bluuebunny/crossref_metadata_2025 huggingface dataset:
Hotelling T2 chart using the generalized multiple dependent state sampling scheme
Authors: García-Bustos Sandra , León Joseph , Pastuizaca María Nela
Published: October 2020

Purpose

This research proposes a multivariate control chart, whose parameters are optimized using genetic algorithms (GA) in order to accelerate the detection of a change in the vector of means.

Design/methodology/approach

This chart is based on a variation of the Hotelling T2 chart using a sampling scheme called generalized multiple dependent state sampling. For the analysis of performances of this chart, the out-of-control average run length (ARL) values were used for different scenarios. In this comparison, it was considered the classic Hotelling T2 chart and the T2 chart using the scheme called multiple dependent state sampling.

Findings

It was observed that the new chart with its optimized parameters is more efficient to detect an out-of-control process. Additionally, a sensitivity analysis was performed, and it was concluded that the best yields are obtained when the change to be considered in the optimization is small. An application in the resolution of a real problem is given.

Originality/value

In this research, a multivariate control chart is proposed based on the Hotelling T2 statistic but adding a sampling scheme. This makes this control chart more efficient than the classic T2 chart because the new chart not only uses the current information of the T2 statistic but also conditions the decision to consider a process as “in- control” on the statistic's previous information. The practitioner can obtain the optimal parameters of this new chart through a friendly program developed by the authors.
Heritage-led development and historic churches: professional roles in the case of Hamra, Sweden
Authors: Nyström Maria
Published: October 2020

Purpose

Departing from a study of a heritage-led economic development project of a Swedish historic church, the purpose of this paper is to explore and discuss how professional roles within the heritage field are negotiated through a development-centered heritage discourse, focusing on the implications for religious heritage sites.

Design/methodology/approach

A synchronic discourse analysis was conducted on a number of documents originating from the case study project, as well as five semi-structured interviews with key actors from the heritage field and the Church of Sweden.

Findings

The findings of the paper show that professional heritage discourses and practice limit and prevent nonstate heritage actors to engage in heritage-led development schemes of historic churches. Additionally, the professional roles and skills of nonheritage actors are perceived as ambiguous within the current governance system.

Practical implications

Examining emerging forms of management of religious heritage sites can provide inspiration and indicate possible conflicts that need to be addressed by heritage professionals in order to achieve successful management.

Originality/value

While studies of heritage-led economic development projects have previously focused on impact assessment and community engagement, this paper sheds light on how the discourses of these projects affect the conception of professional roles and practices.
“Whatever it takes”: first budgetary responses to the COVID-19 pandemic in France
Authors: Cho Charles H. , Jérôme Tiphaine , Maurice Jonathan
Published: October 2020

Purpose

This paper highlights the emergency budgetary measures taken by the French government in response to the COVID-19 pandemic health crisis and identifies some of the key political, economic, social and environmental factors and consequences associated with those measures.

Design/methodology/approach

The authors conduct a thorough analysis of official reports, bills and academic and news articles related to the pandemic management in France. The authors’ analysis covers the period from January 24 to July 31, 2020.

Findings

Despite previous austerity policies, France faced the health crisis with a very high level of debt, which has complicated the management of the COVID-19 crisis. Although significant, the response brought by the French government seems in the end to be rather choppy.

Originality/value

This paper highlights three elements of analysis that allow a better understanding of the budgetary management process in France. The authors first discuss the notion of budgetary flexibility. Then, they show that the growth of participatory budgets in local communities gives hope for a possible and much needed decentralization process implying a stronger commitment of citizens. Finally, they highlight a budgetary paradox; that is, massive funding of polluting industries versus ecological issues. These three elements of analysis all advocate the need for a deeper engagement among different levels of government and actors.
Social distancing in a social therapy environment
Authors: Akerman Geraldine Ann , Jones Emily , Talbot Harry , Grahame-Wright Gemma
Published: October 2020

Purpose

This paper aims to describe the impact of the COVID-19 pandemic on a prison-based therapeutic community (TC).

Design/methodology/approach

The paper takes the form of a case study where the authors reflect on their current practice, using the findings of research on social isolation and the overarching TC principles to explore the effect of the pandemic on the TC at HMP Grendon. The authors consider how the residents and staff adjusted to the change as the parameters changed when the social distancing rules were imposed and how they adapted to the prolonged break to therapy. Sections in the paper were written by a resident and an operational member of staff. The authors conclude with their thoughts on how to manage the consequences the lockdown has brought and start to think about what returning to “normality” might mean.

Findings

The paper describes the adjustments made by the residents and staff as the UK Government imposed the lockdown. The authors, including a resident and an operational member of staff comment on the psychological and practical impact these adjustments had. The thought is given to the idea of “recovery”, returning to “normality” and how this study can be best managed once restrictions are lifted.

Research limitations/implications

At the time of writing, there are no confirmed cases of COVID-19 at HMP Grendon. The measures and commitment from all staff and residents in the prison to keep the prison environment safe may in part account for this. This paper explores the effects of lockdown on the emotional environment in a TC and highlights the consequences that social isolation can have on any individual. To the authors’ knowledge, there is currently no research undertaken on the impact of lockdown/social isolation on a TC. This research would be useful, as the authors postulate from reflections on current practice that the effects of the lockdown will be greater in a social therapy environment.

