bluuebunny/crossref_metadata_2025 huggingface dataset:
Postpartum Hemorrhage Trends and Outcomes in the United States, 2000–2019
Authors: Corbetta-Rastelli Chiara M. , Friedman Alexander M. , Sobhani Nasim C. , Arditi Brittany , Goffman Dena , Wen Timothy
Published: December 2022

OBJECTIVE:

To analyze temporal trends in and risk factors for postpartum hemorrhage and to analyze the association of risk factors with postpartum hemorrhage–related interventions such as blood transfusion and peripartum hysterectomy.

METHODS:

This repeated cross-sectional study analyzed delivery hospitalizations from 2000 to 2019 in the National (Nationwide) Inpatient Sample. Trends analyses were conducted using joinpoint regression to estimate the average annual percent change (AAPC) with 95% CIs. Unadjusted and adjusted survey-weighted logistic regression models were performed to evaluate the relationship between postpartum hemorrhage risk factors and likelihood of 1) postpartum hemorrhage, 2) postpartum hemorrhage that requires blood transfusion, and 3) peripartum hysterectomy in the setting of postpartum hemorrhage, with unadjusted odds ratios and adjusted odds ratios with 95% CIs as measures of association.

RESULTS:

Of an estimated 76.7 million delivery hospitalizations, 2.3 million (3.0%) were complicated by postpartum hemorrhage. From 2000 to 2019, the rate of postpartum hemorrhage increased from 2.7% to 4.3% (AAPC 2.6%, 94% CI 1.7–3.5%). Over the study period, the proportion of deliveries to individuals with at least one postpartum hemorrhage risk factor increased from 18.6% to 26.9% (AAPC 1.9%, 95% CI 1.7–2.0%). Among deliveries complicated by postpartum hemorrhage, blood transfusions increased from 5.4% to 16.7% from 2000 to 2011 and then decreased from 16.7% to 12.6% from 2011 to 2019. Peripartum hysterectomy among hospitalized individuals with postpartum hemorrhage increased from 1.4% to 2.4% from 2000 to 2009, did not change significantly from 2009 to 2016, and then decreased significantly from 2.1% to 0.9% from 2016 to 2019 (AAPC −27.0%, 95% CI −35.2% to −17.6%). Risk factors associated with postpartum hemorrhage and transfusion and hysterectomy in the setting of postpartum hemorrhage included prior cesarean delivery with previa or placenta accreta, placenta previa without prior cesarean delivery, and antepartum hemorrhage or placental abruption.

CONCLUSION:

Postpartum hemorrhage and related risk factors increased over a 20-year period. Despite the increased postpartum hemorrhage rates, blood transfusions, and hysterectomy rates decreased in recent years.
Association of Sickle Cell Disease With Severe Maternal Morbidity
Authors: Ha Thoa K. , Boulet Sheree L. , Cotsonis George , Geary Franklyn , Jamieson Denise J. , Lindsay Michael
Published: December 2022

OBJECTIVE:

To evaluate the association between sickle cell disease (SCD) and severe maternal morbidity (SMM) in a contemporary cohort of deliveries by non-Hispanic Black people.

METHODS:

We retrospectively examined SMM by using electronic health record data on deliveries by non-Hispanic Black patients between 2011 and 2020 at a single tertiary, public institution. Sickle cell disease was identified during the delivery admission by using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) and International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes. The primary outcome, SMM at delivery hospitalization, was ascertained using ICD-9-CM and ICD-10-CM codes and excluded sickle cell crisis as an indicator of SMM. We also constructed a secondary measure of SMM that excluded deliveries in which blood transfusion was the only indication of SMM. Poisson regression models were used to estimate risk ratios (RRs) and 95% CIs for the associations between SCD and SMM (overall and for individual indicators). Multivariable models adjusted for age, parity, insurance type, chronic conditions (chronic hypertension, diabetes mellitus, obesity), and multiple gestation.

RESULTS:

Among 17,493 deliveries by non-Hispanic Black patients during the study period, 132 (0.8%) had a diagnosis of SCD. Of those patients, 87 (65.9%, 95% CI 57.2–73.9) with SCD and 2,035 (11.7%), 95% CI 11.2–12.2) without SCD had SMM. Sickle cell disease was associated with increased risk of SMM (87 vs 2,035, adjusted risk ratio [aRR] 5.4, 95% CI 4.6–6.3) and nontransfusion SMM (51 vs 1,057, aRR 6.0, 95% CI 4.6–8.0). Effect estimates were highest for cardiac arrest (3 vs 14, RR 28.2, 95% CI 3.8–209.3), air and thrombotic embolism (14 vs 72, RR 25.6, 95% CI 12.0–54.6), and puerperal cerebrovascular disorders (10 vs 53, RR 24.8, 95% CI 10.2–60.5).

