bluuebunny/crossref_metadata_2025 huggingface dataset:
Cross-cultural experience unlocks entrepreneurial tendencies for rule-breaking: a priming experiment
Authors: Pidduck Robert J. , Kelemen Thomas K.
Published: December 2024

Purpose

Drawing on covariance attribution theory, this study investigates how and when cross-cultural experience develops the entrepreneurial aptitude for rule-breaking. The authors sought to replicate findings in general psychology that morally relativistic thinking mediates these relationships. Further, extant ideas surrounding rebel-like archetypes of successful entrepreneurs were tested: that is, the more entrepreneurial a person considers themselves to be, the more likely they adopt such modes of thinking.

Design/methodology/approach

A second-stage moderated mediation model is applied using a novel between-subjects experimental priming design. Participants were recruited to reflect a generalizable sample of prospective entrepreneurs from the United States. Participants engaged in a randomly assigned priming activity to re-active their prior cultural immersion experiences. They then completed a context-adjusted experimental judgment task to assess rule-breaking.

Findings

Results show that reflection on prior cross-cultural experience is positively related to proximal scores in morally relativistic cognition. Moderating effects of entrepreneurial intention provide robust evidence that those high in entrepreneurial intention are more likely to rule-break when morally relativistic thinking is high, but that those low in entrepreneurial intention are not.

Originality/value

A growing research stream suggests cross-cultural experience can uniquely instill a range of entrepreneurial aptitudes. While psychology research has found evidence for “dark side” implications of cross-cultural experience, the authors posit that entrepreneurship scholars in this domain have been reluctant to tackle this due to the ethical grey areas between breaking rules constructively and breaking rules in more nefarious ways. This study provides evidence that morally relativistic cognition is more likely to drive people who consider themselves highly entrepreneurial to engage in rule-breaking tendencies.
Physical activity and wellbeing in prisoners: a scoping review
Authors: Liguori Fabrizio , Calella Patrizia
Published: December 2024

Purpose

This scoping review aims to evaluate the impact of physical activity interventions on the well-being of incarcerated individuals. It seeks to provide a comprehensive overview of existing research on various forms of physical activity, including structured exercise programs, yoga and mindfulness, and their effects on both mental and physical health within prison populations.

Design/methodology/approach

A scoping review was conducted by searching Google Scholar, PubMed and Web of Science in June 2024. Keywords used included “physical activity,” “exercise,” “fitness,” “sports,” “prisoners,” “inmates,” “incarcerated individuals,” “well-being,” “mental health,” “physical health,” “psychological well-being” and “emotional well-being.” After screening 1,736 potential articles, 54 relevant studies were selected. These included structured exercise programs, yoga/mindfulness programs and evaluations of physical activity levels. Two authors independently reviewed and selected studies based on predefined inclusion criteria, ensuring a comprehensive overview of the literature on physical activity interventions in prison settings.

Findings

The review identified 12 relevant studies, revealing that physical activity interventions, including structured exercise programs, yoga and mindfulness, positively impact the psychological and physical well-being of incarcerated individuals. Consistent improvements were noted in mental health outcomes, such as reduced depression and anxiety, and enhanced physical health indicators, including lower body mass index and increased fitness levels. The findings underscore the necessity for age- and gender-specific interventions to address the unique health challenges faced by different inmate demographics, highlighting the importance of incorporating diverse and culturally relevant exercise programs in prisons.

Originality/value

This review uniquely synthesizes the impact of various physical activity interventions on the well-being of incarcerated individuals, emphasizing the necessity for tailored, culturally relevant programs. Notably, no previous review has comprehensively analyzed this aspect. By comparing diverse types of interventions, it provides comprehensive insights into the benefits of structured exercise, yoga and mindfulness in prison settings. This work highlights the importance of implementing physical activity in various forms, especially for female inmates, to enhance health and well-being. It offers valuable guidance for developing effective rehabilitation strategies in correctional facilities.
A novel architecture for the detection, exploitation and historical archival of indoor semantic trajectories: a case study on nursing homes
Authors: Varela Rodeiro Tirso , Gutiérrez Asorey Pablo , R. Brisaboa Nieves , Rodríguez Penabad Miguel , Cortiñas Alejandro
Published: December 2024

Purpose

This paper aims to build an indoor positioning system capable of tracking residents and caregivers and feeding a novel information system with this data. This information system introduces three main interesting modules: a compact data structure to efficiently store the gathered data, an activity deduction module that add semantics to the raw captured trajectories and a user-friendly interface able to display this spatio-temporal information.

Design/methodology/approach

Their proposal was built following an iterative and incremental development. Nursing home managers cooperated in the requirement composition phase, while some residents and caregivers contributed testing the system with their real trajectories.

Findings

Their contribution is a functional information system that can evaluate the quality of healthcare provided to residents and assess the efficiency of the nursing home as a business. This information system includes a novel state-of-the-art compact data structure to efficiently work with the captured data.

