bluuebunny/crossref_metadata_2025 huggingface dataset:
Process mining based on patient waiting time: an application in health processes
Authors: Dogan Onur
Published: June 2022

Purpose

Similar to many business processes, waiting times are also essential for health care processes, especially in obstetrics and gynecology outpatient department (GOD), because pregnant women may be affected by long waiting times. Since creating process models manually presents subjective and nonrealistic flows, this study aims to meet the need of an objective and realistic method.

Design/methodology/approach

In this study, the authors investigate time-related bottlenecks in both departments for different doctors by process mining. Process mining is a pragmatic analysis to obtain meaningful insights through event logs. It applies data mining techniques to business process management with more comprehensive perspectives. Process mining in this study enables to automatically create patient flows to compare considering each department and doctor.

Findings

The study concludes that average waiting times in the GOD are higher than obstetrics outpatient department. However, waiting times in departments can change inversely for different doctors.

Research limitations/implications

The event log was created by expert opinions because activities in the processes had just starting timestamp. The ending time of activity was computed by considering the average duration of the corresponding activity under a normal distribution.

Originality/value

This study focuses on administrative (nonclinical) health processes in obstetrics and GOD. It uses a parallel activity log inference algorithm (PALIA) to produce process trees by handling duplicate activities. Infrequent information in health processes can have critical information about the patient. PALIA considers infrequent activities in the event log to extract meaningful information, in contrast to many discovery algorithms.
Design and implementation of an augmented reality mobile application for navigating ATM counters (AR-ATM)
Authors: K.G. Preetha , Antony Subin K. , K.R. Remesh Babu , S. Saritha , U. Sangeetha
Published: June 2022

Purpose

This paper aims to bring in augmented reality (AR) into navigation systems to rectify the issues mentioned. This paper proposes an AR enhanced navigation system for location automated teller machine (ATM) counters (AR-ATM) and branches of banks based on user’s choice. Upon selecting the ATM, the navigational path to the destination is drawn from the current location, thereby the user can reach the ATM through the optimal path.

Design/methodology/approach

Traditional navigation systems require users to map with the real world environment as and when required and also may lead to incorrect path due to minor difference in distance. The traditional navigation systems’ also does not take into consideration the ergonomics and safety of the user.

Findings

In this system, a camera lens is used, which is directed down the street at eye level and the application displays the location of ATMs and bank branches and also provides information about the locations like distance and time through the AR superimposed object.

Originality/value

The application also provides indoor navigation, especially in a multi-storeyed building. Experiments are performed on smartphones that support AR, and the results are promising with no lag in time frame of the real object and virtual object. To determine the factors that regulate the suggested AR tracking mechanism, a quantitative evaluation of the experimental data is also performed. The testing of implemented AR-ATM from the standpoint of end-users is undertaken to evaluate real-time usage comfortability, and the results have been determined to be extremely satisfactory.
Entrepreneurial orientation and innovation performance of social enterprises in an emerging economy
Authors: Oduro Stephen
Published: June 2022

Purpose

Drawing on the resource-based view of the firm, the study aims to develop a holistic conceptual model to examine the nexus between entrepreneurial orientation (EO) and innovation performance (INPF) of social enterprises in an emerging economy, Ghana.

Design/methodology/approach

A quantitative research approach was used to collect and analyse 206 usable survey questionnaires through structural equation modelling-partial least square.

Findings

Results demonstrate that all the dimensions of EO – innovativeness, proactiveness, autonomy, risk-taking and competitive aggressiveness significantly influence the INPF of social enterprises. However, a pairedt-test analysis shows that risk-taking has the largest effect size, followed by innovativeness, proactiveness, autonomy and competitive aggressiveness, in that order. The results highlight that social enterprises must exploit EO as a strategic asset in their corporate strategies and initiatives to realize competitive advantage and enhance INPF.

Originality/value

This study makes an incremental contribution to the extant literature by examining the impact of EO on INPF of social enterprises; it thus extends the EO framework from the conservative entrepreneurship context to the social entrepreneurship context, thereby advancing our understanding of the development and application of the EO framework in the social entrepreneurship context in emerging economies. The study concludes with the theoretical and managerial implications of the findings.
Insider ownership and share collateral with the incentive for share repurchases
Authors: Chen Ni-Yun
Published: June 2022

Purpose

This study examines whether insider share ownership and personal share collateral affect corporate payout decisions.

Design/methodology/approach

This study estimates logit, Tobit and ordinary least squares regression models to explore how insider ownership is related to share repurchase probability, completion rates and the long-term performance following the repurchase announcements and how insider share collateral affects the above associations.

Findings

The results show that insider share ownership is negatively associated with the probability of announcing share repurchases and repurchase completion rates and is positively associated with the firm's post-announcement performance. This study further explores the incentive of insiders with high share collateral announcing share repurchases under a threat of margin call. For firms with a high percentage of insider share collateral, the results show that insider share ownership is associated with higher repurchase probability but is associated with lower repurchase completion rates and poorer post-announcement performance.

Originality/value

This study clarifies the interrelationships between insider ownership, insider share collateral and decisions in share repurchases and subsequent performance. This study provides evidence for both the convergence of interest and the entrenchment theories.
The expression of demographic costs of reproduction varies among coexisting plants with different life history traits
Authors: Sun Hai‐Qin , Zhou Ting‐Hong , Sletvold Nina
Published: June 2022

Demographic costs of reproduction in flowering plants should depend on life history and reproductive efforts, but how the expression of costs varies with life‐history traits is poorly understood.