CONCLUSION:

Sickle cell disease was associated with a more than fivefold increased risk of SMM during the delivery hospitalization. Our data suggest cardiovascular morbidity as the driving major risk. The identification and monitoring of cardiovascular pathology in patients with SCD before and during pregnancy may reduce SMM.
Pressure Volume Loop Analysis of the Right Ventricle in Heart Failure With Computed Tomography
Authors: Scott Anderson , Chen Zhennong , Hernandez Hernandez Diana , Kligerman Seth , Kim Paul , Tran Hao , Adler Eric , Contijoch Francisco
Published: December 2022

Right ventricular (RV) function is an important marker of mortality in chronic left-sided heart failure. Right ventricular function is particularly important for patients receiving left ventricular assist devices as it is a predictor of postoperative RV failure. RV stroke work index (RVSWI), the area enclosed by a pressure–volume (PV) loop, is prognostic of RV failure. However, clinical RVSWI approximates RVSWI as the product of thermodilution-derived stroke volume and the pulmonary pressure gradient. This ignores the energetic contribution of regurgitant flow and does not allow for advanced energetic measures, such as pressure–volume area and efficiency. Estimating RVSWI from forward flow may underestimate the underlying RV function. We created single-beat PV loops by combining data from cine computed tomography (CT) and right heart catheterization in 44 heart failure patients, tested the approximations made by clinical RVSWI and found it to underestimate PV loop RVSWI, primarily due to regurgitant flow in tricuspid regurgitation. The ability of RVSWI to predict post-operative RV failure improved when the single-beat approach was used. Further, RV pressure–volume area and efficiency measures were obtained and show broad agreement with other functional measures. Future work is needed to investigate the utility of these PV metrics in a clinical setting.
No Smell, No Taste—Dealing With a “Senseless” Phase of the Pandemic
Authors: Naidu A. Satyanarayan , Clemens Roger A.
Published: December 2022

The SARS-CoV-2 infection alters smell and taste sensations in many patients. These 2 neurosensory impairments, namely, (1) the loss of smell, an olfactory dysfunction (OD) or anosmia, and (2) the loss of taste, a gustatory dysfunction (GD) or ageusia, are often the earliest and, sometimes, the only signs in otherwise asymptomatic individuals. Both OD and GD are recognized by the international scientific community as one of the critical symptoms of COVID-19. The prevalence of COVID-19–related OD is higher among women (although less likely to experience severe forms of SARS-CoV-2 infection) than men. The total loss of taste sense or GD is more common among the elderly COVID-19 patients than in the younger population. In “long” COVID or postacute sequelae of COVID-19 (PASC) patients, OD/GD could persist for months to years, depending on the extent of damage caused by the SARS-CoV-2 infection to the olfactory and gustatory systems. Olfactory dysfunction and GD manifestations may severely disrupt quality of life, which includes altered eating habits, loss of appetite, weight change, and loss of pleasure in food consumption, and may further affect psychological well-being, social bonding, altered intimacy, and relationship to self and others. The hedonic value of diet relies exclusively on its flavor; however, the onset of OD/GD during SARS-CoV-2 infection deprives such organoleptic experiences of nutrition. To compensate for these OD/GD issues, the chemosensory focus of COVID-19/PASC patients during dietary consumption may shift toward food texture (to stimulate trigeminal nerves) and food colors (to stimulate brain activity), to sustain appetite as well as enhance the pleasure of eating. Olfactory training with repeated exposure to 4 intense odors twice daily has been a traditional rehabilitation practice to alleviate olfactory impairments in COVID-19. The neurosensory impairments in COVID-19 pathobiology culminate from iron-redox dysregulation, viral-induced host metabolic reprogramming, and host mitochondrial dysfunction. Therefore, nutritional restoration of host metabolic reprogramming and mitochondrial function could provide an effective strategy to reverse iron-redox dysregulation syndrome and combat OD/GD in COVID-19 and PASC patients. Innate regulators of iron-redox homeostasis, such as lactoferrin, heme oxygenase-1, erythropoietin, and hepcidin modulators, could serve as potential interventions for OD/GD recovery.
Black Seeds
Authors: Singletary Keith W.
Published: December 2022

Black seeds, sometimes called black cumin, are obtained from the spicy medicinal herb Nigella sativa that is native to a broad region encompassing the eastern Mediterranean, southwest Asia, and northern Africa. The seed and its oil have a distinctive aroma and taste, diversely described as bitter, peppery, metallic, and pungent. Both are frequent ingredients in numerous foods, especially in the Middle East and India. In these same regions N sativa has an extensive history as a folk medicine dating back millenia for relief for a variety of health conditions such as asthma, headache, bronchitis, amenorrhea, allergies, infections, and hypertension. The antioxidant, anti-inflammatory, and immunomodulatory properties of N sativa seeds observed in preclinical studies provided an impetus for clinical trials examining the seeds' effects on cardiovascular, respiratory, and neurological disorders, among others. This narrative review summarizes findings from publications addressing several these and other disorders and provides suggestions for future research.
Laparoscopic Versus Open Pancreatoduodenectomy in Patients With Periampullary Tumors
Authors: Sattari Shahab Aldin , Sattari Ali Reza , Makary Martin A. , Hu Chen , He Jin
Published: December 2022

Objective:

To conduct a systematic review and meta-analysis of randomized controlled trials compared laparoscopic pancreatoduodenectomy (LPD) versus open pancreatoduodenectomy (OPD) in patients with periampullary tumors.

Background:

LPD has gained attention; however, its safety and efficacy versus OPD remain debatable.

Methods:

We searched PubMed and Embase. Primary outcomes were the length of hospital stay (LOS) (day), Clavien-Dindo grade ≥III complications, and 90-day mortality. Secondary outcomes were blood loss (milliliter), blood transfusion, duration of operation (minute), readmission, reoperation, comprehensive complication index score, bile leak, gastrojejunostomy or duodenojejunostomy leak, postoperative pancreatic fistula, postpancreatectomy hemorrhage, delayed gastric emptying, surgical site infection, intra-abdominal infection, number of harvested lymph nodes, and R0 resection. Pooled odds ratio (OR) or mean difference (MD) of data was calculated using the random-effect model. The grading of recommendations, assessment, development and evaluation approach was used for grading the level of evidence.