Originality/value

HMP Grendon started in 1962, as this time there have been no significant events that have meant the suspension of therapy for such a sustained period. It is, therefore, important that the impact of such is considered and reflected upon.
Elastic properties of a reservoir sandstone: a broadband inter‐laboratory benchmarking exercise
Authors: Ògúnsàmì Abdulwaheed , Jackson Ian , Borgomano Jan V.M. , Fortin Jérôme , Sidi Hasan , Gerhardt Andre , Gurevich Boris , Mikhaltsevitch Vassili , Lebedev Maxim
Published: October 2020

Low‐frequency forced‐oscillation methods applied to a reservoir sandstone allowed determination of the Young's modulus and Poisson's ratio (from axial loading), bulk modulus (by oscillation of the confining pressure) and shear modulus (from torsional‐forced oscillations) for comparison with conventional ultrasonic data. All tests were performed on a common sandstone core sample from an oil reservoir offshore West Africa. The results show a steady increase in ultrasonic velocities and shear modulus of the dry specimen as functions of pressure, which suggests a progressive closure of the inter‐granular contacts. An increase of bulk and Young's moduli and Poisson's ratio is observed on decane saturation of the sample when tested with a sufficiently small dead volume. This observation, consistent with Gassmann's theory, suggests that such measurements probe undrained (saturated isobaric) conditions. Diminution or absence of such fluid‐related stiffening for low‐frequency measurements with dead volumes comparable with the pore volume of the specimen indicates partially drained conditions and highlights the critical role of experimental boundary conditions. Directly measured bulk and shear moduli are consistent with those derived from Young's modulus and Poisson's ratio. These results of the inter‐laboratory testing using different measurement devices are consistent in terms of the effect of frequency and fluid saturation for the reservoir sandstone specimen. Such broad consistency illustrates the validity of forced‐oscillation techniques and constitutes an important benchmarking of laboratory testing of the elastic properties of a porous medium.
Deer grazing changes seed traits and functions of grazing‐intolerant plants
Authors: Shinoda Yushin , Uchida Kei , Koyama Asuka , Akasaka Munemitsu
Published: October 2020

Grazing by ungulates can affect seed production in plants, and consequently seed recruitment into seed banks, which is a plant strategy to increase their resilience. The impact of grazing on seed quantity has been well studied; however, the impact of grazing on seed quality has received less attention, despite its role in determining the longevity of a seed bank. Here, we examined the impact of ungulate grazing on seed quality in plants, using two grazing‐intolerant grassland species (Hemerocallis dumortieri var. esculenta and Geranium yesoense var. nipponicum). We found that grazing reduced seed length and weight, while increasing the germination rate. These changes in seed quality induced by grazing could reduce the persistence of seed banks and would thus seem to be an important mechanism involved in the impact of ungulate grazing on plant population dynamics.
Urban Fashion Formations in the Twenty‐First Century: Weberian Ideal Types as a Heuristic Device to Unravel the Fashion City
Authors: Casadei Patrizia , Gilbert David , Lazzeretti Luciana
Published: October 2020

In recent years, local governments and academic researchers have drawn increasing attention to the idea of the fashion city as a strategic factor for urban economic growth. In addition to renowned fashion capitals, second‐tier cities of fashion have proliferated, giving rise to a large heterogeneity of centres of production, design, consumption and culture. Despite its rising popularity, however, the concept of the fashion city is still weakly codified, and only simplistic tool‐kit strategies have been adopted to transform cities into contemporary fashion hubs. Drawing upon Weber's ideal‐type approach, this intervention develops an analytical framework for thinking about the diverse nature of fashion's relation with cities. The search for the elusive singular fashion city is replaced by three ideal types—the ‘manufacturing fashion city’, the ‘design fashion city’ and the ‘symbolic fashion city’—which can be used as a heuristic device to trigger debate about the distinctive characteristics of fashion centres and speculate about future developmental pathways. The essay stimulates critical reflection on the different kinds of positioning that fashion takes in urban economies and the developmental pathways of different forms of fashion city formations.
Estimating the frequency and cost of emergency department presentations and hospitalisation of chronic obstructive pulmonary disease patients: A retrospective analysis from regional Queensland
Authors: Rana Rezwanul , Gow Jeff , Moloney Clint , King Alex , Keijzers Gerben , Beccaria Gavin , Mullens Amy
Published: October 2020

Objective

Chronic obstructive pulmonary disease (COPD) patients commonly have frequent visits to the ED. Consequently, COPD has a significant effect on total healthcare expenditure. The objective was to measure the frequency of ED presentation and hospitalisation among COPD patients and to estimate the costs resulting from such care utilisation.

Methods

This was a causal‐comparative non‐experimental research design conducted in three regional hospitals between 2016 and 2018. Two different original data sets were used: an automated hospital data set and an audit of patient charts. Secondary cost data were also used. Data were analysed using Pearson's χ2 test to estimate the relationship between several patient and treatment‐related characteristics.