We experimentally increased and reduced reproductive effort (fruit production) to quantify demographic costs of reproduction in four coexisting species with contrasting growth forms (clonal vs. non‐clonal) and flower production (single‐ vs. multi‐flowered). We repeated the experiment for 3 years and measured the demographic rates the year after the treatment. In 2 years, we also quantified the costs of flower maintenance by contrasting the performance of non‐fruiting plants with intact flowers and plants with their flowers removed.

Costs varied among species, in both magnitude and demographic rate affected. Costs of natural reproduction were expressed as reductions in size and fecundity next year, whereas increased reproduction additionally reduced sprouting probability. The magnitude of demographic costs of both reproduction and flower maintenance was highest in the non‐clonal, multi‐flowered species, and costs were more frequently detected in the two multi‐flowered species than in the single‐flowered ones. This may be explained by higher biomass allocation to reproductive parts and a longer flowering period in the former. Demographic costs of reproduction did not depend on clone size.

Synthesis. These results document that demographic costs vary among coexisting species sharing similar niches and are associated with divergence in life‐history traits. Such trait‐dependent variation in costs may reduce competition among coexisting species and facilitate diversity.
Where is education? Arendt's educational philosophy in between private and public
Authors: Kloeg Julien
Published: June 2022

Arendt-inspired philosophy of education has been a lively field of research in recent years. This research is mostly based on Arendt's essay ‘The Crisis in Education’. In the same historical context, Arendt wrote her initial essay on education, the controversial ‘Reflections on Llittle Rock’, and her political-theoretical work The Human Condition. All three texts show Arendt's concern about the public realm and its capture by ‘society’, which she understands as discarding the distinction between private and public. This raises the question of where education should be located in Arendt's thought: in the private realm, in society or in the public realm? In her ‘Reflections’ Arendt places education in the societal realm, but this approach fails to convince. The answer consistent with Arendt's use of the category of the ‘in-between’ in her educational thought is that it is in none of the above. Instead, education takes place in an ambiguous zone in between private and public, where both make their influence felt, but neither dominates the other. This has implications not only for how we should understand Arendt's educational philosophy but also for her notions of private and public spheres as well as for other political-theoretical concepts in her work. This answers the question about the location of education in a second way: education in Arendt's thought is not simply derivativeof her political works but can itself serve as an interesting perspective from which to view her writings.
The hidden cost of smoking: Rent premia in the housing market
Authors: Gedikli Cigdem , Hill Robert , Talavera Oleksandr , Yilmaz Okan
Published: June 2022

In this article, we provide novel evidence on the additional costs associated with smoking. While it may not be surprising that smokers pay a rent premium, we are the first to quantify the size of this premium. Our approach is innovative in that we use text mining methods that extract implicit information on landlords’ attitudes to smoking directly from Zoopla UK rental listings. Applying hedonic, matching, and machine‐learning methods to the text‐mined data, we find a positive smoking rent premium of around 6%. This translates into £14.40 of indirect costs, in addition to £40 of weekly spending on cigarettes estimated for an average smoker in the United Kingdom.
Perceived benefits, negative impacts, and willingness‐to‐pay to improve urban green space
Authors: Cheung Lewis T O , Ma Anson T H , Wong Gwendolyn K L , Lo Alex Y , Jim C Y
Published: June 2022

Urban green spaces provide multiple benefits but incur some negative impacts. We employed the contingent valuation method to investigate Hong Kong residents’ willingness‐to‐pay to improve urban green space provision. A questionnaire collected 316 responses from urban‐park visitors. It assessed perceptions of positive benefits and negative impacts and influences on willingness‐to‐pay. Health benefits attracted top scores, followed by environment and ecology. For negative impacts, road safety ranked first, followed by risks and hazards, and health and sanitation concerns. More educated and younger respondents were more willing to pay. One third of respondents, mainly the less educated and older people, registered protest votes for diverse reasons. Logistic regression was used to analyse the probability of positive bids with a socio‐demographic model and an extended model incorporating explanatory perception variables. Ordinal regression identified willingness‐to‐pay determinants. Both statistical tests found perceived environmental and ecological benefits as key willingness‐to‐pay predictors. The perceived negative impacts of health and sanitation concerns were correlated with willingness‐to‐pay, indicating a desire to improve and contradicting past studies and expectations. The results highlighted the importance of exploring willingness‐to‐pay from a rarely studied perspective of valuating the potential improved utility of urban green space through suppressing negative impacts. The findings can inform park and urban management to meet user expectations.
Lysyl oxidase‐like 2 inhibitor rescues D‐galactose‐induced skeletal muscle fibrosis
Authors: Wu Yongxin , Wu Yaoxuan , Yang Yunfei , Yu Jing , Wu Jianghao , Liao Zhiyin , Guo Ai , Sun Yue , Zhao Yuxing , Chen Jinliang , Xiao Qian
Published: June 2022

