bluuebunny/crossref_metadata_2025 huggingface dataset:
Co-encapsulation of vitamin D3 and Cordia myxa fruit peel extract in nanoemulsions
Authors: Rousta Parisa , Shahamirian Mozhgan , Yazdanpanah Sedigheh , Shirazinejad Alireza
Published: December 2024

Purpose

This study investigated the production of free and encapsulated nanoemulsions using Cordia myxa fruit peel (CMFP) extract and vitamin D3.

Design/methodology/approach

The CMFP extract was obtained using an ultrasonic technique, and its characteristics such as total phenolic content (TPC), antioxidant activity, cytotoxicity and gas chromatography-mass spectrometry (GC/MS) analysis were assessed. CMFP was encapsulated in vitamin D3 oil droplets of nanoemulsion prepared by ultra-homogenization using calcium alginate polymer. The nanoemulsions were evaluated for 2,2-diphenyl-1-picrylhydrazyl (DPPH) scavenging activity, antimicrobial activity, morphology, Fourier transform infrared (FTIR) analysis and release rate in a simulated gastrointestinal model.

Findings

The GC/MS results revealed that pyrocatechol, cholestanoids and propionaldehyde were the predominant compounds in the extract. The highest cytotoxicity effect of CMFP was observed at concentrations of 6.25 and 12.5 ppm of the extract. Encapsulated nanoemulsions exhibited the highest antimicrobial activity against Escherichia coli (ATCC 35218). The antioxidant activity of the free and encapsulated nanoemulsions ranged from 25.81 to 36.08 mg/100g and 49.25–55.7 mg/100g, respectively. Free nanoemulsions showed a higher release rate in the simulated gastric model compared to encapsulated ones. The FTIR spectrum allowed for the identification of functional groups responsible for antioxidant and antibacterial properties, indicating that these properties of the nanoemulsions were maintained.

Originality/value

This study demonstrates the successful co-encapsulation of CMFP extract and vitamin D3 in nanoemulsions, which significantly enhanced the stability, bioavailability and functional properties of both compounds. Encapsulated nanoemulsions exhibited higher antioxidant and antimicrobial activities compared to their free counterparts, with controlled release in simulated gastrointestinal conditions. These findings confirm that nanoemulsion-based encapsulation is an effective strategy to protect and enhance the bioactivity of plant extracts and vitamins, supporting their potential use in functional food products and therapeutic application.
How does the regulatory focus of CEOs spur firms’ innovation? Moderating roles of CEO tenure, gender diversity and industry munificence
Authors: Lahyani Fathia Elleuch , Mardini Ghassan H. , Kohin Levi
Published: December 2024

Purpose

Grounded on regulatory focus theory, this study aims to explore whether the regulatory focus of leadership (promotion versus prevention) influences a firm’s innovation. Moreover, it examines the moderating effect of industry munificence, gender diversity and chief executive officer (CEO) tenure.

Design/methodology/approach

Using random effects and the generalized method of moments (GMM), this relationship was examined using firms listed in the S&P 500 index in the period 2015–2020.

Findings

The evidence suggests that CEOs with a promotion focus significantly impact firms’ innovation, with the relationship being moderated by CEO tenure, gender diversity and industry munificence. However, CEO prevention focus does not determine strategic choices in relation to innovation. The study offers insights into corporate governance and corporate management that address stakeholders’ growing demands to innovate and appoint experienced CEOs with a promotion focus so as to ensure firm growth, particularly under the circumstances of strong market competition.

Originality/value

The study enhances the comprehension of the relevance of CEO regulatory focus and innovation while considering the effect of CEO tenure, gender diversity and industry munificence.
From intent to impact: top management’s commitment influence on sustainable risk management under stakeholder pressure
Authors: Irfan Muhammad , Ghufran Maria , Musarat Muhammad Ali
Published: December 2024

Purpose

The present study adopted a system thinking methodology to investigate the influence of top management commitment (TMC) on sustainable risk management (SRM) influenced by stakeholder pressures.

Design/methodology/approach

Three variables and 23 measurement items were derived from existing literature sources. Moreover, the methodology employed for data collection in this study involved a questionnaire. The constructs previously documented in the literature were utilized as the foundation for developing the questionnaire. Of 220 sent questionnaires, 106 valid responses were used for further analysis. To enhance objectivity, a causal loop diagram and a stock and flow diagram were created using a system thinking approach. These visual representations aim to illustrate the impact of top management factors on SRM under stakeholder pressure-related factors.

Findings

The results of the descriptive test indicate that the safety and quality issues emerged as the most significant, with the highest mean impact of 4.08 on sustainable risk impact assessments. Employee influence on customer relationships also showed a high mean impact of 4.08, while understanding customer requirements closely followed with a mean of 3.98. Additionally, causal loop analysis uncovered complex interconnections among these factors, emphasizing the intricate nature of SRM. Further, a five-year simulation analysis highlighted that SRM effectiveness is significantly enhanced when top management fosters a robust organizational culture. These findings emphasize the critical roles of safety, quality and customer-focused factors in sustainability, underscoring the importance of leadership in fostering effective, holistic sustainability and risk management strategies.

