bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of digital transformation model in hospital
Authors: Baihaqy Ahmad , Subriadi Apol Pribadi
Published: July 2024

Purpose

This paper aims to develop a digital transformation model in hospitals. This study proposes a digital transformation model in hospitals by formulating dimensions and sub-dimensions. The proposed hospital digital transformation model outlines why and how each of dimensions and sub-dimensions are important in the hospital digital transformation model.

Design/methodology/approach

This study chose the type of qualitative research using a phenomenology approach. This study used observation techniques and in-depth interviews with 11 informants and conducted group discussion forums with information technology governance experts, a hospital information technology department manager who has an information technology background, and doctor representatives. The data were documented and analyzed using triangulation techniques.

Findings

This research provides empirical insights into the dimensions and sub-dimensions of hospital digital transformation models. The findings of the digital transformation dimension in hospitals are 7 dimensions and 37 sub-dimensions, namely, the governance and management dimension which has 8 sub-dimensions; the person has 9 sub-dimensions; strategy dimension which has 5 sub-dimensions; information technology capability has 3 sub-dimensions; the data interoperability dimension has 3 sub-dimensions; the data analytics dimension has 5 sub-dimensions; patient dimensions have 4 sub-dimensions; the findings of the sub-dimensions involved in the digital transformation dimension of the hospital can provide input on the accuracy of the indicators measuring the hospital’s digital transformation.

Research limitations/implications

This research is limited to the qualitative type of phenomenology approach so that future research can test empirically with quantitative methods with techniques through surveys of dimensional and sub-dimensional relationships to hospital digital transformation. The researchers also recommend further assessing the findings of this paper which can develop as a model for measuring the maturity of hospital digital transformation.

Practical implications

This paper covers the implications of developing a hospital digital transformation model that can be used to organize and manage hospital digital transformation.

Originality/value

This paper can be used as a guideline for hospital stakeholders when carrying out digital transformation. This paper can be used as a reference for further research to find, study and develop dimensions and sub-dimensions of digital transformation models.
Plasticity in mosquito size and thermal tolerance across a latitudinal climate gradient
Authors: Lyberger Kelsey , Farner Johannah E. , Couper Lisa , Mordecai Erin A.
Published: July 2024

Variation in heat tolerance among populations can determine whether a species is able to cope with ongoing climate change. Such variation may be especially important for ectotherms whose body temperatures, and consequently, physiological processes, are regulated by external conditions.

Additionally, differences in body size are often associated with latitudinal clines, thought to be driven by climate gradients. While studies have begun to explore variation in body size and heat tolerance within species, our understanding of these patterns across large spatial scales, particularly regarding the roles of plasticity and genetic differences, remains incomplete.

Here, we examine body size, as measured by wing length, and thermal tolerance, as measured by the time to immobilisation at high temperatures (“thermal knockdown”), in populations of the mosquito Aedes sierrensis collected from across a large latitudinal climate gradient spanning 1300 km (34–44° N).

We find that mosquitoes collected from lower latitudes and warmer climates were more tolerant of high temperatures than those collected from higher latitudes and colder climates. Moreover, body size increased with latitude and decreased with temperature, a pattern consistent with James' rule, which appears to be a result of plasticity rather than genetic variation.

Our results suggest that warmer environments produce smaller and more thermally tolerant populations.
Pruned tea biomass plays a significant role in functional food production: A review on characterization and comprehensive utilization of abandon‐plucked fresh tea leaves
Authors: Liang Shuang , Gao Ying , Granato Daniel , Ye Jian‐Hui , Zhou Weibiao , Yin Jun‐Feng , Xu Yong‐Quan
Published: July 2024

Tea is the second largest nonalcoholic beverage in the world due to its characteristic flavor and well‐known functional properties in vitro and in vivo. Global tea production reaches 6.397 million tons in 2022 and continues to rise. Fresh tea leaves are mainly harvested in spring, whereas thousands of tons are discarded in summer and autumn. Herein, pruned tea biomass refers to abandon‐plucked leaves being pruned in the non‐plucking period, especially in summer and autumn. At present, no relevant concluding remarks have been made on this undervalued biomass. This review summarizes the seasonal differences of intrinsic metabolites and pays special attention to the most critical bioactive and flavor compounds, including polyphenols, theanine, and caffeine. Additionally, meaningful and profound methods to transform abandon‐plucked fresh tea leaves into high‐value products are reviewed. In summer and autumn, tea plants accumulate much more phenols than in spring, especially epigallocatechin gallate (galloyl catechin), anthocyanins (catechin derivatives), and proanthocyanidins (polymerized catechins). Vigorous carbon metabolism induced by high light intensity and temperature in summer and autumn also accumulates carbohydrates, such as soluble sugars and cellulose. The characteristics of abandon‐plucked tea leaves make them not ideal raw materials for tea, but suitable for novel tea products like beverages and food ingredients using traditional or hybrid technologies such as enzymatic transformation, microbial fermentation, formula screening, and extraction, with the abundant polyphenols in summer and autumn tea serving as prominent flavor and bioactive contributors.
Review of SNP assays for disaster victim identification: Cost, time, and performance information for decision‐makers
Authors: Gettings Katherine Butler , Tillmar Andreas , Sturk‐Andreaggi Kimberly , Marshall Charla
Published: July 2024

