bluuebunny/crossref_metadata_2025_split huggingface dataset:
Moral minds: How and when does servant leadership influence employees to benefit multiple stakeholders?
Authors: Lemoine G. James , Hartnell Chad A. , Hora Snehal , Watts Daniel I. 
Published: June 2023

AbstractServant leadership's unique focus on care and concern for multiple stakeholders has caught the attention of academic and practitioners alike. Its theoretical novelty, however, remains underutilized as a means to contribute unique insights to the leadership literature. We draw on servant leadership's moral foundation—utilitarian consequentialism—and social learning theory to identify cognitive mechanisms (follower other‐orientation and cognitive reflection) through which servant leadership affects employee behavior benefiting two stakeholder groups: a community nonprofit organization and the employing organization. Furthermore, we evaluate the degree to which an employee's moral identity internalization acts as a boundary condition of servant leadership's effects. Data were collected from 274 employee‐supervisor dyads across three waves with objective cognitive reflection scores and objective measures of workplace charitable giving and employee performance. Results supported all hypothesized predictions even after accounting for three alternative mediators. In particular, servant leadership had a positive indirect effect on workplace charitable giving through follower other‐orientation; it also had a positive indirect effect on objective follower financial performance through other‐orientation and cognitive reflection. Both indirect effects were significant at low levels of moral identity internalization but not at high levels. We discuss the implications of these findings and delineate directions for future research.
Phylogenomics resolves major relationships ofCatocalaunderwing moths
Authors: Homziak Nicholas T. , Storer Caroline G. , Gall Lawrence F. , Borth Robert J. , Kawahara Akito Y. 
Published: June 2023

AbstractUnderwing moths in the genusCatocalaSchrank are among the most charismatic of Lepidoptera.Catocalais also one of the most diverse genera worldwide in the speciose family Erebidae, but a phylogenetic framework for the genus is lacking. Here we reconstruct the first comprehensive molecular phylogeny for the genus based on 685 anchored hybrid enrichment loci sampled from 161Catocalaspecies (99 Nearctic, 62 Palearctic), four species ofUlotrichopusWallengren and 33 outgroups. Phylogenetic analysis unambiguously recoversCatocalaandCatocala + Ulotrichopusas monophyletic with strong support and resolves many backbone relationships withinCatocala.Our results confirm the classification of previously proposed taxonomic subgroups ofCatocala, including seven based on recent molecular/morphological evidence, and ten based on early twentieth‐century morphological research. Mapping of larval host plant use onto the tree shows Fabaceae to be the likely ancestral host plant family forCatocalaandCatocala + Ulotrichopus. There appear to have been at least 18 independent larval host plant shifts to nine plant families, the most common shift being from Fabaceae to Fagaceae. Larval host plant use has likely played an important role in the evolutionary history ofCatocala, with several rapid diversification events propelled by shifts to novel larval host plants, particularly in the North AmericanCatocalafauna.
Bronchodilator response by interrupter technique to guide management of preschool wheeze
Authors: Seddon Paul C , Willson Rhian , Olden Catherine , Symes Elizabeth , Lombardi Enrico , Beydon Nicole 
Published: May 2023

ObjectiveWe examined relationships between clinical features and pulmonary function before and after inhaled corticosteroid (ICS) treatment in wheezy preschool children, and specifically, whether measuring bronchodilator response (BDR) could predict benefit from ICS.DesignClinical non-randomised intervention studySettingSecondary care.PatientsPreschool children (2 years to <6 years) with recurrent wheeze.InterventionsInhaled beta-agonist, ICS.Outcome measuresWe measured prebronchodilator and postbronchodilator interrupter resistance (Rint) and symptom scores at 0 (V1), 4 (V2) and 12 (V3) weeks. At V2, those with a predetermined symptom level commenced ICS. Modified Asthma Predictive Index (mAPI) and parental perception of response to bronchodilator were recorded. Response to ICS was defined as a reduction in daily symptom score of >0.26. Positive BDR was defined as fall in Rint of ≥0.26 kPa.s/L, ≥35% predicted or ≥1.25 Z Scores.ResultsOut of 138 recruited children, 67 completed the full study. Mean (SD) prebronchodilator Rint at V2 was 1.22 (0.35) kPa.s/L, and fell after starting ICS (V3) to 1.09 (0.33) kPa.s/L (p<0.001), while mean (SD) daily symptom score fell from 0.56 (0.36) to 0.28 (0.36) after ICS (p<0.001). Positive Rint BDR before ICS (at V1 and/or V2), using all three threshold criteria, was significantly associated with response to ICS on symptom scores at V3 (p<0.05). mAPI was not significantly associated with response to ICS, and parents’ perception of response to bronchodilator was not related to measured Rint BDR .ConclusionsRint BDR may be helpful in selecting which wheezy preschool children are likely to benefit from ICS.
Clinicopathological and immunological characteristics and outcome of concomitant coeliac disease and non-alcoholic fatty liver disease in adults: a large prospective longitudinal study
Authors: Kamal Sanaa , Aldossari Khaled K , Ghoraba Dhalia , Abdelhakam Sara Mahmoud , Kamal Amgad H , Bedewi Mohamad , Nabegh Leila , Bahnasy Khaled , Hafez Tamer 
Published: May 2023