Originality/value

This research highlights top management’s pivotal role in effective SRM by integrating sustainability into core strategies. It identifies critical factors and emphasizes the solid organizational culture fostered by senior management, which is essential for long-term SRM effectiveness. The study’s focus on safety, quality and customer relations underscores the need for comprehensive sustainability strategies.
Investigating the influence of cutting fluid on tool life and power usage during AISI-4130 steel turning
Authors: Ghuge Nilesh C. , Palande Dattatray D.
Published: December 2024

Purpose

This study evaluates the impact of cutting fluids on energy consumption and tool life in machining, focusing on sustainable practices to reduce environmental impact and improve efficiency. By comparing vegetable-based soyabean oil with mineral-based blasocut oil, the study assesses their effects on power usage and tool life.

Design/methodology/approach

This study introduces a novel approach by applying both response surface methodology (RSM) and artificial neural network (ANN) models to validate the performance of vegetable-based cutting fluids, specifically soyabean oil, in machining operations.

Findings

Results indicate that soyabean oil reduces energy use by 9% and extends tool life by 29% compared to blasocut oil, with strong alignment between model predictions and actual results.

Research limitations/implications

The findings, though specific to certain fluids and conditions, suggest that soyabean oil offers a viable eco-friendly alternative for machining processes.

Practical implications

Adoption of such fluids could lower greenhouse gas emissions, reduce dependency on mineral oils and benefit farmers by creating additional demand for vegetable oils.

Originality/value

This dual-model validation of cutting fluid performance marks an innovative contribution to sustainable machining, supporting the adoption of greener, resource-efficient manufacturing practices. This study underscores the potential of vegetable-based cutting fluids to enhance sustainability in manufacturing.
Online knowledge sharing and employee innovation: the role of job self-efficacy and innovative climate
Authors: Smith David
Published: December 2024

Purpose

This paper aims to review the latest management developments across the globe and pinpoint practical implications from cutting-edge research and case studies.

Design/methodology/approach

This briefing is prepared by an independent writer who adds their own impartial comments and places the articles in context.

Findings

A study from Vietnam of 353 IT workers showed online knowledge sharing positively influenced employee innovation both directly and indirectly through job self-efficacy. The results also revealed that the innovative climate positively affected employee innovation, as well as moderated the relationship between online knowledge sharing and employee innovation.

Originality/value

The briefing saves busy executives, strategists and researchers hours of reading time by selecting only the very best, most pertinent information and presenting it in a condensed and easy-to-digest format.
Understanding dynamics between public policy and global value chains (GVCs): governance for sustainability in the Brazilian Amazon beef cattle GVC
Authors: Loomis John James , Puppim de Oliveira José Antônio
Published: December 2024

Purpose

This article unveils the governance dynamics of a frontier region for global value chains (GVCs). For this purpose, we developed a replicable methodology to analyze the interaction between public policies and the governance of GVCs to better assess sustainability impacts and business responses. We apply this methodology to understand the governance dynamics in the beef cattle GVC in the Brazilian Amazon. In Brazil, cattle ranching increasingly concentrates in the Amazon region, notably in the state of Pará, becoming the major driver of deforestation as public policies and law enforcement are ineffective. Using our methodology, we were able to identify the main weaknesses in governance pertaining to sustainability in the beef GVC.

Design/methodology/approach

The methodology employed a case study approach and utilized GVC mapping and analysis using primary (semi-structured interviews and site visits) and secondary data sources. The governance structures along the GVC were characterized. Finally, the sustainability and upgrading within and beyond the GVC were analyzed.

Findings

Based on our methodology, emerging beef GVCs, such as those in Santarém, Pará State, primarily supply the domestic market without external pressures to improve sustainability. This fact coupled with a lack of local capacity to implement public policies presents challenges for sustainable governance. Efforts to enhance the performance of the value chain predominantly stem from private sector capacity-building initiatives targeting ranchers.

Originality/value

Through the development of our method, the governance of the Brazilian beef GVC in the Amazon is mapped and analyzed. This study introduces a novel sustainability-focused GVC mapping methodology aimed at establishing a standardized framework to enhance the comparability of research. As a result, this study offers useful theoretical and empirical contributions to the literature on the sustainability of GVCs in frontier regions where public governance capacity is low.
The glue that binds: how organizational identification drives innovation performance in foreign-owned subsidiaries
Authors: Dahms Sven , Cabrilo Sladjana , Kingkaew Suthikorn
Published: December 2024

Purpose

Although organizational identification has been recognized as crucial for multinational enterprises, its configurations regarding innovation performance at the subsidiary level have hitherto received scant attention. Accordingly, the purpose of this research is to identify the types of configurations in which organizational identification in foreign-owned subsidiaries leads to high innovation performance.

Design/methodology/approach

We base our research on social identity theory and the neo-configurational perspective to test our framework using survey data collected from subsidiaries located in Thailand and Vietnam.

