bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using systems thinking to increase understanding of the innovation system of healthcare organisations
Authors: Linnéusson Gary , Andersson Thomas , Kjellsdotter Anna , Holmén Maria 
Published: July 2022

PurposeThis paper applies systems thinking modelling to enhance the dynamic understanding of how to nurture an innovative culture in healthcare organisations to develop the innovation system in practice and speed up the innovative work. The model aims to provide a holistic view of a studied healthcare organisation's innovation processes, ranging from managerial values to its manifestation in improved results.Design/methodology/approachThe study is based on empirical material from a healthcare unit that, within a few years, changed from having no innovations to repeatedly generating innovations. The study uses the modelling language of causal loop diagrams (CLDs) in the system dynamics methodology to identify the key important aspects found in the empirical material.FindingsThe proposed model, based on the stories of the interviewees, explores the dynamics of inertia when nurturing an innovative culture, identifying delays attributed to the internal change processes and system relationships. These findings underscored the need for perseverance when developing an innovative culture in the entrepreneurial phases.Practical implicationsThe approach of using systems thinking to make empirical healthcare research results more tangible through the visual notations of CLDs and mental simulations is believed to support exploring complex phenomena to induce and nurture both individual and organisational learning.Originality/valueThe results from this approach provide deepened analysis and provoke the systems view to explain how the nurturing of the culture can accelerate the innovation processes, which helps practitioners and researchers to further expand their understanding of their healthcare contexts.
Nocturnal dissolved organic matter release by turf algae and its role in the microbialization of reefs
Authors: Mueller Benjamin , Brocke Hannah J. , Rohwer Forest L. , Dittmar Thorsten , Huisman Jef , Vermeij Mark J. A. , de Goeij Jasper M. 
Published: July 2022

Abstract

The increased release of dissolved organic matter (DOM) by algae has been associated with the fast but inefficient growth of opportunistic microbial pathogens and the ongoing degradation of coral reefs. Turf algae (consortia of microalgae and macroalgae commonly including cyanobacteria) dominate benthic communities on many reefs worldwide. Opposite to other reef algae that predominantly release DOM during the day, turf algae containing cyanobacteria may additionally release large amounts of DOM at night. However, this night‐DOM release and its potential contribution to the microbialization of reefs remains to be investigated.

We first tested the occurrence of hypoxic conditions at the turf algae–water interface, as a lack of oxygen will facilitate the production and release of fermentation intermediates as night‐time DOM. Second, the dissolved organic carbon (DOC) release by turf algae was quantified during day time and nighttime, and the quality of day and night exudates as food for bacterioplankton was tested. Finally, DOC release rates of turf algae were combined with estimates of DOC release based on benthic community composition in 1973 and 2013 to explore how changes in benthic community composition affected the contribution of night‐DOC to the reef‐wide DOC production.

A rapid shift from supersaturated to hypoxic conditions at the turf algae–water interface occurred immediately after the onset of darkness, resulting in night‐DOC release rates similar to those during daytime. Bioassays revealed major differences in the quality between day and night exudates: Night‐DOC was utilized by bacterioplankton two times faster than day‐DOC, but yielded a four times lower growth efficiency. Changes in benthic community composition were estimated to have resulted in a doubling of DOC release since 1973, due to an increasing abundance of benthic cyanobacterial mats (BCMs), with night‐DOC release by BCMs and turf algae accounting for >50% of the total release over a diurnal cycle.

Night‐DOC released by BCMs and turf algae is likely an important driver in the microbialization of reefs by stimulating microbial respiration at the expense of energy and nutrient transfer to higher trophic levels via the microbial loop, thereby threatening the productivity and biodiversity of these unique ecosystems.

