bluuebunny/crossref_metadata_2025 huggingface dataset:
Costs and length of sepsis-related hospitalizations in Taiwan
Authors: Chen Yen-Jung , Chen Fu-Lun , Chen Jin-Hua , Wu Man-Tzu Marcie , Chien Du-Shieng , Ko Yu
Published: May 2020

To investigate the healthcare expenditures and length of stay (LOS) of sepsis-related hospitalizations in Taiwan.

This is a retrospective claim database study. Data were obtained from the two-million-sample longitudinal health and welfare database (LHWD). Adult patients hospitalized with sepsis between 2010 and 2014 were identified by International Classification of Diseases 9th Edition Clinical Modification (ICD-9-CM) codes, and these patients were divided into three levels of sepsis severity. The amount and distribution of their total medical expenditures were investigated.

In total, 62,517 patients with 97,790 sepsis-related hospitalizations were included in the present study. It was found that ward fees and medicines comprised the largest component of expenses for sepsis-related hospitalizations. In addition, our study results indicated that the median sepsis-related hospitalization cost was 66.4 thousand New Taiwan Dollar (NT dollars) in 2014, and a significant temporal change was found between 2010 and 2014. The median LOS in a hospital and in an intensive care unit were 11 and 7 days, respectively. Both expenditures and LOS were found to increase with sepsis severity.

This study provides an updated and better understanding of the costs and LOS of sepsis-related hospitalizations in Taiwan. It was found that ward fees and medicine fees were the major components of hospital costs.
Association of CYP4F2 and CTRP9 polymorphisms and serum selenium levels with coronary artery disease
Authors: Huang Hao , Wang Yong , Wang Xianen , Lei Yuhua
Published: May 2020

Aims to explore the interaction between serum selenium level and CYP4F2 and CTRP9 gene polymorphisms in the development of coronary artery disease (CAD).

A total of 200 cases of CAD were selected from the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Hubei, China, and 200 healthy subjects cases were served as controls. The polymorphism of CYP4F2 and CTRP9 gene was detected by Sanger sequencing, and the serum selenium level was measured by hydride generation atomic fluorescence spectrometry.

The serum selenium level in the CAD group was significantly lower than that in the control group. The risk of CAD was decreased in the patients carrying the AA genotype in CYP4F2 rs3093135, while the frequency of the CC genotype of CTRP9 rs9553238 in CAD patients was higher than that in control subjects. Low serum selenium level and CTRP9 rs9553238 CC genotype play a positive role in the occurrence of CAD.

The serum selenium level is negatively correlated with CAD. The polymorphism of the CYP4F2 rs3093135 and CTRP9 rs9553238 was significantly related to the susceptibility of CAD, and there is a synergistic effect between the serum selenium level and the CTRP9 rs9553238 CC genotype, which significantly increases the risk of CAD.
Primary transitional cell carcinoma of the fallopian tube
Authors: Lee Dong-Hyun , Cho Dong-Hyu , Kim Kyoung Min , Yim Chang-Yeol , Lee Na-Ri
Published: May 2020

Introduction:

Primary transitional cell carcinoma (TCC) of the fallopian tube is an extremely rare tumor.

Patient concerns:

A 79-year-old woman presenting with vaginal discharge.

Diagnosis:

Pelvic magnetic resonance imaging revealed a predominantly solid mass with a lobulated contour, measuring 5.5 cm × 4.6 cm, in the left ovary. The patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy. Pathological analysis revealed a high-grade TCC, measuring 7.5 cm × 4 cm, in the left fallopian tube (International Federation of Gynecology and Obstetrics stage IIB).

Intervention:

Forty-three months postoperation, recurrence was diagnosed as peritoneal metastasis. The patient underwent 6 cycles of palliative chemotherapy consisting of cisplatin and gemcitabine, the recommended regimen for TCC of the urinary tract.

Outcome:

The patient has survived for 27 months without recurrence after palliative chemotherapy, 76 months after diagnosis.

Conclusion:

It is rare that primary TCC of the fallopian tube responds to a urinary tract treatment regimen for TCC, even when followed up for an extended period. More research is warranted to determine which treatment regimen will benefit patients the most.
Effects of compound Caoshi silkworm granules on stable COPD patients and their relationship with gut microbiota
Authors: Hu Yibing , Shi Qinghuan , Ying Songmin , Zhu Dan , Chen Hui , Yang Xiguang , Xu Jilin , Xu Feila , Tao Feibao , Xu Bin
Published: May 2020

Background and purpose:

Patients with chronic obstructive pulmonary disease (COPD) usually experience recurrent acute exacerbations. These patients, especially those with stable COPD, require an effective intervention for treating exacerbations. This study aimed to evaluate the efficacy of Compound Caoshi silkworm granules (CCSGs) in stable COPD patients and to investigate their potential mechanism.

Methods:

A randomized controlled trial was performed at Jinhua Hospital, Zhejiang University. Patients were enrolled in this study if they met the criterion of stable COPD. A total of 40 patients were randomly divided into the following 2 groups: Group A (n = 20, routine treatment (RT) group) and Group B (n = 20, RT plus CCSGs [RT plus CCSGs] group). The duration of treatment was 3 months. Stool samples were collected from all patients on day 0 and the gut microbiota was analyzed using 16s rRNA sequencing. The St. George's Respiratory Questionnaire (SGRQ) scores and lung function were assessed at month 0 and month 3.

