bluuebunny/crossref_metadata_2025 huggingface dataset:
Development and Design of E_MOTIV
Authors: Fontaine Guillaume , Cossette Sylvie
Published: July 2022

Brief counseling, when provided by adequately trained nurses, can motivate and support patient health behavior change. However, numerous barriers can impede nurses' capability and motivation to provide brief counseling. Theory-based interventions, as well as information and communication technologies, can support evidence-based practice by addressing these barriers. The purpose of this study was to document the development process of the E_MOTIV asynchronous, theory-based, adaptive e-learning program aimed at supporting nurses' provision of brief counseling for smoking cessation, healthy eating, and medication adherence. Development followed French's stepwise theory- and evidence-based approach: (1) identifying who needs to do what, differently, that is, provision of brief counseling in acute care settings by nurses; (2) identifying determinants of the provision of brief counseling; (3) identifying which intervention components and mode(s) of delivery could address determinants; and (4) developing and evaluating the program. The resulting E_MOTIV program, guided by the Theory of Planned Behavior, Cognitive Load Theory, and the concept of engagement, is unique in its adaptive functionality—personalizing program content and sequence to each learners' beliefs, motivation, and learning preferences. E_MOTIV is one of the first adaptive e-learning programs developed to support nurses' practice, and this study offers key insights for future work in the field.
Organizational Factors That Promote Error Reporting in Healthcare: A Scoping Review
Authors: Wawersik Dawn , Palaganas Janice
Published: July 2022

Goal:

The overarching aim of this systematic review was to offer guidelines for organizations and healthcare providers to create psychological safety in error reporting. The authors wanted to identify organizational factors that promote psychological safety for error reporting and identify gaps in the literature to explore innovative avenues for future research.

Methods:

The authors conducted an online search of peer-reviewed articles that contain organizational processes promoting or preventing error reporting. The search yielded 420 articles published from 2015 to 2021. From this set, 52 full-text articles were assessed for eligibility. Data from 29 articles were evaluated for quality using Joanna Briggs Institute critical appraisal tools.

Principal Findings:

We present a narrative review of the 29 studies that reported factors either promoting error reporting or serving as barriers. We also present our findings in tables to highlight the most frequently reported themes. Our findings reveal that many healthcare organizations work at opposite ends of the process continuum to achieve the same goals. Finally, our results highlight the need to explore cultural differences and personal biases among both healthcare leaders and clinicians.

Applications to practice:

The findings underscore the need for a deeper dive into understanding error reporting from the perspective of individual characteristics and organizational interests toward increasing psychological safety in healthcare teams and the workplace to strengthen patient safety.
Establishing a Sustainable Healthcare Delivery Workforce in the Wake of COVID-19
Authors: Weidman Allison J.
Published: July 2022

Prior to the COVID-19 pandemic, the U.S. healthcare sector was facing challenges that threatened the sustainability of its workforce. These challenges included changing demographics, competition from other employers, and burnout. Now in the wake of the pandemic, the labor market is seeing more disruption with the exacerbation of these issues. Healthcare organizations have a responsibility to prevent further labor shortages so that they can continue to deliver high quality care and achieve positive health outcomes. Given the changes in people’s values and behaviors, healthcare leaders can consider four innovative strategies to meet the needs of their current and future employees: flexible work arrangements, alternative benefits packages, career pathways, and mental health services. Organizations need to take into account their employee populations and the ability to invest in these changes when considering how to move forward.
Practice Variations in the Management of Infants With Non–IgE-Mediated Cow’s Milk Protein Allergy
Authors: Granot Maya , Machnes Maayan Diti , Weiss Batia , Haberman Yael , Agmon-Levin Nancy , Shouval Dror S.
Published: July 2022

Objectives:

Infants with non–IgE-mediated food allergies are often referred to gastroenterologists or immunologists. We hypothesized that there are practice variations between these disciplines in the diagnosis and management of such infants.

Methods:

A computerized questionnaire was distributed between pediatric gastroenterologists and immunologists. The questions addressed diagnosis, management, and follow-up in 3 scenarios of infants with concern for food protein–induced allergic proctocolitis (FPIAP) due to non–IgE-mediated responses to cow’s milk.

Results:

Three cases of infants with suspected FPIAP were presented: milk-based formula-fed (case 1) or breast-fed (case 2) infants that are well appearing and thriving, and a breast-fed infant who is not growing appropriately along with a personal and family history of atopy (case 3). Fifty-eight pediatric gastroenterologists and 32 immunologists completed the questionnaire. Significant differences between gastroenterologists and immunologists were noted regarding the recommended dietary changes in these scenarios. Moreover, despite available guidelines generated by both societies, most physicians confirm the diagnosis based on resolution of symptoms after the dietary change, without re-exposure to the the suspected trigger. In addition, time for recommended re-exposure in infants with FPIAP was also different; most gastroenterologists recommended waiting until 12 months of age, while immunologists suggested reintroduction earlier, up to 6 months of age.

