bluuebunny/crossref_metadata_2025 huggingface dataset:
Full genomeNobecovirussequences from Malagasy fruit bats define a unique evolutionary history for this coronavirus clade
Authors: Kettenburg Gwenddolen , Kistler Amy , Ranaivoson Hafaliana Christian , Ahyong Vida , Andrianiaina Angelo , Andry Santino , DeRisi Joseph L. , Gentles Anecia , Raharinosy Vololoniaina , Randriambolamanantsoa Tsiry Hasina , Fifi Ravelomanantsoa Ny Anjara , Tato Cristina M. , Dussart Philippe , Heraud Jean-Michel , Brook Cara E.
Published: September 2021

Bats are natural reservoirs for bothAlpha- andBetacoronavirusesand the hypothesized original hosts of five of seven known zoonotic coronaviruses. To date, the vast majority of bat coronavirus research has been concentrated in Asia, though coronaviruses are globally distributed; indeed, SARS-CoV and SARS-CoV-2-relatedBetacoronavirusesin the subgenusSarbecovirushave been identified circulating inRhinolophidbats in both Africa and Europe, despite the relative dearth of surveillance in these regions. As part of a long-term study examining the dynamics of potentially zoonotic viruses in three species of endemic Madagascar fruit bat (Pteropus rufus, Eidolon dupreanum, Rousettus madagascariensis), we carried out metagenomic Next Generation Sequencing (mNGS) on urine, throat, and fecal samples obtained from wild-caught individuals. We report detection of RNA derived fromBetacoronavirussubgenusNobecovirusin fecal samples from all three species and describe full genome sequences of novelNobecovirusesinP. rufusandR. madagascariensis. Phylogenetic analysis indicates the existence of five distinctNobecovirusclades, one of which is defined by the highly divergent sequence reported here fromP. rufusbats. MadagascarNobecovirusesderived fromP. rufusandR. madagascariensisdemonstrate, respectively, Asian and African phylogeographic origins, mirroring those of their fruit bat hosts. Bootscan recombination analysis indicates significant selection has taken place in the spike, nucleocapsid, and NS7 accessory protein regions of the genome for viruses derived from both bat hosts. Madagascar offers a unique phylogeographic nexus of bats and viruses with both Asian and African phylogeographic origins, providing opportunities for unprecedented mixing of viral groups and, potentially, recombination. As fruit bats are handled and consumed widely across Madagascar for subsistence, understanding the landscape of potentially zoonotic coronavirus circulation is essential for mitigation of future zoonotic threats.
The impact of cognitive style on the level of satisfaction and image search behavior in the textual and content search system of Google Images
Authors: Alvandi Poor Zahra , Mirzabeigi Mahdieh , Nabavi Majid
Published: September 2021

Purpose

The purpose of this study aims to identify the impact of verbal-visual cognitive styles on the level of satisfaction and behavior in the textual and content search of Google Images.

Design/methodology/approach

“Riding” cognitive style test and satisfaction questionnaire were used as data collection tools. Also, to collect data related to the image search behavior, the subjects’ transaction files were recorded using Camtasia software and then the files observed and reviewed. The research sample was 90 postgraduate students of Shiraz University.

Findings

The results showed that cognitive styles in interaction with the text-based and content-based search system of “Google Images” affected user’s satisfaction. Text-based image retrieval, in which vocabulary-based information needs were expressed, was more compatible with the verbal cognitive style and resulted in greater satisfaction. In contrast, in content-based image retrieval, where it was possible to express information needs in the form of images, users were more satisfied with the visual cognitive style. Verbal users performed more positively in text-based search and visual users in content-based search.

Originality/value

Considering the research gap, which has identified the performance of visual text-based and content-based systems in terms of satisfaction and cognitive style search behavior, the present study could be considered a small effort to promote science.
Leading as sensing: connecting within to navigate through chaos
Authors: Yeo Roland K.
Published: September 2021

Purpose

The aim of the paper is to explore leadership behavior as a process of sensing through the connection of various aspects of the self to external dynamics.

Design/methodology/approach

The paper is based on an in-depth study of an international technology firm where 36 managers were interviewed. Content analysis was used to interpret the data.

Findings

If leaders learn to be more authentic in the way they think, feel, and act, they will be more connected to who they are and what they stand for in the face of uncertainty.

Practical implications

Leaders should embrace adversity as an opportunity to connect more deeply to their inner senses by breaking away from their comfort zones and acting courageously through their decisions.

Originality/value

The paper offers a different understanding of adaptive leadership from the sensing perspective. The firsthand experience of managers challenged by the Covid-19 pandemic offers fresh insights into the study of leadership behavior.
Stakeholder identification methods used in private organisations’ projects in Nigeria
Authors: Olatunde Nathaniel Ayinde , Awodele Imoleayo Abraham , Odeyinka Henry Agboola
Published: September 2021

Purpose

The purpose of the study is to examine the stakeholder identification (SI) methods used in building projects procured by private corporate organisations in Southwestern Nigeria to draw a correlation between methods used for SI and project performance in the study area, thereby enhancing project performance.

