bluuebunny/crossref_metadata_2025 huggingface dataset:
Gatekeeping, Fast and Slow: An Empirical Study of Referral Errors in the Emergency Department
Authors: Freeman Michael , Robinson Susan , Scholtes Stefan
Published: October 2020

Using data from over 300,000 visits to an emergency department (ED), we study the accuracy of gatekeeping decisions—the choices that physicians make regarding patient discharge or admission to the hospital. In our study context, we focus specifically on the effectiveness of a second gatekeeping stage in the ED—a clinical decision unit (CDU). Although only 9.9% of patients in our sample are routed through the CDU, we find that had the unit not been in place during the observation period, the rates of unnecessary hospitalization and wrongful patient discharge from the ED would have increased by 14.3% and 29.6%, respectively. We also find that the CDU is especially beneficial for patients with a high ex ante risk of experiencing unnecessary hospitalization, with the rate for the most high-risk patients reduced from 14.0% without the CDU to just 4.8% had all such patients been routed through the CDU. The appropriateness of referrals is therefore a key contributor to the CDU’s effectiveness: We estimate that random allocation of patients in our study hospital to the CDU would have reduced the unit’s effectiveness by more than half. Finally, we investigate a critical trade-off in designing a two-stage gatekeeping system: Resources must be split between the two stages, increasing congestion in the first stage when the second stage is enlarged. We demonstrate that in the study hospital, the combination of an ED and CDU performs better than a pooled system that combines the capacity of both stages to enlarge the ED but does not have a designated CDU. In fact, we estimate that in this specific case, reducing the size of the first-stage ED in order to expand CDU capacity from the current 9.9% of ED patients to 25% would further reduce unnecessary hospitalizations by up to 33%. We discuss the insights that these results provide as to the circumstances under which it may be advantageous to add a second stage to a gatekeeping system.

This paper was accepted by David Simchi-Levi, operations management.
Setting Retail Staffing Levels: A Methodology Validated with Implementation
Authors: Fisher Marshall , Gallino Santiago , Netessine Serguei
Published: October 2020

Problem definition: How should retail staffing levels be set? While cost of labor is well understood, the revenue implications of having the right staffing level are hard to estimate. Moreover, these implications vary by store; hence, staffing levels should vary as well. Academic/practical relevance: We provide a novel method for setting store associate staffing at the individual store level. We discuss a field implementation that tested this methodology. Methodology: We use historical data on revenue and planned and actual staffing levels by store to estimate how revenue varies with the staffing level at each store. We disentangle the endogeneity between revenue and staffing levels by focusing on randomly occurring deviations between planned and actual labor. Using historical analysis as a guide, we validate these results by changing the staffing levels in a few test stores. We implement the results chain-wide and measure the impact in a large specialty retailer. Results: We find that the implementation validates predictions of the historical analysis. The implementation in 168 stores over six months produces a 4.5% revenue increase and a nearly $7.4 million annual profit increase. The impact of staffing level on revenue varies greatly by store. Managerial implications: Our paper makes three contributions to academic literature and to retail practice. First, we describe a process by which retailers can improve the most common industry practice: set store labor to be proportional to forecasted store revenue. Our proposed approach systematically sets the labor level in each store. Second, we demonstrate the effectiveness of that process via a field test and then via chain-wide implementation over a six-month time period. Finally, most retailers set store labor at the same level across stores, proportionate to revenue. We show that this is not the best approach because the revenue impact of store labor varies by store. The stores in our study that could benefit from relatively more labor were those with high potential demand, closely located competition for that demand, and experienced store managers. Overall, we provide the first simple but rigorous, field-tested approach that any retailer can use to increase revenue and profitability through better labor management.
Optimal Duration of Innovation Contests
Authors: Korpeoglu C. Gizem , Körpeoğlu Ersin , Tunç Sıdıka
Published: October 2020

Problem definition : We study the contest duration and the award scheme of an innovation contest where an organizer elicits solutions to an innovation-related problem from a group of agents. Academic/practical relevance : Our interviews with practitioners at crowdsourcing platforms have revealed that the duration of a contest is an important operational decision. Yet, the theoretical literature has long overlooked this decision. Also, the literature fails to adequately explain why giving multiple unequal awards is so common in crowdsourcing platforms. We aim to fill these gaps between the theory and practice. We generate insights that seem consistent with both practice and empirical evidence. Methodology : We use a game-theoretic model where the organizer decides on the contest duration and the award scheme while each agent decides on her participation and determines her effort over the contest duration by considering potential changes in her productivity over time. The quality of an agent’s solution improves with her effort, but it is also subject to an output uncertainty. Results : We show that the optimal contest duration increases as the relative impact of the agent uncertainty on her output increases, and it decreases if the agent productivity increases over time. We characterize an optimal award scheme and show that giving multiple (almost always) unequal awards is optimal when the organizer’s urgency in obtaining solutions is below a certain threshold. We also show that this threshold is larger when the agent productivity increases over time. Finally, consistent with empirical findings, we show that there is a positive correlation between the optimal contest duration and the optimal total award. Managerial implications : Our results suggest that the optimal contest duration increases with the novelty or sophistication of solutions that the organizer seeks, and it decreases when the organizer can offer support tools that can increase the agent productivity over time. These insights and their drivers seem consistent with practice. Our findings also suggest that giving multiple unequal awards is advisable for an organizer who has low urgency in obtaining solutions. Finally, giving multiple awards goes hand in hand with offering support tools that increase the agent productivity over time. These results help explain why many contests on crowdsourcing platforms give multiple unequal awards.
Strength from Within: Internal Mobility and the Retention of High Performers
Authors: Benson Alan , Rissing Ben A.
Published: October 2020