Conclusions:

We identified significant practice variations in diagnosis and management of FPIAP between pediatric gastroenterologists and immunologists, with lack of adherence to society guidelines. Joint task forces of primary care pediatricians, gastroenterologists, and immunologists should provide uniform guidelines to standardize care.
Opioid use for a first-incident upper extremity fracture in 220,440 patients without recent prior use in Ontario, Canada: a retrospective cohort study
Authors: MacDermid Joy C. , McClure J. Andrew , Richards Lucie , Faber Kenneth J. , Jaglal Susan
Published: July 2022

Objective:

To describe opioid use for a first upper extremity fracture in a cohort of patients who did not have recent opioid use.

Design:

Descriptive epidemiological study.

Setting:

Emergency Department, Hospital.

Patients/Participants:

We obtained health administrative data records of adults presenting with a first adult upper extremity fracture from 2013 to 2017 in Ontario, Canada. We excluded patients with previous fractures, opioid prescription in the past 6 months or hospitalization >5 days after the fracture.

Intervention:

Opioid prescription.

Main Outcome Measurements:

We identified the proportion of patients filling an opioid prescription within 7 days of fracture. We described this based on different upper extremity fractures (ICD-10), Demographics (age, sex, rurality), comorbidity (Charlson Comorbidity Index, Rheumatoid arthritis, Diabetes), season of injury, and social marginalization (Ontario Marginalization Index-a data algorithm that combines a wide range of demographic indicators into 4 distinct dimensions of marginalization). We considered statistical differences (P< .01) that reached a standardized mean difference of 10% as being clinically important (standardized mean difference [SMD] ≥ 0.1).

Results:

From 220,440 patients with a first upper extremity fracture (50% female, mean age 50), opioids were used by 34% of cases overall (32% in males, 36% in females, P< .001, SMD ≥ 0.1). Use varied by body region, with those with multiple or proximal fractures having the highest use: multiple shoulder 64%, multiple regions 62%, shoulder 62%, elbow 38%, wrist 31%, and hand 21%; and was higher in patients who had a nerve/tendon injury or hospitalization (P< .01, SMD ≥ 0.1). Social marginalization, comorbidity, and season of injury had clinically insignificant effects on opioid use.

Conclusions:

More than one-third of patients who are recent-non-users will fill an opioid prescription within 7 days of a first upper extremity fracture, with usage highly influenced by fracture characteristics.

Level of Evidence: Level II
Patients value their own pain over braking safety when deciding when to return to driving: a discrete choice experiment on lower extremity injuries
Authors: DeLeon Genaro A. , Rolle Nicholas P. , Burke Cynthia E. , McKegg Phillip C. , Hannan Zachary D. , Ghulam Qasim M. , Gupta Jayesh , Bangura Abdulai , O’Connor Katherine C. , Slobogean Gerard P. , O’Toole Robert V. , O’Hara Nathan N.
Published: July 2022

Objective:

To quantify patient preferences towards time to return to driving relative to compromised reaction time and potential complication risks.

Design:

Cross-sectional discrete choice experiment.

Setting:

Academic trauma center.

Patients:

Ninety-six adult patients with an operative lower extremity fracture from December 2019 through December 2020.

Intervention:

None.

Main Outcome Measurement:

Patient completed a discrete choice experiment survey consisting of 12 hypothetical return to driving scenarios with varied attributes: time to return to driving (range: 1 to 6 months), risk of implant failure (range: 1% to 12%), pain upon driving return (range: none to severe), and driving safety measured by braking distance (range: 0 to 40 feet at 60 mph). The relative importance of each attribute is reported on a scale of 0% to 100%.

Results:

Patients most valued a reduced pain level when resuming driving (62%), followed by the risk of implant failure (17%), time to return to driving (13%), and braking safety (8%). Patients were indifferent to returning to driving at 1 month (median utility: 28, interquartile range [IQR] −31 to 80) or 2 months (median utility: 59, IQR: 41 to 91) postinjury.

Conclusion:

Patients with lower extremity injuries demonstrated a willingness to forego earlier return to driving if it might mean a decrease in their pain level. Patients are least concerned about their driving safety, instead placing higher value on their own pain level and chance of implant failure. The findings of this study are the first to rigorously quantify patient preferences toward a return to driving and heterogeneity in patient preferences.

