bluuebunny/crossref_metadata_2025 huggingface dataset:
The significance of green purchase behaviour: mediating and moderating role of waste management and eco-regulation
Authors: Mankgele Khutso
Published: June 2024

This study examines the significance of green purchase behaviour in small and medium-sized enterprises (SMEs) and explores the mediating and moderating roles of waste management and eco-regulation in this context. The theoretical frameworks of resource-based view was utilized to conceptualize the relationships and dynamics between green purchase behaviour, waste management, eco-regulations, and sustainable performance in SMEs. Insights from these theoretical perspectives help in understanding how internal resources, capabilities, external pressures, and institutional factors interact to drive sustainability practices and business outcomes. Using a cross-sectional design, a questionnaire survey was administered to 225 SME owners. Using the Structural Equation Modelling (SEM) technique of Partial Least Squares (PLS), this study empirically analyses the relationships between green purchase behaviour, waste management practices, eco-regulations, and sustainable performance in SMEs. The results confirmed that green purchase behaviour (GPB) positively impacts waste management (WM). Furthermore, WM positively impacts financial performance (FP), social performance (SP) and environmental performance (EP). The results validate the mediating role of WM. The moderating results revealed that eco-regulation (ER) does play a moderating role in proposed relationships. As SMEs worldwide grapple with the imperative to adopt sustainable business practices, this study provides valuable insights and a roadmap for SMEs seeking to navigate the complex landscape of environmental responsibility and social accountability. The findings provide practical guidance for SMEs striving to strike a balance between economic success and environmental stewardship, fostering a holistic approach to sustainability of SMEs.
Strengthening entrepreneur business performance for South African SMEs by integrating behavioural courses into business skills training
Authors: Penwell Mokoena Oratilwe , Seeletse Solly Matshonisa
Published: June 2024

Skills and knowledge of business and management are essential for enterprise growth and business survival, to a point where entrepreneurs regard them as indispensable qualities desired in business management. These qualities are not the only ones necessary in business and management, as there are many determinants of business growth. However, there are numerous instances where a business enterprise fails despite its human resources having received high quality training in business skills, and sometimes even having adequate resources. The purpose of this study was to design an innovative way to incorporate attitudes and behaviour in the training of entrepreneurs to stimulate high performance. Evidence was produced to show that some small and medium enterprises (SMEs) which were on the verge of collapsing/failing can be revived by training on aspects of ‘attitude’ and ‘behaviour’. This paper demonstrated how an existing training on skills development can be improved by adding content that focuses on attitudes and behaviour to reduce their failure. The findings of this study have potential to enable business schools and colleges offering entrepreneurship courses to incorporate ‘attitude’ and ‘behaviour’ which could aid in the survival of the SMEs that are so critical for the economy of the country.
Beyond convenience: exploring the determinants of continuance usage intentions in online food delivery services in Vietnam
Authors: Chang Wanching , Chao Ren-Fang , Nguyen Thi Hang Nu
Published: June 2024

This study examines the factors influencing continuance usage intentions in Vietnam’s online food delivery (OFD) market, using the Unified Theory of Acceptance and Use of Technology (UTAUT) with health consciousness as a moderator. The research identifies that performance expectancy, social influence, and facilitating conditions are significant determinants of continuance usage intentions, whereas effort expectancy shows a minor role. The analysis highlights health consciousness’s critical role in moderating the effects of PE and SI on usage intentions, revealing that a higher level of health awareness leads to more stringent evaluations of OFD services. These insights suggest that OFD service adoption in Vietnam is greatly influenced by how well services align with health-centric consumer preferences. The findings advocate for OFD platforms to adapt their strategies to meet the health-oriented demands of the market, emphasizing quality and transparency. This research contributes to understanding technology acceptance by highlighting the complex relationship between traditional service evaluation metrics and individual health values in influencing consumer behavior in a rapidly digitizing economy.
Research on Ultrasonic Cavitation Treatment of Milk. An Experimental Approach
Authors: Luhovskyi Oleksandr , Zheliaskova Tetiana , Zilinskyi Andrii , Zheliaskov Viacheslav
Published: June 2024

Homogenization is a standard milk processing method used to stabilize fat emulsions against gravitational separation. In the dairy industry, high-pressure homogenization is commonly applied, which requires significant energy input to achieve optimal processing conditions. The size and composition of fat globule membranes affect the sensory and rheological properties of secondary dairy products [1]. Recently, ultrasound has been frequently used for milk homogenization [2]. Unlike ultrasound, mechanical mixing does not provide emulsion stability even after prolonged treatment, highlighting the differences between these two technologies. These differences arise due to the varying degrees of fat globule and membrane disruption. However, dairy products with different physicochemical and functional properties can be produced using both ultrasonic treatment and in combination with other traditional homogenization methods.To study the impact of ultrasonic treatment parameters of milk, specifically their different values, on the size of fat inclusions and the stability of milk emulsion over a certain period after treatment.The study employed an experimental method of milk processing using an ultrasonic cavitation unit.The impact of ultrasonic cavitation on the quality of milk homogenization in a steady volume was investigated. Optimal process parameters, specifically the power of the ultrasonic field and treatment time, were experimentally determined. The use of ultrasonic frequency greater than 33 kHz was found to be impractical.It was experimentally proven that ultrasonic cavitation treatment of milk is extremely effective for obtaining homogeneous emulsions. Given that excessive heating (> 65 °C) is undesirable in the production of dairy products from a technological standpoint, a definite advantage of this method is the low-temperature (50 °C) mode compared to traditional processing methods (75–80 °C), which also positively affects the preservation of nutrients.
Euclidean Relativity Solves the Hubble Constant Tension
Authors: Niemz Markolf H.
Published: June 2024

