bluuebunny/crossref_metadata_2025 huggingface dataset:
Ill-being or well-being? Energising international business travellers
Authors: Rattrie Lucy , Kittler Markus
Published: June 2020

Purpose

The purpose of this qualitative study is to explore well-being experiences of international business travellers (IBTs) and contribute to our understanding of personal and job characteristics as antecedents of ill- or well-being.

Design/methodology/approach

The authors’ insights are based on semi-structured in-depth interviews with 32 IBTs assigned to various destinations ranging from single-country travel to global operation. Participants in this study represent a range of traveller personas (regarding demographics, type of work, travel patterns). Thematic analysis is used to reveal new insights.

Findings

The authors’ analysis revealed trip-load (i.e. workload, control, organisational support) and intensity of travel (i.e. frequency, duration and quality) as job characteristics that sit on an energy stimulation continuum, driving work-related outcomes such as stress and burnout or health and well-being. Energy draining and boosting processes are moderated by cognitive flexibility and behavioural characteristics.

Practical implications

Findings represent a framework for managing IBT well-being via adjustments in job and travel characteristics, plus guidance for training and development to help IBTs self-manage.

Originality/value

The insights within this paper contribute to the conversation around how to enhance well-being for IBTs and frequent flyers. The study intends to offer direction as to which specific job, psychological and behavioural characteristics to focus on, introducing a novel framework for understanding and avoiding serious consequences associated with international mobility such as increased stress, burnout and ill-health.
Tourism research progress – a bibliometric analysis of tourism review publications
Authors: Leong Lai-Ying , Hew Teck-Soon , Tan Garry Wei-Han , Ooi Keng-Boon , Lee Voon-Hsien
Published: June 2020

Purpose

Tourism review (TR) celebrates its 75th anniversary in 2020. The purpose of this paper is to proffer a holistic overview of TR based on bibliometric analyses of the publications from 2001 to 2019.

Design/methodology/approach

The research method entails performance analyses and science mapping analyses on TR. The performance analyses engage a sequence of bibliometric statistics, including citation analysis, most cited authors and papers, most influential and productive authors, countries and institutions to name a few. The authors also used visualization of similarities viewer to perform the science mapping analysis of TR based on co-citations of cited authors, bibliographic couplings of authors and countries and co-occurrences of authors’ keywords from 2001 to 2019 and from 2014 to 2019. To examine the thematic evolution using SciMAT, a de-duplicating process was conducted in which 1,485 keywords were refined to 128 word groups before thematic evolution map and strategic diagrams for the three sub-periods were generated.

Findings

The thematic evolution map revealed ten thematic areas. The key themes of each of these thematic areas are destination studies, tourism destination and hospitality tourism; destination studies, competitiveness and innovations, co-operations and experience tourism; business studies, sports tourism, tourism destination and satisfaction; quality studies, networks, social studies and co-operation; business model and sports tourism; tourism management and tourism destination; political studies, perception and satisfaction; political studies, sustainability studies, social studies and health tourism; behavior, perception and satisfaction; and cultural tourism and tourism destination.

Research limitations/implications

The study has managed to unveil the key trends of publications, authors, affiliations, nations and authors’ keywords. The findings are useful for potential authors to have a quick snapshot of what is expected from and what is happening in TR.

Originality/value

The study serves as a historical record of TR’s publications. It presents comprehensive bibliometric analyses of the publications in TR and identifying the key research trends.
Artificial reefs increase fish abundance in habitat‐limited estuaries
Authors: Folpp Heath R. , Schilling Hayden T. , Clark Graeme F. , Lowry Michael B. , Maslen Ben , Gregson Marcus , Suthers Iain M.
Published: June 2020

Human activities have reduced the carrying capacity of many estuarine systems by degrading and removing habitat. Artificial reefs may increase estuarine rocky‐reef habitat, but our understanding of their ecological impact is limited. In particular, the question of whether fish on artificial structures are produced by the habitat or attracted from nearby natural rocky‐reefs is of concern.

We used baited remote underwater video at artificial reef sites and nearby natural reef sites to investigate the influence of artificial reefs on fish abundance in estuaries with low amounts of natural rocky‐reef. We measured total fish abundance and the abundance of three species of fisheries importance (all in the family Sparidae) before artificial reef deployment (Reefballs®), 1 year after and 2 years after. This design was replicated in three widely separate estuaries over 4 years.

During the 2 years post‐deployment, abundance of Sparidae fish increased on both artificial and natural rocky‐reefs, even when artificial reefs were deployed in different years and seasons. Total fish abundance increased at artificial reef sites with no evidence of change at natural rocky‐reef sites.

Our findings provide evidence that the fish seen on artificial reefs were not attracted from the nearby rocky‐reefs and were likely ‘produced’ by the addition of artificial reefs in these estuaries. Artificial reefs can increase the carrying capacity in these estuaries by providing refuge that would otherwise be unavailable.

Synthesis and applications. The increased fish abundance in three estuaries at both artificial reef and natural reef locations shows that purpose‐built artificial reefs can be used in conjunction with restoration/protection of existing natural habitat, to increase estuarine carrying capacity and fish abundance. This may be for fisheries enhancement or estuarine restoration.
A cross‐sectional study of dermatological conditions in rural and urban Timor‐Leste
Authors: Hao Evelyn Y. , Rhodes Julia E.J. , Nixon Rosemary L. , Saunderson Rebecca B.
Published: June 2020

Background

There is limited information about the type of skin disease in Timor‐Leste. In order to determine the type and magnitude of skin disease in Timor‐Leste, we conducted a cross‐sectional point prevalence study of 271 patients from rural and urban Timor‐Leste. The aim of the study was to estimate the magnitude and burden of dermatological disease.

