bluuebunny/crossref_metadata_2025 huggingface dataset:
Aortic Valve Replacement and Repair With or Without Concomitant Ascending Aorta Replacement: Impact on Outcomes: A Systematic Review
Authors: Zhang Chen , Butt Sundas , Kashif Hadi , Rowe Clarissa , Harky Amer , Zeinah Mohamed
Published: October 2023

Aortic valve surgery is a common procedure used to treat significant aortic valve stenosis or insufficiency. Some of these patients have coexisting pathology affecting the ascending aorta requiring ascending aorta replacement (AAR). Although the outcomes of these procedures are independently positive, it is proposed that concomitant AAR improves outcomes and minimizes the chances of future ascending aorta replacement. A comprehensive literature search for relevant studies published since 2010 comparing outcomes of aortic valve repair and replacement with or without concomitant ascending aorta replacement was undertaken using electronic databases PubMed, Cochrane Library, Embase Ovid, and SCOPUS. Major exclusion criteria were (1) conference posters, literature reviews, editorials; (2) aortic root surgery, aortic arch surgery, or other surgeries (3) case series with less than 5 participants. A total of 1189 patients from 6 retrospective cohort studies were included in the final review, from which clinical outcomes such as mortality and complications were compared. Mortality rates were similar in both intervention groups. No significant differences were found between the 2 groups in reexploration rates due to bleeding, stroke, postoperative dialysis, and atrial fibrillation. Survival rates varied but had no significant difference between interventions. Both isolated aortic valve surgery and concomitant AAR procedures offer comparable favourable outcomes in terms of mortality, survival rates, and complication risks. However, the evidence is limited by the lack of randomized controlled trials. We recommend that future studies should standardize reporting on postoperative recovery, complications, long-term freedom from reoperations, and long-term changes to aorta dimensions.
Utilization of ChatGPT-4 in Plastic and Reconstructive Surgery: A Narrative Review
Authors: Aljindan Fahad K. , Shawosh Mohammed H. , Altamimi Lamees , Arif Sultan , Mortada Hatan
Published: October 2023

Background:

ChatGPT-4 (Chat Generative Pre-Trained Transformer) has demonstrated remarkable capabilities in natural language processing and understanding, making it a promising tool for various medical domains. This article presents a comprehensive overview of the potential applications of ChatGPT-4, a cutting-edge language model developed by OpenAI, in the field of plastic and reconstructive surgery.

Methods:

After conducting a thorough literature review, we discovered pertinent articles that explore the application of ChatGPT-4 in plastic surgery. By examining these findings and integrating the information with our personal experience using ChatGPT-4 in the field of plastic surgery, we have produced an all-encompassing narrative review.

Results:

The narrative review focuses on three main areas: clinical applications, research applications, and medical education. In the clinical realm, ChatGPT-4 has the potential to streamline documentation processes, improve communication, and enhance personalized patient care. It can assist in generating accurate and comprehensive progress notes, operative notes, surgical consent forms, on-call schedules, and consultation reports. However, it is important to note that ChatGPT-4 should be used as a supportive tool and should not replace human doctors.

Conclusions:

The potential applications of ChatGPT-4 in plastic and reconstructive surgery are vast and promising. This technology has the potential to revolutionize documentation, research, and medical education in the field. However, it is crucial to integrate this tool responsibly, considering its limitations and ensuring that human expertise remains paramount.
Feasibility of Different Exercise Modalities for Community-Dwelling Residents With Physical Inactivity: A Randomized Controlled Trial
Authors: CHANG Yu-Hsuan , SHUN Shiow-Ching , CHEN Min-Hsin , CHANG Yin-Fan
Published: October 2023

Background

Exercise interventions can promote health, but they can be difficult to implement. Moreover, no consensus has been reached regarding which exercise modality promotes the most significant improvement in metabolic health.

Purpose

This feasibility study was conducted to (a) determine the implementation efficacy of supervised and home-based exercise interventions by investigating their respective rates of intervention adherence, adherence to targeted intensity, attrition, and adverse events and (b) explore the preliminary efficacy of 12-week exercise programs among aerobic exercise, aerobic exercise combined with resistance exercise, and high-intensity interval training on body composition, anthropometric parameters, and lipid profiles for community-dwelling residents with physical inactivity.

Methods

This randomized controlled trial was conducted from April to October 2020. Seventy-two sedentary participants aged 40–70 years were enrolled and randomized into one of four groups: 12-week aerobic exercise, aerobic exercise combined with resistance exercise, high-intensity interval training, and control. The three exercise groups performed at least moderate-intensity supervised exercise twice a week and home-based exercise once a week, whereas the control group maintained their usual daily activities. The target variables, including body composition, anthropometric parameters, and lipid profiles, were measured before and after the 12-week intervention.

Results

The intervention adherence rates were 74.01%–87.54% for the supervised exercise group, 64.98%–83.90% for the home-based exercise group, and 82.65%–92.65% for the target exercise intensity group. The attrition rate ranged from 12.50% to 17.65%, and no adverse events were reported in any of the exercise groups. Preliminary efficacy data show the reductions in body weight (95% CI [0.01, 1.20], p = .048) and low-density lipoprotein (95% CI [2.76, 30.32], p = .02) were greater in the exercise groups than the control group, although the intergroup differences were not significant.

