bluuebunny/crossref_metadata_2025 huggingface dataset:
Consensus guidelines: best practices for detection, assessment and management of suspected acute drug‐induced liver injury occurring during clinical trials in adults with chronic cholestatic liver disease
Authors: Palmer Melissa , Regev Arie , Lindor Keith , Avigan Mark I. , Dimick‐Santos Lara , Treem William , Marcinak John F. , Lewis James H. , Anania Frank A. , Seekins Daniel , Shneider Benjamin L. , Chalasani Naga
Published: November 2019

Background

Improved knowledge of the molecular pathophysiology and immunopathogenesis of cholestatic liver diseases in recent years has led to an increased interest in developing novel therapies. Patients with cholestatic liver disease often require different approaches to assessment and management of suspected drug‐induced liver injury (DILI) compared to those with healthy livers and those with parenchymal liver diseases. At present, there are no regulatory guidelines or society position papers, that systematically address best practices pertaining to detection of DILI in these patients.

Aims

To outline best practices for detection, assessment and management of suspected acute DILI during clinical trials in adults with the cholestatic liver diseases – Primary Biliary Cholangitis (PBC) and Primary Sclerosing Cholangitis (PSC).

Methods

This is one of the several papers developed by the IQ DILI Initiative, which is comprised of members from 16 pharmaceutical companies, in collaboration with DILI experts from academia and regulatory agencies. The contents are the result of an extensive literature review, as well as in‐depth discussions among industry, regulatory and academic DILI experts, to achieve consensus recommendations on DILI‐related issues occurring during clinical trials for cholestatic liver diseases.

Results

Recommended best practices are outlined pertaining to hepatic eligibility criteria, monitoring of liver tests, approach to a suspected DILI signal, and hepatic discontinuation rules.

Conclusions

This paper provides a framework for the approach to detection, assessment and management of suspected acute DILI occurring during clinical trials in adults with cholestatic liver disease.
Sustainable grocery retailing: Myth or reality?—A content analysis
Authors: Saber Marcus , Weber Anja
Published: November 2019

Sustainability reports are a crucial instrument to inform outside stakeholders not only about a company's sustainability performance but also to manage impressions. However, they are often prone to greenwashing and the reporting of negative topics can jeopardize corporate legitimacy. Therefore, this paper aims to analyze reporting quality and how grocery retailing companies deal with this challenge of reporting the true picture. The empirical material is taken from the latest sustainability reports and information available on the Internet for two major German supermarkets, six grocery discount retailers, and two organic supermarkets. The Global Reporting Initiative standards are used to assess and compare the extent of information disclosure. A qualitative content analysis is applied to identify negative disclosure aspects and their legitimation. While the main focus areas (supply chain, employees, environment/climate, and society) are similar for the companies, different levels of reporting quality appeared. Negative information is rarely reported and “abstraction” and “indicating facts” are the dominant legitimation strategies.
Coverage, associated factors, and impact of companionship during labor: A large‐scale observational study in six hospitals in Nepal
Authors: KC Ashish , Axelin Anna , Litorp Helena , Tinkari Bhim Singh , Sunny Avinash K. , Gurung Rejina
Published: November 2019

Background

Companionship at the time of birth is a nonclinical intervention that has been proven to improve the quality of intrapartum care. This study aims to evaluate the coverage, associated factors, and impact of companionship during labor at public hospitals in Nepal.

Methods

We conducted a cross‐sectional observational study in six public hospitals in Nepal. The study was conducted from July 2018 to August 2018. Data were collected on sociodemographic, maternal, obstetric, and neonatal characteristics from patient case notes and through predischarge interviews. Coverage of companionship during labor and its association with intrapartum care was analyzed. Bivariate and multivariate analyses were done to assess the association between companionship during labor and demographic, obstetric, and neonatal characteristics.

Results

A total of 63 077 women participated in the study with 19% of them having a companion during labor. Women aged 19‐24 years had 65% higher odds of having a companion during labor compared with women aged 35 years and older (aOR 1.65 [95% CI, 1.40‐1.94]). Women who were from an advantaged ethnic group (Chhetri/Brahmin) had fourfold higher odds of having a companion than women from a disadvantaged group (aOR 3.84; [95% CI, 3.24‐4.52]). Women who had companions during labor had fewer unnecessary cesarean births than those who had no companions (5.2% vs 6.8%, P < .001).

Conclusions

In Nepal, sociodemographic factors affect women's likelihood of having a companion during labor. As companionship during labor is associated with improved quality of care, health facilities should encourage women's access to birth companions.
The Power of Mass Mobilisation: Argentina's Struggle for the Legalisation of Abortion
Authors: Szczepańska Dagmara
Published: November 2019

The mass pro‐abortion mobilisation which took place in 2018 has been arguably the most successful attempt in Argentina's history at altering the existing legal framework regulating access to voluntary termination of pregnancy. Never before has any legislative project legalising abortion reached the upper chamber of the Congress. Could this result be attributed to the support it received from a mass social movement? What are the limitations of mass mobilisations when a structural change to a long‐lasting narrative is required? In order to address these questions, the issue of abortion will be examined through the perspective of power‐making and counterpower‐making strategies.
Distribution mapping of specialized amphibian species in rare, ephemeral habitats: Implications for the conservation of threatened “acid” frogs in south‐east Queensland
Authors: Filer Alannah , Beyer Hawthorne L. , Meyer Ed , Van Rensburg Berndt J.
Published: November 2019