Level of Evidence:

V
The Impact of Gender-affirming Hormone Therapy on Anatomic Structures of the Brain Among Transgender Individuals
Authors: O’Leary Kerry B. , Garcia-Altieri Mauro A.
Published: July 2022

Despite the growing numbers of individuals who identify as transgender, this population continues to face worse mental health outcomes compared with the general population. Transgender individuals attempt suicide at a rate that is almost 9 times that of the general population. Few studies have reported on the positive effect of gender-affirming hormone therapy on mental health outcomes in transgender individuals. It is likely that this effect is due in part to the physiological responses that occur as a result of hormone therapy that mitigate incongruencies between one’s gender identity and assigned sex. To our knowledge, only limited studies have shown a connection between gender-affirming hormone therapy, its effect on the brain’s structure, and long-term effects that this may have on mental health outcomes. The authors propose that, in addition to the physiological responses that occur as a direct result of hormone therapy and the validation that results from receiving gender-affirming medical care, mental health outcomes in transgender individuals may also improve due to the role that hormone therapy plays in altering the brain’s structure, possibly shaping the brain to become more like that of the gender with which an individual identifies. In this article, the authors review the current literature on the effects that gender-affirming hormone therapy has on mental health outcomes and anatomic structures of the brain in transgender individuals.
Optimizing Obsessive-Compulsive Symptom Measurement With the Yale-Brown Obsessive-Compulsive Scales—Second Edition
Authors: Vogt Gregory S. , Avendaño-Ortega Michelle , Schneider Sophie C. , Goodman Wayne K. , Storch Eric A.
Published: July 2022

The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) is a widely used measure for assessing the presence and severity of obsessive-compulsive disorder symptoms. The Yale-Brown Obsessive-Compulsive Scale—Second Edition (Y-BOCS-II) was developed, in part, to more comprehensively evaluate symptom severity, especially in extremely ill patients, and improve consistency in detecting and incorporating avoidance behaviors. We present 3 case studies that demonstrate the enhanced ability of the Y-BOCS-II to: (1) detect fluctuations in symptom severity among extremely ill patients, (2) systematically incorporate avoidance variables for more accurate ratings, and (3) maintain strong convergence with the Y-BOCS in assessing patients presenting with mild to moderate symptoms. In addition, we outline how to obtain both Y-BOCS and Y-BOCS-II scores within 1 administration by adding Y-BOCS item 4 to the Y-BOCS-II assessment, then “back-coding” the Y-BOCS-II ratings to Y-BOCS ratings and using Y-BOCS item 4 in place of Y-BOCS-II item 2. The use of this method allows for more robust data collection while providing comparability across the literature.
Psychosis as Initial Presentation of Small Cell Lung Cancer: A Case Report
Authors: Amole Morolake , Abusrur Sammy , El Sayed Adel , O’Leary Charlotte , Specter Ross
Published: July 2022

Paraneoplastic neurological syndromes (PNS) are a group of symptoms and physical findings that can reflect various neurological conditions, which may uncommonly include acute psychosis. In this report, we present the case of a 62-year-old African American male with a medical history significant for sarcoidosis and adrenal insufficiency who presented with several months of altered mentation and aggressive behavior of unknown etiology. Extensive laboratory workup, including lumbar puncture and cerebrospinal fluid antibodies, did not reveal any significant findings. Imaging studies, including computed tomography of the chest, showed mediastinal adenopathy and densities suggestive of metastatic small cell carcinoma, which was later confirmed following bronchoscopy and lymph node biopsy. A PNS was suspected as the explanation for the patient’s psychiatric symptoms. Treatment with steroids and intravenous immunoglobulins was started, but there was no improvement. Surgery and systemic therapy were not recommended, and the family elected to pursue a palliative care option for the remainder of the patient’s treatment. Our goal in this report is to provide basic information on PNS and highlight the need for a multidisciplinary approach to the diagnosis and treatment of these rare, albeit interesting, presentations.
Cellular microRNAs correlate with clinical parameters in multiple injury patients
Authors: Vicente Diego A. , Schobel Seth A. , Anfossi Simone , Hensman Hannah , Lisboa Felipe , Robertson Henry , Khatri Vivek , Bradley Matthew J. , Shimizu Masayoshi , Buchman Timothy G. , Davis Thomas A. , Dente Christopher J. , Kirk Allan D. , Calin George A. , Elster Eric A.
Published: July 2022

INTRODUCTION

The pathophysiology of the inflammatory response after major trauma is complex, and the magnitude correlates with severity of tissue injury and outcomes. Study of infection-mediated immune pathways has demonstrated that cellular microRNAs may modulate the inflammatory response. The authors hypothesize that the expression of microRNAs would correlate to complicated recoveries in polytrauma patients (PtPs).

METHODS

Polytrauma patients enrolled in the prospective observational Tissue and Data Acquisition Protocol with Injury Severity Score of >15 were selected for this study. Polytrauma patients were divided into complicated recoveries and uncomplicated recovery groups. Polytrauma patients' blood samples were obtained at the time of admission (T0). Established biomarkers of systemic inflammation, including cytokines and chemokines, were measured using multiplexed Luminex-based methods, and novel microRNAs were measured in plasma samples using multiplex RNA hybridization.

