bluuebunny/crossref_metadata_2025 huggingface dataset:
The social welfare impact of double tax treaties in Sub Saharan Africa
Authors: Soondram Hema , Samy Martin , Jugurnath Bhavish
Published: March 2021

Purpose

This study aims to analyze tax revenue in the presence of double tax treaties affecting social welfare of the inhabitants in the Sub-Saharan African (SSA) developing economies, whose fiscal regimes are being branded as responsible for exacerbating poverty for the inhabitants. This paper seeks to determine if double tax treaties are negatively impacting on human development of the host countries.

Design/methodology/approach

This study analyses 21 SSA countries from 1996 to 2016 using panel models and bootstrapped quantile regression. It uses a devised mathematical model which introduces the interaction between tax revenue and double tax treaties and measures the social welfare impact using the human development index (HDI).

Findings

The findings have broadly shown that (i) the net effect from the complementarity between tax revenue and double tax treaty (DTTs) in influencing the human development is for the most part negative (ii) the impact of tax revenue from international trade has the most positive net effect as compared to other tax revenues when interacted with the DTT and (iii) the DTT complements the tax revenue from income, profits and capital gains to progressively increase human development in the upper quartiles of HDI.

Research limitations/implications

This study has examined how the presence of double tax treaties has impacted the effect of tax revenue on human development in 21 SSA countries for the period 1996–2016. A mathematical model was devised and bootstrapped quantile regression was used owing to the specificities of the sample. In accordance with recent literature on net effects, the results were interpreted.

Practical implications

It is evident that further research is required on whether double tax treaties are indirectly responsible for poverty on the rise in SSA countries or on the contrary, they bring FDI alongside with other positive spillovers which in the end contribute to a rise in the human development aspect of societies in developing host economies.

Social implications

The HDI is an important measure used nowadays for human development as a proxy for social welfare. This research will use an HDI mathematical model devised by Sinha and Sengupta (2019) and adapt it to the context to testing econometrically whether double tax treaties have an impact on welfare or poverty reduction. The empirical results will help determine whether tax treaties are impacting the social welfare positively or negatively.

Originality/value

This result is the first research attempt to consider both the impact of tax revenue (which is expected to have a positive impact on social welfare of the people of the host developing countries) and the impact of double tax treaties simultaneously. It is the first empirical study focusing on the impact of tax revenue on human development in the presence of double tax treaties. Its methodology is original and adds to the current literature to benefit policymakers and academia.
Teledermatology in times of COVID‐19
Authors: Stadler Pia‐Charlotte , Senner Sonja , Frey Surina , Clanner‐Engelshofen Benjamin M. , H. Frommherz Leonie , French Lars E. , Reinholz Markus
Published: March 2021

Remote consultations are likely to grow in importance in the following years, especially if the coronavirus disease 2019 (COVID‐19) pandemic continues. Patients’ opinions on teledermatology have already been analyzed, but a current analysis during the COVID‐19 pandemic is lacking. The purpose of this survey was to investigate the satisfaction of patients who had received dermatological advice via telephone during the COVID‐19 pandemic and to analyze their general opinion about eHealth as well as possible limitations for a broad implementation. Ninety‐one patients managed in the dermatology department using telephone consultation during the COVID‐19 pandemic were interviewed. An anonymous questionnaire, including the established quality of life questionnaire (Dermatology Life Quality Index [DLQI]), was used. It was found that men were more satisfied with telephone consultations than women (p = 0.029), educational level and age did not correlate with satisfaction (p = 0.186 and 388, respectively), and the longer the waiting time for a telephone consultation, the lower the satisfaction (p = 0.001). Grouped analysis of all participants showed that the majority (54.0% n = 38/71) were “very happy” with the telephone consultation. Higher disease burden (DLQI) was associated with lower satisfaction (p = 0.042). The main stated reasons for using telemedicine were shorter waiting times (51.6% n = 47/91) and no travel requirement (57.1% n = 47/91). Almost one‐quarter (23.1% n = 21/89) of patients would use teledermatology in the future, 17.6% (n = 16/89) would not, and 57.1% (n = 51/89) would only use it in addition to a traditional consultation with personal contact. In conclusion, most patients in the study group still preferred traditional face‐to‐face medical consultations to telephone consultations, but also desired an add‐on telemedical tool. Dermatological care using more modern telemedicine technologies than telephone conferencing is needed to better address patients’ desires, especially in times of the COVID‐19 pandemic.
Characteristics, treatments, and prognosis of a critical illness polyneuromyopathy patient with positive anti‐GM1 after severe traumatic brain injury: A case report
Authors: Luo Jiemin , Xia Zhiyuan , Che Yanjun , Zhou Ke
Published: March 2021

To investigate the clinical features, treatment and prognosis of critical illness polyneuromyopathy (CIPNM) in patients with severe traumatic brain injury (sTBI) who had positive anti‐ganglioside GM1 (anti‐GM1) antibody IgG. A case of CIPNM with positive anti‐GM1 antibody IgG was retrospectively analysed and followed‐up for 30 months. After 1 week of treatment with large dose of short‐term glucocorticoid and human immunoglobulin, the muscle strength of both lower extremities was restored to grade 1. Three months later, the muscle strength and muscle tension of the patient’s limbs returned to normal except for grade 3 of bilateral dorsal extensor muscle strength. In addition, the patient can walk alone with a waddling gait. After 30 months, there was no recurrence. The application of large dose of short‐term glucocorticoid and human immunoglobulin to CIPNM that are positive for anti‐GM1 antibodies may be an effective treatment.
Manipulation of host ecdysteroid hormone levels facilitates infection by the fungal insect pathogen,Metarhizium rileyi
Authors: Zhu Shengan , Feng Xueyao , Keyhani Nemat O. , Liu Yu , Jin Dan , Tong Sheng , Pei Yan , Fan Yanhua
Published: March 2021

