bluuebunny/crossref_metadata_2025 huggingface dataset:
Policy interventions and productive employment in rural sub-Saharan Africa: a gender-differentiated meta-analysis
Authors: Singbo Alphonse , Lokossou Jourdain Chambord
Published: June 2023

Purpose

The farm sector is crucial for rural poverty alleviation, alongside the non-farm sector, which contributes to mitigating risks associated with crop failures. This paper investigates the effects of public policies on productive employment within both the farm and non-farm sectors in sub-Saharan Africa.

Design/methodology/approach

A meta-analysis is conducted exclusively on the results of the Partnership for Economic Policy (PEP)-funded studies under the Policy Analysis on Growth and Employment (PAGE II) initiative. Selected studies focused on the impact of public policies on productive employment in rural farm and non-farm sectors, encompassing a total of nine sub-Saharan Africa countries in: Benin, Burkina Faso, Cote d'Ivoire, Democratic Republic of Congo, Ghana, Lesotho, Nigeria, Senegal and South Africa.

Findings

The results indicate that public investments in rural areas and public policies that facilitate access to productive resources are likely to enhance productive employment. The overall effect size is positive and significant, ranging from 2% to 10% increases in productive employment. Sources of variation include the sector of activity and the policy instrument. In addition, the policy effects are gender-sensitive and seem more consistent in the non-farm sector.

Research limitations/implications

Although the selected working papers addressed several aspects of productive employment, other aspects warrant further investigation. Policies involving restrictions or regulations have received little attention in the impact analysis. Researches to fill this gap would be important. Another suggestion for further research is the analysis of the relative importance of non-farm employment in rural areas in developing countries. It is always assumed that rural households depend heavily on agriculture for their subsistence.

Originality/value

The contribution of the paper lies in the comparative analysis of numerous public policies implemented in nine distinct countries. By consolidating data from fourteen 14 different experiences into a single study, the paper offers valuable insights on factors that determine policy effectiveness and contribute to understanding what worked for whom and why.
Adding value through enterprise building information models in health-care services
Authors: Petersen Sobah Abbas , Evjen Tor Åsmund , Krogstie John
Published: June 2023

Purpose

The main aim of this paper is to describe the potential benefits of enterprise building information models (EBIMs) for health-care institutions. The main research question addressed is how data from EBIM could be leveraged to create value for hospitals beyond design, construction and traditional facility management.

Design/methodology/approach

Three different prototypes, which use different technologies in combination with EBIM, are described to illustrate different uses of EBIM within the context of a hospital and health-care operations. The case study approach has been used to present the prototypes.

Findings

EBIM data, in combination with other data sources, increases the potential benefits of the data with respect to many health-care-related processes, during the operation of a health-care institution. The benefits of EBIM span beyond the design and construction life cycle phases of a hospital and provide value to a variety of stakeholders in multiple health-care-related processes.

Research limitations/implications

The main limitation of this work is the limited sources of data and information such as the specific methods that were used in the design and development of each of the prototypes and a deeper insight into the design rationale and decisions. Another limitation of this paper is that the findings have not been validated.

Practical implications

This study demonstrates the value of convergence of a number of technologies such as EBIM, data and different types of technologies, throughout the life cycle of a building. This study also highlights the value of building information models (BIMs) data for supporting the design of novel educational and other types of application areas. The practical implications include the value for multiple stakeholders, such as resources planning, fleet and equipment management and contract negotiation. Benefits identified for resource planning can have strategic and financial implications at the management level. For patients, visitors and health-care personnel, there may be reduced infections, cleaner and pleasant facilities as well as a reduction of time to find relevant resources.

Social implications

Social implications" could be replaced by "For patients, visitors and health-care personnel, there may be cleaner and pleasant facilities and easy navigation support through the hospital. Furthermore, enhanced access to knowledge and information about the artefact and assets in the hospital can enhance learning and knowledge sharing.

Originality/value

This study identifies the lack of research in using BIM with other data for value-added services for multiple stakeholders in the operations phase of a hospital and addresses that research gap.
Self-governing organizations and culture: addressing condominium law developments in China
Authors: Chen Lei
Published: June 2023

Purpose

This paper aims to unfold the intricate relations between private law design, the structure of organizations for collective action and cultural values and orientations that practically guide interpersonal interactions in Chinese society.

Design/methodology/approach

Drawing upon the Hofstede Insights National Culture survey (The Culture Compass) data and some judicial rulings in China, this paper examines the legislative development and judicial approach to settle condominium disputes to explain and address the cultural orientation for future legal reform. This paper examines how the law reflects and responds to the cultural and social variations/interactions among the stakeholders, namely, local government, developers, homeowner associations, condo owners and property management agents.

Findings

Culture plays a significant role in shaping how condominiums are governed in China. This analysis can highlight the role of cultural factors that influence the success or failure of condominium governance and suggest ways in which governance structures can be adapted to reflect the legal culture of the community better. The emphasis on social harmony, respect for authority, relationships and networks and knowledge and expertise all contribute to a unique approach to condominium governance that reflects the values and priorities of Chinese society.