RESULTS

Polytrauma patients (n = 180) had high Injury Severity Score (26 [20–34]) and complicated recovery rate of 33%. MicroRNAs were lower in PtPs at T0 compared with healthy controls, and bivariate analysis demonstrated that variations of microRNAs correlated with age, race, comorbidities, venous thromboembolism, pulmonary complications, complicated recovery, and mortality. Positive correlations were noted between microRNAs and interleukin 10, vascular endothelial growth factor, Acute Physiology and Chronic Health Evaluation, and Sequential Organ Failure Assessment scores. Multivariable Lasso regression analysis of predictors of complicated recovery based on microRNAs, cytokines, and chemokines revealed that miR-21-3p and monocyte chemoattractant protein-1 were predictive of complicated recovery with an area under the curve of 0.78.

CONCLUSION

Systemic microRNAs were associated with poor outcomes in PtPs, and results are consistent with previously described trends in critically ill patients. These early biomarkers of inflammation might provide predictive utility in early complicated recovery diagnosis and prognosis. Because of their potential to regulate immune responses, microRNAs may provide therapeutic targets for immunomodulation.

LEVEL OF EVIDENCE

Diagnostic Tests/Criteria; Level II.
HLA-II-dependent neuroimmune changes in Group A Streptococcal Necrotizing Fasciitis
Authors: Ambigapathy Ganesh , Satpati Abhijit , Mukundan Santhosh , Nagamoto-Combs Kumi , Combs Colin K. , Nookala Suba
Published: July 2022

Introduction

Streptococcus pyogenes (Group A Streptococcus, GAS) bacteria cause a spectrum of human diseases ranging from self-limiting pharyngitis and mild uncomplicated skin infections (impetigo, erysipelas, cellulitis) to highly morbid and rapidly invasive life-threatening infections such as streptococcal toxic shock syndrome and necrotizing fasciitis (NF). HLA-Class II allelic polymorphisms are linked with differential outcomes and severity of GAS infections. The dysregulated immune response and peripheral cytokine storm elicited due to invasive GAS infections increase the risk for toxic shock and multiple organ failure in genetically susceptible individuals. We hypothesized that while the host immune mediators regulate the immune responses against peripheral GAS infections, these interactions may simultaneously trigger neuropathology and, in some cases, induce persistent alterations in the glial phenotypes. Here we studied the consequences of peripheral GAS skin infection on the brain in an HLA-II transgenic mouse model of GAS NF with and without treatment with an antibiotic, clindamycin (CLN).

Methods

Mice expressing the human HLA-II DR3 (DR3) or the HLA-II DR4 (DR4) allele were divided into three groups: i) uninfected controls, ii) subcutaneously infected with a clinical GAS strain isolated from a patient with GAS NF, and iii) GAS infected with CLN treatment (10mg/kg/5 days, intraperitoneal). The groups were monitored for 15 days post-infection. Skin GAS burden and lesion area, splenic and hippocampal mRNA levels of inflammatory markers, and immunohistochemical changes in hippocampal GFAP and Iba-1 immunoreactivity were assessed.

Results

Skin GAS burden and hippocampal mRNA levels of inflammatory markers S100A8/A9, IL-1β, IL-33, inflammasome-related caspase-1 (Casp1), and NLRP6 were elevated in infected DR3 but not DR4 mice. The levels of these markers were significantly reduced following CLN treatment in DR3 mice. Although GAS was not detectable in the brain, astrocyte and microglia activation were evident from increased GFAP and Iba-1 mRNA levels respectively, in DR3 and DR4 mice. However, CLN treatment significantly reduced GFAP immunoreactivity in DR3 mice and not DR4 mice.

Conclusion

Our data suggest a skin-brain axis during GAS NF demonstrating that peripherally induced pathological conditions regulate neuroimmune and gliotic events, and CLN may attenuate peripheral infection and subsequent neuroimmune changes in an HLA-II-dependent manner.
Polymorphisms Predicting Phylogeny in Hepatitis B Virus (HBV)
Authors: Lourenço José , McNaughton Anna L , Pley Caitlin , Obolski Uri , Gupta Sunetra , Matthews Philippa C
Published: July 2022

