bluuebunny/crossref_metadata_2025 huggingface dataset:
Long-Term Adaptation of Acidophilic Archaeal Ammonia Oxidisers Following Different Soil Fertilisation Histories
Authors: Zhao Jun , Wang Baozhan , Zhou Xue , Alam Mohammad Saiful , Fan Jianbo , Guo Zhiying , Zhang Huimin , Gubry-Rangin Cécile , Zhongjun Jia
Published: May 2021

Ammonia oxidising archaea (AOA) are ecologically important nitrifiers in acidic agricultural soils. Two AOA phylogenetic clades, belonging to order-level lineages of Nitrososphaerales (clade C11; also classified as NS-Gamma-2.3.2) and family-level lineage of Candidatus Nitrosotaleaceae (clade C14; NT-Alpha-1.1.1), usually dominate AOA population in low pH soils. This study aimed to investigate the effect of different fertilisation histories on community composition and activity of acidophilic AOA in soils. High-throughput sequencing of ammonia monooxygenase gene (amoA) was performed on six low pH agricultural plots originating from the same soil but amended with different types of fertilisers for over 20 years and nitrification rates in those soils were measured. In these fertilised acidic soils, nitrification was likely dominated by Nitrososphaerales AOA and ammonia-oxidising bacteria, while Ca. Nitrosotaleaceae AOA activity was non-significant. Within Nitrososphaerales AOA, community composition differed based on the fertilisation history, with Nitrososphaerales C11 only representing a low proportion of the community. This study revealed that long-term soil fertilisation selects for different acidophilic nitrifier communities, potentially through soil pH change or through direct effect of nitrogen, potassium and phosphorus. Comparative community composition among the differently fertilised soils also highlighted the existence of AOA phylotypes with different levels of stability to environmental changes, contributing to the understanding of high AOA diversity maintenance in terrestrial ecosystems.
Einstein, von Frisch and the honeybee: a historical letter comes to light
Authors: Dyer Adrian G. , Greentree Andrew D. , Garcia Jair E. , Dyer Elinya L. , Howard Scarlett R. , Barth Friedrich G.
Published: May 2021

The work of the Nobel LaureateKarl von Frisch, the founder of this journal, was seminal in many ways. He established the honeybee as a key animal model for experimental behavioural studies on sensory perception, learning and memory, and first correctly interpreted its famous dance communication. Here, we report on a previously unknown letter by the Physicist and Nobel LaureateAlbert Einsteinthat was written in October 1949. It briefly addresses the work of von Frisch and also queries how understanding animal perception and navigation may lead to innovations in physics. We discuss records proving that Einstein and von Frisch met in April 1949 when von Frisch visited the USA to present a lecture on bees at Princeton University. In the historical context of Einstein’s theories and thought experiments, we discuss some more recent discoveries of animal sensory capabilities alien to us humans and potentially valuable for bio-inspired design improvements. We also address the orientation of animals like migratory birds mentioned by Einstein 70 years ago, which pushes the boundaries of our understanding nature, both its biology and physics.
The performance of private companies in China before and during the global financial crisis: firms’ characteristics and entrepreneurs’ attributes
Authors: Fracasso Andrea , Jiang Kun
Published: May 2021

This work sheds light on how firm- and entrepreneur-specific attributes covariate with Chinese private firms’ growth rates before and during the global financial crisis. In order to do so, we exploit the exceptional presence of data regarding the firms’ sales over the previous three years in the 2010 China Private Enterprises Survey. Firms run by entrepreneurs with a high level of education and a positive subjective perception of their economic and social status tend to grow more in both periods. The age and the gender of the entrepreneurs, on the contrary, are not associated with different growth performances. As shown in the literature, companies that are smaller, more productive and have higher capital at start-up perform better in both periods. Notably, the relationship between firm growth rates and other relevant factors changes between 2007/2008 and 2008/2009: privatized companies outperform the others before the crisis, whereas joint-stock enterprises and companies with articulated systems of corporate governance do better in the crisis period. These and other novel results contribute to the understanding of the heterogeneous performances of the private firms in China and of the evolution of entrepreneurship during its transition toward a market-oriented economy.
A comparative study between CT, MRI, and intraoral US for the evaluation of the depth of invasion in early stage (T1/T2) tongue squamous cell carcinoma
Authors: Takamura Masaki , Kobayashi Taichi , Nikkuni Yutaka , Katsura Kouji , Yamazaki Manabu , Maruyama Satoshi , Tanuma Jun-ichi , Hayashi Takafumi
Published: May 2021

Objectives

This study aimed to clarify the accuracy of intraoral ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI) in preoperative image depth of invasion (DOI) measurement of T1/T2 tongue cancer through comparison with histopathological measurements.

Methods

Imaging of the primary lesions was performed at our hospital; the lesions were classified into T1 and T2 based on the 8th edition of the AJCC/UICC, and surgery performed. There was histopathological confirmation of lesions as squamous cell carcinoma in 48 patients with tongue cancer. T3 and T4 cases, cases in which preoperative chemotherapy and radiation therapy were performed, and cases where biopsy was performed before imaging were excluded. The radiological DOI in US, CT, and MRI and the histopathological DOI as base were comparatively investigated and statistical analyses were performed by Bland–Altman analysis and Spearman's rank correlation coefficient.

