bluuebunny/crossref_metadata_2025 huggingface dataset:
Can the Future of ID Escape the Inertial Dogma of Its Past? The Exemplars of Shorter Is Better and Oral Is the New IV
Authors: Davar Kusha , Clark Devin , Centor Robert M , Dominguez Fernando , Ghanem Bassam , Lee Rachael , Lee Todd C , McDonald Emily G , Phillips Matthew C , Sendi Parham , Spellberg Brad
Published: December 2022

Like all fields of medicine, Infectious Diseases is rife with dogma that underpins much clinical practice. In this study, we discuss 2 specific examples of historical practice that have been overturned recently by numerous prospective studies: traditional durations of antimicrobial therapy and the necessity of intravenous (IV)-only therapy for specific infectious syndromes. These dogmas are based on uncontrolled case series from >50 years ago, amplified by the opinions of eminent experts. In contrast, more than 120 modern, randomized controlled trials have established that shorter durations of therapy are equally effective for many infections. Furthermore, 21 concordant randomized controlled trials have demonstrated that oral antibiotic therapy is at least as effective as IV-only therapy for osteomyelitis, bacteremia, and endocarditis. Nevertheless, practitioners in many clinical settings remain refractory to adopting these changes. It is time for Infectious Diseases to move beyond its history of eminent opinion-based medicine and truly into the era of evidenced-based medicine.
Janus kinase inhibitors alter NK cell phenotypes and inhibit their antitumour capacity
Authors: Meudec Loïc , Richebé Pauline , Pascaud Juliette , Mariette Xavier , Nocturne Gaetane
Published: December 2022

Objective

Janus kinase inhibitors (JAKi) are efficacious in RA but concerns regarding the risk of cancer associated with their exposure have recently emerged. Given the role of NK cells in antitumour response, we investigated the impact of JAKi [tofacitinib (TOFA), baricitinib (BARI), upadacitinib (UPA) and filgotinib (FIL)] on NK cells.

Methods

We first performed an ex vivo phenotype of NK cells in RA patients treated with TOFA, BARI or MTX. We next phenotyped sorted NK cells from healthy donors cultured with four JAKi or dimethyl sulphoxide (DMSO) at three concentrations, including the licensed dose (therapeutic concentration). Third, we assessed NK cell function using anti-NKp30 cross-linking and co-cultures with two different tumour cell lines: A549 and SU-DHL-4.

Results

Twenty-eight RA patients were included. Patients treated with TOFA had reduced expression of CD69 on NK cells compared with MTX (P < 0.05). We confirmed in vitro the negative impact of JAKi on NK cell maturation (CD57), activation (CD69) and activating receptor (NKp30), these latter two being specifically altered with TOFA and UPA. When NK cells were stimulated by NKp30, we observed reduced CD107a (P < 0.01) and IFN-γ/TNF expression (P < 0.05) with TOFA. Lastly, NK cells exposed to TOFA showed reduced CD107a (P < 0.05) and altered cytotoxicity (P < 0.05) when co-cultured with the two cell lines.

Conclusion

JAKi have a phenotypic and functional impact on NK cell activation and impair their antitumour activity, with a variable impact depending on the JAKi. It remains an open question whether this mechanism can explain the increased tumour risk observed with TOFA.
APPLICATION OF CT PULMONARY ANGIOGRAPHY WITH “ULTRA-DOUBLE-LOW” AND ITERATIVE MODEL RECONSTRUCTION FOR ACUTE PULMONARY EMBOLISM
Authors: Bai Jiayuan , Zhang Wanjun , Zhang Wei , Zhang Bo
Published: December 2022

The study is to investigate the feasibility of computed tomography pulmonary angiography (CTPA) with iterative model reconstruction (IMR) and “Ultra-double-low” (Ultra-low dose, Ultra-low contrast agent volume). Thirty-six patients who tested positive for pulmonary embolism in CTPA were enrolled in the study. Another CTPA was performed 1 week after thrombolytic therapy. The first examination was routine CTPA (Routine Group) with the parameters as follows: automatic mA scanning, 120 kV and image reconstruction by using iDose4 iterative reconstruction (Lever 4), iodine concentration and dose of contrast agent: 300 mgI/ml and 0.5 gI/kg, respectively. The latter one was ultra-low dose CTPA examination (Ultra-low Group): 40 mAs, 80 kV and IMR (Lever 3), contrast agent: 300 mgI/ml and 15 mL, respectively. Effective dose (ED), CT dose index volume (CTDIvol), dose length product (DLP), attenuation of pulmonary artery, contrast noise ratio (CNR) and signal noise ratio (SNR) were recorded and calculated. The imaging qualities were subjectively assessed. The Eds/CTDIvols/DLPs of Ultra-low Group are lower than the Routine Group (P < 0.05). The differences in attenuation between the two groups are not significant (P > 0.05). The differences in CNR and SNR between the two groups are significant (P < 0.05). The differences in imaging qualities between the two groups when subjectively assessed are not significant (P > 0.05). The 256-slice spiral CT combined with IMR and “Ultra-double-low” is feasible for the acute pulmonary embolism examination and the radiation dose and the volume of contrast agent can be greatly reduced.
Linking Ecological Specialization to Its Macroevolutionary Consequences: An Example with Passerine Nest Type
Authors: Zenil-Ferguson Rosana , McEntee Jay P , Burleigh J Gordon , Duckworth Renée A
Published: December 2022

