bluuebunny/crossref_metadata_2025 huggingface dataset:
Anesthesia for tracheal and carinal resection and reconstruction
Authors: Schieren Mark , Wappler Frank , Defosse Jerome
Published: December 2021

Purpose of review

The aim of this review is to provide an overview of current anesthetic management of tracheal and carinal resection and reconstruction.

Recent findings

In addition to the traditional anesthetic approach using conventional tracheal intubation after induction of general anesthesia and cross-field intubation or jet-ventilation once the airway has been surgically opened, there is a trend toward less invasive anesthetic procedures. Regional anesthetic techniques and approaches focusing on the maintenance of spontaneous respiration have emerged. Especially for cervical tracheal stenosis, laryngeal mask airways appear to be an advantageous alternative to tracheal intubation.

Extracorporeal support can ensure adequate gas exchange and/or perfusion during complex resections and reconstructions without interference of airway devices with the operative field. It also serves as an effective rescue technique in case other approaches fail.

The spectrum of available anesthetic techniques for major airway surgery is immense. To find the safest approach for the individual patient, comprehensive interdisciplinary planning is essential. The location and anatomic consistency of the stenosis, comorbidities, the functional status of respiratory system, as well as the planned reconstructive technique need to be considered. Until more data is available, however, a reliable evidence-based comparison of different approaches is not possible.
Identification of heterogeneity and prognostic key genes associated with uveal melanoma using single-cell RNA-sequencing technology
Authors: Sun Songlin , Shi Rui , Xu Liang , Sun Fengyuan
Published: December 2021

Uveal melanoma (UM) is the most common intraocular malignancy in adults. The prognosis is poor once metastasis has developed. The treatment of metastatic UM remains challenging nowadays due to lacking a deep understanding of the biological characteristics of this disease. Here, we revealed the cell subpopulations with distinct functional status and the existence of cells with high invasive potential within heterogeneous primary and metastatic UM. The single-cell sequencing data were retrieved from GSE139829 and GSE138433, through which we identified a new cell cluster related to metastatic UM as a unique type of immune cell. The cell–cell communication was conducted by ‘Cellchat’ to understand the cell crosstalk between these immune cells and their surrounding cells. The crucial signals contributing most to outgoing or incoming signaling of this cell group were identified to reveal the crucial pathway genes. Furthermore, we judged the prognostic value of these candidates on the basis of the data downloaded from The Cancer Genome Atlas. The results demonstrated that the increased IL10, SELPLG, EPHB and ITGB2 signaling pathways could be promising predicting factors for the patient prognosis in UM. Conclusively, we discover the potential key signals of UM for occurrence and metastasis, and also provide a theoretical basis for judging whether there is a high risk of metastasis or recurrence.
Treatment Patterns, Toxicity, and Outcomes of Older Adults With Advanced Pancreatic Cancer Receiving First-line Palliative Chemotherapy
Authors: McAndrew Erin N. , Zhang Hanbo , Lambert Pascal , Rittberg Rebekah , Dawe David E. , Kim Christina A.
Published: December 2021

Objectives:

Advanced pancreatic cancer (APC) disproportionately impacts older adults. Randomized trials demonstrate improved overall survival (OS) with combination chemotherapy including 5-fluorouracil, irinotecan, leucovorin, and oxaliplatin (FOLFIRINOX) or nab-paclitaxel and gemcitabine compared with gemcitabine alone, but with increased toxicity. Older adults are at increased risk of side effects from chemotherapy. The aim of this study was to assess the efficacy and toxicity of chemotherapy in older adults with APC.

Methods:

Patients diagnosed with APC from 2011 to 2016 were identified using the Manitoba Cancer Registry. Patient and treatment characteristics, toxicity, and outcomes of patients 65 years of age and above treated with palliative chemotherapy were compared by treatment regimen. OS was assessed using the Kaplan-Meier method. A Cox regression was used to identify independent predictors of OS.

Results:

A total of 87 patients aged 65 years and above received palliative chemotherapy: 52 (59.7%) FOLFIRINOX, 21 (24.1%) nab-paclitaxel and gemcitabine, and 14 (16.1%) gemcitabine, with a median age of 69 (65 to 84), 75 (65 to 88), and 73 (67 to 82), Eastern Cooperative Oncology Group (ECOG) performance status difference in hematologic toxicity between regimens (P=0.807). An increase in nonhematologic toxicity was seen with FOLFIRINOX (P<0.001), specifically neuropathy (P=0.008), fatigue (P<0.001), and nausea/vomiting (P=0.008). FOLFIRINOX was associated with improved radiologic response (P=0.05) and OS (P=0.035). PS, baseline carbohydrate antigen 19-9 level, and chemotherapy regimen were independent predictors of survival.

Conclusions:

FOLFIRINOX is associated with improved response and OS in older adults with APC. FOLFIRINOX has a manageable safety profile in this population and should be considered in fit older adults with APC.
A Hand Call Curriculum for Plastic Surgery Residents
Authors: Bjorklund Kim A. , Bourgeois Tran , O’Brien Meghan
Published: December 2021

Background:

The ability to diagnose and manage patients with acute hand injuries is an essential component of plastic surgery residency. This study proposes an innovative and feasible curriculum to improve hand surgery education for plastic surgery residents and ensure optimal care for patients with hand injuries.