In mass disaster events, forensic DNA laboratories may be called upon to quickly pivot their operations toward identifying bodies and reuniting remains with family members. Ideally, laboratories have considered this possibility in advance and have a plan in place. Compared with traditional short tandem repeat (STR) typing, single nucleotide polymorphisms (SNPs) may be better suited to these disaster victim identification (DVI) scenarios due to their small genomic target size, resulting in an improved success rate in degraded DNA samples. As the landscape of technology has shifted toward DNA sequencing, many forensic laboratories now have benchtop instruments available for massively parallel sequencing (MPS), facilitating this operational pivot from routine forensic STR casework to DVI SNP typing. Herein, we present the commercially available SNP sequencing assays amenable to DVI, we use data simulations to explore the potential for kinship prediction from SNP panels of varying sizes, and we give an example DVI scenario as context for presenting the matrix of considerations: kinship predictive potential, cost, and throughput of current SNP assay options. This information is intended to assist laboratories in choosing a SNP system for disaster preparedness.
Macauba (Acrocomia aculeata) pulp oil reduces fat accumulation and enhances the lifespan of Caenorhabditis elegans at low temperatures via fat‐1‐ and fat‐7‐dependent pathway
Authors: Ana Cíntia Tomaz Santʼ , Ju Jaehyun , de Barros Frederico Augusto Ribeiro , Kim Kee‐Hong
Published: July 2024

Macauba (Acrocomia aculeata) is a Brazilian palm tree whose oil in the pulp is rich in oleic acid and carotenoids. However, its physiological function remains unknown. This study aimed to investigate the effects of macauba pulp oil (MPO) on the metabolic link between lipid metabolism and lifespan using Caenorhabditis elegans (C. elegans). C. elegans were treated with 5.0 mg/mL of MPO for analyzing triglyceride and glycerol accumulation, fatty acid profile, gene expression of lipid and oxidative metabolism proteins under cold (4°C) stress conditions, and lifespan analysis under stress conditions such as cold (4°C), heat (37°C), and oxidative (paraquat) stress. MPO significantly suppressed fat accumulation and increased glycerol (a lipolysis index) and the lifespan of C. elegans at low temperature (4°C). This was accompanied by decreased mRNA levels of the genes involved in lipogenesis (spb‐1 and pod‐2) and increased levels of the genes involved in fatty acid β‐oxidation (acs‐2 and nhr‐49) and fat mobilization genes (hosl‐1 and aak‐2). Additionally, MPO treatment modulated fatty acid pools in C. elegans at low temperatures in that MPO treatment decreased saturated fatty acid levels and shifted the fatty acid profile to long‐chain fatty acids. Moreover, the effect of MPO on fat accumulation at low temperatures was abolished in fat‐7 mutants, whereas both fat‐1 and fat‐7 contribute, at least in part, to MPO‐elevated survival of C. elegans under cold conditions.

Practical Application

The results obtained in the present study may contribute to the understanding of the health benefits of consuming macauba pulp oil and consequently stimulate economic growth and the industrial application of this new type of oil, which may result in the creation of new jobs and increased value of small producers.
Changes in the recent three decades and survey on the current status of surgical treatment for esophageal cancer in China
Authors: Li Yong , Liu Wei‐Xin , Qi Ling , Li Yin , Liu Jun‐Feng , Fu Jian‐Hua , Han Yong‐Tao , Fang Wen‐Tao , Yu Zhen‐Tao , Chen Ke‐Neng , Mao You‐Sheng
Published: July 2024

Background

To review the changes and survey on status quo of the surgical treatment for esophageal cancer in China. The differences in diagnosis and treatment for esophageal cancer among hospitals in different regions across China were also investigated.

Methods

We sent questionnaires to 46 hospitals across China, investigating the volume of esophageal cancer surgeries, surgical procedures, and perioperative management under the guidance of esophageal surgery chiefs.

Results

A total of 46 questionnaires were sent out and collected. The survey results showed that in the past 5 years, the volume of surgeries for esophageal cancer remained stable by 23.9% of those hospitals, increased by 30.4%, and decreased by 45.7%. Of those patients treated by surgery, 19.1% were in the early stages, and 80.9% were in locally advanced stages. In terms of surgical procedures, 73.4% of the patients were treated by minimally invasive surgery and 85.7% of esophageal substitutes were a gastric conduit, 93.1% of the substitutes were pulled to the neck through the esophageal bed. For the lymph node dissection, 78.5% of the patients had a complete two‐field lymph node dissection including the para‐recurrent laryngeal nerve lymph nodes. Of the patients with neoadjuvant therapy, 53.5% received chemotherapy or chemotherapy plus immunotherapy (47.0%), and 43.5% had chemoradiation.

Conclusions

Currently, in China, minimally invasive surgery‐oriented multimodality treatment, including complete two‐field lymph node dissection, has become the standard approach for esophageal cancer management. Over the past decade, this standardized approach has significantly improved prognosis compared to previous decades.
Study of pediatric appendicitis scores and management strategies: A prospective observational feasibility study
Authors: Lee Wei Hao , O'Brien Sharon , McKinnon Elizabeth , Collin Michael , Dalziel Stuart R. , Craig Simon S. , Borland Meredith L.
Published: July 2024

Objective

The objective was to investigate the feasibility of prospectively validating multiple clinical prediction scores (CPSs) for pediatric appendicitis in an Australian pediatric emergency department (ED).