Methods

Two Australian‐trained dermatologists conducted clinics in the city of Dili (urban) and village of Manusae (rural) in Timor‐Leste between the period of June and July 2016. They independently recorded all patient presentations and diagnoses.

Results

A total of 271 patients were reviewed over two months, of whom 37% were seen in an urban setting and 63% in a rural setting. Scabies accounted for 96% of all presentations in the rural setting, which was significantly higher than its presentation in the urban setting (8%), P < 0.001. Scabies also accounted for the majority of presentations in the paediatric population aged 10 years or younger. Fungal and bacterial skin and soft tissue infections were both more common in urban areas (P < 0.001).

Conclusions

Scabies infection remains the most prevalent dermatological condition encountered in the Timor‐Leste rural population and has hopefully been addressed by a recent mass drug administration. It is important to raise awareness of the systemic problems that can arise from untreated skin infections.
The use of magnetic resonance imaging to predict placenta previa with placenta accreta spectrum
Authors: Ishibashi Hiroki , Miyamoto Morikazu , Shinmoto Hiroshi , Soga Shigeyoshi , Matsuura Hiroko , Kakimoto Soichiro , Iwahashi Hideki , Sakamoto Takahiro , Hada Taira , Suzuki Rie , Takano Masashi
Published: June 2020

Introduction

Massive hemorrhage due to placenta previa with placenta accreta spectrum is associated with high maternal mortality and morbidity. Therefore, accurate prediction of placenta previa with placenta accreta spectrum is essential; magnetic resonance imaging (MRI) is a useful tool for this purpose. This study investigated novel predictors of anterior and posterior placenta previa with placenta accreta spectrum using MRI.

Material and methods

This was a retrospective study at a tertiary obstetrics hospital in Japan. The singleton patients with placenta previa who were scanned with MRI prenatally and had a cesarean section at our institution between 2007 and 2018 were included. The prediction of anterior and posterior placenta previa with placenta accreta spectrum was evaluated using four MRI findings: heterogeneous signals in the placenta, dark T2‐weighted intraplacental bands, myometrial thinning or interruption, and focal uterine bulging. The prediction of posterior placenta previa with placenta accreta spectrum was performed using the quantification of cervical varicosities, which were defined as the ratio of the distance between the minimum distance from the most dorsal cervical varicosities (a) to the deciduous and amniotic placenta (b) on a sagittal image.

Results

Among 202 patients, 14 (6.9%) patients were pathologically diagnosed as having placenta accreta spectrum. Further, 38 (18.8%) patients had anterior placenta previa and 164 (81.2%) patients had posterior placenta previa. When anterior placenta previa with placenta accreta spectrum was predicted using at least one of the four MRI findings, the sensitivity and specificity of the anterior placenta previa with placenta accreta spectrum were 87.5% and 86.7%, respectively. In contrast, the sensitivity and specificity of posterior placenta previa with placenta accreta spectrum were 42.9% and 96.2%, respectively. But when the A/B ratio was set at 0.20, the sensitivity and specificity of the prediction for posterior placenta previa with placenta accreta spectrum using cervical varicosities were 100.0% and 89.2%, respectively.

Conclusions

The findings of MRI to predict the anterior placenta previa with placenta accreta spectrum were different from posterior placenta previa. The cervical varicosities may be useful in predicting posterior placenta previa with placenta accreta spectrum.
A clinical pathway for the management of Peyronie’s disease: integrating clinical guidelines from the International Society of Sexual Medicine, American Urological Association and European Urological Association
Authors: Chung Eric , Gillman Michael , Tuckey John , La Bianca Shane , Love Chris
Published: June 2020

Objective

To provide a clinical framework and key guideline statements to assist clinicians in the evidence‐based management of Peyronie’s disease (PD).

Methods

We conducted a review of the published literature relevant to PD management, with an emphasis on published clinical guidelines. References used in the text have been assessed according to their level of evidence, and guideline recommendations have been graded based on the Oxford Centre for Evidence‐based Medicine Levels of Evidence.

Results

The management of PD involves taking a detailed penile and sexual history, with a focused penile examination to identify plaque and hourglass deformity, and digital photographs of the erect curved (deformed) penis. Penile colour Duplex ultrasonography evaluates tunical plaque and underlying cavernosal smooth muscle and blood flow variables. The current therapy for PD can be divided into two main groups, namely, medical therapy and penile reconstructive surgery, and the patient should be counselled on the benefits and risks of each treatment option.

Conclusions

Peyronie’s disease remains a clinical challenge and presents a considerable therapeutic dilemma as the current therapy addresses existing penile curvature only and is not very effective in preventing future penile fibrosis and/or reversing underlying erectile dysfunction.
Guidelines for Reporting of Figures and Tables for Clinical Research in Urology
Authors: Vickers Andrew J. , Assel Melissa J. , Sjoberg Daniel D. , Qin Rui , Zhao Zhiguo , Koyama Tatsuki , Botchway Albert , Wang Xuemei , Huo Dezheng , Kattan Michael , Zabor Emily C. , Harrell Frank
Published: June 2020

In an effort to improve the presentation of and information within tables and figures in clinical urology research, we propose a set of appropriate guidelines. We introduce six principles: (1) include graphs only if they improve the reader’s ability to understand the study findings; (2) think through how a graph might best convey information, do not just select a graph from preselected options on statistical software; (3) do not use graphs to replace reporting key numbers in the text of a paper; (4) graphs should give an immediate visual impression of the data; (5) make it beautiful; and (6) make the labels and legend clear and complete. We present a list of quick “dos and don’ts” for both tables and figures. Investigators should feel free to break any of the guidelines if it would result in a beautiful figure or a clear table that communicates data effectively. That said, we believe that the quality of tables and figures in the medical literature would improve if these guidelines were to be followed.

