bluuebunny/crossref_metadata_2025 huggingface dataset:
Examining the opportunities and challenges of the Kra Canal: a PESTELE/SWOT analysis
Authors: Tseng Po-Hsing , Pilcher Nick
Published: August 2021

Purpose

Much literature considers future impacts of the Kra Canal on shipping times and on individual countries. In this paper, the authors consider the maritime business potential of the Kra Canal for companies, ports and countries.

Design/methodology/approach

Based on a combination of a review of the extant literature, quantitative data from relevant calculations and qualitative data from semi-structured interviews with experts (n = 20) from four countries in the region, this paper contextualises the business potential of the Kra Canal through a PESTELE (political, economic, social, technological, environmental, legal and ethical) analysis before outlining a more targeted SWOT (strengths weaknesses, opportunities and threats) analysis to consider the potential for maritime business.

Findings

The PESTELE analysis reveals that there are a number of challenges related to the construction and possibility of the Kra Canal being built such as its impact on the political balance within the Association of South East Asian Nations (ASEAN) region. The SWOT analysis shows that the potential of the Kra Canal for maritime business is significant, and that the strengths and opportunities of increased route possibilities and reduced sailing times outweigh any weaknesses and threats.

Originality/value

Most studies into the Kra Canal focus on highly specific research targets or provide a particular perspective (e.g. historical). This paper, by drawing on two commonly used analytical frameworks, considers the canal for the first time from a wider context perspective as well as a specifically business one. Recommendations are made for policy makers and maritime businesses on the basis of the results.
Employer branding and psychological contract in family and non-family firmsEmployer branding e contrato psicológico em empresas familiares e não familiaresEmployer branding y contrato psicológico en empresas familiares y no familiares
Authors: Pimentel Duarte , Almeida Pedro , Marques-Quinteiro Pedro , Sousa Marta
Published: August 2021

Purpose

The purpose of this paper is to assess differences between employees of family and non-family firms regarding their perceptions of employer branding and psychological contract levels. Moreover, focusing on family firms, the authors assess the relation between the employees’ perceptions of employer branding and the psychological contract levels.

Design/methodology/approach

The empirical evidence is provided by a sample of 165 Portuguese employees, 76 employees of family firms and 89 non-family firms’ employees, who responded to a questionnaire that included employer branding and psychological contract measures. All respondents study in small and medium-sized private companies.

Findings

The results confirmed the research hypotheses, suggesting that employees of family companies show higher perceptions of employer branding and psychological contract levels than employees of non-family companies. Results also reveal that the perceptions of employer branding are positively related to the psychological contract levels of the family firm’s employees.

Originality/value

This paper aims to contribute to the literature by addressing two contemporary organizational aspects yet under-addressed in the comparison between family and non-family firms while pursuing to offer insights on the relationship between the perceptions of employer branding and levels of the psychological contract of employees working in family firms.
Is it attractive to invest in alternative energy? Evidence from a five-factor Fama-French model for regional DJSI and renewable stock indexes
Authors: Garcia-Amate Antonio , Ramírez-Orellana Alicia , Rojo Ramirez Alfonso A.
Published: August 2021

Purpose

This study aims to examine the attractiveness of the regional Dow Jones Sustainability Indexes (DJSI) and several renewable energy indexes during December 31, 2010 to December 31, 2019. This study uses a risk-return analysis and a set of explanatory factors. Lastly, this study conducts a comparative analysis of these indexes with conventional indexes.

Design/methodology/approach

This study uses data from Eikon, a Thomson Reuters database. To analyze the indexes’ behavior, this study uses the indexes’ annual return as of December 31 for each year. Next, this study estimates the Fama and French’s five-factor model using an ordinary least squares regression for regional DJSI and renewable energy indexes.

Findings

The results show that regional DJSIs delivered returns both above and below conventional indexes. In contrast, renewable energy indexes had high betas and negative returns, making them unattractive to investors.

Practical implications

The results imply the need for public financing programs that support the transition to a sustainable economy and reduce risk and increase the return on private investment.

Social implications

This study provides insights for policymakers regarding the importance of sustainability indexes in the transition to a green economy.

Originality/value

This study contributes to the growing literature on Fama and French’s five-factor model of sustainability indexes, especially in the current context characterized by intense green political changes. In particular, this study complements the few studies that have addressed the economic implications of renewable energy indexes in markets.
Emotional intelligence, voice and flow: a team-level study of work teams
Authors: Xie Lei , Chang Chi-Ning , Singh Shailen
Published: August 2021

Purpose

This paper aims to investigate how emotional intelligence and voice climate interact with flow in work teams.

Design/methodology/approach

The authors used multilevel structural equation modeling to analyze the nested data (individuals within teams). A total of 42 work teams (166 full-time employees) from the service industry participated in this research.

Findings

The results showed that emotional intelligence and voice behavior are positively associated with flow experience at the individual level. It was also demonstrated that emotional intelligence exerts partial influence on flow via individual voice behavior. At the team level, the authors only found a positive relationship between emotional intelligence and flow.

Originality/value

This research fills the knowledge gap of flow’s antecedents in teams. Members who are emotional intelligent and active in making suggestions to teams are more likely to experience flow in teams. Practitioners should be able to facilitate flow in the workplace through implementing training modules related to emotion appraisal/regulation and effective voice behavior.
Older people as represented in English quality newspapers
Authors: Rovelli Giulia
Published: August 2021

Purpose

This paper aims at tracing how older people and old age have been portrayed in English quality newspapers from 1989 to 2018 by comparing newspaper articles and readers’ letters to the editor.