Originality/value

A new system has been designed and implemented using a wide range of technologies to support the necessities of a real enterprise. The rudimentary position tracking systems were upgraded to a feasible automatic indoor positioning solution. The amount of information generated by this new strategy is dealt with compact data structures, reducing space usage without jeopardizing query times. Those compressed positions are tagged with semantic information that enables individual activity analysis. Last, a user-friendly interface lets the final user interact with the gathered and calculated information. As future work, the authors plan to improve the integration of this new information system with other systems already in use in indoor mobile workforce environments.
The role of rule-following and accountability leadership and management support in internal control effectiveness moderated by organizational culture
Authors: Qaiser Adeel , Hassan Saima
Published: December 2024

Purpose

The current study intends to explore the internal control effectiveness through leadership who follow rules and emphasize accountability with support from management. It also examines the influence of organizational culture. Current research aims to enhance the internal control effectiveness in organizations by examining leadership roles, support from management and organizational culture specifically in the segment of accounting and finance.

Design/methodology/approach

The study surveys professionals from the accounting and finance segment to accumulate insights into the influence of leadership, management support and organizational culture on internal control effectiveness. Statistical tools were applied by using the AMOS and SPSS program to draw practical recommendations for the optimization of internal control mechanisms.

Findings

The findings direct that internal control effectiveness is positively linked to rule-following and accountability leadership while presenting a negative association with top management support. Prominently, organizational culture demonstrates a central moderating role, highlighting its significant influence on internal control effectiveness.

Practical implications

The study provides real-world insights to aid accounting and finance professionals in implementing effective internal controls. The findings provide actionable recommendations for top management to improve organizational practices and financial processes.

Originality/value

The unique combination of exploring leadership impact, top management support and organizational culture adds value to existing knowledge. The findings provide a novel perspective for practitioners and researchers seeking to enhance internal control mechanisms in organizational settings.
The influence of corporate governance on succession planning and organizational performance in Chinese family firms
Authors: Li Zeyu , Mustapha Mazlina , Sheikh Hassan Ahmad Fahmi , Saidin Saidatunur Fauzi
Published: December 2024

Purpose

This study examines the impact of corporate governance on succession planning and organizational performance. Drawing on agency theory, the main purpose of this study is to identify the effect of corporate governance on succession planning by measuring the different characteristics of the board of directors.

Design/methodology/approach

This multi-quantitative research used primary and archival data. A total of 281 valid questionnaires were collected from Chinese listed family firms to gauge succession planning. Relevant archival data were obtained to measure board characteristics and organizational performance. All hypotheses were examined through structural equation modeling.

Findings

The outcomes indicate that corporate governance positively influences succession planning and, in turn, boosts superior organizational performance, which uncovers the mediating effect of succession planning on the relationship between corporate governance and organizational performance. Our findings reveal that board independence and education facilitate the development of succession planning, which is crucial in the family business’s life cycle.

Originality/value

The results of this study contribute to management succession, strategic management and leadership research by demonstrating how corporate governance fosters organizational performance through succession planning, thereby expanding the application scenarios of agency theory in family firms. Additionally, the article also enriches our understanding of how family businesses apply sound governance structures to promote organizational strategic decision-making during the succession process.
How to engineer sustainability: from resource-wise manufacturing towards ecosystem-wide impacts
Authors: Müller Julian M. , Kazantsev Nikolai , Allmendinger Richard , Salehi-Amiri Amirhossein , Reis Jacqueline Zonichenn , Jaradat Shaden , Bartolo Helena , Da Silva Bartolo Paulo Jorge
Published: December 2024

Purpose

This conceptual paper aims to present a perspective on how to engineer sustainability through the prism of Industry 4.0 technologies and outline propositions to guide future research.

Design/methodology/approach

This study presents a literature review developing four research propositions, focusing on the nine leading technologies underpinning Industry 4.0 to engineer economic, environmental and social sustainability dimensions.

Findings

The authors derive benefits and challenges of Industry 4.0 technologies across all three business model elements: value creation, value delivery and value capture. The authors derive those for the economic, environmental and social dimensions of sustainability. Thereupon, we develop several propositions for future research.

Practical implications

The authors provide suggestions to practice how to better achieve value in all three sustainability dimensions through implementing a business model perspective, ecosystem thinking, societal demands and Data Governance and AI integration.

Social implications

By linking societal aspects of Industry 4.0 technologies with environmental, and economic aspects, the authors provide several suggestions how to implement Industry 4.0. For instance, policymakers are recommended to support entire ecosystems than isolated solutions.

