bluuebunny/crossref_metadata_2025 huggingface dataset:
Cross-sector collaboration and nonprofit boundary work for female workers in developing countries: evidence from Bangladesh
Authors: Fontana Enrico , Heuer Mark , Koep Lisa
Published: May 2021

Purpose

The purpose of this paper is to shed new light on the way the cross-sector collaboration (CSC) process can foster gender-focused sustainability initiatives to improve female workers’ conditions in developing countries. The study does so by introducing and examining the influence of nonprofit boundary work during the CSC process.

Design/methodology/approach

The paper is based on thirty-four interviews and qualitative fieldwork. It draws on a case analysis of a regional CSC between multiple organizations operating locally in the apparel industry of Bangladesh, a developing country.

Findings

Scaffolding work in the CSC formation stage – performed by development agency implementers who construe boundaries – and sensitization work in the CSC implementation stage – performed by a non-governmental organization (NGO) implementers who blur and expand boundaries – emerge as two conceptual categories of nonprofit boundary work. This allows NGO implementers to identify and enable the agency of sustainability envoys or socially privileged individuals who capitalize on their social credentials to support female workers in the factory and in the community.

Originality/value

The study offers novel insights into the CSC process. It contributes to the CSC literature and the literature on boundary work, with a focus on gender-focused sustainability initiatives for female workers in developing countries.
Systemic risk contagion within US states
Authors: Choudhury Tonmoy , Daly Kevin
Published: May 2021

Purpose

This study aims to examine the systemic risk contagion in banks from 15 US states using extreme shocks in their distance to risk.

Design/methodology/approach

The authors contemplate a model that inputs co-exceedances in the base US states’ banking sector as the dependent variable and the co-exceedances in other states’ banking sector (along with other underlying variables of a banking system) as the explanatory variables.

Findings

The authors find smaller states transmit and receive more systemic shocks than their larger counterparts and larger states exhibit a better shock-resisting capacity than their smaller counterparts. The authors also find that bigger shocks are more contagious than the smaller shocks.

Originality/value

This will be the first paper that will investigate the inner linkage of US states’ banking network using three different distance to risk methods, thus providing timely guidance for regulators.
Hydroa vacciniforme‐like lymphoproliferative disorder: A clinicopathological, immunohistochemical, and prognostic study of 24 cases in China
Authors: Wang Xinhua , Liang Yuanzheng , Yang Yanxin , Li Wencai , Wang Guannan , Wang Shuangfeng , Li Yan , Zhang Mingzhi
Published: May 2021

Hydroa vacciniforme‐like lymphoproliferative disorder (HV‐LPD) is a rare cutaneous disease associated with Epstein–Barr virus infection. We retrospectively analyzed the clinical presentation, histopathological characteristics, and prognostic study of HV‐LPD in 24 Chinese patients. All patients presented with recurrent papulovesicular and necrotic eruptions on the face, neck, and extremities, with 11 showing systemic symptoms. Twenty patients were diagnosed with HV‐LPD in childhood (age < 18 years) and four in adulthood (age ≥ 18 years). The median age at diagnosis was 8.5 years old (range, 2–50). Histopathology revealed variably dense lymphocyte infiltration throughout the dermis. All cases were strongly positive for CD3 and Epstein–Barr encoding region based onin situhybridization. Of 18 cases with a T‐cell phenotype, 15 harbored monoclonal rearrangements in T‐cell receptor (TCR) genes. Four cases with a natural killer cell phenotype carried polyclonal rearrangements in TCR genes. Among 24 patients, eight (33.3%) received chemotherapy, two (8.3%) allogeneic hematopoietic stem cell transplantation, and both are currently alive without disease. The median follow‐up period was 24 months (range, 7–120) and 23 patients were available: 15 (62.5%) were alive, and eight (33.3%) had died. Fourteen cases had a relapse of disease and three developed lymphoma within 24 months of diagnosis. The mean survival time of childhood‐onset patients was longer than that of adult‐onset patients (36.4 vs. 20.8 months). In summary, the wide clinical course and representative presentation of cases in our center reflect the pedigree characteristics of HV‐LPD. Allogeneic hematopoietic stem cell transplantation should be a preferred choice for relapse and refractory patients due to the poor effect of chemotherapy. Adult‐onset and high serum EBV DNA loads may indicate an increased risk of aggressive disease in patients with HV‐LPD.
Recommendations for COVID‐19 vaccination in people with rheumatic disease: Developed by the Singapore Chapter of Rheumatologists
Authors: Santosa Amelia , Xu Chuanhui , Arkachaisri Thaschawee , Kong Kok Ooi , Lateef Aisha , Lee Tau Hong , Leong Keng Hong , Low Andrea Hsiu Ling , Sriranganathan Melonie K. , Tan Teck Choon , Teng Gim Gee , Thong Bernard Yu‐hor , Fong Warren , Lahiri Manjari
Published: May 2021

Aim

People with rheumatic diseases (PRD) remain vulnerable in the era of the COVID‐19 pandemic. We formulated recommendations to meet the urgent need for a consensus for vaccination against SARS‐CoV‐2 in PRD.

Methods

Systematic literature reviews were performed to evaluate: (a) outcomes in PRD with COVID‐19; (b) efficacy, immunogenicity and safety of COVID‐19 vaccination; and (c) published guidelines/recommendations for non‐live, non‐COVID‐19 vaccinations in PRD. Recommendations were formulated based on the evidence and expert opinion according to the Grading of Recommendations Assessment, Development and Evaluation methodology.

