bluuebunny/crossref_metadata_2025 huggingface dataset:
The optimal use of management
Authors: Sickles Robin C. , Sun Kai , Triebs Thomas P.
Published: March 2021

We analyze the management input from the perspective of shadow cost minimization. Using Bloom and Van Reenen's management measure, we estimate management's shadow price, dual Morishima elasticities of substitution, and relative price efficiencies. We find that the shadow price of management is about 1.3 million US dollars. Management is a weak dual complement for labor but a strong dual complement for capital. Increases in management reduce the relative income share of labor but not capital. Most firms use too little management, but relative use of management improves over time, with the combination of ownership and control, and competition.
Feeding ecology and coexistence dynamics in a community of fishes in a temperate temporary water body
Authors: M. Tessy Muñoz‐Campos , Sharon Valdez‐Carbajal , Omar Domínguez‐Castanedo
Published: March 2021

Temporary water bodies are temporally variable ecosystems supported primarily by rainwater. The biota supported by such water bodies present a range of capacities to remain in this environment for all or part of their life cycles. During floods, temporary pools can connect with permanent streams, promoting changes in trophic networks in the aquatic food webs. The aim of this research was to analyse the feeding ecology of a fish community in a temporary pool near of Tlacotalpan, in the Mexican southeast, in order to understand the dynamics of the feeding habits. First, we identified feeding habits that can be interpreted as guilds of the fishes in the temporary pool: the annual killifish Millerichthys robustus (the only autochthonous species) is planktophagous; Cynodonichthys tenuis and Astyanax aeneus are insectivores; Dormitator maculatus and larvae of amphibians (Lithobates sp.) are mainly detritivorous; and Poecilia mexicana is planktophagous and insectivorous. We then estimated the effect of coexistence on niche breadth and overlap. The niches of M. robustus and P. mexicana evidenced overlap, but the breadth was adjusted inversely, suggesting feeding specialisation in M. robustus in response to competition. We documented the existence of two cohorts of M. robustus; the niche breadth of the first and second cohorts suggesting different strategies probably related to competition under variable conditions. The niche of C. tenuis and A. aeneus, and D. maculatus and tadpoles overlapped, following a pattern of feeding generalisation in response to competition.
Translation, validation, and usability of the International Society on Thrombosis and Haemostasis Bleeding Assessment Tool (Self‐ISTH‐BAT)
Authors: Hansen Rasmus Søgaard , Carlsen Mette , Rasmussen Kristina Fruerlund , Vinholt Pernille Just
Published: March 2021

Background

Bleeding questionnaires are effective and recommended screening tools for potential bleeding disorder, but healthcare practitioner–administered bleeding assessment tools (expert‐ISTH‐BATs) are time‐consuming. A patient‐administered ISTH‐BAT (self‐ISTH‐BAT) has been developed and validated. We translated, validated, and evaluated the usability of self‐ISTH‐BAT.

Methods

We conducted a forward–backward translation of self‐ISTH‐BAT from English to Danish. Expert‐ISTH‐BAT and Danish self‐ISTH‐BAT were administered to 106 random individuals aged ≥18 years attending Odense University Hospital between August and November 2020 for elective blood sampling. Results comprise a score of bleeding symptoms.

Results

Mean age of included individuals were 49 years (range: 18‐83), and 59% were female. Median self‐ISTH‐BAT score was 2 (range: 0‐18) and 1 (range: 0‐22) for expert‐ISTH‐BAT (P = .09). All organ systems had ≥90% exact score agreement between expert‐ISTH‐BAT and self‐ISTH‐BAT, except gastrointestinal bleeding (77%) and other bleedings (72%). We found an acceptable correlation (r2 = .80) between expert‐ISTH‐BAT and self‐ISTH‐BAT. The self‐ISTH‐BAT had 82% sensitivity and 89% specificity at the recommended cutoff for expert‐BAT (female:<6; male:<4). At this cutoff, 10 had abnormal self‐ISTH‐BAT scores with normal expert‐ISTH‐BAT. Three (3%) had normal self‐ISTH‐BAT with abnormal expert‐ISTH‐BAT.

Conclusion

Self‐ISTH‐BAT can replace expert‐ISTH‐BAT as a screening tool for bleeding disorders in Danish individuals as only 3% were not identified with the self‐ISTH‐BAT tool.
Impaired posterior cingulate cortex–parahippocampus connectivity is associated with episodic memory retrieval problems in amnestic mild cognitive impairment
Authors: Vanneste Sven , Luckey Alison , McLeod S. Lauren , Robertson Ian H. , To Wing Ting
Published: March 2021

