bluuebunny/crossref_metadata_2025 huggingface dataset:
Resilient banking: model-based assessment of business continuity policies on commercial banks
Authors: Bastan Mahdi , Tavakkoli-Moghaddam Reza , Bozorgi-Amiri Ali
Published: August 2023

Purpose

Commercial banks face several risks, including credit, liquidity, operational and disruptive risks. In addition to these risks that are challenging for banks to control and manage, crises and disasters can exert substantially more destructive shocks. These shocks can exacerbate internal risks and cause severe damage to the bank's performance, leading banks to bankruptcy and closure. This study aims to facilitate achieving resilient banking policies through a model-based assessment of business continuity management (BCM) policies.

Design/methodology/approach

By applying a system dynamics (SD) methodology, a systemic model that includes a causal structure of the banking business is presented. To build a simulation model, data are collected from a commercial bank in Iran. By presenting the simulation model of the bank's business, the consequences of some given crises on the bank's performance are tested, and the effectiveness of risk and crisis management policies is evaluated. Vensim Personal Learning Edition (PLE) software is used to construct the simulation model.

Findings

Results indicate that the current BCM policies do not show appropriate resilience in the face of various crises. Commercial banks cannot create sustainable value for the banks' shareholders despite the possibility of profitability, as the shareholders lack adequate resilience and soundness. These commercial banks do not have the appropriate resilience for the next pandemic after coronavirus disease 2019 (COVID-19). Moreover, the robustness of the current banking business model is very fragile for the banking run crisis.

Practical implications

A forward-looking view of resilient banking can be obtained by combining liquidity coverage, stable funding, capital adequacy and insights from stress tests. Resilient banking requires a balanced combination of robustness, soundness and profitability.

Originality/value

The present study is a combination of bank business management, risk and resilience management and SD simulation. This approach can analyze and simulate the dynamics of bank resilience. Additionally, present of a decision support system (DSS) to analyze and simulate the outcomes of different crisis management policies and solutions is an innovative approach to developing effective and resilient banking policies.
Exploring local job seekers perception toward employment in the private and public sectors in Qatar: implications for workforce nationalization policies
Authors: Elsharnouby Tamer H. , Elbanna Said , Obeidat Shatha M. , Mauji Nasrina Issa
Published: August 2023

Purpose

The influx of expatriates to the Gulf Cooperation Council (GCC) countries has led to labor imbalance inducing these countries to initiate workforce nationalization policies. However, despite the policies' emphasis on increasing the presence of nationals in all sectors, employing nationals in the private sector is still a critical challenge for policymakers. This paper explores local job seekers' and employees' perceptions of employment choices in the private and public sectors.

Design/methodology/approach

Adopting a qualitative approach, data were collected through in-depth interviews with 28 local job seekers, either not currently employed or employed but seeking another job.

Findings

The data revealed a contextualized understanding of positive and negative connotations pertaining to employment in the private and public sectors in Qatar.

Research limitations/implications

Understanding nationals' negative preconceived notions against working in the private sector and the perceived benefits of public sector employment lays the groundwork for developing measures to help policymakers to create labor market-oriented policies that stimulate mobility between the public and private sectors.

Originality/value

This study contributes to the workforce nationalization literature in the GCC countries by examining local job seekers' perceptions associated with employment in the private sector and the public sector. A closer examination of why nationals are hesitant to enter the private sector can propel the pendulum towards higher success rates of workforce nationalization.
A novel optimization framework for minimizing the surface roughness while increasing the material processing rate in the SLM process of 316L stainless steel
Authors: La Fé-Perdomo Iván , Ramos-Grez Jorge Andres , Quiza Ramón , Jeria Ignacio , Guerra Carolina
Published: August 2023

Purpose

316 L stainless steel alloy is potentially the most used material in the selective laser melting (SLM) process because of its versatility and broad fields of applications (e.g. medical devices, tooling, automotive, etc.). That is why producing fully functional parts through optimal printing configuration is still a key issue to be addressed. This paper aims to present an entirely new framework for simultaneously reducing surface roughness (SR) while increasing the material processing rate in the SLM process of 316L stainless steel, keeping fundamental mechanical properties within their allowable range.

Design/methodology/approach

Considering the nonlinear relationship between the printing parameters and features analyzed in the entire experimental space, machine learning and statistical modeling methods were defined to describe the behavior of the selected variables in the as-built conditions. First, the Box–Behnken design was adopted and corresponding experimental planning was conducted to measure the required variables. Second, the relationship between the laser power, scanning speed, hatch distance, layer thickness and selected responses was modeled using empirical methods. Subsequently, three heuristic algorithms (nonsorting genetic algorithm, multi-objective particle swarm optimization and cross-entropy method) were used and compared to search for the Pareto solutions of the formulated multi-objective problem.

Findings

A minimum SR value of approximately 12.83 μm and a maximum material processing rate of 2.35 mm3/s were achieved. Finally, some verification experiments recommended by the decision-making system implemented strongly confirmed the reliability of the proposed optimization methodology by providing the ultimate part qualities and their mechanical properties nearly identical to those defined in the literature, with only approximately 10% of error at the maximum.