Results

Bland–Altman analysis showed that the US radiological DOI was overestimated by an average of 0.2 mm compared to the histopathological DOI, while CT and MRI radiological DOI were overestimated by an average of 2–3 mm. The comparison of CT and MRI revealed that the difference between the MRI and histopathological DOI, as well as the 95% limit of agreement, were smaller than those of the CT radiological DOI.

Conclusions

US is the most accurate preoperative diagnostic tool for T1 and T2 squamous cell carcinoma; CT and MRI tend to have an overestimation of about 2–3 mm and so caution is required.
Leadership Through Influence: What Mechanisms Allow Leaders to Steer a Swarm?
Authors: Bernardi Sara , Eftimie Raluca , Painter Kevin J.
Published: May 2021

Collective migration of cells and animals often relies on a specialised set of “leaders”, whose role is to steer a population of naive followers towards some target. We formulate a continuous model to understand the dynamics and structure of such groups, splitting a population into separate follower and leader types with distinct orientation responses. We incorporate leader influence via three principal mechanisms: a bias in the orientation of leaders towards the destination (orientation-bias), a faster movement of leaders when moving towards the target (speed-bias), and leaders making themselves more clear to followers when moving towards the target (conspicuousness-bias). Analysis and numerical computation are used to assess the extent to which the swarm is successfully shepherded towards the target. We find that successful leadership can occur for each of these three mechanisms across a broad region of parameter space, with conspicuousness-bias emerging as the most robust. However, outside this parameter space we also find various forms of unsuccessful leadership. Forms of excessive influence can result in either swarm-splitting, where the leaders break free and followers are left rudderless, or a loss of swarm cohesion that leads to its eventual dispersal. Forms of low influence, on the other hand, can even generate swarms that move away from the target direction. Leadership must therefore be carefully managed to steer the swarm correctly.
Reduction Mechanism of Fine Hematite Ore Particles in Suspension
Authors: Chen Zhiyuan , Zeilstra Christiaan , van der Stel Jan , Sietsma Jilt , Yang Yongxiang
Published: May 2021

In order to understand the pre-reduction behaviour of fine hematite particles in the HIsarna process, change of morphology, phase and crystallography during the reduction were investigated in the high temperature drop tube furnace. Polycrystalline magnetite shell formed within 200 ms during the reduction. The grain size of the magnetite is in the order of magnitude of 10 µm. Lath magnetite was observed in the partly reduced samples. The grain boundary of magnetite was reduced to molten FeO firstly, and then the particle turned to be a droplet. The Johnson-Mehl-Avrami-Kolmogorov model is proposed to describe the kinetics of the reduction process. Both bulk and surface nucleation occurred during the reduction, which leads to the effect of size on the reduction rate in the nucleation and growth process. As a result, the reduction rate constant of hematite particles increases with the increasing particle size until 85 µm. It then decreases with a reciprocal relationship of the particle size above 85 µm.
Documentation of chaperone presence in breast clinic, a complete audit cycle
Authors: Alameer Aqeel , Mohammed Amira , Elwahab Sami Abd , Boland Michael , Elfadul Amr , Tiwary Tej , Power Colm , Allen Michael , Butt Abeeda , Hill Arnold
Published: May 2021

Objective

The General Medical Council (GMC) and Irish Medical Council (IMC) recommend the presence of a chaperone for all intimate examinations and that it should be clearly documented. The aim of this report is to assess doctors’ compliance with obtaining a chaperone and documenting their presence, determining possible causes of non-compliance and implement interventions to increase compliance.

Methods

Prospective audit of patients seen in the breast clinic in Beaumont hospital over the week starting 8th February 2021. The medical charts were reviewed for documentation of chaperone presence. Doctors were surveyed using (SurveyMonkey) for causes of non-compliance. Interventions included a stamp in the medical notes for chaperone presence and details, an educational email with GMC and IMC guidelines, and posters put up in clinic rooms. The intervention was reassessed at 1-week and 6-week intervals.

Results

In the assessment phase, 126 patients were recruited. A chaperone was present 100% of the time where a male doctor examined a female patient; however, chaperone presence was not documented in any of the medical charts (0/126). A survey was sent to 22 breast surgery doctors to explore causes of non-compliance. Response rate was 95%, 50% did not know documentation was necessary, and 25% forgot to document. One week after intervention, 64 patients were recruited. Chaperone documentation increased to 80% (51/64). Reassessment at six weeks included 120 patients, and chaperone documentation rate was 74% (89/120).
Regulatory Requirements for the Quality of Allergen Products for Allergen Immunotherapy of Food Allergy
Authors: Englert Lisa , Mahler Vera , Bonertz Andreas
Published: May 2021

Purpose of Review

Medicinal products for allergen immunotherapy (AIT) of food allergies have gained enormous momentum in recent years. With this new class of products entering marketing authorization procedures, compliance to regulatory requirements becomes a critical element. Here, an overview is provided on specific requirements and aspects concerning the quality control and manufacturing of these products.