Episodic memory retention and retrieval decline are the most common impairments observed in amnestic mild cognitive impairment (aMCI) patients who progress to Alzheimer's disease (AD). Clinical electroencephalography research shows that patients with dementia due to AD exhibit a slowing of neural electrical activity in the parietal cortex. Memory research has further suggested that successful memory performance is associated with changes in a posterior cingulate–parahippocampal cortical network together with increased θ–γ oscillatory coupling, where θ oscillations act as carrier waves for γ oscillations, which contain the actual information. However, the neurophysiological link between the memory research and clinical studies investigating aMCI and AD is lacking. In this study, we look at brain activity in aMCI and how it relates to memory performance. We demonstrate decreased γ power in the posterior cingulate cortex and the left and right parahippocampus in aMCI patients in comparison to control participants. This goes together with reduced θ coherence between the posterior cingulate cortex and parahippocampus associated with altered memory performance aMCI patients in comparison to control participants. In addition, comparing patients with aMCI to control participants reveals an effect for θ–γ coupling for the posterior cingulate cortex, and the left and right parahippocampus. Taken together, our results show that parahippocampus and posterior cingulate cortex interact via θ–γ coupling, which is associated with memory recollection and is altered in aMCI patients, offering a potential candidate mechanism for memory decline in aMCI.
Kant is a soft determinist
Authors: Scholten Matthé
Published: March 2021

The aim of this paper is to situate Kant in the debate on free will. Whereas Kantians often assume that Kant's views on free will cannot be brought under any of the headings of this debate, contemporary free will theorists commonly assume that Kant is an incompatibilist of the libertarian type. I argue against both assumptions: Kant can and should be characterized as a compatibilist and more specifically as a soft determinist. After removing some persistent misconceptions about Kant's position in the free will debate, I contend that Kant affirms the truth of determinism, that he rejects the possibility of libertarian free will and that he considers the sort of freedom required for moral responsibility to be compatible with determinism.
Impact of the COVID‐19 pandemic and a national lockdown on hospitalizations for stroke and related 30‐day mortality in France: A nationwide observational study
Authors: Gabet Amélie , Grave Clémence , Tuppin Philippe , Chatignoux Edouard , Béjot Yannick , Olié Valérie
Published: March 2021

Background and purpose

The aim of this nationwide study was to assess the impact of the COVID‐19 pandemic on stroke hospitalization rates, patient characteristics and 30‐day case fatality rates.

Methods

All hospitalizations for stroke from January to June of each year from 2017 to 2020 were selected using International Classification of Diseases, 10th revision, codes I60 to I64 in the national hospital discharge database. Patient characteristics and management were described according to three time periods: pre‐lockdown, lockdown, and post‐lockdown. Weekly incidence rate ratios (IRRs) were computed to compare time trends in the rates of patients hospitalized for stroke as well as in‐hospital and 30‐day case fatality rates between the years 2017–2019 and 2020.

Results

In 2020, between weeks 1 and 24, 55,308 patients were hospitalized for stroke in France. IRRs decreased by up to 30% for all age groups, sex, and stroke types during the lockdown compared to the period 2017–2019. Patients hospitalized during the second and third weeks of the lockdown had higher in‐hospital case fatality rates compared to 2017–2019. In‐hospital case fatality rates increased by almost 60% in patients aged under 65 years. Out‐of‐hospital 30‐day case fatality rates increased between weeks 11 and 15 among patients who returned home after their hospitalization. Important changes in care management were found, including fewer stroke patients admitted to resuscitation units, more admitted to stroke care units, and a shorter mean length of hospitalization.

Conclusions

During the first weeks of the lockdown, rates of patients hospitalized for stroke fell by 30% and there were substantial increases of both in‐hospital and out‐of‐hospital 30‐day case fatality rates.
Allosteric communication regulates ligand‐specific GPCR activity
Authors: Ma Ning , Nivedha Anita K. , Vaidehi Nagarajan
Published: March 2021

G protein‐coupled receptors (GPCRs) are membrane‐bound proteins that are ubiquitously expressed in many cell types and take part in mediating multiple signaling pathways. GPCRs are dynamic proteins and exist in an equilibrium between an ensemble of conformational states such as inactive and fully active states. This dynamic nature of GPCRs is one of the factors that confers their basal activity even in the absence of any ligand‐mediated activation. Ligands selectively bind and stabilize a subset of the conformations from the ensemble leading to a shift in the equilibrium toward the inactive or the active state depending on the nature of the ligand. This ligand‐selective effect is achieved through allosteric communication between the ligand binding site and G protein or β‐arrestin coupling site. Similarly, the G protein coupling to the receptor exerts the allosteric effect on the ligand binding region leading to increased binding affinity for agonists and decreased affinity for antagonists or inverse agonists. In this review, we enumerate the current state of our understanding of the mechanism of allosteric communication in GPCRs with a specific focus on the critical role of computational methods in delineating the residues involved in allosteric communication. Analyzing allosteric communication mechanism using molecular dynamics simulations has revealed (a) a structurally conserved mechanism of allosteric communication that regulates the G protein coupling, (b) a rational structure‐based approach to designing selective ligands, and (c) an approach to designing allosteric GPCR mutants that are either ligand and G protein or β‐arrestin selective.
Prediction on fatigue properties of the plain weave composite under broadband random loading
Authors: Sun Yi , Zhang Yuli , Yang Chaozhi , Liu Yizhi , Chen Xiaojie , Yao Liaojun , Gao Weicheng
Published: March 2021