Conclusions/Implications for Practice

Body weight and low-density lipoprotein may be efficiently reduced in a 12-week period using any of the three exercise modalities with at least 82.65% adherence to moderate-intensity exercise and 70.84% adherence to exercising 3 times a week.
Genetic alterations and tumor mutation burden predict chemosensitivity of pancreatic cancer: a retrospective study
Authors: Hu Manyi , Xu Yiting , Wang Yangyang , Chen Cao , He Junjun , Sun Ke , Zhang Qi , Liang Tingbo
Published: October 2023

Background:

Chemotherapy stands as a recommended approach for all stages of pancreatic cancer. However, its efficacy stratification remains obscure. Genomic sequencing is extensively applied across diverse diseases. This study aims to explore the potential genomic markers in relation to the decision-making of chemotherapy.

Methods:

A total of 140 patients with pancreatic cancer were categorized into chemotherapy-first group and adjuvant chemotherapy group. The genomic alterations were detected from the next-generation sequencing using surgical or fine-needle-biopsy specimens. Chemotherapy response was defined according to objective response based on the RECIST criteria (version 1.1).

Results:

In the chemotherapy-first group, the patients who harbored higher tumor mutation burden (TMB) levels had significant shorter progress-free survival (PFS) than that with low TMB levels (hazard ratio [HR] = 30.362, P = .002). No independent risk factors were found to be correlated with chemoresistance in patients receiving chemotherapy at first (all P > .05). In the adjuvant chemotherapy group, the increased carbohydrate antigen 125 (CA125) level of more than 35 U/mL potentially elucidated a shorter period of DFS (HR = 3.695, P = .020).

Conclusion:

Our study indicated that a high level of TMB may predict earlier tumor progression in pancreatic cancer patients received chemotherapy at first. The elevation of CA125 presents itself as a predictive indicator for postoperative chemotherapy patients’ tumor recurrence, whereas gene mutations remain unrelated to this phenomenon.
Ultrasound Assessment of Ankle Syndesmotic Injuries in a Pediatric Population
Authors: Heitz Pierre-Henri , Miron Marie-Claude , Beauséjour Marie , Hupin Mathilde , DiLiddo Lydia , Jourdain Nathalie , Nault Marie-Lyne
Published: October 2023

Objective:

To determine sensitivity and specificity for anterior-inferior tibiofibular ligament (AiTFL) integrity and tibiofibular clear-space (TFCS) cut-off points for dynamic evaluation using ultrasound (US) in a pediatric population.

Design:

Prospective cohort study.

Setting:

Tertiary care university-affiliated pediatric hospital patients between the ages of 12 and 18 sustaining acute ankle trauma with syndesmotic injury.

Interventions:

Participants were assigned to the syndesmotic injury protocol that included a standardized MRI and US.

Main Outcome Measures:

Anterior-inferior tibiofibular ligament integrity for static assessment and TFCS measurements for dynamic assessment on US. For dynamic assessment, the distance between the distal tibia and fibula was first measured in neutral position and then in external rotation for each ankle. The US results on AiTFL integrity were compared with MRI, considered as our gold standard. Optimal cut-off points of TFCS values were determined with receiver operating characteristics curve analysis.

Results:

Twenty-six participants were included. Mean age was 14.8 years (SD = 1.3 years). Sensitivity and specificity for AiTFL integrity were 79% and 100%, respectively (4 false negatives on partial tears). For dynamic assessment, the cut-off points for the differences in tibiofibular distance between the 2 ankles in 1) neutral position (TFCS N I-U) and 2) external rotation (TFCS ER I-U) were 0.2 mm (sensitivity = 83% and specificity = 80%) and 0.1 mm (sensitivity = 83% and specificity = 80%), respectively.

Conclusions:

Static US could be used in a triage context as a diagnostic tool for AiTFL integrity in a pediatric population as it shows good sensitivity and excellent specificity.
Pitfall of 18F-PSMA PyL PET/CT Imaging of a Displaced Urinary Bladder as Recurrent Prostate Malignancy
Authors: Tewari Sanjit O. , Metwalli Zeyad A. , Xu Guofan
Published: October 2023

We herein present a potential pitfall in the setting of restaging PSMA PyL PET/CT. In this case, there is large non–PSMA-avid cystic structure in the mid pelvis, probably representing a postprostatectomy lymphocele, which was mistaken for the urinary bladder, resulting in the displaced and somewhat crescentic urinary bladder to be deemed recurrence. Subsequently, biopsy and retrospective review of images confirms displaced urinary bladder containing physiologic excreted activity.
Elevated FAPI Activity in Ulcerative Fungal Esophagitis
Authors: Xie Yang , Tang Wenxin , Liu Huipan , Chen Yue
Published: October 2023

We report a case of ulcerative fungal esophagitis with elevated activity of 18F-FDG and 68Ga-FAPI (fibroblast-activating protein inhibitor). Our findings suggest that ulcerative fungal esophagitis should be considered in the differential diagnosis of cancer-like esophageal mass with increased 68Ga-FAPI uptake.
Solitary Prostate Carcinoma Penile Metastasis on 18F-DCFPyL PET/CT
Authors: Chen Jeffrey , Russon Andrew , Mansberg Victor , Mansberg Robert
Published: October 2023