Recent Findings

Recent developments in the field of AIT for food allergies are divers, including products for oral, epicutaneous, and subcutaneous application, most notably targeting egg, milk, and peanut allergy. As the source materials for food AIT product are typically produced for food consumption and not for medicinal purposes, unique challenges arise in the manufacturing processes and controls of these medicinal products. Individual approaches are needed to assure acceptable quality, including control of relevant quantitative and qualitative characteristics. Major characteristics for quality verification include determination of protein content, total allergenic activity, and major allergen content. The applied manufacturing processes need to be established such that relevant process parameters are kept within justified limits and consistency of produced batches is assured.

Allergen products for food AIT present specific challenges with respect to quality aspects that differentiate them from other commonly available AIT products. While established regulation is available and provides clear guidance for most aspects, other issues require consideration of new and individual settings relevant here. Consequently, as experience grows, respective amendments to currently available guidance may be needed.
True Symphalangism of All Bilateral Proximal Interphalangeal Joints with Multi-carpal Coalition and Hypoplasia of the Ulnar Styloid Process
Authors: Yu Hao , Li Chongjie
Published: May 2021

Symphalangism is a rare genetic condition characterized by ankylosis of the proximal interphalangeal (PIP) or/and distal interphalangeal (DIP) joints. The patient presented with fused bilateral PIP joints and poor flexion, and an unsatisfactory range of motion (ROM) in the metacarpophalangeal (MP) and DIP joints. Concomitantly, multi-carpal coalition, proximal carpal malalignment, and ulnar styloid process abnormality were also observed in radiographs obtained at diagnosis. Rehabilitation training of the MP and DIP joints and a wrist supporter were recommended to achieve MP and DIP functional motion and restrict dramatic wrist motion. This is the first case report of symphalangism with multi-carpal coalition and abnormality of the ulnar styloid process to the best of our knowledge.
Wie konnte es zur Krise im Rakhine-Staat in Myanmar kommen? Ein Blick zurück nach vorn
Authors: Fox Mandy , Hellmann-Rajanayagam D. , Korff Rüdiger
Published: May 2021

Wie konnte es zu dem Konflikt im Rakhine-Staat in Myanmar kommen, der eine Flucht von mehr als 700.000 Muslim*innen nach Bangladesch zur Folge hatte? Um dieser Frage auf den Grund gehen zu können, ist es wichtig, die Ursachen und Hintergründe des Konfliktes zu betrachten und in den historischen Kontext einzubetten. Vielfältige Ebenen überlagern sich in dem Konflikt. Es ist zunächst ein lokaler Konflikt zwischen der muslimischen Minderheit und den buddhistischen Rakhine, desweiteren ein Konflikt zwischen dem Staat Myanmar, den Rakhine und den muslimischen Rohingya und letztlich ein internationaler Konflikt, der vor dem Internationalen Gerichtshof in Den Haag verhandelt wird.
Hydrate formation as a method for natural gas separation into single compounds: a brief analysis of the process potential
Authors: Gambelli Alberto Maria , Rossi Federico
Published: May 2021

In both natural gas and petroleum reservoirs, the extracted gas is not only composed of methane: a variable and significant quantity of other compounds, such as different hydrocarbons (ethane, butane, pentane, propane, etc.), inert gas (nitrogen), and toxic and corrosive molecules (i.e., carbon dioxide and hydrogen sulfide), are present. In order to reach commercial specifications, natural gas has to be treated, in particular for reaching the minimum gross calorific value required and decreasing CO2 and H2S presence under the respective tolerance values. To do this, several different treatments are commonly applied, like inlet separation, sweetening, mercury removal, dehydration, liquid recovery, and, finally, compression for its transportation. Considering the growing demand and the necessity of exploiting also lower quality natural gas reservoirs, in the present paper, an original solution, for performing a gas treatment, is proposed and analyzed. It consists of promoting hydrates formation for both different compounds separation and gas storage. The greatest part of chemicals commonly present in natural gas is capable to form hydrates, but at different thermodynamic conditions than others. Parameters such as the typology of stored compound and the formation process efficiency are mainly related to partial pressure of each element. Here, the present strategy has been explored and the results achievable were shown. In particular, different possible natural gas compositions were taken into account and specifications required for gas commercialization were considered target of the process. Results led to different possibilities of raw gas treatment: in some cases, gas separation led to contemporary CH4 storage into hydrate structures, while, in the presence of different mixture compositions, contaminants were trapped into water cages and methane (and, eventually, other hydrocarbon compounds) remained in the gas phase.
Distinctive clinical and laboratory features of COVID-19 and H1N1 influenza infections among hospitalized pediatric patients
Authors: Asseri Ali Alsuheel , Shati Ayed A. , Al-Qahtani Saleh M. , Alzaydani Ibrahim A. , Al-Jarie Ahmed A. , Alaliani Mohammed J. , Ali Abdelwahid Saeed
Published: May 2021

Background

It had been documented in many studies that pediatric coronavirus disease 2019 (COVID-19) is characterized by low infectivity rates, low mortalities, and benign disease course. On the other hand, influenza type A viruses are recognized to cause severe and fatal infections in children populations worldwide. This study is aimed to compare the clinical and laboratory characteristics of COVID-19 and H1N1 influenza infections.