Hepatitis B viruses (HBV) are compact viruses with circular genomes of ∼3.2kb in length. Four genes (HBx, Core, Surface and Polymerase) generating seven products are encoded on overlapping reading frames. Ten HBV genotypes have been characterised (A-J), which may account for differences in transmission, outcomes of infection, and treatment response. However, HBV genotyping is rarely undertaken, and sequencing remains inaccessible in many settings. We used a machine learning approach based on random forest algorithms (RFA) to assess which amino acid (aa) sites in the genome are most informative for determining genotype. We downloaded 5496 genome-length HBV sequences from a public database, excluding recombinant sequences, regions with conserved indels, and genotypes I/J. Each gene was separately translated into aa, and the proteins concatenated into a single sequence (length 1614aa). Using RFA, we searched for aa sites predictive of genotype, and assessed co-variation among the sites with a Mutual Information (MI)-based method. We were able to discriminate confidently between genotypes A-H using 10 aa sites. 5/10 sites were identified in Polymerase (Pol), of which 4/5 were in the spacer domain, and a single site in reverse transcriptase. A further 4/10 sites were located in Surface protein, and a single site in HBx. There were no informative sites in Core. Properties of the aa were generally not conserved between genotypes at informative sites. Co-variation analysis identified 55 pairs of highly-linked sites. Three RFA-identified sites were represented across all pairs (two sites in spacer, and one in HBx). Residues that co-vary with these sites are concentrated in the small HBV surface gene. We also observe a cluster of sites adjacent to the Surface promoter region that co-vary with a spacer residue. Overall, we have shown that RFA analysis is a powerful tool for identifying aa sites that predict HBV lineage, with an unexpectedly high number of such sites in the spacer domain, which has conventionally been viewed as unimportant for structure or function. Our results improve ease of genotype prediction from limited regions of HBV sequence, and may have implications for understanding HBV evolution and the role of the spacer domain.
Understanding the dynamic relation between wastewater SARS-CoV-2 signal and clinical metrics throughout the pandemic
Authors: Hegazy Nada , Cowan Aaron , D’Aoust Patrick M. , Mercier Élisabeth , Towhid Syeda Tasneem , Jia Jian-Jun , Wan Shen , Zhang Zhihao , Kabir Md Pervez , Fang Wanting , Graber Tyson E. , MacKenzie Alex E. , Guilherme Stéphanie , Delatolla Robert
Published: July 2022

Wastewater surveillance (WWS) of SARS-CoV-2 was proven to be a reliable and complementary tool for population-wide monitoring of COVID-19 disease incidence but was not as rigorously explored as an indicator for disease burden throughout the pandemic. Prior to global mass immunization campaigns and during the spread of the wildtype COVID-19 and the Alpha variant of concern (VOC), viral measurement of SARS-CoV-2 in wastewater was a leading indicator for both COVID-19 incidence and disease burden in communities. As the two-dose vaccination rates escalated during the spread of the Delta VOC in Jul. 2021 through Dec. 2021, relations weakened between wastewater signal and community COVID-19 disease incidence and maintained a strong relationship with clinical metrics indicative of disease burden (new hospital admissions, ICU admissions, and deaths). Further, with the onset of the vaccine-resistant Omicron BA.1 VOC in Dec. 2021 through Mar. 2022, wastewater again became a strong indicator of both disease incidence and burden during a period of limited natural immunization (no recent infection), vaccine escape, and waned vaccine effectiveness. Lastly, with the populations regaining enhanced natural and vaccination immunization shortly prior to the onset of the Omicron BA.2 VOC in mid-Mar 2022, wastewater is shown to be a strong indicator for both disease incidence and burden. Hospitalization-to-wastewater ratio is further shown to be a good indicator of VOC virulence when widespread clinical testing is limited. In the future, WWS is expected to show moderate indication of incidence and strong indication of disease burden in the community during future potential seasonal vaccination campaigns.

Highlights

Need to elucidate interpretation of CoV-2 WWS for seasonal vaccination campaigns.

WWS to incidence relation weakens with peak natural and vaccination immunization.

WWS to hospitalization remains strong with natural and vaccination immunization.

WWS as indicator of hospitalization during future seasonal vaccination campaigns.

WWS/hospitalization as indicator of VOC virulence with limited clinical testing.
Dual targeting factors are required for LXG toxin export by the bacterial type VIIb secretion system
Authors: Klein Timothy A. , Grebenc Dirk W. , Shah Prakhar Y. , McArthur Owen D. , Dickson Brandon H. , Surette Michael G. , Kim Youngchang , Whitney John C.
Published: July 2022

Bacterial type VIIb secretion systems (T7SSb) are multi-subunit integral membrane protein complexes found in Firmicutes that play a role in both bacterial competition and virulence by secreting toxic effector proteins. The majority of characterized T7SSb effectors adopt a polymorphic domain architecture consisting of a conserved N-terminal Leu-X-Gly (LXG) domain and a variable C-terminal toxin domain. Recent work has started to reveal the diversity of toxic activities exhibited by LXG effectors; however, little is known about how these proteins are recruited to the T7SSb apparatus. In this work, we sought to characterize genes encoding domains of unknown function (DUFs) 3130 and 3958, which frequently co-occur with LXG effector-encoding genes. Using coimmunoprecipitation-mass spectrometry analyses,in vitrocopurification experiments and T7SSb secretion assays, we find that representative members of these protein families form heteromeric complexes with their cognate LXG domain and in doing so, function as targeting factors that promote effector export. Additionally, an X-ray crystal structure of a representative DUF3958 protein, combined with predictive modelling of DUF3130 using AlphaFold2, reveals structural similarity between these protein families and the ubiquitous WXG100 family of T7SS effectors. Interestingly, we identify a conserved FxxxD motif within DUF3130 that is reminiscent of the YxxxD/E “export arm” found in Mycobacterial T7SSa substrates and mutation of this motif abrogates LXG effector secretion. Overall, our data experimentally link previously uncharacterized bacterial DUFs to type VIIb secretion and reveal a molecular signature required for LXG effector export.