Findings

Our results provide evidence that organizational identification serves as a glue that binds strong inter- and intra-organizational network relationships to drive innovation performance. While we find some variation in that pattern between the two host countries, it appears overall that the conditions of expatriates in top management and the geographic distance between home and host country only play a peripheral role. We identify the “integrated innovation driver” and “distant local hub” as two subsidiary archetypes that show how organizational identity can drive high innovation performance in subsidiaries.

Originality/value

This study is one of the first to empirically investigate the main complementing factors in the context of organizational identification and innovation in foreign-owned subsidiaries, which have previously predominantly been investigated in isolation of each other.
Role of leadership in promoting health and safety culture: “A comprehensive review of GCC countries”
Authors: Alamri Reem Abdullah
Published: December 2024

Purpose

This study aims to investigate the pivotal role of leadership in fostering a health and safety (H&S) culture in Gulf Cooperation Council (GCC) countries and identify key challenges faced by these nations. The promotion of H&S culture has become increasingly crucial, with GCC leaders playing a vital role in reducing employee turnover rates by ensuring a safe and healthy work environment. Despite substantial research into issues such as the lack of training, workforce diversity and employee engagement in promoting H&S culture in the Gulf region, significant gaps remain. These gaps highlight the need for additional investigation into the impact of H&S culture, constrained by limited time and resources.

Design/methodology/approach

Using a content analysis method, 18 previous studies were thoroughly reviewed to identify the main themes and areas requiring further improvement.

Findings

The findings of this study suggest that enhancing the understanding and implementation of H&S practices provide significant implications for leaders and organizations in the GCC. Effective strategies to improve workplace safety and employee retention are crucial. The study underscores the necessity for GCC leaders to actively drive the H&S agenda, emphasizing that a robust H&S culture is essential for reducing turnover and fostering a safer, more productive work environment.

Originality/value

Despite substantial research into issues such as the lack of training, workforce diversity and employee engagement in promoting H&S culture in the Gulf region, significant gaps remain. These gaps highlight the need for additional investigation into the impact of H&S culture, constrained by limited time and resources.
Early identification of potentially low performing community health workers using an ensemble classification model
Authors: Bora Girdhari , Kumar Rajiv , Joseph Ajil
Published: December 2024

Purpose

Community health workers (CHWs) are vital to addressing public health system limitations in developing countries. However, effective identification and support of underperforming CHWs remains a challenge. This study develops a predictive model to proactively identify underperforming CHWs, facilitating targeted interventions for improved CHW programmes.

Design/methodology/approach

We developed a predictive model to identify underperforming CHWs in Uttar Pradesh, India. Data from 140,101 CHWs over a 12-month period was used to build, test and validate the model. Classification techniques, ensemble modeling and a model tuning algorithm were employed for accuracy optimization and early identification.

Findings

Logistic regression, decision trees and random forests yielded the best performance. While ensemble models offered no significant performance improvements over the base models, the model tuning algorithm effectively increased prediction accuracy by 19 percentage points. This enabled early identification of poor-performing CHWs and high-risk CHW clusters early in the year.

Practical implications

The developed model has significant potential to improve CHW programmes. It enables targeted support, feedback and resource allocation, leading to enhanced CHW performance, motivation and healthcare outcomes in the communities they serve. The model can provide personalised feedback to help CHWs overcome challenges and dynamic clustering facilitates proactive identification and tailored support for those at risk of underperformance.

Originality/value

This study is the first attempt to use predictive modelling to identify underperforming CHWs, advancing the nascent field of CHW performance analytics. It underscores the effectiveness of digital technologies and data in improving CHW programmes.
Beyond Sharpe ratio: comparison of risk-adjusted performance of Shariah-compliant and conventional indices
Authors: Raza Muhammad Wajid , Ye Jiang
Published: December 2024

Purpose

Upper bound on Sharpe ratio helps to evaluate the risk-adjusted performance in real market setting. The purpose of this study is to evaluate the performance of Shariah-compliant indices (SCIs) and also estimate the upper bound on Sharpe ratio in real-market setting. For comparison, the authors also report the same statistics for conventional indices (CIs).

Design/methodology/approach

This study considers returns of 12 indices from Asia-Pacific and the USA for the time period May 31, 2013-Aug 25, 2022. These indices are further classified as small-, mid- and large-cap indices. The upper bound is estimated in three settings, an unconstrained setting, correlation constraint and copula constraint.

Findings

The authors found that upper bound estimation is sensitive to both the choice of index, geographic location and size of constituents within the index. Interestingly, SCIs outperform CIs both in terms of Sharpe ratio and upper bound estimations. The ability of SCIs to achieve high Sharpe ratio boosts investors’ confidence. The results are robust even after introducing correlation and copula constraints to the model.

Practical implications

Any violation of the upper bound on Sharpe ratio is not necessarily an indication of fraud or dubious Sharpe ratio. It should be interpreted only as a signal for inflated risk-adjusted performance and requires further investigation. Together with risk-adjusted performance, fund managers should report upper bounds to insure investor protection.

