bluuebunny/crossref_metadata_2025 huggingface dataset:
Measures for the Core Outcome Set for Research Evaluating Interventions to Prevent and/or Treat Delirium in Critically Ill Adults: An International Consensus Study (Del-COrS)
Authors: Rose Louise , Blackwood Bronagh , Needham Dale M. , Devlin John W. , Clarke Mike , Burry Lisa D. ,   for the Del-COrS group
Published: April 2023

OBJECTIVES:

To gain consensus on measurement methods for outcomes (delirium occurrence, severity, time to resolution, mortality, health-related quality of life [HrQoL], emotional distress including anxiety, depression, acute stress, and post-traumatic stress disorder, and cognition) of our Core Outcome Set (COS) for trials of interventions to prevent and/or treat delirium in critically ill adults.

DESIGN:

International consensus process.

SETTING:

Three virtual meetings (April 2021).

PATIENTS/SUBJECTS:

Critical illness survivors/family, clinicians, and researchers from six Countries.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Measures (selected based on instrument validity, existing recommendations, and feasibility) and measurement time horizons were discussed. Participants voted on instruments and measurement timing (a priori consensus threshold ≥ 70%). Eighteen stakeholders (28% ICU survivors/family members) participated. We achieved consensus on the Confusion Assessment Method-ICU or Intensive Care Delirium Screening Checklist to measure delirium occurrence and delirium resolution (100%), Hospital Anxiety and Depression Scale for emotional distress (71%), and Montreal Cognitive Assessment-Blind for cognition (83%). We did not achieve consensus on EQ-5D five-level for HrQoL (69%) or its measurement at 6 months. We also did not achieve consensus on the Impact of Event Scale (IES)–Revised or IES-6 for post-traumatic stress (65%) or on measurement instruments for delirium severity incorporating delirium-related emotional distress. We were unable to gain consensus on when to commence and when to discontinue assessing for delirium occurrence and time to resolution, when to determine mortality. We gained consensus that emotional distress and cognition should be measured up to 12 months from hospital discharge.

CONCLUSIONS:

Consensus was reached on measurement instruments for four of seven outcomes in the COS for delirium prevention or treatment trials for critically ill adults. Further work is required to validate instruments for delirium severity that include delirium-related emotional distress.
Downregulation of cardiac PIASy inhibits Cx43 SUMOylation and ameliorates ventricular arrhythmias in a rat model of myocardial ischemia/reperfusion injury
Authors: Wang Tingting , Liu Jinmin , Hu Chenchen , Wei Xin , Han Linlin , Zhu Afang , Wang Rong , Chen Zhijun , Xia Zhengyuan , Yao Shanglong , Mao Weike
Published: April 2023

Background:

Dysfunction of the gap junction channel protein connexin 43 (Cx43) contributes to myocardial ischemia/reperfusion (I/R)-induced ventricular arrhythmias. Cx43 can be regulated by small ubiquitin-like modifier (SUMO) modification. Protein inhibitor of activated STAT Y (PIASy) is an E3 SUMO ligase for its target proteins. However, whether Cx43 is a target protein of PIASy and whether Cx43 SUMOylation plays a role in I/R-induced arrhythmias are largely unknown.

Methods:

Male Sprague–Dawley rats were infected with PIASy short hairpin RNA (shRNA) using recombinant adeno-associated virus subtype 9 (rAAV9). Two weeks later, the rats were subjected to 45 min of left coronary artery occlusion followed by 2 h reperfusion. Electrocardiogram was recorded to assess arrhythmias. Rat ventricular tissues were collected for molecular biological measurements.

Results:

Following 45 min of ischemia, QRS duration and QTc intervals statistically significantly increased, but these values decreased after transfecting PIASy shRNA. PIASy downregulation ameliorated ventricular arrhythmias induced by myocardial I/R, as evidenced by the decreased incidence of ventricular tachycardia and ventricular fibrillation, and reduced arrythmia score. In addition, myocardial I/R statistically significantly induced PIASy expression and Cx43 SUMOylation, accompanied by reduced Cx43 phosphorylation and plakophilin 2 (PKP2) expression. Moreover, PIASy downregulation remarkably reduced Cx43 SUMOylation, accompanied by increased Cx43 phosphorylation and PKP2 expression after I/R.

Conclusion:

PIASy downregulation inhibited Cx43 SUMOylation and increased PKP2 expression, thereby improving ventricular arrhythmias in ischemic/reperfused rats heart.
Rapid Detection of Lithium Concentrations in Oral Fluid
Authors: Granger Douglas A. , Parkin Georgia M. , Buspavanich Pichit , Findeisen Peter , Rietschel Marcella , McCarthy Michael J. , Thomas Elizabeth A.
Published: April 2023

Background:

Lithium medication is considered to be the first-line treatment for bipolar disorder as a monotherapy, and for treatment-resistant depression with lithium augmentation. However, because of potential toxicity, lithium levels must be monitored frequently. Recent studies have demonstrated a significant correlation between lithium levels measured in serum and those detected in oral fluid, suggesting that oral fluid analysis may represent an easy, noninvasive means to monitor lithium levels. The aim of this study was to evaluate the analytical performance of rapid assays for lithium measurements in oral fluid.