Originality/value

While much has been written on the importance of property rights to economic development, relatively little seems to be understood about processes of change in complex property systems, particularly in China, a socialist-transforming country. Specifically, there is a lack of reliable knowledge about the intricate relations between the structure of organizations for collective action and cultural orientations that practically guide interpersonal interactions in Chinese society. The question at the heart of this research relates to the condominium rules most suitable for an emerging Chinese private property market.
A multi-case induction adaptation study of tacit knowledge based on NRS and CBR
Authors: Zhang Jianhua , Li Liangchen , Boamah Fredrick Ahenkora , Zhang Shuwei , He Longfei
Published: June 2023

Purpose

This study aims to deal with the case adaptation problem associated with continuous data by providing a non-zero base solution for knowledge users in solving a given situation.

Design/methodology/approach

Firstly, the neighbourhood transformation of the initial case base and the view similarity between the problem and the existing cases will be examined. Multiple cases with perspective similarity or above a predefined threshold will be used as the adaption cases. Secondly, on the decision rule set of the decision space, the deterministic decision model of the corresponding distance between the problem and the set of lower approximate objects under each choice class of the adaptation set is applied to extract the decision rule set of the case condition space. Finally, the solution elements of the problem will be reconstructed using the rule set and the values of the problem's conditional elements.

Findings

The findings suggest that the classic knowledge matching approach reveals the user with the most similar knowledge/cases but relatively low satisfaction. This also revealed a non-zero adaptation based on human–computer interaction, which has the difficulties of solid subjectivity and low adaptation efficiency.

Research limitations/implications

In this study the multi-case inductive adaptation of the problem to be solved is carried out by analyzing and extracting the law of the effect of the centralized conditions on the decision-making of the adaptation. The adaption process is more rigorous with less subjective influence better reliability and higher application value. The approach described in this research can directly change the original data set which is more beneficial to enhancing problem-solving accuracy while broadening the application area of the adaptation mechanism.

Practical implications

The examination of the calculation cases confirms the innovation of this study in comparison to the traditional method of matching cases with tacit knowledge extrapolation.

Social implications

The algorithm models established in this study develop theoretical directions for a multi-case induction adaptation study of tacit knowledge.

Originality/value

This study designs a multi-case induction adaptation scheme by combining NRS and CBR for implicitly knowledgeable exogenous cases. A game-theoretic combinatorial assignment method is applied to calculate the case view and the view similarity based on the threshold screening.
Intuitionistic fuzzy gained and lost dominance score based on symmetric point criterion to prioritize zero-carbon measures for sustainable urban transportation
Authors: Hezam Ibrahim M. , Basua Debananda , Mishra Arunodaya Raj , Rani Pratibha , Cavallaro Fausto
Published: June 2023

Purpose

Achieving a zero-carbon city requires a long-term strategic perspective. The authors propose a decision-making model which would take into account the economic, environmental and social impacts for prioritizing the zero-carbon measures for sustainable urban transportation.

Design/methodology/approach

An integrated intuitionistic fuzzy gained and lost dominance score (IF-GLDS) model is introduced based on intuitionistic fuzzy Yager weighted aggregation (IFYWA) operators and proposed weight-determining IF-SPC procedure. In addition, a weighting tool is presented to obtain the weights of decision experts. Further, the feasibility and efficacy of developed IF-SPC-GLDS model is implemented on a multi-criteria investment company selection problem under IFS context.

Findings

The results of the developed model, “introducing zero-emission zones” should be considered as the first measure to implement. The preference of this initiative offers sustainable transport in India to achieve a zero-carbon transport by having the greatest impact on the modal shift from cars to sustainable mobility modes with a lower operational and implementation cost as well as having greater public support. The developed model utilized can be relocated to other smart cities which aim to achieve a zero-carbon transport. Sensitivity and comparative analyses are discussed to reveal the robustness of obtained result. The outcomes show the feasibility of the developed methodology which yields second company as the suitable choice, when compared to and validated using the other MCDA methods from the literature, including TOPSIS, COPRAS, WASPAS and CoCoSo with intuitionistic fuzzy information.

Originality/value

A new intuitionistic fuzzy symmetry point of criterion (IF-SPC) approach is presented to find weights of criteria under IFSs setting. Then, an IF-GLDS model is introduced using IFYWA operators to rank the options in the realistic multi-criteria decision analysis (MCDA) procedure. For this purpose, the IFYWA operators and their properties are developed to combine the IFNs. These operators can offer a flexible way to deal with the realistic MCDA problems with IFS context.
Exploring the impact of digitalisation and technology on corruption: evidence from cross-country panel data within a cultural-economic framework
Authors: Bota-Avram Cristina
Published: June 2023

Purpose

This study aims to contribute to the existing literature by empirically investigating the impact of digital competitiveness and technology on corruption under the moderating effect of some cultural and economic control variables and providing evidence on the links between corruption and various cultural dimensions at the country level.

Design/methodology/approach

The cross-sectional sample covers 61 countries (41 high-income and 20 lower-income countries) during the 2016–2020 period, and the analysis was carried out for both the full sample and the subsamples.