An 83-year-old man was referred for an 18F-DCFPyL PET scan for the evaluation of rising serum prostate-specific antigen level on the background of previous radical prostatectomy for prostate adenocarcinoma and urinary outflow tract obstruction requiring in-dwelling catheter insertion. The PET scan demonstrated focal increased activity (SUVmax, 35.7) at the dorsal aspect of the mid penile shaft, with histopathological confirmation of penile metastasis from primary prostate cancer.
Proposal of Allopseudospirillum gen. nov. as a replacement name for the illegitimate prokaryotic generic name Pseudospirillum Satomi et al. 2002
Authors: Molinari Novoa Eduardo A. , Oren Aharon
Published: October 2023

The prokaryotic generic name

Pseudospirillum

Satomi et al. 2002 is illegitimate because it is a later homonym of

Pseudospirillum

Alexeieff 1917, a genus of uncertain affiliation, possibly belonging to the Mesomycetozoa (Principle 2 and Rule 51b(5) of the International Code of Nomenclature of Prokaryotes). We therefore propose the replacement generic name Allopseudospirillum, with type species Allopseudospirillum japonicum.
The parapoxvirus Orf virus inhibits dsDNA-mediated type I IFN expression via STING-dependent and STING-independent signalling pathways
Authors: AlDaif Basheer A. , Mercer Andrew A. , Fleming Stephen B.
Published: October 2023

Type I interferons (IFNs) are critical in the host defence against viruses. They induce hundreds of interferon-stimulated genes (ISGs) many of which have an antiviral role. Poxviruses induce IFNs via their pathogen-associated molecular patterns, in particular, their genomic DNA. In a majority of cell types, dsDNA is detected by a range of cytoplasmic DNA sensors that mediate type I IFN expression via stimulator of interferon genes (STING). Orf virus (ORFV) induces cutaneous pustular skin lesions and is the type species of the Parapoxvirus genus within the Poxviridae family. The aim of this study was to investigate whether ORFV modulates dsDNA-induced type I IFN expression via STING-dependent signalling pathways in human dermal fibroblasts (hNDF) and THP-1 cells. We showed that ORFV infection of these cell types treated with poly(dA:dT) resulted in strong inhibition of expression of IFN-β. In hNDFs, we showed using siRNA knock-down that STING was essential for type I IFN induction. IFN-β expression was further reduced when both STING and RIG-I were knocked down. In addition, HEK293 cells that do not express STING or Toll-like receptors also produce IFN-β following stimulation with poly(dA:dT). The 5′ triphosphate dsRNA produced by RNA polymerase III specifically results in the induction of type I IFNs through the RIG-I receptor. We showed that ORFV infection resulted in strong inhibition of IFN-β expression in HEK293 cells stimulated with poly(dA:dT). Overall, this study shows that ORFV potently counteracts the STING-dependent and STING-independent IFN response by antagonizing dsDNA-activated IFN signalling pathways.
SEMA6A drives GnRH neuron-dependent puberty onset by tuning median eminence vascular permeability
Authors: Lettieri A. , Oleari R. , van den Munkhof M.H. , van Battum E.Y. , Verhagen M.G. , Tacconi C. , Spreafico M. , Paganoni A.J.J. , Azzarelli R. , Andre’ V. , Amoruso F. , Palazzolo L. , Eberini I. , Dunkel L. , Howard SR. , Fantin A. , Pasterkamp R.J. , Cariboni A.
Published: October 2023

Innervation of the hypothalamic median eminence by Gonadotropin-Releasing Hormone (GnRH) neurons is vital to ensure puberty onset and successful reproduction. However, the molecular and cellular mechanisms underlying median eminence development and pubertal timing are incompletely understood. Here we show that Semaphorin-6A is strongly expressed by median eminence-resident oligodendrocytes positioned adjacent to GnRH neuron projections and fenestrated capillaries, and that Semaphorin-6A is required for GnRH neuron innervation and puberty onset.In vitroandin vivoexperiments reveal an unexpected function for Semaphorin-6A, via its receptor Plexin-A2, in the control of median eminence vascular permeability to maintain neuroendocrine homeostasis. To support the significance of these findings in humans, we identify patients with delayed puberty carrying a novel pathogenic variant ofSEMA6A. In all, our data reveal an undescribed role for Semaphorin-6A in regulating GnRH neuron patterning by tuning the median eminence vascular barrier and thereby controlling puberty onset.
Phage-mediated resolution of genetic conflict alters the evolutionary trajectory ofPseudomonas aeruginosalysogens
Authors: Suttenfield Laura C. , Rapti Zoi , Chandrashekhar Jayadevi H. , Steinlein Amelia C. , Vera Juan Cristobal , Kim Ted , Whitaker Rachel J.
Published: October 2023

The opportunistic human pathogenPseudomonas aeruginosais naturally infected by a large class of temperate, transposable, Mu-like phages. We examined the genotypic and phenotypic diversity ofP. aeruginosaPA14 populations as they resolve CRISPR autoimmunity, mediated by an imperfect CRISPR match to the Mu-like DMS3 prophage, and show that lysogen evolution is profoundly impacted by CRISPR autoimmunity and phage transposition around the chromosome. After 12 days of evolution, we measured a decrease in spontaneous induction in both exponential and stationary phase growth. Co-existing variation in spontaneous induction rates in exponential phase corresponded to a difference in the type of CRISPR self-targeting resolution, mediated either by host mutation or phage transposition. Multiple mutational modes to resolve genetic conflict between host and phage resulted in coexistence in evolved populations of single lysogens that maintained CRISPR immunity to other phages and polylysogens that have lost immunity completely. This work highlights a new dimension of the role of lysogenic phages in the evolution of their hosts.