Results

The consensus comprises 2 overarching principles and 7 recommendations. Vaccination against SARS‐CoV‐2 in PRD should be aligned with prevailing national policy and should be individualized through shared decision between the healthcare provider and patient. We strongly recommend that eligible PRD and household contacts be vaccinated against SARS‐CoV‐2. We conditionally recommended that the COVID‐19 vaccine be administered during quiescent disease if possible. Immunomodulatory drugs, other than rituximab, can be continued alongside vaccination. We conditionally recommend that the COVID‐19 vaccine be administered prior to commencing rituximab if possible. For patients on rituximab, the vaccine should be administered a minimum of 6 months after the last dose and/or 4 weeks prior to the next dose of rituximab. Post‐vaccination antibody titers against SARS‐CoV‐2 need not be measured. Any of the approved COVID‐19 vaccines may be used, with no particular preference.

Conclusion

These recommendations provide guidance for COVID‐19 vaccination in PRD. Most recommendations in this consensus are conditional, reflecting a lack of evidence or low‐level evidence.
Expectoration of tonsillar metastasis of pulmonary pleomorphic carcinoma after pseudoprogression: A case report
Authors: Kuge Tomoki , Okabe Fukuko , Yamamoto Yuji , Ishijima Mikako , Uenami Takeshi , Kanazu Masaki , Akazawa Yuki , Yano Yukihiro , Yamaguchi Toshihiko , Mori Masahide
Published: May 2021

Pulmonary pleomorphic carcinoma is a rare malignant tumor that grows rapidly and has a poor prognosis. Although no effective treatments have so far been established, immune checkpoint inhibitors (ICIs) have shown clinical improvement in some cases of pleomorphic carcinoma. However, pseudoprogression is a major concern for treatment of this carcinoma using ICIs. Here, we report the case of a 61‐year‐old man who was diagnosed with large cell carcinoma of the lung with brain metastases. Systemic chemotherapy comprising carboplatin and pemetrexed was administered as a first‐line therapy; however, disease progression was observed. A tonsillar lesion grew rapidly after the administration of nivolumab as a second‐line therapy. Tracheostomy was planned to avoid suffocation, but the patient naturally expectorated the tumor. Pathological examination revealed that it was a palatine tonsillar metastasis of pulmonary pleomorphic carcinoma with infiltration of CD8+/CD4‐ lymphocytes and necrosis. The primary lesion expanded after nivolumab administration and shrank with no additional nivolumab administration. We therefore concluded that pseudoprogression caused expectoration of the tonsillar metastasis. Hence, ICIs can cause serious adverse events due to pseudoprogression.
Cattle, climate and complexity: food security, quality and sustainability of the Australian cattle industries
Authors: Lean IJ , Moate PJ
Published: May 2021

Background

Marked increases in atmospheric CO2 concentrations are largely associated with the release of sequestered carbon in fossil fuels. While emissions of green‐house gasses (GHG) from cattle have significant global warming potential, these are biogenic sources and substantially involve carbon in natural cycles, rather than fossil fuel. Cattle use human inedible feeds and by‐products of human food production to produce nutrient‐dense foods of great value to humans.

Interventions to reduce GHG production

Reductions in land clearing and burning of grasslands and increased carbon sequestration in soils and trees have potential to substantially reduce GHG emissions. Increased efficiencies of production through intensified feeding and enteric modification have markedly reduced intensity of GHG emissions for cattle in Australia. Genetic selection for lower emissions has modest, but cumulative potential to reduce GHG (mostly CH4) emissions and intensity. Improved reproductive performance can reduce intensity of GHG emissions, especially in beef production. Feeds and technologies that reduce GHG production and intensity include improved pastures, grain feeding, dietary lipids, nitrates, ionophores, seaweed, 3‐NOP, hormonal growth promotants in beef, and improved diets for peri‐parturient dairy cattle. There is considerable potential to further reduce emissions from cattle using the technologies reviewed.

Interventions to reduce heat stress

Cattle are susceptible to heat stress and ameliorating interventions include tree and shelter belts, shade, housing, cooling with fans and water and dietary manipulations.

Conclusions

Numerous interventions can reduce GHG emissions and intensity from cattle. There are opportunities to increase carbon capture and maintain biodiversity in Australia's extensive rangelands, but these require quantification and application. We can reduce the intensity of CH4 emissions for cattle in Australia and simultaneously improve their well‐being.
An exploration of how gender stereotypes influence how practitioners identify and respond to victims (or those at risk) of child sexual exploitation
Authors: Hill Lauren , Diaz Clive
Published: May 2021

Child sexual exploitation (CSE) has been found to have a detrimental and long‐lasting impact upon a victim's physical and emotional well‐being. A large body of research has raised concerns about how practitioners identify and respond to CSE. In particular, research has indicated that male victims of CSE are commonly being overlooked by practitioners. It has been suggested that this may occur as a result of gender stereotypes. However, this has not been specifically explored by existing research. Therefore, this research project explored how gender stereotypes may influence how practitioners identify and respond to children and young people who are victims (or at risk) of CSE. Semi‐structured interviews were conducted with eight practitioners from one Youth Offending Service in the South West of England. Three key themes emerged from the interviews. These themes highlight that as a result of gender stereotypes, practitioners may be less likely and/or slower to identify males as victims and may be less likely to provide males with supportive multi‐agency responses. This paper makes recommendations about how this issue can be addressed to ensure that all victims of CSE are adequately safeguarded.
Child welfare in non‐metro and rural communities: Experiences of child‐serving professionals addressing substance use
Authors: Orsi Rebecca , Boissy Lauren , Yuma Paula , Palmer Fred , Torres‐Molinar Stephanie
Published: May 2021