Results:

The components of gut microbiota differed between stable COPD patients and the healthy population. The RT plus CCSGs group showed improved SGRQ scores compared to the RT group. There was no difference in forced expiratory volume-one second, forced vital capacity, and forced expiratory volume-one second/forced vital capacity between the two groups. Furthermore, the abundance of gut microbiota in patients with the top 10 SGRQ scores (Group N) differed from the abundance of gut microbiota in those with the lowest 10 SGRQ scores (Group T).

Conclusion:

CCSGs have beneficial effects in the improvement of symptoms in stable COPD patients over a 3-month treatment period. The potential underlying mechanism may be attributable to the difference in gut microbiota among patients. However, more research is needed to confirm this conclusion.
A Systematic Review of Intra-Articular Ketamine for Postoperative Analgesia
Authors: Covington Stephen M. , D’Souza Ryan S. , Erwin Patricia J. , Qu Wenchun
Published: May 2020

Background

This systematic review appraises the evidence from human clinical trials comparing postoperative pain scores and opioid consumption in patients receiving intra-articular ketamine versus other modalities of analgesia after orthopedic joint procedures.

Methods

Studies were identified from Embase, Scopus, and OVID Medline databases. Included studies compared patients receiving intra-articular ketamine versus other modalities of analgesia. The primary outcome of interest was postprocedural pain score and total opioid consumption, whereas secondary outcomes included time to rescue analgesic medication request, active range of motion, time to mobilization, and adverse effects.

Results

Seventeen studies were included. Dosage of ketamine varied widely from 0.25 to 2 mg/kg. Fifteen of 17 demonstrated decreased overall pain scores and decreased total postoperative opioid consumption in patients receiving intra-articular ketamine versus control groups. Included studies generally demonstrated reduced time to mobilization and increased latency until rescue analgesic medication in the intra-articular ketamine group.

Conclusions

Patients who received intra-articular ketamine generally reported lower pain scores and had lower postoperative opioid consumption after orthopedic joint procedures. This suggests that the intra-articular route of ketamine delivery may be a useful analgesic modality, although future larger-scale trials should explore its pharmacokinetics, optimal dosing, safety, and cost-effectiveness.
Engaging Children as Simulated Patients in Healthcare Education
Authors: Budd Natasha , Andersen Patrea , Harrison Penny , Prowse Nycole
Published: May 2020

Summary Statement

The value of “simulation” as a learning strategy is well established among healthcare professionals (Educ Prim Care 2015; 26(4):242–7).1 The use of “simulated patients (SPs)” to present real-world scenarios provides opportunities for students to develop “soft skills,” including interpersonal communication, critical thinking, and problem solving.4 These skills are particularly relevant in pediatric care, where healthcare providers must consider the patient's cognitive development, emotional state, and familial context. This article focuses on middle childhood (6–12 years)11 a distinctive developmental stage between 2 major developmental transition stages: infancy and adolescence. Middle childhood is associated with compulsory school attendance, developing skills in self-discipline, conflict resolution, and decision-making. Child SPs can play an important role in healthcare education providing direct insight into this unique period of development. They can contribute to the design and delivery of simulations to increase fidelity and provide meaningful real-time feedback to learners on children's experience of the healthcare system. Despite children's expertise and particular care delivery needs, documented simulations using child SPs are limited. This article considers the role of child SPs to support a case for further research into the value of engaging middle years children in the development and delivery of “simulation-based learning experiences”.4 It addresses the gap in child-focused education, the challenges inherent in working with children and outlines strategies and guidelines for effective practice.
Immunotherapeutic options for inflammation in trauma
Authors: Tobin Joshua M. , Gavitt Brian J. , Nomellini Vanessa , Dobson Geoffrey P. , Letson Hayley L. , Shackelford Stacy A.
Published: May 2020

BACKGROUND

Surgical management of trauma in the last 20 years has evolved in parallel with the military's experience in the current conflicts. Therapies such as widespread tourniquet use, empiric administration of fresh frozen plasma, and airborne intensive care units had been viewed skeptically but are now common practice. There is an opportunity to expand the envelope of care even further through similarly innovative approaches and varied avenues of research.

RESULTS

As the molecular biology of trauma is elucidated, research methodologies must also be developed to capitalize on innovative approaches to resuscitation. Blood component therapy and control of bleeding remain as the fundamental concepts in trauma care. The inflammo-immune response to injury, however, plays an increasingly recognized role in recovery of organ function. Perhaps the inflammatory cascade of trauma can be manipulated to extend the treatment envelope of at risk trauma patients.

In trauma, the additional challenge of delivering effective treatment, often required very early after injury, necessitates the development of treatments to be implemented on the front lines of trauma care that are cost-effective, portable, and environmentally stable. Future conflicts may not offer ready access to high-level surgical care; therefore, resuscitative therapies will be needed for wounded service members because they are evacuated to the surgeon. Manipulation of the inflammatory response to trauma may offer a solution. As our understanding of the immune response continues to develop, the potential for improved outcomes for the wounded expands.