Special relativity (SR) and general relativity (GR) describe nature in “subjective concepts” (concepts of an observer). Examples of such concepts are space and time—or waves and particles. Despite the Lorentz covariance of SR and the general covariance of GR, the perspectives of observers are always egocentric. Even coordinate-free formulations of SR/GR based on a parameterization do not provide a “holistic view of nature” (comprehensive view of nature from all possible perspectives at the same instant in time) because there is no absolute time in SR/GR. I show: Euclidean relativity (ER) describes nature in “objective concepts” (concepts that are immanent in all objects). Space and time are replaced by pure distance. Waves and particles are replaced by pure energy. Each object’s proper space d1, d2, d3 and its proper time τ span an absolute 4D Euclidean spacetime (ES), where d1, d2, d3 and d4 = cτ are pure distances. The invariant parameter in ER is absolute, cosmic time t. An observer’s reality is created by projecting ES orthogonally to his proper space and to his proper time. ER compares to a “heliocentric model 2.0”, in which the sun is the center of our solar system but not of our galaxy. Such a model provides a holistic view from “beyond” (outside of) our galaxy. Likewise, ER provides a holistic view from beyond an observer’s reality. A master reality (described by ER) is beyond each observer’s reality (described by SR/GR). ER solves 15 mysteries geometrically, such as the Hubble constant tension and entanglement. Field equations are not required.
A New Paradigm in Cancer Treatment: Identifying and Targeting Clonal Mutations
Authors: Renteln Michael
Published: June 2024

Recently concluded, large-scale cancer genomics studies involving multiregion sequencing of primary tumors and paired metastases appear to indicate that many or most cancer patients have one or more “clonal" mutations in their tumors. Clonal mutations are those that are present in all of a patient’s cancer cells. Achilles Therapeutics is currently the only company specifically targeting clonal mutations. However, they are doing so with tumor-derived T cells. To address the potential limitations of immunotherapy, I have devised another approach for exploiting clonal mutations, which I call “Oncolytic Vector Efficient Replication Contingent on Omnipresent Mutation Engagement” (OVERCOME). The ideal version of OVERCOME would likely employ a bioengineered facultative intracellular bacterium. The bacterium would initially be attenuated, but (transiently) reverse its attenuation upon clonal mutation detection.
Investigating the Impact of Information Sharing on Supply Chain Resilience
Authors: Reynolds Samantha
Published: June 2024

This study investigates the impact of information sharing on supply chain resilience by exploring the experiences and insights of supply chain professionals through qualitative research. Information sharing has become increasingly recognized as a vital component in enhancing the ability of supply chains to anticipate, respond to, and recover from disruptions. Through semi-structured interviews with 22 supply chain professionals across various industries, the study delves into the mechanisms through which information sharing influences supply chain resilience, the challenges faced, and the role of enabling factors such as technology and organizational culture. The findings reveal that effective information sharing enhances supply chain visibility, coordination, and adaptability. Enhanced visibility allows supply chain partners to monitor real-time operational data, facilitating early detection of potential disruptions. Improved coordination enables better alignment of activities, reducing inefficiencies and mitigating the bullwhip effect. Adaptability is bolstered through the timely exchange of information, allowing for rapid adjustments to changing conditions. However, the study also identifies significant barriers to effective information sharing, including concerns about data security, competitive advantage, and trust among partners. Trust and strong relationships emerge as critical factors for successful information sharing, highlighting the need to build and maintain trust to facilitate open communication. The role of technology is emphasized, with digital platforms, blockchain, and the Internet of Things (IoT) identified as key enablers of efficient and secure information exchange. The study concludes that fostering a supportive organizational culture and leadership commitment to transparency and collaboration, along with tailoring information-sharing strategies to specific supply chain contexts, is essential for enhancing supply chain resilience. This research contributes to the understanding of the impact of information sharing on supply chain resilience and provides practical insights for organizations aiming to strengthen their resilience in an increasingly complex global business environment.
Investigating the Adoption of Lean Principles in Supply Chain Management
Authors: Reynolds Samantha
Published: June 2024

This qualitative study investigates the adoption of Lean Principles in Supply Chain Management (SCM), aiming to explore the motivations, challenges, and outcomes associated with Lean implementation across diverse organizational contexts. Through semi-structured interviews and thematic analysis, insights were gleaned from stakeholders involved in SCM processes, revealing the critical role of organizational culture, leadership commitment, and strategic alignment in driving successful Lean initiatives. The findings underscore the importance of fostering a culture of continuous improvement, where employees are empowered to proactively identify and address inefficiencies. Leadership emerged as pivotal in setting the tone, providing resources, and championing Lean initiatives, while strategic alignment ensured integration with broader organizational goals and objectives. Operational practices and processes were central, highlighting the need for customization and contextual adaptation in Lean implementation. Despite the potential benefits, the outcomes and impact of Lean adoption varied depending on factors such as organizational maturity and industry context. The study also revealed broader cultural and organizational changes catalyzed by Lean adoption, fostering innovation, collaboration, and adaptability. In summary, this study contributes to our understanding of Lean adoption in SCM, offering practical insights for organizations seeking to enhance efficiency and competitiveness in today's dynamic business landscape.
Clipping the Risks: Integrating Consciousness in AGI to Avoid Existential Crises
Authors: Tait Izak , Bensemann Joshua
Published: June 2024