The purpose of this study is to explore the challenges and strengths that child welfare professionals experience in non‐metro areas, with a secondary focus on how they encounter and respond to substance use in families and communities. We conducted three focus groups in non‐metro counties (n = 35). We used thematic analysis supported by Dedoose, beginning with line by line coding, then thematic identification and mapping. Emergent themes focused on challenges and strengths experienced in non‐metro communities, including (Community context)—unique community attributes; the call for treatment; (Challenges)—uphill battles; reporting; access to appropriate care; funding; interacting with state systems; and (Strength)—finding strengths and creative solutions. Child welfare professionals in non‐metro communities embody and respond to both challenges and strengths. They feel frustrated by standards that do not take available resources into account, yet they effectively leverage social capital to complete their work. Giving voice to child welfare professionals can enhance policy making and create more sustainable systems for child welfare practice in non‐metro settings.
Design and conduct considerations for studies in patients with impaired renal function
Authors: Ravenstijn Paulien , Chetty Manoranjenni , Manchandani Pooja
Published: May 2021

An impaired renal function, including acute and chronic kidney disease and end‐stage renal disease, can be the result of aging, certain disease conditions, the use of some medications, or as a result of smoking. In patients with renal impairment (RI), the pharmacokinetics (PKs) of drugs or drug metabolites may change and result in increased safety risks or decreased efficacy. In order to make specific dose recommendations in the label of drugs for patients with RI, a clinical trial may have to be conducted or, when not feasible, modeling and simulations approaches, such as population PK modeling or physiologically‐based PK modelling may be applied. This tutorial aims to provide an overview of the global regulatory landscape and a practical guidance for successfully designing and conducting clinical RI trials or, alternatively, on applying modeling and simulation tools to come to a dose recommendation for patients with RI in the most efficient manner.
Lower risk of hospitalization for heart failure, kidney disease and death with sodium‐glucose co‐transporter‐2 inhibitors compared with dipeptidyl peptidase‐4 inhibitors in type 2 diabetes regardless of prior cardiovascular or kidney disease: A retrospective cohort study in UK primary care
Authors: Idris Iskandar , Zhang Ruiqi , Mamza Jil Billy , Ford Mike , Morris Tamsin , Banerjee Amitava , Khunti Kamlesh
Published: May 2021

Aim

To assess if sodium‐glucose co‐transporter‐2 inhibitors (SGLT2is) reduce the risk of all‐cause mortality, cardiovascular death and hospitalization for heart failure (HF) or chronic kidney disease (CKD) to a greater extent than dipeptidyl peptidase‐4 inhibitors (DPP4is) in people with type 2 diabetes (T2D) with or without established cardiovascular and/or renal disease (CVRD).

Methods

This retrospective cohort study propensity‐matched 24 438 patients receiving an SGLT2i 1:1 to a patient receiving a DDP4i, stratified based on the presence of CVRD. The primary outcomes were the time to each of the following: all‐cause mortality, cardiovascular death or hospitalization for HF, myocardial infarction, stroke and CKD.

Results

Overall, SGLT2is were associated with reductions in all‐cause mortality, cardiovascular mortality, hospitalization for HF and hospitalization for CKD compared with DPP4is. In patients with no CVRD history, SGLT2is were associated with reductions in all‐cause mortality (HR 0.71, 95% CI 0.57‐0.88; P = .002), hospitalization for HF (HR 0.76, 95% CI 0.59‐0.98; P = .035) and hospitalization for CKD (HR 0.75, 95% CI 0.63‐0.88; P < .001). In patients with established cardiovascular disease (CVD) or at high risk, SGLT2is were associated with reductions in all‐cause mortality (HR 0.69, 95% CI 0.59‐0.82; P < .001), cardiovascular mortality (HR 0.76, 95% CI 0.62‐0.95; P = .014), hospitalization for HF (HR 0.73, 95% CI 0.63‐0.85; P < .001), hospitalization for stroke (HR 0.75, 95% CI 0.59‐0.94; P = .013) and hospitalization for CKD (HR 0.49, 95% CI 0.43‐0.54; P < .001).

Conclusion

There was consistency across subgroups and sensitivity analyses. SGLT2is were associated with a reduced risk of all‐cause mortality and hospitalization for HF and CKD compared with DPP4‐is, highlighting the need to introduce SGLT2is early in the management of patients with T2D.
Correlation of echocardiographic parameters in prone and supine positions in normal adults using a novel approach
Authors: Taha Hesham S. , Mohamed Ahmed M. , Mahrous Hossam A. , Shaker Mirna M. , Alsayed Osama S. , Sayed Hadeer G. , Rizk Hussien H. , Abdelwahab Mohamed A.
Published: May 2021

Background

Transthoracic echocardiography (TTE) in prone position is challenging. Innovative use of transesophageal echocardiography (TEE) probe to perform TTE for such patients has been described; but reproducibility and correlation of the TTE measurements by this technique with those obtained by the standard supine TTE study are still unknown.

Methods

We enrolled 30 non–COVID‐19 individuals, with a mean (SD) age 35 (10.9) years and 11 females, to study the agreement between the transthoracic measurements of the left ventricular (LV), left atrial (LA), aortic dimensions, and ejection fraction (EF) obtained in prone position using an external TEE probe versus the standard supine position using the conventional TTE probe.