CONCLUSION

A review of basic concepts in immunology is necessary to appreciate any potential impact of immunotherapeutic approaches to trauma and inflammation. An overview of current options will focus on outcome benefits of available therapies and suggest possible areas for future investigation. Quantitative approaches will leverage basic science to identify high-yield strategies to improve care of the injured combatant.

LEVEL OF EVIDENCE

Review, level III.
Long-term Outcome of Orthotopic Liver Transplantation in Patients With Hemochromatosis: A Summary of a 30-year Transplant Program
Authors: Dobrindt Eva Maria , Keshi Eriselda , Neulichedl Julian , Schöning Wenzel , Öllinger Robert , Pratschke Johann , Eurich Dennis
Published: May 2020

Background.

Hemochromatosis (HC) is an autosomal recessive disease characterized by impaired iron metabolism and a rare indication for orthotopic liver transplantation (LT). Data about iron reaccumulation and remodeling of the liver graft after LT are limited. Therefore, we performed an evaluation of the histopathologic changes during long-term follow-up in patients with HC.

Methods.

A retrospective analysis of patients undergoing LT at our center between 1990 and 2016 identified 29 patients with HC. End points were the evaluation of post-LT iron reaccumulation and the stage of fibrosis as well as the degree of inflammation of the liver graft. Secondary end points were patient survival and postoperative complications.

Results.

The median age was 52.7 y, and there were more male (82.8%) than female patients (17.2%). Post-LT serum ferritin values (>1000 μg/L) were only temporarily elevated in 2 patients. The median estimated survival after LT was 45.5 mo (0.1–285.9 mo). Twenty patients (69%) died during follow-up of 10 y. The survival of patients with HC was significantly worse (P = 0.001) when compared with the overall cohort of patients undergoing LT because of to other causes.

Conclusions.

There was no significant iron overload detected in patients with HC after LT, and only minimal iron deposits were described in liver biopsies. Nevertheless, patients suffering from HC show a lower post-LT survival when compared with patients without iron storage disease but mostly because of extrahepatic causes.
Hoogsteen base pairs increase the susceptibility of double-stranded DNA to cytotoxic damage
Authors: Xu Yu , Manghrani Akanksha , Liu Bei , Shi Honglue , Pham Uyen , Liu Amy , Al-Hashimi Hashim M.
Published: May 2020

As the Watson-Crick faces of nucleobases are protected in double-stranded DNA (dsDNA), it is commonly assumed that deleterious alkylation damage to the Watson-Crick faces of nucleobases predominantly occurs when DNA becomes single-stranded during replication and transcription. However, damage to the Watson-Crick faces of nucleobases has been reported in dsDNAin vitrothrough mechanisms that are not understood. In addition, the extent of protection from methylation damage conferred by dsDNA relative to single-stranded DNA (ssDNA) has not been quantified. Watson-Crick base-pairs in dsDNA exist in dynamic equilibrium with Hoogsteen base-pairs that expose the Watson-Crick faces of purine nucleobases to solvent. Whether this can influence the damage susceptibility of dsDNA remains unknown. Using dot-blot and primer extension assays, we measured the susceptibility of adenine-N1 to methylation by dimethyl sulfate (DMS) when in an A-T Watson-Crick versus Hoogsteen conformation. Relative to unpaired adenines in a bulge, Watson-Crick A-T base-pairs in dsDNA only conferred ~130-fold protection against adenine-N1 methylation and this protection was reduced to ~40-fold for A(syn)-T Hoogsteen base-pairs embedded in a DNA-drug complex. Our results indicate that Watson-Crick faces of nucleobases are accessible to alkylating agents in canonical dsDNA and that Hoogsteen base-pairs increase this accessibility. Given the higher abundance of dsDNA relative to ssDNA, these results suggest that dsDNA could be a substantial source of cytotoxic damage. The work establishes DMS probing as a method for characterizing A(syn)-T Hoogsteen base pairsin vitroand also lays the foundation for a sequencing approach to map A(syn)-T Hoogsteen and unpaired adenines genome-widein vivo.
Unspecific post-mortem findings despite multiorgan viral spread in COVID-19 patients
Authors: Remmelink Myriam , De Mendonça Ricardo , D’Haene Nicky , De Clercq Sarah , Verocq Camille , Lebrun Laetitia , Lavis Philomène , Racu Marie-Lucie , Trépant Anne-Laure , Maris Calliope , Rorive Sandrine , Goffard Jean-Christophe , Dewitte Olivier , Peluso Lorenzo , Vincent Jean-Louis , Decaestecker Christine , Taccone Fabio Silvio , Salmon Isabelle
Published: May 2020

Background

Post-mortem studies can provide important information for understanding new diseases and small autopsy case series have already reported different findings in COVID-19 patients.

Methods

We evaluated whether some specific post-mortem features are observed in these patients and if these changes are related to the presence of the virus in different organs. Complete macroscopic and microscopic autopsies were performed on different organs in 17 COVID-19 non-survivors. Presence of SARS-CoV-2 was evaluated with immunohistochemistry (IHC) in lung samples and with real-time reverse-transcription polymerase chain reaction (RT-PCR) test in lung and other organs.