Originality/value

The paper contributes to extant literature by conceptualising how Industry 4.0 can leverage value in reaching sustainability in all three dimensions and produce broader ecosystems-wide impacts.
“Build the New City as Fast as Possible”: Speculation as Subsistence in Peri‐Urban Myanmar
Authors: Wittekind Courtney T.
Published: December 2024

This article examines an ambitious plan to construct a built‐from‐scratch new city outside Yangon, Myanmar and sheds light on the contradictory responses sparked by rapid urban expansion. Despite fears that this megaproject would threaten the region's way of life, hopes for the new city's construction remained high throughout the project's early phases. Residents of areas targeted for development went so far as to publicly demand the city be built “as fast as possible”. In this article, I highlight the gap between residents’ pro‐project enthusiasm and the expectations of civil society activists and development actors, who predicted locals would reject the planned new city. I argue that this divergence exposes the perceived limitations of solutions held out for populations facing de‐agrarianisation. Equally, it refocuses attention on how project‐affected populations envision their own post‐agrarian future. In doing so, I demonstrate how and why speculation on peri‐urban land has emerged as a compelling mode of subsistence for even the poor among the region's landowning class.
In‐Hospital Screening Campaign Against Hepatitis C Could Be Effective for Identifying More Patients Who Still Need Treatment
Authors: Ferrarese Alberto , Zanaga Paola , Battistella Sara , Zanella Silvia , Zappitelli Teresa , Boldrin Caterina , Pacenti Monia , Cattai Margherita , Bordignon Greta , Gomiero Federica , Epifani Magdalena , Villano Marco , Gambato Martina , Zanetto Alberto , Cazzagon Nora , Chemello Liliana , Pasin Francesca , Calò Lorenzo , Doria Andrea , Trentin Livio , Illiceto Sabino , Avogaro Angelo , Venturini Francesca , Simioni Paolo , Angeli Paolo , Tessarin Michele , Burra Patrizia , Cattelan Annamaria , Russo Francesco Paolo
Published: December 2024

Background

Screening programmes for the detection of patients with hepatitis C virus (HCV) and positive viral load have been developed in many countries to achieve the World Health Organization's goal of HCV elimination by 2030. In Italy, a phased screening programme starting with individuals born between 1969 and 1989 has been implemented.

Aim

To assess the prevalence of patients with positive viraemia identified through a universal screening campaign conducted among hospitalised patients at our centre during the calendar year 2022.

Methods

All adult (aged ≥ 18 years) hospitalised patients, who participated in HCV screening from January to December 2022 were included, without any age restriction. Screening initially involved testing for anti‐HCV antibodies and then patients who tested positive underwent further HCV‐RNA testing.

Results

A total of 10,846 samples were collected. Five hundred and thirty cases (4.8%) tested positive for HCV antibodies, and 109 (1%) tested positive for both HCV antibodies and HCV‐RNA. Among patients with a positive viral load, the median [IQR] age was 62 [53–77] years, with a significant age difference between males and females (59 [48–67] vs. 78 [62–88]; Mann–Whitney U‐test, p = 0.001). Eighty‐four (77%) patients with a positive viral load were outside the target age range specified in the current National Recommendations for free‐of‐charge screening.

Conclusions

The non‐negligible prevalence of patients with a positive viral load among an unselected group of hospitalised patients suggests that such settings could effectively enhance screening programmes aimed at HCV elimination. Additionally, this approach may help identify patients who are not currently included in the National Recommendations.
The University in Transformation: Rationales, Challenges and Prospective Actions
Authors: Gallifa Josep , Sangrà Albert
Published: December 2024

The purpose of this paper is to understand the diverse rationales of the transformation of the University to respond to the challenges, evolutions and crises of the current global world, finding out what are the key aspects that articulate the discourses about its transformation. From a qualitative approach, the selected method was discourse analysis of interviews with 11 representative experts from different university cultures, sizes and World regions with senior experience in different kinds of transformation processes. The interviews explored the challenges and possible responses of universities and then were analysed to formulate ‘the right questions of our time’ on the transformation of the University in the global context. The results of the analysis allowed understanding the different meanings and levels involved as well as the motivations that are impelling the transformation of universities. Ten implicated tensions were also identified. The discussion is appropriate for substantiating the discourse on the transformation of the University, useful for the agents involved in it, as well as for understanding the prospective trends.
A meta‐analysis of the Big Five traits, organizational citizenship behavior, and counterproductive work behavior in Mechanical Turk workers
Authors: Philip Jestine , Kosmidou Vasiliki
Published: December 2024

Amazon's Mechanical Turk (MTurk) is an online data collection platform that has gained popularity in the recent past among social science researchers. Even with such an increasing presence of MTurk samples in behavioral management studies, a deeper understanding of MTurkers as actual workers is largely lacking in literature. Our research meta‐analyzed the effects of MTurkers' Big Five personality traits and age on their organizational citizenship behavior (OCB) and counterproductive work behavior (CWB) using 14 papers that contained 19 samples with an overall sample size of 7603 MTurkers. Findings revealed that MTurker openness to new experiences, conscientiousness, extraversion, and agreeableness were all positively related to OCB, whereas openness to new experiences, conscientiousness, and agreeableness were negatively related to CWB and MTurker neuroticism had a positive association with their CWB. Additionally, MTurker age had significant moderating effects on conscientiousness–OCB, extraversion–OCB, and agreeableness–OCB such that for extraversion, younger MTurkers reported a stronger positive correlation than older MTurkers and for conscientiousness and agreeableness, older MTurkers reported a stronger positive correlation than younger MTurkers. MTurker age also had significant moderating effects on neuroticism–CWB. A contribution of this research is that MTurker personality traits do influence their OCB and CWB similar to the trait–behavior relationship for organizational employees. We discuss the theoretical and methodological contributions for management research and practical implications of this study for Amazon and survey recruiters on the MTurk platform.
The Impact of Membrane Stabilization for Alveolar Ridge Preservation in Periodontally Compromised Extraction Sockets: A Non‐Inferiority Randomized Controlled Trial
Authors: Lee Seung‐Ju , Lee Jungwon , Suh Hyemee , Ko Young‐Chang , Urban Istvan , Koo Ki‐Tae
Published: December 2024