Entomopathogenic fungi such asMetarhizium rileyiandBeauveria bassianaare widely used insect biological control agents. Little, however, is known concerning genetic or enzymatic factors that differentiate the mechanisms employed by these two fungal pathogens to infect target hosts. Infection by either of these organisms is known to increase levels of the growth and molting hormone, ecdysone, which also regulates the expression of a number of innate immune pathways.M. rileyi, but notB.bassiana, has apparently evolved an ecdysteroid‐22‐oxidase (MrE22O) that inactivate ecdysone. We show that deletion ofMrE22Oimpaired virulence compared with the wild‐type strain, with an increase in ecdysone titer seen in hosts that was coupled to an increase in the expression of antimicrobial genes. AnM.rileyistrain engineered to overexpressMrE22O(MrE22OOE), as well as trans‐expression inB.bassiana(Bb::MrE220OE) resulted, in strains displaying enhanced virulence and dampening of host immune responses compared with their respective wild‐type parental strains. These results indicate that ecdysone plays an important role in mediating responses to fungal infection and that some insect pathogenic fungi have evolved mechanisms for targeting this hormone as a means for facilitating infection.
Foraging behavior of an invasive alien hornet (Vespa velutina) at Apis mellifera hives in Korea: Foraging duration and success rate
Authors: Choi Moon Bo
Published: March 2021

The introduction of an invasive alien hornet (Vespa velutina) to Korea in 2003 has caused severe economic impacts on the beekeeping industry. We observed this hornet attacking honeybees at hives and need to develop control and management approaches for the hornet. We recorded the duration of foraging attacks and the success rate of V. velutina at beehives from July to October. The foraging duration was 40–50 s from July to early August but fell to ~20 s from the end of August, and 10 s was recorded in September. Twenty seconds was recorded at the beginning of October and foraging duration increased to 80 s at the end of October. This seems to be because the number of experienced, mature workers within the V. velutina nest is high from August. The foraging success was 80.63% overall but exceeded 96% in September. This is much higher than the success rate in the native region, which means that the local honeybees have not yet developed adequate defense mechanisms against predation by this new, invasive species.
Integrated molecular network and HPLC‐UV‐FLD analysis to explore antioxidant ingredients in camellia nitidissima Chi
Authors: Cheng Chuan‐jing , Hou Xiao‐tao , Hao Er‐wei , Palachai Nut , Wattanathorn Jintanaporn , Bai Gang , Hou Yuan‐yuan
Published: March 2021

At present, screening of active ingredients from natural products for pharmacological and clinical research is mostly time‐consuming and costly. In this study, a molecular network (MN) guided high performance liquid chromatography‐ultraviolet‐fluorescence detector (HPLC‐UV‐FLD) method was carried out to profile the global antioxidant activity compounds, including the trace amount ingredients in Camellia nitidissima Chi (CNC). Firstly, HPLC‐UV‐FLD postcolumn derivatization system was utilized to screen the antioxidants. Then the MN of CNC was established via mass spectrometry (MS) data for getting the connection between ingredient structures. As a result, HPLC‐UV‐FLD indicated three antioxidant ingredients: gallic acid (126.3 mg/g), catechin (564.8 mg/g), and salicylic acid (24.3 mg/g). Combined with the MN, the actives' precise location and connection relationship were clarified based on the structural similarities. A new antioxidant ingredient, okicamelliaside, was suggested and evaluated at free radical scavenging and enzymatic protection. The novel method of activity and structural correlation analysis based on MN could provide a useful guide for screening trace active ingredients in natural products.

Practical Application

Three main ingredients were screened out from Camellia nitidissima Chi by HPLC‐UV‐FLD postcolumn derivatization system. Integrated molecular network and HPLC‐UV‐FLD analysis, a new type of antioxidant okicamelliaside was selected. The novel method of activity and structural correlation analysis based on molecular network could provide a useful guide for screening trace active ingredients in natural products.
Fatalism Knowledge and Inquiry in African American Family Stories of Death Premonition
Authors: Fraser Gertrude Jacinta
Published: March 2021

In stories of unexpected death, rural African Americans investigate signs of premonition and personal destiny in the predeath behavior, biographical attributes, and conversations of deceased relatives. Premonition is clouded in misdirection; stories explore the conundrum that the future is known and actively communicated by those who will die, but the information only becomes accessible to the living after the person's death. Latent predictive powers exist in the universe, but they must be discovered and ratified. Drawing on epistemologies of surprise and the exotic, I argue that premonition is an individual and communal knowledge inquiry process through which the living test fate's edges, respond to its possibilities, and seek to predict its influence. I challenge scholarly interpretations of fatalism as a passive, ultimately defeatist worldview. [death communication, premonition knowledge, family stories, fatalism, surprise and intentionality, African American]
Children hospitalised with four common viral diseases showed epidemiological differences but few socio‐economic variations
Authors: Widgren Katarina , Eriksson Margareta , Bennet Rutger , Giesecke Johan
Published: March 2021

Aim

This study explored the differences in demographic and socio‐economic factors between children hospitalised due to four common viral infections.

