bluuebunny/crossref_metadata_2025_split huggingface dataset:
Accuracy of Ultrasound-Guided Needle Placement on the L5 Lumbar Nerve Root: A Cadaveric Study
Authors: Rodríguez-Sanz Jacobo , Borrella-Andrés Sergio , Pérez-Bellmunt Albert , Fernández-de-las-Peñas César , Albarova-Corral Isabel , López-de-Celis Carlos , Arias-Buría José L. , González-Rueda Vanessa , Malo-Urriés Miguel 
Published: May 2023

ABSTRACT

Objective
To analyze and describe the accuracy of an ultrasound-guided approach to target the L5 root in cadaveric specimens and evaluate if gender differences exist.

Design
A cross-anatomical study on forty cadaver L5 nerve roots was performed. A needle was introduced until contacting the L5 nerve root using ultrasound guidance. After that, specimens were frozen and studied by a cross-anatomical view to see the needle's path. The angulation, length, distance from the vertebral spine, the relevant ultrasound anatomical references, and the accuracy of the procedure were evaluated.

Results
The needle tip reached the L5 root at a 72.5% rate. The mean angulation degrees of the needle relative to the skin surface was 75.53 ± 10.17°, the length of the needle inserted was 5.83 ± 0.82 cm, and the distance from the vertebral spine to the point of entry of the needle was 5.39 ± 1.44 cm.

Conclusion
An ultrasound-guided technique can potentially be an accurate technique to perform invasive procedures on the L5 root. There were statistically significant differences between males and females in the length of the needle introduced. If the L5 root is not clearly visualized, ultrasound will not be the technique of choice.
The effect of tDCS on patients with disorders of consciousness: a systematic review and meta-analysis
Authors: Fan Wei , Fan Yuanteng , Liao Zhenjun , Yin Yatao 
Published: May 2023

Abstract

Objective
The aim of this study was to evaluate the efficacy of transcranial direct current stimulation (tDCS) for improving disorders of consciousness (DOCs), and to compare efficacy of the different etiologies of DOCs.

Design
Randomized controlled trials or crossover trials examining effects of tDCS in patients with DOCs were searched in PubMed, EMBASE, Cochrane Library and Web of Science. The sample characteristics, etiology, tDCS treatment characteristics and outcomes were extracted. Meta-analysis was performed using the RevMan software.

Results
We included nine trials providing data with 331 participants and found that tDCS improved the Coma Recovery Scale- Revised (CRS-R) score of DOCs patients. We found a significant improvement of CRS-R score in the minimally conscious state (MCS) group (WMD = 0.77, 95%CI [0.30, 1.23], P = 0.001), but not in the VS/UWS group. The effects of tDCS are related to etiology, as the CRS-R score was improved in the traumatic brain injury (TBI) group (WMD = 1.18, 95%CI [0.60, 1.75], P < 0.001), but not in vascular accident and anoxia groups.

Conclusions
This meta-analysis revealed the evidence for positive effects of tDCS on DOCs without side-effects observed in MCS patients. In particular, tDCS may be an effective treatment in rehabilitating cognitive functions in people with TBI.
Impact of Prehabilitation on Postoperative Mortality and the Need for Non-Home Discharge in High-Risk Surgical Patients
Authors: Zarate Rodriguez Jorge G , Cos Heidy , Koenen Melanie , Cook Jennifer , Kasting Christina , Raper Lacey , Guthrie Tracey , Strasberg Steven M , Hawkins William G , Hammill Chet W , Fields Ryan C , Chapman William C , Eberlein Timothy J , Kozower Benjamin D , Sanford Dominic E 
Published: May 2023

BACKGROUND:
The preoperative period is an important target for interventions (eg Surgical Prehabilitation and Readiness [SPAR]) that can improve postoperative outcomes for older patients with comorbidities.

STUDY DESIGN:
To determine whether a preoperative multidisciplinary prehabilitation program (SPAR) reduces postoperative 30-day mortality and the need for non-home discharge in high-risk surgical patients, surgical patients enrolled in a prehabilitation program targeting physical activity, pulmonary function, nutrition, and mindfulness were compared with historical control patients from 1 institution’s American College of Surgeons (ACS) NSQIP database. SPAR patients were propensity score–matched 1:3 to pre-SPAR NSQIP patients, and their outcomes were compared. The ACS NSQIP Surgical Risk Calculator was used to compare observed-to-expected ratios for postoperative outcomes.