Methods:

A hand call curriculum for plastic surgery residents (n = 29) from two institutions was implemented from 2018 to 2020. In 2018 and 2019, a hand call boot camp was conducted, while additional curricular sessions for anatomy and didactic learning were added in 2019–2020. Pre and post test assessments, as well as confidence assessments were conducted in 2018 and 2019.

Results:

In 2019, after having completed the boot camp, residents indicated significantly more confidence in identifying hand emergencies and formulating a basic treatment plan, including when to enlist help (P = 0.0313). Overall, residents in earlier years (PGY 1–3) demonstrated steeper changes in confidence and readiness to take hand call than those in more senior years (PGY 4-8). Knowledge test scores improved amongst residents in both PGY groups following boot camp in both 2018 and 2019.

Conclusion:

Findings from our study will be used to optimize the hand call curriculum following limitations with COVID-19 and consider wider implementation across other plastic surgery programs nationally.
Marked intrafamilial aggregation and heritability of aortic flow in a community with prevalent volume-dependent hypertension in Africa
Authors: Yusuf Suraj M. , Norton Gavin R. , Peterson Vernice , Libhaber Carlos D. , Mmopi Keneilwe N. , Bello Hamza , Masiu Mohlabani , Da Silva Fernandes Daniel , Tade Grace , Mthembu Nonhlanhla , Peters Ferande , Dessein Patrick , Sareli Pinhas , Woodiwiss Angela J.
Published: December 2021

Aims:

Although peak aortic flow (Q) is now recognized as a major determinant of hypertension in Africa, current therapy has no proven ability to target this change. The mechanisms of this effect, therefore, require elucidation. We compared the intrafamilial aggregation and heritability of Q to that of the vascular determinants of pulse pressure (PP) and SBP in Africa.

Methods:

The intrafamilial aggregation and heritability of Q and aortic characteristic impedance (Z
c) or total arterial compliance (TAC) was determined in 669 participants of 194 families (69 father–mother, 385 parent–child, 157 sibling–sibling pairs) in a community in Africa with prevalent flow-dependent primary hypertension. Haemodynamics were determined from velocity and diameter measurements in the outflow tract (echocardiography) and central arterial pressures.

Results:

No mother–father correlations were noted for either Q or Z
c. However, with adjustments for confounders, parent–child (P < 0.0001) and sibling–sibling (P < 0.0001) correlations were noted for Q. Parent–child and/or sibling–sibling correlations were also noted for Z
c or TAC but were weaker for Z
c and mother–father correlations were noted for TAC. Moreover, Q showed markedly stronger multivariate adjusted heritability estimates (h
2 = 0.82 ± 0.07, P < 0.0001) than Z
c (h
2 = 0.44 ± 0.10, P < 0.0001)(P < 0.005 for comparisons) and TAC (h
2 = 0.47 ± 0.08, P < 0.0001)(P < 0.005 for comparisons). Importantly, the heritability of Q was also greater than that for PP (h
2 = 0.12 ± 0.09, P = 0.11) (P < 0.0001 for comparisons), or SBP (h
2 = 0.13 ± 0.10, P = 0.08) (P < 0.0001 for comparisons).

Conclusion:

Of the haemodynamic determinants of SBP, peak aortic flow is the most strongly inherited in Africa. Peak aortic flow, therefore, represents an important target for identifying novel therapeutic approaches to controlling SBP in Africa.
Epiphora and Dacryocystitis After Transcanalicular Laser-assisted Dacryocystorhinostomy due to an Undiagnosed Dacryolith
Authors: Ozturker Can , Kaynak Pelin
Published: December 2021

A 45-year-old female patient who had previously undergone endoscopic dacryocystorhinostomy (EN-DCR) at another surgical center was diagnosed with functional failure after DCR and underwent an uneventful transcanalicular laser-assisted DCR (TCL-DCR). After 5 months, the patient underwent endoscopic examination due to persistent epiphora and dacryocystitis attacks. Endonasal visualization revealed a large dacryolith that filled the ostium and sac and was removed en bloc mechanically with forceps. Carbonized material on the dacryolith’s superior part indicated that it was perforated through-and-through by the laser beam during TCL-DCR. The patient’s complaints were resolved completely following the removal of the dacryolith. The transcanalicular lacrimal procedures do not allow complete visualization of the contents of the lacrimal sac, and the laser beam can ablate even an undetected dacryolith and may result in unsuccessful DCR, although the surgical course may look completely uneventful.
Implantation of a Coronary Stent Into the Canaliculus of a Human Cadaver: A Pilot Study
Authors: Daigle Patrick , Morand Meggie , Nijhawan Navdeep
Published: December 2021

Purpose:

To evaluate the possibility of implanting a drug-eluting coronary stent into the canaliculus of a human cadaver.

Methods:

The punctum and canaliculus of an embalmed human cadaver were identified and dilated using a punctum dilator and Bowman probes. At this stage, the integrity of the lacrimal drainage system was assessed by dacryoendoscopy. A drug-eluting coronary stent, which was collapsed around a balloon at the tip of a catheter, was inserted into the canaliculus. The balloon was inflated to expand and lock the spring-like stent into position. The balloon catheter was then deflated and removed from the canaliculus. Dacryoendoscopy was used once again to assess the position of each stent after implantation.