Results

There were no significant differences between LV end‐diastolic and end‐systolic diameters, septal wall thickness, posterior wall thickness, and aortic root dimensions in the prone versus the supine positions, while the mean EF (60.3% vs 63.1%, P = .014) and mean LA dimensions (1.8 vs 1.9 cm/m2, P < .001) were significantly lower in the prone position. The mean time of scans was significantly longer in the prone as compared to the supine position (12.5 vs 4.5 minutes, P < .001). All supine studies had good quality while in the prone position four studies were of poor quality, and one was nondiagnostic.

Conclusions

Assessment of cardiac dimensions and systolic function in the prone position using transthoracic TEE probe was feasible. LV and aortic dimensions agreed well with the standard TTE in supine position; however, LA dimensions and EF were lower in the prone position.
Unexpected pacemaker lead in an 84‐year‐old patient
Authors: Sams Lauren , Brunner Stefan , Näbauer Michael , Steffen Julius
Published: May 2021

An elderly patient with a history of atrial fibrillation presented to our emergency room. Previous medical records from another hospital described a pacemaker lead in the echocardiography although the patient had no known history of a pacemaker implantation. Finally, by close examination, chest X‐ray, and computed tomography, we found that a kyphoplasty of the spine had caused a so‐called palacos embolism, which had repeatedly been mistaken for a pacemaker lead. Unusually, there were no further signs of kyphoplasty material in the pulmonary veins. As the patient was asymptomatic and the embolism caused only moderate tricuspid regurgitation, a conservative treatment was agreed on.
Pressure‐dimension index: A novel “morphologic‐functional” index of right ventricle that predicts short‐term survival after left ventricular assist device implantation
Authors: Kalenderoğlu Koray , Güvenç Tolga Sinan , Ağustos Semra , Velibey Yalçın , Taşdemir Mete Müge , Kuplay Hüseyin , Çetin Güvenç Rengin , Aykut Aka Serap
Published: May 2021

Background

Right ventricular failure (RVF) after left ventricular assist device (LVAD) implantation is a major cause of postoperative morbidity and mortality. Despite the availability of multiple imaging parameters, none of these parameters had adequate predictive accuracy for post‐LVAD RVF.

Aim

To study whether right ventricular pressure‐dimension index (PDI), which is a novel echocardiographic index that combines both morphologic and functional aspects of the right ventricle, is predictive of post‐LVAD RVF and survival.

Methods

49 cases that underwent elective LVAD implantation were retrospectively analyzed using data from an institutional registry. PDI was calculated by dividing systolic pulmonary artery pressure to the square of the right ventricular minor diameter. Cases were categorized according to tertiles.

Results

Patients within the highest PDI tertile (PDI>3.62 mmHg/cm2) had significantly higher short‐term mortality (42.8%) and combined short‐term mortality and severe RVF (50%) compared to other tertiles (P < .05 for both, log‐rank p for survival to 15th day 0.014), but mortality was similar across tertiles in the long‐term follow‐up. PDI was an independent predictor of short‐term mortality (HR:1.05‐26.49, P = .031) and short‐term composite of mortality and severe RVF (HR:1.37‐38.87, P = .027).

Conclusions

Increased PDI is a marker of an overburdened right ventricle. Heart failure patients with a high PDI are at risk for short‐term mortality following LVAD implantation.
Factors associated with COVID‐19 in people with Parkinson’s disease: a systematic review and meta‐analysis
Authors: Chambergo‐Michilot Diego , Barros‐Sevillano Shamir , Rivera‐Torrejón Oscar , De la Cruz‐Ku Gabriel A. , Custodio Nilton
Published: May 2021

Background

There is debate as to whether there is an increased risk of COVID‐19 infection in people with Parkinson's disease (PD), possibly due to associated factors. This study aimed to systematically review the factors associated with COVID‐19 in people with PD.

Methods

A search was carried out in PubMed, Scopus, and Web of Science up to November 2020 (updated until 1 April 2021). Observational studies that analyzed factors associated with COVID‐19 in people with PD were selected and revised.

Results

The authors included six studies (four case‐controlled studies and two cross‐sectional studies) in the qualitative and quantitative syntheses. The authors found that the following factors were associated with COVID‐19 in people with PD: obesity (OR: 1.79, 95% CI: 1.07–2.99, I2: 0%), any pulmonary disease (OR: 1.92, 95% CI: 1.17–3.15, I2: 0%), COVID‐19 contact (OR: 41.77, 95% CI: 4.77 – 365.56, I2: 0%), vitamin D supplementation (OR: 0.50, 95% CI: 0.30–0.83, I2: 0%), hospitalization (OR: 11.78, 95% CI: 6.27–22.12, I2: 0%), and death (OR: 11.23, 95% CI: 3.92–32.18, I2: 0%). The authors did not find any significant association between COVID‐19 and hypertension, diabetes, cardiopathy, cancer, any cognitive problem, dementia, chronic obstructive pulmonary disease, renal or hepatic disease, smoking, and tremor.

Conclusions

Meta‐analyses were limited by the number of events and some methodological limitations. Despite this, the authors assessed the available evidence, and the results may be useful for future health policies.
COVID‐19 in DMARD‐treated patients with inflammatory rheumatic diseases: Insights from an analysis of the World Health Organization pharmacovigilance database
Authors: Dernoncourt Amandine , Schmidt Jean , Duhaut Pierre , Liabeuf Sophie , Gras‐Champel Valérie , Masmoudi Kamel , Bennis Youssef , Batteux Benjamin
Published: May 2021

Background

To determine whether the use of disease‐modifying antirheumatic drugs (DMARDs) is linked to the risk of COVID‐19 among patients with inflammatory rheumatic diseases (IRDs).

