bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of Industry 4.0 implementation on supply chains
Authors: Ghadge Abhijeet , Er Kara Merve , Moradlou Hamid , Goswami Mohit
Published: March 2020

Purpose

The study aims to analyse the impact of Industry 4.0 implementation on supply chains and develop an implementation framework by considering potential drivers and barriers for the Industry 4.0 paradigm.

Design/methodology/approach

A critical literature review is performed to explore the key drivers and barriers for Industry 4.0 implementation under four business dimensions: strategic, organisational, technological and legal and ethical. A system dynamics model is later developed to understand the impact of Industry 4.0 implementation on supply chain parameters, by including both the identified driving forces and barriers for this technological transformation. The results of the simulation model are utilised to develop a conceptual model for a successful implementation and acceleration of Industry 4.0 in supply chains.

Findings

Industry 4.0 is predicted to bring new challenges and opportunities for future supply chains. The study discussed several implementation challenges and proposed a framework for an effective adaption and transition of the Industry 4.0 concept into supply chains.

Research limitations/implications

The results of the simulation model are utilised to develop a conceptual model for a successful implementation and acceleration of Industry 4.0 in supply chains.

Practical implications

The study is expected to benefit supply chain managers in understanding the challenges for implementing Industry 4.0 in their network.

Originality/value

Simulation analysis provides examination of Industry 4.0 adoption in terms of its impact on supply chain performance and allows incorporation of both the drivers and barriers of this technological transformation into the analysis. Besides providing an empirical basis for this relationship, a new conceptual framework is proposed for Industry 4.0 implementation in supply chains.
Population fitness has a concave relationship with migration distance in Sanderlings
Authors: Sandercock Brett K.
Published: March 2020

In Focus: Reneerkens, J., Versluijs, T. S. L., Piersma, T., Alves, J. A., Boorman, M., Corse, C., … Lok, T. (2020). Low fitness at low latitudes: wintering in the tropics increases migratory delays and mortality rates in an Arctic breeding shorebird. Journal of Animal Ecology, 89, 691–703. A central question in migratory ecology has been to understand the fitness consequences of individual variation in migration distance among different species and populations. Reneerkens et al. (2020) investigated the demographic consequences of long‐distance migration for Sanderlings Calidris alba, an Arctic‐breeding species of sandpiper. Their study population has a remarkable geographic distribution with a breeding range that is concentrated in northeast Greenland and Ellesmere Island, Canada but a nonbreeding range that extends across 85° of latitude from Scotland to Namibia. The authors report on unexpected patterns of latitudinal variation in three demographic parameters: timing of passage on northward migration, probability of juvenile migration and apparent survival of adults. Sanderlings travelling 1,800–2,800 km to settle at north temperate sites during the nonbreeding season had earlier passage dates, and also higher probabilities of migration and apparent survival. In contrast, birds travelling 6,000–7,800 km to equatorial sites experienced later passage dates, delayed maturity and lower apparent survival. However, if Sanderlings migrated even farther and flew over 11,000 km to nonbreeding sites in Namibia, then their performance was restored to early passage dates and higher survival. Movement tracks from birds tagged with geolocators showed that birds wintering in Namibia make nonstop flights of 7,500 km that bypass West Africa during northward migration. Thus, all lines of evidence suggest that Sanderlings face adversity when spending the nonbreeding season at equatorial latitudes. Moreover, the central finding that components of fitness can have nonlinear relationships with migration distance is a novel discovery that leads to many additional questions. The new findings have broader implications for theoretical models of migration, and for understanding how different patterns of movements may arise or be maintained in migratory species.
Mesh inlay, mesh kit or native tissue repair for women having repeat anterior or posterior prolapse surgery: randomised controlled trial (PROSPECT)
Authors: Glazener CMA , Breeman S , Elders A , Hemming C , Cooper KG , Freeman RM , Smith ARB , Hagen S , Montgomery I , Kilonzo M , Boyers D , McDonald A , McPherson G , MacLennan G , Norrie J , Reid FM ,   for the PROSPECT Study Group
Published: March 2020

Objective

To compare standard (native tissue) repair with synthetic mesh inlays or mesh kits.

Design

Randomised controlled trial.

Setting

Thirty‐three UK hospitals.

Population

Women having surgery for recurrent prolapse.

Methods

Women recruited using remote randomisation.

Main outcome measures

Prolapse symptoms, condition‐specific quality‐of‐life and serious adverse effects.

Results

A Mean Pelvic Organ Prolapse Symptom Score at 1 year was similar for each comparison (standard 6.6 versus mesh inlay 6.1, mean difference [MD] −0.41, 95% CI −2.92 to 2.11: standard 6.6 versus mesh kit 5.9, MD −1.21 , 95% CI −4.13 to 1.72) but the confidence intervals did not exclude a minimally important clinical difference. There was no evidence of difference in any other outcome measure at 1 or 2 years. Serious adverse events, excluding mesh exposure, were similar at 1 year (standard 7/55 [13%] versus mesh inlay 5/52 [10%], risk ratio [RR] 1.05 [0.66–1.68]: standard 3/25 [12%] versus mesh kit 3/46 [7%], RR 0.49 [0.11–2.16]). Cumulative mesh exposure rates over 2 years were 7/52 (13%) in the mesh inlay arm, of whom four women required surgical revision; and 4/46 in the mesh kit arm (9%), of whom two required surgical revision.