In this paper, the fatigue properties of the plain weave composite subjected to broadband random loading are investigated. A prediction method is proposed to calculate the failure probability of the composite under random loading by combining the probability density function of the residual strength and the probability density function of the stress peaks. The stress randomness and the strength dispersity are both taken into account in the analysis of the residual strength and the failure probability curves. The fatigue life data of the plain weave composite under broadband random responses are obtained from the random vibration tests. The predicted results are in good agreement with the experiments.
The role of anthropogenic habitats in freshwater mussel conservation
Authors: Sousa Ronaldo , Halabowski Dariusz , Labecka Anna M. , Douda Karel , Aksenova Olga , Bespalaya Yulia , Bolotov Ivan , Geist Juergen , Jones Hugh A. , Konopleva Ekaterina , Klunzinger Michael W. , Lasso Carlos A. , Lewin Iga , Liu Xiongjun , Lopes‐Lima Manuel , Mageroy Jon , Mlambo Musa , Nakamura Keiko , Nakano Mitsunori , Österling Martin , Pfeiffer John , Prié Vincent , Paschoal Lucas R. P. , Riccardi Nicoletta , Santos Rogério , Shumka Spase , Smith Allan K. , Son Mikhail O. , Teixeira Amílcar , Thielen Frankie , Torres Santiago , Varandas Simone , Vikhrev Ilya V. , Wu Xiaoping , Zieritz Alexandra , Nogueira Joana G.
Published: March 2021

Anthropogenic freshwater habitats may provide undervalued prospects for long‐term conservation as part of species conservation planning. This fundamental, but overlooked, issue requires attention considering the pace that humans have been altering natural freshwater ecosystems and the accelerated levels of biodiversity decline in recent decades. We compiled 709 records of freshwater mussels (Bivalvia, Unionida) inhabiting a broad variety of anthropogenic habitat types (from small ponds to large reservoirs and canals) and reviewed their importance as refuges for this faunal group. Most records came from Europe and North America, with a clear dominance of canals and reservoirs. The dataset covered 228 species, including 34 threatened species on the IUCN Red List. We discuss the conservation importance and provide guidance on how these anthropogenic habitats could be managed to provide optimal conservation value to freshwater mussels. This review also shows that some of these habitats may function as ecological traps owing to conflicting management practices or because they act as a sink for some populations. Therefore, anthropogenic habitats should not be seen as a panacea to resolve conservation problems. More information is necessary to better understand the trade‐offs between human use and the conservation of freshwater mussels (and other biota) within anthropogenic habitats, given the low number of quantitative studies and the strong biogeographic knowledge bias that persists.
Old‐growth forests show low canopy resilience to droughts at the southern edge of the taiga
Authors: Liu Feng , Liu Hongyan , Xu Chongyang , Shi Liang , Zhu Xinrong , Qi Yang , He Wenqi
Published: March 2021

Forest mortality and resilience driven by drought disturbances have attracted tons of attention. However, the acquisition of continuous spatial–temporal data is generally enslaved to the conventional field investigations. In this study, the resilience of semiarid forest was characterized with canopy dynamics from remote sensing observations, combining the variations in canopy greenness and water content. We integrated dense normalized difference vegetation index (NDVI) and normalized difference infrared index (NDII) time series from Landsat datasets, intending to assess the canopy resilience in 24 conifer patches along a climatic aridity gradient at the southern edge of the taiga in northern Mongolia and southern Siberia of Russia. The results exhibited four patterns of coordinated NDVI–NDII variation trends, indicating that the canopy water content of coniferous forests may decrease at first during a drought period, and sustained water loss may, in turn, induce an accompanying reduction in canopy greenness. Meanwhile, the patches with canopy recovery growth after initial declines were considered to have resilience to climate change. We further observed the combined effects of aridity degree and tree age on canopy resilience, and all seven patches with no resilience corresponded to the old‐tree group (the oldest trees reached or exceeded the age of 90). The observations indicated that the old‐growth forests in semiarid regions were less likely to show canopy resilience, which corresponded to a higher risk of sustained decline.
Trapped within ideological wars: Femininities in a Muslim society and the contest of women as leaders
Authors: Oktaviani Fitri Hariana , McKenna Bernard , Fitzsimmons Terrance
Published: March 2021

This paper analyzes the discursive contestation among online news media about women in leadership roles within a Muslim majority society, Indonesia. Indonesian women have established a substantial leadership role in which the “ideal” modern woman has been the image of “wanita karir,” a commingling of various Indonesian feminist discourses and Western (post)feminist discursive formations. Despite the progress, women's leadership in Indonesia has recently been challenged by reactionary Islamist forces. Using a critical poststructural discourse perspective, we identify a range of four forms of femininity and female leadership in Indonesian online media that reside at the intersections of competing discourses. This paper offers two areas of contributions. First, we identify the leadership challenges faced by women in a South‐East Asian context, in particular within a democratic Muslim society like Indonesia. Second, we contribute to the theorization of women's leadership challenges from the perspective of femininity construction. In particular, we want to emphasize the notion of the multiplicity of discourses in shaping femininities. In doing so, we demonstrate the permutability, transformability, and adaptability of gender discrimination in our identified forms of femininity, and the limitations of the virtuous burden imposed by apparently supportive discourse.
Emotional labor, ordinary affects, and the early childhood education and care worker
Authors: Fairchild Nikki , Mikuska Eva
Published: March 2021