Originality/value

Many studies have compared the risk-adjusted performance of SCIs and CI. To the best of the authors’ knowledge, this study is the first effort to evaluate and compare the upper bounds on Sharpe ratio of SCIs in a real-market setting.
Do economic uncertainty and political risk steer CDS dynamics? An analysis of the Türkiye CDS
Authors: Tekin Bilgehan
Published: December 2024

Purpose

This study aims to identify critical determinants of sovereign credit risk by examining the influence of oil prices, gold prices, geopolitical risk, market volatility, exchange rates, inflation and non-performing loans on Türkiye’s credit default swap (CDS) spreads. This analysis provides a comprehensive understanding of how economic uncertainty and political risk impact Türkiye’s financial stability, as reflected in its CDS market. This study investigates the importance of ex ante proxies in explaining changes in CDS spread by financial and economic indicators in Türkiye.

Design/methodology/approach

This research explores the connections between critical financial and economic indicators and the credit risk of Türkiye between 2009 and 2022 by using advanced econometric techniques such as ARDL bound tests, fully modified ordinary least squares (FMOLS), dynamic ordinary least squares (DOLS), Johansen co-integration tests and VECM Granger causality analyses.

Findings

ARDL bound test results reveal significant negative impacts of BIST and non-performing loans on CDS, and positive associations with inflation, VIX and geopolitical risk on CDSs. The short-term results show that BIST, INFL, NPL, USD, VIX and GPRT have negative coefficients. Johansen co-integration, FMOLS and DOLS results reinforce the ARDL findings. Moreover, BIST is a significant Granger cause of CDS.

Originality/value

This study is significant, as it jointly considers economic and political risk factors, thereby integrating multiple econometric models to provide more robust, meaningful and comparable results. By examining these factors together, the analysis offers a more comprehensive understanding of risk dynamics, yielding insights relevant to Türkiye. Although the findings are specific to Türkiye, they have broader implications, enriching the understanding of emerging economies. Türkiye’s status as a key representative of emerging markets strengthens the study’s value, as the results can serve as a reference point for other countries with similar economic structures. The importance of this study is also underscored by its potential to inform risk management strategies, guide policy decisions and offer insights to investors and financial analysts. By elucidating the intricate relationships among a broad spectrum of macroeconomic variables, this research contributes to a more comprehensive risk assessment framework. It equips stakeholders with a more informed perspective on the factors influencing credit risk in Türkiye’s economic landscape.
Surviving the COVID-19 pandemic: European and African SMEs and domestic public policies compared
Authors: Croucher Richard , Moe Chit Myint , Osabutey Ellis , Rizov Marian
Published: December 2024

Purpose

The paper investigates factors that contribute to small and medium enterprises (SMEs) surviving major exogenous shocks. Global crises such as the coronavirus disease 2019 (COVID-19) have increasingly heightened scholarly interest in post-crises responses. However, studies that compare the relative responses to external shocks and the outcomes for SMEs operating in different institutional settings are limited. We examine the relative degrees of success European and African SMEs experienced in avoiding the worst consequences of the COVID-19 pandemic.

Design/methodology/approach

We use the resource dependency theory (RDT) with variants of institutional theory since the RDT has been shown in practice to have greater explanatory power when used in this way. We augment our framework with a feminist theory dimension. To test our hypotheses, we apply regression analyses using cross-sectional data from the World Bank Enterprise Surveys (WBES), which include responses from private enterprises in 26 European and eight African countries. We construct our data by combining the COVID-19 follow-up surveys with relevant firm-specific characteristics from the WBES conducted in 2020–2021 using firm-specific unique IDs. After removing the firms with missing observations, the sample number of SMEs is 15,178.

Findings

Our empirical findings support the theoretically posited positive effects of innovativeness, institutional connectedness and governance capability on SMEs’ survival in the face of external shocks. Further, we confirm the importance of firm-specific characteristics (financial status, size and age) for SMEs’ survival. Female-owned SMEs are more likely to suffer during COVID-19, especially in Africa. The results are more nuanced when we consider industry specificity and heterogeneity of government support.

Originality/value

Our article helps answer the theoretical (and policy-relevant) question of whether SMEs that are resilient to major exogenous shocks may share certain characteristics despite operating in different institutional environments. If that is so, then it may be that lessons from one continent may have at least some relevance for the other. Our approach’s broad value lies in its capacity to test the degree to which established bodies of theory developed in the Northern Hemisphere may be deployed in Africa, well beyond the contexts which provided their initial empirical basis. This paper also contributes to the literature on the effect of environmental-change shocks on entrepreneurship performance outcomes.
Tandem politics and kusturizatsia: Power and money in contemporary Kyrgyzstan
Authors: Ismailbekova Aksana
Published: December 2024

