bluuebunny/crossref_metadata_2025 huggingface dataset:
Functional decline after major elective non‐cardiac surgery: a multicentre prospective cohort study
Authors: Ladha K. S. , Cuthbertson B. H. , Abbott T. E. F. , Pearse R. M. , Wijeysundera D. N.
Published: July 2021

Self‐reported postoperative functional recovery is an important patient‐centred outcome that is rarely measured or considered in research and decision‐making. We conducted a secondary analysis of the measurement of exercise tolerance before surgery (METS) study for associations of peri‐operative variables with functional decline after major non‐cardiac surgery. Patients who were at least 40 years old, had or were at risk of, coronary artery disease and who were scheduled for non‐cardiac surgery were recruited. Primary outcome was a reduction in mobility, self‐care or ability to conduct usual activities (EuroQol 5 dimension) from before surgery to 30 days and 1 year after surgery. A decline in at least one function was reported by 523/1309 (40%) participants at 30 days and 320/1309 (24%) participants at 1 year. Participants who reported higher pre‐operative Duke Activity Status indices more often reported functional decline 30 days after surgery and less often reported functional decline 1 year after surgery. The odds ratios (95%CI) of functional decline 30 days and 1 year after surgery with moderate or severe postoperative complications were 1.46 (1.02–2.09), p = 0.037 and 1.44 (0.98–2.13), p = 0.066. Discrimination of participants who reported functional decline 30 days and 1 year after surgery were poor (c‐statistic 0.61 and 0.63, respectively). In summary, one quarter of participants reported functional decline up to one postoperative year.
Continuous positive airway pressure treatment may negatively affect auditory maturation in preterm infants
Authors: Antinmaa Jaana , Salonen Jaakko , Jääskeläinen Satu K. , Kaljonen Anne , Lapinleimu Helena
Published: July 2021

Aim

Nasal continuous positive airway pressure (CPAP) devices generate loud noise, which might harm auditory function and maturation. The function of auditory pathways can be examined by using brainstem auditory evoked potential (BAEP) and brainstem audiometry (BA) recordings. Our objective was to study whether CPAP treatment during the neonatal period is associated with abnormalities in BAEP and BA recordings.

Methods

Included in this retrospective study were preterm infants (birth weight ≤1500 g and/or gestational age ≤32 weeks) born between 2002 and 2006 with a comprehensive clinical background and follow‐up data, including the duration of CPAP treatment (n = 162). BAEP and BA were recorded near the mean corrected age of one month. The following variables from BAEP and BA examinations were analysed: latencies of BAEP components I, III, V, interpeak intervals (IPI) I‐V, I‐III, III‐V (ms), amplitude I and V (µV), amplitude ratio I/V and BA thresholds.

Results

In the adjusted analysis, a longer CPAP treatment leads to longer latencies of BAEP component III (p = 0.01) and V (p = 0.02) in the right ear.

Conclusion

CPAP treatment may impair the auditory maturation and processing mediated via the dominant right ear. The hearing and neurodevelopment of the children who are treated with CPAP should be followed.
Sleep disturbances in the irritable bowel syndrome and functional dyspepsia are independent of psychological distress: a population‐based study of 1322 Australians
Authors: Koloski Natasha A. , Jones Michael , Walker Marjorie M. , Keely Simon , Holtmann Gerald , Talley Nicholas J.
Published: July 2021

Background

Psychological distress, strongly associated with functional gastrointestinal disorders (FGIDS), likely plays a central role in the pathophysiology. The role of sleep disturbances in FGIDs is unclear, and an association with psychological factors is uncertain.

Aim

To determine whether sleep disturbances are associated with irritable bowel syndrome (IBS) and functional dyspepsia (FD) and if a potential association is explained by psychological distress.

Methods

Adult sample randomly selected from a region in New South Wales, Australia in 2015 who returned a follow‐up mail survey in 2018 (response rate, 60.5%) that contained questions on IBS, FD, sleep (MOS‐Sleep Scale) and psychological distress (Kessler 6 scale).

Results

Among this population, 10.4% (95% CI 8.8‐12.2) and 17.9% (95% CI 15.9‐20.1) met Rome III criteria for IBS and FD, respectively. The prevalence of any sleep disturbance at least most of the time was common, with a significantly higher prevalence in FGID (IBS and/or FD) compared with the remaining population (41.8% vs 32.2%, P = 0.003). The total sleep problem index was significantly higher for IBS (OR = 1.71 [95% CI 1.29‐2.27], P < 0.0001) (IBS‐diarrhoea predominant and IBS‐mixed but not IBS‐constipation) and FD (OR = 1.80 [1.43‐2.26], P < 0.0001) (both epigastric pain syndrome and postprandial distress syndrome) even after adjusting for age, sex and psychological distress.

Conclusion

Both IBS and FD, and most of their major subtypes except IBS‐C, are associated with a range of sleep disturbances. These sleep problems do not appear to be explained by psychological factors and may play an independent role in the pathophysiology.
Laparoscopic and open surgery methods in managing surgical intussusceptions: A randomized clinical trial of postoperative complications
Authors: Jamshidi Masoud , Rahimi Bahman , Gilani Neda
Published: July 2021

Purpose

To compare postoperative complications of laparoscopic surgery (LS) with open surgery (OS) in surgical intussusception patients.

