bluuebunny/crossref_metadata_2025 huggingface dataset:
How policy designs influence the innovation performance of China's emergency industry: an institutional grammar perspective
Authors: Yang Chao , Jia Wei
Published: November 2023

Purpose

This study provides a configurational examination of how policy designs influence the innovation performance of the emergency industry in China.

Design/methodology/approach

This study employs the Data Envelopment Analysis Malmquist index (DEA-Malmquist) to quantify the innovation performance of the emergency industry and then codes the innovation policies to calculate the syntactic components based on institutional grammar tools (IGTs). The configurations of syntactic components were determined by applying the fuzzy-set qualitative comparative analysis (fsQCA).

Findings

The results indicate that rules- and norms-oriented policy designs would improve the innovation performance of China's emergency industry. In the developed provinces, the “Deontic” and “aIm” combinations in the policy are useful for improving performance. In the developing provinces, the ambiguity of the “aIm” and “Context” conditions in the policy is leading to low performance. Additionally, a lack of strategy-oriented policy design would also result in poor performance.

Originality/value

Most previous studies used substitute variables to understand policy impacts. This study contributes to identifying the impacts of the syntactic components of policy designs on the innovation performance of the emergency industry. The findings can assist policymakers in developing more effective policies to stimulate innovation development in the emergency industry.
The impact of inclusive leadership on employees' innovative behavior – an intermediary model with moderation
Authors: Zhang Guangning , Zhao Wenjia
Published: November 2023

Purpose

This study aims to explore the influence mechanism of inclusive leadership on employees' innovative behavior, in order to provide useful inspiration for leaders and enterprises to develop.

Design/methodology/approach

This study constructs a moderated mediation model based on the valid questionnaire data of 211 employees in service in enterprises and used SPSS23.0 and AMOS24.0 analysis software to analyze the data and test the theoretical hypotheses, and explore the influence mechanism of inclusive leadership on employees' innovative behavior.

Findings

The empirical findings show that inclusive leadership has a significant positive impact on employees' innovative behavior; organizational harmony plays a mediating role in the relationship between inclusive leadership and employees' innovative behavior; and innovation self-efficacy plays a positive moderating role between organizational harmony and employees' innovative behavior. Therefore, inclusive leadership can create a harmonious organizational climate and further improve employees' innovative behavior under the influence of employees' creative self-efficacy, which can promote innovative behavior and sustainable development of enterprises.

Originality/value

The authors put two variables, organizational harmony and employees' innovation self-efficacy, into the same model for correlation tests for the first time, and introduced into the mechanism of inclusive leadership's influence on employees' innovation behavior, which broadened people's understanding of organizational harmony and innovation self-efficacy and broadened the ideas for the subsequent research about the relationship between them.
Cutaneous vasculitis in autoinflammatory diseases
Authors: Chen Ko‐Ron
Published: November 2023

Autoinflammatory diseases (AIDs) characterized by recurrent episodes of localized or systemic inflammation are disorders of the innate immune system. Skin lesions are commonly found in AIDs and cutaneous vasculitis can coexist with AIDs and even present as the most striking feature. This review aims to focus on the frequent cutaneous vasculitis association in three monogenic AIDs including familial Mediterranean fever (FMF), deficiency of adenosine deaminase type 2 (DADA2), and the recently identified adult‐onset VEXAS (vacuoles, E1 enzyme, X‐linked, autoinflammatory, somatic) syndrome. Cutaneous vasculitis in FMF is characterized by: (1) small‐vessel vasculitis similar to IgA vasculitis with palpable purpura but increased intussusception complication and less vascular IgA deposit, and (2) cutaneous arteritis–like vasculitis presenting as subcutaneous nodules most often with higher glomerular involvement. DADA2 has a wide spectrum of clinical presentations ranging from fatal systemic vasculitis with multiple strokes, especially in pediatric patients, to limited cutaneous disease in middle‐aged patients. DADA2 shares similar clinical and histopathological features with polyarteritis nodosa (PAN). As a result, DADA2 is commonly initially misdiagnosed as childhood PAN. Livedo racemosa reveals the most common cutaneous manifestation of cutaneous vasculitis in patients with DADA2. VEXAS syndrome is a life‐threatening disease. A diagnosis of VEXAS syndrome should be strongly considered or could be made in patients with skin lesions characterized by Sweet syndrome–like eruption, livedo racemosa, concomitant relapsing polychondritis, deep venous thrombosis, pulmonary involvement, and progressive hematologic abnormalities such as myelodysplastic syndrome with a unique finding of cytoplasmic vacuoles in myeloid and erythroid precursor cells from bone marrow aspirate smear. As skin involvement is common in AIDs and may present as the most frequent manifestation, especially in DADA2 (70% to 90%) and VEXAS syndrome (83% to 91%), dermatologists play a crucial role in contributing to the early diagnosis of these AIDs with early initiation of the appropriate therapy to avoid progressing fatal outcomes.
Towards a mechanistic understanding of animal–ecosystem interactions
Authors: Meyer G. Adam , Leroux Shawn J.
Published: November 2023

