bluuebunny/crossref_metadata_2025 huggingface dataset:
Whose experience is it anyway? Toward a constructive engagement of tensions in patient-centered health care
Authors: Vogus Timothy J. , Gallan Andrew , Rathert Cheryl , El-Manstrly Dahlia , Strong Alexis
Published: August 2020

Purpose

Healthcare delivery faces increasing pressure to move from a provider-centered approach to become more consumer-driven and patient-centered. However, many of the actions taken by clinicians, patients and organizations fail to achieve that aim. This paper aims to take a paradox-based perspective to explore five specific tensions that emerge from this shift and provides implications for patient experience research and practice.

Design/methodology/approach

This paper uses a conceptual approach that synthesizes literature in health services and administration, organizational behavior, services marketing and management and service operations to illuminate five patient experience tensions and explore mitigation strategies.

Findings

The paper makes three key contributions. First, it identifies five tensions that result from the shift to more patient-centered care: patient focus vs employee focus, provider incentives vs provider motivations, care customization vs standardization, patient workload vs organizational workload and service recovery vs organizational risk. Second, it highlights multiple theories that provide insight into the existence of the tensions and how they may be navigated. Third, specific organizational practices that engage the tensions and associated examples of leading organizations are identified. Relevant measures for research and practice are also suggested.

Originality/value

The authors develop a novel analysis of five persistent tensions facing healthcare organizations as a result of a shift to a more consumer-driven, patient-centered approach to care. The authors detail each tension, discuss an existing theory from organizational behavior or services marketing that helps make sense of the tension, suggest potential solutions for managing or resolving the tension and provide representative case illustrations and useful measures.
On some alleged “problems” and alleged “solutions” in democratic firms
Authors: Ellerman David
Published: August 2020

Purpose

This paper will discuss two problems that have plagued the literature on the Ward-Domar-Vanek labor-managed firm (LMF) model, the perverse supply response problem and the horizon problem. The paper also discusses the solution to the horizon problem and the alleged “solution” of a membership market.

Design/methodology/approach

This is a conceptual paper so it analyzes the two problems and shows how they can be resolved. It also shows how one alleged “solution” (membership market) is based on several conceptual mistakes about the structure of rights in a democratic firm.

Findings

The perverse supply response is based on the assumption that the members of a democratic firm can expel for no cause some members when it would benefit the remaining members. It is shown that the same perverse behavior happens conceptually and historically in a conventional firm under the same assumptions. The horizon problem is resolved by the system of internal capital accounts (ICAs) that has been independently invented at least four times.

Research limitations/implications

The idea of a democratic firm is quite often dismissed by conventional economists: “At first it seems like a good idea but unfortunately it is plagued by structural problems such as the perverse supply response and the horizon problem.” Hence it is important to see that the first is not a problem under ordinary assumptions and that the second is a solved problem.

Practical implications

The perverse supply response problem can be reproduced in a conventional firm under similar assumptions, and the horizon problem is real problem for social or common ownership firms but is solved in the Mondragon-type worker cooperatives by the system of ICAs. This has been known and published since the early 1980s, but conventional economists ignore the solution and still cite it as an inherent structure problem of a democratic firm.

Originality/value

It has not been previously shown in the LMF literature that the perverse supply response can be reproduced in a conventional corporation under similar assumptions since the maximand for the conventional firm is not total market value but that value per current shareholder. The solution to the horizon problem using ICAs has long been “known” but never acknowledged in the conventional literature as if it was a necessary feature of workplace democracy. The idea of a membership market is analyzed and criticized.
Sensation Seeking and Overconfidence in day traders: evidence from Brazil
Authors: Antonelli-Filho Paulo , Bressan Aureliano Angel , Vieira Kelmara Mendes , Potrich Ani Caroline Grigion
Published: August 2020

Purpose

In this work, the authors conduct an online survey to evaluate how Sensation Seeking and Overconfidence influences the transaction volume of day traders in Brazil.

Design/methodology/approach

The authors conducted a survey to gather the primary data. They applied linear regressions between the variables, and then the stepwise technique in order to eliminate the ones with the least explanatory power.

Findings

The authors found that the aggregated trace Sensation Seeking did not positively influence the trading volume of day traders, but some of its facets did, like Thrill and Adventure Seeking and Boredom Susceptibility/Impulsivity. For the Overconfidence bias, only its Overplacement form showed a positive effect on the transaction volume of day traders, while Overestimation and Miscalibration did not.

Originality/value

This is the first study that seeks to identify the relationship of Sensation Seeking and Overconfidence, considering their different facets and forms, in a more homogeneous sample of day traders, which have mostly speculative reasons for trading. Its results reveal the multidimensional characteristics of the Sensation Seeking and Overconfidence behavioral aspects and lighten some of the motivations for day traders to overtrade.
Evolutionary history, not ecogeographic rules, explains size variation of tropical insects along elevational gradients
Authors: Garcia‐Robledo Carlos , Baer Christina S. , Lippert Kes , Sarathy Vikas
Published: August 2020

One of the best‐known biogeographic rules for ectotherms is the temperature‐size rule, which asserts that ectotherms produce smaller adults at warmer temperatures. Although this is often true, it has become clear that there is no single process behind the pattern and many exceptions to the rule. To disentangle such complex temperature–size relationships, individual clades must be examined at ecological and evolutionary scales.