Aging‐related sarcopenia is currently the most common sarcopenia. The main manifestations are skeletal muscle atrophy, replacement of muscle fibers with fat and fibrous tissue. Excessive fibrosis can impair muscle regeneration and function. Lysyl oxidase‐like 2 (LOXL2) has previously been reported to be involved in the development of various tissue fibrosis. Here, we investigated the effects of LOXL2 inhibitor on D‐galactose (D‐gal)‐induced skeletal muscle fibroblast cells and mice. Our molecular and physiological studies show that treatment with LOXL2 inhibitor can alleviate senescence, fibrosis, and increased production of reactive oxygen species in fibroblasts caused by D‐gal. These effects are related to the inhibition of the TGF‐β1/p38 MAPK pathway. Furthermore, in vivo, mice treatment with LOXL2 inhibitor reduced D‐gal‐induced skeletal muscle fibrosis, partially enhanced skeletal muscle mass and strength and reduced redox balance disorder. Taken together, these data indicate the possibility of using LOXL2 inhibitors to prevent aging‐related sarcopenia, especially with significant fibrosis.
Omics technologies in allergy and asthma research: An EAACI position paper
Authors: Radzikowska Urszula , Baerenfaller Katja , Cornejo‐Garcia José Antonio , Karaaslan Cagatay , Barletta Elena , Sarac Basak Ezgi , Zhakparov Damir , Villaseñor Alma , Eguiluz‐Gracia Ibon , Mayorga Cristobalina , Sokolowska Milena , Barbas Coral , Barber Domingo , Ollert Markus , Chivato Tomas , Agache Ioana , Escribese Maria M.
Published: June 2022

Allergic diseases and asthma are heterogenous chronic inflammatory conditions with several distinct complex endotypes. Both environmental and genetic factors can influence the development and progression of allergy. Complex pathogenetic pathways observed in allergic disorders present a challenge in patient management and successful targeted treatment strategies. The increasing availability of high‐throughput omics technologies, such as genomics, epigenomics, transcriptomics, proteomics, and metabolomics allows studying biochemical systems and pathophysiological processes underlying allergic responses. Additionally, omics techniques present clinical applicability by functional identification and validation of biomarkers. Therefore, finding molecules or patterns characteristic for distinct immune‐inflammatory endotypes, can subsequently influence its development, progression, and treatment. There is a great potential to further increase the effectiveness of single omics approaches by integrating them with other omics, and nonomics data. Systems biology aims to simultaneously and longitudinally understand multiple layers of a complex and multifactorial disease, such as allergy, or asthma by integrating several, separated data sets and generating a complete molecular profile of the condition. With the use of sophisticated biostatistics and machine learning techniques, these approaches provide in‐depth insight into individual biological systems and will allow efficient and customized healthcare approaches, called precision medicine. In this EAACI Position Paper, the Task Force “Omics technologies in allergic research” broadly reviewed current advances and applicability of omics techniques in allergic diseases and asthma research, with a focus on methodology and data analysis, aiming to provide researchers (basic and clinical) with a desk reference in the field. The potential of omics strategies in understanding disease pathophysiology and key tools to reach unmet needs in allergy precision medicine, such as successful patients’ stratification, accurate disease prognosis, and prediction of treatment efficacy and successful prevention measures are highlighted.
Beyond dystopia: Regenerative cultures and ethics among European climate activists
Authors: Harms Arne
Published: June 2022

In this article, I analyze practices of self‐formation among European climate activists. I develop the concept of regenerative cultures as a lens to capture nonspectacular practices that embody intimate forms of activism. Drawing on ethnographic research among climate activists, I show that regenerative cultures employs recursive circuits of practicing, retrospective visions, and subjunctive ecologies in order to enable ethical self‐formations geared toward personal or planetary regeneration. I identify two implications of such practices. First, I argue that intimate forms of activism reshuffle the sphere of politics in rendering the intimate a locus of concerted action that is deemed to radiate out. Second, I argue that such ethical labor is situated between what in the anthropology of ethics figures as virtue ethics and endurance. What I identify as utopian becomings instantiated by climate activists’ ethical labor embodies attempts to open spaces for caring differently. Moving beyond an understanding of the utopian as prefigurative move, I argue that utopian becomings operate by enabling to become otherwise in affectively loaded encounters.
Alone in the COVID‐19 lockdown: An exploratory study
Authors: Leary Rowena , Asbury Kathryn
Published: June 2022

Feelings of isolation have been prevalent worldwide since March 2020 due to COVID‐19 pandemic lockdowns. This has prompted increased concerns about loneliness and related mental health problems. During the first UK COVID‐19 lockdown, 71 participants were asked to share their high and low point stories from lockdown. These were analyzed using thematic analysis to explore how “aloneness” was experienced at this time. A deductive analyses supported three key facets of aloneness reported in the literature: emotional loneliness, social loneliness, and existential loneliness, as well as a more positive form of aloneness, solitude. An inductive analysis identified risk and protective factors for loneliness, comprising worry, lockdown changes, and poor mental health; and social contact, emotional contact, stability and simple life. The study highlights the importance of understanding how facets of aloneness interrelate, and how understanding risk and protective factors can help us to develop social and policy interventions to alleviate loneliness. In particular, solitude is proposed as a potential mechanism for alleviating loneliness, particularly existential loneliness, alongside more common social methods.
A global evaluation of the effectiveness of voluntary REDD+ projects at reducing deforestation and degradation in the moist tropics
Authors: Guizar‐Coutiño Alejandro , Jones Julia P. G. , Balmford Andrew , Carmenta Rachel , Coomes David A.
Published: June 2022