Methods:

Levels of lithium in oral fluid from psychiatric patients (n = 108 in total) taking lithium medications were quantified using 2 rapid techniques: an automated clinical chemistry analyzer and a novel, commercially available colorimetric lithium assay. These results were compared with those obtained using inductively coupled plasma optical emission spectrometry (ICP-OES).

Results:

The mean and median oral fluid lithium levels in this cohort were 1.43–1.61 mM and 1.32–1.52 mM, respectively, depending on the method, with the overall range, across all methods, being 0.213–4.42 mM. Linear regression analysis showed excellent agreement between the oral fluid values measured using ICP-OES and the colorimetric method (r2 value = 0.926; P < 0.0001; slope = 1.084 ± 0.038). Similarly, excellent agreement was observed between ICP-OES and the automated method (r2 = 0.872; P < 0.0001; slope = 1.019 ± 0.057).

Conclusions:

These results demonstrate that lithium levels in oral fluid can be rapidly and reliably quantified using colorimetric approaches. These findings may facilitate the development of point-of-care lithium monitoring systems for use in oral fluid.
Impact of CYP2D6 Genotype on Paroxetine Serum Concentration
Authors: Hole Kristine , Haslemo Tore , Molden Espen
Published: April 2023

Background:

Paroxetine is a selective serotonin reuptake inhibitor metabolized by cytochrome P450 (CYP)2D6. Only small-scale studies have reported the impact of CYP2D6 genotype on paroxetine exposure, and international guidelines differ in their recommendations on whether paroxetine should be administered according to CYP2D6 genotype. To clarify this issue, the aim of the present study was to investigate the impact of CYP2D6 genotype on paroxetine serum concentration in a large population of patients after adjusting for CYP2C19 genotype, age, and sex.

Methods:

Patients from a therapeutic drug monitoring database with records on their paroxetine serum concentrations and CYP2D6 and CYP2C19 genotyping between 2010 and 2021 were included in the study. The impact of CYP2D6 and CYP2C19 genotypes, age, and sex on the paroxetine concentration-to-dose (C/D) ratio was investigated by multiple linear regression analysis. Patients treated with relevant CYP inhibitors or inducers were excluded.

Results:

In total, 304 patients were included in the study: 17 CYP2D6 poor metabolizers (PMs), 114 intermediate metabolizers (IMs), 168 extensive metabolizers (EMs), and 5 ultrarapid metabolizers. Multiple linear regression analysis showed that CYP2D6 IMs and PMs had 2.2-fold and 3.8-fold higher paroxetine C/D-ratios than extensive metabolizers, respectively (P < 0.001). Patients who were CYP2C19 IMs (n = 70) or PMs (n = 13) had 1.6-fold higher paroxetine C/D ratio than extensive metabolizers (P = 0.04). An age ≥65 years was associated with a 2.9-fold increased C/D ratio (P < 0.001), whereas sex was not significantly associated with paroxetine exposure.

Conclusions:

The present study showed that CYP2D6 genotype is of significant importance for paroxetine dose adjustments. For CYP2D6 PMs, 25% of the regular paroxetine starting dose may be sufficient, whereas CYP2D6 IMs could receive 50% of the regular dosage. This well-powered study shows that the guidelines should consider the importance of CYP2D6 genotype for personalized dosing of paroxetine.
Clinical Effectiveness of a Supervised Exercise Therapy Program for Treatment of Peripheral Artery Disease: A Translational Study
Authors: Salisbury Dereck L. , Brown Rebecca , Elgersma Kristin , Larson Kayla , Treat-Jacobson Diane
Published: April 2023

Purpose:

National guidelines for the treatment and management of symptomatic peripheral artery disease (PAD) recommend supervised exercise therapy (SET) as a first line of therapy. However, it is unknown how these expert opinion–based SET guidelines work in clinical practice as SET programs become established following the 2017 Centers for Medicare & Medicaid Services coverage announcement. The purpose of this prospective, nonrandomized translational study was to evaluate the clinical effectiveness of a SET program and specifically walking exercise modalities that did not incorporate a treadmill (TM).

Methods:

Participants enrolled in a 12-wk SET program housed in four rural Midwest cardiac rehabilitation settings and were prescribed an exercise program by an exercise physiologist or nurse based on current SET guidelines. Groups included TM walking, total body recumbent stepping (TBRS), TM walking + TBRS, and multimodal. Pre- and post-tests of walking capacity, physical function, and quality of life were administered.

Results:

The sample (n = 93) was all White, with 55% female representation, age of 73.7 ± 9.0 yr, and mild-moderate PAD (ankle-brachial index = 0.71 ± 0.19). Collectively, SET significantly improved the 6-min walk test (32.1 ± 6.6 m; P < .01). Within-group changes in the 6-min walk test were seen for all groups except the multimodal group; there were no significant between-group differences in change scores (P = .30). No significant between-group changes were seen for the TM walking, TBRS, and TM walking + TBRS groups for physical function measures.

Conclusion:

This study demonstrates the clinical effectiveness of SET programs following current guidelines and potential utilization of non-TM walking modalities in SET programs.
The SCARE 2023 guideline: updating consensus Surgical CAse REport (SCARE) guidelines
Authors: Sohrabi Catrin , Mathew Ginimol , Maria Nicola , Kerwan Ahmed , Franchi Thomas , Agha Riaz A ,   Collaborators
Published: April 2023

Background:

The Surgical CAse REport (SCARE) guidelines were first published in 2016 as a tool for surgeons to document and report their surgical cases in a standardised and comprehensive manner. However, with advances in technology and changes in the healthcare landscape, it is important to revise and update these guidelines to ensure they remain relevant and valuable for surgeons.