Methods

From March 2015 to February 2018, infants between 6 to 24 months old had the clinical and sono‐graphical signs of intussusception enrolled in this double‐blind, randomized clinical trial. We divided surgical intussusception patients into two groups. In the LS group, we evaluated patients by direct laparoscopic observation, on‐table hydrostatic enema, and mechanical reduction of intussusception. In the OS group, we performed the conventional technique. These patients were followed for 2 years after procedures for comparison of postoperative complications between the two groups.

Results

We had 52 patients who needed surgical exploration (26 in each group). There were four (15%) and seven (27%) patients with self‐reduced intussusception in LS and OS groups, respectively. The conversion rate was 31% (eight cases). Five cases (19%) in the LS group and four cases (15%) in the OS group needed bowel resections. Operating time was longer in the LS group (P ≤ 0.006), and the postoperative complication rate was higher in the OS group (P ≤ 0.021).

Discussion

Laparoscopy is a screening tool to determine the need for OS in surgical intussusception patients. Laparoscopy reduces the incidence of OS and its complications.
Functional redundancy of Amazonian dung beetles confers community‐level resistance to primary forest disturbance
Authors: Nunes Cássio Alencar , Barlow Jos , França Filipe , Berenguer Erika , Solar Ricardo R. C. , Louzada Julio , Leitão Rafael P. , Maia Laís F. , Oliveira Victor H. F. , Braga Rodrigo Fagundes , Vaz‐de‐Mello Fernando Z. , Sayer Emma J.
Published: July 2021

Tropical forest biodiversity is being threatened by human activities, and species losses during forest disturbance can compromise important ecosystem functions and services. We assessed how species losses due to tropical forest disturbance affect community functional structure, using Amazonian dung beetles as a model group. We collected empirical data from 106 forest transects and used simulated extinction scenarios to determine how species loss influences community structure at regional and local scales. Although functional and taxonomic community metrics were largely unaffected by primary forest disturbance, they differed markedly between primary and secondary forests. However, our extinction scenarios demonstrated scale‐dependence of species losses, whereby functional structure only eroded with species extinction at the local scale. Hence, we extend the spatial insurance hypothesis by demonstrating that landscape‐scale functional redundancy offsets the impact of local species losses and confers community‐level resistance to primary forest disturbance.

Abstract in portuguese is available with online material.
G protein‐coupled estrogen receptor in the rostral ventromedial medulla contributes to the chronification of postoperative pain
Authors: Xu Jia‐Jia , Gao Po , Wu Ying , Yin Su‐Qing , Zhu Ling , Xu Sai‐Hong , Tang Dan , Cheung Chi‐Wai , Jiao Ying‐Fu , Yu Wei‐Feng , Li Yuan‐Hai , Yang Li‐Qun
Published: July 2021

Aims

Chronification of postoperative pain is a common clinical phenomenon following surgical operation, and it perplexes a great number of patients. Estrogen and its membrane receptor (G protein‐coupled estrogen receptor, GPER) play a crucial role in pain regulation. Here, we explored the role of GPER in the rostral ventromedial medulla (RVM) during chronic postoperative pain and search for the possible mechanism.

Methods and Results

Postoperative pain was induced in mice or rats via a plantar incision surgery. Behavioral tests were conducted to detect both thermal and mechanical pain, showing a small part (16.2%) of mice developed into pain persisting state with consistent low pain threshold on 14 days after incision surgery compared with the pain recovery mice. Immunofluorescent staining assay revealed that the GPER‐positive neurons in the RVM were significantly activated in pain persisting rats. In addition, RT‐PCR and immunoblot analyses showed that the levels of GPER and phosphorylated μ‐type opioid receptor (p‐MOR) in the RVM of pain persisting mice were apparently increased on 14 days after incision surgery. Furthermore, chemogenetic activation of GPER‐positive neurons in the RVM of Gper‐Cre mice could reverse the pain threshold of pain recovery mice. Conversely, chemogenetic inhibition of GPER‐positive neurons in the RVM could prevent mice from being in the pain persistent state.

Conclusion

Our findings demonstrated that the GPER in the RVM was responsible for the chronification of postoperative pain and the downstream pathway might be involved in MOR phosphorylation.
Redefining and mapping global irreplaceability
Authors: Baisero Daniele , Schuster Richard , Plumptre Andrew J.
Published: July 2021