Patient Summary

A set of guidelines were developed for presenting figures and tables in urology research. The guidelines were developed by a broad group of statistical experts with special interest in urology.
Occupational respiratory allergy to lettuce in lettuce farmers
Authors: Sekiya Reina , Nagano Tatsuya , Moriyama Tatsuya , Kishi Toshiyuki , Shinke Haruko , Yano Erika , Hatano Naoya , Katsurada Masahiro , Umezawa Kanoko , Katsurada Naoko , Hori Suya , Hazeki Nobuko , Fukunaga Atsushi , Yamamoto Masatsugu , Kamiryo Hiroshi , Shinohara Masakazu , Kobayashi Kazuyuki , Kotani Yoshikazu , Nishimura Yoshihiro
Published: June 2020

Background

Lettuce‐associated respiratory allergy has never been reported before. The aim of this study was to clarify the clinical condition of lettuce‐associated respiratory allergy and to identify the lettuce antigen which induces allergic symptoms.

Methods

We distributed questionnaires to 1168 lettuce farmers and performed medical examinations in those who exhibited respiratory symptoms related to occupational exposure to lettuce. We analysed specific IgE‐binding proteins in the sera of patients through immunoblotting analysis and determined molecular characterization of the IgE‐binding bands using liquid chromatography‐mass spectrometry.

Results

A total of 932 farmers (80%) responded to the questionnaire. Of those, 7% exhibited lettuce‐associated respiratory symptoms, during harvesting and packaging. Thirteen patients were diagnosed with allergy to lettuce and agreed to undergo further examinations. The percentage of activated basophils in these patients was significantly higher compared with that reported in negative controls (P < .05). Lettuce‐specific IgE (ImmunoCAP®) and skin prick testing was positive in 46% and 62% of patients, respectively. Notably, occupational lettuce‐allergic asthma was detected in one patient through specific bronchial provocation testing. The IgE‐binding bands recognized in the sera of >50% of patients were identified as epidermis‐specific secreted glycoprotein EP1‐like (51 kDa).

Conclusion

The present analysis identified a novel lettuce allergen. This allergen may have clinically useful applications, such as specific IgE testing and allergen‐specific immunotherapy.
Engineering of chimeric natural killer cell receptors to develop precision adoptive immunotherapies for cancer
Authors: Obajdin J , Davies D M , Maher J
Published: June 2020

Natural killer (NK) cells are innate immune effectors which play a crucial role in recognizing and eliminating virally infected and cancerous cells. They effectively distinguish between healthy and distressed self through the integration of signals delivered by germline-encoded activating and inhibitory cell surface receptors. The frequent up-regulation of stress markers on genetically unstable cancer cells has prompted the development of novel immunotherapies that exploit such innate receptors. One prominent example entails the development of chimeric antigen receptors (CAR) that detect cell surface ligands bound by NK receptors, coupling this engagement to the delivery of tailored immune activating signals. Here, we review strategies to engineer CARs in which specificity is conferred by natural killer group 2D (NKG2D) or other NK receptor types. Multiple preclinical studies have demonstrated the remarkable ability of chimeric NK receptor-targeted T cells and NK cells to effectively and specifically eliminate cancer cells and to reject established tumour burdens. Importantly, such systems act not only acutely but, in some cases, they also incite immunological memory. Moreover, CARs targeted with the NKG2D ligand binding domain have also been shown to disrupt the tumour microenvironment, through the targeting of suppressive T regulatory cells, myeloid-derived suppressor cells and tumour vasculature. Collectively, these findings have led to the initiation of early-phase clinical trials evaluating both autologous and allogeneic NKG2D-targeted CAR T cells in the haematological and solid tumour settings.
Importance of second‐look endoscopy after per‐oral endoscopic myotomy for safe postoperative management
Authors: Fujiyoshi Yusuke , Inoue Haruhiro , Abad Mary Raina Angeli , Rodriguez de Santiago Enrique , Nishikawa Yohei , Sakaguchi Takuki , Toshimori Akiko , Shimamura Yuto , Tanabe Mayo , Sumi Kazuya , Kimura Ryusuke , Izawa Shinya , Ikeda Haruo , Onimaru Manabu
Published: June 2020

Objectives

Per‐oral endoscopic myotomy (POEM) is a safe and effective treatment for achalasia and esophageal motility disorders. The role of second‐look endoscopy (SE) on postoperative day 1 has not been examined. This study aimed to evaluate the findings and need of SE after POEM.

Methods

This is a single‐center, retrospective study. All consecutive patients who underwent POEM and SE on postoperative day 1 between December 2017 and September 2019 were included. The primary endpoint was the rate of newly‐detected adverse events (nAE) during SE that required endoscopic intervention or deviation from the normal postoperative course. Multivariate logistic regression was used to identify predictors of nAE.