Research Highlight: Ferraro, K. M., Welker, L., Ward, E. B., Schmitz, O. J., & Bradford, M. A. (2023). Plant mycorrhizal associations mediate the zoogeochemical effects of calving subsidies by a forest ungulate. Journal of Animal Ecology, https://doi.org/10.1111/1365‐2656.14002. Animals play large roles in ecosystem elemental cycling but predicting effects in diverse contexts remains a substantial challenge. Fundamental to progress is (1) identifying mechanisms by which animals impact nutrient distribution and cycling, and (2) disentangling how environmental context mediates the operation of alternative mechanisms. In an elegant field experiment, Ferraro et al. (2023) provide the first detailed exploration of the impact of nutrient inputs from mammalian parturition on soil functioning and the stoichiometry of plant tissues. The authors find that nitrogen from experimental additions of ungulate parturition material (natal fluids) is rapidly incorporated into microsite soil organic pools and plant tissues. They also find that soil processes (soil microbial biomass, rates of carbon mineralization, nitrogen mineralization and nitrification) and the nitrogen content of plant tissues above‐ and belowground are increased by addition of parturition material. Notably, the authors identify that increases in some soil processes and plant tissue nitrogen are weaker in microsites dominated by ericoid mycorrhizal plants than those dominated by ectomycorrhizal plants. These findings demonstrate that parturition depositions, a ubiquitous but overlooked mechanism of mammalian impacts on ecosystems, impact ecosystem processes and plant tissue stoichiometry. Furthermore, plant–fungal associations are a predictive axis of context dependency mediating zoogeochemical effects at fine scales. Ferraro et al.'s (2023) novel approach simultaneously advances mechanistic understanding of animal–ecosystem interactions at fine scales and facilitates prediction of ungulate effects on nutrient availability at landscape extents.
Measuring restrictiveness of Medicare Advantage networks: A claims‐based approach
Authors: Feyman Yevgeniy , Pizer Steven D. , Shafer Paul R. , Frakt Austin B. , Garrido Melissa M.
Published: November 2023

Objective

To develop and validate a measure of provider network restrictiveness in the Medicare Advantage (MA) population.

Data Sources

Prescription drug event data and beneficiary information for Part D enrollees from the Center for Medicare and Medicaid Services, along with prescriber identifiers; geographic variables from the Area Health Resources Files.

Study Design

A prediction model was used to predict the unique number of primary care providers that would have been seen by MA beneficiaries absent network restrictions. The model was trained and validated on Traditional Medicare (TM) beneficiaries. A pseudo‐Poisson and a random forest model were evaluated. An observed‐to‐expected (O/E) ratio was calculated as the number of unique providers seen by MA beneficiaries divided by the number expected based the TM prediction model. Multivariable linear models were used to assess the relationship between network restrictiveness and plan and market factors.

Data Collection/Extraction Methods

Prescription drug event data were obtained for a 20% random sample of beneficiaries enrolled in prescription drug coverage from 2011 to 2017.

Principal Findings

Health Maintenance Organization plans were more restrictive (O/E = 55.5%; 95% CI 55.3%–55.7%) than Health Maintenance Organization‐Point of Service plans (67.2%; 95% CI 66.7%–67.8%) or Preferred Provider Organization plans (74.7%; 95% CI 74.3%–75.1%), and rural areas had more restrictive networks (31.6%; 95% CI 29.0%–34.2%) than metropolitan areas (61.5%; 95% CI 61.3%–61.7%). Multivariable results confirmed these findings, and also indicated that increased provider supply was associated with less restrictive networks.

Conclusions

We developed a means of estimating provider network restrictiveness in MA from claims data. Our results validate the approach, providing confidence for wider application (e.g., for other markets and specialties) and use for regulation.
Trout bioenergetics as a process‐based tool to estimate ecological risk in a regulated river
Authors: Rhoades Suzanne J. , Caldwell Timothy J. , McBain Scott , Henery Rene , Stauffer‐Olsen Natalie , McKinnon Tara , Rossi Gabriel J. , Chandra Sudeep
Published: November 2023

Bioenergetics models produce quantitative flow‐ecology relationships that summarize changes in habitat and food resources from altered flows. We used a drift‐foraging bioenergetics model to quantify the net rate of energetic intake (NREI) for trout above and below a water diversion. NREI is reduced by >95% below the water diversion in July–September, when up to 98% of unimpaired flows are diverted. We then used a risk‐based approach to estimate the maximum diversion rate, expressed as a percentage of unimpaired flow, that would produce NREI values that are not significantly lower than values under unimpaired flows throughout a 62‐year period. NREI decreased with increased precent‐of‐flow diversion rates in low‐flow months (July–September). Diversion rates of 16% in July and 9% in August and September would maintain NREI within the range of unimpaired flow conditions. In higher flow months, May–June, increasing diversions brought estimated instream flows closer to the peak NREI flow, leading to the assessment that increased diversions would increase NREI. Bioenergetic models can be used to develop protective flow rates at times of the year when fish growth and production would be high under unimpaired flows, which often coincides with when water is diverted. Our study is the first to develop protective percent‐of‐flow diversion rates for holistic flow management using a quantitative process‐based and fish‐centric ecological metric.
Spatial market integration during a pandemic: Evidence from food markets in Nigeria
Authors: Amare Mulubrhan , Abay Kibrom A. , Hatzenbuehler Patrick
Published: November 2023

