bluuebunny/crossref_metadata_2025_split huggingface dataset:
How to handle the policy conflict between resource circulation and hazardous substances in the use of waste?
Authors: Johansson Nils , Krook Joakim 
Published: January 2021

AbstractA circular economy creates a policy conflict between increased resource circulation and decreased dispersal of hazardous substances. On the basis of three case studies in the EU, we have therefore identified various regulatory questions that can be posed to address the occurrence of hazardous substances in the use of waste. For each of these questions, we have proposed two possible responses influencing the design of the regulation and analyzed their consequences both from a circularity and from a toxicity perspective.Currently, the regulations focus on reducing the dispersal of hazardous substances rather than stimulating resource circulation. The allowable contamination levels in the waste are typically regulated in relation to its mass rather than its content of valuable resources. The regulation of hazards in waste can be further developed in two general ways, by emphasizing either the risk of exposure to hazards or the total content of hazards. A risk approach is beneficial for short‐term circularity and waste producers. A hazard approach is beneficial for long‐term circularity and waste users. In order to improve the balancing of the policy conflict in question, values, underlying assumptions, and the effects of hazardous substances and resource circulation need to be better understood.
Untangling the effect of insulin action on brain mitochondria and metabolism
Authors: Schell Mareike , Wardelmann Kristina , Kleinridders André 
Published: January 2021

AbstractThe regulation of energy homeostasis is controlled by the brain and, besides requiring high amounts of energy, it relies on functional insulin/insulin‐like growth factor (IGF)‐1 signalling in the central nervous system. This energy is mainly provided by mitochondria in form of ATP. Thus, there is an intricate interplay between mitochondrial function and insulin/IGF‐1 action to enable functional brain signalling and, accordingly, propagate a healthy metabolism. To adapt to different nutritional conditions, the brain is able to sense the current energy status via mitochondrial and insulin signalling‐dependent pathways and exerts an appropriate metabolic response. However, regional, cell type and receptor‐specific consequences of this interaction occur and are linked to diverse outcomes such as altered nutrient sensing, body weight regulation or even cognitive function. Impairments of this cross‐talk can lead to obesity and glucose intolerance and are linked to neurodegenerative diseases, yet they also induce a self‐sustainable, dysfunctional ‘metabolic triangle’ characterised by insulin resistance, mitochondrial dysfunction and inflammation in the brain. The identification of causal factors deteriorating insulin action, mitochondrial function and concomitantly a signature of metabolic stress in the brain is of utter importance to offer novel mechanistic insights into development of the continuously rising prevalence of non‐communicable diseases such as type 2 diabetes and neurodegeneration. This review aims to determine the effect of insulin action on brain mitochondrial function and energy metabolism. It precisely outlines the interaction and differences between insulin action, insulin‐like growth factor (IGF)‐1 signalling and mitochondrial function; distinguishes between causality and association; and reveals its consequences for metabolism and cognition. We hypothesise that an improvement of at least one signalling pathway can overcome the vicious cycle of a self‐perpetuating metabolic dysfunction in the brain present in metabolic and neurodegenerative diseases.
Intranasal insulin
Authors: Hallschmid Manfred 
Published: January 2021