Results:

Four randomized controlled trials yielding 818 patients were included, of which 411 and 407 patients underwent LPD and OPD, respectively. The meta-analysis concluded that 2 approaches were similar, except in the LPD group, the LOS tended to be shorter [MD=−2.54 (−5.17, 0.09), P=0.06], LOS in ICU was shorter [MD=−1 (−1.8, −0.2), P=0.01], duration of operation was longer [MD=75.16 (23.29, 127.03), P=0.005], blood loss was lower [MD=−115.40 (−152.13, −78.68), P<0.00001], blood transfusion was lower [OR=0.66 (0.47, 0.92), P=0.01], and surgical site infection was lower [OR=0.35 (0.12, 0.96), P=0.04]. The overall certainty of the evidence was moderate.

Conclusions:

Within the hands of highly skilled surgeons in high-volume centers, LPD is feasible and as safe and efficient as OPD.
Partial vs Full Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in a Swine Model of Raised Intracranial Pressure and Hemorrhagic Shock
Authors: Edwards Joseph , Abdou Hossam , Stonko David P , Treffalls Rebecca N , Elansary Noha , Lang Eric , Morrison Jonathan J
Published: December 2022

BACKGROUND:

Partial resuscitative endovascular balloon occlusion of the aorta (pREBOA) is a potential method to mitigate the ischemia observed in full REBOA (fREBOA). However, the effect of pREBOA on cerebral perfusion in the setting of raised intracranial pressure (rICP) is unknown. The aim was to evaluate the effects of no REBOA (nREBOA) vs pREBOA vs fREBOA on cerebral perfusion in a swine model of rICP and hemorrhagic shock.

STUDY DESIGN:

Anesthetized swine (n = 18) underwent instrumentation. Controlled hemorrhage was performed over 30 minutes. rICP was achieved using an intracranial Fogarty catheter inflated to achieve an ICP of 20 mmHg. Animals underwent intervention for 30 minutes, followed by resuscitation. The primary outcome was cerebral perfusion measured by ICP (millimeters of mercury), cerebral perfusion pressure (CPP; millimeters of mercury), and cerebral blood flow (CBF; milliliters per minute per 100 g) derived from CT perfusion. The secondary outcomes included hemodynamics and lactate (millimoles per liter).

RESULTS:

The peak ICP of pREBOA animals (22.7 ± 2.5) was significantly lower than nREBOA and fREBOA. pREBOA CPP was significantly higher compared with nREBOA and fREBOA during resuscitation. The pREBOA CBF was greater during intervention and resuscitation compared with nREBOA (p < 0.001). Systolic blood pressure was similar between pREBOA and fREBOA, and coronary perfusion was significantly greater in pREBOA. fREBOA had significantly higher lactate during the intervention (9.3 ± 1.3) and resuscitation (8.9 ± 3.5) compared with nREBOA and pREBOA.

CONCLUSION:

pREBOA produced greater cerebral perfusion, as demonstrated by more favorable CPP, CBF, and ICP values. fREBOA was associated with metabolic derangement and diminished pressure during resuscitation. pREBOA is superior to fREBOA in a swine model and should be considered over fREBOA for aortic occlusion.
Intimate Partner Violence and Pregnancy: Nationwide Analysis of Injury Patterns and Risk Factors
Authors: Albini Paul T , Zakhary Bishoy , Edwards Sara B , Coimbra Raul , Brenner Megan L
Published: December 2022

BACKGROUND:

Intimate partner violence (IPV) is a significant cause of injury, and in pregnant patients (PIPV) poses a risk to both mother and fetus. Characteristics and outcomes for PIPV patients have not been well described. We hypothesize that PIPV patients have higher admission rates and mortality than non-IPV pregnant trauma (PT) patients and nonpregnant female IPV patients of childbearing age. We also hypothesize differences exist between PIPV and PT patient injury patterns, allowing for targeted IPV screening.

STUDY DESIGN:

The Nationwide Emergency Department Sample database was queried from 2010 to 2014 to identify IPV in adult women patients by injury code E967.3. Patients were compared in 2 ways, PIPV vs PT and PIPV vs nonpregnant female IPV patients. Demographics, injury mechanisms, and National Trauma Data Standard injury diagnoses were surveyed. Primary outcomes were hospital admissions and mortality. Logistic regression was used to estimate risk factors of the outcomes of hospitalization and IPV victimization in pregnant injured patients.

RESULTS:

There were 556 PIPV patients, 73,970 PT patients, and 56,543 nonpregnant female IPV patients. When comparing PIPV to PT, more PIPV patients had Medicaid coverage or were self-pay. Suffocation, head injuries, face/neck/scalp contusions, multiple contusions, and abrasions/friction burns were more prevalent in PIPV patients. Mortality and hospital admissions were scarce among all cohorts. Predictors of IPV victimization among injured pregnant patients include multiple injuries, head injuries, face/neck/scalp contusions, abrasions/friction burns, contusions of multiple sites, and those with Medicaid or self-pay coverage.