Results

There were 5253 patient presentations at ED and hospital length of stay data were available for 5079 COPD patients. The total cost of hospital stays was $42.14 million for the time period and the mean average cost was $8297 for ED patients who were admitted to hospital. Factors significantly associated with hospital length of stay were age and time spent in the ED. Noticeably, one (51.7%) in two COPD patients were discharged from ED (all destinations) within 4 h irrespective of their triage category.

Conclusions

COPD patient presentation to ED and admission to hospital is an expensive method of providing healthcare to manage this chronic condition. Clinical practitioners and policy makers need to develop and implement optimal integrated care management systems to reduce this hospitalisation rate and reduce the societal costs associated with COPD patient management.
Elevated c‐di‐GMP levels promote biofilm formation and biodesulfurization capacity of Rhodococcus erythropolis
Authors: Dorado‐Morales Pedro , Martínez Igor , Rivero‐Buceta Virginia , Díaz Eduardo , Bähre Heike , Lasa Iñigo , Solano Cristina
Published: October 2020

Bacterial biofilms provide high cell density and a superior adaptation and protection from stress conditions compared to planktonic cultures, making them a very promising approach for bioremediation. Several Rhodococcus strains can desulfurize dibenzothiophene (DBT), a major sulphur pollutant in fuels, reducing air pollution from fuel combustion. Despite multiple efforts to increase Rhodococcus biodesulfurization activity, there is still an urgent need to develop better biocatalysts. Here, we implemented a new approach that consisted in promoting Rhodococcus erythropolis biofilm formation through the heterologous expression of a diguanylate cyclase that led to the synthesis of the biofilm trigger molecule cyclic di‐GMP (c‐di‐GMP). R. erythropolis biofilm cells displayed a significantly increased DBT desulfurization activity when compared to their planktonic counterparts. The improved biocatalyst formed a biofilm both under batch and continuous flow conditions which turns it into a promising candidate for the development of an efficient bioreactor for the removal of sulphur heterocycles present in fossil fuels.
A single‐centre, prospective cohort study of COVID‐19 patients admitted to ICU for mechanical ventilatory support
Authors: Søvik Signe , Bådstøløkken Per M. , Sørensen Vibecke , Myhre Peder Langeland , Prebensen Christian , Omland Torbjørn , Berdal Jan‐Erik
Published: October 2020

Background

Mortality rates in COVID‐19 patients in need of mechanical ventilation are high, with wide variations between countries. Most studies were retrospective, and results may not be generalizable due to differences in demographics, healthcare organization and surge capacity. We present a cohort of mechanically ventilated COVID‐19 patients from a resource‐rich, publicly financed healthcare system.

Methods

Prospective study from a tertiary hospital. Consecutive SARS‐CoV‐2 positive adult patients admitted to the ICU for mechanical ventilation from 10 March 2020 to 04 May 2020 were included. Triage and treatment were protocolized. High‐dose dalteparin was adjusted by D‐dimer. Demographics, treatments and high‐resolution physiological variables were collected. Outcomes were 30‐day and hospital mortality. Data are medians (quartiles).

Results

Of the 1484 persons in the hospital catchment area testing positive for SARS‐CoV‐2, 201 (13.5%) were hospitalized. Thirty‐eight (19%) patients were mechanically ventilated, of whom five (13%) died. Of the 163 patients treated with supplemental oxygen, eight (5%) died.

In ventilated patients (75% males, age 61 (53‐70) years), severe, moderate and mild ARDS was present in 25%, 70% and 5%. Tidal volume ≤8 mL/kg ideal bodyweight was achieved in 34 (94%) patients. Proning and neuromuscular blockers were used in 19 (54%) and 20 (61%) patients. Duration of ventilation was 12 days (8‐23). D‐dimer peaked at 3.8 mg/L (2.1‐5.3), and maximum dalteparin dose was 15 000 IU/24 h (10 000‐15 000). Despite organizational changes, a high degree of adherence to treatment protocols was achieved.

Conclusion

In a prospective cohort study of mechanically ventilated COVID‐19 patients treated in a resource‐rich, publicly financed healthcare system, mortality was considerably lower than previously reported in retrospective studies.
Regulatory feedback cycle of the insulin‐degrading enzyme and the amyloid precursor protein intracellular domain: Implications for Alzheimer’s disease
Authors: Lauer Anna A. , Mett Janine , Janitschke Daniel , Thiel Andrea , Stahlmann Christoph P. , Bachmann Cornel M. , Ritzmann Felix , Schrul Bianca , Müller Ulrike C. , Stein Reuven , Riemenschneider Matthias , Grimm Heike S. , Hartmann Tobias , Grimm Marcus O. W.
Published: October 2020

