Additional Tests Research Articles

Structural changes in spinal cord following optic neuritis: Insights from quantitative spinal MRI

ObjectivesPrevious studies have demonstrated that optic neuritis (ON) affects brain plasticity. However, whether ON affects the spinal cord remains unclear. We aimed to investigate the spinal cord changes in ON and their associations with disability. MethodsA total of 101 ON patients, and 41 healthy controls (HC) were retrospectively recruited. High-resolution imaging was conducted using a Magnetization Prepared Rapid Acquisition Gradient-Echo (MP-RAGE) sequence for T1-weighted images and an echo planar imaging (EPI) sequence for Diffusion Tensor Imaging (DTI) data collection. Additionally, patients' disability and cognitive impairment were evaluated using the Expanded Disability Status Scale (EDSS) and the Paced Auditory Serial Addition Test (PASAT), respectively. The quantitative spinal MRI was employed to examine the cross-sectional area (CSA) and diffusion indicators, with a specific focus on calculating the average values across the C2-C7 cervical spinal cord segments. CSA, fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were compared between groups. Correlation analyses were performed between CSA, diffusion indicators, and clinical variables. ResultsNo significant differences were found in CSA between ON patients and HCs. MD (p = 0.007) and RD (p = 0.018) were increased in ON patients compared with HCs, and AD was decreased in ON (p = 0.013). The AD values of the ON patients were significantly positively correlated with PASAT scores (r = 0.37, p < 0.001). ConclusionsThis study provided imaging evidence for DTI abnormalities in patients with ON. Spinal cord DTI can improve our knowledge of the path physiology of ON, and clinical progression.

Influence of Minimal Residual Disease at Day 15 of Induction Therapy on Survival of Children with Acute Lymphoblastic Leukemia.

The aim of the study was to evaluate the impact of minimal residual disease (MRD) on day 15 of induction therapy (d15) on the treatment outcome in children with acute lymphoblastic leukemia (ALL). The study included 74 patients (1-18 years) with ALL, who were treated at the Pediatric Clinic of the University Clinical Center Banja Luka from January 2011 to May 2021. All patients were treated according to ALL IC-BFM 2009 protocol. MRD on bone marrow was assessed d15, using the multiparameter flow cytometry method (FCM). Of all, 59.46% of patients had MRD d15 0.1-10%, MRD<0.1% had 18.92% of patients, and 21.62% had MRD >10%. Patients with the lowest MRD had the highest 5-year overall survival (OS) and event-free survival (89.5% and 91% respectively) and the lowest cumulative risk for relapse or death (9.7% and 8.1%), in contrast to patients with MRD>10% in whom OS was 80.0%, and the risk of recurrence is 20%. Predicted MRD d15 was significantly associated with prednisone response assessed in the peripheral blood on day 8 (P<0.001) and statistically significantly positive correlation (r=0.498; P<0.001) was found. MRD measurement d15 has a great prognostic significance for patients in the standard and high risk groups, but not for patients in the intermediate risk group. The introduction of additional testing is necessary for better identification of patients with an increased risk of disease recurrence.

Genotypic difference in physico-chemical grain composition of three species of grain amaranth selected for the Brazilian Savannah

Seventeen genotypes, representing three species of grain amaranth, were analyzed for physico-chemical components. These genotypes are considered outstanding in terms of agronomical performance, necessitating an understanding of protein, lipids, fiber, and carbohydrate content. It has been demonstrated that A. cruentus, A. hypochondriacus, and A. caudatus differ in the content and properties of these compounds. Based on field experiments conducted in the Brazilian Savannahs, these genotypes were initially tested for germination and vigor after 12 years of storage under low moisture conditions at 10°C in air-tight plastic bags. Assuming that the physico-chemical characteristics were maintained, as indicated by an average 80% germination rate, samples of amaranth seeds were milled and used for analysis. The results indicate protein content below expectations, with the highest values above 14g per 100g, while lipids, fiber, and carbohydrates are within the expected range. The possible factors to explain these results are related to the cultivation environment, although genotypic differences are also significant. Additional testing with broad-based selected lines is necessary to improve selection for both agronomic and physico-chemical composition. The present results suggest that efforts should be concentrated on A. cruentus and A. hypochondriacus.