We examined temperature–size relationships for 2,106 individuals from 64 populations and 40 species of Cephaloleia rolled‐leaf beetles (Chrysomelidae; Cassidinae) occurring along two tropical elevational gradients: Barva and the Talamanca Cordillera in Costa Rica, Central America. We tested whether the temperature‐size rule applied to interspecific elevational assemblages, intraspecific elevational populations or different rearing temperatures for individual populations.

At the interspecific scale, evolutionary history, rather than elevation, explains body size. At the intraspecific scale, only one of seven species followed the temperature–size rule across elevations. When larvae were reared at different temperatures, only one of five populations followed the temperature–size rule. Most populations grew to a fixed size regardless of temperature.

Size in Cephaloleia beetles is constrained by their evolutionary history and responds to factors that rarely correlate with temperature. As temperature increases, ectotherms will not universally shrink, but determining if and why their size will change will require further investigation.

A free Plain Language Summary can be found within the Supporting Information of this article.
A comparative study of the antioxidant profiles of olive fruit and leaf extracts against five reactive oxygen species as measured with a multiple free‐radical scavenging method
Authors: Sueishi Yoshimi , Nii Risako
Published: August 2020

Olive fruits and leaves are recognized to have great potential as natural sources of antioxidants. The major phenolic antioxidant component in these plant tissues is oleuropein. The antioxidant activity of olive fruits and leaves was evaluated in this study using multiple free‐radical scavenging (MULTIS) methods, wherein we determined the scavenging abilities of different extracts against five reactive oxygen species (ROS; HO·, O2−·, RO·, t‐BuOO·, and 1O2). Raw olive fruits taste bitter and are inedible without undergoing a debittering treatment. Following the NaOH‐debittering process, the radical scavenging activity of olives decreased by 90%. The MULTIS measurements indicated that oleuropein and hydroxytyrosol are responsible for the radical scavenging activity of olive fruits. Furthermore, we evaluated the radical scavenging profiles of olive leaf extracts against five ROS and found significant seasonal variations in their antioxidant activities. Leaves picked in August possessed greater radical scavenging abilities (180% to 410% for different ROS) than those picked in the cold season (December and February). In roasted olive leaves, we found marked increases (230% to 300% and 180% to 220%) in the antioxidant activities of Maillard reaction products against RO· and t‐BuOO·, respectively. This study presented a useful comparative analysis of the antioxidant capacities of food against various types of ROS.

Practical Application

In this study, we evaluated the natural antioxidant activity of olive fruits and leaves against five reactive oxygen species (ROS). We found characteristic differences in the antioxidant profiles of different olive tissues, which varied after different treatments (debittering [fruit], drying [leaf], and roasting [leaf]). Comparative studies of the antioxidant capacities of foods against various ROS are useful to improve the functionality of food products.
African Americans now outpace whites in opioid‐involved overdose deaths: a comparison of temporal trends from 1999 to 2018
Authors: Furr‐Holden Debra , Milam Adam J. , Wang Ling , Sadler Richard
Published: August 2020

Aims

To estimate racial differences in rates of opioid‐involved overdose deaths (OOD) between whites and African Americans in the United States from 1999 to 2018 to (1) identify racial variation in the temporal trends of OOD during the 20‐year period and (2) compare trends in OOD rates between whites and African Americans using the Centers for Disease Control and Prevention's (CDC) three defined OOD epidemic periods.

Methods

Data were obtained from the CDC wide‐ranging on‐line data for epidemiological research, which combines OOD data from the National Vital Statistics System, and population data from the US Census Bureau. Joinpoint regression models were used to estimate age‐adjusted annual percentage change (APC) in OOD by race from 1999 to 2018.

Results

The temporal trends of OOD varied by race. African Americans had a persistently low rate of OOD and statistically non‐significant rate of change in OOD from 1999 to 2012 (APC = 0.47; P > 0.05), with a statistically significant and rapid acceleration in OOD rates in 2012 that persisted to 2018 (APC = 26.16; P < 0.01). Whites had three statistically significant periods of acceleration in OOD rate from 1999 to 2006 (APC = 12.43; P < 0.01), 2006 to 2013 (APC = 4.34, P < 0.01) and the greatest increase from 2013 to 2016 (APC = 18.96; P < 0.01). Whites had a statistically non‐significant decrease in OOD from 2016 to 2018 (P = 0.16). The trend for whites more closely aligned with the CDC‐defined epidemic periods than for African Americans. During wave 1 (1999–2010), the average annual percentage change (AAPC) for African Americans was significantly lower than for whites (0.47 versus 9.42, P < 0.01); however, by wave 3 (2013–current; defined by the introduction of illicitly manufactured fentanyl), the AAPC was significantly higher in African Americans (26.16 versus 13.19, P < 0.01).