Irreplaceability is a concept used to describe how close a site is to being essential for achieving conservation targets. Current methods for measuring irreplaceability are based on representative combinations of sites, giving them an extrinsic nature and exponential computational requirements. Surrogate measures based on efficiency (complementarity) are often used as alternatives, but they were never intended for this purpose and do not measure irreplaceability. Current approaches used to estimate irreplaceability have key limitations. Some of these are a result of the tools used, but some are due to the nature of the current definition ofirreplaceability. For irreplaceability to be stable and useful for conservation purposes and to resolve limitations, irreplaceability measures should adhere to five axioms; baseline coherence, monotonic responsiveness, proportional responsiveness, intrinsic stability, and bounded outputs. We designed a robust method for measuring a site's proximity to irreplaceability that adheres to these requirements and used it to develop the first systematic global map of irreplaceability based on data for terrestrial vertebrates (n= 29,837 species, >1 million grid cells). At least 3.5% of land surface was highly irreplaceable, and 47.6% of highly irreplaceable cells were contained in 12 countries. More generous thresholds of irreplaceability flag greater portions of land surface that would still be realistic to protect under current global objectives. Irreplaceable sites should form a critical component of any global conservation plan and should be part of the UN Convention on Biological Diversity's post2020 Global Biodiversity Framework strategy, forming part of the 30% protection by 2030 target that is gaining support. The reliable identification of irreplaceable sites will be crucial to halting extinctions.
First identification of probable nursery habitat for critically endangered great hammerhead Sphyrna mokarran on the Atlantic Coast of the United States
Authors: Macdonald Catherine , Jerome Jacob , Pankow Christian , Perni Nicholas , Black Kristina , Shiffman David , Wester Julia
Published: July 2021

Great hammerheads (Sphyrna mokarran) have undergone significant global population declines and were assessed as Critically Endangered by the IUCN in 2019. Identification and protection of critical habitat, particularly during early life stages, is considered imperative for species conservation and management. We report the first identification of a probable nursery area for young‐of‐the‐year and juvenile great hammerheads off the Atlantic coast of the United States. Notably, these animals were all encountered within highly human‐impacted marine habitats near Miami, Florida. The capture of nine individuals under 200 cm total length in a 10‐month period supports the hypothesis that this area represents a primary or secondary nursery habitat for great hammerheads.
Discrepant subtyping of blood type A2 living kidney donors: Missed opportunities in kidney transplantation
Authors: Garg Neetika , Warnke Leza , Redfield Robert R. , Miller Karen M. , Cooper Matthew , Roll Garrett R. , Chipman Valerie , Thomas Alvin , Leeser David , Waterman Amy D. , Mandelbrot Didier A.
Published: July 2021

Background

Despite the institution of a new Kidney Allocation System in 2014, A2/A2B to B transplantation has not increased as expected. The current Organ Procurement and Transplantation Network policy requires subtyping on two separate occasions, and in the setting of discrepant results, defaulting to the A1 subtype. However, there is significant inherent variability in the serologic assays used for blood group subtyping and genotyping is rarely done.

Methods

The National Kidney Registry, a kidney paired donation (KPD) program, performs serological typing on all A/AB donors, and in cases of non‐A1/non‐A1B donors, confirmatory genotyping is performed.

Results

Between 2/18/2018 and 9/15/2020, 13.0% (145) of 1,111 type A donors registered with the NKR were ultimately subtyped as A2 via genotyping. Notably, 49.6% (72) of these were subtyped as A1 at their donor center, and in accordance with OPTN policy, ineligible for allocation as A2.

Conclusion

Inaccurate A2 subtyping represents a significant lost opportunity in transplantation, especially in KPD where A2 donors can not only facilitate living donor transplantation for O and highly sensitized candidates, but can also facilitate additional living donor transplants. This study highlights the need for improved accuracy of subtyping technique, and the need for policy changes encouraging optimal utilization of A2 donor kidneys.
Adjuvant anti‐PD‐1 antibody treatment in stage III/IV melanoma: real‐world experience and health economic considerations
Authors: Koelblinger Peter , Hoellwerth Magdalena , Dernoscheg Marie‐Therese , Koch Lukas , Richtig Erika , Wanner Marina , Nguyen Van‐Anh , Ostermann Herwig , Bauer Johann W. , Laimer Martin
Published: July 2021

Background

Anti‐programmed death 1 (PD‐1) antibodies have evolved as a new standard of care in the adjuvant treatment of completely resected melanoma. Real‐world data on treatment efficacy and safety as well as cost‐effectiveness are still limited.

Patients and Methods

Treatment outcomes were retrospectively analyzed in a continuous patient cohort receiving adjuvant nivolumab (91 patients) or pembrolizumab (9 patients). Based on the obtained clinical data, a semi‐Markov model was developed to evaluate cost‐effectiveness.

Results

After a median follow‐up of 11.5 months, disease recurrence was observed in 39 patients (39 %). The site of first recurrence was locoregional in 17, distant in 19, and combined locoregional and distant in three patients. Twelve‐month estimates for recurrence‐ and distant‐metastasis‐free survival were 64.8 % and 77.4 %, respectively. Sixteen patients experienced grade 3 or 4 treatment‐related adverse events, while 22 patients discontinued treatment due to adverse events. The base‐case Markov model yielded an incremental cost‐effectiveness ratio of 13,330 € per quality‐adjusted life year for adjuvant anti‐PD‐1 antibody treatment compared to a simulated observation cohort.