This paper discusses society's lack of recognition of the Early Childhood Education and Care (ECEC) workforce as professionals, and its emotional impact that this deficit has on them. The concerns are that the role of the ECEC worker has been mainly conceptualized as maternal, where emotional labor is taken for granted and needs to be suppressed or harnessed as part of the caring role. This is at odds with successive government policy agenda which has focused on professionalizing the workforce. In this paper, we engage with qualitative data gathered from 24 experienced ECEC workers to explore the impact that “affect” has upon them. In this respect, we build on the theorizations of Massumi and Stewart, which connect affect theory with emotional labor; we argue that affect theory offers different ways to consider how objects, spaces, material, and discursive entities and bodies impact ECEC workers' emotions and emotional labor.
Invisible people: A story of fertility treatment and loss during the pandemic
Authors: Griffiths Heather
Published: March 2021

This account of fertility treatment during the pandemic weaves autobiographical narrative with empirical evidence to show how infertility and loss is experienced by women in the modern workplace. It charts my experience of fertility treatment during the lockdown of 2020 and draws on recent studies to highlight the psychological impact of infertility, the impact it has on work and career, and the stark absence of workplace support. By offering an in‐depth portrayal of fertility treatment, I hope to not only to raise awareness about the experience but also explore the interaction between infertility, health, and work, and how this has changed—for better and worse—during lockdown.
Panic buying research: A systematic literature review and future research agenda
Authors: Billore Soniya , Anisimova Tatiana
Published: March 2021

Panic buying has re‐emerged as a ‘new’ normal consumer behaviour and has become a coping mechanism for real and perceived dangers associated with COVID‐19. Despite the need for a better understanding of the panic buying phenomenon, there has been a lack of scholarly research on this topic. This study seeks to fill this gap. In this article, we systematically review extant studies in panic buying from the last two decades. We analyse and categorize them according to Callahan's 4W (2014) review structure and Paul and Rosado‐Serrano's (2019) TCCM framework. We found that the existing publications in panic buying are fragmented across multiple disciplines. Due to the nature of the panic‐induced behaviour, most of them have been written as a reaction to the pandemic crisis. We contribute to marketing research by providing theoretical, contextual and methodological insights into the field of panic buying. Furthermore, we develop a research agenda related to retailer and consumer perspectives. Additionally, we identify research issues related to policymaking and governance, as well as broader societal impacts that need to be addressed in the future.
FcRn is not the receptor mediating the transfer of serum IgG to colostrum in pigs
Authors: Ke Cuncun , Ma Yonghe , Pan Dengke , Wan Zihui , Feng Tao , Yu Dawei , Liu Xiaojuan , Wang Haitao , Du Minjie , Huang Linhua , Zhang Yifu , Du Lijuan , Wang Xifeng , Li Kongpan , Yu Di , Zhang Ming , Huang Jinwei , Qu Junwei , Ren Liming , Hu Yanzhong , Cao Gengsheng , Hu Xiaoxiang , Wu Sen , Han Haitang , Zhao Yaofeng
Published: March 2021

In contrast to humans or rabbits, in which maternal IgG is transmitted to offspring prenatally via the placenta or the yolk sac, large domestic animals such as pigs, cows and sheep transmit IgG exclusively through colostrum feeding after delivery. The extremely high IgG content in colostrum is absorbed by newborns via the small intestine. Although it is widely accepted that the neonatal Fc receptor, FcRn, is the receptor mediating IgG transfer across both the placenta and small intestine, it remains unclear whether FcRn also mediates serum IgG transfer across the mammary barrier to colostrum/milk, especially in large domestic animals. In this study, using a FcRn knockout pig model generated with a CRISPR‐Cas9‐based approach, we clearly demonstrate that FcRn is not responsible for the IgG transfer from serum to colostrum in pigs, although like in other mammals, it is involved in IgG homeostasis and mediates IgG absorption in the small intestine of newborns.
Extension of social insurance coverage to informal economy workers in China: An administrative and institutional perspective
Authors: Qian Jiwei , Wen Zhuoyi
Published: March 2021

This article reviews administrative issues in the context of decentralized social protection in China. In particular, what are the main obstacles to expanding social insurance coverage for workers in the informal economy? Over the last two decades, China has achieved remarkable progress toward universal social protection when this target was set as a national policy priority. However, the social insurance enrolment of informal economy workers still lags significantly behind. This article reviews the application of the International Labour Organization’s definition of informality in the Chinese context and overviews existing pension and health insurances in China. This article discusses the impact of China’s inter‐governmental fiscal relations and decentralized social protection in the multilevel government system. The article highlights that under a system of decentralized managed social insurance many informal economy workers choose to opt out of the system because of low benefits and high compliance costs. This result in deficits in social insurance coverage amongst informal economy workers.
Explainable anomaly detection for procurement fraud identification—lessons from practical deployments
Authors: Westerski Adam , Kanagasabai Rajaraman , Shaham Eran , Narayanan Amudha , Wong Jiayu , Singh Manjeet
Published: March 2021