Results:

The four canaliculi of one human cadaver were successfully identified, dilated, and intubated using drug-eluting coronary stents. Dacryoendoscopy confirmed that each stent achieved a satisfactory position within the canaliculi. The seamless integration of the stent with the surrounding tissues resulted in a significant dilation of the canaliculi. The procedure was deemed short and simple, with the time required to implant a stent into the canaliculus and asses its position being less than a minute.

Conclusions:

Canalicular obstructions can often be a source of therapeutic challenges. Our pilot study shows that a drug-eluting coronary stent can be implanted with precision into the canaliculus of a human cadaver. We propose that at least some canalicular obstructions could be treated using a novel rigid mesh tube similar to drug-eluting coronary stents.
Current state and future potential of AI in occupational respiratory medicine
Authors: Tran Dylan , Kwo Elizabeth , Nguyen Ethan
Published: December 2021

Purpose of review

The COVID-19 pandemic has accelerated the pace of technological development relating to pulmonary diseases. The advent of newer technologies, such as Artificial Intelligence (AI), continues to be adapted for diagnostic purposes. AI offers comparable precision to trained physicians under certain circumstances, as well as the unique ability to process the information characteristic of Big Data. With respect to individual susceptibilities/pre-existing diseases, AI seems poised to integrate such individualized information and contribute to a greater implementation of precision medicine.

Recent findings

AI can match trained clinicians in specific applications, but AI has limitations that require clearly defined questions and a high quality of data. Data collected for this purpose is predicted to increase both in quality and volume, as technology concerned with personal health (FitBit, Apple Watch) proliferates. However, the role of AI with respect to physicians in a clinical setting is still being debated. AI generally aims to increase objectivity through its correlational methodology.

AI continues to be a proliferative field of study. It has defined strengths and weaknesses which, if accounted for, has the potential to increase healthcare access as well as the quality of care delivered.
Physical Literacy in Elementary Physical Education: A Survey of Fundamental Movement Skill Practice Patterns
Authors: Butler Lauren S. , Gupta Apeksha , DeVerna Amie , Moore James G. , Latz Kevin , Foley Davelaar Cassidy M , Salyakina Daria , Sugimoto Dai
Published: December 2021

Purpose:

To describe fundamental movement skill (FMS) practice patterns in the elementary physical education (PE) curriculum.

Methods:

A cross-sectional survey was sent to PE teachers of grades 1 through 6. Sixty-eight responses were included for analysis.

Results:

Only 38.2% of teachers taught all 12 FMS components. Compared with PE teachers for grades 4 to 6, a significantly higher proportion of PE teachers for grades 1 to 3 taught all 12 FMS and used direct instruction methods. For children falling behind, only 8.8% reported referring to an exercise program and no PE teacher sought a health care referral. A video abstract can be found in Supplemental Digital Content 1 (available at: http://links.lww.com/PPT/A342).
Functional Symmetry Observation Scale, Version 2: Development and Content Validation Using a Modified Delphi Method
Authors: Rahlin Mary , Barnett Joyce , Sarmiento Bernadette
Published: December 2021

Purpose:

To describe the development of the Functional Symmetry Observation Scale (FSOS) Version 2 and its content validation.

Methods:

The FSOS Version 2 is an observational assessment that quantifies symmetry in spontaneous movement and posture in infants with congenital muscular torticollis, age birth to 18 months. Twenty expert pediatric physical therapists were identified through purposive sampling and invited to participate in a modified Delphi study. Survey data were collected on Qualtrics. Consensus was evaluated using median ratings and percent agreement on Likert Scale items. Thematic analysis was performed for open-ended question responses.

Results:

Thirteen experts completed Round 1 and 2 surveys. In Round 1, consensus was achieved on all but 1 item. The scale was modified based on received feedback. In Round 2, consensus was achieved on all items (median rating of 4, agreement at 85%-100%).

Conclusions:

This study established the content validity of the FSOS Version 2.
Sincalide-Stimulated Cholescintigraphy
Authors: Vasireddi Anil , Nguyen Nghi C.
Published: December 2021

Purpose

Current guidelines for sincalide-stimulated cholescintigraphy (SSC) call for a 60-minute sincalide infusion, and a gallbladder ejection fraction (GBEF) ≥38% is considered normal. In this retrospective study, we hypothesize that most patients reach a normal GBEF by 30 minutes.

Methods

Eligible patients had undergone a 60-minute SSC from January to December 2019. The clinical SSC data were previously processed on a Xeleris workstation (GE Healthcare). In subjects with GBEF ≥38% based on standard SSC, the GBEF at 20 minutes and 30 minutes were retrospectively calculated using manual pixel height measurements. Receiving operating characteristic was analyzed to determine the best GBEF cutoff at 30 minutes.

Results

Of 302 subjects, mean age of 46 ± 17 years, 33 (10.9%) showed an abnormal GBEF <38% suggestive of functional gallbladder disorder. In the remaining 269 patients (89.1%) with a normal GBEF, 60.6% and 86.6% reached a normal GBEF at 20 minutes and 30 minutes, respectively. Moreover, a GBEF threshold >29.1% at 30 minutes was associated with a negative predictive value of 99.6%, indicating that a 60-minute SSC was not necessary. The GBEF values were not associated with sex, age, patient symptoms, or type of referral. Manually calculated GBEFs on the time-activity curve showed excellent correlation with the primary values. We propose a modified workflow that splits the 60-minute SSC into two 30-minute image sets to allow for a screening GBEF at 30 minutes. If GBEF is >29.1% at 30 minutes, the second image set may be stopped, and the examination is complete.