Conclusions

Real‐world outcomes of adjuvant anti‐PD‐1 antibody therapy in completely resected melanoma appear comparable to clinical trial data. Moreover, our data suggests this treatment strategy to be cost‐effective according to Austrian health economic standards.
Neuromuscular electrical stimulation for motor recovery in pediatric neurological conditions: a scoping review
Authors: Yan Derek , Vassar Rachel
Published: July 2021

Aim

To explore the breadth of pediatric neurological conditions for which neuromuscular electrical stimulation (NMES) has been studied.

Method

Databases (PubMed, Google Scholar, Scopus, and Embase) were searched from 2000 to 2020, using the search terms ‘neuromuscular electrical stimulation’ OR ‘functional electrical stimulation’ with at least one of the words ‘pediatric OR child OR children OR adolescent’, and without the words ‘dysphagia OR implanted OR enuresis OR constipation’. Articles focused on adults or individuals with cerebral palsy (CP) were excluded.

Results

Thirty‐five studies met the inclusion criteria, with a total of 353 pediatric participants (293 unique participants; mean age 7y 4mo, range 1wk–38y). NMES was applied in a range of pediatric conditions other than CP, including stroke, spinal cord injury, myelomeningocele, scoliosis, congenital clubfoot, obstetric brachial plexus injury, genetic neuromuscular diseases, and other neuromuscular conditions causing weakness.

Interpretation

All 35 studies concluded that NMES was well‐tolerated and most studies suggested that NMES could augment traditional therapy methods to improve strength. Outcome measurements were heterogeneous. Further research on NMES with larger, randomized studies will help clarify its potential to improve physiology and mobility in pediatric patients with neuromuscular conditions.

What this paper adds

Neuromuscular electrical stimulation (NMES) appears to be tolerated by pediatric patients.

NMES shows potential for augmenting recovery in pediatric patients with a range of rehabilitation needs.
Early interventions for children with an increased likelihood of autism: opportunities and challenges
Authors: Van Goidsenhoven Leni
Published: July 2021

This commentary is on the original article by Tran et al. on pages 1410–1416 of this issue.
Association between body weight variability and incidence of Parkinson disease: A nationwide, population‐based cohort study
Authors: Park Joo‐Hyun , Choi Yeonjoo , Kim Hyunjin , Nam Myung Ji , Lee Chung‐woo , Yoo Ji Won , Jung Jin‐Hyung , Park Yong‐Gyu , Han Kyungdo , Kim Do‐Hoon
Published: July 2021

Background and purpose

Although body weight variability has been associated with mortality, cardiovascular disease, and dementia, the relationship between body weight variability and Parkinson disease (PD) has rarely been studied. We aimed to investigate the longitudinal association between body weight variability and PD incidence.

Methods

A nationwide population‐based, cohort study was conducted using the database from the Health Insurance Review and Assessment Service of the whole Korean population. We analyzed 2,815,135 participants (≥40 years old, mean age = 51.7 ± 8.6 years, 66.8% men) without a previous PD diagnosis. We determined individual body weight variability from baseline weight and follow‐up visits. We used Cox proportional hazards regression models.

Results

The highest quartile group was associated with increased PD incidence compared with the lowest quartile group after adjustment for confounding factors (hazard ratio [HR] = 1.18, 95% confidence interval [CI] = 1.08–1.29). In contrast, baseline body mass index, baseline waist circumference, and waist circumference variability were not associated with increased PD incidence. In the body weight loss group, individuals within the quartile of the highest variation in body weight showed a higher HR of PD risk than those within other quartiles (HR = 1.41, 95% CI = 1.18–1.68).

Conclusions

Body weight variability, especially weight loss, was associated with higher PD incidence. This finding has important implications for clinicians and supports the need for preventative measures and surveillance for PD in individuals with fluctuating body weight.
The boundary node method for multi‐robot multi‐goal path planning problems
Authors: Saeed Raza Abdulla , Reforgiato Recupero Diego , Remagnino Paolo
Published: July 2021

In this paper, we investigate the multi‐goal path planning problem to find the shortest collision‐free path connecting a given set of goal points located in the robot working environment. This problem combines two sub‐problems: first, optimize the sequence of the goal points located in the free workspace; second, compute the shortest collision‐free path between goal points. In this study, a genetic algorithm is used to optimize the sequence of the goal points that the robot should visit. Once the sequence of the goal points is available, our developed method called Boundary Node Method (BNM) is applied to generate an initial collision‐free path between every pair of the sequenced goal points. Subsequently, an additional developed method called Path Enhancement Method (PEM) is used to find an optimal or near‐optimal path by reducing the overall initial path length. In the BNM, the robot and its immediate surroundings are simulated by a nine‐node quadrilateral element, where the centroid node represents the robot's position. The robot moves between goals with boundary nodes in the working environment depending on the boundary node's potential value. The potential value of each point in the working environment is calculated based on the proposed potential function. Additionally, this article investigates the multi‐goal path planning problem for multi‐robot systems, when each goal reached by several robots. Finally, simulations and experiments are performed on a real mobile robot to demonstrate the effectiveness of the developed methods.
Different functional traits among closely related algal symbionts dictate stress endurance for vital Indo‐Pacific reef‐building corals
Authors: Hoadley Kenneth D. , Pettay Daniel. T. , Lewis Allison , Wham Drew , Grasso Chris , Smith Robin , Kemp Dustin W. , LaJeunesse Todd , Warner Mark E.
Published: July 2021