Results

Four‐hundred‐ninety‐seven patients (mean age, 50.3 years; female, 49.9%) were included. SE identified abnormal findings in a total of 71 patients (14.3%). nAE which required endoscopic intervention or deviation from the normal postoperative course were identified in 12 patients (2.4%): eight (1.6%) entry site dehiscence; two (0.4%) submucosal hemorrhage or hematoma; and two (0.4%) dehiscence of an intraoperative perforation site after endoclip closure. Other findings such as mucosal thermal damage without perforation and small submucosal hematoma were found in 54 patients (10.9%) and five patients (1.0%), respectively. Multivariate analysis showed that longer operation time and intraoperative adverse events (AE) were associated with clinically significant nAE during SE.

Conclusions

Second‐look endoscopy can detect and treat nAE that may lead to severe AE. Thus, SE should be highly considered before starting oral ingestion in all cases, and especially in those who present an intraoperative AE and longer operation time.
Reading and Teaching Literature as Writing
Authors: Ekholm Christer
Published: June 2020

Christer Ekholm's point of departure in this article is Gert J. J. Biesta's call for a new pedagogical attitude that takes a stand against the current trend in education. At present, the dominant approach is to make what we do in school into something wholly predictable, measurable, and assessable, which (as Biesta argues) misses important aspects of what education actually is or should be. One such aspect has to do with “subjectification,” that is, events where someone makes an appeal to me, singles me out in my uniqueness, and makes me ethically responsible to the other one before me. What role can literary education play in facilitating such events? What kind of reading strategies should be promoted with the aim of such an ambition? On the basis of a critical analysis of the discursive construction of an opposition between reading as engagement and reading as distance, Ekholm argues that the answer to these questions is to be found in an alternative literature didactics, where the work of fiction is understood not as text, but as utterance; not as something written, but as writing; perhaps even, not in terms of object(ification), but of subject(ification)?
Cluster exchange reactivity of [2Fe‐2S]‐bridged heterodimeric BOLA1‐GLRX5
Authors: Sen Sambuddha , Hendricks Amber L. , Cowan James A.
Published: June 2020

Mitochondrial BOLA1 is known to form a [2Fe‐2S] cluster‐bridged heterodimeric complex with mitochondrial monothiol glutaredoxin GLRX5; however, the function of this heterodimeric complex is unclear. Some reports suggest redundant roles for BOLA1 and a related protein, BOLA3, with both involved in the maturation of [4Fe‐4S] clusters in a subset of mitochondrial proteins. However, a later report on the structure of BOLA1‐GLRX5 heterodimeric complex demonstrated a buried cluster environment and predicted a redox role instead of the cluster trafficking role suggested for the BOLA3‐GLRX5 heterodimeric complex. Herein, we describe a detailed kinetic study of relative cluster exchange reactivity involving heterodimeric complex of BOLA1 with GLRX5. By the use of CD spectroscopy, it is demonstrated that [2Fe‐2S]‐bridged BOLA1‐GLRX5 can be readily formed by cluster uptake from donors such as ISCU or [2Fe‐2S](GS)4 complex, but not from ISCA1 or ISCA2. Rapid holo‐formation following delivery from [2Fe‐2S](GS)4 supports possible physiological relevance in the cellular labile iron pool. Holo [2Fe‐2S] BOLA1‐GLRX5 heterodimeric complex is incapable of donating cluster to apo protein acceptors, providing experimental support for a nontrafficking role. Finally, we report the formation and reactivity of the holo [2Fe‐2S]‐bridged BOLA1 homodimer (lacking a partner GLRX). While the holo‐heterodimer is thermodynamically more stable, by contrast the holo BOLA1 homodimer does demonstrate facile cluster exchange reactivity.
Plant protein phosphatases: What do we know about their mechanism of action?
Authors: Bheri Malathi , Mahiwal Swati , Sanyal Sibaji K. , Pandey Girdhar K.
Published: June 2020

Protein phosphorylation is a major reversible post‐translational modification. Protein phosphatases function as ‘critical regulators’ in signaling networks through dephosphorylation of proteins, which have been phosphorylated by protein kinases. A large understanding of their working has been sourced from animal systems rather than the plant or the prokaryotic systems. The eukaryotic protein phosphatases include phosphoprotein phosphatases (PPP), metallo‐dependent protein phosphatases (PPM), protein tyrosine (Tyr) phosphatases (PTP), and aspartate (Asp)‐dependent phosphatases. The PPP and PPM families are serine(Ser)/threonine(Thr)‐specific phosphatases (STPs), while PTP family is Tyr specific. Dual‐specificity phosphatases (DsPTPs/DSPs) dephosphorylate Ser, Thr, and Tyr residues. PTPs lack sequence homology with STPs, indicating a difference in catalytic mechanisms, while the PPP and PPM families share a similar structural fold indicating a common catalytic mechanism. The catalytic cysteine (Cys) residue in the conserved HCX5R active site motif of the PTPs acts as a nucleophile during hydrolysis. The PPP members require metal ions, which coordinate the phosphate group of the substrate, followed by a nucleophilic attack by a water molecule and hydrolysis. The variable holoenzyme assembly of protein phosphatase(s) and the overlap with other post‐translational modifications like acetylation and ubiquitination add to their complexity. Though their functional characterization is extensively reported in plants, the mechanistic nature of their action is still being explored by researchers. In this review, we exclusively overview the plant protein phosphatases with an emphasis on their mechanistic action as well as structural characteristics.
Intraductal carcinoma has a minimal impact on Grade Group assignment in prostate cancer biopsy and radical prostatectomy specimens
Authors: Rijstenberg L. Lucia , Hansum Tim , Hollemans Eva , Kweldam Charlotte F , Kümmerlin Intan P , Bangma Chris H , van der Kwast Theodorus H , Roobol Monique J , van Leenders Geert J L H
Published: June 2020

Aims

Intraductal carcinoma (IDC) is an adverse histopathological parameter for prostate cancer outcome, but is not incorporated in current tumour grading. To account for its dismal prognosis and to omit basal cell immunohistochemistry, it has been proposed to grade IDC on the basis of its underlying architectural pattern. The aim of this study was to determine the impact of IDC grade assignment on prostate cancer biopsy and radical prostatectomy tumour grading.