A study of level of procalcitonin as marker of early onset sepsis in neonates

Background: Neonatal sepsis is one of the commonest causes of morbidity and mortality. It is one of the four leading causes of morbidity and mortality in India. The purpose of this study was to evaluate the levels of procalcitonin as a rapid diagnostic test, to identify those with infection as soon as possible, and to classify them into definitive, clinical, or no sepsis. The rise in Procalcitonin levels in the neonate with sepsis is very rapid. Hence, it can be used for the diagnosis of early onset neonatal sepsis. Objectives were to estimate the concentration of Procalcitonin for diagnosis of early onset neonatal sepsis and to compare the Procalcitonin levels amongst 3 categories of neonatal sepsis (definite, clinical and no sepsis). Methods: This is a hospital based analytical prospective study. Results: 104 babies with early onset sepsis were included in the study from the NICU in tertiary health care center. Procalcitonin is positive in 69 (66.35%) and negative in 35 (33.65%). Out of the total 69 neonates with Procalcitonin positive, 42 (60.8%) neonates are preterm and 27 (39.1%) are term neonates. Out of the total 35 neonates with Procalcitonin negative, 24 (68.5%) neonates are preterm and 11 (31.4%) are term neonates. There was no sepsis observed in 57 (54.8%) of cases, clinical sepsis was observed in 34 (32.6%) of cases and definite sepsis was observed in 13 (12.5%). The mean value of level of Procalcitonin in different categories of sepsis as determined from the data is 3.27 ng/ml in cases of No sepsis, 11.79 ng/ml in cases of clinical sepsis and 17.2 ng/ml in cases of definitive sepsis. Conclusions: Procalcitonin has good sensitivity and hence can detect most cases of neonatal sepsis and good negative predictive value. Procalcitonin contributes more significantly to the diagnosis of newborn septicemia when paired with additional testing and helps in identifying the categories of sepsis in neonates.

LIQUIDITY-PROFITABILITY DYNAMICS: IS THE BANKING INDUSTRY RESILIENT IN TIMES OF CRISIS?

The banking industry contributes to the economic expansion since it is considered the keeper and supplier of liquid capital, essential for all commercial and industrial activity. The primary goal of commercial banks is to generate profits while serving clients and maintaining liquidity positions. Hence, this study aims to examine and evaluate the relationship between liquidity (measured through the Liquid assets and Liquid assets to short-term liabilities ratio) and profitability (measured through ROA and ROE) position of the commercial banking system in North Macedonia and Serbia in order to determine whether changes in liquidity levels influence profitability. Since the ten-year examination period (2012-2021) includes the emergence of the Coronavirus global health pandemic, additional tests were conducted to find out whether the sanitary crisis caused changes in the liquidity-profitability dynamics.By employing descriptive, correlation and regression analysis, and observing two sub-periods (2010-2019 vs 2020-2021), we infer changes in the liquidity-profitability positions in times of crisis in both countries. These findings reinvigorate the knowledge on liquidity and profitability performance in times of instability as this is a pioneer study in evaluating the pandemic impact on liquidity and performance using empirics in these two markets. Furthermore, by scrutinizing the interrelationship between liquidity and profitability, the findings reveal that associations are time-dependent, with policy implications for banks and financial industry regulators.

The utility of nasal nitric oxide in the diagnostic evaluation of primary ciliary dyskinesia.