Conclusions

We did not find evidence of a difference in terms of prolapse symptoms from the use of mesh inlays or mesh kits in women undergoing repeat prolapse surgery. Although the sample size was too small to be conclusive, the results provide a substantive contribution to future meta‐analysis.

Tweetable abstract

There is not enough evidence to support use of synthetic mesh inlay or mesh kits for repeat prolapse surgery.
Thriving and career outcomes: The roles of achievement orientation and resilience
Authors: Jiang Zhou , Jiang Yiqi , Nielsen Ingrid
Published: March 2020

This research investigated how and under what conditions thriving at work affects career attitudes and behaviors. Using an experimental design (n = 174), Study 1 found that the effects of thriving on career satisfaction, career commitment, and career engagement were mediated by career resilience. The positive effect of thriving on career resilience and the resilience‐mediated effects of thriving on career satisfaction, commitment, and engagement were stronger when achievement orientation was higher. Study 2 verified these findings with a survey of another sample of 296 employees. These studies offer important insights for human resource managers and career consultants or practitioners regarding what may enhance employees' career outcomes. Our findings imply that thriving‐enabling practices might be beneficial among highly achievement‐oriented employees.
Census and distribution of large carnivores in the Tsavo national parks, a critical east African wildlife corridor
Authors: Henschel Philipp , Petracca Lisanne S. , Ferreira Sam M. , Ekwanga Steven , Ryan Steven Dennis , Frank Laurence G.
Published: March 2020

Kenya's Tsavo National Parks are a critical conservation area and the only wilderness corridor through densely populated human‐dominated landscapes stretching from the East African coast to Lake Victoria, separating extensive undeveloped grasslands south of the equator from the undeveloped semiarid bushlands to the north. At nearly 21,000 km2, Tsavo is one of four lion strongholds in East Africa and part of Africa's most important populations of all other large African carnivores. To provide baseline data on the status of large carnivores, a track survey was undertaken in 2013. Lions and both hyaena species were widely distributed across both parks, while cheetahs and wild dogs were more patchily distributed. Spotted hyaenas were the most abundant, with an estimated population of 3,903 ± 514 (95% CI), followed by lion (706 ± 201), striped hyaena (679 ± 144), leopard (452 ± 98), cheetah (154 ± 74) and wild dog (111 ± 92). Tsavo's carnivores suffer from bushmeat poaching, illegal grazing and retaliatory killing, and increasing human numbers on its periphery. Given Tsavo's importance as a stronghold for lions and an ecological corridor, increased investment in effective protection is strongly recommended. Evaluating trends will require complementary techniques in light of intensive monitoring requirements.
Can fishing communities escape marginalisation? Comparing overfishing, environmental pressures and adaptation in Thailand and the Philippines
Authors: Andriesse Edo , Kittitornkool Jawanit , Saguin Kristian , Kongkaew Chaturong
Published: March 2020

In this article, we compare four fishing‐based areas in Thailand and the Philippines to examine if and how small‐scale fishing communities are able to escape marginalisation. Three questions guide our inquiry: (i) How have fishing communities been affected by overfishing, climate change and other pressures? (ii) What adaptive strategies have these communities employed to mitigate socio‐economic and environmental challenges? (iii) What has been the impact of these strategies on (escaping) marginalisation? Through a survey of 393 fishing‐based households and semi‐structured interviews with 59 key informants we find an uneven mixture of drivers, strategies and impacts. Respondents varyingly attribute declining fish catch to illegal fishing, overfishing, population increase, climate change and pollution. The case studies illustrate various degrees of adaptive successes that result from integration of top‐down and bottom‐up initiatives, and availability and access to livelihood strategies. However, the impact of adaptive strategies on overcoming marginalisation remains meagre and constrained by, among others, the power of illegal and commercial fishing and the absence of integrated spatial planning. We call for policy interventions and further research that takes into account the integration of top‐down and bottom‐up institutions, and the multiple dimensions and spaces of the drivers that shape fisherfolk marginalisation.
Design patterns for teaching in academic settings in future learning spaces
Authors: Eyal Liat , Gil Einat
Published: March 2020

A Future Learning Space (FLS) is a dynamic and a technology‐rich learning environment that enables teaching and learning using innovative pedagogical methods. However, introducing innovation and technology into any educational setting, whether in K‐12 schools or higher education institutions, is known to be challenging. This paper introduces design patterns (DPs) for teaching in FLS. The patterns emerged from creative teaching in a college of education, which was preceded by mentoring for some of the lecturers. The patterns involve hybridity, including both formal and informal social structures and a combination of physical and digital tools mediating individuals’ interactions with peers. Based on a process of mining patterns, we extracted four DPs for teaching in academic FLS. The patterns, which encapsulate threads of hybridity, are: convergent groups; teaching in an interactive orchestrated learning space; presentation fair; and Think‐Join‐Share. These patterns can be used as learning design scaffolds in a social constructivist approach in which pedagogy, technology and space interact.
Emerging therapies in sickle cell disease
Authors: Nardo‐Marino Amina , Brousse Valentine , Rees David
Published: March 2020