This paper uses comprehensive and long time series monthly food price data and a panel dyadic regression framework to evaluate the impact of the COVID‐19 pandemic and associated policy responses on spatial market integration across a diverse set of food items in Nigeria. The empirical results reveal several important insights. First, we show that a significant slowdown in the speed of adjustment and price transmission occurred during the pandemic. For some food items, the speed of adjustment and, by implication, spatial market integration weakened by two‐ to‐threefold after the outbreak of the pandemic. The effect was especially pronounced for perishable food items. Second, lockdown measures and the spread of the pandemic triggered additional dispersion in market prices across markets. For example, lockdown measures were associated with a 5%–10% reduction in the speed of readjustment toward long‐term equilibrium. Third, additional underlying attributes of markets, including lack of access to digital infrastructure and distance between markets, exacerbated impacts associated with the pandemic. For instance, access to Internet service reduced the slowdown in the speed of adjustment caused by the pandemic, but longer distances between market pairs induced greater slowdown in the speed of price transmission. Our findings offer important insights for revitalizing the efficiency of food markets affected by the pandemic. The heterogenous impacts of the pandemic across value chains and markets reinforce the need to properly target post‐pandemic recovery interventions and investments. Finally, we offer some insights to reduce the vulnerability of food and market systems to disruptions in future pandemics or similar phenomena that inhibit food marketing and trade.
Kinetic–pharmacodynamic model of warfarin for prothrombin time–international normalized ratio in Japanese patients
Authors: Hirai Toshinori , Aoyama Takahiko , Tsuji Yasuhiro , Itoh Toshimasa , Matsumoto Yoshiaki , Iwamoto Takuya
Published: November 2023

Aims

Genotype‐guided dosing algorithms can explain about half of the interindividual variability in prothrombin time–international normalized ratio (PT‐INR) under warfarin treatment. This study aimed to refine a published kinetic–pharmacodynamic model and guide warfarin dosage for an optimal PT‐INR based on renal function.

Methods

Using a retrospective cohort of adult patients (>20 years) who were administered warfarin and underwent PT‐INR measurements, we refined the kinetic–pharmacodynamic model with age and the genotypes of cytochrome P450 2C9 and vitamin K epoxide reductase complex subunit 1 using the PRIOR subroutine in the nonlinear‐mixed‐effect modelling programme. We searched the significant covariates for parameters, such as the dose rate for 50% inhibition of coagulation (EDR50), using a stepwise forward and backward method. Monte Carlo simulation determined a required daily dose of warfarin with a target range of PT‐INR (2.0–3.0 or 1.6–2.6) based on the significant covariates.

Results

A total of 350 patients with 2762 PT‐INR measurements were enrolled (estimated glomerular filtration rate [eGFR]: 47.5 [range: 2.6–199.0] mL/min/1.73 m2). The final kinetic–pharmacodynamic model showed that the EDR50 changed power functionally with body surface area, serum albumin level and eGFR. Monte Carlo simulation revealed that a lower daily dose of warfarin was required to attain the target PT‐INR range as eGFR decreased.

Conclusions

Model‐informed precision dosing of warfarin is a valuable approach for estimating its dosage in patients with renal impairment.
On generating plausible values for multilevel modelling with large‐scale‐assessment data
Authors: Zheng Xiaying
Published: November 2023

Large‐scale assessments (LSAs) routinely employ latent regressions to generate plausible values (PVs) for unbiased estimation of the relationship between examinees' background variables and performance. To handle the clustering effect common in LSA data, multilevel modelling is a popular choice. However, most LSAs use single‐level conditioning methods, resulting in a mismatch between the imputation model and the multilevel analytic model. While some LSAs have implemented special techniques in single‐level latent regressions to support random‐intercept modelling, these techniques are not expected to support random‐slope models. To address this gap, this study proposed two new single‐level methods to support random‐slope estimation. The existing and proposed methods were compared to the theoretically unbiased multilevel latent regression method in terms of their ability to support multilevel models. The findings indicate that the two existing single‐level methods can support random‐intercept‐only models. The multilevel latent regression method provided mostly adequate estimates but was limited by computational burden and did not have the best performance across all conditions. One of our proposed single‐level methods presented an efficient alternative to multilevel latent regression and was able to recover acceptable estimates for all parameters. We provide recommendations for situations where each method can be applied, with some caveats.
Integrating microbiome science and evolutionary medicine into animal health and conservation
Authors: Bornbusch Sally L. , Power Michael L. , Schulkin Jay , Drea Christine M. , Maslanka Michael T. , Muletz‐Wolz Carly R.
Published: November 2023

Microbiome science has provided groundbreaking insights into human and animal health. Similarly, evolutionary medicine – the incorporation of eco‐evolutionary concepts into primarily human medical theory and practice – is increasingly recognised for its novel perspectives on modern diseases. Studies of host–microbe relationships have been expanded beyond humans to include a wide range of animal taxa, adding new facets to our understanding of animal ecology, evolution, behaviour, and health. In this review, we propose that a broader application of evolutionary medicine, combined with microbiome science, can provide valuable and innovative perspectives on animal care and conservation. First, we draw on classic ecological principles, such as alternative stable states, to propose an eco‐evolutionary framework for understanding variation in animal microbiomes and their role in animal health and wellbeing. With a focus on mammalian gut microbiomes, we apply this framework to populations of animals under human care, with particular relevance to the many animal species that suffer diseases linked to gut microbial dysfunction (e.g. gut distress and infection, autoimmune disorders, obesity). We discuss diet and microbial landscapes (i.e. the microbes in the animal's external environment), as two factors that are (i) proposed to represent evolutionary mismatches for captive animals, (ii) linked to gut microbiome structure and function, and (iii) potentially best understood from an evolutionary medicine perspective. Keeping within our evolutionary framework, we highlight the potential benefits – and pitfalls – of modern microbial therapies, such as pre‐ and probiotics, faecal microbiota transplants, and microbial rewilding. We discuss the limited, yet growing, empirical evidence for the use of microbial therapies to modulate animal gut microbiomes beneficially. Interspersed throughout, we propose 12 actionable steps, grounded in evolutionary medicine, that can be applied to practical animal care and management. We encourage that these actionable steps be paired with integration of eco‐evolutionary perspectives into our definitions of appropriate animal care standards. The evolutionary perspectives proposed herein may be best appreciated when applied to the broad diversity of species under human care, rather than when solely focused on humans. We urge animal care professionals, veterinarians, nutritionists, scientists, and others to collaborate on these efforts, allowing for simultaneous care of animal patients and the generation of valuable empirical data.
Discovery and development of COVID‐19 vaccine from laboratory to clinic
Authors: Saravanan Venkatesan , Chagaleti Bharath Kumar , Narayanan Pavithra Lakshmi , Anandan Vijay Babu , Manoharan Haritha , Anjana G.V. , Peraman Ramalingam , Namasivayam S. Karthik Raja , Kavisri M. , Arockiaraj Jesu , Muthu Kumaradoss Kathiravan , Moovendhan Meivelu
Published: November 2023