Findings

The results provide clear evidence supporting the hypothesis that digitalisation and technology significantly affect the perceived level of corruption under the moderating role of cultural framework and economic development. Furthermore, the most significant cultural dimensions of corruption are individualism versus collectivism, uncertainty avoidance, long-term orientation and indulgence versus restraint, even if, in some cases, its influence might be felt differently when the results are estimated on subsamples. Thus, in the case of indulgence versus restraint, high-income countries with higher indulgence scores would register higher scores for the corruption perception index and thus a better control of corruption, while for lower-income countries, the more indulgent these countries are, the weaker the corruption control will be. Furthermore, our results validate a powerful and significant correlation between the index of economic freedom and corruption in both digitalisation and technology.

Research limitations/implications

This study may have relevant implications for policymakers who need to recognise the role of digitalisation and technology in the fight against corruption but considering the cultural and economic characteristics specific to each country.

Originality/value

To the authors' knowledge, the relationship between digital competitiveness, technology and corruption within an economic and cultural framework, while highlighting the differences between high-income and lower-income countries, has not been previously documented in the literature. Thus, this article argues that the level of digital competitiveness and the adoption of technology would significantly impact the level of perceived corruption, although this impact could be felt differently by countries in the high-income category compared to countries in the lower-level income category.
Hygroscopic analysis and tribo-mechanical characterization of biocompatible PP/PA6/Boron sesquioxide composite
Authors: Randhawa Kawaljit Singh
Published: June 2023

Purpose

The purpose of this study is to look into the hygroscopic and tribo-mechanical properties of a polypropylene/polyamide-6 (PP/PA6) blend and a PP/PA6/Boron sesquioxide composite.

Design/methodology/approach

The hygroscopic behaviour of the PP/PA6 blend and PP/PA6/Boron sesquioxide composite was studied using a water contact angle goniometer in this study. To validate the hygroscopic behaviour of the blend and composite, water contact angles and surface energy of the materials were investigated. Tensile strength and hardness tests were used to determine mechanical characteristics, and tribological experiments on a pin-on-disc tribometer were used to demonstrate the friction and wear rates of dry and water-conditioned blends and composites. The melting temperature of dry and water-conditioned composites was determined using DSC analysis.

Findings

The hygroscopic effect of the PP/PA6 blend was found to be minimal in the experiment, while it was relatively dominating in the PP/PA6/Boron sesquioxide composite. Tensile strength was found to be somewhat lower in blend and composite compared to virgin PP, whereas hardness was found to be higher in both blend and composite. The composite’s tribological testing findings were fairly outstanding, with the coefficient of friction (COF) and wear rates significantly reduced due to boron sesquioxide reinforcement. The reaction between boron sesquioxide and water molecules produced boric acid, which increased the tribological characteristics of the composite even further. Following 30 days of water conditioning, the weight of the blend increased by 3.64% and the weight of the composite increased by 6.45% as compared to the dry materials. After water conditioning, tensile strength reduced by 0.8% for the blend and 14.16% for the composite. Hardness was determined to be the same in the dry state and after water-conditioning for blend but dropped 1% for composite. As compared to blend, the COF and wear resistance of composite were 15.52% and 25.16% higher, respectively. After absorbing some water, the results increased to 28.57% and 34.9%, respectively.

Originality/value

The mechanical and thermal behaviour of polymer composites (particularly polyamide composites) vary depending on the surrounding environment. Tests were carried out to explore the effect of water treatment on the tribo-mechanical and thermal characteristics of PP/PA6/Boron sesquioxide composite. Water treatment caused polyamides to bind with water molecules, resulting in voids in the material. The interaction between boron sesquioxide and water molecules produced boric acid, which increased the tribological characteristics of the composite.
Occurrence of aerobic bacterial endospores in dried dairy ingredients
Authors: Jha Sheetal , Singh Neha , Anand Sanjeev
Published: June 2023

The present study investigated types of bacterial endospores in powdered dairy ingredients. For enumeration, the samples were heat‐treated at 80°C/12 min for regular spore type, 100°C/30 min for high‐heat‐resistant spores (HHRS), and 106°C/30 min for specially thermoresistant spores (STS), followed by incubation for 24 h at 37°C (for mesophiles) and 55°C (for thermophiles). Of the three types, the regular spore type (80°C/12 min) was observed to be the most prominent endospore type, and Bacillus licheniformis as the predominant bacterial species in the tested dairy ingredients. This study would be helpful to utilise dry ingredients based on the potential activation of endospores during the product manufacturing processes.
Nonbovine milk and its products as sources of probiotics delivery: An overview of its viability,functionality and product quality characteristics
Authors: Wang Shi , Naumovski Nenad , Ajlouni Said , Ayyash Mutamed , Silva Ramon , Balthazar Celso Fasura , Esmerino Erick Almeida , Freitas Mônica Queiroz , da Silva Márcia Cristina , Sant'Ana Anderson S. , da Cruz Adriano Gomes , Ranadheera Chaminda Senaka
Published: June 2023

Dairy products are the most predominant food carriers for probiotics, providing adequate therapeutic and functional benefits to the host when sufficient probiotics are maintained. Bovine milk currently dominates the global probiotic food market, but there is an increasing trend of applying nonbovine milk from other dairy animals as probiotic carrier food matrices as described in this review. Nonbovine dairy products can be considered suitable food matrices for probiotic delivery due to their excellent probiotic viability (mostly >log 7 cfu/mL or g) during shelf life, functional properties and product quality characteristics, being considered desirable and novel dairy products.
The distribution of child physicians and early academic achievement
Authors: Drescher Jessica , Domingue Benjamin W.
Published: June 2023

Objective

To describe the distribution of pediatricians and family physicians (child physicians) across school districts and examine the association between physician supply and third‐grade test scores.