AbstractThe intranasal (IN) route enables the delivery of insulin to the central nervous system in the relative absence of systemic uptake and related peripheral side effects. Intranasally administered insulin is assumed to travel along olfactory and adjacent pathways and has been shown to rapidly accumulate in cerebrospinal fluid, indicating efficient transport to the brain. Two decades of studies in healthy humans and patients have demonstrated that IN insulin exerts functional effects on metabolism, such as reductions in food intake and body weight and improvements of glucose homeostasis, as well as cognition, ie, enhancements of memory performance both in healthy individuals and patients with mild cognitive impairment or Alzheimer's disease; these studies moreover indicate a favourable safety profile of the acute and repeated use of IN insulin. Emerging findings suggest that IN insulin also modulates neuroendocrine activity, sleep‐related mechanisms, sensory perception and mood. Some, but not all studies point to sex differences in the response to IN insulin that need to be further investigated along with the impact of age. “Brain insulin resistance” is an evolving concept that posits impairments in central nervous insulin signalling as a pathophysiological factor in metabolic and cognitive disorders such as obesity, type 2 diabetes and Alzheimer's disease, and, notably, a target of interventions that rely on IN insulin. Still, the negative outcomes of longer‐term IN insulin trials in individuals with obesity or Alzheimer's disease highlight the need for conceptual as well as methodological advances to translate the promising results of proof‐of‐concept experiments and pilot clinical trials into the successful clinical application of IN insulin.
Effectiveness of a Nurse‐Led Tele‐Homecare Program for Patients With Multiple Chronic Illnesses and a High Risk for Readmission: A Randomized Controlled Trial
Authors: Liang Hui Yu , Hann Lin Lieh , Yu Chang Chang , Mei Wu Fu , Yu Shu 
Published: January 2021

AbstractPurposeMultiple chronic illnesses, such as those associated with advanced age, are leading causes of poor health, disability, death, and high healthcare expenditures. Tele‐homecare is a novel method for providing home care to patients with chronic illnesses. The purpose of this study was to evaluate the effectiveness of an integrated nurse‐led tele‐homecare program for patients with multiple chronic illnesses and a high risk for readmission.DesignA randomized controlled trial.MethodsTwo hundred patients from a regional hospital who were scheduled to receive home care after discharge were randomly assigned to the intervention group (n = 100) or the control group (n = 100). The patients in the intervention group participated in an integrated tele‐homecare program. For outcome evaluation, primary outcomes included the number of emergency department (ED) visits as well as readmittance and mortality. Secondary outcomes included patients’ medication adherence, activities of daily living, health status, and quality of life (QOL). Data were collected at three time points: pretest baseline (T0), 3 months after intervention (T3), and 6 months after intervention (T6). A generalized estimating equation model was used to compare changes and evaluate the effect of differences between the two groups over time.FindingsFor primary outcome evaluation, we found that the tele‐homecare program significantly reduced mortality and ED visits, whereas no significant effect on readmission was observed. For secondary outcome evaluation, patients’ QOL indicated significant improvement.Conclusions and Clinical RelevanceThe nurse‐led tele‐homecare program involves daily 24‐hr remote monitoring and surveillance. In this study, the system detected patients’ physical changes early and provided timely and appropriate management, consequently reducing ED visits and mortality. Additionally, it improved patients’ QOL. On the basis of our findings, nurses’ independent roles and functions revealed that the effectiveness of this nurse‐led tele‐homecare program strengthened the care of patients with multiple chronic illnesses.
Chronic wound care delivery in wound clinics, community nursing and residential aged care settings: A qualitative analysis using Levine’s Conservation Model
Authors: Monaro Susan , Pinkova Jana , Ko Natalie , Stromsmoe Nicole , Gullick Janice 
Published: January 2021

AbstractAims and objectivesTo explore patient experience of chronic wound care across diverse models of outpatient wound care delivery.BackgroundChronic wounds represent a significant personal, family and healthcare system burden. Evidence suggests specialist wound clinics are more effective and less expensive, however, most outpatient wound care is delivered by general community nurses. There is little understanding of how patients experience diverse models of wound care delivery and the subsequent impact on their capacity to adapt to imbalances in their internal/external environment.DesignDescriptive, qualitative study.MethodsEighteen patients with chronic wounds from three wound services were engaged in semi‐structured interviews. Initial inductive analysis was refined deductively using Levine's Conservation Model.ResultsChronic wounds lead to imbalances and subsequent adaptions in energy conservation and personal, social and structural integrity. Nursing process and wound care system responses suggest specialist wound clinics provide access to the right person and care at the right time, with less care variation. The community nursing model is most effective with a small team of nurses and a documented care plan, with specialist wound nurse oversight. Residential aged care facilities emerged as important sites for wound care delivery revealing higher variance in care and less specialist wound oversight.ConclusionsThe application of Levine's conservation model provides a theoretical understanding and important insights into the patient experience of nurse and system elements across diverse models of wound care delivery. Specialist oversight by expert wound nurses with the capacity for medical specialist referral is the cornerstone of good wound care. A frequently reviewed wound care plan and skill development for nurses in primary, aged care and community settings are vital.Relevance to clinical practiceShared care between specialist and primary care should include evidence‐based pain assessment, clear referral pathways, collaborative relationships, telehealth capacity, patient‐held wound plans and upskilling of frontline clinicians.
“MANY‐CITEDNESS”: CITATIONS MEASURE MORE THAN JUST SCIENTIFIC QUALITY
Authors: D'Ippoliti Carlo 
Published: January 2021