There is no gold-standard test for primary ciliary dyskinesia (PCD), rather American Thoracic Society guidelines recommend starting with nasal nitric oxide (nNO) in children ≥5 years old and confirming the diagnosis with genetic testing or ciliary biopsy with transmission electron microscopy (TEM). These guidelines have not been studied in a clinical setting. We present a case series describing the PCD diagnostic process at our pediatric PCD center. Diagnostic data from 131 patients undergoing PCD consultation were reviewed. In all participants ≥ 5 years old and who completed nNO using resistor methodology, the first diagnostic test performed was nNO in 77% (73/95), genetic testing in 14% (13/95), and TEM in <1% (9/95). nNO was the only diagnostic test performed in 75% (55/73) of participants who completed nNO first. Seventy-five percent (55/73) had a single above the cutoff nNO value and PCD was determined to be unlikely in 91% (50/55) without performing additional confirmatory testing. Eleven percent(8/73) had multiple below the cutoff nNO values, with 38% (3/8) being diagnosed with PCD by confirmatory testing and 50% (4/8) with negative confirmatory testing, but being managed as PCD. The genetic testing positivity rate was 50% in participants who completed nNO first and 8% when genetic testing was completed first. nNO is useful in three situations: an initial above the cutoff nNO value makes PCD unlikely and prevents additional confirmatory testing, repetitively below the cutoff nNO values without positive confirmatory testing suggests a probable PCD diagnosis and the yield of genetic testing is higher when nNO is performed first.

Construction and optimization of multi-platform precision pathways for precision medicine

In the enduring challenge against disease, advancements in medical technology have empowered clinicians with novel diagnostic platforms. Whilst in some cases, a single test may provide a confident diagnosis, often additional tests are required. However, to strike a balance between diagnostic accuracy and cost-effectiveness, one must rigorously construct the clinical pathways. Here, we developed a framework to build multi-platform precision pathways in an automated, unbiased way, recommending the key steps a clinician would take to reach a diagnosis. We achieve this by developing a confidence score, used to simulate a clinical scenario, where at each stage, either a confident diagnosis is made, or another test is performed. Our framework provides a range of tools to interpret, visualize and compare the pathways, improving communication and enabling their evaluation on accuracy and cost, specific to different contexts. This framework will guide the development of novel diagnostic pathways for different diseases, accelerating the implementation of precision medicine into clinical practice.

Environmental risk assessment related to using resource recovery-based bio-composite materials in the aquatic environment with new laboratory leaching test data.

The concept of circular economy, aiming at increasing the sustainability of products and services in the water and other sectors, is gaining momentum worldwide. Driven by this concept, novel bio-composite materials produced by recovering resources from different parts of the water cycle are now manufactured in The Netherlands. The new materials are used for different products such as canal bank protection elements, as an alternative to similar elements made of hardwood. As much as these new materials are appealing from the sustainability point of view, they may leach toxic substances into the aquatic environment given some of their ingredients, e.g., cellulose recovered from wastewater treatment. Therefore, a methodology for the assessment of related environmental risks is needed and it does not exist currently. This paper addresses this knowledge gap by presenting a framework for this. The framework is based on European environmental risk assessment guidelines, and it includes four key steps: (i) hazard identification, (ii) dose-response modelling, (iii) exposure assessment and (iv) risk characterisation (i.e. assessment). As part of the first step, laboratory leaching tests were carried out to evaluate the potential release of specific chemical substances such as heavy metals and resin compounds into the aquatic environment. Laboratory test results were then used as input data to evaluate the risk of potential leaching from canal bank protection elements into surface water. A deterministic model was used first to identify the chemicals exceeding the guideline threshold. Subsequently, a stochastic model was applied to evaluate the environmental risks across a range of leachate concentrations and water velocities in the canal, thereby simulating a broader spectrum of possible situations. The risk analyses were conducted for four alternative bio-composite materials made of different ingredients, two different flow conditions (stagnant water and advective flow) in two types of canals (wide ditch and primary watercourse) and for two different water levels based on season conditions (summer and winter conditions). The results obtained from leaching tests identified Cu, Mn, Zn, styrene and furfuryl alcohol as potentially troublesome chemicals. In the case of stagnant water, the absence of a flow rate increases the residence time of the chemicals in the surface water, resulting in a higher PEC/PNEC (i.e. risk) value. However, under stagnant case conditions, environmental risks for all chemicals considered turned out to be below the safety threshold. In the advective case, the existence of a flow rate, even at low velocities simulating the conditions of 'almost no flow,' contributes to increased dilution, resulting in lower PEC/PNEC ratio values. The results presented here, even though representing real-case scenarios, are only indicative as these are based on laboratory leaching tests and a number of assumptions made. Additional field tests involving collecting and analysing water and sediment samples from the canal where the canal bank protection elements are located, over a prolonged period, are required to come up with more conclusive findings.