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Ecological strategies of (pl)ants: Towards a world‐wide worker economic spectrum for ants
Authors: Gibb Heloise , Bishop Tom R. , Leahy Lily , Parr Catherine L. , Lessard Jean‐Philippe , Sanders Nathan J. , Shik Jonathan Z. , Ibarra‐Isassi Javier , Narendra Ajay , Dunn Robert R. , Wright Ian J. 
Published: July 2022

AbstractCurrent global challenges call for a rigorously predictive ecology. Our understanding of ecological strategies, imputed through suites of measurable functional traits, comes from decades of work that largely focussed on plants. However, a key question is whether plant ecological strategies resemble those of other organisms.Among animals, ants have long been recognised to possess similarities with plants: as (largely) central place foragers. For example, individual ant workers play similar foraging roles to plant leaves and roots and are similarly expendable. Frameworks that aim to understand plant ecological strategies through key functional traits, such as the ‘leaf economics spectrum’, offer the potential for significant parallels with ant ecological strategies.Here, we explore these parallels across several proposed ecological strategy dimensions, including an ‘economic spectrum’, propagule size‐number trade‐offs, apparency‐defence trade‐offs, resource acquisition trade‐offs and stress‐tolerance trade‐offs. We also highlight where ecological strategies may differ between plants and ants. Furthermore, we consider how these strategies play out among the different modules of eusocial organisms, where selective forces act on the worker and reproductive castes, as well as the colony.Finally, we suggest future directions for ecological strategy research, including highlighting the availability of data and traits that may be more difficult to measure, but should receive more attention in future to better understand the ecological strategies of ants. The unique biology of eusocial organisms provides an unrivalled opportunity to bridge the gap in our understanding of ecological strategies in plants and animals and we hope that this perspective will ignite further interest.Read the freePlain Language Summaryfor this article on the Journal blog.
Revisiting Gendered Representations of Humility: An Examination of Sources from Late Medieval Italy
Authors: Negri Silvia 
Published: July 2022

AbstractDuring the Middle Ages, gender‐neutral representations of humility as a quality linked to spiritual love and voluntary service competed with representations according to gendered patterns, such as those related to the naked and dressed body in terms of its biological and social functions and its appearance. Moving from Dante's examples of humility in Purgatory, Canto X, this article focuses on representations of humility in textual and pictorial sources authored by women and men between the thirteenth and early fourteenth centuries in Italy. By showing the complexity of these representations, this article revisits and reconsiders one‐sided historiographical narratives according to which humility in the Middle Ages was intrinsically, persistently and negatively related to feminine suppression and servility.
Advances in diagnostic codes to document sexual assault in health care service
Authors: Medel‐Herrero Alvaro , Smiley‐Jewell Suzette , Shumway Martha , Reidy Dennis E. , Bonomi Amy 
Published: July 2022

AbstractObjectiveTo explore trends in documented sexual abuse/assault (SA) related episodes in California hospitals and emergency departments (ED), including the impact of a change in health care service reporting codification (from ICD‐9‐CM to ICD‐10‐CM) that more clearly defined SA in October 2015.Data SourcesHospital and ED data were drawn from California's Office of Statewide Health Planning and Development (OSHPD).Study DesignDescriptive and trend analyses of SA‐related hospital and ED records (including patients' demographic information) were conducted to determine whether changes in ICD codification had an impact on documented SA‐related episodes.Data CollectionAll SA‐related episodes (ICD‐9‐CM codes 995.83, 995.53; ICD‐10‐CM codes T74.21‐T74.22, T76.21‐T76.22) in California hospitals and EDs for the last decade of available data (2008–2017) were analyzed (n = 20,215).Principal FindingsAn abrupt increase in documented SA episodes in hospitals and EDs began in October 2015, when specific ICD10 codes for suspected cases of SA were created. Documented SA‐related episodes doubled in 1 month (164 vs. 385 episodes in September 2015 and October 2015, respectively). More than half (58.2%) of all SA‐related episodes documented in Oct 2015 were coded as suspicious. The number of documented SA‐related episodes continued increasing to the end of the time series (December 2017). Overall, the annual number of documented SA‐related episodes increased by over 700% in only 4 years (900 vs. 6441 in 2013 and 2017, respectively), suggesting high rates of prior under‐reporting and the need to introduce the new codes. African Americans were disproportionally impacted; however, the highest increases in age‐adjusted rates between the ICD‐9‐CM and the ICD‐10 codification period were found among the White population (2.46 vs. 16.53 per 100,000 inhabitants).ConclusionsSA episodes in the clinical population have been underestimated for many decades. Identifying SA victims and measuring SA‐related health care utilization is a real challenge that needs further investigation.
Disaster, demographics, and vulnerability: Interrogating the long‐term effects of an extreme weather event
Authors: García‐Hernández Cristina 
Published: July 2022