Methods

We performed a disproportionality analysis of the World Health Organization pharmacovigilance database between January 1, 2020, and June 10, 2020. The frequency of COVID‐19 reports for all DMARD classes identified was compared with that for all other reports for all other drugs and quoted as the reporting odds ratio (ROR) (95% confidence interval [CI]).

Results

Among 980,446 individual case‐safety reports voluntarily recorded in the database, 398 identified COVID‐19 in DMARD‐treated patients with IRDs. There were 177 (44.5%) patients with rheumatoid arthritis (RA), 120 (30.1%) with ankylosing spondylitis (AS), 93 (23.4%) with psoriatic arthritis (PsA), and 8 (2.0%) with juvenile idiopathic arthritis. Most of the cases of COVID‐19 occurred in patients taking anti‐TNF agents (84.2%), resulting in a significant disproportionality signal (ROR [95% CI]: 8.31 [7.48–9.23]) – particularly in patients with RA, AS or PsA. A significant inverse disproportionality was found for the anti‐IL‐6 agent tocilizumab (ROR [95% CI]: 0.12 [0.02–0.88]) and JAK inhibitors (ROR [95% CI]: 0.33 [0.19–0.58]) in patients with RA – suggesting that these two drug classes are safer in the context of RA.

Conclusion

Our results are in line with the literature on a potentially better safety profile for anti‐IL‐6 agents and JAK inhibitors. The WHO pharmacovigilance data suggest that COVID‐19 is significantly more frequent in patients with IRDs treated with TNF inhibitors.
Two hepatectomy cases for initially unresectable hepatocellular carcinoma after achieving a radiological complete response to sequential therapy with lenvatinib and transcatheter arterial chemoembolization
Authors: Endo Kei , Kuroda Hidekatsu , Abe Tamami , Sato Hiroki , Kooka Youhei , Oikawa Takayoshi , Sato Ayaka , Nishiya Masao , Sugai Tamotsu , Takikawa Yasuhiro
Published: May 2021

We herein report two cases of locally advanced unresectable hepatocellular carcinoma (u‐HCC) that were resected after achieving a radiological complete response to initially administered lenvatinib followed by transcatheter arterial chemoembolization (LEN‐TACE sequential therapy). A 78‐year‐old woman and an 80‐year‐old man with HCC of Barcelona Clinic Liver Cancer classification stage C were treated for 15 and 14 months with lenvatinib, respectively. Both patients were subsequently treated with TACE, resulting in complete remission on imaging. The α‐fetoprotein level in the woman and man decreased markedly from 9370 ng/ml to 46 ng/ml and from 6380 ng/ml to 3 ng/ml, respectively, leading to hepatectomy. A histopathological examination showed coagulative necrosis of the entire HCC in one case, while the other showed a small population of viable HCC cells. The results showed that LEN‐TACE sequential therapy has a synergic effect and could be a promising option for locally advanced u‐HCC.
Stroke in patients with cancer in the era of hyperacute stroke intervention
Authors: Davies Amy , van Leer Lyndal , Chan Jasmine , Wijayaratna Ruwan , Singhal Shaloo , Ly John , Clissold Benjamin , Ma Henry , Phan Thanh G.
Published: May 2021

Background

The natural history of patients with stroke and cancer remains poorly understood in the modern era of hyperacute stroke therapies (recombinant tissue plasminogen activator and endovascular clot retrieval (ECR)). Prior to these advances in stroke treatment, a highly cited study reported median overall survival (mOS) 4.5 months after stroke in a cohort of patients with cancer (2004, n = 96).

Aims

Our hypothesis is that patients with stroke and cancer have better outcome than in earlier studies.

Methods

Retrospective analysis of admission to a tertiary Stroke Unit between January 2015 and September 2017 (n = 1910), evaluation of hospital records and cancer treatment records. Cancer was categorised as early stage (Stages I and II) and advanced stage (Stage III or IV) using the RD‐Staging system. Survival analysis was performed in R.

Results

There were 143 stroke patients with cancer (62% male) with mean age 73.2 ± 12.5 years. Ischaemic stroke occurred in 74.1% and 45 of 106 (42.5%) patients received intravenous thrombolysis (34/45) and/or ECR (11/45). One patient who received ECR died within 30 days of stroke. Those with early stage disease had mOS of 19.6 months (interquartile range (IQR) 3.1–31.5 months) and in advanced stage cancer mOS was 2.5 months (IQR 0.4–6.3 months; P < 0.01).

Conclusion

In the modern era of stroke therapy, our cohort of patients with advanced cancer has lower survival post‐stroke compared to those with early stage cancer.
Drought stress during the growing season: Changes in reducing sugars, starch content and respiration rate during storage of two potato cultivars differing in drought sensitivity
Authors: Grudzińska Magdalena , Boguszewska‐Mańkowska Dominika , Zarzyńska Krystyna
Published: May 2021