ObjectiveConcomitant non-alcoholic fatty liver disease (NAFLD) and coeliac disease (CD) have not been adequately studied. This study investigated the frequency of CD among NAFLD patients and the clinicopathological and immunological patterns and outcome of concomitant NAFLD and CD.DesignThis prospective longitudinal study screened patients with NAFLD for CD (tissue transglutaminase antibodies (TTGA); anti-TTGA and antiendomysial antibodies (EMA)). Patients with concomitant NAFLD and CD and patients with either NAFLD or CD were enrolled and followed. Duodenal biopsy, transient elastography, tumour necrosis factor (TNF)-alpha, transforming growth factor-beta, interleukins (ILs) 1, 6, 10, 15 and 17, folic acid and vitamins B12 and D were performed at baseline and 1 year after gluten-free diet (GFD).ResultsCD was confirmed in 7.2% of patients with NAFLD. Refractory anaemia and nutritional deficiencies were frequent in patients with concomitant NAFLD and CD who had advanced intestinal and hepatic lesions, higher levels of TNF-α, IL-15 and IL-17 compared with patients with CD and NAFLD. Patients concomittant CD and NAFLD showed clinical response to GFD, but intestinal histological improvement was suboptimal. Combining EMA-IgA or anti-TTGA with either IL-15 or IL-17 enhances the prognostic performance of both tests in predicting histological response to GFD.ConclusionConcomitant NAFLD and CD is not uncommon. Recurrent abdominal symptoms, refractory anaemia, nutritional deficiencies in patients with NAFLD warrant screening for CD. The study has important clinical implications since failure in diagnosing CD in patients with NAFLD patients results in marked intestinal and hepatic damage and suboptimal response to GFD that can be alleviated by early diagnosis and initiation of GFD.
A community-based contact isolation strategy to reduce the spread of Ebola virus disease: an analysis of the 2018–2020 outbreak in the Democratic Republic of the Congo
Authors: Keita Mory , Polonsky Jonathan A , Ahuka-Mundeke Steve , Ilumbulumbu Michel Kalongo , Dakissaga Adama , Boiro Hamadou , Anoko Julienne Ngoundoung , Diassy Lamine , Ngwama John Kombe , Bah Houssainatou , Tosalisana Michel Kasereka , Kitenge Omasumbu Richard , Chérif Ibrahima Sory , Boland Samuel T , Delamou Alexandre , Yam Abdoulaye , Flahault Antoine , Dagron Stéphanie , Gueye Abdou Salam , Keiser Olivia , Fall Ibrahima Socé 
Published: June 2023