Design/methodology/approach

The study used a census survey to purposively select 30 projects managers (who indicated from a first-stage questionnaire) that they have participated in structured stakeholder management (SM) from a list of 106 project managers and client representatives who have been involved in SM of building projects procured by private corporate organisations between 2008 and 2017 in the study area. A second-stage questionnaire was designed to elicit information from the respondents. The quantitative data that were collected were analysed using mean score (MS) analysis and Analysis of variance (ANOVA).

Findings

The study found that brainstorming in group meetings (MS = 4.33), interviews with the expert (MS = 3.20) and identification by other stakeholders (MS = 3.00) are the most frequently used SI methods in the study area. It was also found that the use of a questionnaire (MS = 0.87), Delphi method (MS = 0.80) and public hearing (MS = 0.57) was rare for SI in the study area. A further result showed that there was no significant difference in the opinion of project managers on 85% of methods used for SI in the study area irrespective of the procurement method employed.

Practical implications

The study examined the methods project managers used for SI on building projects procured by private corporate organisations to advocate for more robust and all-inclusive SI methods.

Originality/value

The study empirically examined methods used for SI and correlated them to project performance.
The interrelationships among the formal, semiformal and informal credit demands of farm households in Vietnam
Authors: Tuan Anh Nguyen , Gan Christopher , Anh Dao Le Trang
Published: September 2021

Purpose

This study simultaneously explores the nexus among formal, semiformal and informal credit markets and farm households' credit demand determinants in Vietnam.

Design/methodology/approach

This study uses a multistage stratified random sampling process for a survey of 648 smallholder farmers in the Red River Delta (RRD), Vietnam. The trivariate probit model (TVPM) is used to address the interdependence of farm households' credit demands in different credit markets.

Findings

The results reveal complementary relationships among two pairs of credit markets (formal versus informal and semiformal versus informal). There are dissimilarities among the determinants (household characteristics, household head's characteristics, credit history and geographic factors) of farm households' credit demands in different markets, reflecting segmentation of Vietnam credit markets.

Practical implications

The study's empirical findings are important for policymakers and credit providers to enhance farm households' access to credit for agriculture and to improve the operations of the three credit markets.

Originality/value

This is the first empirical study in Vietnam and one of few in other developing countries simultaneously exploring the determinants of credit demand in and interrelationships among all three credit markets to provide more comprehensive and accurate results.
Patents and small business risk: longitudinal evidence from the global financial crisis
Authors: Barontini Roberto , Taglialatela Jonathan
Published: September 2021

Purpose

The purpose of this study is to shed light on the relationship between patent applications and long-term risk for small firms across the global financial crisis of 2008. During a crisis, firm risk often skyrockets, and small and medium enterprises face significant dangers to their business continuity. However, managers have a set of strategies that could be implemented to increase a firm’s resilience, sustaining competitive advantages and improving access to financial resource. The authors focused on the investigating the impact of patenting activities on small business risk in a time of crisis.

Design/methodology/approach

This is a quantitative study based on a sample of Italian firms that applied for a patent in 2005. The changes in corporate credit ratings over a five-year period are related to different proxies of patent activity using multivariate regression analysis.

Findings

Firms that filed for a patent were more resilient, compared to the control sample, during the financial crisis. Innovative activities resulting in patent application seem to deliver strategic resources useful to tackle the crisis rather than increase riskiness. The moderating effect of patents on risk sensitivity is stronger for small firms and when the number of patents or the patent intensity is larger.

Originality/value

Limited evidence is available on how patent applications are related to risks for small firms during an economic crisis. The authors highlight that the innovative efforts resulting in patent applications can support small business resilience. The authors also point out that the implementation of patent information in small firms' credit score modeling is still an uncommon practice, while it is useful in estimating firm risk in a way more robust to exogenous credit shocks.
Optimizing the multiple trip vehicle routing plan for a licensee green tea dealer in Sri Lanka
Authors: Samarakkody Thakshila , Alagalla Heshan
Published: September 2021

Purpose

This research is designed to optimize the business process of a green tea dealer, who is a key supply chain partner of the Sri Lankan tea industry. The most appropriate trips for each vehicle in multiple trip routing systems are identified to minimize the total cost by considering the traveling distance.

Design/methodology/approach

The study has followed the concepts in vehicle routing problems and mixed-integer programming mathematical techniques. The model was coded with the Python programming language and was solved with the CPLEX Optimization solver version 12.10. In total, 20 data instances were used from the subjected green tea dealer for the validation of the model.

Findings

The result of the numerical experiment showed the ability to access supply over the full capacity of the available fleet. The model achieved optimal traveling distance for all the instances, with the capability of saving 17% of daily transpiration cost as an average.

Research limitations/implications

This study contributes to the three index mixed-integer programing model formulation through in-depth analysis and combination of several extensions of vehicle routing problem.