The research was carried out on two potato (Solanum tuberosum L.) varieties with different tolerance to drought stress. Both varieties were cultivated in various moisture conditions: No stress, which uses the natural atmospheric conditions prevailing during the growing season and supplemented with water using drip irrigation and two combinations of drought conditions: 40 days stress at tuberizations, and intermittent drought (3 stress periods of 7 days). After harvesting, the tubers were stored at two temperatures, that is, 5°C and 8°C, for 39, 67, 143 and 164 days. The main aim of the research was the evaluation of the reaction of two potato varieties differing in drought stress tolerance to the accumulation of sugars and the respiration rate of tubers. It was found that tubers of drought stress‐sensitive variety (Cekin) accumulated more glucose and fructose than tubers of drought‐resistant variety (Tajfun), regardless of the type of drought applied during the growing season. The applied drought, both constant and intermittent, resulted in an increase in the content of reducing sugars compared with the control conditions. After applying both types of drought during the vegetation period, the respiration rate increased during tuber storage. Larger changes were recorded in the case of an intermittent drought. At a higher storage temperature, in the variety resistant to drought stress, a decrease in glucose content was found after long‐term storage, while in the sensitive variety, the content of this component increased, regardless of the moisture conditions during the growing season.
Qianliexin capsule exerts anti‐inflammatory activity in chronic non‐bacterial prostatitis and benign prostatic hyperplasia via NF‐κB and inflammasome
Authors: Zang Linghe , Tian Fangyuan , Yao Yuancheng , Chen Yiran , Shen Yuan , Han Mingyu , Meng Zhaoqing , Fan Shengci , Zhang Xinyi , Cai Tian , Gao Qi , Zhang Yuwei , Lu Jincai
Published: May 2021

Qianliexin capsule (QLX) is a standardized traditional Chinese herbal preparation that has long been used to treat chronic non‐bacterial prostatitis (CNP) and benign prostatic hyperplasia (BPH). This study investigated the anti‐inflammatory activity of QLX in improving lower urinary tract symptoms (LUTS) associated with CNP and BPH. Rat models of CNP and BPH were induced by oestradiol or testosterone (hormonal imbalance) or chemical inflammation (carrageenan). QLX significantly relieved LUTS in CNP and BPH rat model by reducing prostate enlargement, epithelial thickness, pain response time, urine volume and bleeding time, and by improving prostatic blood flow. The expression of the pro‐inflammatory cytokines interleukin (IL)‐1β and tumour necrosis factor (TNF)‐α, the pro‐inflammatory transcription factor nuclear factor kappa‐light‐chain‐enhancer of activated B cells (NF‐κB), and inflammasome components (NLRP3, caspase‐1 and ASC) in CNP and BPH tissues was reduced by QLX addition. QLX treatment was followed by reduced cellular malondialdehyde and increased superoxide dismutase, catalase and glutathione peroxidase activity, consistent with antioxidant activity. Increases in Beclin‐1 expression and the LC3II/I ratio following QLX treatment indicated that autophagy had been induced. QLX relieved LUTS in CNP and BPH rat models by inhibiting inflammation. The underlying mechanisms included inhibition of inflammasome activation, NF‐κB activation, oxidant stress and autophagy.
Extinction in complex communities as driven by adaptive dynamics
Authors: Nguyen Vu A. T. , Vural Dervis Can
Published: May 2021

In a complex community, species continuously adapt to each other. On rare occasions, the adaptation of a species can lead to the extinction of others, and even its own. ‘Adaptive dynamics’ is the standard mathematical framework to describe evolutionary changes in community interactions, and in particular, predict adaptation driven extinction. Unfortunately, most authors implement the equations of adaptive dynamics through computer simulations that require assuming a large number of questionable parameters and fitness functions. In this study, we present analytical solutions to adaptive dynamics equations, thereby clarifying how outcomes depend on any computational input. We develop general formulas that predict equilibrium abundances over evolutionary time scales. Additionally, we predict which species will go extinct next, and when this will happen.
Systematic review of applied usability metrics within usability evaluation methods for hospital electronic healthcare record systems
Authors: Wronikowska Marta Weronika , Malycha James , Morgan Lauren J. , Westgate Verity , Petrinic Tatjana , Young J Duncan , Watkinson Peter J.
Published: May 2021

Background and objectives

Electronic healthcare records have become central to patient care. Evaluation of new systems include a variety of usability evaluation methods or usability metrics (often referred to interchangeably as usability components or usability attributes). This study reviews the breadth of usability evaluation methods, metrics, and associated measurement techniques that have been reported to assess systems designed for hospital staff to assess inpatient clinical condition.

Methods

Following Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) methodology, we searched Medline, EMBASE, CINAHL, Cochrane Database of Systematic Reviews, and Open Grey from 1986 to 2019. For included studies, we recorded usability evaluation methods or usability metrics as appropriate, and any measurement techniques applied to illustrate these. We classified and described all usability evaluation methods, usability metrics, and measurement techniques. Study quality was evaluated using a modified Downs and Black checklist.

Results

The search identified 1336 studies. After abstract screening, 130 full texts were reviewed. In the 51 included studies 11 distinct usability evaluation methods were identified. Within these usability evaluation methods, seven usability metrics were reported. The most common metrics were ISO9241‐11 and Nielsen's components. An additional “usefulness” metric was reported in almost 40% of included studies. We identified 70 measurement techniques used to evaluate systems. Overall study quality was reflected in a mean modified Downs and Black checklist score of 6.8/10 (range 1–9) 33% studies classified as “high‐quality” (scoring eight or higher), 51% studies “moderate‐quality” (scoring 6–7), and the remaining 16% (scoring below five) were “low‐quality.”

Conclusion

There is little consistency within the field of electronic health record systems evaluation. This review highlights the variability within usability methods, metrics, and reporting. Standardized processes may improve evaluation and comparison electronic health record systems and improve their development and implementation.
Metabolically healthy obesity and risk of non‐alcoholic fatty liver disease severity independent of visceral fat
Authors: Chen Tsung‐Po , Lin Wen‐Yuan , Chiang Chien‐Hsieh , Shen Ting‐Hsin , Huang Kuo‐Chin , Yang Kuen‐Cheh
Published: May 2021

Background and Aim

Obesity and metabolic conditions may be related to non‐alcoholic fatty liver disease (NAFLD). The study assesses the risk of NAFLD according to obesity and metabolic health status in a community‐based population.