AbstractCitation counts are increasingly used to create rankings of scholars or institutions: while social scientists are often skeptical of the resulting indexes, economists have mostly been supporters of this approach. Yet, citation metrics have raised two debates in the literature: empirical, regarding their technical use, and theoretical, regarding their meaning and, more generally, the meaning of “scientific quality.” I review this literature highlighting the consequences for the use of citations for research assessment. As an application, I further study the network of citations of publications indexed in Web of Science, authored by all Italian academic economists between 2011 and 2015. I find that the probability of a citation between any two authors depends on similarity in their methods and topics but also, significantly, on various measures of social community and even of ideological proximity. The influence of social relations does not cancel out in the aggregate, as total citations to an individual depend on their network centrality. In the case of economics, citations cannot be interpreted as unbiased proxies of scientific quality.
Relationship between ascites volume and clinical outcomes in epithelial ovarian cancer
Authors: Quan Quan , Zhou Shuwei , Liu Yao , Yin Wanchun , Liao Qianqian , Ren Siling , Zhang Fenfen , Meng Yu , Mu Xiaoling 
Published: January 2021

AbstractObjectiveAscites is a tumor microenvironment, ascites and massive ascites‐induce compression could promote the progression of epithelial ovarian cancer (EOC); however, the impact of ascites volume on clinical outcomes has not been studied extensively. We aimed to investigate the association between ascites volume and clinical outcomes especially platinum resistance in EOC.MethodsWe retrospectively evaluated a total of 546 EOC patients with respect to the amount of ascites, clinicopathologic factors, and survival. Using the threshold of 1500 ml to classify patients into small‐ and large‐volume ascites groups, we analyzed the correlation between ascites volume and clinicopathological factors, including platinum‐free interval (PFI), and prognosis.ResultsPatients with large volume ascites were more likely to present with later stage disease, primary platinum‐resistant (PPR) cancer, and suboptimal cytoreduction. Prolonged PFI was associated with decreased ascites volume. The large‐volume ascites group showed worse progression‐free survival (PFS) and overall survival (OS). An increase in ascites volume was associated with an increased risk of disease recurrence (hazard ratio [HR] = 1.115, 95% confidence interval [CI]: 1.035–1.200) and death (HR = 1.213, 95% CI: 1.090–1.350).ConclusionsAscites was an independent predictor of PFS and OS in EOC patients. A large volume of ascites predicated a shortened PFI, an increased incidence of PPR and suboptimal cytoreduction. Thus, the volume of ascites is a simply available clinical parameter, which could be used to evaluate the prognosis and platinum resistance of EOC patients early, it contributes to formulate individualized treatment plan and improve the outcome of EOC patients.
Soil fungal networks moderate density‐dependent survival and growth of seedlings
Authors: Liang Minxia , Shi Liuqing , Burslem David F. R. P. , Johnson David , Fang Miao , Zhang Xinyi , Yu Shixiao 
Published: January 2021

Summary

Pathogenic and mutualistic fungi have contrasting effects on seedling establishment, but it remains unclear whether density‐dependent survival and growth are regulated by access to different types of mycorrhizal fungal networks supported by neighbouring adult trees.