A long-standing hypothesis in evolutionary biology is that the evolution of resource specialization can lead to an evolutionary dead end, where specialists have low diversification rates and limited ability to evolve into generalists. In recent years, advances in comparative methods investigating trait-based differences associated with diversification have enabled more robust tests of this idea and have found mixed support. We test the evolutionary dead end hypothesis by estimating net diversification rate differences associated with nest-type specialization among 3224 species of passerine birds. In particular, we test whether the adoption of hole-nesting, a nest-type specialization that decreases predation, results in reduced diversification rates relative to nesting outside of holes. Further, we examine whether evolutionary transitions to the specialist hole-nesting state have been more frequent than transitions out of hole-nesting. Using diversification models that accounted for background rate heterogeneity and different extinction rate scenarios, we found that hole-nesting specialization was not associated with diversification rate differences. Furthermore, contrary to the assumption that specialists rarely evolve into generalists, we found that transitions out of hole-nesting occur more frequently than transitions into hole-nesting. These results suggest that interspecific competition may limit adoption of hole-nesting, but that such competition does not result in limited diversification of hole-nesters. In conjunction with other recent studies using robust comparative methods, our results add to growing evidence that evolutionary dead ends are not a typical outcome of resource specialization. [Cavity nesting; diversification; hidden-state models; passerines; resource specialization.]
Covid-period-associated changes in organism profile of neonatal sepsis in a tertiary center from East India
Authors: Mukherjee Mausumi , Poddar Sumon , Mukherjee Amrita , Bathia Jigna N
Published: December 2022

Introduction

Neonatal sepsis is a major cause of morbidity and mortality with a higher burden from the low- and middle-income countries. The coronavirus disease 2019 (Covid 19) pandemic has impacted healthcare in various ways including healthcare-associated infections (HAI). The objective of the present study was to determine changes in organism profile and incidence rates of HAI in neonates admitted to the index hospital during the pandemic and compared it with the data from the pre-pandemic period.

Materials and methods

The study design was a retrospective, observational analysis of data from neonates with culture-positive sepsis, in a tertiary care children’s hospital, between January 2018 and December 2021. Pre-Covid (January 2018 to December 2019) and Covid period data (January 2020 to December 2021) were analyzed for the significance of change.

Results

The prevalence of culture-positive sepsis, in pre-Covid and Covid periods, was 19.55% [95% confidence interval (95% CI) 17.13–21.52)] and 18.36% (CI 16.05–20.74), respectively. HAI rates/1000 patient days increased slightly during the Covid pandemic [7.2% (95% CI 6.98–10.08) to 9.8% (95% CI 9.78–13.67)] mainly due to an increase in fungal HAI (26% pre- vs. 41.5% Covid period). However, the proportion of Gram-negative (GN) infections fell significantly (70.5% vs. 48.6%) during the same period. In the pre-Covid period, Klebsiella followed by Burkholderia cepacia, Acinetobacter spp and Pseudomonas, were the major HAI isolates. During the Covid period, there was a decline in these isolates and Burkholderia spp was not detected. All fungal isolates were Candida species. The case fatality ratio (CFR) from HAI decreased significantly from 38% to 15.45%, mainly due to a decrease in GN HAI.

Conclusion

During Covid pandemic, there was a significant decline in GN HAI and CFR from HAI, due to improved compliance with infection control measures in the neonatal intensive care unit (NICU). At the same time, there was a rise in the fungal HAI, possibly because of a higher proportion of premature, and sick neonates with longer hospital stay and more invasive procedures. Consolidations of gains in infection control and restriction of invasive procedures could help to minimize HAI in NICUs.
Bovine milk-based and human milk-based fortification for postnatal weight gain in very preterm neonates—a cohort study
Authors: Senthilkumaran Ravikumar , Devi Usha , Amboiram Prakash , Balakrishnan Umamaheswari
Published: December 2022

BACKGROUND AND OBJECTIVES

Postnatal growth failure happens in about half of the very low birth weight infants and this can have long-term consequences. Human milk-based multi-nutrient fortifiers (HMBF) are thought to be better tolerated than bovine milk-based multi-nutrient fortifiers (BMBF), thus facilitating early progression to full feeds and improved growth in preterm neonates. This study was done to find the advantage of HMBF over BMBF on postnatal growth and other clinical outcomes.

METHODS

This is a retrospective cohort study where babies <1500 g birth weight or gestational age <32 weeks were included to compare the velocity of weight gain (g/kg/day), duration of hospital stay and clinical outcomes between fortification using HMBF and BMBF till 34 weeks postmenstrual age.

RESULTS

Eligible neonates included in the study were 322, out of whom 123 (37%) received HMBF and 209 (63%) received BMBF. During the stay, 18 babies were changed from BMBF to HMBF and vice versa in 24 babies due to logistic reasons and parents' preferences. The mean birth weight of the babies was 1124 ± 237 g. Weight gain was higher in the exclusive HMBF group [mean difference 0.77 (0.14, 1.39) g/kg/day; p-value = 0.018]. Feed intolerance [odds ratio (OR) 0.45 (0.22, 0.95), p-value 0.037] was also significantly less in this group. However, other morbidities did not differ significantly between the groups.