RESULTS:
A total of 246 patients were enrolled in SPAR. A 6-month compliance audit revealed that overall patient adherence to the SPAR program was 89%. At the time of analysis, 118 SPAR patients underwent surgery with 30 days of follow-up. Compared with pre-SPAR NSQIP patients (n = 4,028), SPAR patients were significantly older with worse functional status and more comorbidities. Compared with propensity score–matched pre-SPAR NSQIP patients, SPAR patients had significantly decreased 30-day mortality (0% vs 4.1%, p = 0.036) and decreased need for discharge to postacute care facilities (6.5% vs 15.9%, p = 0.014). Similarly, SPAR patients exhibited decreased observed 30-day mortality (observed-to-expected ratio 0.41) and need for discharge to a facility (observed-to-expected ratio 0.56) compared with their expected outcomes using the ACS NSQIP Surgical Risk Calculator.

CONCLUSIONS:
The SPAR program is safe and feasible and may reduce postoperative mortality and the need for discharge to postacute care facilities in high-risk surgical patients.
Trajectories of multiple long-term conditions and mortality in older adults: A retrospective cohort study using English Longitudinal Study of Ageing (ELSA)
Authors: Chalitsios Christos V. , Santoso Cornelia , Nartey Yvonne , Khan Nusrat , Simpson Glenn , Islam Nazrul , Stuart Beth , Farmer Andrew , Dambha-Miller Hajira 
Published: May 2023

AbstractObjectivesTo classify older adults with MLTC into clusters based on accumulating conditions as trajectories over time, characterise clusters and quantify associations between derived clusters and all-cause mortality.DesignWe conducted a retrospective cohort study using the English Longitudinal Study of Ageing (ELSA) over nine years (n=15,091 aged 50 years and older). Group-based trajectory modelling was used to classify people into MLTC clusters based on accumulating conditions over time. Derived clusters were used to quantify the associations between MLTC trajectory memberships, sociodemographic characteristics, and all-cause mortality.ResultsFive distinct clusters of MLTC trajectories were identified and characterised as: “no-LTC” (18.57%), “single-LTC” (31.21%), “evolving MLTC” (25.82%), “moderate MLTC” (17.12%), and “high MLTC” (7.27%). Increasing age was consistently associated with an increased number of MLTC. Female sex (aOR = 1.13; 95%CI 1.01 to 1.27) and ethnic minority (aOR = 2.04; 95%CI 1.40 to 3.00) were associated with the “moderate MLTC” and “high MLTC” clusters, respectively. Higher education and paid employment were associated with a lower likelihood of progression over time towards an increased number of MLTC. All the clusters had higher all-cause mortality than the “no-LTC” cluster.ConclusionsThe development of MLTC and the increase in the number of conditions over time follow distinct trajectories. These are determined by non-modifiable (age, sex, ethnicity) and modifiable factors (education and employment). Stratifying risk through clustering will enable practitioners to identify older adults with a higher likelihood of worsening MLTC over time to tailor effective interventions.Strengths and limitationsThe main strength of the current study is the use of a large dataset, assessing longitudinal data to examine MLTC trajectories and a dataset that is nationally representative of people aged 50 years and older, including a wide range of long-term conditions and sociodemographics.The measurement of MLTC was limited to ten long-term conditions, which was all of what was available in the English of Longitudinal Study of Ageing, which may not be exhaustive of all possible long-term conditions.
Mepolizumab induced changes in nasal methylome and transcriptome to predict response in asthma
Authors: Rakkar Kamini , Pang Yik Lam , Rajasekar Poojitha , Portelli Michael A , Hall Robert J , Clifford Rachel L , Shaw Dominick , Sayers Ian 
Published: May 2023