Methods

A retrospective study comprising 107 children hospitalized at Abha Maternity and Children Hospital, Southern region of Saudi Arabia, with laboratory-confirmed COVID-19 and H1N1 influenza infections was carried out. A complete follow-up for all patients from the hospital admission until discharge or death was made. The clinical data and laboratory parameters for these patients were collected from the medical records of the hospital.

Results

Out of the total enrolled patients, 73 (68.2%) were diagnosed with COVID-19, and 34 (31.8%) were diagnosed with H1N1 influenza. The median age is 12 months for COVID-19 patients and 36 months for influenza patients. A relatively higher number of patients with influenza had a fever and respiratory symptoms than COVID-19 patients. In contrast, gastrointestinal symptoms were observed in a higher number of COVID-19 patients than in influenza patients. A statistically significant increase in white cell counts is noted in COVID-19 but not in influenza patients (P < 0.05). There are no obvious variations in the mean period of duration of hospitalization between COVID-19 and influenza patients. However, the total intensive care unit length of stay was longer for influenza compared to COVID-19 patients.

Conclusions

A considerable number of children infected with COVID-19 and H1N1 influenza were noted and reported in this study. There were no significant variations in the severity of the symptomatology and laboratory findings between the two groups of patients. Significant differences between these patients in some hospitalization factors and diagnosis upon admission also were not observed. However, more severe clinical manifestations and serious consequences were observed among pediatric patients hospitalized with influenza infections than among those with COVID-19.
A Literature Review on Interactions Between Stakeholders Through Accessibility Indicators Under Mobility as a Service Context
Authors: PHAM Hoang Duy , Shimizu Tetsuo , NGUYEN Truong Van
Published: May 2021

This study aims to explore accessibility indicators influencing the interactions between users, transport service providers (TSPs), and a platform operator, generating a conceptual framework for modeling these interactions under Mobility as a Service context. A systematic literature review was conducted to identify all studies focusing on indicators and modeling the interactions. There are limitations in integrating psychological indicators and dynamic pricing into the existing models. Moreover, there are gaps in considering monthly service packages, the efficiency of transport systems, and the perspectives of the TSPs for modeling the demand–supply interactions. The study ends with conclusions, discussions, and directions for further studies.
Editorial
Authors: van Bezooijen Bart
Published: May 2021

Samenvatting

Iedere week verheug ik me weer op het NTvG en Medisch Contact. Maar extra blij word ik als daar tegelijkertijd het Tijdschrift voor Urologie bij zit. Dat krijgt dan uiteraard meteen voorrang in de leesvolgorde. Zeker in deze tijd, waarin ons onderling contact beperkt blijft tot zoombijeenkomsten en een Nieuwsbrief. Altijd een klein feestje om dit tijdschrift te lezen.
(Nederlands) Tijdschrift voor Urologie: Van ‘Kloten’ (1992) tot heden
Authors: Lock M.T.W.T. , van der Poel Henk G.
Published: May 2021

Samenvatting

De jongere collega-urologen (minder dan 10 jaar in het vak) kennen alleen het ‘rode’ Tijdschrift voor Urologie (TvU) , met daarin De Urograaf als apart katern.
Universal Taylor Series in Several Variables Depending on Parameters
Authors: Gavrilopoulos G. , Maronikolakis K. , Nestoridis V.
Published: May 2021

We establish generic existence of Universal Taylor Series on products $$\varOmega = \prod \varOmega _i$$

Ω
=
∏

Ω
i

of planar simply connected domains $$\varOmega _i$$

Ω
i

where the universal approximation holds on products K of planar compact sets with connected complements provided $$K \cap \varOmega = \emptyset $$

K
∩
Ω
=
∅

. These classes are with respect to one or several centers of expansion and the universal approximation is at the level of functions or at the level of all derivatives. Also, the universal functions can be smooth up to the boundary, provided that $$K \cap \overline{\varOmega } = \emptyset $$

K
∩

Ω
¯

=
∅

and $$\{\infty \} \cup [{\mathbb {C}} {\setminus } \overline{\varOmega }_i]$$

{
∞
}

∪

[
C
\

Ω
¯

i

]

is connected for all i. All previous kinds of universal series may depend on some parameters; then the approximable functions may depend on the same parameters, as it is shown in the present paper.
Biochemical predictors of structural hypothalamus–pituitary abnormalities detected by magnetic resonance imaging in men with secondary hypogonadism
Authors: Cipriani S. , Todisco T. , Ghiandai N. , Vignozzi L. , Corona G. , Maggi M. , Rastrelli G.
Published: May 2021

Purpose

Organic conditions underlying secondary hypogonadism (SH) may be ascertained by magnetic resonance imaging (MRI) of the hypothalamic–pituitary region that could not be systematically proposed to each patient. Based upon limited evidence, the Endocrine Society (ES) guidelines suggest total testosterone (T) < 5.2 nmol/L to identify patients eligible for MRI. The study aims to identify markers and their best threshold value predicting pathological MRI findings in men with SH.

Methods

A consecutive series of 609 men seeking medical care for sexual dysfunction and with SH (total T < 10.5 nmol/L and LH ≤ 9.4 U/L) was retrospectively evaluated. An independent cohort of 50 men with SH was used as validation sample. 126 men in the exploratory sample and the whole validation sample underwent MRI.