Conclusions

Despite historically lower rates of opioid misuse and opioid‐involved overdose deaths among African Americans compared with whites, the growth in opioid‐involved overdose deaths among African Americans now outpaces that of whites in the United States.
Ablation of premature ventricular contraction triggering ventricular fibrillation in a patient with early repolarization syndrome
Authors: Qifang Liu , Jing Huang , Yidong Zhao , Long Yang
Published: August 2020

Early repolarization syndrome is associated with an increased risk of arrhythmic death caused by ventricular fibrillation (VF). VF is usually initiated by premature ventricular contractions (PVCs), and PVCs commonly arise from Purkinje system, the ventricular outflow tract, and papillary muscles. We report the case of a patient with J wave syndromes and recurrent VF, triggered by PVCs originating from the tricuspid annular region. VF was successfully suppressed by catheter ablation of the triggering PVCs, and there has been no recurrence of VF during a follow‐up period of 6 months.
Our life at home: Photos from families inform discharge planning for medically complex children
Authors: Barone Silvana , Boss Renee D. , Raisanen Jessica C. , Shepard Jennifer , Donohue Pamela K.
Published: August 2020

Background

Infants with medical complexity are increasingly cared for at home, creating unique challenges for their caregivers. The sickest of these are those with chronic critical illness (CCI). These infants’ medical fragility and resource‐intensive needs puts them at increased risk for suboptimal transitions from hospital‐ to home‐based care. It is unclear whether, and if so, to what extent clinicians gather and use knowledge of a family's home context during discharge planning.

Methods

This study is a pilot of a novel program, using Photovoice methodology, which aims to record and reflect the experience of caring for a child with CCI at home from caregivers’ perspectives and to provide direct feedback to inpatient discharging clinicians, with the goal of increasing awareness of (a) the importance of home context and (b) current discharge limitations.

Results

Through photographs, parents described the importance of developing new routines, learning how to be a family, the impact of medical technology on nearly all aspects of everyday life, the critical role played by clinicians during the transition home, and feelings of social stigma and isolation. Clinicians, in turn, learned about gaps in discharge planning and the value of making families part of the decision‐making team. They also found meaning in seeing the children they had cared for doing well at home, which subsequently bolstered enthusiasm for their job.

Conclusions

Findings from this pilot study highlight the importance of understanding the lived experience of families caring for medically complex children at home and suggest that this knowledge can be used to address gaps in the transition home.
Time‐to‐event survival statistics in ophthalmology: Methodological research
Authors: Layton Christopher J. , Layton Danielle M.
Published: August 2020

Importance

Understanding the outcomes of interventions over time is essential for clinical decision making in surgical specialties.

Background

Analysis of survival time (or time to event) is complicated when loss to follow up occurs. This article explores transparent data analysis methods where missing (“censored”) data are present.

Design

Manual search of the top 20 Ophthalmology journals from a recent year of the established literature (2014).

Samples

A total of 4565 articles were identified, of which 218 reported outcomes of treatment over time in humans.

Methods

Pertinent details to assist the use of Kaplan‐Meier and life table actuarial statistics are explained, and criteria that define whether each has high, acceptable or poor quality are explored. The quality of reporting from the literature sample is analysed.

Main Outcome Measures

Reporting quality of survival curves and life tables from each sampled article is assessed according to the established criteria.

Results

In total, 31.2% of samples (n = 68) presented survival curves, 53.2% (n = 116) presented life tables, 22% (n = 48) presented both, whilst 46.8% (n = 102) presented neither; 2% of survival curves and 13% of life tables were high quality, with quality of life tables significantly better than survival curves (P = .0042). 90.36% (n = 197) of articles reported time to event data which was classified as poor: due to poor analysis of survival curves (n = 50, 43.10%) poor analysis of life tables (n = 45, 66.18%); and complete omission of survival graphics (n = 102, 46.97%).

Conclusions and Relevance

Ophthalmology research that follows patient outcomes over time can be analysed with “time‐to‐event” statistics, and reported with transparency. This analysis showed that important contextural information was omitted from 90% of ophthalmic studies, and this could impact patient decision making.
Reduction in global habitat loss from fossil‐fuel‐dependent increases in cropland productivity
Authors: Goklany Indur M.
Published: August 2020

Terrestrial biodiversity loss and climate change, driven mainly by loss of habitat to agriculture and fossil fuel (FF) use, respectively, are considered among the world's greatest environmental threats. However, FF‐dependent technologies are currently essential for manufacturing synthetic nitrogen fertilizers (SNFs) and synthetic pesticides (SPs) critical to increasing agricultural productivity, which reduces habitat loss. Fossil fuel use increases CO2 levels, further enhancing agricultural productivity. Based on estimates of global increases in yields from SNFs, SPs, and atmospheric CO2 fertilization, I estimated that FF‐dependent technologies are responsible for at least 62.5% of current global food production (GFP) from cropland. Thus, if FF use is eschewed in the future, maintaining current GFP means croplands would have to increase from 12.2% of global land area (GLA) excluding Antarctica to 32.7%. The additional 20.4% of GLA needed exceeds habitat lost currently to cropland (12.2% of GLA) and cumulative conservation areas globally (14.6% of GLA). Thus, although eliminating FF use could reduce climate change, its unintended consequences may be to significantly exacerbate biodiversity loss and indirectly increase food costs, reducing food security which, moreover, disproportionately affects the poor. Although it may be possible to replace SNFs and SPs with FF‐free technologies, such substitutes have not yet been demonstrated to be sufficiently economical or efficient. In the interim, meeting global food demand and keeping food prices affordable would increase habitat conversion and food prices. These trade‐offs should be considered in analyses of climate change policies.
Understanding the distribution of bushmeat hunting effort across landscapes by testing hypotheses about human foraging
Authors: Brodie Jedediah F. , Fragoso Jose M. V.
Published: August 2020