Drawing on fresh ethnographic research, this article examines how President Japarov and Security Chief Tashiev built their political alliance in post‐2020 Kyrgyzstan. Their ‘tandem’ rule rests on a mix of friendship ties, family bonds and economic control through kusturizatsia – legalized extortion of criminal networks and corrupt officials. Using Sahlins’ concept of reciprocity, I show how money flows form the heart of their power, binding allies through gifts while crushing opponents through force. The tandem's fusion of state authority with criminal enterprise reveals new patterns of authoritarian rule in post‐Soviet space.
Comprehensive propagation of errors for the prediction of woody biomass
Authors: Roxburgh Stephen H. , Paul Keryn I.
Published: December 2024

Managing vegetation to sequester carbon in biomass requires estimates to meet standards for accuracy, with methods that are transparent, verifiable and cost‐effective. Allometric models are commonly used to predict biomass from non‐destructive field inventory data. Although a number of studies have addressed biomass error propagation, none have provided a general set of methods for linking errors all the way from initial allometric model development through to the final site‐based biomass prediction, for both above‐ and below‐ground biomass.

Error sources in total biomass (above‐ + below‐ground) were quantified using a combination of analytical and Monte Carlo methods, illustrated with four contrasting case studies using either site‐ and‐species‐specific, species‐specific or generalised allometric models.

Sampling error was found to be the most important contributor to site‐level biomass uncertainty, arising from the interaction between spatial variability and the field sampling design. The contribution of allometric model covariance to total error was also quantified, with errors in the determination of moisture content during allometric model development identified as a potentially important yet often overlooked error source. Application of different allometric models to the same inventory data suggested the error from generalised models was no greater than that from site‐ or species‐specific models, with increases in the generalised model prediction error balanced by decreases in other error sources associated with the increased sample size on which generalised models are based.

Recommendations for reducing errors in predicted biomass include increasing field survey sample size, adopting field survey designs that ensure spatial representativeness and improving moisture content measurement protocols and increasing the moisture content sample size during allometric model development. To reduce costs while maintaining acceptable accuracy, the use of generalised allometric models is recommended, with the caveat that additional biomass sampling for model validation may be required to limit the potential for biased predictions.
Cyclophosphamide‐Induced Infertility and the Impact of Antioxidants
Authors: Abdi Morteza , Fadaee Manouchehr , jourabchi Amirreza , Karimzadeh Hadi , Kazemi Tohid
Published: December 2024

An important drawback of anticancer chemotherapy is the harm it causes to healthy cells. Cyclophosphamide (CP) is a widely used chemotherapeutic alkylating agent that is regularly used in cancer treatment. However, it can cause severe side effects, including genotoxicity, due to its ability to damage DNA. This toxicity is thought to be associated with oxidative stress induced by an excessive amount of reactive oxygen species (ROS). Therefore, there is a specific focus on the potential effects of anticancer treatments on fertility. Due to the increasing life expectancy of cancer patients, those desiring parenthood may face the negative impacts of therapies. Utilizing substances with antioxidant and cytoprotective characteristics to protect the reproductive system from harmful consequences during chemotherapy would be highly beneficial. This review introduces the physiological and pathological roles of ROS in the reproductive systems of both males and females, then we address the adverse effects of CP administration on infertility and discuss how antioxidants can reverse these effects.
Immunophenotyping and Activation Status of Maternal Lymphocytes to Predict Spontaneous Preterm Birth in Women With Threatened Preterm Labor: A Prospective Observational Study
Authors: Wendremaire Maeva , Hadi Tarik , Lopez Tatiana E. , Guy Julien , Neiers Fabrice , Garrido Carmen , Simon Emmanuel , Jaffal Zohra , Bernigal Virginie , Bardou Marc , Lirussi Frédéric
Published: December 2024

Problem

Preterm birth (PTB) remains the leading cause of neonatal morbidity and mortality. Identifying women at high risk of spontaneous preterm labor (PTL) is challenging due to limited efficient diagnostic markers. Since human parturition involves inflammatory immune processes, we hypothesized that phenotyping of maternal peripheral lymphocytes might predict PTL. Therefore, we aimed to explore the relationship between maternal lymphocyte subpopulations and labor onset characterized by delivery within 7 days of admission in women hospitalized for PTL between 24 and 34 weeks of gestation.

Methods of Study

Lymphocyte subpopulations were obtained from peripheral blood samples and characterized by flow cytometry: activated and regulatory T cells, natural killer and B cells, and TH1/TH2/TH17 lymphocytes. Data analysis was conducted retrospectively based on the delivery within 7 days of admission.

Results

Among 167 women admitted for PTL, less than 10% delivered within 7 days post‐admission. HLA‐DR expression was significantly increased on CD4+CD8−, CD4−CD8+, and CD4+CD8+ lymphocytes in women who delivered within 7 days. Subset levels below 5% of CD4+CD8−HLA‐DR+ lymphocytes and 20% of CD4+CD8+HLA‐DR+ lymphocytes were associated with no probability of delivering within 7 days.