Assessment of diagnostic criteria for multifocal motor neuropathy in patients included in the Italian database.

This study aimed to assess the diagnostic criteria, ancillary investigations and treatment response using real-life data in multifocal motor neuropathy (MMN) patients. Clinical and laboratory data were collected from 110 patients enrolled in the Italian MMN database through a structured questionnaire. Twenty-six patients were excluded due to the unavailability of nerve conduction studies or the presence of clinical signs and symptoms and electrodiagnostic abnormalities inconsistent with the MMN diagnosis. Analyses were conducted on 73 patients with a confirmed MMN diagnosis and 11 patients who did not meet the diagnostic criteria. The European Federation of Neurological Societies/Peripheral Nerve Society (EFNS/PNS) diagnostic criteria were variably applied. When applying the American Association of Electrodiagnostic Medicine criteria, an additional 17% of patients fulfilled the criteria for probable/definite diagnosis whilst a further 9.5% missed the diagnosis. In 17% of the patients only compound muscle action potential amplitude, but not area, was measured and subsequently recorded in the database by the treating physician. Additional investigations, including anti-GM1 immunoglobulin M antibodies, cerebrospinal fluid analysis, nerve ultrasound and magnetic resonance imaging, supported the diagnosis in 46%-83% of the patients. Anti-GM1 immunoglobulin M antibodies and nerve ultrasound demonstrated the highest sensitivity. Additional tests were frequently performed outside the EFNS/PNS guideline recommendations. This study provides insights into the real-world diagnostic and management strategies for MMN, highlighting the challenges in applying diagnostic criteria.

Cracking a cancer code DNA methylation in epigenetic modification: an in-silico approach on efficacy assessment of Sri Lanka-oriented nutraceuticals

DNA methyltransferase (DNMTs) are essential epigenetic modifiers that play a critical role in gene regulation. These enzymes add a methyl group to cytosine’s 5'-carbon, specifically within CpG dinucleotides, using S-adenosyl-L-methionine. Abnormal overexpression of DNMTs can alter the gene expression patterns and contribute to cancer development in the human body. Therefore, the inhibition of DNMT is a promising therapeutic approach to cancer treatment. This study was aimed to identify potential nutraceutical inhibitors from the Sri Lanka Flora database using computational methods, which provided an atomic-level description of the drug binding site and examined the interactions between nutraceuticals and amino acids of the DNMT enzyme. A series of nutraceuticals from Sri Lanka-oriented plants were selected and evaluated to assess their inhibitory effects on DNMT using absorption, distribution, metabolism, excretion and toxicity analysis, virtual screening, molecular docking, molecular dynamics simulation and trajectory analysis. Azacitidine, a DNMT inhibitor approved by the US Food and Drug Administration, was selected as a reference inhibitor. The complexes with more negative binding energies were selected and further assessed for their potency. Seven molecules were identified from 200 nutraceuticals, demonstrating significantly negative binding energies against the DNMT enzyme. Various trajectory analyses were conducted to investigate the stability of the DNMT enzyme. The results indicated that petchicine (NP#0003), ouregidione (NP#0011) and azacitidine increased the stability of the DNMT enzyme. Consequently, these two nutraceuticals showed inhibitory efficacies similar to azacitidine, making them potential candidates for therapeutic interventions targeting DNMT enzyme-related cancers. Additional bioassay testing is recommended to confirm the efficacies of these nutraceuticals and explore their applicability in clinical treatments. Communicated by Ramaswamy H. Sarma

Transient synovitis of the hip: Development and validation of a new diagnostic algorithm.