We develop and test a theoretically informed and generalizable empirical framework for evaluating the performance gap between internally and externally hired workers. First, human capital theory predicts that internal hires will be immediately more productive than external hires. Second, contextual learning predicts that internal hires will be more productive with time. Finally, theories of commitment, which are rarely applied to this literature, predict that internal advancement enhances retention among high performers (“positive retention”). Applying a general empirical framework for quantifying the relative contributions of these mechanisms to a retailer with 109,063 commissioned salespeople and their 12,931 managers, we find that the gap in our setting is primarily driven by positive retention: High performers and internal hires are less likely to quit, and crucially, high-performing internal hires are especially unlikely to quit. When high-performing internal hires do quit, they tend to cite reasons unrelated to work rather than advancement opportunities. By typically examining performance and retention in isolation, researchers and organizations may be underestimating the importance of internal advancement as a means of retaining of high performers.
Personnel Mobility and Organizational Performance: The Effects of Specialist vs. Generalist Experience and Organizational Work Structure
Authors: Fahrenkopf Erin , Guo Jerry , Argote Linda
Published: October 2020

This study advances understanding of the conditions under which a new worker improves organizational performance. We argue that the extent to which new group members have experience working as specialists or generalists is a critical factor in explaining performance after the new member joins. We conceptualize specialists as those who concentrate on a particular component of an organization’s task, whereas generalists perform all components of the task. As such, a specialist must coordinate with other group members to complete the group’s task, which makes a specialist more interdependent with other members and in possession of more organization-specific knowledge than a generalist. We predict that (1) groups receiving specialist new members do not perform as well after the new member joins as compared with groups receiving generalist new members and (2) groups with new members whose work experience and recipient group structure are aligned (i.e., generalist movers into generalist groups and specialist movers into specialist groups) perform better than groups with new members whose experience and recipient group structure are not aligned. We test our hypotheses using a laboratory study in which we manipulate the extent to which new members and incumbent members of recipient groups work as specialists or generalists. Participants work as generalists or specialists in three-person groups and receive a new member who acquired experience as a specialist or generalist in another group. We find support for our hypotheses and provide evidence on mechanisms through which potential new members’ backgrounds enable them to contribute significantly to their recipient groups. New members who acquire experience in a structure similar to that of their recipient organizations report that they experience greater fit with their new groups, which enables their recipient groups to perform better than groups where new members’ experience and recipient group structure are not aligned. Additionally, our results suggest generalists may be more likely than specialists to transfer knowledge to their new groups.
COVID-19: the epidemiology and treatment
Authors: Qu Liujing , Li Jinchun , Ren Hao
Published: October 2020

After initially emerging in late 2019, coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread rapidly to cause a global pandemic. SARS-CoV-2 is a betacoronavirus that is closely related to severe acute respiratory syndrome coronavirus and Middle East respiratory syndrome coronavirus, all of which can cause severe lung injury, respiratory distress and cytokine storm. While mortality rates associated with SARS-CoV-2 are lower than those associated with severe acute respiratory syndrome coronavirus or Middle East respiratory syndrome coronavirus, it is more contagious and spreads more rapidly than these other viruses. This article summarises the epidemiology and potential options for treating COVID-19 to give a foundation for future studies of the diagnosis, treatment and prevention of this deadly disease.
Collagen stimulants in facial rejuvenation: a systematic review
Authors: Millar-Hume Lucy
Published: October 2020

Collagen-stimulating agents relating to facial rejuvenation are part of the family of soft tissue fillers that can be used for facial contouring, volume restoration and skin rejuvenation through bio-stimulation of the tissues ( Strawford, 2020 ). Radiesse®, made from calcium hydroxylapatite, was US Food and Drug Adminstration-approved in 2006. Ellansé®, made from polycaprolactone, was CE-approved in 2009. However, polycaprolactone (which makes up 70% of Ellansé®) has been an FDA-approved biomaterial since 2001 ( Christen and Vercesi, 2020 ). This systematic review will evaluate the available evidence and evaluate if it continues to support the safety and efficacy of these two facial collagen stimulating materials.
Neurological examination
Authors: Kirk Andrew
Published: October 2020

The clinical examination is an important part of any patient consultation. After the primary survey and taking the patient history, a more in-depth examination is sometimes required to aid making a working diagnosis and help negate other differential diagnoses. The extent of this depends on the stability of the patient and may not be possible in time-critical circumstances. However, clinical examination is an increasing part of paramedic practice owing to the continued expansion of the scope of the paramedic role in both urgent and emergency care. Education on clinical examination concerning each of the main body systems is now an integral part of undergraduate paramedic curricula.

This clinical examination series provides a step-by-step overview for each of the main body systems. Continuing professional development (CPD) is an essential requirement for all clinicians to maintain and to demonstrate that they are staying up to date and advancing in their roles.