Design/methodology/approach

This study follows the methodology of corpus-assisted discourse analysis and examines a corpus of readers’ letters to the editor and newspaper articles published in The Guardian and The New York Times, paying particular attention to the use and evolution of terminology and related stereotypes.

Findings

The investigation revealed how the portrayal of old age in newspaper articles and readers’ letters to the editor has mostly evolved symmetrically, with negatively connoted terms, including “elderly,” “old” and “aged,” which are generally perceived as unrepresentative of the new generation of older people, being replaced by more neutral or euphemistic expressions such as “older” and “senior.”

Originality/value

The analysis provides an interesting insight into how both the language and the discourse surrounding old age has evolved in the past few decades to accommodate to a changing society, taking into consideration how different professional and social groups, including older people themselves, represent and portray such an important life stage.
Melatonin and its derivative disrupt cancer stem‐like phenotypes of lung cancer cells via AKT downregulation
Authors: Phiboonchaiyanan Preeyaporn Plaimee , Puthongking Ploenthip , Chawjarean Verisa , Harikarnpakdee Saraporn , Sukprasansap Monruedee , Chanvorachote Pithi , Priprem Aroonsri , Govitrapong Piyarat
Published: August 2021

Cancer stem cells (CSCs), a small subpopulation of tumour cells, have properties of self‐renewal and multipotency, which drive cancer progression and resistance to current treatments. Compounds potentially targeting CSCs have been recently developed. This study shows how melatonin, an endogenous hormone synthesised by the pineal gland, and its derivative suppress CSC‐like phenotypes of human non‐small cell lung cancer (NSCLC) cell lines, H460, H23, and A549. The effects of MLT and its derivative, acetyl melatonin (ACT), on CSC‐like phenotypes were investigated using assays for anchorage‐independent growth, three‐dimensional spheroid formation, scratch wound healing ability, and CSC marker and upstream protein signalling expression. Enriched CSC spheroids were used to confirm the effect of both compounds on lung cancer cells. MLT and ACT inhibited CSC‐like behaviours by suppression of colony and spheroid formation in NSCLC cell lines. Their effects on spheroid formation were confirmed in CSC‐enriched H460 cells. CSC markers, CD133 and ALDH1A1, were depleted by both compounds. The behaviour and factors associated to epithelial–mesenchymal transition, as indicated by cell migration and the protein vimentin, were also decreased by MLT and ACT. Mechanistically, MLT and ACT decreased the expression of stemness proteins Oct‐4, Nanog, and β‐catenin by reducing active AKT (phosphorylated AKT). Suppression of the AKT pathway was not mediated through melatonin receptors. This study demonstrates a novel role, and its underlying mechanism, for MLT and its derivative ACT in suppression of CSC‐like phenotypes in NSCLC cells, indicating that they are potential candidates for lung cancer treatment.
Is thyroid hormone supplementation avoidable for patients with low‐risk papillary thyroid cancer after thyroid lobectomy? A two‐center observational study
Authors: Xiao Liu , Wu Jie , Jiang Lisha , Xu Yangmengyuan , Liu Bin
Published: August 2021

Objective

Changing insights regarding the extent of surgery for low‐risk papillary thyroid cancer (PTC) stir up discussions on the benefits and harms of thyroid lobectomy versus total thyroidectomy. The chance of needing postoperative thyroid hormone supplementation after thyroid lobectomy is still unclear. The purpose of this retrospective two‐center study was to identify the incidence and risk factors of postoperative thyroid‐stimulating hormone (TSH) elevation (>2.0 μIU/ml) after thyroid lobectomy for low‐risk PTC.

Design and Methods

Medical records of 201 consecutive patients with low‐risk PTC from two tertiary centers who underwent thyroid lobectomy between 2015 and 2019 were retrospectively reviewed. Postoperative thyroid function tests were measured regularly and patients were prescribed levothyroxine if the TSH level was higher than 2.0 μIU/ml. Multivariable regression models were used to evaluate potential risk factors associated with postoperative TSH elevation after thyroid lobectomy.

Results

At 6 weeks postoperatively, 85% had TSH level of >2 μIU/ml; this increased to 88% by 3–6 months. Receiver operating characteristic analysis identified preoperative TSH cut‐off (>1.7 μIU/ml) to predict postoperative TSH elevation. Multivariate analysis revealed that only a high preoperative TSH level (>1.7 μIU/ml) was an independent risk factor for a postoperative TSH level of >2 μIU/ml (odds ratio = 7.71; p < .001).