To develop and validate an algorithm to rapidly distinguish transient synovitis (TS) of the hip from differential diagnoses without additional tests. This retrospective cohort study included all children admitted for non-traumatic limping in the emergency department at Lille University-Hospital between 2016 and 2020. The gold standard was a definitive diagnosis at follow-up visit. All variables associated with acute limping in children were analysed in univariate and multivariable analyses. An algorithm was then developed using recursive partitioning and validated internally on a subset of patients. There were 995 patients included (mean age 5.3 years; males 63%); 337 had a TS including 210 confirmed at follow-up visit and 354 another diagnosis. After multivariable analysis, the relevant variables for distinguishing between TS and differential diagnoses were: age 3-10 years, absence of fever, absence of local inflammation, sudden onset of limping on awakening. An algorithm combining these variables was developed (n = 297) and validated internally (n = 175) for children >12 months with limping for ≤10 days, with a specificity of 98.2% and a positive likelihood ratio of 19.6. No serious differential diagnoses were missed. Use of this algorithm enables the diagnosis of TS without additional tests and without missing serious differential diagnoses.

Nonlinear Semi-Numeric and Finite Element Analysis of Three-Point Bending Tests of Notched Polymer Fiber-Reinforced Concrete Prisms

A nonlinear semi-numeric and finite element analysis of three-point bending tests of notched polymer fiber-reinforced concrete prisms was performed. The computational and experimental results were compared in terms of the load-displacement behavior. The vertical midspan displacement and the crack mouth opening displacement results were considered. The nonlinear semi-numeric computational procedure involved the moment-curvature relation, calculated by considering the constitutive material law from the fib Model Code for Concrete Structures 2010, and considered a plastic hinge mechanism to simulate the cracked region behavior. Two sets of tensile mechanical properties were considered for the constitutive material law: back-calculated (by an inverse analysis) tensile strength properties from the experimental results, and tensile strength properties calculated by simplified expressions from the fib Model Code for Concrete Structures 2010. Other mechanical properties were determined by additional compressive tests and standard relations for the dependency of various mechanical properties on the concrete compressive strength. The nonlinear finite element analysis incorporated the Menetrey-Willam material model to simulate the fiber-reinforced concrete behavior. The nonlinear semi-numeric analysis load-displacement results based on the back-calculated tensile strength properties relatively accurately matched with the experimental results, whereas the nonlinear semi-numeric analysis load-displacement results based on tensile strength properties calculated by simplified expressions from the fib Model Code for Concrete Structures 2010 and the nonlinear finite element analysis load-displacement results showed certain shortcomings.

FinTech penetration, charter value, and bank risk-taking

Using a sample of U.S. community banks and FinTech loans data from LendingClub and Prosper, I find that banks’ future change in risk-taking is positively associated with their current exposure to FinTech penetration. Path analysis shows that FinTech penetration influences bank risk-taking through the erosion of bank charter value. Additionally, cross-sectional analysis shows that the risk-increasing effect of FinTech penetration is stronger for banks with lower ex-ante charter value and greater reliance on hard information. My results are robust to alternative measures of bank risk-taking and FinTech penetration, propensity score matching, and a battery of sensitivity and additional tests. Regarding policy implications, the findings imply that reasonable estimations of banks’ charter value may serve as an early indicator of banks’ future risk-taking incentives.

Using case vignettes to study the presence of outcome, hindsight, and implicit bias in acute unplanned medical care: a cross-sectional study.