Originality/value

To the best of the authors’ knowledge, this is the first study dealing with an entirely different and more comprehensive approach for optimizing the 316 L SLM process, embedding it in a unique framework of mechanical and surface properties and material processing rate.
Scaling‐up RADseq methods for large datasets of non‐invasive samples: Lessons for library construction and data preprocessing
Authors: Arantes Larissa S. , Caccavo Jilda A. , Sullivan James K. , Sparmann Sarah , Mbedi Susan , Höner Oliver P. , Mazzoni Camila J.
Published: August 2023

Genetic non‐invasive sampling (gNIS) is a critical tool for population genetics studies, supporting conservation efforts while imposing minimal impacts on wildlife. However, gNIS often presents variable levels of DNA degradation and non‐endogenous contamination, which can incur considerable processing costs. Furthermore, the use of restriction‐site‐associated DNA sequencing methods (RADseq) for assessing thousands of genetic markers introduces the challenge of obtaining large sets of shared loci with similar coverage across multiple individuals. Here, we present an approach to handling large‐scale gNIS‐based datasets using data from the spotted hyena population inhabiting the Ngorongoro Crater in Tanzania. We generated 3RADseq data for more than a thousand individuals, mostly from faecal mucus samples collected non‐invasively and varying in DNA degradation and contamination level. Using small‐scale sequencing, we screened samples for endogenous DNA content, removed highly contaminated samples, confirmed overlap fragment length between libraries, and balanced individual representation in a sequencing pool. We evaluated the impact of (1) DNA degradation and contamination of non‐invasive samples, (2) PCR duplicates and (3) different SNP filters on genotype accuracy based on Mendelian error estimated for parent–offspring trio datasets. Our results showed that when balanced for sequencing depth, contaminated samples presented similar genotype error rates to those of non‐contaminated samples. We also showed that PCR duplicates and different SNP filters impact genotype accuracy. In summary, we showed the potential of using gNIS for large‐scale genetic monitoring based on SNPs and demonstrated how to improve control over library preparation by using a weighted re‐pooling strategy that considers the endogenous DNA content.
Tendências e lacunas na literatura sobre palmeiras nativas da Mata Atlântica Brasileira
Authors: Cerqueira Amanda Freitas , Benchimol Maíra , Sousa‐Santos Catriane , Bezerra Inajara Marques , dos Santos Martielly Santana , Dalmolin Ândrea Carla , Gaiotto Fernanda Amato , Mielke Marcelo Schramm
Published: August 2023

As palmeiras (Arecaceae) exercem grande relevância na estrutura e funcionamento dos ecossistemas de florestas tropicais, além de compreenderem recursos‐chave para animais frugívoros. Entretanto, muitas espécies estão atualmente em risco de extinção devido à superexploração e/ou perda de habitat. Nosso estudo visou realizar uma revisão sistemática com uma abordagem cientométrica de todas as 78 espécies de palmeiras nativas da Mata Atlântica brasileira, buscando identificar as espécies e regiões mais bem estudadas, principais tópicos estudados, padrões gerais, tendências e lacunas na pesquisa científica associada a esta família botânica. No total, foram realizados estudos para 48 espécies pertencentes a 10 gêneros, com o número de estudos aumentando exponencialmente a partir dos anos 70 e exibindo grande diferença no número de publicações entre as espécies. Euterpe edulis foi a espécie mais estudada (n = 274), seguida por Acrocomia aculeata (n = 205), enquanto Bactris bahiensis (1), Geonoma litoralis (1), Syagrus santosii (1) e Trithrinax acanthocoma (0) foram as espécies menos estudadas. O maior número de estudos foi realizado nos estados do sudeste do Brasil. Com relação ao tipo de estudos, 34% e 27% estavam relacionados a propriedades bioquímicas e processos ecológicos, respectivamente, enquanto os estudos sobre entomologia (n = 26), cultura de tecidos (n = 23) e taxonomia (n = 7) representaram o menor número. Dado o papel fundamental das palmeiras nas florestas tropicais, nosso estudo sugere que as pesquisas futuras devem se concentrar em espécies menos estudadas, incluindo Desmoncus spp., Geonoma spp. e Trithrinax sp. e em algumas áreas menos estudadas, como a porção nordeste da Mata Atlântica.
Detection of severe congenital heart defects in live‐born infants in Norway 2017–2020
Authors: Wik Gunnar , Jortveit Jarle , Sitras Vasilis , Perminow Karl Viktor , Pripp Are Hugo , Døhlen Gaute , Rønnestad Arild , Holmstrøm Henrik
Published: August 2023

Aim

The aims of this nationwide retrospective cohort study were to determine the time and causes of detection of severe congenital heart defects (CHDs) in live‐born infants in Norway between 2017 and 2020.

Methods

Information regarding live‐born infants with severe CHDs was retrieved from national registries and medical records.

Results

A total of 219 776 infants were born in Norway from 01.01.2017 to 31.12.2020. Severe CHDs were diagnosed in 442 (0.2%) infants. Of these, 376 (85%) infants were diagnosed either prenatally (n = 203, 46%) or before discharge from hospital after birth (n = 173, 39%). A total of 56 (13%) infants were discharged with undetected CHDs. Time of detection was unknown in 10 cases (2%). The most frequent undetected CHDs at discharge were coarctation of the aorta/aortic arch hypoplasia (n = 24), atrioventricular septal defect (n = 13), anomalous pulmonary venous connection (n = 5) and coronary artery anomalies (n = 4). Seven (13%) children with undetected CHD experienced circulatory collapse out of hospital.