AbstractClimate risk events act on existing inequalities, causing unequal damage across social groups and showing that established vulnerability should be a key consideration in preventing and mitigating the consequences of weather extremes. The disastrous snowfalls that affected Asturias in Northern Spain in the winter of 1888 provide an intriguing and useful historical example of why such consideration is vital. This article is based on analysis of church records and population censuses of 22 mountain parishes over a 21‐year period. It examines the long‐term sociodemographic impacts of that weather event and reveals dramatic changes in fertility, mortality, and nuptiality. Marriages and births decreased by 67% in the 2 years following the snowstorms, when the highest levels of mortality were reached. The excess mortality especially affected those adults over 70, infants under 5, and, most notably, women. A livelihood crisis was at the base of these long‐term effects. Those demographic impacts point to the event’s severity and show that the repercussions of a disaster go far beyond deaths and material losses and are deeply rooted in social factors. These findings reinforce the idea that reconstructing old disastrous episodes is of great social and scientific interest now. That is because, as governments and others are progressively paying more attention to the possibilities of adaptation to global change, there is greater appreciation of the fact that delving into the long‐term impacts of past natural disasters can guide our main future strategies.
Dual bacterial strains TTI for monitoring fish quality in food cold chain
Authors: Liu Chia‐Yu , Tsai Guo‐Jane , Pan Chorng‐Liang , Shang Kuo‐Chung , Tseng Hsiang‐Jung , Chai Huey‐Jine , Hsiao Hsin‐I 
Published: July 2022

AbstractMost microbial time–temperature indicators (TTIs) considered only one spoilage strain. This research compared single and dual spoilage strains‐based microbial TTI for quality changes of chilled grouper fish (Epinephelus fuscoguttatus x
E. lanceolatus) fillet products during distribution. The next‐generation sequencing (NGS) and traditional plate count approach showed that Pseudomonas fragi and Vibrio parahaemolyticus were specific spoilage bacteria at 7 and 15°C. A dual‐strain TTI response provides more accurate results than a single‐strain TTI and provides an irreversible color change from yellow to reddish‐brown, showing levels of fish freshness. The microbial TTI comprises fish spoilage bacteria strains with 3 log CFU/ml, a nutrient broth supplemented with 2% NaCl as a medium, and phenol red with 0.25 mg/ml as a pH indicator. Overall, this study points to the applicability of a dual‐strain microbial TTI as a valuable tool for monitoring fish quality changes during cold chain break condition.
Increased neutrophil count Is associated with the development of chronic kidney disease in patients with diabetes
Authors: Zhang Rui , Chen Jin , Xiong Yanqin , Wang Lihong , Huang Xinmei , Sun Tiange , Zha Bingbing , Wu Yueyue , Yan Cuili , Zang Shufei , Zhou Qin , Huang Zhe , Liu Jun 
Published: July 2022

