bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of psychoactive drugs in injured patients presenting to an emergency department
Authors: Isles Siobhan , McBride Paul , Gee Paul , Fleischer Dominic , Kappatos Diana , Pandey Rishi , Civil Ian , Gabbe Belinda
Published: July 2022

Objective

The aim of the present study was to obtain an unbiased understanding of the prevalence of psychoactive drugs in trauma patients presenting to a large ED.

Methods

Consecutive adult patients presenting to the ED with an injury resulting in a trauma call had an anonymised, additional blood test taken for detection of over 2000 drugs. Laboratory testing was to judicial standards. Drugs given by ambulance pre‐hospital were detected but excluded from the analysis.

Results

Over 6 months 276 (74.7%) of 371 patients were tested. Of the 276 patients tested, 158 (57.2%) had one or more psychoactive drug present. Recreational drugs were detected in 101 (36.6%) patients and medicinal drugs in 88 (31.8%) patients, with a combination of both detected in 31 (11.2%) patients. The most common drugs detected were cannabis (22.1%), antidepressants (18.4%), alcohol (15.5%), opioids (10.1%), benzodiazepine/z‐drugs (9.4%) and methamphetamine (7.2%). The prevalence of psychoactive drugs differed by age group, sex and cause of injury.

Conclusions

The prevalence of psychoactive drugs in injury presentations to an ED is high, and provides an opportunity to reduce harm. The present study demonstrates the feasibility of an approach which limits bias and obtains results that accurately reflect the drug prevalence in injured cohorts. Systematic testing of injured patients is an important contribution to the epidemiology of injury.
Clinical utility of EBUS‐TBNA of hilar, interlobar, and lobar lymph nodes in patients with primary lung cancer
Authors: Wi Seungbum , Kim Bo‐Guen , Shin Sun Hye , Jhun Byung Woo , Yoo Hongseok , Jeong Byeong‐Ho , Lee Kyungjong , Kim Hojoong , Kwon O Jung , Han Joungho , Kim Jhingook , Um Sang‐Won
Published: July 2022

Background

Endobronchial ultrasound‐guided transbronchial needle aspiration (EBUS‐TBNA) is used to evaluate hilar/interlobar/lobar lymph nodes. This study aimed to assess the clinical utility of EBUS‐TBNA for station 10/11/12 lymph nodes (LNs) in patients with primary lung cancer.

Methods

This was a retrospective analysis of a prospectively collected database of patients with primary lung cancer who underwent EBUS‐TBNA for station 10/11/12 LNs from January 2015 to December 2019. Patients with benign results from EBUS‐TBNA who did not undergo surgical sampling/clinical follow‐up or who received radiotherapy/chemotherapy were excluded.

Results

The analyses were conducted on 889 LNs from 797 patients. The overall diagnostic sensitivity, specificity, accuracy, negative predictive value (NPV), and positive predictive value of EBUS‐TBNA were 95.7, 100, 97.3, 93.2, and 100%, respectively. Diagnostic sensitivity was significantly lower for LNs <10 mm than ≥10 mm in size (90.1% vs. 97.8%; p < 0.001). There was no significant difference in diagnostic performance according to the nodal station (10 vs. 11/12) and left‐ versus right‐sided LNs. The diagnostic sensitivity (100 vs. 95.5%; p = 0.221) and specificity (100 vs. 100%) of N3 LNs was not significantly different from those of N1 LNs. In this study, eight (8/91, 8.8%) patients with cN1 NSCLC received neoadjuvant treatment based on the results of EBUS‐TBNA.

Conclusion

EBUS‐TBNA accurately evaluates station 10/11/12 LNs of both N1 and N3 disease. The diagnostic performances of EBUS‐TBNA for station 10/11/12 LNs seem to be comparable to those of EBUS‐TBNA for mediastinal LNs.
Moderating Effect of Error Source on the Continued Influence of Retracted Disclosure on Individual Investors’ Judgements
Authors: Tan Seet‐Koh
Published: July 2022

This study undertakes an experiment, in which Masters of Business Administration students participate as individual investors, to examine the impact of error sources (management versus press) on the continued influence of retracted disclosures. Given the increasing role of third parties in disseminating information, it is vital to examine the moderating effect of error source, a factor not previously emphasized in research on the continued influence effect. The results show that investors are more susceptible to the continued influence effect when the error is from the press (rather than from management), suggesting that individual investors should be more vigilant about the quality of information provided by external organizations. Additional analysis reveals that the differential effect found is mediated by the level of scepticism experienced by the participants. Unlike previous research, this study's results provide evidence that post‐exposure scepticism may moderate the continued influence effect under the conditions of task familiarity and clarity of actual error. Implications for regulators and researchers are also discussed.
The Title VII Amendments Act: A Proposal
Authors: Reed Alex
Published: July 2022

Given the narrow framing of the Supreme Court's decision in Bostock v. Clayton County, that employers cannot fire someone simply for being gay or transgender, numerous questions persist as to whether and to what extent LGBTQ Americans are protected against employment discrimination. Resolving these issues is likely to require years, if not decades, of litigation, leaving LGBTQ workers and their employers without meaningful guidance in the interim. This article contends that the most efficient means of clarifying these uncertainties is for Congress to enact a new employment statute known as the Title VII Amendments Act. As proposed, the Act would resolve each of Bostock's ambiguities in favor of affording greater protections to workers generally and LGBTQ persons specifically while avoiding the controversies that have derailed LGBTQ civil rights legislation in the past. Thus, the Title VII Amendments Act represents LGBTQ persons' best hope of attaining immediate, comprehensive employment protections and employers' best prospect of securing definitive, timely legal guidance post‐Bostock.
Morphological description of early zoeal stages of the snapping shrimp Alpheus buckupi (Caridea: Alpheidae) reared in the laboratory
Authors: Pescinelli Régis Augusto , Sanches Nádia de Moraes , Costa Rogerio Caetano
Published: July 2022