This article reports the results of our work to construct a system for the detection of fraudulent behavior in procurement transactions. To solve the problem, we model different types of fraud via separate statistical indicators. We propose a formalized framework to describe the severity of fraud in a unified way regardless of underlying fraud mechanics. Subsequently, we leverage this concept to build indicator ensembles that collect evidence from multiple indicators and deliver an interpretable per transaction score to the procurement audit officer. As a case study, we overview 48 such fraud indicators constructed for our client and describe two examples in detail showing how our formal definitions can be transformed into a practical implementation. The presented results include experiments with all indicators on data covering four years of procurement activity with approximately 216,000 transactions coming from a large government organization in Singapore. The final evaluation of our system shows 67.1% precision in detecting suspicious transactions. The article describes how outcome of our work helped to effectively cope with the problem of anomaly detection explainability and the lessons learned from integrating this solution to operational practices of a procurement department.
Platelet‐rich plasma for striae distensae: What do we know about processed autologous blood contents for treating skin stretchmarks?—A systematic review
Authors: Sawetz Isabelle , Lebo Patricia B. , Nischwitz Sebastian P. , Winter Raimund , Schaunig Caroline , Brinskelle Petra , Kamolz Lars P. , Gualdi Alessandro , Lumenta David B.
Published: March 2021

Striae distensae, also known as stretch marks, particularly associated with female sex, pregnancy, obesity, and/or hormonal change, are linear bands of benign dermal lesions. Although not posing any health risk, aesthetically unpleasing stretch marks can cause significant psychological distress among those affected. In abundance of therapeutic approaches, some literature sources proclaim platelet‐rich plasma to be a promising treatment modality for striae distensae. We aimed to shed some light on the current literature evidence of platelet‐rich plasma for treating stretch marks and performed an English literature analysis with two independent reviewers in accordance with PRISMA guidelines searching the PubMed and Web of Science databases in June 2019. Of the 12 found studies, 6 matched inclusion criteria. With no control groups in two, just two other reports used intraindividual comparisons, and all but one publication performed histopathological assessments. All studies observed clinical and subjective improvements without using validated scores or patient‐reported outcome measures (PROMs). The main findings were that multiple treatments with platelet‐rich plasma demonstrated increased epidermal thickness, rete ridges formation, and collagen/elastin formation, while decreasing the inflammatory cell infiltrate. The current literature evidence supporting the use of platelet‐rich plasma for striae distensae is poor. We propose in this review an outline for a study protocol with intraindividual control groups, standardised scores, validated PROMs, and participant incentives to enhance the scientific power in future clinical trials.
Modified compression therapy in mixed arterial–venous leg ulcers: An integrative review
Authors: Lim Sheryl Li Xin , Chung Rui En , Holloway Samantha , Harding Keith G.
Published: March 2021

Leg ulcers remain an increased burden to healthcare cost and morbidity in modern society. While most leg ulcers are venous in origin, recognition and prompt identification of concomitant arterial occlusive disease is critical to determine underlying aetiology and subsequent management. This integrative review presents the current evidence to establish the role of modified compression therapy (MCT) in treatment of mixed arterial venous leg ulcers (MAVLU). A literature search was conducted using the electronic databases CINAHL, MEDLINE, PUBMED, and Embase. Ten studies met the eligibility criteria and were subsequently analysed. Our review concludes that MCT, with compression pressures between 20 and 30 mmHg, can promote healing in MAVLU with moderate arterial insufficiency (0.5 ≤ ABPI ≤0.8). If ABPI is <0.5, MCT can be considered once restoration of acceptable ABPI is achieved. Intolerance, lack of response or further deterioration of disease within 3 months should prompt further arterial imaging and intervention. MCT is generally well tolerated with no adverse outcomes reported. A holistic yet individualised approach is vital in order to account for all factors influencing this patient‐led decision‐making process, ultimately ensuring effective treatment, which improves patient's quality of life and reduces socioeconomic burden of the disease.
Prevention of hypothermia in trauma victims ‐ the HYPOTRAUM 2 study
Authors: Lapostolle Frédéric , Garrigue Bruno , Richard Olivier , Weisslinger Lisa , Chollet Charlotte , Lagadec Steven , Soulat Louis , Ricard‐Hibon Agnès , Hilaire‐Schneider Christelle , Debaty Guillaume , Mazur Valérie , Vicaut Eric
Published: March 2021

Introduction

Hypothermia is common in trauma patients. It contributes to increasing mortality rate. Hypothermia is multifactorial, favoured by exposure to cold, severity of the patient's state and interventions such as infusion of fluids at room temperature.

Aim

To demonstrate that specific management of hypothermia (or of the risk of hypothermia) increases the number of trauma patients arriving at the hospital with a temperature >35°C.

Design

This is a prospective, multicentre, open‐label, pragmatic, cluster randomized clinical trial of an expected 1,200 trauma patients included by 12 out‐of‐hospital mobile intensive care units (MICU). Trauma patients are included in a prehospital setting if they present at least one of the following criteria known to be associated with an increased incidence of hypothermia: ambient temperature <18°C, Glasgow coma scale <15, systolic arterial blood pressure <100 mm Hg or body temperature <35°C. Patients are randomized, by cluster, to receive a conventional management or ‘interventional’ nursing management associating: continuous epitympanic temperature monitoring, early installation in the heated ambulance (temperature target >30°C controlled by infrared thermometer), protection by a survival blanket, and use of heated solutes (temperature objective >35°C controlled by infrared thermometer). The primary end point is the prevalence of hypothermia on arrival at the hospital. The hypothesis tested is a reduction from 20% to 13% in the prevalence of hypothermia. Secondary end points are to evaluate the interaction between the effectiveness of the measures taken and: (1) the severity of the patients assessed by the Revised Trauma Score; (2) the meteorological conditions when they are managed; (3) the time of care; and (4) therapeutic interventions.