Various biases can impact decision-making and judgment of case quality in the Emergency Department (ED). Outcome and hindsight bias can lead to wrong retrospective judgment of care quality, and implicit bias can result in unjust treatment differences in the ED based on irrelevant patient characteristics. First, to evaluate the extent to which knowledge of an outcome influences physicians' quality of care assessment. Secondly, to examine whether patients with functional disorders receive different treatment compared to patients with a somatic past medical history. A web-based cross-sectional study in which physicians received case vignettes with a case description and care provided. Physicians were informed about vignette outcomes in a randomized way (no, good, or bad outcome). Physicians rated quality of care for four case vignettes with different outcomes. Subsequently, they received two more case vignettes. Physicians were informed about the past medical history of the patient in a randomized way (somatic or functional). Physicians made treatment and diagnostic decisions for both cases. One hundred ninety-one Dutch emergency physicians (EPs) and general practitioners (GPs) participated. Quality of care was rated on a Likert scale (0-5) and dichotomized as adequate (yes/no). Physicians estimated the likelihood of patients experiencing a bad outcome for hindsight bias. For the second objective, physicians decided on prescribing analgesics and additional diagnostic tests. Large differences existed in rated quality of care for three out of four vignettes based on different case outcomes. For example, physicians rated the quality of care as adequate in 44% (95% CI 33-57%) for an abdominal pain case with a bad outcome, compared to 88% (95% CI 78-94%) for a good outcome, and 84% (95% CI 73-91%) for no outcome ( P < 0.01). The estimated likelihood of a bad outcome was higher if physicians received a vignette with a bad patient outcome. Fewer diagnostic tests were performed and fewer opioids were prescribed for patients with a functional disorder. Outcome, hindsight, and implicit bias significantly influence decision-making and care quality assessment by Dutch EPs and GPs.

Safety profile of ZnO active packaging PBAT based biomaterial for food packaging. First tier evaluation

Materials produced with polybutylene adipate terephthalate (PBAT) and starch are raising great interest for packaging and food contact applications, including as support for active antimicrobial agents such as zinc oxide nanoparticles (ZnO). Studies focusing on the safety of these materials as evaluated with the current reference rules for food contact materials, are lacking. A commercially available PBAT/starch-based material was incorporated with ZnO and the overall and specific migration of the films were studied at different conditions of simulants and temperature. The overall migration (OM) limit is exceeded due to the release of starch as confirmed by infrared spectroscopy. The impact of temperature on the OM was higher for the ethanol 10%. The incorporation of ZnO particles reduced the OM, for both temperatures tested for ethanol 10%. The impact of incorporating ZnO in the migration into acetic acid was relevant at 20 °C only. Beside starch, most relevant migrants were PBAT oligomers made of butanediol and two different kinds of diacids, terephthalic acid or adipic acid. The cyclic diester of 1,4-butanediol and adipic acid, butenyl butanediol adipate in either cyclic and linear form and oligomers terephthalic acid, but-3-enyl hexadecyl ester were detected in an untargeted screening with GC-MS. A second TPA oligomer was not fully identified. The specific migration was in several cases, depending on the simulant and on the temperature, higher than 50 μgkg−1 (semi-quantification), the threshold value for requiring additional toxicity test (genotoxicity tests applied to oligomers below 1000 Da). This indicates the need for more detailed studies with more precise quantification to verify the need for toxicity tests.

Retrospective analysis of discordant results between histology and other clinical diagnostic tests on helicobacter pylori infection.

A reliable test is essential for diagnosing Helicobacter pylori (H. pylori) infection, and crucial for managing H. pylori-related diseases. Serving as an excellent method for detecting H. pylori infection, histologic examination is a test that clinicians heavily rely on, especially when complemented with immunohistochemistry (IHC). Additionally, other diagnostic tests for H. pylori, such as the rapid urease test (CLO test) and stool antigen test (SA), are also highly sensitive and specific. Typically, the results of histology and other tests align with each other. However, on rare occasions, discrepancy between histopathology and other H. pylori diagnostic tests occurs. To investigate the discordance between histology and other H. pylori tests, the underlying causes, and the impact on clinical management. Pathology reports of gastric biopsies were retrieved spanning August 2013 and July 2018. Reports were included in the study only if there were other H. pylori tests within seven days of the biopsy. These additional tests include CLO test, SA, and H. pylori culture. Concordance between histopathology and other tests was determined based on the consistency of results. In instances where histology results were negative while other tests were positive, the slides were retrieved for re-assessment, and the clinical chart was reviewed. Of 1396 pathology reports were identified, each accompanied by one additional H. pylori test. The concordance rates in detecting H. pylori infection between biopsy and other tests did not exhibit significant differences based on the number of biopsy fragments. 117 discrepant cases were identified. Only 20 cases (9 with CLO test and 11 with SA) had negative biopsy but positive results in other tests. Four cases initially stained with Warthin-Starry turned out to be positive for H. pylori with subsequent IHC staining. Among the remaining 16 true discrepant cases, 10 patients were on proton pump inhibitors before the biopsy and/or other tests. Most patients underwent treatment, except for two who were untreated, and two patients who were lost to follow-up. There are rare discrepant cases with negative biopsy but positive in SA or CLO test. Various factors may contribute to this inconsistency. Most patients in such cases had undergone treatment.