Methods and results

A cohort of 1031 prostate cancer biopsies and 835 radical prostatectomies were assigned a Grade Group according to the 2014 International Society of Urological Pathology guidelines, without incorporation of IDC in grading. Tumour grading was compared with a Grade Group in which IDC was graded on the basis of its underlying architecture. Of 1031 biopsies, 139 (13.5%) showed IDC. Grade assignment of IDC led to a Grade Group change in 17 (1.6%) cases: four of 486 (0.8%) Grade Group 1 cases were reclassified as Grade Group 2, nine of 375 (2.4%) Grade Group 2 cases were reclassified as Grade Group 3, and four of 58 (6.9%) Grade Group 4 cases were reclassified as Grade Group 5. IDC was observed in 213 of 835 (25.5%) radical prostatectomies, and its grading led to a change in tumour grade in five of 835 (0.6%) patients, with upgrading in two of 207 (1.0%) patients with Grade Group 1 cancer, in two of 420 (0.5%) patients with Grade Group 2 cancer, and in one of 50 (2%) patients with Grade Group 4 cancer.

Conclusion

IDC grade assignment led to a Grade Group change in 1.6% of prostate biopsy specimens and in 0.6% of radical prostatectomy specimens. Although the inclusion of IDC in or the exclusion of IDC from the Grade Group might affect decision‐making in individual patients, it has a minimal impact on overall prostate cancer management.
Ethnicity, socioeconomic status and the nutritional status of Chinese children and adolescents: Findings from three consecutive national surveys between 2005 and 2014
Authors: Dong Yanhui , Ma Yinghua , Hu Peijin , Dong Bin , Zou Zhiyong , Yang Yide , Xu Rongbin , Wang Zhenghe , Yang Zhaogeng , Wen Bo , Tan Monique , He Feng J. , Song Yi , Ma Jun , Sawyer Susan M. , Patton George C.
Published: June 2020

Background

Economic development has brought rapid shifts in the food environment of Chinese children and adolescents.

Objectives

To assess the changes in childhood nutritional status across ethnic groups and economic status from 2005 to 2014.

Methods

664 094 Chinese Han and 224 151 ethnic minority children and adolescents aged 7 to 18 years were assessed in three national cross‐sectional surveys (2005, 2010 and 2014). Gross domestic product (GDP) per capita of each ethnic group was categorized into four strata of socioeconomic status. To assess ethnic disparities at each time point, we used logistic regression to estimate the prevalence odds ratios (OR) for thinness, overweight and obesity in the 24 ethnic minority groups vs Han Chinese.

Results

Children in the two upper economic strata (over about US$4000 GDP per capita) had a high prevalence of overweight and obesity, while those in the two lower economic strata (below US$4000 GDP per capita) had a high prevalence of thinness. From 2005 to 2014, the prevalence of thinness decreased from 18.6% to 13.1% in Han children, and from 20.4% to 17.1% in ethnic minority students. At the same time, the prevalence of overweight and obesity increased from 10.4% to 17.7% in Han children, and from 4.3% to 9.2% in ethnic minority students, respectively.

Conclusions

A rapid nutritional transition has occurred from 2005 to 2014 with shifts from thinness to overweight and obesity in both Han and ethnic minority children and adolescents, reflecting local GDP per capita.
No fever, no worries? A retrospective audit of bacteraemic patients in the emergency department
Authors: Chiodo‐Reidy Jessica , Loftus Michael J. , Holmes Natasha E.
Published: June 2020

Background

Early identification and treatment of serious infections improve clinical outcomes. Previous studies have found that septic patients without fever are more likely to die than those with fever, due to delay in antibiotic administration.

Aim

To determine whether antibiotic treatment and mortality differed in afebrile adult patients presenting to the emergency department (ED) with bacteraemia, compared with those with a history of fever.

Methods

Retrospective 6‐month audit of all adult patients with positive blood cultures taken in the ED of a single tertiary hospital. Outcomes included the receipt of antibiotics within 4 and 24 h of ED arrival, in‐hospital mortality and 30‐day mortality.

Results

A total of 227 patients with clinically significant bacteraemia was identified, of which 38 (16.7%) were afebrile in the ED. There was no statistically significant difference in the proportion of afebrile or febrile patients receiving antibiotics within 4 h (44.7% vs 55.6%, P = 0.222) or 24 h (89.5% vs 95.2%, P = 0.163) of arrival at the ED. Inpatient mortality was not statistically different in the afebrile and febrile groups 15.8% vs 6.9%, P = 0.070), but 30‐day mortality was higher among afebrile patients (27.6% vs 10.1%, P = 0.010).