Conclusion

Nearly 90% of the patients who underwent thyroid lobectomy for low‐risk PTC had a postoperative TSH level of >2 μIU/ml, necessitating thyroid hormone supplementation in accordance with current guidelines. This finding highlights that preoperative patient counseling should also focus on raising awareness about postoperative thyroid hormone supplementation for low‐risk PTC patients seeking thyroid lobectomy.
The association between the congenital heart diseases and congenital anomalies of the kidney and the urinary tract in nonsyndromic children
Authors: Alp Esma Keleş , Dönmez Muhammet İrfan , Alp Hayrullah , Elmacı Ahmet Midhat
Published: August 2021

Several congenital heart diseases (CHD) are present in children with congenital anomalies of the kidney and the urinary tract (CAKUT) in syndromic or nonsyndromic patterns. The purpose of this study was to identify nonsyndromic children with CAKUT who required echocardiographic evaluation and to find the prevalence of CHD in these patients. Retrospective chart review of nonsyndromic patients with CAKUT between 2012 and 2018 was conducted. Types of congenital anomalies of the kidney and urinary tract and echocardiogram reports of the patients, age, gender, prematurity, prenatal diagnosis of CAKUT, and family history were noted. Among 806 children with CAKUT, 135 patients underwent transthoracic echocardiographic evaluation and CHD was detected in 91 (11.2%). The most common type of CHD was secundum type atrial septal defect that was found in 73 (80.2%) patients. On the other hand, the most frequent types of congenital anomalies of the kidney and the urinary tract were isolated hydronephrosis and primary vesicoureteral reflux (61.4% and 12.8%, respectively). Our results showed that 75.8% of the patients with congenital heart diseases had isolated hydronephrosis. Finally, only 18 (2.2%) cases out of 806 patients that were evaluated via transthoracic echocardiography due to the clinical findings and family history had a CHD that required close (<6 months) follow‐up. Congenital heart diseases that required close follow‐up are rarely observed in nonsyndromic patients with CAKUT. Therefore, we suggest echocardiography should be performed in cases of clinical suspicion and family history rather than routinely in this patient group.
Retrobulbar lidocaine injection via the supraorbital fossa is safe in adult horses but produces regionally variable periocular anaesthesia
Authors: Yang Vanessa Y. , Eaton Joshua Seth , Harmelink Katherine , Hetzel Scott J. , Sanchez Adriana , Lund Jane R. , Smith Lesley J.
Published: August 2021

Background

Injection techniques for retrobulbar anaesthesia are published in horses, but neither safety nor anaesthetic efficacy and duration have been evaluated objectively in vivo.

Objective

To characterise the safety and efficacy of one published technique for retrobulbar anaesthesia.

Study design

Randomised, controlled descriptive experiment.

Methods

Unilateral retrobulbar injection with 10 mL lidocaine (2%) was performed in eight sedated adult mares. Contralateral eyes served as untreated controls. Neurophthalmic parameters, intraocular pressure (IOP), and corneal and periocular sensation were measured awake, post‐sedation and at periodic time points for 24 hours following injection. Adverse effects were documented.

Results

Injection of 10 mL lidocaine significantly increased IOP for up to 2 hours (P < .05) maximally at 30 min (mean [95% CI]: 6.0 [2.7, 9.2] mm Hg,P < .001). Six of the eight treated eyes developed mild to moderate reversible chemosis for 2 to 24 hours. One eye developed severe chemosis and superficial corneal ulceration at 24 and 48 hours following injection respectively. Corneal sensitivity significantly decreased for 6 hours (P < .05), maximally at 10 min (−44.4 [−34.6, −54.1] mm,P < .001). Periocular sensitivity (measured as increase in applied force) significantly decreased dorsally and medially for up to 2 hours (maximal at 2 hours (367.1 [238.5, 495.7] g,P < .001, and at 30 min: 345.8 [202.6, 488.9] g,P < .001) respectively). Ventral and lateral sensitivity were not effectively decreased beyond 30 min. Optic nerve function was not consistently reduced following injection.

Main limitations

Investigators were not masked to the treated eye.

Conclusions

Retrobulbar injection using 10 mL lidocaine is safe in normal eyes of adult horses, but carries risk in structurally compromised or glaucomatous eyes due to transient IOP increase. Reversible chemosis commonly develops 2‐4h following injection, and may be severe in some horses with risk for corneal ulceration. Corneal anaesthesia is rapid and prolonged, but all periocular regions are not consistently anaesthetised. Retrobulbar injection should be combined with other local anaesthetic injections for eyelid surgeries or enucleations.
Sparsity‐aware support vector data description reinforced by expectation maximization
Authors: Eghdami Mahdie , Sadoghi Yazdi Hadi , Salehi Neshat
Published: August 2021

Support vector data description (SVDD) characterizes a dataset by a spherically shaped boundary around it. Since the complexity of SVDD training is O(N3), its performance decreases for large‐scale datasets. In this paper, we propose an improved SVDD algorithm, called EM‐SVDD, which combines the expectation maximization (EM) algorithm and SVDD to reduce the complexity and accelerate the training phase, while the accuracy of the classifier remains unchanged. First, the dataset is clustered to obtain smaller subsets, and then the boundary of each subset is identified by SVDD. After that, to construct the dataset boundary and get the optimal weighted combination of SVDDs, the EM algorithm is utilized to estimate the parameters and weights of SVDDs. The time complexity of the proposed method is N/i times lower than SVDD, where i is the number of EM iterations. In addition to EM‐SVDD, Sparse EM‐SVDD is proposed to guarantee the sparsity of the iteratively estimated parameters. EM‐SVDD is well compared with several similar methods. Simulation results indicate higher speed and performance of the proposed method in the training and testing phases. Furthermore, the capability of the proposed method is tested on a large image dataset acquired from social networks and our method identifies in‐class and outlier images with 0.71 accuracy rate.
Development and validation of a constipation treatment toolkit for patients on hemodialysis
Authors: Ng Patrick , Lei Katelyn , Teng Lisa , Thomas Alison , Battistella Marisa
Published: August 2021

Introduction

The cause of constipation is multifactorial and common problem for patients on hemodialysis. A lack of strong evidence on suitable treatment strategies means there is an unorganized approach to selecting therapies, which can exacerbate constipation or worsen symptoms. Clinicians and patients would benefit from a content and face validated treatment algorithm for treating constipation. In this study, our objective was to develop and content and face validate a constipation treatment toolkit for patients on hemodialysis, consisting of treatment algorithm, and patient information tools (pamphlet and video).