Methods

A literature search was conducted to identify potential CPSs and a single‐center prospective observational feasibility study was performed between November 2022 and May 2023 to evaluate the performance of identified CPSs. Children 5–15 years presenting with acute right‐sided or generalized abdominal pain and clinician suspicion of appendicitis were included. CPSs were calculated by the study team from prospectively clinician‐collected data and/or review of medical records. Accuracy of CPSs were assessed by area under the receiver operating characteristic curve (AUC) and proportions correctly identifiable as either low‐risk or high‐risk with the best performing CPS compared to clinician gestalt. Final diagnosis of appendicitis was confirmed on histopathology or by telephone/email follow‐up for those discharged directly from ED.

Results

Thirty CPSs were identified in the literature search and 481 patients were enrolled in the study. A total of 150 (31.2%) patients underwent appendectomy with three (2.0%) having a normal appendix on histopathology. All identified CPSs were calculable for at least 50% of the patient cohort. The pediatric Appendicitis Risk Calculator for pediatric EDs (pARC‐ED; n = 317) was the best performing CPS with AUC 0.90 (95% confidence interval [CI] 0.86–0.94) and specificity 99.0% (95% CI 96.4%–99.7%) in diagnosing high‐risk cases and a misclassification rate of 4.5% for low‐risk cases.

Conclusions

The study identified 30 CPSs that could be validated in a majority of patients to compare their ability to assess risk of pediatric appendicitis. The pARC‐ED had the highest predictive accuracy and can potentially assist in risk stratification of children with suspected appendicitis in pediatric EDs. A multicenter study is now under way to evaluate the potential of these CPSs in a broader range of EDs to aid clinical decision making in more varied settings.
Sex differences in self‐harm and suicide in young autistic adults
Authors: Hull Laura , Stark Isidora , Lundberg Michael , Ahlqvist Viktor H. , Nordström Selma Idring , Ohlis Anna , Hadlaczky Gergö , Rai Dheeraj , Magnusson Cecilia
Published: July 2024

Introduction

Both suicide and self‐harm are disproportionately common in autistic people. Sex differences in risk of self‐harm and suicide are observed in the general population, but findings are mixed for autistic people. Self‐cutting may be a particularly risky self‐harm behaviour for suicide in autistic people. We aimed to explore sex differences and differences in method of self‐harm in the association between self‐harm and suicide in autistic and non‐autistic adolescents and young adults.

Methods

We used a total population register of 2.8 million Swedish residents. Participants were followed from age 12 until December 2021 for medical treatment because of self‐harm, and death from suicide. We used Cox proportional hazard regression models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for risk of death from suicide following self‐harm, and Relative Excessive Risk due to Interaction (RERI) to explore the interaction between self‐harm and autism in females and males.

Results

We identified 85,143 autistic individuals (31,288 female; 53,855 male) and 2,628,382 non‐autistic individuals (1,286,481 female; 1,341,901 male) aged 12–37 years. Incidence of suicide following self‐harm was higher in autistic males (incidence per 100,000 risk‐years = 169.0 [95% CI 135.1, 211.3]) than females (125.4 [99.4, 158.3]). The relative risk was higher for autistic females (HR 26.1 [95% CI 20.2, 33.7]) than autistic males (12.5 [9.9, 15.8]). An additive effect of both autism and self‐harm was observed in both females (RERI = 9.8) and males (2.0). Autistic individuals who self‐harmed through cutting were at greatest risk of death from suicide (HR 25.1 [17.9, 35.2]), compared to other methods.

Conclusion

Autistic males and females are at increased risk of death from suicide following severe self‐harm, particularly self‐cutting.
Safety and efficacy of immunosuppressive therapy for elderly patients with severe aplastic anaemia
Authors: Prabahran Ashvind , Durrani Jibran , Coelho‐Da Silva Juan , Shalhoub Ruba , Lotter Jennifer , Rios Olga , Ritchie David S. , Wu Colin O. , Patel Bhavisha A. , Young Neal S. , Groarke Emma M.
Published: July 2024

Uncertainty remains regarding the safety and tolerability of immunosuppressive therapy (IST) with anti‐thymocyte globulin (ATG) and cyclosporine (CSA) in older patients. We retrospectively analysed two prospective clinical trials of IST in treatment‐naïve severe aplastic anaemia (SAA) to assess safety in older compared to younger patients. Patients ≥18 years of age who had received IST with ATG and CSA +/− eltrombopag (EPAG) were included. Pre‐treatment baseline characteristics and co‐morbidities were assessed as predictors of therapy‐related complications in younger (<60 years) versus older (≥60 years) patients. Out of 245 eligible patients, 54 were older and 191 were younger. Older patients had a similar frequency of SAEs, ICU admissions and hospital length of stay compared to younger patients. Older patients had a higher frequency of cardiac events related to IST, but none resulted in death. Older patients had worse long‐term overall survival, and more relapse and clonal evolution post‐IST. However, older patients who responded to IST had a similar survival at a median follow‐up to younger patients. Disease‐related factors and limited therapeutic options in refractory disease likely contribute to poorer outcomes in older patients, not complications of upfront IST. Therefore, IST should be considered first‐line therapy for most older SAA patients.
Penile intraepithelial neoplasia incidence, clinical classification, microenvironment and implications for imiquimod treatment
Authors: Avitan Ofir , Rafael Tynisha , Vreeburg Manon , Elst Laura , Bekers Elise M. , Albersen Maarten , Jordanova Ekaterina S. , Brouwer Oscar
Published: July 2024