AbstractRationaleMepolizumab is effective for a subset of severe asthma patients in reducing exacerbation frequency. Discovery of a predictive/early marker accurately identifying patients that will have a long-term beneficial clinical response would enable targeting of treatment.ObjectivesWe aimed to characterise the nasal methylome and transcriptome post Mepolizumab and identify signatures related to responder/non-responder status.MethodsNasal brushes were taken at baseline (pre-drug) and following 3 months of treatment with Mepolizumab from patients with severe asthma. Both DNA and RNA were extracted. Gene expression was investigated using poly-A RNA sequencing (25M reads) and DNA methylation analysed using the EPIC Array.Measurements and Main Results27 paired samples were included, 17 patients were clinical responders and 10 were non-responders at one year. Differential gene expression and DNA methylation analyses identified 6719 genes and 53 CpG sites respectively that changed in response to Mepolizumab. There were 1784 genes which were unique to responders and 893 genes unique to non-responders. Pathway analyses revealed unique gene expression signatures. Respiratory disease associations and regulators of ongoing T2 inflammation pathway were still active in non-responders, and there was an inhibition of neutrophil activation pathways in responders.ConclusionsThere was a significant change in both the transcriptome and methylome in the nasal epithelium in patients three months post-Mepolizumab therapy suggesting broad effects on the airway epithelium in severe asthma. Responder and non-responder group analyses indicate there is a responder-specific gene expression profile that may aid in predicting response at one year.
Dual-topology of collagen XV and tenascin C acts in concert to guide and shape developing motor axons
Authors: Nemoz-Billet Laurie , Balland Martial , Gilquin Laurent , Gillet Benjamin , Stévant Isabelle , Guillon Emilie , Hughes Sandrine , Carpentier Gilles , Vaganay Elisabeth , Gonzalez-Melo Mary-Julieth , Koch Manuel , Ghavi-Helm Yad , Ruggiero Florence , Bretaud Sandrine 
Published: May 2023

AbstractDuring development, motor axons are guided towards their muscle target by various extrinsic cues including extracellular matrix (ECM) proteins those identities remain poorly documented. Using single-cell RNA-sequencing of differentiating slow muscle progenitors (SMP) in zebrafish, we charaterized the SMP as a major source of ECM proteins that were computationally predicted to form a basement membrane-like structure tailored for motor axon guidance. Multiplein vivoandin vitroapproaches further revealed that motor axon shape and growth relies on the timely expression of the attractive cue Collagen XV-B (ColXV-B) that locally provides motor axons with a permissive soft microenvironment and separately organizes the repulsive cue Tenascin C into a unique functional dual topology. Bioprinted micropatterns mimicking their unique topology provide compelling evidence that it represents a sufficient condition to elicit directional motor axon growth. Our study provides the first evidence that ECM topology and stiffness critically influence motor axon navigation in vertebrates with potential applications in regenerative medicine for peripheral nerve injury.
Covalent Targeting of Glutamate Cysteine Ligase to Inhibit Glutathione Synthesis
Authors: Zhang Lydia , Tang Michelle , Tao Xavier , Shao Qian , Thomas Vienna , Shimizu Saki , Kasano Miki , Ishikawa Yoshinori , Inukai Takayuki , Nomura Daniel K. 
Published: May 2023

AbstractDysregulated oxidative stress plays a major role in cancer pathogenesis and some types of cancer cells are particularly vulnerable to inhibiting cellular antioxidant capacity. Glutamate-cysteine ligase (GCL) is the first and rate-limiting step in the synthesis of the major cellular antioxidant glutathione (GSH). Developing a GCL inhibitor may be an attractive therapeutic strategy for certain cancer types that are particularly sensitive to oxidative stress. In this study, we reveal a cysteine-reactive covalent ligand EN25 that covalently targets an allosteric cysteine C114 on GCLM, the modifier subunit of GCL, leading to inhibition of GCL activity, lowering of cellular GSH levels, and impaired cell viability in ARID1A-deficient cancer cells that are particularly vulnerable to glutathione depletion, but not in ARID1A-positive cancer cells. Our studies uncover a novel potential ligandable site within GCLM that can be targeted to inhibit the GSH synthesis in cancer cells to target vulnerable cancer cell types.
State Variation in Neighborhood COVID-19 Burden: Findings from the COVID Neighborhood Project
Authors: Noppert Grace A , Clarke Philippa , Hoover Andrew , Kubale John , Melendez Robert , Duchowny Kate , Hegde Sonia T 
Published: May 2023