One of the major pathological hallmarks of Alzheimer´s disease (AD) is an accumulation of amyloid‐β (Aβ) in brain tissue leading to formation of toxic oligomers and senile plaques. Under physiological conditions, a tightly balanced equilibrium between Aβ‐production and ‐degradation is necessary to prevent pathological Aβ‐accumulation. Here, we investigate the molecular mechanism how insulin‐degrading enzyme (IDE), one of the major Aβ‐degrading enzymes, is regulated and how amyloid precursor protein (APP) processing and Aβ‐degradation is linked in a regulatory cycle to achieve this balance. In absence of Aβ‐production caused by APP or Presenilin deficiency, IDE‐mediated Aβ‐degradation was decreased, accompanied by a decreased IDE activity, protein level, and expression. Similar results were obtained in cells only expressing a truncated APP, lacking the APP intracellular domain (AICD) suggesting that AICD promotes IDE expression. In return, APP overexpression mediated an increased IDE expression, comparable results were obtained with cells overexpressing C50, a truncated APP representing AICD. Beside these genetic approaches, also AICD peptide incubation and pharmacological inhibition of the γ‐secretase preventing AICD production regulated IDE expression and promoter activity. By utilizing CRISPR/Cas9 APP and Presenilin knockout SH‐SY5Y cells results were confirmed in a second cell line in addition to mouse embryonic fibroblasts. In vivo, IDE expression was decreased in mouse brains devoid of APP or AICD, which was in line with a significant correlation of APP expression level and IDE expression in human postmortem AD brains. Our results show a tight link between Aβ‐production and Aβ‐degradation forming a regulatory cycle in which AICD promotes Aβ‐degradation via IDE and IDE itself limits its own production by degrading AICD.
Bilateral antler sequestration above the coronet in a red deer (Cervus elaphus) stag—Insights into the process of antler casting
Authors: Kierdorf Uwe , Kierdorf Horst
Published: October 2020

This paper reports a case of delayed velvet shedding and bilateral premature antler casting above the coronets in a young adult red deer stag from Germany. Based on the established role of testosterone in the control of the antler cycle, the antler abnormality is considered to have been the result of a (temporary) androgen deficiency. The basal surfaces (separation planes or seals) of the cast antlers were markedly concave. Scanning electron microscopy revealed that the separation plane was densely covered with Howship's lacunae, denoting intense osteoclastic activity along the border between the proximal (living) and distal (dead) antler portions. Our observations and those of previous studies indicate that antler casting does not occur at a pre‐determined separation plane, but along the border between living and dead bone, regardless of the position of this border within the cranial appendages. This is a major difference to autotomy of (living) appendages at fixed breakage planes, as it occurs for instance in lizard tails.
Children discharged from an emergency department with bacteraemia had lower C‐reactive protein and better outcomes than admissions
Authors: Gelernter Renana , Lazarovitch Tsilia , Kozer Eran , Youngster Ilan
Published: October 2020

Aim

To investigate whether there are common clinical findings in bacteraemic children that were discharged from the emergency department (ED) and to follow their clinical outcome.

Methods

A retrospective chart review of children above one‐month‐old with positive blood cultures obtained in Shamir Medical Center's ED between January 2011 and December 2019 was conducted.

Results

A total of 250 cases were analysed, of which 68 discharged after first evaluation. Streptococcus pneumonia was the most commonly isolated pathogen. Compared to children that were admitted when first evaluated in the ED, discharged children had lower C‐reactive protein (mean 50.5 ± 62.8 vs 121.7 ± 113.2 mg/L, p < 0.001). Dyspnoea and being ill‐looking were less prevalent among the latter (6.7% versus 35.1%, p = <0.001, 3.0% versus 22.2% p < 0.001, respectively), as were presence of Kingella kingae and other Gram‐negative bacteria. Of the children hospitalised in our institution, the duration of hospitalisation was significantly lower than in those admitted during the first visit (6.3 ± 4.3 vs 9.0 ± 7.4 days, p = .002). None of the discharged children were admitted to paediatric intensive care unit.

Conclusion

Children with bacteraemia who were discharged home before knowing their positive blood cultures results had lower C‐reactive protein and better outcome compared to those admitted on first evaluation in emergency department.
Moderating effects of corruption and informality on the fiscal decentralization—economic growth nexus: Insights from OECD countries
Authors: Huynh Cong Minh , Tran Hoai Nam
Published: October 2020

The impact of fiscal decentralization on economic growth has been controversial in the literature, especially when this impact depends on the forms of fiscal decentralization and other moderating factors. This article investigates how expenditure decentralization and tax revenue decentralization affect economic growth, and how these impacts depend on corruption and informality in 23 OECD countries over the period 2002–16. By using estimators of fixed effect (FE), random effect (RE) and the system generalized method of moments (SGMM) for panel data; we find that economic growth is positively affected by both expenditure decentralization and tax revenue decentralization. Furthermore, corruption reduces not only economic growth but also the beneficial impact of expenditure decentralization on economic growth. Likewise, the presence of informality negatively affects not only economic growth but also the advantageous impact of tax revenue decentralization on economic growth. Results imply that unless governments control corruption and informality, the effectiveness of fiscal decentralization will not be attained as expected.
“There are ways … drug companies will get into DTC decisions”: How Australian drug and therapeutics committees address pharmaceutical industry influence
Authors: Parker Lisa , Bennett Alexandra , Mintzes Barbara , Grundy Quinn , Fabbri Alice , Karanges Emily A. , Bero Lisa
Published: October 2020

Aims

One tool for protecting quality use of medicines in hospitals is a drug and therapeutics committee (DTC) that oversees medicines availability. Pharmaceutical industry marketing to prescribers is associated with less appropriate prescribing and increased costs. There is little data on decision‐making practices of DTCs so it is unknown whether or how they might be vulnerable to pharmaceutical industry influence. This project explores DTC decision‐making with a focus on how pharmaceutical industry influence on access and use of medicines is identified and managed.