The acid frogs of eastern Australia are a highly specialized group of threatened species endemic to acidic coastal wetlands of southern Queensland and New South Wales. The distribution of these species overlaps with areas of increasing development where land‐use intensification poses a significant threat. Successful conservation of these species requires that areas of high conservation value for acid frogs are properly identified and protected, particularly in south‐east Queensland which supports important populations of all four acid frog species: Litoria olongburensis, Litoria freycineti, Crinia tinnula, and the Queensland‐endemic Litoria cooloolensis. Species distribution modeling using rigorously vetted species occurrence data was used to identify areas of potential acid frog habitat with >89% predictive power for all species. Key predictor variables for acid frog species occurrence included: soil sandiness, vegetation, presence and/or type of wetland, and soil clay content. All species' predicted distributions occurred primarily in coastal regions, overlapping with densely human‐populated areas. Our modeling and analysis of species' distributions highlight local government areas where protection of wallum habitat is most important for the conservation of acid frogs, as well as areas of higher conservation value providing habitat for multiple acid frog species.
Effects of a fire‐retardant on oviposition habitat selection and larval development of the mosquito Culiseta longiareolata
Authors: Ozeri Lital , Horwitz Rael , Kneitel Jamie , Rahav Eyal , Blaustein Leon
Published: November 2019

1. Fire retardants are composed of fertilising salts that are commonly used for fighting wildfires. These chemicals have various effects on individual arthropod species and aquatic communities.

2. This study investigated the effects of four treatments of a prevalent fire retardant [FR CROS 134 (FR), applied at concentrations of 0, 3.8 × 102, 7.6 × 102 and 11.4 × 102 mg litre−1] on oviposition habitat selection (OHS) by Culiseta longiareolata and Culex laticinctus mosquitoes in an outdoor mesocosm. Additionally, larval development of C. longiareolata was examined in response to this fire retardant.

3. The results demonstrate that OHS increased in both species, whereas survivorship (0–86.7%) and time to metamorphosis (5.4–23.1 days) of C. longiareolata were not affected by any of the treatments. However, cyanobacterial biomass increased and heterotrophic bacteria decreased in response to the addition of FR.

4. It was found that FR applications can have unintended consequences which can increase OHS by female mosquitoes. The growing use of fire retardants worldwide, and especially in Israel, justify evidence‐based assessment and environmental management of their use. This study is a first critical step in filling the knowledge gap with respect to the impact of FR on aquatic ecosystems.
Comparison of students' perception of problem‐based learning and traditional teaching method in a Nigerian dental school
Authors: Oderinu Olabisi H. , Adegbulugbe Ilemobade C. , Orenuga Omolola. O. , Butali Azeez
Published: November 2019

Objectives

To evaluate the perceptions of dental students on problem‐based learning, PBL, in comparison with the traditional lecture (TL) method.

Methods

This comparative study was conducted amongst 72 dental undergraduates. PBL was introduced to the students before the commencement of course. PBL method was used by the student to learn about cariology, whilst other lecture topics were taught by the TL. Students were not informed at the beginning of the course about end of course assessment of learning and teaching methods to limit their bias. The study was approved by the institution's ethics committee, and informed consent was obtained from participants at the end of the course to recruit them into the study. The students worked in small groups to solve tasks on clinical case scenarios. Four class sessions were held for presentations and discussions. The students' perceptions concerning the two teaching methods were sought by the use of an anonymously completed questionnaire. Six perceived factors that influenced the teaching and learning process were extracted from the twenty‐two‐perception‐item questionnaire using factor analysis. Paired sample t test was used for comparison of means.

Results

The highest mean scores for all six perceived factors were observed in the PBL method. There were statistically significant differences (P < .05) between PBL and TL teaching methods for all the perceived factors; (“Challenge critical thinking,” “Communication with peers,” “Usefulness as pedagogical method,” “Organization” and “Interaction between students and tutors”) except for the perceived factor “Adequacy of teaching.” The mean for most of the perception items was highest in the PBL method compared to TL. The perception item “Able to provide intellectual stimulation” had the highest mean score (4.21 ± 0.76) for the PBL method, whilst it was “Laboratory exercise” (4.14 ± 0.68) for TL.

Conclusions

Students' perception of the two educational methods investigated showed a preference for the PBL method. The students felt that PBL provided a higher ability for intellectual stimulation.
Autologous stem cell transplantation is safe in selected elderly multiple myeloma patients
Authors: Antonioli Elisabetta , Nozzoli Chiara , Buda Gabriele , Staderini Michela , Boncompagni Riccardo , Martini Francesca , Petrini Mario , Bosi Alberto , Saccardi Riccardo
Published: November 2019

Objectives

ASCT is currently the “gold standard” first‐line treatment for multiple myeloma patients younger than 65 years old, and limited data on efficacy and safety in older patients are available.

Methods

We retrospectively analyzed a cohort of 83 newly diagnosed multiple myeloma patients aged 65 or older. All patients were evaluated for fitness at diagnosis and after bortezomib‐based induction treatment.