Results

Pulmonary findings revealed early-stage diffuse alveolar damage (DAD) in 15 out of 17 patients and microthrombi in small lung arteries in 11 patients. Late-stage DAD, atypical pneumocytes and/or acute pneumonia were also observed. Four lung infarcts, two acute myocardial infarctions and one ischemic enteritis were observed. There was no evidence of myocarditis, hepatitis or encephalitis. Kidney evaluation revealed the presence of hemosiderin in tubules or pigmented casts in most patients. Spongiosis and vascular congestion were the most frequently encountered brain lesions. No specific SARS-CoV-2 lesions were observed in any organ. IHC revealed positive cells with a heterogeneous distribution in the lungs of 11 of the 17 (65%) patients; RT-PCR yielded a wide distribution of SARS-CoV-2 in different tissues, with 8 patients showing viral presence in all tested organs (i.e. lung, heart, spleen, liver, colon, kidney and brain).

Conclusions

In conclusion, autopsies revealed a great heterogeneity of COVID-19-related organ injury and the remarkable absence of any specific viral lesions, even when RT-PCR identified the presence of the virus in many organs.
Collaborative contracting in the Singapore construction industry: current status, major barriers and best solutions
Authors: Zhang Na , Hwang Bon-Gang , Deng Xiaopeng , Tay Fiona
Published: May 2020

Purpose

Collaborative contracting (CC) is the direction that Singapore is venturing into in line with the Construction Industry Transformation Map. For its successful adoption, it is necessary to examine the potential barriers and possible solutions. Therefore, this study aims to explore the current status, major barriers and best solutions for the adoption of CC in the Singapore construction industry.

Design/methodology/approach

To achieve these objectives, a comprehensive literature review was carried out and 26 barriers, as well as 21 solutions, were identified. Then a questionnaire was designed to assess the priority of these barriers and solutions. After a pilot study, 165 questionnaires were distributed, and 31 responses were received. And the survey result was validated by post-survey with three industry professionals.

Findings

Results revealed that only a small percent of projects adopted CC in Singapore. Seven significant barriers hindering CC implementation were found out. They are “inherent difficulties in changing organizational culture,” “lack of incentives/financial support,” “lack of legislative regulations,” “resistant to change the current way of working,” “seeking for the lowest cost” and “difficulties in converting strategic decisions to operational levels” and “unclear contract terms and objectives.” Also, five best solutions were suggested to overcome the identified barriers.

Originality/value

The findings of this study could enable industry practitioners to be aware of the potential barriers to adopting CC and choose suitable solutions to overcome these barriers. It is also helpful for authorities to come up with effective policies to promote the adoption of CC.
Existing apartment buildings as a spatial reserve for assisted living
Authors: Kaasalainen Tapio , Huuhka Satu
Published: May 2020

Purpose

Ageing populations induce needs to adapt existing housing. With ageing, the number of frail old people, who require assistance in daily life, is also increased. Converting existing housing into assisted living enables them to remain in their community while receiving necessary support and care. The purpose is to investigate whether post-war mass housing is spatially appropriate for adaptation into group homes for older people.

Design/methodology/approach

The research material is attained from Finland. Spatial requirements for group homes are drawn from 130 units built or renovated during 2000–2015. Spatial characteristics of mass housing are mapped from 105 apartment buildings built in the 1970s. The latter are matched with the former by comparing the connectivity of layouts, sizes of units and the numbers and sizes of individual spaces.

Findings

Group homes typically utilize a linear layout, which can easily be created in apartment buildings. Individual spaces of a group home fit apartment buildings effortlessly. Whole group home units mostly prove to be spatially feasible but result in looser dimensioning than is typical in existing units. The mass housing stock can be considered a spatial reserve for adaptation into group homes.

Originality/value

This is the first study to employ a large-scale, multi-case spatial mapping approach to analyse the adaptability properties of mass housing into assisted living. The findings pertain primarily to the Finnish context, but a methodology is presented which can be applied to other countries and also to other spatial functions.
Student food insecurity and the social equity pillar of campus sustainability
Authors: White Stacey Swearingen
Published: May 2020

Purpose

College and university campuses serve as a vital test bed for sustainability solutions of various types. To date, though, campus sustainability efforts have focused more on the environmental and economic aspects of sustainability, with less attention to its social aspects. This paper aims to draw on a study of student food insecurity to consider how sustainability’s three pillars might be more holistically engaged.

Design/methodology/approach

First, the paper reviews the literature on-campus food sustainability and student food insecurity to propose a preliminary characterization of sustainable food. Second, data from a study of food insecurity among students at a major research university are presented. The survey data measure the degree and attributes of food insecurity among undergraduate and graduate students. The focus group and interview data provide a detailed understanding of students’ experience with food insecurity, particularly with regard to how that experience resonates with the characteristics of sustainable food. Finally, the paper suggests that the systems thinking approach may be the best way to engage the social pillar of sustainability.

Findings

Food insecurity is prevalent among university students. These students find affordability and nutrition to be the most important characteristics of the diets they desire to have. The ability to access such foods conveniently is also important, whereas the sourcing of foods is not resonant.

Research limitations/implications

This is a study of a single campus in the USA. Findings may be different on campuses that have different demographics and other characteristics.