Methods

Literature searches were performed to develop an initial toolkit using Lynn's method for developing content‐valid clinical tools. Content and face validity were evaluated as per Lynn's method for determining content validity; the algorithm was evaluated by Canadian nephrology clinicians, while patient information tools were evaluated by clinicians and patients. Components were rated on a Likert scale for content relevance and on a 5‐point scale for face validity. After each round, the content validity index (CVI) score was calculated and revisions were made based on feedback.

Findings

A total of 23 clinicians and 15 patients were interviewed across three validation rounds. After three rounds, the treatment algorithm achieved content (overall CVI = 0.93) and face (91% agreement) validity. Our patient information tools achieved content and face validity (pamphlet overall CVI = 0.99, 85.5% agreement; video overall CVI = 0.99, 90.5% agreement).

Discussion

A treatment algorithm and patient information toolkit for the treatment of constipation in patients on hemodialysis were content and face validated via expert review. Further research will be needed to ascertain the effectiveness and implementation of this toolkit.
Hybridization between wild non‐congeneric parrots may be more common than previously thought
Authors: Hingston Andrew B.
Published: August 2021

Hybridization in the wild is a relatively common occurrence between species of parrots (Psittaciformes) within the same genus. However, a recent publication documented the successful production of hybrids following mating in the wild between parrot species from different genera, which was the only such case known to the authors. Here, I summarize other cases of apparent successful intergeneric hybridization in wild parrots that have been published in low‐impact regional journals. These cases of intergeneric hybridization in wild parrots have generally occurred when one or both parental species are uncommon, and thus have limited opportunities to mate with conspecifics.
Treatment use and satisfaction in Australian women with endometriosis: a mixed‐methods study
Authors: Evans Subhadra , Villegas Valeria , Dowding Charlotte , Druitt Marilla , O'Hara Rebecca , Mikocka‐Walus Antonina
Published: August 2021

Aims

To document the frequency of conventional and complementary treatments used by Australian women with endometriosis and the perceived efficacy of these treatments, and to qualitatively explore women's treatment satisfaction.

Background

We do not adequately understand whether Australian women with endometriosis are satisfied with their medical care.

Methods

Using a mixed‐methods design, 532 women with self‐reported endometriosis were recruited from the community. Participants were asked about their medication, complementary and self‐care treatment use, as well as perceived efficacy on a 0 (not effective) to 10 (extremely effective) numeric rating scale, and open‐ended qualitative survey items about treatment satisfaction.

Results

Ninety‐seven percent of women used medication for pain relief (mean perceived efficacy = 5.05) and 89% used complementary/self‐care strategies (mean perceived efficacy = 3.70), with medication rated as significantly more effective (P < 0.001). Content analysis of the qualitative data identified that 36% of women were dissatisfied with treatment, 34% were somewhat satisfied and 24% were satisfied. We identified qualitative themes relating to: (i) barriers to treatment, which included lack of access, stigma and disappointment with medical professionals who were perceived as uncaring, unhelpful and, in some cases, psychologically damaging; (ii) the need for holistic, interdisciplinary care; and (iii) patient knowledge, advocacy and resilience in endometriosis management.

Conclusions

Our findings reveal important limitations in the current Australian healthcare model, including the need for patient‐centred interdisciplinary care that treats the biopsychosocial needs of people with endometriosis, and widespread pain education, spanning medical training to community awareness.
Can multifaceted educational intervention improve clinical practice and patient outcomes regarding delirium in nursing homes?
Authors: Jeong Eunhye , Chang Sung Ok
Published: August 2021

Aim

We aimed to develop and evaluate a multifaceted and evidence‐based delirium educational program for practitioners in nursing home settings.

Methods

A pre‐ and posttest comparison group design was employed. The recruited practitioners included nurses and care workers from two nursing homes. The intervention group (n = 51) received the developed delirium educational program for 3 weeks, whereas the control group (n = 23) received a delirium handbook. We examined pre‐ and posttest differences in the scores for delirium knowledge and confidence in providing delirium care. We also examined the nurses' ability to clinically detect delirium in patients and delirium incidence for 8‐week periods both before and after the intervention.

Results

There were significant improvements in the participants' aptitudes (delirium knowledge and confidence in providing delirium care) and clinical practice (ability to clinically detect delirium in the patients) only in the intervention group; however, there were no significant differences in patient outcomes (incidence of delirium) between either group. Additionally, it was observed that the nurses' improved understanding of distinct clinical features of delirium, such as acute change or fluctuation, was the key factor that directly affected the success of delirium screening.