Conclusion

Most infants with severe CHDs in Norway were identified prior to hospital discharge. However, some infants were discharged undiagnosed. Awareness of undetected CHDs and immediate cardiac assessment in infants with signs of circulatory failure early in life are still important.
Prematurity has no impact on the quality of parents' sleep 6 months after birth
Authors: Langlois‐D'Estaintot Hortense , Pellae Elisabeth , Rioualen Stéphane , Sizun Jacques , Roué Jean‐Michel
Published: August 2023

Aim

Due to the stress that is classically associated with the premature birth of a child, these parents may be prone to sleep disorders. The aim of this study was to compare sleep quality of preterm infants' parents with that of term infants' parents.

Methods

Prospective observational cohort study conducted at the University Hospital of Brest between January 2019 and January 2021. The primary outcome criterion was the score obtained by the parents on the Pittsburg Sleep Quality Index (PSQI) 6 months after their child's birth. Each parent was recruited in the days following their child's birth and completed the PSQI online.

Results

Overall, 316 parents were included. The median gestational age at birth was 34.3 (31.6–35.5) weeks in the preterm infant group and 39.7 (38.6–40.7) weeks in the term infant group. Of the 948 expected questionnaires, 771 were completed and collected. On average, 59% of the parents obtained a PSQI global score >5. Six months after birth, no differences were reported between parents of preterm and full‐term infants.

Conclusion

This study did not reveal any difference between sleep quality of preterm infants' parents and term infants' parents.
Successful rehabilitation and release of a powerful owl chick with suspected rodenticide poisoning
Authors: Cooke R , Carter N , Groves J , Scarfe N , Mason P , White JG
Published: August 2023

The successful rehabilitation and release of raptor chicks can be challenging, especially when the chicks are still in the post‐fledging dependency period. Here, we report on a recently fledged powerful owl chick that was held in care for 33 days before being successfully reunited with its parents. We document the steps undertaken during the entire process from collection from the wild to post‐release monitoring and recommend clinical procedures for treatment of raptors entering veterinary facilities. Success of this rehabilitation was facilitated by early care and treatment for potential rodenticide poisoning, as well as the integration of citizen scientists monitoring the family unit in the field while the chick was in care and during the post‐release period. Given the emerging evidence of widespread rodenticide poisoning in raptors both in Australia and globally, it is critical to suspect all raptors may have been exposed to anticoagulant rodenticides and commence treatment with vitamin K immediately. Routine treatment for rodenticides early increases the probability of successful recovery post‐trauma as well as reducing the time in treatment as much as possible.
Markers of refractory primary immune thrombocytopenia
Authors: Moulis Guillaume , Garabet Lamya
Published: August 2023

Refractory immune thrombocytopenia (ITP) is a challenging disease that can be defined by refractoriness to second‐line treatments. In this review, we list and comment available evidence about clinical and biological factors associated with refractoriness to splenectomy, thrombopoietin receptor agonists (TPO‐RAs), rituximab and fostamatinib, as well as those associated with multirefractory ITP (active disease with failure of rituximab, TPO‐RAs and splenectomy).
Item Selection Algorithm Based on Collaborative Filtering for Item Exposure Control
Authors: Pan Yiqin , Livne Oren , Wollack James A. , Sinharay Sandip
Published: August 2023

In computerized adaptive testing, overexposure of items in the bank is a serious problem and might result in item compromise. We develop an item selection algorithm that utilizes the entire bank well and reduces the overexposure of items. The algorithm is based on collaborative filtering and selects an item in two stages. In the first stage, a set of candidate items whose expected performance matches the examinee's current performance is selected. In the second stage, an item that is approximately matched to the examinee's observed performance is selected from the candidate set. The expected performance of an examinee on an item is predicted by autoencoders. Experiment results show that the proposed algorithm outperforms existing item selection algorithms in terms of item exposure while incurring only a small loss in measurement precision.
Incisional complications after skin closure with stainless‐steel skin staples compared to nylon sutures in horses undergoing colic surgery
Authors: Haion Orr , Tatz Amos J. , Dahan Roee , Harel Shiran , Sutton Gila Abells , Kelmer Gal
Published: August 2023

Background

Incisional complications following ventral midline celiotomy represent a challenge for equine surgeons. Preventative measures to minimise risks of incisional complications are continuously being investigated. This includes the search for an ideal surgical closure method.

Objective

To compare the incidence of incisional complications after skin closure with nylon sutures versus stainless‐steel skin staples (SSS) following ventral midline celiotomy for colic surgery in horses and to assess additional risk factors for incisional complications.

Study design

Prospective blinded randomised study (2012–2014).

Methods

One hundred and twenty‐three horses that underwent colic surgery between May 2012 and May 2014 and survived for >2 weeks were included in the study. Horses were allocated randomly to two groups—65 horses were closed with skin staples, and 58 horses were closed with skin sutures (nylon‐0). Patient records and a follow‐up questionnaire were used to record incisional complications that occurred during hospitalisation and after discharge.