Here, we conducted an extensive field survey to test how mycorrhizal and pathogenic fungal colonization of arbuscular mycorrhizal (AM) and ectomycorrhizal (ECM) seedlings in a subtropical forest respond to density of neighbouring adult trees. In addition, we undertook a hyphal exclusion experiment to explicitly test the role of soil fungal networks in driving density‐dependent effects on seedling growth and survival.

Conspecific adult density was a strong predictor for the relative abundance of putative pathogens, which was greater in roots of AM than of ECM seedlings, while mycorrhizal fungal abundance and colonization were not consistently affected by conspecific adult density. Both ECM and AM fungal networks counteracted conspecific density‐dependent mortality, but ECM fungi were more effective at weakening the negative effects of high seedling density than AM fungi.

Our findings reveal a critical role of common fungal networks in mitigating negative density‐dependent effects of pathogenic fungi on seedling establishment, which provides mechanistic insights into how soil fungal diversity shapes plant community structure in subtropical forests.
Determining the short‐term effects of different maxillary protraction methods on pharyngeal airway dimensions
Authors: Kale Burak , Buyukcavus Muhammed Hilmi 
Published: January 2021

AbstractObjectiveThis study sought to evaluate the effects of different maxillary protraction methods on the pharyngeal airway in Class III patients with maxillary retrognathia.Setting and Sample PopulationA total of 59 individuals (31 females and 28 males) with a mean age of 11.38 ± 1.24 years were included in this study.Material and MethodsFifty‐nine treated maxillary retrognathic patients who underwent different protraction methods were evaluated. Twenty patients treated with RME (Rapid Maxillary Expansion) made up the first group, and 20 patients treated with 5‐week Alt‐RAMEC (Alternate Rapid Maxillary Expansion and Constriction) protocol comprised the second group. Lastly, 19 patients on whom face masks with miniplates were applied were included in the skeletal anchorage (SA) group. Sixteen linear and four areal pharyngeal airway measurements were made on lateral cephalograms before and after treatment. Differences between the groups were assessed using analysis of variance (ANOVA) tests.ResultsThe mean maxillary protraction levels were determined as 2.7, 3.69 and 4.01 mm in the RME, Alt‐RAMEC and SA groups, respectively. In the nasopharynx, AD1‐PNS, AD2‐PNS, PNS‐Ba and PNS‐Ho measurements revealed a significant increase in the SA group compared to the other groups (P < .05). In the oropharynx, PNS‐Ep measurement increased significantly in the RME group (P < .05). In the total pharyngeal airway area, an increase was detected in the SA, Alt‐RAMEC, and RME groups.ConclusionThe most effective protraction method in terms of pharyngeal airway dimensions, especially in the nasopharynx, is the application of the face mask with skeletal anchorage. A greater increase in vertical airway length (PNS‐Ep) was observed with RME.
Root zone warming represses foliar diseases in tomato by inducing systemic immunity
Authors: Gupta Rupali , Leibman‐Markus Meirav , Marash Iftah , Kovetz Neta , Rav‐David Dalia , Elad Yigal , Bar Maya 
Published: January 2021

AbstractPlants employ systemic‐induced resistance as part of their defence arsenal against pathogens. In recent years, the application of mild heating has been found to induce resistance against several pathogens. In the present study, we investigated the effect of root zone warming (RZW) in promoting tomato's resistance against the necrotrophic fungus Botrytis cinerea (Bc), the hemibiotrophic bacterium Xanthomonas campestris pv. vesicatoria (Xcv) and the biotrophic fungus Oidium neolycopersici (On). We demonstrate that RZW enhances tomato's resistance to Bc, On and Xcv through a process that is dependent on salicylic acid and ethylene. RZW induced tomato immunity, resulting in increased defence gene expression, reactive oxygen species (ROS) and ethylene output when plants were challenged, even in the absence of pathogens. Overall, the results provide novel insights into the underlying mechanisms of warming‐induced immune responses against phytopathogens with different lifestyles in tomato.
Nudging Public Employees Through Descriptive Social Norms in Healthcare Organizations
Authors: Belle Nicola , Cantarelli Paola 
Published: January 2021