Larval information plays an important role in life history and population dynamics studies, as well as in phylogenetic and systematic ones. The early zoeal stages (zoea I, II and III) of the snapping shrimp Alpheus buckupi were described and illustrated based on laboratory‐hatched larvae from parental females sampled in Cananéia, São Paulo State, Brazil. The morphological characters of the species were compared with descriptions of other Alpheus species with a known first zoeal stage. The first zoeal stage of this species can be separated from the first zoeal stage described for the other 26 species using the following combination of characteristics: basial endite of maxillule with 2 stout spines (distal one with two rows of spinules) and 2 small plumose setae; basial endite of maxilla bilobed, with 3 and 4 simple setae on proximal and distal lobe, respectively, and five (3 strong and 2 slender) simple setae arranged (2 + 2 + 1) on the basis of first maxilliped. The substantial progress in larval knowledge is fundamental to areas such as ecology and will allow us to better understand the distribution of different early life stages of Alpheus species in the meroplankton community.
Pharmacogenetic and drug interaction aspects on ketamine safety in its use as antidepressant ‐ implications for precision dosing in a global perspective
Authors: Langmia Immaculate M. , Just Katja S. , Yamoune Sabrina , Müller Julian Peter , Stingl Julia C.
Published: July 2022

Ketamine and its enantiomer S‐ketamine (esketamine) are known to produce rapid‐onset antidepressant effects in major depression. Intranasal esketamine has recently come onto the market as an antidepressant. Besides experience from short‐term use in anaesthesia and analgesia, the experience with ketamine as long‐term medication is rather low. The use of ketamine and esketamine is limited due to potential neurotoxicity, psychotomimetic side effects, potential abuse and interindividual variability in treatment response including cessation of therapy. Therefore, taking a look at individual patient risks and potential underlying variability in pharmacokinetics may improve safety and dosing of these new antidepressant drugs in clinical practice.

Differential drug metabolism due to polymorphic cytochrome P450 (CYP) enzymes and gene‐drug interactions are known to influence the efficacy and safety of many drugs. Ketamine and esketamine are metabolized by polymorphic CYP enzymes including CYP2B6, CYP3A4, CYP2C9 and CYP2A6. In antidepressant drug therapy, usually multiple drugs are administered which are substrates of CYP enzymes, increasing the risk for drug–drug interactions. We reviewed the potential impact of polymorphic CYP variants and common drug–drug interactions in antidepressant drug therapy affecting ketamine pharmacokinetics, and the role for dose optimization. The use of ketamine or intranasal esketamine as antidepressants demands a better understanding of the factors that may impact its metabolism and efficacy in long‐term use. In addition to other clinical and environmental confounders, prior information on the pharmacodynamic and pharmacokinetic determinants of response variability to ketamine and esketamine may inform on dose optimization and identification of individuals at risk of adverse drug reactions.
Pentoxifylline as a therapeutic option for pre‐eclampsia: a study on its placental effects
Authors: Broekhuizen Michelle , de Vries Rene , Smits Marja A. W. , Dik Willem A. , Schoenmakers Sam , Koch Birgit C. P. , Merkus Daphne , Reiss Irwin K. M. , Danser A. H. Jan , Simons Sinno H. P. , Hitzerd Emilie
Published: July 2022

Background and Purpose

Recently pentoxifylline, a non‐selective phosphodiesterase inhibitor and adenosine receptor antagonist, has attracted much interest for the treatment of the increased vascular resistance and endothelial dysfunction in pre‐eclampsia. We therefore investigated the placental transfer, vascular effects and anti‐inflammatory actions of pentoxifylline in healthy and pre‐eclamptic human placentas.

Experimental Approach

The placental transfer and metabolism of pentoxifylline were studied using ex vivo placenta perfusion experiments. In wire myography experiments with chorionic plate arteries, pentoxifyllines vasodilator properties were investigated, focusing on the cGMP and cAMP pathways and adenosine receptors. Its effects on inflammatory factors were also studied in placental explants.

Key Results

Pentoxifylline transferred from the maternal to foetal circulation, reaching identical concentrations. The placenta metabolized pentoxifylline into its active metabolite lisofylline (M1), which was released into both circulations. In healthy placentas, pentoxifylline potentiated cAMP‐ and cGMP‐induced vasodilation, as well as causing vasodilation by adenosine A1 antagonism and via NO synthase and PKG. Pentoxifylline also reduced inflammatory factors secretion. In pre‐eclamptic placentas, we observed that its vasodilator capacity was preserved, however not via NO‐PKG but likely through adenosine signalling. Pentoxifylline neither potentiated vasodilation through cAMP and cGMP, nor suppressed the release of inflammatory factors from these placentas.