CONCLUSION

Higher weight gain and lower feed intolerance in the HMBF group underscores the possible advantage of using HMBF over BMBF. Larger prospective studies might bring out its effect on the duration of hospital stay and other morbidities.
Barriers to and Facilitators of Early Hearing Detection and Intervention in the United States: A Systematic Review
Authors: Findlen Ursula M. , Davenport Carrie A. , Cadieux Jamie , Gehred Alison , Frush Holt Rachael , Vaughn Lisa M. , Houston Derek , Hunter Lisa L.
Published: December 2022

Objectives:

Early hearing detection and intervention (EHDI) is guided by the 1-3-6 approach: screening by one month, diagnosis by 3 mo, and early intervention (EI) enrollment by 6 mo. Although screening rates remain high, successful diagnosis and EI–enrollment lag in comparison. The aim of this systematic review is to critically examine and synthesize the barriers to and facilitators of EHDI that exist for families, as they navigate the journey of congenital hearing loss diagnosis and management in the United States. Understanding barriers across each and all stages is necessary for EHDI stakeholders to develop and test novel approaches which will effectively reduce barriers to early hearing healthcare.

Design:

A systematic literature search was completed in May and August 2021 for empirical articles focusing on screening, diagnosis, and EI of children with hearing loss. Two independent reviewers completed title and abstract screening, full-text review, data extraction, and quality assessments with a third independent reviewer establishing consensus at each stage. Data synthesis was completed using the Framework Analysis approach to categorize articles into EHDI journey timepoints and individual/family-level factors versus system-level factors.

Results:

Sixty-two studies were included in the narrative synthesis. Results revealed that both individual/family-level (e.g., economic stability, medical status of the infant including middle ear involvement) and system-level barriers (e.g., system-service capacity, provider knowledge, and program quality) hinder timely diagnosis and EI for congenital hearing loss. Specific social determinants of health were noted as barriers to effective EHDI; however, system-level facilitators such as care coordination, colocation of services, and family support programs have been shown to mitigate the negative impact of those sociodemographic factors.

Conclusions:

Many barriers exist for families to obtain appropriate and timely EHDI for their children, but system-level changes could facilitate the process and contribute to long-term outcomes improvement. Limitations of this study include limited generalizability due to the heterogeneity of EHDI programs and an inability to ascertain factor interactions.
Predictors of Resistance to Ceftazidime-Avibactam in Carbapenem-Resistant Enterobacterales
Authors: Park Tae Eun , Cani Eris , Kelly Paul , Raymond Lendelle , Roy Banibrata , Zeana Cosmina , Menon Anupama
Published: December 2022

Background

Ceftazidime-avibactam (CAZ-AVI) is a safe and effective treatment option for carbapenem-resistant Enterobacterales (CRE). However, predictors of resistance to CAZ-AVI have not been well defined. Therefore, our study describes risk factors for resistance to CAZ-AVI in hospitalized patients with CRE infections.

Methods

This was a single-center, retrospective cohort study conducted at an urban community hospital including adults older than 18 years with at least 1 culture growing CRE.

Results

Among 36 adults who had at least 1 CRE culture, 30 had a CRE isolate that was susceptible to CAZ-AVI, and 6 had resistant isolates. Previous CAZ-AVI use was significantly associated with an increased risk of resistance to CAZ-AVI (odds ratio, 17.2; 95% confidence interval [CI], 1.157–255.688; P = 0.039). When 30-day, all-cause mortality was assessed based on susceptibility to CAZ-AVI, it was 36.7% (n = 11 of 30) and 50% (n = 3 of 6) in susceptible and resistant groups, respectively (P = 0.658). When it was based on the type of antibiotic therapy, it was 36.8% (n = 7 of 19) for the patients on CAZ-AVI and 41.2% (n = 7 of 17) on other antibiotic therapy (n = 0.791).

Conclusions

Emergence of resistance to CAZ-AVI is an evolving problem for patients with prolonged hospitalization in large urban hospital settings and is associated with prior receipt of CAZ-AVI. Further studies are warranted to confirm our data and assess for additional predictors of CAZ-AVI resistance.
The Global Prevalence of Pulmonary Fibrosis Among Post–COVID-19 Follow-up Patients
Authors: Mulu Getaneh Baye , Atinafu Bantalem Tilaye , Tarekegn Fetene Nigussie , Adane Tigist Demssew , Kebede Worku Misganaw
Published: December 2022

Background

Severe acute respiratory syndrome coronavirus 2 is the virus that causes a massive pandemic of the decade and has brought more than 215 million infections and nearly 4.5 million deaths worldwide as of August 2021. In addition, survivors of COVID-19 patients suffer from acute, chronic, and persistent lung problems and pulmonary fibrosis, which is the sequel of future morbidity and mortality.

Method

Electronic databases searched were PubMed, Cochrane Library, Google Scholar, HINARI, Web of Science, and direct Google search. For publication bias, a funnel plot and the Egger regression test were used. The I
2 statistic was used to check the heterogeneity between the studies. DerSimonian and Laird random-effects model was applied to estimate the pooled effect size. Subgroup analysis was done by using publication year and mean sample size. For the effect of a single study on the overall estimation, sensitivity analysis was deployed. STATA version 14 software using the random-effects model was used to conduct all statistical analyses.