Methods

Demographic data were obtained from Statistics Sweden on >3000 children admitted to Astrid Lindgren Children's Hospital in 2009–2014 with rotavirus, influenza, respiratory syncytial virus (RSV) or chickenpox. We compared demographic and socio‐economic factors between case groups using logistic regression with rotavirus cases as reference.

Results

There were differences in the median age at admission; RSV cases were younger (0.4 years), influenza (2.4 years) and chickenpox cases (2.7 years) older than rotavirus cases (1.2 years). RSV, influenza and chickenpox cases lived in families with more children than rotavirus cases. RSV and influenza cases were more likely to have underlying chronic conditions. Mothers of RSV cases were more likely to be born in Sweden. Further socio‐economic differences were not robustly confirmed in sensitivity analyses.

Conclusion

We found a few differences in demographic factors between children hospitalised with the four common infections, which were mainly explained by the epidemiology and transmission patterns of these infections.
Food constituent– and herb–drug interactions in oncology: Influence of quantitative modelling on Drug labelling
Authors: Pilla Reddy Venkatesh , Jo Heeseung , Neuhoff Sibylle
Published: March 2021

Aims

Herbal products, spices and/or fruits are perceived as inherently healthy; for instance, St. John's wort (SJW) is marketed as a natural antidepressant and patients often self‐administer it concomitantly with oncology medications. However, food constituents/herbs can interfere with drug pharmacokinetics, with risk of altering pharmacodynamics and efficacy. The objective of this work was to develop a strategy to prioritize herb– or food constituent–drug interactions (FC‐DIs) to better assess oncology drug clinical risk.

Methods

Physiologically based pharmacokinetic (PBPK) models were developed by integrating in vitro parameters with the clinical pharmacokinetics of food constituents in grapefruit juice (bergamottin), turmeric (curcumin) or SJW (hyperforin). Perpetrator files were linked to verified victim PBPK models through appropriate interaction mechanisms (cytochrome P450 3A, breast cancer resistance protein, P‐glycoprotein) and applied in prospective PBPK simulations to inform the likelihood and magnitude of changes in exposure to osimertinib, olaparib or acalabrutinib.

Results

Reported FC‐DIs with oncology drugs were well recovered, with absolute average fold error values of 1.10 (bergamottin), 1.05 (curcumin) and 1.01 (hyperforin). Prospective simulations with grapefruit juice and turmeric showed clinically minor to insignificant changes in exposure (<1.50‐fold) to acalabrutinib, osimertinib and olaparib, but predicted 1.57‐fold FC‐DI risk between acalabrutinib and curcumin. Moderate DDI risk was expected when acalabrutinib, osimertinib or olaparib were dosed with SJW.

Conclusions

A model‐informed decision tree based on mechanistic understanding of transporter and/or enzyme‐mediated FC‐DI is proposed based on bergamottin, curcumin and hyperforin FC‐DI clinical data. Adopting this quantitative modelling approach should streamline herbal product safety assessments, assist in FC‐DI management, and ultimately promote safe clinical use of oncology drugs.
Review: The mental health implications for children and adolescents impacted by infectious outbreaks – a systematic review
Authors: Berger Emily , Jamshidi Negar , Reupert Andrea , Jobson Laura , Miko Amy
Published: March 2021

Background

This systematic review synthesized available research on the psychological implications for children and adolescents who either were directly or indirectly exposed to an infectious outbreak. On this basis, the current paper aims to provide recommendations for future research, practice and policy regarding children during pandemics.

Method

A total of 2195 records were retrieved from the PsycINFO, SCOPUS and MEDLINE databases, and three from Google Scholar.

Results

Including only those papers that focused on children or adolescent’s mental health in association with respiratory infectious outbreaks, 11 articles were identified. The majority of research utilized qualitative or retrospective hospital record data. Children and adolescents reported fear and anxiety, as well as disruptions to their day to day routines as a result of outbreaks. However, children were also able to demonstrate resilience during outbreaks with the right support.

Conclusions

Children’s psychological response to the outbreak appeared to be largely attributed to how their parents, healthcare providers and the media communicated the event. Recommendations for policy, practitioners and researchers concerning the current COVID‐19 outbreak concludes the paper.
Representational commissions and policy‐making on Indigenous and women’s issues: A case‐study of the Liberal Party and the New Democratic Party of Canada
Authors: Allsop Corinne , Richez Emmanuelle
Published: March 2021

The New Democratic Party of Canada and the Liberal Party of Canada have put in place representational commissions to encourage politically underrepresented groups, such as women and Indigenous Peoples, to be active party members and to contribute to policy development. Whether they influence policy on Indigenous and women’s issues is unclear. This article analyzes political conventions’ policy resolutions, electoral platforms, and governmental actions. Can representational commissions influence policy on Indigenous and women’s issues?
Delayed symptoms and orthostatic intolerance following peanut challenge
Authors: Turner Paul J. , Ruiz‐Garcia Monica , Patel Nandinee , Abrantes Gonçalo , Burrell Sarah , Vazquez‐Ortiz Marta , Skypala Isabel , Durham Stephen R. , Boyle Robert J.
Published: March 2021

Background

Clinical reactions to Oral Food Challenge (OFC) in peanut‐allergic individuals have been well‐characterised, but rates and phenotypes of symptom recurrence beyond the first hour after objective symptoms are less well‐characterised.