IntroductionDespite tremendous progress in the development of diagnostics, vaccines and therapeutics for Ebola virus disease (EVD), challenges remain in the implementation of holistic strategies to rapidly curtail outbreaks. We investigated the effectiveness of a community-based contact isolation strategy to limit the spread of the disease in the Democratic Republic of Congo (DRC).MethodsWe did a quasi-experimental comparison study. Eligible participants were EVD contacts registered from 12 June 2019 to 18 May 2020 in Beni and Mabalako Health Zones. Intervention group participants were isolated to specific community sites for the duration of their follow-up. Comparison group participants underwent contact tracing without isolation. The primary outcome was measured as the reproduction number (R) in the two groups. Secondary outcomes were the delay from symptom onset to isolation and case management, case fatality rate (CFR) and vaccination uptake.Results27 324 EVD contacts were included in the study; 585 in the intervention group and 26 739 in the comparison group. The intervention group generated 32 confirmed cases (5.5%) in the first generation, while the comparison group generated 87 (0.3%). However, the 32 confirmed cases arising from the intervention contacts did not generate any additional transmission (R=0.00), whereas the 87 confirmed cases arising from the comparison group generated 99 secondary cases (R=1.14). The average delay between symptom onset and case isolation was shorter (1.3 vs 4.8 days; p<0.0001), CFR lower (12.5% vs 48.4%; p=0.0001) and postexposure vaccination uptake higher (86.0% vs 56.8%; p<0.0001) in the intervention group compared with the comparison group. A significant difference was also found between intervention and comparison groups in survival rate at the discharge of hospitalised confirmed patients (87.9% vs 47.7%, respectively; p=0.0004).ConclusionThe community-based contact isolation strategy used in DRC shows promise as a potentially effective approach for the rapid cessation of EVD transmission, highlighting the importance of rapidly implemented, community-oriented and trust-building control strategies.
Association of access to water, sanitation and handwashing facilities with undernutrition of children below 5 years of age in Bangladesh: evidence from two population-based, nationally representative surveys
Authors: Hasan Md Mehedi , Asif Chowdhury Abdullah Al , Barua Alina , Banerjee Archis , Kalam Md Abul , Kader Abdul , Wahed Tasnuva , Noman Mohammad Wali , Talukder Aminuzzaman 
Published: June 2023

ObjectiveTo examine the association between household access to water, sanitation and handwashing (WaSH) facilities and child undernutrition in Bangladesh.Design, setting and participantsCross-sectional study of children less than 5 years using data collected from the 2019 Multiple Indicator Cluster Survey (MICS) and the 2017–2018 Bangladesh Demographic and Health Survey (BDHS).Outcome measuresStunting, wasting and underweight, defined as a Z-score <−2 SD for height-for-age, weight-for-height and weight-for-age, respectively. We applied hierarchical multiple binary logistic regression models.ResultsAmong 30 514 children 0–59 months, there was a high prevalence of child undernutrition (MICS: 28.0% stunted, 9.8% wasted, 22.6% underweight; BDHS: 30.8% stunted, 8.4% wasted, 21.7% underweight). Most children came from households lacking basic sanitation (MICS: 39.1%, BDHS: 55.3%) or handwashing facilities (MICS: 43.8%, BDHS: 62.6%). Children from households without access to WaSH facilities experienced the highest rates of undernutrition. Exposure-specific adjusted logistic regression models showed that a lack of access to improved water sources was associated with greater odds of wasting (MICS: adjusted OR (AOR) 1.36, 95% CI 1.00 to 1.85, p<0.05); basic sanitation facility with higher rates of stunting (MICS: 1.13, 1.04 to 1.23, p<0.01) and underweight (BDHS: 1.18, 1.02 to 1.37, p<0.05); and a lack of handwashing facilities with stunting (BDHS: 1.27, 1.10 to 1.48, p<0.01) and underweight (MICS: 1.10, 1.01 to 1.19, p<0.05). In fully adjusted models, no basic sanitation facility was associated with higher odds of stunting (MICS: AOR 1.12, 1.03 to 1.22, p<0.01) and a lack of handwashing facilities with higher odds of underweight (BDHS: AOR 1.30, 1.10 to 1.54, p<0.01;MICS: AOR 1.09, 1.01 to 1.19, p<0.05).ConclusionThese findings demonstrate a significant association between poor household WaSH facilities and high prevalence of child undernutrition. Improving WaSH may help reduce child undernutrition in Bangladesh.
Association between toileting and falls in older adults admitted to the emergency department and hospitalised: a cross-sectional study
Authors: Zou Min , Lu Rong , Jiang Yijun , Liu Ping , Tian Bingjie , Liang Yuqi , Wang XiaoLing , Jiang Liping 
Published: June 2023