This series gives an overview of each type of examination to support students, newly qualified paramedics and paramedics wishing to use these articles as a CPD development activity and an aide-memoire for clinical practice. This article, which explores the the neurological examination, gives an overview of initial examination considerations, and assessment of the upper limbs.
Alcohol/substance use and occupational/post-traumatic stress in paramedics
Authors: Hichisson Andrew David , Corkery John Martin
Published: October 2020

Background:

Paramedics work in high-pressure environments and experience traumatic events, which contribute to high levels of occupational and post-traumatic stress. Such stress can result in alcohol and substance misuse in other health professionals, but this relationship has not been examined in paramedics. This review is the first exploration of the literature on this.

Methods:

A systematic literature review was conducted using PRISMA guidelines, with databases searched using terms relevant to paramedics and alcohol/substance use. Studies were analysed using descriptive statistics for quantitative data and thematic analysis for qualitative information.

Findings:

Eleven studies were identified. Nine studies examined alcohol use; seven examined substance use; five examined both. Alcohol and smoking may be linked to occupational stress.

Conclusions:

The nature and extent of alcohol and substance use in relation to occupational and post-traumatic stress among paramedics need further investigation to facilitate advice and support.
Probe-hosted large area silicon photomultiplier and high-throughput timing electronics for enhanced performance time-domain functional near-infrared spectroscopy
Authors: Di Sieno L. , Behera A. , Rohilla S. , Ferocino E. , Contini D. , Torricelli A. , Krämer B. , Koberling F. , Pifferi A. , Mora A. Dalla
Published: October 2020

Two main bottlenecks prevent time-domain diffuse optics instruments to reach their maximum performances, namely the limited light harvesting capability of the detection chain and the bounded data throughput of the timing electronics. In this work, for the first time to our knowledge, we overcome both those limitations using a probe-hosted large area silicon photomultiplier detector coupled to high-throughput timing electronics. The system performances were assessed based on international protocols for diffuse optical imagers showing better figures with respect to a state-of-the-art device. As a first step towards applications, proof-of-principle in-vivo brain activation measurements demonstrated superior signal-to-noise ratio as compared to current technologies.
Variance lower bound on fluorescence microscopy image denoising
Authors: Li Yilun , Liu Sheng , Huang Fang
Published: October 2020

The signal to noise ratio of high-speed fluorescence microscopy is heavily influenced by photon counting noise and sensor noise due to the expected low photon budget. Denoising algorithms are developed to decrease these noise fluctuations in microscopy data by incorporating additional knowledge or assumptions about imaging systems or biological specimens. One question arises: whether there exists a theoretical precision limit for the performance of a microscopy denoising algorithm. In this paper, combining Cramér-Rao Lower Bound with constraints and the low-pass-filter property of microscope systems, we develop a method to calculate a theoretical variance lower bound of microscopy image denoising. We show that this lower bound is influenced by photon count, readout noise, detection wavelength, effective pixel size and the numerical aperture of the microscope system. We demonstrate our development by comparing multiple state-of-the-art denoising algorithms to this bound. This method establishes a framework to generate theoretical performance limit, under a specific prior knowledge, or assumption, as a reference benchmark for microscopy denoising algorithms.
Multi-resolution open-top light-sheet microscopy to enable efficient 3D pathology workflows
Authors: Barner Lindsey A. , Glaser Adam K. , Huang Hongyi , True Lawrence D. , Liu Jonathan T. C.
Published: October 2020

Open-top light-sheet (OTLS) microscopes have been developed for user-friendly and versatile high-throughput 3D microscopy of thick specimens. As with all imaging modalities, spatial resolution trades off with imaging and analysis times. A hierarchical multi-scale imaging workflow would therefore be of value for many volumetric microscopy applications. We describe a compact multi-resolution OTLS microscope, enabled by a novel solid immersion meniscus lens (SIMlens), which allows users to rapidly transition between air-based objectives for low- and high-resolution 3D imaging. We demonstrate the utility of this system by showcasing an efficient 3D analysis workflow for a diagnostic pathology application.
Quantum rangefinding
Authors: Frick Stefan , McMillan Alex , Rarity John
Published: October 2020

Quantum light generated in non-degenerate squeezers has many applications such as sub-shot-noise transmission measurements to maximise the information extracted by one photon or quantum illumination to increase the probability in target detection. However, any application thus far fails to consider the thermal characteristics of one half of the bipartite down-converted photon state often used in these experiments. We show here that a maximally mixed state, normally viewed as nuisance, can indeed be used to extract information about the position of an object while at the same time providing efficient camouflaging against other thermal or background light.
Verification of hybrid-integrated 400-Gb/s (4 × 100 Gb/s) CWDM4 ROSA using a bandwidth-improved multilayer board
Authors: Kang Sae-Kyoung , Huh Joon Young , Song Jongtae , Lee Joon Ki
Published: October 2020

We have successfully demonstrated a hybrid-integrated 400-Gb/s (4 × 100 Gb/s) CWDM4 PAM-4 receiver optical sub-assembly (ROSA) with a bandwidth-improved multilayer evaluation board. The proposed ROSA offers packaging simplification through passive optical alignment assembly of main components. In addition, we have proposed a structure to mitigate the bandwidth limitation issue caused by the typical edge connector mounting on the multilayer board, when needed bandwidth exceeds ∼20 GHz. With the bandwidth-improved multilayer board, the 3-dB bandwidth of the ROSA was observed to be >35.7 GHz and its receiver sensitivity was successfully measured to be <−10 dBm at FEC limit, bit error rate of 2.4e-4, for all channels.
Low-loss and ultra-broadband silicon nitride angled MMI polarization splitter/combiner
Authors: Kudalippalliyalil Ramesh , Murphy Thomas E. , Grutter Karen E.
Published: October 2020