Enhanced multimodal biometric recognition systems based on deep learning and traditional methods in smart environments.

In the field of data security, biometric security is a significant emerging concern. The multimodal biometrics system with enhanced accuracy and detection rate for smart environments is still a significant challenge. The fusion of an electrocardiogram (ECG) signal with a fingerprint is an effective multimodal recognition system. In this work, unimodal and multimodal biometric systems using Convolutional Neural Network (CNN) are conducted and compared with traditional methods using different levels of fusion of fingerprint and ECG signal. This study is concerned with the evaluation of the effectiveness of proposed parallel and sequential multimodal biometric systems with various feature extraction and classification methods. Additionally, the performance of unimodal biometrics of ECG and fingerprint utilizing deep learning and traditional classification technique is examined. The suggested biometric systems were evaluated utilizing ECG (MIT-BIH) and fingerprint (FVC2004) databases. Additional tests are conducted to examine the suggested models with:1) virtual dataset without augmentation (ODB) and 2) virtual dataset with augmentation (VDB). The findings show that the optimum performance of the parallel multimodal achieved 0.96 Area Under the ROC Curve (AUC) and sequential multimodal achieved 0.99 AUC, in comparison to unimodal biometrics which achieved 0.87 and 0.99 AUCs, for the fingerprint and ECG biometrics, respectively. The overall performance of the proposed multimodal biometrics outperformed unimodal biometrics using CNN. Moreover, the performance of the suggested CNN model for ECG signal and sequential multimodal system based on neural network outperformed other systems. Lastly, the performance of the proposed systems is compared with previously existing works.

Cardiovascular reactivity to acute psychological stress is associated with generalized self-efficacy and self-efficacy outcomes during adventure challenges.

Outdoor adventure challenges are commonly used to enhance self-efficacy, but the physiological mechanisms involved remain unexplored. Additionally, while studies have documented the influence of self-efficacy on stress management, general self-efficacy has yet to be fully understood in the context of cardiovascular stress reactivity (CVR). This study investigated the influence of self-efficacy beliefs on CVR during acute psychological stress tasks. Additionally, it explored whether CVR serves as a novel mechanism underlying the outcomes of outdoor adventure challenges. As part of a wider randomized controlled trial, participants (n = 55) were invited to complete a laboratory session to assess CVR to an active (paced auditory serial addition test (PASAT)) and a passive (cold pressor test (CPT)) stress task. Randomized participants (n = 33) to the experimental condition also engaged in a high ropes challenge course after the laboratory session. It was found that greater self-reported self-efficacy was associated with larger CVR during the CPT and positively associated with perceived engagement and performance during the PASAT. Secondly, participants reporting positive change in self-efficacy post-intervention were associated with greater CVR and greater CVR was associated with higher ratings of intervention engagement and perceived challenge. This study provides preliminary evidence suggesting that greater efficacy beliefs may heighten CVR to passive acute psychological stressors. Habitual stress reactivity may represent a novel mechanism involved in outdoor and adventure-based interventions. Future research should continue to explore the impact of psychological variables on stress physiology and examine CVR as a potential mechanism in adventure experiences.