Conclusions

This study revealed that implementation of a multifaceted and evidence‐based delirium educational program for practitioners in nursing home settings was effective in promoting the knowledge, confidence, and ability to detect delirium. The developed program can also be implemented in settings where most patients are older individuals, such as geriatric care units, or long‐term care hospitals.
Pregnancy after percutaneous ethanol sclerotherapy for uterine arteriovenous fistula: Case report
Authors: Xu Lei , Wang Yu , Yuan Hai , Zhang Shiyi , Wu Xuejun , Huo Ran
Published: August 2021

Uterine arteriovenous fistula is a rare but life‐threatening gynecologic entity. Meanwhile, long‐term radiation exposure will do serious harm to doctors' health. So we improve the operation method to reduce the radiation exposure time. The patient, a 24‐years‐old woman with a history of dilation and curettage, had long‐term menorrhagia and anemia. Uterine arteriovenous fistula was confirmed by ultrasonography and computed tomography angiograph. Percutaneous anhydrous ethanol sclerotherapy was performed under the guidance of the X‐ray imaging. The patient was followed up for 2 years without recurrence and had normal menstruation. Recently, she is successfully pregnant again. Percutaneous anhydrous ethanol sclerotherapy is a new option treating uterine arteriovenous fistula, which can greatly shorten the irradiation time and reduce the recurrence rate and has no obvious adverse effect on fertility.
Cyclooxygenase‐2 protein expression modulates cell proliferation and apoptosis in solid ameloblastoma and odontogenic keratocyst. An immunohistochemical study
Authors: Escobar Enrico , Peñafiel Cristian , Gómez‐Valenzuela Fernán , Chimenos‐Küstner Eduardo , Pérez‐Tomás Ricardo
Published: August 2021

Background

Cyclooxygenase‐2 protein is a critically important mediator in inflammation that influences proliferation, apoptosis, angiogenesis and metastasis. Previous works showed a relationship between cyclooxygenase‐2 and tumourigenesis in humans and animal models. In epithelial odontogenic tumours and cysts, increased cell proliferation and survival have been linked to its pathogenesis and tumour development. The aim of the present study was to analyse the immunohistochemical expression of cyclooxygenase‐2 in solid ameloblastoma and odontogenic keratocyst and its association with proteins related to cell proliferation and apoptosis.

Methods

This study was conducted on 40 cases from the Pathological Anatomy Service, University of Chile. The cases were diagnosed as solid ameloblastoma (n = 21) and odontogenic keratocyst (n = 19) according to WHO 2017. Slides prepared from paraffin‐embedded sections were immunohistochemically stained for cyclooxygenase‐2, cyclin D1, Ki‐67, p63 and Bcl‐2. Statistical evaluation was performed by the Shapiro–Wilk test, ANOVA Mann–Whitney test and Spearman's correlation coefficient (p < 0.05).

Results

There were significant differences in the immunoexpression of cyclin D1, Ki‐67 and Bcl‐2 between solid ameloblastoma and odontogenic keratocyst. Likewise, there was a significant difference in the immunoexpression of p63 between follicular and plexiform histological types/subtypes of solid ameloblastoma. Lastly, there were statistical associations between cyclooxygenase‐2 and Ki‐67 for solid ameloblastoma and between cyclooxygenase‐2 and p63 for odontogenic keratocyst.

Conclusion

A high level of cyclooxygenase‐2 is related to increased cell survival and proliferative activity in solid ameloblastoma and odontogenic keratocyst. This event might contribute to tumoural progression and local invasiveness in these lesions.
School Administrators' Experiences in a 6‐Month Health and Wellness Community of Practice
Authors: Townsley Matt , Waldron Jennifer , Alborn‐Yilek Susan , Schares Denise , Huckstadt Kim , McNamara Scott , Gute Deeanne
Published: August 2021

BACKGROUND

A statewide 6‐month school administrator health and wellness program encouraged participants to use a fitness tracker to self‐monitor their physical activity and sleep patterns. The purpose of this study was to examine participants' experience in a school administrator health and wellness program and their perceptions of the impact on health‐related behaviors, including activity/movement, nutrition, and sleep.

METHODS

Each of the 45 participants completed a semi‐structured interview at three points in the program. Questions were designed to discern school administrators' perceptions of their ideal health and wellness balance at home and work.

RESULTS

School administrators reported new insights into their own well‐being, benefits of social supports in their personal wellness journey, an expanded understanding of their ideal health and wellness balance at home and work, and a stronger sense of serving as a role model who needs to take care of him/herself.

CONCLUSIONS

Although the program was helpful in establishing an ideal health and wellness balance at home and work for some school administrators, future programs should better emphasize nutrition and scaffold opportunities to maintain new habits following program completion.
Optimizing the Agrobacterium tumefaciens-mediated transformation conditions in Colletotrichum lindemuthianum: a step forward to unravel the functions of pathogenicity arsenals
Authors: Nabi A. , Banoo A. , Rasool R.S. , Dar M.S. , Mubashir S.S , Masoodi K.Z. , Shah M.D. , Khan A.A. , Khan I. , Padder B.A.
Published: August 2021