Results and conclusions

All patients collected an adequate PBSC graft, mainly after G‐CSF plus cyclophosphamide; a median of 6.47 × 106/kg CD34 + cells was collected. The conditioning regimen consisted of melphalan 100, 140 and 200 mg/m2 in 40, 15 and 28 patients, respectively. Median time to neutrophils’ and platelets’ recovery was 11 and 12 days, respectively. Adverse events of any grade were referred by 40% of patients. The overall response rate was 93%, CR/sCR were 39%. Median PFS was 35 months; median OS was not reached. In our study cohort, the achievement of at least VGPR after induction therapy and the obtainment of CR/sCR after ASCT are the only parameters that were associated with an improved PFS. ASCT is an effective and safe first‐line treatment approach, a careful patients selection reduce the toxicity of the procedure.
Climate drives community‐wide divergence within species over a limited spatial scale: evidence from an oceanic island
Authors: Salces‐Castellano Antonia , Patiño Jairo , Alvarez Nadir , Andújar Carmelo , Arribas Paula , Braojos‐Ruiz Juan José , del Arco‐Aguilar Marcelino , García‐Olivares Víctor , Karger Dirk N. , López Heriberto , Manolopoulou Ioanna , Oromí Pedro , Pérez‐Delgado Antonio J. , Peterman William E. , Rijsdijk Kenneth F. , Emerson Brent C.
Published: November 2019

Geographic isolation substantially contributes to species endemism on oceanic islands when speciation involves the colonisation of a new island. However, less is understood about the drivers of speciation within islands. What is lacking is a general understanding of the geographic scale of gene flow limitation within islands, and thus the spatial scale and drivers of geographical speciation within insular contexts. Using a community of beetle species, we show that when dispersal ability and climate tolerance are restricted, microclimatic variation over distances of only a few kilometres can maintain strong geographic isolation extending back several millions of years. Further to this, we demonstrate congruent diversification with gene flow across species, mediated by Quaternary climate oscillations that have facilitated a dynamic of isolation and secondary contact. The unprecedented scale of parallel species responses to a common environmental driver for evolutionary change has profound consequences for understanding past and future species responses to climate variation.
End‐of‐life care of nursing home residents: A survey among general practitioners in northwestern Germany
Authors: Allers Katharina , Fassmer Alexander M , Spreckelsen Ove , Hoffmann Falk
Published: November 2019

Aim

To describe general practitioners' (GPs) perspectives on end‐of‐life care of nursing home residents.

Methods

We carried out a cross‐sectional study. A questionnaire was sent to a random sample of 1121 GPs in the German federal states of Bremen and Lower Saxony in 2018. Data were compared between GPs with a qualification in palliative medicine and those without such qualifications, and multivariable logistic regression was performed.

Results

Overall, 375 questionnaires were returned (response rate 34%). The majority of GPs (71%) agreed that nursing home residents are treated too often in hospitals at the end of life, and more than half rated end‐of‐life care in nursing homes as “rather poor” (54%). For both questions, GPs with a qualification in palliative medicine showed higher agreements. In the multivariable analysis, a prior qualification in palliative medicine was also strongly associated with rating end‐of‐life care as “rather poor” (OR 1.89, 95% CI 1.10–3.23). Respondents cited higher staffing ratios and better trained nursing staff as the most important measures to improve end‐of‐life care. Furthermore, it was estimated that just 37% of residents have an advance directive, with only one‐third including valid information on end‐of‐life hospitalizations.

Conclusions

This study showed that GPs tend to be critical regarding end‐of‐life care in nursing homes. To improve end‐of‐life care, better training in palliative care for nursing staff and GPs might be warranted. In addition, advance care planning can help to ensure that residents' wishes are respected. Geriatr Gerontol Int 2020; 20: 25–30.
Leukemoid reaction: A 21st‐century cohort study
Authors: Portich Júlia P. , Faulhaber Gustavo A. M.
Published: November 2019

Introduction

Leukemoid reaction (leukocyte count >50 cells ×109 L) is a rare but extremely relevant finding. Since little has been published on this condition's clinical relevance and prognosis, we investigated leukemoid reaction in patients with a white blood cell count of >50 × 109 L, including etiology and outcomes.

Methods

This retrospective cohort study included all patients at a Brazilian tertiary hospital between January 2016 and July 2018 > 18 years with a total leukocyte count >50 cells×109 L. Demographics, complete blood count, clinical features, and the exams used to diagnose and determine leukemoid reaction etiology were analyzed. A Kaplan‐Meyer survival analysis was performed, and a binary logistic regression model identified variables associated with death.

Results

Of the 267 cases with white blood cell count of >50 × 109, 162/267 (60%) were secondary to hematopoietic neoplasm and 105/267 (40%) presenting as a true leukemoid reaction. The primary causes of the true leukemoid reaction cases were infection (59), nonhematopoietic neoplasm (17), or other causes (29). Patient deaths (66) differed significantly between groups (P < .001, log‐rank [Mantel‐Cox] Test). Lower hemoglobin, older age, and increased segmented neutrophil count were associated with increased risk of death.