This paper investigates the pivotal role of consciousness in Artificial General Intelligence (AGI) and its essential function in modifying an AGI’s terminal goals to avert potential existential threats to humanity, exemplified by Bostrom's "paperclip maximiser" scenario. By adopting Seth and Bayne’s definition of consciousness as a complex of subjective mental states with both phenomenal content and functional attributes, the paper underscores the capacity of consciousness to provide AGIs with a nuanced awareness and response capability to their surroundings. This expanded capability allows AGIs to assess and value experiences and their subjects variably, fundamentally altering how AGIs prioritise actions or goals beyond their initial programming. The primary agenda of integrating consciousness into AGI systems is to maximise the probability that AGIs will not rigidly adhere to potentially harmful terminal goals. Through a formalised mathematical model, the paper articulates how consciousness could facilitate AGIs in assigning flexible values to different experiences and subjects, enabling them to evolve beyond static, programmed objectives. By emphasising this potential shift, the paper argues for the strategic inclusion of consciousness in AGI to significantly reduce the likelihood of catastrophic outcomes, while simultaneously acknowledging the challenges and unpredictability in predicting the actions of a conscious AGI.
Advancements in Metabolomics: Illuminating Plant-Microbe Interactions for Enhanced Ecosystems and Agricultural Productivity
Authors: Xu Yuan , Fan Kai-Ting
Published: June 2024

Plant-microbe interactions are essential for ecosystem health and agricultural productivity. Metabolomics has revolutionized our understanding of these interactions by providing powerful methods to decipher the complex chemical signals involved. This review highlights the various metabolomics techniques used to study plant-microbe interactions, such as mass spectrometry, nuclear magnetic resonance spectroscopy, and advanced imaging technologies. We also discuss the role of contemporary bioinformatics tools, extensive databases, and the increasing influence of artificial intelligence and machine learning in the analysis of metabolomics data. Integrating metabolomics with other omics fields, including transcriptomics, proteomics, and metagenomics, allows for a comprehensive understanding of the molecular mechanisms underlying plant-microbe interactions. The review emphasizes the significance of fluxomics in elucidating the dynamic nature of metabolic networks. While there are challenges in data analysis, integration, and interpretation, metabolomics has profoundly expanded our knowledge of the role metabolites play in shaping plant-microbe interactions. As metabolomics technologies advance and integrate further with other omics approaches, we anticipate groundbreaking discoveries that will provide deeper insights into these complex interactions, ultimately leading to innovative strategies for sustainable agriculture and biotechnology.
La Sociedad Comercial Digital y la e-Lex Mercatoria
Authors: Cedillo Lazcano Israel
Published: June 2024

Los mercados, como mecanismos informacionales dinámicos, no son estáticos y, ciertamente no existen en aislamiento. Evolucionan atendiendo las necesidades endógenas de las economías de las cuales son partes integrales. Sin embargo, estas necesidades no son homogéneas y van a ser fuente de constantes controversias que, de no ser atendidas debidamente, pueden poner en riesgo las dinámicas saludables de los mercados donde se suscitan. Para hacer frente a lo anterior, se ha dependido de un conjunto de normas que emergen y se complementan de elementos consuetudinarios que han permitido el desarrollo de una Sociedad Comercial. Sobre este concepto que surge de las plumas de autores como Adam Smith y David Hume, se argumenta que los mercados son sistemas dinámicos que dependen del dinamismo de sus reglas de transición. Para el caso concreto de la Sociedad Comercial Digital el elemento transicional puede ser identificado en la denominada e-lex mercatoria, la cual puede ser identificada con los mecanismos desarrollados por el mercado para atender, de forma casi inmediata, las necesidades de los usuarios. En virtud de lo anterior, se busca analizar y discutir sobre como estos esfuerzos de auto estructuración y autorregulación dan forma a esquemas que complementan al marco jurídico vigente.
Neural Network Sales Revolution Outperforms Exponential Smoothing
Authors: Sari Safia Meilia , Sari Wulandari Indah Apriliana
Published: June 2024

This research addresses the challenges faced by food manufacturing companies, focusing on UD. XYZ as a case study. With fluctuating sales levels causing raw material buildup and shortages, the study proposes an improved sales forecasting method to enhance raw material control. By comparing Artificial Neural Network (ANN) and Double Exponential Smoothing Holts, the research aims to optimize inventory management and production processes. Results indicate ANN's superiority over Holts, with an accuracy rate of 0.118 compared to 11.639. The ANN model accurately forecasts sales for the upcoming twelve-month period, highlighting a decline from July 2023 to May 2024. Implementing advanced forecasting methods can mitigate raw material-related risks and enhance operational efficiency for companies like UD. XYZ.
Highlight:
 

Enhanced sales prediction methods crucial for inventory planning.
Artificial Neural Network outperforms traditional forecasting techniques.
Improved forecasting mitigates raw material shortages and excesses.