AbstractWe draw on the focus theory of normative conduct and nudge theory to experimentally test the effect of descriptive social norms on desired behaviors that public employees may engage in at suboptimal levels, namely, vaccination and help‐seeking. Through a series of framed randomized controlled trials with 19,984 public healthcare professionals, we demonstrate that descriptive norms—doing what the majority of others do—trigger conformity. Specifically, employees are more likely to get a flu shot and advocate vaccination when knowing that the majority of their colleagues get vaccinated against the seasonal influenza compared to when most colleagues do not. Similarly, the probability of making help requests on the job is noticeably higher when asking colleagues for advice is the norm rather than not. We discuss the theoretical and practical implications of these experiments for scholars and policy makers interested in predictably altering high‐stakes behaviors among public employees through low‐powered incentives.
The Timing of Managerial Responses to Fiscal Stress
Authors: Brien Spencer T. , Eger Robert J. , Matkin David S. T. 
Published: January 2021

AbstractUsing 34 years of data from Florida counties, we examine the effect of multiple fiscal stressors on expenditures over time to test theoretical propositions in Charles Levine's seminal study on cutback management. We demonstrate support for Levine's stages model and his claims on linkages between the causes of fiscal stress and managerial responses. Specifically, unemployment levels produce differential effects by service area (e.g., human services bear the most significant share of the reductions), especially in relation to the persistence of the stressor. We cannot support the stages model with other stressor measures. We expand the literature to include county governments, enhancing the contemporary literature on local government fiscal stress.
When nothing is certain, anything is possible: open innovation and lean approach at MVM
Authors: Di Guardo Maria Chiara , Marku Elona , Bonivento Walter Marcello , Castriotta Manuel , Ferroni Fernando , Galbiati Cristiano , Gorini Giuseppe , Loi Michela 
Published: January 2021

Using a participatory observation approach, this paper aims at exploring how public and private organizations have collaborated in response to the COVID‐19 pandemic. We examine the case of Mechanical Ventilator Milano (MVM), an international project with over 250 contributors and partners; this project aimed to achieve the challenging goal of designing and realizing a mechanical ventilator for mass production in about 6 weeks. The project received the Emergency Use Authorization granted by the U.S. Food and Drug Administration. The MVM ventilator is a reliable, fail‐safe, and easy‐to‐operate mechanical ventilator that can be produced quickly at a large‐scale, based on the readily available parts. The success of the MVM case is unique as it adopts open innovation practices to generate technology innovation, in addition to a lean perspective. Through the MVM project description, this study offers a framework that explains the interplay between open innovation and lean approach, highlighting the different internal and external forces and types of collaborations, and offering fine‐grained insights into the role of universities as platforms of multidisciplinary knowledge. This framework might serve as a basis for future theoretical and empirical research, providing practitioners with new best practices that are essential when facing a severe crisis like COVID‐19.
The examination of a vignette activity sequence in a secondary mathematics methods course
Authors: Shelton Ryann N. , Kerschen Keith , Wilkerson Trena L. 
Published: January 2021

AbstractBecause of their brief nature, vignettes are a strategic way to highlight or explore complex instructional practices. Using a qualitative approach, we examined how the use of vignettes in a Vignette Activity Sequence contributed to secondary mathematics preservice teachers’ understanding of the Mathematical Practices and the Mathematics Teaching Practices. By examining three vignettes used in two iterations of a secondary mathematics methods course, the researchers found that preservice teachers were able to draw connections between the vignettes and their own teaching experiences. However, some misconceptions or incomplete understandings related to the practices were revealed. Preservice teachers sometimes provided vague evidence when identifying particular practices in the vignettes that did not clearly indicate if they understood the practices. Taken together, the researchers found the Vignette Activity Sequence to be a valuable formative assessment that could be used to inform instruction in a secondary mathematics methods course. These findings have implications for teacher preparation programs and mathematics teacher educators.