Objective

To evaluate the rate of new‐onset symptoms occurring at least 1 h after stopping OFC in peanut‐allergic children and adults undergoing peanut‐OFC.

Methods

We prospectively collected data relating to adverse events following positive reactions at double‐blind, placebo‐controlled food challenges (DBPCFC) to peanut in children and adults evaluated for eligibility to participate in two clinical trials (NCT02149719, NCT02665793). The trials included people aged 8 to 45 with primary, IgE‐mediated peanut allergy at DBPCFC. The challenge protocol included consumption of a light meal 1 h after reaction.

Results

A total of 121 participants (64 children, 57 adults) had immediate, objective symptoms at DBPCFC, 25 (17 children, 8 adults) with anaphylaxis. Thirty‐three (27%) had progression or recurrence of symptoms ≥ 1 h after objective clinical reaction, of whom 8 developed anaphylaxis. In 23 cases, the onset of new symptoms was associated with consumption of a light meal. In eight cases, symptoms were limited to a symptomatic postural fall in blood pressure noted in preparation for discharge, without any other new features of an allergic reaction.

Conclusions & Clinical Relevance

Progressive or new‐onset symptoms ≥1 h following initial allergic reaction at OFC are common and can include orthostatic hypotension. Recurrent symptoms may be temporally associated with food consumption.
The prevalence of peri‐implant diseases around subcrestally placed implants: A cross‐sectional study
Authors: Obreja Karina , Ramanauskaite Ausra , Begic Amira , Galarraga‐Vinueza Maria Elisa , Parvini Puria , Sader Robert , Schwarz Frank
Published: March 2021

Objectives

To evaluate the prevalence of peri‐implant health, peri‐implant mucositis or periimplantitis for subcrestally placed implants (1–3 mm) on the short‐, medium‐ and long term.

Material and Methods

Two hundred patients were enrolled in this cross‐sectional study that were treated and screened during regular maintenance visits at one university center. A total of 657 implants were evaluated. Peri‐implant health and diseases were assessed according to predefined case definitions. Binary logistic regression was used to assess the correlation with local and systemic factors.

Results

After a median function time of 9.36 ± 6.44 years (range: 1–26 years), the prevalence of peri‐implant mucositis and peri‐implantitis was 66.5% and 15.0%, at the patient level, corresponding to 62.6% and 7.5%, at the implant level, respectively. Peri‐implantitis was significantly associated with patients’ history of periodontitis (odds ratio, OR 5.33).

Conclusion

Peri‐implant diseases were a common finding around subcrestally placed implants.
Clinical efficacy of simvastatin gel combined with polypropylene membrane on the healing of extraction sockets: A triple‐blind, randomized clinical trial
Authors: Cruz Rebecca , Moraschini Vittorio , Calasans‐Maia Monica Diuana , de Almeida Daniel Costa Ferreira , Sartoretto Suelen Cristina , Granjeiro José Mauro
Published: March 2021

Objectives

This study aimed to evaluate dimensional changes, level of soft tissue healing, and pain/discomfort perception in post‐extraction sockets filling with 1.2% simvastatin (SIM) gel covered with polypropylene membranes (PPPM).

Material and methods

Twenty‐six post‐extraction sockets of posterior teeth were randomly allocated in two groups: (a) socket filling with 1.2% SIM gel and covered with PPPM (n = 13) and (b) socket filling with placebo gel and covered with PPPM (n = 13). Cone‐beam computed tomography (CBCT) images before and 90 days after the extraction enabled alveolar bone dimensional changes calculation using horizontal and vertical measurements. The measurements occurred at three different levels for thickness located 1, 3, and 5 mm from the top of the bone crest. The vertical (depth) measure was assessed from the most apical portion of the socket to the bone crest's most coronal portion. Seven days after the extractions, the level of soft tissue healing and pain perception were also analyzed.

Results

After 90 days of extractions, the dimensional changes in thickness in the test group were significantly smaller in sections A (p = .044), B (p = .036) and C (p = .048) when compared to the control group. The test group showed a significantly lower height‐dimensional change than the control group (p < .0001). Soft tissue healing index (p = .63), perception of pain (p = .23), and number of analgesics consumed (p = .25) were similar between groups.

Conclusions

Simvastatin at 1.2% compared with placebo effectively reduced the dimensional changes in post‐extraction sockets covered with PPPM. There was no significant difference in the level of soft tissue healing and postoperative pain between the test and control groups.
Enamel matrix derivative promotes new bone formation in xenograft assisted maxillary anterior ridge preservation—A randomized controlled clinical trial
Authors: Mercado Faustino , Vaquette Cedryck , Hamlet Stephen , Ivanovski Sašo
Published: March 2021

Objectives

To compare the effectiveness of deproteinized bovine bone mineral with 10% collagen alone (DBBMC) or with enamel matrix derivative (DBBMC‐EMD) in ridge preservation.

Methods

42 maxillary anterior teeth were extracted and received either a DBBMC (control) or DBBMC‐EMD (test) treatment protocol. CBCT taken before and 4 months after the extraction procedure was used to measure changes in alveolar ridge width (RW), buccal bone height (BH) and palatal bone height (PH). Bone cores were harvested during implant osteotomy preparation, and the samples processed histomorphometrically to assess the fraction of new bone (%NB), residual graft (%RG) and soft tissue matrix (%STM).