Reef‐building corals in the genus Porites are one of the most important constituents of Indo‐Pacific reefs. Many species within this genus tolerate abnormally warm water and exhibit high specificity for particular kinds of endosymbiotic dinoflagellates that cope with thermal stress better than those living in other corals. Still, during extreme ocean heating, some Porites exhibit differences in their stress tolerance. While corals have different physiological qualities, it remains unknown whether the stability and performance of these mutualisms is influenced by the physiology and genetic relatedness of their symbionts. We investigated two ubiquitous Pacific reef corals, Porites rus and Porites cylindrica, from warmer inshore and cooler offshore reef systems in Palau. While these corals harbored a similar kind of symbiont in the genus Cladocopium (within the ITS2 C15 subclade), rapidly evolving genetic markers revealed evolutionarily diverged lineages corresponding to each Porites species living in each reef habitat. Furthermore, these closely related Cladocopium lineages were differentiated by their densities in host tissues, cell volume, chlorophyll concentration, gross photosynthesis, and photoprotective pathways. When assessed using several physiological proxies, these previously undifferentiated symbionts contrasted in their tolerance to thermal stress. Symbionts within P. cylindrica were relatively unaffected by exposure to 32℃ for 14 days, whereas P. rus colonies lost substantial numbers of photochemically compromised symbionts. Heating reduced the ability of the offshore symbiont associated with P. rus to translocate carbon to the coral. By contrast, high temperatures enhanced symbiont carbon assimilation and delivery to the coral skeleton of inshore P. cylindrica. This study indicates that large physiological differences exist even among closely related symbionts, with significant implications for thermal susceptibility among reef‐building Porites.
Interest group governance and policy agendas
Authors: Perera Isabel M.
Published: July 2021

This article proposes that the internal political organization of an interest group can shape its policy agenda. In doing so, it recommends that public policy research draw on scholarship on comparative political institutions to identify and theorize how alternative organizational rules, structures, and mechanisms can shape preference formation and expression. For example, confederal interest groups can amplify minority voices, whereas majoritarian groups can silence them. Contrasting cases of physician advocacy in mental health policy illustrate how the confederal approach to medical organization in France expanded the influence of a small group of public sector psychiatrists; while the majoritarian, “winner‐take‐all” approach to medical organization in the United States sidelined their American counterparts in favor of the private sector majority. These findings suggest that the politics of interest‐aggregation merit further investigation.
Combinations of antibiotics and vonoprazan for the treatment of Helicobacter pylori infections—Exploratory study
Authors: Gunaratne Anoja W , Hamblin Harrison , Clancy Annabel , Magat Aleja Jane Marie C , Dawson Marie Vic M , Tu Jeffrey , Borody Thomas J
Published: July 2021

Background

Vonoprazan fumarate is a novel potassium‐competitive acid blocker more effective in suppressing acid production than proton pump inhibitors (PPIs) and when combined with antibiotics has been used to eradicate Helicobacter pylori (H. pylori) infection. However, it has not yet been examined in an Australian setting. This study aimed to report on the efficacy and safety of vonoprazan‐containing antibiotic combination therapies in the eradication of H. pylori.

Methods

A single‐center, exploratory, clinical review of patients 18 years or over, positive for H. pylori on Urea Breath Test (UBT), and/or histopathology who underwent a 10‐day treatment of combination antibiotics plus vonoprazan between January 2017 and September 2019 was conducted. Eleven different combinations of antibiotics that included 2–5 different antibiotics predominantly amoxicillin, rifabutin, levofloxacin, furazolidone, nitazoxanide, and tetracycline were included. The eradication success was based on negative UBT results and/or histopathology results after the treatment. Descriptive statistics were summarized.

Results

One hundred and fifty‐three patients (Female n = 74, 48%) with a positive for H. pylori were treated with vonoprazan‐containing antibiotic combination therapy during the study period. Of the 153 patients, 48 (31%) had previously failed a PPI‐based H. pylori treatment. Follow‐up was available for 66/153 (43%) patients. In those who completed follow‐up, overall eradication was achieved in 97% (64/66) of patients. In the subgroup of patients treated for the first time, eradication was achieved in 100% (44/44). In those who had failed prior, non‐vonoprazan‐containing treatment, eradication was achieved in 91% (20/22) of patients.

Conclusions

Vonoprazan‐containing antibiotic therapy is an effective H. pylori eradication treatment. It is capable of achieving 100% efficacy in patients treated for the first time and even 91% efficacy in patients with previous eradication failure. Subsequent studies utilizing a factorial design will be needed to optimize each regimen as most regimens contained more than two antibiotics.
Patient participation during primary health‐care encounters among adult patients with multimorbidity: A cross‐sectional study
Authors: Paukkonen Leila , Oikarinen Anne , Kähkönen Outi , Kyngäs Helvi
Published: July 2021

Background

Patient participation is essential for achieving high‐quality care and positive outcomes, especially among patients with multimorbidity, which is a major challenge for health care due to high prevalence, care complexity and impact on patients' lives.