Reducing emissions from deforestation and forest degradation (REDD+) projects aim to contribute to climate change mitigation by protecting and enhancing carbon stocks in tropical forests, but there have been no systematic global evaluations of their impact. We used a new data set for tropical humid forests and a standardized evaluation approach (based on pixel matching) to quantify the performance of a representative sample of 40 voluntary REDD+ projects in 9 countries certified under the Verified Carbon Standard (VCS). In the first 5 years of implementation, deforestation within project areas was reduced by 47% (95% confidence interval [CI]: 24–68) compared with matched counterfactual pixels, and degradation rates were 58% lower (95% CI: 49–63). Reductions were small in absolute terms but greater in sites located in high‐deforestation settings and did not appear to be substantially undermined by leakage activities in forested areas within 10 km of project boundaries. At the 26th Conference of the Parties of the United Nations Framework Convention on Climate Change, the international community renewed its commitment to tackling tropical deforestation as a nature‐based solution to climate change. Our results indicate that incentivizing forest conservation through voluntary site‐based projects can slow tropical deforestation and highlight the particular importance of prioritizing financing for areas at greater risk of deforestation.
Microsecretory adenocarcinoma of the external ear canal
Authors: Dibbern Megan E. , Gru Alejandro A. , Stelow Edward B.
Published: June 2022

Microsecretory adenocarcinoma (MSA) is a recently described salivary gland tumor characterized by unique histomorphologic and immunohistochemical features as well as recurrent MEF2C::SS18 gene fusion. Since 2019, 24 cases have been reported in the literature, primarily arising in the oral cavity, with a single reported case arising in the parotid gland. Here, we present a case of MSA that arose in the external ear canal in an 89‐year‐old woman and was discovered during management of vertigo symptoms. Excisional biopsy of the lesion showed multiple fragments of squamous epithelium with hyperplastic changes and a distinct subepithelial infiltrating neoplasm composed of bland cells forming tubules and cords. Neoplastic cells expressed keratin, S100 protein, p63, and TLE1 and did not express p40, mammaglobin, pan‐TRK, synaptophysin, or chromogranin by immunohistochemistry. SS18 gene rearrangement was shown with break‐apart fluorescent in situ hybridization. Overall, the histomorphologic, immunohistochemical, and cytogenetic findings confirm a diagnosis of MSA arising in a unique extraoral location.
Komorbidität bei Patienten mit bullösem Pemphigoid in Deutschland: Ergebnisse einer Fall‐Kontroll‐Studie
Authors: Martin Eva , Mauer Isabell , Malzahn Uwe , Heuschmann Peter Ulrich , Goebeler Matthias , Benoit Sandrine
Published: June 2022

Hintergrund und Ziele

Patienten mit bullösem Pemphigoid (BP) leiden gehäuft an neuropsychiatrischen Krankheiten. Im Gegensatz dazu werden Assoziationen mit anderen Krankheiten kontrovers diskutiert. Daher haben wir in dieser großen Fall‐Kontroll‐Studie einer repräsentativen Region Deutschlands das Spektrum komorbider Erkrankungen von BP‐Patienten untersucht.

Patienten und Methodik

Die Krankenakten aller zwischen Juni 2002 und Mai 2013 an der Klinik für Dermatologie des Universitätsklinikums Würzburg behandelten BP‐Patienten wurden retrospektiv ausgewertet. Die Diagnose BP wurde anhand definierter Kriterien gestellt. Jedem Patienten wurden zwei Kontrollen zugeordnet. Erhoben wurden Daten wie Alter, Geschlecht, Medikation, Begleiterkrankungen und Laborparameter. Die Ergebnisse wurden mittels bedingt logistischer Regression, multivariabler Regressionsanalyse sowie eines komplexen Regressionsmodells ausgewertet.

Ergebnisse

300 BP‐Patienten wurden ermittelt und mit 583 Kontrollpersonen verglichen. Bei Patienten mit BP zeigte sich eine Assoziation mit neuropsychiatrischen Erkrankungen. Zudem wiesen BP‐Patienten häufiger eine Leukozytose und Eosinophilie auf. Bemerkenswert war die hochsignifikante Assoziation zwischen BP und Anämie (OR 2,127; 95 % KI 1,532–2,953) beziehungsweise Nierenfunktionsstörungen (OR 2,218; 95 % KI 1,643–2,993). Keine signifikanten Zusammenhänge konnten zwischen BP und Tumorerkrankungen sowie arterieller Hypertonie ermittelt werden.

Schlussfolgerungen

Unsere Untersuchungen weisen auf ein vermehrtes Auftreten von Anämien und Nierenfunktionsbeeinträchtigungen bei BP‐Patienten hin. Die starke Assoziation mit neuropsychiatrischen Erkrankungen (p < 0,0005) bestätigt Ergebnisse vorangegangener Studien.
Dermatoskopisch kontrollierte, schmalere Resektionsränder bei Basalzellkarzinomen an Kopf und Hals: Retrospektive Fallkontrollstudie
Authors: Herzum Astrid , Burlando Martina , Tavilla Pietro Paolo , Micalizzi Claudia , Molle Mattia Fabio , Cozzani Emanuele , Parodi Aurora
Published: June 2022

Hintergrund: Unbehandelt kann das Basalzellkarzinom (BCC) erhebliche Gewebezerstörungen verursachen. Die komplette chirurgische Exzision ist die Behandlung der Wahl. Allerdings stellt es besonders im Gesichts‐ und Halsbereich eine Herausforderung dar, den Tumor vollständig zu entfernen und möglichst viel gesundes Gewebe zu erhalten.

Material und Methoden: Bereits exzidierte kleine BCC (≤ 1 cm) von Kopf oder Hals wurden retrospektiv analysiert. Verglichen wurde die histologisch kontrolliert angemessene Breite des Resektionsrandes nach präoperativer dermatoskopischer Untersuchung (Fälle) im Vergleich zur rein klinischen Untersuchung (Kontrollen), sowie die Rezidivrate.