Significance statement

Type VIIb secretion systems (T7SSb) are protein secretion machines used by an array of Gram-positive bacterial genera includingStaphylococcus, Streptococcus, Bacillus, andEnterococcus. These bacteria use the T7SSb to facilitate interbacterial killing and pathogenesis through the secretion of toxins. Although the modes of toxicity for a number of these toxins have been investigated, the mechanisms by which they are recognized and secreted by T7SSb remains poorly understood. The significance of this work is the discovery of two new protein families, termed Lap1 and Lap2, that directly interact with these toxins and are required for their secretion. Overall, Lap1 and Lap2 represent two widespread families of proteins that function as targeting factors that participate in T7SSb-dependent toxin release from Gram-positive bacteria.
A Spectroscopic Approach to Unravel the Local Conformations of G-quadruplex Using CD-active Fluorescent Base Analogues
Authors: Jose Davis , Michael Miya Mary , Bentsen Christopher , Rosenblum Brandon , Zelaya Adriana
Published: July 2022

The formation of a stable G-quadruplex (GQ) can inhibit the elevated telomerase activity that is common in most cancers. The global structure and the thermal stability of the GQs are usually evaluated by spectroscopic methods and thermal denaturation properties. However, most biochemical processes involving GQs might require local conformational changes at the guanine tetrad (G4) level. These local conformational changes of individual G4 layers during protein and drug interactions have not yet been explored in detail. In this study we monitored the local conformations of individual G4 layers in GQs using 6-methylisoxanthopterine (6MI) chromophores, which are circular dichroism (CD)-active fluorescent base analogues of guanine, as local conformational probes. A synthetic, tetra-molecular, parallel GQ with site-specifically positioned 6MI monomers or dimers was used as the experimental construct. Analytical ultracentrifugation studies and gel electrophoretic studies showed that properly positioned 6MI monomers and dimers could form stable GQs with CD-active fluorescent G4 layers. The local conformation of individual fluorescent G4 layers in the GQ structure was then tracked by monitoring the absorbance, fluorescence intensity, thermal melting, fluorescence quenching and CD changes of the incorporated probes. Overall, these studies showed that site-specifically incorporated fluorescent base analogues could be used as probes to monitor the local conformational changes of individual G4 layers of a GQ structure. This method can be applied to explore the details of small molecule-GQ interaction at the level of the individual G4 layers, which may prove useful in designing drugs to treat GQ-related genetic disorders, cancer and aging.
Patterns of inconsistency: a literature review of empirical studies on the multinationality–performance relationship
Authors: Schmuck Alice , Lagerström Katarina , Sallis James
Published: July 2022

Purpose

This study aims to understand the performance implications of when a business internationalizes. Many managers take the performance implications of internationalization for granted. Whether seeking a broader customer base or cost reduction through cross-border outsourcing, the overwhelming belief is that internationalization leads to higher profits.

Design/methodology/approach

This paper offers a systematic review, content analysis and cross-tabulation analysis of 115 empirical studies from over 40 major journals in management, strategy and international business between 1977 and 2021. Focusing on research settings, sample characteristics, underlying theoretical approaches, measurements of key variables and moderators influencing the multinationality and performance relationship, this study offers a detailed account of definitions and effects.

Findings

The findings of this study suggest a tenuous connection between internationalization and performance. No strain of research literature conclusively identifies a consistent direct path from internationalization to performance. The context specificity of the relationship makes general declarations impossible.

Research limitations/implications

Future researchers should recognize that internationalization is a process taking different forms, with no specific dominant form. General declarations are misleading. The focus should be on the process of internationalization rather than on the outcome.

Originality/value

This study contributes to the international business literature by exploring reasons for the inconsistent results and lack of consensus. Through a detailed account of definitions and effects, this paper explores the lack of consensus as well as the identified shapes of the relationship.
Paving the way for industry 4.0 maturity of construction enterprises: a state of the art review
Authors: Das Priyadarshini , Perera Srinath , Senaratne Sepani , Osei-Kyei Robert
Published: July 2022

Purpose

Industry 4.0 is characterised by the exponential pace of technological innovations compelling organisations to transform or be displaced. Industry 4.0 transformation of construction enterprises lacks systematic guidance and notable earlier studies have utilised maturity models to map transformation of enterprises. This paper proposes a conceptual maturity model for construction enterprises for business scenarios leading to Industry 4.0.

Design/methodology/approach

The requirements for designing maturity models, including comparison with existing models and scientifically documenting the design process, make Systematic Literature Reviews (SLR) appropriate. Two systematic literature reviews (SLRs) are conducted to shortlist a total of 95 papers, which are subjected to subsequent content analysis.