The property of self-imaging combined with the polarization birefringence of the angled multimode waveguide is used to design a silicon nitride (SiN) polarization splitter (PS) at λ ∼ 1550 nm. The demonstrated PS on a 450 nm thick SiN device layer (with 2.5 µm cladding oxide) has a footprint of 80 µm×13 µm and exhibits nearly wavelength independent performance over the C+L bands. Also, the device can be configured as a polarization combiner (PC) in reverse direction with similar bandwidth and performance. The measured crosstalk (CT) and insertion loss (IL) are respectively <−18 dB (<−20 dB) and ∼0.7 dB (∼0.8 dB) for TE (TM) polarization over the measurement wavelength range of 1525 nm ≤λ ≤ 1625 nm. The measured device parameter variations suggest some tolerance to fabrication variations. Such a device is a good candidate for a photonics integrated chip (PIC) foundry-compatible, SiN PS.
The distribution pattern and growth factor level in platelet-rich fibrin incorporated skin-derived mesenchymal stem cells: An in vitro study
Authors: Ihsan Igo Syaiful , Karsari Deya , Ertanti Nora , Dinaryanti Aristika , Nugraha Alexander Patera , Purwati Purwati , Sudjarwo Sri Agus , Rantam Fedik Abdul
Published: October 2020

Background and Aim: A skin wound in an animal must be cared for to prevent further health issues. Platelet-rich fibrin (PRF) and skin-derived mesenchymal stem cells (SMSCs) have been reported to have potential in increasing the rate of wound healing. This study aimed to analyze the distribution patterns and levels of platelet-derived growth factor (PDGF), insulin-like growth factor (IGF), vascular endothelial growth factor (VEGF), and transforming growth factor-β (TGF-β) in PRF incorporated with SMSCs.

Materials and Methods: This study employed a true experiment (in vitro) design with post-test only performed in the control group alone. PRF and SMSCs were extracted from the blood and skin of 16 rabbits. SMSCs were characterized using immunocytochemistry to examine clusters of differentiation for 45, 73, 90, and 105. PRF was incorporated into the SMSCs and then divided into four groups (N=32/n=8): Group A (PRF only), Group B (PRF+SMSCs, incubated for 1 day), Group C (PRF+SMSCs, incubated for 3 days), and Group D (PRF+SMSCs, incubated for 5 days). Scanning electron microscopy was used to examine the distribution pattern of SMSCs between groups. The supernatant serum (Group A) and supernatant medium culture (Group D) were collected for the measurement of PDGF, IGF, VEGF, and TGF-β using an enzyme-linked immunosorbent assay sandwich kit. An unpaired t-test was conducted to analyze the differences between Groups A and D (p<0.01).

Results: Group D had the most morphologically visible SMSCs attached to the PRF, with elongated and pseudopodia cells. There was a significant difference between the levels of growth factor in Groups A and D (p=0.0001; p<0.01).

Conclusion: SMSCs were able to adhere to and distribute evenly on the surface of PRF after 5 days of incubation. The PRF incorporated SMSCs contained high levels of PDGF, IGF, VEGF, and TGF- β, which may prove to have potential in enhancing wound healing.
Comportamento Empreendedor, a partir de Características Comportamentais e da Intenção Empreendedora
Authors: Krüger Cristiane , Feksa Ramos Lucas
Published: October 2020

Objetivo do estudo: desenvolver um modelo difuso, para mensurar o comportamento empreendedor, a partir de características comportamentais e da intenção empreendedora.Metodologia/abordagem: a pesquisa é aplicada, quantitativa, descritiva e exploratória. Para solucionar o problema levantado, instrumentos de coleta de dados já validados foram utilizados, compondo uma amostra de 2.519 respondentes. A modelagem fuzzy pautou a construção do modelo de mensuração.Principais resultados: os métodos tradicionais de avaliação do comportamento empreendedor carregam um grau de incerteza e de subjetividade, quando envolvem diferentes variáveis independentes e incontroláveis. Diante dessa fragilidade, a modelagem fuzzy mostrou-se adequada, já que é uma ferramenta contributiva para a compreensão de tal comportamento.Contribuições teóricas/metodológicas: a pesquisa contribui com a apresentação de um modelo diferenciado para a mensuração do comportamento empreendedor; e, igualmente, com sugestões para estudos futuros, que emergiram dos resultados.Relevância/originalidade: o modelo difuso desenvolvido é mais detalhado e confiável, se comparado ao método tradicionalmente utilizado. A originalidade do estudo reside no desenvolvimento de um modelo fuzzy para medir o comportamento empreendedor.
Ações Empreendedoras e Políticas Públicas: Uma Articulação para Promover o Esporte
Authors: Hipólito Borges Denise Aparecida , Cappelle Mônica Carvalho Alves
Published: October 2020