Objectives

To provide an outline of the existing data on penile intraepithelial neoplasia (PeIN), as well as a narrative review on imiquimod (IQ; a toll‐like receptor 7 agonist) treatment and immune microenvironment markers that may predict response to treatment.

Methods

A narrative review of the literature from 2000 to the present was conducted on PubMed, and we describe the most relevant data and cross references.

Results

The incidence of PeIN is increasing. Local therapy with IQ may offer an easy applicable treatment with complete response rates of up to 63% but can be associated with considerable side‐effects. There is no conclusive data on the optimal treatment schedule for PeIN, but evaluation of treatment results for other human papillomavirus‐related pre‐malignancies suggest three times a week for a duration up to 16 weeks. There are no published studies concerning the PeIN immune microenvironment. However, findings from the few studies on penile cancer and pre‐cancerous vulvar and cervical lesions imply that specific immune cell subpopulations can serve as future predictors for successful immunomodulation treatments such as IQ.

Conclusions

Overall, limited data are available on IQ treatment for PeIN and no published data exists on the PeIN immune microenvironment. Further translational studies are warranted to gain more understanding on the pathophysiology of PeIN and potential predictors of progression and of response to topical treatments.
Fostering the transition towards circular economy through collaborations: An open innovation perspective in the building industry
Authors: Sgambaro Lucrezia , Chiaroni Davide , Urbinati Andrea
Published: July 2024

The current linear economy has led to environmental pollution and resource depletion. To tackle these issues, a new economy model has emerged, namely the circular economy. Being a new economic model, the transition to a circular economy is particularly challenging for existing companies that have designed their business models and collaborations in a linear fashion. This aspect holds particularly true in resource‐intensive industries characterized by long value chains. Among these industries, the building one stands out as characterized by high resource consumption and complex value chains. We argue that in such an industry, the transition to circular economy calls for establishing collaborations between the different players involved to access external competences and engage in a new way the whole value chain. Open innovation enables to access these external competences and fosters collaboration throughout the whole value chain. Taking the façade of a building as a unit of analysis, we aimed at investigating how companies exploit open innovation to implement circular economy initiatives. To address this issue, we leverage the original open innovation framework developed by West & Bogers (2014) adapting it to the peculiarities of the circular economy transition. By applying the action research methodology to analyse the interplay between circular economy and open innovation in the building façade industry, we get evidence that open innovation plays a key role in enabling the transition towards circular economy in a façade‐as‐a‐service model. The need for external knowledge sources in circular product design is reported in order not to have mismatches throughout the product useful life. Besides, we point out the relevance of collaborations in circular economy transition to jointly design products and business models according to the circular economy principles.
Technology market, product market and aggregate innovation
Authors: Xia Shiyun
Published: July 2024

This paper examines the growth maximization mix for intellectual property rights (IPR) in an economy in which incumbents and outside inventors endogenously choose how to develop inventions and commercialization strategies, both of which determine the innovation rate. Outside inventors can choose to commercialize their inventions by (i) launching a new product or (ii) selling to incumbents. I find that if inventors all sell on the technology market, then protecting inventors' patents from imitation by firms raises aggregate innovation. If, instead, all inventors enter the product market, the IPR policy that regulates the ability of incumbents' patents to block the entry of improved products faces a trade‐off between innovation from existing firms and inventors, which leads to a single‐peaked relationship between economic growth and the blocking strength. When both commercialization strategies are chosen, a balanced IPR policy can raise aggregate innovation by encouraging inventors to choose the more efficient commercialization method.
Systematic review of educator behaviours associated with physical activity of early years children
Authors: Wright Chris , Kirkhope Sarah , Buckler E. Jean
Published: July 2024

Background

Educators in early years settings influence children's physical activity (PA) levels through their pedagogical choices and behaviours. To date, minimal research has been conducted on the relationship between educator action and children's PA levels. The purpose of this systematic review was to understand which educator behaviours and actions in early years settings have been shown to engage children in PA.

Methods

Five online databases (Academic Search Complete, ERIC, SPORTDiscus, CINAHL Complete and PubMed) were searched for articles that showed an association between educator behaviour and the PA level of children between the ages of zero and eight.

Results

Eleven studies met all inclusion criteria, yet showed great variability in design and data collection methods. The risk of bias was assessed using previously published criteria adapted to this study and inline with the CONSORT statement. A binomial test on the data revealed a statistically significant deviation from chance expectation (p < .001) in relation to educator action influencing child PA. Ten of the studies focussed on educator PA, four studies highlighted the use of prompting and encouragement, three studies analysed broad statements of adult interaction, two studies called for planning activity sessions and discussions and two studies encouraged role modelling. The low number of studies included in the review and the high risk of bias indicates that caution with these results is needed.