Findings

The first SLR identifies the following process categories as critical levers of industry 4.0 maturity; data management, people and culture, leadership and strategy, collaboration and communication, automation, innovation and change management. The second SLR ascertains that the existing maturity models in construction literature do not adequately correspond to Industry 4.0 business scenarios with limited emphasis on data management, automation, change management and innovation. The findings are assimilated to propose a conceptual Smart Modern Construction Enterprise Maturity Model (SMCeMM).

Originality/value

The paper systematises the transformation of construction enterprises in Industry 4.0 and leads to state-of-the-art development of Industry 4.0 and maturity model research in construction. The proposed conceptual model addressed both the demands of the construction industry as well as what is required to navigate Industry 4.0 better.
Respect for patients’ rights in health facilities: experiences of patients during the early period of the COVID-19 pandemic in Ghana
Authors: Golo Harrison Kwame
Published: July 2022

Purpose

This paper aims to identify human rights violations of patients during the early periods of the COVID-19 pandemic in Ghana by investigating the experiences of people on how health-care professionals discharged their responsibilities during the time in question.

Design/methodology/approach

Explanatory design of the mixed methods approach was adopted, with the intention of collecting both quantitative and qualitative data sequentially, and then integrating the results at the interpretation stage. The approach enriched the quality of data collected as it offered the advantage of shedding light on the primary motivations and reasons for attitudes and behaviours and helped to provide an in-depth understanding of how individuals interpret the happenings around them and their experiences. Thus, although some amount of quantitative method was used in the data collection, the core of this paper is based on the qualitative interpretations.

Findings

The study reveals that health-care professionals, especially those in the Tema Metropolis, undermined certain fundamental human rights of patients during the early period of the COVID-19 pandemic. This includes failure to provide information to patients about treatment options and potential risks of medications; failure to seek the informed consent of patients before performing medical procedures; denial of access to medical files of patients for transfer; and inability or failure to provide medical ambulances services to patients on time.

Originality/value

Although many publications on human rights dimensions and health protective issues on COVID-19 pandemic are available on a global scale, still little information pertaining to experiences of individuals with health-care professionals during the early days of the COVID-19 pandemic, especially in Ghana through the lens of patient’s rights exists. This paper, therefore, fills an important gap in health-care management information, critical for policy decision-making processes regarding patient’s rights in times of pandemic control.
Business process management effectiveness and maturity through lean management practices: the Brazilian federal police experience
Authors: Klein Leander Luiz , de Pádua Silvia Inês Dallavalle , Gera Rajat , Vieira Kelmara Mendes , Dorion Eric Charles Henri
Published: July 2022

Purpose

This study aims to examine the influence of lean management practices on organizational process effectiveness and maturity. The underlying assumption of this paper is that lean management practices may have a positive relation with the initiation and the adoption of a process management approach and be a first step to process management success.

Design/methodology/approach

Through a quantitative perspective, a survey was carried out in the Brazilian Federal Police with a valid sample of 991 participants. Data analysis was executed with confirmatory factor analysis and structural equations modeling.

Findings

Lean management practices have a positive influence on the Brazilian Federal Police process maturity and on process effectiveness. Process maturity has a positive impact on process effectiveness. The results extend the applicability of lean management practices in the public service scenario. The results will decrease the high failure rates in process transformation projects.

Research limitations/implications

The main limitation of this study is that the researchers could not maintain full control of the research respondents because the data collection was carried out online.

Practical implications

Considering a scenario of increased pressure to upgrade organizational decisional process in the public sector and to offer better public services, the lean management practices can effectively contribute to the development of strategies and actions that will enhance a more effective public service management reality.

Social implications

This study may contribute as a source of empirical data for future research in other national public organizations and may assist others to redesigning its strategies and actions to achieve excellence in decision-making, by adopting a more agile quality public service with less costs and waste.

Originality/value

New measurement and structural models were defined to analyze lean management practices in the public service as the predictors of organizational process maturity and effectiveness. The discussion on lean management practices, as a first step in process approach applicability, enhances a new process-based management perspective.
Need for cognitive closure and mobile personalization: a cluster analysis
Authors: Quach Xuan , Lee Seung Hwan (Mark)
Published: July 2022

Purpose

This study aims to profile mobile users based on their need for cognitive closure (NFC) (preference for order, preference for predictability, discomfort with ambiguity, close-mindedness and decisiveness) and identify differences among the groups regarding their perceptions of personalized preferences and privacy concerns.

Design/methodology/approach

Based on the data from 285 participants, the authors seek to identify and profile unique consumer segments (mobile users) generated based on their NFC. Second, once the segments are established, the authors analyze how the segments differ across their personalized preferences and privacy concerns.

Findings

The data generated three distinct consumer segments: equivocal users, structured users and eclectic users. Across the segments, there were differences in their mobile personalization (experience, value and actions) and preference for information privacy (perceived risks and fabrication of personal information).

Research limitations/implications

United States (US)-based sample may restrict the generalizability of this research. Thus, future research should include participants from other geographic regions to increase external validity.

Practical implications

Retail managers can apply this knowledge to implement appropriate personalization strategies for these distinct target groups.