Conclusions

The majority of patients (77.2%) undergoing the standard 60-minute SSC reach a normal GBEF already by 30 minutes. The proposed workflow shortens the SCC procedure by 30 minutes, while maintaining high diagnostic accuracy and contributing to improved procedure efficiency and reduced patient discomfort as well as symptoms.
Vibrio ulleungensis sp. nov., isolated from Mytilus coruscus
Authors: Moon Yea-Lin , Park Jin-Sook
Published: December 2021

A Gram-stain-negative, rod-shaped, motile via polar flagellum, facultatively aerobic, light-yellow, bacterium (designated 188UL20-2T) was isolated from a mussel sample of Mytilus coruscus collected on Ulleung Island, Ulleung-gun, Gyeongsangbuk-do, Republic of Korea. On the basis of 16S rRNA gene sequencing results, strain 188UL20-2T clustered with species of the genus

Vibrio

and appeared closely related to

Vibrio marisflavi

DSM 23086T (96.59%),

Vibrio variabilis

DSM 26147T (96.57%),

Vibrio penaeicida

DSM 14398T (96.37%) and

Vibrio litoralis

DSM 17657T (95.97%). The average nucleotide identity and digital DNA–DNA hybridization values between strain 188UL20-2T and its closest related strain were 71.3 and 16.4%, indicating that 188UL20-2T represents a novel species of the genus

Vibrio

. Growth occurred at 18–37 °C on MA medium in the presence of 1–4% NaCl (w/v) and at pH 5.0–10.0. The DNA G+C content of the genomic DNA was 45.4 mol%, and ubiquinone-8 (Q-8) was the major respiratory quinone. The major cellular fatty acids (>5%) were C16:1
ω6c and/or C16:1
ω7c (summed feature 3), C18:1
ω7c and/or C18:1
ω6c (summed feature 8), C16:0, C16:0 iso, C14:0, C14:0 iso and C12:0. The polar lipids consisted of phosphatidylglycerol, phosphatidylethanolamine, two unidentified phospholipids, unidentified aminophospholipid, unidentified glycolipid and seven unidentified lipids. Physiological and biochemical characteristics indicated that strain 188UL20-2T represents a novel species of the genus

Vibrio

, for which the name Vibrio ulleungensis sp. nov. is proposed. The type strain is 188UL20-2T (=KACC 22258T=LMG 32202T).
Medication Related Osteonecrosis of the Jaw: 2021 Position Statement of the Korean Society for Bone and Mineral Research and the Korean Association of Oral and Maxillofacial Surgeons
Authors: Kim Jin-Woo , Kwak Mi Kyung , Han Jeong Joon , Lee Sung-Tak , Kim Ha Young , Kim Se Hwa , Jung Junho , Lee Jeong Keun , Lee Young-Kyun , Kwon Yong-Dae , Kim Deog-Yoon
Published: December 2021

Antiresorptives are the most widely prescribed drugs for the treatment of osteoporosis. They are also used in malignant bone metastases, multiple myeloma, and Paget's disease, and provide therapeutic efficacy on those diseases. However, it was reported that the occurrence of osteonecrosis of the jaw (ONJ) could be related to antiresorptive exposures, and there have been many cases regarding this issue. Therefore, a clearer definition and treatment guidelines were needed for this disease. The American Society for Bone and Mineral Research and the Amnerican Association of Oral and Maxillofacial Surgeons reported statements on bisphosphonate-related ONJ (BRONJ), and a revised version was recently presented. In the revised edition, the diagnosis BRONJ was changed to medication-related ONJ (MRONJ), which reflects consideration of the fact that ONJ also occurs for denosumab, a bone resorption inhibitor of the receptor activator of the nuclear factor-κB ligand antibody family, and bevacizumab, an anti-angiogenesis inhibitor. The Korean Society for Bone and Mineral Research and the Korean Association of Oral and Maxillofacial Surgeons had collectively formed a task force for the preparation of an official statement on MRONJ based on a previous position paper in 2015. The task force reviewed current knowledge and coordinated dental and medical opinions to propose the guideline customized for the local Korean situation.
Changes in natural transformation after salt adaptation
Authors: Kittredge HA , Evans SE
Published: December 2021

The exchange of genes between potentially unrelated bacteria is termed horizontal gene transfer (HGT) and is a driving force in bacterial evolution. Natural transformation is one mechanism of HGT where extracellular DNA (eDNA) from the environment is recombined into a host genome. The widespread conservation of transformation in bacterial lineages implies there is a fitness benefit. However, the nature of these benefits and the evolutionary origins of transformation are still unknown. Here, I examine how ∼330 generations or 100 days of serial passage in either constant or increasing salinities impacts the growth rate and transformation efficiency of Pseudomonas stutzeri. While the growth rate generally improved in response to serial transfer, the transformation efficiency of the evolved lineages varied extensively, with only 39-64% of populations undergoing transformation at the end of adaptive evolution. In comparison, 100% of the ancestral populations were able to undergo natural transformation. I also found that evolving P. stutzeri with different cell lysates (or populations of dead cells) minimally affected the growth rate and transformation efficiency, especially in comparison to the pervasiveness with which transformation capacity was lost across the evolved populations. Taken together, I show that the efficiency of eDNA uptake changes over relatively rapid timescales, suggesting that transformation is an adaptive and selectable trait that could be lost in environments where it is not beneficial.
A tool for the in vivo gating of gene expression in neurons using the co-occurrence of neural activity and light
Authors: Vogel Adam T. , Russek Shelley J.
Published: December 2021