Practical implications

This study contributes to the three index mixed-integer programming model formulation through in-depth analysis and combination of several extensions of the vehicle routing problem.

Social implications

The proposed model provides a cost-effective optimal routing plan to the green tea dealer, which satisfies all the practical situations by following the multiple trip vehicle routing problems. Licensee green tea dealer is able to have an optimal fleet size, which is always less than the original fleet size. Elimination of a vehicle from the fleet has the capability of reducing the workforce. Hence, this provides managerial implication for the optimal fleet sizing and route designing.

Originality/value

Developing an optimization model for a tea dealer in Sri Lankan context is important, as this a complex real world case which has a significant importance in export economy of the country and which has not been analyzed or optimized through any previous research effort.
The History of the Data Economy: Part III: The New Kings and Queens of Data
Authors: Harkness Timandra
Published: September 2021

Data is now the fuel that drives business – identifying potential markets, shaping new products and targeting consumers. To understand where we may be heading next, Significance has partnered with Impact, the magazine of the Market Research Society, to jointly publish a series exploring the past, present and future of the data economy. This third part tells the story of the evolution of social media, which created rich and detailed data sources and positioned tech giants as data economies in their own right. By Timandra Harkness
What's Both Massive and Slender, and thin But Convincing?
Authors: Gandy Rob
Published: September 2021

Answer: poll results with a 52%–48% split. Rob Gandy examines the contradictory adjectives used by the media to describe the same numbers in different contexts
Surgical treatment for synchronous multiple primary lung cancer: Is it possible to achieve both curability and preservation of the pulmonary function?
Authors: Watanabe Takuya , Tanahashi Masayuki , Suzuki Eriko , Yoshii Naoko , Tsuchida Hiroyuki , Yobita Shogo , Iguchi Kensuke , Uchiyama Suiha , Nakamura Minori
Published: September 2021

Background

With the advent of high‐resolution chest imaging, the number of patients diagnosed with multiple primary lung cancers is increasing. For the treatment of multiple lung cancers, a surgical procedure that preserves pulmonary function while ensuring curability is required.

Methods

The study population included 85 patients with synchronous multiple primary lung cancer who received surgical resection between January 2010 and September 2020. Patients with synchronous lung cancer within the same lobe were excluded, and only patients with ≥2 involved lobes were included. The postoperative pulmonary function was examined at 3–6 months after the surgery.

Results

Sixty‐seven patients had cancers within the ipsilateral lobe, and 18 patients had cancers in bilateral lobes. Seventy‐six patients (89.4%) underwent combination surgery with limited resection (e.g., segmentectomy and wedge resection). The preoperative pulmonary functions (mean VC/%VC, mean FEV1/%FEV1, and mean %DLCO) were 3.06 L/100.2%, 2.23 L/96.1%, and 117.2%, respectively, and the postoperative pulmonary functions were 2.45 L/81.4%, 1.87 L/81.2%, and 102.6%. In each parameter, the predicted reductions of pulmonary function were almost the same as the predicted values. The 5‐year survival rate was 85.0%. The 5‐year survival rate according to the most advanced pathological stage was 94.9% for stage I disease, and 62.6% for stage ≥II, which was a significant difference (p < 0.001).

Conclusions

Surgical treatment including limited resection, especially segmentectomy and wedge resection, for synchronous multiple primary lung cancer can preserve pulmonary function while ensuring curability.
Is information really efficient for the market? Evidence of confirmatory bias in China
Authors: Chen Qingchong , Xiong Xiong , Gao Ya
Published: September 2021

We use the earnings forecast revisions during the period 2005–2019 to study the performance of confirmatory bias in China. As we have found, analysts are less likely to make earnings forecast revisions when the latest two signals are opposite or different from their previous beliefs. In addition, we find confirmatory bias has a significantly positive influence on analysts' forecast dispersions, especially when new signals are negative. Finally, we extend the practical significance by combining confirmatory bias with pricing efficiency and find significant harms, especially in bull markets. Uninformed investors and market supervisors should take precautions to avoid this bias.
Effect of reductions in opioid prescribing on opioid use disorder and fatal overdose in the United States: a dynamic Markov model
Authors: Alexander G. Caleb , Ballreich Jeromie , Mansour Omar , Dowdy David W.
Published: September 2021

Background and aims

Despite prescribing declines between 2011 and 2019, opioid morbidity and mortality in the United States continued to rise during this period. We estimated the relationship between opioid prescribing, opioid use disorder (OUD) and fatal opioid overdose in the United States.

Design

Dynamic Markov model.

Setting

United States, using data from the National Survey on Drug Use and Health, Centers for Disease Control and Prevention, National Health and Nutrition Examination Survey and National Epidemiologic Survey on Alcohol and Related Conditions III.

Participants

Simulated US individuals 12+ years of age from the general population or with prescription opioid medical use, prescription opioid non‐medical use, illicit opioid (e.g. heroin, illicit fentanyl) use, prescription OUD, illicit OUD with a history of prior prescription opioid non‐medical use or non‐fatal or fatal opioid overdose.