Materials and methods:

The updated guidelines were produced through a Delphi consensus exercise. Members of the SCARE 2020 guidelines Delphi group, editorial board members, and peer reviewers were invited to participate. Potential contributors were contacted by e-mail. An online survey was completed to indicate their agreement with the proposed changes to the guideline items.

Results:

A total of 54 participants were invited to participate and 44 (81.5%) completed the survey. There was a high degree of agreement among reviewers, with 36 items (83.7%) meeting the threshold for inclusion.

Conclusion:

Through a completed Delphi consensus exercise we present the SCARE 2023 guidelines. This will provide surgeons with a comprehensive and up-to-date tool for documenting and reporting their surgical cases while highlighting the importance of patient-centred care.
Vasectomy has No Impact on Future Lower Urinary Tract Symptoms Diagnoses: A Retrospective Cohort Claims Database Analysis
Authors: Venigalla Greeshma , Kohn Taylor P. , Pozzi Edoardo , Ramasamy Ranjith
Published: April 2023

Purpose:

The aim of this study was to assess whether there is an association between vasectomy and benign prostatic hyperplasia with associated lower urinary tract symptoms (BPH/LUTS) due to inflammatory etiology.

Materials and Methods:

We assessed the incidence of BPH/LUTS in men who had undergone vasectomy in a matched cohort analysis using the TriNetX Research Network. We identified men aged 30 to 60 years who underwent vasectomy and had a follow-up visit within 6 months to 5 years after vasectomy from January 2010 through December 2022 and compared them with matched controls. Outcomes recorded include diagnoses of BPH (N40, N40.1), BPH-related medication prescriptions, and BPH-related procedures. We accounted for confounding variables through propensity score-matching for age; race; and history of comorbid medical conditions: hyperlipidemia (International Classification of Disease-10: E78), metabolic syndrome (E88.81), overweight or obesity (E66), testicular hypofunction (E29.1), hypertension (I10-I16), nicotine dependence (F17), and obstructive sleep apnea (G47.33).

Results:

There was no significant difference in BPH diagnosis between postvasectomy men vs controls (0.84% vs 0.80%, RR: 0.95, 95% CI 0.86-1.05) or BPH/LUTS diagnosis (0.48% vs 0.44%, RR: 0.92, 95% CI 0.81-1.05) within 6 months to 5 years after vasectomy, respectively. No differences in BPH medication prescription (0.94% vs 0.84%) or rate of BPH procedures (0.022% vs 0.017%) were detected between the 2 groups.

Conclusions:

This study suggests that vasectomy does not increase the risk of BPH development and/or LUTS worsening compared with the general population, providing assurance to both patients and health care providers who may consider vasectomy as a safe family planning option.
Are open access article processing charges affordable for otolaryngologists in low-income and middle-income countries?
Authors: Seguya Amina , Salano Valerie , Okerosi Samuel , Kim Eric K. , Shrime Mark G. , Viljoen Gerrit , Fagan Johannes J.
Published: April 2023

Purpose of review

Open access articles are more frequently read and cited, and hence promote access to knowledge and new advances in healthcare. Unaffordability of open access article processing charges (APCs) may create a barrier to sharing research. We set out to assess the affordability of APCs and impact on publishing for otolaryngology trainees and otolaryngologists in low-income and middle-income countries (LMICs).

Recent findings

A cross-sectional online survey was conducted among otolaryngology trainees and otolaryngologists in LMICs globally. Seventy-nine participants from 21 LMICs participated in the study, with the majority from lower middle-income status (66%). Fifty-four percent were otolaryngology lecturers while 30% were trainees. Eighty-seven percent of participants received a gross monthly salary of less than USD 1500. Fifty-two percent of trainees did not receive a salary. Ninety-one percent and 96% of all study participants believed APCs limit publication in open access journals and influence choice of journal for publication, respectively. Eighty percent and 95% believed APCs hinder career progression and impede sharing of research that influences patient care, respectively.

APCs are unaffordable for LMIC otolaryngology researchers, hinder career progression and inhibit the dissemination of LMIC-specific research that can improve patient care. Novel models should be developed to support open access publishing in LMICs.
Robotic-assisted retroperitoneal lymph node dissection for testicular cancer
Authors: Gereta Sofia , Hung Michael , Hu Jim C.
Published: April 2023

Purpose of review

Robotic-assisted retroperitoneal lymph node dissection (R-RPLND) is an emerging surgical option for testicular cancer with less morbidity than open RPLND. We outline the operative technique used at our center and review contemporary evidence in the advancement of R-RPLND.

Recent findings

R-RPLND is being applied effectively beyond clinical stage I testicular cancer to treat low-volume, clinical stage II disease in both the primary and postchemotherapy setting. Compared with the open approach, R-RPLND offers shorter hospitalization and less blood loss with comparably low complications and oncologic control.