Advancements in genetically based technologies have begun to allow us to better understand the relationships between underlying neural activity and the patterns of measurable behavior that can be reproducibly studied in the laboratory. As this field develops, there are key limitations to the currently available technologies hindering their full potential to deliver meaningful datasets. The limitations which are most critical to advancement of these technologies in behavioral neuroscience are: the temporal resolution at which physiological events can be windowed, the divergent molecular pathways in signal transduction that introduce ambiguity into the output of activity sensors, and the impractical size of the genetic material that requires 3-4 separate AAV vectors to deliver a fully functional system into a cell. To address these limitations and help bring the potential of these types of technologies into better realization, we have engineered a nucleus localized light-sensitive Ca2+-dependent gene expression system based on AsLOV2 and the downstream responsive element antagonist modulator (DREAM). The design and engineering of each component was performed in such a way to: 1) preserve behaviorally relevant temporal dynamics, 2) preserve signal fidelity appropriate for studying experience-driven neural activity patterns and their relationship to specific animal responses, and 3) have full delivery of the genetic material via a single AAV vector. The system was tested in vitro and subsequently in vivo with neural activity induced by Channelrhodopsin and could be used in the future with behaviorally-driven neural activity. To our knowledge this is the first optogenetic tool for the practical use of linking activity-dependent gene activation in response to direct nuclear calcium transduction.
Combinatorial T cell engineering eliminates on-target off-tumor toxicity of CD229 CAR T cells while maintaining anti-tumor activity
Authors: Vander Mause Erica R. , Baker Jillian M. , Dietze Kenneth A. , Radhakrishnan Sabarinath V. , Iraguha Thierry , Davis Patricia , Panse Jens , Marvin James E. , Olson Michael L. , Steinbach Mary , Ng David P. , Lim Carol S. , Atanackovic Djordje , Luetkens Tim
Published: December 2021

T cells expressing chimeric antigen receptors have shown remarkable therapeutic activity against different types of cancer. However, their wider use has been hampered by the potential for life-threatening toxicities due to the unintended targeting of healthy cells expressing low levels of the targeted antigen. We have now developed an affinity-tuning approach for the generation of minimally modified, low-affinity antibody variants derived from existing high-affinity antibodies. Using this approach, we engineered low affinity variants of the fully human CD229-specific antibody 2D3. Parental 2D3 originally efficiently targeted multiple myeloma cells but also healthy T cells expressing low levels of CD229. We demonstrate that CAR T cells based on a low affinity variant of 2D3, engineered to also express CJUN to increase CAR T cell expansion, maintain the parental antibody’s anti-tumor activity but lack its targeting of healthy T cells in vitro and in vivo. In addition, we found that low affinity CD229 CAR T cells show reduced trogocytosis potentially augmenting CAR T cell persistence. The fast off-rate CAR produced using our affinity tuning approach eliminates a key liability of CD229 CAR T cells and paves the way for the effective and safe treatment of patients with multiple myeloma and other lymphoid malignancies.

One sentence summary

Rational T cell engineering yields low affinity CD229 CAR T cells overexpressing CJUN, which maintain the parental cells’ anti-tumor activity but eliminate killing of healthy T cells, increasing CAR T cell expansion, and decreasing trogocytosis.
Toilets for all: corporate social entrepreneurship in Bangladesh and countries in Sub-Saharan Africa
Authors: Trusty Juanita , Fabian Frances , Montague-Mfuni Michelle Amy
Published: December 2021

Case overview

This case uniquely challenges students by introducing the history of how LIXIL transformed its corporate social responsibility (CSR) program to create shared value within the global sanitation sector by launching the SATO business unit as a social enterprise. SATO is a “self-sustaining social business that establishes a local Make, Sell, Use cycle in the community – creating jobs and allowing local manufacturers and stakeholders to continue the business independently” (LIXIL, 2019). From 2012 to 2021, NGOs helped the company design and market the SATO toilet pan and other products that form the SATO business unit. The SATO business unit must balance its social mission of improved sanitation with the need to gain a profit and become a sustainable business – the ongoing challenge of social entrepreneurship.

Leaning objectives

After completing this case study, students will be able to meet the following objectives: understand the difference in corporate strategy between CSR and ventures that create shared value; understand the sometimes-competing goals of social enterprises and analyze how they can balance both economic and social objectives; understand that developing and emerging markets are different from each other; explain how corporations can decide which markets to pursue, and how they can meet the needs of the diverse BOP markets; understand how the pursuit of the Sustainable Development Goals can create economic opportunities for corporations; and (optional: suggested for post-graduates) identify activities and challenges of MNC market entry in developing country contexts. Analyze institutional voids in developing country contexts and explore how partnerships can help to address these voids.

Complexity academic level

This case is most appropriate for the study of international business, corporate social responsibility, and social entrepreneurship students at both the undergraduate and post-graduate levels. The case may be used for undergraduate students to illustrate corporate social entrepreneurship, creating shared value, NGO partnerships, and marketing to the base of the pyramid (BOP) consumers. An optional section on BOP market entry is presented for early- and late-stage post-graduate students, illustrating the concepts of the liability of foreignness and institutional voids.