Objetivo: compreender as ações desenvolvidas no esporte de Lavras/MG, para afirmar se elas podem ser consideradas empreendedoras. O propósito é entender como articular políticas públicas e ações empreendedoras na promoção do esporte nesse município.Metodologia: o estudo seguiu uma orientação epistemológica interpretativista, apoiada na metodologia de pesquisa-ação, e utilizou, como técnica, a análise de conteúdo temática. Optou-se por uma abordagem qualitativa, com os seguintes métodos de pesquisa: entrevistas presenciais com roteiro aberto, análise documental, diário de campo e brainstorming.Principais resultados: os resultados apontam a existência de uma ação empreendedora no contexto público, que envolve o poder público de modo particular sem, entretanto, nele ter se originado.Contribuições teóricas/metodológicas: a abordagem da ação empreendedora para o contexto público; e a utilização da pesquisa-ação como metodologia, para os estudos sobre o empreendedorismo.Relevância/originalidade: o estudo evidencia outra forma de interpretar o empreendedorismo, no contexto público, desviando o foco do empreendedor para a ação empreendedora, propriamente dita. As suas aplicações ao fenômeno estudado atestam o ineditismo da pesquisa.Implicações sociais ou para a gestão: os achados deste estudo permitem aos gestores públicos rever suas decisões, a fim de articular ações empreendedoras e políticas públicas, na promoção de ações inovadoras no esporte.
Orientação de Mercado para Pequenas e Médias Empresas de Imigrantes Brasileiros no Exterior
Authors: Cruz Eduardo Picanço , Falcão Roberto Pessoa de Queiroz
Published: October 2020

Objetivo: contribuir para o campo de estudo do empreendedorismo, no contexto das empresas étnicas ou de imigrantes, ao analisar variáveis que definem sua orientação de mercado e as decisões estratégicas tomadas, aprofundando o conhecimento sobre o assunto.Método: foi utilizada a coleta de dados com estratégias multimétodos (quantitativa e qualitativa), sendo sua principal estratégia a entrevista em profundidade, que compõe a análise de múltiplos casos de empreendedores no exterior, oriundos de diferentes comunidades brasileiras. Essas informações foram trianguladas, a partir de dados de surveys realizadas com brasileiros na Austrália, no Canadá, em Portugal e na Estônia, da netnografia e da análise documental. Sendo assim, análises intra e intercasos foram feitas, visando encontrar similaridades e diferenças nos resultados alcançados.Originalidade/Relevância: o artigo enfoca uma importante questão, que envolve as grandes economias mundiais – os imigrantes. Dadas as dificuldades em sua inserção nas sociedades acolhedoras, eles tendem a ser identificados como “problemas sociais”. Por outro lado, a aplicação de modelos de negócios e de propostas de orientação mercadológica para empreendedores imigrantes, viabiliza um caminho para a sua ascensão econômica e social. Ao se tornarem empreendedores bem-sucedidos, eles podem reverter essa percepção discriminatória a seu respeito.Resultados: com base nos dados coletados, bem como na análise de artigos da literatura existente, foram identificadas quatro orientações diferentes de mercado: (1) foco no nicho de mercado étnico, (2) foco em interesses específicos, (3) foco em produtos exóticos para o cliente local, e (4) foco em mercados altamente competitivos. Uma matriz 2 x 2 é apresentada, incluindo as variáveis: (a) grau de afiliação de empreendedores com suas comunidades étnicas e seu público-alvo, e (b) segmentos de mercado enfocados.Contribuições teóricas/metodológicas: uma das principais contribuições teóricas deste artigo é apoiar a discussão sobre a orientação para o mercado de imigrantes, os empreendimentos étnicos e as decisões do público-alvo a ser atendido. Além disso, o artigo inova, ao discutir decisões estratégicas, no contexto de pequenos e médios negócios de brasileiros no exterior.
Clashes Among Founding Partners: How Entrepreneurs Overcome Conflicts?
Authors: Sarfati Gilberto Sarfati Gilberto , Martins Thomaz , Abrahão Gabriel Akel
Published: October 2020

Objective: Conflicts have negative impacts on organizational performance and can lead to company mortality. The GVentures Accelerator, from the School of Business Administration of São Paulo (EAESP-FGV) identified that several startups that failed during and after the acceleration process had conflicts among the founding partners. This work aims to understand why some entrepreneurial teams in a pre-seed stage are able to overcome conflicts while others are not Methodology: We conducted a case study of 9 accelerated startups using in-depth interviews with 20 founding partners, and the interviews were followed by the codification and analysis of the cases with support from the manager responsible for the accelerator.Results: The research concludes that operational conflicts that escalate to affective conflicts due to disagreements in the process of giving and receiving feedback and/or mistrust between partners can lead to the dissolution of a company. On the other hand, founding members, even if they experience affective conflicts, are able to overcome the problems using the strategies of taking a step aside, giving in and putting their egos aside. It was also identified that the acceleration process tends to exacerbate the operational conflicts between founding partners.Theoretical/methodological contributions: The research contributes to the literature about founding teams by pointing out that operational conflict does not necessarily lead to the dissolution of the organization or closing the business, but operational conflicts that intensify to affective conflicts due to disagreements in the process of giving and receiving feedback and/or distrust among partners can lead to the dissolution of the organizationRelevance/originality: Founding teams are the backbone of any company. In spite of several articles discussing team conflict little is known about why some entrepreneurial team are able to overcome conflicts while other not. Moreover, also little is known about the role accelerators play in these conflicts.Social/management contribution: The conclusions about the strategies for managing founding team conflicts: taking a step aside, giving in and putting their egos aside; may be very useful for both entrepreneurs and accelerators’ management team in dealing with conflicts among founders.
Autoantibodies Toward ATP4A and ATP4B Subunits of Gastric Proton Pump H+,K+-ATPase Are Reliable Serological Pre-endoscopic Markers of Corpus Atrophic Gastritis
Authors: Lahner Edith , Marzinotto Ilaria , Lampasona Vito , Dottori Ludovica , Bazzigaluppi Elena , Brigatti Cristina , Secchi Massimiliano , Piemonti Lorenzo , Conti Laura , Pilozzi Emanuela , Davidson Howard W. , Wenzlau Janet M. , Annibale Bruno
Published: October 2020