Mitigating the massive impacts of defaunation on natural ecosystems requires understanding and predicting hunting effort across the landscape. But such understanding has been hindered by the difficulty of assessing the movement patterns of hunters in thick forests and across complex terrain. We statistically tested hypotheses about the spatial distribution of hunting with circuit theory and structural equation models. We used a data set of >7000 known kill locations in Guyana and hunter movement models to test these methods. Comparing models with different resistance layers (i.e., different estimates of how terrain and land cover influence human movement speed) showed that rivers, on average, limited movement rather than serving as transport arteries. Moreover, far more kills occurred close to villages than in remote areas. This, combined with the lack of support for structural equation models that included latent terms for prey depletion driven by past overhunting, suggests that kill locations in this system tended to be driven by where hunters were currently foraging rather than by influences of historical harvest. These analyses are generalizable to a variety of ecosystems, species, and data types, providing a powerful way of enhancing maps and predictions of hunting effort across complex landscapes.
Protected areas are now the last strongholds for many imperiled mammal species
Authors: Pacifici Michela , Di Marco Moreno , Watson James E. M.
Published: August 2020

The global network of terrestrial protected areas (PAs) has experienced a fourfold expansion since the 1970s. Yet, there is increasing debate around the role of the global PA estate in covering and sustaining threatened species, with serious ramifications for current PA financing and the setting of post‐2020 global conservation targets. By comparing “past” (1970s) and current distribution range of 237 mammals, and measuring the proportion of range covered by PAs in the past and in the present, we show that a small number of PAs have now become the last bastions of hope for ensuring the persistence of many mammal species. For 187 species (∼79% of those analyzed) the proportion of range covered by PAs has doubled over the time period, with 10% of all species now having most of their current range protected. This increase in proportional protection over time is largely due to a retreat of species distribution (outside existing PAs) and, in smaller part, to PA expansion. It is clear that adequately resourcing those PAs critical in sustaining mammal species is now essential, to avert a worldwide rapid mammal loss.
Smooth muscle hamartoma and striated muscle hamartoma: Clinicopathologic characterization of two rare entities and literature review
Authors: González Iván A. , Dehner Louis P.
Published: August 2020

Smooth muscle hamartoma (SMH) and striated muscle hamartoma (STH) are anomalous proliferations of smooth muscle or striated muscle, respectively, in anatomic sites where these tissues are normally present. To date, only limited cases have been reported describing these lesions. In this study, we sought to characterize the clinicopathologic features of both SMH and STH. A total of 27 cases of SMH and 12 cases of STH from 1990 to 2020 were identified. SMH cases had a slight male predominance (63%) and a mean age of presentation of 20 years (range: 4 months‐91 years), with a mean size of 9.3 mm (±13.3). In contrast, STH were equally distributed in gender, with a mean age of presentation of 40 years (range: 3 months‐66 years) and a mean size of 5.7 mm (±3.6). SMH were more commonly located in the torso and extremities (70%) and STH in the head and neck area (92%). One case of SMH recurred after 1.1 years and in the initial diagnosis the lesion was present at the tissue edge. None of the cases of STH had a recurrence. We present the largest cohort of SMH and STH, and report the first case of a recurrent SMH, suggesting the importance of obtaining a clean margin for these lesions.
Overdiagnosis of melanoma – causes, consequences and solutions
Authors: Kutzner Heinz , Jutzi Tanja B. , Krahl Dieter , Krieghoff‐Henning Eva I. , Heppt Markus V. , Hekler Achim , Schmitt Max , Maron Roman C. R. , Fröhling Stefan , von Kalle Christof , Brinker Titus J.
Published: August 2020

Malignant melanoma is the skin tumor that causes most deaths in Germany. At an early stage, melanoma is well treatable, so early detection is essential. However, the skin cancer screening program in Germany has been criticized because although melanomas have been diagnosed more frequently since introduction of the program, the mortality from malignant melanoma has not decreased. This indicates that the observed increase in melanoma diagnoses be due to overdiagnosis, i.e. to the detection of lesions that would never have created serious health problems for the patients. One of the reasons is the challenging distinction between some benign and malignant lesions. In addition, there may be lesions that are biologically equivocal, and other lesions that are classified as malignant according to current criteria, but that grow so slowly that they would never have posed a threat to patient’s life. So far, these “indolent” melanomas cannot be identified reliably due to a lack of biomarkers. Moreover, the likelihood that an in‐situ melanoma will progress to an invasive tumor still cannot be determined with any certainty. When benign lesions are diagnosed as melanoma, the consequences are unnecessary psychological and physical stress for the affected patients and incurred therapy costs. Vice versa, underdiagnoses in the sense of overlooked melanomas can adversely affect patients’ prognoses and may necessitate more intense therapies. Novel diagnostic options could reduce the number of over‐ and underdiagnoses and contribute to more objective diagnoses in borderline cases. One strategy that has yielded promising results in pilot studies is the use of artificial intelligence‐based diagnostic tools. However, these applications still await translation into clinical and pathological routine.
Are juveniles as tolerant to salinity stress as adults? A case study of Northern European, Ponto‐Caspian and North American species
Authors: Paiva Filipa , Pauli Nora‐Charlotte , Briski Elizabeta
Published: August 2020

Aim

Global biodiversity and ecosystems are highly impacted by anthropogenic activities, such as climate change and introduction of non‐indigenous species. As numerous species from the Ponto‐Caspian region have established in the North and Baltic Seas, as well as in the Laurentian Great Lakes, there have been large number of studies examining environmental tolerance of these species to determine their future potential to spread. However, many of those studies were conducted only on adult stages, while neglecting the possibility that early life history stages might not be equally resilient.