Despite sickle cell disease (SCD) being the most common and severe inherited condition worldwide, therapeutic options are limited. To date, hydroxyurea remains the main treatment option in SCD. However, in the last decade the numbers of interventional clinical trials focussing on therapies for SCD have increased significantly. Many new drugs with various pharmacological targets have emerged and, although the majority have failed to show benefit in clinical trials, some have produced encouraging results. It seems probable that more drugs will soon become available for the treatment of SCD. Furthermore, promising clinical trials with improved outcomes have recently changed the perspective of curative therapies in SCD. Nevertheless, the application of novel therapeutic agents and potential curative treatments will most likely be limited to high‐income countries and, thus, will remain unavailable for the majority of people with SCD in the foreseeable future.
Mélange development in the Neyriz region of Zagros Orogen, Iran: Record of convergence and collision in the Neotethyan Realm
Authors: Gholami Zadeh Parisa , Adabi Mohammad Hossein , Ghassemi Mohammad Reza , Sadeghi Abbas , Eshraghi Safar Ali
Published: March 2020

Mélanges are formed by sedimentary, tectonic and diapiric processes and are generally found in collisional belts. The Zagros Orogeny provides an intriguing geological laboratory for the study of mélange‐forming processes during the progressive tectonic evolution of the Neotethys Ocean. Different types of tectonic and sedimentary mélanges occur in specific structural positions within the Zagros orogenic belt in the Neyriz Region (Iran). Based on their block‐in‐matrix fabrics, and tectonostratigraphic positions, we differentiated 14 different mélange types, which mark different episodes of the tectonic evolution of the Neyriz Region from the Cretaceous subduction to the Miocene collision. The Cretaceous subduction stage is recorded by volcanic‐sedimentary mélanges (Mv). Sedimentary mélanges characterized by megabreccia from the Cretaceous limestone (Ms1) and Eocene polymictic megabreccia (Ms2) represent epi‐nappe mélanges formed during the Palaeocene–Eocene in wedge‐top basins. The ophiolite emplacement in the Oligocene resulted in local extensional tectonics in the upper part of the ophiolitic nappe, and deposition of a polymictic megabreccia (Ms3, Ms4). As the final production of the Neotethys Ocean closure and the Eurasian‐Arabian collision, the sedimentary mélanges characterized by different types of chaotic rock units (Ms5, Ms6, Ms7 and Ms8 facies) were developed in front of the Cretaceous–Eocene nappes due to growth of the orogenic wedge in the Miocene. Our findings indicate that the recognition and distinction of different types of mélange may provide additional constraints for a better understanding of the tectono‐sedimentary evolution of the Neotethyan region.
Influence of family environment on the development of speech and language in pre‐lingually deaf children after cochlear implantation
Authors: Zhang Biaoxin , Qiu Jianxin , Yu Yinxiang , Hu Cuixia , Zhu Zixiu , Yu Chongxian , Yin Liping , Zhong Mei
Published: March 2020

Objective

To investigate the influence of family environment on the development of speech and language in pre‐school children after cochlear implantation.

Methods

A total of 88 pre‐lingually deaf children, aged 2‐5 years, who received cochlear implantation, were included in this study. All families completed a self‐report family environment questionnaire (FES). The deaf children's linguistic progress was assessed by Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR) at 0, 3, 6 and 12 months after implantation.

Results

The family environment was the significant factor associated with CAP and SIR at 6 months post‐implantation. The children in families with higher levels of Cohesion, Intellectual‐Cultural Orientation and the ability to express emotion effectively had better auditory and speech abilities, while children in families with low intimacy and high incompatibility exhibited a delay in the development of auditory speech (P < .05).

Conclusions

The development of speech and language in pre‐lingually deaf children after cochlear implantation can be influenced by family environment and parents' roles.
Out of scale out of place: Black rhino forage preference across the hierarchical organization of the savanna ecosystem
Authors: Duthé Vanessa , Defossez Emmanuel , van der Westhuizen Rickert , Glauser Gaëtan , Rasmann Sergio
Published: March 2020

The successful conservation plans of megaherbivores necessitate precisely characterizing their ecological needs in order to optimize reproduction rates and reintroduction plans. The black rhino (Diceros bicornis L.) is among the most endangered species of megaherbivores in Africa and its conservation relies on nature reserves that are bound and habitat‐restricted. Therefore, identifying the optimal amount of space this species needs and the factors driving its habitat use are crucial for establishing reserve priority plans. Knowing that forage selection is an important component linked to herbivore spatial distribution, we combined 5 years of sightings data with observations of rhinos' vegetation type and forage preferences to address their forage selection across multiple spatial scales. We found that black rhinos' spatial distribution was negatively associated with ecosystem productivity, but positively associated with specific vegetation types that contain highly preferred, chemically distinct, plant species. Black rhinos thus occupy their habitat across space and time through selective foraging on preferred plants.
Investment in Financial Information and Portfolio Performance
Authors: Guiso Luigi , Jappelli Tullio
Published: March 2020