Conclusion

Our study suggests that combining these two consecutive markers allowed us to identify 57% of women hospitalized for PTL with no probability of delivering within 7 days while retaining patients who delivered within 7 days. If prospectively validated, these markers may be able to identify patients at high risk of PTB and avoid a significant number of unnecessary admissions and healthcare costs.

Trial Registration

ANSM number: 2010‐A00516‐33; ClinicalTrials.gov identifier: NCT01340222
Mechanism of Endometrial Receptivity Affected by Fibroids
Authors: Sun Ping , Zhang Chunyan , Wang Weisha , Ma Huagang
Published: December 2024

Fibroids are the most common benign tumors of the female reproductive system. Most patients with fibroids are asymptomatic, but the presence of fibroids can still cause some abnormal clinical symptoms, such as increased menstrual volume, abnormal uterine bleeding, pelvic pain, urinary tract and gastrointestinal tract compression symptoms, etc. The impact of fibroids on pregnancy is worth discussing. At present, it is believed that submucosal myoma and intramural myoma affecting uterine cavity shape affect the pregnancy outcome of patients, while the impact of type III intramural myoma on pregnancy is still controversial. A number of studies have found that in addition to direct contact with the endometrial compression, uterine myoma also affects the endometrial flexibility through other ways. In this review, we summarized the effects of fibroids on endometrial receptivity and discussed in depth the mechanisms of such effects, including secretion of cytokines, changes in endometrial blood flow and angiogenesis, effects on endometrial peristalsis and mechanical stress conduction, changes in uterine microecological environment, and abnormal signal transduction pathways. Understanding the mechanism of endometrial receptivity affected by fibroids is significant for exploring the treatment of fibroids, improving the pregnancy outcome of patients with fibroids and increasing the clinical pregnancy rate.
Inter‐rater agreement for detection of potentially inappropriate medication according to explicit and implicit STOPP criteria
Authors: Parodi López Naldy , Svensson Staffan A. , Wallerstedt Susanna M.
Published: December 2024

The Screening Tool of Older Person's Prescriptions (STOPP) is used to detect potentially inappropriate medication. Version 2 includes 80 criteria, whereof two can be considered implicit as their detection primarily relies on the assessor's expertise: (A1) drugs without indication and (A2) drug treatment beyond recommended duration. To explore the inter‐rater agreement for detection of explicit and implicit criteria, data on consecutive primary care patients from a previous study (n = 302, 65–99 years of age) were used, including independent assessments of the 78 explicit criteria (23 556 assessments) and the two implicit criteria (604 assessments) by two specialist physicians. Overall, 123 (0.5%) explicit and 10 (2%) implicit criteria were fulfilled according to both physicians. The positive agreement for a criterion being fulfilled was 56% for explicit and 16% for implicit criteria, with kappa values of 0.56 and 0.09. Discordant detection of furosemide and proton pump inhibitors was common using explicit and implicit criteria.
New Light on the Squiggle Game: The Unexpected in Sufficient Safety in the Treatment of an Adolescent
Authors: Velt Johanna , Tirilly Anne
Published: December 2024

In this article, we discuss the technique of the Squiggle Game (SG) and aim to shed new light on it by illustrating it with a clinical vignette. We present the case of a depressed adolescent for whom the use of SG as a wildcard avoids traumatic repetition and allows the creation of a therapeutic space that contains the paradox of guaranteed safety and the use of the unexpected. We begin by recalling the SG technique invented by Winnicott and then our own use of this technique. We then describe the clinical situation of a young depressed adolescent. We then discuss the therapeutic effects observed, linking them to the recognition of the need for security. We describe how the SG joker reduces patient–therapist asymmetry, helps to moderate interpretation and encourages a side‐by‐side situation. In the case of adolescents, their narcissistic fragility makes psychotherapeutic approaches difficult, so long‐term SG offers a technical way of taking account of the need for security that this fragility entails. We depart from Winnicott by offering the SG technique over a long period of therapy, and we make theoretical and clinical suggestions based on our original use of SG.
Smoking‐independent DNA methylation markers for lung cancer risk: External validation in a large population‐based cohort study
Authors: Zhao Zitong , Bhardwaj Megha , Fan Ziwen , Li Xianzhe , Schrotz‐King Petra , Brenner Hermann
Published: December 2024