Results

Overall, both treatment groups showed significant reductions in mean RW from baseline to 4 months after extraction, but no significant change in either mean BH or PH over this time. When CBCT measurements were analysed according to the initial thickness of the buccal wall (BT < 1 mm vs. BT ≥ 1 mm), significant reductions in all ridge dimensions (RW, BH and PH) were noted in the <1 mm BT group. Histomorphometrically, the DBBMC‐EMD test group showed significantly increased new bone formation (%NB): (control = 16.5 ± 6.9% cf.; test = 45.1 ± 8.8%) with less residual graft (%RG): (control = 36.8 ± 8.8% cf.; test = 20.3 ± 7.2%) compared to the DBBMC control group.

Conclusions

Both DBBMC alone and DBBMC‐EMD treated sites 4 months after extraction lost RW but showed no significant change in BH or PH. Irrespective of treatment, maxillary anterior teeth with thick initial buccal walls (≥1 mm) exhibited less alveolar ridge reduction 4 months after treatment. The addition of EMD to DBBMC resulted in more new bone formation in the test group.
Chronic cough is associated with depressive mood in women regardless of smoking status and lung function
Authors: Heo I Re , Kim Ju‐Young , Go Se‐Il , Kim Tae Hoon , Ju Sunmi , Yoo Jung‐Wan , Lee Seung Jun , Cho Yu Ji , Jeong Yi Yeong , Lee Jong Deog , Kim Ho Cheol
Published: March 2021

Background

Chronic cough is a common respiratory symptom, and, if persistent, the patient’s quality of life can worsen and result in a depressive mood, or vice versa. Although previous reports suggest a relationship between chronic cough and depression, we further investigated this relationship according to smoking status and lung function.

Methods

This observational study used cross‐sectional data from the 6th Korean National Health and Nutrition Examination Survey (2014 and 2016). Propensity score matching using age, sex, smoking status, and lung function was performed for participants with and without chronic cough to reduce the confounding effects associated with depressive mood. Questionnaires recorded coughs persisting for >3 months and the Patient Health Questionnaire‐9 (PHQ‐9) assessed the severity of depressive mood.

Results

Among 12 494 participants who were >18 years old, 226 with chronic cough were matched with 226 with non‐chronic cough. Overall, chronic cough participants showed higher PHQ‐9 scores than the non‐chronic cough participants (4.29 ± 5.23 vs. 2.63 ± 3.38, P < .001). When stratified by sex, the difference remained significant in women (5.69 ± 5.96 vs. 3.05 ± 3.97, P < .001) but not in men (3.18 ± 4.27 vs. 2.31 ± 3.65, P = .092). When stratified by lung function status, the difference remained significant for those with normal lung function (4.32 ± 5.32 vs. 2.78 ± 3.86, P = .003) and reduced lung function (4.19 ± 4.93 vs. 2.11 ± 3.55, P ≤ 0.001). Multivariate logistic regression analysis revealed that chronic cough was associated with PHQ‐9 score (odds ratio [OR], 1.06; 95% confidence interval [CI], 1.014–1.27, P = .014), chronic obstructive pulmonary disease (OR, 4.87; 95% CI, 1.041–22.86, P = .044) and physician‐diagnosed bronchial asthma (OR, 2.93; 95% CI, 1.162–7.435, P = .023).

Conclusions

Depressive mood is significantly correlated with chronic cough in females.
A comparison of cardiopulmonary bypass versus extracorporeal membrane oxygenation: Does intraoperative circulatory support strategy affect outcomes in pediatric lung transplantation?
Authors: Parikh Amisha N. , Merritt Taylor C. , Carvajal Horacio G. , Shepard Mark S. , Canter Matthew W. , Abarbanell Aaron M. , Eghtesady Pirooz , Nath Dilip S.
Published: March 2021

Objective

Data on adult lung transplantation suggest perioperative benefits of intraoperative extracorporeal membrane oxygenation (ECMO) compared to cardiopulmonary bypass (CPB). Information regarding their pediatric counterparts, however, is limited. This study compares outcomes of intraoperative ECMO versus CPB in pediatric lung transplantation.

Methods

We reviewed all pediatric lung transplants at our institution from 2014 to 2019 and compared those supported intraoperatively on ECMO (n = 13) versus CPB (n = 22), plus a conditional analysis excluding re‐transplantations (ECMO [n = 13] versus CPB [n = 20]). We evaluated survival, surgical times, intraoperative transfusions, postoperative support, complications, and duration of hospitalization.

Results

Total time on ECMO support was significantly less than that of CPB support (P = .018). Intraoperatively, the ECMO group required fewer transfusions of fresh‐frozen plasma (8.9 [5.8‐22.3] vs 16.6 [11.4‐39.0] mL/kg, P = .049) and platelets (4.2 [0.0‐6.7] vs 8.0 [3.5‐14.0] mL/kg, P = .049). When excluding re‐transplantations, patients on ECMO required fewer packed red blood cells intraoperatively (12.6 [2.1‐30.7] vs 28.2 [14.0‐54.0] mL/kg, P = .048). There were no differences in postoperative support requirements, complications, or mortality at one, six, and twelve months.