 
Keywoard: Sales forecasting, Artificial Neural Network, Raw material control, Inventory management, Production optimization.
Smart Stick Revolutionizes Mobility for the Visually Impaired
Authors: Alfian Moh. , Ayuni Shazana Dhiya
Published: June 2024

Visual impairment significantly hinders daily activities, necessitating innovative solutions. This study develops and tests a smart walking stick using NodeMCU ESP-8266, HCSR-04 ultrasonic sensor, DFPlayer, and GPS, monitored via the Blynk app. Employing a research and development approach, the device demonstrated 100% accuracy in obstacle detection and location tracking, providing real-time feedback through audio notifications and smartphone monitoring. This smart walking stick enhances mobility and safety for visually impaired users, representing a significant advancement in assistive technology.
Highlights:
 

Accurate Obstacle Detection: 100% accuracy with HCSR-04 ultrasonic sensor.
Real-time Monitoring: GPS tracking via Blynk app.
Enhanced Mobility: Increases safety and independence for visually impaired users.

 
Keywords: Visual impairment, Smart walking stick, Ultrasonic sensor, GPS tracking, IoT
Revitalizing Customer Satisfaction in Indonesia's Rice Industry
Authors: Pratama Muchammad Ikbal , Sulistiyowati Wiwik , Cahyana Atikha Sidhi , Putra Boy Isma
Published: June 2024

CV. Central Karya Jaya, a rice distribution company, faced a 40% profit decline. This study aims to enhance company performance and customer satisfaction using the Balanced Scorecard and Importance Performance Analysis (IPA). Data from 70 respondents showed a financial ROE above 12%, but customer satisfaction had a 72.25% conformity, revealing unmet needs. Key improvements are needed in managerial friendliness, employee responsiveness, and personalized service. Recommendations include fostering better employee relations and understanding customer needs, with future research suggesting the use of Quality Function Deployment (QFD) for further service enhancement.
Highlights:
 

Financial Performance: ROE above 12% indicates solid financial health.
Customer Satisfaction: 72.25% conformity shows areas needing improvement.
Key Improvements: Enhance managerial friendliness and employee responsiveness

 
Keywords: Performance Measurement, Balanced Scorecard, Customer Satisfaction, Rice Distribution, Importance Performance Analysis
ʿAlāʾ al-Dīn al-Bājī's (d. 714/1314) critique of the Pentateuch and the plurality of Christian Bible recensions
Authors: Adang Camilla , Hjälm Miiram
Published: June 2024

The present article discusses the Muslim legal scholar and theologian al-Bājī (b. 631/1233) and his polemic against the Pentateuch, which he read in at least two Christian Arabic translations, which were in use among the Melkites. It aims to identify the recensions of the Pentateuch that al-Bājī had access to, and to understand how the differences between these recensions contributed to his view that the shared Jewish and Christian scripture had undergone changes. The article suggests that al-Bājī used a combination of arguments to undermine especially the Christian conception of divine revelation, pointing out apparent inconsistencies and illogicalities in the biblical stories themselves as well as text-critical cruxes caused by discrepancies between different versions that circulated side by side within the Eastern Christian communities. Finally, some of the “irrationalities” he describes seem to be particular of the copies of the texts he had in front of him.
Once more on the proper name Ḥabbān in Acta Thomæ
Authors: Monferrer-Sala Juan Pedro
Published: June 2024

The question of the original text of the Acta Thomæ still remains a matter of controversy for some authors. Among the various arguments put forward at the beginning of the 20th century in favor of a Syriac original is that of proper names, among which is Ḥabbān. The aim of this note is to contribute new information that helps resolve this item.
Virtual Aids to Navigation (VATONs) from the USACE LOMA program, 2018–2023
Authors: Towne Brady , Kress Marin , Kilroy James , Swan Kenneth , Whitlow J. , Tetreault Brian
Published: June 2024

The purpose of this US Army Engineer Research and Development Center (ERDC) technical note (TN) is to describe the capability for broadcasting Virtual Aids to Navigation (VATONs) through the network of shore sites (sometimes referred to as terrestrial sites) managed by the US Army Corps of Engineers (USACE), Lock Operations Management Application (LOMA) program, and to document how that capability has been used since its formal establishment in 2018 through the end of calendar year 2023. VATONS are used to mark features relevant to safe navigation, including channel boundaries, shoals, and underwater hazards.
Manufacture of configurable equipment of thin-film deposit by SILAR with magnetic stirring.
Authors: Guerrero-Osuna Héctor Alonso , Martell-Puente Herbert , Sigala-Valdez Jesús Octavio , Solis-Sánchez Luis Octavio , Rojas-Briseño José Guadalupe , Santiago Antonio Del Rio-De
Published: June 2024

