bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative analysis of buoyancy-driven hydromagnetic flow and heat transfer in a partially heated square enclosure using Cu-Fe3O4 and MoS2-Fe3O4 nanofluids
Authors: Ameer Ahammad N.
Published: October 2024

Purpose

This study aims to investigate entropy generation through natural convection and examine heat transfer properties within a partially heated and cooled enclosure influenced by an angled magnetic field. The enclosure, subjected to consistent heat production or absorption, contains a porous medium saturated with a hybrid nanofluid blend of Cu-Fe3O4 and MoS2-Fe3O4.

Design/methodology/approach

The temperature and velocity equations are converted to a dimensionless form using suitable non-dimensional quantities, adhering to the imposed constraints. To solve these transformed dimensionless equations, the finite-difference method, based on the MAC (Marker and Cell) technique, is used. Comprehensive numerical simulations address various control parameters, including nanoparticle volume fraction, Rayleigh number, heat source or sink, Darcy number, Hartmann number and slit position. The results are illustrated through streamlines, isotherms, average Nusselt numbers and entropy generation plots, offering a clear visualization of the impact of these parameters across different scenarios.

Findings

Results obtained show that the Cu-Fe3O4 hybrid nanofluid exhibits higher entropy generation than the MoS2-Fe3O4 hybrid nanofluid when comparing them at a Rayleigh number of 106 and a Darcy number of 10–1. The MoS2 hybrid nanofluid demonstrates a low permeability, as evidenced by an average Darcy number of 10–3, in comparison to the Cu hybrid nanofluid. The isothermal contours for a Rayleigh number of 104are positioned parallel to the vertical walls. Additionally, the quantity of each isotherm contour adjacent to the hot wall is being monitored. The Cu and MoS2 nanoparticles exhibit the highest average entropy generation at a Rayleigh number of 105 and a Darcy number of 10–1, respectively. When a uniform heat sink is present, the temperature gradient in the central part of the cavity decreases. In contrast, the absence of a heat source or sink leads to a more intense temperature distribution within the cavity. This differs significantly from the scenario where a uniform heat sink regulates the temperature.

Originality/value

The originality of this study is to examine the generation of entropy in natural convection within a partially heated and cooled enclosure that contains hybrid nanofluids. Partially heated corners are essential for optimizing heat transfer in a wide range of industrial applications. This enhancement is achieved by increasing the surface area, which improves convective heat transfer. These diverse applications encompass fields such as chemical engineering, mechanical engineering, surface research, energy production and heat recovery processes. Researchers have been working on improving the precision of heated and cold corners using various methods, such as numerical, experimental and analytical approaches. These efforts aim to enhance the broad utility of these corners further.
Unraveling the customer orientation paradox
Authors: Oh Hyunghwa , Jo WooMi , Kim Jinok Susanna , Park Jeongdoo
Published: October 2024

Purpose

This study aims to examine the roles of customer orientation (CO) and two distinct stress coping strategies – problem-focused (PC) and emotion-focused (EC) – in the positive relationship between customer incivility (CI) and job stress (JS).

Design/methodology/approach

Data were collected via a survey of casino dealers in South Korea. Common method variance was assessed using an unmeasured latent method construct, confirming both convergent and discriminant validity. Collinearity diagnostics were conducted to evaluate potential multicollinearity among independent variables. Hypotheses were tested using PROCESS Macro Models 1 and 3 to examine moderating effects and three-way interactions.

Findings

CI is positively related to JS. Employees with high CO experience greater JS when faced with CI compared to those with low CO. Highly customer-oriented employees with low coping strategies encounter significant JS when dealing with uncivil casino patrons.

Practical implications

Casino practitioners should balance CO strategies with effective stress management and support systems. This finding calls for a reevaluation of training programs and policies to maintain high service quality while ensuring employee well-being.

Originality/value

This study challenges the traditional view of CO as merely a stress-buffering factor by revealing its paradoxical role. It identifies individuals more susceptible to JS and demonstrates how the interaction between CI, CO and coping strategies (i.e. PC or EC) can escalate JS.
The mediating role of psychological capital in the relationship between LMX and cyberloafing
Authors: Gupta Megha , Mehta Nikhil Kewal Krishna , Agarwal Upasna A. , Jawahar I.M.
Published: October 2024

Purpose

The purpose of this paper is to investigate the direct impact of leader-member exchange (LMX) quality on cyberloafing as well as its indirect impact through psychological capital.

Design/methodology/approach

Using a two-wave time-lagged design, data were collected from 417 full-time employees of 15 information technology service organizations in the Mumbai metropolis area of India.

Findings

Results indicate that LMX quality is negatively related to cyberloafing and psychological capital partially mediates this association. Even though data were collected at two points in time, the self-reported nature of the data is a limitation.

Practical implications

Results of the study have practical implications. Designing interventions to help managers enhance the quality of their relationship with their followers will directly and indirectly reduce cyberloafing by enhancing psychological capital.

Originality/value

This study is among the first to examine the impact of LMX quality on cyberloafing. In addition, the reliance on psychological capital theory to predict cyberloafing is a novel contribution. This study explores why and when LMX quality inhibits workplace cyberloafing.
The play’s the thing: reflections on the use of playwriting as creative practice within an education studies PhD
Authors: Curtis Beth , Husband Gary
Published: October 2024

Purpose

Expanding on Harris and Sinclair (2014, p. 5) claim that “the writing of a play is an act of inquiry”, this paper aims to consider the joyful entanglements, messiness and friction-led use of creative methods within the context of a PhD in education studies.