Methods

A total of 1651 subjects were recruited from the community. Individuals were categorized into four groups according to obesity status (defined as a body mass index ≥ 25 kg/m2) and metabolically healthy status: metabolically healthy nonobesity (MHNO), metabolically healthy obesity (MHO), metabolically unhealthy nonobesity (MUHNO), and metabolically unhealthy obesity (MUHO). NAFLD was diagnosed based on a semiquantitative ultrasonography measurement. Visceral fat was assessed through bioelectrical impedance analysis and is shown by tertile (T1, T2, and T3). A proportional odds model was used to assess the cumulative risk of NAFLD.

Results

The NAFLD prevalence was 26.7%, 62.8%, 47.0%, and 76.7% in subjects with MHNO, MHO, MUHNO, and MUHO, respectively (P < 0.0001). After adjustment for age, sex, exercise habits, alcohol consumption, cigarette smoking, and visceral fat, the odds ratios for more severe NAFLD were 2.44 (95% confidence interval [CI]: 1.64–3.65), 2.75 (95% CI: 1.91–3.94), and 7.41 (95% CI: 4.94–11.12) in the MHO, MUHNO, and MUHO groups, respectively, compared with the MHNO group. In addition, the odds ratios for more severe NAFLD significantly increased with the increase in visceral fat level (T2 vs T1: 3.83, 95% CI: 2.65–5.53; T3 vs T1: 9.17, 95% CI: 5.33–15.79).

Conclusion

Both obesity and metabolically unhealthy status were associated with a higher risk of NAFLD independent of visceral fat level.
Effect of early childhood cow's milk elimination diet on eating behaviours, nutrition and growth status at age 2–6 years
Authors: Ercan Nazli , Tel Adıgüzel Kübra
Published: May 2021

Background

The present study aimed to investigate the eating behaviour, nutritional status and growth of Caucasian children in ages 2–6 years who had a diet because of cow's milk protein allergy (CMA) [immunoglobulin (Ig)E‐mediated and/or non‐IgE‐mediated] in early childhood.

Methods

In this cross‐sectional, case–control study, the cow's milk elimination (CME) group comprised children aged 0–2 years who were receiving a CME diet because of CMA, as confirmed by an oral food challenge test, and had reintroduced cow's milk for at least ≥ 3 months. The control group never had a restricted diet. Eating behaviour and children's growth was assessed. A 3‐day food record was taken to determine the macronutrient and micronutrient intake of the children. Data on the children's socio‐demographic, infant nutrition and family allergy history were collected from their medical records and face‐to‐face interviews with mothers.

Results

In total, 62 children with a median age of 32 months were recruited for the study. The total scores of food avoidance and satiety responsiveness in the CME group (n:31) were higher than in the controls (n = 31) (p = 0.036 and 0.006, respectively). Weight‐for‐age and height‐for‐age are statistically lower in the CME group than in the control group (p < 0.001). A significant difference between groups in terms of dairy intake was recorded (p = 0.011). In the CME group, the current frequency of adequate energy, vitamin B1, folic acid, vitamin C and calcium intake was significantly lower than in the control group (p < 0.05).

Conclusions

Dietary interventions because of CMA at age 0–2 years can affect children's nutritional habits and parental‐reported assessment of children's eating behaviours, resulting in growth restriction with insufficient micro/macronutrients and/or dairy products at the age of 2–6 years.
Evaluating the efficacy and safety of ureteral stent placement as a preoperative procedure for gynecological cancer surgeries: A retrospective cohort study
Authors: Okawa Masayo , Komatsu Hiroaki , Iida Yuki , Osaku Daiken , Sato Shinya , Oishi Tetsuro , Harada Tasuku
Published: May 2021

Aim

To evaluate the efficacy and safety of ureteral stent placement (USP) as a preoperative procedure for gynecological cancer surgeries.

Methods

This was a single‐institution retrospective cohort study of 259 patients with gynecological cancer who underwent laparotomy. In 126 patients (USP+ group), a ureteral stent was inserted into the bilateral ureters after the induction of general anesthesia. The remaining 133 patients (USP− group) did not undergo USP. We compared operation time, blood loss, and frequency of laparotomy‐related perioperative urinary complications between the groups. The stent was removed 5–7 days postoperatively. Patients were evaluated for signs of hydronephrosis at discharge. The Fisher's exact test was used to investigate the significance of differences in patient characteristics, and multivariate analysis was performed using a Cox proportional hazards model. A p‐value of <0.05 was considered statistically significant.

Results

There were no significant differences in age and body mass index between the groups. Two patients in the USP− group experienced intraoperative ureteral injury. Total operation time and blood loss were significantly increased in the USP+ group. The risk of bladder tamponade and postoperative hydronephrosis was influenced by USP. USP was unaffected by a history of abdominal surgery, stage of tumor progression, lymphadenectomy type, or hysterectomy type.

Conclusions

The incidence of bladder tamponade and hydronephrosis postoperatively was significantly higher in patients with USP than in those without USP.
Chin tuck against resistance exercise for dysphagia rehabilitation: A systematic review
Authors: Park Ji‐Su , Hwang Na‐Kyoung
Published: May 2021

Background

Chin tuck against resistance (CTAR) exercise has been recently reported to be a new therapeutic exercise method that can help improve swallowing function in patients with dysphagia. However, due to the differences in exercise protocols, methods and the tools used across studies of CTAR exercise, an overall systematic review of these studies is necessary.

Objective

The present study investigated the exercise protocols, methods and tools used in various studies of CTAR exercise and summarised their findings.

