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Decentralized autonomous organizations (DAOs)--collectively owned human-machine systems deployed on a blockchain that self-govern through smart contracts and the voluntary contributions of autonomous community members--exhibit the potential to facilitate collective action in managing digital commons. Yet the promise of decentralization and collective action is difficult to sustain. To this end, this paper critically examines the transformational potential of DAOs in the case of decentralized finance. Using a polycentric governance lens, we contribute to the literature on technology-enabled forms of organizing with a model explaining the transformational potential of DAOs to facilitate collective action in digital commons. Our study highlights that (1) DAOs are a new form of organizing enabled by blockchain technology in which individuals are free to pursue their objectives within a general system of rules enforced by smart contracts, (2) collective action for managing digital commons can be sustained through a set of three mechanisms--sustained participation, collective direction, and scaled organizing, and (3) DAOs tend to strike a balance between centralized and fully decentralized or community-based governance by implementing a polycentric governance system involving a combination of human and machine agency that creates skin in the game. [ABSTRACT FROM AUTHOR]

Research on platform owners' entry into complementary markets points in divergent directions. One strand of the literature reports a squeeze on post-entry complementor profits due to increased competition, while another observes positive effects as increased customer attention and innovation benefit the complementary market as a whole. In this research note, we seek to transcend these conflicting views by comparing the effects of the early and late timing of platform owners' entry. We apply a difference-in-differences design to explore the drivers and effects of the timing of platform owners' entry using data from three entries that Amazon made into its Alexa voice assistant's complementary markets. Our findings suggest that early entry is driven by the motivation to boost the overall value creation of the complementary market, whereas late entry is driven by the motivation to capture value already created in a key complementary market. Importantly, our findings suggest that early entry, in contrast to late entry, creates substantial consumer attention that benefits complementors offering specialized functionality. In addition, the findings also suggest that complementors with more experience are more likely to benefit from the increased consumer attention. We contribute to platform research by showing that the timing of the platform owner's entry matters in a way that can potentially reconcile conflicting findings regarding the consequences of platform owners' entry into complementary markets. [ABSTRACT FROM AUTHOR]

To investigate how the co-occurrence of diabetes, hypertension and overweight/obesity is associated with pain following an exercise intervention for knee and hip osteoarthritis (OA). Register-based cohort study. We included people from the Swedish Osteoarthritis Register who underwent education and exercise for knee or hip OA. Diabetes and hypertension were defined using medical records and dispensation of medication. Body Mass Index (BMI) was used to identify people with overweight (≥25 to <30), and obesity (≥30). We used linear mixed-effect models with patients nested into clinics to estimate the associations between the exposures and pain (Numeric Rating Scale 0–10), adjusting for age, sex, education, and physical activity. We analysed 80,893 patients with knee or hip OA. The accumulation of metabolic conditions was associated with worse pain at baseline and follow-ups. When obesity, hypertension and diabetes coexisted, patients treated for knee OA reported more pain at baseline (adjusted mean pain difference 0.9 [95 %CI: 0.8; 1.0]), 3 months (1.0 [0.9; 1.1]) and 12 months (1.3 [1.1; 1.4]) compared to those without any of the conditions. Similar results were observed for patients treated for hip OA when obesity, hypertension and diabetes coexisted (baseline (0.7 [0.5; 0.8], 3 (0.8[0.6; 1.0]) and 12 months (1.1[0.8; 1.3]). When diabetes, hypertension and obesity coexist with OA, patients not only experience heightened baseline pain compared to metabolically healthy individuals, but the disparity increases after an education and exercise intervention suggesting that a one-size-fits-all approach may be inadequate in addressing the complex interplay between metabolic health and OA. [ABSTRACT FROM AUTHOR]