Conclusions

There was no significant difference in receipt of antibiotics within 4 h or 24 h ED arrival between the febrile and afebrile groups. However, afebrile patients experienced higher 30‐day mortality. While most bacteraemic patients received antibiotics within 24 h, only half received antibiotics within 4 h, representing a key area for improvement.
Poverty Status Moderates the Relationship between Cardiorespiratory Fitness and Academic Achievement
Authors: Pate Russell R. , Clennin Morgan , Shull Emily R. , Reed Julian A. , Dowda Marsha
Published: June 2020

BACKGROUND

The purpose of the study was to examine the associations among cardiorespiratory fitness (CRF), weight status and academic achievement in youth, and to determine if these relationships are moderated by poverty status.

METHODS

The sample included 5th (N = 27,791) and 8th grade (N = 16,047) South Carolina students. Academic achievement was assessed using a state‐wide assessment and classified into 2 categories (ie, does not meet/approaches standards vs meets/exceeds standards). CRF was assessed and expressed as Healthy Fitness Zone (HFZ) or Needs Improvement/Needs‐Improvement‐Health Risk. Students' demographics and poverty status were reported. Multilevel logistic regression analyses were used to examine the association between CRF, weight status and academic achievement. Interaction terms were introduced into the final models. Analyses were performed separately by grade level and academic subject.

RESULTS

The CRF was significantly associated with the odds of meeting/exceeding academic standards after controlling for covariates and adjusting for weight status. The relationship between CRF and academic achievement varied significantly by poverty status. After adjustment for CRF, weight status was not significantly associated with academic achievement.

CONCLUSIONS

The odds of achieving academic standards were significantly higher among students achieving CRF HFZ regardless of poverty status. CRF may partially mitigate the adverse effect of poverty on academic achievement.
Breast is Best, but Where? Hostile Sexism Underlies Men's Opposition to Breastfeeding in Public
Authors: Huang Yanshu , Sibley Chris G. , Osborne Danny
Published: June 2020

Breastfeeding in public remains controversial in many Western nations. Prior work reveals that restrictive gender role attitudes and hostility toward women's empowerment contribute to the policing of women's bodies, especially when it comes to breastfeeding in public. Using a national sample of New Zealand adults (N = 16,789), we investigated the relationships of hostile and benevolent sexism with attitudes toward breastfeeding in public, as well as the potential moderating effects of gender. Results revealed that, although benevolent sexism only positively correlated with opposition to public breastfeeding for women, hostile sexism correlated positively with opposition to public breastfeeding among both women and men. These results suggest that opposition to breastfeeding in public is primarily rooted in hostile attitudes toward women who are perceived as violating traditional gender roles. Accordingly, social and health policies including information campaigns that reduce hostilely sexist stigmas of breastfeeding in public could help promote women's breastfeeding autonomy.
Randomized controlled clinical study evaluating the efficacy and safety of intratumoral treatment of canine mast cell tumors with tigilanol tiglate (EBC‐46)
Authors: De Ridder Thomas R. , Campbell Justine E. , Burke‐Schwarz Cheryl , Clegg David , Elliot Emily L. , Geller Samuel , Kozak Wendy , Pittenger Stephen T. , Pruitt Jennifer B. , Riehl Jocelyn , White Julie , Wiest Melissa L. , Johannes Chad M. , Morton John , Jones Pamela D. , Schmidt Peter F. , Gordon Victoria , Reddell Paul
Published: June 2020

Objective

To evaluate the efficacy and safety of tigilanol tiglate (TT) for local intratumoral treatment of mast cell tumors (MCTs) in dogs.

Methods

A randomized controlled clinical study in 2 phases involving 123 dogs with cytologically diagnosed MCT. Phase 1 compared 81 TT‐treated dogs with 42 control dogs; phase 2 allowed TT treatment of control dogs and retreatment of dogs that failed to achieve tumor resolution after TT treatment in phase 1. Tigilanol tiglate (1 mg/mL) was injected intratumorally with dose based on tumor volume. Concomitant medications were used to minimize potential for MCT degranulation. Modified response evaluation criteria in solid tumors were used to evaluate treatment response at 28 and 84 days. Adverse events and quality of life were also assessed.

Results

A single TT treatment resulted in 75% complete response (CR) (95% confidence interval [CI] = 61‐86) by 28 days, with no recurrence in 93% (95% CI = 82‐97) of dogs by 84 days. Eight TT‐treated dogs that did not achieve CR in phase 1 achieved CR after retreatment, increasing the overall CR to 88% (95% CI = 77‐93). Control dogs had 5% CR (95% CI = 1‐17) at 28 days. Wound formation after tumor slough and wound size relative to tumor volume were strongly associated with efficacy. Adverse events typically were low grade, transient, and directly associated with TT's mode of action.