Location

Northern European, Ponto‐Caspian and North American regions.

Methods

To determine whether juveniles would demonstrate the same environmental tolerance as their parents, we examined the salinity tolerance of adults and juveniles of one Northern European (Gammarus salinus), one Ponto‐Caspian (Pontogammarus maeoticus) and one North American species (Gammarus tigrinus). Additionally, we compared our study to that of Paiva et al. (Global Change Biology, 24, 2018, 2708), who tested the salinity tolerance of the same species using only adults.

Results

Our study determined that both adults and juveniles of all three species tolerated wide ranges of salinity, with juveniles of G. salinus tolerating only slightly narrower salinity range than their parents, while those of P. maeoticus and G. tigrinus much narrower range. Additionally, we determined better survival and higher growth rates of juveniles of G. salinus in higher salinities and better survival of P. maeoticus in lower salinities.

Main conclusions

Based on juvenile salinity tolerance, our study further supported findings of Paiva et al. (2018), where Northern European species may be adapted to marine, while Ponto‐Caspian to lower saline and freshwater environments. The North American species is probably adapted to intermediate salinities. As juveniles do not tolerate the same salinity stress as adults, we emphasize the importance of testing all life history stages when predicting species resilience to environmental stressors.
Deep brain stimulation in Parkinson’s disease patients and routine 6‐OHDA rodent models: Synergies and pitfalls
Authors: Stefani Alessandro , Cerroni Rocco , Pierantozzi Mariangela , D’Angelo Vincenza , Grandi Laura , Spanetta Matteo , Galati Salvatore
Published: August 2020

The history of deep brain stimulation for Parkinson's disease (PD) represented a paradigmatic cross‐talk between mammalian disease models and clinical evidence in humans. Fascinating were the results achieved by high frequency stimulation (HFS) into the subthalamic nucleus (STN) of MPTP‐treated primates. An analogous strategy relieved tremor and hypokinetic parameters in PD patients. The 6‐hydroxydopamine (6‐OHDA) rodent model has mastered decades of research, contributing to understanding of the PD pathology. However, this review wonders about the actual synergy between the routine neurotoxic models and PD patients underlying STN‐DBS. At first, some findings collected following 6‐OHDA, promoted dogmatic visions, as the wrong contention that suppression of STN glutamate was the key therapeutic player. Instead, changes of glutamate release are negligible in humans during transition to ON‐state. Besides, the imbalance of basal ganglia endogenous band frequencies, the beta (β) band increase and the cortical‐basal ganglia synchronization, undisputedly shared by models and PD patients, do not govern the whole spectrum of non‐motor PD signs, difficult to investigate in rodents. Furthermore, the tonic release of dopamine, inferred during HFS in rodents, was not replicated in humans. Finally, neurotoxic rodent models describe a ‘pure’ dopamine depletion sparing pathways crucial in parkinsonian phenotypes, that is, noradrenergic and cholinergic ones. Although the utilization of neurotoxic models is still providing major advancements, we pore over these contradictions and try to support possible amendments of neurotoxic models (advocating modern ‘in vivo’ approaches and recordings extending towards motor thalamus) for pursing the development of new DBS technology.
NBAS disease: 14 new patients, a recurrent mutation, and genotype–phenotype correlation among 24 Chinese patients
Authors: Li Zhong Die , Abuduxikuer Kuerbanjiang , Zhang Jing , Yang Ye , Qiu Yi‐Ling , Huang Yuge , Xie Xin‐Bao , Lu Yi , Wang Jian‐She
Published: August 2020

Aim

Neuroblastoma amplified sequence (NBAS)‐associated disease has a wide phenotypic spectrum, including infantile liver failure syndrome type 2 (ILFS2, OMIM #616483), short stature with optic nerve atrophy and Pelger–Huët anomaly (SOPH) syndrome (OMIM #614800), and a combined phenotype overlapping ILFS2 and SOPH syndrome. The mutation spectra of NBAS and its genotype–phenotype correlation among Chinese were not clear.

Methods

Clinical and genetic data were retrospectively collected from the medical charts of patients with biallelic NBAS mutations, as well as from Chinese patients in previously published reports.