Results

In the exploratory sample, patients with pathological MRI findings (n = 46) had significantly lower total T, luteinizing hormone (LH), follicle stimulating hormone (FSH) and prostate specific antigen (PSA) than men with normal MRI (n = 80). Receiver Operating Characteristics analysis showed that total T, LH, FSH and PSA are accurate in identifying men with pathologic MRI (accuracy: 0.62–0.68, all p < 0.05). The Youden index was used to detect the value with the best performance, corresponding to total T 6.1 nmol/L, LH 1.9 U/L, FSH 4.2 U/L and PSA 0.58 ng/mL. In the validation cohort, only total T ≤ 6.1 nmol/L and LH ≤ 1.9 U/L were confirmed as significant predictors of pathologic MRI.

Conclusion

In men with SH, total T ≤ 6.1 nmol/L or LH ≤ 1.9 U/L should arise the suspect of hypothalamus/pituitary structural abnormalities, deserving MRI evaluation.
Multi-functionalization Strategies Using Nanomaterials: A Review and Case Study in Sensing Applications
Authors: Song Ji-Hyeon , Min Soo-Hong , Kim Seung-Gi , Cho Younggyun , Ahn Sung-Hoon
Published: May 2021

Remarkable advances in nanomaterials and nanotechnology have led researchers in various fields. The scale effects imparted by nanomaterials are associated with unexpected macroscale phenomena and properties that find many applications. However, multi-functionalization may be accompanied by physical and commercial limitations. Therefore, research must proceed in several different directions. Here, we define multi-functionalization and the electrical applications thereof in terms of increasing performance, addition of new and valuable properties, and multi-physics in play. We deal with sensors, actuators, energy harvesters, and solar cells and explore research that seeks to increase sensitivity, append “stretchability”, and facilitate untethered communication. Furthermore, we analyze research trends in materials use and manufacturing, and highlight useful fabrication methods. With the aim of predicting future research trends, our review presents a roadmap that will aid research on sensing and multi-functional applications.
Sustaining Meaningful Patient Engagement Across the Lifecycle of Medicines: A Roadmap for Action
Authors: Cavaller-Bellaubi Maria , Faulkner Stuart D. , Teixeira Bryan , Boudes Mathieu , Molero Eva , Brooke Nicholas , McKeaveney Laura , Southerton Jeffrey , Vicente Maria José , Bertelsen Neil , García-Burgos Juan , Pirard Vinciane , Reid Kirsty , Ferrer Elisa
Published: May 2021

Background

There is increased recognition that incorporating patients’ perspectives and insights into the medicines development process results in better health outcomes and benefits for all involved stakeholders. Despite the increased interest and the existence of frameworks and practical recommendations, patient engagement (PE) is not yet considered standard practice. The objective of this work was to provide a roadmap to support systematic change in all stakeholder organisations involved in medicines development across Europe, patients and patient organisations, medicines developers, academia, regulatory authorities, Health Technology Assessment bodies, payers, policy-makers and public research funders, to sustain PE practices.

Methods

A mixed-methods approach was used by the EU-funded Innovative Medicines Initiative PARADIGM Consortium to co-develop the sustainability roadmap including background work to identify success factors and scenarios for sustainable PE. The roadmap development was based on the Theory of Change concept and populated with findings from (1) interviews with national/ and international institutions with the potential to increase PE uptake by other stakeholders; (2) multi-stakeholder workshops and webinars; and (3) consultations with specific stakeholder groups, Consortium members and a consultative body formed by international PE initiatives.

Results

This roadmap sets strategic goals for the PE community to achieve meaningful and systematic PE through changes in the culture, processes and resources of stakeholder organisations. It brings in key PARADIGM outputs to work in a coordinated fashion with existing frameworks and mechanisms to achieve system-wide sustained PE.

Conclusions

The roadmap provides a framework for all stakeholders to take collective action within their organisations and across Europe to implement PE in a sustainable manner.
Sole Traders? The Role of the Extended Family in Eighteenth-Century Atlantic Business Networks
Authors: Jones Sophie H. , Talbott Siobhan
Published: May 2021

Despite significant developments in understanding the role of women in early-modern business, more is needed to fully understand women’s impact on eighteenth-century trading networks. Further, much less is known about the role of wider family members, especially children, in the eighteenth-century Atlantic economy. The formal documentation that is privileged in business histories does not tell the whole story, and it frequently represents mercantile activity as a pursuit dominated by a patriarch at the center of a trading network. This article explores eighteenth-century familial commercial networks through extensive use of the personal family correspondence of three merchant families who lived and traded within different locales of the northern Atlantic: Hugh Hall, a merchant and vice judge of the admiralty in Barbados; the Black family, who were wine merchants in Bordeaux; and Joseph Symson, a mercer and shopkeeper from Kendal, England. This article will show that women appear as autonomous players with the power and ability to make informed and independent decisions that directed the business interests of their families. Moreover, it includes an assessment of the ways in which merchants cultivated the expertise of their extended families to enhance their commercial networks and advance their business pursuits. Focusing on children who supported or enhanced the prosperity of the family firm, this article emphasizes that their participation was intentional, not incidental. This article asks questions about the emotional consequences of such activity—which have rarely been considered in any detail—as well as the financial benefit of operating in this manner.
A simulation study to evaluate contamination during reuse of N95 respirators and effectiveness of interventions to reduce contamination
Authors: Li Daniel F. , Alhmidi Heba , Scott Jacob G. , Charnas Ian C. , Pearlmutter Basya , Silva Sandra Y. , Wilson Brigid M. , Donskey Curtis J.
Published: May 2021

Objective:

To assess the potential for contamination of personnel, patients, and the environment during use of contaminated N95 respirators and to compare the effectiveness of interventions to reduce contamination.