INTRODUCTION:

Noninvasive assessment of corpus atrophic gastritis (CAG), a condition at increased risk of gastric cancer, is based on the measurement of pepsinogens, gastrin, and Helicobacter pylori antibodies. Parietal cell autoantibodies (PCAs) against the gastric proton pump (ATP4) are potential serological biomarkers of CAG. The purpose of this study was to compare the diagnostic performance of PCA and pepsinogen I tests in patients with clinical suspicion of CAG with the histopathological evaluation of gastric biopsies as reference standard.

METHODS:

A prospective case-finding study was performed on 218 naive adult patients (131 women, median age 65 years) who underwent gastric biopsies to confirm/exclude CAG. Patients with histopathological CAG were defined as cases, conversely as controls. Autoantibodies against the individual alpha (ATP4A) and beta (ATP4B) subunits of ATP4 were measured by luciferase immunoprecipitation, and global PCA and pepsinogen I by enzyme-linked immunosorbent assay.

RESULTS:

Histopathology classified 107 subjects (49%) as cases (CAG+, autoimmune 81.2%, and multifocal extensive 18.8%) and 111 subjects (51%) as controls (CAG−). In cases, ATP4A, ATP4B, and PCA titers were increased compared with controls, whereas pepsinogen I was reduced (P < 0.0001 for all). ATP4B, ATP4A, and pepsinogen I tests showed sensitivities of 77%, 75%, and 73% and specificities of 88%, 88%, and 80%, respectively. The receiver operating characteristic (ROC) area under the ROC curve (AUC) of these serological biomarkers confirmed their ability to discriminate cases from controls (ATP4B = 0.838, ATP4A = 0.826, pepsinogen I = 0.775, and PCA = 0.805), whereas the partial ROC-pAUC90 analysis showed that the ATP4B test had the best diagnostic performance (P = 0.008 vs ATP4; P = 0.0002 vs pepsinogen I). The presence of autoimmune or extensive gastritis was not significantly different between ATP4B positive or negative cases (P = 0.217).

DISCUSSION:

PCAs are promising serological biomarkers for the identification of CAG in high-risk individuals, particularly in an autoimmune pattern but also in an extensive-multifocal atrophy pattern.
Determinants of Pouch-Related Symptoms, a Common Outcome of Patients With Adenomatous Polyposis Undergoing Ileoanal Pouch Surgery
Authors: Gilad Ophir , Gluck N. , Brazowski E. , Kariv R. , Rosner G. , Strul H.
Published: October 2020

INTRODUCTION:

Total proctocolectomy with ileal pouch anal anastomosis (IPAA) is performed in patients with adenomatous polyposis syndromes (APSs). Data regarding pouch outcomes in APS are scarce. The purposes of this study were to determine the prevalence of pouch-related symptoms in patients with APS and to identify the contributing factors.

METHODS:

This is a prospective cohort study. Demographic, surgical, and clinical data were collected. Endoscopy was performed, and biopsies from the terminal ileum, pouch, and cuff were obtained in all patients and reviewed by a dedicated pathologist.

RESULTS:

Fifty-one patients with APS after IPAA were followed. Twenty patients (39.2%) had pouch-related symptoms. Single-stage IPAA had better outcomes than 2-stage IPAA: fewer daily bowel movements (42.9% vs 13.8% with ≤5 daily bowel movement, P = 0.02), more solid consistency (52.4% vs 6.9%, P < 0.001), and less abdominal pain (19% vs 48.3%, P = 0.034). Younger age at IPAA (<20) was also associated with better outcomes: fewer daily bowel movement (58.3% vs 17.9% with ≤5 daily bowel movement, P = 0.011), less watery consistency (8.3% vs 53.8%, P = 0.005), and abdominal pain (8.3% vs 43.6%, P = 0.037). Eighteen patients (35.3%) had endoscopic signs of inflammation, and 22 patients (43.1%) had histologic signs of pouchitis. However, no correlation was found between symptoms and endoscopic or histologic findings. The median pouchitis disease activity index was low (2, interquartile range 1–4) and did not correlate with clinical symptoms.

DISCUSSION:

Pouch-related symptoms are common in patients with APS after IPAA. One-stage IPAA and younger age at surgery are associated with better clinical outcomes. However, symptoms do not correlate well with endoscopic or histologic findings or with pouchitis disease activity index and might be attributed to a functional pouch disorder.
Clinical Features and Genomic Characterization of Post-Colonoscopy Colorectal Cancer
Authors: Tanaka Hidenori , Urabe Yuji , Oka Shiro , Shimohara Yasutsugu , Nishimura Tomoyuki , Inagaki Katsuaki , Okamoto Yuki , Matsumoto Kenta , Yamashita Ken , Sumimoto Kyoku , Ninomiya Yuki , Yuge Ryo , Tanaka Shinji , Chayama Kazuaki
Published: October 2020

INTRODUCTION:

Some colorectal cancers (CRCs) may be missed during colonoscopies. We aimed to determine the clinicopathological, biological, and genomic characteristics of post-colonoscopy CRCs (PCCRCs).