Background and Aims Register-based research suggests a shared pathophysiology between inflammatory bowel disease [IBD] and spondyloarthritis [SpA], but the role of familial [genetic and environmental] factors in this shared susceptibility is largely unknown. We aimed to compare the risk of SpA in first-degree relatives [FDRs] and spouses of IBD patients with FDRs and spouses of matched, population-based, reference individuals. Methods We identified 147 080 FDRs and 25 945 spouses of patients with incident IBD [ N  = 39 203] during 2006–2016, and 1 453 429 FDRs and 258 098 spouses of matched reference individuals [ N  = 390 490], by linking nationwide Swedish registers and gastrointestinal biopsy data. Study participants were followed 1987–2017. Cox regression was used to estimate hazard ratios [HRs] of SpA. Results During follow-up, 2430 FDRs of IBD patients [6.5/10 000 person-years] and 17 761 FDRs of reference individuals [4.8/10 000 person-years] were diagnosed with SpA, corresponding to an HR of 1.35 [95% CI:1.29, 1.41]. In subgroup analyses, the increased risk of SpA was most pronounced in FDRs of Crohn's disease patients [HR = 1.44; 95% CI:1.34,1.5 6] and of IBD patients aged <18 years at diagnosis [HR = 1.46; 95% CI: 1.27, 1.68]. IBD patients' spouses also had a higher SpA rate than reference individuals' spouses, but the difference was less pronounced [4.3 vs 3.5/10 000 person-years; HR = 1.22; 95% CI:1.09, 1.37]. No subgroup-specific risk pattern was identified among spouses. Conclusions The observed shared familial risks between IBD and SpA support shared genetic factors in their pathogenesis. However, spouses of IBD patients were also at increased risk for SpA, reflecting the influence of environmental exposures or similarities in health-seeking patterns. [ABSTRACT FROM AUTHOR]

Purpose: of review Accurate assessment of dietary intake, especially energy and protein intake, is crucial for optimizing nutritional care and outcomes in patients with cancer. Validation of dietary assessment methods is necessary to ensure accuracy, but the validity of these methods in patients with cancer, and especially in those with cancer cachexia, is uncertain. Validating nutritional intake is complex because of the variety of dietary methods, lack of a gold standard method, and diverse validation measures. Here, we review the literature on validations of dietary intake methods in patients with cancer, including those with cachexia, and highlight the gap between current validation efforts and the need for accurate dietary assessment methods in this population. Recent findings: We analyzed eight studies involving 1479 patients with cancer to evaluate the accuracy and reliability of 24-hour recalls, food records, and food frequency questionnaires in estimating energy and protein intake. We discuss validation methods, including comparison with biomarkers, indirect calorimetry, and relative validation of dietary intake methods. Summary: Few have validated dietary intake methods against objective markers in patients with cancer. While food records and 24-hour recalls show potential accuracy for energy and protein intake, this may be compromised in hypermetabolic patients. Additionally, under- and overreporting of intake may be less frequent, and the reliability of urinary nitrogen as a protein intake marker in patients with cachexia needs further investigation. Accurate dietary assessment is important for enhancing nutritional care outcomes in cachexia trials, requiring validation at multiple time points throughout the cancer trajectory. [ABSTRACT FROM AUTHOR]

In patients with low-gradient aortic stenosis (AS) and low transvalvular flow, dobutamine stress echocardiography (DSE) is recommended to determine AS severity, whereas the degree of aortic valve calcification (AVC) supposedly correlates with AS severity according to current European and American guidelines. The purpose of this study was to assess the relationship between AVC and AS severity as determined using echocardiography and DSE in patients with aortic valve area <1 cm2 and peak aortic valve velocity <4.0 m/s. All patients underwent DSE to determine AS severity and multislice computed tomography to quantify AVC. Receiver-operating characteristics curve analysis was used to assess the diagnostic value of AVC for AS severity grading as determined using echocardiography and DSE in men and women. A total of 214 patients were included. Median age was 78 years (25th-75th percentile: 71-84 years) and 25% were women. Left ventricular ejection fraction was reduced (<50%) in 197 (92.1%) patients. Severe AS was diagnosed in 106 patients (49.5%). Moderate AS was diagnosed in 108 patients (50.5%; in 77 based on resting transthoracic echocardiography, in 31 confirmed using DSE). AVC score was high (≥2,000 for men or ≥1,200 for women) in 47 (44.3%) patients with severe AS and in 47 (43.5%) patients with moderate AS. AVC sensitivity was 44.3%, specificity was 56.5%, and positive and negative predictive values for severe AS were 50.0% and 50.8%, respectively. Area under the receiver-operating characteristics curve was 0.508 for men and 0.524 for women. Multi-slice computed tomography–derived AVC scores showed poor discrimination between grades of AS severity using DSE and cannot replace DSE in the diagnostic work-up of low-gradient severe AS. [Display omitted] [ABSTRACT FROM AUTHOR]