Design/methodology/approach

Amplifying the voices of both doctoral student and supervisor, the authors explain how the construction of a dramatic script informed the crafting of an alternative format thesis within which “the play’s the thing” (Hamlet, Act 2, Scene 2). In responding to the influence of creativity in the lives of both the student and the supervisor, the paper uses creative and reflective writing as a method of inquiry to explore how practice and procedure are navigated in relation to non-standard theses submissions.

Findings

The authors find that academic expectancy continues to influence the structure, form and presentation of the PhD thesis and argue that enduring tensions surrounding the reverence of “tradition” impact the application and nature of creativity.

Originality/value

The piece aims to examine the multiple challenges faced but, importantly, highlights how the creative partnership between supervisor and student has forged changes in contemporary doctoral education in the awarding institution and the implications for future practice within doctoral education more broadly.
Effect of water quenching into strength, hardness and microstructure of the welded AA 6061 plates
Authors: Ayush Ayush , Dewangan Saurabh , Ishwar Sidhant , Agarwal Ayush
Published: October 2024

Purpose

The purpose of this study is to find the effect of heat treatment on the mechanical proeprties of aluminum. Aluminum exhibits a good response to heat treatment, especially quenching, according to the mechanical property improvement. The presence and orientation of secondary phases (Al-Fe-Mn-Si) are greatly affected by the quenching process.

Design/methodology/approach

The present work deals with the effect of water quenching on the mechanical properties of welded AA 6061 plates which were joined by using metal inert gas (MIG) welding, tungsten inert gas welding and friction stir welding (FSW). Three tests like tensile, bending and hardness were considered. The microstructural variation was analyzed by optical microscopy and elemental mapping through field emission scanning electron microscope.

Findings

A significant enhancement in the tensile strength and hardness was achieved on postquenched specimens. This improvement in mechanical properties is caused by the distribution of fine alloying elements throughout the metal solution rather than precipitation at the grain boundaries. In comparison to the “untreated specimens,” an improvement of 76.7%, 25.32% and 56.81% in the tensile strength of quenched TIGW, MIGW and FSW specimens, respectively, was observed.

Originality/value

The quenching process has increased the strength of the MIG welded joint over the base metal. The MIG welded joint has a larger flexural modulus than the other two welded plates, according to the results of the bending test. Furthermore, a uniform distribution of hardness was observed in postquenched welded specimens. It was found that welded zone was harder than heat-affected zone. Out of all the specimens, the base metal zone has the lowest hardness.
Anterior quadratus lumborum blocks for postoperative pain treatment following intra‐abdominal surgery: A systematic review with meta‐analyses and trial sequential analyses
Authors: Tanggaard Katrine , Gronlund Caroline , Nielsen Martin V. , la Cour Kirstine , Tvarnø Casper D. , Børglum Jens , Maagaard Mathias , Mathiesen Ole
Published: October 2024

Background

The anterior quadratus lumborum (QL) block may be used for postoperative pain management for intra‐abdominal surgeries, but the evidence is uncertain. We aimed to investigate the benefit and harm of the anterior QL block compared to placebo/no block for intra‐abdominal surgery.

Methods

We searched Medline, Embase, and CENTRAL for randomized controlled trials investigating anterior QL block for postoperative pain management for adult patients undergoing any intra‐abdominal surgery. The two co‐primary outcomes were cumulative 24‐h opioid consumption and serious adverse events. We performed meta‐analysis, trial sequential analysis (TSA), assessed the risk of bias, and present the certainty of evidence with the Grading of Recommendations, Assessment, Development and Evaluation approach.

Results

Thirty‐five trials randomizing 2418 patients were included in the meta‐analyses. Anterior QL block may reduce cumulative 24‐h intravenous opioid consumption compared to placebo/no block (MD −10.42 mg, 96.7% CI −14.83 to −6.01, TSA‐adjusted CI −17.03 to −3.82, p < .01). Two trials reported on SAEs. Anterior QL block may have little to no effect on the number of serious adverse events compared to placebo (RR 1.49, 96.7% CI 0.19 to 11.47, p = .68), but the evidence is very uncertain. All trial results were assessed as being high risk of bias.

Conclusions

The anterior QL block may reduce cumulative 24‐h opioid consumption. Reported serious adverse events were few and the anterior QL block may have little to no effect on the number of SAEs, but the evidence was very uncertain.
Emerging Roles of IL‐27 in Trophoblast Cells and Pregnancy Complications
Authors: Luo Yi‐Hua , Zhang Yang‐Yang , Li Ming‐Qing , Zhang Xin‐Yan , Zheng Zi‐Meng
Published: October 2024

Problem

Pregnancy complications such as spontaneous abortion, preeclampsia, and preterm birth persist, despite current interventions aimed at their prevention and treatment largely proving unsuccessful. Interleukin‐27 (IL‐27), composed of p28 and EBI3 subunits, binds to IL‐27R, which consists of gp130 and IL‐27Rα (also known as WSX‐1 or TCCR), and plays a pivotal role in tumor development and inflammation regulation. At the maternal‐fetal interface, IL‐27 expression has been detected in trophoblasts, endometrial stromal cells, and decidual cells. Abnormal levels of IL‐27/IL‐27R have been linked to adverse pregnancy outcomes, including spontaneous miscarriage, preeclampsia, and preterm birth. This review aims to explore the expression of IL‐27 at the maternal‐fetal interface and its signaling pathway, uncovering the complex role of IL‐27 in pregnancy complications.