CONCLUSIONS:

Among injured pregnant patients, those with multiple injuries, head injuries, contusions of the face/neck/scalp, abrasions/friction burns, and multiple contusions should undergo IPV screening. Admissions and mortality are low; therefore, prevention measures should be implemented in the emergency department to reduce repeat victimization.
Outcomes of Liver Transplantation Using Machine Perfusion in Donation after Cardiac Death vs Brain Death in the US
Authors: Okumura Kenji , Dhand Abhay , Misawa Ryosuke , Sogawa Hiroshi , Veillette Gregory , Nishida Seigo
Published: December 2022

BACKGROUND:

Liver transplant (LT) outcomes using machine perfusion (MP) in donation after brain death (DBD) is promising, but the LT outcomes of MP in donation after cardiac death (DCD) is limited in the US. The aim of this study was to compare LT outcomes of MP between DCD and DBD.

STUDY DESIGN:

We analyzed data from the United Network for Organ Sharing between 2016 and 2021 among adult LT recipients. Propensity score matching was performed to assess the outcomes between DCD and DBD.

RESULTS:

A total of 380 LTs (295 from DBD and 85 from DCD) were performed using MP. When compared with DBD, DCD group had older median recipient age (61 vs 58 years, p = 0.03), higher prevalence of diabetes (41% vs 28%, p = 0.02), lower model for end-stage liver disease score (17 vs 22, p < 0.01), longer wait time (276 vs 143 days, p < 0.01) and younger median donor age (40 vs 51 years, p < 0.01). The most common primary diagnosis was alcohol-related liver disease, and hepatocellular carcinoma was more common in the DCD group (22% vs 13%). On survival analysis, 1-year overall/graft survivals (DCD 95.4% vs DBD 92.1%, p = 0.54; DCD 91.7% vs DBD 89.8%, p = 0.86) were the same. After propensity score matching, overall/graft survivals were the same. In Cox regression analysis, DCD was not an independent risk factor of mortality (hazard ratio 0.80; 95% CI 0.25 to 2.52; p = 0.70) and graft failure (hazard ratio 0.58; 95% CI 0.17 to 1.97; p = 0.38).

CONCLUSIONS:

In transplant recipients who underwent LT using MP, posttransplant outcomes of overall and graft survival were similar among DCD and DBD cohorts.
Restrictive Firearm Laws and Firearm-Related Suicide
Authors: Kawano Bradley , Agarwal Suresh , Krishnamoorthy Vijay , Raghunathan Karthik , Fernandez-Moure Joseph S , Haines Krista L
Published: December 2022

BACKGROUND:

There were 23,854 suicides by firearms in 2017 in the US, accounting for 60% of all gun deaths. Studying firearm-related mortalities is vital for reducing preventable gun deaths. This study aims to determine the association between state-level presence of restrictive firearm laws and suicide rates with firearms.

STUDY DESIGN:

This ecological study used data from the CDC Wide-Ranging Online Data for Epidemiologic Research on decedents older than 18 years who died from intentional self-harm with firearms between 2009 and 2018. Exposures of interest were state-level restrictive firearm laws: background checks on private sales, mandatory waiting periods, and prohibited possession for domestic violence restraining orders or mental health red flags. Outcomes were rates of suicide with firearms per 100,000 persons over the 10-year period within each state. Welch’s t-tests compared mean mortality rates in exposed and unexposed states.

RESULTS:

There were 208,621 deaths from intentional self-harm with firearms from 2009 to 2018. States with background checks, mandatory waiting periods, and prohibited possession were associated with lower suicide rates for all firearm types compared with states without these laws (p < 0.05). Only states with background checks and mandatory waiting periods were associated with lower suicide rates by handguns and large firearms (p < 0.05).

CONCLUSION:

Background checks and mandatory waiting periods correlated with fewer suicides by all firearms and specific firearm types. This reduction could be due to firearm laws directly preventing people from accessing guns or existing concurrently with other suicide prevention measures. More research should be directed to understanding how firearm laws can help reduce suicide rates.
Wound Complication Rates after Inguinal Lymph Node Dissection: Contemporary Analysis of the NSQIP Database
Authors: Chua Kevin J , Balraj Vasundhara , Patel Hiren V , Srivastava Arnav , Doppalapudi Sai Krishnaraya , Elsamra Sammy E , Jang Thomas L , Singer Eric A , Ghodoussipour Saum B
Published: December 2022

BACKGROUND:

Inguinal lymph node dissection (ILND) is used for diagnosis and treatment in penile cancer (PC), vulvar cancer (VC), and melanomas draining to the inguinal lymph nodes. However, ILND is often characterized by its morbidity and high wound complication rate. Consequently, we aimed to characterize wound complication rates after ILND.

STUDY DESIGN:

The NSQIP database was queried for ILND performed from 2005 to 2018 for melanoma, PC, or VC. Thirty-day wound complications included wound disruption and superficial, deep, and organ-space surgical site infection. Multivariable logistic regression was performed with covariates, including cancer type, age, American Society of Anesthesiologists score ≥3, BMI ≥30, smoking history, diabetes, operative time, and concomitant pelvic lymph node dissection.

RESULTS:

A total of 1,099 patients had an ILND with 92, 115, and 892 ILNDs performed for PC, VC, and melanoma, respectively. Wound complications occurred in 161 (14.6%) patients, including 12 (13.0%), 17(14.8%), and 132 (14.8%) patients with PC, VC, and melanoma, respectively. Median length of stay was 1 day (interquartile range 0 to 3 days), and median operative time was 152 minutes (interquartile 83 to 192 minutes). Readmission rate was 12.7%. Wound complications were associated with longer operative time per 10 minutes (odds ratio 1.038, 95% CI 1.019 to 1.056, p < 0.001), BMI ≥30 (odds ratio 1.976, 95% CI 1.386 to 2.818, p < 0.001), and concomitant pelvic lymph node dissection (odds ratio 1.561, 95% CI 1.056 to 2.306, p = 0.025).