Discussion

This trial will assess the effectiveness of an invasive, out‐of‐hospital, temperature management on the onset of hypothermia in moderate to severe trauma patients.

Impact

Specific management of hypothermia is expected to decrease hypothermia in trauma patients.
Inequality, autocracy, and sovereign funds as determinants of foreign portfolio equity flows
Authors: Kemme David M. , Parikh Bhavik , Steigner Tanja
Published: March 2021

We identify new country characteristics that influence cross‐border equity flows: income inequality, autocracy, and sovereign wealth funds. Using 149 source countries and 34 Organisation for Economic Co‐operation and Development (OECD) host countries for 2002–2013, we find that OECD host countries receive higher foreign portfolio investment (FPI) inflows from source countries with high income inequality and source countries with a sovereign wealth fund, but lower inflows from autocratic source countries. We argue that concentrated wealth in a society, overseas investments for the benefit of future generations, and political regimes influence FPI. These variables have been understudied though they provide valuable indicators for policy makers and investors. We supplement our core analysis with realistic interactions between these new variables and with the increasing importance of tax havens. Our results hold throughout a variety of robustness checks.
Alternative freezing: Effects on rehydration properties of freeze‐dried daikon (Raphanus sativusL.)
Authors: Gonçalves Maíra de Paula , Tojo Seishu , Nazari Siti Aqilah Mohd , Silveira Junior Vivaldo
Published: March 2021

Freeze‐drying of daikon was performed using four different freezing conditions: two processes at constant temperature (−20 and −30°C—conventional); and two alternative approaches (dynamic and variable by levels). Freezing rates were evaluated and all methods achieved commercial freezing requirements (10–50°C hr−1). The two modified processes presented similar freezing rates to the conventional operation; moreover, evidence was found to consider these two processes statistically equivalent. Then, freeze‐dried samples were rehydrated by immersion in distilled water, and rehydration kinetic curves were adjusted to semi‐empirical models; the Weibull model presented the best fit. Finally, rehydration quality parameters of the samples were evaluated. The dynamic freezing process showed the best rehydration quality, while the variable by levels showed the closest results to the conventional one. In conclusion, these results indicate a technologically attractive improvement as an alternative for traditional industrial processes.

Practical Applications

A new freezing methodology was proposed, which consists of changing the freezing operating conditions, considering the product temperature throughout the process. Such an operation provides high‐quality freeze‐dried products, regarding rehydration properties. The procedure can be used in the replacement of conventional freezing, resulting in better freeze‐dried products.
Too little, too late: Palliation and end‐stage liver disease
Authors: Chen Hayley , Johnston Alexander , Palmer Andrew , Mickenbecker Matthew , O'Sullivan Timothy , Clark Paul
Published: March 2021

Background and Aim

End‐stage liver disease is a leading cause of mortality. Fewer than 60% of patients with decompensated cirrhosis survive after 2 years, with patients often experiencing distressing symptoms impairing quality of life. Early advanced care planning and timely palliative care referral can improve quality of life and the end of life experience. We aimed to determine palliative care referral rates and patterns for patients admitted with decompensated cirrhosis, and to identify the factors associated with referral.

Methods

This was a retrospective, single‐center study undertaken at a metropolitan tertiary referral hospital. Patients admitted between the 1 June 2016 and 31 January 2019 with a Child–Pugh score of B or C, and a model for end‐stage liver disease score ≥ 15 were included. We assessed survival and compared those referred and not referred to palliative care, adjusting for lag‐time to referral (Kaplan–Meier analysis).

Results

One‐hundred and sixteen admissions met eligibility criteria for referral. The median age at admission was 59 years, with 76% male participants. Only a fifth of eligible patients (25/116) were referred to palliative care. The median survival (from referral) for those referred to palliative care was 20 days, versus 148 days for those not referred.

Conclusions

Despite benefits from timely referral, less than one quarter of palliative care eligible patients was referred. Referral appears reserved for those facing imminent death—surviving just under 3 weeks postreferral, yet mortality in nonreferred patients remained high (148‐day median). Low rates and late referral are a missed opportunity to improve the end of life care for patients with end‐stage liver disease.
Worries, attitudes, and mental health of older adults during the COVID‐19 pandemic: Canadian and U.S. perspectives
Authors: Reppas‐Rindlisbacher Christina , Finlay Jessica M. , Mahar Alyson L. , Siddhpuria Shailee , Hallet Julie , Rochon Paula A. , Kobayashi Lindsay C.
Published: March 2021

Background/Objectives

Differences in older adults' worry, attitudes, and mental health between high‐income countries with diverging pandemic responses are largely unknown. We compared COVID‐19 worry, attitudes towards governmental responses, and self‐reported mental health symptoms among adults aged ≥55 in the United States and Canada early in the COVID‐19 pandemic.