Method of Study

A comprehensive literature review was conducted using PubMed/Medline, Scopus, and Embase databases, analyzing studies on IL‐27 expression and its signaling pathways at the maternal‐fetal interface. The review focused on identifying the presence of IL‐27 in various cell types and linking abnormal IL‐27/IL‐27R expression to pregnancy complications such as spontaneous miscarriage, preeclampsia, and preterm birth.

Discussion and Conclusion

IL‐27 plays a complex role at the maternal‐fetal interface, with abnormal expression linked to several pregnancy complications. These findings highlight the need for further research to elucidate IL‐27's mechanisms and develop targeted interventions. Future studies should aim to develop targeted interventions and improve therapeutic strategies for managing pregnancy complications.
Is tobacco consumption a risk factor for central serous chorioretinopathy? A systematic review and meta‐analysis
Authors: Fakhril‐Din Zainab , Arnold‐Vangsted Andreas , Boberg‐Ans Lars Christian , Anguita Rodrigo , Desideri Lorenzo Ferro , van Dijk Elon H. C. , Grauslund Jakob , Klefter Oliver Niels , Yanik Özge , Subhi Yousif
Published: October 2024

Central serous chorioretinopathy (CSC) is a prevalent exudative maculopathy. Understanding risk factors for CSC is important for disease prevention and to provide evidence‐based advice to patients. In this study, we systematically reviewed the literature and performed meta‐analysis on the association between tobacco consumption and CSC. We searched 12 literature databases on May 5, 2024, and identified 11 eligible studies of 27 595 patients with CSC and 105 354 control individuals. Studies were predominantly clinic‐based case–control studies. We calculated a summary estimate of tobacco consumption as a risk factor for CSC at an odds ratio of 2.99 (95% CI: 1.82–4.93, p = 0.000017), which remained statistically significant in the sensitivity analyses. The exact mechanism by which tobacco consumption contribute to the pathophysiology of CSC remains unclear, although several potential hypotheses exist. However, tobacco consumption is a modifiable behaviour and tobacco cessation is an actionable advice with which patients with CSC themselves can play a large role in disease management. Further studies are warranted to understand the impact of tobacco cessation for risk modification and for the prognosis of patients who already have CSC.
Serial manual bolus irrigation leads to critical intrarenal pressures during flexible ureterorenoscopy – time to abandon this manoeuvre
Authors: Hong Anne , Browne Cliodhna , Jack Greg , Bolton Damien
Published: October 2024

Objective

To characterise the effect of solitary and serial manual bolus irrigations on intrarenal pressures (IRPs) and observe the clinical consequences.

Patients and Methods

A pressure guidewire was used for IRP measurement during routine flexible ureterorenoscopy for management of renal stone disease, including manual bolus irrigation when required to maintain vision. The fluid bolus was either as a solitary manual bolus or a series of manual boluses in quick succession. The pre‐bolus, maximal and difference between IRPs were calculated.

Results

A total of 50 procedures in 46 patients were analysed. In all, 68 solitary manual boluses and 38 serial manual boluses were observed to have been undertaken during these procedures. After a solitary manual bolus, the median (standard deviation [SD], range) increase in IRP was 22.4 (34.0, 0.1–160.8) mmHg, and the mean (SD, range) maximum IRP was 46.1 (41.7, 15.8–190.0) mmHg, with elevated IRPs persisting for a median (range) duration of 19 (4–66) s. After serial manual boluses, the median (SD, range) rise in IRP was 58.4 (64.7, 10.2–242.84) mmHg and the mean (SD, range) maximum IRP reached was 100.8 (69.7, 34.3–303.5) mmHg. The elevated IRPs endured for a median (range) of 42 (9–121 s; P < 0.01 in all comparisons), suggesting a much greater elevation of IRP with instances where serial bolus irrigation was undertaken.

Conclusions

Manual bolus irrigation, both solitary but particularly serial boluses, produces significant rises in IRP and could logically result in pyelovenous backflow and sepsis. We suggest that this manoeuvre should be avoided to reduce complications during ureterorenoscopy.
Clinical Utility of Donor‐Derived Cell‐Free DNA in Heart Transplant Recipients With Multi‐Organ Transplants
Authors: Moeller Cathrine M. , Oren Daniel , Fernandez Valledor Andrea , Rubinstein Gal , Lotan Dor , Mehlman Yonatan , Slomovich Sharon , Rahman Salwa , Lee Changhee , Baranowska Julia , Regan Matthew , Elad Boaz , DeFilippis Ersilia M. , Hennecken Carolyn , Salazar Ruben , Raikhelkar Jayant , Clerkin Kevin J. , Fried Justin , Lin Edward , Bae David , Oh Kyung T. , Latif Farhana , Topkara Veli K. , Naka Yoshifumi , Takeda Koji , Majure David , Uriel Nir , Sayer Gabriel
Published: October 2024

Background

Donor‐derived cell‐free DNA (dd‐cfDNA) has emerged as a reliable, noninvasive method for the surveillance of allograft rejection in heart transplantation (HT) patients, but its utility in multi‐organ transplants (MOT) is unknown. We describe our experience using dd‐cfDNA in simultaneous MOT recipients.