Methods

We used a qualitative methodology with individual interviews of 29 participants who were current or recent members of public hospital DTCs across New South Wales, Australia. Participants included medical, pharmacy and nursing staff and 1 citizen. Committees were linked to specific hospitals or regions, and some were affiliated with paediatric, neonatal, rural or mental health services.

Results

Drug committee processes for oversight of medicines in public hospitals are vulnerable to pharmaceutical industry influence at several points. Applications for formulary additions are sometimes initiated and completed by company representatives. Conflict of interest disclosures among applicants and committee members may be incomplete. In some institutions, medicines are available from pharmaceutical companies without committee review, including through free samples and industry‐supported medicines access programmes. Participants noticed the presence and impact of pharmaceutical company marketing activities to local clinicians, resulting in increased prescriber demand for products.

Conclusion

Improved DTC practices and review of hospital policies concerning pharmaceutical marketing activities might preserve the independence of evidence‐based decision‐making for safe, cost‐effective prescribing.
Socially responsible consumption in Russia: Testing the theory of planned behavior and the moderating role of trust
Authors: Petrovskaya Irina , Haleem Fazli
Published: October 2020

This paper adopts a multilevel approach to explore how socially responsible consumer behavior (SRCB) is shaped by a combination of micro‐level psychological drivers and specifics of the institutional context in which the behavior is performed. The model first applies the theory of planned behavior (TPB) to test the effects of TPB‐based behavioral predictors on the SRCB. Broad‐scope trust in business (BST) is then applied to the model as a variable that characterizes quality of an informal institutional environment, hypothesizing that BST moderates the relationship between TPB‐based behavioral antecedents and SRCB. The paper is based on a survey of 466 Russian consumers. Data were collected by self‐administered questionnaires completed by students and alumni of a large public university in Moscow. Results show that BST moderates the effects of TPB‐based predictors on SRCB. This implies that consumers who believe that the business is overall trustworthy are more likely to take company’s corporate social responsibility (CSR) into account when making purchasing decisions. This study contributes to the multilevel research on SRCB and CSR and adds to the literature on public trust in business as a nascent area of study. Its findings are especially relevant for companies operating in low‐trust environments, including postsocialist economies.
Identifying individual predictive factors for treatment efficacy
Authors: Alonso Ariel , Van der Elst Wim , Sanchez Lizet , Luaces Patricia , Molenberghs Geert
Published: October 2020

Given the heterogeneous responses to therapy and the high cost of treatments, there is an increasing interest in identifying pretreatment predictors of therapeutic effect. Clearly, the success of such an endeavor will depend on the amount of information that the patient‐specific variables convey about the individual causal treatment effect on the response of interest. In the present work, using causal inference and information theory, a strategy is proposed to evaluate individual predictive factors for cancer immunotherapy efficacy. In a first step, the methodology proposes a causal inference model to describe the joint distribution of the pretreatment predictors and the individual causal treatment effect. Further, in a second step, the so‐called predictive causal information (PCI), a metric that quantifies the amount of information the pretreatment predictors convey on the individual causal treatment effects, is introduced and its properties are studied. The methodology is applied to identify predictors of therapeutic success for a therapeutic vaccine in advanced lung cancer. A user‐friendly R library EffectTreat is provided to carry out the necessary calculations.
Surprisingly long survival of premature conclusions about naked mole‐rat biology
Authors: Braude Stan , Holtze Susanne , Begall Sabine , Brenmoehl Julia , Burda Hynek , Dammann Philip , del Marmol Delphine , Gorshkova Ekaterina , Henning Yoshiyuki , Hoeflich Andreas , Höhn Annika , Jung Tobias , Hamo Dania , Sahm Arne , Shebzukhov Yury , Šumbera Radim , Miwa Satomi , Vyssokikh Mikhail Y. , von Zglinicki Thomas , Averina Olga , Hildebrandt Thomas B.
Published: October 2020

Naked mole‐rats express many unusual traits for such a small rodent. Their morphology, social behaviour, physiology, and ageing have been well studied over the past half‐century. Many early findings and speculations about this subterranean species persist in the literature, although some have been repeatedly questioned or refuted. While the popularity of this species as a natural‐history curiosity, and oversimplified story‐telling in science journalism, might have fuelled the perpetuation of such misconceptions, an accurate understanding of their biology is especially important for this new biomedical model organism. We review 28 of these persistent myths about naked mole‐rat sensory abilities, ecophysiology, social behaviour, development and ageing, and where possible we explain how these misunderstandings came about.
The role of interleukin-18 in the diagnosis and monitoring of hemophagocytic lymphohistiocytosis/macrophage activation syndrome – a systematic review
Authors: Krei J M , Møller H J , Larsen J B
Published: October 2020

Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening, hyperinflammatory disorder, characterized by multiorgan failure, fever and cytopenias. The diagnosis of HLH and its subtype Macrophage Activation Syndrome (MAS) remains a challenge. Interleukin 18 (IL-18) is emerging as a potential biomarker for HLH/MAS but is currently not a part of diagnostic criteria. This systematic review aimed to assess the potential role of IL-18 in the diagnosis and monitoring of HLH and MAS, and was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed and Embase were searched on 30 January 2020. Studies included all subtypes of HLH and a range of underlying disorders in both children and adults. A total of 14 studies were included. Generally, serum IL-18 was elevated in both primary and secondary HLH (> 1000 pg/ml) compared with other inflammatory conditions and with healthy individuals; thus, serum IL-18 may be able to discriminate between HLH and other inflammatory conditions. Significantly increased IL-18 (> 10 000 pg/ml) was also consistently described in MAS compared with other subtypes of HLH. The ability of IL-18 to distinguish MAS from systemic juvenile idiopathic arthritis (JIA) is less unambiguous, as IL-18 levels > 100 000 pg/ml were described in sJIA patients both with and without MAS. IL-18 may help to differentiate between HLH subtypes and other inflammatory conditions. As HLH and MAS are rare disorders, only few and relatively small studies exist on the subject. Larger, prospective multi-center studies are called for to assess the diagnostic precision of IL-18 for HLH and MAS.
The severity of obstructive sleep apnoea does not influence ambient IGF‐I levels
Authors: Lynch Julie , Kyriakakis Nikolaos , Seejore Khyatisha , Nix Mitchell , Watts Sue , Ghosh Dipansu , Murray Robert D.
Published: October 2020

Objective

Obstructive sleep apnoea (OSA) is reported to have effects on a number of hormone systems including the hypothalamo‐pituitary axis. We aimed to determine the impact of OSA severity on insulin‐like growth factor‐I (IGF‐I) levels.

Design and Methods

This is a prospective cohort study performed between November 2014 and May 2017. IGF‐I was measured on serum samples, and data were collected on demographics, BMI and parameters of OSA.

Results

611 participants were recruited (202 female, 53.5 ± 12.5 years; mean BMI 36.2 ± 8.0 kg/m2). 26.2% had mild OSA; 27.3%, moderate OSA; and 44.5%, severe OSA. 15.2% of IGF‐I values were below the age‐related reference range. Increasing BMI correlated with greater AHI (r = .28, p < .001), ODI (r = .30, p < .001), severity of OSA (r = .17, p < .001), duration with oxygen saturation (SaO2) <90% (r = .29, p = .001) and reduced median SaO2 levels (r = .19, p < .001). IGF‐I levels correlated negatively with age (r = −.13, p = .001), BMI (r = −.16, p < .001), diabetes (r = −.108, p = .009), AHI (r = ‐0.10, p = .043) and severity of OSA (r = −.10, p = .013). No association of IGF‐I was observed with ODI, median SaO2 levels or duration of SaO2 < 90%. Regression analyses were used to examine determinants of IGF‐I, all of which contained the independent variables of age, gender and BMI. All models showed IGF‐I to be predicted by age and BMI (p < .05); however, none of the parameters of OSA were significant within these models.

Conclusion

Insulin‐like growth factor‐I levels in OSA are dependent on age and BMI; however, no additional effect of any OSA parameter was observed, supporting the hypothesis that OSA effects on IGF‐I are indirect through concomitant body composition and metabolic parameters.
Ultrasonography‐guided radiofrequency ablation vs. surgery for the treatment of solitary T1bN0M0 papillary thyroid carcinoma: A comparative study
Authors: Xiao Jing , Zhang Yan , Zhang Mingbo , Lan Yu , Yan Lin , Luo Yukun , Tang Jie
Published: October 2020

Objective

Ultrasonography‐guided radiofrequency ablation (RFA) has been used to treat low‐risk small papillary thyroid carcinoma (PTC) and yielded promising results. However, little research has been conducted on the application of RFA for the management of T1bN0M0 PTC. Therefore, this study was to compare the midterm outcome of RFA with that of surgery for the treatment of clinical solitary T1bN0M0 PTC.

Design

This is a retrospective study.

Patients

In total, 182 patients with solitary T1bN0M0 PTC between April 2014 and May 2019 were treated with RFA or surgery (n = 91/group).

Measurements

The primary end points were local tumour progression and complication rates. Local tumour progression were defined as: (a) new or persistent PTC confirmed by core needle biopsy; (b) cervical lymph node metastasis (LNM) confirmed by core needle biopsy or surgery; (c) ablation zone increased in the RFA group.

Results

In the RFA group, local tumour progression was seen in four patients (4.4%, three persistent PTC and one LNM). In the surgery group, two patients (2.2%) developed LNM; no new or persistent PTC was confirmed. There was no significant difference between the two groups in local tumour progression. Permanent hypoparathyroidism was observed in four patients (4.4%) in the surgery group, while no major or minor complications were observed in the RFA group.

Conclusions

Ultrasonography‐guided RFA is feasible and safe for treating solitary T1bN0M0 PTC, so it may be considered an alternative to surgery in select patients, especially those who are ineligible for or refusal of surgery.
Prenatal exposure to gestational diabetes is associated with anxiety and physical inactivity in children during COVID‐19
Authors: Alves Jasmin M. , Yunker Alexandra G. , DeFendis Alexis , Xiang Anny H. , Page Kathleen A.
Published: October 2020

Background

The coronavirus disease 2019 (COVID‐19) is associated with adverse child mental health outcomes and reduced physical activity. Moreover, prenatal exposure to gestational diabetes (GDM) is associated with increased risk for adverse psychological outcomes in children.