The world has recently experienced one of the biggest and most severe public health disasters with severe acute respiratory syndrome coronavirus (SARS‐CoV‐2). SARS‐CoV‐2 is responsible for the coronavirus disease of 2019 (COVID‐19) which is one of the most widespread and powerful infections affecting human lungs. Current figures show that the epidemic had reached 216 nations, where it had killed about 6,438,926 individuals and infected 590,405,710. WHO proclaimed the outbreak of the Ebola virus disease (EVD), in 2014 that killed hundreds of people in West Africa. The development of vaccines for SARS‐CoV‐2 becomes more difficult due to the viral mutation in its non‐structural proteins (NSPs) especially NSP2 and NSP3, S protein, and RNA‐dependent RNA polymerase (RdRp). Continuous monitoring of SARS‐CoV‐2, dynamics of the genomic sequence, and spike protein mutations are very important for the successful development of vaccines with good efficacy. Hence, the vaccine development for SARS‐CoV‐2 faces specific challenges starting from viral mutation. The requirement of long‐term immunity development, safety, efficacy, stability, vaccine allocation, distribution, and finally, its cost is discussed in detail. Currently, 169 vaccines are in the clinical development stage, while 198 vaccines are in the preclinical development stage. The majority of these vaccines belong to the Ps—Protein subunit type which has 54, and the minor BacAg‐SPV (Bacterial antigen‐spore expression vector) type, at least 1 vaccination. The use of computational methods and models for vaccine development has revolutionized the traditional methods of vaccine development. Further, this updated review highlights the upcoming vaccine development strategies in response to the current pandemic and post‐pandemic era, in the field of vaccine development.
Orlando Protocol for single session ductal clearance of common bile duct stones at endosopic retrograde cholangiopancreatography
Authors: Bang Ji Young , Wilcox C. Mel , Navaneethan Udayakumar , Hawes Robert , Varadarajulu Shyam
Published: November 2023

Objectives

Approach to management of common bile duct stones (CBDS) by endoscopic retrograde cholangiopancreatography (ERCP) is not standardized. We examined outcomes by applying predetermined protocol for CBDS management.

Methods

When standard extraction techniques failed at ERCP, presence of tapered bile duct and stone–duct ratio were calculated. Large balloon sphincteroplasty (LBS) and/or mechanical/single‐operator cholangioscopy‐guided lithotripsy was performed based on presence of tapered bile duct and stone–duct mismatch. Primary outcome was single‐session ductal clearance. Secondary outcome was adverse events.

Results

Of 409 patients treated over 16 months, 321 (78.5%) had no tapered bile duct or stone–duct mismatch, and single‐session ductal clearance was achieved using standard techniques in 99.7% over median duration of 14 min (interquartile range [IQR] 9–21 min). Of 88 (21.5%) patients with difficult CBDS, tapered duct was seen in 79 (89.8%) and/or stone–duct mismatch in 36 (40.9%). Single‐session ductal clearance was achieved in all 88 patients (100%) by LBS in 79 (89.8%), mechanical lithotripsy in 20 (22.7%), and single‐operator cholangioscopy‐guided lithotripsy in 16 (18.2%) over a median duration of 29 min (IQR 17–47 min). Overall, single‐session ductal clearance was achieved in 99.8% with adverse events in 17 (4.2%) that included perforation in two, postsphincterotomy bleeding in one, and mild/moderate post‐ERCP pancreatitis in 14 patients.

Conclusions

A predetermined protocol optimized outcomes by enabling single‐session ductal clearance of CBDS with high technical success and low adverse events.
Apmerrke Areye‐kenhe Utnenge Rlterrke‐irrirtne‐tyenhenge
Authors: Liddle Joel , Langton Marcia , Rose James , Rice Simon
Published: November 2023