Results

Follow‐up information was available in 119 of 123 horses. Four horses without follow‐up were excluded. With strict inclusion criteria, incisional drainage was recorded in 43% (49/115) of the horses, including 40% (25/63) of the surgical staples skin closure group and 46% (24/52) of the nylon suture skin closure group. Pregnancy and large colon intestinal lesions were risk factors for incisional complications. Surgeon 3 was found to decrease the incidence of incisional infection. No association was detected between incisional complications and hernia development.

Main limitations

The non‐uniformity of the follow‐up examination; reliance on owners or caregiver of the horse for follow‐up information, horses lost to follow‐up, incomplete data. Another limitation was the single‐centre design of the study.

Conclusions

Although not significantly superior, the use of staples may serve as a valid alternative for ventral midline abdominal incision skin closure.
THE FULL RECESSION: PRIVATE VERSUS SOCIAL COSTS OF COVID‐19
Authors: Cordoba Juan‐Carlos , Ripoll Marla , Yang Siqiang
Published: August 2023

2020 official recession figures ignore the costs associated with the loss of human life due to COVID‐19. This article constructs full recession measures that consider the death toll. Our model features nonexpected utility, leisure, age‐specific survival rates, and tractable heterogeneity. We find an average full recession of 10.7%, which reflects the net value of an aggregate drop in consumption of 2.7%, an average increase of 197 leisure hours and about 540,000 lives lost in the first pandemic year. The full recession for a utilitarian planner is 14.5%, which aligns with that of individuals in their late 50s.
Five decades of self‐congruity in consumer behaviour research: A systematic review and future research agenda
Authors: Kolańska‐Stronka Magdalena , Singh Balgopal
Published: August 2023

The conceptualization of self‐congruity is more than five decades old. However, the research on its effect on consumer behaviour is still evolving, ensuing the literature developed being fragmented and dispersed. This concern state‐of‐art summarization of the literature to consolidate knowledge on self‐congruity. The purpose of this review article is to structure the self‐congruity literature on understanding consumer behaviour developed over five decades in terms of significant theories, contexts, frameworks, and methodologies. This review also aims to provide an integrative research model and outline future research directions. To this end, Scientific procedure and rationales for systematic literature reviews (SPAR‐4‐SLR) protocol with the lens of the Theory, Context, Characteristics, Methods (TCCM) framework was adopted for review procedure. The review was conducted with a corpus containing 339 research articles on exploring self‐congruity facets and its effect on consumer behaviour published between 1973 and 2022. The findings are reported using TCCM convention adopting inductive approach. Further, based on the review findings, an integrative model of self‐congruity is put forth summarizing the research frameworks and constructs adopted as antecedents, modifiers, and implications in investigating self‐congruity effect on consumer behaviour. This review paper concludes recommending future research agendas with the intention of expanding self‐congruity research in emerging contexts applying cutting‐edge methodology.
Discrepancy between recipient and donor rs4364254 heparanase single nucleotide polymorphism impacts graft‐versus‐host disease after allogeneic stem cell transplant
Authors: Metafuni Elisabetta , Giammarco Sabrina , Bellesi Silvia , Rossi Monica , Minnella Gessica , Limongiello Maria Assunta , Valentini Caterina Giovanna , Teofili Luciana , Sica Simona , Chiusolo Patrizia
Published: August 2023

Introduction

The heparanase (HPSE) gene is highly polymorphic, but only a minority of its single nucleotide polymorphisms (SNPs) have been studied. Among these, rs4693608 and rs4364254 SNPs are closely associated with mRNA expression and HPSE protein levels in healthy subjects. Given the association between HPSE and inflammatory response, we aimed to evaluate whether HPSE rs4693608 and rs4364254 SNPs could have an impact on graft‐versus‐host disease after allogeneic stem cell transplants (HSCT).

Methods

A total of 228 consecutive patients who underwent HSCT at our center between 2005 and 2018 were included. The rs4693608 SNP was identified by polymerase chain reaction‐restriction fragment length polymorphism (PCR‐RFLP) analysis, while the rs4364254 was detected by allele‐specific amplification.

Results

The recipient‐donor discrepancy for rs4364254 HPSE SNP was significantly associated with grade II‐IV aGvHD (HR 1.75, p = 0.03). Patients were stratified into risk groups as follows: low‐risk group (LDR) including TT‐TT, TT‐CT, CT‐TT, CC‐CC; high‐risk group (HDR) including CC‐CT, CC‐TT, CT‐CC, CT–CT, TT‐CC. Day 100 cumulative incidence of grade II‐IV aGvHD was 23.4% in the LDR group and 41.4% in the HDR group (p = 0.01). One‐year cumulative incidence of moderate/severe cGvHD was 42.6% in the LDR group and 58.6% in the HDR group (p = 0.04). Independent variables for moderate/severe cGvHD in patients who received myeloablative conditioning included donor rs4693608 SNP (GA/AA vs. GG: HR 6.86, p = 0.008), rs4693608‐rs4364254 SNP combination in recipient (HR/MR vs. LR: HR 3.67, p = 0.01), and previous grade II‐IV aGvHD (HR 3.28, p = 0.0005). Finally, donors with rs4364254 SNP CC conferred increased transplant‐related mortality (TRM) (39.1% vs. 25%, p = 0.03) and decreased graft‐relapse free survival (GRFS) (23.5% vs. 34.4%, p = 0.04) compared with CT or TT genotypes.