Aim

The aim of this study was to investigate the non‐inferiority of alveolar ridge preservation (ARP) with membrane stabilization compared with non‐stabilization, focusing on changes of soft‐tissue contour in periodontally compromised extraction sockets. Secondary outcomes included changes in hard‐tissue contour, patient‐reported outcomes and new bone formation.

Materials and Methods

Twenty‐four patients with periodontally compromised teeth were randomly assigned to ARP with (test group) or without (control group) membrane stabilization. To assess profilometric and hard‐tissue dimensional changes, dental impressions and cone beam computed tomography scans were performed at baseline (T0), immediately after ARP (T1) and 4 months post surgery (T2). Soft‐tissue healing in open healing sites was evaluated at T2, and wound closure was assessed 10 days post surgery. Patient‐reported outcomes were documented, and core biopsies were obtained for histomorphometric analysis.

Results

The absolute profilometric horizontal width change at 3 mm below the crest in the test group was not inferior to that in the control group. For the relative values, horizontal width reduction (3 and 5 mm below the crest) and volumetric shrinkage (3–5 mm below the crest) were lower in the test group. No significant differences were observed in bone dimensional changes, wound healing, pain and swelling or histomorphometric outcomes.

Conclusion

ARP with membrane stabilization in periodontally compromised extraction sockets is non‐inferior in terms of soft‐tissue contour changes to those without membrane fixation.

Trial Registration: Clinical Research Information Service (CRIS), KCT0005280. Registered 4 August 2020, https://cris.nih.go.kr/cris/search/detailSearch.do?seq=19165&search_page=L
A retrospective single cohort study on the 5–13 year clinical outcomes of implant‐supported cross‐arch fixed dental prostheses with monolithic zirconia‐based frameworks
Authors: Luo Jia , Zhang Yifan , Yu Ziyang , Jiang Xi , Li Jianhui , Chen Bo , Di Ping , Lin Ye , Zhang Yu
Published: December 2024

Purpose

To investigate the mid‐to‐long term clinical outcomes of the implant‐supported cross‐arch fixed dental prostheses (IFCDPs) with monolithic zirconia‐based frameworks and related risk factors of success and survival.

Materials and Methods

This retrospective study encompassed individuals exhibiting terminal dentition or edentulism in the maxilla and/or mandible who underwent treatment involving IFCDPs with monolithic zirconia frameworks. Inclusion criteria required a documented follow‐up period of at least five years post‐definitive prosthesis delivery. Evaluation of outcomes focused on the survival rates of implant and prosthesis, along with the incidence of biological and technical complications. The mixed‐effects Cox regression model was employed to analyze the risk factors associated with prosthesis failure and peri‐implantitis.

Results

A cohort of 47 patients, consisting of 14 women and 33 men with a mean age of 55.2 ± 12.5 years (range: 25–83), was included in this study. The mean follow‐up period was 71.6 ±13.2 months (mean ± SD, range: 60–147). A total of 51 cross‐arch prostheses supported by 302 implants, distributed between the maxilla (27 prostheses) and mandible (24 prostheses), were assessed. By the end of the follow‐up period, 289 (97.64%) of the 302 implants remained functional. Peri‐implantitis was observed in 27 implants (24 in mandible), yielding an overall implant‐related success rate of 91.06%. Nine frameworks experienced fractures (eight in mandible), resulting in an overall prosthesis‐related survival rate of 82.35%. Subsequent analysis revealed the mandible to be a significant risk factor for framework fracture (HR = 11.64, p = 0.024) and peri‐implantitis (HR = 10.88, p = 0.003).

Conclusions

The implant‐supported cross‐arch fixed dental prostheses featuring monolithic zirconia‐based frameworks demonstrated favorable clinical outcomes throughout a 5–13‐year observation period. Notably, in the design of monolithic zirconia‐based framework prostheses, the mandible emerged as a significant risk factor for framework fractures and an independent risk factor for peri‐implantitis.
A narrative review about the intricate crosstalk among endometrium, adipose tissue, and neurons in endometriosis. The multifaceted role of leptin
Authors: Neves Delminda , Neto Ana Catarina , Salazar Maria , Fernandes Ana Sofia , Martinho Margarida , Charrua Ana , Rodrigues Adriana Raquel , Gouveia Alexandra Maria , Almeida Henrique
Published: December 2024