Financial information allows investors to condition the portfolio allocation on valuable signals on asset returns. Therefore investors have incentives to spend on information gathering. If interpreted correctly, information signals allow investors to obtain higher returns and more efficient portfolios. Since information is costly, wealthier and more risk tolerant investors have stronger incentives to invest in information. Overconfident investors who overstate the value of the information still obtain higher average returns but end up with less efficient portfolios. We study these implications using two unique surveys of customers of a leading Italian bank, with portfolio data and measures of individual investment in financial information. We find that investment in information is positively associated with returns to financial wealth and negatively associated with the portfolio Sharpe ratio. Furthermore, the latter falls with proxies of overconfidence. We relate these findings to the wealth inequality debate.
Effect of non‐pharmacological interventions on source memory processes in the early course of psychosis: A systematic review
Authors: Lajoie Marie‐Pier , Gilbert Elsa , Rouleau Nancie
Published: March 2020

People with a psychotic disorder suffer from major cognitive impairments which prevent their functional recovery. Source memory impairments have been shown to be associated with psychotic symptoms and even to precede their onset. Source memory has thus been hypothesized as a cognitive precursor of psychosis. However, few interventions targeting source memory are included in current therapeutic approaches for early psychosis.

Aim

This systematic review aimed to identify non‐pharmacological interventions for early psychosis which have impacted source memory processes.

Methods

Studies were selected from nine databases when they included: (a) a non‐pharmacological intervention involving a sample of patients with early‐onset psychotic disorder or subclinical psychotic symptoms; and (b) effects on source memory processes, measured directly or inferred through an episodic memory task.

Results

Thirteen studies were identified, including two cognitive remediation programs and one repetitive transcranial magnetic stimulation treatment that reported beneficial effects on source memory.

Conclusions

Relevant intervention strategies for source memory impairments were identified. This review points up a need to further develop interventions targeting theoretically defined source memory concepts and assess their effects with specific and valid tasks. Recommendations regarding underlying mechanisms which could have a beneficial impact on source memory may provide guidance for the future development of early psychosis interventions.
Hemostatic prophylaxis and colonoscopy outcomes for patients with bleeding disorders: A retrospective cohort study and review of the literature
Authors: Azer Sarah M. , Eckerman Amy L. , Rodriguez Vilmarie , Nichols William L. , Ashrani Aneel A. , Hook C. Christopher , Marshall Ariela L. , Pruthi Rajiv K.
Published: March 2020

Introduction

Hemostatic prophylaxis (HP) is recommended for patients with bleeding disorders (PWBD) before invasive procedures. However, evidence‐based guidelines are needed to determine optimal HP strategies.

Aim

To determine outcomes of HP for PWBD undergoing colonoscopy.

Methods

We undertook a retrospective cohort study of HP and outcomes of colonoscopy procedures performed between 9 November 1993 and 13 February 2018 for PWBD who received care in the Mayo Clinic Comprehensive Hemophilia Treatment Center.

Results

During the study period, 73 PWBD (58 with milder phenotypes: haemophilia, von Willebrand disease [subtypes 1 and 2; II, VII and XI deficiency]) underwent 141 procedures. Preprocedural HP was given to 61%, and interventions were performed in 47%. Of the 39% without preprocedural HP, postprocedural HP was given for 11%. One major (0.7%; 6 days postprocedure despite HP) and 10 minor (7%) bleeding complications occurred, which tended to be in patients with severe disease and/or after excision of larger polyps. There was no significant difference in the rate of bleeding complications with or without preprocedural HP (8.1% vs 5.5%, respectively; P = .74, Fisher's exact test).

Conclusion

The low bleeding rates in our cohort suggest that preprocedure HP may be withheld for patients with mild bleeding disorders who undergo colonoscopy with a low likelihood of requiring an intervention or who require only low‐risk intervention. This strategy may be best used in experienced centres, provided optimal local hemostasis measures are undertaken and postprocedural HP is rapidly available if high‐risk intervention is required. Further studies are needed to determine optimal evidence‐based HP strategies for PWBD undergoing colonoscopy.
An unusual cause of subacute airway obstruction in a hemodialysis patient with brachio‐cephalic arteriovenous fistula: A rare presentation of central venous occlusion
Authors: Hamzan Muhammad Izzuddin , Hamid Ahmad Rizal , Halim Ahmad Sukari , Mat Saad Arman Zaharil
Published: March 2020

A young lady with an arteriovenous (AV) fistula on hemodialysis was referred for surgical management following a failed endovascular approach to relieve central venous occlusion. She had an obstructed left brachiocephalic vein with a history of numerous central vein catheter placements. Alternative routes for new arteriovenous fistula creation had been exhausted due to previous contralateral upper limb fistula rupture and ligation. To the best of our knowledge, no similar cases of airway obstruction in central venous occlusion occurring in hemodialysis patients with AV fistula have been reported. The importance of identifying the possible emergency red flags in hemodialysis patients with central venous occlusion is important to prevent unwanted consequences.
Clinicopathological and survival analyses of primary cutaneous angiosarcoma in an Asian population: prognostic value of the clinical features of skin lesions
Authors: Moon Ik Jun , Kim Young Jae , Won Chong Hyun , Chang Sung Eun , Lee Mi Woo , Choi Jee Ho , Lee Woo Jin
Published: March 2020

Background

Primary cutaneous angiosarcoma (CA) is a rare but aggressive tumor with a high rate of local recurrence. This study was designed to analyze the clinicopathological features of primary CA and identify factors of cutaneous manifestations associated with the prognosis of angiosarcoma.

Methods

Medical records of 55 patients with primary CA were retrospectively analyzed to investigate clinical features, survivals, and prognostic factors. Anatomical location of tumor was classified to the scalp, face, and neck, and sites outside the head and neck.