Conclusion

The differences in incidence of GvHD according to recipient‐donor genotype combinations suggests a possible role for rs4364254 HPSE SNP in predicting GvHD. A high level of HPSE, particularly linked to CC genotype of rs4364254 SNP may promote alloreactive T lymphocytes activation and migration toward target organs.
Avicularin alleviates acute liver failure by regulation of the TLR4/MyD88/NF‐κB and Nrf2/HO‐1/GPX4 pathways to reduce inflammation and ferroptosis
Authors: Shi Pei , Zhu Wentao , Fu Jiwei , Liang An , Zheng Ting , Wen Zhilong , Wu Xincheng , Peng Yuchen , Yuan Songsong , Wu Xiaoping
Published: August 2023

Acute liver failure (ALF) is an inflammation‐mediated hepatocyte death process associated with ferroptosis. Avicularin (AL), a Chinese herbal medicine, exerts anti‐inflammatory and antioxidative effects. However, the protective effect of AL and the mechanism on ALF have not been reported. Our in vivo results suggest that AL significantly alleviated lipopolysaccharide (LPS)/D‐galactosamine (D‐GalN)‐induced hepatic pathological injury, liver enzymes, inflammatory cytokines, reactive oxygen species and iron levels and increased the antioxidant enzyme activities (malondialdehyde and glutathione). Our further in vitro experiments demonstrated that AL suppressed inflammatory response in LPS‐stimulated RAW 264.7 cells via blocking the toll‐like receptor 4 (TLR4)/myeloid differentiation protein‐88 (MyD88)/nuclear factor kappa B (NF‐κB) pathway. Moreover, AL attenuated ferroptosis in D‐GalN‐induced HepG2 cells by activating the nuclear factor erythroid 2‐related factor 2 (Nrf2)/heme oxygenase 1 (HO‐1)/glutathione peroxidase 4 (GPX4) pathway. Therefore, AL can alleviate inflammatory response and ferroptosis in LPS/D‐GalN‐induced ALF, and its protective effects are associated with blocking TLR4/MyD88/NF‐κB pathway and activating Nrf2/HO‐1/GPX4 pathway. Moreover, AL is a promising therapeutic option for ALF and should be clinically explored.
A potential growth thermal index for estimating juvenile Atlantic salmon (Salmo salar) size‐at‐age across geographical scales
Authors: Ouellet‐Proulx Sébastien , Daigle Anik , St‐Hilaire André , Gillis Carole‐Anne , Linnansaari Tommi , Dauphin Guillaume , Bergeron Normand Émile
Published: August 2023

We present a potential growth thermal index (PGTI) and assess its correlation with juvenile Atlantic salmon Salmo salar fork length data collected near the end of the growth season in a range of latitudinal locations and geographic scales (watershed, regional, continental) across the American north‐east. The PGTI is based on two components: a water temperature‐dependent growth curve and a water temperature time series continuously describing the thermal environment preceding fish sampling. Testing various shapes and characteristics of the temperature–growth curve against fish length data revealed strong positive correlations for all combinations. PGTI warming, calculated only from the beginning of the growth season until maximum summer temperature is reached, consistently performed well in explaining fish size‐at‐age across the latitudinal gradient and the three geographic scales that were considered. Varying thermal contrasts created by repeat subsampling of the dataset showed that fish length is better explained by the level of thermal contrast within the dataset than the geographical scale of analysis. A simple generalized linear model using a log link function with PGTI warming, fish density and water discharge as predictors explained 87% of the variance of size‐at‐age of 0+ and 1+ juvenile Atlantic salmon.
Epidemiological characteristics of pressure injury and the predictive validity of Braden scale among the older hospitalized patients: A cross‐sectional study
Authors: Fu Hongqiong , She Dongli , Zhang Hongyan , Guo Jiali , Zhang Guoli , Ma Yuxia , Han Lin
Published: August 2023

Aims and Objectives

To investigate the epidemiological characteristics of pressure injury (PI) in older inpatients and predictive validity of the Braden scale.

Design

Cross‐sectional study.

Methods

Conducted in a 2600‐bed tertiary hospital in Northwestern China from January to June 2022, the study included older patients (≥60 years). The Braden scale was used for the risk assessment of PI, and the epidemiological characteristics of PI were observed. The contributing factors of PI in older inpatients were examined using univariate and multiple or multivariable logistic regression analysis. The predictive validity and optimal cut‐off value were assessed using receiver operating curve (ROC).

Results

The study included 13,064 older patients, with a PI incidence of 0.20%, with the highest incidence (0.95%) in those aged ≥80. Age, BMI, Braden score and length of hospital stay were related to PI occurrence. The Braden scale showed an AUC of 0.905 for predicting PI in older inpatients, with a sensitivity of 84.6% and specificity of 86.4%. The optimal cut‐off value of 19 yielded the best predictive performance with a Yoden index of 0.710.

Conclusion

PI is most likely to occur in older inpatients with older age, longer hospital stay, lower BMI and Braden score. The Braden scale demonstrated good suitability for predicting PI risk in this population, with an optimal cut‐off value of 19 showing improved predictive accuracy.