Measurements

Active OUD cases and fatal prescription opioid overdoses.

Findings

Between 2010 and 2019, opioid prescribing declined 42.5%. Although fatal opioid overdoses increased by 103.2%, these reductions in opioid prescribing averted an estimated 9600 [95% uncertainty interval (UI) = 7205, 15 478] deaths starting in 2011 relative to continued prescribing at 2010 levels—and are projected to avert another 50 918 (95% UI = 38 829, 79 795) overdose deaths between 2020 and 2029. The median time from initial opioid prescription to fatal opioid overdose was 5.2 years. Of the 2.4 million (95% UI = 2.2 million, 2.7 million) individuals in the United States with estimated active OUD in 2019, 65% (95% UI = 59%, 71%) were attributable to initial opioid use occurring prior to 2011, whereas 14% (95% UI = 12%, 17%) were attributable to initial opioid use occurring between 2017 and 2019. The impact, by 2029, of additional reductions in prescribing initiated in 2020 would be more than three times greater than that of similar reductions initiated in 2025.

Conclusions

Observed reductions in opioid prescribing volume in the United States from 2010 to 2019 appear to have saved approximately 9600 lives by 2019 and are anticipated to avert more than 50 000 fatal overdoses by 2029.
Exploring the implementation of public involvement in local alcohol availability policy: the case of alcohol licensing decision‐making in England
Authors: David Genevieve , Cooper Richard , Dixon Simon , Holmes John
Published: September 2021

Background and Aims

In 2003, the UK government passed the Licensing Act for England and Wales. The Act provides a framework for regulating alcohol sale, including four licensing objectives with local governments having devolved responsibility for granting licences to sell alcohol. Members of the public can make representations of oppositions to licence applications. Applying the theories of the policy process, we explored the practices employed by licensing authorities when deciding on alcohol licences in situations of conflict between licence applicants and members of the public.

Design

Qualitative study comprising a framework analysis of in‐depth semi‐structured interviews and application of the theories of institutionalism, the advocacy coalition framework and role of ideas.

Setting

Eleven local authorities in five regions in England in 2019.

Participants

Purposive sample of 15 licensing officers, licensing subcommittee chairs, public health leads for licensing and police licensing officers.

Measurements

The interview schedule included mechanisms of public involvement in licensing, parties involved, the subject of conflicts and how licensing authorities made decisions.

Findings

When members of the public opposed licence applications, licensing authorities employed three key decision‐making practices: procedural fairness, partnership working and framing. The normativity of procedural fairness was an important institutional structure within which conflicts were resolved. Licensing authorities also worked in partnership with the involved parties, who often appeared as advocacy coalitions that shared beliefs and advanced specific issues to determine mutually acceptable solutions. At times, licensing authorities framed issues through ideational processes to solve problems.

Conclusion

Licensing decision‐making under the United Kingdom's Licensing Act for England and Wales appear in many cases to focus on resolution of conflicts between licence applicants and members of the public rather than on promotion of licensing objectives. This raises uncertainty regarding the impact of public involvement on reducing alcohol availability, but ultimately represents a pragmatic process that seeks to restore balance in powers, improve transparency in decision‐making and empower communities.
Comparison of the diagnostic predictability of serum amyloid A, white blood cell count and immunoglobulin G tests as indicators of early‐onset, acute‐phase morbidities in newborn foals
Authors: Nieman N. M. , Chan D. S.
Published: September 2021

Background

Acute‐phase proteins (APPs) have diagnostic value as nonspecific, early indicators of inflammation and infectious disease.

Objectives

To assess the ability of serum amyloid A (SAA) testing to distinguish between healthy and nonhealthy newborn foals, and to compare the diagnostic predictability of SAA with white blood cell (WBC) counts and serum immunoglobulin G (IgG) concentration.

Study design

Three‐year prospective clinical evaluation and diagnostic sample collection from newborn foals.

Methods

Following an examination, a blood sample was obtained from each foal and tested for SAA and IgG concentrations, complete blood count (CBC) and standard biochemistry values. Foals were categorised as healthy or nonhealthy based on the clinical examination. The presence of clinical signs of infectious origin or certain noninfectious morbidities with a pro‐inflammatory component was sufficient for a nonhealthy designation. Serum amyloid A, IgG and WBC test results were determined and compared for healthy and nonhealthy foals.

Results

A total of 24 (13.7%) foals were diagnosed as clinically sick and 151 (86.3%) as normal based on physical examinations performed within 24 h after parturition. Mean SAA values were 27.7 ± 129.0 mg/L and 247.2 ± 454.8 mg/L for healthy and nonhealthy foals, respectively, a significant (p < 0.05) difference indicating that elevated SAA values are associated with a nonhealthy diagnosis. Using a positive threshold of 100 mg/L, the SAA test had a positive predictive value (PPV) of 55.6% and IgG had the lowest PPV (16.7%) followed by WBC count (23.3%).