Originality/value

Campus sustainability efforts must fully engage the social aspects of sustainability. This paper uses the example of food and food insecurity to show how and why this is important. It also points to systems thinking approach as appropriate for this holistic effort.
How spatial contexts, institutions and self-identity affect entrepreneurial intentions
Authors: Ndofirepi Takawira Munyaradzi
Published: May 2020

Purpose

This study aims to examine how spatial contexts, institutions and entrepreneurial self-identity affected the formation of entrepreneurial intentions of a sample of students in Zimbabwe.

Design/methodology/approach

Data were obtained from 284 students enrolled in two vocational education institutions located in Midlands Province of Zimbabwe. To select the respondents, convenience sampling was used. The sample size was determined by the total number of students agreeing to participate in the research. Hypotheses were tested using structural equation modelling (maximum likelihood estimation method).

Findings

Social approval, supportive cultural environment and entrepreneurial self-identity had positive statistically significant direct effects on entrepreneurial intentions. Also, entrepreneurial self-identity partially mediated the effects of social approval and supportive cultural environment on entrepreneurial intentions. The total effect of supportive higher education institutions on entrepreneurial intentions was statistically significant, despite the direct and indirect effects being non-significant.

Practical implications

The findings suggest a need to cultivate supportive social contexts and higher education institutions for nurturing entrepreneurial self-identity and entrepreneurial intentions, factors that are integral to the development of future entrepreneurs.

Originality/value

The study examined the validity of a novel conceptual model based on the contribution of entrepreneurial self-identity, spatial context and institutional variables in shaping entrepreneurial intentions of selected college students in the global south.
The relevance of leadership styles and Islamic work ethics in managerial effectiveness
Authors: Javed Sarfaraz , Malik Azam , Alharbi Mutaz Minwer Hala
Published: May 2020

Purpose

Managerial effectiveness is considered as an essential element for sustainable development and competitive advantage for organisations, and its core conceptualisation revolves around the capability of management to manage self, subordinates and relationships. However, very few research addressed this important phenomenon; this study aims to fill this gap by investigating the mediating role of Islamic work ethics between leadership styles and managerial effectiveness.

Design/methodology/approach

Data collection was done through a structured questionnaire, and the hypothesized relationships were tested with the help of SmartPLS.

Findings

Results of the statistical analysis showed that transformational and transactional leadership styles are positively associated with managerial effectiveness. Also, Islamic work ethics mediated the association between transactional leadership and managerial effectiveness, and however, no mediation effect of Islamic work ethics was found in the relationship of transformational leadership and managerial effectiveness

Originality/value

Although volumes of research have been conducted into the nature of management and leadership over the past 50 years or so, there have been significant shortcomings in terms of little attention having been given to the issue of managerial effectiveness, lack of generalizability of findings and lack of relevance and utility; thus, this study contributed to human resource management literature by providing a macro-level model to measure managerial effectiveness.
How is value co-created in a sport business-to-business context?
Authors: Gerke Anna , Woratschek Herbert , Dickson Geoff
Published: May 2020

Purpose

There are different streams of research in the service marketing literature concerning value co-creation. Most of the research focuses on value co-creation for the benefit of the customer. However, value is also co-created for the benefit of the provider, especially in a business-to-business context. The purpose of this research is to understand (1) how value is co-created in a sport business-to-business context (i.e. sailing) and (2) how the prevailing value co-creation approaches explain value co-creation processes differently in a sport business-to-business context.

Design/methodology/approach

The research was contextualised within the Auckland sailing cluster. Primary data were collected via 27 interviews, as well as observations at events. Secondary data include 13 documents of organisational information and archival data. Data were analysed deductively and interpreted using two different theoretical lenses: service-dominant logic (SDL) and service logic (SL).

Findings

The value co-creation analysis of the sailing cluster permitted theorising about relationships in sport management at different levels of aggregation and abstraction. Every actor is embedded in a wider sport eco-system triggered by sport activities and always has a dual role as provider and beneficiary. Actors that are in control of specific sport activities are pivotal actors and provide a value network for others.

Research limitations/implications

This research suggests that SDL and SL approaches to value co-creation are complementary and that further research is necessary to integrate and operationalise these approaches.

Practical implications

It helps practitioners to better understand how value is co-created in sport business-to-business contexts.

Originality/value

This research shows the complementarity of two differing theoretical approaches to explain value co-creation in sport business-to-business settings.
Virtual workplaces and lean leadership: integrative conceptualization and organizational implications
Authors: Mishra Talina , Jena Lalatendu Kesari
Published: May 2020

Purpose

The purpose of this paper is to integrate the concept of lean in the world of virtual leadership by continuously engaging employees and building efficient teams to increase the effectiveness of digital workplaces.

Design/methodology/approach

Secondary research from various research articles by authors in lean and leadership was done.

Findings

Lean leadership can serve as a great way to boost employee morale and enrich their experience in times of global crisis. Employees can effectively contribute to the organization with the help of virtual lean teams and tools.

Originality/value

This paper adds to the scarce literature on the integration of lean and leadership by exploring the various ways in which employees can be empowered to achieve organizational goals in the virtual workplace.
Recovery of a boreal ground‐beetle (Coleoptera: Carabidae) fauna 15 years after variable retention harvest
Authors: Wu Linhao , He Fangliang , Spence John R.
Published: May 2020

Retention harvests are preferred over traditional clear‐cuts for sustainable forest management because maintenance and re‐establishment of native forest biodiversity is a priority. However, few studies have examined long‐term responses of biotic assemblages to retention harvest at particular sites.