Patient or Public Contribution

Throughout the investigation, patients or family members cooperated to complete all data investigation and evaluation, and nurses assisted in PI risk assessment, skin evaluation and other work.
Stony coral tissue loss disease intervention with amoxicillin leads to a reversal of disease‐modulated gene expression pathways
Authors: Studivan Michael S. , Eckert Ryan J. , Shilling Erin , Soderberg Nash , Enochs Ian C. , Voss Joshua D.
Published: August 2023

Stony coral tissue loss disease (SCTLD) remains an unprecedented disease outbreak due to its high mortality rate and rapid spread throughout Florida's Coral Reef and wider Caribbean. A collaborative effort is underway to evaluate strategies that mitigate the spread of SCTLD across coral colonies and reefs, including restoration of disease‐resistant genotypes, genetic rescue, and disease intervention with therapeutics. We conducted an in‐situ experiment in Southeast Florida to assess molecular responses among SCTLD‐affected Montastraea cavernosa pre‐ and post‐application of the most widely used intervention method, CoreRx Base 2B with amoxicillin. Through Tag‐Seq gene expression profiling of apparently healthy, diseased, and treated corals, we identified modulation of metabolomic and immune gene pathways following antibiotic treatment. In a complementary ex‐situ disease challenge experiment, we exposed nursery‐cultured M. cavernosa and Orbicella faveolata fragments to SCTLD‐affected donor corals to compare transcriptomic profiles among clonal individuals from unexposed controls, those exposed and displaying disease signs, and corals exposed and not displaying disease signs. Suppression of metabolic functional groups and activation of stress gene pathways as a result of SCTLD exposure were apparent in both species. Amoxicillin treatment led to a ‘reversal’ of the majority of gene pathways implicated in disease response, suggesting potential recovery of corals following antibiotic application. In addition to increasing our understanding of molecular responses to SCTLD, we provide resource managers with transcriptomic evidence that disease intervention with antibiotics appears to be successful and may help to modulate coral immune responses to SCTLD. These results contribute to feasibility assessments of intervention efforts following disease outbreaks and improved predictions of coral reef health across the wider Caribbean.
Sink–source imbalance triggers delayed photosynthetic induction: Transcriptomic and physiological evidence
Authors: Ozawa Yui , Tanaka Aiko , Suzuki Takamasa , Sugiura Daisuke
Published: August 2023

Sink–source imbalance causes accumulation of nonstructural carbohydrates (NSCs) and photosynthetic downregulation. However, despite numerous studies, it remains unclear whether NSC accumulation or N deficiency more directly decreases steady‐state maximum photosynthesis and photosynthetic induction, as well as underlying gene expression profiles. We evaluated the relationship between photosynthetic capacity and NSC accumulation induced by cold girdling, sucrose feeding, and low nitrogen treatment in Glycine max and Phaseolus vulgaris. In G. max, changes in transcriptome profiles were further investigated, focusing on the physiological processes of photosynthesis and NSC accumulation. NSC accumulation decreased the maximum photosynthetic capacity and delayed photosynthetic induction in both species. In G. max, such photosynthetic downregulation was explained by coordinated downregulation of photosynthetic genes involved in the Calvin cycle, Rubisco activase, photochemical reactions, and stomatal opening. Furthermore, sink–source imbalance may have triggered a change in the balance of sugar‐phosphate translocators in chloroplast membranes, which may have promoted starch accumulation in chloroplasts. Our findings provide an overall picture of photosynthetic downregulation and NSC accumulation in G. max, demonstrating that photosynthetic downregulation is triggered by NSC accumulation and cannot be explained solely by N deficiency.
A comparative evaluation of video modeling and social stories for improving oral hygiene in children with autism spectrum disorder: A pilot study
Authors: Gandhi Roopa , Jackson Jennifer , Puranik Chaitanya P.
Published: August 2023

Introduction

The purpose of this pilot study was to compare video modeling (VM) to a toothbrushing social story (TSS) for improving oral hygiene in children with autism spectrum disorder (ASD).

Methods

Four to 17‐year‐old children and adolescents with ASD were evaluated at a pre‐intervention visit for quality of oral hygiene using plaque and gingival indices. A pre‐intervention survey assessed caregivers' perceptions of their children's daily oral hygiene practices. Participants were randomized into VM or TSS groups and caregivers received daily emails to access a VM or TSS presentation when completing toothbrushing for their child for 30 days. At the one‐month visit, oral hygiene was re‐evaluated, and post‐intervention surveys were completed.

Results

There were significant improvements in plaque and gingival scores for VM (0.68 ± 0.20; 0.59 ± 0.15) and TSS (0.50 ± 0.11; 0.40 ± 0.10) groups at post‐intervention compared to pre‐intervention visits. No significant improvements in plaque or gingival scores were noted between the VM and TSS groups. Caregivers’ perceptions regarding oral hygiene acceptance by their children was promising for the VM group.

Conclusions

VM and TSS interventions improved oral hygiene in subjects with ASD. There was greater acceptance of daily oral hygiene in the VM compared to the TSS group.
Clinical presentations of suicidality in relation to medical assistance in dying
Authors: Baylis Peter , Shaw Jessica , Schatzmann Ella‐Jean , Pouliot Veronique , Lalonde Lise
Published: August 2023

Introduction

This study explores the assessments of mental health clinicians working with suicidal patients who requested access to medical assistance in dying (MAiD).