Main limitations

A larger number of clinically nonhealthy foals with SAA levels >100 would have given the study greater statistical power.

Conclusions

Equine practitioners can consider SAA testing to be a reliable newborn examination diagnostic tool for detecting early‐onset, acute‐phase infection or noninfectious morbidities with an inflammatory component.
Structural characterisation, biological activities and pharmacological potential of glycosaminoglycans and oligosaccharides: a review
Authors: Sharma Rajan , Kataria Ankita , Sharma Savita , Singh Baljit
Published: September 2021

Carbohydrates are the potential food components holding prime significance in biological functionality and technological performance of food products. They are predominant sources of energy requirement for human body and more recently, they have been explored for their nutraceutical properties and pharmacological effects. The objective of the present article was to critically examine and document up‐to‐date literature for biological activities and health benefits of two functional carbohydrates groups, that is, glycosaminoglycans and oligosaccharides. Glycosaminoglycans are polymeric forms of sulphated/non‐sulphated glycans while oligosaccharides studied in the present article were galacto‐oligosaccharides, fructo‐oligosaccharides and xylo‐oligosaccharides. These two carbohydrate classes have been classified on a structural basis which dictates their unique biological properties. Attributing to their compositional and structural features, they have been found to exhibit several pharmacological properties including prebiotic potential, wound healing, antioxidant potential, immunomodulatory effects and prevention against several other degenerative diseases. Significant emphasis has been given to the structural characterisation and bio‐functionality of these polysaccharides in addition to their sources and extraction mechanisms.
The ‘sleeping elephant’: The role of mentorship of critical care nurses in Zambia
Authors: Carter Chris , Mukonka Priscar Sakala , Sitwala Lilian Jere , Mulawisha Godwin , Notter Joy
Published: September 2021

Aim

To develop and evaluate a Zambian context‐specific mentorship model that supports registered nurses completing emergency, trauma and critical care programmes in Zambia.

Background

In Zambia, emergency and trauma and critical care nursing are relatively new specialties, with education and training programmes less than a decade old. A train the trainer mentorship programme was developed and delivered at two colleges of nursing. Ethics approval was gained in both Zambia and the UK.

Sources of evidence

Documentary data analysis and focus groups were used. Focus groups included stakeholders and nurses in practice who had completed the train the trainer programme and were using the mentorship model.

Discussion

The critical review of the literature revealed there was a paucity of evidence on the role of mentors in critical care. However, national documentation identified that most post basic education programmes are at Diploma Level with limited content that focuses on bedside teaching, mentorship and assessment content.

Conclusion

Feedback from representatives attending the stakeholder workshops and focus groups which included participants who had completed the training programme enabled the mentorship model and workshop to be developed and evaluated.

Implications for nursing practice

Nurses are the backbone of healthcare systems in Africa and the world. Mentorship and assessment in practice enables nurses to develop the competence and skills to lead practice, support peers and junior colleagues.

Implications for nursing policy

This paper has identified the need for a context‐specific formalised mentorship model to support specialist practice and this project has provided the foundations for mentorship of emergency, trauma and critical care nurses in Zambia.
Evaluation of several immune and inflammatory indicators and their association with alopecia areata
Authors: Gao Yamei , Huo Shaohu , Sun Minghui , Zhang Chenchen , Wang Jing , Gao Jing , Wang Na , Lv Yongmei
Published: September 2021

Background

Alopecia areata (AA) is an autoimmune disorder and chronic recurrent inflammatory disease that results in non‐scarring hair loss.

Objectives

Our aim is to investigate several parameters related to autoimmunity and inflammation in AA patients and to evaluate their association with this disease.

Methods

This study included a total of 672 eligible AA patients and 580 age‐ and sex‐matched healthy individuals who were treated at a third‐class hospital in Hefei from January 2016 to May 2020. Data for serum C‐reactive protein (CRP), 25‐hydroxy vitamin D (25(OH)D), T3, T4, thyroid‑stimulating hormone (TSH), thyroid antibodies (TPOAbs and TGAbs), antinuclear antibodies (ANA), complements (C3, C4), and several immunoglobulins (IgA, IgM, and IgG) were collected in this study.

Results

Regarding autoimmune‐related functional indicators, there were no statistically significant differences between TSH, TGAbs, C3, C4, IgA, IgM, and IgG levels between AA patients and healthy controls. Only T3, T4, TPOAbs, and ANA values were significantly abnormal in the AA group compared with the healthy individuals (p < 0.05). In addition, the mean serum 25(OH)D concentration was significantly lower in the patient group than that in control group (p < 0.05), and serum CRP was significantly increased (p < 0.05).