Background We aimed to explore the epidemiology of inflammatory bowel diseases [IBD] in association with the COVID-19 pandemic in two countries with different lockdown policies. Methods We utilized nationwide IBD cohorts in Israel and Sweden to explore the incidence of IBD during the pandemic compared to 3 years prior [2017–2019]. We examined temporal trends through the presence of inflection points by Joinpoint regression analysis and reported average monthly percentage changes [AMPC]. Results A total of 155 837 patients with IBD were included [Israel, 58 640; Sweden, 97 197]. The annual incidence of IBD was stable until 2019 in both countries but then decreased in Israel (AAPC −16.6% [95% confidence interval, CI, −19.9% to −10.0%]) and remained stable in Sweden (AAPC −3.5% [95% CI −11.6% to 3.7%]). When exploring the monthly incidence during the pandemic, in Israel the rate remained stable until November 2020 (AMPC 2.3% [95% CI −13.4% to 29.9%]) and then decreased sharply (AMPC –6.4% [95% CI –20.8% to 17.0%] until February 2021 and to −20.1% [95% CI –38.9% to –4.7%] from February 2021), while in Sweden, which had a less stringent lockdown policy, it decreased slightly until July 2020 (AMPC −3.3% [95% CI −21.6% to 20.3%]), but increased thereafter (AMPC 13.6% [95% CI –12.6% to 27.0%]). The change of incidence rate in Sweden occurred mainly in elderly-onset patients, the only population with significant restrictions during the pandemic. Conclusion The incidence of IBD decreased during the pandemic in association with lockdowns, more so in Israel, which had more stringent policies. Future studies are needed to determine the long-term effect of the pandemic on IBD. [ABSTRACT FROM AUTHOR]

Inflammatory bowel disease (IBD) is frequently accompanied by kidney complications. Potential triggers or subpopulations at high-risk of kidney problems are not well-elucidated. We hypothesized that surgical interventions, specifically colectomy, might in part explain this risk. This study was a nationwide Swedish cohort study comprising 82,051 individuals with biopsy-proven IBD diagnosed during 1965 to 2017, with follow-up until 2019. We investigated the association between incident colectomy (time-varying exposure) and future risk of acute kidney injury (AKI) and kidney failure (diagnosis of end-stage kidney disease or death due to chronic kidney disease) using Cox proportional hazard models. We also examined the impact of partial vs total colectomy and the presence/duration of a stoma. Covariates included demographics, education level, and selected comorbidities. Over a median follow-up of 14 years, 16,479 individuals underwent colectomy, and 2556 AKI and 1146 kidney failure events occurred. Colectomy was associated with an increased relative risk of both AKI (adjusted hazard ratio, 2.37; 95% confidence interval, 2.17–2.58) and kidney failure (adjusted hazard ratio, 1.54; 95% confidence interval, 1.34–1.76). Compared with pre-colectomy periods, undergoing total colectomy and colectomy with prolonged stoma showed higher risks of both kidney outcomes versus partial colectomy or colectomy with a temporary stoma, respectively. Subgroup analyses suggested higher risks in patients with ulcerative colitis. In people with IBD, rates of AKI and kidney failure are higher among those undergoing colectomy, particularly among those following total colectomy, or colectomy with a prolonged stoma. This study identifies a high-risk population that may benefit from established protocols for kidney function monitoring/surveillance and referral to nephrologist care. [ABSTRACT FROM AUTHOR]

Food packaging must guarantee the products' quality during the different operations including packing and maintenance throughout transportation and storage until to consumption. Thus, it should satisfy, both, food freshness and quality preservation and consumers health safety. Natural bio-sourced polymers have been explored as safe edible materials for several packaging applications, being interestingly carrier of bioactive substances, once added to improve films' properties. Gelatin and chitosan are among the most studied biomaterials for the preparation of edible packaging films due to their excellent characteristics including biodegradability, compatibility and film-forming property. These polymers could be used alone or in combination with other polymers to produce composite films with the desired physicochemical and mechanical properties. When incorporated with bioactive substances (natural extracts, polyphenolic compounds, essential oils), chitosan/gelatin-based films acquired various biological properties, including antioxidant and antimicrobial activities. The emerging bioactive composite films with excellent physical attributes represent excellent packaging alternative to preserve different types of foodstuffs (fruits, meat, fish, dairy products, ...) and have shown great achievements. This chapter provides the main techniques used to prepare gelatin-and chitosan- based films, showing some examples of bioactive compounds incorporated into the films' matrix. Also, it illustrates the outstanding advantages given by these biomaterials for food preservation, when used as coating and wrapping agents. [ABSTRACT FROM AUTHOR]