Result

The study included 9 studies with a total sample size of 1241. The overall pooled prevalence of pulmonary fibrosis among post–COVID follow-up patients was found to be 54.04% (95% confidence interval, 40.54%–67.54%).

Conclusions

The overall pooled prevalence of pulmonary fibrosis among post–COVID-19 follow-up patients was higher in magnitude and recognized as a potential sequela among survivors. Because of exaggerated viral and immune response, further searching for better diagnostic and efficacious treatment strategies is recommended.
Helmet noninvasive ventilation in acute hypoxic respiratory failure
Authors: Buell Kevin G. , Patel Bhakti K.
Published: December 2022

Purpose of review

Invasive mechanical ventilation is a lifesaving intervention for patients with severe acute hypoxic respiratory failure (AHRF), but it is associated with neuromuscular, cognitive, and infectious complications. Noninvasive ventilation (NIV) may provide sufficient respiratory support without these complications. The helmet interface for NIV could address concerns raised for the use of NIV as first-line therapy in AHRF. This review will summarize and appraise the current evidence for helmet NIV in AHRF.

Recent findings

There are only six randomized controlled trials comparing helmet NIV to standard nasal cannula, facemask NIV, or high-flow nasal oxygen in patients with AHRF. Lower rates of endotracheal intubations and fewer days of mechanical ventilation were reported, with inconsistent findings on patient survival. Facemask NIV may worsen preexisting lung injury, delay intubations, and be inferior at delivering lung protective ventilation strategies compared with mechanical ventilation. The helmet interface could circumvent some of these concerns through the delivery of higher positive end expiratory pressure and more uniform distribution of negative pleural pressure.

There is limited evidence to support or refute the use of helmet NIV in AHRF. Further studies investigating the interface of helmet in NIV as a separate clinical entity are needed.
Novel therapies for treatment of antibody-mediated rejection of the kidney
Authors: Sethi Supreet , Jordan Stanley C.
Published: December 2022

Purpose of review

We aim to discuss current literature on novel therapies for antibody-mediated rejection (AMR) in kidney transplantation with a focus on chronic AMR.

Recent findings

IL-6/IL-6 receptor blockers appear promising in the treatment of chronic AMR. Blocking this pathway was shown to reduce human leucocyte antigen-antibodies, improve histologic inflammation and increase T-regulatory cells. Based on experience in desensitization, IgG degrading endopeptidase, imlifidase, could be effective in AMR. There have been case reports describing the successful use of plasma cell/natural killer-cell-directed anti-CD38 antibody in the treatment of AMR. Off-target effects have been noted and strategies to mitigate these will be needed when using these agents. Complement inhibitors could be an effective add-on strategy to antibody-depleting therapies but their role in AMR needs to be better defined. Combining proteasome inhibitors and costimulation blockers has shown encouraging results in the prevention of AMR in animal models and is now being investigated in humans. Other novel strategies such as Fc neonatal receptor blockers which inhibit the recycling of pathogenic IgG and bispecific antibodies against B-cell maturation antigen/CD3+ T cells warrant further investigation.

There are now a number of emerging therapies with varied targets and mechanism(s) of action that hold promise in the management of AMR and improving allograft survival.
A New Era for Nursing Education
Authors: Giddens Jean , Mansfield Jerry A.
Published: December 2022

With the release of The Essentials: Core Competencies for Professional Nursing Education, nurse educators and practice leaders are transforming how nurses are prepared to meet current and future practice expectations. Working together using a competency-based approach to education, academic–practice partners are redefining entry- and advanced-level nursing education, including new approaches to clinical experiences and competency assessment. This monumental shift will help clarify what new nurses are prepared to do while enhancing their practice readiness.
Recurrent EWSR1::COLCA2 Fusions Define a Novel Sarcoma With Spindle/Round Cell Morphology and Strong Predilection for the Sinonasal Tract
Authors: Agaimy Abbas , Baněčková Martina , De Almeida John , Dickson Brendan C. , Dimmler Arno , Hartmann Wolfgang , Laé Marick , Pablik Jessica , Schubart Christoph , Skálová Alena , Stoehr Robert , Trautmann Marcel , Wardelmann Eva , Wassef Michel , Weinreb Ilan
Published: December 2022