Conclusion

Although the etiopathogenesis of AA is not clear, the importance of monitoring the levels of T3, T4, TPOAbs, ANA, and 25 (OH)D in AA cases is indispensable.
Trust in financial institutions: A survey
Authors: van der Cruijsen Carin , de Haan Jakob , Roerink Ria
Published: September 2021

Trust in financial institutions is widely considered important. However, a clear overview of studies on the drivers of trust is missing. We intend to fill this gap in the literature. After discussing why trust in financial institutions is important, we turn to its measurement, where we distinguish between trust in one's own institution and trust in institutions in general (narrow‐scope and broad‐scope trust), and discuss how these measures differ from generalized trust (i.e. trust in other people with whom there is no direct relationship). Finally, we survey the determinants of trust in financial institutions and discuss a wide range of drivers. First, trust in financial institutions depends on the economic situation: it behaves procyclically and is negatively affected by financial crises. Second, the behavior of financial institutions matters: prudent conduct, the provision of good services and financial health have a positive effect on trust. Third, although consumer characteristics also relate to trust, many of these relationships are context‐dependent. Fourth, there is a positive association between narrow‐scope trust on the one hand and broad‐scope trust and generalized trust on the other. Last, policy measures and supervisory actions can help prevent loss of trust.
Acute fatty liver of pregnancy at 19 weeks and 0 days of gestation after prolonged hyperemesis gravidarum
Authors: Komura Airi , Komatsu Yushiro , Yamamoto Takao , Tsuchimochi Saki , Kurishita Gaku , Yoshida Mitsuyo , Ishino Tomomi , Sodemoto Takeo , Kagawa Hideyuki
Published: September 2021

Acute fatty liver of pregnancy (AFLP) is a rare disorder that typically develops in the third trimester. We successfully diagnosed and treated a case of AFLP that developed at 18 weeks' gestation. A 34‐year‐old woman—gravida 4, para 3—presented with continuous vomiting and abdominal pain and developed convulsive seizures and lost consciousness after transfusion therapy. Cerebral apoplexy was excluded by computed tomography of the brain. Blood tests revealed severe metabolic acidosis, coagulopathy, and leukocytosis, followed by severe hypoglycemia and elevated levels of transaminases and ammonia. The fetus was delivered dead. Whole‐body computed tomography showed fatty liver. The patient was diagnosed with AFLP based on the Swansea criteria. AFLP may be a differential diagnosis in the second trimester, and rapid termination should be considered as radical treatment. Starvation may be a risk factor for this disorder.
Middle Managers' Struggle Over Their Subject Position in Open Strategy Processes
Authors: Splitter Violetta , Jarzabkowski Paula , Seidl David
Published: September 2021

In this paper we examine middle managers’ struggle over their subject position as strategists in the context of participative strategy processes. Based on a longitudinal case study of a company undertaking an Open Strategy process, we show how the wider inclusion of front‐line employees in developing new strategy undermines the traditional subject position of middle managers. Based on these findings, we develop a process model depicting the recursive dynamics of middle managers’ struggles to maintain their subject positions in the face of employee participation. With these findings we contribute to the literature on middle managers by advancing our understanding of the implications of employee participation for middle managers’ subject position as strategists and their different ways of reclaiming their subject position. We also contribute to the literature on Open Strategy by revealing the implications for traditional strategy actors as well as by explaining the processual dynamics of participation over time.
Association of job strain with accelerometer‐based sleep duration and timing of sleep among older employees
Authors: Myllyntausta Saana , Kronholm Erkki , Pulakka Anna , Pentti Jaana , Vahtera Jussi , Virtanen Marianna , Stenholm Sari
Published: September 2021

Job strain has been associated with poor sleep quality and could lead to changes in duration and timing of sleep as well. This study examined the association of job strain with sleep duration, bedtimes and awakening times among public sector employees close to their retirement age. Differences in these sleep parameters between workdays and free days across job strain groups were examined. Duration and timing of sleep were measured repeatedly with accelerometers among 466 public sector employees in Finland (mean age 63 years, 86% women), who contributed to 759 measurements in total. Job demands (low/high) and control (low/high) measured by self‐reports and job exposure matrix were used to identify low strain (low demand, high control), passive (low, low), active (high, high) and high strain (high, low) jobs. No differences in sleep duration were observed on workdays, whereas on free days those in the high strain group had longer sleep duration than those in the low strain and passive job groups. The high strain group also extended their sleep from workdays to free days more, the extension being on average 59 min (95% CI 42 min–75 min) when adjusted for several sociodemographic, work and health factors. This extension of sleep duration resulted mostly from a greater delay of awakening times from workdays to free days. Psychosocial work factors, such as job strain, need to be considered when promoting sufficient sleep duration among older employees, as those with job strain may have a greater need for recovery and sleep.
Rethinking Supreme Court power in the study of judicial impact
Authors: Strother Logan
Published: September 2021

The extent to which courts meaningfully affect policy change has been the subject of heated debate among socio‐legal and other public law scholars. I argue here that one key source of tension in the literature has been the lack of any clear theory of judicial power, especially in compliance and other impact studies. Indeed, many studies have conflated “impact” and power—a move that serves to confuse rather than clarify the topic. In this paper, I outline a theory of judicial power for the study of judicial impact. I then demonstrate the utility of this theory using two historical case studies. Ultimately, I argue that this theory allows for clearer and better‐grounded inferences about the roles played by courts in policy and politics.
Internal carotid artery dissection due to Eagle syndrome: Case report and review of literatures
Authors: Abe Katsuya , Iida Yu , Mori Kentaro , Takeda Mutsuki , Yamashita Ryotaro , Kawahara Yosuke , Fukui Issei , Nakano Tatsu , Nomura Motohiro
Published: September 2021