Objective

To explore the patient participation related to their own care among patients with multimorbidity in primary health‐care settings.

Methods

A cross‐sectional survey was conducted among adult multimorbid patients who visited primary health‐care facilities. The key instrument used was the Participation in Rehabilitation Questionnaire. Data representing 125 patients were analysed using various statistical methods.

Results

The respondents generally felt patient participation to be important, yet provided highly varying accounts regarding the extent to which it was realized by professionals. Information and knowledge and Respect and encouragement were considered the most important and best implemented subcategories of participation. Several patient‐related factors had a statistically significant effect on patient perceptions of participation for all subcategories and as explanatory factors for perceptions of total participation in univariate models. Most patients reported active participation in health‐care communication, positively associated with patient activation and adherence. Gender, perceived health, patient activation and active participation were explanatory factors for total importance of participation in multivariate models, while patient activation was retained for realization of participation.

Conclusions

Multimorbid patients require individualized care that promotes participation and active communication; this approach may further improve patient activation and adherence. Poor perceived health and functional ability seemed to be related to worse perceptions of participation.

Patient and public involvement

The study topic importance was based on the patients' experiences in author's previous research and the need to develop patient‐centred care.
Arc‐parallel extension in preparation of the rotation of southwest Japan: Tectonostratigraphy and structures of the Lower Miocene Ichishi Group
Authors: Kinoshita Hideki , Yamaji Atsushi
Published: July 2021

Opening of the Japan Sea back arc basin was accompanied by extensional tectonics in the drifting southwest Japan arc. Various trends of Early Miocene grabens in the arc suggest multi‐directional rifting, which necessarily involved strike‐slip components of some of basin‐margin faults. However, such components are not well understood. In this work we conducted a field survey in the Early Miocene Ichishi basin on the northern side of the Median Tectonic Line, central southwest Japan. We found that the basin was a compound of grabens that were formed along normal and sinistral strike‐slip faults, the latter of which had northeast–southwest trends. The block faulting in this phase produced basement highs between sub‐basins, which were filled with the lower part of the Ichishi Group. We found a low‐angle angular unconformity at a middle horizon in the group, with which we define the upper and lower part of the group. The upper part onlapped both the basement highs and the lower part. It means that the transtensional basin formation ceased sometime between 18 and 17.5 Ma in the Ichishi area. The Ichishi basin turned subsequently into a sag basin subsided due to normal faulting probably along the Nunobiki‐sanchi‐toen fault zone. The transtension and the basin sag were driven by ENE–WSW extensional stress. This arc‐parallel extension produced grabens various areas including Ichishi in the Early Miocene. The extensional deformation was eventually localized to the deep rift along the Fossa Magna to make the lithosphere under southwest Japan decoupled from that under northeast Japan. The decoupling allowed the rapid rotation of southwest Japan from ~17.5 Ma. The cluster of those grabens around the Ise bay probably determined the southeastern margin of the Kinki triangle.
THE IMPLICATIONS OF HOUSING FOR THE DESIGN OF WEALTH TAXES
Authors: Rotberg Shahar
Published: July 2021

How does housing—an important asset for many households—affect the design of optimal wealth taxes? I analyze the macroeconomic and distributional consequences of wealth taxation using a model with two forms of wealth: capital used by entrepreneurs to produce goods, and housing that provides shelter services. Without housing, taxing wealth instead of capital income would improve the capital allocation and raise welfare. With housing, taxing capital and housing equally would worsen the capital allocation and lower welfare. Instead, wealth should be taxed progressively, exempting most housing, resulting in a worse capital allocation but high welfare gains.
Green banana starch enhances physicochemical and sensory quality of baru almond‐based fermented product with probiotic bacteria
Authors: Coutinho Gabriela Silva Mendes , Ribeiro Alline Emannuele Chaves , Prado Priscylla Martins Carrijo , Oliveira Érica Resende , Careli‐Gondim Ítalo , Oliveira Aryane Ribeiro , Soares Júnior Manoel Soares , Caliari Márcio , Vilas Boas Eduardo Valério de Barros
Published: July 2021

This study aimed to isolate and characterise green banana starch (GBS) and to investigate the effect of adding 0%, 1.5%, 3.0%, 4.5% and 6.0% GBS on physicochemical and sensory properties of a fermented product based on baru almond (Dipteryx alata Vogel) water extract with probiotic bacteria. GBS showed high gelatinisation temperature (73.37 °C), enthalpy (16.61 J g−1) and final viscosity (239.6 RVU). On the contrary, it showed a low tendency to retrograde (67.53 RVU), water solubility (0.02%), water absorption (1.85 g g−1) and gel hardness (6.7 N). Higher addition levels of GBS increased firmness, reduced syneresis and positively affected pH, titratable acid, soluble solids and colour of baru almond‐based fermented products. The incorporation of 4.5% GBS was well accepted and preferred over the control sample (no GBS addition). GBS can be used as a natural thickener. The baru almond‐based fermented product with 4.5% GBS stands out for having potential probiotic properties and for being a promising dairy alternative.
Effect of salt ions on an ultrasonically modified soybean lipophilic protein nanoemulsion
Authors: Wang Diqiong , Qi Baokun , Xu Qingqing , Zhang Shuang , Xie Fengying , Li Yang
Published: July 2021