The last 2 decades have attended a dynamic evolution in the nosology of poorly differentiated sinonasal tract malignancies, with several new molecularly defined entities having been described in addition to delineation of the genetic driver/s of some established older entities. These discoveries, however, mostly concerned epithelial-derived neoplasms (carcinomas). Adamantinoma-like Ewing sarcoma and biphenotypic sinonasal sarcoma are the major representatives of the newly defined mesenchymal categories. The colorectal cancer associated 2 (COLCA2) has been discovered recently as a colorectal cancer risk gene locus, but fusions involving this gene have not been well characterized. We, herein, describe clinicopathologic and molecular features of a novel sinonasal sarcoma characterized by undifferentiated spindle/round cell morphology and defined by recurrent EWSR1::COLCA2 fusions. All patients (n=5) were adults (3 female and 2 male) with a median age of 46 years (range, 23 to 60 y). The tumors originated in different subsites of the sinonasal tract with frequent multisite involvement. Original diagnoses were undifferentiated or unclassified round cell/spindle cell neoplasm/sarcoma (n=4) and neuroendocrine carcinoma (n=1). Surgery with or without adjuvant chemoradiation was the treatment in all cases. At the last follow-up, 1 patient developed multiple local recurrences over 21 years and another developed local recurrence and distant metastasis to bone 27 months after diagnosis. A third patient developed local recurrence 11 months later. Two patients were disease-free at 23, and 24 months. Histology showed nondescript highly cellular neoplasms with an admixture of spindled and round cells disposed into solid sheets and fascicles with brisk mitotic activity. Immunohistochemistry was negative for all lineage-specific markers with only limited focal membranous CD99 (4 of 5 cases) and weak pankeratin (1 of 5 cases) expression. Targeted RNA sequencing revealed an EWSR1::COLCA2 fusion, verified by EWSR1 fluorescence in situ hybridization, in all cases. This series identifies a novel member in the undifferentiated spindle/round cell sarcoma category with strong predilection for the sinonasal tract. None of >10,000 epithelial and mesenchymal neoplasms tested at the authors’ centers during the same period showed this fusion, highlighting rarity of tumors carrying this gene fusion. Accordingly, molecular testing of unclassified sinonasal malignancies/sarcomas showing round and spindle cell morphology is recommended to enhance the identification and further characterization of this entity.
Considerations for Laser Therapy, Microneedling, and Chemical Peels When Treating Patients With Skin of Color
Authors: Amechi Marisa , Halpin Jacklyn
Published: December 2022

Over the past 10 years, we have seen exponential growth in the aesthetic industry. With this growth, we have also seen an influx of patients of differing ethnicities, in all varying shades of color. Some clinicians may not have the necessary knowledge and skill to appropriately treat these patients using modalities such as laser therapy, microneedling, and chemical peels. The aesthetic industry provides courses, conferences, and educational guides for helping aesthetic practitioners determine which patients are eligible to undergo these treatments. However, there is a considerable lack of information available for clinicians about treatment modalities that can be safely and effectively used on patients with Fitzpatrick skin types IV–VI. As the population of patients of various ethnic origins seeking aesthetic treatments continues to grow, it is imperative for clinicians performing these treatments to increase their knowledge and skill related to treating patients with skin of color. The purpose of this article is to educate aesthetic clinicians about appropriate treatments, procedures, and protocols for preventing adverse reactions in patients with skin of color who are undergoing aesthetic treatments using lasers, microneedling, and chemical peels.
Testing the Acceptability and Usability of an AI-Enabled COVID-19 Diagnostic Tool Among Diverse Adult Populations in the United States
Authors: Schilling Josh , Moeller F. Gerard , Peterson Rachele , Beltz Brandon , Joshi Deepti , Gartner Danielle , Vang Jee , Jain Praduman
Published: December 2022

Background and Objectives:

Although at-home coronavirus disease-2019 (COVID-19) testing offers several benefits in a relatively cost-effective and less risky manner, evidence suggests that at-home COVID-19 test kits have a high rate of false negatives. One way to improve the accuracy and acceptance of COVID-19 screening is to combine existing at-home physical test kits with an easily accessible, electronic, self-diagnostic tool. The objective of the current study was to test the acceptability and usability of an artificial intelligence (AI)-enabled COVID-19 testing tool that combines a web-based symptom diagnostic screening survey and a physical at-home test kit to test differences across adults from varying races, ages, genders, educational, and income levels in the United States.

Methods:

A total of 822 people from Richmond, Virginia, were included in the study. Data were collected from employees and patients of Virginia Commonwealth University Health Center as well as the surrounding community in June through October 2021. Data were weighted to reflect the demographic distribution of patients in United States. Descriptive statistics and repeated independent t tests were run to evaluate the differences in the acceptability and usability of an AI-enabled COVID-19 testing tool.

Results:

Across all participants, there was a reasonable degree of acceptability and usability of the AI-enabled COVID-19 testing tool that included a physical test kit and symptom screening website. The AI-enabled COVID-19 testing tool demonstrated overall good acceptability and usability across race, age, gender, and educational background. Notably, participants preferred both components of the AI-enabled COVID-19 testing tool to the in-clinic testing.

Conclusion:

Overall, these findings suggest that our AI-enabled COVID-19 testing approach has great potential to improve the quality of remote COVID testing at low cost and high accessibility for diverse demographic populations in the United States.
The Role of Symptom Clusters in Triage of COVID-19 Patients
Authors: Wojtusiak Janusz , Bagais Wejdan , Vang Jee , Guralnik Elina , Roess Amira , Alemi Farrokh
Published: December 2022

Background and Objective:

COVID-19 manifests with a broad range of symptoms. This study investigates whether clusters of respiratory, gastrointestinal, or neurological symptoms can be used to diagnose COVID-19.