Endometriosis is a highly prevalent gynecological disease characterized by the presence of endometrium‐like tissue outside the uterus, whose etiopathology is far from being elucidated. The most frequent complains of patients are pelvic pain and infertility. Increasing evidence supports the systemic impact of endometriosis suggesting that an intricate crosstalk among distinct organs underlies the development of the disease. In this setting, endometriosis patients present an increased risk for developing other diseases, such as cancer, cardiovascular pathologies, and autoimmune diseases, and manifest neurologic disturbances, including neuropathic hyperalgesia. Whilst the ovary‐secreted estrogen dependency of ectopic endometrium growth is well established, we conjecture that adipose tissue‐secreted molecules also intervene in endometriosis development and pain manifestation. In fact, women with endometriosis present a peculiar pattern of adipokine secretion that ensues the disease onset. Unexpectedly, the levels of adipose tissue‐secreted molecules in those women present similarities with those found in patients with obesity, despite the recognized association of low body mass index with endometriosis. Taking this evidence into consideration, we hypothesize that endometriosis patients present a dysfunctional adipose tissue, which is associated with enhanced metabolism and unregulated browning that not only intervene in the control of body weight but also in peculiar pain processing pathways.
Phenotypic Spectrum of GNA11R183C Mosaicism
Authors: Zhang Donglin , Sánchez‐Espino Luis Fernando , Ivars Marta , Pope Elena , Nopper Amy J. , Arkin Lisa M. , Tollefson Megha M. , Lavarino Cinzia E. , Muldowney Maya , Olaciregui Nagore Gené , Paco Sonia , Drolet Beth A. , Baselga Eulàlia
Published: December 2024

Background

Many vascular anomalies harbor postzygotic somatic variants in GNAQ and GNA11; however, the phenotype of specific G‐protein variants has not been well described. We report the clinical characteristics of 17 patients with a GNA11 R183C variant.

Methods

This case series is derived from a multinational cohort of vascular anomaly patients whose pathogenic mutations were identified using high‐depth next generation sequencing. Data include vascular anomaly features, imaging reports, and extracutaneous manifestations of the GNA11 R183C variant.

Results

We identified 17 subjects (median age 18 years [range 6–67]) with somatic GNA11 R183C variant. All patients had vascular lesions of the skin that presented as pink‐to‐red in children and deeper red in adults. Most lesions were large, poorly demarcated, and reticulated patches that were often bilaterally distributed. Nevus anemicus was observed in 53% (N = 9) and dermal melanocytosis in 13.3% (N = 2) of individuals. 82% (N = 14) of patients had limb growth discrepancies, and 1 patient had marked thoracic hypoplasia. 47% (N = 8) of patients had facial involvement, and 41% (N = 7) had forehead involvement. One patient experienced seizures due to right hemispheric leptomeningeal angiomatosis consistent with Sturge–Weber syndrome. Other findings included glaucoma (29%, N = 5) and psychomotor delay (29%, N = 5).

Conclusion

These findings contribute to our understanding of the clinical spectrum of GNA11 R183C capillary malformations (CMs); patients characteristically present with extensive, bilateral, poorly demarcated, pink‐to‐red CMs associated with nevus anemicus. Glaucoma and growth discrepancies (overgrowth or undergrowth) are common. Leptomeningeal angiomatosis and developmental delay can occur, appearing potentially less prevalent and severe than GNAQ‐associated disease.
Fidelity of infrasound measurements with balloon-borne sensors
Authors: Godin Oleg A.
Published: December 2024

Deploying acoustic sensors on free-flying, long-living balloons helps to reach the areas not accessible with the traditional ground-based sensors, reduce flow noise, and improve characterization of various infrasound sources. Instrumented balloons can potentially increase the infrasonic detection range and early warning lead time for natural hazards. Balloons are also considered as platforms for planetary exploration. When assessing the capabilities of balloon-borne infrasonic sensors and interpreting the measurements, it is imperative to recognize that the balloon inevitably distorts the signals and background infrasound field by scattering the incoming sound. This paper quantifies the effects of hot-air and helium balloons on acoustic pressure and particle acceleration and the role of balloon skin in infrasound diffraction. It is found that balloon-borne vector sensors are more susceptible to distortions than pressure sensors, leading to major differences between the apparent and true source bearing and directionality.
Spectrum of bacterial keratitis at a tertiary eye center in Indonesia
Authors: Lutfiamida Rifna , Widyasari Rien , Kalandra Kara Citra
Published: December 2024