Soybean lipophilic proteins (LP) are promising emulsifiers for nanoemulsion delivery systems. We analysed the effect of common salt ions on the stability of nanoemulsion delivery systems that contained ultrasonically modified soybean LP. Moreover, explored the mechanism of influence. The LP nanoemulsions presented large absolute zeta (ζ) potentials at low salt ion concentrations, and their particle size distribution was relatively uniform. The emulsification, encapsulation efficiency and oxidation stability were superior to those of other nanoemulsions. The ultrasonically modified samples presented higher absolute ζ potentials and smaller droplet sizes than the pristine ones and formed uniform protein films at different salt ion concentrations. Therefore, ultrasonication improved the emulsification, encapsulation efficiency and oxidation stability of the emulsions, effectively improve the stability of nano‐delivery systems in different salt ion environments and maximise delivery efficiency at low salt ion concentrations. These results are helpful for the development of LP nanoemulsion systems that are stable at different salt ion concentrations.
Between liberal legislation and preventive political practice: Ecuador’s political reactions to Venezuelan forced migration
Authors: Malo Gabriela
Published: July 2021

The political handling of Venezuelan forced migration in Ecuador has evolved since 2017. This article distinguishes three stages in this evolution. First, from 2017 to mid‐2018, Ecuadorian authorities treated Venezuelan entries as those of other South American citizens. Second, from mid‐2018 to mid‐2019, the Venezuelan exodus was managed as a humanitarian crisis. In the third phase, since mid‐2019, authorities imposed restrictive measures, including a mandatory entry visa. The article further identifies the drivers that have motivated these changes in the reception of Venezuelan migrants, that is the political, social and economic factors that directly or indirectly effected migration management. These factors include both changing foreign policy interests and adjustments in domestic policy. The latter was influenced by strained state capacities and negative trends in public opinion against the backdrop of increasing numbers of Venezuelan migrants and highly mediatized crimes. The article also discusses related literature and provides policy recommendations.
The signaling role of trade credit in bank lending decisions: Evidence from small and medium‐sized enterprises
Authors: Del Gaudio Belinda L. , Sampagnaro Gabriele , Porzio Claudio , Verdoliva Vincenzo
Published: July 2021

Using confidential data at the bank–firm loan‐level, we provide direct evidence of the signaling role of trade credit in bank lending decisions. Especially for firms that are opaque in their relationship with banks, the findings reveal that trade credit ameliorates information asymmetries. We address the questions of whether and, if so, how the presence of trade credit affects banks’ decisions to grant commercial loans. We base the analysis on a sample of small and medium‐sized enterprises to examine suppliers’ informational advantage in screening activities in relation to relationship lending arguments. We provide evidence that supports the role of trade credit as a signaling instrument in lending decisions. More precisely, the analysis suggests that trade credit plays a signaling role, increasing the probability of obtaining a loan. Suppliers bearing credit risk lead banks to lend to firms. Thus, a bank receiving this signal is more likely to grant a loan even though abnormal payment delays are perceived as negative and function as friction during the lending process. This paper has two implications: Banks should use suppliers to signal a “good” type of borrower and for firms, sharing credit information could ameliorate the rationing problems arising in the context of credit asymmetries.
Home‐based primary care: A systematic review of the literature, 2010–2020
Authors: Zimbroff Robert M. , Ornstein Katherine A. , Sheehan Orla C.
Published: July 2021

Background

Although more than seven million older adults struggle or are unable to leave their homes independently, only a small minority access home‐based primary care (HBPC). Despite substantial growth of HBPC, fueled by growing evidence supporting positive patient outcomes and cost savings, the population remains dramatically underserved and many evidence gaps still exist around scope of practice and key issues in care delivery and quality. Understanding the current state of the field is critical to the delivery of high‐quality home‐based care.

Methods

We conducted a systematic search of the peer‐reviewed literature on HBPC, published between January 2010 and January 2020, using Medline, CINAHL, Embase, Web of Science, and Scopus online libraries. All studies were evaluated by two members of the research team, and key findings were extracted.

Results

The initial search yielded 1730 unique studies for screening. Of these initial results, 1322 were deemed not relevant to this review. Of the 408 studies deemed potentially relevant, 79 were included in the study. Researchers identified five overarching themes: the provision of HBPC, the composition of care teams, HBPC outcomes, the role of telehealth, and emergency preparedness efforts.

Conclusion

The need and desire for growth of HBPC has been highlighted by the recent COVID‐19 pandemic. Current research on HBPC finds a diverse scope of practice, successful use of interdisciplinary teams, positive outcomes, and increasing interest in telehealth with many areas ripe for further research.
Post‐injection syringe bacterial contamination of hyaluronic acid fillers
Authors: Dairi Motaz , Sawan Sami , Aref Alaa , Helmi Noof , Abdulmajed Hind , Aldigs Eman
Published: July 2021

Aims

Hyaluronic acid (HA) gel fillers are the most commonly used filler materials for dermal purposes to augment soft tissue due to their superior properties and advantages over other alternative filling materials. One of the key drawbacks associated with the use of fillers is contamination and possible subsequent infection.