Methods

A sample of convenience completed an online questionnaire about their experiences with suicidal patients. Respondents described their encounters with 227 suicidal patients: 44 requested access to MAiD, and 183 did not. Data were analyzed using chi‐squared and simple t‐test to identify differences between the respondents’ descriptions of the two groups.

Results

Results noted differences between patients who experience suicide ideation and request MAiD (SPM), and those who experience suicide ideation and do not (SP). Overall, the SPM group was older, more physical health concerns, chronic pain, existential distress, and less hope. Many had experienced several episodes of mental health care and medication trials, though unlike the SP group, they had a split between accessing a little care and a lot of care. They also engaged in less suicide planning, and some had no history of suicide attempts.

Conclusion

It is important that mental health clinicians learn to differentiate between MAiD requests due to an ongoing and irremediable mental disorder, and MAiD requests in response to circumscribed psychological suffering that could be relieved via a change in circumstances and/or access to different treatment options amenable to the patient.
The SOAP Feedback Training Program
Authors: Chokshi Binny , Battista Alexis , Merkebu Jerusalem , Hansen Shana , Blatt Benjamin , Lopreiato Joseph
Published: August 2023

Background

Accessible and efficient opportunities for health professional faculty to hone feedback skills are limited. In addition, feedback models to apply to the objective structured clinical examination (OSCE) setting are lacking.

Approach

Annually, paediatric interns from Children's National Hospital and Walter Reed National Military Medical Center participate in an OSCE, which includes faculty observation and immediate feedback to trainees. In 2018, we incorporated the subjective, objective, assessment, plan (SOAP) Feedback Training Program during 20 min of the pre‐OSCE faculty orientation. The SOAP Feedback Training Program introduced the SOAP feedback model (subjective, objective, assessment, plan), facilitated practice in pairs and distributed a cognitive aid referencing the model. We evaluated the quality of faculty feedback exchanges during the 2018 OSCE via retrospective video review using the Direct Observation of Clinical Skills Feedback Scale (DOCS‐FBS). We compared the results to the 2015 initial evaluation and used focus groups to understand how and why faculty feedback changed.

Evaluation

Comparison of the initial evaluation to the post‐SOAP Feedback Training Program intervention data using a Wilcoxon signed rank test showed statistically significant improvement in six of eight feedback items on the DOCS‐FBS. Causal coding of focus group transcripts revealed that the SOAP Feedback Training Program evoked affective responses, reinforced prior practice in feedback delivery, improved feedback organisation and increased feedback delivery preparation.

Implications

The SOAP Feedback Training Program is an effective intervention to teach the SOAP feedback model and improve faculty feedback quality in an OSCE setting. It is efficient and low resource, facilitating its potential use in settings beyond the OSCE.
Good bedside teaching on secondary care placement: The student perspective
Authors: Edwards Lydia , Quinton Naomi
Published: August 2023

Background

Students' experience of bedside teaching (BST) on clinical placement has significantly decreased, with a shift in teaching away from the bedside. The educational value of teaching on ward rounds (WRs) has also been debated.

Objective

This research considered what constitutes good BST from the student perspective; guidance to support clinician teachers was produced.

Methods

Semi‐structured interviews were conducted with 10 second‐year students and 10 fourth‐ and fifth‐year students studying at Leeds Medical School. Data were analysed using thematic analysis.

Findings

We identified four themes: (1) benefits of early clinical experience, (2) qualities of good clinical teachers, (3) shift in preference from structured to opportunistic learning and (4) increased valuing of the WR as a site of learning.

Conclusion

The structure of BST should be adapted to the learners' stage of training with a graduated approach, from a structured preparation for observation to authentic, observed participation with feedback. Students' early lack of clinical knowledge makes it difficult to meaningfully observe and partake in ward activities. During early clinical experience, good teaching is perceived as structured and supported by the clinician. As learners progress, they are better able to engage in opportunistic learning, which actively involves them in patient care. They also valued structured teaching and feedback. While patient contact should be supervised, a more participatory, observed and feedback‐driven approach should be adopted in the later years. Teaching must address both knowledge and skills required to be a doctor; this is facilitated by an active role in patient care.
Structure–activity relationship of 2,4‐D correlates auxinic activity with the induction of somatic embryogenesis in Arabidopsis thaliana
Authors: Karami Omid , de Jong Hanna , Somovilla Victor J. , Villanueva Acosta Beatriz , Sugiarta Aldo Bryan , Ham Marvin , Khadem Azadeh , Wennekes Tom , Offringa Remko
Published: August 2023