Results

Fourteen new patients were identified, including 10 novel mutations: c.648‐1G>A, c.2563_c.2577+5del/p.His855_Gln859del, c.3115C>T/p.Gln1039Ter, c.3284G>A/p.Trp1095Ter, c.2570C>T/p.Ala857Val, c.6859G>T/p.Asp2287Tyr, c.1028G>A/p.Ser343Asn, c.1177_1182delinsAGATAGA/p.Val393ArgfsTer2, c.3432_3435dupCAGT/p.Ala1146GlnfsTer14, and c.680_690dupACTGTTTCAGC/p.Phe231ThrfsTer35. All 14 patients presented as fever‐triggered liver injury, including nine patients that satisfied the criteria of acute liver failure (ALF) in whom c.3596G>A/p.Cys1199Tyr occurred five times. Nine patients had extrahepatic manifestations including short stature, skeletal abnormalities, intellectual disability, ophthalmic abnormalities, low levels of serum immunoglobulins, facial dysmorphism, and cardiac abnormalities. Ten other Chinese patients were collected through a review of published works. Genotype–phenotype analysis in 24 Chinese patients revealed that the percentage of ALF patients with variants in the Sec39 domain was significantly higher than that in the C‐terminal (100% vs. 12.5%, P = 0.000), and the percentage of multi‐organ/system involvement in patients with variants in the Sec39 domain was significantly lower than that in the C‐terminal (40% vs. 100%, P = 0.0128).

Conclusions

We reported 14 new patients, 10 novel mutations, and a unique recurrent mutation. Correlation analysis indicated that the domain of missense and non‐frameshift insertion/deletion mutations in NBAS protein is related to phenotype among Chinese patients.
Percutaneous nephrostomy versus JJ ureteric stent as the initial drainage method in kidney stone patients presenting with acute kidney injury: A prospective randomized study
Authors: Elbatanouny Ahmed M , Ragheb Ahmed M , Abdelbary Ahmed M , Fathy Hany , Massoud Amr M , Abd El Latif Ahmed , Moussa Ayman S , Ibrahim Rabie M
Published: August 2020

Objective

To compare percutaneous nephrostomy tube versus JJ stent as an initial urinary drainage procedure in kidney stone patients presenting with acute kidney injury.

Methods

Between January 2017 and January 2019, 143 patients with acute kidney injury secondary to obstructive kidney stone were prospectively randomized into the percutaneous nephrostomy tube group (71 patients) and JJ stent group (72 patients) at Beni‐Suef University Hospital, Beni‐Suef, Egypt. Exclusion criteria included candidates for acute dialysis, fever (>38°C), pyonephrosis, pregnancy and uncontrolled coagulopathy. The period required for serum creatinine normalization, failure of insertion, operative and fluoroscopy time were recorded. Definitive stone management for proximal ureteral stones >1.5 cm consisted of percutaneous nephrolithotomy for the percutaneous nephrostomy group and ureteroscopic laser lithotripsy for the JJ stent group. For stone size <1.5 cm, ureteroscopy or shockwave lithotripsy was carried out for both groups. Percutaneous nephrolithotomy was carried out for renal stones >2 cm, and shockwave lithotripsy for stones <2 cm. Distal and mid ureteral stones were treated by ureteroscopy.

Results

The percutaneous nephrostomy group had shorter operative time (P = 0.001). There was no significant difference in the recovery period for normalization of serum creatinine between both groups (P = 0.120). Procedural failure, ureteric mucosal injury and perforations increased in the case of male sex, stone size >1.5 cm and upper ureteric stones in the JJ stent group. Procedural failure, pelvic perforations and intraoperative bleeding increased in case of male sex, mild hydronephrosis and stone size >2.5 cm in the percutaneous nephrostomy group. Suprapubic pain, urethral pain and lower urinary tract symptoms were significant in the JJ stent group. The presence of a JJ stent directed us toward ureteroscopy (P = 0.002) and the presence of a percutaneous nephrostomy directed us toward percutaneous nephrolithotomy (P = 0.001).

Conclusions

Percutaneous nephrostomy facilitates subsequent percutaneous nephrolithotomy, especially when carried out by a urologist, and it has a higher insertion success rate, a shorter operative time and a lesser incidence of postoperative urinary tract infection than a JJ stent. A JJ stent facilitates subsequent ureteroscopy, but operative complications can increase in the case of proximal ureteral stones >1.5 cm.
Role of hospital anxiety and depression on the healing of chronic leg ulcer: A prospective study
Authors: Kumar Navin , Huda Farhanul , Mani Rishit , Singla Tanuj , Kundal Ashikesh , Sharma Jyoti , Gajula Bhargav
Published: August 2020

A chronic leg ulcer is a debilitating illness, owing to the local condition of the wound and a decrease in physical activity and productivity, resulting in anxiety and depression among patients. The study aimed to find any association of anxiety and depression in the healing of chronic wounds. A total of 125 patients with chronic leg ulcers were enrolled in the study. HADS questionnaire assessment followed the local wound examination in all patients. A follow‐up assessment of the ulcer was done after appropriate local treatment, and data analysed with the HADS scale. In the present study, the ROC curve showed a cutoff value of 14 for the HADS score in predicting ulcer status (non‐healing vs healed) after 30 days. A total of 54.4% (68) patients had a HADS score ≥ 14 and 39% (49) were true positive for the non‐healing wound at a 1‐month follow‐up. This study revealed a sensitivity and specificity of 83.1% and 71.2%, respectively (P‐value <.001), and diagnostic accuracy of 76.8%, for HADS score > 14 in the detection of non‐healing ulcers. Chronic leg ulcers should be subjected to HADS assessment and if found significant corrective measures must be instituted for improving wound healing.
Skeletal Muscle Fibres and Muscle Enzyme Activities in Monozygous and Dizygous Twins of Both Sexes
Authors: Komi P. V. , Viitasalo J. H. T. , Havu M. , Thorstensson A. , Sjödin B. , Karlsson J.
Published: August 2020

Komi, P. V., J. H. T. Viitasalo, M. Havu, A. Thorstensson, B. Sjödin and J. Karlsson. Skeletal muscle fibres and muscle enzyme activities in monozygous and dizygous twins of both sexes. Acta physiol. scand. 1977. 100. 385‐392.