Ergebnisse: Bei 281 BCC: 6 % (8/139) der Fälle und 8 % (12/142) der Kontrollen zeigten inadäquate basale Resektionsränder; 4 % (5/139) der Fälle und 20 % (29/142) der Kontrollen zeigten inadäquate laterale Resektionsränder (P < 0.001). Laterale Resektionsränder von 3 mm waren in 0 % (15/66) der Fälle, jedoch in 15 % (10/66) der Kontrollen inadäquat (P >0.005); laterale Resektionsränder von 1–2 mm waren in 7 % (5/73) der Fälle und in 25 % (19/76) der Kontrollen inadäquat (P < 0.01). Rezidive traten in den Fällen mit 3 mm Resektionsrand in 1,5 % auf, in den Fällen mit 1–2 mm Resektionsrand bei 0 %, und bei den Kontrollen bei 7,7 %.

Schlussfolgerung: Für BCC im Kopf‐ und Halsbereich erscheint ein Resektionsrand von 3 mm angemessen, sofern das BCC klein, dermatoskopisch gut definiert und wenig aggressiv ist. Hier zeigten sich operative Heilungsraten von 100 % mit 1,5 % Rezidiven. Resektionsränder von 1–2 mm sollten nur für BCC in sehr schwierig zu behandelnden Bereichen in Betracht gezogen werden, da die Heilungsrate hier nur bei 93 % lag.
Generalisierte pustulöse Psoriasis: Überblick zum Status quo und Ergebnisse einer Diskussionsrunde
Authors: Reich Kristian , Augustin Matthias , Gerdes Sascha , Ghoreschi Kamran , Kokolakis Georgios , Mößner Rotraut , Mrowietz Ulrich , Navarini Alexander A. , Pinter Andreas , Schäkel Knut , Staubach Petra , Sticherling Michael , Thaçi Diamant , Wilsmann‐Theis Dagmar
Published: June 2022

Die generalisierte pustulöse Psoriasis (GPP) ist eine seltene, schwere, potenziell lebensbedrohliche, autoinflammatorische, neutrophile Hauterkrankung, die von Fieber und Leukozytose begleitet sein kann. Diese Arbeit beschreibt den aktuellen Wissensstand zur GPP bezüglich Klassifizierung, (Differential‐)Diagnostik und Prävalenz. Wir präsentieren eine Gegenüberstellung der Genetik und Pathoimmunologie der GPP und Psoriasis vulgaris mit den zentralen Mechanismen der Autoimmunologie und Autoinflammation. Die derzeit verfügbaren therapeutischen Optionen, Expertenempfehlungen zur Therapie sowie Daten früher klinischer Studien zur Untersuchung zielgerichteter Therapien werden in dieser Arbeit vorgestellt. Als Ergebnis unserer Diskussionsrunde mit 13 Experten für Psoriasis vulgaris und GPP geben wir einen integrierten Überblick über Indikation und Therapie basierend auf unseren persönlichen Erfahrungen und präsentieren einen Ausblick zu weiteren Forschungsfragen. Dieser Artikel verdeutlicht insbesondere den hohen ungedeckten Bedarf bei der GPP, da es bis heute keine zufriedenstellende Diagnose‐ oder Behandlungsmethode gibt und neue Behandlungsmöglichkeiten für die Betroffenen von großem therapeutischem Nutzen sein werden.
S1‐Leitlinie: Kaposi‐Sarkom
Authors: Esser Stefan , Schöfer Helmut , Hoffmann Christian , Claßen Johannes , Kreuter Alexander , Leiter Ulrike , Oette Mark , Becker Jürgen C. , Ziemer Mirjana , Mosthaf Franz , Sirokay Judith , Ugurel Selma , Potthoff Anja , Helbig Doris , Bierhoff Erhard , Schulz Thomas F. , Brockmeyer Norbert H. , Grabbe Stephan
Published: June 2022

Das Kaposi‐Sarkom (KS) ist eine seltene, maligne, von lymphatischen Endothelzellen ausgehende, multilokuläre Gefäßerkrankung, die vor allem Haut und Schleimhäute, aber auch das lymphatische System und innere Organe wie den Gastrointestinaltrakt, die Lunge oder die Leber befallen kann. Fünf epidemiologische Subtypen des KS mit variablem klinischem Verlauf und unterschiedlicher Prognose werden unterschieden, die in spezifischen Populationen vermehrt auftreten: (1) klassisches KS, (2) iatrogenes KS bei Immunsuppression, (3) endemisches (afrikanisches) lymphadenopathisches KS, (4) epidemisches, HIV‐assoziiertes KS und mit einem Immunrekonstitutions‐Inflammations‐Syndrom (IRIS) assoziiertes KS und (5) KS bei Männern, die Sex mit Männern haben (MSM) ohne HIV‐Infektion. Diese interdisziplinäre Leitlinie fasst aktuelle praxisrelevante Empfehlungen zu Diagnostik und Therapie der verschiedenen Formen des KS zusammen. Die in dieser Kurzleitlinie genannten Empfehlungen werden in der Langfassung der Leitlinie (Online‐Version des JDDG) detaillierter ausgeführt.
Bromocriptine quick‐release as adjunct therapy in youth and adults with type 1 diabetes: A randomized, placebo‐controlled crossover study
Authors: Tell Shoshana S. , Schafer Michal , Vigers Timothy , Baumgartner Amy D. , Lyon Ellen , Gross Susan , Polsky Sarit , Snell‐Bergeon Janet K. , Schauer Irene E. , Nadeau Kristen J.
Published: June 2022

Aim

To evaluate the potential for glycaemic, renal and vascular benefits of bromocriptine quick release (BCQR) in adolescents and adults with type 1 diabetes.