Results

Primary CA presented cutaneous nodules (31/55, 47.2%), patches (13/55, 23.6%), and indurated plaques (11/55, 20.0%). Nodular lesion was significantly more common in CA on the scalp compared to CA on sites outside the scalp. Histologically, tumors presenting as nodular lesions on the scalp was predominantly composed of solid sheets of large pleomorphic cells, whereas non‐nodular lesions composed of tumor cells between collagen bundles forming irregular vascular spaces. Cutaneous angiosarcoma on the scalp showed a worse prognosis compared to CA on sites outside the scalp. Patients presenting clinical morphology with nodules and multiple skin lesions showed significantly reduced overall survival (OS).

Conclusion

In primary CA, location on the scalp, morphology with nodules, and multiplicity of skin lesions significantly affected survival outcomes.
Accuracy and acceptability of survivorship care plans: results of a pilot study
Authors: Koczwara Bogda , Doherty Tracey N. , Hislop Chantelle C. , Cameron Kate , Bessen Taryn , Christensen Chris , Corsini Nadia , Fitzgerald Michael K. , Loft Nicole , Poprawski Dagmara M. , Turpin Kate H. , Eckert Marion C.
Published: March 2020

Survivorship treatment summaries and care plans are increasingly incorporated into cancer care but there are limited data on their accuracy and acceptability. We have evaluated written care plans developed as part of a once‐off, nurse‐led survivorship consultations across four medical oncology clinics in South Australia as part of a state‐wide pilot. While the accuracy of treatment summaries was high, level of detail in care plans was moderate to low, as was survivors' perception of plans' utility.
James Cook's first Pacific voyage: alleged scurvy‐freedom unmasked
Authors: Short Bruce H.
Published: March 2020

The east coast of New Holland was discovered 250 years ago during a voyage of covert strategic exploration of the Pacific Ocean regions by Lieutenant James Cook acting under instructions of the Royal Navy espionage chief, Philip Stephens, Secretary of the Admiralty. In addition to the study of the transit of Venus, the well resourced mission included some clandestine mapmaking during August 1768 to July 1771. Tasked by the Royal Society of London to investigate the anti‐scorbutic effects of a variety of foods and herbs, Cook's post‐operational debrief to the Admiralty included the inaccurate supposition that HM Bark Endeavour's cruise was scurvy‐free. Why did Cook extend deceptive cartographic practices deliberately to conceal the apparent failure of the anti‐scorbutic comestibles?
Antibiotic tigecycline inhibits cell proliferation, migration and invasion via down‐regulating CCNE2 in pancreatic ductal adenocarcinoma
Authors: Yang Jie , Dong Zhen , Ren Aishu , Fu Gang , Zhang Kui , Li Changhong , Wang Xiangwei , Cui Hongjuan
Published: March 2020

Recently, many researches have reported that antibiotic tigecycline has significant effect on cancer treatment. However, biomedical functions and molecular mechanisms of tigecycline in human pancreatic ductal adenocarcinoma (PDAC) remain unclear. In the current study, we tried to assess the effect of tigecycline in PDAC cells. AsPC‐1 and HPAC cells were treated with indicated concentrations of tigecycline for indicated time, and then, MTT, BrdU and soft agar assay were used to test cell proliferation. The effect of tigecycline on cell cycle and cellular apoptosis was tested by cytometry. Migration and invasion were detected by wound healing assay and transwell migration/invasion assay. Expressions of cell cycle‐related and migration/invasion‐related protein were determined by using Western blot. The results revealed that tigecycline observably suppressed cell proliferation by inducing cell cycle arrest at G0/G1 phase and blocked cell migration/invasion via holding back the epithelial‐mesenchymal transition (EMT) process in PDAC. In addition, tigecycline also remarkably blocked tumorigenecity in vivo. Furthermore, the effects of tigecycline alone or combined with gemcitabine in vitro or on PDAC xenografts were also performed. The results showed that tigecycline enhanced the chemosensitivity of PDAC cells to gemcitabine. Interestingly, we found CCNE2 expression was declined distinctly after tigecycline treatment. Then, CCNE2 was overexpressed to rescue tigecycline‐induced effect. The results showed that CCNE2 overexpression significantly rescued tigecycline‐inhibited cell proliferation and migration/invasion. Collectively, we showed that tigecycline inhibits cell proliferation, migration and invasion via down‐regulating CCNE2, and tigecycline might be used as a potential drug for PDAC treatment alone or combined with gemcitabine.
Organizational structures and early mobilization practices in South African public sector intensive care units—A cross‐sectional study
Authors: Tadyanemhandu Cathrine , van Aswegen Heleen , Ntsiea Veronica
Published: March 2020

Rationale

Understanding current early mobilization practice of patients in intensive care unit (ICU) is critical to the design and implementation of strategies to facilitate its application in a diverse population of critically ill patients encountered in public sector hospitals.

Aim

To evaluate the organizational structures of South African public sector hospital ICUs and to describe early mobilization practices in these units.

Methods

A cross‐sectional survey was done in participating public hospitals from eight provinces in South Africa. Convenience sampling was done. Data collected included hospital and ICU structure, adult patient demographic and clinical data, and mobilization activities done in ICU over the previous 24 hours prior to the day of the survey.