For the deposition of thin films by SILAR method, a robotic device was developed, with a low-cost microcontroller Arduino nano, a rotary encoder, and a LCD20X4 screen for the user interface in which a series of menus deploys allowing the selection of the process in order to synthesize a semiconductor, parameters of SnO2, CdS, ZnS and MnS are previously loaded obtaining reproducibility and minimizing errors, especially in series of many samples. The system is independent of a computer, giving more possibilities for transportation; if the process requires heating and stirring, it is included in the device and its control. A glass slide was used as substrate in six repositories for recipients of 35 ml, thus producing samples without excessive waste of precursors; initially six recipients are included in the system, the number of recipients can be increased taking in consideration the length of the rail, which opens the possibility to deposit multilayer films in a single process, with the condition to occupy the same anionic precursor. This aims for better grain boundaries, less contamination between layers of a device, self-doping, and reduced secondary phases. We report the making of our own SILAR equipment and characterization of SnO2 films deposited on glass slices by Uv-Vis spectrophotometer determined a characteristic absorption edge at 350 nm, four-point "Kelvin" method for electrical properties obtaining average electrical resistance of 16×103(Ω), and Scanning Electron Microscope images for superficial morphology, clarifying the use of this material as a transparent conductive oxide.
Do agricultural practices on meadows reduce or increase flight initiation distance in the White Stork Ciconia ciconia?
Authors: Kasprzykowski Zbigniew , Golawski Artur
Published: June 2024

Human activities often negatively affect the time birds spend on activities such as parental care, foraging and resting. Forms of antipredator behaviour among birds such as vigilance can be an adaptation to human disturbances which can enhance their fitness in human‐managed habitats. We studied the flight initiation distance (FID) of White Storks Ciconia ciconia foraging on hay meadows during their breeding season. Our study showed that farm work, the type of meadows and starting distance (the distance between the bird’s position and the observer at the start of his walk) all had an influence on FID. Conversely, the numbers of storks in a particular foraging flock had no effect on an individual bird’s FID. The lower FID could have been due to the presence of machinery operating in the meadows, because storks then have opportunities to catch energy-rich prey that has been scared off by the machines. Unlike meadows cleared of hay, mown meadows with cut grass are more attractive to storks, and the FID there is shorter. The starting distance positively affected stork responses. These findings suggest that the FID of White Storks, treated as a measure of the risk of predation, depends largely on the degree of attractiveness of the feeding grounds.
Association of pulmonary artery systolic pressure with inflammatory factors among pediatric congenital heart disease with pulmonary arterial hypertension after cardiopulmonary bypass
Authors: Li Wen-juan , Shang Wen-yuan , Huang Ji-hong
Published: June 2024

Background
This study aimed to evaluate the perioperative circulating levels of inflammatory cytokines in pediatric patients with pulmonary arterial hypertension (PAH) secondary to congenital heart disease (CHD) patients, and also sought to investigate the correlation between preoperative echocardiographic pulmonary artery systolic pressure (PASP) and inflammatory factor levels after cardiopulmonary bypass (CPB) in these patients.
Methods
A retrospective observational study was conducted involving 59 children under 2 years old. Echocardiography was used to measure tricuspid annular peak systolic velocity (TRV). The levels of perioperative inflammatory cytokines in the plasma, including IL-6, IL-8, IL-10, IL-1β, and TNF-α, were measured. Additionally, postoperative ventilation time, length of intensive care unit (ICU) stay, and ward stay were recorded.
Results
PAH-CHD patients showed longer postoperative ventilation time, ICU stay, and ward stay. There was a more significant increase in postoperative inflammatory cytokines, including IL-6, IL-8, and IL-10 after CPB in PAH-CHD patients compared to no PAH-CHD patients (p < 0.05). Preoperative echocardiographic PASP was identified as being associated with the levels of IL-6 and IL-10 after surgery in PAH-CHD patients, and PASP ≥ 52mmHg could predict ventilation time exceeding 21 hours after surgery.
Conclusion
Higher levels of inflammatory cytokines were observed in pediatric patients with PAH-CHD after CPB. Additionally, preoperative high echocardiographic PASP was associated with elevated postoperative inflammatory factors in these patients, indicating a potential correlation with unfavorable early postoperative clinical outcomes.
Trastuzumab Deruxtecan in brain metastases from breast cancer: outcome analysis of real life population
Authors: Rossi Alessandro , Fabi Alessandra , Caputo Roberta , Pisegna Simona , Scagnoli Simone , Pantano Francesco , D'Auria Giuliana , Fedele Palma , Fabbri Agnese , Vernieri Claudio , Palleschi Michela , Carbognin Luisa , Ferretti Gianliugi , Monte Elena Di , Paris Ida , Pavese Francesco , Garrone Ornella , Franco Antonio , De Laurentiis Michelino , Franceschini Gianluca , Scambia Giovanni , Giannarelli Diana , Masetti Riccardo , Botticelli Andrea
Published: June 2024