Design:

Simulation study of patient care interactions using N95 respirators contaminated with a higher and lower inocula of the benign virus bacteriophage MS2.

Methods:

In total, 12 healthcare personnel performed 3 standardized examinations of mannequins including (1) control with suboptimal respirator handling technique, (2) improved technique with glove change after each N95 contact, and (3) control with 1-minute ultraviolet-C light (UV-C) treatment prior to donning. The order of the examinations was randomized within each subject. The frequencies of contamination were compared among groups. Observations and simulations with fluorescent lotion were used to assess routes of transfer leading to contamination.

Results:

With suboptimal respirator handling technique, bacteriophage MS2 was frequently transferred to the participants, mannequin, and environmental surfaces and fomites. Improved technique resulted in significantly reduced transfer of MS2 in the higher inoculum simulations (P < .01), whereas UV-C treatment reduced transfer in both the higher- and lower-inoculum simulations (P < .01). Observations and simulations with fluorescent lotion demonstrated multiple potential routes of transfer to participants, mannequin, and surfaces, including both direct contact with the contaminated respirator and indirect contact via contaminated gloves.

Conclusion:

Reuse of contaminated N95 respirators can result in contamination of personnel and the environment even when correct technique is used. Decontamination technologies, such as UV-C, could reduce the risk for transmission.
Psychotic-like experiences? Trajectories and typologies of hallucinations and delusions from early adolescence to early adulthood in a population-based sample of Irish youth
Authors: Coughlan H. , Humphries N. , Clarke M.C. , Healy C. , Cannon M.
Published: May 2021

Objectives:

Hallucinations and delusions that occur in the absence of a psychotic disorder are common in children and adolescents. Longitudinal phenomenological studies exploring these experiences are notably lacking. The objective of the current paper was to explore the phenomenology and characteristics of hallucinations and delusions from early adolescence to early adulthood.

Methods:

Participants were 17 young people aged 18–21 years from the general population, all of whom had a history of childhood hallucinations and/or delusions. Longitudinal data on the phenomenological characteristics and attributions of reported hallucinatory and delusional phenomena spanning nine years were explored using content analysis.

Results:

Hallucinatory and delusional phenomena were transient for two-thirds of the sample. The remaining one-third reported reoccurring hallucinatory and delusional phenomena into early adulthood. In those, two typologies were identified: (1) Paranormal typology and (2) Pathological typology. The former was characterised by hallucinatory and delusional phenomena that were exclusively grounded in subcultural paranormal or spiritual belief systems and not a source of distress. The latter was characterised by delusion-like beliefs that were enmeshed with individuals’ mood states and a source of distress. The perceived source, the subcultural context and how young people appraised and integrated their experiences differentiated the Paranormal and Pathological typologies.

Conclusions:

Not all hallucinatory and delusion-like experiences are psychotic-like in nature. To reliably differentiate between pathological and non-pathological hallucinations and delusions, assessments need to explore factors including the phenomenology of individuals’ experiences, how people make sense and appraise them, and the subcultural contexts within which they are experienced.
Radiological findings in spontaneous cerebrospinal fluid leaks of the temporal bone
Authors: Hendriks T , Thompson A , Boeddinghaus R , Tan H E I , Kuthubutheen J
Published: May 2021

Background and objective

Spontaneous cerebrospinal fluid leak of the temporal bone is an emerging clinical entity for which prompt and accurate diagnosis is difficult given the subtle signs and symptoms that patients present with. This study sought to describe the key temporal bone abnormalities in patients with spontaneous cerebrospinal fluid leak.

Methods

A retrospective cohort study was conducted of adult patients with biochemically confirmed spontaneous cerebrospinal fluid leak. Demographics and radiological features identified on computed tomography imaging of the temporal bones and/or magnetic resonance imaging were analysed.

Results

Sixty-one patients with spontaneous cerebrospinal fluid leak were identified. Fifty-four patients (88.5 per cent) underwent both temporal bone computed tomography and magnetic resonance imaging. Despite imaging revealing bilateral defects in over 75 per cent of the cohort, only two patients presented with bilateral spontaneous cerebrospinal fluid leaks. Anterior tegmen mastoideum defects were most common, with an average size of 2.5 mm (range, 1–10 mm).