The purpose of this study is to analyze the bacterial spectrum and antibiotic susceptibility patterns in bacterial keratitis at a tertiary eye center in Jakarta, Indonesia. The study design is a retrospective analytic study. A retrospective cross-sectional analytic review of medical records was conducted for patients with bacterial keratitis who underwent corneal cultures over an 8-year period. The study exclusively included eyes with culture-positive bacterial keratitis. The data were divided into two distinct periods: January 2012 to December 2017 and January 2018 to June 2020. A total of 129 eyes with keratitis were examined, and culture-positive bacteria were found in 74 eyes. Gram-negative bacteria were identified in 65 eyes (69.1%), and Gram-positive bacteria were identified in 29 eyes (30.9%). The most common bacteria identified was
Pseudomonas aeruginosa
(34 positive cultures, 36.2%). Gram-negative bacteria had the highest susceptibility toward ceftazidime (94.7%; 95% CI, 88.9–100). Gram-positive bacteria had the highest susceptibility toward vancomycin (100%; 95% CI, 98.8–100). Gentamicin demonstrated broad sensitivity across all bacterial types (85.7%; 95% CI, 78.2–93.2%), surpassing fluoroquinolones. There were no significant changes in antibiotic susceptibility patterns between the two periods studied (
P
> 0.05). The stability observed in both the bacterial spectrum and antibiotic susceptibility patterns throughout the study period indicates that the current empirical treatment is still effective. However, the results highlight gentamicin as a highly valuable option for the empirical treatment of bacterial keratitis, while targeted treatment with ceftazidime should be considered for Gram-negative infections and vancomycin for Gram-positive infections when culture results are available.

IMPORTANCE

Bacterial keratitis poses a significant public health concern in Indonesia due to its potential for vision loss and morbidity. Understanding the spectrum of bacterial pathogens causing keratitis is crucial for guiding appropriate treatment strategies and improving patient outcomes. This study aims to investigate the prevalence, antibiotic susceptibility patterns, and risk factors associated with bacterial keratitis cases, providing valuable insights for clinicians to optimize management protocols and enhance the overall ocular health landscape in Indonesia or in other countries that have similar geographical conditions.
Palmitoleic acid sensitizes vancomycin-resistant
Staphylococcus aureus
to vancomycin by outpacing the expression of resistance genes
Authors: Tabashsum Zajeba , Angeles-Solano Michelle , Sidders Ashelyn E. , Parsons Joshua B. , Rowe Sarah E.
Published: December 2024

The rise in antibiotic resistance limits the availability of antibiotics to treat bacterial infections. Despite this, antibiotic development pipelines remain sparse which makes using adjuvants to reverse antibiotic resistance a promising therapeutic strategy. The use of vancomycin, a frontline antibiotic used to treat hospitalized patients with methicillin-resistant
Staphylococcus aureus
(MRSA) infections, is complicated by high rates of treatment failure. Vancomycin binds to the D-ala-D-ala terminus of the nascent peptidoglycan precursor lipid II, preventing cell wall biosynthesis. Vancomycin-resistant strains of
S. aureus
and
Enterococci
typically express a
van
gene cluster that is induced in response to vancomycin and results in the synthesis of an alternative lipid precursor with a peptide chain ending in D-ala-D-lac. Vancomycin has low affinity for the D-ala-D-lac terminus, and the bacteria can resume growth even in the presence of an otherwise lethal dose of vancomycin. We previously showed that palmitoleic acid, a host-produced monounsaturated fatty acid, combined with vancomycin led to an accumulation of large fluid patches in the bacterial membrane, resulting in membrane destabilization and cell death. In this study, we observed that palmitoleic acid increases the rate of vancomycin killing by more than 50-fold, compared to vancomycin alone. This rapid bactericidal activity by the combined treatment sensitized vancomycin-resistant
S. aureus
(VRSA) and vancomycin-resistant
Enterococcus
(VRE) to vancomycin, likely by outpacing the expression of vancomycin resistance genes. This study represents an important step in the ongoing effort to mitigate antibiotic resistance.

IMPORTANCE

The development of antibiotics has transformed medicine, reducing the incidence and severity of bacterial infections and allowing for advancements in healthcare, including invasive surgeries and organ transplants. However, the rise of antibiotic resistance poses a significant threat to these medical advancements, leading to treatment failures that result in increased patient morbidity and mortality, as well as substantial healthcare costs. Vancomycin-resistant
Enterococcus
(VRE) species are prevalent in hospital settings and chronic infections. Although high-level vancomycin resistance in
S. aureus
is rare,
S. aureus
can acquire plasmids expressing vancomycin resistance genes from resistant Enterococcal species during infection, further complicating treatment. In this study, we find that palmitoleic acid increases the rate of vancomycin killing and restores sensitivity to vancomycin-resistant
S. aureus
(VRSA) and VRE isolates.
Infection of nonclassic monocytes by respiratory syncytial virus induces an imbalance in the CD4
+
T-cell subset response
Authors: Han Lianlian , Li Danyang , Wang Conghui , Ren Lili , Guo Li , Wang Jianwei
Published: December 2024