Conclusions

Intraoperative ECMO support during pediatric lung transplantation appears to decrease intraoperative transfusion requirements when compared to CPB. Data from additional institutions may strengthen these observations.
Trends in adolescent alcohol and other risky health‐ and school‐related behaviours and outcomes in Australia
Authors: Vashishtha Rakhi , Pennay Amy , Dietze Paul M. , Livingston Michael
Published: March 2021

Introduction

Adolescent drinking has been declining in Australia over the past two decades, but this trend may be part of a broader shift towards healthier lifestyles for adolescents. We examined trends in the prevalence of multiple risky health‐ and school‐related behaviours and outcomes to test whether this was the case.

Methods

Data on multiple behaviours and outcomes were collated from Australian government agencies and other relevant sources for 10–19‐year‐olds from the year 2000 onward. Trends were examined descriptively.

Results

Rates of substance use, youth offending and injuries due to underage driving declined over the study period. Some health‐related behaviours (physical activity and diet) worsened between 2001 and 2017; however, obesity rates remained stable. Risky sexual behaviours increased in terms of early initiation of lifetime sexual intercourse and decreased condom use. However, sexual health outcomes improved with a reduction in teenage pregnancies and there was a recent decline in sexually transmitted infection rates from 2011 onward. Suicide rates and rates of major depressive disorders increased. School attendance and engagement in full‐time work or study remained stable.

Discussion and Conclusions

The decline in adolescent drinking does not appear to correspond with increased engagement in healthier behaviours; however, it may be related to a more risk‐averse way of living. Future work could be directed towards identifying which social, economic, policy and environmental factors have impacted positive changes in risky behaviours. Public health efforts can then be directed towards behaviours or outcomes, which have not yet improved.
Attitudinal factors associated with drink counting
Authors: Booth Leon , Jongenelis Michelle I. , Drane Catherine , Miller Peter G. , Chikritzhs Tanya , Hasking Penelope , Hastings Gerard , Thorn Michael , Pettigrew Simone
Published: March 2021

Introduction

‘Count your drinks’ is a protective behavioural strategy (PBS) that has been found to be effective in reducing alcohol consumption. Previous research has shown that females, older people and low‐risk drinkers are more likely to use this strategy, but little is known about the attitudinal factors associated with engaging in drink counting. This information is important for developing effective interventions to encourage use of this PBS. The aim of this paper was to assess whether the following attitudinal factors are associated with frequency of enactment of the ‘Count your drinks’ PBS: (i) perceived ease of use; (ii) perceived effectiveness; (iii) personal relevance; and (iv) believability.

Methods

A total of 683 Australian drinkers completed an online survey assessing demographic variables, alcohol consumption, frequency of drink counting and attitudes to the ‘Count your drinks’ PBS. A hierarchical regression analysis was used to determine whether the attitudinal factors were associated with frequency of enactment after controlling for demographic and alcohol‐related factors.

Results

Attitudes to the ‘Count your drinks’ PBS accounted for 28% of the variance in reported frequency of drink counting. Perceptions of personal relevance, ease of use and effectiveness were found to be significantly associated with frequency of enactment.

Discussion and Conclusions

Interventions designed to encourage drinkers to count their drinks should aim to increase the perceived personal relevance, ease of use and effectiveness of this strategy.
Sperm performance limits the reproduction of an invasive fish in novel salinities
Authors: Green Leon , Niemax Jan , Herrmann Jens‐Peter , Temming Axel , Behrens Jane W. , Havenhand Jonathan N. , Leder Erica , Kvarnemo Charlotta
Published: March 2021

Aim

The few fish species able to reproduce across wide osmotic ranges either plastically acclimate sperm performance to, or are locally adapted to, different salinities. The invasive round goby (Neogobius melanostomus) is spreading in Eurasia and the Americas, into both fresh and brackish water. We aim to understand if reproduction in different salinities is affected by an ability to acclimate.

Location

Brackish and freshwater systems of northern Europe and the Baltic Sea.

Methods

We cross‐exposed round gobies of freshwater and brackish origin to 0 and 16 practical salinity units (PSU), and the fish were given nest boxes in which to spawn. After 4 weeks, we measured their sperm performance in both 0 and 16 PSU; fertilization success of each egg clutch was measured through visual analysis of eggs. Clutches were split and allowed to develop in both 0 and 16 PSU salinity, and reproductive success (zygote development) was measured 20 ± 1 days later. Responses were analysed using generalized mixed models.

Results

After a month, the fish showed no plasticity in sperm performance to their acclimation salinity, regardless of their origin. Sperm velocity was highest in the salinity similar to the males’ origin. Significantly lower fertilization success was measured for individuals that reproduced outside their salinity of origin despite recurring spawning events in all treatment groups. Among fertilized eggs, zygote development was similar regardless of salinity treatment of either eggs or parents.