We studied the effects of decreasing initial harvest intensities (clear‐cut, 10%, 20%, 50% and 75% dispersed green‐tree retention) on carabid beetle assemblages relative to assemblage changes in un‐harvested control stands in four successionally ordered cover‐types of boreal mixedwood forest. We also studied temporal effects by comparing assemblages over a 16‐year pre‐ and post‐harvest period, using data collected through monitoring of the EMEND (Ecosystem Management Emulating Natural Disturbance) experiment in NW Alberta, Canada.

Retention harvests affected assemblages differently across cover‐types. Assemblages in compartments harvested in the earlier forest successional stages of ‘deciduous’ or ‘deciduous with spruce understorey’ converged towards the pre‐harvest structure of corresponding controls over time. In contrast, beetle assemblages in ‘mixed’ or ‘conifer’ compartments, that represent later successional forest, moved steadily away from their pre‐harvest structures during the first post‐harvest decade. These latter assemblages became strikingly more similar to those under deciduous canopies by 15‐year post‐harvest.

Synthesis and applications. Variable retention harvests will promote and maintain biodiversity better than clear‐cutting. Higher retention levels promote faster recovery, but towards fauna typical of early successional forest in all cover‐types. Carabids associated with conifer habitats are less resistant to impact from harvesting than are those from broadleaf deciduous forest. Therefore, conifer‐dominated stands present the most significant management challenge and higher retention levels are required to promote rapid and effective faunal recovery in such late successional stands.
Computer Says...
Authors: Wheeler Nicole
Published: May 2020

As AI-augmented decision-making advances, Nicole Wheeler wonders who will be left behind
Informing emergency care for all patients: The Registry for Emergency Care (REC) Project protocol
Authors: O'Reilly Gerard M , Mitchell Rob D , Mitra Biswadev , Noonan Michael P , Hiller Ryan , Brichko Lisa , Luckhoff Carl , Paton Andrew , Smit De Villiers , Cameron Peter A
Published: May 2020

Objective

In Australia, the current ED burden related to COVID‐19 is from ‘suspected’ rather than ‘confirmed’ cases. The initial aim of the Registry for Emergency Care (REC) Project is to determine the impact of isolation processes on the emergency care of all patients.

Methods

The REC Project builds on the COVID‐19 Emergency Department Quality Improvement (COVED) Project. Outcomes measured include times to critical assessment and management.

Results

Clinical tools will be generated to inform emergency care, both during and beyond the COVID‐19 pandemic.

Conclusions

The REC Project will support ED clinicians in the emergency care of all patients.
Systematic review and meta‐analysis: Association of a pre‐illness Western dietary pattern with the risk of developing inflammatory bowel disease
Authors: Li Tong , Qiu Yun , Yang Hong Sheng , Li Man Ying , Zhuang Xiao Jun , Zhang Sheng Hong , Feng Rui , Chen Bai Li , He Yao , Zeng Zhi Rong , Chen Min Hu
Published: May 2020

Objective

Previous studies have presented conflicting results on Western diets and the risk of inflammatory bowel disease (IBD). This study aimed to evaluate the role of a pre‐illness Western dietary pattern in the development of IBD.

Methods

The Western dietary pattern was defined as that met at least two of the following, either a high intake of refined grains, red and processed meat, animal protein, animal fats or high‐fat dairy products, or with a low consumption of fruit and vegetables. Four medical databases (PubMed, EMBASE, the Cochrane Library and the China National Knowledge Infrastructure) were searched to identify all relevant references. Risk estimate and corresponding 95% confidence interval (CI) were pooled using a random‐effects model.

Results

Nine studies (seven case‐control studies and two prospective cohorts) were included, with a total of 1491 IBD cases and 53 089 controls. A Western dietary pattern was associated with a risk of all IBD (relative risk [RR] 1.92, 95% CI 1.37‐2.68) and separately with Crohn's disease (CD) (RR 1.72, 95% CI 1.01‐2.93) and ulcerative colitis (UC) (RR 2.15, 95% CI 1.38‐3.34). Subgroup analysis by region showed that a Western dietary pattern was associated with the risk of CD and UC for studies performed in Europe (RR 2.25, 95% CI 1.44‐3.50 for CD; RR 2.65, 95% CI 1.61‐4.36 for UC). The pooled RR was 2.26 (95% CI 1.42‐3.59) in the pediatric CD subgroup.