Materials and Methods

Forty adolescents and 40 adults with type 1 diabetes aged 12‐60 years old were enrolled in a double‐blind, placebo‐controlled, random order crossover study of 4 weeks of treatment in the morning with BCQR (titrated weekly from 0.8 mg to 1.6 mg to 3.2 mg, minimum dose 1.6 mg). Study assessments after each phase included blood pressure (BP), lipids, peripheral arterial stiffness and autonomic function, mixed meal tolerance test, continuous glucose monitoring (CGM), creatinine, estimated glomerular filtration rate, estimated insulin sensitivity, insulin dose and indirect calorimetry.

Results

Adolescents displayed baseline hyperglycaemia, insulin resistance, metabolic dysfunction and increased renal filtration compared with adults. In both age groups, continuous glucose monitoring measures, estimated insulin sensitivity and insulin dose did not differ with BCQR treatment. In adolescents, BCQR decreased systolic BP, diastolic BP and triangular index and increased serum creatinine. In adults, systolic BP, mean arterial pressure, systemic vascular resistance, and mixed meal tolerance test glucose and glucagon‐like peptide 1 areas under the curve were lower, and the orthostatic drop in systolic BP was greater with BCQR.

Conclusions

Greater hyperglycaemia, insulin resistance, metabolic dysfunction and renal hyperfiltration in adolescents argues for increased attention during this high‐risk age period. Although BCQR had little impact on glycaemia or insulin sensitivity, initial vascular and renal responses suggest potential benefits of BCQR in adolescents and adults with type 1 diabetes requiring further study.
Does mixed ownership reform affect private firms’ ESG practices? Evidence from a quasi‐natural experiment in China
Authors: Cao June , Li Wenwen , Xiao Shujuan
Published: June 2022

This study investigates the impact of property rights reform on private firms’ environmental, social, and governance (ESG) practices. ESG investing has become mainstream and a hot topic globally, but it is a black box of corporate ESG practices and performance. Importantly, it is not clear how to specifically enhance private firms’ ESG practices. This study addresses this problem by exploring an ideal setting of China's mixed‐ownership reform in which private firms acquire equity in state‐owned enterprises (SOEs). We examine whether and how this reform affects private acquirer firms’ ESG practices. Using a powerful difference‐in‐differences design, we find that mixed‐ownership reform significantly enhances private firms’ ESG practices through heightened public scrutiny and the privileges of formal financing and government subsidies that are available due to the firms’ partial government ownership after mixed‐ownership reform. Our findings have policy implications for promoting ESG practices and SOE reform. Specifically, our empirical evidence indicates that mixed‐ownership reform can facilitate sustainable development for both SOEs and private firms.
The fuel–climate–fire conundrum: How will fire regimes change in temperate eucalypt forests under climate change?
Authors: McColl‐Gausden Sarah C. , Bennett Lauren T. , Clarke Hamish G. , Ababei Dan A. , Penman Trent D.
Published: June 2022

Fire regimes are changing across the globe in response to complex interactions between climate, fuel, and fire across space and time. Despite these complex interactions, research into predicting fire regime change is often unidimensional, typically focusing on direct relationships between fire activity and climate, increasing the chances of erroneous fire predictions that have ignored feedbacks with, for example, fuel loads and availability. Here, we quantify the direct and indirect role of climate on fire regime change in eucalypt dominated landscapes using a novel simulation approach that uses a landscape fire modelling framework to simulate fire regimes over decades to centuries. We estimated the relative roles of climate‐mediated changes as both direct effects on fire weather and indirect effects on fuel load and structure in a full factorial simulation experiment (present and future weather, present and future fuel) that included six climate ensemble members. We applied this simulation framework to predict changes in fire regimes across six temperate forested landscapes in south‐eastern Australia that encompass a broad continuum from climate‐limited to fuel‐limited. Climate‐mediated change in weather and fuel was predicted to intensify fire regimes in all six landscapes by increasing wildfire extent and intensity and decreasing fire interval, potentially led by an earlier start to the fire season. Future weather was the dominant factor influencing changes in all the tested fire regime attributes: area burnt, area burnt at high intensity, fire interval, high‐intensity fire interval, and season midpoint. However, effects of future fuel acted synergistically or antagonistically with future weather depending on the landscape and the fire regime attribute. Our results suggest that fire regimes are likely to shift across temperate ecosystems in south‐eastern Australia in coming decades, particularly in climate‐limited systems where there is the potential for a greater availability of fuels to burn through increased aridity.
Factors related to a sense of security with medical and long‐term care services among community‐dwelling middle‐aged and older adults in Japan
Authors: Fujita Junko , Fukui Sakiko , Fujikawa Aya , Iwahara Yuka , Ishikawa Takako
Published: June 2022

Aim

The aim of this study was to identify factors related to a sense of security with regard to medical and long‐term care services among middle‐aged and older adults. These are for consideration of strategies for the establishment of a community‐based integrated care system.

Methods

A cross‐sectional survey was conducted in 2400 men and women aged ≥40 years in two cities. Survey items included a scale for sense of security for medical and long‐term care, experience of medical and long‐term care services, and social and demographic factors. Data were analyzed using univariate and multiple regression analyses.