CONCLUSIONS:

Predictors of wound complications after ILND include BMI ≥30, longer operative time, and concomitant pelvic lymph node dissection. There have been efforts to decrease ILND complication rates, including minimally invasive techniques and modified templates, which are not captured by NSQIP, and such approaches may be considered especially for those with increased complication risks.
Addiction of Smartphones and Its Relationship to Academic Achievement of Medical Students in Saudi Arabia,2022
Authors: Alharbi Rayan Saud , Mohamed Baderldeen Abdulrahman , Alshammari Thamir M
Published: December 2022

Background

Smartphones and their increasing capabilities have helped humans to communicate and perform many tasks and it leads to a form of dependency, and it may have negative effects on everyone, especially students.

Objectives

To assess smartphone addiction and its relationship to academic performance among medical students at King Saud University, Kingdom of Saudi Arabia.

Methods

An observational cross-sectional study was conducted from July to September 2022 including students of the College of Medicine at King Saud University, Kingdom of Saudi Arabia. The data collection tool was structured and utilized an electronic survey.

Results

A total of 330 participants answered the study questionnaire. The most common age range of study participants was 18-28 years with 64.2% of the study sample. Male participants represented 63%. The study income is less than 5000 riyals 54.5% per month. Majority of ftudents (65%) believe that using smartphones them to study more efficiently. Analysis of the study results shows that there is a statistically significant correlation between phone addiction and a decrease in the academic performance of college students.

Conclusion

Our study found that there is a significant correlation between phone addiction and a drop in academic performance. Despite its attractiveness, smartphone addiction is a time waster for students that might disrupts their sleep and causes stress. It is, therefore, necessary to create a comprehensive plan that directs the students towards balanced use.
Hyobanche hanekomii(Orobanchaceae) is pollinated by non-flying mammals and birds
Authors: Niedzwetzki-Taubert Tim
Published: December 2022

H. hanekomiiwas recently described as a new member of the genusHyobancheinside the Orobanchaceae family.H. hanekomiiis a small geoflorous holoparasitic plant, which often grows under shrubs and has red-flowered inflorescences, which do not emit a scent. The plant combines characteristics from bird- and mammal-pollinated plants. Until now it was uncertain ifH. hanekomiiis pollinated by birds or by non-flying mammals, since the species is showing an intermediate morphology when compared toH. atropurpurea(mammal pollinated) andH. sanguinea(bird pollinated). Elephantulus edwardiiandNectarinia famosawere observed foraging onH. hanekomiiinflorescences indicating a mixed pollination syndrome or a transmission state between bird pollination to pollination by non-flying mammal. In this study I prove thatE. edwardiiandN. famosaare indeed pollinators ofH. hanekomii. This was done by observing the interaction between different animal species andH. hanekomiiinflorescences in their natural habitat by using camera traps and camcorders.

It could be observed thatE. edwardiilicked nectar from flowers ofH. hanekomiiwith its long tongue. The animals pressed their rostra deep into the flowers. While foraging on the flowers, it could be observed that pollen was placed onto the rostra of the animals. It was also observed, that the stigma of the flower touched the animals on the same spots where pollen was placed. To drink on the flowers,Nectarinia famosainserted its beak into the flowers. While doing so, it was observed that pollen was placed on the beaks and that the stigma touched the animals. It is possible that both species transport pollen from oneH. hanekomiiflower to another while foraging on them, and that the pollen reaches the stigma of another flower. Because of this both species are considered as pollinators ofH. hanekomii.

E. edwardiiwas identified as the main pollinator ofH. hanekomiias they visit the inflorescences frequently.N. famosawas detected as a secondary pollinator ofH. hanekomiias they visit the flowers infrequently. This issue has to be examined further since the rarity ofN. famosavisits could be influenced by different factors like removal of perching positions around the plants to have a better camera angel or by the cameras itself, so thatN. famosawould visit theH. hanekomiiinflorescences more often in an non altered surrounding.

In addition UV photography and spectrometry revealed that no UV reflecting areas are present on the plants indicating adaption to non-flying mammal than bird pollination syndrome. The same counts for missing stinging hairs on the flowers. In contrary some of the important flower characteristics (Flower entrance width and height) are significant smaller than those of the non-flying mammal pollinated plantH. atropurpureaindicating a bird pollination syndrome.
Seasonality and the persistence of vector-borne pathogens
Authors: Khong Van Hai , Carmona Philippe , Gandon Sylvain
Published: December 2022

Many vector-borne diseases are affected by the seasonality of the environment. Yet, seasonality can act on distinct steps of the life-cycle of the pathogen and it is often difficult to predict the influence of the periodic fluctuations of the environment on the persistence of vector-borne pathogens. Here we analyse a general vector-borne disease model and we account for periodic fluctuations of different components of the pathogen’s life-cycle. We develop a perturbation analysis framework to obtain useful approximations to evaluate the overall consequences of seasonality on the persistence of pathogens. This analysis reveals when seasonality is expected to increase or to decrease pathogen persistence. We show that seasonality in vector density or in the biting rate of the vector can have opposite effects on persistence and we provide a useful biological explanation for this result based on the covariance between key compartments of the epidemiological model. This framework could be readily extended to explore the influence of seasonality on other components of the life cycle of vector-borne pathogens.