The effect of breadth of external pressure on leaders in small and medium-sized enterprises: does the firm become more entrepreneurial?

PurposeThe study explores the relationship between the breadth of external pressures facing leaders of small and medium-sized enterprises (SMEs) and the entrepreneurial stance they adopt for their firm, that is, entrepreneurial orientation (EO).Design/methodology/approachBlending attention theory with EO literature, we argue that increasing breadth of external pressures will challenge leaders' attentions with implications for how they seek innovation, risk-taking and bold acts. We highlight an inflection point after which a negative relationship between the breadth of external pressure and EO will turn positive. We use data from a survey of 125 small-sized wineries in France to test this and capture a range of 15 external pressures on entrepreneurs.FindingsThe main tests and additional robustness tests provide support. It is the breadth of external pressures – as opposed to intensity of any one specific form of pressure – that plays a fundamental role in shaping leaders' adoption of EO in small enterprises over and above internal characteristics.Research limitations/implicationsWhile the results may be context-dependent, they provide support for an attention-based view of entrepreneurial responses by leaders of SMEs under pressure.Practical implicationsSME leaders and entrepreneurs should be aware of how their attention is challenged by breadth of pressures from external sources, as this can influence the EO they adopt for their SME.Originality/valueThis nonlinear perspective on external pressures influencing the EO of small firms has not been taken in the EO literature to date, despite some recent work that considers only a small range of external pressures.

Genomic mining of Vibrio parahaemolyticus highlights prevalence of antimicrobial resistance genes and new genetic markers associated with AHPND and tdh + /trh + genotypes

BackgroundAcute Hepatopancreatic Necrosis Disease (AHPND) causes significant mortality in shrimp aquaculture. The infection is primarily instigated by Vibrio parahaemolyticus (Vp) strains carrying a plasmid encoding the binary toxin PirAB. Yet, comprehension of supplementary virulence factors associated with this relatively recent disease remains limited. Furthermore, the same holds for gastroenteritis in humans caused by other Vp genotypes. Additionally, given the prevalent use of antibiotics to combat bacterial infections, it becomes imperative to illuminate the presence of antimicrobial resistance genes within these bacteria.ResultsA subsampled number of 1,036 Vp genomes was screened for the presence of antimicrobial resistance genes, revealing an average prevalence of 5 ± 2 (SD) genes. Additional phenotypic antimicrobial susceptibility testing of three Vp strains (M0904, TW01, and PV1) sequenced in this study demonstrated resistance to ampicillin by all tested strains. Additionally, Vp M0904 showed multidrug resistance (against ampicillin, tetracycline, and trimethoprim-sulfamethoxazole). With a focus on AHPND, a screening of all Vibrio spp. for the presence of pirA and/or pirB indicates an estimated prevalence of 0.6%, including four V. campbellii, four V. owensii, and a Vibrio sp. next to Vp. Their pirAB-encoding plasmids exhibited a highly conserved backbone, with variations primarily in the region of the Tn3 family transposase. Furthermore, an assessment of the subsampled Vp genomes for the presence of known virulence factors showed a correlation between the presence of the Type 3 Secretion System 2 and tdh, while the presence of the Type 6 Secretion System 1 was clade dependent. Furthermore, a genome-wide association study (GWAS) unveiled (new) genes associated with pirA, pirB, tdh, and trh genotypes. Notable associations with the pirAB genotype included outer membrane proteins, immunoglobulin-like domain containing proteins, and toxin-antitoxin systems. For the tdh + /trh + genotypes (containing tdh, trh, or both genes), associations were found with T3SS2 genes, urease-related genes and nickel-transport system genes, and genes involved in a ‘minimal’ type I-F CRISPR mechanism.ConclusionsThis study highlights the prevalence of antimicrobial resistance and virulence genes in Vp, identifying novel genetic markers associated with AHPND and tdh + /trh + genotypes. These findings contribute valuable insights into the genomic basis of these genotypes, with implications for shrimp aquaculture and food safety.