Significance of the genetic component in determining the interindividual variation observed in skeletal muscle fibre composition and enzyme activities was investigated in 31 pairs of male and female monozygous (MZ) and dizygous (DZ) twins, whose ages ranged in all but one pair (11 years) from 15 to 24 years. Percent distribution of slow twitch muscle fibres and activities of Ca2+ and Ng2+ stimulated ATPases, creatine phosphokinase, myokinase, phosphorylase, lactate dehydrogenase (LDH) and distribution of its isozyme LDH‐1 were all analyzed in biopsy samples taken from the vastus lateralis muscle. The data disclosed that in contrast to DZ twins the MZ twins of both sexes had an essentially identical muscle fibre composition. Calculation of the heritability estimate for this parameter gave the values of 99.5% and 92.8%, respectively for males and females. In contrast to the fibre composition presence of a significant genetic component was not observed in any of the enzyme activities studied. It was concluded that there is a predominant genetic influence on the skeletal muscle fibre composition in man, and thus also on the potential capacity of the muscles to perform work.
Are γδ T cells important for the elimination of virus‐infected cells?
Authors: Malkovsky Miroslav , Bartz Steven R. , Mackenzie Debra , Radtke Brian E. , Wallace Marianne , Manning Judith , Pauza C. David , Fisch Paul
Published: August 2020

Rhesus monkeys (Macaca mulatta) γδ T cells were identified using a monoclonal antibody. The relative representation of γδ T lymphocytes in the peripheral blood, lymph nodes, and spleen resembles that of Homo sapiens. The analysis of function and specificity revealed further significant similarities between the simian and human γδ T‐cell systems. Since both human and monkey γδ T lymphocytes can effectively lyse cells infected with immunodeficiency viruses, it is possible that the primate γδ T‐cell systems contribute to antiviral immunosurveillance.
Comparison of protection from homologous cell‐free vs cell‐associated SIV challenge afforded by inactivated whole SIV vaccines
Authors: Heeney J.L. , de Vries P. , Dubbes R. , Koornstra W. , Niphuis H. , ten Haaft P. , Boes J. , Dings M.E.M. , Morein B. , Osterhaus A.D.M.E.
Published: August 2020

This study attempted to determine if SIV vaccines could protect against challenge with peripheral blood mononuclear cells (PBMCs) from an SIV infected rhesus monkey. Mature Macaca mulatta were vaccinated four times with formalin inactivated SIVmac32H administered in MDP adjuvant (n = 8) or SIVmac32H ISCOM vaccine (n = 8). Controls included animals vaccinated with measles virus in MDP adjuvant (n = 4) or ISCOM (n = 4) preparations. Of each group, half were challenged intravenously (IV) with ten MID50 of the cell‐free SIVmac32H (11‐88) SIV stock and half were challenged with ten MID30 of PBMCs from the SIVmac32H infected macaque 1XC. All SIV vaccinated animals challenged with the 11‐88 cell free stock of SIVmac32H were protected, whereas only half of the SIV vaccinated monkeys receiving the same infectious dose of the 1XC cell stock were protected.
Trans‐specific Mhc polymorphism and the origin of species in primates
Authors: Klein Jan , Satta Yoko , Takahata Naoyuki , O'hUigin Colm
Published: August 2020

The major histocompatibility complex (Mhc) is a cluster of loci controlling the specific immune response in vertebrates. Mhc alleles often differ by a large number of nucleotide substitutions, some of which began to accumulate before the emergence of extant species. We have applied the theory of allelic genealogy to the primate Mhc genes with the aim of estimating the size of the founding populations. The calculations indicate that the long‐term effective population size of the studied species was between 104 and 105 individuals and that it most likely never dropped below 103 individuals.
Brg1 regulates murine liver regeneration by targeting miR‐187‐5p dependent on Hippo signalling pathway
Authors: Gong Junhua , Mou Tong , Wu Hao , Wu Zhongjun
Published: August 2020

Brg1 and Hippo signalling pathway are abnormally expressed in many malignant tumours, especially in Hepatocellular carcinoma, but their role in liver regeneration (LR) is unknown. In our research, we investigated the role of Brg1 and Hippo signalling pathway in hepatocyte proliferation and LR. Following 2/3 partial hepatectomy (PH) in liver‐specific Brg1 deleted mice (Brg1−/−) (KO) mice and sex‐matched wild‐type (WT), depletion of Brg1 in mouse embryos caused liver cell growth disorders and significantly decreased expression of miR‐187‐5p. We identified LATS1 as a target gene of miR‐187‐5p and the introduction of miR‐187‐5p decrease the expression of LATS1 and inactivated the Hippo signalling pathway, which facilitated the expression of cell cycle‐related proteins, and rescues the inhibitory effect of Brg1 in LR. Taken together, our findings suggested that deletion of Brg1 inhibits hepatocyte proliferation and LR by targeting miR‐187‐5p dependent on Hippo signalling pathway.
A review of the genus Strophidon (Anguilliformes: Muraenidae), with description of a new species
Authors: Huang Wen‐Chien , Mohapatra Anil , Thu Pham The , Chen Hong‐Ming , Liao Te‐Yu
Published: August 2020