Conclusions

Tigilanol tiglate is efficacious and well tolerated, providing a new option for the local treatment of MCTs in dogs.
Convergence of optimal expected utility for a sequence of discrete‐time markets
Authors: Kreps David M. , Schachermayer Walter
Published: June 2020

We examine Kreps' conjecture that optimal expected utility in the classic Black–Scholes–Merton (BSM) economy is the limit of optimal expected utility for a sequence of discrete‐time economies that “approach” the BSM economy in a natural sense: The nth discrete‐time economy is generated by a scaled n‐step random walk, based on an unscaled random variable ζ with mean 0, variance 1, and bounded support. We confirm Kreps' conjecture if the consumer's utility function U has asymptotic elasticity strictly less than one, and we provide a counterexample to the conjecture for a utility function U with asymptotic elasticity equal to 1, for ζ such that .
How to ascribe beliefs to animals
Authors: Newen Albert , Starzak Tobias
Published: June 2020

In this article, we analyze and reject two versions of the content‐argument against animal beliefs, namely, the ontological argument from Davidson and the epistemological argument from Stich. One of the main defects of the strongest version of the argument is that it over‐intellectualizes belief ascriptions in humans and thus sets the comparative bar for belief ascriptions in animals too high. In the second part of the article, we develop a gradualist notion of belief which captures basic beliefs as well as Davidsonian linguistic beliefs, and we specify the conditions under which belief ascriptions to nonlinguistic animals are justified.
Impact of gastric per‐oral endoscopic myotomy on static and dynamic pyloric function in gastroparesis patients
Authors: Watts Lydia S. , Baker Jason R. , Lee Allen A. , Harer Kimberly , Bowers Nicole , Law Ryan , Hasler William L.
Published: June 2020

Background

Functional Lumen Imaging Probe (EndoFLIP) tests typically measure static pyloric parameters, but the pylorus exhibits phasic variations on manometry. Dynamic changes in pyloric function have not been quantified using EndoFLIP, and the impact of Gastric Per‐Oral Endoscopic Myotomy (G‐POEM) on static and dynamic pyloric activity in gastroparesis is unknown.

Methods

EndoFLIP balloon inflation to 30, 40, and 50 mL was performed to measure mean, maximum, and minimum values and variability in pyloric diameter and distensibility before and after G‐POEM in 20 patients with refractory gastroparesis. The impact of phasic contractions on these pyloric measures was compared.

Key Results

G‐POEM increased mean (P < .0001) and maximum (P = .0002) pyloric diameters and mean (P = .02) and maximum (P = .02) pyloric distensibility on 50 mL EndoFLIP inflation but not intraballoon pressures or minimum diameters or distensibility. Temporal variability of pyloric diameter (P = .02) and distensibility (P = .02) also increased after G‐POEM. Phasic coupled contractions propagating from the antrum through the pylorus were observed in 37.5% of recordings; other phasic activity including isolated pyloric contractions were seen in 23.3%. Variability of pyloric diameter and distensibility tended to be higher during recordings with phasic activity. Some pyloric responses to G‐POEM were influenced by age, gastroparesis etiology, gastric emptying, and prior botulinum toxin injection.

Conclusions & Inferences

Pyloric activity exhibits dynamic changes on EndoFLIP testing in gastroparesis. G‐POEM increases maximal but not minimal diameter and distensibility with increased variations, suggesting this therapy enhances pyloric opening but may not impair pyloric closure. Phasic pyloric contractions contribute to variations in pyloric activity.
Laypeople's and dental students' perceptions of a diastema between central and lateral incisors: Evaluation using scanpaths and colour‐coded maps
Authors: Tanaka Orlando , Vitral Robert Willer Farinazzo , Miyoshi Caio Seiti , Meira Thiago Martins , Camargo Elisa Souza , Pithon Matheus Melo
Published: June 2020

Objective

This study aimed to use eye tracking to analyse people's visual perceptions of smiles with a diastema between the maxillary central and lateral incisors, based on different categories of observers.

Setting and Sample Populations

An image of a diastema between the maxillary central and lateral incisors was shown to dental students and laypeople.

Materials and Methods

Our null hypothesis was that there would be no difference in the visual perception of the different graduations of diastemas between the two groups. The diastemas were edited in Photoshop® to gradually increase the distance between the maxillary central and lateral incisors from no diastema to 1.5 mm and 3.5 mm diastemas. These diastemas were evaluated by using a TheEyeTribe© tracker in conjunction with OGAMA© 5.0 software. A total of 37 dental students and 33 laypeople looked at eight randomly arranged images of smiles. The data were analyzed using color coded maps, scanpaths, and the Kruskal‐Wallis test with a level of significance of 5%.

Results

Laypeople tended to observe the eyes, focusing more on the right than the left, and spent less time focusing on the diastema region than did the dental students. There were differences for the same magnitude of diastema within participant groups. As the width of the diastema increased, both students and laypeople focused more on the diastema region.

Conclusions

The two groups of evaluators presented different perceptions of smiles in cases of diastema between the maxillary central and lateral incisors when evaluated using eye‐tracking.
A novel pathogenic mutation in the COL7A1 gene resulting in mild autosomal dominant bullous dermolysis of the newborn
Authors: Lor Michael , Liu Michael , Kuklinski Lawrence F. , Hogeling Marcia
Published: June 2020

Bullous dermolysis of the newborn is a subtype of dystrophic epidermolysis bullosa that typically resolves within the first two years of life. We present a case of autosomal dominant bullous dermolysis of the newborn and report a novel pathogenic mutation. This case highlights that collagen VII mutations may present clinically with a mild phenotype.
The least effective pollinator principle: specialized morphology despite generalized ecology
Authors: Pauw A. , Cocucci A. A. , Sérsic A. N.
Published: June 2020

The large body of work on the adaptation of plants to pollinators is still somewhat incomplete because most studies focus on one‐to‐one interactions. How will adaptation proceed in a multi‐pollinator environment? According to Stebbins' Most Effective Pollinator Principle, ‘the characteristics of the flower will be moulded by those pollinators that visit it most frequently and effectively.’