AbstractBackgroundThis study aims to investigate the potential association of peripheral inflammatory blood cell parameters with the incidence and progression of chronic kidney disease (CKD) in patients with diabetes.MethodsThe cross‐sectional study included 1192 subjects with diabetes derived from one center. The cohort study included 2060 subjects with diabetes derived from another two centers followed up for 4 years. Logistic regression and Cox proportional hazards models were used to evaluate the association of peripheral inflammatory blood cell with CKD.ResultsIn the cross‐sectional study, neutrophil count performed best as an independent risk factor for CKD (odds ratio 2.556 [95% confidence interval 1.111, 5.879]) even after 1:1 case–control matching for age, gender, history of high blood pressure and duration of diabetes. Spline regression revealed a significant linear association of CKD incidence with continuous neutrophil count in excess of 3.6 × 109/L. In the cohort study, subjects were grouped based on tertile of neutrophil count and neutrophil‐to‐lymphocyte ratio. Cox regression analysis results showed that only neutrophil count was independently associated with CKD progression (the highest group vs. the lowest group, hazard ratio 2.293 [95% confidence interval 1.260, 4.171]) after fully adjusting for potential confounders. The cumulative incidence of CKD progression in patients with diabetes gradually increased with increasing neutrophil count (53 (7.7%) subjects in the lowest group vs. 60 (8.2%) in the middle group vs. 78 (12.2%) in the highest group).ConclusionsThis study suggested that neutrophil count is an independent risk factor for progression of CKD in patients with diabetes.
Effect of continued perioperative antithrombotic therapy on bleeding outcomes following laparoscopic nephrectomy and nephroureterectomy
Authors: Kubota Masashi , Matsuoka Takashi , Mine Yuta , Hagimoto Hiroki , Kokubun Hidetoshi , Murata Shiori , Makita Noriyuki , Hattori Yuto , Suzuki Issei , Abe Yohei , Tohi Yoichiro , Tsutsumi Naofumi , Yamasaki Toshinari , Inoue Koji , Kawakita Mutsushi 
Published: July 2022

AbstractIntroductionIn this study, we aimed to assess the impact of perioperative continuation of antithrombotic therapy on bleeding and complications in patients undergoing laparoscopic radical nephrectomy (LRN) and nephroureterectomy (LNU).MethodsThis was a retrospective observational study. Patients who underwent LRN and LNU between January 2017 and July 2019 at our institution were recruited. All patients taking antithrombotic agents continued taking them during the perioperative phase (AA group). Surgical outcomes of patients in the AA group were compared with those of patients who were not taking antithrombotic agents (NA group). The primary outcome was the rate of bleeding complications. Secondary outcomes included intraoperative estimated blood loss, transfusion rate, and complications for up to 90 days.ResultsA total of 100 patients were included in the analysis, with 36 and 64 patients assigned to the AA and NA groups, respectively. Patients in the AA group were found to have more severe comorbidities than those in the NA group, with a Charlson Comorbidity Index ≥5, totaling 14 (39%) and 12 (19%), respectively (P = .03). According to surgical outcomes, none of the patients in the AA group required secondary procedures for bleeding complications. Moreover, there were no significant differences between the groups in intraoperative blood loss, hemoglobin deficit, rate of perioperative transfusion, readmission rate, or high‐grade complications.DiscussionThese results indicate that perioperative use of antithrombotic agents does not increase the risk of bleeding and can be considered safe during LRN and LNU.
Morphological variations of an invasive cyprinid fish (Carassius gibelio) in lentic and lotic environments inferred from the body, otolith, and scale shapes
Authors: Dürrani Ömerhan , Ateşşahin Tuncay , Eroğlu Mücahit , Düşükcan Mustafa 
Published: July 2022