Conclusions

While this review highlights the importance of educator PA (and other behaviours that had a positive association) on child PA level, it underscores the need for high‐quality research to examine the relationship between educator actions and child PA. (PROSPERO registration: CRD42022338819).
Predictors of animal sponsorship to support zoo‐based conservation activities
Authors: Doarks Thomas , Arbuckle Kevin
Published: July 2024

Public donations are an important form of fundraising for zoos and are used to support conservation activities. Understanding what influences zoo animal sponsorship by the public is crucial if zoos are to optimize strategies for increasing income from sponsors. Using sponsorship data obtained from seven diverse zoos within the UK, we used a phylogenetically informed approach to investigate predictors of the number of sponsors a species receives. We found no support for an effect of body mass, conservation status, solitary versus group housing, phylogenetic distance from humans, daily activity patterns, or the diet of the species on the number of sponsors a species attracts. However, we found strong phylogenetic signal, suggesting that particular groups of animals attract disproportionate sponsorship attention (but the specific species within these groups is of limited importance). Moreover, we found support for species with common names that are found toward the start of the alphabet having more sponsors. This is likely driven by the common practice of listing species that can be sponsored in alphabetical order when presenting them to potential sponsors (with people being more likely to choose species near the start of a list). Interestingly, the lack of effect of body mass, phylogenetic distance, and conservation status contrast with previous work on non‐zoo conservation preferences, suggesting possible differences between motivations of zoo and non‐zoo conservation donors, or between animal sponsorship and other forms of conservation involvement. We suggest two strategies for maximizing sponsorship for zoo animals. If zoos manage sponsorship income as a collective pool then allowing sponsorship of a range of species within particularly well‐sponsored animal groups should improve uptake. Alternatively, if zoos allocate sponsorship income to the specific species sponsored, then funding may be effectively diverted to priority species simply by altering the order of lists of animals which can be sponsored.
Cardio‐Renal‐Metabolic Outcomes Associated With the Use of GLP‐1 Receptor Agonists After Heart Transplantation
Authors: Donald Elena M. , Driggin Elissa , Choe Jason , Batra Jaya , Vargas Fabian , Lindekens Jordan , Fried Justin A. , Raikhelkar Jayant K. , Bae David J. , Oh Kyung T. , Yuzefpolskaya Melana , Colombo Paolo C. , Latif Farhana , Sayer Gabriel , Uriel Nir , Clerkin Kevin J. , DeFilippis Ersilia M.
Published: July 2024

Background

The use of glucagon‐like‐peptide 1 receptor agonists (GLP1‐RA) has dramatically increased over the past 5 years for diabetes mellitus type 2 (T2DM) and obesity. These comorbidities are prevalent in adult heart transplant (HT) recipients. However, there are limited data evaluating the efficacy of this drug class in this population. The aim of the current study was to describe cardiometabolic changes in HT recipients prescribed GLP1‐RA at a large‐volume transplant center.

Methods

We retrospectively reviewed all adult HT recipients who received GLP1‐RA after HT for a minimum of 1‐month. Cardiometabolic parameters including body mass index (BMI), lipid panel, hemoglobin A1C, estimated glomerular filtration rate (eGFR), and NT‐proBNP were compared prior to initiation of the drug and at most recent follow‐up. We also evaluated for significant dose adjustments to immunosuppression after drug initiation and adverse effects leading to drug discontinuation.

Results

Seventy‐four patients were included (28% female, 53% White, 20% Hispanic) and followed for a median of 383 days [IQR 209, 613] on a GLP1‐RA. The majority of patients (n = 56, 76%) were prescribed semaglutide. The most common indication for prescription was T2DM alone (n = 33, 45%), followed by combined T2DM and obesity (n = 26, 35%). At most recent follow‐up, mean BMI decreased from 33.3 to 31.5 kg/m2 (p < 0.0001), HbA1C from 7.3% to 6.7% (p = 0.005), LDL from 78.6 to 70.3 mg/dL (p = 0.018) and basal insulin daily dose from 32.6 to 24.8 units (p = 0.0002).

Conclusion

HT recipients prescribed GLP1‐RA therapy showed improved glycemic control, weight loss, and cholesterol levels during the study follow‐up period. GLP1‐RA were well tolerated and were rarely associated with changes in immunosuppression dosing.
Prevalence of very high cardiovascular disease risk in patients with type 2 diabetes mellitus: A population‐based cross‐sectional screening study
Authors: Wang Weihao , Qiao Jingtao , Zhang Lina , Zhang Jie , Luo Jingyi , Chen Chen , Wang Xiaoxia , Jia Peng , Zhang Jia , Pan Qi , Guo Lixin
Published: July 2024

Aim

The 2019 ESC/EASD guidelines categorize cardiovascular disease risk (CVD) in patients with diabetes mellitus (DM). Assessing CVD risk is necessary to identify individuals at very high risk of CVD, enabling tailored and precise intervention for this high‐risk population. This study aims to evaluate the severity of a very high risk for CVD stratification among patients with type 2 DM (T2DM) across different regions in China.