Methods

A single‐center retrospective review of all HT recipients between 2018 and 2022 that had at least one measurement of dd‐cfDNA collected. Patients who had simultaneous MOT were identified and included in this study. Levels of dd‐cfDNA were paired with endomyocardial biopsies (EMB) performed within 1 month of blood testing if available. Acute cellular rejection (ACR) was defined as ISHLT (International Society for Heart and Lung Transplantation) grade ≥ 2R. and antibody‐mediated rejection (AMR) was defined as pAMR grade > 0. The within‐patient variability score of the dd‐cfDNA was calculated by the variance/average.

Results

The study included 25 multiorgan transplant recipients: 13 heart–kidney (H‐K), 8 heart–liver (H‐Li), and 4 heart–lung (H‐Lu). The median age was 55 years, 44% were female; the median time from HT until the first dd‐cfDNA measurement was 4.5 months (IQR 2, 10.5). The median dd‐cfDNA level was 0.18% (IQR 0.15%, 0.27%) for H‐K, 1.15% (IQR 0.77%, 2.33%) for H‐Li, and 0.69% (IQR 0.62%, 1.07%) for H‐Lu patients (p < 0.001). Prevalence of positive dd‐cfDNA tests (threshold of 0.20%) were 42.2%, 97.3%, and 92.3% in the H‐K, H‐Li, and H‐Lu groups, respectively. The within‐patient variability score was highest in the H‐Li group (median of 0.45 [IQR 0.29, 0.94]) and lowest in the H‐K group (median of 0.09 [IQR 0.06, 0.12]); p = 0.002. No evidence of cardiac ACR or AMR was found. Three patients experienced renal allograft ACR and/or AMR, two patients experienced rejection of the liver allograft, and one patient experienced an episode of AMR‐mediated lung rejection. One person in the H‐K group experienced an episode of cardiac allograft dysfunction that was not associated with biopsy‐confirmed rejection.

Conclusion

Dd‐cfDNA is chronically elevated in most MOT recipients. There is a high degree of within‐patient variability in levels (particularly for H‐Li and H‐Lu recipients), which may limit the utility of this assay in monitoring MOT recipients.
Effectiveness and safety of insulin glargine 300 U/mL in insulin‐naïve individuals according to diabetes duration: Results from the REALI European pooled data analysis
Authors: Gourdy Pierre , Bonadonna Riccardo C. , Mauricio Didac , Müller‐Wieland Dirk , Mauquoi Celine , Vera Carine , Bonnemaire Mireille , Freemantle Nick
Published: October 2024

Aim

To evaluate the effectiveness and safety of insulin glargine 300 U/mL (Gla‐300) initiation according to diabetes duration (DD).

Materials and Methods

We analysed patient‐level data from 2381 insulin‐naïve individuals with type 2 diabetes (T2D), of whom 2349 (98.7%) were treated with Gla‐300 for 24 weeks. Of the 2381 participants, 1048 (44.0%) had a DD of less than 8 years and 1333 (56.0%) had a DD of 8 years or longer. We further analysed the subgroups of participants having a DD of less than 4 years (N = 450), 4‐8 years (N = 598), 8‐12 years (N = 627) and 12 years or longer (N = 706).

Results

Mean ± standard deviation age was 60.2 ± 9.0 years in participants with a DD less than 8 years and 64.2 ± 8.8 years in those with a DD of 8 years or longer. At 24 weeks of Gla‐300 therapy, HbA1c improved with a least‐squares (LS) mean change from baseline of −1.88% (95% confidence interval [CI], −1.95 to −1.80) and −1.71% (95% CI, −1.77 to −1.65), respectively, resulting in a LS mean difference between groups of 0.17% (95% CI, 0.07 to 0.26; P = .0005). In the subgroup analysis, LS mean HbA1c reduction from baseline to week 24 was highest in participants with a DD of less than 4 years and lowest in participants with a DD of 12 years or longer. Overall, incidences of symptomatic and severe hypoglycaemia were low, irrespective of DD, without body weight changes.

Conclusions

Gla‐300 was effective and safe in insulin‐naïve individuals with T2D, regardless of DD. Improvement in HbA1c was greater when Gla‐300 was initiated in participants with a DD of less than 4 years, although the difference between the groups was modest.
Genetic Independence of Naturally Correlated Variation in Resistance to Endemic and Novel Pathogens
Authors: Hood Michael E. , Bruns Emily L. , Antonovics Janis , Davis Isabel , Launi Michelle , Bulzoni Sophia , Rothberg Samantha E.
Published: October 2024

The emergence of new diseases is an urgent concern, but hosts can also vary in resistance to pathogens that are novel to them, facilitating evolutionary rescue. However, little is known about the genetic source for polymorphic resistance to novel pathogens or its relationship to defences against endemic diseases. With anther‐smut disease from wild plant populations, we used selection experiments and genetic analyses to show that resistances to novel and endemic pathogens are genetically independent, despite being positively correlated in nature. Moreover, novel‐pathogen resistance presented a much simpler genetic basis and more rapid response to selection. We demonstrate that polymorphic resistance to a newly introduced disease is genetically determined and not an extension of defences against the related endemic pathogen, challenging the conventional view of nonhost resistance.
Pharmacological Impacts of Mucopolysacccharide Polysulfates in the Epidermis Involves Inhibition of Amphiregulin‐Mediated Signals in Keratinocytes
Authors: Hirase Ryo , Fujita Tomoyuki , Miyai Tomohiro , Kawasaki Hiroshi , Koseki Haruhiko
Published: October 2024