Conclusion and Implications

Pentoxifylline is transferred across and metabolized by the placenta. Its beneficial effects on the NO pathway and inflammation are not retained in pre‐eclampsia, limiting its application in this disease, although it could be useful for other placenta‐related disorders. Future studies might focus on selective A1 receptor antagonists as a new treatment for pre‐eclampsia.
In vitro scanning accuracy using different aids for multiple implants in the edentulous arch
Authors: Kernen Florian R. , Recca Mario , Vach Kirstin , Nahles Susanne , Nelson Katja , Flügge Tabea V.
Published: July 2022

Objectives

Optical impressions of implants in the edentulous arch are challenged by the absence of distinct surface morphology between multiple implant scan bodies. The purpose of this in vitro study was to evaluate a newly developed scan aid in various designs and colors to improve the accuracy of multi‐implant scans.

Materials and Methods

A universal scan aid in three different designs (circular, square, irregular) and three different materials (colors: beige, gray, white) was applied to the implant scan bodies of a master model of six implants in an edentulous maxilla. Ten scans using an intra‐oral scanner of each scan aid were acquired. Reference scanning was performed using a desktop optical scanner. Alignment of scans was performed at the first scan body in a three‐dimensional modeling and inspection software and deviations for trueness and precision were calculated using the signed nearest‐neighbor method and then statistically analyzed (α = .05).

Results

Overall, the beige irregular scan aid had the highest trueness and showed significant differences compared to unsplinted scans. The precision showed more heterogenous results and decreased when using the scan aid. Ease of use was observed with the irregular gray scan aid due to its increased elongation at break.

Conclusions

The evaluated scan aid led to improved trueness when compared to unsplinted scans. Even though the irregular design in beige color showed highest trueness, the poor fracture strength of the tested material requires further improvement.
Cardiac remodeling after atrial septal defects device closure
Authors: Saedi Tahereh , Firouzi Ata , Saedi Sedigheh
Published: July 2022

Background

Trans‐catheter device closure of secundum type atrial septal defects (ASDs) has now become the treatment of choice. Device closure affects the hemodynamics and function of the heart. In the current study, we investigated the remodeling of the heart as assessed by advanced echocardiographic parameters following successful device closure.

Methods

A prospective cohort study was conducted and 45 patients who were eligible for ASD device closure were evaluated for volumetric, functional, Doppler, strain, and strain rate data of left and right atrium and ventricle pre‐procedural and 48 h post‐procedure

Results

In a prospective cohort study 45 patients who were eligible for ASD device closure; atrial and ventricular volumetric, functional, Doppler, strain, and strain rate data were recorded and compared pre‐procedurally and 48 h post‐procedure.We found significant changes in the left ventricular (LV) end diastolic volume index (p‐value = .03), right ventricular (RV) diameter (p‐value = <.001), left atrial (LA) volume index (p‐value = .05), right atrial (RA) volume index (p‐value = .001), and right and left sided E/e’ ratio with a p‐value of .001 and .004, respectively. Our findings showed a significant reduction in the strains of the right and left atria and the right ventricular free wall after ASD device closure. LV global longitudinal strain decreased after the procedure but did not reach statistical significance.

Conclusion

ASD patients have impaired global strains compared to normal defined ranges. LA, RA, and RV strains show significant reduction after device closure. Decline in LA function following closure was greater in those with larger ASDs. In adult patients undergoing the procedure, abnormal LA function is a clinically relevant issue demanding pre and post‐ procedural precautions and treatment.
Characterisation of the immune microenvironment of cutaneous squamous cell carcinoma in immunosuppression
Authors: Rajesh Aarthi , Saito Mayumi , Morrin Helen , Tschirley Allison , Simcock Jeremy , Currie Margaret , Hibma Merilyn
Published: July 2022

Cutaneous squamous cell carcinoma (cSCC) is a common cancer. Systemic immunosuppression with drugs such as Prednisone results in more aggressive disease. We hypothesise that more aggressive disease in immunosuppression is the result of immune changes in the tumor microenvironment. We characterised T cell, phagocytic and antigen presenting cell subsets in cSCC and determined if these infiltrates were altered by immunosuppressive therapy. We found a dominant “CD8 profile” in the centre of cSCC lesions, with CD8 cells correlating with Tbet, FoxP3, OX40 and “M2‐like” macrophages, whereas a “Tbet and granulocyte profile” with associated inflammation predominated at the margin of the tumor. Individuals on systemic immunosuppressive therapy had lesions that were comparable in size, stage and number of vessels to immune competent individuals; however, the number of CD11c positive cells in the lesion centre was significantly reduced. We conclude that cSCC lesions are immunologically heterogeneous across the lesion and that systemically immunosuppressed individuals have reduced CD11c positive cells in the centre of the lesion. The role and detailed phenotype of CD11c positive cells in cSCC lesions warrant further investigation.
A susceptibility putative haplotype within NLRP3 inflammasome gene influences ischaemic stroke risk in the population of Punjab, India
Authors: Kumar Nitin , Kaur Manminder , Singh Gurjinderpal , Valecha Srishti , Khinda Rubanpal , Di Napoli Mario , Singh Monica , Singh Puneetpal , Mastana Sarabjit
Published: July 2022