Colletotrichum lindemuthianum is a hemibiotrophic fungal pathogen that causes bean anthracnose and it is rated among the top 10 important diseases infecting beans. Currently our knowledge on molecular mechanisms underlying C. lindemuthianum pathogenesis is limited. About five pathogenicity genes have been identified in C. lindemuthianum using Restricted Enzyme Mediated Integration and the transformation using Agroinfection has not been optimized. In this study, a series of experiments were conducted to optimize the key parameters affecting the Agrobacterium tumefaciens-mediated transformation for C. lindemuthianum. The transformation efficiency increased with increase in spore concentration and co-cultivation time. However, the optimum conditions that yielded significant number of transformants were 106 ml−1 spore concentration, co-cultivation time of 72 h, incubation at 25°C and using a cellulose membrane filter for the co-cultivation. The optimized protocol resulted in establishment of large mutant library (2400). A few mutants were melanin deficient and a few were unable to produce conidia. To determine the altered pathogenicity, two new approaches such as detached leaf and twig techniques proved reliable and require fewer resources to screen the large mutant libraries in a short time. Among the 1200 transformants tested for virulence, 90% transformants were pathogenically similar to wild type (race 2047), 96 and 24 were reduced and impaired, respectively. The altered avirulent transformants can prove vital for understanding the missing link between growth and developmental stages of pathogen with virulence. This platform will help to develop strategies to determine the potential pathogenicity genes and to decipher molecular mechanisms of host–pathogen interactions in more detail.
United European Gastroenterology (UEG) and European Society for Neurogastroenterology and Motility (ESNM) consensus on gastroparesis
Authors: Schol Jolien , Wauters Lucas , Dickman Ram , Drug Vasile , Mulak Agata , Serra Jordi , Enck Paul , Tack Jan ,   the ESNM Gastroparesis Consensus Group
Published: August 2021

Background

Gastroparesis is a condition characterized by epigastric symptoms and delayed gastric emptying (GE) rate in the absence of any mechanical obstruction. The condition is challenging in clinical practice by the lack of guidance concerning diagnosis and management of gastroparesis.

Methods

A Delphi consensus was undertaken by 40 experts from 19 European countries who conducted a literature summary and voting process on 89 statements. Quality of evidence was evaluated using grading of recommendations assessment, development, and evaluation criteria. Consensus (defined as ≥80% agreement) was reached for 25 statements.

Results

The European consensus defined gastroparesis as the presence of symptoms associated with delayed GE in the absence of mechanical obstruction. Nausea and vomiting were identified as cardinal symptoms, with often coexisting postprandial distress syndrome symptoms of dyspepsia. The true epidemiology of gastroparesis is not known in detail, but diabetes, gastric surgery, certain neurological and connective tissue diseases, and the use of certain drugs recognized as risk factors. While the panel agreed that severely impaired gastric motor function is present in these patients, there was no consensus on underlying pathophysiology. The panel agreed that an upper endoscopy and a GE test are required for diagnosis. Only dietary therapy, dopamine‐2 antagonists and 5‐HT4 receptor agonists were considered appropriate therapies, in addition to nutritional support in case of severe weight loss. No consensus was reached on the use of proton pump inhibitors, other classes of antiemetics or prokinetics, neuromodulators, complimentary, psychological, or more invasive therapies. Finally, there was consensus that gastroparesis adversely impacts on quality of life and healthcare costs and that the long‐term prognosis of gastroparesis depends on the cause.

Conclusions and Inferences

A multinational group of European experts summarized the current state of consensus on definition, symptom characteristics, pathophysiology, diagnosis, and management of gastroparesis.
Impact of microbial contamination of haematopoietic stem cells on post‐transplant outcomes: A retrospective study from tertiary care centre in India
Authors: Garg Vikas , Kodan Parul , Pushpam Deepam , Bakhshi Sameer , Kumar Lalit , Sharma Atul , Gupta Gopila , Gupta Nitin
Published: August 2021

Background

Haematopoietic stem cells (HSC) may act as a source of infection for the recipient due to manipulation at multiple levels from collection to infusion. Due to the high risk of contamination cultures are usually taken during multiple steps. The clinical significance of microbial contamination of HSC on the post‐transplant course and the role of prophylactic antibiotics is relatively unknown.

Aims and methods

The aim of our study is to investigate the incidence of microbial contamination of haematopoietic stem cell and to assess its impact on the post‐transplant febrile neutropenia, engraftment kinetics, hospitalisation and day 100 mortality. Details of all patients admitted in the bone marrow transplantation unit of a tertiary care centre in India between January 2014 and December 2018 were collected from case records.

Results

Of the 1306 stem cell harvests from 503 patients sent for culture, 17 harvests (1.3%) were found to have a culture positive report. Sixteen patients had undergone autologous transplant. Multiple myeloma was most common indication of HSC transplant followed by Non‐Hodgkin Lymphoma (NHL). Twelve of 17 HSC cultures were positive at the time of infusion and five were positive at the time of harvest. The five HSC that were culture positive at the time of harvest were culture negative at the time of infusion. Gram‐positive organisms were isolated in six cultures and gram‐negative in rest. All patients developed febrile neutropenia post‐transplantation between day 1 and day 7. The median time of onset of fever was day +5 (1–7), the median duration of fever was 4 days (2–7), the median duration of antibiotic use was 11 days (9–16). Median day for neutrophil engraftment was 11 days (9–16), the median day for platelet engraftment was 14 days (10–25) and median duration of hospitalisation was 15 days (12–78). All patients were alive at day 100 of transplant.