Importance

The chronic opportunistic multi-drug resistant pathogenPseudomonas aeruginosais persistently infected by temperate phages. We assess the contribution of temperate phage infection to the evolution of the clinically relevant strain UCBPP-PA14. We found that a low level of CRISPR-mediated self-targeting resulted in polylysogeny evolution and large genome rearrangements in lysogens; we also found extensive diversification in CRISPR spacers andcasgenes. These genomic modifications resulted in decreased spontaneous induction in both exponential and stationary phase growth, increasing lysogen fitness. This work shows the importance of considering latent phage infection in characterizing the evolution of bacterial populations.
Large-scale brainstem neuroimaging and genetic analyses provide new insights into the neuronal mechanisms of hypertension
Authors: Gurholt Tiril P. , Elvsåshagen Torbjørn , Bahrami Shahram , Rahman Zillur , van der Meer Dennis , Shadrin Alexey , Frei Oleksandr , Kaufmann Tobias , Sønderby Ida E , Halvorsen Sigrun , Westlye Lars T. , Andreassen Ole A.
Published: October 2023

Background

While brainstem regions are central regulators of blood pressure, the neuronal mechanisms underlying their role in hypertension remain poorly understood. Here, we investigated the structural and genetic relationships between global and regional brainstem volumes and blood pressure.

Methods

Using magnetic resonance imaging data from n=32,666 UK Biobank participants, we assessed the association of volumes of the whole brainstem and its main regions with blood pressure. We applied powerful statistical genetic tools, including bivariate causal mixture modeling (MiXeR) and conjunctional false discovery rate (conjFDR), to summary statistics from genome-wide association studies of brainstem volumes (n=27,034) and blood pressure (n=318,891) and evaluated their genetic architectures.

Results

We observed negative associations between the whole brainstem and medulla oblongata volumes and systolic blood and pulse pressure, and positive relationships between midbrain and pons volumes and blood pressure traits when adjusting for the whole brainstem volume (all ∣r∣ 0.03-0.05, p≤0.0042). We observed the largest genetic overlap for the whole brainstem, sharing between 54% and 69% of its trait-influencing variants with blood pressure. We identified 42 shared loci between brainstem volumes and blood pressure traits and mapped these to 83 genes, implicating molecular pathways linked to the development of the brainstem, cranial nerves, and sympathetic neurons, and to metal ion transport and cell-matrix adhesions.

Conclusions

The present findings support a link between brainstem structures and blood pressure and provide new insights into their shared genetic underpinnings. The overlapping genetic architectures and mapped genes offer new mechanistic information about the roles of brainstem regions in hypertension.
Saliva direct PCR protocol for HLA-DQB1*02 genotyping
Authors: Carrillo Angeles , Manzur María Jimena , Ayub Maximiliano Juri
Published: October 2023

Celiac Disease (CD) is an immune disorder that is triggered by gluten ingestion in genetically predisposed individuals. The HLA-DQB1*02 allele is the main predisposing genetic factor, and a candidate for first-line genotyping screening. We designed and validated a simple, DNA purification-free PCR protocol directly from crude saliva, enabling the detection of the DQB1*02 allele. This assay also distinguishes homozygous from heterozygous carriers. We propose this method for use in mass screening and/or epidemiological studies.
Establishing CRISPR-Cas9 in the sexually dimorphic moss,Ceratodon purpureus
Authors: Tavernier Emilie-Katherine , Lockwood Emily , Perroud Pierre-François , Nogué Fabien , McDaniel Stuart F.
Published: October 2023

The development of CRISPR technologies provides a powerful tool for understanding the evolution and functionality of essential biological processes. Here we demonstrate successful CRISPR-Cas9 genome editing in the dioecious moss species,Ceratodon purpureus. Using an existing selection system from the distantly related hermaphroditic moss,Physcomitrium patens, we generated knock-outs of theAPTreporter gene by employing CRISPR targeted mutagenesis under expression of native U6 snRNA promoters. Next, we used the native homology-directed repair (HDR) pathway, combined with CRISPR-Cas9, to knock-in two reporter genes under expression of an endogenous RPS5A promoter in a newly developed landing site inC. purpureus. Our results show that the molecular tools developed inP. patenscan be extended to other mosses across this ecologically important and developmentally variable group. These findings pave the way for precise and powerful experiments aimed at identifying the genetic basis of key functional variation within the bryophytes and between the bryophytes and other land plants.