AbstractA lack of fine, spatially-resolute case data for the U.S. has prevented the examination of how COVID-19 burden has been distributed across neighborhoods, a known geographic unit of both risk and resilience, and is hampering efforts to identify and mitigate the long-term fallout from COVID-19 in vulnerable communities. Using spatially-referenced data from 21 states at the ZIP code or census tract level, we documented how the distribution of COVID-19 at the neighborhood-level varies significantly within and between states. The median case count per neighborhood (IQR) in Oregon was 3,608 (2,487) per 100,000 population, indicating a more homogenous distribution of COVID-19 burden, whereas in Vermont the median case count per neighborhood (IQR) was 8,142 (11,031) per 100,000. We also found that the association between features of the neighborhood social environment and burden varied in magnitude and direction by state. Our findings underscore the importance of local contexts when addressing the long-term social and economic fallout communities will face from COVID-19.
Role of managerial innovativeness for small Finnish firms' product and market performance
Authors: Nisula Anna-Maija , Vanhala Mika , Hussinki Henri , Kianto Aino 
Published: May 2023

PurposeSuccessful firms are important sources of productivity, employment and economic stability in societies. As the micro-level origins of firm innovations are increasingly attracting attention amongst innovation scholars, the purpose of this study is to investigate the role of managerial innovativeness, i.e. small firm managers' innovative behaviour for firm performance. Specifically, the present study investigates managerial innovativeness as a predictor of small firms' product innovativeness and market performance.Design/methodology/approachThis research model suggests that managerial innovativeness is positively linked to firms' market performance and that product innovativeness partially mediates the relationship between managerial innovativeness and market performance. The model was tested using partial least squares structural equation modelling (PLS-SEM) with a dataset (N = 93) collected from small logistics firms in South-Eastern Finland.FindingsThe findings support the authors' hypotheses and show that managerial innovativeness had a direct effect on firms' product innovativeness and market performance. The authors also found that firms' product innovativeness mediated the relationship between managerial innovativeness and firms' market performance.Originality/valueThis is one of the few studies that shed light on and show that managerial innovativeness is significantly and positively related with small firms' product innovativeness and market performance, whereas earlier research tended to focus on managers' personalities, traits, characteristics or managerial actions, leaving managerial innovativeness unexplored.
Auditor choice in real estate firms: a quality signal?
Authors: Palm Peter , Bohman Helena 
Published: May 2023

PurposeReal estate is a capital-intensive industry for which the asset values tend to be highly volatile and uncertain. Transaction costs in the industry are therefore high, and transparency for investors may be low. The need to signal reliable estimates of property assets, in the communication to external stakeholders, can therefore be expected to be of extra importance in this sector. The purpose of this paper is to investigate how real estate firms use big four auditors to signal quality.Design/methodology/approachThe authors use Swedish firm level data containing all limited liability real estate companies in the country to determine the determinants of big four auditors. The data set consists of 34,306 observations and is analyzed through logit regressions.FindingsThe results show that big four companies are primarily contracted by large and mature companies, rather than new firms or firms with volatile financial records, although the latter could be expected to have a large need to signal quality. The authors also find that firms listed on the stock market and firms targeting public use real estate are more inclined to use big four companies.Originality/valueReal estate is a capital-intensive industry for which the asset values tend to be highly volatile and uncertain. Transaction costs in the industry are therefore high, and transparency for investors may be low. The need to signal reliable estimates of property assets, in the communication to external stakeholders, can therefore be expected to be of extra importance in this sector. No prior study of this area has been detected.
Do free-floated shares and board characteristics influence corporate risk disclosure? An empirical analysis on conventional banks in a developing country
Authors: Radwan Elhassan Kotb Abdelrahman , Ali Nada Omar Hassan , Mohamed Mostafa Kayed Abdelazeem 
Published: May 2023