To test this hypothesis, we studied the pollination biology of Pelargonium incrassatum (Geraniaceae) in the Namaqualand Region of Southern Africa. This species has a long floral tube and we expected its most important pollinator to have a long proboscis.

Contrary to expectations, the most important pollinator was a short proboscid fly (a new species of Prosoeca), while Prosoeca peringueyi, which had a proboscis that matched the floral tube length, was a rare visitor. Consistent with the high degree of trait mismatching, we did not detect selection on tube length at most sites.

The paradox of mismatching traits can be resolved by considering the strength of the trade‐off involved. Adaptation to the rare species can apparently occur without incurring the cost of reduced pollination by the abundant species. Generally, species may often evolve specialized morphology if they do not incur the cost of ecological specialization.
Effect of short‐course exercise training on the frequency of exacerbations and physical activity in patients with COPD: A randomized controlled trial
Authors: Ko Fanny Wai‐San , Tam Wilson , Siu Eddy H.S. , Chan Ka‐Pang , Ngai Jenny Chun‐Li , Ng So‐Shan , Chan Tat On , Hui David Shu‐Cheong
Published: June 2020

Background and objective

Previous studies have suggested that early pulmonary rehabilitation (PR) programmes post‐AECOPD are an effective and safe intervention for reducing hospital admissions and improving quality of life. This study assessed whether a short course of exercise training post‐AECOPD with periodic reinforcement exercise training and phone call reminders reduces readmissions and increases physical activity in COPD patients.

Methods

Subjects were randomized into either the (i) intervention group (IG), consisting of 4–8 weeks of training supervised by a physiotherapist and phone contact every 2 weeks by a case manager providing support and reinforcement of continuous exercise at home or (ii) usual care group (UG), which had no input by a physiotherapist or case manager. Readmissions were assessed at 12 months. Activities of all patients were assessed by an activity monitor at baseline, 3 and 12 months.

Results

Altogether, 136 subjects were included and randomized (68 in IG and 68 in UG). The age, gender and FEV1% predicted were 75.0 ± 6.7 years, 132 males and 47.0 ± 16.2%, respectively. The mean number of readmissions for AECOPD (1.06 vs 1.72 times, P = 0.014) was less and time to first readmission was increased (146.8 vs 122.4 days, P = 0.005) in the IG versus UG at 12 months. At 12 months, there was no change in activity measured by activity monitor between the two groups.

Conclusion

This programme decreased exacerbation frequency and increased the time of readmissions for AECOPD. It did not improve physical activities and exercise tolerance at 12 months.
Validity of the Finnish version of the Parental Burnout Assessment (PBA)
Authors: Aunola Kaisa , Sorkkila Matilda , Tolvanen Asko
Published: June 2020

The aim of the present study was to validate the Finnish version of the Parental Burnout Assessment (PBA) using data from 1,688 Finnish parents (91% mothers) living in Finland with at least one child living at home. Confirmatory factor analyses supported the theoretical four‐factor structure of the PBA – emotional exhaustion in one’s parental role, contrast with previous parental self, feelings of being fed up with one’s parental role, and emotional distancing from one’s children. Internal consistency for the total scale was excellent (Cronbach’s alpha ≥ 0.90) and for the subscales from acceptable (alpha ≥ 0.70) to excellent. The results further demonstrated strict factorial invariance of PBA across genders and educational status groups. Finally, the PBA and its four subscales correlated as expected with the three criteria variables (depressive symptoms, sleep disruptions, and self‐esteem), the latent factors of all three criteria variables being still clearly unique and separate constructions from parental burnout factors.
‘The Sea is Our Life’. Woman in the Fishery Sector of the Valencian Community
Authors: Herrera‐Racionero Paloma , Lizcano Emmánuel , Miret‐Pastor Luis , Mascarell Yesmina
Published: June 2020

Traditionally the role of women in fishing has gone largely unnoticed, but now in recent years there has been a growing interest about them. However, the task of identifying and quantifying the role played by women in fisheries has yet to be fully developed. This study tackles the role of women in fishing from a double perspective, both quantitatively and qualitatively, focusing on the case of inshore fishing in the Valencia Community (VC) in Spain. Official statistics now incorporate some important changes in order to reflect a more realistic view of women’s involvement in fishing. However, beyond ‘official’ trades and figures, there is a wealth of work largely done by women that goes unnoticed but it's essential for the fishing sector. Overcoming this, introducing women into fishing studies, statistics and fishing institutions, recognising the work of women in the fishing sector or promoting women who work in tasks traditionally carried out by men is a challenge for such a traditional sector, immersed in profound economic and social change.
The use of smartphone‐obtained images to extrapolate canine packed cell volume
Authors: Breheny Craig R. , Kinsey Steven E. , Gow Adam G.
Published: June 2020

Objective

To determine whether a smartphone‐obtained image can be used to extrapolate the PCV of canine blood samples.

Design

Prospective study of surplus blood obtained from clinical cases.

Setting

University teaching hospital.

Interventions

Blood samples were placed on filter paper, and images were obtained with a smartphone in different environments. These results were then compared to the PCV measurements on the same samples following the World Health Organization guidelines.

Measurements

Sixty‐nine samples were assessed and identified that smartphone images, obtained in a controlled environment, were able to predict the PCV of the samples. This prediction was most accurate when assessing samples of a normal erythroid mass or polycythemic samples.

Conclusions

The results of this study suggest that smartphone‐obtained images do have a utility in predicting canine PCV. If this can be incorporated into a smartphone application, there would be scope to use this in low resource settings.