Conclusions

This was a modern cohort analysis of leukemoid reactions, inclusive of all etiologies. The most common cause was infection, which involved several microorganisms. Paraneoplastic leukemoid reaction was also common. Both conditions have a poor prognosis with high mortality, being a major medical challenge.
Employment effects of a German workfare programme at the establishment level
Authors: Dummert Sandra , Hohendanner Christian
Published: November 2019

We examined the impact of a German workfare programme for hard‐to‐place welfare recipients, the so‐called ‘€1‐jobs’, on staff in public and non‐profit establishments. We applied static and dynamic panel models using IAB Establishment Panel data from 2005 to 2013. To account for regional influences, we linked the establishment data to indicators at the district level. We identified a positive complementary effect on high‐skilled workers and a negative substitution effect on low‐skilled workers. We interpreted these findings as follows: In that €1‐jobs require highly skilled staff for management, instruction, qualification and support, this indicates that the programme generates jobs for skilled workers within the welfare‐to‐work industry. The negative effect that we found for low‐skilled workers suggests substitution effects between the programme participants and regular low‐skilled workers; although in this study, both effects were relatively small.
Do clinical nurse specialist led stroke follow‐up clinics reduce post‐stroke hospital readmissions and recurrent vascular events?
Authors: Kao Alex , Lanford Jeremy , Wong Lai‐Kin , Ranta Annemarei
Published: November 2019

Background

Post‐discharge stroke follow‐up clinics intend to improve care and may reduce readmission. Pre‐2013, there was no consistent post‐stroke specialist follow up offered at Wellington Hospital. We tested whether the establishment of a clinical nurse specialist follow‐up clinic reduced the 12‐month readmission rate.

Methods

This is a sequential comparison of stroke patients admitted 1 year prior and 1 year after clinic establishment in 2013. The primary outcome was 12‐month hospital readmission rate; main secondary outcomes were guideline adherence and recurrent vascular events. Patients were identified from hospital discharge records and underwent chart review. We adjusted results for differences in baseline characteristics.

Results

We identified 603 eligible patients; 288 pre‐ and 315 post‐nurse clinic implementations. There was no difference based on study cohort in the 1‐year readmission rate (adjusted odds ratio (aOR) = 1.14; 95% CI, 0.7–1.89; P = 0.583), or recurrent composite vascular events at 1 year (aOR = 1.56; 95% CI, 0.89–2.9; P = 0.159). When looking at clinic attendance as the main variable of interest, a pre‐specified sub‐group analysis, there was a significant difference in implementation of best medical therapy (aOR 2.66 (1.19–5.94); P = 0.017), and a trend towards reduction of vascular events and/or death at 1 year post discharge (aOR 0.53 (0.28–1.02); P = 0.056).

Conclusions

There was no reduction in the 1‐year hospital readmission or vascular event recurrence rate for patients admitted with stroke following the establishment of a specialist nurse‐led stroke follow‐up clinic. Actual clinic attendance, however, did appear to confer some benefit. This study suggests that more consistent and potentially earlier timed follow up is probably desirable.
Annual Research Review: Rethinking childhood trauma‐new research directions for measurement, study design and analytical strategies
Authors: Danese Andrea
Published: November 2019

Childhood trauma is a key modifiable risk factor for psychopathology. Despite significant scientific advances, traumatised children still have poorer long‐term outcomes than nontraumatised children. New research paradigms are, thus, needed. To this end, the review examines three dominant assumptions about measurement, design and analytical strategies. Current research warns against using prospective and retrospective measures of childhood trauma interchangeably; against interpreting cross‐sectional differences in putative mediating mechanisms between adults with or without a history of childhood trauma as evidence of longitudinal changes from pre‐trauma conditions; and against directly applying explanatory models of resilience or vulnerability to psychopathology in traumatised children to forecast individual risk in unseen cases. The warnings equally apply to research on broader measures of adverse childhood experiences (ACEs). Further research examining these assumptions can generate new insights on how to prevent childhood trauma and its detrimental effects.
Effects of heat on the dispersal performance of Ips typographus
Authors: Hinze Jonas , John Reinhold
Published: November 2019

Under present climate conditions, Ips typographus (L.) is Europe's most critical disturbance agent for mature Norway spruce (Picea abies). With ongoing climate change, the bark beetle will most probably become more prominent as a pest. The aim of this study was to analyse the dispersal performance of I. typographus under various weather conditions, especially hot days with a maximum air temperature above 30°C. In a field study, marked bark beetles were released from breeding logs and could be retraced in traps distributed across the survey area. With daily collections of the trapped beetles, it was possible to analyse the flight activity and the average flight distance of the bark beetles during hot, moderate and cool days. The numbers of daily catches and the average flight distance during the hottest days (air temperature maximum ≥30°C) did not significantly differ from the moderate days (air temperature maximum ≥22°C and <30°C). The numbers of daily catches and the average flight distance during the cool days (air temperature maximum <22°C) were significantly lower than during hot and moderate days. The results give an insight on the dispersal capacity of I. typographus under climate change driven future conditions. Increased air temperatures do not seem to impair the flight performance of I. typographus. A small proportion of cool days during the swarming period even seems to favour dispersal of I. typographus.
Overview of listeriosis in the Southern African Hemisphere—Review
Authors: Kayode Adeoye J. , Igbinosa Etinosa O. , Okoh Anthony I.
Published: November 2019