Main Conclusions

Short‐term acclimation to new salinities does not affect sperm performance in the round goby. Alternative hypotheses such as local adaption should be further investigated. Limits to the species’ reproductive success, and therefore invasion processes, are likely dependent on environment‐phenotype matches. Fish of brackish origin spawned successfully in freshwater, pointing to an increased risk of introducing populations of brackish origin into freshwater.
Charting a path forward for clinical research in artificial intelligence and gastroenterology
Authors: Glissen Brown Jeremy R. , Waljee Akbar K. , Mori Yuichi , Sharma Prateek , Berzin Tyler M.
Published: March 2021

Gastroenterology has been an early leader in bridging the gap between artificial intelligence (AI) model development and clinical trial validation, and in recent years we have seen the publication of several randomized clinical trials examining the role of AI in gastroenterology. As AI applications for clinical medicine advance rapidly, there is a clear need for guidance surrounding AI‐specific study design, evaluation, comparison, analysis and reporting of results. Several initiatives are in the publication or pre‐publication phase including AI‐specific amendments to minimum reporting guidelines for clinical trials, society task force initiatives aimed at priority use cases and research priorities, and minimum reporting guidelines that guide the reporting of clinical prediction models. In this paper, we examine applications of AI in clinical trials and discuss elements of newly published AI‐specific extensions to the Consolidated Standards of Reporting Trials and Standard Protocol Items: Recommendations for Interventional Trials statements that guide clinical trial reporting and development. We then review AI applications at the pre‐trial level in both endoscopy and other subfields of gastroenterology and explore areas where further guidance is needed to supplement the current guidance available at the pre‐trial level.
Developing context‐relevant project experiences for marketing analytics students
Authors: Lim Jeen‐Su , Heinrichs John H.
Published: March 2021

Today's firms are inundated with a huge volume of data and face requirements to use this data to gain and maintain competitive advantage. In this teaching brief, we address the confirmed analytic skills gap by providing context‐relevant learning experiences to business students. Specifically, a marketing analytics project development model is proposed, with details on its design and implementation in a senior‐level course at a major Midwestern university. The course content and project were administered through a learning management system using HubSpot's CRM software tools. For the project, students were provided with data visualizations for a hypothetical firm; then they performed additional analysis using HubSpot CRM dashboards. Final student projects, as well as course evaluations, suggest that students gained enhanced marketing analytics skills that will be valuable in the future job market.
Developing a distinctive consulting capstone course in a supply chain curriculum
Authors: Roethlein Christopher J. , McCarthy Byrne Teresa M. , Visich John K. , Li Suhong , Gravier Michael J.
Published: March 2021

This article describes a required capstone course for students in the Global Supply Chain Management (GSCM) Program at Bryant University, designed to prepare students for a career in supply chain management. Student teams work on semester‐long projects for locally and regionally based companies. The projects are supported by all GSCM faculty who teach in the Information Systems and Analytics, Management, and Marketing departments. Since the inception of this capstone course in the fall of 2010, a total of 83 projects for 42 companies have been completed. Hence this article discusses an extensive number of projects over an extended period of time, and our insights should be of interest to supply chain faculty who currently have, or plan to include, empirical projects as a key component of their course or supply chain program. We present a brief literature review on teaching supply chain management, and then describe the practicum capstone course, Empirical Applications in Global Supply Chain Management. We provide company and project descriptions and discuss project outcomes. Students have estimated savings/earnings impact of $109.5 million from 35 projects completed over a 4‐year period. Although not without challenges, the practicum capstone course provides students with an integrative, multidisciplinary experience that better prepares them for their careers.
Diastolic function as an early marker for systolic dysfunction and all‐cause mortality among cancer patients
Authors: Arnold Joshua H. , Rozenbaum Zach , Hochstadt Aviram , Rosen Roni , Sherez Chen , Sivan Ayelet , Mor Liat , Moshkovits Yonatan , Sadeh Ben , Havakuk Ofer , Milwidsky Assi , Shamai Sivan , Sirota Dorfman Svetlana , Arbel Yaron , Topilsky Yan , Laufer‐Perl Michal
Published: March 2021

Background

Increased survival among active cancer patients exposes a wide range of side effects, including cardiotoxicity, manifested by systolic dysfunction and associated with morbidity and mortality. Early diagnosis of subclinical function changes and cardiac damage is essential in the management of these patients. Diastolic dysfunction is considered common among cancer patients; however, its effect on systolic dysfunction or mortality is still unknown.

Methods

Data were collected as part of the Israel Cardio‐Oncology Registry, enrolling and prospectively following all patients evaluated in the cardio‐oncology clinic in the Tel Aviv Sourasky Medical Center. All patients underwent echocardiographic examinations including evaluation of diastolic parameters and global longitudinal strain (GLS). Systolic dysfunction was defined as either an absolute reduction >10% in left ventricular ejection fraction to a value below 53% or GLS relative reduction >10% between the 1st and 3rd echocardiography examinations.

Results

Overall, 190 active cancer patients were included, with a mean age of 58 ± 15 years and a female predominance (78%). During a median follow‐up of 243 days (interquartile ranges [IQR]: 164‐401 days), 62 (33%) patients developed systolic dysfunction. Over a median follow‐up of 789 days (IQR: 521‐968 days), 29 (15%) patients died. There were no significant differences in baseline cardiac risk factors between the groups. Using multivariate analysis, E/e′ lateral and e′ lateral emerged as significantly associated with systolic dysfunction development and all‐cause mortality (P = .015).