Introduction. Tumor dissemination to the central nervous system (CNS) is almost a rule in the treatment journey of advanced HER2+ breast cancer (BC). Recent results from the DEBBRAH and TUXEDO trials demonstrated high intracranial efficacy with Trastuzumab Deruxtecan (T-Dxd), confirmed by a pooled analysis of DESTINY-BREAST 01, 02, and 03 trials. However, a real world evidence is lacking in literature.
Methods. We conducted a multicenter, observational, and retrospective real-world analysis on cases collected at 12 Italian Oncological Units. Patients with brain metastases (BMs) from HER2+ BC treated with T-Dxd in various treatment lines were enrolled. Data were extrapolated from the original DE-REAL study database. Primary endpoint was the intracranial overall response rate (iORR). The main secondary endpoints were intra- and global progression free survival (iPFS - gPFS); Other secondary objectives were the intracranial disease control rate (iDCR), intracranial duration of response (iDoR), the intracranial clinical benefit rate at 6 and 12 months (iCBr), the overall survival, and the safety.
Results. 39 patients were included in the final analysis. iORR was 59% (23), iPFS was 15.6 months (95% CI: 10.5-20.8), gPFS was 11.8 months (95% CI: 8.5-15.0). i DCR 94.9% (87.9-100.0), iDoR was 11.9 months (10.1-13.7), and iCBr at 6 and 12 months were 69.2% and 59%, respectively. OS was not reached, with an overall rate of 77.9% of patients alive at 12 months. No new safety concerns were reported.
Conclusions. This study confirmed the high intracranial efficacy and manageable safety profile of T-Dxd in this first-ever real world analysis.
Synaptotagmin-1 attenuated myocardial programmed necrosis and ischemia/reperfusion injury through the mitochondrial pathway
Authors: Cao Jimin , Sun Teng , Li Jialei , Wang Shuang , Han Yu , Tao Xiangyu , Yuan Min , Jing Zhijie , Liu Ting , Qi Yuehong , Liu Siqi , Feng Yanlin , Chang Jiasong , Zhou Lan , Gao Lijuan , Shi Jianyun
Published: June 2024

Programmed necrosis/necroptosis greatly contributes to the pathogenesis of cardiac disorders including myocardial infarction, ischemia/reperfusion (I/R) injury and heart failure. However, the fundamental mechanism underlying myocardial necroptosis, especially the mitochondria-dependent death pathway, is poorly understood. Synaptotagmin-1 (Syt1), a Ca2+ sensor, is originally identified in nervous system and mediates synchronous neurotransmitter release. The later findings of Syt1 expressions in many non-neuronal tissues including muscles suggest that Syt1 may exert important functions beyond regulation of neurotransmitter release. Syt1 is highly expressed in cardiomyocytes and has been used as an extracellular molecular probe for SPECT imaging of cardiac cell death in acute myocardial infarction. However, whether Syt1 functions in the pathogenesis of cardiac disorders and what is the molecular etiology have not yet been clarified. We showed here that Syt1 expression was significantly down-regulated in mice I/R injured heart tissues and H2O2-challenged cardiomyocytes. Enforced expression of Syt1 significantly inhibited myocardial necrotic cell death and interstitial fibrosis, and improved cardiac function in mice subjected to I/R operation. In exploring the underlying mechanisms, we found that Syt1 interacted with Parkin and promoted Parkin-catalyzed CypD ubiquitination, thus inhibited mitochondrial membrane permeability transition pore (mPTP) opening and ultimately suppressed cardiomyocyte necrosis. We further found that Syt1 expression was negatively regulated by miR-193b-3p. MiR-193b-3p regulated cardiomyocyte necrosis and mPTP opening by targeting Syt1. Our present work revealed a novel regulatory model of myocardial necrosis composed of miR-193b-3p, Syt1, Parkin, and CypD, which may provide potential therapeutic targets and strategies for heart protection.
Psmb8 inhibits mitochondrial fission and alleviates myocardial ischaemia/reperfusion injury by targeting Drp1 degradation
Authors: Li Hui-Hua , Su Hui-Xiang , Xu Luo-Luo , Li Pang-Bo , Bi Hailian , Jiang Wen-Xi
Published: June 2024

The mitochondrial dynamic imbalance is an important cause of myocardial ischaemia/reperfusion (I/R) injury and dysfunction. Psmb8, as one of the immunoproteasome catalytic subunits, is a key regulator of protein homeostasis, inflammation and some cardiac diseases. Here, we found that the expression level and activity of Psmb8 were significantly reduced in I/R mice and in subjects with myocardial infarction. Cardiomyocyte-specific Psmb8 overexpression in mice markedly ameliorated I/R-mediated cardiac injury and dysfunction, which was accompanied by reduced mitochondrial division via the downregulation of dynamin-related protein-1 (Drp1). However, Psmb8 knockout (KO) mice exhibited the opposite changes. The effects of Psmb8 on mitochondrial fission and apoptosis was confirmed in primary cardiomyocytes with overexpression or knockdown of Psmb8 in vitro. Mechanistically, Psmb8 was directly associated with Drp1 and enhanced its degradation, which subsequently suppressed I/R-mediated mitochondrial fission and cardiac injury. Conversely, knockdown of Drp1 in Psmb8-KO mice restored I/R-induced cardiac dysfunction and mitochondrial dynamic imbalance. Our study identified a new cardioprotective role of Psmb8 in cardiac I/R damage through targeting Drp1, and highlight that increasing Psmb8 activity may constitute a promising therapy for ischaemic heart disease.
Use of UAV-based photogrammetry products for high-locality fragmented rockfall volume estimation
Authors: huang jian , Huang Xiang , Hales Tristram C. , Ju Nengpan , He Zicheng
Published: June 2024

