bkhebukh Anmar Slman
Published: October 2022

This research aims to present the analysis and measurement of the impact of credit risks on the quality of profits for commercial banks. This research was applied to a sample of commercial banks listed in the Iraq Stock Exchange that were selected according to the date of their establishment, namely, the Commercial Bank of Iraq (BCOI), Bank of Baghdad (BBOB), for the period 2011-2020, and the descriptive analytical approach was used in describing, analyzing and measuring all the variables from Through the actual financial data available from the research sample banks, with the aim of evaluating and measuring the independent variable (credit risk) and the dependent variable (profit quality), and analyzing and interpreting the relationship and the effect between them. The analysis of variance was used using the program (spss rv20) to measure the correlation and effect between the results of the study. The credit risk was used in the research and the quality of profits, and this research reached a set of conclusions within the framework of its main and subsidiary hypotheses, which can be summarized as follows, it appeared that there was a correlation with a significant impact and statistical significance between credit risk and the quality of profits in commercial banks, the research sample. And its benefits are on their due dates, so banks should seek the assistance of experts who have practical competence and benefit from their expertise and advice regarding credit risks in particular, bearing in mind that there are other determinants that commercial banks must take caution and try to monitor and control them constantly.
Factors Associated With Dermatologic Follow-up vs Emergency Department Return in Patients With Hidradenitis Suppurativa After an Initial Emergency Department Visit
Authors: Wang Cynthia X. , Buss Joanna L. , Keller Matthew , Anadkat Milan J.
Published: October 2022

Importance

Emergency department (ED) visitation is common for the treatment of hidradenitis suppurativa (HS), whereas dermatology outpatient care is low. The reasons underlying this differential follow-up have not been elucidated.

Objective

To assess the interventions and patient factors associated with ED return following an initial ED visit for HS.

Design, Setting, and Participants

This retrospective cohort study used data from the IBM® MarketScan® Commercial and Multi-State Medicaid databases (trademark symbols retained per database owner requirement). An HS cohort was formed from patients who had 2 or more claims for HS during the study period of 2010 to 2019 and with at least 1 ED visit for their HS or a defined proxy. Data were analyzed from November 2021 to May 2022.

Exposures

Factors analyzed included those associated with the ED visit and patient characteristics.

Main Outcomes and Measures

Primary outcomes were return to the ED or dermatology outpatient follow-up for HS or related proxy within 30 or 180 days of index ED visit.

Results

This retrospective cohort study included 20 269 patients with HS (median [IQR] age, 32 [25-41] years; 16 804 [82.9%] female patients), of which 7455 (36.8%) had commercial insurance and 12 814 (63.2%) had Medicaid. A total of 9737 (48.0%) patients had incision and drainage performed at the index ED visit, 14 725 (72.6%) received an oral antibiotic prescription, and 9913 (48.9%) received an opioid medication prescription. A total of 3484 (17.2%) patients had at least 1 return ED visit for HS or proxy within 30 days, in contrast with 483 (2.4%) who had a dermatology visit (P < .001). Likewise, 6893 (34.0%) patients had a return ED visit for HS or proxy within 180 days, as opposed to 1374 (6.8%) with a dermatology visit (P < .001). Patients with Medicaid and patients who had an opioid prescribed were more likely to return to the ED for treatment of their disease (odds ratio [OR], 1.48; 95% CI, 1.38-1.58; and OR, 1.48; 95% CI, 1.39-1.58, respectively, within 180 days) and, conversely, less likely to have dermatology follow-up (OR, 0.16; 95% CI, 0.14-0.18; and OR, 0.81; 95% CI, 0.71-0.91, respectively, within 180 days).

Conclusions and Relevance

This cohort study suggests that many patients with HS frequent the ED for their disease but are not subsequently seen in the dermatology clinic for ongoing care. The findings in this study raise the opportunity for cross-specialty interventions that could be implemented to better connect patients with HS to longitudinal care.
Effects of Kisspeptin Administration in Women With Hypoactive Sexual Desire Disorder
Authors: Thurston Layla , Hunjan Tia , Ertl Natalie , Wall Matthew B. , Mills Edouard G. , Suladze Sofiya , Patel Bjial , Alexander Emma C. , Muzi Beatrice , Bassett Paul A. , Rabiner Eugenii A. , Bech Paul , Goldmeier David , Abbara Ali , Comninos Alexander N. , Dhillo Waljit S.
Published: October 2022

Importance

Despite being the most common female sexual health complaint worldwide, current treatment options for hypoactive sexual desire disorder (HSDD) are limited in their safety and effectiveness. The hormone kisspeptin is a key endogenous activator of the reproductive hormonal axis with additional emerging roles in sexual and emotional behavior; however, its effects in women with HSDD are unknown.

Objective

To test the hypothesis that kisspeptin enhances sexual and attraction brain processing in women with HSDD.