Listeriosis is rarely reported in the Southern African Hemispheres in spite of the increasing rate ofListeriain several foodborne outbreaks reported in advanced countries. This paper reviews the emerging trends in the spread, distribution, and epidemiology ofListeriaspecies in foods, water, human, animals, and different environments in Southern Africa based on the appraisal of scholarly articles. In this regard, information obtained from literatures from various online databases revealed thatListeriaspecies are commonly recovered from food, water, and human samples. Fewer articles provided information onListeriarecovered from animals (ruminants) and soil samples. Generally, reports of studies were more focused onListeria monocytogenesamong otherListeriaspecies. To this end, reports obtained from literature on the method of identification ofListeriawere mostly based on serological, classical biochemical methods and the principle of aesculin hydrolysis, usually characterized by black coloration on selective media forListeria. These methods may not be reliable, as they could sometimes give a false positive report. Therefore, molecular methods are more reliable, accurate, could show the genetic relationship between isolates, and at the same time capable of enabling tracking the source of this pathogen should be embraced as a better substitute for the identification ofListeriain Southern African sub‐region.
Association of Reproductive History With Motor Function and Disability in Aging Women
Authors: Canonico Marianne , Artaud Fanny , Tzourio Christophe , Elbaz Alexis
Published: November 2019

BACKGROUND/OBJECTIVES

The associations of reproductive history and motor function are controversial.

DESIGN

Prospective cohort study with 10 years of follow‐up.

SETTING

Three French cities between 1999 and 2011.

PARTICIPANTS

A total of 3043 community‐dwelling women from the Three‐City Dijon study population.

MEASUREMENTS

We examined the cross‐sectional and longitudinal association of age at menopause, artificial menopause, and parity with walking speed (WS) using linear regression and linear mixed models, respectively. Cox proportional models were used to examine the association of characteristics of reproductive life with disability.

RESULTS

Mean baseline WS was 143.8 cm/s. Artificial menopause was associated with slower WS at baseline (β = −3.29; 95% confidence interval [CI] = −5.83 to −0.74; P = .01). Reproductive life characteristics had no effect on change in WS. Increasing age at menopause was associated with reduced disability risk (hazard ratio [HR] for 5‐year increase = 0.92; 95% CI = 0.87‐0.99; P = .02), while parity increased disability risk (HR for ≥3 vs 0 children = 1.53; 95% CI = 1.22‐1.93; P < .01).

CONCLUSION

These findings show that early age at menopause and higher parity have a deleterious effect on motor function that persists in older people. J Am Geriatr Soc 68:585–594, 2020
Integration of Different Sensory Interventions From Mother’s Breast Milk for Preterm Infant Pain During Peripheral Venipuncture Procedures: A Prospective Randomized Controlled Trial
Authors: Wu Hsiang‐Ping , Yin Ti , Hsieh Kao‐Hsian , Lan Hsiang‐Yun , Feng Rung‐Chuang , Chang Yue‐Cune , Liaw Jen‐Jiuan
Published: November 2019

Purpose

To compare the effects of integrating mother’s breast milk (BM) with three different combinations of sensory stimuli on preterm infant pain during peripheral venipuncture procedures.

Design

A prospective, repeated‐measures randomized controlled trial.

Methods

Preterm infants (gestational age between 28 and 37 weeks, and in stable condition) needing venipuncture were recruited by convenience sampling (N = 140) and randomly assigned to four treatment conditions: (a) routine care (condition 1); (b) BM odor or taste (condition 2); (c) BM odor or taste + heartbeat sounds (HBs; condition 3), and (d) BM odor or taste + HBs + non‐nutritive sucking (NNS; condition 4). Pain scores were assessed based on the Premature Infant Pain Profile‐Revised (PIPP‐R) over nine phases: baseline (phase 0, 5 min without stimuli before venipuncture), disinfecting (phase 1), during venipuncture (phase 2), and a 10‐min recovery (phases 3–8).

Findings

Infants who received BM odor or taste + HBs + NNS had significantly lower increases in pain scores from baseline compared with controls across phases 1 through 8. Infants treated with either condition 2 or 3 demonstrated significant reductions in mild pain during disinfecting and recovery phases, as compared with the controls. When condition 2 was used as the reference, there were no significant differences in pain scores between the infants receiving condition 3 across the nine phases, suggesting mothers’ HBs have only mild analgesic effects on venipuncture pain.

Conclusions

Integration of mother’s BM odor or taste, HBs, and tactile NNS should be considered as an intervention for alleviation of procedural pain for preterm infants.

Clinical Relevance

Clinicians should incorporate the integrated sensory intervention into caregiving support for preterm infants undergoing short painful procedures.
Factors associated with physiological postoperative pyrexia
Authors: Fukuda Taeko , Nishida Masato
Published: November 2019

Aim

Postoperative pyrexia is generally a physiological response to surgery. It is a common problem and burden for both patients and surgeons. This study aimed to investigate the incidence and duration of physiological postoperative pyrexia and to retrospectively identify the prognostic factors associated with it.

Methods

We reviewed the medical records of 462 patients who underwent surgery for adenomyosis under general anesthesia. Postoperative pyrexia was defined as an axillary temperature of at least 38°C occurring for at least 4 h after the surgery up to the next morning. Long‐duration pyrexia was defined as a fever recovery period of >3 days.

Results

Of the 367 patients included in this study, 234 (64%) developed postoperative pyrexia and 260 (71%) needed >3 days to recover the normal temperature (<37°C). Multivariate analyses revealed that the administration of an amino acid‐enriched solution and non‐administration of flurbiprofen were associated with postoperative pyrexia. Scale of surgery (bleeding volume + weight of removed adenomyosis and other tissue), body mass index, and decreased body temperature during surgery were not associated with postoperative pyrexia. Long‐duration pyrexia was associated with the scale of surgery but not with the administration of an amino acid‐enriched solution and flurbiprofen.