Data Sources and Study Setting

Data come from the January 2020 American Medical Association Physician Masterfile, the 2009–2013 and 2014–2018 waves of American Community Survey 5‐Year Data, and the Stanford Education Data Archive (SEDA), which uses test scores from all U.S. public schools. We use covariate data provided by SEDA to describe student populations.

Study Design

This descriptive analysis constructs a physician‐to‐child‐population ratio for every school district in the country and describes the child population served by the current distribution of physicians. We fit a set of multivariable regression models to estimate the associations between district test score outcomes and district physician supply. Our model includes state fixed effects to control for unobservable state‐level factors, as well as a covariate vector of sociodemographic characteristics.

Data Collection

Public data from three sources were matched by district ID.

Principal Findings

Physicians are highly unequally distributed across districts: nearly 3640 (29.6%) of 12,297 districts have no child physician, which includes 49% of rural districts. Rural children of color in particular have very little access to pediatric care, and this inequality is more extreme when looking exclusively at pediatricians. Districts that have higher child physician supplies tend to have higher academic test scores in early education, independent of community socioeconomic status and racial/ethnic composition. While the national data show this positive relationship (0.012 SD, 95% CI, 0.0103–0.0127), it is most pronounced for districts in the bottom tertile of physician supply (0.163 SD, 95% CI, 0.108–0.219).

Conclusions

Our study demonstrates a highly unequal distribution of child physicians in the U.S., and that children with less access to physicians have lower academic performance in early education.
Microwave drying of quince coated with seed gum and pectin: A Taguchi optimization, techno‐functional properties, and aromatic compounds
Authors: Berktas Serap , Cam Mustafa , Salum Pelin , Erbay Zafer
Published: June 2023

In this study, the effects of coating quince slices with CaCl2 and pectin (C + P) followed by drying with microwave (MWD‐C + P) or with hot air (HAD‐C + P) were investigated to determine the physicochemical, techno‐functional, textural, and volatile components of dried quince slices. A Taguchi orthogonal experimental design was set up with 18 points (L18), and the best conditions for drying were obtained using signal/noise ratio method. Coating quince slices with C + P and then drying with microwave at 450 W displayed the higher results compared to other points in terms of color, total phenolic, antioxidant activity, antimicrobial activity, and water holding capacity. MWD‐C + P application dramatically changed the textural properties of dried quince slices in terms of hardness, gumminess, and chewiness. Moreover, MWD, lasted 12–15 min, was superior to HAD in the context of drying time. Ultrasonication as a pretreatment had no positive impact on dried products. GC–MS analyses revealed that MWD‐C + P had positive effects on dried quince slices in terms of ethyl hexanoate and octanoic acid. However, MWD‐C + P application triggered the formation of furfural in dried products.
Computed X‐ray Tomography Investigation of Porosity and Permeability of the Liujiagou Formation Sandstone Exposed to CO2‐Saturated Brine
Authors: XUE Quan , ZHANG Liwei , XU Liang , MYERS Matthew , WHITE Cameron , MEI Kaiyuan , WANG Hanwen , LI Qi , LI Xiaochun
Published: June 2023

In order to improve CO2 capture, utilization and storage (CCUS) to solve carbon emission, sandstone from the Triassic Liujiagou Formation (LF) from the Ordos Basin in China was investigated using permeability tests and computed X‐ray tomography (CT) scanning. The presence of reactive minerals within the geological CO2 sequestration target storage formation can allow reaction with injected CO2, which changes the porosity and permeability of the LF beds, affecting storage effectiveness. To investigate the effect of chemical reactions on the pore structure and permeability of sandstone cores representing the LF CO2 storage, tests were conducted to analyze the changes in porosity and permeability of sandstone cores induced by CO2‐saturated brine at different reaction times (28‐day maximum reaction period). Porosity and permeability of the sandstone increased after reaction with CO2‐saturated brine due to mineral dissolution. The sandstone exhibited an increase in porosity and permeability after 15 days of reaction with CO2‐saturated brine. Moreover, there was an increase in the volume of large pores in the sandstone after the 28‐day period. The pore network of the sandstone was established through CT results, and the porosity calculated based on the obtained pore network was close to that measured in the test, demonstrating the feasibility to use CT to study the evolution of the microstructure of sandstone after long‐time exposure to CO2‐saturated brine.
The D3‐creatine dilution method non‐invasively measures muscle mass in mice
Authors: Wimer Lauren , Goncharova Elena , Galkina Sofiya , Nyangau Edna , Shankaran Mahalakshmi , Davis Asia , Prado Leandro , Munoz Maria Castro , Epstein Sharon , Patterson Cavan , Shaum Nicholas , Hellerstein Mark , Evans William , Melov Simon
Published: June 2023