METHODS:

Of the 1,619 consecutive patients with 1,765 CRCs detected between 2008 and 2016, 63 patients with 67 PCCRCs, when colonoscopies were performed 6–60 months before diagnosis, were recruited. After excluding patients with inflammatory bowel disease, familial polyposis syndrome, CRCs that developed from diminutive adenomatous polyps, and recurrent CRCs after endoscopic resection, 32 patients with 34 PCCRCs were enrolled. The lesions' clinicopathological features, mismatch repair proteins (MMRs), and genomic alterations were investigated.

RESULTS:

The overall PCCRC-5y rate, rate of intramucosal (Tis) lesions, and rate of T1 or more deeply invasive cancers were 3.7% (66/1,764), 3.9% (32/820), and 3.6% (34/944), respectively. Thirty-three patients' MMRs were investigated; 7 (21%) exhibited deficient MMRs (dMMRs), comprising 4 with T2 or more deeply invasive cancers and 5 whose lesions were in the proximal colon. Twenty-three tumors' genomic mutations were investigated; PIK3CA had mutated in 5 of 6 T2 or more deeply invasive cancers, of which, 4 were located in the proximal colon. Two patients with dMMRs and BRAF

V600E
mutations had poor prognoses. Sixty-one percent (17/28) of the macroscopic type 0 lesions were superficial. All superficial Tis and T1 PCCRCs were detected <24 months after the negative colonoscopies. They were distributed throughout the colon and rectum.

DISCUSSION:

PCCRCs may be invasive cancers in the proximal colon that exhibit dMMRs and/or PIK3CA mutations or missed early CRCs especially superficial lesions.
L-Menthol for Gastrointestinal Endoscopy: A Systematic Review and Meta-Analysis
Authors: You Qiang , Li Lan , Chen Hongping , Chen Lin , Chen Xia , Liu Youping
Published: October 2020

INTRODUCTION:

In randomized controlled trials, L-menthol inhibits gastrointestinal peristalsis during endoscopy. Our goal was to quantitatively synthesize the available evidence to evaluate the efficacy and safety of L-menthol for gastrointestinal endoscopy.

METHODS:

We comprehensively searched for relevant studies published up to January 2020 in PubMed, EMBASE, Web of Science, and Cochrane Library. The main outcomes consisted of the proportion of no peristalsis, proportion of no or mild peristalsis, adenoma detection rate, and adverse events.

RESULTS:

Eight randomized controlled trials analyzing 1,366 subjects were included. According to the pooled data, L-menthol significantly improved the proportion of no peristalsis (odds ratio [OR] = 6.51, 95% confidence interval [CI] = 4.94–8.57, P < 0.00001), and the proportion of no or mild peristalsis (OR = 7.89, 95% CI = 5.03–12.39, P < 0.00001) compared with the placebo, whereas it was not associated with an improvement in the adenoma detection rate (OR = 1.03, 95% CI = 0.54–1.99, P = 0.92). Adverse events did not differ significantly between the 2 groups (OR = 1.40, 95% CI = 0.75–2.59, P = 0.29).

DISCUSSION:

The findings of this study support the use of L-menthol to suppress gastrointestinal peristalsis during endoscopic procedure.
Literature Survey on Islamic Microfinance
Authors: Azmi Nik Nur Izzati Nik Muhammad , Thaker Mohamed Asmy Bin Mohd Thas
Published: October 2020

Islamic microfinance can be seen as an emerging industry in some Muslim countries like Indonesia, Malaysia, Pakistan, Bangladesh, and MENA regions. It acts as a movement to eradicate poverty in the society and to help improve the social standard of the poor people. The concept of Islamic microfinance is similar to those implemented in conventional microfinance except for it adheres to several points and concepts which in line with the Shariah rulings. As a growing industry, Islamic microfinance does facing several challenges such as limited outreach in the market, lack of expertise in the industry, governance and management problems, and many more. Hence, this paper will discuss further the issues and challenges faced by Islamic microfinance institutions in selected Muslim countries. Plus, some suggestions are given at the end of this paper to solve these issues.
IFCC Interim Guidelines on Serological Testing of Antibodies against SARS-CoV-2
Authors: Bohn Mary Kathryn , Loh Tze Ping , Wang Cheng-Bin , Mueller Robert , Koch David , Sethi Sunil , Rawlinson William D. , Clementi Massimo , Erasmus Rajiv , Leportier Marc , Grimmler Matthias , Yuen KY , Mancini Nicasio , Kwon Gye Cheol , Menezes María Elizabeth , Patru Maria-Magdalena , Gramegna Maurizio , Singh Krishna , Najjar Osama , Ferrari Maurizio , Horvath Andrea R. , Lippi Giuseppe , Adeli Khosrow
Published: October 2020