ObjectivesThis study aimed to explore the potential risk factors associated with toileting-related falls in community-dwelling older adults who presented to the emergency department and were subsequently hospitalised.DesignThis was a cross-sectional study.Setting and participantsThis study was conducted in two teaching hospitals in Shanghai, China between October 2019 and December 2021 among community-dwelling adults aged ≥60 years.MethodsIn-person interviews, physical assessment and medical record review were performed to collect data on the characteristics and risk factors of falls. Associations of toileting-related falls with demographic characteristics and geriatric syndromes were examined using logistic regression models.Main outcome measuresPotential risk factors for toileting-related falls.ResultsThis study included 419 older patients with a mean age of 73.8±9.7 years. Among 60 (14.3%) patients with toileting-related falls (mean age: 78.8±9.2 years), 63.3% of toileting-related falls, mainly occurred between 00:00 and 05:59 hours, compared with 17.3% of non-toileting-related falls, which primarily occurred during the daytime. The rate of recurrent falls (35%) was significantly higher in the toileting-related falls group than in the non-toileting-related falls group (21.2%) (p=0.02). Logistic regression showed that visual impairment (OR 2.7, 95% CI 1.1 to 7.1), cognitive impairment (OR 3.3, 95% CI 1.3 to 8.4), gait instability (OR 3.1, 95% CI 1.1 to 8.8) and urinary incontinence (OR 3.4, 95% CI 1.2 to 9.9) were strongly associated with toileting-related falls. Twenty-three (38.3%) patients in the toileting-related falls group had moderate and severe injuries, compared with 71.7% in the non-toileting-related falls group (p<0.05).ConclusionsThis study revealed that patients who reported toileting-related falls were more likely to have cognitive impairment, urinary incontinence, gait instability, visual impairment than patients who fell during other activities. Social and healthcare professionals should prioritise the management of toileting activities in older patients and provide targeted interventions to those in the high-risk group.
Acute exercise as active inference in chronic musculoskeletal pain, effects on gait kinematics and muscular activity in patients and healthy participants: a study protocol for a randomised controlled laboratory trial
Authors: Westergren Jens , Sjöberg Veronica , Vixner Linda , Nyberg Roger G , Moulaee Conradsson David , Monnier Andreas , LoMartire Riccardo , Enthoven Paul , Äng Björn O 
Published: May 2023

IntroductionChronic musculoskeletal pain is a highly prevalent, complex and distressing condition that may negatively affect all domains of life. In view of an active inference framework, and resting on the concept of allostasis, human movement per se becomes a prerequisite for health and well-being while chronic pain becomes a sign of a system unable to attenuate an allostatic load. Previous studies on different subgroups of chronic pain conditions have demonstrated alterations in gait kinematics and muscle activity, indicating shared disturbances in the motor system from long-term allostatic load. We hypothesise that such alterations exist in heterogenous populations with chronic musculoskeletal pain, and that exposure to acute and controlled exercise may attenuate these alterations. Therefore, the main aim of this study is to investigate the acute effects of exercise on gait kinematics and activity of the back and neck muscles during diverse walking conditions in patients with chronic musculoskeletal pain compared with a reference sample consisting of healthy participants.Methods and analysisThis two-sample two-armed parallel randomised controlled laboratory trial will include 40 participants with chronic musculoskeletal pain (>3 months) and 40 healthy participants. Participants will be randomly allocated to either 30 min of aerobic exercise or rest. Primary outcomes are gait kinematics (walking speed, step frequency, stride length, lumbar rotation, gait stability) and muscular activity (spatial and temporal) of the back and neck during diverse walking conditions. Secondary outcomes are variability of gait kinematics and muscle activity and subjective pain ratings assessed regularly during the trial.Ethics and disseminationThe study has been approved by the Regional Ethics Review Board in Uppsala, Sweden (#2018/307). Findings will be disseminated via conference presentations, publications in peer-reviewed journals and engagement with patient support groups and clinicians.Trial registration numberNCT03882333.
Novel application of multi-facility process map analysis for rapid injury care health system assessment in Northern Malawi
Authors: Whitaker John , Amoah Abena S , Dube Albert , Chirwa Lindani , Munthali Boston , Rickard Rory F , Leather Andrew J M , Davies Justine 
Published: June 2023