Despite strong genetic implications of NLRP3 inflammasome, its examination as genetic determinant of ischaemic stroke (IS) remains to be done in Punjab, which has been investigated in this study. In this case control study, 400 subjects (200 IS patients, 200 stroke free controls) were included. Contributions of 5 single nucleotide polymorphisms (SNPs) including a functional SNP within NLRP3 gene (rs10754558, rs4612666, rs2027432, rs3738488 and rs1539019) for the risk of IS were investigated through genetic models after correcting the effect of significant variables. Plasma levels of three pro‐inflammatory markers, that is, C‐reactive protein (CRP), interleukin‐1beta (IL‐1β) and interleukin‐18 (IL‐18) were measured by enzyme‐linked immunosorbent assays (ELISA). Minor alleles of 3 out of 5 SNPs (rs10754558, rs4612666 and rs1539019) exhibited association with IS risk in additive, recessive and multiplicative models. Multivariable regression analysis confirmed that higher levels of systolic blood pressure (β ± SE: 1.42 ± 0.57, p = .013), CRP (β ± SE: 1.22 ± 0.41, p = .003), IL‐1β (β ± SE: 1.78 ± 0.88, p = .043) and IL‐18 (β ± SE: 1.13 ± 0.49, p = .021) were independent risk predictors for IS. Haplotype analysis revealed a susceptibility putative haplotype GTGTA, which approximately doubled the IS risk (OR: 1.98, 95% CI: 1.12–3.78, p = .04) in dominant mode after adjusting the effect with confounding variables. This susceptibility putative haplotype GTGTA was significantly associated with increased concentrations of CRP (β = 1.21, p = .014) and IL‐1β (β = 1.53, p = .034) in dose‐dependent manner (less in carriers of 1 copy than those who had 2 copies of GTGTA).

The present study has revealed a susceptibility putative haplotype GTGTA within NLRP3 gene, carriers of which have double the risk of IS by having increased plasma levels of CRP and IL‐1β in a dose‐dependent manner.
Relationship between the number of lymph nodes dissected and prognosis in muscle‐invasive bladder cancer in the era of neoadjuvant chemotherapy
Authors: Tochigi Kosuke , Nagayama Jun , Bando Shoko , Ishiyama Akinobu , Yuba Takuma , Yuguchi Yuri , Matsui Hirotaka , Hattori Kyosuke , Gotoh Momokazu
Published: July 2022

Objectives

Many studies have shown a good prognostic association with a large number of lymph node dissections. However, most of these studies did not include patients who have received neoadjuvant chemotherapy. The purpose of this study was to verify the relationship between survival outcomes and the number of lymph nodes removed during radical cystectomy in patients with muscle‐invasive bladder cancer in the era of neoadjuvant chemotherapy.

Methods

This retrospective study considered patients who were diagnosed with clinical ≥T2N0M0 muscle‐invasive bladder cancer and treated with radical cystectomy at the Nagoya University Hospital and affiliated hospitals from January 2004 to December 2019. We excluded patients who had a history of upper tract urothelial cancer or non‐urothelial carcinoma. The association between prognosis and the number of lymph nodes removed was investigated.

Results

We retrospectively enrolled a total of 477 patients. The mean number of lymph nodes dissected was 14. Two hundred and twenty‐six patients (47.4%) received neoadjuvant chemotherapy. More extensive lymphadenectomy (≥15 lymph nodes) correlated with better 5‐year overall survival across all patients (68% vs. 57%, p = 0.01). In patients who received neoadjuvant chemotherapy, there was no difference in overall survival according to the number of dissected lymph nodes (66% vs. 71%, p = 0.433). In patients who did not receive neoadjuvant chemotherapy, ≥15 lymph nodes dissected was associated with significantly better overall survival (70.3% vs. 46.9%, p < 0.01).

Conclusions

No association between more aggressive lymph node dissection and prognosis was found in patients who underwent neoadjuvant chemotherapy. Conversely, extended lymph node dissection is desirable for patients who have not received neoadjuvant chemotherapy.
Hemodynamic stress‐induced cardiac remodelling is not modulated by ablation of phosphodiesterase 4D interacting protein
Authors: Mohamed Belal A. , Elkenani Manar , Mobarak Sherok , Marques Rodrigues Daniel , Annamalai Karthika , Schnelle Moritz , Bader Michael , Hasenfuss Gerd , Toischer Karl
Published: July 2022

Adrenergic stimulation in the heart activates the protein kinase A (PKA), which phosphorylates key proteins involved in intracellular Ca2+ handling. PKA is held in proximity to its substrates by protein scaffolds, the A kinase anchoring proteins (AKAPs). We have previously identified the transcript of phosphodiesterase 4D interacting protein (Pde4dip; also known as myomegalin), one of the sarcomeric AKAPs, as being differentially expressed following hemodynamic overload, a condition inducing hyperadrenergic state in the heart. Here, we addressed whether PDE4DIP is involved in the adverse cardiac remodelling following hemodynamic stress. Homozygous Pde4dip knockout (KO) mice, generated by CRISPR‐Cas9 technology, and wild‐type (WT) littermates were exposed to aortocaval shunt (shunt) or transthoracic aortic constriction (TAC) to induce hemodynamic volume overload (VO) or pressure overload (PO), respectively. The mortality, cardiac structure, function and pathological cardiac remodelling were followed up after hemodynamic injuries. The PDE4DIP protein level was markedly downregulated in volume‐overloaded‐ but upregulated in pressure‐overloaded‐WT hearts. Following shunt or TAC, mortality rates were comparably increased in both genotypes. Twelve weeks after shunt or TAC, Pde4dip‐KO animals showed a similar degree of cardiac hypertrophy, dilatation and dysfunction as WT mice. Cardiomyocyte hypertrophy, myocardial fibrosis, reactivation of cardiac stress genes and downregulation of ATPase, Ca2+ transporting, cardiac muscle, slow twitch 2 transcript did not differ between WT and Pde4dip‐KO hearts following shunt or TAC. In summary, despite a differential expression of PDE4DIP protein in remodelled WT hearts, Pde4dip deficiency does not modulate adverse cardiac remodelling after hemodynamic VO or PO.
Boundary of the firm with endogenous firm structure
Authors: Ma Qing , Wang Susheng
Published: July 2022