Supplementary materials

Teaching notes are available for educators only.

Subject code

CCS 3: Entrepreneurship.
Understanding firm survival in a global crisis
Authors: Salunkhe Uday , Rajan Bharath , Kumar V.
Published: December 2021

Purpose

Global crises create an environment that is characterized by a fight for survival by countries, companies and citizens. While firms have adopted business initiatives to ensure survival in a global crisis, many measures are geared toward preventing customer churn, declining revenues and eroding market share. Such short-term focus raises an important question regarding long-term survival – how can firms survive a global crisis? The purpose of this study is to investigate how firms can survive a global crisis.

Design/methodology/approach

This study considers pandemics as the study context and uses a triangulation methodology (past research, managerial insights and popular press articles) to advance the organizing framework. Using the process study approach, the proposed framework recognizes the onset characteristics of a global crisis with a focus on pandemics and the government actions that reflect the pandemic onset. The framework also identifies a logical order of three marketplace reactions to the pandemic – management response, consumer response and critical business transformations that ultimately lead to firm survival – and advances related research propositions of such reactions.

Findings

By deploying critical business transformations, firms can ensure firm survival in a pandemic by fostering engagement with customers, employees and resources. Additionally, the moderators that influence the relationships between (1) management response and critical business transformations, (2) consumer response and critical business transformations, and (3) critical business transformations and firm survival are identified. Finally, this study presents an agenda for future research.

Research limitations/implications

To the authors' best knowledge, this is the first study to adopt an interdisciplinary approach to study firm survival in a global crisis such as a pandemic. This study answers the call for more research to the growing field of pandemic research in the areas of marketing research and marketing strategy.

Practical implications

The learnings from this study can help firms on what to anticipate and how to respond in a crisis such as a pandemic.

Social implications

Societal welfare is accounted for as firms plan to deal with a crisis.

Originality/value

This is the first study to propose a strategic framework to deal with a crisis that is largely unanticipated where the duration and the impact is not predictable.
Family business successors' motivation and innovation capabilities: the case of Kosovo
Authors: Toska Asdren , Ramadani Veland , Dana Léo-Paul , Rexhepi Gadaf , Zeqiri Jusuf
Published: December 2021

Purpose

This study aims to investigate the second-generation successors’ motives to join family businesses and their ability to generate innovation within them.

Design/methodology/approach

A qualitative methodology is used in this study. Data were collected through structured interview with the second-generation representatives, where the data obtained helped us to come to the results and answer the research questions of the study. A total of 15 interviews were conducted.

Findings

The findings of this study show that the second generation is motivated to continue the family business, cases show that successors since childhood have been oriented towards building an entrepreneurial mindset and also after entering the family business have generated innovation.

Originality/value

The study will bring theoretical implications to the family business literature, providing scientific evidence for the second generation of family businesses, from an emerging country such as Kosovo. As Kosovo is an emerging country, the study will contribute to the literature, suggesting other studies by emerging countries in this way to see the similarities and differences.
Moral failure: a jeremiad of the war on drugs in Guatemala
Authors: O'Neill Kevin Lewis
Published: December 2021

The current consensus among social scientists and political pundits is that the war on drugs failed, with a raft of failed programmes, failed interventions, failed policies, and even failed states. But these critics have tended to overlook a more existential form of failure that plays a key role in the ongoing effects of the war on drugs. This failure, which anthropologists of Christianity are well positioned to understand, is the perceived failure of Pentecostal Christians to make right with the Lord. Based on extensive fieldwork in Guatemala, a country profoundly transformed by the illicit movement of cocaine from the Andes to the United States, this article assesses how and to what effect a sense of moral failure among the country's Christian communities sustains a now expansive network of Pentecostal drug rehabilitation centres. Reading one such centre's archive of intake forms as a jeremiad – a Christian lament that bemoans the failures of society to keep its covenant with God – this article concludes that a sense of moral failure sustains the fading edges of today's war on drugs.
Anchorites, Wise Folk and Magical Practitioners in Twelfth‐Century England
Authors: LICENCE TOM
Published: December 2021

This article considers the role of anchorites in twelfth‐century England in relation to the less familiar categories of wise folk and magical practitioners. It examines previously unpublished evidence for the presence of healers, wise women and other magical practitioners in Anglo‐Norman England and asks whether anchorites took on some of their roles. It also discusses whether their clients were primarily interested in the anchorites’ spiritual credentials, or in their ability to fulfil the roles elsewhere taken on by magical practitioners. Though our surviving pen‐portraits of anchorites tend to represent them as saints in an authoritative mould, this article seeks to blur boundaries between anchorites as holy men and women and the kinds of practitioners who did not win the approval of clerical authorities.
Experiencing whole type: living into the archetypal Self
Authors: Spoto Angelo
Published: December 2021

Expanding on Jung’s use of the role of the superior and inferior functions, Angelo Spoto advances a new typological model based on ‘whole type’ that utilizes a typological perspective on the archetypal Self. In this new model four cognitive modes taking superior positions are developed in the first half of life and four cognitive modes taking inferior positions are encountered in the second half of life. This model indicates that type development and type dynamics take place through the holding of the tension of opposites between superior and inferior functions, helped by the transcendent function operating differently in the first and second halves of life. Specifically, in the first half of life, the transcendent function produces a tertium that moves typological development along to consolidate an ego‐pattern. In the second half of life, the transcendent function takes the individual into encounters having to do with an appreciation of sacrifice, transformation, and symbol‐making, as the personality advances towards a greater awareness of wholeness, by way of the inferiors.
Alcohol consumption in India: a systematic review and modelling study for sub‐national estimates of drinking patterns
Authors: Rastogi Ankit , Manthey Jakob , Wiemker Veronika , Probst Charlotte
Published: December 2021