With ongoing adoption and optimization of R-RPLND, future studies will assess long-term oncologic outcomes and disseminate R-RPLND in the treatment of testicular cancer.
The Association Between Autism Spectrum Disorder and Attention Deficit Hyperactivity Disorder Symptoms in Medical Students
Authors: Heidari Arash , Motamed Mahtab , Rahimi Forushani Abbas , Alaghband-Rad Javad
Published: April 2023

Autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) are the two most prevalent neurodevelopmental disorders affecting communication and behavior. The co-occurrence of these conditions is probable and can contribute to several challenges in adaptive functioning and academic achievement.

In this cross-sectional study, 168 Iranian medical students (107 female, 61 male) studying at Tehran University of Medical Sciences in 2021 were enrolled. We administered the Ritvo Autism Asperger Diagnostic Scale–Revised (RAADS-R) and Adult ADHD Self-Report Scale (ASRS) questionnaires online to assess different symptoms of ASD and ADHD in our sample. In this study, the RAADS-R was translated into Persian and validated for the first time in Iran.

The correlation tests demonstrated a significant association between the total score and different subscales' scores of the RAADS-R and the total score and the two subscales' scores of the ASRS questionnaire (p < 0.001, 0.27 < Spearman correlation coefficient < 0.51). This study also illustrated a high prevalence of ASD and ADHD symptoms among the participants. Moreover, male respondents had a significantly higher prevalence of ASD symptoms (57.3% in males vs. 28.03% in females, p < 0.001).

This study indicated that the distinct impairments in behavior and cognition attributed to ASD and ADHD could be common manifestations in medical students. Given that the co-occurrence of these disorders may lead to significant challenges in their professional life, the early diagnosis and subsequent support for medical students with co-occurring expressions of ASD and ADHD could be extremely helpful, as it could indirectly improve the medical services provided to patients by future physicians, leading to an improvement in public health.
Undiagnosing St Joan
Authors: Phillips James , Fallon Brian , Majeed Salman , Meador Keith , Merlino Joseph , Neely Hunter , Nields Jenifer , Saunders David , Norko Michael
Published: April 2023

This article traces the history of Joan of Arc through her brief life that includes leading an army in defense of France at the age of 17 and ending with her death at the stake at the age of 19. In her activities, St Joan reported that she was guided by voices and visions in which she communicated with venerated spiritual figures such as St Michael and St Margaret. Questions have arisen about the nature of these experiences, and various medical and psychiatric diagnoses have been offered by contemporary experts. In our effort to evaluate the diagnostic proposals, we have examined the incidence of voices and visions in the Middle Ages, and we have followed that with a review of nonpathologic voice-hearing in our own era. We then move on to an analysis of some proposed medical and psychiatric diagnoses, all of which we find unconvincing. With this background, we argue that St Joan does not warrant a medical or psychiatric diagnosis. Such a conclusion, however, leaves us with another issue, that of Joan's achievements. How do we understand an adolescent being able to lead an army? Addressing this question proves more difficult than deciding whether St Joan warrants a diagnosis. In addition to her achievements in the war against Britain, Joan of Arc stands out as both the most documented person in Western civilization up until her era, and as the only person who has been both condemned and canonized by the Catholic Church.
Reducing Team Burnout Through Enhanced Scope of Practice for Nursing Assistive Personnel
Authors: Zimmerman Alissa , Johnas Jennifer , Determan Amy C. , Cambern Kari , Gerlach Dayna
Published: April 2023

Persistent nursing workforce shortages, in conjunction with the COVID-19 pandemic and increased patient acuity, have led to increased utilization of nursing assistive personnel (NAP) within acute care settings. Although the work demand of NAPs continues to increase, their delegated work autonomy remains ambiguous and diverse. This lack of clarity impacts effective teamwork, collaboration, and delegation. This study successfully enhanced the scope of practice for NAPs, resulting in increased staff and patient satisfaction.
Niche conservatism and ecological change during the Late Devonian mass extinction
Authors: Brisson Sarah K. , Pier Jaleigh Q. , Beard J. Andrew , Fernandes Anjali M. , Bush Andrew M.
Published: April 2023

Studies of the fossil record can inform our understanding of not only the causes of mass extinctions, but also their effects on biodiversity, ecology and evolution. Here, we examine regional-scale ecological changes resulting from a Late Devonian mass extinction event using brachiopod fossil assemblages from the Appalachian Basin. About half of the species went extinct, but were largely replaced by new immigrant taxa. Both before and after the extinction, the primary gradient in faunal composition was correlated with onshore–offshore position, with a second gradient attributed to frequency of disturbance. Survivors of the extinction displayed a strong degree of niche conservatism along these gradients. Despite these indicators of ecological stability, the pre- and post-extinction faunas were quite distinct at the order level, with atrypids and strophomenids largely replaced by productids, whose spiny shells may have provided greater resistance to disturbance and/or predation. Thus, extinction survivors persisted in similar ecological niches despite environmental perturbations and considerable change in the taxonomic and ecological composition of the regional species pool.
Mitochondrial fatty acid synthesis is essential for coordinated energy transformation
Authors: Haumann Friederike , Evangelakos Ioannis , Worthmann Anna , Liebold Imke , Kotschi Stefan , Bischoff Almut Turid , Neuhofer Christiane M. , Schweizer Michaela , Heine Markus ,   the mitoNET consortium, Büchner Boriana , Klopstock Thomas , Prehn Cornelia , Dyar Kenneth Allen , Prokisch Holger , Bosurgi Lidia , Heeren Joerg , Bartelt Alexander , Kubisch Christian , Schlein Christian
Published: April 2023