Conventional techniques used in oral and maxillofacial reconstruction focus mainly on utilizing autologous tissues that have unquestionably improved function and esthetics for many patients, worldwide. However, the success depends on countless factors such as: donor and recipient sites conditions, patient's medical history, surgeon's experience, restricted availability of high-quality autogenous tissues or stem cells, and increased surgical cost and time. Lately, teaming researchers, scientists, surgeons, and engineers, to address these limitations, have allowed tremendous progress in recombinant protein therapy, cell-based therapy, and gene therapy. Over the past few years, biomedical engineering has been evolving from the laboratory to clinical applications, for replacement of damaged body tissues due to trauma, cancer, congenital or acquired disorders. This review provides an outlook on the content, benefits, recent advances, limitations, and future expectations of biomedical engineering for salivary glands, oral mucosa, dental structures, and maxillofacial reconstruction. [ABSTRACT FROM AUTHOR]

Background: The staging and management of patients with breast cancer are significantly influenced by the pathological state of the axillary lymph nodes (ALN). Thus, it is very desirable to have a differential diagnosis of metastatic ALN. Purpose: The aim of this research is to assess the effectiveness of non-invasive ALN staging using PEM versus traditional breast mammography and ultrasound in patients presenting with early-stage breast cancer. This study focuses on determining if PEM can reliably stage ALNs and potentially eliminate the need for more invasive methods. Methods: In a study involving 94 breast cancer patients, PEM was used to assess ALNs. The nodes were visually evaluated for positive or negative uptake, and further categorized as non-specific, indeterminate, or malignant based on their maximum uptake values. This classification was then compared with histopathological results. Results: There were a total of 94 breast cancer patients; the results from PEM demonstrated an ALN detection sensitivity of 83.3%. The specificity of PEM in this context was found to be 98.08%, and the overall accuracy rate was 91.49%. Additionally, the Positive Predictive Value (PPV) was calculated to be 97.2%, and the Negative Predictive Value (NPV) was 87.9%. Conclusions: The initial study has shown encouraging outcomes in terms of accurate lymph node assessment. [ABSTRACT FROM AUTHOR]

This modified Delphi study aimed to develop a consensus on optimal wound closure and incision management strategies for total hip arthroplasty (THA). Given the critical nature of wound care and incision management in influencing patient outcomes, this study sought to synthesize evidence-based best practices for wound care in THA procedures. An international panel of 20 orthopedic surgeons from Europe, Canada, and the United States evaluated a targeted literature review of 18 statements (14 specific to THA and 4 related to both THA and total knee arthroplasty). There were 3 rounds of anonymous voting per topic using a modified 5-point Likert scale with a predetermined consensus threshold of ≥ 75% agreement necessary for a statement to be accepted. After 3 rounds of voting, consensus was achieved for all 18 statements. Notable recommendations for THA wound management included (1) the use of barbed sutures over non-barbed sutures (shorter closing times and overall cost savings); (2) the use of subcuticular sutures over skin staples (lower risk of superficial infections and higher patient preferences, but longer closing times); (3) the use of mesh-adhesives over silver-impregnated dressings (lower rate of wound complications); (4) for at-risk patients, the use of negative pressure wound therapy over other dressings (lower wound complications and reoperations, as well as fewer dressing changes); and (5) the use of triclosan-coated sutures (lower risk of surgical site infection) over standard sutures. Through a structured modified Delphi approach, a panel of 20 orthopedic surgeons reached consensus on all 18 statements pertaining to wound closure and incision management in THA. This study provides a foundational framework for establishing evidence-based best practices, aiming to reduce variability in patient outcomes and to enhance the overall quality of care in THA procedures. [ABSTRACT FROM AUTHOR]

The reader will come to appreciate: • Many adults who were born extremely preterm in the 1980s and 1990s, and who did not develop bronchopulmonary dysplasia, have lung function in the low normal range. • Extremely preterm born infants with a history of bronchopulmonary dysplasia may be at increased risk of a chronic obstructive pulmonary disease in middle age and older years based on the trajectory of their lung function. • Despite improved neonatal care and the advent of surfactant therapy, the rate of bronchopulmonary dysplasia has not decreased. Extreme preterm (EP) birth, denoting delivery before the onset of the third trimester, interrupts intrauterine development and causes significant early-life pulmonary trauma, thereby posing a lifelong risk to respiratory health. We conducted a systematic review and meta -analysis to investigate adult lung function following EP birth (gestational age <28 weeks); comparing forced expiratory volume in first second (FEV 1), forced vital capacity (FVC), and FEV 1 /FVC to reference values. Subgroup differences were explored based on timing of birth relative to surfactant use (1991) and bronchopulmonary dysplasia (BPD) status. Systematic searches were performed in Medline, EMBASE, Web of Science and Cochrane Central. Quality assessments were carried out using a modified Newcastle-Ottawa Scale for cohort studies. Sixteen studies encompassing 1036 EP-born adults were included, with 14 studies (n = 787) reporting data as %predicted, and 11 (n = 879) as z-score (not mutually exclusive). Overall mean [95 % confidence interval (CI)] %FEV 1 was 85.30 (82.51; 88.09), %FVC was 94.33 (91.74; 96.91), and FEV 1 /FVC was 79.54 (77.71 to 81.38), all three with high heterogeneity. Overall mean (95 %CI) zFEV 1 was −1.05 (-1.21; −0.90) and zFVC was. −0.45 (-0.59; −0.31), both with moderate heterogeneity. Subgroup analyses revealed no difference in FEV 1 before versus after widespread use of surfactant, but more impairments after neonatal BPD. This meta -analysis revealed significant airflow limitation in EP-born adults, mostly explained by those with neonatal BPD. FEV 1 was more reduced than FVC, and FEV 1 /FVC was at the lower limit of normal. Although at a group level, most adult EP-born individuals do not meet COPD criteria, these findings are concerning. [ABSTRACT FROM AUTHOR]