Background and Aims

In India, alcohol per capita consumption (APC) has substantially increased over the past 2 decades. Although consumption does vary across the country, consistent state‐level data are lacking. We aimed to identify all state‐level alcohol exposure estimates since 2000 to (i) model consistent current drinking (CD) (12 months) prevalence estimates for all 36 states/union territories (UT) in 2019 and (ii) compare state‐level CD trends with national‐level APC trends.

Design

A systematic review for studies on the Indian state‐level prevalence of CD, lifetime abstinence (LA), alcohol use disorders (AUD) or the quantity of alcohol consumed among current drinkers (QU) was conducted. Subsequently, statistical modelling was applied.

Setting

Data were collected and modelled for all Indian states/UTs.

Participants

Studies since 2000 referring to the general adult population (≥15 years) of at least one Indian state/UT were eligible. The total sample size covered was ~29 600 000 (males: females, 1:1.6).

Measurements

Results on LA, AUD and QU were summarized descriptively. For (i) the state‐, sex‐ and age‐specific CD prevalence was estimated using random intercept fractional response models. For (ii) random intercept and slope models were performed.

Findings

Of 2870 studies identified, 30 were retained for data extraction. LA, AUD and QU data were available for 31, 36 and 12 states/UTs, respectively. CD model estimates ranged from 6.4% (95% CI = 2.1%–18.1%; males) in Lakshadweep and 1.3% (95% CI = 0.7%–2.6%; females) in Delhi to 76.1% (95% CI = 68.1%–82.6%; males) and 63.7% (95% CI = 49.4%–75.7%; females) in Arunachal Pradesh. Over time, CD decreased in most states/UTs in the observed data, contradicting increasing national‐level APC trends.

Conclusions

Alcohol use (measured as consistent current drinking) in India has large regional variations, with alcohol consumption being most prevalent in the North‐East, Chhattisgarh, Telangana, Himachal Pradesh, Punjab and Jharkhand.
Education and training on addiction psychiatry in low and middle income countries: Observations from existing literature and recommendations going ahead
Authors: Balhara Yatan Pal Singh , Sharma Pawan , Chawla Nishtha
Published: December 2021

Background

Addictive disorders are a significant contributor to the global burden of disease. The burden of addictive disorders in LMIC is expected to grow further over the coming years.

Aims

In this article we present the observations from the existing literature on the current status of education and training on addiction psychiatry in LMIC and provide recommendation on way forward for this specialized field of psychiatry.

Materials and Methods

We searched electronic databases of PubMed to access the literature on the current status of education and training on addiction psychiatry. Additional searches were also conducted in other database of Google Scholar for potential ‘grey’ literature.

Results

We were able to identify a total of 11 relevant articles.

Discussion

Currently there is limited published literature on education and training on addiction psychiatry from the LMICs.

Conclusions

Strengthening of the training on addictive disorders shall not only help bridge the gap of the unmet need for the evidence‐based interventions of addictive disorders across these countries it shall also help enhance the research capacity on addictive disorders in these countries.
Clinical study of drug–drug interaction between omeprazole and pyrotinib after meal
Authors: Li Xiaoyu , Wang Ying , Zhu Xiaohong , Zheng Li
Published: December 2021

Aims

We aimed to investigate the effect of omeprazole on the pharmacokinetics (PK) of pyrotinib and determine the safety of this combination in healthy Chinese volunteers.

Methods

Eighteen healthy volunteers were enrolled in this single‐dose and self‐controlled study. Pyrotinib (400 mg per oral) was administered 30 minutes after the standard meal. Omeprazole was administered from day 6 (D6) to D10 (40 mg, per oral). On D10, the subjects took omeprazole under fasting conditions, followed by pyrotinib 30 minutes after the standard meal. Blood samples for PK analyses in each phase were collected for analysing the drug concentration. Safety was assessed via clinical laboratory tests and physical examinations.

Results

Compared with a single dose of pyrotinib, pyrotinib coadministered with omeprazole showed no significant difference in exposure, elimination, half‐life and apparent clearance rate. The mixed‐effects model revealed that the least‐squares geometric mean ratios of area under the concentration–time curve (AUC)0‐t, AUC0‐∞ and maximum plasma concentration (Cmax,90% confidence intervals) of pyrotinib alone and pyrotinib coadministered with omeprazole were 0.94 (0.82, 1.08), 0.94 (0.83, 1.08) and 0.91 (0.806, 1.038), respectively, indicating the absence of significant differences in AUC0‐t, AUC0‐∞ and Cmax. During the treatment period, 6 subjects (33.3%) reported 8 adverse events during pyrotinib monotherapy and omeprazole administration, respectively; 10 subjects (55.6%) reported 34 adverse events in the combined administration phase.