Serological testing for the detection of antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is emerging as an important component of the clinical management of patients with coronavirus disease 2019 (COVID-19) as well as the epidemiological assessment of SARS-CoV-2 exposure worldwide. In addition to molecular testing for the detection of SARS-CoV-2 infection, clinical laboratories have also needed to increase testing capacity to include serological evaluation of patients with suspected or known COVID-19. While regulatory approved serological immunoassays are now widely available from diagnostic manufacturers globally, there is significant debate regarding the clinical utility of these tests, as well as their clinical and analytical performance requirements prior to application. This document by the International Federation for Clinical Chemistry and Laboratory Medicine (IFCC) Taskforce on COVID-19 provides interim guidance on: (A) clinical indications and target populations, (B) assay selection, (C) assay evaluation, and (D) test interpretation and limitations for serological testing of antibodies against SARS-CoV-2 infection. These evidence-based recommendations will provide practical guidance to clinical laboratories in the selection, verification, and implementation of serological assays and are of the utmost importance as we expand our pandemic response from initial case tracing and containment to mitigation strategies to minimize resurgence and further morbidity and mortality.
Pseudohypoparathyroidism type 1B (PHP1B), a rare disorder encountered in adolescence
Authors: Vlachopapadopoulou Elpis-Athina , Anagnostou Elli , Dikaiakou Eirini , Hanna Patrick , Tsolia Maria , Michalacos Stefanos , Linglart Agnès , Karavanaki Kyriaki
Published: October 2020

Objectives

The objective of this paper is to report a peculiar case of a patient with pseudohypoparathyroidism type 1b (PHP1B). Pseudohypoparathyroidism (PHP) refers to a group of disorders characterized by hypocalcemia, hyperphosphatemia, and elevated parathyroid hormone (PTH) concentrations as the result of end-organ unresponsiveness to PTH.

Case presentation

We present a 14-year-old boy, who was admitted with severe symptomatic hypocalcaemia, absence of dysmorphic features and Albright's hereditary osteodystrophy features. Laboratory investigations revealed markedly low serum calcium, high phosphate, markedly elevated PTH levels and vitamin D insufficiency, while magnesium, albumin, ALP and TSH were normal. The clinical and laboratory findings were consistent with PHP1B. Molecular analysis revealed loss of methylation at the AB DMR of the GNAS locus, confirming the diagnosis. Yet no STX16 deletion was detected.

Conclusions

It is possible that delSTX16- patients carry a defect in an element that controls the methylation both at the GNAS-A/B DMR and at the GNAS-AS2. This rare case emphasizes the need of individualized molecular analysis in PHP1B patients in order to elucidate the possible molecular defect.
Mechanisms and early patterns of dyslipidemia in pediatric type 1 and type 2 diabetes
Authors: Nwosu Benjamin Udoka , Villalobos-Ortiz Tony R. , Jasmin Gabrielle A. , Parajuli Sadichchha , Zitek-Morrison Emily , Barton Bruce A.
Published: October 2020

Objectives

The is no consensus on the early patterns of lipid-based cardiovascular disease (CVD) risk in youth with either type 1 diabetes (T1D) or type 2 diabetes (T2D). The aim was todetermine the differences in CVD risk, using lipid profiles, in children and adolescents with either T1D or T2D at the time of their first lipid assessment, after stratifying the T1D cohort into remitters and non-remitters based on their honeymoon history.

Methods

A cross-sectional study of 249 subjects consisting of 73 controls, 53 T2D subjects, and 123 T1D subjects stratified into remitters (n=44), and non-remitters (n=79). Partial clinical remission (PCR) was defined as insulin-dose adjusted HbA1c of ≤9. Pubertal status was determined by Tanner staging.

Results

After adjusting for age, sex, BMI, race, and pubertal status, T2D patients had significantly higher LDL-C compared to the controls (p=0.022), the remitters (p=0.029), but not the non-remitters (103.1 ± 5.9 mg/dL vs. 91.4 ± 4.2 mg/dL, p=0.49). Similarly, T2D patients had significantly higher non-HDL-C compared to the controls (p=0.006), the remitters (p=0.0002), but not the non-remitters (137.6 ± 7.1 mg/dL vs. 111.71 ± 5.0 mg/dL, p=0.053). Total cholesterol was also significantly higher in T2D patients compared to the controls (p=0.0005), the remitters (p=0.006) but not the non-remitters (183.5 ± 6.6 mg/dL vs. 166.2 ± 4.8 mg/dL, p=0.27).

Conclusions

Lack of the honeymoon phase in children and adolescents with T1D confers early and significantly increased lipid-based cardiovascular risk to these patients that is similar to the elevated cardiovascular risk seen in T2D.
Topological photonics: Where do we go from here?
Authors: Segev Mordechai , Bandres Miguel A.
Published: October 2020

Topological photonics is currently one of the most active research areas in optics and also one of the spearheads of research in topological physics at large. We are now more than a decade after it started. Topological photonics has already proved itself as an excellent platform for experimenting with concepts imported from condensed matter physics. But more importantly, topological photonics has also triggered new fundamental ideas of its own and has offered exciting applications that could become real technologies in the near future.
The Impact of Neoliberalism on Civil Society and Nonprofit Advocacy
Authors: Alexander Jennifer , Fernandez Kandyce
Published: October 2020

The following manuscript employs critical inquiry to analyze the effects of neoliberalism on nonprofits in the U.S. and their capacity to engage in political advocacy and the production of meaning, a pivotal role for civil society institutions. Three false narratives of how nonprofits support democracy are presented followed by a discussion of how neoliberalism and the economization of the sector has delimited their capacity to fulfill their roles of engaging in emancipatory projects or social change. The manuscript concludes with a discussion of how nonprofits can reclaim civic space and empower citizens in a representative democracy.