We study the boundary of the firm with endogenous firm structure. The firm has two restructuring options: internal restructuring by which the firm centralizes or decentralizes decision making, or external restructuring by which the firm spins off a division. We investigate the firm's restructuring options to determine its boundary based on the optimal firm structure. Our conclusion depends on market uncertainty, market size, market competition, synergy among divisions, and coordination costs. We find that when market uncertainty rises, a decentralized firm (D‐firm) conducts internal restructuring, whereas a centralized firm (C‐firm) conducts external restructuring. A D‐firm chooses to stay put when market competition intensifies, whereas a C‐firm chooses to conduct either internal or external restructuring depending on whether a positive synergy exists among its divisions.
Banks' Strategic Responses to Supervisory Coverage: Evidence from a Natural Experiment
Authors: IVANOV IVAN T. , RANISH BEN , WANG JAMES
Published: July 2022

U.S. bank supervisors conduct frequent and comprehensive loan‐level exams of the syndicated loan market. These exams are costly as adverse exam loan ratings may increase supervisory scrutiny and reduce bank capital. Relying on an unexpected change in supervisory coverage in 1998, we estimate that the cost of bank credit for borrowers excluded from supervision decreases by approximately 18%. We show that large lenders use the coverage change to exclude deals from supervision, especially riskier deals. Strikingly, small lenders shift their lending to increase supervisory coverage, suggesting the potential importance of supervision in reducing information asymmetries within lending syndicates.
Cooling‐activated dorsomedial hypothalamic BDNF neurons control cold defense in mice
Authors: Zhou Qian , Liu Changhao , Chen Ting , Liu Yanyang , Cao Ren , Ni Xinyan , Yang Wen Z. , Shen Qiwei , Sun Hongbin , Shen Wei L.
Published: July 2022

BDNF and its expressing neurons in the brain critically control feeding and energy expenditure (EE) in both rodents and humans. However, whether BDNF neurons would function in thermoregulation during temperature challenges is unclear. Here, we show that BDNF neurons in the dorsomedial hypothalamus (DMHBDNF) of mice are activated by afferent cooling signals. These cooling‐activated BDNF neurons are mainly GABAergic. Activation of DMHBDNF neurons or the GABAergic subpopulations is sufficient to increase body temperature, EE, and physical activity. Conversely, blocking DMHBDNF neurons substantially impairs cold defense and reduces energy expenditure, physical activity, and UCP1 expression in BAT, which eventually results in bodyweight gain and glucose/insulin intolerance. Therefore, we identify a subset of DMHBDNF neurons as a novel type of cooling‐activated neurons to promote cold defense. Thus, we reveal a critical role of BDNF circuitry in thermoregulation, which deepens our understanding of BDNF in controlling energy homeostasis and obesity.

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Association between BNT162b2 vaccination and the development of delayed inflammatory reactions to hyaluronic acid‐based dermal fillers—A nationwide survey
Authors: Safir Ari , Samuelov Liat , Sprecher Eli , Daniely Danny , Artzi Ofir
Published: July 2022

Background

Delayed inflammatory reactions (DIRs) to hyaluronic acid‐based dermal fillers following COVID‐19 vaccination has been reported in a few anecdotal reports and small series of cases.

Aim

To evaluate the clinical characteristics, incidence, and management options relevant to BNT162b2 vaccination‐associated DIR—A nationwide survey was conducted.

Methods

An online self‐administered survey was sent to physicians who actively practice tissue filler injections. The data acquired included demographic and clinical characteristics of relevant DIR cases.

Results

Out of 262 responders, 20 cases with DIR following the vaccination were reported. 35% and 65% occurred shortly after the first and second vaccination dose, respectively. Overall, 65% of the DIRs appeared ≤5 days after vaccine administration and most DIRs resolved within 21 days. The filler's volume (p = 0.016) was associated with higher DIR severity, and the same tendency was noted among some filler types and locations of injection. Medical intervention was provided in 12 (60%) cases.

Conclusion

DIR associated with BNT162b2 vaccination is rare and tends to resolve spontaneously or with short‐term medical intervention.
Intellectual Property Rights (IPRs) and its role in propelling the growth of the MSME sector
Authors: Madhusoodanan Lavanya , Sharma Rahul , Soni Patrika , Dubey Amit
Published: July 2022