Eagle syndrome is a rare condition induced by an elongated styloid process. A 51‐year‐old man became aware of weakness and numbness of the right upper extremity. Magnetic resonance images and angiography revealed fresh multiple infarctions in the left cerebrum, and stenosis and dilatation of the left internal carotid artery. Angiography, cone‐beam computed tomography, and contrast‐enhanced computed tomography demonstrated dissection of the left internal carotid artery and an elongated styloid process close to the internal carotid artery. These findings indicated that cerebral infarction due to internal carotid artery dissection resulted from mechanical compression by an elongated styloid process. The patient was treated by carotid artery stenting on the 7th day. His symptoms induced by cerebral infarction gradually improved. Follow‐up MRI on the 29th day showed patency of the left internal carotid artery. Although the incidence of internal carotid artery dissection due to Eagle syndrome is low, the possibility of this rare condition should be taken into consideration as an etiology of cerebral infarction.
Signs of difference
Authors: Balme Christopher
Published: September 2021

Shylock and Othello are the characters in the Shakespearean oeuvre with the clearest racial markers. However one interprets the ethnic characteristics of ‘the Moor’—as a light‐skinned Arab or as a darker ‘African’—he seems to be a character marked by clear racial distinctions vis‐à‐vis the other figures. Shylock also has an iconographic history of racial marking. In this paper I shall examine how both figures can be read as tokens of ethnic or racial anxiety. Shakespeare’s African play is one of the works seldom performed in the contemporary German repertoire system. The Merchant of Venice is more frequently performed but poses different problems in terms of visual representation. It will be argued that German director’s theatre, with its love of experimentation and above all bold metaphoric images, is uncomfortable with the metonymic representation implied by ethnic casting. The discussion draws on Othello and The Merchant of Venice in productions by Fritz Kortner, Peter Zadek, George Tabori and Luk Perceval. Whereas Kortner, Zadek and Tabori stage the alterity figures in a mode of hypertrophic blackness or Jewish stereotyping bordering on (or indeed transgressing) overt racism, Perceval’s Othello is white and the alterity conflict seems to be one of age and gender not race.
Hepatic macrosteatosis in the US pediatric deceased liver donor population
Authors: Purvis Joshua W. , Orandi Babak J. , Dhall Deepti , McLeod Chandler , Gutierrez Sanchez Luz Helena , Gray Meagan , Frey Kayla , Sheikh Saulat S. , Cannon Robert M. , Terrault Norah A. , Lewis Cora E. , Locke Jayme E.
Published: September 2021

Introduction

The pediatric obesity epidemic is associated with early development of hepatic macrosteatosis, a hallmark of non‐alcoholic fatty LI disease, which is thought to be more rapidly progressive in children than adults. Macrosteatosis in adult allografts is associated with allograft loss, but this has not been examined in pediatric donors.

Methods

We studied all pediatric potential whole LI donors (2005–2018) who had a LI biopsy in the SRTR (n = 862) and whose LI was transplanted (n = 862). Macrosteatosis was abstracted from biopsy reports and compared to values in the SRTR standard analytic file. Recipients of macrosteatotic pediatric allografts were matched 1:1 to recipients of non‐macrosteatotic pediatric allografts by propensity score matching on donor/recipient variables. All‐cause allograft loss was estimated via Kaplan–Meier analysis and Cox proportional hazards model.

Results

From 2005 to 2018, the proportion of pediatric donors (age ≥2 years) with obesity increased (14.8% to 21.7%; p < .001), as did the proportion of pediatric deceased whole LI‐only donor allografts with macrosteatosis (n = 10 648; 1.8% to 3.9%; p < .001). The median degree of macrosteatosis among macrosteatotic donors was 10% (IQR 5–30). There were no significant differences in all‐cause allograft loss between recipients of pediatric LI allografts with and without macrosteatosis at 90 days (p = .11) or 1 year (p = .14) post‐transplant in Kaplan–Meier analysis or a Cox proportional hazards model (p > .05).

Conclusion

Obese pediatric LI donors have increased over time and were more likely to have hepatic macrosteatosis; however, pediatric macrosteatosis did not appear to adversely affect recipient outcomes.
Keeping it human: Pandemic era psychiatry teaching
Authors: Morris Simon George , Greenstone Harriet , Chute Rachel
Published: September 2021

Background

Mental health is an important global issue, and doctors in training need a grounding in the principles of psychiatry. Undergraduate clinical placements in psychiatry can develop core knowledge and skills as well as challenging stigma towards mental illness. The onset of the coronavirus pandemic saw disruption to undergraduate clinical placements. In a U.K. medical school, th e authors were tasked with transforming a 6‐week clinical placement in psychiatry into a primarily online course.