PurposeThis study aims to explore the status and drivers (including free-floated shares, board size, rule duality and board independence) of corporate risk disclosure (CRD) for the conventional listed banks in the Egyptian stock market from 2010 to 2021, which include the country’s major political upheavals and the COVID-19 pandemic.Design/methodology/approachThis study based on a sample of 117 annual reports of sampled banks from 2010 to 2021. RD index of Al-Maghzom (2016) was developed and adopted to quantify CRD using an unweighted scoring system. The multiple linear regression model was used to validate the hypotheses.FindingsThe analysis shows that the COVID-19 pandemic increased insignificantly disclosure of all risks except for segment risks. In addition, findings reveal that all sampled banks adhere highly to the requirements of mandatory RD, with a low level of adherence to voluntary RD. Moreover, the analysis concluded that the board size and free-floating shares positively affect the disclosure of financial, operational, general information.Research limitations/implicationsThe study’s limitations include the content analysis methodology, reliance on annual reports, emphasis on financial and non-financial risks, focus on listed conventional banks in Egypt.Practical implicationsCurrent study’s findings are more likely to be useful for many parties. It informs investors about the characteristics of the boards’ directors of Egyptian listed banks that disclosed risk information. Banks should disclose more comprehensive risk information. For academics, the current study’s limitations can be considered in their future research.Originality/valueThis work fills a new research area in which there is relatively little research in emerging financial markets that adds new evidence to the relationship between RD and both free-floating shares and board characteristics, particularly in Egypt.
Workplace coaching to develop leadership flexibility: the impact of after-event review
Authors: Baron Louis , Boies Kathleen 
Published: May 2023

PurposeThe main goal of this study was to determine whether coachees assigned to complete an after-event review (AER) to prepare for each coaching session would experience greater development in their leadership flexibility than participants assigned to a group experiencing process-oriented coaching without AERs.Design/methodology/approachData were obtained using a quasi-experimental design with multi-source and longitudinal data, including 46 coachees and 103 external raters.FindingsThe AER was associated with greater improvement in leadership flexibility (forcing-enabling duality). In contrast, participants who did not use AER had lower leadership flexibility as assessed by external respondents. Leadership flexibility was associated with team performance and vitality.Practical implicationsResults show that during this process, clients' ownership of their development plan is reinforced, as is their capacity to internalize this process of reflection once the coaching is finished, thus allowing the development to continue beyond the approach.Originality/valueThese results are among the first to suggest that a specific structured facilitation process used by coaches may be more effective in the development of coachees than regular process-oriented coaching.
Exploring walkability research trends based on systematic literature review (SLR) by applying PRISMA
Authors: Hijriyah Linda , Alias Anuar , Mohd Sahabuddin Mohd Firrdhaus 
Published: May 2023

PurposeThis study intends to analyze the trend of walkability research over two years (2021–2022) in several aspects, including the research problem, gap and aim underlying walkability issues, research setting, the scale of analysis, the type of data, the data collection tool, the analysis method and contribution.Design/methodology/approachPreferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) is employed to conduct a systematic literature review from three leading databases including Web of Science (WoS), Scopus and Sage.FindingsFrom the review, it can be concluded that the research focuses on two aspects, namely, the built environment and people. The studies in this field are conducted at different scales of the built environment, from macroscale to microscale, including region, city, neighborhood and street-level studies that are conducted around the world including Asia, Europe and America which receive high attention from researchers. Meanwhile, the study of walkability in Australia and Africa gains less attention. It is revealed that there are four factors of walkability including land use and accessibility for macroscale which cover region, city and neighborhood, while street network and pedestrian infrastructure and facility are mainly analyzed for street-level. Most of the studies widely utilize a quantitative approach for analyzing physical walkability factors in a measurement-based approach by using certain tools/software, and a perception-based approach by using questionnaires.Research limitations/implicationsThe findings can assist to keep up with the rapid pace of scientific publications and help accelerate the understanding of particular ideas in the field of walkability for the planning and design practice and policy that can be used by researchers/academia, urban designers, urban planners, architects, engineers and policymakers. Also, this study hopefully could assist further research direction for the future and could add value to a more advanced way of understanding the research on walkability.Originality/valueThis research provides a robust framework for walkability trend analysis and a comprehensive understanding of the main ideas from the existing research on walkability worldwide.