For micro‐, small‐, and medium‐sized enterprises (MSMEs), the current economic scenario might be altering. The transformation of a country's socioeconomic standing, particularly in a developing country like India, is not a simple process. Micro, small, and medium‐sized firms are a varied and heterogeneous collection of enterprises with a wide range of ailments and constraints. In this respect, MSMEs should get involved in invention/innovation by doing continuous and productive research and development. Intellectual Property Rights (IPR), is one aspect that can help MSMEs avoid stumbling blocks and achieve global standards. IPR is a broad term that encompasses all aspects of a company and serves as a valuable corporate asset. Patent and trademark databases include a plethora of technological and commercial information that MSMEs may use to learn about recent technological advances, discover prospective partners, and learn about rivals' creative activities. For entrepreneurs all around the world, efficiently managing intellectual property and leveraging it to develop company strategies is becoming increasingly important. In the last 7 years, India has launched several programs such as Digital India, Start‐Up India, Make in India, and Stand‐up India, as well as the current Aathmanirbhar Bharat, which aims to achieve a $5 trillion economy and long‐term sustainability. The enterprise, via its vigilance and vitality, should demonstrate remarkable innovativeness and flexibility to withstand the recent economic downturn, and IPR will provide many chances for future growth in this respect. MSMEs' IP strategies should take a comprehensive approach to the various forms of IP assets. In this article, we have emphasized the impact and relevance of IPR as a competitive strategy for propelling the growth of MSMEs. The objective is to raise MSME knowledge of IPRs so that they may take steps to safeguard their ideas and business plans.
Predicting hepatitis B e Antigen seroconversion after pregnancy—The SydPregScore
Authors: Thilakanathan Cynthuja , Kayes Tahrima , Di Girolamo Julia , Nguyen Vi , Glass Anne , Manandhar Sicha , Lawler Joseph , Meredith Chris , Maley Michael , Lloyd Andrew , Levy Miriam T.
Published: July 2022

Background and Aims

Achieving Hepatitis B e antigen seroconversion (HBeAg SC) at an earlier age confers a better prognosis. We examined baseline and post‐partum factors associated with HBeAg SC after pregnancy. We developed a tool, the SydPregScore, to estimate the likelihood of HBeAg SC in the years after pregnancy.

Methods

A retrospective analysis of an HBeAg‐positive pregnant cohort was conducted. Variables including baseline age, parity, alanine aminotransferase level, HBV viral load, quantitative HBsAg, use of antiviral therapy and post‐partum flare were collected. Univariate and multivariate Cox regression analyses to determine predictors of HBeAg SC and develop a predictor score were performed.

Results

We analysed HBeAg SC rates in 220 pregnancies to 149 HBeAg‐positive women from 2006 to 2019. At baseline, their median age was 33 (IQR 29–37), ALT 23 U/L (IQR 17–33) and viral load 8 log10IU/mL (IQR 6.3–8.2 log10IU/mL). The majority (133/198, 67.2%) received short‐course antiviral therapy to prevent mother‐to‐child transmission, and 109/192 (56.8%) had a post‐partum flare. HBeAg SC occurred in 74/220 (33.6%) after pregnancy (median follow‐up 814 days, IQR 405–1531). Multivariate analysis identified baseline viral load <8 log10IU/mL (HR 2.426 [1.224–4.809], p = .011), baseline ALT ≥2 ULN (HR 2.726 [1.299–5.721], p = .008) and age <35 (HR 2.859 [1.255–6.513], p = .012) to be positive predictors of HBeAg SC. The ‘SydPreg Score’ estimated the probability of HBeAg SC at 2000 days as 10%, 30%, 70% and 80% for 0, 1, 2, and 3 predictors respectively.

Conclusion

The SydPreg Score allows the prediction of HBeAg SC in the years after pregnancy. Even in those without elevated ALT, age <35 and viral load <8 log10IU/mL can identify women with a good chance of subsequent HBeAg SC. Those without a chance may benefit from viral suppression.
Decreases in scabies and lice cases among the pediatric and adult populations during COVID‐19
Authors: Bonanno Marianne , Lee Olivia S. , Sayed Christopher
Published: July 2022

The influence of the nationwide lockdown orders during the COVID‐19 pandemic on the transmission of scabies and lice remains unknown. We conducted a cross‐sectional study utilizing UNC patient registry i2b2 to investigate monthly cases and prescriptions for scabies and lice in adult and pediatric patients in North Carolina. There were significant decreases in the cases and prescriptions for scabies and lice in the pediatric and adult populations. These results provide early insights on how COVID‐19 pandemic lockdown orders affected the prevalence of these two conditions and suggest that physical distancing measures reduce transmission of these parasitic conditions.
Clinical and molecular change induced by repeated low‐dose visible light exposure in both light‐skinned and dark‐skinned individuals
Authors: Kim Sooyoung , Rainer Barbara M. , Qi Ji , Brown Isabelle , Ogurtsova Aleksandra , Leung Sherry , Garza Luis A. , Kang Sewon , Chien Anna L.
Published: July 2022

Background

Visible light (VL) is known to induce pigmentation in dark‐skinned individuals and immediate erythema in light‐skinned individuals. However, the effects of accumulated low‐dose VL exposure across skin types are not well established.

Methods

Thirty‐one healthy subjects with light (Fitzpatrick skin types [FST] I‐II, n = 13) and dark (FST V‐VI, n = 18) skin types were enrolled. Subjects' buttocks were exposed daily to VL, wavelength 400–700 nm, with a dose of 120 J/cm2 at 50 mW/cm2, for four consecutive days. Microarray using Affymetrix GeneChip (49,395 genes) was performed followed by qRT‐PCR on skin samples.

Results

Repeated low‐dose VL irradiation induced immediate pigment darkening and delayed tanning in dark‐skinned individuals while no discernable pigmentation and erythema were observed in light‐skinned individuals. Top ten upregulated genes by repeated VL exposure in microarray included melanogenic genes such as tyrosinase (TYR), tyrosinase‐related protein‐1 (TYRP1), dopachrome tautomerase (DCT), premelanosome protein (PMEL), melan‐A (MLANA), and solute carrier family 24, member 5 (SLC24A5) and genes involved in inflammation/matrix remodeling/cell signaling including chemokine (C‐C motif) ligand 18 (CCL18), BCL2‐related protein A1 (BCL2A1), and cartilage oligomeric matrix protein (COMP). In qRT‐PCR CCL18 was upregulated in light skin with a greater extent (mean fold change ± SD; 4.03 ± 3.28, p = .04) than in dark‐skinned individuals (1.91 ± 1.32, p = .07) while TYR was not significantly upregulated in both skin types.