ObjectivesWe used the process mapping method and Three Delays framework, to identify and visually represent the relationship between critical actions, decisions and barriers to access to care following injury in the Karonga health system, Northern Malawi.DesignFacilitated group process mapping workshops with summary process mapping synthesis.SettingProcess mapping workshops took place in 11 identified health system facilities (one per facility) providing injury care for a population in Karonga, Northern Malawi.ParticipantsFifty-four healthcare workers from various cadres took part.ResultsAn overall injury health system summary map was created using those categories of action, decision and barrier that were sometimes or frequently reported. This provided a visual summary of the process following injury within the health system. For Delay 1 (seeking care) four barriers were most commonly described (by 8 of 11 facilities) these were ‘cultural norms’, ‘healthcare literacy’, ‘traditional healers’ and ‘police processes’. For Delay 2 (reaching care) the barrier most frequently described was ‘transport’—a lack of timely affordable emergency transport (formal or informal) described by all 11 facilities. For Delay 3 (receiving quality care) the most commonly reported barrier was that of ‘physical resources’ (9 of 11 facilities).ConclusionsWe found our novel approach combining several process mapping exercises to produce a summary map to be highly suited to rapid health system assessment identifying barriers to injury care, within a Three Delays framework. We commend the approach to others wishing to conduct rapid health system assessments in similar contexts.
Protocol for the OCAY study: a cohort study of orphanhood and caregiver loss in the COVID-19 era to explore the impact on children and adolescents
Authors: Steventon Roberts Kathryn J , Du Toit Stefani , Mawoyo Tatenda , Tomlinson Mark , Cluver Lucie D , Skeen Sarah , Laurenzi Christina A , Sherr Lorraine 
Published: June 2023

IntroductionGlobally, no person has been untouched by the COVID-19 pandemic. Yet, little attention has been given to children and adolescents in policy, provision and services. Moreover, there is a dearth of knowledge regarding the impact of COVID-19-associated orphanhood and caregiver loss on children. This study aims to provide early insights into the mental health and well-being of children and adolescents experiencing orphanhood or caregiver loss in South Africa.Methods and analysisData will be drawn from a quantitative longitudinal study in Cape Town, South Africa. A sample of children and adolescents between the ages of 9 and 18 years, experiencing parental or caregiver loss from COVID-19, will be recruited together with a comparison group of children in similar environments who did not experience loss. The study aims to recruit 500 children in both groups. Mental health and well-being among children will be explored through the use of validated and study-specific measures. Participants will be interviewed at two time points, with follow-up data being collected 12–18 months after baseline. A combination of analytical techniques (including descriptive statistics, regression modelling and structural equation modelling) will be used to understand the experience and inform future policy and service provision.Ethics and disseminationThis study received ethical approval from the Health Research Ethics Committee at Stellenbosch University (N 22/04/040). Results will be disseminated via academic and policy publications, as well as national and international presentations including high-level meetings with technical experts. Findings will also be disseminated at a community level via various platforms.
Clinical, pathological, genetics and intratumoural immune milieu of micropapillary carcinoma of the colon
Authors: Deshpande Vikram , Lee Soo Hyun , Crabbe Andrew , Pankaj Amaya , Neyaz Azfar , Ono Yuho , Rickelt Steffen , Sonal Swati , Ferrone Cristina R , Ting David T , Patil Deepa , Yilmaz Omer , Berger David , Yilmaz Osman 
Published: May 2023

AimMicropapillary carcinoma (MPC) is a recognised WHO variant of colonic carcinoma (CC), although little is known about its prognosis, immune microenvironment and molecular alterations. We investigated its clinical, pathological and immunological characteristics.MethodsWe assessed 903 consecutive CCs and used the WHO definition to identify MPC. We recorded serrated and mucinous differentiation and mismatch repair (MMR) status. We performed immunohistochemistry and quantification on tissue microarrays for HLA class I/II proteins, beta-2-microglobulin (B2MG), CD8, CD163, LAG3, PD-L1, FoxP3, PD-L1and BRAF V600E.ResultsWe classified 8.6% (N=78) of CC as MPC. Relative to non-MPC, MPC was more often high grade (p=0.03) and showed serrated morphology (p<0.01); however, we found no association with extramural venous invasion (p=0.41) and American Joint Committee on Cancer stage (p=0.95). MPCs showed lower numbers of CD8 positive lymphocytes (p<0.01), lower tumour cell B2MG expression (p=0.04) and lower tumour cell PD-L1 expression (p<0.01). There was no difference in HLA class I/II, LAG3, FOXP3, CD163 and PD-L1 positive histiocytes. There was no association with MMR status or BRAF V600E relative to non-MPC. MPC was not associated with decreased disease-specific survival (p=0.36).ConclusionMPCs are associated with high-grade differentiation and a less active immune microenvironment than non-MPC. MPC is not associated with inferior disease-specific survival.