Smoking‐associated epigenetic changes have been linked to lung cancer (LC) risk; however, the role of epigenetic alterations independent of smoking is yet to be fully understood. This study aimed to validate 16 previously reported CpG sites that are independent of smoking yet associated with LC risk within a population‐based prospective cohort. Using the Infinium Methylation EPIC BeadChip kit or the Infinium HumanMethylation450K BeadChip Assay, DNA methylation (DNAm) in whole blood was assessed in four subsets (n = 736, 1027, 997, and 312) of a population‐based cohort from Germany. The DNAm levels of the 16 smoking‐independent CpG sites were analyzed. Hazard ratios (HRs) and their 95% confidence intervals (95% CIs) were calculated to assess associations of DNAm at the 16 CpG sites with LC risk, adjusting for multiple covariates, including smoking habits and a smoking‐associated DNAm score. Over 17 years of follow‐up, a total of 199 LCs were observed. Among the 16 CpGs, cg02211449 showed a negative association with LC risk (HR [95% CI] per SD increase, = 0.70 [0.63–0.78]), while cg11385536 (1.04 [1.01–1.07]), cg09736286 (1.64 [1.10–2.44]), cg19907023 (1.64 [1.01–2.66]), and cg22032485 (1.52 [1.04–2.21]) displayed positive associations with LC risk. Five of the 16 suggested smoking‐independent CpGs could be externally validated as predictors of LC risk. Further research should address their potential contribution to enhanced LC risk stratification.
On the Interplay Between Interpretation and Reasoning in Compelling Fallacies
Authors: Picat Léo , Mascarenhas Salvador
Published: December 2024

We investigate the articulation between domain‐general reasoning and interpretive processes in failures of deductive reasoning. We focus on illusory inferences from disjunction‐like elements, a broad class of deductive fallacies studied in some detail over the past 15 years. These fallacies have received accounts grounded in reasoning processes, holding that human reasoning diverges from normative standards. A subset of these fallacies, however, can be analyzed differently: human reasoning is not to blame, instead the premises were interpreted in a nonobvious, yet perfectly predictable and reasonable way. Once we consider these interpretations, the apparent fallacious conclusion is no mistake at all. We give a two‐factor account of these fallacies that incorporates both reasoning‐based elements and interpretive elements, showing that they are not in real competition. We present novel experimental evidence in favor of our theory. Cognitive load such as induced by a dual‐task design is known to hinder the interpretive mechanisms at the core of interpretation‐based accounts of the fallacies of interest. In the first experiment of its kind using this paradigm with an inferential task instead of a simpler truth‐value‐judgment task, we found that the manipulation affected more strongly those illusions where our theory predicts that interpretive processes are at play. We conclude that the best way forward for the field to investigate the elusive line between reasoning and interpretation requires combining theories and methodologies from linguistic semantics and the psychology of reasoning.
Intellectually Rigorous but Morally Tolerant: Exploring Moral Leniency as a Mediator Between Cognitive Style and “Utilitarian” Judgment
Authors: Gouiran Manon D. , Cova Florian
Published: December 2024

Past research on people's moral judgments about moral dilemmas has revealed a connection between utilitarian judgment and reflective cognitive style. This has traditionally been interpreted as reflection is conducive to utilitarianism. However, recent research shows that the connection between reflective cognitive style and utilitarian judgments holds only when participants are asked whether the utilitarian option is permissible, and disappears when they are asked whether it is recommended. To explain this phenomenon, we propose that reflective cognitive style is associated with a greater moral leniency—that is, a greater tendency to be tolerant of moral violations, and that moral leniency predicts utilitarian judgment when utilitarian judgment is measured through permissibility. In Study 1 (N = 192), we design a set of vignettes to assess moral leniency. In Studies 2 and 3 (N = 455, 428), we show that reflective cognitive style is indeed associated with greater moral leniency, and that moral leniency mediates the connection between cognitive style and utilitarian judgment. We discuss the implication of our results for the interpretation of the relationship between utilitarianism and reflective cognitive style.
Myosteatosis Is Associated With Frailty and Poor Physical Function in Patients Undergoing Liver Transplant Evaluation: A Cohort Study
Authors: Johnston Heidi E. , Andelkovic Melita , Mayr Hannah L. , Chen Yanyan , Thrift Aaron P. , Macdonald Graeme A. , Hickman Ingrid J.
Published: December 2024

Introduction

Myosteatosis is fat infiltration within skeletal muscle. The impact of myosteatosis on physical function and clinical outcomes in patients referred for liver transplantation (LT) is unclear. We explored associations between myosteatosis and sarcopenia, frailty, physical function, and pre‐ and early post‐LT outcomes.

Methods

Myosteatosis was assessed by computed tomography (CT) in 237 patients referred for LT (March 2018 to September 2022). Chi‐square/Fishers exact tests and multivariable regression compared myosteatosis and sarcopenia, frailty (liver frailty index), physical function (short physical performance battery, SPPB); and associations with pre‐LT unplanned hospitalizations, post‐LT surgical complications (Clavien–Dindo grade ≥ 3), and LT admission length of stay (LOS). Kaplan–Meier and Cox‐proportional hazards models explored myosteatosis and time to LT and unplanned admission. Fine–Gray model evaluated the competing risks of receiving an LT.

Results

Myosteatosis was present in 74 (31%) patients. Patients with myosteatosis were 2.5 times (95% confidence interval [CI] 1.1–5.7, p = 0.03) more likely to be frail, and 3.0 times (95% CI 1.6–5.6, p < 0.001) more likely to have a poor physical function (SPPB ≤ 9/12) than those without myosteatosis. Patients with myosteatosis versus those without were more likely to have a pre‐LT unplanned hospitalization (51% vs. 36%, p = 0.03), but significance was lost after adjusting for age, sex, Model for End‐stage Liver Disease (MELD), and the presence of hepatocellular carcinoma. Myosteatosis did not impact the likelihood of receiving an LT (p = 0.39), post‐LT complications (p = 0.93), or LOS in intensive care unit (ICU) (p = 0.66) or hospital (p = 0.34).