Results

A total of 29 ICUs from 13 participating hospitals were surveyed resulting in 205 patient records. Majority of the surveyed ICUs were “open” type (n = 16; 55.2%). A standardized sedation scoring system was used in 18 units (62.1%) and only two units (6.9%) had an early mobilization protocol in place. Mean age of the patients surveyed was 43.5 (±17.7) years and 148 (72.2%) patients were on mechanical ventilation. Primary reasons for admission to ICU included traumatic injury (n = 86; 42%) and postoperative care (n = 33; 16.1%). Mobilization activities performed in the previous 24 hours included turning the patient in bed (n = 88; 42.9%), marching on the spot (n = 9; 4.4%) and walking (n = 10; 4.9%). Out‐of‐bed mobilization was done in only 40 (19.5%) patients. The most common barriers to early mobilization included patient unresponsiveness (n = 50; 24.4%) and hemodynamic instability (n = 42; 20.5%). The type of ventilation was found to have a significant positive relationship with out‐of‐bed patient mobilization (P= .000).

Conclusions

A small proportion of patients attained their highest level of mobilization in ICU. The type of ventilation influenced early mobilization practices in public sector ICUs in South Africa.
Frequent emergency department use in the paediatric population: A systematic literature review
Authors: Giannouchos Theodoros V. , Washburn David J. , Gary Jodie C. , Foster Margaret J.
Published: March 2020

Objective

We systematically reviewed the literature on paediatric frequent emergency department (ED) users to identify and to synthesize characteristics and factors associated with frequent ED utilization among this population in the United States.

Methods

We searched Medline (Ovid), CINAHL (Ebsco), and Embase (Ovid) to identify all relevant studies after 1990. We focused on US studies analysing paediatric frequent ED (PFED) users excluding those focused on specific subgroups. Two reviewers independently selected articles and extracted data on predisposing, enabling, behavioural, need and reinforcing factors.

Results

Fifteen studies met the inclusion criteria. PFED users comprised 3% to 14% of all paediatric ED users and accounted for 9% to 42% of all paediatric ED visits in 11 studies that defined frequent use as four to six ED visits per year. Most PFED users were less than 5 years old who had public insurance coverage and a regular provider. Public insurance compared to private residency in disadvantaged areas, having at least one chronic or complex condition and a history of hospitalization, were associated with frequent use. Children who had a regular primary care provider were less likely to exhibit frequent ED use.

Conclusions

Minimizing unnecessary ED visits by frequent utilizers is a quality improvement and cost‐saving priority for health systems. Our findings indicate that many PFED users have greater healthcare needs and face barriers accessing care in a timely manner, even though some have regular providers. To better address the needs of this vulnerable group, health systems should focus on educating caregivers and expanding access to providers in other settings.
Early Childhood Trauma Impact on Adolescent Brain Development, Decision Making Abilities, and Delinquent Behaviors: Policy Implications for Juveniles Tried in Adult Court Systems
Authors: Williams Ashley
Published: March 2020

By examining previous literature on the brain’s developmental process during adolescence, this paper aims to determine how early childhood trauma potentially effects decision making in adolescence through exploring self‐regulation theory. Through a self‐regulation framework, the hope is to determine the connection, if any, between early childhood trauma, delinquent behavior, and involvement in the juvenile justice system. The author insists that not only do adolescents have less culpability due to their brain developmental stage compared to adults, but also early childhood trauma puts adolescents at a greater risk of impaired self‐regulation which allows for more probable delinquent behavior. This paper also considers implications for social policy makers and youth advocates concerned with juvenile offenders tried in adult courts and existing racial disparities in the system.
Sustained Outcomes? an Exploratory Study of Juvenile Drug Courts and Long‐Term Recidivism
Authors: Belisle Linsey , Thompson Kevin
Published: March 2020

This exploratory study examined juvenile drug courts’ effect on adulthood recidivism. Utilizing a twelve‐year average follow up time, adult recidivism rates were compared between previous juvenile drug court participants and a comparison group of juveniles who participated in traditional probation. Linear regression models indicated limited recidivism effects of drug court on arrests or convictions into adulthood. The findings suggest that gender and race may play a role in how justice‐involved juveniles interact and experience juvenile drug court, highlighting the need for gender‐responsive and culturally responsive policies, practices, and programs within juvenile drug courts. Recommendations are made regarding future research areas and ways to potentially improve long‐term juvenile drug court outcomes.
Adverse Drug Events in Older Adults: Review of Adjudication Methods in Deprescribing Studies
Authors: Ross, MSc candidate Sydney B. , Wu Peter E. , Atique, MD candidate Anika , Papillon‐Ferland Louise , Tamblyn Robyn , Lee Todd C. , McDonald Emily G.
Published: March 2020

OBJECTIVES

Polypharmacy is common in older adults and associated with adverse drug events (ADEs). Several methods have been described in studies to help correlate ADE causation. We performed a narrative review to identify methods for ADE adjudication. We compared their strengths and limitations to assess their applicability to deprescribing studies (of which clinical trials are a subset) and to encourage the use of a standardized method in future studies.

DESIGN

We performed a review of original articles (1946‐2019) using the Medline (Ovid) and Cochrane databases. We also conducted a manual reference search of review articles. Abstracts were screened for relevance.