Objectives

Assess prenatal exposure to GDM on anxiety levels and physical activity in children during the COVID‐19 pandemic.

Methods

Sixty‐five children age 9 to 15 reported their physical activity and anxiety levels using the 24‐hours physical activity recall and the State‐Trait Anxiety Inventory for Children via phone or video meetings. Prenatal exposure to GDM was obtained from maternal electronic medical records.

Results

The 38 GDM‐exposed children reported significantly higher anxiety levels and were less likely to engage in any vigorous physical activity (VPA) (5% vs 30%) compared to the 27 GDM‐unexposed children. Lower levels of physical activity were significantly associated with higher levels of anxiety. Less engagement in VPA explained 75% of the association between GDM exposure and anxiety levels.

Conclusions

Engaging in physical activity during the COVID‐19 pandemic may be beneficial for reducing anxiety, particularly amongst GDM‐exposed children.
Micro‐ and macrovascular cardiac allograft vasculopathy in relation to 91 cardiovascular biomarkers in heart transplant recipients—An exploratory study
Authors: Bjerre Kamilla Pernille , Clemmensen Tor Skibsted , Poulsen Steen Hvitfeldt , Hvas Anne‐Mette , Holm Niels Ramsing , Grove Erik Lerkevang , Bouchelouche Kirsten , Kristensen Steen Dalby , Eiskjær Hans
Published: October 2020

Background

Cardiac allograft vasculopathy (CAV) limits survival after heart transplantation (HTx), and the pathogenesis is not fully clarified. We aimed to investigate a wide range of biomarkers and their correlation with micro‐ and macrovascular CAV and major adverse cardiac events in HTx patients.

Methods

We evaluated 91 cardiovascular disease‐related proteins in 48 HTx patients using a novel proteomic panel. Patients were dichotomized according to micro‐ and macrovascular CAV burden determined by coronary angiography, optical coherence tomography, and 15O‐H2O positron emission tomography imaging. Major adverse cardiac events included significant CAV progression, heart failure, treated rejection, and cardiovascular death.

Results

We found consistent differences in two proteins involved in cholesterol homeostasis: significantly increased proprotein convertase subtilisin/kexin type 9 (PCSK9) (p < .05) and significantly decreased paraoxonase 3 (PON3) (p < .05). N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) was significantly increased in patients with microvascular CAV (p < .05) and borderline significantly increased in patients experiencing major adverse cardiac events (p = .10) and patients with macrovascular CAV (p = .05).

Conclusions

We identified consistent changes in two proteins involved in cholesterol homeostasis which may be important players in the pathogenesis of CAV: PON3 and PCSK9. NT‐proBNP also showed consistent changes across all groups but only reached statistical significance in patients with microvascular CAV. Our results warrant further validation in future studies.
Incidence and risk factors of primary non‐function after liver transplantation using grafts from uncontrolled donors after circulatory death
Authors: Justo Iago , Nutu Anisa , García‐Conde María , Marcacuzco Alberto , Manrique Alejandro , Calvo Jorge , García‐Sesma Álvaro , Caso Óscar , Martín‐Arriscado Carmen , Andrés Amado , Paz Estela , Jiménez‐Romero Carlos
Published: October 2020

Background

Graft primary non‐function (PNF) is the most severe complication after orthotopic liver transplantation (OLT) and is frequently associated with livers from uncontrolled circulatory death (uDCD).

Methods

We reviewed retrospectively the incidence, risk factors, and outcome of patients showing PNF after receiving uDCD liver grafts. The series comprises 75 OLT performed during 11 years.

Results

The incidence of PNF using uDCD livers was 8%. We compared patients who developed PNF (n = 6) vs. patients without PNF (n = 69). Mean pump flow of donors during normothermic regional perfusion (NRP) was significantly lower in PNF (p = .032). Day 1 post‐OLT levels of transaminases and the incidence of renal complications and postoperative mortality were also significantly higher in the PNF group, but 5‐year patient survival was similar in both groups (66.7% in PNF and 68.5% in non‐PNF). All PNF patients underwent re‐OLT, and 2 died. PNF incidence has decreased in the last 5‐years. Binary logistic regression analysis confirmed final ALT value >4 times the normal value as risk factor for PNF, and median donor pump flow >3700 ml/min as protective effect.