Mitochondria warrant cellular energy demands by generating energy equivalents in central carbon metabolism. They are also able to newly synthesize fatty acids via mitochondrial fatty acid synthesis (mtFAS), however, the role of mtFAS for systemic metabolism has been poorly investigated. Here we show that mitochondrial Trans-2-Enoyl-CoA Reductase (MECR), a key enzyme of mtFAS, critically regulates cellular and systemic glucose and lipid homeostasis. In mice, liver or adipose tissue-specific deletion ofMecrreduces the capacity for aerobic glycolytic catabolism and lipogenesis and causes severe mitochondrial as well as fatal parenchymal organ dysfunction. Mechanistically, mtFAS is essential for pyruvate dehydrogenase activity, resulting in low NAD(P)H synthesis and reduced non-mitochondrial lipogenesis. In different human mitochondriopathies we further identify a dysregulation of mtFAS-associated lipid species, thus linking inherited mitochondrial disease to mtFAS. In summary, we introduce mtFAS as an important player in metabolic health via facilitating cellular glycolysis-derived metabolite transformation ultimately linking mtFAS to mitochondrial function and diseases.
Sensitivity analysis-guided Bayesian Parameter Estimation for Neural Mass Models: Applications in Epilepsy
Authors: Puthanmadam Subramaniyam Narayan , Hyttinen Jari
Published: April 2023

It is well established that neural mass models (NMMs) can effectively simulate the mesoscopic and macroscopic dynamics of electroencephalography (EEG), including epileptic EEG. However NMMs are characterized by a high-dimensional parameter space and a lack of knowledge on what NMM parameters can be reliably estimated, thus limiting their application to clinical EEG data. In this article, we analyze the parameter sensitivity of Jansen and Rit NMM (JR NMM) in order to identify the most sensitive NMM parameters for reliable parameter estimation from EEG data. We also propose a joint estimation method for NMM states and parameters based on expectation–maximization combined with unscented Kalman smoother (UKS-EM). Global sensitivity analysis methods including Morris method and Sobol method are used to perform sensitivity analysis. Results from both the Morris and Sobol method show that the average inhibitory synaptic gain,Band the time constant of the average inhibitory post-synaptic potentials (PSPs),b−1have significant impact on the JR NMM output along with having the least interaction with other model parameters. The UKS-EM method for estimating the parametersBandbis validated using simulations under varying levels of measurement noise. Finally we apply the UKS-EM algorithm to intracranial EEG data from 16 epileptic patients. Our results, both at individual and group-level show that the parametersBandbchange significantly between the pre-seizure and seizure period, and between the seizure and post-seizure period, with transition to seizure characterized by decrease in averageBand high frequency activity in seizure characterized by an increase inb. These results establish sensitivity analysis guided Bayesian parameter estimation as a powerful tool for reducing the parameter space of high dimensional NMMs enabling reliable and efficient estimation of the most sensitive NMM parameters, with the potential for online and fast tracking of NMM parameters in applications such as seizure tracking and control.
When and why does motor preparation arise in recurrent neural network models of motor control?
Authors: Schimel Marine , Kao Ta-Chu , Hennequin Guillaume
Published: April 2023

During delayed ballistic reaches, motor areas consistently display movement-specific activity patterns prior to movement onset. It is unclear why these patterns arise: while they have been proposed to seed an initial neural state from which the movement unfolds, recent experiments have uncovered the presence and necessity of ongoing inputs during movement, which may lessen the need for careful initialization. Here, we modelled the motor cortex as an input-driven dynamical system, and we asked what the optimal way to control this system to perform fast delayed reaches is. We find that delay-period inputs consistently arise in an optimally controlled model of M1. By studying a variety of network architectures, we could dissect and predict the situations in which it is beneficial for a network to prepare. Finally, we show that optimal input-driven control of neural dynamics gives rise to multiple phases of preparation during reach sequences, providing a novel explanation for experimentally observed features of monkey M1 activity in double reaching.
Syndecan-1 and thrombomodulin are early biomarkers for development of endotheliopathy in trauma and hemorrhagic shock
Authors: Chance Tiffani C. , Meledeo Michael A. , Cap Andrew P. , Darlington Daniel N. , Bynum James A. , Wu Xiaowu
Published: April 2023

The causes of endotheliopathy are multifactorial and trauma dependent, and the temporal mechanistic link that it has with acute traumatic coagulopathy (ATC) has yet to be fully determined. Therefore, we sought to define early characteristics and markers of endotheliopathy in two rat models, a time-course of acute lethal hemorrhage shock and polytrauma with hemorrhagic shock, to answer the following questions: (1) how soon can elevated biomarkers of endotheliopathy be detected in non-survivable (decompensated) hemorrhagic shock; (2) does extended hemorrhage time and accumulated hemorrhage impact biomarker levels; and (3) does the addition of polytrauma contribute to the further elevation of said biomarkers? In this study, we delineated a significant, acute elevation in end plasma levels of syndecan-1, thrombomodulin, and heparan sulfate, whose shedding patterns are a function of time as well as total hemorrhage volume vs. the addition of polytrauma. Additionally, we found that correlation of syndecan-1 and thrombomodulin to lactate levels and prothrombin times at trauma end revealed a potential for these markers to acutely predict downstream consequences of these trauma indications. Our results are of great relevance to the continued effort towards the identification and characterization of vascular dysfunction for early interventions in combat casualty care.
Optimal design of electrodes for functional electrical stimulation applications to single layer isotropic tissues
Authors: Cassar Mary Grace , Sebu Cristiana , Pidcock Michael , Chandak Shubham , Andrews Brian
Published: April 2023