Conclusion

Temporal bone computed tomography is sensitive for the identification of defects when suspicion exists. In the setting of an opacified middle ear and/or mastoid, close examination of the skull base is crucial given that this fluid is potentially cerebrospinal fluid.
NATO's strategic narratives: Angelina Jolie and the alliance's celebrity and visual turn
Authors: Wright Katharine A. M. , Bergman Rosamond Annika
Published: May 2021

Angelina Jolie's high-profile visit to NATO in 2018 signals a move to brand the alliance's strategic narrative within the language of celebrity through engagement with popular culture. The partnership represents a significant change in the alliance's approach to global security. It also builds on a shift in NATO's self-narrative through the advocacy of gender justice related to the Women, Peace and Security (WPS) agenda. Rather than fading into the background, NATO appears to be pursuing the limelight for the purpose of ‘awareness raising’ as a tool to implement the WPS agenda. Drawing upon feminist scholarship on the WPS agenda, NATO, and research on celebrity humanitarianism and politics, we provide a critical study of this change in NATO's strategic narrative, through the analysis of visual and textual material related to Jolie's visit to NATO. Our focus is on the significance of this partnership and its contribution to legitimising the alliance's self-defined ‘military leadership’ in the area of conflict-related sexual violence. While Jolie's visit to NATO opened the alliance to public scrutiny it also symbolised a form of militarism, surrounded by orchestrated visual representations. As such, it only marginally disrupted the militarist logic present in NATO's wider WPS engagement.
The Englishisation of personal names in Nigeria
Authors: Mensah Eyo O.
Published: May 2021

Naming is a linguistic universal. Every known human society distinguishes and individuates its members by their names. In the context of Africa and beyond, names are not just ordinary labels for the identification of their bearers; they mirror the culture, tradition and worldview of the people. Essien (1986: 5) argues that ‘naming is not an arbitrary affair, it is at once a mental, an emotional, a linguistic and a cultural matter’. It is widely believed that names and naming can influence the personality development and behaviour of their bearers. This claim justifies Camden's (1984: 43) admonition that ‘names should be chosen with good and gracious significations to inspire the bearer to good action’. This implies that people are assumed to live according to the message contained in their names. Significantly, names also embed deep cultural insights that reflect their bearers’ social lives, philosophy, religion, emotions and worldview. African names, for instance, are important cultural and symbolic resources that reflect the peculiarities of the African people, and capture their beliefs, values, identity and personality.
Identifying gaps in parental support for families of children with hypoplastic left heart syndrome
Authors: Landry Meghan , Katers Meghan , Olson Erica , Cern Lynn , Nelson Timothy J , Campbell Katherine A
Published: May 2021

Purpose:

The purpose of this study is to identify gaps in support for parents of children with Hypoplastic Left Heart Syndrome.

Design and methods:

Using a mixed-methods approach, the researchers first studied the parental and care team experience through interviews of Hypoplastic Left Heart Syndrome mothers and members of the inter-professional care team and then conducted an international survey of 690 Hypoplastic Left Heart Syndrome primary caregivers to validate the qualitative findings.

Results:

Parental and care team interviews revealed three main gaps in parental support, including lack of open communication, unrealistic parental expectations, and unclear inter-professional team roles. Survey results found that parents whose children were diagnosed with Hypoplastic Left Heart Syndrome after birth indicated significant dissatisfaction with the care team’s open communication and welcoming of feedback (p = 0.008). As parents progress through the stages of surgical intervention, they also indicate significant dissatisfaction with the care team’s anticipation of parental emotional needs and provision of coping resources (p = 0.003).

Conclusions:

Parental support interventions should focus on providing resources to help parents cope, helping the care team model open communication, and welcoming feedback on the parental experience.

Practice implications:

Interventions should be piloted with parents who are in the later stages of the surgical intervention timeline or whose children were diagnosed after birth as they are the populations who perceived the least support within this study.
Xylological Variant of Reverse Fregoli Syndrome, Delusions of Being a Tree
Authors: Bakhshi Harsimran Singh , Hirsch Alan Richard
Published: May 2021

Introduction

The delusion of being a living animate non-animal object has not heretofore been reported.

Methods

A 21-year-old right-handed cisgender female, two months prior to presentation, noted stiffness and difficulty with ambulation. One-month prior to admission, she experienced recurrent depression with myriad vegetative and nonvegetative symptoms of depression. On admission her chief complaint was I am a tree, standing motionless and minimally responding to query. After treatment with quetiapine, mirtazapine and hydroxyzine for a one-week period, her perception of being a tree fully resolved.

Results

Abnormalities in Mental Status Examination: Anxious mood repeatedly stating, I am a tree. Standing still for long periods of time, refusing blood pressure to be obtained and expressing fear of constricting flow. Neuropsychiatric Testing: Beck Depression Inventory Type II: 33 (severe depression)