Conclusions

Adequate donor pump flow during NRP was a protective.
Toker cell hyperplasia in Zuska disease: A tricky association
Authors: Torre‐Castro Juan , Haya‐Martínez Lara , Ruffin‐Vicente Belen , Moya‐Martínez Cristina , Núñez‐Hipólito Lucía , Díaz de la Pinta Javier , Cullen‐Aravena Daniella , Jo‐Velasco Margarita , Requena Luis
Published: October 2020

Toker cells (TCs) are sometimes present in the nipple epidermis as oval cells with pale cytoplasm and roundish nuclei. In most cases, TCs may be easily distinguished from cancerous cells of Paget disease of the nipple (PCs). Especially in TC hyperplasia, in which mild‐to‐moderate atypia may be present, it may be challenging to distinguish between TCs and PCs. The combination of chronic inflammatory changes in the nipple, in the context of Zuska disease, and TC hyperplasia, may easily lead to an erroneous diagnosis of mammary Paget disease.
MYC gene amplification by fluorescence in situ hybridization and MYC protein expression by immunohistochemistry in the diagnosis of cutaneous angiosarcoma: Systematic review and appropriate use criteria
Authors: Motaparthi Kiran , Lauer Scott R. , Patel Rajiv M. , Vidal Claudia I. , Linos Konstantinos
Published: October 2020

Background

Secondary angiosarcoma (AS) most commonly follows breast cancer and includes postirradiation AS (PRAS) and lymphedema‐associated AS. The frequent amplification of MYC (8q24.21) in secondary AS and the rising incidence of PRAS and atypical vascular lesions (AVLs) have prompted interest in the diagnostic and prognostic utility of MYC in AS.

Methods

Retrospective series with ≥2 cases of cutaneous AS and describing the use of fluorescence in situ hybridization (FISH) for MYC amplification or immunohistochemistry (IHC) for MYC overexpression were included.

Results

Sixteen studies met inclusion criteria. Overall, 93% of cases evaluated by FISH and IHC were concordant. The sensitivity of FISH in primary AS was only 6.8%, and protein overexpression occurred without amplification in sun‐damaged skin. FISH and IHC were over 78% sensitive in secondary AS but negative in over 98% of AVLs. MYC amplification and FLT4 coamplification were associated with shorter overall survival in secondary AS.

Conclusion

FISH for MYC amplification and IHC for MYC overexpression are useful in distinguishing PRAS from AVLs and may also have prognostic value in secondary AS. In contrast, these methods have little diagnostic or prognostic value in primary AS and should not be used to distinguish primary AS from benign vascular neoplasms.
Endothelial dysfunction and cardiovascular risk in lupus nephritis: New roles for old players?
Authors: Mancardi Daniele , Arrigo Elisa , Cozzi Martina , Cecchi Irene , Radin Massimo , Fenoglio Roberta , Roccatello Dario , Sciascia Savino
Published: October 2020

In systemic lupus erythematosus (SLE) patients, most of the clinical manifestation share a vascular component triggered by endothelial dysfunction. Endothelial cells (ECs) activation occurs both on the arterial and venous side, and the high vascular density of kidneys accounts for the detrimental outcomes of SLE through lupus nephritis (LN). Kidney damage, in turn, exerts a negative feedback on the cardiovascular (CV) system aggravating risk factors for CV diseases such as hypertension, stroke and coronary syndrome among others. Despite the intensive investigation on SLE and LN, the role of endothelial dysfunction, as well as the underlying mechanisms, remains to be fully understood, with no specifically targeted pharmacological treatment. It is not known, in fact, if the activation pathway(s) in venous ECs are similar to the one in arterial ECs and doubts persist on the shared manifestation of microcirculation compared to macrocirculation. In this work, we aim to review the recent literature about the role of endothelial activation and dysfunction in the development of CV complications in SLE and LN patients. We, therefore, focus on arteriovenous similarities and differences and on specific pathways of great vessels compared to capillaries. Critically summarising the available data is of pivotal importance for both basic researchers and clinicians in order to develop and test new pharmacological approaches in the treatment of basic components of SLE and LN.
Growing up in a civil war and political participation: Evidence from Guatemala*
Authors: Fuentes Cordoba Gabriel
Published: October 2020

Guatemala experienced a 36‐year‐long civil war from 1960 to 1996. I use this event to understand whether growing up in an area of political violence has any impact on future political participation. I combine data from the distribution of the number of human rights violations during Guatemala's civil war with nationally representative data on political participation from the 2001 Living Standard Measurement Survey. Results suggest that exposure to conflict during youth affects political participation in adulthood. Exposure to conflict has a small negative association with formal political engagement and it has no effect on community participation. The results also indicate a negative relationship between growing up in an area of political violence and trust in the judicial system as adults.
Public and private higher education institutions in Serbia: Legal regulations, current status and opinion survey
Authors: Franceško Mirjana , Nedeljković Jasmina , Živković Milan , Đurđić Sanja
Published: October 2020

This article provides insight into the state of higher education in Serbia, particularly in the context of reform processes based on European Higher Education Area principles. A multidimensional approach was taken, encompassing (a) a review and analysis of legal regulations relevant to the historical context of Serbia, (b) an examination of current working conditions at accredited state and private higher education institutions, (c) and a pilot survey of attitudes among the main participants in higher education teaching. The research gauged attitudes of university professors and students with work or study experiences, respectively, at both state and private higher education institutions. Specific instruments for measuring attitudes were constructed for this study. Professors' attitudes toward state and private higher education were compared through the assessment of aspects of organisational culture including work organisation, stimulating atmosphere, innovation, and creativity. Students expressed their attitudes toward state and private higher education in terms of general atmosphere, curricula, grading criteria, and student status. The results indicate that private higher education was appreciated slightly more than state higher education; both professors and students held more positive attitudes of private higher education for all dimensions investigated.