Arrurle‐nge‐ntyele researchers lhentere areye‐le intelhe‐ilepe‐ileme apmerrke areye‐akerte. Itne akaltye‐arle‐irreke apmerrke areye akwele urreme‐urreme‐irreme, utnenge alhwarrpe awelhemele. Kenhe alhentere nhenhe areye akaltye‐irretyakenhe iwenhenge‐arle apmerrke areye alakenhe anerlte‐aneme. Itne itelaretyakenhe nthakenhe‐arle arne ingkirreke urrperle‐areye‐kenhe‐le apmerrke areye atnerre ilirtnemere. Researchers itne akaltye‐irreke artwe apmerrke Central Australia‐arenye‐arle akwele health akurne anthurre‐ulkere, Australia arenye‐arrpenhe areye‐nge. Arrpenheme apeke clinic‐werne alheme, kenhe itne akenhe itelaretyakenhe iwenhe‐arle alhentere ngangkere‐le itneke ileme, health itnekenhe‐akerte, medications‐akerte‐arlke. Artwe atningke apeke itelaretyakenhe iwenhenge‐arle itne ilkelhetyakenhe uthene akangketyakenhe uthene. The kwenhe PhD project mpwarerle‐aneme apmerrke anwerneke‐akerte. Anwerne ahentye aneme apmerrke areye atyenpe‐irrirtnetyeke, atnerre anemele. Project nhenhe arne atyeperre anwerne‐kenhe areye‐akerte, angkentye, anpernirrentye, nthakenhe angkentye anwernekenhe intelhetyeke, anyenhenge, apmere‐kenhe arritnye ingkirreke, thipe‐kenhe arritnye, arne‐kenhe arritnye, atnunthe apmere‐altye‐arlke. Apmerrke areye kwenhe akaltye‐irretyeke nthakenhe English angketyeke, read‐eme‐iletyeke, intelhetyeke‐arlke. Apmerrke areye apeke akaltye‐irretyeke Akngerrepate arrwekelenye areye‐ke, arne mwerre areye itne‐arle mpware‐warretyarte, kele itne anteme itnenhe ingkentetyeke. Artwe akaperte altywere‐areye role models anwernekenhe aneme. 1930's‐nge‐ntyele governments‐le laws mpwareke arritnye Assimilation Policy. Yanhe‐iperre, atningke areye uye‐akaltye‐irreke urrperle‐kenhe arne areye‐kenhe‐ke. Alhentere areye‐le anamelhe‐ileke arrpenheme apmere itnekenhe‐nge‐ntyele bungalow‐atheke, ayerrere‐werne atheke, antekerre‐arlke. Assimilation Policys‐nge ularre, tyerrtye atningke angkentye‐ke uye akaltye‐irreke, apmere‐akerte, apmere‐ke‐artweye‐ke, kwertengwerle‐ke, laws anwernekenhe‐arlke. Lhentere arrpenheme ahentye‐aneke akaltye‐irretyeke Tywerrenge‐ke. Arne arrpenheme‐ke itne‐arle akaltye‐irreke artwe‐kenhe‐ante, kenhe arrpenhe akenhe ingkirreke‐ke. Arne nhenhe areye museums‐uthene‐le organisations arrpenhe areye uthene‐le akwete atnyeneme. Alhentere areye‐le itnenhe akeme “archives.” Itnekenge‐ntyele anwerne apmerrke areye akaltye‐le‐anthetyeke, nthakenhe arrwekelenye anwernekenhe anirntyeke‐arteke. Kele, the pipe nhenhe intelhe‐ileke apmerrke itnenhe alpeme‐iletyeke rlterrke‐irrirtnetyeke.
High risk of ischaemic stroke amongst patients with hereditary haemorrhagic telangiectasia
Authors: Kofoed Mikkel Seremet , Tørring Pernille M. , Christensen Alex Alban , Lange Bibi , Kjeldsen Anette Drøhse , Nielsen Troels Halfeld
Published: November 2023

Background and purpose

Hereditary haemorrhagic telangiectasia (HHT) is a genetic disease with fragile blood vessels and vascular malformations, potentially causing neurological manifestations, including stroke and cerebral abscesses. The study aimed to investigate neurological manifestations in the Danish HHT database, focusing on pulmonary arteriovenous malformations (PAVMs) as a risk factor for cerebral events.

Methods

Retrospective analysis of the Danish HHT database was conducted, cross‐referencing neurological outcomes with the Danish Apoplexy Register for accuracy. Patients were stratified by HHT type. Primary outcomes included ischaemic stroke, transient ischaemic attack and cerebral haemorrhage. Secondary outcomes comprised age, age at HHT diagnosis, age at cerebral ischaemic event, and PAVM and cerebral arteriovenous malformation status.

Results

Six hundred and sixty‐four HHT patients were included. PAVM was diagnosed in 54% of patients, with higher prevalence in HHT type 1 (70%) compared to HHT type 2 (34%) and juvenile polyposis HHT (66%). Ischaemic stroke or transient ischaemic attack occurred in 12.5%, with a higher risk associated with macroscopic PAVM. Logistic regression showed a nearly 10 times increased risk of ischaemic stroke with macroscopic PAVM. Cerebral abscesses occurred in 3.2% of patients, all with macroscopic PAVM. Incomplete PAVM closure increased cerebral abscess risk.

Conclusion

This study provides valuable insights into the prevalence of neurological manifestations and vascular events in HHT patients. The presence of PAVM was associated with an increased risk of ischaemic stroke, highlighting the importance of early screening and intervention. The findings emphasize the need for comprehensive management strategies targeting both vascular and neurological complications in HHT patients, especially regarding secondary stroke prevention.
Responder rates with eptinezumab over 24 weeks in patients with prior preventive migraine treatment failures: post hoc analysis of the DELIVER randomized clinical trial
Authors: Ashina Messoud , Lipton Richard B. , Ailani Jessica , Versijpt Jan , Sacco Simona , Mitsikostas Dimos D. , Christoffersen Cecilie Laurberg , Sperling Bjørn , Ettrup Anders
Published: November 2023

Background and purpose

Eptinezumab reduced monthly migraine days more than placebo in the DELIVER study, a clinical trial with patients with difficult‐to‐treat migraine and prior preventive treatment failures. This post hoc analysis assesses the sustained response to eptinezumab at the population and patient level and evaluates the potential for response in initial non‐responders.