The epidermis, the most superficial layer of the human skin, serves a critical barrier function, protecting the body from external pathogens and allergens. Dysregulation of epidermal differentiation contributes to barrier dysfunction and has been implicated in the pathology of various dermatological diseases, including atopic dermatitis (AD). Mucopolysaccharide polysulphate (MPS) is a moisturising agent used to treat xerosis in patients with AD. However, its mechanism of action on keratinocytes, the main constituents of the epidermis, remains unclear. In this study, we investigated the effect of MPS on keratinocytes by subjecting adult human epidermal and three‐dimensional cultured keratinocytes to MPS treatment, followed by transcriptome analysis. The analysis revealed that MPS treatment enhances keratinocyte differentiation and suppresses proliferation. We focused on amphiregulin (AREG), a membrane protein that belongs to the epidermal growth factor (EGF) family and possesses a heparin‐binding domain, as a significant target among the genes altered by MPS. MPS exerted an inhibitory effect directly on AREG, rather than on EGF receptors or other members of the EGF family. Furthermore, AREG leads to a reduction in epidermal barrier function, whereas MPS contributes to barrier enhancement via AREG inhibition. Collectively, these findings suggest that MPS modulates barrier function through AREG inhibition, offering insights into potential therapeutic strategies for skin barrier restoration.
Stress enhances aggression in male rats with genetic stress hyper‐reactivity
Authors: Harter Aspen M. , Kim Chris , Yamazaki Anna , Lee Luca , Ji Michelle T. , Nemesh Mariya , Redei Eva E.
Published: October 2024

The current study investigated stress‐induced aggressive behavior in the resident‐intruder test in males of the genetically stress hyper‐reactive Wistar Kyoto More Immobile (WMI), and the nearly isogenic, control Wistar Kyoto Less Immobile (WLI) strains. Tests were carried out against same‐age intruders during adolescence, and same‐age and juvenile intruders in adulthood. In adolescence and adulthood, prior acute restraint stress decreased social interactions and decreased aggressive behaviors of adolescents and adult WLIs. However, prior stress precipitated aggression in the adult WMI males toward both same‐age, and juvenile intruders compared with control WMIs and WLIs. Trunk blood levels of testosterone and androstenedione increased in stressed WLIs, but not in WMIs, suggesting no direct role of androgens in the increased aggression of WMIs. Expressions of aggression‐relevant genes showed patterns commensurate with being causative in aggressive behavior. The methyl‐CpG binding protein 2 was lower in the frontal cortex of control WMIs, and in the amygdala of stressed WMIs compared with their respective WLIs. Frontal cortex expression of vasopressin receptor 1a and serotonin transporter increased, solely in WMI males after stress. As behaviors were the same toward same‐age and non‐threatening juvenile intruders, the stress‐induced increase in confrontational behavior of the adult WMI male was not because of enhanced fear or anxiety. These results suggest that genetic stress hyper‐reactivity is a risk factor for stress‐induced increases in aggression in males. Additionally, as known aggression‐related genes showed expression patterns paralleling aggressive behavior, this model system could identify novel molecular pathways leading to stress‐enhanced aggression.
A Biofilm Channel Origin for Vermiform Microstructure in Carbonate Microbialites
Authors: Ibarra Yadira , Marenco Pedro J. , Centlivre Jakob P. , Hedlund Brian P. , Rademacher Laura K. , Greene Sarah E. , Bottjer David J. , Corsetti Frank A.
Published: October 2024

A three‐dimensional tubular fabric known as “vermiform microstructure” in Phanerozoic and Neoproterozoic carbonate microbialites has been hypothesized to represent the body fossil of nonspicular keratose demosponges. If correct, this interpretation extends the sponge body fossil record and origin of animals to ~890 Ma. However, the veracity of the keratose sponge interpretation for vermiform microstructure remains in question, and the origin of the tubular fabric is enigmatic. Here we compare exceptionally well‐preserved microbialite textures from the Upper Triassic to channel networks created by modern microbial biofilms. We demonstrate that anastomosing channel networks of similar size and geometries are produced by microbial biofilms in the absence of sponges, suggesting the origin for vermiform microstructure in ancient carbonates is not unique to sponges and perhaps best interpreted conservatively as likely microbial in origin. We present a taphonomic model of early biofilm lithification in seawater with anomalously high carbonate saturation necessary to preserve delicate microbial textures. This work has implications for the understanding of three‐dimensional biofilm architecture that goes beyond the current micro‐scale observations available from living biofilm experiments and suggests that biofilm channel networks have an extensive fossil record.
Gendered industry and feminization of the labor force: A social reproduction analysis from China
Authors: Nyangchak Niangjijia
Published: October 2024