Purpose

The purpose of this paper is to investigate the design of skin surface electrodes for functional electrical stimulation using an isotropic single layered model of the skin and underlying tissue. A concentric ring electrode geometry was analysed and compared with a conventional configuration, specifically to localise and maximise the activation at depth and minimise the peak current density at the skin surface.

Design/methodology/approach

The mathematical formulation determines the spatial electric potential distribution in the tissue, using the solution to the Laplace equation in the lower half space subject to boundary conditions given by the complete electrode model and appropriate asymptotic decay. Hence, it is shown that the electric potential satisfies a weakly singular Fredholm integral equation of the second kind which is then solved numerically in MATLAB for a novel concentric ring electrode configuration and the conventional two disk side-by-side electrode configuration.

Findings

In both models, the electrode geometry can be optimised to obtain a higher activation and lower maximum current density. The concentric ring electrode configuration, however, provides improved performance over the traditional two disk side-by-side electrode configuration.

Research limitations/implications

In this study, only a single layer of medium was investigated. A comparison with multilayer tissue models andin vivovalidation of numerical simulations are required.

Originality/value

The developed mathematical approaches and simulations revealed the parameters that influence nerve activation and facilitated the theoretical comparison of the two electrode configurations. The concentric ring configuration potentially may have significant clinical advantages.
Is satisfaction a moderator? The effect of sensory experience on perceived environmental sustainability and WOM: a study on the world's first organic state – Sikkim, India
Authors: Nukhu Rhulia , Singh Sapna
Published: April 2023

Purpose

The study seeks to analyze the influence of sensory experience on perceived environmental sustainability and word-of-mouth (WOM) of tourists and residents. The study also tests the moderation effect of satisfaction on the relationship between perceived environmental sustainability and WOM.

Design/methodology/approach

The study was conducted in Sikkim, a state in the northeastern part of India, which is regarded as the world's first organic state. The study was done in two phases. In the first phase, the data were collected from the tourists. And in the second phase, data were collected from the residents. A structured questionnaire was distributed to 700 tourists and residents in Sikkim. Out of these only 484 responses were considered for the study. Multivariate analyses were done using SPSS software and packages like Process Macro, and Amos to test the hypotheses.

Findings

The findings of the study indicated that sensory experience significantly influences perceived environmental sustainability and WOM. The study model fit with GFI = 0.955, CFI = 0.946 NFI = 0.929 and RMSEA = 0.07. The findings also indicate that satisfaction moderates the relation between sensory experience and word-of-mouth with apvalue = 0.018.

Research limitations/implications

The study was conducted in Sikkim and it used a convenience sampling method. Therefore, the study cannot be generalized.

Practical implications

An emphasis on building an organic brand image can positively impact the local community. A study of this kind will encourage the community to work toward sustainable development.

Originality/value

The study is unique as it explores the evaluation of destination environmental sustainability. And it is one of the first to test the impact of satisfaction in the relationship between the independent and dependent variables in the context of the tourism experience.
How does Salam financing affect farmers’ income? A system dynamics approach
Authors: Sifa Eka Nurhalimatus , Wiryono Sudarso Kaderi
Published: April 2023

Purpose

This study aims to simulate and compare the effect of two financing schemes, Salam and conventional financing, on farmers’ cash flows.

Design/methodology/approach

The system dynamics simulation is used to conduct a multiple scenario-driven analysis to understand the behavior and the dynamic patterns concerning relationships among the variables in the model that are chosen and parameterized using both qualitative and quantitative data collected from West Java, Indonesia.

Findings

The authors affirm that farmers cannot rely solely on paddy fields and should seek other livelihoods to support their daily needs. The main finding is that the Salam scheme provides a higher income that can contribute to improving farmer welfare. The Islamic scheme also requires less adjustment than the standard scheme to meet the farmers’ needs.

Research limitations/implications

The probable effect of implementing the Salam method is not considered from the point of view of the financiers, as the scope of the study is limited to farmers. Furthermore, the implications of this study and recommendations for future research are presented.

Originality/value

To the best of the authors’ knowledge, this study adds to the extensive literature on Salam financing by being among the first to provide a quantifiable evaluation of the Islamic method compared to its conventional counterpart.
Residential satisfaction with affordable housing in northern Iran
Authors: Ahmadi Ferial
Published: April 2023

Purpose

The current study is an attempt to investigate the residential satisfaction and prioritize effective components on residents' satisfaction based on household surveys conducted in eight Mehr housing complexes in Mazandaran province located in different counties of this region.

Design/methodology/approach

In the current work, using software of SmartPLS 3, second-order confirmatory factor analysis has been employed to evaluate and rank influential factors on residents' satisfaction.