Conclusion

This meta‐analysis indicates that a pre‐illness Western dietary pattern may increase the risk of developing CD and UC.
Editorial for the Michael Bull special issue
Authors: Gardner Michael G. , Godfrey Stephanie S. , Wapstra Erik
Published: May 2020

A review of the role of parasites in the ecology of reptiles and amphibians

Parasite in peril? A new species of mite in the genus Ophiomegistus Banks (Parasitiformes: Paramegistidae) on an endangered host, the pygmy bluetongue lizard Tiliqua adelaidensis (Peters) (Squamata: Scincidae)
Phylogenetic position and morphology of Andrewia gen. nov. (Hemiptera: Miridae), a new plant bug genus from New Guinea
Authors: Konstantinov Fedor V , Namyatova Anna A
Published: May 2020

A new plant bug genus and species, Andrewia bochkovi gen. et sp. nov., of the Phylinae is described from the Biak Island, Papua Province of Indonesia. The described species has been characterised molecularly based on COI, 16S and 28S markers, and its phylogenetic position has been tested using model‐based (RAxML and Bayesian) phylogenetic analyses. Photographs of habitus, male and female genitalia, illustrations of male genitalia, scanning electron micrographs of morphological structures and host information are also provided. The systematic position of the new genus within Phylinae is discussed. Andrewia gen. nov. forms a separate clade sister to all other phylines except for the tribe Hallodapini.
Early graft function and intrarenal resistant index after kidney transplantation using Biolasol—A new solid organ preservation fluid
Authors: Kolonko Aureliusz , Król Robert , Chudek Jerzy , Skrzypek Michał , Cierpka Lech , Więcek Andrzej
Published: May 2020

Biolasol is a newly developed preserving solution for cold organ storage prior to transplantation. To date, only animal model experiments results are available. The aim of this single‐center analysis was to summarize the clinical experience concerning the early post‐transplant course of kidney grafts preserved with Biolasol in comparison with other preservation solutions. Before transplantation, 173 kidney grafts were preserved using Biolasol and 240 organs with other solutions (University of Wisconsin—UW, Institute Georges Lopez—IGL‐1, or StoreProtect Plus solutions). Early graft function was defined based on serum creatinine concentration at day 3 (<3 mg/dL—immediate graft function, IGF or >3 mg/dL—slow graft function, SGF) or the need of dialysis therapy during first post‐operative week (delayed graft function, DGF). The analysis included intrarenal resistive indices measured by Doppler sonography early after transplantation and before discharge from the hospital. IGF was more frequent in patients with organs preserved with IGL‐1 (33.5%) and StoreProtect Plus (38.8%) than Biolasol (18.5%), whereas there was no difference in the occurrence of DGF. Both initial and discharge median resistance index values were significantly higher in the Biolasol subgroup (0.77 and 0.75) than in all three other subgroups (P values for all comparisons <.001), also after 1:1 propensity score matching for baseline characteristics. Multiple logistic regression analysis based on the propensity score‐matched cohort revealed that the use of Biolasol solution [OR 0.59 (0.35‐0.98); P < .05] independently decreased the occurrence of IGF. In our single‐center clinical experience, kidney preservation using Biolasol solution was associated with significantly higher intrarenal resistant index in comparison with other preservation fluids, as well as worse early graft function than in the IGL‐1 and the StoreProtect Plus subgroups. Long‐term follow‐up is needed in order to assess the kidney graft and patient survival.
Verification of a thrombus induction method at the target point inside the blood pump using a fibrinogen coating for a thrombus detection study
Authors: Seki Haruna , Fujiwara Tatsuki , Hijikata Wataru , Murashige Tomotaka , Maruyama Takuro , Yokota Sachie , Ogata Asato , Ouchi Katsuhiro , Mizuno Tomohiro , Arai Hirokuni
Published: May 2020

Although the magnetically levitated centrifugal blood pump (mag‐lev pump) is considered superior to other pumps in antithrombogenicity, thrombotic complications are still reported. Research into thrombus detection inside a mag‐lev pump is very important for solving this problem. Our research group has already proposed a method to detect a thrombus inside a mag‐lev pump in real time without an additional sensor, which is named the impeller vibration method. To efficiently advance our research with reproducibility, a preconditioning method to induce thrombus inside the pump was thought to be necessary. Therefore, this study aimed to develop a preconditioning method that induces thrombus formation. To verify this method, in vitro experiments for thrombus detection were performed. A mag‐lev pump developed at Tokyo Institute of Technology was used. A fibrinogen solution was coated on the inner surfaces of the bottom housing to induce thrombus formation at the target point inside the pump. The thrombus is detected by utilizing the phenomenon that the phase difference between the impeller displacement and input current to the magnetic bearing increases when a thrombus is formed inside a pump. Five hundred mL of porcine blood anticoagulated with heparin sodium was circulated in the mock circuit, and protamine sulfate was administered. Flow rate (1 L/min), impeller vibrational frequency (70 Hz), and vibrational amplitude (30 µm) were set to constant. The experiment was terminated when the phase difference increased by over 2° from the minimum value. The experiments were performed in fibrinogen‐coated (group F, n = 5) and non‐coated pumps (group N, n = 5). In group F, thrombus formation was observed at the fibrinogen‐coated point of the housing. In contrast, a relatively small thrombus was observed in varying locations such as the housing or the impeller in group N. Thrombus formation time (the time from when the phase difference takes the minimum value to when the experiment is terminated) was different between the two groups. The mean time was significantly shorter in group F (44 ± 29 minutes) than in group N (143 ± 38 minutes; p = 0.0019). Therefore, a preconditioning method that induced thrombus formation at the target point inside a blood pump was successfully developed.
Increased number of large non‐atretic follicles and co‐dominance effects account for high litter sizes in Bonga sheep
Authors: Tera Dolebo Asrat , Melesse Aberra , Porcu Cristian , Getachew Tesfaye , Haile Aynalem , Rouatbi Mariem , Abate Zelalem , Zeleke Muluken , Rischkowsky Barbara , Mwacharo Joram M. , Rekik Mourad
Published: May 2020