Significance statement

Does seasonality increase or decrease the persistence of vector-borne diseases? The devil is in the details and our analysis shows that the effect of seasonality depends on which pathogen traits are affected by seasonality. We highlight the contrasting effects of seasonality in the abundance and/or in the biting rate of the vector on pathogen persistence.
A Landscape Analysis of the Recent Rise of Healthcare Data Science Degree Programs
Authors: Bhandari Aman , Cohen Austin , Fung Maxwell , Panch Trishan , Aronov Alex , Michaud Nicholas
Published: December 2022

There has been an explosion in formal data science and healthcare data science programs, degrees and tracks at the university level over the last five years, with over 100 universities currently offering formal data science degrees. We conducted a landscape analysis of healthcare-related data science programs in the United States to characterize these new academic degree offerings, identifying 29 healthcare focused data science programs at four-year colleges and universities in the United States. Programs were analyzed across a range of features, providing the first view into what constitutes “healthcare data science” education.
Genome-wide Association Study Meta-analysis of Neurofilament light (NfL) levels in blood reveals novel loci related to neurodegeneration
Authors: Ahmad Shahzad , Imtiaz Mohammad Aslam , Mishra Aniket , Wang Ruiqi , Herrera-Rivero Marisol , Bis Joshua C , Fornage Myriam , Roshchupkin Gennady , Hofer Edith , Logue Mark , Longstreth WT , Xia Rui , Bouteloup Vincent , Mosley Thomas , Launer Lenore , Khalil Michael , Kuhle Jens , Rissman Robert A. , Chene Genevieve , Dufouil Carole , Djoussé Luc , Lyons Michael J. , Mukamal Kenneth J. , Kremen William S. , Franz Carol E. , Schmidt Reinhold , Debette Stephanie , Breteler Monique M.B. , Berger Klaus , Yang Qiong , Seshadri Sudha , Aziz N. Ahmad , Ghanbari Mohsen , Ikram M. Arfan
Published: December 2022

Background

Neurofilament light chain (NfL) levels in circulation have been established as a sensitive biomarker of neuro-axonal damage across a range of neurodegenerative disorders. Elucidation of the genetic architecture of blood NfL levels and its genetic correlation with neurological traits could therefore provide new insights into shared molecular mechanisms underlying neurodegenerative disorders.

Methods

To identify the genetic variations underlying blood NfL levels, we conducted an ancestry-specific meta-analyses of genome-wide association studies (GWAS) based on 18,532 participants from 11 cohorts of European and 1142 participants (3 cohorts) of African-American ancestry. In the post-GWAS analyses, we performed expression quantitative trait loci (eQTL) analysis, LD-regression, and genetic risk score (GRS) association analysis with neurological traits.

Results

In the European ancestry GWAS meta-analysis, we identified two genome-wide significant (P< 5x10−8) loci at 16p12 (UMOD), and 17q24 (SLC39A11). In the African-American ancestry GWAS meta-analysis, we identified three novel loci at 1q43 (FMN2), 12q14, and 12q21. Genetic correlation based on the European ancestry meta-analysis with neurological traits showed a strong genetic correlation of NfL with Alzheimer’s disease(AD) (rg= 0.32,P= 1.74x10−6), total-tau (rg= 2.01,P= 1.03x10−6), amyloid-beta (Aβ)-40 (rg= 0.80,P= 6.92x10−6), and Aβ-42 (rg= 1.03,P= 4.39x10−5). A higher genetic risk score based on NfL-associated genetic variants was also related to increased plasma levels of total-tau (P= 1.97x10−4), Aβ-40 (P= 2.24x10−5), Aβ-42 (P= 2.92x10−4) in the Rotterdam Study.

Conclusion

This large-scale GWAS meta-analysis revealed multiple novel genetic loci of NFL levels in blood in participants from European and African-American ancestry. Significant genetic correlation of genes underlying NfL with AD, Aβ-42, and total-tau may indicate a common underlying pathway of neurodegeneration.
Variabilities and similarities of adult stem cells derived intestinal organoids originating from different intestinal segments in pig
Authors: Kar Soumya K. , te Pas Marinus F.W. , Rikkers Roxann , Madsen Ole , Taverne Nico , Ellen Esther D. , Wells Jerry M. , Schokker Dirkjan
Published: December 2022

1.

Organoids arein vitromodel systems generated from tissues. Organoids express specific physiological functions associated with their original tissue location and they express tissue-segment-specific genes. The aim of this study was to culture pig organoids from different areas of intestinal segments: duodenum, ileum (with or without Peyers Patches (PP)), and colon, to investigate the resemblance with thein vivotissues and variability of multiple adjacent sampling sites based on histology and transcriptome profiles. The transcriptome profiles of thein vivotissues and the derived organoids showed high resemblance for all intestinal segments. For the transcriptomic cluster analysis it was shown that it is important to use tissue important genes to shown the resemble between tissue and their derived organoids. The transcriptome profiles clearly separated the intestinal segments, and samples of the same segment from adjacent tissue locations showed high transcriptome profile similarity. Ileum samples with and without PP were also separated. Pathway analysis of differentially expressed genes from PP compared with non-PP suggested the importance of several aspects of cell cycle progression regulation, including DNA metabolism, chromatin organization, regulation of mitotic stage progression, and regulation of inflammation. Based primarily on the transcriptomics results, we conclude that organoids reflect the sampled intestinal segment and that organoids derived from adjacent sampling sites in an intestinal tissue segment showed low variability. The results from the ileum indicate that organoids have potential to study intestinal innate immune processes.
Long-term neutralizing antibody dynamics against SARS-CoV-2 in symptomatic and asymptomatic infections: a systematic review and meta-analysis
Authors: Lu Wanying , Zheng Nan , Chen Xinhua , Sun Ruijia , Dong Jiayi , Ge Shijia , Deng Xiaowei , Yu Hongjie
Published: December 2022