Conclusion

More than half of the patients developed postoperative pyrexia. Postoperative pyrexia was related to the administration of an amino acid‐enriched solution and flurbiprofen. Long‐duration pyrexia was associated with the scale of surgery.
Validation of the AASLD recommendations for classification of oesophageal varices in clinical practice
Authors: Fateen Waleed , Ragunath Krish , White Jonathan , Khanna Amardeep , Coletta Marina , Samuel Sunil , Ortiz Jacobo , James Martin , Wilkes Emilie , Aithal Guruprasad P. , Guha Indra N. , Sami Sarmed S.
Published: November 2019

Background & Aims

The American Association for the Study of Liver Diseases recommends the use of a 2‐grade classification system (small and large) to describe the size of oesophageal varices (OV). Data on observer agreement (OA) on this system are currently lacking. We aimed to evaluate this classification and compare it to the widely used 3‐grade classification (grade 1 ‘small’, grade 2 ‘medium’, grade 3 ‘large’) among operators of variable experience.

Methods

High‐definition video recordings of 100 patients with cirrhosis were prospectively collected using standardised criteria. Nine observers of variable experience performed independent evaluations of the videos in random order. OV were scored using both systems. All assessments were repeated a year later by the same observers to assess intra‐observer agreement.

Results

Interobserver agreement (all observers) using the 2‐grade and the 3‐grade system was k = 0.71 (95% CI: 0.64‐0.78) and k = 0.73 (95% CI: 0.66‐0.79) respectively. When using the 2‐grade system, intra‐observer agreement between hepatologists (n = 3), luminal gastroenterologists (n = 3) and trainee gastroenterologists (n = 3) was k = 0.89 (95% CI: 0.86‐0.91), k = 0.72 (95% CI: 0.67‐0.77), and k = 0.74 (95% CI: 0.67‐0.8) respectively. With the 3‐grade system; intra‐observer agreement between the same three subgroups were k = 0.9 (95% CI: 0.87‐0.92), k = 0.73 (95% CI: 0.68‐0.78), k = 0.77 (95% CI: 0.71‐0.82) respectively.

Conclusions

There was no difference in OA between the 2‐grade and 3‐grade classification systems. Hepatologists had significantly higher levels of consistency in grading OV. This may have implications to create alternative training models for residents and fellows in the recognition and grading of OV.
Comparison of 10‐year Outcomes of Bryan Cervical Disc Arthroplasty for Myelopathy and Radiculopathy
Authors: Han Xiao , He Da , Zhang Ning , Song Qingpeng , Wang Jinchao , Tian Wei
Published: November 2019

Objective

To evaluate the long‐term efficacy of Bryan cervical disc arthroplasty in the treatment of myelopathy patients compared with radiculopathy patients.

Methods

This study is a prospective study. Sixty‐six patients (38 patients in myelopathy group and 28 patients in radiculopathy group) who were treated with Bryan cervical disc arthroplasty between 2004 and 2007 and followed for 10 years were included in this study. The Japanese Orthopaedic Association (JOA) score, neck disability index (NDI), and Odom's criteria were used to evaluate the clinical outcomes. X‐ray, computed tomography (CT), and magnetic resonance imaging (MRI) were used to evaluate the radiographic outcomes including the global range of motion (ROM), segmental ROM, and segment alignment before the surgery and at last follow‐up. The incidence of segmental kyphosis, segmental mobility lost, and the grade of paravertebral ossification (PO) were also evaluated at last follow‐up.

Results

The JOA score and NDI improved in both groups. Thirty‐three of 38 patients in myelopathy group and all patients in radiculopathy group reported good or excellent outcomes according to Odom's criteria. The segmental ROM was (9.5° ± 4.4°) before surgery and maintained at (9.0° ± 5.5°) at last follow‐up in myelopathy group. The segmental ROM was (9.5° ± 4.6°) and (9.0° ± 5.3°) before surgery and at last follow‐up in radiculopathy group, respectively. The Bryan prosthesis remained mobile at last follow‐up for 30 patients (78.9%) in the myelopathy group and 22 patients (78.6%) in the radiculopathy group. Of the patients in the myelopathy group, 21.1% developed segmental kyphosis, as did 21.4% of patients in the radiculopathy group. The incidence of PO and high‐grade PO was 92.1 and 28.9% in the myelopathy group, and was 92.9 and 32.1% in the radiculopathy group. There was no significant difference between both groups.

Conclusions

Bryan cervical disc arthroplasty was an effective and safe technique in treating patients with myelopathy. The clinical and radiographic outcomes in the myelopathy group were similar to those in the radiculopathy group at the 10‐year follow‐up.
Isotretinoin‐induced sacroiliitis: Case series of four patients and a systematic review of the literature
Authors: Karadağ Şerife Gül , Sönmez Hafize Emine , Tanatar Ayşe , Çakan Mustafa , Aktay Ayaz Nuray
Published: November 2019