MEASUREMENTS

Adjudication methods were compared for advantages and limitations including validity, ease of use, and applicability to clinical trials with deprescribing as the primary intervention.

RESULTS

The search yielded 1881 articles of which 175 articles were included for full‐text review. Following in‐depth review, 135 were excluded: 79 had no ADE outcome data, 35 were not specific to older adults, 9 were not relevant, 6 were review articles, 5 contained duplicate data, and 1 was not written in French or English. Forty articles remained for analysis, from which we identified 10 unique ADE adjudication methods. No method was developed originally for use in a deprescribing setting.

CONCLUSION

A standard method to identify ADEs is important to capture the outcome reliably in deprescribing studies. All methods we identified had limitations in terms of capturing adverse events from the withdrawal of medications. Future work should focus on refining adjudication methods for capturing ADEs related not only to medication continuation and new drug starts but also to deprescribing and drug discontinuation. J Am Geriatr Soc 68:1594‐1602, 2020.
Brain region‐specific amyloid plaque‐associated myelin lipid loss, APOE deposition and disruption of the myelin sheath in familial Alzheimer’s disease mice
Authors: Kaya Ibrahim , Jennische Eva , Lange Stefan , Tarik Baykal Ahmet , Malmberg Per , Fletcher John S.
Published: March 2020

There is emerging evidence that amyloid beta (Aβ) aggregates forming neuritic plaques lead to impairment of the lipid‐rich myelin sheath and glia. In this study, we examined focal myelin lipid alterations and the disruption of the myelin sheath associated with amyloid plaques in a widely used familial Alzheimer's disease (AD) mouse model; 5xFAD. This AD mouse model has Aβ42 peptide‐rich plaque deposition in the brain parenchyma. Matrix‐assisted laser desorption/ionization imaging mass spectrometry of coronal brain tissue sections revealed focal Aβ plaque‐associated depletion of multiple myelin‐associated lipid species including sulfatides, galactosylceramides, and specific plasmalogen phopshatidylethanolamines in the hippocampus, cortex, and on the edges of corpus callosum. Certain phosphatidylcholines abundant in myelin were also depleted in amyloid plaques on the edges of corpus callosum. Further, lysophosphatidylethanolamines and lysophosphatidylcholines, implicated in neuroinflammation, were found to accumulate in amyloid plaques. Double staining of the consecutive sections with fluoromyelin and amyloid‐specific antibody revealed amyloid plaque‐associated myelin sheath disruption on the edges of the corpus callosum which is specifically correlated with plaque‐associated myelin lipid loss only in this region. Further, apolipoprotein E, which is implicated in depletion of sulfatides in AD brain, is deposited in all the Aβ plaques which suggest apolipoprotein E might mediate sulfatide depletion as a consequence of an immune response to Aβ deposition. This high‐spatial resolution matrix‐assisted laser desorption/ionization imaging mass spectrometry study in combination with (immuno) fluorescence staining of 5xFAD mouse brain provides new understanding of morphological, molecular and immune signatures of Aβ plaque pathology‐associated myelin lipid loss and myelin degeneration in a brain region‐specific manner.

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Retinol and α‐tocopherol in pregnancy: Establishment of reference intervals and associations with CBC
Authors: Liu Jingrui , Zhan Sien , Jia Yan , Li Youran , Liu Ying , Dong Ying , Tang Guodong , Li Lin , Zhai Yanhong , Cao Zheng
Published: March 2020

Profound physiological changes during pregnancy may affect the requirement of retinol and tocopherol, which are essential micronutrients for the maintenance of maternal health and foetal development. However, the current reference intervals (RIs) of retinol and tocopherol are based on non‐pregnant population. In the present study, a liquid chromatography–tandem mass spectrometry quantitation method for serum retinol and α‐tocopherol was established and validated. In addition, we established trimester‐specific RIs of retinol and α‐tocopherol using the data from paired screening test for 31,301 outpatients who participated in the prenatal vitamins A/E evaluation program at our hospital using the Hoffmann method, which is a simple indirect RI estimation method that does not require the recruitment of healthy subjects. Further, to explore the associations between the levels of retinol and α‐tocopherol and the parameters of complete blood count (CBC), the results of retinol, α‐tocopherol, and CBC of 1,977 pregnant outpatients in the third trimester were analysed. The testing interval between the levels of vitamins and CBC was no more than 7 days. Although no significant changes were noticed in the levels of retinol, the α‐tocopherol levels continuously increased with normal physiological changes throughout pregnancy. Lower retinol levels were associated with the higher incidence of anaemia, whereas higher levels of retinol and lower levels of α‐tocopherol were associated with higher platelet count.
Understanding feeding practices of Latinx mothers of infants and toddlers at risk for childhood obesity: A qualitative study
Authors: McFarren Hannah , Vazquez Christian , Jacobs Elizabeth A. , Dela Tejera Giovanna , Gray Megan
Published: March 2020