Methods:

We surveyed symptoms of 483 subjects who had completed COVID-19 laboratory tests in the last 30 days. The survey collected data on demographic characteristics, self-reported symptoms for different types of infections within 14 days of onset of illness, and self-reported COVID-19 test results. Robust LASSO regression was used to create 3 nested models. In all 3 models, the response variable was the COVID-19 test result. In the first model, referred to as the “main effect model,” the independent variables were demographic characteristics, history of chronic symptoms, and current symptoms. The second model, referred to as the “hierarchical clustering model,” added clusters of variables to the list of independent variables. These clusters were established through hierarchical clustering. The third model, referred to as the “interaction-terms model,” also added clusters of variables to the list of independent variables; this time clusters were established through pairwise and triple-way interaction terms. Models were constructed on a randomly selected 80% of the data and accuracy was cross-validated on the remaining 20% of the data. The process was bootstrapped 30 times. Accuracy of the 3 models was measured using the average of the cross-validated area under the receiver operating characteristic curves (AUROCs).

Results:

In 30 bootstrap samples, the main effect model had an AUROC of 0.78. The hierarchical clustering model had an AUROC of 0.80. The interaction-terms model had an AUROC of 0.81. Both the hierarchical cluster model and the interaction model were significantly different from the main effect model (α = .04). Patients with different races/ethnicities, genders, and ages presented with different symptom clusters.

Conclusions:

Using clusters of symptoms, it is possible to more accurately diagnose COVID-19 among symptomatic patients.
Evaluation of Influence of Arthroscopy on the Range of Mandibular Movements Based on Medical Records
Authors: Santos Adilson Chaves dos , Leal Marilia de Oliveira Coelho Dutra , Costa Sarah Teixeira , Santos Elda Ribeiro , Teixeira Rubens Gonçalves , Jodas Cláudio Roberto Pacheco
Published: December 2022

The Temporomandibular Joint Dysfunction Syndrome (TJDS) is a group of pathologies that affect the temporomandibular joint, mastication muscles, and attached structures, 1 of the leading causes of orofacial pain. Arthroscopy is a technique used as a method of treatment for TJSD. This was a retrospective cohort study, and data were collected from the medical records of patients with TJDS. The diagnosis of TJDS was established based on computed tomography and nuclear magnetic resonance imaging tests, and clinical examination. All patients, who underwent arthroscopy, were operated on by the same surgeon in 2020. The variables analyzed in this study were: maximum mouth opening, laterality, and protrusion of patients undergoing arthroscopy at time intervals of 30, 90 days, and 6 months after surgery. Data from anamnesis of the medical records and findings on clinical examination were used to verify whether there was any correlation with good postoperative evolution. Afterward, these data were compared and submitted to statistical analysis (Wilcoxon (nonparametric and paired) and Mann-Whitney (nonparametric, unpaired) tests) to verify the degree of correlation between them. It could be concluded that in this sample, arthroscopy reduced the degree of pain in patients, increased mouth opening amplitude, and did not influence laterality and protrusion. The use of previous medication was correlated with a slight decrease in postoperative pain; patients who had undergone previous orthodontic treatment showed better results regarding maximum mouth opening without pain; patients who had previously felt pain on professional palpation had greater maximum mouth opening with and without pain after arthroscopy, and patients with noise at professional auscultation had greater maximum mouth opening without pain. Further studies should be conducted, with larger samples, associated with complementary exams (computed tomography and nuclear magnetic resonance) before and after arthroscopy.
ESMOLOL PROTECTS AGAINST LPS-INDUCED CARDIAC INJURY VIA THE AMPK/mTOR/ULK1 PATHWAY IN RAT
Authors: Liu Mao-xia , Yang Jia , Qin Yan , Li Zheng-da , Jin Jun , Zhang Yan-bing , Yang Xin-jing
Published: December 2022

Aim: The purpose of this study was to investigate the effect of esmolol (ES) on LPS-induced cardiac injury and the possible mechanism. Methods: Sepsis was induced by i.p. injection of LPS (10 mg/kg) in male Sprague-Dawley rats pretreated with ES, 3-methyladenine or rapamycin. The severity of myocardial damage was analyzed by hematoxylin-eosin staining, and myocardial damage scores were calculated. The concentration of cardiac troponin was measured by enzyme-linked immunosorbent assay. The expression of autophagy-related proteins (beclin-1, LC3-II, p-AMPK, p-ULK1, p-mTOR) in myocardial tissue was detected by Western blotting. Autophagosome formation and the ultrastructural damage of mitochondria were assessed using transmission electron microscopy. Results: LPS induced an increase in myocardial damage score in a time-dependent manner, accompanied with an increase in autophagy at 3 h and decrease in autophagy at 6, 12, and 24 h. Pretreatment of LPS-treated rats with ES or rapamycin reduced myocardial injury (release of cardiac troponin, myocardial damage score) and increased autophagy (LC3-II, beclin-1, p-AMPK, and p-ULK1 levels and autophagosome numbers) at 12 and 24 h. In contrast, 3-methyladenine showed no effect. Conclusion: Esmolol alleviates LPS-induced myocardial damage through activating the AMPK/mTOR/ULK1 signal pathway–regulated autophagy.
SDGs disclosure: evidence from cruise corporations’ sustainability reporting
Authors: Di Vaio Assunta , Varriale Luisa , Lekakou Maria , Pozzoli Matteo
Published: December 2022

Purpose

This study investigates how cruise corporations, which have shown consistent and high growth rates in recent years, address the Sustainable Development Goal 17 (SDG17) “Partnership for the Goals” to meet the UN 2030 Agenda. This study aims to fill the existent gap in the literature, as also highlighted by practitioners in the First Research Conference on Tourism, through the lens of stakeholder theory.