Design

Online cross‐sectional survey administered between April 2nd and May 31st in the United States and between May 1st and June 30th, 2020 in Canada.

Setting

Nationally in the United States and Canada.

Participants

Convenience sample of older adults aged ≥55.

Measurements

Likert‐type scales measured COVID‐19 worry and attitudes towards government support. Three standardized scales assessed mental health symptoms: the eight‐item Center for Epidemiological Studies Depression Scale, the five‐item Beck Anxiety Inventory, and the three‐item UCLA loneliness scale.

Results

There were 4453 U.S. respondents (71.7% women; mean age 67.5) and 1549 Canadian (67.6% women; mean age 69.3). More U.S. respondents (71%) were moderately or extremely worried about the pandemic, compared to 52% in Canada. Just 20% of U.S. respondents agreed or strongly agreed that the federal government cared about older adults in their COVID‐19 pandemic response, compared to nearly two‐thirds of Canadians (63%). U.S. respondents were more likely to report elevated depressive and anxiety symptoms compared to Canadians; 34.2% (32.8–35.6) versus 25.6% (23.3–27.8) for depressive and 30.8% (29.5–32.2) versus 23.7% (21.6–25.9) for anxiety symptoms. The proportion of United States and Canadian respondents who reported loneliness was similar. A greater proportion of women compared to men reported symptoms of depression and anxiety across all age groups in both countries.

Conclusion

U.S. older adults felt less supported by their federal government and had elevated depressive and anxiety symptoms compared to older adults in Canada during early months of the COVID‐19 pandemic. Public health messaging from governments should be clear, consistent, and incorporate support for mental health.
“You helped me out of that darkness” Children as dialogical partners in the collaborative post‐family therapy research interview
Authors: Helimäki Mira , Laitila Aarno , Kumpulainen Kirsti
Published: March 2021

Applying Dialogical Methods for Investigations of Happening of Change (DIHC), this study investigated how children who had been diagnosed with an oppositional defiant or conduct disorder participated in a collaborative post‐therapy research interview and talked about their experiences of family therapy. The results showed that the children participated as dialogical partners talking in genuine, emotional, and reflective ways. Encountered as full‐membership partners, the children also co‐constructed meanings for their sensitive experiences. However, their verbal initiatives and responses appeared in very brief moments and could easily have been missed. The collaborative post‐therapy interview offered a safe forum for co‐reflection by participants on what they had found useful or difficult in the family therapy process. In this interview setting, the family first listens to reflection by the therapists on the therapy process and their thoughts on some of the family's related sensitive issues. The results indicate that when therapists present themselves as not‐knowing, receptive and accountable, therapists may facilitate reflection for all family members, including children.
Perspectives on mental health recovery from Egyptian mental health professionals: A qualitative study
Authors: Ibrahim Nashwa , Ghallab Eman , Ng Fiona , Eweida Rasha , Slade Mike
Published: March 2021

Accessible Summary

What is known on the subject?

Personal recovery concept is dominant in mental health systems when service user involvement is emphasized; however, service user involvement in mental health research and practice does not exist in Egypt.

Definitions of recovery from high‐income and English‐speaking countries should be carefully adapted to other settings.

Nurses providing mental health care in Egypt generally do not have specialized mental health nursing qualifications.

What the paper adds to existing knowledge?

Both cultural and contextual uniqueness of Egypt as a Middle Eastern, low‐middle‐income country were clear in the findings of this paper.

There are differences in the definition of family and service user engagement in the current study and in high‐income countries.

Seeking faith healers as a barrier to mental health recovery is culturally unique.

Functional recovery prevails as a model in Egypt as there is limited service user involvement.

Nursing values and code of ethics are consistent with enablers of mental health recovery.

What are the implications for practice?

Changing the pre‐registration nursing education to prepare specialized graduates in mental health nursing.

Training of mental health professionals on recovery approaches which involve service users is needed in Egypt. Mental health nurses in Egypt can use the current findings to implement national campaigns to raise public awareness of mental health problems.

Introduction

Recovery‐oriented mental health practice is an emerging approach that aims to empower individuals to define their goals and take responsibility for their own recovery. However, mental health practice in Egypt is still custodial.

Aim

To explore perspectives of Egyptian mental health professionals on recovery.

Method

Semi‐structured interviews were conducted with 15 mental health professionals identified through snowball sampling.

Results

The current study identified that functional recovery outweighed other definitions. Four facilitators of mental health recovery were identified: therapeutic relationship; family engagement; cultural sensitivity; and professionals’ self‐awareness. Six barriers to recovery were found, comprising mental health stigma and lack of awareness, seeking traditional healers, shortage of psychiatrists, cost of treatment, lack of training and effective rehabilitation programs.

Discussion

The concept of functional recovery predominates among nurses and other mental health professionals, which may be due to limited training and the historical lack of service user involvement in Egypt. Lack of support from family and society, inadequate training MHPs and perceived system inefficiencies are also major impeding factors for recovery.