Methods

A prospective cross‐sectional study conducted in Renew Cosmetic Clinics and King Abdulaziz University, Faculty of Medicine, female section from November 2019 to March 2020.

Results

A total of 50 samples with different concentrations (from five different brands) of hyaluronic acid gel fillers were collected. Samples were taken at four different time points: before injection, immediately after injection, 1 month after injection, and 3 months after injection. The 50 samples were injected into nine different sites and collected from 27 females, aged between 18–55 years. No bacteria were detected in the culture media from any samples from the aerobic and anaerobic culture plates.

Conclusion

Our study did not find any evidence of contamination associated with the reuse of HA gel fillers regardless of the concentration and the injection site. Applying appropriate sterilization procedure for HA gel fillers extends its usability. There was no correlation between the length of storage time and the risk of contamination.
Psychological distress among the family members of Intensive Care Unit (ICU) patients: A scoping review
Authors: Abdul Halain Azura , Tang Li Yoong , Chong Mei Chan , Ibrahim Noor Airini , Abdullah Khatijah Lim
Published: July 2021

Aims and objectives

To map research‐based psychological distress among the family members with patients in the intensive care unit (ICU).

Background

Having a loved one in the ICU is a stressful experience, which may cause psychological distress for family members. Depression, anxiety and stress are the common forms of psychological distress associated with ICU patient's family members. Directly or indirectly, psychological distress may have behavioural or physiological impacts on the family members and ICU patient's recovery.

Design

The study was based on the five‐stage methodological framework by Arksey and O'Malley (International Journal of Social Research Methodology, 2005, 8, 19) and were guided by the PRISMA‐ScR Checklist.

Methods

A comprehensive and systematic search was performed in five electronic databases, namely the Scopus, Web of Sciences, CINAHL® Complete @EBSCOhost, ScienceDirect and MEDLINE. Reference lists from the screened full‐text articles were reviewed.

Results

From a total of 1252 literature screened, 22 studies published between 2010–2019 were included in the review. From those articles, four key themes were identified: (a) Prevalence of psychological distress; (b) Factors affecting family members; (c) Symptoms of psychological distress; and (d) Impact of psychological distress.

Conclusions

Family members with a critically ill patient in ICU show high levels of anxiety, depression and stress. They had moderate to major symptoms of psychological distress that negatively impacted both the patient and family members.

Relevance to clinical practice

The review contributed further insights on psychological distress among ICU patient's family members and proposed psychological interventions that could positively impact the family well‐being and improve the patients' recovery.
Emergency healthcare workers’ preparedness for disaster management: An integrative review
Authors: Almukhlifi Yasir , Crowfoot Gary , Wilson Amanda , Hutton Alison
Published: July 2021

Background

Around 2 billion people globally were affected by natural disasters between 2008–2018. The World Health Organization requires countries and governments to have disaster plans and emergency health workers ready and prepared at all times.

Objectives

To conduct an integrative review of literature of emergency healthcare workers’ perceived preparedness for disaster management.

Methodology

An integrative literature review using the PRISMA checklist guidelines was conducted to explore physicians, nurses, emergency medical services and allied medical professionals’ preparedness for disasters. Literature was searched from 2005, published in the English language and from MEDLINE (PubMed), Google Scholar, EMBASE, PsycINFO, SCOPUS, ProQuest and CINAHL databases. Reviews, case reports, clinical audits, editorials and short communications were excluded. Studies were critically appraised using the Mixed Methods Appraisal Tool.

Results

The initial search yielded 9589 articles. Twenty‐seven articles were included following application of the eligibility criteria. Included studies were geographically diverse including North America, the Middle East and the Asia Pacific. Most studies (n = 24) assessed the knowledge of healthcare workers in general disasters. Studies using the Disaster Preparedness Evaluation Tool reported moderate disaster preparedness and knowledge, while studies using other instruments largely reported inadequate disaster preparedness and knowledge. Regional variations were recorded, with high‐income countries’ reporting a higher perceived preparedness for disasters than low‐income countries.

Conclusion

The majority of the emergency healthcare workers appear to have inadequate disaster preparedness. Previous disaster experience and training improved disaster preparedness. Future research should focus on interventions to improve emergency healthcare workers preparedness for disasters.
Real Estate Shocks and Financial Advisor Misconduct
Authors: DIMMOCK STEPHEN G. , GERKEN WILLIAM C. , VAN ALFEN TYSON
Published: July 2021

We test whether personal real estate shocks affect professional misconduct by financial advisors. We use a panel of advisors' home addresses and examine within‐advisor variation relative to other advisors who work at the same firm and live in the same ZIP code. We find a negative relation between housing returns and misconduct. We show that advisors' housing returns explain misconduct against out‐of‐state customers, breaking the link between customer and advisor housing shocks. Furthermore, the results are stronger for advisors with lower career risk from committing misconduct, and for advisors with greater borrowing constraints.