Significance Statement

We have developed CRISPR-Cas9 genome editing tools and protocols for the sexually dimorphic moss,Ceratodon purpureusto generate gene knock-outs and knock-ins within targeted loci. This work facilitates future functional genomic experiments in this fast growing, haploid, dioecious system and suggests these tools will function across much of moss diversity.
Rapid life-history evolution reinforces competitive asymmetry between invasive and resident species
Authors: Chapuis Elodie , Jarne Philippe , David Patrice
Published: October 2023

Biological invasions by phylogenetically and ecologically similar competitors pose an evolutionary challenge to native species. Cases of character displacement following invasions suggest that they can respond to this challenge by shifting their traits. However, the actual impact of such shifts on competition are seldom studied. Here, we study competition between two freshwater snails from Guadeloupe (French Antilles), the nativeAplexa marmorataand the introducedPhysa acuta. The former has responded to invasion by rapid life-history evolution towards earlier maturity, higher fecundity and higher juvenile survival, traits that might favor rapid population growth in a noncompetitive context, but not necessarily in a competitive one. We here observe negative impacts of competition by both species on each other, thoughP. acutais dominant and over generations largely displacesA. marmoratafrom co-cultures. In addition, our experiments suggest thatA. marmoratapopulations having experienced competition byP. acutafor sufficient time in nature, have evolved to become even less tolerant to it. Though apparently paradoxical, this result supports the hypothesis that rapid life-history evolution has allowedA. marmoratanot to resist competition, but to avoid it by increasing its specialization into the colonizer lifestyle previously documented by long-term field surveys. This example illustrates how evolution, in accordance with metacommunity coexistence theory, sometimes takes other ways than specialization into distinct types of resources or habitats to ensure coexistence between related species inhabiting the same landscape.
Data Simulation to Optimize the GWAS Framework in Diverse Populations
Authors: Mugo Jacquiline Wangui , Chimusa Emile Rugamika , Mulder Nicola
Published: October 2023

Whole-genome or genome-wide association studies have become a fundamental part of modern genetic studies and methods for dissecting the genetic architecture of common traits based on common polymorphisms in random populations. It is hoped that there will be many potential uses of these identified variants, including a better understanding of the pathogenesis of traits, the discovery of biomarkers and protein targets, and the clinical prediction of drug treatments for global health. Questions have been raised on whether associations that are largely discovered in populations of European descent are replicable in diverse populations, can inform medical decision-making globally, and how efficiently current GWAS tools perform in populations of high genetic diversity, multi-wave genetic admixture, and low linkage disequilibrium (LD), such as African populations. In this study, we employ genomic data simulation to mimic structured African, European, and multi-way admixed populations to evaluate the replicability of association signals from current state-of-the-art GWAS tools in these populations. We then leverage the results to discuss an optimized framework for the analysis of GWAS data in diverse populations and outline the implications, challenges, and opportunities these studies present for populations of non-European descent.
Automated, self-resistance gene-guided, and high-throughput genome mining of bioactive natural products fromStreptomyces
Authors: Yuan Yujie , Huang Chunshuai , Singh Nilmani , Xun Guanhua , Zhao Huimin
Published: October 2023

Natural products (NPs) produced by bacteria, fungi and plants are a major source of drug leads.Streptomycesspecies are particularly important in this regard as they produce numerous natural products with prominent bioactivities. Here we report a fullyautomated,scalable and high-throughput platform for discovery of bioactivenaturalproducts inStreptomyces(FAST-NPS). This platform comprises computational prediction and prioritization of target biosynthetic gene clusters (BGCs) guided by self-resistance genes, highly efficient and automated direct cloning and heterologous expression of BGCs, followed by high-throughput fermentation and product extraction fromStreptomycesstrains. As a proof of concept, we applied this platform to clone 105 BGCs ranging from 10 to 100 kb that contain potential self-resistance genes from 11Streptomycesstrains with a success rate of 95%. Heterologous expression of all successfully cloned BGCs inStreptomyces lividansTK24 led to the discovery of 23 natural products from 12 BGCs. We selected 5 of these 12 BGCs for further characterization and found each of them could produce at least one natural product with antibacterial and/or anti-tumor activity, which resulted in a total of 8 bioactive natural products. Overall, this work would greatly accelerate the discovery of bioactive natural products for biomedical and biotechnological applications.

Graphic Abstracts
When we were young: how labour market attachment during mid-life affects labour market exit
Authors: Öylü Gülin , Focacci Chiara Natalie , Serratos-Sotelo Luis , Motel-Klingebiel Andreas , Kelfve Susanne
Published: October 2023

Purpose

In this paper, the authors attempt to understand how labour market attachment during the ages of 30–59 influences individuals' transition out of the labour market.

Design/methodology/approach

Using high-quality Swedish register data, the authors follow individuals born in 1950 and observe their labour market attachment during mid-life and their exit from the labour market.

Findings

The authors find evidence that labour market attachment in different stages of the career is differently related to exit from the labour market. At the age of 30, as well as between the ages 50–59, low attachment is related with earlier exit from the labour market. On the contrary, low labour market attachment during the ages 40–49 is related with later exit from the labour market. However, regardless of age, lower labour market attachment increases the risk of work-related benefit receipt in the exit year. The authors also find evidence that gender, migration status and childhood socioeconomic disadvantages may represent obstacles to longer working lives, while high education is a consistent factor in avoiding early exit from the labour market.