Design, Setting, and Participants

This randomized clinical trial was double-masked and placebo controlled with a 2-way crossover. The trial was conducted in a university research setting in the UK from October 2020 to April 2021. Eligible participants were premenopausal women with HSDD. Functional neuroimaging, psychometric, and hormonal analyses were employed to investigate the effects of kisspeptin administration on brain processing, in response to erotic stimuli (erotic videos) and facial attraction (face images of varying attractiveness). Data were analyzed from May to December 2021.

Interventions

A 75-minute intravenous infusion of kisspeptin-54 (1 nmol/kg/h) vs equivalent-rate placebo infusion.

Main Outcomes and Measures

Blood oxygen level–dependent responses across the whole brain and regions of interest during kisspeptin vs placebo administration in response to erotic and facial attraction stimuli.

Results

Of the 40 participants who were randomized, 32 women completed both kisspeptin and placebo visits, with a mean (SE) age of 29.2 (1.2) years. Kisspeptin administration resulted in modulations in sexual and facial attraction brain processing (deactivation of the left inferior frontal gyrus:Zmax, 3.76;P = .01; activation of the right postcentral and supramarginal gyrus:Zmax, 3.73;P < .001; deactivation of the right temporoparietal junction:Zmax 4.08;P = .02). Furthermore, positive correlations were observed between kisspeptin-enhanced hippocampal activity in response to erotic videos, and baseline distress relating to sexual function (r = 0.469;P = .007). Kisspeptin’s enhancement of posterior cingulate cortex activity in response to attractive male faces also correlated with reduced sexual aversion, providing additional functional significance (r = 0.476,P = .005). Kisspeptin was well-tolerated with no reported adverse effects.

Conclusions and Relevance

These findings lay the foundations for clinical applications for kisspeptin in women with HSDD.

Trial Registration

ISRCTN trial registry identifier:ISRCTN17271094
Assessment of Oncology Advanced Practice Professional Willingness to Participate in Medical Aid in Dying
Authors: Singer Jonathan , Daum Courtney , Shen Megan J. , Zecha Gabrielle , Kaplan Louise , Plakovic Kathy , Blazey Meagan , Arnold Molly , Silko Barbara , Baker Kelsey , Loggers Elizabeth T.
Published: October 2022

Importance

In 2021, New Mexico passed legislation allowing nurse practitioners and physician assistants (referred to herein as advanced practice professionals [APPs]) to prescribe medications for medical aid in dying (MAID). Other US states with existing MAID laws (eg, Washington) are also considering expanding MAID prescribing authority to APPs. There is a lack of research exploring APP knowledge of, willingness to, and comfort with acting as a prescribing or consulting clinician for MAID.

Objective

To assess perspectives of oncology APPs regarding MAID, including their willingness to prescribe and/or consult for MAID and factors associated with willingness.

Design, Setting, and Participants

This cross-sectional, self-report survey study used data collected from APPs working at a comprehensive cancer center in Washington State in fall 2021.

Main Outcomes and Measures

The primary survey question was whether APPs would be willing to participate in death with dignity, the term used for MAID in Washington. Survey questions evaluated how influential specific factors were on APP views on MAID as well as respondents’ knowledge of and comfort with aspects of the MAID process.

Results

Of 167 eligible APPs, 77 (46.1%) responded to the survey. Most respondents (68 [88.3%]) reported their race and ethnicity as White; 72 (93.5%) identified as a woman. Medical oncology (28 [36.4%]) was the most common field of practice, and 21 respondents (27.3%) reported having practiced as an APP for 6 to 10 years. Of all respondents, 61 (79.2%) reported having at least 1 patient who inquired about MAID; depending on the question, less than a third of respondents (5.0%-27.0%) endorsed feeling knowledgeable or very knowledgeable about any aspect of the MAID process. In this study, 39 APPs (50.6%) endorsed being willing to participate in MAID either as a consulting or prescribing clinician, whereas 31 (40.3%) were uncertain of whether they would participate. Willingness to participate was associated with having had more patients pursue MAID (33 of the 39 willing participants [84.6%] vs 15 of the 31 unsure participants [48.4%] reported having 1 or more patients pursue MAID). Higher knowledge and comfort scores were both significantly associated with increased odds of being willing to participate (odds ratio, 1.14 per 1-point score increase [95% CI, 1.03-1.27]; P = .01) vs unsure (1.18 [95% CI, 1.07-1.30; P = .001).