2,4‐dichlorophenoxyacetic acid (2,4‐D) is a synthetic analogue of the plant hormone auxin that is commonly used in many in vitro plant regeneration systems, such as somatic embryogenesis (SE). Its effectiveness in inducing SE, compared to the natural auxin indole‐3‐acetic acid (IAA), has been attributed to the stress triggered by this compound rather than its auxinic activity. However, this hypothesis has never been thoroughly tested. Here we used a library of forty 2,4‐D analogues to test the structure–activity relationship with respect to the capacity to induce SE and auxinic activity in Arabidopsis thaliana. Four analogues induced SE as effectively as 2,4‐D and 13 analogues induced SE but were less effective. Based on root growth inhibition and auxin response reporter expression, the 2,4‐D analogues were classified into different groups, ranging from very active to not active auxin analogues. A halogen at the 4‐position of the aromatic ring was important for auxinic activity, whereas a halogen at the 3‐position resulted in reduced activity. Moreover, a small substitution at the carboxylate chain was tolerated, as was extending the carboxylate chain with an even number of carbons. The auxinic activity of most 2,4‐D analogues was consistent with their simulated TIR1‐Aux/IAA coreceptor binding characteristics. A strong correlation was observed between SE induction efficiency and auxinic activity, which is in line with our observation that 2,4‐D‐induced SE and stress both require TIR1/AFB auxin co‐receptor function. Our data indicate that the stress‐related effects triggered by 2,4‐D and considered important for SE induction are downstream of auxin signalling.
Would doctors dream of electric blood bankers? Large language model‐based artificial intelligence performs well in many aspects of transfusion medicine
Authors: Hurley Nathan C. , Schroeder Kristopher M. , Hess Aaron S.
Published: August 2023

Background

Large language models (LLMs) excel at answering knowledge‐based questions. Many aspects of blood banking and transfusion medicine involve no direct patient care and require only knowledge and judgment. We hypothesized that public LLMs could perform such tasks with accuracy and precision.

Study Design and Methods

We presented three sets of tasks to three publicly‐available LLMs (Bard, GPT‐3.5, and GPT‐4). The first was to review short case presentations and then decide if a red blood cell transfusion was indicated. The second task was to answer a set of consultation questions common in clinical transfusion practice. The third task was to take a multiple‐choice test experimentally validated to assess internal medicine postgraduate knowledge of transfusion practice (the BEST‐TEST).

Results

In the first task, the area under the receiver operating characteristic curve for correct transfusion decisions was 0.65, 0.90, and 0.92, respectively for Bard, GPT‐3.5 and GPT‐4. All three models had a modest rate of acceptable responses to the consultation questions. Average scores on the BEST‐TEST were 55%, 40%, and 87%, respectively.

Conclusion

When presented with transfusion medicine tasks in natural language, publicly available LLMs demonstrated a range of ability, but GPT‐4 consistently scored very well in all tasks. Research is needed to assess the utility of LLMs in transfusion medicine practice. Transfusion Medicine physicians should consider their role alongside such technologies, and how they might be used for the benefit and safety of patients.
Increased red blood cell alloimmunization rates in transfused aplastic anemia and myelofibrosis patients
Authors: Sotolongo G. , Poisson J. L.
Published: August 2023

Background

Red blood cell (RBC) alloimmunization (AI) is a well‐known complication of RBC transfusions, which results in the formation of alloantibodies to non‐self antigens on donor RBCs, putting patients at risk of transfusion‐related complications. The rate of AI with RBC transfusions in the general hospitalized population is estimated to be 2%–3%. However, some patients who are deemed “transfusion‐dependent” require regular transfusions of blood products due to persistently low cell counts, putting them at even greater risk of RBC AI and increased morbidity. However, few studies currently exist investigating RBC AI in some transfusion‐dependent patient populations, e.g., aplastic anemia (AA) and myelofibrosis (MF).

Study Design and Methods

We conducted a 5‐year retrospective review to investigate the prevalence of RBC AI, alloantibody incidence, and the number of RBC transfusions in AA and MF patients, who received RBC transfusions within our hospital system.

Results

During the study period, 64 AA and 93 MF patients received 1301 and 2766 RBC transfusions, respectively. Compared to the RBC AI rate in the generalized hospitalized patient population (1%–2%), patients with AA and MF had an increased rate of RBC AI incidence rate at 14.1% and 12.9%, respectively. Furthermore, patients with primary MF demonstrated an isolated increased RBC AI incidence rate of 13.3%. The most common alloantibodies produced were anti‐E and anti‐K.

Discussion

Within our institution, patients with AA and MF had increased incidence rates of RBC AI compared to the general hospitalized patient population and may benefit from an antigen‐matched protocol to minimize AI‐related complications.
DEVELOPMENT AND ANALYSIS OF DEEP LEARNING MODEL BASED ON MULTICLASS CLASSIFICATION OF RETINAL IMAGE FOR EARLY DETECTION OF DIABETIC RETINOPATHY
Authors: Meshram Amita , Dembla Deepak , A Anooja
Published: August 2023

Diabetic retinopathy (DR) is a leading cause of blindness, and early detection is crucial for effectively managing and preventing vision loss. This paper proposes a deep learning-based model for the early detection of diabetic retinopathy (DR) using retinal images. The proposed model uses a convolutional neural network (CNN) architecture and transfer learning-based EfficientNet architecture for multiclass classification (0- No DR, 1- Low, 2- Medium, 3- High, 4- Proliferative) of DR, on a large dataset of annotated retinal images. The performance of the model is evaluated on an independent test set and compared with CNN and EfficientNet methods. Results show that the efficient model achieves high accuracy and outperforms existing methods for DR detection. Moreover, the model can detect DR at an early stage, enabling timely interventions and preventing vision loss. The results show that we achieved a training accuracy of 94.42% after 20 epochs and a testing accuracy of 81.81%. The model's accuracy and early detection capability make it a promising tool for enhancing DR screening programs and enabling timely interventions to prevent vision loss.