Background

The kinetics of the neutralizing antibody response against SARS-CoV-2 is crucial for responding to the pandemic as well as developing vaccination strategies. We aimed to fit the antibody curves in symptomatic and asymptomatic individuals.

Methods

We systematically searched PubMed, Embase, Web of Science, and Europe PMC for articles published in English between Jan 1, 2020, and Oct 2, 2022. Studies evaluating neutralizing antibody from people who had a natural SARS-CoV-2 infection history were included. Study quality was assessed using a modified standardized scoring system. We fitted dynamic patterns of neutralizing antibody using a generalized additive model and a generalized additive mixed model. We also used linear regression model to conduct both univariate and multivariable analyses to explore the potential affecting factors on antibody levels. This study is registered with PROSPERO, CRD42022348636.

Results

7,343 studies were identified in the initial search, 50 were assessed for eligibility after removal of duplicates as well as inappropriate titles, abstracts and full-text review, and 48 studies (2,726 individuals, 5,670 samples) were included in the meta-analysis after quality assessment. The neutralization titer of people who infected with SARS-CoV-2 prototype strain peaked around 27 days (217.4, 95%CI: 187.0-252.9) but remained below the Omicron BA.5 protection threshold all the time after illness onset or confirmation. Furthermore, neither symptomatic infections nor asymptomatic infections could provide over 50% protection against Omicron BA.5 sub-lineage. It also showed that the clinical severity and the type of laboratory assays may significantly correlated with the level of neutralizing antibody.

Conclusions

This study provides a comprehensive mapping of the dynamic of neutralizing antibody against SARS-CoV-2 prototype strain induced by natural infection and compared the dynamic patterns between prototype and variant strains. It suggests that the protection probability provided by natural infection is limited. Therefore, timely vaccination is necessary for both previously infected symptomatic and asymptomatic individuals.
Molecular versus structural chirality
Authors: Nespolo Massimo
Published: December 2022

The rigorous proof that a structure crystallizing in any of the 65 Sohncke types of space groups is necessarily chiral is presented.
Characterization of Lean Six Sigma projects in healthcare settings: empirical research
Authors: Sordan Juliano Endrigo , Marinho Clésio Aparecido , Oprime Pedro Carlos , Pimenta Márcio Lopes , Andersson Roy
Published: December 2022

Purpose

This paper aims to characterize a sample of Lean Six Sigma (LSS) projects in healthcare settings and discuss some specificities of operational excellence (OPEX) initiatives in hospitals and healthcare organizations in the USA.

Design/methodology/approach

A content analysis involving a sample of 23 documents shared by US hospitals was performed in order to achieve the research objectives. Such analysis was based on a conceptual framework developed from the literature review. It was also applied to a quantitative approach, including descriptive statistics, hypothesis testing and correspondence analysis that supported the research.

Findings

Most LSSH projects were focused on business transformation and strategic improvements. Simple techniques and tools were predominant such as descriptive statistics, process mapping, 5S and spaghetti charts, usually implemented by Green Belts and Black Belts through the define, measure, analyze, improve and control (DMAIC) method. In addition to the expressive findings reported, these projects' results have been aligned with lead time and operational cost reduction, quality improvement and capacity increase.

Research limitations/implications

The study adds knowledge to the OPEX literature by analyzing the Lean Six Sigma healthcare (LSSH) in hospitals and healthcare institutions in the USA. It also demonstrates that different approaches, such as the kaizen event and DMAIC project show different results according to some techniques and tools applied in the hospital environment.

Originality/value

The empirical evidence presented in this study provides scenery of the LSS practices in the healthcare settings, highlighting the implementation areas, outcomes, tools and techniques mostly used in the North American healthcare institutions.
Evaluation of success factors to implement digitalization in the construction industry
Authors: Bajpai Avirag , Misra Subhas C.
Published: December 2022

Purpose

This study aims to identify and rank the key success factors linked with digitalization in the Indian construction sector. Because the construction firms in India are in the early stages of implementing digitalization in their operations, it provides a framework from which they may focus on the effectiveness of digitalization.

Design/methodology/approach

This research study examines 12 success factors related to digitalization in construction, which are derived from various sectors. Furthermore, experts from the construction industry and academia have validated these factors with respect to the Indian construction sector. The multi-criteria decision-making techniques are further used to examine the interrelationship, ranking and weightage of digitalization success. Finally, the success factors are validated through a questionnaire-based empirical study followed by ranking using a t-test. The results from both approaches (company-specific and generalized) are compared and discussed.

Findings

This research identifies that selecting appropriate digital methods and techniques is a critical success factor as far as digitalization in the Indian construction scenario is concerned. Besides that, continuous monitoring and control in digital implementation significantly impact other factors.