This study examines the effect of industrialization on the feminization of the labor focusing on a Tibetan embroidery industry in China. The industry is pivotal in addressing poverty, employing women, safeguarding ethnic culture, and stimulating local economic growth. Through the lens of social reproduction in feminist political economy, an analytical framework was developed to discuss the findings. The results reveal that while the embroidery industry is gendered and serves as a vital source of income for women, it inadvertently overlooks the inherent paradoxes in unpaid labor of social reproduction. State subsidies push forward the industry, but the unpaid and hidden labor rooted within household and community spheres, coupled with the industry's nascent stage, pulls back growth. These push‐pull dynamics underlie a homebound trap where most embroidery artisans are confined to low‐paid, home‐based piecework in an informal labor market. The study outlines implications to navigate a way out of this trap.
Discordance of human epidermal growth factor receptor 2‐low status between breast primary and distant metastases with clinical–pathological correlation
Authors: Yang Ellen , D'Alfonso Timothy M , Morrow Monica , Brogi Edi , Wen Hannah Y
Published: October 2024

Aims

Breast cancer with human epidermal growth factor receptor 2 (HER2) immunohistochemistry (IHC) 1+ or 2+ with negative in‐situ hybridisation (ISH) (HER2‐low) can now be targeted by HER2 antibody drug conjugates. We set out to compare HER2 status between matched primary invasive breast carcinoma (IBC) and distant metastases (DM) with clinical–pathological correlation, with specific interest in HER2‐low.

Methods

Biomarker studies and clinical–pathological features of primary IBC with matched DM diagnosed between 2021 and 2022 were retrospectively analysed. HER2 status was assessed per 2023 American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) guidelines for IHC (4B5) and ISH (IQFISH pharmDX). Bilateral breast primaries were excluded. HER2 IHC 0 to 1+ were reassessed.

Results

One hundred and forty‐seven cases of primary IBC with matched DM were identified. Biomarkers were performed on core biopsy (n = 74) and resection (n = 73). One hundred and twenty‐six (86%) were initially classified as ‘HER2‐negative’; of these, 67 (46%) were reclassified as HER2‐low. Patients with HER2‐positive primaries were younger (P = 0.01) and had an increased incidence of micropapillary carcinoma (P = 0.02). HER2‐low primaries also had an increased incidence of micropapillary carcinoma (P = 0.02) and oestrogen receptor (ER) positivity (P = 0.02) compared to HER2 0. One hundred and sixty‐nine matched DM cases excluding bone metastasis were identified (range = one to seven metastases per IBC). The most common sites of metastases were liver (50 of 169, 30%), lung (36 of 169; 21%), distant lymph node (26 of 169, 15%); 138 DM cases (82%) were previously classified as ‘HER2‐negative’, and 62 (37%) were reclassified as HER2‐low. Like HER2‐low primaries, HER2‐low metastases were frequently ER‐positive (52 of 62; 84%) (P = 0.02). Brain metastases were more frequently HER2‐positive (five of 32; 16%) (P = 0.04). Comparing HER2 status in matched primaries and DM, HER2 status was discordant in 62 cases (37%). Most changes occurred from HER2‐low to HER2 0 (33 of 169, 20%), HER2 0 to HER2‐low (17 of 169, 10%) and HER2‐low to positive (10 of 169, 6%). All HER2‐low to HER2 0 changes were HER2 1+ to 0. In 30 patients with multiple DM sites (47 cases), HER2 status among different DM samples was discordant in 16 patients (53%), mainly from HER2‐low to HER2 0 (16 of 47, 34%).

Conclusion

A significant proportion of previous ‘HER2‐negative’ primaries and DM cases were reclassified as HER2‐low. Discordant HER2 status between IBC primary and metastasis and between different DM sites demonstrated tumour heterogeneity and highlights the need for HER2 retesting in distant metastasis.
Self‐Deception in Human–Sex Robot Intimacy
Authors: Lee Jin Hee , Chuang Christina
Published: October 2024

A common sentiment among anti‐sex‐robot scholars is the apprehension that sex robots will normalize and perpetuate sexual violence towards humans. In this new chapter within the feminist sex war, the authors of this article tend to agree with anti‐sex‐robot concerns and seek to further identify potential harms of sex robots. However, instead of characterizing the harm in terms of what the robots represent and symbolize, we are primarily interested in the internal state of the user and the type of relationship that will emerge between human users and sex robots, which we argue is an unprecedented sexual relation. Unlike other comparable sex products and services, sex robots occupy a liminal space between being perceived as both a sexual property and agent, oscillating based on the preferences and convenience of the user. We argue that this oscillation that enables human–sex robot intimacy requires self‐deception, which in turn entails individual moral responsibility. Thus, we articulate a novel virtue‐based approach of examining human–robot intimacy that focuses on cultivating erotic flourishing. We conclude that people have a moral responsibility to exhibit self‐awareness within the dynamics of their intimate relationship with sex robots and the (contradictory) beliefs required to maintain such intimacy.
The effect of interprofessional education on the surgical team members' self‐efficacy perception of interprofessional communication in the healthcare system
Authors: Hosseinpour Azam , Keshmiri Fatemeh
Published: October 2024

Aim

The current study aimed to assess the effect of interprofessional education on participants' self‐efficacy perception of interprofessional communication at different levels of a healthcare system (relationships in the interpersonal, interprofessional, and administration levels).

Design

This is a sequential explanatory mixed‐method study.