Methods

We conducted a cross‐sectional screening study from 1 January 2020 to 30 December 2022. Disease duration, body mass index (BMI), targeted organ damage, such as atherosclerotic heart disease, proteinuria, impaired renal function, left ventricular hypertrophy, retinopathy and known CVD risk factors, were collected from diabetic patients by professionally trained physicians. The risk of CV in patients with DM was categorized into two groups: very high risk and others, according to the 2019 ESC/EASD guidelines.

Results

In total, 1 870 720 participants from 1669 hospitals in 30 provinces of China, excluding Tibet, Taiwan, Hong Kong and Macao, were enrolled from 2020 to 2022, among whom 67.50% of patients with T2DM were at very high risk for CVD. The proportions of very high‐risk T2DM were higher in Northeast China (75.82%), Central China (73.65%) and Southwest China (72.66%), while the lowest prevalence of very high‐risk T2DM was found in Southern China (60.15%). The multivariate binary logistic regression analyses suggested that the category of very high risk for CVD is associated with age [odds ratio (OR) = 1.04; 95% confidence interval (CI): 1.04‐1.04; p < .0001], BMI (OR = 1.07; 95% CI: 1.07‐1.07; p < .0001), duration of DM (OR = 1.05; 95% CI: 1.05‐1.05; p < .0001), hypertension (OR = 3.75; 95% CI: 3.72‐3.78; p < .0001), dyslipidaemia (OR = 5.22; 95% CI: 5.18‐5.27; p < .0001) and smoking (OR = 2.92; 95% CI: 2.89‐2.95; p < .0001).

Conclusions

This study represented the largest observational study of CVD risk assessment in patients with T2DM in China. The CVD risk situation of patients with diabetes in China is critical, and comprehensive control and management of CVD risk factors, such as hypertension, BMI and dyslipidaemia, in patients with DM need to be strengthened in patients with T2DM in China.
Collet–Sicard syndrome due to cervical artery dissection disclosed by high‐resolution magnetic resonance imaging
Authors: Theodorou Aikaterini , Lachanis Stefanos , Papagiannopoulou Georgia , Maili Maria , Pachi Ioanna , Velonakis Georgios , Bakola Eleni , Vassilopoulou Sofia , Tsivgoulis Georgios
Published: July 2024

Background and purpose

Cervical artery dissection (CAD) represents a leading cause of unilateral lower cranial nerve IX–XII palsy, known as Collet–Sicard syndrome (CSS). High‐resolution magnetic resonance imaging (HR‐MRI) is widely used in the evaluation of patients with CAD, providing information regarding vessel wall abnormalities and intraluminal thrombus.

Methods

We present a patient with palsy of multiple lower cranial nerves in the context of CSS, attributed to unilateral spontaneous internal carotid artery dissection.

Results

We describe a 68‐year‐old man with unremarkable previous history, who presented with subacute, gradually worsening dysphagia and hoarse voice. Clinical examination revealed right‐sided palsy of cranial nerves IX–XII. Three‐dimensional fat‐saturated black‐blood T1‐weighted high‐resolution vessel wall imaging disclosed spontaneous dissection with intramural hematoma along the distal right internal carotid artery. Neck MRI showed inward displacement of right aryepiglottic fold, right pyriform sinus dilatation, and right true vocal cord in middle position, indicative of right vagus nerve palsy, atrophy of right trapezius and sternocleidomastoid muscles, due to right spinal accessory nerve palsy, and unilateral tongue atrophy with fatty infiltration, characteristic for right hypoglossal nerve palsy.

Conclusions

This case highlights the utility of high‐resolution vessel wall imaging and especially fat‐saturated T1‐weighted black‐blood SPACE (sampling perfection with application‐optimized contrast using different flip‐angle evolutions) sequences in the accurate diagnosis of CAD, revealing the characteristic mural hematoma and intimal flap. HR‐MRI is also valuable in the recognition of indirect signs of lower cranial nerve compression.
Pyroptosis and its role in autoimmune skin disease
Authors: Yao Yuanjun , Wang Zehong , Li Junqin , Peng Aihong , Cao Yue , Liang Nannan , Zhang Kaiming
Published: July 2024

Autoimmune skin disease is a kind of heterogeneous disease with complicated pathogenesis. Many factors such as genetic, infectious, environmental and even psychological factors may interact together to trigger a synergistic effect for the development of abnormal innate and adaptive immune responses. Although the exact mechanisms remain unclear, recent evidence suggests that pyroptosis plays a pivotal role in the development of autoimmune skin disease. The feature of pyroptosis is the first formation of pores in cellular membranes, then cell rupture and the release of intracellular substances and pro‐inflammatory cytokines, such as interleukin‐1 beta (IL‐1β) and IL‐18. This hyperactive inflammatory programmed cell death damages the homeostasis of the immune system and advances autoimmunity. This review briefly summarises the molecular regulatory mechanisms of pyrin domain‐containing protein 3 (NLRP3) inflammasome and gasdermin family, as well as the molecular mechanisms of pyroptosis, highlights the latest progress of pyroptosis in autoimmune skin disease, including systemic lupus erythematosus, psoriasis, atopic dermatitis and systemic scleroderma and attempts to identify its potential advantages as a therapeutic target or prognostic biomarker for these diseases.
Effect of Lactobacillus gasseriBIO6369 and Lacticaseibacillus rhamnosusBIO5326 on Gastric Carcinogenesis Induced by Helicobacter pylori Infection
Authors: Jauvain Marine , Lepied Gorann , Bénéjat Lucie , Roudier Nathalie , Dussert Christelle , Lehours Philippe , Varon Christine , Bessède Emilie
Published: July 2024