Respiratory syncytial virus (RSV) causes lower respiratory tract infections in infants and young children, leading to a pathogenesis-associated imbalance in CD4
+
T-cell subsets and monocyte subsets. To investigate whether RSV affects the imbalance of CD4
+
T-cells through monocytes, we examined the effects of the RSV-infected monocyte subset on CD4
+
T-cell subsets, namely, Th1, Th2, Th17, and regulatory T (Treg) subsets, on proliferation
in vitro
and identified key monocyte-derived cytokines. We found that RSV efficiently infects CD16
+
monocytes, but not CD16
-
monocytes,
via
cocultures of CD4
+
T-cells with RSV-infected CD16
+
monocytes, inhibits Treg cell proliferation and increases Th2 cell frequency, suggesting that RSV causes an imbalance in the CD4
+
T-cell subset by primarily infecting CD16
+
monocytes. Our data also revealed that IL-1β and IL-10 are key cytokines responsible for the activities of RSV-infected CD16
+
monocytes. In a mouse model, we found that high-efficiency RSV infection of mouse Ly6C
-
monocytes, corresponding to CD16
+
monocytes in humans, and adoptive transfer of Ly6C
-
monocytes during RSV infection decreased the Treg frequency in the lungs and aggravated pneumonia. Our data indicate that RSV can increase its pathogenesis through infection of nonclassic monocytes, leading to a CD4
+
T-cell imbalance.

IMPORTANCE

This study identified a pathogenesis pathway related to the RSV-nonclassic monocyte–IL-1β/IL-10-CD4
+
T-cell subset balance, which links the heterogeneity of monocytes to RSV pathogenesis and elucidates a new mechanism by which RSV infection disrupts the balance of CD4
+
T cells during RSV infection. These new findings provide potential therapeutic targets for RSV infection.
Access to and utilisation of COVID-19 antigen rapid diagnostic tests (Ag-RDTs) among the general population in Phnom Penh: a cross-sectional study
Authors: Seang Kennarey , Vogt Florian , Ky Sovathana , Ouk Vichea , Kaldor John , Vallely Andrew John , Saphonn Vonthanak
Published: December 2024

Objectives

Globally, there is a lack of evidence regarding access to and utilisation of antigen rapid diagnostic tests (Ag-RDTs). This might hinder public health interventions to increase testing. We conducted a survey to understand access to and utilisation of COVID-19 Ag-RDT among residents in Phnom Penh, Cambodia.

Design

This is a representative household survey using linear regression models with random effects to account for clustering and a logistic model with random effects to assess factors associated with Ag-RDT access.

Setting

We conducted the study in 10 villages in Phnom Penh between August and mid-September 2022.

Participants

We enrolled one member per household (n=280), aged between 18 and 65 years.

Outcome measures

Both access and utilisation were defined at the individual level (self-reports). We defined access as having undergone COVID-19 rapid testing within 6 months and utilisation as having administered this test (to themselves or others) within 12 months, prior to the study interview.

Results

In a clustering-adjusted linear model, access to Ag-RDTs among the general population from the 10 villages was 34% (n=95) and utilisation was 28% (n=77). Price and advice from the pharmacist were commonly reported to be the main selection criteria for Ag-RDTs, with 41% (n=111) and 62% (n=175), respectively. In the logistic model, those with higher educational attainment were more likely to have access to the Ag-RDT compared with those with lower education levels (adjusted OR4.42, 95% CI 1.82 to 10.74).

Conclusions

Unfamiliarity with Ag-RDT tests and low education levels negatively affect access and utilisation of Ag-RDTs among the general population in Phnom Penh.
Promoting Intensive Transitions for Children and Youth with Medical Complexity from Paediatric to Adult Care: the PITCare study—protocol for a randomised controlled trial
Authors: Santos Sara , Thomson Donna , Diaz Sanober , Soscia Joanna , Adams Sherri , Amin Reshma , Bernstein Stacey , Blais Brenda , Bruno Natasha , Colapinto Kimberly , Espin Sherry , Fayed Nora , Greenaway Jon , Henze Megan , Ivers Noah M , LeGrow Karen , Lim Audrey , Lippett Robyn , Lunsky Yona , Macarthur Colin , Mahant Sanjay , Malecki Sarah , Miranda Susan , Moharir Mahendranath , Moretti Myla E , Phillips Lacey , Robeson Paula , Taryan Monica , Thorpe Kevin , Toulany Alene , Vandepoele Eryn , Weitzner Brenda , Orkin Julia , Cohen Eyal
Published: December 2024

Introduction

Children with medical complexity (CMC) have chronic, intensive care needs managed by many healthcare practitioners. Medical advances have enabled CMC to survive well into adulthood. However, the availability of supports as CMC transition into the adult care system remain suboptimal, contributing to poor care coordination, and discontinuity. Promoting Intensive Transitions for Children and Youth with Medical Complexity from Paediatric to Adult Care (PITCare) aims to assess whether intensive patient and caregiver-oriented transition support beyond age 18 will improve continuity of care for CMC compared with usual care.

Methods and analysis

This is a pragmatic superiority randomised controlled trial in a parallel group, two-arm design with an embedded qualitative component. CMC turning 17.5 years old will be recruited (n=154), along with their primary caregiver. Participants randomised to the intervention arm will be provided with access to a multidisciplinary transition team who will support patients and caregivers in care planning, integration with an adult primary care provider (PCP), adult subspecialty facilitation and facilitation of resource supports for 2 years. Outcomes will be measured at baseline, 12 and 24 months. The primary outcome measure is successful transfer completion, defined as continuous care in the 2 years after age 18 years old. Secondary outcomes include satisfaction with transitional care, self-management, care coordination, healthcare service use, caregiver fatigue, family distress, utility and cost-effectiveness. Qualitative interviews will be conducted to explore the experiences of patients, caregivers, the transition team, and healthcare providers with the PITCare intervention.