Method

Learners include surgical residents, surgical technology nurses, and anesthesia nurses (n = 130) who participated in the intervention and control groups. The quasi‐experimental study was conducted in the first step. The educational strategy was interprofessional education and the main teaching method was case‐based learning. The self‐efficacy perception of the participants was assessed by a 26‐item questionnaire before and 1 month after the intervention. The descriptive tests (mean, SD, percentage), student t‐tests, and ANOVA were analyzed. The participants' experiences were explored through semi‐structured interviews. Qualitative content was analyzed by Lundman and Graneheim's approach.

Results

The results showed that the scores of the learners in the intervention group (4.05 ± 0.31) improved significantly compared to the control group (3.35 ± 0.37) (p = 0.0001). In the present study, the experiences of the participants were categorized into a theme “explicit and implicit confrontations with perceived distrust in the system” which includes two categories “failure to internalize professionalism among team members” and “dominance of a paternalistic culture within the health care system”.

Conclusion

The results showed the positive impact of interprofessional education interventions on participants' self‐efficacy perception of interprofessional communication. The results showed that interprofessional education, with the participation of different professionals and managers at different levels of a healthcare system, improved the participants' perception of self‐efficacy regarding interprofessional communication. The results showed the improvement in the participants' communication with team members and managers required to solve the perceived explicit and implicit confrontations in the surgical departments.

Implications For the Profession

The implementation of an interprofessional education strategy focused on interprofessional professionalism and collaboration principles in clinical activities, formal and informal education in the surgical department is recommended.
A qualitative exploratory study into medical, nursing and allied health professional experiences of elective withdrawal of non‐invasive ventilation in a motor neurone disease cohort
Authors: Cox Gemma , Davis Charlie , Woodley Julie
Published: October 2024

Rationale, Aims and Objectives

With absence of a cure, the mainstay of management for patients with motor neurone disease (MND) is holistic supportive care and symptom control. Non‐invasive ventilation (NIV) can provide relief from distressing dyspnoea which often accompanies progressive respiratory muscle weakness. Some patients using NIV will become dependent on it, with a small proportion of these patients going on to request withdrawal. Despite being legal in the UK, elective withdrawal of NIV can be emotionally and ethically challenging for the staff involved. To guide the process of symptom‐controlled withdrawal, in 2015 the Association for Palliative Medicine (APM) released clinical guidance. The aim of this study is to explore the experiences of the multi‐disciplinary team (MDT) involved in elective withdrawal of NIV in an MND cohort following the publication of this guidance.

Method

A qualitative, semi‐structured interview study of eight NHS qualified staff members (three Doctors, four Nurses, one Allied Health Professional). Clinicians were asked questions relating to their experiences of the withdrawals. After full transcription, data was analysed thematically.

Results

Four main themes were identified, offering insight into how the withdrawals affected staff's well‐being and summarised via an ‘enablers and barriers’ model. The setting was important, as was the depth and longevity of the clinician's investment in the patient. Positive influences on staff's well‐being arose from the sense of fulfilling the patient's wishes, good teamwork, presence of an experienced clinician and awareness of the APM (2015) Guidance. Conversely, barriers to well‐being were expressed through the unpredictability of each scenario, moral and ethical uncertainties, external pressures on time, mismatched expectations, poor communication and the emotional intensity of the act.

Conclusion

Elective withdrawal is highly emotive, simultaneously positively and negatively influencing staff well‐being. By addressing the potential mitigating factors, the overall impact on staff's mental health and well‐being maybe improved and thus, subsequently, patient care.
How can we reduce healthcare costs by using Enhanced Recovery After Surgery more effectively in different groups of gynaecological patients? A single‐centre experience
Authors: Polková Markéta , Koliba Peter , Kabele Pavel , Dubová Oľga , Hodyc Daniel , Škodová Magdalena Kolínková , Zikán Michal , Sládková Petra , Tichá Marie , Brtnický Tomáš
Published: October 2024

Introduction

The objective of this study was to assess the impact of the Enhanced Recovery After Surgery (ERAS) programme implementation on treatment costs at a university‐type centre, using the DRG scheme.

Materials and Methods

Retrospective analysis of patients' data in a group of 604 individuals enroled in the study. We evaluated three groups of patients according to the ERAS clinical protocol (CP): (1) CP oncogynaecology, (2) CP simple hysterectomy, (3) CP laparoscopy. The study aimed to evaluate the impact on the length of stay (LOS), savings in bed‐days, and the reduction in direct treatment costs. Three parameters—antibiotic consumption, blood derivative consumption and laboratory test costs—were chosen to compare direct treatment costs. The statistical significance of the difference in the observed parameters was tested by a two‐sample unpaired t test with unequal variances at the 0.05 significance level.

Results

We analysed data from 604 patients. In all three groups, the length of stay (LOS) was significantly reduced. The most significant reduction was observed in the CP oncogynaecology group, where the LOS was reduced from 11.1 days to 6.8 days (2022) and 7.6 days (2023) compared to 2019 (p < 0.05). Furthermore, there was a notable reduction in inpatient bed‐days, which resulted in the capacity being made available to admit additional patients. A statistically significant reduction in direct costs was observed in the group of CP hysterectomy (antibiotic use) and in the CP laparoscopy (laboratory test costs).