Conclusion

This study highlights the genes upregulated by cumulative VL exposure involved in pigmentation, immune response, oxidation/reduction, and matrix remodeling across skin types providing relevant information on daily solar exposure.
Construction of path analysis model on related factors of social isolation in older people
Authors: Li Weitong , Wang Qing , Yin Haiyan , Song Yulei , Tu Wenjing , Wang Lulu , Liang Yongqi , Bai Yamei , Xu Guihua
Published: July 2022

Background

With the gradual acceleration of population ageing, social isolation in older people has increasingly become a hot topic of social concern. The reduction of valid social participation will cause older people to weaken their sense of belonging to the community and social acquisition, negatively impacting on older people's quality of life. This study is aimed to explore the main related factors affecting the social isolation of older people, so as to provide a solid scientific basis for improving the health behaviour of older people in China.

Method

A cross‐sectional study was conducted among 2267 community residents over 60 years old from four cites in Jiangsu Province, China. Perceived social support scale, Geriatric Depression Scale, Connor‐Davidson Resilience Scale, Comprehensive Ability of Older People Assessment Scale and other influencing factors scales were used to investigate the current situation. Social isolation was measured with the Lubben Social Network Scale. Demographic data were evaluated using descriptive statistical analyses and relationships among study variables were determined to use a path analysis. All data were analyzed using SPSS version 22 and AMOS version 26 using T‐test, analysis of variance, logistic regression analyses, and path analysis method. The test level was set at alpha = 0.05, and the difference was statistically significant at P‐value <0.05.

Results

The results of the model test analysis indicated that the hypothesised paths were supported by data from our samples and demonstrated significance on the path coefficients (P < 0.05). Related factors in the three dimensions of social risk, economic risk and cultural risk have an impact on the social isolation of older people in the community through direct and indirect pathways, and also indirectly through the partially mediated role of depression. Overall, our hypothesised model was retained, indicating empirical support and adequate model fit indices for the theoretical model.

Conclusion

The findings demonstrated the predictive role of related factors of social isolation in older people. In the future, we should focus on developing interventions by uniting many forces such as society, family and older people themselves to reduce social isolation among this vulnerable population and improve the quality of life of older people and promote healthy ageing.
Treatable traits in the NOVELTY study
Authors: Agustí Alvar , Rapsomaniki Eleni , Beasley Richard , Hughes Rod , Müllerová Hana , Papi Alberto , Pavord Ian D. , van den Berge Maarten , Faner Rosa ,   for the NOVELTY Study Investigators
Published: July 2022

Background and objective

Asthma and chronic obstructive pulmonary disease (COPD) are two prevalent and complex diseases that require personalized management. Although a strategy based on treatable traits (TTs) has been proposed, the prevalence and relationship of TTs to the diagnostic label and disease severity established by the attending physician in a real‐world setting are unknown. We assessed how the presence/absence of specific TTs relate to the diagnosis and severity of ‘asthma’, ‘COPD’ or ‘asthma + COPD’.

Methods

The authors selected 30 frequently occurring TTs from the NOVELTY study cohort (NOVEL observational longiTudinal studY; NCT02760329), a large (n = 11,226), global study that systematically collects data in a real‐world setting, both in primary care clinics and specialized centres, for patients with ‘asthma’ (n = 5932, 52.8%), ‘COPD’ (n = 3898, 34.7%) or both (‘asthma + COPD’; n = 1396, 12.4%).

Results

The results indicate that (1) the prevalence of the 30 TTs evaluated varied widely, with a mean ± SD of 4.6 ± 2.6, 5.4 ± 2.6 and 6.4 ± 2.8 TTs/patient in those with ‘asthma’, ‘COPD’ and ‘asthma + COPD’, respectively (p < 0.0001); (2) there were no large global geographical variations, but the prevalence of TTs was different in primary versus specialized clinics; (3) several TTs were specific to the diagnosis and severity of disease, but many were not; and (4) both the presence and absence of TTs formed a pattern that is recognized by clinicians to establish a diagnosis and grade its severity.

Conclusion

These results provide the largest and most granular characterization of TTs in patients with airway diseases in a real‐world setting to date.
The social amplification of risk framework: New perspectives
Authors: Kasperson Roger E. , Webler Thomas , Ram Bonnie , Sutton Jeannette
Published: July 2022

Several decades have elapsed since the introduction in 1988 of the social amplification of risk framework (SARF) by researchers from Clark University and Decision Research. SARF was offered as an umbrella under which social, psychological, and cultural theories of risk could be integrated and thereby supplement technical risk analyses. Some critics suggest that SARF cannot be tested thus, the framework is useful, at most, as a post hoc analysis of some kinds of risks. Others counter that predictability is not required for a framework to be useful and that SARF is an effective tool in organizing data related to public perceptions, values, and behaviors. It can also be used to design more effective risk communication and public engagement strategies. SARF also suggests how to conceptually view the dynamics of social media channels, despite the fact that SARF was developed before the explosion of global digital platforms. The papers in this special issue consider developments, refinements, critiques, contributions, extensions of the approach to new risk issues, as well as the findings and hypotheses that have grown out of what is now close to three decades of empirical research. This introductory paper provides background on SARF, presents a literature review since 2003, introduces the contributions to this issue, and highlights several areas for future research.
Do fiscal opacity, fiscal impulse, and fiscal credibility affect disagreement about economic growth forecasts? Empirical evidence from Brazil considering the period of political instability and presidential impeachment
Authors: Montes Gabriel Caldas , Luna Paulo Henrique Lourenço
Published: July 2022