Methods

We searched for studies related to CTAR exercise using electronic databases and selected nine articles for review. The articles were categorised on the basis of four criteria: study design and quality, training protocol, outcome measures and clinical effect.

Results

Four articles reported that CTAR exercise not only helped activate the suprahyoid muscle in healthy adults, but also activated the sternocleidomastoid muscle less than Shaker exercise. In addition, five articles reported that CTAR exercise was effective in improving swallowing function and oral diet stage in the pharyngeal phase, including reduction of airway aspiration in patients with dysphagia after stroke.

Conclusions

CTAR exercise more selectively activates the suprahyoid muscle and is an effective therapeutic exercise for improving swallowing function in patients with dysphagia. Because it is less strenuous than Shaker exercise, it requires less physical burden and effort, allowing greater compliance.
A Case Study of a Consultation Using the Two‐Circles Method With a Junior High School Teacher1
Authors: Ayashiro Hatsuho
Published: May 2021

To resolve various problems in schools, a “school as a team” approach for teachers to cooperate with other professionals as well as other teachers has been introduced in Japan. Consultations are one method school counselors use to support teachers as a team. This study examines a consultation case using the two‐circles method based on narrative therapy and discusses the possibilities and challenges when using this method in Japan. Using a case study analysis, the author found that the two‐circles method contributed positively to the consultation by externalizing the problem, gathering local knowledge, visualizing the participants' narratives, and applying scaffolding to develop the consultee's story. The results suggest that this method could be useful for achieving the “school as a team” approach because it combines teachers' narratives to resolve problems in schools.
Normative (and objective) analysis in Sraffa's system
Authors: D'Agata Antonio
Published: May 2021

With the exception of Pasinetti's work on structural change, the sraffian literature remains silent on normative issues. By generalizing Smith's notion of free competition, this paper identifies and formalizes an ideal social arrangement yielding a unique income distribution configuration which is fair in terms of the “equality of opportunity” norm, and which can be used as a benchmark for normative analysis in Sraffa's system. In this hypothetical economy, the price vector, the wage rate and the profit rates depend only on physical quantities. The relation between this result and Sraffa's “physical real cost” theory of value and distribution is also discussed.
Leptomeningeal and intraventricular myelomatosis manifesting an aggressive form of communicating hydrocephalus
Authors: Miki Yasuo , Kamata Kosuke , Akemoto Yui , Tsushima Fumiyasu , Sakuraba Hirotake , Yamagata Kazufumi , Kurose Akira , Fukuda Shinsaku , Wakabayashi Koichi
Published: May 2021

Leptomeningeal myelomatosis (LMM) is a fatal complication that occurs in < 1% of patients with multiple myeloma. Many patients with LMM present with neurologic symptoms referable to cranial neuropathies, while the manifestation of communicating hydrocephalus has been underrecognized. A Japanese man with Bence Jones protein‐κ multiple myeloma developed fever and headache at age 54 years. He then became somnolent and went into a coma. Neuroimaging analyses identified rapidly progressive communicating hydrocephalus due to meningitis. He died 83 days after the onset of headache without any response to treatment at age 55 years. No symptoms or signs associated with cranial nerves were found during the course of illness. Postmortem examination revealed hydrocephalus and diffuse infiltration of myeloma cells into the subarachnoid space of the cerebrum, cerebellum, and brainstem. In addition, the interstitial tissue of the choroid plexuses was filled with myeloma cells. These myeloma cells were positive for CD156 and light chain κ. The Ki‐67 labeling index in myeloma cells of the central nervous system (CNS) was 30–40%. Histopathological examination further revealed many myeloma cells on the surface of the lateral, third and fourth ventricles and at the area postrema of the medulla oblongata. Patients with LMM can develop an aggressive form of communicating hydrocephalus. Given that cerebrospinal fluid, produced by epithelial cells in the choroid plexuses of the ventricles, passes into the subarachnoid space through the third and fourth ventricles, myeloma cells may invade the CNS through the choroid plexuses.
Relationships of wind speed and precipitable water vapor with regional PM2.5 based on WRF‐Chem model
Authors: Liu Yuan
Published: May 2021

Air pollution, especially the particulate matter (PM2.5) remains to be a severe problem for the environmental managers and researchers because it causes many respiratory diseases even casualties and huge economic losses. Therefore, it is significant to study the distribution characteristics of regional PM2.5 and analyze the mutual influence relationship between it and some influencing factors including air humidity, wind speed, and atmospheric boundary conditions. Some scholars have studied the relationship between PM2.5 and the atmospheric planetary boundary layer or relative humidity. However, the relationships between air pollution and meteorological conditions in China has been extensively studied in recent years. Therefore, the association between the pollution and precipitation water vapor and wind speed in the northeast of China (e.g., Jilin and Heilongjiang province) could be strengthened. Considering all components in the atmosphere affecting each other and the ability of Weather Research and Forecast (WRF) and WRF‐Chemistry (WRF‐Chem) simulating all of the atmospheric parameters, we utilized the WRF and WRF‐Chem to simulate the precipitable water vapor, wind speed, and PM2.5. Then first, the PM2.5 concentration values predicted from WRF‐Chem are validated with those at the ground stations to evaluate the accuracy of WRF‐Chem model. Second, the relationship analysis between the PM2.5 and wind speed or PWV was done. And the results demonstrate that the wind is helpful to decrease the severe air pollution in winter while the precipitable water vapor plays a small effect on the elimination of the particulate matter. WRF‐Chem is a potential and effective tool for the study of air pollution.