Conclusion

Omeprazole, a proton‐pump inhibitor, did not significantly impact the PK properties of pyrotinib, and a good safety profile was observed on coadministration.
Review: The impact of climate change awareness on children's mental well‐being and negative emotions – a scoping review
Authors: Martin Gina , Reilly Kristen , Everitt Haley , Gilliland Jason A.
Published: December 2021

Background

Climate change is a threat to children’s physical health, but there are also implications for mental well‐being. Additionally, children may experience negative emotional responses stemming from an overarching awareness of the imminent threats to the planet due to climate change.

Method

Using a scoping review, we examined the impact of climate change awareness on children’s mental well‐being and negative emotions. Our aim was to identify and describe the existing literature and highlight priorities for future research. Three specific objectives guided the review: (1) to identify and provide an overview of research regarding the impact of climate change awareness on children’s mental well‐being and negative emotions; (2) to summarize and clarify the terminology related to climate change awareness and children’s mental well‐being and negative emotions; and (3) to make recommendations for areas of future research.

Results

Thirty‐three articles were included in a narrative synthesis. Many articles were reviews or editorials/commentaries. Of the empirical research, most were from Europe, North America, and Australia. The articles emphasized a large range of negative emotions that children felt about climate change, with anxiety and worry being the most researched and discussed.

Conclusions

The research on the impact of awareness of climate change on children’s mental well‐being and negative emotions is in its early phases. Efforts are needed to advance conceptual clarity and operationalize concepts. Additionally, there is a need for research into the impact of climate change awareness on children’s mental well‐being and negative emotions among a greater diversity of people and places. Existing studies provide an encouraging basis from which to develop future research.
Synthesis and structure–activity relationship of L‐methionine‐coupled 1,3,4‐thiadiazole derivatives with activity against influenza virus
Authors: Tatar Esra , Yaldız Seda , Kulabaş Necla , Vanderlinden Evelien , Naesens Lieve , Küçükgüzel İlkay
Published: December 2021

In previous investigations, we identified a class of 1,3,4‐thiadiazole derivatives with antiviral activity. N‐{3‐(Methylsulfanyl)‐1‐[5‐(phenylamino)‐1,3,4‐thiadiazole‐2‐yl]propyl}benzamide emerged as a relevant lead compound for designing novel influenza A virus inhibitors. In the present study, we elaborated on this initial lead by performing chemical synthesis and antiviral evaluation of a series of structural analogues. During this research, thirteen novel 1,3,4‐thiadiazole derivatives were synthesized by the cyclization of the corresponding thiosemicarbazides as synthetic precursors. The structures and the purities of the synthesized compounds were confirmed through chromatographic and spectral data. Four L‐methionine‐based 1,3,4‐thiadiazole derivatives displayed activity against influenza A virus, the two best compounds being 24 carrying a 5‐(4‐chlorophenylamino)‐1,3,4‐thiadiazole moiety and 30 possessing a 5‐(benzoylamino)‐1,3,4‐thiadiazole structure [antiviral EC50 against influenza A/H3N2 virus: 4.8 and 7.4 µM, respectively]. The 1,3,4‐thiadiazole derivatives were inactive against influenza B virus and a wide panel of unrelated DNA and RNA viruses. Compound 24 represents a new class of selective influenza A virus inhibitors acting during the virus entry process, as evidenced by our findings in a time‐of‐addition assay. Molecular descriptors and in silico prediction of ADMET properties of the active compounds were calculated. According to in silico ADMET and drug similarity studies, active compounds have been estimated to be good candidates for oral administration with no apparent toxicity considerations.
Assessment of diastolic function in aortic stenosis: A comparison between 2009 and 2016 guidelines
Authors: Carter‐Storch Rasmus , Mortensen Nils Sofus Borg , Ali Mulham , Laursen Kristian , Pellikka Patricia A. , Møller Jacob E. , Dahl Jordi S.
Published: December 2021

Aims

New diastolic dysfunction (DD) guidelines were introduced in 2016 to replace the 2009 guidelines, but have not yet been evaluated in aortic stenosis (AS). We aimed to compare the 2009 and 2016 DD guidelines in severe AS patients in terms of association with left ventricular (LV) and left atrial (LA) remodeling, with pulmonary capillary wedge pressure (PCWP) at rest and exercise, and with prognosis.

Methods and results

We included 212 patients with severe AS (112 undergoing AVR, 100 asymptomatic). Echocardiography, magnetic resonance imaging, and brain natriuretic peptides (BNP) were performed/measured. Thirty‐nine asymptomatic patients had PCWP measured during rest and maximal exertion. Asymptomatic patients were followed for 3.1 years for the combined endpoint of death, AVR or admission with heart failure. The 2009 and 2016 DD guidelines agreed poorly with each other (Cohens’ κ = .15). 2009 guidelines showed many ambiguous DD findings. With the 2016 guidelines, 20% of patients had indeterminate DD. DD grade 2 according to 2016 guidelines showed stronger association with symptom status, BNP, global longitudinal strain (GLS) and peak exercise PCWP than 2009 guidelines. For indeterminate DD patients according to 2009 guidelines, GLS above the median was associated with event‐free survival (HR .11 (95% CI .02–.53)). For neither guideline was DD associated with the combined endpoint in asymptomatic patients.

Conclusion

The 2016 guidelines show a stronger association with BNP, GLS, and exercise PCWP than the 2009 guidelines. The 2016 guidelines result in 20% of patients with indeterminate DD; however, these patients may possibly be stratified according to GLS.