Originality/value

Segmenting clusters based on differences in consumption trait (NFC) provides key insights to retailers looking to deliver personalized customer experience, particularly in a mobile shopping context.
Think before you share: building a civic media literacy framework for everyday contexts
Authors: Middaugh Ellen , Bell Sherry , Kornbluh Mariah
Published: July 2022

Purpose

In response to concerns about fake news (Allcott et al., 2019) and polarization (Wollebaek et al., 2019), youth media literacy interventions have emerged to teach strategies for assessing credibility of online news (McGrew et al., 2018) and producing media to mobilize others for civic goals (Kahne et al., 2016). However, in light of evidence that practices learned in classroom contexts do not reliably translate to the context of sharing social media (Middaugh, 2018), this study aims to provide a better understanding of youth social media practices needed to design meaningful and relevant educational experiences.

Design/methodology/approach

Semistructured interviews with a think-aloud component were conducted with a diverse sample of 18 California youth (15–24) to learn about factors that guide behavior as they access, endorse, share, comment and produce civic media.

Findings

Findings suggest a shift toward reliance on incidental exposure and noninstitutional sources when accessing information and a tendency toward endorsement and circulation of posts (vs producing original posts) when engaging with civic issues on social media. As participants engaged in these practices, they not only applied judgments of credibility and civic impact but also concerned for personal relevance, relational considerations and fit with internet culture.

Originality/value

The authors recommend moving beyond models that reflect linear processes of effortful search, credibility analysis and production. Instead, the authors propose a new dynamic model of civic media literacy in which youth apply judgments of credibility, relational considerations, relevance to lived experience, civic impact and fit with internet culture as they receive, endorse, share, comment on and produce media in a nonlinear fashion.
Examining the perceived transparency of DTC genetic testing company communication and its impact on consumer trust, attitude and behavioral intentions
Authors: Abitbol Alan , Lee Nicole M. , VanDyke Matthew S.
Published: July 2022

Purpose

This study examines perceived transparency of direct-to-consumer (DTC) genetic testing communication and measures its impact on consumers' trust, attitudes, and the intention to recommend the test to others.

Design/methodology/approach

An online survey of US–based adults (over 18 years of age) (N = 271) was administered by the online panel company Qualtrics Panels. The sample consisted of participants who have taken a DTC genetic test previously because only existing consumers could provide insight into companies' transparency about the entire genetic testing process (including the communication before, during, and after) as they experienced it. Participants were asked questions that measured intention to recommend DTC genetic tests to others, trust, attitude toward the DTC testing, and perceptions of transparency of the DTC companies' communication.

Findings

Results indicated that consumers who perceive DTC genetic testing companies to be transparent in their communication tend to trust the genetic testing process more, have more positive attitudes toward DTC genetic tests, and are more likely to recommend the tests to others.

Research limitations/implications

This study integrates corporate communication and science communication through the theoretical framework of transparency. It empirically demonstrates that message transparency is key to increasing the publics' trust, attitude and behavioral intentions toward companies that involve sensitive health information or online privacy.

Originality/value

This paper answers previous calls to explore the organizational approach of science communication in the context of the under-examined companies in the science and health sectors, specifically the DTC genetic testing industry.
The regulation of RegTech and SupTech in finance: ensuring consistency in principle and in practice
Authors: McCarthy Jonathan
Published: July 2022

Purpose

The paper’s aim is to consider how best to formulate sturdy regulatory frameworks for RegTech and SupTech. The paper appraises how key features of EU and UK regulatory and policy initiatives can contribute to a functional framework for RegTech and SupTech.

Design/methodology/approach

The paper refers to the most comprehensive empirical findings within the EU and the UK on RegTech and SupTech, including reports released by the European Banking Authority and the Bank of England. As data is only gradually becoming available about the true rate of adoption of RegTech and SupTech, the paper identifies salient areas that warrant analysis from emerging findings. In light of the relatively restricted sources of empirical data, the article’s methodological approach is directed towards the most wide-ranging and detailed sources that are currently available at EU and UK levels.

Findings

The paper reveals distinct variations in how the EU and UK have pursued regulatory approaches towards RegTech and SupTech growth. However, there are many shared features in the respective approaches. The paper argues that a regulatory framework should ideally be imbued with overarching strategies and policy objectives, as well as with practical measures through innovation facilitators, such as sandboxes. Yet, legislative (top-down) intervention will be the significant ingredient in guaranteeing legal clarity for RegTech and SupTech.

Originality/value

By understanding the nuances in EU and UK approaches, the paper advocates for pragmatic reasoning when formulating a regulatory response. The importance of the article is in its focus on the elements of EU and UK regulatory approaches that are most capable of guaranteeing clarity on standards relating to RegTech and SupTech. The paper makes a vital contribution to existing commentary by determining how a balance can be struck between “top-down” and “bottom-up” types of regulation (i.e. should regulation be entirely concerned with industry-driven standards, such as codes of conduct?).