Objectives: Orthostatic hypotension& hypertension; are unrecognized in the clinical care for pre-diabetics. We aimed to investigate the relationship between postural blood pressure changes and pre-diabetes compared to euglycemia and diabetes mellitus and to study the predicted risk factors. Subjects& Methods: A cross- sectional analytic study including 100 adults in- patients with and without past history of diabetes mellitus was done in medical units. Information was taken regarding demographic, clinical data and comorbidities. Supine& upright blood pressure changes were assessed in relation to glycemic status. Results: Mean age of study sample was 42.47 years ± 14.579 and 62% were females. Of total, 30% were diabetics and 70% were non-diabetics (23% with euglycemia, 36% with prediabetes and 11% with new hyperglycaemia). From diabetics, 15% met the definition of orthostatic hypotension compared to 5% from prediabetics, while 6% of diabetics met the definition of orthostatic hypertension compared to 15% from pre-diabetics. In multivariable models, family history of diabetes was associated with diabetic orthostatic hypotension. Age, current smoking, chronic obstructive pulmonary disease was associated with orthostatic hypertension. Conclusions: In the current study; orthostatic hypotension was common in patients with diabetes while orthostatic hypertension was common and clinically unrecognized in patients with pre-diabetes. [ABSTRACT FROM AUTHOR]

• Positive results for plasma ELISA testing for IFN-I autoantibodies (aAbs) were observed in 20 % of ICU-admitted COVID-19 patients, with the percentage of positive cases increasing with age, and males being predominant. • Saliva samples validated plasma ELISA results, showcasing the potential of saliva-based testing for aAbs screening. Over half of the individuals testing positive for ELISA exhibited autoantibodies that neutralize type I interferons (naAbs). • The presence of both aAbs and naAbs was indeed associated with a higher need for mechanical ventilation and higher in-hospital mortality rates. Autoantibodies have been demonstrated to dampen the interferon (IFN) response in viral infections. Elevated levels of these preexisting autoantibodies (aAbs) decrease basal interferon levels, increasing susceptibility to severe infections. This study aimed to evaluate the prevalence of type I IFN aAbs in both plasma and saliva from COVID-19 patients, analyze their neutralizing activity, and examine their associations with clinical outcomes, including the need for mechanical ventilation and in-hospital mortality. Prospective analyses of patients admitted to intensive care units in three UAE hospitals from June 2020 to March 2021 were performed to measure aAbs using enzyme-linked immunosorbent assay (ELISA), assess aAbs activity via neutralization assays, and correlate aAbs with clinical outcomes. Type I IFN aAbs (α2 and/or ω) were measured in plasma samples from 213 ICU patients, and positive results were obtained for 20 % (n = 42) of the patients, with half exhibiting neutralizing activity. Saliva samples from a subgroup of 24 patients reflected plasma levels. In multivariate regression analyses, presence of type I IFN aAbs was associated with a higher need for mechanical ventilation (OR 2.58; 95 % CI 1.07–6.22) and greater in-hospital mortality (OR 2.40; 95 % CI 1.13 – 5.07; P = 0.022). Similarly, positive neutralizing aAbs (naAbs) were associated with a greater need for mechanical ventilation (OR 4.96; 95 % CI 1.12–22.07; P = 0.035) and greater odds of in-hospital mortality (OR 2.87; 95 % CI 1.05–7.89; P = 0.041). Type I IFN autoantibodies can be detected in noninvasive saliva samples, alongside conventional plasma samples, from COVID-19 patients and are associated with worse outcomes, such as greater mechanical ventilation needs and in-hospital mortality. [ABSTRACT FROM AUTHOR]