Findings

As a result of descriptive analysis, 51.8% of the respondents were highly satisfied with Mehr housing complexes. Moreover, the results showed that there was the highest level of satisfaction (76.3%) with the security, while the lowest one (34.4%) was related to satisfaction with the facilities of the housing complexes. The standardized coefficients obtained showed that the components of physical characteristics (0.901), facility (0.863), neighborhood relationship (0.810), visual quality (0.774), security (0.737) and environmental health (0.715) have the most influence on the satisfaction of the residents, respectively.

Originality/value

This paper proved that migration has a significant effect on the level of residents' satisfaction, in multicultural cities. Therefore, it is crucial to promote social interaction and involvement among different ethnic groups in residential complexes that can result in intimacy, hence satisfying sociocultural needs, improving neighborhood relationships and consequent satisfaction of residents in Mehr housing projects in Iran.
A review on flexible dye-sensitized solar cells as new sustainable energy resources
Authors: Hosseinnezhad Mozhgan , Ranjbar Zahra
Published: April 2023

Purpose

The purpose of this paper is to introduce flexible dye-sensitized solar cells (FDSSCs).

Design/methodology/approach

In the third generation solar cells, glass was used as a substrate, which due to its high weight and fragility, was not possible to produce continuously. However, in flexible solar cells, flexible substrates are used as new technology. The most important thing may choose a suitable substrate to produce a photovoltaic (PV) device with optimal efficiency.

Findings

Conductive plastics or metallic foils are the two main candidates for glass replacement, each with its advantages and disadvantages. As some high-temperature methods are used to prepare solar cells, metal substrates can be used to prepare PV devices without any problems. In contrast to the advantage of high thermal resistance in metals, metal substrates are dark and do not transmit enough light. In other words, metal substrates have a high loss of photon energy. Like all technologies, PV devices with polymer substrates have technical disadvantages.

Practical implications

In this study, the development of FDSSCs offers improved photovoltaic properties.

Social implications

The most important challenge is the poor thermal stability of polymers compared to glass and metal, which requires special methods to prepare polymer solar cells. The second important point is choosing the suitable components and materials for this purpose.

Originality/value

Dependence of efficiency and performance of the device on the angle of sunlight, high-cost preparation devices components, limitations of functional materials such as organic-mineral sensitizers, lack of close connection between practical achievements and theoretical results and complicated fabrication process and high weight.
Enforced Disappearances and Torture Today: A View from Analytical Psychology
Authors: Luci Monica
Published: April 2023

In very rare cases, individuals survive the atrocities of abduction, imprisonment and torture that are part of the hallmark of enforced disappearances. Cases of people who survive torture and seek asylum in a third country help us understand some important aspects related to the crime of enforced disappearance.

In the psychotherapy of torture survivors, at an early stage and for a long time, words often do not convey the core of the patient’s experience. Survivors usually have tormented bodies in which individual and collective violence, hatred, anger, guilt and shame are painfully inscribed. Corporeal countertransference becomes the only possible way for a therapist to get in touch with a survivor’s experience through a kind of body‐to‐body communication.

The centrality of the body in these therapies suggests that the body is the involuntary recipient and container of mass political atrocities and, for this reason, the place where, in the case of horrific social violence, the possibility of social “knowing” is stored and can be retrieved. Thus, when it comes to forced disappearance, the determination of the relatives to get to the truth through the discovery of the remains of their disappeared demonstrates the importance of the body as the final witness of what happened, beyond any possible manipulation.
Confirming the identity of the Hypogeococcus species (Hemiptera: Pseudococcidae) associated with Harrisia martinii (Labour.) Britton (Cactaceae) in Australia: implications for biological control
Authors: Ezeh Angela E. , Hereward James P. , Day Michael D. , Taylor Tamara , Furlong Michael J.
Published: April 2023

Determining the identity of potential control agents is critical to successful biological control and can contribute to our understanding of the failures of previous introductions, especially in cases where host‐associated cryptic species may be present. In 1975, a mealybug was introduced into Australia from Argentina for the classical biological control of the invasive cactus Harrisia martinii (Cactaceae). This cactus also originates from Argentina and is an environmental and agricultural weed in parts of Australia. Since its release, the imported mealybug species has been incorrectly referred to as Hypogeococcus festerianus (Hemiptera: Pseudococcidae) in the applied literature, and its performance as a biological control agent has been considered poor in some locations. In this study, the identities of mealybug specimens collected from 10 locations in Queensland and New South Wales, Australia, were assessed. The genetic, morphological and reproductive characteristics of these specimens were compared with those of two congeneric mealybug species, Hypogeococcus pungens sensu stricto (Hemiptera: Pseudococcidae) and Hypogeococcus festerianus. Specimens from the different Australian localities examined were all very similar to each other morphologically and genetically, based on comparisons of mitochondrial and nuclear DNA sequence data. The morphological features of all the specimens were typical of Hypogeococcus pungens sensu stricto. H. pungens is now considered to constitute a species complex, and the specimens from Australia are genetically similar to the Cactaceae clade of this species complex from Argentina. In common with H. pungens s. s., the insects collected in Australia can also reproduce parthenogenetically. These findings help confirm that all populations of the mealybug in Australia are not H. festerianus, but part of the H. pungens cryptic species complex. There is no mismatch between this agent and the host plant in Australia, as H. martinii is one of the host plants of the most closely related cryptic species of H. pungens in the native range in Argentina. Thus, despite the original confusion around its identity, the variable performance of the introduced mealybug as a biological control agent of H. martini in Australia is likely due to other factors, and these require further investigation.
Timing of emergency caesareans – what's the rush? A retrospective multi‐centred observational study into decision‐to‐delivery interval and maternal and fetal outcomes
Authors: McIntyre Rachel , Maas Zak , Brenman Claire
Published: April 2023