Background

Helicobacter pylori infection‐associated gastric adenocarcinoma is influenced by various factors, including the digestive microbiota. Lactic acid bacteria role in digestive carcinogenesis has been discussed, and some Lactobacillaceae family species have been shown to act against H. pylori‐induced inflammation and colonization. However, their effects on H. pylori‐related carcinogenesis have not yet been studied. Lactobacillaceae family effects on the epithelial‐to‐mesenchymal transition (EMT), emergence of cells with cancer stem cell (CSC) properties and the pro‐inflammatory response of gastric epithelial cells to H. pylori infection were investigated.

Materials and Methods

A co‐culture model of AGS gastric epithelial cells infected with a carcinogenic strain of H. pylori associated with 18 different probiotic strains candidates were used. Different EMT indicators and CSC properties were studied, including quantification of the mesenchymal phenotype, tumorsphere formation, EMT marker expression, and tight junction evaluation with immunofluorescence microscopy. The effect of the strains on the pro‐inflammatory response to H. pylori was also evaluated by quantifying interleukin‐8 (IL‐8) production using ELISA.

Results

Among the strains tested, Lactobacillus gasseri BIO6369 and Lacticaseibacillus rhamnosus BIO5326 induced a 30.6% and 38.4% reduction in the mesenchymal phenotype, respectively, caused a significant decrease in Snail and Zeb1 EMT marker expression and prevented the loss of tight junctions induced by H. pylori infection. A separate co‐culture with a Boyden chamber maintained the effects induced by the two strains. H. pylori‐induced IL‐8 production was also significantly reduced in the presence of L. gasseri BIO6369 and L. rhamnosus BIO5326.

Conclusion

Lactobacillus gasseri BIO6369 and L. rhamnosus BIO5326 strains decreased epithelial‐to‐mesenchymal transition and inflammation induced by H. pylori infection, suggesting that these species may have a protective effect against H. pylori‐induced gastric carcinogenesis.
The effect of TiO2/Yb2O3 binary sintering aids on the properties of UV‐cured Al2O3‐based ceramics
Authors: Miao Xinyu , Liu Shuangyu , Lu Ping , Chu Hongtao , Zhang Fulong , Huang Chuanjin , Wang Liyan
Published: July 2024

In this study, an Al2O3‐based ceramic pastes with high solid content and low viscosity for photocuring was prepared. The effects of TiO2/Yb2O3 binary sintering aid on the rheological properties, curing behavior, and bending strength of the sintered parts were systematically investigated. Ceramic samples with an intact surface and no defects were prepared through debinding in various atmospheres followed by pressure‐less sintering at 1600°C. The bending strength of the sintered material was 329 MPa, which represents a 231% increase compared to the bending strength of 99.4 MPa for pure Al2O3 ceramic material prepared using the same process, with the highest recorded bending strength reaching 478.47 MPa. Scanning electron microscopy and X‐ray diffraction analyses revealed that the binary sintering aid acts as a bridge between grains by forming a solid solution with Al2O3 powder at high temperatures, which decreased the pore size and number between Al2O3 ceramic grains, thereby enhancing the bending strength of the ceramics. The prepared ceramic pastes is expected to meet the manufacturing requirements of high‐performance ceramic substrates and accelerate the development of high‐performance ceramic substrate processing technology.
Fresh‐look effect of audit firm and audit partner rotations? Evidence from European key audit matters
Authors: Federsel Florian Philipp
Published: July 2024

Many countries worldwide mandate the rotation of audit partners or audit firms to reinforce independence and professional skepticism. The European Union is a rare instance requiring audit firm and audit partner rotation simultaneously. By analysing 6,103 firm‐year observations of non‐financial firms from 29 European countries between 2018 and 2022, this study finds that audit firm rotations are associated with considerable changes in key audit matters, suggesting the existence of a fresh‐look effect. In contrast, audit partner rotations appear to induce only limited variations in the key audit areas. Additional analyses reveal that the results are consistent across mandatory and voluntary rotations. Collectively, the findings suggest that audit firm rotations enable auditors to overcome institutional pressures toward standardisation within audit firms, while practical considerations such as the requirement of gradual rotation mechanisms within audit firms might limit individual audit partners' influence. This study adds to the inconclusive literature on the effects of (mandatory) audit partner and audit firm rotations. Further, the results contribute new insights into the consequences of the EU audit reform that has introduced mandatory audit firm rotation and provide evidence in favour of audit firm rotation requirements for other regulators.
The effect of web‐designed education on medication adherence, asthma control and fatigue in patients with asthma: A randomized controlled trial
Authors: Erdoğan Eylül Gülnur , Örsal Özlem
Published: July 2024

Aims

This study aimed to determine the effect of web‐designed education developed for asthma patients on drug adherence, asthma control and fatigue.