Originality/value

This study provides insights on the link between labour market attachment in different stages of the career and the exit from the labour market as well as work-related benefits dependency in the year of exit.
Must social performance ratings be idiosyncratic? An exploration of social performance ratings with predictive validity
Authors: Svanberg Jan , Ardeshiri Tohid , Samsten Isak , Öhman Peter , Neidermeyer Presha E. , Rana Tarek , Maisano Frank , Danielson Mats
Published: October 2023

Purpose

The purpose of this study is to develop a method to assess social performance. Traditionally, environment, social and governance (ESG) rating providers use subjectively weighted arithmetic averages to combine a set of social performance (SP) indicators into one single rating. To overcome this problem, this study investigates the preconditions for a new methodology for rating the SP component of the ESG by applying machine learning (ML) and artificial intelligence (AI) anchored to social controversies.

Design/methodology/approach

This study proposes the use of a data-driven rating methodology that derives the relative importance of SP features from their contribution to the prediction of social controversies. The authors use the proposed methodology to solve the weighting problem with overall ESG ratings and further investigate whether prediction is possible.

Findings

The authors find that ML models are able to predict controversies with high predictive performance and validity. The findings indicate that the weighting problem with the ESG ratings can be addressed with a data-driven approach. The decisive prerequisite, however, for the proposed rating methodology is that social controversies are predicted by a broad set of SP indicators. The results also suggest that predictively valid ratings can be developed with this ML-based AI method.

Practical implications

This study offers practical solutions to ESG rating problems that have implications for investors, ESG raters and socially responsible investments.

Social implications

The proposed ML-based AI method can help to achieve better ESG ratings, which will in turn help to improve SP, which has implications for organizations and societies through sustainable development.

Originality/value

To the best of the authors’ knowledge, this research is one of the first studies that offers a unique method to address the ESG rating problem and improve sustainability by focusing on SP indicators.
Rethinking tourism: the Portuguese Hotels Association's view
Authors: Trindade Bernardo
Published: October 2023

Purpose

This viewpoint aims to present Portuguese Hotels Association’s (AHP) views on the main challenges facing the sector and the need for a closer relationship with public entities and the government in order to gain support and address limitations. This viewpoint also highlights a successful project, HOSPES, a corporate program for social responsibility and environmental sustainability and the impact it has made since its launch in 2013.

Design/methodology/approach

This paper analyses the development of the Portuguese hospitality sector in the post-COVID-19 era. It highlights the scarcity of human resources, and how this impacts the performance of hotels and the quality of the service offered. It also outlines the AHP program (HOSPES) that is designed to encourage social responsibility and environmental sustainability as a good practice with real impacts for the market and society.

Findings

The hospitality sector is facing various challenges, but its workforce, its companies and its associations are well aware of the responsibility that is entrusted to them in the context of the country's macroeconomic framework. AHP is fully aware of the challenges facing the sector and its operators and it equally recognizes the need for public support by decision makers and government to overcome limitations and move forward.

Originality/value

Despite the challenges facing the hospitality sector, AHP takes the view that it is on the right path to support its members and the wider Portuguese economy in the quest for a more dynamic, profitable, sustainable and inclusive society.
Assessment of the association between ambient air pollution and stillbirth in the UK: Results from a secondary analysis of the MiNESS case–control study
Authors: Hammer Lucy , Heazell Alexander E. P. , Povey Andrew , Myers Jenny E. , Thompson John M. D. , Johnstone Edward D.
Published: October 2023

Objective

We examined whether the risk of stillbirth was related to ambient air pollution in a UK population.

Design

Prospective case–control study.

Setting

Forty‐one maternity units in the UK.

Population

Women who had a stillbirth ≥28 weeks’ gestation (n = 238) and women with an ongoing pregnancy at the time of interview (n = 597).

Methods

Secondary analysis of data from the Midlands and North of England Stillbirth case–control study only including participants domiciled within 20 km of fixed air pollution monitoring stations. Pollution exposure was calculated using pollution climate modelling data for NO2, NOx and PM2.5. The association between air pollution exposure and stillbirth risk was assessed using multivariable logistic regression adjusting for household income, maternal body mass index (BMI), maternal smoking, Index of Multiple Deprivation quintile and household smoking and parity.

Main Outcome Measure

Stillbirth.

Results

There was no association with whole pregnancy ambient air pollution exposure and stillbirth risk, but there was an association with preconceptual NO2 exposure (adjusted odds ratio [aOR] 1.06, 95% CI 1.01–1.08 per microg/m3). Risk of stillbirth was associated with maternal smoking (aOR 2.54, 95% CI 1.38–4.71), nulliparity (aOR 2.16, 95% CI 1.55–3.00), maternal BMI (aOR 1.05, 95% CI 1.01–1.08) and placental abnormalities (aOR 4.07, 95% CI 2.57–6.43).