Discussion

The rapid response to risperidone is consistent with Cotard’s syndrome, which has been noted to respond rapidly to neuroleptics (Sharma, 2014). However, in Cotard’s syndrome, replacement by a living non-animal object has not hitherto been reported. Body infestation with animate objects, as in Ekbom syndrome, only includes animals not botanicals (Chaudhary, 2019). This could be viewed as Reverse Inanimate Capgras Syndrome: instead of an imposter replacing a close friend, who then is inserted into the sufferer; a tree has replaced the sufferer. Peradventure, this may fit into the construct of Intermetamorphosis, a misidentification syndrome associated with the belief that individuals have transformed into other persons (Jariwala, 2017). Botanical Intermetamorphosis, the belief by the sufferer that the other individual is transformed from a person into a plant has not been described. Reverse Intermetamorphosis is the projection of an external individual into the person suffering or a syndrome of altered physical and psychological identities of the self (Silva, 1990). However, in this situation, the objects are all human or animate animals not botanicals. In Fregoli syndrome, there is an altered physical identity of others. In Reverse Fregoli syndrome, the sufferer assumes the physical but not the psychological identity of the stranger (Silva, 1990). But in this instance, the stranger is human as opposed to a plant life form. In the current case there is only altered physical identity (into a tree) not psychological identity. The current case may also be interpreted as a Botanical Variant of Interparietal Syndrome. In this condition, parts of the body are perceived to be lifeless, due to lesions of the inferior parietal lobe including supramarginalis gyrus, angular gyrus and the basalis parietalis area (Angyal, 1935). Investigation for those whom have Intermetamorphosis, Fregoli syndrome, Capgras syndrome, Interparietal syndrome, and Cotard’s syndrome for the presence of delusions involving plant life is warranted.
Understanding the Evolving Continuing Medical Education Needs of Physicians Managing Patients with TD
Authors: Wiley Shereta , Cerenzia Wendy , Stacy Sylvie , Shah Chirag , Lundt Leslie , Farahmand Khody
Published: May 2021

This study sought to understand the evolving continuing medical education (CME) needs of physicians managing patients with tardive dyskinesia (TD). A case-based survey was developed, and later updated, to assess current practice, knowledge, and attitudes of neurologists and psychiatrists in the management of patients with TD. The original and updated survey were fielded in May 2018 and March 2020, respectively, to US-practicing psychiatrists and neurologists. Results were obtained from 213 psychiatrists and 187 neurologists in 2018 and from 125 psychiatrists and 128 neurologists in 2020. Less than half of physicians in both 2018 and 2020 were able to correctly identify the prevalence of TD in patients on maintenance antipsychotics, with many underestimating reported prevalence. Respondents reported moderate familiarity with VMAT2 inhibitor therapies for TD, with self-reported familiarity increasing more among neurologists than psychiatrists since the 2018 study. Psychiatrists are more likely than neurologists to take responsibility for medical management of TD symptoms and antipsychotic medication adjustment. Despite recommendations from APA guidelines and AAN reviews, 15% of physicians would use an anticholinergic to manage TD symptoms and only about half would opt for a VMAT2 inhibitor. There was a larger increase in VMAT inhibitor use between 2018 and 2020 among neurologists as compared to psychiatrists. The findings support the need for CME on TD focused toward specific provider groups. While both types of specialists would benefit from CME on the topic of TD epidemiology, there is an increased need for CME that includes treatment updates among psychiatrists.

Funding. Neurocrine Biosciences, Inc.
Phase 3 Safety and Tolerability Results of the Combination Olanzapine and Samidorphan in Patients with Schizophrenia: The 1 Year ENLIGHTEN-2-Extension
Authors: Kahn Rene , Silverman Bernard , DiPetrillo Lauren , Graham Christine , Jiang Ying , Yin Jiani , Simmons Adam , Bhupathi Vasudev , Yu Bei , Hopkinson Craig , McDonnell Davidd
Published: May 2021

Objective

Combination olanzapine and samidorphan (OLZ/SAM) is in development for treatment of schizophrenia and bipolar I disorder and is intended to provide the antipsychotic efficacy of olanzapine while mitigating olanzapine-associated weight gain. This 52-week open-label extension study (NCT02873208; ENLIGHTEN-2-EXT) in schizophrenia assessed the safety and tolerability of OLZ/SAM. Methods: Patients completing the 24-week, randomized, double-blind, phase 3 ENLIGHTEN−2 study comparing weight gain with OLZ/SAM vs olanzapine were eligible for ENLIGHTEN-2-EXT enrollment. Initial OLZ/SAM doses were based on olanzapine dose (10 or 20 mg) received at the conclusion of ENLIGHTEN-2; subsequent olanzapine dose adjustments were allowed. The samidorphan dose (10 mg) remained fixed throughout. Assessments included adverse events (AEs), weight, waist circumference, metabolic laboratory parameters, and Positive and Negative Syndrome Scale (PANSS) scores. Analyses were based on observed results using descriptive statistics. Baseline was relative to the first OLZ/SAM dose in the extension study.

Results

265 patients received OLZ/SAM; 167 (63.0%) completed the extension study. Common AEs (= 5%) were weight decreased (n=23; 8.7%), extra dose administered (n=21; 7.9%), headache (n=18; 6.8%), and weight increased (n=16; 6.0%). At week 52, mean (SD) change from baseline for weight and waist circumference was −0.03 (6.216) kg and −0.35 (6.115) cm, respectively. Changes in fasting lipid and glycemic parameters were generally small and remained stable over 52 weeks. PANSS total scores remained stable during the extension.

Conclusions

OLZ/SAM was generally well tolerated over 52 weeks. Weight, waist circumference, metabolic laboratory parameters, and schizophrenia symptoms remained stable throughout the study.

Funding

Alkermes, Inc.