Strophidon McClelland is a muraenid genus with characteristic appearance of a very elongated body, a large mouth cleft and anteriorly placed eyes. The nomenclature and taxonomic history of species within Strophidon are contentious and its members are easily misidentified. In the present study, species of the genus Strophidon are revised based on morphological and molecular data, and five species are considered valid, including S. dawydoffi Prokofiev, S. dorsalis (Seale), S. sathete (Hamilton), S. ui Tanaka and a new species, S. tetraporus. Strophidon tetraporus sp. nov. is described based on 15 specimens from Indonesia, the Philippines, Taiwan and Vietnam with the unique characteristic of the constant presence of the fourth infraorbital pore among species of Strophidon. The intraspecific variation of vertebral formula within S. dorsalis is discussed based on molecular data. Muraena macrurus Bleeker and Thyrsoidea longissima Kaup are synonyms of S. sathete that can be distinguished from the most similar congener S. ui by a longer tail, smaller eyes and more inner maxillary and inner dentary teeth. A key to identify species of Strophidon is provided. The distribution and maximum size of each species are also re‐evaluated.
Minimizing endoscopist facial exposure to droplets: Optimal patient‐endoscopist distance and use of a barrier device
Authors: Suzuki Sho , Gotoda Takuji , Ikehara Hisatomo , Ichijima Ryoji , Kusano Chika
Published: August 2020

Background and Aim

Minimizing endoscopist exposure to bodily fluids is important for reducing the risk of infection transmission. This study investigated the patient‐endoscopist vertical distance necessary to minimize an endoscopist's facial exposure to a patient's visible droplets during upper gastrointestinal endoscopy and the ability of a new device to prevent droplets from reaching the endoscopist's face.

Methods

A model was developed to simulate a patient experiencing a forceful cough during an upper gastrointestinal endoscopy with a model endoscopist. Fluorescent dye was expelled from the model patient's mouth towards the model endoscopist during simulated coughs; dye adhesion to the model endoscopist's face was evaluated using ultraviolet light. The simulation was repeated with the model patient positioned 70–100 cm above the floor, with and without a barrier to shield the patient's face. The accuracy of the cough simulation model and the relationship between patient‐endoscopist vertical distance and endoscopist's facial exposure were evaluated.

Results

The flow dynamics of the cough simulation model were similar to that of an actual human cough. There was a significant inverse correlation between the patient‐endoscopist vertical distance and the model endoscopist's facial exposure, with positive exposures decreasing from 87% at 70 cm to 0% at 100 cm (P < 0.001). The barrier device prevented facial exposure to droplets at all distances.

Conclusions

We found that positioning the patient at least 100 cm below the top of the endoscopist's head or using a barrier device minimized the endoscopist's facial exposure to visible droplets during upper gastrointestinal endoscopy.
Effect of newborn bathing training with the swaddled and tub bathing methods given to primiparous pregnant women on the mother's experience, satisfaction and newborn's stress during the first bathing of the newborn at home: A mixed method study
Authors: Çınar Nursan , Yalnızoğlu Çaka Sinem , Uslu Yuvacı Hilal
Published: August 2020

Aim

The aim of this study is to compare the effect of two different bathing methods training given during pregnancy on the mother's experience, satisfaction and newborn's physiological and behavioral parameters during the first bathing of the newborn at home.

Methods

A mixed methods research was used in this study. The groups were determined as swaddled bathing (SB) (n = 31) and tub bathing (TB) (n = 31). After training given to the groups, the first bath of the newborn in both groups was built by the mothers. The body temperature, heart rate, oxygen saturation, respiration rate, crying times, stress parameters of the newborns and mother satisfaction in both groups were evaluated. The open‐ended questions were used to determine mothers' experiences.

Results

There was a statistically significant difference between the groups in terms of oxygen saturation, respiration rate, crying time, face/forehead grimacing, unrest and maternal satisfaction. Four categories and 14 subcategories made up the qualitative part of the study which includes the experiences of the mother about two different bathing methods. “The feelings and worries of the mothers about first bathing” refers to the participants in both groups how they feel during the first bathing; “Positive aspects of this method compared to other bath method” and “Negative aspects of this method compared to other bath method” refers to positive and negative aspects of different bathing methods applied to groups; “Difference between the applied bathing method and other methods” refers to differences they observed when compared to other bathing methods. The mothers in the SB group had less fear of drowning hazard and injuring the newborn, and the fear of uneasiness and the newborn slipping down from hands were more frequent in the TB group.

Conclusion

It was determined that both bath methods reduced body temperature, the SB method decreased the stress of newborns and had a positive effect on mother satisfaction and experience.