Approach

A 4‐week online course was developed in preparation for a condensed clinical placement. A range of resources were drawn upon to address key learning objectives and to engage students in broader thinking about mental health. These included videos and blogs describing personal experiences of mental illness, as well as interviews with prominent psychiatrists. Peer‐ and tutor‐led sessions complemented these self‐directed elements and reduced social isolation.

Evaluation

Sixty‐seven students undertook the course, supported by eight consultant tutors. The content and structure of the course were highly rated; however, students indicated that peer group activities could benefit from further development. Students felt prepared for clinical placements and performed equally well in summative written examinations. Feedback indicated the development of positive attitudes towards mental health and illness.

Implications

This course demonstrates how, even when clinical contact is challenged, a strong focus can be maintained on social elements of learning and patients' experiences of mental illness. This approach provides opportunities to develop essential knowledge and skills alongside broader attitudinal learning that may have a de‐stigmatising effect.
Real‐time analysis of intraoperative delays and variations in intraoperative workflow with level of experience of the primary surgeon in small animal surgery
Authors: Estrin Alexander , Rodriguez‐Diaz Jenniffer M. , Hayes Galina M.
Published: September 2021

Objective

To describe the causes of intraoperative delays and the changes in delays and surgical workflow with the level of training of the primary surgeon.

Study design

Prospective observational study.

Sample population

Seventy‐three small animal surgical procedures performed at an academic teaching institution between January 17, 2018 and April 10, 2018.

Methods

Procedures (trainee = 37, faculty = 36) totaling 103.2 h were observed and video recorded. Operative time was allocated to the surgical approach, exploration, exposure, intervention, and closure phases. Suballocations were made to specific tasks within these categories (such as cutting or hemostasis). Intraoperative delays and reasons were recorded. Differences in use of time between trainee and faculty surgeons were analyzed.

Results

Delays constituted 9.2% (±4.4) of the operative time, of which 6.5%(±3.6) were surgeon controlled and 2.6% (±2.7) were non‐surgeon controlled. Surgeons preparing instrumentation outside of the operative field and retrieval of equipment from supply areas were the greatest contributors to delays. Intraoperative delays did not increase when the trainee was placed in the primary surgeon role (P = .78). During the approach faculty surgeons spent proportionally less time on hemostasis (P = .02), and during closure they spent less time suturing (P = .03) than trainees.

Conclusion

Trainee surgeons did not have greater intraoperative delays. Delays were created when surgeons prepared their own instrumentation. Workflow differed between experts and trainees.

Clinical significance

Advancing a trainee surgeon into the primary role is unlikely to increase intraoperative delays, which can be reduced by the inclusion of trained scrub technicians. A focus on efficient hemostasis and fluidity when suturing may improve operative efficiency for surgical trainees.
Computational Modeling of Aortic Stenosis With a Reduced Degree-of-Freedom Fluid-Structure Interaction Valve Model
Authors: Zhu Chi , Seo Jung-Hee , Mittal Rajat
Published: September 2021

In this study, a novel reduced degree-of-freedom (rDOF) aortic valve model is employed to investigate the fluid-structure interaction (FSI) and hemodynamics associated with aortic stenosis. The dynamics of the valve leaflets are determined by an ordinary differential equation with two parameters and this rDOF model is shown to reproduce key features of more complex valve models. The hemodynamics associated with aortic stenosis is studied for three cases: a healthy case and two stenosed cases. The focus of the study is to correlate the hemodynamic features with the source generation mechanism of systolic murmurs associated with aortic stenosis. In the healthy case, extremely weak flow fluctuations are observed. However, in the stenosed cases, simulations show significant turbulent fluctuations in the ascending aorta, which are responsible for the generation of strong wall pressure fluctuations after the aortic root mostly during the deceleration phase of the systole. The intensity of the murmur generation increases with the severity of the stenosis, and the source locations for the two diseased cases studied here lie around 1.0 inlet duct diameters (Do) downstream of the ascending aorta.
ESFR-SMART Core Safety Measures and Their Preliminary Assessment
Authors: Rineiski Andrei , Mériot Clément , Marchetti Marco , Krepel Jiri , Coquelet-Pascal Christine , Tsige-Tamirat Haileyesus , Álvarez-Velarde Francisco , Girardi Enrico , Mikityuk Konstantin
Published: September 2021

A large 3600 MW-thermal European sodium fast reactor (ESFR) concept has been studied in a European Horizon-2020 project since September 2017, following an earlier European project. In the paper, we describe new ESFR core safety measures focused on prevention and mitigation of severe accidents. In particular, we propose a new core configuration for reducing the sodium void effect, introduce passive shutdown systems, and implement special paths in the core for facilitation of molten fuel discharge in order to avoid recriticalities after a hypothetical severe accident. We describe and assess the control and shutdown system, and consider options for burning minor actinides.