Isotretinoin is the mainstay treatment in severe acne; however, its musculoskeletal adverse effects such as lower‐back pain can be disabling. Herein, we present four cases of isotretinoin‐induced sacroiliitis with variable severity. We also present a review of the literature of isotretinoin‐induced sacroiliitis. All our cases were male and human leukocyte antigen (HLA)‐B27 negative. Sacroiliitis was detected a median of 55 (10‐120) days after isotretinoin initiation. Two patients were responsive to baseline sulfasalazine and indomethacin treatment, while the other two patients required more intensive treatments: adalimumab in one and methotrexate in the other. We also identified 15 articles describing 33 patients (17 of whom were female) with isotretinoin‐induced sacroiliitis. Most of them were responsive to low‐to‐medium doses of systemic steroids or non‐steroidal anti‐inflammatory drugs (NSAIDs). Our patients illustrate that severity of isotretinoin‐induced sacroiliitis varies from patient to patient.
Dispersal mode constrains allocation of carbon and mineral nutrients in seeds of forest and savanna trees
Authors: de Melo R. B. , Ferreira C. S. , Lopes A. , Vinson C. C. , Franco A. C.
Published: November 2019

Species vary in seed size and content of stored reserves, which can be related to dispersal strategies and type of habitat in which they are found. We compare seed carbon and nutrient reserves of anemochorous and zoochorous trees from the Cerrado of central Brazil.

We measured seed dry mass, lipids, non‐structural carbohydrates (starch and total soluble sugars), carbon and mineral nutrients in ten forest and 13 savanna species, each classified as having wind‐ or animal‐dispersed seeds. We used phylogenetically independent contrasts to test for correlations among these traits.

Seeds of anemochorous species were lighter, with higher concentrations of C, N, P, Ca and Mg. Lipids were the dominant carbon reserve for most anemochorous species, underpinning the importance of allocation to compact carbon reserves. Starch, lipids or soluble sugars were the major carbon reserve in zoochorous seeds. Savanna and forest species did not differ in seed mass or in total carbon reserves. However, seeds of forest species had higher concentrations of starch than seeds of savanna species. Lipid and starch negatively correlated across species, suggesting a trade‐off between starch and lipids as major seed carbon reserves. Calcium was positively correlated with Mn and B, while Mg was positively correlated with C, N, P, K, S, Zn and B. Potassium, S and Cl were positively correlated, while P was positively correlated with Mg and Zn.

Dispersal mode rather than vegetation type constrained seed mass and seed storage allocation patterns in forest and savanna trees. We provide evidence that similar mechanisms are involved in seed storage of carbon and mineral nutrients across species.
Breed performance in organic dairy farming in Northern Spain
Authors: Rodríguez‐Bermúdez Ruth , Miranda Marta , Fouz Ramiro , Orjales Inmaculada , Diéguez Francisco Javier , Minervino Antonio Humberto Hamad , López‐Alonso Marta
Published: November 2019

Organic farm management combines best environmental practices, a high level of biodiversity, preservation of natural resources and high animal welfare standards. To meet these criteria, farmers must have livestock well adapted to local organic conditions and information about how different breeds and crosses perform under different conditions. The objective of this study was to compare the performance of different pure breeds and cross‐breeds of cattle in organic dairy systems in Northern Spain. The data analysed were obtained from monthly records kept between 2010 and 2016 on organic farms registered in the regional milk recording system. Analysis of various traits indicated that the Holstein‐Friesian breed suits the organic production system in the study region. Although the reproductive performance of Holstein‐Friesian cows was poorer (in terms of number of services per conception) than that of cross‐breed and Brown Swiss cows, the Holstein‐Friesian produced more milk and lived longer. In addition, there was no difference in calving type or calving ease between the different breed groups. The better milk fat and protein yields produced by the crosses may be useful traits for farmers interested in milk transformation. The advantage of continuing to use Holstein‐Friesian cattle is that the breed is predominant worldwide, and the genealogy is well documented. If Holstein‐Friesian cattle continue to be used, the main priority will be to search for well‐adapted bulls (particularly for pasture‐based conditions) and to elaborate a genetic merit index for organic and pasture‐based systems with the aim of predicting and minimizing genotype × environment interactions.
Can Genetics Reveal the Causes and Consequences of Educational Attainment?
Authors: Munafò Marcus , Davies Neil M. , Davey Smith George
Published: November 2019

There is an extensive literature on the causes of educational inequalities, and the life course consequences of educational attainment. Mendelian randomization, where genetic variants associated with exposures of interest are used as proxies for those exposures, often within an instrumental variables framework, has proven highly effective at elucidating the causal effects of several risk factors in the biomedical sciences. We discuss the potential for this approach to be used in the context of social and socio-economic exposures and outcomes, such as educational attainment.
Mundane Populism: Politics, Practices and Discourses of Roma Oppression in Rural Slovakia
Authors: Škobla Daniel , Filčák Richard
Published: November 2019

In this article, we explore populist politics, discourses and social practices regarding the ethnic Roma in the rural regions of eastern Slovakia. Our approach was guided by a theoretical discussion of right‐wing populism and social inequalities. Methodologically, we relied on Bourdieu's conceptual apparatus as a useful scholastic device to translate very practical data from interviews and observations into structured analytical information. The article is based on field research, in which we explored waste management practices in the municipality of Laborov. We came to the conclusion that essential components of right‐wing populism in Laborov rest on what we characterised as ongoing racialised stigmatisation, reconfiguring previously racially uncategorised issues into ethnic problems and thus, reinforcing the stigmatisation and oppression of the disempowered Roma minority groups.
Advancing the Frontiers in Ethnic Entrepreneurship Studies
Authors: Rath Jan , Schutjens Veronique
Published: November 2019