Methods

Adults with chronic or episodic migraine and two to four prior preventive treatment failures were randomized to eptinezumab 100 mg, 300 mg or placebo every 12 weeks. Primary outcomes in this post hoc analysis are the proportion of patients with ≥30%, ≥50% or ≥75% reduction in monthly migraine days (i.e., migraine responder rates [MRRs]) during weeks 1–12 and weeks 13–24 and across 4‐week intervals. Secondary outcomes are maintenance and shifts in MRRs from weeks 1–12 to weeks 13–24.

Results

Between weeks 1–12 and 13–24, ≥30% MRRs increased from 65.9% to 70.4% (100 mg) and from 71.0% to 74.5% (300 mg), versus 36.9% to 43.1% (placebo). The ≥50% and ≥75% MRRs were sustained or increased over the 24‐week period. The largest increase in ≥30% MRRs occurred after the second infusion with eptinezumab. The percentage of initial non‐responders (<30% MRRs during weeks 1–12) who experienced response (≥30% MRRs during weeks 13–24) to the second dose was 34.7% (100 mg) and 30.4% (300 mg) with eptinezumab versus 21.1% with placebo.

Conclusion

Across MRR thresholds, most patients who responded to eptinezumab during weeks 1–12 maintained or improved response during weeks 13–24. More than one‐third of initial non‐responders became responders after their second infusion.
Dopamine agonist serum concentrations and impulse control disorders in Parkinson's disease
Authors: Staubo Sara C. , Fuskevåg Ole Martin , Toft Mathias , Lie Ingeborg H. , Alvik Kirsti M. J. , Jostad Pål , Tingvoll Stein H. , Lilleng Hallvard , Rosqvist Kristina , Størset Elisabet , Odin Per , Dietrichs Espen , Dietrichs Erik Sveberg
Published: November 2023

Background and purpose

Impulse control disorders (ICDs) are common among Parkinson's disease patients using dopamine agonists. We wanted to determine whether ICD patients have higher dopamine agonist serum concentrations than those without any sign of ICD.

Methods

Patients who used either pramipexole or ropinirole depot once daily were screened for ICDs using the validated Questionnaire for Impulsive‐Compulsive Disorders in Parkinson's Disease–Rating Scale. Those who scored above the cut‐off for one or more of the four defined ICDs (gambling, compulsive sexual behavior, compulsive shopping, and binge‐eating) were compared in a case–control study to patients who scored zero points (no evidence of ICD) on the same items. They were examined clinically and evaluated using relevant scales. Three blood samples were taken on the same day: before daily dose, and then 6 and 12 h later.

Results

Forty‐six patients were included: 19 ICD‐positive and 27 controls. Ropinirole serum concentrations 6 h after daily intake (Cmax) were higher in the case group compared to the control group, as was the daily ropinirole dosage. No differences were observed in serum concentrations, dosage or total drug exposure for pramipexole. Disease duration and length of dopamine agonist treatment was significantly longer among ICD patients for ropinirole, but not for pramipexole.

Conclusions

The use of pramipexole may in itself confer high ICD risk, whereas ICDs among ropinirole users depend more on serum concentration and drug exposure. The pharmacokinetic properties of ropinirole make it challenging to predict its effects on patients, which supports the need for therapeutic drug monitoring to reduce risk of ICD.
Delays to care in infantile epileptic spasms syndrome: Racial and ethnic inequities
Authors: Abath Christina Briscoe , Gupta Nishtha , Hadjinicolaou Aristides , Donatelli Stephanie , Singh Avantika , Merchant Sabrina , Ryan Morgan E. , Soby Meghann , Ryan Christopher , Nelson Adrianne Katrina , Maldonado Pacheco John E. , Zhang Bo , Williams David N. , Yuskaitis Christopher J. , Harini Chellamani
Published: November 2023

Objective

Non‐Hispanic (NH) Black children are less likely to receive a standard treatment course for infantile epileptic spasms syndrome (IESS) than White/NH children at pediatric tertiary care epilepsy centers in the United States. However, if inequities exist in time to diagnosis is unknown. Diagnostic delays as little as 1 week can be associated with worse developmental outcomes.

Methods

Diagnostic delays were evaluated in a retrospective cohort of 100 children with new onset IESS between January 2019 and May 2022.

Results

Children with Black, Indigenous, and People of Color (BIPOC) caregivers were more likely to experience clinically significant delays in referral from first provider to neurologist, when compared to White/NH children, even after controlling for other demographic and clinical variables (odds ratio = 4.98, confidence interval = 1.24–19.94, p = .023).

Significance

Disproportionate diagnostic delays place BIPOC children at risk of adverse developmental and epilepsy outcomes. Further interventional prospective and qualitative studies are needed to address inequities in care.
Bergmann patterns in planktivorous fishes: A light‐size or zooplankton community‐size rule is just as valid explanation as the temperature‐size rule
Authors: Ljungström Gabriella , Langbehn Tom , Jørgensen Christian
Published: November 2023

Aim

Bergman patterns, the tendency of organisms to be larger at higher latitudes and lower temperatures, are a well‐studied biogeographic pattern. Yet, there is no consensus on the driver or underlying mechanisms. We aim to scrutinize the influence of several key proposed drivers of Bergmann patterns (temperature, seasonal light availability, prey size and seasonal abundance) on optimal body size in planktivorous fishes across high latitudes in the Northeast Atlantic.

Location

Northeast Atlantic between 55 and 75° N, with implications for high‐latitude oceans globally.

Time period

Present day.

Major taxa studied

Pelagic planktivorous fishes, with Atlantic herring (Clupea harengus) as model organism.