Results

In total, 945 respondents were included in the analysis. In multiple regression analysis, sense of security was significantly higher with ability to consult with medical professionals on medical and long‐term care, availability of emotional and instrumental support, norm of reciprocity in the community, community attachment, economic comfort, higher age and male gender, and significantly lower with experience of bereavement at a hospital and depression.

Conclusions

These findings stress the importance of facilitating consultation with medical professionals, support for caregivers of terminally ill patients, and mutual support in the community in a community‐based integrated care system. Geriatr Gerontol Int 2022; 22: 568–574.
Dynamics of vascular refilling in extended nocturnal hemodialysis
Authors: Kron Susanne , Schneditz Daniel , Leimbach Til , Schneider Johanna , Kron Joachim
Published: June 2022

Introduction

Long dialysis treatments are generally assumed to mitigate the ultrafiltration (UF) induced volume perturbation and to improve vascular refilling because of reduced UF rates and sufficient time for volume re‐equilibration. The time course of vascular refilling was therefore examined during extended nocturnal dialysis.

Methods

For each hour of dialysis, vascular refilling volume was calculated from the absolute blood volume changes and UF volume removed. Absolute blood volume was estimated by indicator dilution at the beginning of dialysis and then tracked with a relative blood volume monitor. The refilling fraction was defined as the ratio of refilling volume to UF volume.

Findings

Ten stable chronic hemodialysis (HD) patients were studied during extended (7 h) nocturnal treatment sessions. Specific UF rate was 4.8 ± 1.8 ml/kg/h. In the 1 h, refilling volume amounted to only 23% of UF volume. Thereafter, refilling fraction steeply increased and reached maximum values in the 2, 3 and 4 h at about mean 90% (91.5%, 88.7%, and 91.1% respectively). From the 5 h on, refilling volume decreased (5 h 81.3%, 6 h 72.5%, 7 h 70.0% of UF volume). Cumulative refilling reached 73.6% of UF volume after 4 h of treatment time. This did not change during the further course of HD. Cumulative refilling volume showed a strong correlation (r = 0.94; p < 0.001) with UF volume. The ratio of blood volume to extracellular volume (Rbex) was 0.306 ± 0.029 before and slightly but significantly increased to 0.326 ± 0.030 after UF.

Discussion

In spite of low‐UF rates and extended treatment times, overall refilling fraction reached only 74% and was not different from the refilling fraction observed in regular HD. This value seems to represent a point where UF‐induced volume perturbation is adequately compensated by physiologic control mechanisms.
Downregulation of thrombomodulin contributes to ischemia‐reperfusion injury in mice with steatotic liver
Authors: Yamaguchi Megumi , Tashiro Hirotaka , Kuroda Shintaro , Okimoto Sho , Kobayashi Tsuyoshi , Hinoi Takao , Ohdan Hideki
Published: June 2022

Aim

Ischemia‐reperfusion (IR) injury is one of the most critical complications commonly associated with liver surgery, including liver transplantation. Steatotic livers are particularly vulnerable to IR injury. However, the underlying mechanisms of this increased susceptibility have not fully been understood. In the present study, we used heterogeneous thrombomodulin (TM)‐knockout (KO) (TM+/−) mice, which express about 50% functional activity of TM as compared with wild type, to investigate whether dysregulation of TM enhances IR injury in steatotic livers.

Methods

Steatotic livers were induced using choline‐deficient diets (CDD) in mice. The biological activity of TM was assessed using the productivity of protein C. Susceptibility to IR injury was compared between steatotic livers and non‐steatotic livers and also assessed in TM‐KO mice. We investigated whether recombinant TM (rTM) and the lectin‐like domain of TM (rTM‐D1) ameliorated IR injury in steatotic livers.

Results

Protein C activity was significantly decreased to less than 20% in CDD‐fed mice compared with mice with non‐steatotic livers. Steatotic livers showed exaggerated IR injury compared with non‐steatotic livers. Recombinant TM (rTM) and the lectin‐like domain of TM (rTM‐D1), which has anti‐inflammatory effects, ameliorated IR injury in steatotic livers. TM+/− mice showed increased susceptibility to IR injury, and rTM ameliorated the increased IR injury in TM+/− mice.

Conclusion

We conclude that downregulation of TM increases susceptibility to hepatic IR injury in steatotic livers and that rTM ameliorates hepatic IR injury through anti‐inflammatory action.
Nurses' mental health and coping strategies throughout COVID‐19 outbreak: A nationwide qualitative study
Authors: Maideen Aminol Azrin , Idris Deeni Rudita , Lupat Agong , Chung Yea Fui , Haji‐Badarudin Haji‐Salehkamal , Suhai Hajah‐Kartini , Abdullah Hajah Noraliah , Omar Haji‐Rahim , Kisut Ramlah , Abdul Rahman Hanif , Abdul‐Mumin Khadizah H.
Published: June 2022