Ethics and dissemination

Institutional approval was obtained from the Hospital for Sick Children Research Ethics Board. Our findings and resources will be shared with child health policymakers and transitions advocacy groups provincially, nationally, and internationally.

Trial registration number

ClinicalTrials.gov, US National Library of Medicine, National Institutes of Health, #NCT06093386.
Service availability and readiness to provide maternal and newborn healthcare services in Kilimanjaro region, Tanzania: a cross sectional study
Authors: Kimario Agathon Avelin , Mahmoud Ashraf , Thomas Jonaviva A , Mallilah Benardine P , Mlay Pendo S , Olomi Gaudensia , Mmbaga Blandina
Published: December 2024

Objective

To assess service availability and readiness of health facilities to provide maternal and newborn care in the Kilimanjaro region, northern Tanzania: a study conducted between August to October 2022.

Design

The study used a cross-sectional design by adopting WHO Service Availability and Readiness Assessment tool to assess basic maternal, newborn and child health services delivery in the health facilities of the Kilimanjaro region.

Setting

The study was conducted in seven districts of Kilimanjaro region at health facilities with a labour ward and where delivery and maternal services for women and neonatal care were offered.

Participants

The study included all district hospitals, two selected health centres and two dispensaries within every district with high utilisation of delivery services as well as the regional hospital of Kilimanjaro region making a total of 37 health facilities that were assessed.

Primary outcome

Basic emergency obstetric and newborn care (BEmONC) service availability, BEmONC service readiness, comprehensive emergency obstetric and newborn care (CEmONC) service availability and CEmONC service readiness.

Results

A total of 37 facilities were enrolled that included 14 dispensaries, 14 health centres, 8 district hospitals and 1 regional hospital. The study highlights that majority of the signal functions are available in all levels of health facilities with overall readiness scores in BEmONC and CEmONC being 83% and 98.87%, respectively. However, the study reports that 40.5% of health facilities do not conduct death reviews. Similarly, on-job trainings regarding maternal and newborn healthcare was low, with only 29.8% of all healthcare workers in the region received training for the past 2 years.

Conclusion

Despite progress, challenges persist in delivering tailored maternal and newborn healthcare services in Kilimanjaro region. The study revealed strong readiness in essential care functions, but shortcomings in maternal and neonatal death reviews and training, emphasise the need for improved practices to further enhance maternal and newborn health outcomes.
Cost-effectiveness of long-acting progestogens versus the combined oral contraceptives pill for preventing recurrence of endometriosis-related pain following surgery: an economic evaluation alongside the PRE-EMPT trial
Authors: Melyda Melyda , Monahan Mark , Cooper Kevin G , Bhattacharya Siladitya , Daniels Jane P , Cheed Versha , Middleton Lee , Roberts Tracy E
Published: December 2024

Objectives

To evaluate the cost-effectiveness of long-acting progestogens (LAP), including levonorgestrel-releasing intrauterine system (LNG-IUS) and depot-medroxyprogesterone acetate (DMPA), compared with the combined oral contraceptives pill (COCP) in preventing recurrence of endometriosis-related pain postsurgery.

Design

Within-trial economic evaluation alongside a multicentre, pragmatic, parallel-group, open-label, randomised controlled trial (Preventing Recurrence of Endometriosis by means of Long-Acting Progestogen Therapy trial).

Setting

Thirty-four UK hospitals recruiting participants from November 2015 to March 2019.

Patients

Four hundred and five women aged 16–45 years undergoing conservative endometriosis surgery.

Interventions

The ratio of 1:1 randomisation to receive LAPs (LNG-IUS or DMPA) or COCP.

Main outcome measures

The primary evaluation was a cost-utility analysis based on cost per quality-adjusted life-year (QALY) gained at 3 years. We adopted a UK National Health Service perspective. Secondary analyses in the form of cost-effectiveness analysis based on a range of outcomes were also undertaken.

Results

For the primary analysis, the COCP group incurred an additional cost of £533 (95% CI £52 to £983) per woman compared with LAPs. Treatment with COCP generated additional QALYs of 0.031 (95% CI −0.079 to 0.139) compared with the LAP group over 36-month follow-up. The incremental cost-effectiveness ratio for COCP compared with LAPs is therefore approximately £17 193 per QALY. The probabilistic sensitivity analysis suggested that there was a 54.7% probability that COCP would be cost-effective at the £20 000/QALY threshold. The secondary analyses revealed results more in favour of LAPs.

Conclusion

Although the COCP has a slightly higher probability of being cost-effective at £20 000/QALY threshold, there remains considerable uncertainty, with only marginal differences in outcomes between the two treatments. The lower rates of further surgery and second-line medical treatment for women allocated to LAPs may make this option preferable for some women.

Trial registration number

ISRCTN 97865475.