Conclusion

Among active cancer patients, evaluation of diastolic function may provide an early marker for the development of systolic dysfunction, as well as all‐cause mortality.
Two cases of acute endocarditis misdiagnosed as COVID‐19 infection
Authors: Hayes Dena E. , Rhee David W. , Hisamoto Kazuhiro , Smith Deane , Ro Richard , Vainrib Alan F. , Bamira Daniel , Zhou Fang , Saric Muhamed
Published: March 2021

The COVID‐19 pandemic has presented countless new challenges for healthcare providers including the challenge of differentiating COVID‐19 infection from other diseases. COVID‐19 infection and acute endocarditis may present similarly, both with shortness of breath and vital sign abnormalities, yet they require very different treatments. Here, we present two cases in which life‐threatening acute endocarditis was initially misdiagnosed as COVID‐19 infection during the height of the pandemic in New York City. The first was a case of Klebsiella pneumoniae mitral valve endocarditis leading to papillary muscle rupture and severe mitral regurgitation, and the second a case of Streptococcus mitis aortic valve endocarditis with heart failure due to severe aortic regurgitation. These cases highlight the importance of careful clinical reasoning and demonstrate how cognitive errors may impact clinical reasoning. They also underscore the limitations of real‐time reverse transcription‐polymerase chain reaction (RT‐PCR) for SARS‐CoV‐2 testing and illustrate the ways in which difficulty interpreting results may also influence clinical reasoning. Accurate diagnosis of acute endocarditis is critical given that surgical intervention can be lifesaving in unstable patients.
Augmented human development in the age of globalization†
Authors: Prados de la Escosura Leandro
Published: March 2021

A long‐run view of well‐being over the last one‐and‐a‐half centuries is presented using an Augmented Human Development Index (AHDI) that combines achievements in health, education, material living standards, and political freedom. The AHDI shows substantial gains in world human development since 1870, although significant room for improvement still remains. The AHDI spread unevenly until 1960, in absolute terms, and up to 1929 in relative ones, and reversed this trend thereafter. The main relative gain went to world countries’ middle class, but the main absolute gain accrued to the top decile. AHD trends and distribution do not match, but compare favourably with, those in per capita income. The absolute gap between present‐day advanced countries and the rest of the world deepened over time, though fell in relative terms. Life expectancy has led progress in AHD, particularly until 1970, and drove the catching‐up by the rest of the world during the epidemiological transition. Political and civil liberties took over thereafter.
A new reliable and highly specific monoclonal antibody to detect the C‐terminal region of silencer of cytokine signaling 1
Authors: Weissinger Stephanie E. , Zahn Malena , Marienfeld Ralf , Tessmer Claudia , Moldenhauer Gerhard , Möller Peter
Published: March 2021

Introduction

SOCS1, a negative regulator of JAK/STAT signaling, is among the most frequently mutated genes in DLBCL and classical Hodgkin lymphoma. The C‐terminal SOCS box domain, mediating the degradation of phospho‐JAK2, is often affected or even lacking. The analysis of such variants is hampered by the lack of a SOCS1‐specific monoclonal antibody recognizing the C‐terminus of SOCS1. As this C‐terminus is often lost or mutated in B‐cell lymphomas, staining with amino‐terminal targeting antibodies in a lymphoma setting might be misleading.

Methods

BALB/c mice were immunized with a truncated SOCS1 C‐terminal protein. The supernatant of generated hybridoma cells was screened by ELISA and, immunohistochemically, on formalin‐fixed and paraffin‐embedded tonsil. After antibody purification by affinity chromatography, epitope mapping and cross‐reactivity check followed via substitution scans. SOCS1 protein expression was investigated on cell cultures and cytoblocks of SOCS1WT stably transfected HEK293T cells, lymphoma cell lines and lymphoid tissues.

Results

Procedures resulted in one monoclonal IgG1 anti‐SOCS1 antibody, 424C, that recognizes and strongly binds to the C‐terminal region of SOCS1 in immunoblot and immunohistochemistry analyses.

Conclusion

This new anti‐SOCS1 monoclonal antibody is a valuable tool to detect SOCS1 expression dependent on an existing SOCS1 box and, therefore, indicating a full‐length SOCS1 protein.
Somatic symptoms have negligible impact on Patient Health Questionnaire‐9 depression scale scores in neurological patients
Authors: Katzan Irene L. , Lapin Brittany , Griffith Sandra , Jehi Lara , Fernandez Hubert , Pioro Erik , Tepper Stewart , Crane Paul K.
Published: March 2021

Background and purpose

There is concern that the Patient Health Questionnaire‐9 (PHQ‐9) depression scale may be impacted by the presence of somatic symptoms (differential item functioning [DIF]) in patients with neurological conditions. We evaluated the PHQ‐9 for the presence and impact of DIF in large clinical samples of neurological patients.

Methods

We conducted a cross‐sectional study of patients seen at the Cleveland Clinic Cerebrovascular, Headache, Movement Disorder, and Neuromuscular clinics who completed the PHQ‐9 and patient‐reported disease severity measures as part of standard care between 29 July 2008 and 21 February 2013. We evaluated PHQ‐9 items for DIF with respect to disease‐specific severity for each condition. Salient DIF impact was characterized as a difference between DIF‐adjusted and unadjusted PHQ‐9 scores.

Results

Included in the study were 2112 patients with stroke, 8221 with migraine, 440 with amyotrophic lateral sclerosis (ALS), and 5022 with Parkinson disease (PD). Several PHQ‐9 items demonstrated DIF with respect to disease‐specific severity, although salient DIF was present in very few patients (stroke, n = 0; migraine, n = 1; ALS, n = 13; PD, n = 1).

Conclusions

PHQ‐9 items function consistently across disease severity, with salient levels of DIF impact found only for a very small proportion of people. These results suggest that the PHQ‐9 provides a consistent measure of depression severity among people with neurological conditions associated with somatic symptoms that overlap with depression.