This qualitative exploratory study explored nurses' mental health and coping strategies working with suspected and confirmed COVID‐19 patients in Brunei Darussalam. Eleven focus group discussions were conducted between October 2020 and January 2021, involving 75 participants. Three themes emerged: ‘COVID‐19 roller‐coaster transitional journey’ explained the different psychological responses of the journey of the nurses from merely hearing about COVID‐19 from far to the invasion of the virus and community outbreak in the country; ‘Mind my mind and heart’ share experiences of the nurses in terms of their mental health and emotional responses; and ‘the psychosocial system’ described the coping mechanisms of the nurses throughout the COVID‐19 pandemic. Nurses' mental health and coping strategies during the COVID‐19 pandemic influenced how they provided care and performed other tasks, which should not be taken for granted. Nurses employed psychosocial coping methods at the different phases of the COVID‐19 pandemic and support from family, friends, the public, and the governmental level. This research is fundamental as a basis for other countries to design psychological interventions during this yet unsettled COVID‐19 pandemic.
Angular absorptance and thermal degradation analysis of TiB2/Ti(B,N)/SiON/SiO2 multilayer solar absorber coating
Authors: Poobalan Ranjith Kumar , Singh Mahander Pratap , K. Niranjan , Chattopadhyay Kamanio , Barshilia Harish C. , Basu Bikramjit
Published: June 2022

Multilayer solar selective absorber coatings have been developed in the last few decades. The thermal stability in terms of microstructure gives an insightful understanding of the optical properties of such coatings. In this context, we extensively utilized transmission electron microscopy (TEM) analysis to establish the thermal stability of TiB2/Ti(B,N)/SiON/SiO2 coating, under thermal cycling/continuous heating to 500°C in vacuum for 250 h. In particular, this work reports the variation in the solar absorptance of TiB2/Ti(B,N)/SiON/SiO2 coating with different angles of incidence of the solar radiation. Extensive analysis using the TEM technique reveals the presence of oxide interlayers that act as diffusion barrier layers to enhance the thermal stability of the coating. Computational simulation using SCOUT software validates the measured reflectance spectrum of the developed multilayer coating. The minor changes in absorptance and emissivity after heat treatment in vacuum at 500°C, together with high solar absorptance over a broad angular variation, establish the potential application of TiB2/Ti(B,N)/SiON/SiO2 as a selective coating in concentrated solar power systems.
Fabrication of anodic aluminum oxide on silica optical fiber with nanopore channels oriented off surface normal
Authors: Tang Renhong , Du Henry
Published: June 2022

Aluminum coating on silica optical fiber was anodized by applying an electric field off‐axis to surface normal of the fiber coating with simulation of the electric field lines between angularly positioned anode and cathode as a guide. The nanostructure features, including nanopore orientation, of the resultant anodized aluminum oxide (AAO) were characterized using scanning electron microscopy. This unique off‐axis electric field arrangement enabled the formation of AAO with uniformly tilted nanopore channel arrays. Nanopore channels with tilting angles around 10°–20° relative to surface normal of AAO were obtained. These results are in general agreement with the simulated electric field lines between the anode and cathode.
The influences of a virtual instructor's voice and appearance on learning from video lectures
Authors: Pi Zhongling , Deng Lixia , Wang Xu , Guo Peirong , Xu Tao , Zhou Yun
Published: June 2022

Background

Video lectures which include the instructor's presence are becoming increasingly popular. Presenting a real human does, however, entail higher financial and time costs in making videos, and one innovative approach to reduce costs has been to generate a virtual speaking instructor.

Objectives

The current study examined whether the use of a virtual instructor in video lectures would facilitate learning as well as a human instructor, and whether manipulating the virtual instructor's characteristics (i.e., voice and appearance) might optimize the effectiveness of the virtual instructor.

Methods

Our study set four conditions. In the control condition, students watched a human instructor. In the experiment conditions, students watched one of (a) a virtual instructor which used the human instructor's voice and an AI image, (b) a virtual instructor which spoke in an AI voice with an AI image made to speak using text‐to‐speech and lip synthesis techniques, or (c) a virtual instructor with used an AI voice and an AI likable‐image of an instructor.

Results and Conclusions

The AI likable instructor condition had a significant positive effect on students' learning performance and motivation, without decreasing the attention students paid to the learning materials.

Implications

Our findings suggest that instructional video designers can make use of AI voices and AI images of likable humans as instructors to motivate students and enhance their learning performance.
A WNT protein therapeutic accelerates consolidation of a bone graft substitute in a pre‐clinical sinus augmentation model
Authors: Coyac Benjamin R. , Wolf Benjamin J. , Bahat Daniel J. , Arioka Masaki , Brunski John B. , Helms Jill A.
Published: June 2022

Aim

Autologous bone grafts consolidate faster than bone graft substitutes (BGSs) but resorb over time, which compromises implant support. We hypothesized that differences in consolidation rates affected the mechanical properties of grafts and implant stability, and tested whether a pro‐osteogenic protein, liposomal WNT3A (L‐WNT3A), could accelerate graft consolidation.

Materials and Methods

A transgenic mouse model of sinus augmentation with immunohistochemistry, enzymatic assays, and histology were used to quantitatively evaluate the osteogenic properties of autografts and BGSs. Composite and finite element modelling compared changes in the mechanical properties of grafts during healing until consolidation, and secondary implant stability following remodelling activities. BGSs were combined with L‐WNT3A and tested for its osteogenic potential.

Results

Compared with autografts, BGSs were bioinert and lacked osteoprogenitor cells. While in autografted sinuses, new bone arose evenly from all living autograft particles, new bone around BGSs solely initiated at the sinus floor, from the internal maxillary periosteum. WNT treatment of BGSs resulted in significantly higher expression levels of pro‐osteogenic proteins (Osterix, Collagen I, alkaline phosphatase) and lower levels of bone‐resorbing activity (tartrate‐resistant acid phosphatase activity); together, these features culminated in faster new bone formation, comparable to that of an autograft.

Conclusions

WNT‐treated BGSs supported faster consolidation, and because BGSs typically resist resorption, their use may be superior to autografts for sinus augmentation.