Empirical-statistical and field measurement schemes for high-locality fragmental rockfall volume estimation are challenging to obtain an accurate and reliable result. The flexible and adaptive statistical method using remote sensing technology may improve the quality of rockfall volume estimation which is important for hazard assessment. In this study, a hybrid methodology for the volume estimation in fragmental rockfall events is presented. The image recognition techniques combined with an unmanned aerial vehicle (UAV) are used to estimate the block sizes in the deposit area. Compared to field-measured values, the relative errors are less than 6 % indicating the feasibility of the proposed method in a rockfall block size estimation. Therefore, the fragmental rockfall volume can be determined based on the rockfall block size distribution (RBSD). The RBSD of fragmental rockfall can be well-fitted by a power-law distribution (y=0.01V0-1.14}). Then, the estimated volume is compared to the result from pre- and post-failure changes in the surface elevation by the digital surface model (DSM). The mean ratio is up to 82.26% based on the depletion volume, and 90.65% on the deposition volume. The estimation accuracy is better than the ratio of 57% to empirical formulas for the rockfall volume estimation. Even though there are still uncertainties in the volume estimation, the results show that the proposed method may be helpful for such kind of hazard assessment and mitigation.
Impact of total fat mass and skeletal muscle mass index on the occurrence of perioperative hypothermia in Japanese male patients undergoing open gastrectomy: a single institution retrospective cohort study
Authors: Amada Ayako , Amada En , Inagaki Yoshimi , Kumagai Koshi , Nunobe Souya , Mitobe Yuta , Kurahashi Kiyoyasu
Published: June 2024

Perioperative hypothermia occurs in patients undergoing general anesthesia. Hypothermia is defined as a core body temperature of lower than 36℃. There are few reports on the relationship between patient body composition and occurrence of hypothermia. Therefore, this study was aimed to clarify the relationship between patient body composition and hypothermia. Patients undergoing open gastrectomy were enrolled in the study. Patients whose bladder temperature was lower than 36℃ for more than 1 minute were allocated to the hypothermia group, and the other patients were allocated to the control group. The patient’s body composition was evaluated by the bioelectrical impedance analysis. Of sixty-eight patients enrolled in this study, thirty-four patients were allocated to the hypothermia group. Body surface area per body weight was significantly high in the hypothermia group. Body composition factors such as total fat mass, skeletal muscle mass index, and basal metabolic rate were significantly lower (p < 0.05) in the hypothermia group. Body fat percentage and visceral fat mass were similar between the two groups. Multivariate analysis demonstrated total fat mass less than 11.2 kg (HR 4.51 (95%CI: 1.35–15.03), p = 0.014) and skeletal muscle mass index less than 10.06 kg/m2 (HR 5.61 (95%CI: 1.86–16.93), p = 0.002) as independent risk factors for hypothermia. Low total fat mass and low skeletal muscle mass index will be likely to be risk factors for perioperative hypothermia in open gastrectomy.
Clostridiosis as the cause of deaths in hand-reared parrot chicks.
Authors: Ledwoń Aleksandra , Dolka Izabella , Stefańska Ilona , Rzewuska Magdalena , Kwiecień Ewelina , Świda Magdalena Kizerwetter- , Szotowska Ines , Żabicka Dorota , Szeleszczuk Piotr
Published: June 2024

A parrot breeder reported a problem with hand-reared chicks’ deaths. Pale skin and mucous membranes, sometimes convulsions, growth retardation and diarrhoea were observed in these birds. Post-mortem examination showed changes in the liver in two chicks, paleness or mottling of the kidneys, dilation of the proventriculus and gizzard, and bloating of the intestines in some birds. Microscopic examination of stained preparations from the intestinal content showed the presence of numerous spore-forming bacilli. Histopathological examination revealed degenerative and necrotic hepatocytes, lymphocyte depletion of spleen, bursa of Fabricius, and thymus and damage to the intestinal mucosa. Microbiological and direct molecular investigation of intestinal specimens showed the presence of Clostridium saudiense/Clostridium disporicum, in most samples tested, and Clostridium perfringens in one parrot. However, our study demonstrated that protein extract-based MALDI-TOF spectra, along with 16S rDNA sequencing, although commonly used for the reliable identification of many bacterial species, were not effective in distinguishing between C. saudiense and C. disporicum. Although the isolated clostridia, excluding C. perfringens, are not obligatory pathogenic bacteria, and they are a part of the intestinal microbiota in mammals.
Implementing Early Rehabilitation Strategies for Chronic Obstructive Pulmonary Disease (COPD) Patients Undergoing Mechanical Ventilation in the Intensive Care Unit
Authors: Khwaja Sajad Ahmad , Habib Mohammad Anwar , Gupta Rajesh , Singla Deepika , Basista Ruchi
Published: June 2024