Design/methodology/approach

This study focuses on the analysis of partnerships and collaborative governance of cruise corporations’ endeavours to meet the UN 2030 Agenda. This study is supported by the sustainability disclosure framework and stakeholder theory, based on the dependence of resources and descriptive and instrumental approaches to describe, analyse and map, through multi-stakeholder partnerships, the sustainability initiatives and practices adopted by cruise corporations. A systematic manual content analysis has been developed on sustainability reporting published by corporations.

Findings

According to the descriptive and instrumental approaches and the dependence resources construct of the stakeholder theory, this study highlights the typology and nature of partnerships with SDGs, and their strategic role in achieving them, although cruise corporations do not highlight in their sustainability reporting the measures of effectiveness regarding the relationship between single partnerships and targets reached for each SDG.

Practical implications

Recommendations at the managerial level are put forward to support cruise corporations’ initiatives and practices to meet UN 2030 Agenda. This study suggests to governors of corporations the cooperation between the cruise industry and institutions at the local, national and international levels for promoting institutional interventions at the infrastructure and economic level.

Originality/value

This study provides further insights into the under-researched topic of sustainability disclosure within the cruise industry, adopting the lens of stakeholder theory from the partnerships’ perspective. To the best of the authors’ knowledge, this is the first study to adopt the analysis of the SDG practices under the lens of the stakeholder theory, based on the dependence of resources and descriptive and instrumental approaches to identify, map and analyse the multi-stakeholder partnerships as an enabling key to meet UN 2030 Agenda in the cruise industry.
Optimal design of a yoke-less axial flux switching PM motor based on multi-objective PSO
Authors: Rahmani Fard Javad , Jamali Arand Saadat , Hemmati Siroos
Published: December 2022

Purpose

In this paper, an improved multiobjective particle swarm optimization (PSO) algorithm is proposed to optimize a three-phase, 12-slot, 19-pole, yokeless axial-field flux-switching permanent magnet (YASA-AFFSPM) motor.

Design/methodology/approach

Based on the structural characteristics of the YASA-AFFSPM, a mathematical model is established to calculate the main size of the YASA-AFFSPM motor. The split ratio, stator axial length, sandwiching pole angle, rotor pole angle, PM arc and number of conductors per slot are selected as optimization variables. Also, the efficiency, power factor, cogging torque and average torque are considered as the optimization objectives. The objectives are optimized by combining the improved multiobjective PSO algorithm with electromagnetic calculation.

Findings

Based on the proposed algorithm, the investigated motor is optimized. The on-load efficiency, power factor and average torque of the motor performance have increased by 0.87%, 3.13% and 10.39%, respectively. Moreover, the cogging torque and slot fill factor have undergone decreases of 8.57% and 3.34%, respectively. Finally, the effectiveness of the algorithm is verified using experiment results.

Originality/value

So far, no comprehensive report has been observed on the optimization of the YASA-AFFSPM motor using evolutionary algorithms and the study of the effect of the motor parameters. Therefore, in this paper, the authors decided to investigate the effect of YASA-AFFSPM motor parameters and improve motor performance with the improved PSO method.
How librarians and firefighters built a special library in Champaign, Illinois, USA: a community informatics story
Authors: Grisales Bohorquez Claudia , Ruan Lian , Williams Kate
Published: December 2022

Purpose

This paper aims to understand how a special library helped firefighters in Illinois navigate the digital revolution by evidencing the elements and forms of work that made its innovative services possible.

Design/methodology/approach

The authors examine the history of a special library through a community informatics lens, drawing from sociomaterial perspectives to highlight forms of work often invisible in digital innovation. Data was collected through documentary revision, oral histories and semi-structured interviews. Deductive-inductive coding and constant comparative analysis was used in the analysis.

Findings

A historical narrative of the library between 1990 and 2021 highlights three sociotechnical innovations that assisted firefighters through the digital revolution: the facilitated collection, the co-created collection and the inside-out library. To develop these innovations the library drew from institutional relations, personal relations, grants, labor, knowledge of firefighters and technology. Various forms of articulation work brought these elements together to create innovative services.

Originality/value

The role of special libraries in addressing the digital divide has not been sufficiently detailed so far; this paper is a contribution in that direction. It also has practical value for professionals working in specialized libraries and information centers.
The effects of transformational leadership and HRM practices on employee outcomes and productivity in the Greek hospitality industry during COVID-19
Authors: Kloutsiniotis Panagiotis V. , Mihail Dimitrios M. , Gounioti Silouani
Published: December 2022

Purpose

The present study investigates the role of “Transformational Leadership (TFL)” on employees' work engagement and its effect on their “Productivity” and “Extra-Role Customer Service” behaviors. In doing so, the present study examines the mediating role of two crucial variables, namely the creation of a “Service Climate” and the role of “Trust” that employees show toward their managers. Last but not least, this research examines the potential role of High Performance Work Systems (HPWS) as a moderator.