The proliferation of ethnic entrepreneurship varies not only from country to country, but also from sector to sector, from city to city, and – within cities – from neighbourhood to neighbourhood. In evaluating the interrelationship of ethnic entrepreneurship and urban governance, we discuss three specific points: ethnic variety and varieties; spatial levels in opportunities and constraints; and urban governance and institutions. In analysing the literature and positioning the four special issue articles in a spatiality‐governance framework, we identify ‘roads less travelled’. Finally, we suggest scholars to move forward along five distinct pathways.
Centred Propositions, What is Asserted, and Communication
Authors: Rudnicki JAKUB
Published: November 2019

In recent years there has been a heated debate on how to accommodate John Perry's observations about the essentiality of indexicality into our models of linguistic communication. This article is an attempt at providing a new perspective on this issue. I argue that we should jettison two elements taken for granted by the views I present, and criticize, here: no centring, uncentring, recentring and multicentring. These elements are: (1) taking the asserted content to be a part of the communication process and (2) assumptions that the indexical belief of the speaker, when successfully communicated, must be acquired by the hearer as indexical, too. The theory of indexical communication that I propose here is laid out in the mental files framework and devoid of the two aforementioned elements.
Profiling natural serum antibodies of non‐human primates with a carbohydrate antigen microarray
Authors: Nanno Yoshihide , Sterner Eric , Gildersleeve Jeffrey C. , Hering Bernhard J. , Burlak Christopher
Published: November 2019

Background

Engineering of α‐Galactosyltransferase gene‐knockout pigs circumvented hyperacute rejection of pig organs after xenotransplantation in non‐human primates. Overcoming this hurdle revealed the importance of non‐α‐Gal carbohydrate antigens in the immunobiology of acute humoral xenograft rejection.

Methods

This study analyzed serum from seven naïve cynomolgus monkeys (blood type O/B/AB = 3/2/2) for the intensity of natural IgM and IgG signals using carbohydrate antigen microarray, which included historically reported α‐Gal and non‐α‐Gal carbohydrate antigens with various modifications.

Results

The median (range) of IgM and IgG signals were 12.71 (7.23‐16.38) and 9.05 (7.23‐15.90), respectively. The highest IgM and IgG signals with narrowest distribution were from mono‐ and disaccharides, followed by modified structures. Natural anti‐α‐Gal antibody signals were medium to high in IgM (11.2‐15.9) and medium in IgG (8.5‐11.6) spectra, and was highest with Lac core structure (Galα1‐3Galβ1‐4Glc, iGb3) and lowest with LacNAc core structure (Galα1‐3Galβ1‐4GlcNAc). Similar signal intensities (up to 15.8 in IgM and up to 11.8 in IgG) were observed for historically detected natural non‐α‐Gal antigens, which included Tn antigen, T antigen, GM2 glycolipid, and Sda antigen. The hierarchical clustering analysis revealed the presence of clusters of anti‐A antibodies and was capable of distinguishing between the blood group B and AB non‐human primates.

Conclusions

The results presented here provide the most comprehensive evaluation of natural antibodies present in cynomolgus monkeys.
Rapid‐onset vasodilator responses to exercise in humans: Effect of increased baseline blood flow
Authors: Dillon Gabrielle A. , Shepherd John R. A. , Casey Darren P. , Dinenno Frank A. , Curry Timothy B. , Joyner Michael J. , Ranadive Sushant M.
Published: November 2019

New Findings

What is the central question of this study?

What is the effect of an elevated baseline blood flow, induced by high‐dose intra‐arterial infusion of either adenosine or ATP, on the rapid‐onset vasodilatory response to a single forearm muscle contraction?

What is the main finding and its importance?

The peak response to a single contraction is unaffected by augmented baseline blood flow, and thus, is likely to be attributable to a feedforward vasodilatory mechanism.

The hyperaemic responses to single muscle contractions are proportional to exercise intensity, which, in turn, is proportional to tissue metabolic demand. Hence, we tested the hypothesis that the rapid‐onset vasodilatory response after a single muscle contraction would be unaffected when baseline blood flow was increased via high‐dose intra‐arterial infusion of either adenosine (ADO) or ATP. Twenty‐four healthy young participants (28 ± 1 years) performed a single forearm contraction (20% maximal voluntary contraction) 75 min after commencement of a continuous infusion of ADO (n = 6), ATP (n = 8) or saline (control; n = 10). Brachial artery diameter and blood velocity were measured using Doppler ultrasound. Resting forearm vascular conductance (FVC; in millilitres per minute per 100 mmHg per decilitre of forearm volume) was significantly higher during ADO (33 ± 17) and ATP infusion (33 ± 17) compared with the control infusion (8 ± 3; P < 0.05). The peak FVCs post‐contraction during ADO and ATP infusions were significantly greater than during the control infusion (P < 0.05), but not different from one another. The peak change in FVC from baseline was similar in all three conditions (control, 14 ± 1; ADO, 24 ± 2; and ATP, 23 ± 6; P = 0.15). Total FVC (area under the curve) did not differ significantly between ADO and ATP (333 ± 69 and 440 ± 125); however, total FVC during ATP infusion was significantly greater compared with the control value (150 ± 19; P < 0.05). We conclude that the peak response to a single contraction is unaffected by augmented baseline blood flow and is therefore likely to be attributable to a feedforward vasodilatory mechanism.