Developing accurate methods to quantify age‐related muscle loss (sarcopenia) could greatly accelerate development of therapies to treat muscle loss in the elderly, as current methods are inaccurate or expensive. The current gold standard method for quantifying sarcopenia is dual‐energy X‐ray absorptiometry (DXA) but does not measure muscle directly—it is a composite measure quantifying “lean mass” (muscle) excluding fat and bone. In humans, DXA overestimates muscle mass, which has led to erroneous conclusions about the importance of skeletal muscle in human health and disease. In animal models, DXA is a popular method for measuring lean mass. However, instrumentation is expensive and is potentially limited by anesthesia concerns. Recently, the D3‐creatine (D3Cr) dilution method for quantifying muscle mass was developed in humans and rats. This method is faster, cheaper, and more accurate than DXA. Here, we demonstrate that the D3Cr method is a specific assay for muscle mass in mice, and we test associations with DXA and body weight. We evaluated the D3Cr method compared to DXA‐determined lean body mass (LBM) in aged mice and reported that DXA consistently overestimates muscle mass with age. Overall, we provide evidence that the D3Cr dilution method directly measures muscle mass in mice. Combined with its ease of use, accessibility, and non‐invasive nature, the method may prove to more quickly advance development of preclinical therapies targeting sarcopenia.
Mendelian randomization supports causality between overweight status and accelerated aging
Authors: Chen Zong , Chen Zhiyou , Jin Xiaolei
Published: June 2023

It is reported that overweight may lead to accelerated aging. However, there is still a lack of evidence on the causal effect of overweight and aging. We collected genetic variants associated with overweight, age proxy indicators (telomere length, frailty index and facial aging), etc., from genome‐wide association studies datasets. Then we performed MR analyses to explore associations between overweight and age proxy indicators. MR analyses were primarily conducted using the inverse variance weighted method, followed by various sensitivity and validation analyses. MR analyses indicated that there were significant associations of overweight on telomere length, frailty index, and facial aging (β = −0.018, 95% CI = −0.033 to −0.003, p = 0.0162; β = 0.055, 95% CI = 0.030–0.079, p < 0.0001; β = 0.029, 95% CI = 0.013–0.046, p = 0.0005 respectively). Overweight also had a significant negative causality with longevity expectancy (90th survival percentile, β = −0.220, 95% CI = −0.323 to −0.118, p < 0.0001; 99th survival percentile, β = −0.389, 95% CI = −0.652 to −0.126, p = 0.0038). Moreover, the findings tend to favor causal links between body fat mass/body fat percentage on aging proxy indicators, but not body fat‐free mass. This study provides evidence of the causality between overweight and accelerated aging (telomere length decreased, frailty index increased, facial aging increased) and lower longevity expectancy. Accordingly, the potential significance of weight control and treatment of overweight in combating accelerated aging need to be emphasized.
The molecular characteristics of non‐small cell lung cancer in the Northern Territory's Top End
Authors: Downton Teesha Dzu Fun , Wing Kristof , Cosentino Stevie Brooke , Karanth Narayan V
Published: June 2023

Aim

Indigenous Australians with lung cancer have poorer survival than non‐Indigenous Australians. The reasons for the disparity are not fully understood and this study hypothesized that there may be a difference in the molecular profiles of tumors. The aim of this study, therefore, was to describe and compare the characteristics of non‐small cell lung cancer (NSCLC) in the Northern Territory's Top End, between Indigenous and non‐Indigenous patients, and describe the molecular profile of tumors in the two groups.

Methods

A retrospective review was conducted of all adults with a new diagnosis of NSCLC in the Top End from 2017 to 2019. Patient characteristics assessed were Indigenous status, age, sex, smoking status, disease stage, and performance status. Molecular characteristics assessed were epidermal growth factor receptor (EGFR), anaplastic lymphoma kinase (ALK), v‐raf murine sarcoma viral oncogene homolog B (BRAF), ROS proto‐oncogene 1 (ROS1), Kirsten rat sarcoma viral oncogene homolog (KRAS), mesenchymal‐epithelial transition (MET), human epidermal growth factor receptor 2 (HER2), and programmed death‐ligand 1 (PD‐L1). Student's t‐test and Fisher's Exact Test were used in the statistical analysis.

Results

There were 152 patients diagnosed with NSCLC in the Top End from 2017–2019. Thirty (19.7%) were Indigenous and 122 (80.3%) were non‐Indigenous. Indigenous patients compared to non‐Indigenous patients were younger at diagnosis (median age 60.7 years versus 67.1 years, p = 0.00036) but were otherwise similar in demographics. PD‐L1 expression was similar between Indigenous and non‐Indigenous patients (p = 0.91). The only mutations identified among stage IV non‐squamous NSCLC patients were EGFR and KRAS but testing rates and overall numbers were too small to draw conclusions about differences in prevalence between Indigenous and non‐Indigenous patients.