Conclusions

The implementation of the ERAS principles resulted in a number of significant positive economic impacts—reduction in the LOS and a corresponding increase in bed capacity for new patients. Additionally, direct treatment costs, including those related to antibiotic use or laboratory testing were reduced. The Czech Republic's acute healthcare system, like the majority of European healthcare systems, is financed by the DRG system. This flat‐rate payment per patient encourages hospital management to seek cost‐reduction strategies. The results of our study indicate that fast‐track protocols represent a potential viable approach to reducing the cost of treatment while simultaneously meeting the recommendations of evidence‐based medicine.
Testing the predictions of Chapman's five love languages theory: Does speaking a partner's primary love language predict relationship quality?
Authors: Flicker Sharon M. , Sancier‐Barbosa Flavia
Published: October 2024

Chapman's claim that the key to marital happiness is “speaking” your partner's primary “love language” has been highly influential in pop culture and incorporated into therapeutic practice. However, the theory has not yet been empirically validated. The current study tests his theory, examining the hypothesis that satisfaction with one's partner's primary love language behavior predicts relationship satisfaction better than satisfaction with one's partner's nonprimary love language behavior. We recruited a sample (n = 696, M = 43.8 years, 70% married, 97.3% cohabitating) through Amazon CloudResearch. Chapman's hypothesis was not supported. Participants' satisfaction with their partners' primary love language behavior no better‐predicted relationship satisfaction or perceived love than the lower‐ranked love languages. Words of Affirmation and Quality Time better predicted perceived love and relationship satisfaction than participants' primary love language. These results replicate previous research and suggest that these should remain targets of intervention for relationship therapists.
Time is the enemy: The speed of proximity‐based knowledge diffusion
Authors: Perri Alessandra , Rullani Francesco , Giuliani Elisa , Sabbadin Elisa , Oriani Raffaele
Published: October 2024

Does knowledge spread more quickly when firms are geographically closer? Focusing on knowledge diffusion from multinational enterprises (MNEs) subsidiaries in the context of the US semiconductor industry, our analysis suggests that the broader MNE patents are, in terms of the knowledge sources they draw on, the slower the speed of knowledge diffusion to more spatially proximate firms, compared to more distant ones. Moreover, our findings suggest that this outcome could be attributed to a greater reliance on knowledge sources that are internal to the MNE network or located geographically distant. We provide interpretative cues for these findings and provide policy recommendations in line with our results.
Pre‐referral ultrasound for cryptorchidism: Still common, still not necessary
Authors: Boyd Grace E , Patel Bhaveshkumar , McBride Craig A
Published: October 2024

Aim

Evidence‐based guidelines do not recommend imaging in cryptorchidism, but anecdotally most referrals include an ultrasound report. We aimed to assess the frequency, utility and burden of imaging in children referred with presumptive disorders of testicular descent, and to assess trends over a 7‐year period before and after local and international guidelines have been introduced.

Methods

This was a prospective cohort study of children referred to the Queensland Children's Hospital for anomalies of testicular descent between 2015–2017 and 2023–2024. Data were collected regarding demographics, referral details, imaging performed and surgical diagnosis.

Results

A total of 268 children were recruited. Ultrasound frequency has not significantly changed over time (72.8%, 2015–2017; 63.6% 2023–2024; P = 0.11). Currently, 17.6% of families are charged, and 31.9% need to take time off work, for the ultrasound. This is a significant increase from the 2015–2017 cohort. Parents report concern and anxiety, and find it traumatic for their child. Following review, the majority (65.7%) had physiologically normal testes, while 4.9% and 22.4% were diagnosed with bilateral or unilateral cryptorchidism, respectively, and 7.0% had other diagnoses. Ultrasound was concordant with the surgical diagnosis in 25.0% (2015–2017) and 30.7% (2023–2024). Ultrasound did not contribute to diagnosis nor management in any patient.

Conclusions

Despite international and local guidelines, cryptorchid children continue to undergo ultrasound prior to referral. Such ultrasounds do not provide utility, or value for cost. We recommend avoiding their routine use for suspicion of testicular maldescent and working together to improve strategies for translating evidence‐based guidelines into clinical practice.
Diagnosis and management of femoral head osteochondritis dissecans (OCD) in two dogs
Authors: Rocheleau P. J. , Yanchik A. E.
Published: October 2024

Patient 1 was seen for severe pelvic limb lameness and evaluated radiographically and via computed tomography. A diagnosis of femoral head osteochondritis dissecans was obtained. The diagnosis was confirmed arthroscopically and treated with flap removal and abrasion arthroplasty. A micro‐total hip arthroplasty was performed 4 weeks later. Patient 2 was also seen for severe pelvic limb lameness and evaluated radiographically. A suspected large osteochondritis dissecans lesion was present. This was confirmed grossly during a total hip arthroplasty procedure and the femoral head submitted for histopathology. In patient 1, the lameness improved from non‐weight‐bearing to mild lameness at re‐evaluation 4 weeks post‐operatively. Due to the extent of the lesion, which was confirmed as osteochondritis dissecans by a team of pathologists, revision to micro‐total hip arthroplasty was performed. Surgery was uneventful and at 12 weeks post‐operatively the patient was fully weight‐bearing with no lameness and normal limb function. In patient 2, the lameness immediately resolved after successful management via uncomplicated total hip arthroplasty. Follow‐up for both patients at the time of publication exceeds 3 years.