Methods

This randomized controlled trial was conducted between August 2021 and January 2022 with 200 individuals suffering from poor asthma control who participated in web‐designed education. After the intervention, the asthma patients were followed up for 6 weeks to measure Medication Adherence Report Scale (MARS), Chronic Obstructive Pulmonary Disease and Asthma Fatigue Scale (CAFS), Asthma Control Test (ACT) and Inhalation Devices Usage Techniques Knowledge Test (IDUSTKT). Data were analysed in the Statistical Package for the Social Sciences program using the Chi‐square test, Independent t‐test, Man–Whitney U test, Wilcoxon test, Paired t‐test, Greenhouse–Geisser (F) test and Linear regression.

Results

The web‐designed education had a statistically significant effect on the total scores of CAFS, ACT and IDUSTKT for individuals with asthma (p < 0.001). This intervention decreased fatigue levels, improved asthma control and enhanced knowledge of inhalation device usage techniques. Although there was an improvement in medication adherence, this difference was not statistically significant.

Conclusion

These results suggest that web‐based educational programs can be an effective tool in asthma management and may improve patients' quality of life. Future research should examine the long‐term effects of such educational programs and their effectiveness across different demographic groups in more detail.
Migration and inflation nexus under high and low interest rate environments: Some panel data evidence
Authors: Salisu Afees A. , Muhammad Rabia Abdul , Saliu Mojeed O.
Published: July 2024

This study analyzes the relationship between migration and inflation as well as the intervening role of interest rates in selected OECD countries from 1995 to 2020, covering periods of turbulence and tranquillity. The study finds that migration increases inflation in the short run but lowers it in the long run. In other words, the inflationary effect of migration is a long‐run phenomenon. Additionally, we find that the high interest rates help mitigate the inflationary effect of migration in the short run relative to the low interest rates. Moreover, additional analysis using the panel threshold technique further lends credence to the mediating role of interest rates in the nexus, thus making our results robust to alternative estimation techniques. These findings have significant implications for policymakers responsible for managing inflation.
Cell‐permeable JNK‐inhibitory peptide regulates intestinal barrier function and inflammation to ameliorate necrotizing enterocolitis
Authors: Bu Chaozhi , Hu Mengyuan , Su Yinglin , Yuan Fuqiang , Zhang Yiting , Xia Jing , Jia Zhenyu , Zhang Le
Published: July 2024

Intestinal dysbiosis is believed to play a role in the development of necrotizing enterocolitis (NEC). The efficacy of JNK‐inhibitory peptide (CPJIP) in treating NEC was assessed. Treatment with CPJIP led to a notable reduction in p‐JNK expression in IEC‐6 cells and NEC mice. Following LPS stimulation, the expression of RNA and protein of claudin‐1, claudin‐3, claudin‐4 and occludin was significantly decreased, with this decrease being reversed by CPJIP administration, except for claudin‐3, which remained consistent in NEC mice. Moreover, the expression levels of the inflammatory factors TNF‐α, IL‐1β and IL‐6 were markedly elevated, a phenomenon that was effectively mitigated by the addition of CPJIP in both IEC‐6 cells and NEC mice. CPJIP administration resulted in improved survival rates, ameliorated microscopic intestinal mucosal injury, and increased the total length of the intestines and colon in NEC mice. Additionally, CPJIP treatment led to a reduction in serum concentrations of FD‐4, D‐lactate and DAO. Furthermore, our results revealed that CPJIP effectively inhibited intestinal cell apoptosis and promoted cell proliferation in the intestine. This study represents the first documentation of CPJIP's ability to enhance the expression of tight junction components, suppress inflammatory responses, and rescue intestinal cell fate by inhibiting JNK activation, ultimately mitigating intestinal severity. These findings suggest that CPJIP has the potential to serve as a promising candidate for the treatment of NEC.
Hypoxia impairs urothelial barrier function by inhibiting the expression of tight junction proteins in SV‐HUC‐1 cells
Authors: Luo Huijiu , Zhou Hui , Chen Yuzhu , Sun Xianwu , Li Yihuan , Li Guangjie , Long Shouyi , Wang Shiyu , Liang Guobiao , Chen Shulian
Published: July 2024

Hypoxia plays an important role in the pathological process of bladder outlet obstruction. Previous research has mostly focused on the dysfunction of bladder smooth muscle cells, which are directly related to bladder contraction. This study delves into the barrier function changes of the urothelial cells under exposure to hypoxia. Results indicated that after a 5‐day culture, SV‐HUC‐1 formed a monolayer and/or bilayer of cell sheets, with tight junction formation, but no asymmetrical unit membrane was observed. qPCR and western blotting revealed the expression of TJ‐associated proteins (occludin, claudin1 and ZO‐1) was significantly decreased in the hypoxia group in a time‐dependent manner. No expression changes were observed in uroplakins. When compared to normoxic groups, immunofluorescent staining revealed a reduction in the expression of TJ‐associated proteins in the hypoxia group. Transepithelial electrical resistance (TEER) revealed a statistically significant decrease in resistance in the hypoxia group. Fluorescein isothiocyanate‐conjugated dextran assay was inversely proportional to the results of TEER. Taken together, hypoxia down‐regulates the expression of TJ‐associated proteins and breaks tight junctions, thus impairing the barrier function in human urothelial cells.