Conclusion

This is the first study to investigate the molecular characteristics of NSCLC in the Top End.
Postoperative pulmonary complications in older patients undergoing elective surgery with a supraglottic airway device or tracheal intubation
Authors: Yang L. Q. , Zhu L. , Shi X. , Miao C. H. , Yuan H. B. , Liu Z. Q. , Gu W. D. , Liu F. , Hu X. X. , Shi D. P. , Duan H. W. , Wang C. Y. , Weng H. , Huang Z. L. , Li L. Z. , He Z. Z. , Li J. , Hu Y. P. , Lin L. , Pan S. T. , Xu S. H. , Tang D. , Sessler D. I. , Liu J. , Irwin M. G. , Yu W. F. ,   the POLMA‐EP investigators
Published: June 2023

The two most commonly used airway management techniques during general anaesthesia are supraglottic airway devices and tracheal tubes. In older patients undergoing elective non‐cardiothoracic surgery under general anaesthesia with positive pressure ventilation, we hypothesised that a composite measure of in‐hospital postoperative pulmonary complications would be less frequent when a supraglottic airway device was used compared with a tracheal tube. We studied patients aged ≥ 70 years in 17 clinical centres. Patients were allocated randomly to airway management with a supraglottic airway device or a tracheal tube. Between August 2016 and April 2020, 2900 patients were studied, of whom 2751 were included in the primary analysis (1387 with supraglottic airway device and 1364 with a tracheal tube). Pre‐operatively, 2431 (88.4%) patients were estimated to have a postoperative pulmonary complication risk index of 1–2. Postoperative pulmonary complications, mostly coughing, occurred in 270 of 1387 patients (19.5%) allocated to a supraglottic airway device and 342 of 1364 patients (25.1%) assigned to a tracheal tube (absolute difference −5.6% (95%CI −8.7 to −2.5), risk ratio 0.78 (95%CI 0.67–0.89); p < 0.001). Among otherwise healthy older patients undergoing elective surgery under general anaesthesia with intra‐operative positive pressure ventilation of their lungs, there were fewer postoperative pulmonary complications when the airway was managed with a supraglottic airway device compared with a tracheal tube.
Association between central obesity and semen quality: A cross‐sectional study in 4513 Chinese sperm donation volunteers
Authors: Wang Tingting , Wang Qiling , Fan Zhaoyu , Xu Ruijun , Deng Xinyi , Li Yingxin , Liang Sihan , Lv Ziquan , Huang Suli , Duan Yong‐Gang , Zhang Xinzong , Liu Yuewei
Published: June 2023

Background

General obesity classified by body mass index has been linked to a reduction in semen quality; however, evidence on the adverse effect of central obesity on semen quality remains limited.

Objectives

To investigate the association between central obesity and semen quality.

Materials and methods

We conducted a cross‐sectional study of 4513 sperm donation volunteers in Guangdong Provincial Human Sperm Bank during 2018–2021. Three central obesity indicators, including waist circumference, waist‐to‐hip ratio, and waist‐to‐height ratio, were measured using a multi‐frequency bioelectrical impedance analysis for each subject. Semen analysis was conducted according to the World Health Organization laboratory manual for the examination and processing of human semen 5th edition. Linear regression models and unconditional logistic regression models were used to quantify the association between central obesity and semen parameters.

Results

With adjustment for age, race, education level, marital status, fertility status, occupation, year of semen collection, abstinence period, ambient temperature, and relative humidity, central obesity defined as waist circumference ≥90 cm, waist‐to‐hip ratio ≥0.9, or waist‐to‐height ratio ≥0.5 was significantly associated with a 0.27 (95% confidence interval: 0.15, 0.38) mL, 14.47 (3.60, 25.34) × 106, 7.06 (0.46, 13.76) × 106, and 6.80 (0.42, 13.18) × 106 reduction in semen volume, total sperm number, total motile sperm number, and total progressive motile sperm number, respectively, and a 53% (10%, 112%) increase in odds of below the World Health Organization 2010 reference value for semen volume. These associations did not significantly vary across age. Similar results were observed for central obesity defined using each of the three indicators, except that subjects with a waist circumference ≥90 cm had a slightly higher total motility (estimated change: 1.30%; 95% confidence interval: 0.27%, 2.34%) and progressive motility (estimated change: 1.27%; 95% confidence interval: 0.23%, 2.31%).

Discussion and conclusion

We found that central obesity was significantly associated with a reduction in semen volume, total sperm number, total motile sperm number, and total progressive motile sperm number. Future studies are warranted to confirm our results in other regions and populations.
Enhanced recovery after surgery protocols and emergency surgery: a systematic review and meta‐analysis of randomized controlled trials
Authors: Mac Curtain Benjamin M. , O'Mahony Aaron , Temperley Hugo C. , Ng Zi Qin
Published: June 2023

Background

This systematic review and meta‐analysis seeks to assess the modified protocols used and patient outcomes when enhanced recovery after surgery (ERAS) protocols are utilized in an emergency setting.

Methods

PubMed, MEDLINE, EMBASE and Cochrane Central Registry of Controlled Trials were comprehensively searched until 13 March 2023. The Cochrane Risk of Bias Assessment Tool was used to assess for bias, along with funnel plot asymmetry. We present log risk ratios for dichotomous variables and raw mean differences for continuous variables.