Infancy and toddlerhood are critical stages for the development of habits that can lead to future obesity, and caregivers have an important influence on these habits. We conducted this qualitative semistructured interview study to explore the feeding practices of Latinx mothers of young children who are at risk for childhood obesity in order to identify targets for obesity prevention. We interviewed Latinx mothers (N = 14) of a child ages 6–18 months with a weight‐for‐length ratio > 85th percentile at the time of recruitment. Two researchers independently read through the interviews, identified sections of the interviews pertaining to feeding, and used constant comparative methods to identify the following common themes: mothers overwhelmingly reported permissive feeding styles, driving overfeeding and frequent night‐time feeding. Mothers expressed some difficulty with transitioning to solid foods and reported desiring to feed their child healthy foods by minimizing juice and giving vegetables. Paediatricians and WIC staff were viewed by mothers as trustworthy sources of nutrition information. Most identified a connection between their child's weight and diet, but many lacked the insight or capacity to change their current practices. The mothers in our study provide insight into factors that may predispose young children to obesity and thus potential avenues to support these families. Healthcare providers can better serve them by giving clear, actionable advice on healthy feeding practices for their child, while understanding constraints that may make healthy habits difficult to implement. Paediatricians should be honest about their child's weight status early on to allow time for intervention.
Breastfeeding and childhood obesity: A 12‐country study
Authors: Ma Jian , Qiao Yijuan , Zhao Pei , Li Wei , Katzmarzyk Peter T. , Chaput Jean‐Philippe , Fogelholm Mikael , Kuriyan Rebecca , Lambert Estelle V. , Maher Carol , Maia Jose , Matsudo Victor , Olds Timothy , Onywera Vincent , Sarmiento Olga L. , Standage Martyn , Tremblay Mark S. , Tudor‐Locke Catrine , Hu Gang ,   for the ISCOLE Research Group
Published: March 2020

This study aimed to examine the association between breastfeeding and childhood obesity. A multinational cross‐sectional study of 4,740 children aged 9–11 years was conducted from 12 countries. Infant breastfeeding was recalled by parents or legal guardians. Height, weight, waist circumference, and body fat were obtained using standardized methods. The overall prevalence of obesity, central obesity, and high body fat were 12.3%, 9.9%, and 8.1%, respectively. After adjustment for maternal age at delivery, body mass index (BMI), highest maternal education, history of gestational diabetes, gestational age, and child's age, sex, birth weight, unhealthy diet pattern scores, moderate‐to‐vigorous physical activity, sleeping, and sedentary time, exclusive breastfeeding was associated with lower odds of obesity (odds ratio [OR] 0.76, 95% confidence interval, CI [0.57, 1.00]) and high body fat (OR 0.60, 95% CI [0.43, 0.84]) compared with exclusive formula feeding. The multivariable‐adjusted ORs based on different breastfeeding durations (none, 1–6, 6–12, and > 12 months) were 1.00, 0.74, 0.70, and 0.60 for obesity (Ptrend = .020) and 1.00, 0.64, 047, and 0.64 for high body fat (Ptrend = .012), respectively. These associations were no longer significant after adjustment for maternal BMI. Breastfeeding may be a protective factor for obesity and high body fat in 9‐ to 11‐year‐old children from 12 countries.
A qualitative study of the operating room experience of patients who underwent surgery under spinal anesthesia: “It was like an adventure”
Authors: Yilmaz Emel , Toğaç Hülya K. , Çetinkaya Aynur , Toğaç Soner
Published: March 2020

This study aimed to explore the experiences of the people who underwent orthopedic surgery under spinal anesthesia and to report their feelings and thoughts. The study was carried out using a qualitative approach. Twenty‐one patients were interviewed who underwent orthopedic surgery on the first or second postoperative day. Content analysis was performed after the collection of raw data. NVIVO 12 Pro software was used for data analysis. The frequency count (f) and participant codes (P) were used for the presentation of the findings. The themes and frequency counts obtained by analyzing the interviews with the patients were as follows: “Time passed like watching a movie” (f = 213), “Like an adventure” (f = 587), and “See, feel, look” (f = 405). Five of 21 participants (23.8%) stated that they would not recommend spinal anesthesia. The findings generally indicated the anxiety caused by the unknown, fear in the preanesthetic period, operation experienced like an adventure, and a process generally completed with satisfaction.
Endosperm enrichment and physicochemical properties of superior and inferior grain starch in super hybrid rice
Authors: Wang L. , Lin G. , Yu X. , Wu Y. , Chen G. , Xiong F.
Published: March 2020

A significant asynchronous phenomenon exists in super hybrid rice because of the differences in spike and spikelet positions, which affect the accumulation and properties of starch. However, little is known about the endosperm enrichment and physicochemical properties of starch in superior and inferior grains in super hybrid rice.

Rice YY2640 was selected as study material to investigate the enrichment and physicochemical properties of starch in superior and inferior grains in super rice using semi‐thin sections, X‐ray diffraction and related technologies.

Superior grain filling was a continuous process, whereas inferior grain only started 8–10 days after anthesis. The order of starch accumulation starts in the central endosperm, then in the endosperm of the proximal vascular bundle and finally in the aleurone layer. Compared with the inferior grains, the superior grains have a higher 1000‐grain weight, apparent amylose content, total starch content, average starch granule size, relative crystallinity, solubility and a resonance peak ratio at 1022/995 cm−1, whereas the swelling power and ratio of the resonance peak at 1045/1022 cm−1 were lower. The final degree of hydrolysis of HCl, AAG and PPA of the superior grains were significantly lower than those of the inferior grains.

The findings indicate that the different physicochemical properties of starch were mainly related to the development order of superior and inferior grains and the spatial enrichment of starch.