AbstractThis study investigated the morphological variation of gibel carp Carassius gibelio collected from various water bodies in Türkiye. The fish samples were obtained from three dams (Karacaören‐1, Karakaya, and Keban), two natural lakes (Beyşehir and Suğla), and a river (the Tigris River). The dimorphism in body shape was examined with geometric morphometrics, while elliptic Fourier analysis and shape indices were used to describe the variation in lapilli otoliths (hereafter “otoliths”) and scale shapes. The body of C. gibelio revealed higher variations, particularly in the body depth, snout length, caudal fin, and caudal peduncle, among different stations. Geometric morphometric analysis determined a streamlined body shape of C. gibelio in the Tigris River compared to other stations, while C. gibelio from the natural lakes had a deeper body shape. The body of C. gibelio exhibited a significant homogenous shape between the Beyşehir and Suğla lakes, providing the lowest Procrustes distance. The elliptic Fourier analysis revealed that the otolith shape varied significantly between all stations. However, the scale shape was remarkably similar among nearby areas such as Karacaören dam, Suğla, and Beyşehir lakes. These results evinced high degree of intra‐population morphological variation in C. gibelio in response to prevailing environmental conditions that probably facilitate their successful establishment in a novel environment.
Efficient and Robust Methods for Causally Interpretable Meta-Analysis: Transporting Inferences from Multiple Randomized Trials to a Target Population
Authors: Dahabreh Issa J. , Robertson Sarah E. , Petito Lucia C. , Hernán Miguel A. , Steingrimsson Jon A. 
Published: July 2022

AbstractWe present methods for causally interpretable meta-analyses that combine information from multiple randomized trials to draw causal inferences for a target population of substantive interest. We consider identifiability conditions, derive implications of the conditions for the law of the observed data, and obtain identification results for transporting causal inferences from a collection of independent randomized trials to a new target population in which experimental data may not be available. We propose an estimator for the potential outcome mean in the target population under each treatment studied in the trials. The estimator uses covariate, treatment, and outcome data from the collection of trials, but only covariate data from the target population sample. We show that it is doubly robust in the sense that it is consistent and asymptotically normal when at least one of the models it relies on is correctly specified. We study the finite sample properties of the estimator in simulation studies and demonstrate its implementation using data from a multicenter randomized trial.
The hidden links between animal weapons, fighting style, and their effect on contest success: a meta‐analysis
Authors: Palaoro Alexandre V. , Peixoto Paulo Enrique Cardoso 
Published: July 2022

ABSTRACTIn many species that fight over resources, individuals use specialized structures to gain a mechanical advantage over their rivals during contests (i.e. weapons). Although weapons are widespread across animals, how they affect the probability of winning contests is still debated. According to theory, understanding weapon function during contests is essential to: (i) understanding its importance in determining the winner, and (ii) identifying what weapon traits (e.g. weapon length versus shape versus performance) are most relevant for contest success. However, quantitative evaluations of how weapon function affects the extent to which weapon traits influence contest success are still lacking. Here, we first develop an individual‐based model to evaluate how increasing the influence of the weapon in determining the winner translates to differences between winners and losers. Then, we use a meta‐analysis to identify: (i) whether different weapon measures influence contest outcome differently; (ii) how animals use their weapons during fights – i.e. weapon function; and (iii) if weapon function correlates to how weapons influence contest outcome. Our model showed that, as weapons increased the chance of determining the winner, the mean difference between winners and losers also increased. Therefore, in our meta‐analysis we used the mean trait difference between winners and losers as a proxy for the extent to which weapons influence contest success. The literature search identified 49 suitable studies, containing information for 52 species, totalling 107 effect sizes. Four main patterns emerged. First, most of the literature focuses on linear measures of weapons, while performance measures are concentrated on Crustacea and Squamata; other types of measures were rare. Second, differences between winners and losers in linear measurements were greater than differences in performance measurements when all species were combined (and when we used only a subset). Third, species that bear weapons almost always perform visual/tactile displays before engaging in physical contact. And fourth, while the way individuals display their weapons did not influence the importance of weapon size on contest outcomes, fighting style predicted when differences between winners and losers would be higher. Species that used their weapons to push or lift (even when combined with other functions) showed greater differences between winners and losers when compared to species that used their weapons to impact, pierce, pull or squeeze. Overall, our results show that we have an incomplete understanding of animal weapons built mostly on weapon size and a few select taxa. Thus, we should start focusing on measuring weapons according to how they are used during contests and in a wider diversity of species. One way forward is to conduct studies that integrate weapon morphology to weapon function to ensure we are measuring the most ecologically relevant variables.