Conclusion

This study shows that there appears to be minimal impact of culture positive HSC on transplant related outcomes in terms of engraftment kinetics, duration of hospitalisation and day 100 mortality. Discarding of contaminated HSC may not be required, though on development of febrile neutropenia appropriate antibiotics should be administered based on sensitivity pattern of HSC culture. Larger prospective studies are needed to determine the clinical relevance of such contaminations. Emphasis should be laid on better infection control practices to minimise contamination rates.
A geologia e os problemas ambientais
Authors: Penha Hélio Monteiro
Published: August 2021

The present paper deals with environmental problems - from a geological point of view - which have been worsened considerably in recent times, due mainly to the exploitation of our natural resources. The classic concepts concerning the environmental problems are reviewed here. It must be emphasized that we must profit from the present experience in order to forecast the problems we can expect to have in the near future. Finally, this contribution enhances the role of the geological sciences in matters concerning the exploitation and the conservation of natural resources.
Experiments on the effect of tropical Atlantic heating anomalies upon GCM rain forecasts over the Americas
Authors: Buchmann Julio , Buja Lawrence E. , Paegle Jan , Dickinson Robert E.
Published: August 2021

A series of real data experiments is performed with a general circulation model in order to ascertain the sensitivity of extended range rain forecasts over the Americas to the structure and magnitude of tropical heating anomalies. The emphasis is upon heat inputs over the tropical Atlantic which have shown particularly significant drying influences over North America in our prior simulations. The heating imposed in the prior experiments is compared to the condensation heating rates that naturally occur in the forecast model, and shown to be excessive by approximately a factor of two. Present experiments reduce the imposed anomaly by a factor of three, and also incorporate sea-surface temperature decreases over the eastern tropical Pacific Ocean. The new experimental results are in many ways consistent with our prior results. The dry North American response is statistically more significant than the South American response, and occurs at least as frequently in the different members of the experimental ensembles as in our prior experiments. The drying effect is accentuated by the presence of East Pacific cooling, but this does not appear to be the dominant influence. Over tropical South America, the Pacific and Atlantic modifications produce compensating influences, with the former dominating dominant, and allowing increased rainfall over the Amazon Basin.
Contribuição ao debate metodológico da geografia agrária
Authors: Galvão Maria Do Carmo Corrêa
Published: August 2021

The methodological question in Agrarian Geography is part of the general theoretical and conceptual problematic in Geography as a whole but also involves parameters specific to agriculture as an extensive activity determined by farmer decision-making as a point-focussed process rather than a spatial process. An important theorical contribution to Agrarian Geography is a more complete view of countryside-city relationships which goes beyond a simplistic mercantil interpretation and examines the mutual and reciprocal perceptions of rural and urban communities of one another. By so examining the different images and values employed by country and city people in their different perceptions of the world one can better comprehend what agrarian means in Geography.
In Vitro
and
In Vivo
Activity of Oxazolidinone Candidate OTB-658 against Mycobacterium tuberculosis
Authors: Guo Shaochen , Wang Bin , Fu Lei , Chen Xi , Zhang Weiyan , Huang Haihong , Lu Yu
Published: August 2021

In this work, we assess antituberculosis activity of OTB-658
in vitro
and
in vivo
.
In vitro
, OTB-658 showed bacteriostatic effectiveness with a lower MIC than linezolid against
Mycobacterium tuberculosis
. The minimal bactericidal concentrations and time-kill curves for OTB-658 indicated inhibition activity similar to that of linezolid.
Combination Adjuvants Enhance Recombinant Protein Vaccine Protection against Fungal Infection
Authors: Wüthrich Marcel , Dobson Hannah E. , Ledesma Taira Cleison , Okaa Uju Joy , dos Santos Dias Lucas , Isidoro-Ayza Marcos , Petrovsky Nikolai , Klein Bruce S.
Published: August 2021

Fungal disease remains a challenging clinical and public health problem. Despite medical advances, invasive fungal infections have skyrocketed over the last decade and pose a mounting health threat in immunocompetent and -deficient hosts, with worldwide mortality rates ranking 7th, even ahead of tuberculosis.
Cerebral venous sinus thrombosis: a complication of nitrous oxide abuse
Authors: de Valck Laura , Defelippe Victoria Margarita , Bouwman Nathalia Anne Maria Geertruida
Published: August 2021

Nitrous oxide (NO) is an inhalant that has become increasingly popular as a recreational drug. While it is presumed to be harmless, a number of adverse effects of NO have been described. We discuss the case of a 24-year-old man with no medical history, who initially presented to the emergency department with progressive polyneuropathy caused by vitamin B12deficiency after NO abuse. Two days after being discharged with hydroxocobalamin supplementation, the patient returned with a severe headache, blurry vision and slurred speech. Imaging revealed cerebral venous sinus thrombosis. Hypercoagulability workup showed slightly elevated homocysteine and normalised vitamin B12after supplementation. Genetic testing showed a heterozygous prothrombin G20210A mutation. He was treated with low-molecular-weight heparin followed by dabigatran. We hypothesise that NO use may increase the risk of developing cerebral venous thrombosis, especially in patients with multiple risk factors and elevated homocysteine levels.
Anthropometric cut-offs to identify hyperglycemia in an Afro-Caribbean population: a cross-sectional population-based study from Barbados
Authors: Wade Alisha N , Hambleton Ian R , Hennis Anselm J M , Howitt Christina , Jeyaseelan Selvi M , Ojeh Nkemcho O , Rose Angela M C , Unwin Nigel
Published: August 2021

Introduction

Body mass index (BMI) and waist circumference (WC) cut-offs associated with hyperglycemia may differ by ethnicity. We investigated the optimal BMI and WC cut-offs for identifying hyperglycemia in the predominantly Afro-Caribbean population of Barbados.