Conclusions

Myosteatosis is prevalent in patients referred for LT and is associated with impaired physical function. Using existing CTs to assess myosteatosis in practice may help identify physically compromised patients.
Core Laboratory Versus Center‐Reported Echocardiographic Assessment of the Native and Bioprosthetic Aortic Valve
Authors: Velders Bart J. J. , Vriesendorp Michiel D. , Weissman Neil J. , Sabik Joseph F. , Reardon Michael J. , Dagenais Francois , Moront Michael G. , Rao Vivek , Fukuhara Shinichi , Günzinger Ralf , van Leeuwen Wouter J. , Brown W. Morris , Groenwold Rolf H. H. , Klautz Robert J. M. , Asch Federico M.
Published: December 2024

Background

Insights into quantitative differences between core laboratory and center‐reported echocardiographic assessment of the native and bioprosthetic aortic valve are lacking. We aimed to explore clinically relevant differences between these evaluations.

Methods

Data were used from the PERIcardial SurGical AOrtic Valve ReplacemeNt (PERIGON) Pivotal Trial for the Avalus valve. In this trial, patients with an indication for surgical aortic valve replacement (SAVR) due to aortic stenosis or regurgitation (AR) were enrolled. Serial echocardiographic examinations were performed at each center and blindly reanalyzed by an independent echocardiographic core laboratory (ECL). For the bioprosthetic valve analysis, postoperative data throughout the 5‐year follow‐up were pooled. Differences between the ECL and the centers in continuous parameters were quantified in mean differences and intraclass correlation coefficients (ICCs). Agreement on AR, paravalvular leak (PVL), and prosthesis‐patient mismatch (PPM) classification was investigated using Cohen's kappa coefficients.

Results

The analysis on the native aortic valve was performed on 1118 echocardiograms. The relative mean difference was largest for the left ventricular outflow tract (LVOT) area, followed by stroke volume and effective orifice area (index), with center‐reported values being 11%–7% higher. High ICCs of around 0.90 were observed for the parameters peak aortic jet velocity, mean pressure gradient, and the velocity‐time integral across the aortic valve. Over 5000 echocardiograms were available for the bioprosthetic valve analysis. Therein, comparable results were observed. The kappa coefficient was 0.59 (95% confidence interval [CI] 0.56, 0.63) for agreement on native AR, 0.28 (95% CI 0.18, 0.37) for PVL, and 0.42 (95% CI 0.40, 0.44) for PPM.

Conclusions

There is high agreement between the ECL and clinical centers on continuous‐wave Doppler‐related measurements. In contrast, agreement is low for parameters that involve measurement of the LVOT diameter. These results provide important context for the interpretation of aortic valve performance in studies that lack central ECL evaluation.

Trial Registration

ClinicalTrials.gov identifier: NCT02088554
Factor Structure and Psychometric Properties of the Chinese Version Perseverative Thinking Questionnaire
Authors: Ye Niansi , Peng Ling , Deng Bei , Hu Hui , Wang Yuncui , Zheng Taoyun , Ai Yating , Liu Xueting , Zhou Shi , Li Yucan
Published: December 2024

Aim

Repetitive negative thinking (RNT) as a cognitive process in multiple mental disorders is a key risk factor for mental disorders. It is associated with the development and maintenance of the illness. The perseverative thinking questionnaire (PTQ) is an instrument to evaluate RNT with excellent reliability and validity. Nevertheless, a Chinese version of the perseverative thinking questionnaire (C‐PTQ) is lack of validation in Chinese college students. The study aimed to establish a C‐PTQ, explore its psychometric properties in college students.

Methods

After translating PTQ into Chinese, we investigated 696 college students. We conducted exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to examine the psychometric properties and factor structures of the C‐PTQ. Content validity was assessed using the content validity index and internal consistency was assessed using the Cronbach's α and McDonald's Omega ω. Multi‐variable linear regressions explored the relationships between variables. We used receiver operating characteristic (ROC) curves to determine the ability of C‐PTQ in identifying depression and anxiety.

Results

The EFA showed a one‐factor structure, which explained 52.227% of the total variance. The CFA showed that both one‐factor structure in this research and three‐factor structure of original demonstrated eligible model fits. The content validity index of 0.93. Results demonstrated good internal consistency (Cronbach's α = 0.934, McDonald's Omega ω = 0.934) and convergent validity. The PTQ is a useful tool in identifying depression (sensitivity = 85.5%, specificity = 64.6%) and anxiety (sensitivity = 84.6%, specificity = 68.5%).

Conclusions

The C‐PTQ has good psychometric properties, which is valid and reliable for assessing RNT in Chinese college students.