Results

Seven randomized trials were included, comprising 573 patients. Results of the primary outcomes when comparing ERAS to standard care are as follows; withdrawal of nasogastric tube (raw mean difference −1.87 CI: −2.386 to −1.359), time to first liquid diet (raw mean difference −2.56 CI: −3.435 to −1.669), time to first solid diet (raw mean difference −2.35 CI: −2.933 to −1.76), time to first flatus (raw mean difference −2.73 CI: −5.726 to 0.257), time to first stool passed (raw mean difference −1.83 CI: −2.307 to −1.349), time to removal of drains (raw mean difference −3.23 CI: −3.609 to −2.852), time to removal of urinary catheter (raw mean difference −1.57 CI: −3.472 to 0.334), mean pain score (raw mean difference −1.79 CI: −2.222 to −1.351) and length of hospital stay (raw mean difference −3.16 CI: −3.688 to −2.63).

Conclusions

The adoption of ERAS protocols in an emergency surgery setting was observed to enhance patient recovery, while not indicating any statistically significant increase in adverse outcomes.
Does pharyngoplasty work? Outcomes of 100 consecutive operations over 10 years
Authors: Haydon Nicholas , Semple Harriet , Ho Kevin , Boorer Catherine
Published: June 2023

Background

Velopharyngeal insufficiency is a commonly encountered problem in Cleft Surgery, with pharyngoplasty being the mainstay of surgical management. In this study we aim to investigate the indications and outcomes of a single institution's experience and compare to international literature.

Methods

A retrospective review was performed looking at over 100 consecutive primary pharyngoplasty operations for velopharyngeal dysfunction over a 10‐year period at a single institution. Aetiology, peri‐operative course and speech outcomes for the cohort between January 2010 through January 2020 were assessed. A comprehensive literature review was performed for comparison and analysis of the studies' data.

Results

Ninety‐seven consecutive patients were included in the study on which 103 operations were performed. Average age at time of surgery was 7.25 years old. Approximately 37% of the patients had a diagnosed syndrome, sequence or chromosomal abnormality. Ninety‐seven of the 103 operations were primary pharyngoplasties, 4 were revision pharyngoplasties and 2 return to theatre procedures. Regarding speech outcomes, 51% of the patients that had formal speech assessments were found to have a significant improvement, 42% moderate improvement and 7% had no improvement. 93% of the patients that underwent pharyngoplasty in this study had significant or moderate improvement in speech outcomes. These speech outcomes and post‐operative complications such as obstructive sleep apnoea are analysed.

Conclusion

This study demonstrates that pharyngoplasty is a safe procedure for velopharyngeal insufficiency with a good overall success rate. The major outcomes assessed including complications & safety, revision rate and speech outcomes are comparative to previous international studies.
Systems design thinking for social innovation: a learning perspective
Authors: Kim Bowon
Published: June 2023

We define social innovation as strategic decision making to improve social conditions and facilitate social changes in a desirable direction by dealing with crucial issues and solving fundamental societal problems. This paper proposes a framework that enables the decision maker to implement social innovation effectively. The framework consists of three influential theories or ways of thinking, that is, design thinking, systems thinking, and learning organization. This paper shows how these three approaches can be integrated to tackle a critical social problem and develop a sustainable solution. We present a case study on an actual social issue to demonstrate its practical application.
CDN1163, an activator of sarco/endoplasmic reticulum Ca2+ ATPase, up‐regulates mitochondrial functions and protects against lipotoxicity in pancreatic β‐cells
Authors: Nguyen Ha Thu , Noriega Polo Carlos , Wiederkehr Andreas , Wollheim Claes B. , Park Kyu‐Sang
Published: June 2023

Background and Purpose

High levels of Ca2+ in the endoplasmic reticulum (ER), established by the sarco/endoplasmic reticulum Ca2+ ATPase (SERCA), are required for protein folding and cell signalling. Excessive ER Ca2+ release or decreased SERCA activity induces unfolded protein accumulation and ER stress in pancreatic β‐cells, leading to defective insulin secretion and diabetes. Here we have investigated the consequences of enhancing ER Ca2+ uptake on β‐cell survival and function.

Experimental Approach

The effects of SERCA activator, CDN1163, on Ca2+ homeostasis, protein expression, mitochondrial activities, insulin secretion, and lipotoxicity have been studied in mouse pancreatic β‐cells and MIN6 cells.

Key Results

CDN1163, increased insulin synthesis and exocytosis from islets. CDN1163 also increased the sensitivity of the cytosolic Ca2+ oscillation response to glucose and potentiated it in dispersed and sorted β‐cells. CDN1163 augmented the ER and mitochondrial Ca2+ content, the mitochondrial membrane potential, respiration, and ATP synthesis. CDN1163 up‐regulated expression of inositol 1,4,5‐trisphosphate receptors and antioxidant enzymes, and mitochondrial biogenesis, including peroxisome proliferator‐activated receptor γ coactivator 1α (PGC1α). Overexpression of SERCA2a or 2b replicated the effects of CDN1163, while knockdown of SERCA2 abolished the stimulatory actions of CDN1163. In palmitate‐treated β‐cells, CDN1163 prevented ER Ca2+ depletion, mitochondrial dysfunction, cytosolic and mitochondrial oxidative stress, defective insulin secretion, and apoptotic cell death.