Implications for Practice

There is a need for nurses to be involved in designing intervention programs targeting the general public and to support increased involvement of people with mental health issues.
Presumptive malignant transformation of chronic polypoid cystitis into an apical transitional cell carcinoma without BRAF mutation in a young female dog
Authors: Butty Emmanuelle Marie , Hahn Shelley , Labato Mary Anna
Published: March 2021

A 3‐year‐old spayed female English Springer Spaniel was presented twice 4 months apart for investigation of hematuria and pollakiuria without urinary tract infection. Both ultrasound examinations identified a stable craniodorsal bladder wall thickening. The first cystoscopic biopsy samples indicated lymphoplasmacytic cystitis and the second polypoid cystitis. The dog was represented 8 months later for recurrent clinical signs despite medical management. Although the ultrasound examination showed stable disease, repeat cystoscopic biopsy identified transitional cell carcinoma (TCC), confirmed on tissue removed by partial cystectomy. No BRAF mutation was ever detected in urine or tissue samples. To our knowledge, this case represents the first report of presumptive malignant transformation of polypoid cystitis into an apical TCC in a dog. Dogs with polypoid cystitis should be followed closely and surgical management considered if rapid resolution is not achieved with medical management.
Generalists yet different: distributional responses to climate change may vary in opportunistic bat species sharing similar ecological traits
Authors: Smeraldo Sonia , Bosso Luciano , Salinas‐Ramos Valeria B. , Ancillotto Leonardo , Sánchez‐Cordero Víctor , Gazaryan Suren , Russo Danilo
Published: March 2021

Climate change is among the key anthropogenic factors affecting species’ distribution, with important consequences for conservation. However, little is known concerning the consequences of distributional changes on community‐level interactions, and responses by generalist species might have many ecological implications in terms of novel interactions with resident species.

In this study, we applied Ecological Niche Models and niche analysis to three generalist bat species, Hypsugo savii, Pipistrellus kuhlii, and Pipistrellus pipistrellus, which share similar ecological traits and are sympatric in parts of their ranges. Our aims were to investigate how predicted climate change will affect species’ distribution and to analyse the degree of climatic niche overlap between the three species, in both the current and the future scenarios (2050 and 2070; Representative Concentration Pathways 4.5 and 8.5).

Temperatures were the most important predictors influencing species’ range expansion in future. According to our models, Pipistrellus kuhlii and Hypsugo savii may expand their geographic ranges towards northern latitudes, whereas the geographic range of the less thermophilous Pipistrellus will shift northwards, resulting in it losing the southern portion in Europe. The already considerable degree of climatic niche overlap between the three species will increase further in future.

On the basis of our findings, within the new areas potentially colonised by all three species in future, alterations in community‐level balance might occur, bringing about effects that are only partially predictable. In view of this, we highlight the need for further research and improved monitoring of bat communities in areas that are predicted to be particularly vulnerable to climate change.
A decision‐making methodology for risk‐informed earthquake early warning
Authors: Cremen Gemma , Galasso Carmine
Published: March 2021

To maximize the potential of earthquake early warning (EEW) as a credible tool for seismic resilience promotion, it should be combined with next‐generation decision‐support tools that use advanced risk‐based predictions and account for unavoidable malfunctions of the system (i.e., false alarms) to determine whether or not alerts/mitigation actions should be triggered. This work contributes to the required effort by developing a novel end‐user‐oriented approach for decision making related to very short‐term earthquake risk management. The proposed methodology unifies earthquake‐engineering‐related performance assessment procedures/metrics (for end‐user‐focused damage and consequence estimation) with multicriteria decision‐making tools (to consider end‐user preferences toward different types of risks). It is demonstrated for EEW in a hypothetical school building, to specifically investigate the optimal decisions (i.e., “trigger”/“do not trigger” alerts) for a range of earthquake scenarios with varying parameter uncertainties. In particular, it is found that the best action for a given ground‐shaking intensity can depend on stakeholder (end‐user) preferences.
Discovery and modulation of diterpenoid metabolism improves glandular trichome formation, artemisinin production and stress resilience in Artemisia annua
Authors: Chen Ruibing , Bu Yuejuan , Ren Junze , Pelot Kyle A. , Hu Xiangyang , Diao Yong , Chen Wansheng , Zerbe Philipp , Zhang Lei
Published: March 2021

Plants synthesize diverse diterpenoids with numerous functions in organ development and stress resistance. However, the role of diterpenoids in glandular trichome (GT) development and GT‐localized biosynthesis in plants remains unknown.

Here, the identification of 10 diterpene synthases (diTPSs) revealed the diversity of diterpenoid biosynthesis in Artemisia annua. Protein–protein interactions (PPIs) between AaKSL1 and AaCPS2 in the plastids highlighted their potential functions in modulating metabolic flux to gibberellins (GAs) or ent‐isopimara‐7,15‐diene‐derived metabolites (IDMs) through metabolic engineering.

A phenotypic analysis of transgenic plants suggested a complex repertoire of diterpenoids in Artemisia annua with important roles in GT formation, artemisinin accumulation and stress resilience. Metabolic engineering of diterpenoids simultaneously increased the artemisinin yield and stress resistance. Transcriptome and metabolic profiling suggested that bioactive GA4/GA1 promote GT formation.

Collectively, these results expand our knowledge of diterpenoids and show the potential of diterpenoids to simultaneously improve both the GT‐localized metabolite yield and stress resistance, in planta.