To understand the ovarian basis for prolificacy of Bonga sheep, a total of 31 ewes were selected based on litter size (LS) records and divided into two groups: High Prolificacy (HP) (n = 20) with LS ≥ 2 and Low Prolificacy (LP) (n = 11) with LS = 1. At a synchronized estrus, follicular dynamics were determined using transrectal ultrasonography. Plasma estradiol concentrations were also monitored. In total 27 ewes were observed in estrus being 9/11 LP (82%) and 18/20 HP (90%). On the day of estrus (day 0), the mean number of large follicles was higher (p < .05) in HP (1.78 ± 0.19) than in LP (1.0 ± 0.28) ewes. Prior to estrus, more (p < .05) medium follicles were visible for HP compared to LP ewes. Plasma estradiol concentrations were higher in HP compared to LP ewes (18.91 ± 0.41 vs. 14.51 ± 0.65 pg/ml; p < .05) and similarly was ovulation number (2.3 ± 0.15 vs. 1.28 ± 0. 14; p < .05). Higher ovulation rates and litter size in Bonga sheep are evidenced by the previous presence of more large follicles and the existence of co‐dominance effects as most likely medium follicles are selected to ovulate.
Chimeric antigen receptor T‐cell therapy toxicities
Authors: Greenbaum Uri , Kebriaei Partow , Srour Samer A. , Olson Amanda , Bashir Qaiser , Neelapu Sattva S. , Rezvani Katayoun , Shpall Elizabeth J.
Published: May 2020

Cancer immunotherapy has greatly advanced in recent years, with chimeric antigen receptor (CAR) T cells emerging as an innovative technology that harnesses the immune system to fight malignant diseases. These genetically engineered T‐cells have shown encouraging results for B‐cell lymphoid malignancies and are now being explored for other cancer types. However, this novel adoptive cell therapy is associated with a new spectrum of immune‐mediated adverse events and toxicities. As CAR T cells recognize and engage tumour cells, cytokines are secreted and activate other immune cells, frequently leading to rapid development of cytokine release syndrome, which can result in acute deterioration of the patient's clinical condition. In many patients, cytokine release syndrome is mild and easy to manage, but others experience persistent fevers accompanied by hypotension and hypoxia, which require management with immune‐modulatory agents. Another deleterious effect of cytokines released by effector cells is immune effector cell–associated neurotoxicity syndrome. This syndrome, caused by a disruption of the blood–brain barrier as a consequence of the immune process, can result in rapid deterioration in cognitive function. This is often associated with subtle changes in handwriting, often progressing to loss of memory and concentration and reduced ability to name objects or follow commands. In some cases, the neurological state is further compromised by seizures and in rare instances with fulminant life‐threatening cerebral oedema. In this review, we discuss these toxicities, as well as other CAR T‐cell–related immune phenomenon, and address their clinical manifestations, grading, and management options.
The pyruvate kinase (PK) to hexokinase enzyme activity ratio and erythrocyte PK protein level in the diagnosis and phenotype of PK deficiency
Authors: Al‐Samkari Hanny , Addonizio Kathryn , Glader Bertil , Morton D. Holmes , Chonat Satheesh , Thompson Alexis A. , Kuo Kevin H. M. , Ravindranath Yaddanapudi , Wang Heng , Rothman Jennifer A. , Kwiatkowski Janet L. , Kung Charles , Kosinski Penelope A. , Al‐Sayegh Hasan , London Wendy B. , Grace Rachael F.
Published: May 2020

Diagnosis of pyruvate kinase deficiency (PKD), the most common cause of hereditary non‐spherocytic haemolytic anaemia, remains challenging in routine practice and no biomarkers for clinical severity have been characterised. This prospective study enrolled 41 patients with molecularly confirmed PKD from nine North American centres to evaluate the diagnostic sensitivity of pyruvate kinase (PK) enzyme activity and PK:hexokinase (HK) enzyme activity ratio, and evaluate the erythrocyte PK (PK‐R) protein level and erythrocyte metabolites as biomarkers for clinical severity. In this population not transfused for ≥90 days before sampling, the diagnostic sensitivity of the PK enzyme assay was 90% [95% confidence interval (CI) 77–97%], whereas the PK:HK ratio sensitivity was 98% (95% CI 87–100%). There was no correlation between PK enzyme activity and clinical severity. Transfusion requirements correlated with normalised erythrocyte ATP levels (r = 0·527, P = 0·0016) and PK‐R protein levels (r = −0·527, P = 0·0028). PK‐R protein levels were significantly higher in the never transfused [median (range) 40·1 (9·8–73·9)%] versus ever transfused [median (range) 7·7 (0·4–15·1)%] patients (P = 0·0014). The PK:HK ratio had excellent sensitivity for PK diagnosis, superior to PKLR exon sequencing. Given that the number of PKLR variants and genotype combinations limits prognostication based on molecular findings, PK‐R protein level may be a useful prognostic biomarker of disease severity and merits further study.