Research design and methods

A cross-sectional study of 865 individuals aged ≥25 years without known diabetes or cardiovascular disease was conducted. Hyperglycemia was defined as fasting plasma glucose ≥5.6 mmol/L or hemoglobin A1c ≥5.7% (39 mmol/mol). The Youden index was used to identify the optimal cut-offs from the receiver operating characteristic (ROC) curves. Further ROC analysis and multivariable log binomial regression were used to compare standard and data-derived cut-offs.

Results

The prevalence of hyperglycemia was 58.9% (95% CI 54.7% to 63.0%). In women, optimal BMI and WC cut-offs (27 kg/m2 and 87 cm, respectively) performed similarly to standard cut-offs. In men, sensitivities of the optimal cut-offs of BMI ≥24 kg/m2 (72.0%) and WC ≥86 cm (74.0%) were higher than those for standard BMI and WC obesity cut-offs (30.0% and 25%–46%, respectively), although with lower specificity. Hyperglycemia was 70% higher in men above the data-derived WC cut-off (prevalence ratio 95% CI 1.2 to 2.3).

Conclusions

While BMI and WC cut-offs in Afro-Caribbean women approximate international standards, our findings, consistent with other studies, suggest lowering cut-offs in men may be warranted to improve detection of hyperglycemia. Our findings do, however, require replication in a new data set.
‘Never again will I be carefree’: a qualitative study of the impact of hypoglycemia on quality of life among adults with type 1 diabetes
Authors: Chatwin Hannah , Broadley Melanie , Valdersdorf Jensen Mette , Hendrieckx Christel , Carlton Jill , Heller Simon , Amiel Stephanie , de Galan Bastiaan , Hermanns Norbert , Finke-Groene Katharina , Speight Jane , Pouwer Frans
Published: August 2021

Introduction

Achieving glycemic targets and optimizing quality of life (QoL) are important goals of type 1 diabetes care. Hypoglycemia is a common barrier to achieving targets and can be associated with significant distress. However, the impact of hypoglycemia on QoL is not fully understood. The aim of this study was to explore how adults with type 1 diabetes are impacted by hypoglycemia in areas of life that are important to their overall QoL.

Research design and methods

Participants responded to a web-based qualitative survey involving a novel ‘Wheel of Life’ activity. Responses were analyzed using reflexive thematic analysis.

Results

The final sample included 219 adults with type 1 diabetes from Denmark, Germany, the Netherlands, and the UK. They had a mean±SD age of 39±13 years and diabetes duration of 20±14 years. Participants identified eight areas of life important to their overall QoL, including relationships and social life, work and studies, leisure and physical activity, everyday life, sleep, sex life, physical health, and mental health. Participants reported emotional, behavioral, cognitive, and social impacts of hypoglycemia within domains. Across domains, participants described interruptions, limited participation in activities, exhaustion, fear of hypoglycemia, compensatory strategies to prevent hypoglycemia, and reduced spontaneity.

Conclusions

The findings emphasize the profound impact of hypoglycemia on QoL and diabetes self-care behaviors. Diabetes services should be aware of and address the burden of hypoglycemia to provide person-centered care. Clinicians could ask individuals how hypoglycemia affects important areas of their lives to better understand the personal impact and develop tailored management plans.
Conducting clinical research in a resource-constrained setting: lessons from a longitudinal cohort study in The Gambia
Authors: Imam Abdulazeez , Wariri Oghenebrume , Dibbasey Tida , Camara Abdoulie , Mendy Anthony , Sanyang Assan N , Ceesay Masaneh , Jallow Samba , Jallow Abdoulie E , Bah Kaddijatou , Johnson Njilan , Trawally Ebrima , Sowe Dawda , Darboe Alansana , Kampmann Beate , Idoko Olubukola T
Published: August 2021

Clinical research conducted to Good Clinical Practice (GCP) standards is increasingly being undertaken in resource-constrained low-income and middle-income countries (LMICs) settings. This presents unique challenges that differ from those faced in high-income country (HIC) contexts, due to a dearth of infrastructure and unique socio-cultural contexts. Field experiences by research teams working in these LMIC contexts are thus critical to advancing knowledge on successful research conduct in these settings. The Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine has operated in The Gambia, a resource-constrained LMIC for over 70 years and has developed numerous research support platforms and systems. The unit was the lead clinical collaborator in a recently completed Expanded Program on Immunization Consortium (EPIC) study, involving a multicountry collaboration across five countries including the USA, Canada, Belgium, Papua New Guinea and The Gambia. The EPIC study recruited and completed follow-up of 720 newborn infants over 2 years. In this paper, we provide in-depth field experience covering challenges faced by the Gambian EPIC team in the conduct of this study. We also detail some reflections on these challenges. Our findings are relevant to the international research community as they highlight practical day-to-day challenges in conducting GCP standard clinical research in resource-constrained LMIC contexts. They also provide insights on how study processes can be adapted early during research planning to mitigate challenges.