Methods

We use a model that incorporates explicit mechanisms for vision‐based feeding and temperature‐dependent physiology of a planktivorous fish to explore how intrinsic and extrinsic constraints affect energy budgeting and thereby expected optimal body size based on bioenergetics. We run the model at latitudes with increasing seasonality and test the individual and joint effects of relevant drivers.

Results

A Bergmann pattern emerges from the interaction between visual feeding opportunities and temperature‐dependent physiology. Small individuals profit from faster energy processing at higher temperatures in the south, whereas large individuals benefit from a lower metabolic cost at colder temperatures and more daylight hours for feeding in the north. In isolation temperature, daylight hours, and prey size each produced Bergmann patterns, but the most pronounced pattern arose from all drivers combined.

Main conclusions

Studying biogeographic body size patterns requires a holistic view, accounting for interactions between drivers and both intrinsic and extrinsic constraints on energy budgeting. Across latitudes, temperature effects on digestion and metabolism interact with effects of light availability, prey size and abundance on food accessibility, and thereby shape the optimal size. Our study highlights how details of ecological mechanisms and lifestyles are important for improving predictive ability.
Numbers needed to treat or harm and likelihood of being helped versus harmed for fremanezumab in patients who had prior inadequate response to two to four classes of migraine preventive medications: A post hoc analysis
Authors: Ashina Messoud , Mitsikostas Dimos D. , Ramirez Campos Verena , Barash Steve , Ning Xiaoping , Diener Hans‐Christoph
Published: November 2023

Objective

This study aimed to determine the number needed to treat (NNT), number needed to harm (NNH), and likelihood of being helped or harmed (LHH) in a post hoc analysis of the phase 3b FOCUS trial.

Background

Fremanezumab, a humanized monoclonal antibody that selectively targets calcitonin gene–related peptide (CGRP), has demonstrated efficacy, tolerability, and safety in adults with episodic migraine (EM) or chronic migraine (CM), with documented previous inadequate response to two to four classes of migraine preventive medications.

Methods

In the 12‐week double‐blind period of the FOCUS study, patients were randomized (1:1:1) to quarterly fremanezumab, monthly fremanezumab, or matched monthly placebo. NNT was based on responder analysis, defined as ≥50% reduction in monthly average number of migraine days at 12 weeks. NNH was based on discontinuations due to adverse events (AEs).

Results

Among patients with CM (n = 509), response rates and discontinuation rates were 27% (45/169) and 0 for quarterly fremanezumab, 29% (50/173) and 2% (3/173) for monthly fremanezumab, and 8% (13/167) and <1% (1/167) for placebo, respectively. These results translated to NNTs of 5.3 and 4.7, NNHs of 1000 and 88, and LHHs of 188 and 19 for quarterly and monthly fremanezumab, respectively. Among patients with EM (n = 328), response rates were 47% (50/107) for quarterly fremanezumab, 43% (47/110) for monthly fremanezumab, and 10% (11/111) for placebo. Discontinuation rates were <1% (n = 1) in all three groups. These results translated to NNTs of 2.7 and 3.0, NNHs of 1000 and 1000, and LHHs of 368 and 328 for quarterly and monthly fremanezumab, respectively.

Conclusions

The NNT, NNH, and LHH for quarterly and monthly fremanezumab compare favorably with those for traditional oral preventive medications, including topiramate, valproate, and propranolol.
King Penguins adjust foraging effort rather than diet when faced with poor foraging conditions
Authors: Brisson‐Curadeau Émile , Bost Charles‐André , Cherel Yves , Elliott Kyle
Published: November 2023

The links between foraging success, foraging effort and diet in a myctophid specialist seabird, the King Penguin Aptenodytes patagonicus, were investigated during seven breeding seasons using tracking and isotopic data. Despite the variable foraging conditions encountered by the birds, isotopic signatures (a proxy for diet) were invariable throughout the study. On the other hand, penguins stayed longer at sea when the foraging success indices (i.e. prey capture attempts per day and mass gained per day) were low. Although King Penguins can compensate for low prey capture rates by increasing foraging effort, their specialist diet during reproduction makes the species particularly sensitive to prey availability, with its conservation tightly linked to its main prey.
Implementation and expansion of laboratory capacity for molecular diagnostics in response to COVID‐19 and preparedness for other emerging infectious diseases in the Islamic Emirate of Afghanistan
Authors: Khan Murad Momin , Tahoun Mohamed Mostafa , Meredith Luke W. , Barakat Amal , Safi Hafizullah , Hanifi Ahmed Nasir , Mashal Mohammad Omar , Amiri Abdul Wahid , Abouzeid Alaa
Published: November 2023

Background

Afghanistan experienced various outbreaks before and during the Covid‐19 pandemic, including dengue, Crimean Congo hemorrhagic fever (CCHF), measles, and acute watery diarrhea (AWD). Diagnostic and surveillance support was limited, with only the Central Public Health Laboratory equipped to handle outbreak responses. This article highlights initiatives taken to improve diagnostic capabilities for COVID‐19 and other outbreaks of public health concern encountered during the pandemic.

Background

The World Health Organization (WHO) Afghanistan Country Office collaborated with the WHO Eastern Mediterranean Regional Office (EMRO), Central Public Health Laboratory (CPHL), and National Influenza Center (NIC) to enhance COVID‐19 diagnostic capacity at national and subnational facilities. To alleviate pressure on CPHL, a state‐of‐the‐art laboratory was established at the National Infectious Disease Hospital (NIDH) in Kabul in 2021–2022, while WHO EMRO facilitated the regionalization of testing to subnational facilities for dengue, CCHF, and AWD in 2022–2023.