Design/methodology/approach

Partial Least Squares Structural Equation Modeling (PLS-SEM) was used on a sample of 459 customer-contact employees across thirteen 4- and 5-star Greek hotel organizations.

Findings

This study reveals the mechanism through which “TFL” impacts employees' productivity. Specifically, “TFL” first impacts employees' “Trust” toward their managers and helps toward creating a “Social Climate”. In turn, both “Trust” and “Social Climate” directly impact employees' “Work Engagement” who respond by showing increased “Productivity” and by exhibiting “Extra-Role Customer Service” behaviors. Nevertheless, the role of HPWS as a moderator was not confirmed.

Practical implications

The present study underscores the need for hotels' management to pay the required attention on creating an employment relationship based on “Trust”, as well as on creating a “Service Climate” in order for their employees to become work engaged and highly productive.

Originality/value

This is among the first studies that examine the “TFL” effects on employee outcomes in the Tourism and Hospitality sector, during the COVID-19 era.
Coping with floods: impacts, preparedness and resilience capacity of Greek micro-, small- and medium-sized enterprises in flood-affected areas
Authors: Skouloudis Antonis , Leal Filho Walter , Deligiannakis Georgios , Vouros Panagiotis , Nikolaou Ioannnis , Evangelinos Konstantinos
Published: December 2022

Purpose

This paper aims to investigate aspects of flood experience, attitudes and responses of micro-, small- and medium-sized enterprises (MSMEs) in Greece and to indicate a typology of strategies associated with their relative effort to build flood resilience capacity.

Design/methodology/approach

A qualitative study protocol was used, based on pertinent literature that considers how business entities withstand, adapt and/or recover from non-linear climate change impacts, natural hazards and extreme weather. Data was obtained by conducting semi-structured interviews with 82 MSMEs’ owners-managers who had recently experienced flooding.

Findings

The study reports limited activities of MSMEs towards flood resilience capacity despite the threat of relevant disasters. Findings suggest that most owners-managers of these enterprises are not adequately preparing their businesses for the impacts of flooding.

Research limitations/implications

The findings call for multi-level and dynamic perspectives to be examined in assessing MSME resilience capacity to floods. It is attitudinal, managerial, organisational, behavioural and regulatory (as well as other institutional) factors that merit further investigation. Such an investigation would allow a better understanding as to whether these factors hinder or enable conditions for microeconomic flood preparedness and resilience as well as how they may interact with each other or create feedback loops.

Practical implications

The study carries managerial implications and policy recommendations in terms of nurturing opportunities towards awareness-raising campaigns for reducing deficits in managerial knowledge and competencies. It also encapsulates practical implications in terms of emphasising supporting mechanisms from key institutional stakeholders to allow MSMEs scan available options they have in effectively reinforcing the business premises from the forces of rising waters.

Originality/value

Most of the related studies have examined flood impacts, responses and/or resilience capacity at the household- or community-level. Empirical work that is conducted to ascertain how MSMEs cope with flooding remains thin on the ground. In response to this, the current study and the typology of MSMEs’ strategic postures that are suggested seek to contribute to this under-researched topic.
The impact of organizational culture and total quality management on the relationship between green practices and sustainability performance
Authors: Fok Lillian , Morgan Yun-Chen , Zee Susan , Mock Valerie E.
Published: December 2022

Purpose

This study aims to examine the direct and indirect effects of organizational culture (OC) and total quality management practices (TQMPs) on the relationship between green practices (GPs) and sustainability performance (SP) by using structural equation modeling (SEM) analysis.

Design/methodology/approach

This study proposed a conceptual research model of the relationships and formulated six hypotheses. This study used a structured questionnaire based on previous studies to collect relationship data to test these hypotheses, and 441 full-time managers from various US businesses responded. The complete and valid survey responses were then tested against the hypotheses using IBM SPSS Statistics and SEM-AMOS.

Findings

Results supported the relationships proposed in the research model. They indicated that a strong supporting OC and TQMPs might improve positive SP and GPs. Additionally, the more managers are aware of their companies' GPs, the more likely they will feel positive about the organization's SP.

Research limitations/implications

A larger sample size to ensure statistically minimum representation in several major industries would better validate the findings and help identify significant differences in industry-specific OCs, TQMPs, GPs and SPs. Similarly, ensuring a varied geographical representation (both within the USA and internationally) would help determine if the findings vary according to the respondent's location. Furthermore, collecting the data during Year 1 of the COVID-19 pandemic may have skewed the results. Thus, once the working environment has been normalized, the survey should be repeated to determine if the findings are valid post-pandemic.

Practical implications

The findings of this study provide important strategic guidance for managers who work to balance the implementation of corporate GPs and the triple bottom line dimensions of SP. For practitioners, the results showed that companies could accomplish both profitability and sustainability if they are willing to continuously pay attention to environmental issues and strategically invest in cost-efficient and eco-friendly initiatives.

Originality/value

To the best of the authors’ knowledge, this research is one of the first to explore how OC and TQMPs, directly and indirectly, affect the relationship between GPs and the triple bottom line dimensions of SP. These results imply that OC and TQMPs have a significant indirect impact on the relationship between GPs and the SP dimensions.