Conclusions and Implications

Activation of SERCA enhanced mitochondrial bioenergetics and antioxidant capability, suppressing the cytotoxic effects of palmitate. Our results suggest that targeting SERCA could be a novel therapeutic strategy to protect β‐cells from lipotoxicity and the development of Type 2 diabetes.
Use of liothyronine (T3) in hypothyroidism: Joint British Thyroid Association/Society for endocrinology consensus statement
Authors: Ahluwalia Rupa , Baldeweg Stephanie E. , Boelaert Kristien , Chatterjee Krishna , Dayan Colin , Okosieme Onyebuchi , Priestley Julia , Taylor Peter , Vaidya Bijay , Zammitt Nicola , Pearce Simon H.
Published: June 2023

Persistent symptoms in patients treated for hypothyroidism are common. Despite more than 20 years of debate, the use of liothyronine for this indication remains controversial, as numerous randomised trials have failed to show a benefit of treatment regimens that combine liothyronine (T3) with levothyroxine over levothyroxine monotherapy. This consensus statement attempts to provide practical guidance to clinicians faced with patients who have persistent symptoms during thyroid hormone replacement therapy. It applies to non‐pregnant adults and is focussed on care delivered within the UK National Health Service, although it may be relevant in other healthcare environments.

The statement emphasises several key clinical practice points for patients dissatisfied with treatment for hypothyroidism. Firstly, it is important to establish a diagnosis of overt hypothyroidism; patients with persistent symptoms during thyroid hormone replacement but with no clear biochemical evidence of overt hypothyroidism should first have a trial without thyroid hormone replacement. In those with established overt hypothyroidism, levothyroxine doses should be optimised aiming for a TSH in the 0.3–2.0 mU/L range for 3 to 6 months before a therapeutic response can be assessed. In some patients, it may be acceptable to have serum TSH below reference range (e.g. 0.1–0.3 mU/L), but not fully suppressed in the long term.

We suggest that for some patients with confirmed overt hypothyroidism and persistent symptoms who have had adequate treatment with levothyroxine and in whom other comorbidities have been excluded, a trial of liothyronine/levothyroxine combined therapy may be warranted. The decision to start treatment with liothyronine should be a shared decision between patient and clinician. However, individual clinicians should not feel obliged to start liothyronine or to continue liothyronine medication provided by other health care practitioners or accessed without medical advice, if they judge this not to be in the patient's best interest.
Congenital hypothyroidism in Northern Ireland: 40 years' experience of national screening programme
Authors: Darrat Milad , Kayes Lucy , Woodside Jayne V. , Mullan Karen , Abid Noina
Published: June 2023

Objective

The incidence of congenital hypothyroidism (CHT) has progressively increased in several regions around the world but has yet to be evaluated in Northern Ireland (NI). CHT screening programme was introduced in NI in 1980 and has had a relatively unchanged protocol since its inception. The purpose of the study was to evaluate the incidence of CHT in NI from 1981 to 2020 and to explore possible contributing factors to any changes seen over the 40‐year period.

Design

This was a retrospective database review of children diagnosed with CHT in NI between 1981 and 2020. Data was collected from the patients' medical (paper and electronic) records, including epidemiological, clinical, laboratory, and radiological features as well as outcomes at 3 years.

Results

Of 800,404 new‐borns who were screened for CHT in NI between January 1981 and March 2020, 471 were diagnosed with CHT. There was a steady and significant increase in incidence of CHT over time with an incidence of 26 cases per 100,000 livebirths in 1981 versus 71 cases per 100,000 in 2019 (p < .001). Of these 471, 77 new‐borns (16%) were born preterm. The incidence of CHT was observed twice as much in female compared to male new‐borns. Diagnostic imaging including radioisotope uptake and thyroid ultrasound scans were performed in 143 cases (30%). Of these, 101 (70%) cases had thyroid dysgenesis and 42 (30%) cases had thyroid dyshormonogenesis. There were 293 (62%) of 471 patients had confirmed permanent CHT, and 90 patients (19%) had transient CHT. Over that period at least 95% of the population were recorded as having United Kingdom/Ireland as country of birth.

Conclusion

Our findings demonstrate a nearly tripling of the CHT incidence observed over the last 40 years. This is against a background of a relatively stable population demographics. Future research should focus on the underlying cause(s) of this condition which may include changing environmental exposures in utero.
Does economic growth benefit the poor? The role of institutions and religions
Authors: Sekkat Khalid
Published: June 2023

This paper seeks to explain the difference across countries of the impact of national growth on the growth of the income of the poor. Traditionally, studies attempting to explain such differences investigate only the impact of some additional variables on the income level of the poor. Here, we introduce interaction terms to explain the change in the elasticity of income of the poor to national income. We focus on the role of formal and informal institutions and religions; variables which have rarely been considered in this context. The results show that only formal institutions (i.e.,Resistance to corruption) and, to some extent, informal institutions (i.e.,Trust all) explain the differences. Religion has no impact. The findings also show that improvements in theResistance to corruptionbenefits the extremely poor more than the poor.