This study primarily aims to investigate the relationship between decision‐to‐delivery interval (DDI) and fetal and maternal outcomes in patients undergoing an emergency caesarean section. A secondary aim was to investigate if any maternal or labour features adversely affected outcomes. Two‐hundred and forty‐six patients underwent an emergency caesarean section within a 9 month period. Outcomes considered included estimated blood loss, need for special care baby unit admission, need for neonatal resus in the form of continuous positive airway pressure and initial APGARs. A multivariate regression analysis was used. This study found no relation between DDI and outcomes.
ReSE‐Net: Enhanced UNet architecture for lung segmentation in chest radiography images
Authors: Agrawal Tarun , Choudhary Prakash
Published: April 2023

Automatic lung segmentation in the chest x‐ray is important for computer aided diagnosis. It helps in the surgical planning and diagnosis of pulmonary diseases. Lung shape, size, overlapped area, and opacities make lung segmentation arduous. In this article, we have proposed a UNet‐based model for lung segmentation. We have evaluated the model on difficult datasets that have chest radiographs of patients affected by tuberculosis and other severe abnormalities. Three chest radiography datasets and a CT‐scan dataset are used to prove the model generalization. The proposed model efficiently uses the residual learning and attention mechanisms to improve the segmentation results against the original UNet for the dice coefficient index (DCI) and Jaccard index. We have also performed an ablation study to highlight the impact of the attention mechanism in the proposed model. The model obtained a 97.62% DCI, 95.43% Jaccard index, and a 4.00 Hausdorff distance on the Montgomery County dataset. While on the Shenzhen and NIH datasets, it achieved a 95.71% and 95.75% DCI, 91.90% and 91.95% Jaccard index, and a 5.23 and 5.20 Hausdorff distance, respectively. The proposed model has achieved better or comparable performance against other state‐of‐the‐art models.
Antecedents of public‐sector auditors’ economic error communication: Evidence from Germany
Authors: Lindermüller David , Lindermüller Irina , Nitzl Christian , Hirsch Bernhard
Published: April 2023

Traditionally, public‐sector auditors are concerned with auditing the legality and regularity of government activities (compliance audits). However, such auditors are increasingly expected to conduct “performance audits” and communicate economic errors due to inefficiency, ineffectiveness, and poor economic decisions to the auditee. This type of role change is often accompanied by role stress. This study explores whether role stress—role conflict and role ambiguity—among local public‐sector auditors and their perception of their new business partner role are precursors of their communication of detected economic errors to their auditees. Therefore, survey data from German local public sector auditors (i.e., municipalities and counties) are gathered and analyzed. Our results show that compare to those in other organizations, auditors who work in more formalized public‐sector audit organizations are less likely to experience role ambiguity and role conflict and to communicate auditees’ economic errors more actively. Furthermore, we find that auditors who do not experience role ambiguity find it easier to see themselves as a business partner of the auditee and show more active economic error communication. The present study informs the literature on performance auditing by transferring the business partner concept to the context of public‐sector auditing and applying a role theory perspective to reveal drivers of economic error communication.
Rapid detection of insect pest with CRISPR‐Cas13a‐Based Lateral Flow Strip: Using Locusta migratoria manilensis
Authors: Zhang Liu , Yang Lijun , Li Hongwei , Yu Yanxue , Zhai Junfeng
Published: April 2023

The Clustered Regularly Interspaced Short Palindromic Repeats‐associated (CRISPR‐Cas) system has been used as a powerful diagnostic tool because of its trans‐cleavage ability to accurately recognize and cleave specific nucleic acid targets. However, its application in insect pest detection has rarely been reported. The aim of the current study was to develop a new molecular identification method for insect based on CRISPR‐Cas13a system. In this study, we have developed a highly specific and sensitive detection system that combines polymerase chain reaction, CRISPR‐Cas13a system and lateral flow dipstick (PCR‐Cas13a‐LFD) to rapidly detect the presence of Locusta migratoria manilensis (Orthoptera: Acrididae) DNA and discriminate it from other species, by using material from different stages of development. A pair of specific primers and crRNA were designed based on the Gene DEAD‐box DDX10 mRNA sequence. For visual readout, a FAM‐RNA‐biotin reporter was used for detection. The CRISPR‐Cas13a‐based detection method utilizes the visual identification of L. migratoria manilensis at different developmental stages or with the use of incomplete samples. The test results could be distinguished within 2 h. The sensitivity of the PCR‐Cas13a‐LFD detection system reached 0.1 ng/μL, a 10‐fold increase compared with that of the PCR with electrophoresis. The LFD coupled with CRISPR‐Cas13a (Cas13a‐LFD) is promising for the portable, onsite and fast identification of insect pests. This study provides a reference for the development of a new method for insect identification.