Results

COVID‐19 testing capacity expanded nationwide to 34 Biosafety Level II labs, improving diagnosis time. Daily testing rose from 1000 in 2020 to 9200 in 2023, with 848,799 cumulative tests. NIDH identified 229 CCHF cases and 45 cases nationally. Dengue and CCHF testing, decentralized to Nangarhar and Kandahar labs, identified 338 dengue and 18 CCHF cases. AWD testing shifted to NIDH and five subnational facilities (Kandahar, Paktia, Balkh, Herat, and Nangarhar labs), while measles testing also decentralized to nine subnational facilities.

Conclusion

Afghanistan implemented a remarkable, multisectoral response to priority pathogens. The nation now possesses diagnostic expertise at national and subnational levels, supported by genomic surveillance. Future efforts should concentrate on expanding and sustaining this capacity to enhance public health responses.
From respiratory diseases to nervous system disorders: Unraveling the certified causes of influenza‐associated deaths in Poland from 2000 to 2019
Authors: Walkowiak Marcin Piotr , Walkowiak Dariusz
Published: November 2023

Background

This study aims to accurately estimate influenza‐associated deaths in Poland and their certified cause of death, due to significant discrepancies between official numbers and expected impact.

Methods

Excess influenza‐associated mortality in Poland from 2000 to 2019 was calculated using Seasonal‐Trend Decomposition Procedure based on LOESS (STL), which can detect non‐linear trends and non‐sinusoidal cycles. Excess mortality was then used as an explanatory variable in a model predicting monthly fluctuations of officially recorded causes of death from 2010 to 2019.

Results

A total of 142,000 conservative estimates of influenza‐associated deaths were identified, representing 1.86% of overall mortality. Only 0.61% of influenza‐associated deaths were officially recorded as influenza. Nearly half of certified influenza deaths were attributed to the seasonal baseline mortality, potentially doubling estimated impact based solely on influenza peaks. Influenza‐associated deaths were frequently recorded as respiratory diseases (24.36%), with majority attributed to underlying conditions such as cardiovascular diseases (45.31%), cancer (9.06%), or diabetes (2.66%). Influenza‐associated deaths were more commonly certified as nervous system diseases (1.84%) or mental disorders (1.04%), rather than influenza itself. There was a noticeable impact of influenza on secondary infections, such as meningococcal and gastrointestinal infections.

Conclusion

These findings highlight the importance of improved estimation for informing public health policy decisions.
RETRACTED: Effects of rapid rehabilitation nursing model on surgical site wound infection and pain of patients with ovarian cancer: A meta‐analysis
Authors: Fan Erlin , Zhang Keke , Wan Yinglu , Hu Shifu
Published: November 2023

To explore the effect of rapid rehabilitation nursing model on surgical site wound infection and pain of patients with ovarian cancer. Computer searches were performed on randomised controlled trials (RCTs) of rapid rehabilitation nursing model applied to ovarian cancer patients in PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), China Biomedical Literature Database (SinoMed), VIP and Wanfang Database from the time each database was constructed to May 2023. Two researchers independently screened the literature, extracted data and completed an assessment of the quality of the literature based on the inclusion and exclusion criteria. Meta‐analysis was performed using RevMan 5.4 software. The database was searched to obtain 255 articles, and 22 articles were finally included, containing 966 patients in the experimental group and 954 patients in the control group, for a total of 1920 patients. The results of the meta‐analysis showed that, compared with other nursing models, the use of the rapid rehabilitation nursing model significantly reduced surgical site wound infections in patients with ovarian cancer (OR = 0.30, 95% CI: 0.15–0.61, p < 0.001) and the rate of post‐operative complications (OR = 0.27, 95% CI: 0.19–0.38, p < 0.001) also reduced the patients' post‐operative wound pain (MD = −0.70, 95% CI: −0.85 to −0.55, p < 0.001). The rapid rehabilitation nursing model applied to patients with ovarian cancer surgery can effectively reduce the rate of post‐operative complications and wound infections, and it can also reduce the post‐operative wound pain.
Low‐k dielectric materials derived from ZSM‐5 zeolite
Authors: Shi Jun Zuo , Sun Tu Lai , Zhou Fu Wei , Zhu Xiao Li , Li Lei , Chen Xiang Ming
Published: November 2023

Low‐k dielectric materials were prepared by sintering ZSM‐5 zeolite powder compacts at temperatures ranged 1200–1300°C, and the microwave dielectric characteristics were investigated together with the structure evolution during sintering. It was failed to obtain ZSM‐5 ceramics by high temperature sintering because the densification could never occur below the tolerable temperature and the ordered porous structure completely collapsed above the tolerable temperature. The structure changed from ZSM‐5 zeolite to SiO2‐Al2O3 glass at 1240°C, and finally to SiO2‐based cristobalite ceramics above 1275°C. A low dielectric constant (2.63‐2.78) combined with low dielectric loss (< 0.0005 at 18 GHz) and small temperature coefficient of resonant frequency (varied from ‐18.6 to ‐8.1 ppm/°C) was achieved in the present materials, and the value of dielectric loss was the lowest one achieved so far in the dielectric materials with a dielectric constant lower than 3. With the structure evolution from ZSM‐5 zeolite to SiO2‐Al2O3 glass and finally to SiO2‐based cristobalite ceramics, the dielectric constant increased from 2.27 to 2.78, while the Qf value indicated a complicated variation tendency, and the higher Qf values were achieved in the amorphous and crystalline states, while significant drop was determined in the partial amorphous state. It should be a great challenge to prepare dense zeolite ceramics without collapse of ordered porous structure, and then the ultra‐low dielectric constant materials with high Q could be expected.