Conclusions

Levels of ambient air pollution exposure during pregnancy in the UK, all of were beneath recommended thresholds, are not associated with an increased risk of stillbirth. Periconceptual exposure to NO2 may be associated with increased risk but further work is required to investigate this association.
Effects of dexmedetomidine on kidney and brain tissue microcirculation and histology in ovine cardiopulmonary bypass: a randomised controlled trial
Authors: Jufar A. H. , May C. N. , Booth L. C. , Evans R. G. , Cochrane A. D. , Marino B. , Birchall I. , Hood S. G. , McCall P. R. , Sanders R. D. , Yao S. T. , Ortega‐Bernal V. , Skene A. , Bellomo R. , Miles L. F. , Lankadeva Y. R.
Published: October 2023

Cardiac surgery requiring cardiopulmonary bypass is associated with postoperative acute kidney injury and neurocognitive disorders, including delirium. Intra‐operative inflammation and/or impaired tissue perfusion/oxygenation are thought to be contributors to these outcomes. It has been hypothesised that these problems may be ameliorated by the highly selective α2‐agonist, dexmedetomidine. We tested the effects of dexmedetomidine on renal and cerebral microcirculatory tissue perfusion, oxygenation and histology in a clinically relevant ovine model. Sixteen sheep were studied while conscious, after induction of anaesthesia and during 2 h of cardiopulmonary bypass. Eight sheep were allocated randomly to receive an intravenous infusion of dexmedetomidine (0.4–0.8 μg.kg‐1.h‐1) from induction of anaesthesia to the end of cardiopulmonary bypass, and eight to receive an equivalent volume of matched placebo (0.9% sodium chloride). Commencement of cardiopulmonary bypass decreased renal medullary tissue oxygenation in the placebo group (mean (95%CI) 5.96 (4.24–7.23) to 1.56 (0.84–2.09) kPa, p = 0.001), with similar hypoxic levels observed in the dexmedetomidine group (6.33 (5.33–7.07) to 1.51 (0.33–2.39) kPa, p = 0.002). While no differences in kidney function (i.e. reduced creatinine clearance) were evident, a greater incidence of histological renal tubular injury was observed in sheep receiving dexmedetomidine (7/8 sheep) compared with placebo (2/8 sheep), p = 0.041. Graded on a semi‐quantitative scale (0–3), median (IQR [range]) severity of histological renal tubular injury was higher in the dexmedetomidine group compared with placebo (1.5 (1–2 [0–3]) vs. 0 (0–0.3 [0–1]) respectively, p = 0.013). There was no difference in cerebral tissue microglial activation (neuroinflammation) between the groups. Dexmedetomidine did not reduce renal medullary hypoxia or cerebral neuroinflammation in sheep undergoing cardiopulmonary bypass.
Intimate partner violence exposure during infancy and social functioning in middle childhood: An Australian mother and child cohort study
Authors: Schulz Madison L. , Wood Catherine E. , Fogarty Alison , Brown Stephanie J. , Gartland Deirdre , Giallo Rebecca
Published: October 2023

Social functioning of children with experiences of intimate partner violence (IPV) between caregivers in early childhood has received less attention than emotional–behavioral outcomes. Drawing on data from 1507 ten‐year‐old Australian‐born children and their mothers participating in a community‐based longitudinal study, this study examined the associations between IPV exposure during infancy and social development during middle childhood. IPV during the first 12 months of life was associated with lower social skills, higher peer problems, and peer victimization at age 10 years, while accounting for concurrent IPV. This study provides evidence for the long‐term impacts of early‐life IPV exposure on children's social functioning, and the importance of prevention and early intervention programs focused on social development following experiences of IPV.
Is ultraviolet light disinfection fit to be the future standard for the disinfection of flexible endoscopes without a working channel?
Authors: Halmans Yana , Wellenstein David J. , Romijn Michael , Cremers Suzan , Smit Jannie J. , Hopman Joost , Takes Robert P. , van den Broek Guido B.
Published: October 2023

Objective

To investigate colony‐forming unit (CFU) reduction on contaminated flexible endoscopes (FEs) without a working channel after UV‐C light disinfection, compared to the current disinfection method with the endoscope washer disinfector (EWD).

Design, setting and participants

After pharyngolaryngoscopy, a manual pre‐cleaning with tap water was performed. A culture was then collected by rolling the distal 8–10 cm of the FE over an Agar plate. The FE was disinfected using the D60 (60‐s disinfection process with UV‐C light) or the EWD (gold standard reprocessing process with water and chemicals). Another culture was then taken. After incubation, a CFU count was performed.

Results

A total of 200 FEs without a working channel were divided equally between the two disinfection groups. After clinical use and manual pre‐cleaning, 84 of the 100 (84.0%) (UV‐C light group) and 79 of the 100 (79.0%) (EWD) FEs were contaminated with at least 1 CFU. FEs that showed no contamination after use were excluded from further analysis. After disinfection with UV‐C light, 72 (85.7%) FEs showed no contamination (i.e., 0 CFUs) versus 66 (83.5%) FEs after reprocessing with the EWD.

Conclusion

There is no difference in CFUs reduction on contaminated FEs without a working channel between UV‐C light disinfection and the current gold standard, the EWD.
Influence of different time framings, reconstruction algorithms and post‐processing methods on the quantification of myocardial blood flow from 13N‐NH3 PET images
Authors: Akil Shahnaz , Székely Anna E. , Hedeer Fredrik , Olsson Berit , Engblom Henrik , Hindorf Cecilia
Published: October 2023

Background

The aim was to investigate to what extent the quantification of myocardial blood flow (MBF) from dynamic 13N‐NH3 positron emission tomography (PET) images is affected by time frame schemes, time‐of‐flight (ToF), reconstruction algorithms, blood pool volume of interest (VOI) locations and compartment models in patients with suspected chronic coronary syndrome.