Conclusions and Relevance

The results of this survey study suggest that oncology APPs may require preparation for the addition of MAID to their scope of practice. This study also raises questions for future research regarding support for APPs who may be considering participation in MAID but question their role or want physician involvement.
Being Precise About Precision Mental Health
Authors: Szatmari Peter , Susser Ezra
Published: October 2022

This Viewpoint discusses the limitations of precision medicine and compares it with evidence-based medicine.
Time‐resolved transcriptomics of mouse gastric pit cells during postnatal development reveals features distinct from whole stomach development
Authors: Wei Ying , Xu Zeqian , Hu Miaomiao , Wu Zhongqin , Liu Axian , Czajkowsky Daniel M. , Guo Yan , Shao Zhifeng
Published: October 2022

Whole‐organ transcriptomic analyses have emerged as a common method for characterizing developmental transitions in mammalian organs. However, it is unclear if all cell types in an organ follow the whole‐organ defined developmental trajectory. Recently, a postnatal two‐stage developmental process was described for the mouse stomach. Here, using laser capture microdissection to obtain in situ transcriptomic data, we show that mouse gastric pit cells exhibit four postnatal developmental stages. Interestingly, early stages are characterized by the up‐regulation of genes associated with metabolism, a functionality not typically associated with pit cells. Hence, beyond revealing that not all constituent cells develop according to the whole‐organ determined pathway, these results broaden our understanding of the pit cell phenotypic landscape during stomach development.
The gut microbiota of silkworm are altered by antibiotic exposure
Authors: Li Chengxu , Xu Shuo , Xiang Chunjie , Xu Shixia , Zhou Qihai , Zhang Junfeng
Published: October 2022

In recent years, antibiotics have frequently been detected in soil, lakes, and rivers. Antibiotic residues in the environment may alter microbial structure and cause bacterial resistance, but their effect on interactions among host microbiota is still poorly understood. To investigate this issue, here we used silkworm (Bombyx mori) fed on antibiotic‐treated mulberry leaf as a model to explore the effects of antibiotic exposure on gut bacteria and fungi. We observed that elimination of fungi significantly reduced bacterial richness and diversity in silkworm intestine after exposure to the antifungal amphotericin B, while the elimination of bacteria dramatically increased the richness and diversity of fungi after exposure to the antibacterial ampicillin–streptomycin. Thus, antibiotic‐treated mulberry leaf significantly altered the community structure of microbiota in the gut of silkworm. Clearance of gut bacteria enhanced the correlation between gut fungi and leaf‐derived fungi, while clearance of gut fungi promoted abnormal proliferation of gut bacteria. These data provide a simple model to explore the comprehensive effect of diet‐derived bacteria, fungi, and antibiotics on gut microbiota.
Multiple Shape Manipulation of Liquid Crystal Polymers Containing Diels‐Alder Network
Authors: Huang Xin , Qin Lang , Wang Jinlei , Zhang Xiao , Peng Bo , Yu Yanlei
Published: October 2022

Multiple shape manipulation of soft materials, including reversible deformation, shape memory effect, and shape remolding, are highly desirable in morphing structures and soft actuators. Although liquid crystal network (LCN) is a promising candidate for realizing anisotropic reversible deformation, developing LCN with multiple shape manipulation remains a multitude of challenges, which is limited to the regulation of mesogens alignment and network topological rearrangement. Here, multiple shape manipulation is demonstrated by a newly designed LCN containing azobenzene moieties and a dynamic Diels‐Alder (DA) network. Photodeformation of the LCN is attributed to the ordered lamellar structure of mesogens formed by annealing‐induced self‐assembly. Light‐induced shape memory effect leads to reprogrammable shape changes due to the light‐switchable glass transition temperature of the azobenzene‐containing LCN. Moreover, the dynamic equilibrium of the DA network endows the LCN with liquid state remoldability and solid state plasticity, which further contributes to diverse 3D geometric shapes in shape remolding. Such LCN exhibiting flexible deformation and remolding properties provides a new photoresponsive block for the fabrication of soft actuators.
3D Printed Fractal Metamaterials with Tunable Mechanical Properties and Shape Reconfiguration
Authors: Wang Dong , Dong Le , Gu Guoying
Published: October 2022

Lattice metamaterials constructed by curved microstructures exhibit large stretchability and are promising in soft electronics and soft robotics. Fractal structures are particularly efficient in improving stretchability as it shows multiple‐order uncurling. However, the development of fractal metamaterials is hindered by hierarchical structures and large deformations. In this study, a design framework combining experiments, hierarchical theoretical models, and finite element simulations is developed to program the mechanical behaviors of fractal metamaterials. For 3D printing, a digital design tool is developed to visualize the structure and automatically generate the manufacturing representations. Results show that large stretchability (≈360%), bionic stress–strain curve matching, and imperfection insensitivity can be programmed by tuning the geometric parameters. An integrated device of an electromyogram sensor embedded in an imperfection‐insensitive fractal metamaterial that matches the J‐shaped stress–strain curve of human skin is demonstrated. Light‐emitting diode devices based on fractal metamaterial with shape reconfiguration are also presented. This st paves a new way to realize multifunctional soft devices using fractal metamaterials.