This study investigates the effects of fiscal opacity, fiscal impulse, and fiscal credibility on disagreement about economic growth forecasts. Regarding fiscal opacity, as a novelty, we use an indicator that captures the ignorance of financial market experts about the real budget balance condition. Fiscal impulse is represented by two fiscal impulse indicators, while fiscal credibility is represented by two credibility indexes. The findings suggest an increase in fiscal opacity and the adoption of discretionary fiscal policy raise disagreement about economic growth forecasts. The results suggest that fiscal credibility improvements reduce disagreement about economic growth forecasts.
Policy implementation through performance measurement: A study of water pollution remediation in China's Huai River Basin
Authors: Li Boying , Tang Shui‐Yan , Wang Feng , Yin Haitao
Published: July 2022

Performance‐oriented management has been proposed as a remedy to policy implementation failure, which is a persuasive woe globally. Recent scholarship on policy implementation through performance measurement and management focuses on client‐oriented services, with less attention paid to the inadequacy of performance indicators in covering all desirable policy goals and in incentivizing all government officials in a non‐client‐oriented service arena, for instance, environmental governance. Based on station‐level water quality data before and after the implementation of China's Huai River Basin Water Quality Accountability Program, we utilize a difference‐in‐differences (DiD) method to investigate how various water quality indicators in the Huai River Basin (HRB) have responded to the new personnel‐based performance measurement system which aimed to enhance environmental policy implementation at the local level. We show that the program succeeded in motivating government officials to meet targeted indicators, but it also led to the worsening of non‐targeted ones. We also find that the impact of this personnel‐based program was sensitive to personal and contextual factors: it affected younger local officials more strongly than those who were older and saw a more limited prospect for promotion. These findings provide evidence for the effectiveness of the personnel‐based measurement system, which may be considered by other countries, particularly those with authoritarian regimes and significant policy implementation failures. At the same time, complementary measures such as institutional arrangements that discover and report omitted important performance aspects, should be considered to safeguard the possible pitfalls of the system.
La función de régimen y vigilancia del ordinario del lugar sobre las asociaciones de fieles a tenor del canon 305
Authors:   , Rodríguez Sánchez John Jairo
Published: July 2022

El primer capítulo de este trabajo desarrolla lo relacionado con el sujeto pasivo de la función de régimen y vigilancia: las asociaciones de fieles. se ofrece una definición y explicación de sus características, para luego ofrecer una clasificación adecuada. En el segundo capítulo se desarrolla la función de régimen y vigilancia del Ordinario del lugar, sus antecedentes al Código de Derecho Canónico de 1917 y al Concilio Vaticano II, para luego pasar a hacer una descripción de su naturaleza y división. Finalmente se abordó de manera particular la función de régimen y de vigilancia, incluyendo la visita canónica y la rendición de cuentas. En el tercer y último capítulo se hace el abordaje del régimen y vigilancia de las asociaciones de fieles por parte del Ordinario del lugar. En este capítulo se desarrollan primero los antecedentes del canon 305 para pasar luego a comprender la relación entre las asociaciones de fieles y la autoridad eclesiástica en el proyecto de nueva codificación, pasando a abordar el contexto, el contenido y la exégesis del canon 305 del Código de Derecho Canónico de 1983. Se termina describiendo los actos de régimen y los actos de vigilancia del Ordinario del lugar sobre las asociaciones de fieles.
Exigencias jurídicas del manual de conducta y acta de compromiso para los clérigos de la Arquidiócesis de Bogotá decreto No. 604,25 noviembre 2013 : Canon 1395 s 2
Authors:   , Castro Roa Fidel
Published: July 2022

El abuso a niños, niñas y adolescentes en los ambientes eclesiales, por parte de los clérigos y religiosos, se cree que son encubiertos por los Obispos y Superiores, dando a pensar a la opinión pública que existe un alto grado de impunidad frente a estos delitos. Por consiguiente, las víctimas y sus familiares han tenido que recurrir a las instancias civiles y los medios de comunicación para denunciar estos atropellos, lo cual ha ocasionado vergonzosos escándalos para la Iglesia Católica. El propósito de esta investigación es identificar las líneas guía para tratar estos casos de arbitrariedad, ceñidos de forma general por el Derecho Canónico, documentos pontificios y los emitidos por las respectivas Conferencias Episcopales. Por ejemplo, la Arquidiócesis de Bogotá está regida por el Decreto 604 del 25 de noviembre del 2013 que establece el manual de conducta y el acta de compromiso donde se especifican las implicaciones jurídicas y las responsabilidades asumidas por los clérigos y religiosos que desempeñen algún cargo pastoral. Además, es importante considerar las obligaciones y derechos de los clérigos presentes en el CIC específicamente en el canon 13955 2. De esta manera, se hace más fácil identificar los ordenamientos adecuados para asistir a las víctimas y a sus familiares con respecto al manejo de tales arbitrariedades, así como, prevenir estos desmanes en los espacios eclesiales apuntando al objetivo propuesto por el Papa Francisco de Tolerancia cero con el abuso sexual.