Methods

A standard MBF value was determined from 25 patients' rest/stress 13N‐NH3 PET/CT images reconstructed with ordered subset expectation maximization (OSEM), 5 s time frame for the first frames without ToF, subsequently analyzed using a basal VOI and the deGrado compartment model. MBFs calculated using 2 or 10 s for the first frames, ToF, block‐sequential regularized expectation maximization (BSREM), apical or large VOI, Hutchins or Krivokapich compartment models were compared to MBFstandard in Bland–Altman plots (bias ± SD).

Results

Good agreement in global rest/stress MBF (mL/min/g) was found when changing the time frame scheme or reconstruction algorithm (MBFstandard vs. MBF2s: −0.02 ± 0.06; MBF10s: 0.01 ± 0.07; MBFBSREM: 0.01 ± 0.07), while a lower level of agreement was found when altering the other factors (MBFstandard vs. MBFToF: −0.07 ± 0.10; MBFapical VOI: −0.27 ± 0.25; MBFlarge VOI: −0.11 ± 0.10; MBFHutchins: −0.08 ± 0.10; MBFKrivokapich: −0.47 ± 0.50).

Conclusions

Quantification of MBF from 13N‐NH3 PET images is more affected by choice of compartment models, ToF and blood pool VOIs than by different time frame schemes and reconstruction algorithms.
In people with type 2 diabetes, sarcopenia is associated with the incidence of cardiovascular disease: A prospective cohort study from the UK Biobank
Authors: Boonpor Jirapitcha , Pell Jill P. , Ho Frederick K. , Celis‐Morales Carlos , Gray Stuart R.
Published: October 2023

Aim

To investigate the association of sarcopenia with cardiovascular disease (CVD) incidence in people with type 2 diabetes.

Materials and Methods

A prospective cohort study with 11 974 White European UK Biobank participants with type 2 diabetes, aged 40‐70 years, included. Sarcopenia was defined based on the European Working Group on Sarcopenia in Older People as either non‐sarcopenic or sarcopenic. Outcomes included CVD, stroke, heart failure (HF) and myocardial infarction (MI). The association between sarcopenia and the incidence of outcomes was investigated using Cox proportional hazard models adjusted for sociodemographic and lifestyle factors. The rate advancement period was used to estimate the time period by which CVD is advanced because of sarcopenia.

Results

Over a median follow‐up of 10.7 years, 1957 participants developed CVDs: 373 had a stroke, 307 had an MI and 742 developed HF. Compared with non‐sarcopenia, those with sarcopenia had higher risks of CVD (HR 1.89 [95% CI 1.61; 2.21]), HF (HR 2.59 [95% CI 2.12; 3.18]), stroke (HR 1.90 [95% CI 1.38; 2.63]), and MI (HR 1.56 [95% CI 1.04; 2.33]) after adjustment for all covariates. Those with sarcopenia had CVD incidence rates equivalent to those without sarcopenia who were 14.5 years older. Similar results were found for stroke, HF and MI.

Conclusions

In people with type 2 diabetes, sarcopenia increased the risk of developing CVD, which might occur earlier than in those without sarcopenia. Therefore, sarcopenia screening and prevention in patients with type 2 diabetes may be useful to prevent the complications of CVD.
The EU Trust Fund for Colombia: Valuable lessons for hybrid peacebuilding
Authors: Ornilla Carlos Madridejos
Published: October 2023

Motivation

The European Union (EU) Trust Fund has supported the implementation of the 2016 Peace Agreement in Colombia. It represents innovative funding that goes beyond the classic parameters of the so‐called “liberal peace”—that is, imposing a standard formula of guaranteeing security and public order, promoting electoral processes through a party system, and fostering economic openness and free markets.

Purpose

We analyse the planning, financing, and operational mechanisms of the Trust Fund to identify those elements that encourage or constrain co‐operation for peacebuilding; elements able to integrate and complement the agendas, actors, and dynamics at international, national, and local levels.

Methods and approach

The article is based on the ongoing support of the Trust Fund for over four years, including an extensive documentary review, participation in numerous events and meetings, and making more than ten field visits to the Fund's intervention areas. More than 50 interviews were conducted with ex‐combatants, local leaders, and representatives of the EU, public institutions, and civil society organizations (CSOs).

Findings

The Trust Fund has tried to build peace at local and territorial levels. It has proved an assertive and pluralistic instrument, innovating in inter‐institutional co‐ordination, political dialogue, and articulation at the local level. This has not only been visible strategically, but also technically by developing innovations with a high potential for adaptation or scaling up; for example, public access to project progress indicators, the widespread use of third‐party funding to distribute resources to the weakest or most isolated CSOs, and inclusion of the territorial approach in project design and intervention logic.

The Fund has been limited, however, by a context in which peacebuilding initiatives have tended to come from central government and donors, rather than from local actors. The government (of President Duque) was reluctant to implement the entirety of its commitments to peace: the EU Delegation was equally reluctant to challenge the government over this.

Policy implications

The experience of the EU Trust Fund in Colombia can provide valuable ideas to support peace processes elsewhere, to enrich the EU's position and approach to managing and resolving armed conflicts. New instruments, such as the “Team Europe Initiatives” or the “Neighbourhood, Development and International Co‐operation instrument – Global Europe,” focused on multi‐stakeholder co‐ordination and international partnerships, can benefit significantly from lessons learned in Colombia.