Research limitations/implications

While similar results are obtained from approaches adopted in the study, a few success factors appear to differ in terms of their ranking position. Further studies can explore the finer details that can explain the behavior pattern. This study can also be extended by assessing the structural relationship among the identified factors that can throw more light on the dynamics of the continuation of digitalization in construction which can further help in formulating policies or digitalization rollout.

Practical implications

The outcome of this study sheds light on construction business knowledge by stressing key success elements connected to digitalization in construction processes in the Indian construction sector. Moreover, this study shows that the success of digitalization in construction is similar to that of transformation in the information technology industry, where adopting suitable digital methods and techniques plays a vital role in the transformation process.

Originality/value

Despite the multiple benefits of construction digitalization, limited research focuses on digitalization success factors, making this study unique. Furthermore, this study demonstrates that integrating Fuzzy decision-making trial and evaluation laboratory and maximum mean de-entropy approaches may be used to successfully prioritize success factors in the nascent stage of construction digitalization.
When feeling good counts! Impact of consumer gratitude and life satisfaction in access-based services
Authors: Chou Cindy Yunhsin , Leo Wei Wei Cheryl , Tsarenko Yelena , Chen Tom
Published: December 2022

Purpose

Informed by the broaden-and-build theory of emotions, this study aims to investigate the relationships between consumers’ motives and personal and social outcomes in access-based services (ABS). Further, drawing on territorial behaviour literature, the second goal of this research is to test the moderating effects of psychological ownership on the relationships between personal outcomes and consumer territorial behaviour.

Design/methodology/approach

This research comprises a quantitative online survey complemented by a qualitative interview study. The quantitative study employed an online consumer panel survey of 317 samples. Later, the qualitative study sought additional insights into the economic benefit motives and manifestation of territorial behaviour of bicycle-sharing users to enrich the results of quantitative study. The quantitative data were analysed using structural equation modelling, and the interviews were transcribed and analysed using an inductive and deductive thematic analysis.

Findings

The results indicated that specific motives significantly affected certain personal outcomes. Namely, economic benefit, enjoyment and reputation motives drove life satisfaction, while enjoyment, sustainability and social relationships promoted feelings of gratitude. Furthermore, life satisfaction positively affected consumer cooperation, helping other consumers and territorial behaviour. In contrast, feelings of gratitude had a positive relationship with cooperation and helping other consumers, but a negative one with territorial behaviour. Additional examination revealed that consumers’ psychological ownership of the shared bicycle in an ABS model moderated the effect of gratitude on consumer territorial behaviour.

Research limitations/implications

This study offers and tests a model on ABS in the context of bicycle-sharing services. Thus, it presents avenues to test the model on other ABS, e.g. clothing or home sharing.

Practical implications

Managers in ABS can foster positive emotional states of gratitude and life satisfaction that will inevitably promote consumer cooperation and helping behaviour.

Originality/value

This study is among the first to propose and examine a model that tests the relationships between consumers’ motives and personal and social outcomes in ABS.
The festival customer experience: a conceptual framework
Authors: Fernandes Jovan Velroy , Krolikowska Ewa
Published: December 2022

Purpose

The purpose of this paper is to contribute to the conceptualisation of the festival customer experience by proposing a new framework based on three interrelated concepts: event design, social environment and digital environment.

Design/methodology/approach

The authors use a theory adaptation research design to adapt an existing customer experience framework to the specific context of festival customer experience based on the literature on customer experience and experiential marketing within events, festivals, tourism and leisure.

Findings

Based on this new conceptual framework, the authors identify interrelationships between event design, social environment and digital environment which can be managed by festival organisers to improve the customer experience.

Research limitations/implications

This study’s analysis identifies five areas which are crucial for managing the contemporary festival customer experience. It offers researchers a conceptual framework for further development.

Originality/value

The paper proposes a new conceptual framework for festival customer experience which can be used to improve brand experiences at festivals. This is an emerging area which warrants further attention since festivals provide a valuable opportunity for brands to engage and build relationships with prospective and existing customers. This study is the first to combine insights from the interrelationships between event design, digital environment and social environment to better understand how to improve the management of brand experiences at festivals.
The effect of Chinese foreign direct investment on Africa's industrialization process
Authors: Darko Eugene Misa , Xu Kangning
Published: December 2022

Purpose

This study empirically investigates the long-run and interactive effect of Chinese foreign direct investment (CFDI) on Africa's industrialization process.

Design/methodology/approach

The authors employed industry and manufacturing value-added (% GDP) as the dependent variables and applied the two-step GMM and panel-corrected standard errors' (PCSE) techniques involving a panel of 49 African countries from 2003 to 2020.

Findings

The industry value-added (% GDP) results show that the presence of CFDI propels industrial productivity by contributing to value-addition in the short and long run. Moreover, the study shows that the magnitude of the CFDI effect on industrialization is pronounced in the short-run when it is associated with labor and natural resources. This result reveals efficiency-seeking behavior of CFDI and the CFDI-Africa industrialization nexus is not primarily resource-driven. More importantly, the authors found human capital, electricity and political stability, as primary factors that magnify CFDI's effect on industrialization in the short and long run.

Originality/value

This study is the first to use macro-level data to empirically investigate and find the significant effect of CFDI on Africa's industrialization in the long run. More importantly, the authors investigated channels through which CFDI magnifies industrialization in Africa in the short and long run.