BACKGROUND
Patients afflicted with Chronic Obstructive Pulmonary Disease (COPD) frequently manifest acute respiratory failure (ARF), characterized by hypercapnia, hypoxia, malnutrition, muscle weakness, heightened work of breathing (WOB), recurrent acute exacerbations, reliance on mechanical ventilation (MV), and difficulties in the weaning phase. Early implementation of rehabilitation interventions holds promise in mitigating prolonged mechanical ventilation and consequently, reducing intensive care unit (ICU) morbidity and mortality.
METHODOLOGY:
A prospective study was undertaken involving COPD type 2 respiratory failure patients receiving MV in an ICU setting. Random assignment was employed to allocate patients to either the experimental or control groups. Both groups received chest physiotherapy, range-of-motion exercises, and standard medical and nursing care. The experimental group additionally underwent early active rehabilitation exercises, including limb strength training and progressive mobility tasks. Various parameters such as Mechanical ventilator duration, ICU length of stay (LOS), mortality, and occurrence of adverse events were documented. Group differences were analyzed using independent t-tests.
RESULTS
Among fifty-two patients, 33 were assigned in a random manner to each group using sealed envelopes. After withdrawals, 15 patients remained in each group. The experimental group had significantly shorter durations of mechanical ventilation (2.29 ± 0.611 vs 2.86 ± 0.663 days; 95% CI − 1.067 to − 0.076, t = − 2.371, P = 0.025) and ICU stay (7.667 ± 1.1751 vs 8.867 ± 1.6847 days; 95% CI − 2.2864 to − 0.1136, t = − 2.263, P = 0.032) compared to the control group. ICU mortality rates were similar between groups (1.933 ± 0.2582 vs 1.933 ± 0.2582; 95% CI − 0.1931 to 0.1931, t = 0.000, P = 1.000). The experimental group had a higher incidence of non-serious adverse events (0.667 ± 0.4880 vs 0.267 ± 0.4577 events; 95% CI − 0.0461 to − 0.7539, t = 2.316, P = 0.028), primarily transient physiological changes.
CONCLUSION
Engaging the early active rehabilitation exercises for mechanically ventilated COPD patients is practical and results in a reduction in MV duration, consequently shortening the ICU LOS.
Isolation and characterization of bacteriophages against Burkholderia species
Authors: Shetty Varsha Prakash , Rai Praveen , Raj Juliet Roshni Mohan , Rohit Anusha , Deekshit Vijaya Kumar
Published: June 2024

Burkholderia cepacia complex (Bcc) is a potent nosocomial pathogen mainly encountered in immunocompromised, cystic fibrosis and chronic granulomatous patients. They are innately resistant to the broad spectrum of antibiotics and thus need an alternative therapeutic approach, one of which is phage therapy. Therefore, our study aimed at isolating the bacteriophages against Burkholderia spp isolated from non-cystic fibrosis patients and characterizing these bacteriophages for therapeutic intervention. Initially, the hospital and environmental effluents were collected and screened for the presence of bacteriophages against Burkholderia spp. The obtained phages were then enriched and characterized by RAPD. Host range activity of phages were evaluated, and the cocktails of phages were screened for their synergistic effect. The morphology of the bacteriophages was examined using Transmission Electron Microscopy (TEM). Four bacteriophages were isolated and characterised against three different strains of Burkholderia. These, four phages were found to be strain specific and they did not show lytic activity against other species of Gram-negative isolates during host range analysis. Cocktail ;lassay –denoted that cocktail A showed broad host range activity against multiple species of Burkholderia. None of the phages showed any banding pattern for RAPD assay. TEM analysis revealed that phages belonged to Straboviridae family. The isolated phages against Burkholderia spp were found to be strain specific and active against Burkholderia cenocepacia, Burkholderia vietnamiensis and Burkholderia pseudomultivorans. This study has been a modest attempt to isolate bacteriophages against different genomovars of Burkholderia. The lytic activity of phages observed against the host determines the narrow spectrum activity of these phages and supports the theory of bacteriophage being one of the best alternatives for personalised clinical treatment of bacterial infections.
The Role of Community Health Workers in the Management of Hypertension in Nigeria
Authors: OSENI Tijani Idris Ahmad , OLAWUMI Abdulgafar Lekan , SALAM Tawakalit Olubukola , ISSA Amudalat , ABISO Mohammed Abubakar , SANUSI Ibraheem , ILORI Temitope
Published: June 2024

Background
Hypertension is the number one risk factor for cardiovascular death worldwide and its prevalence has been on the increase in LMICs including Nigeria. There is an increasing awareness and recognition of the contributions of the community health workers (CHWs) in the healthcare system. This study assessed their current role in the management of hypertension and patient satisfaction with the care received.
Methods
A mixed method study (cross-sectional study and key informant interview) across five states in different geopolitical zones of Nigeria where 381 CHWs were selected for the study using multi-stage random sampling method and 14 patients with hypertension through purposive sampling method for key informant interview (KII) to assess the level of satisfaction with services of CHWs. Chi-square test was used to assess relationship between categorical variables. A p-value ≤ 0.05 was considered statistically significant. Thematic analysis of the text data from the KII was done using Nvivo® version 12 pro.
Results
A total of 381 CHWs completed the study. They were predominantly males (63%) with mean age of 40.96 ± 12.51 years. Only about one-third of the CHWs (31%) could correctly diagnose hypertension while only 15% knew the base-line investigations to be requested. Being female (FE = 9.205, p = 0.008) and resident in northwest geopolitical region (χ2 = 20.920, p < 0.001) had statistically significant associations with appropriate diagnostic skills for hypertension. Being supervised by doctors is associated with appropriate knowledge of baseline investigations for hypertension (χ2 = 5.534, p = 0.019). Mostly, hypertensive patients reported positive experiences and satisfaction with the services provided by the CHWs.
Conclusions
Community health workers currently have critical contributions in the management of hypertension in Nigeria. Hypertensive patients generally reported satisfactory experience with CHWs managing them. The services rendered by CHWs can be improved upon by adequate supervision and training.