bluuebunny/crossref_metadata_2025 huggingface dataset:
Supply chain resilience: a benchmarking model for vulnerability and capability assessment in the automotive industry
Authors: Kaviani Mohamad Amin , Tavana Madjid , Kowsari Fatemeh , Rezapour Roghayeh
Published: June 2020

Purpose

The purpose of this study is to evaluate two supply chain resilience key elements of vulnerability and capability in the automotive industry.

Design/methodology/approach

We propose a fuzzy approach for statistical hypothesis testing and analyze two research hypotheses by synthesizing the results of a questionnaire given to 44 companies in the Iranian automotive industry.

Findings

The results indicate that the automotive industry in Iran should: (1) resist five elements of vulnerability, i.e. “external pressures,” “sensitivity,” “connectivity,” “supplier/customer disruptions,” and “resource limits,” and (2) embrace nine elements of capability, i.e. “flexibility in order fulfillment,” “capacity,” “efficiency,” “visibility,” “adaptability,” “recovery,” “dispersion,” “organization,” “market position” and “security” to achieve greater resiliency elasticity in the supply chain.

Originality/value

This is the first study on the supply chain resilience vulnerabilities and capabilities in the Iranian automotive industry.
Transgenerational innovation capability in family firms
Authors: Hernandez-Perlines Felipe , Ribeiro-Soriano Domingo , Rodríguez-García Maria
Published: June 2020

Purpose

Based on the theory of dynamic capabilities, the purpose of this study is to examine how generation influences the effect of innovation capability on family business performance. To achieve this purpose, a moderation model is tested using the generational level as the moderating variable.

Design/methodology/approach

This study used a sample of 106 family businesses CEOs who were surveyed by mail using the Limesurvey 2.5 platform. The results obtained were analyzed using the second-generation partial least squares (PLS) structural equation model. The MICOM (Measurement Invariance of Composite Models) approach was used to analyze the moderating effect.

Findings

This research sheds lights on the innovation capacity to influence the family businesses performance, and on the generational level moderating this effect. As a result, the influence of the innovation capacity in second generation family businesses performance is higher than in the first generation.

Research limitations/implications

This study reveals the influence that the generational level has on the effect of innovation capacity on the family business performance. A greater dispersion of ownership, more participatory decision-making, and greater CEOs commitment to leadership in second- and later-generation family businesses, are the main key drivers of this result.

Originality/value

In comparison to previous studies, this research provides insights into the moderating effect of the generational level on the influence of innovation capacity on the family businesses performance through the MICOM approach (Measurement Invariance of Composite Models).
Multi-objective optimization of Gas Station performance using response surface methodology
Authors: Asadzadeh Shervin , Akhavan Behrouz , Akhavan Behnaz
Published: June 2020

Purpose

In this paper, the performance of a specific gas station (Parvin) has been studied and investigated. The purpose of this research is to design a second-order regression model based on simulated data to optimize the queuing system in line with the fuel sales and costs. Thus, the influential variables including the number of pumps and the number of pump operators need to be optimally determined.

Design/methodology/approach

The simulation was combined with design of experiments (DoE) techniques to achieve a predictable model for optimizing Gas Station performance considering both the sales rate and the queue length. First, the Gas Station was simulated with Arena software, and then by using DoE and response surface methodology (RSM), the gas station performance was optimized in terms of three objectives including costs. A face-centered central composite design (CCD) has been implemented to reach the optimal number of pumps and pump workers.

Findings

The results of the optimization model derived from the CCD indicate that the performance of the Gas Station system has been improved considerably. Moreover, after the detailed study of optimization and RSM outputs, it seems that the variations of both the pumps and the number of pump operators have significant impacts on the performance of the Gas Station including costs, sales rate and queue length.

Originality/value

In general, it has been proved that simulation-based RSM can be considered as a powerful and effective technique in both single and multi-objective experimental optimization. The present study has been able to help managers to make decisions and conduct the Gas Station in critical conditions in different hours of a day.
Exploring gamified persuasive system design for energy saving
Authors: Böckle Martin , Novak Jasminko , Bick Markus
Published: June 2020

Purpose

The purpose of this paper is to explore user-centered design possibilities at the intersection of gamification and persuasive technology to foster energy saving behavior.

Design/methodology/approach

We performed a large-scale empirical study of 480 participants and analyzed how different HEXAD gamification user types perceive selected persuasive strategies embedded in an energy saving prototype. Furthermore, we investigated the role of existing energy saving behaviors (pro-environmental behavior scale–e.g. regularly turning the lights off) and their effect on the perceived persuasiveness of the proposed persuasive strategies, which may has an impact on the overall design process. Furthermore, we applied partial least squares path modeling and conducted a one-way and repeated measure ANOVA.

Findings

Results show that user types play an important role in the design of persuasive systems for energy saving. For instance, people with a high tendency toward the Socializer user type were motivated by almost all of the employed persuasive strategies, whereas Philanthropists and Players only to a limited number of strategies. Furthermore, our study reveals that existing behaviors like the individual level of energy conservation influences the perceived persuasiveness of certain strategies and therefore should be considered in the design of such applications.

Research limitations/implications

Using storyboards to obtain feedback about the perceived persuasiveness of employed strategies has limitations compared to the actual use of a functional prototype. However, to offset that limitation the mock-ups used in the storyboard reflected the actual designs for a real-world prototype.

Originality

This is the first study that explores how HEXAD gamification user types can be used to inform the design of persuasive applications for energy saving (RQ1). Furthermore, and in particular, this study draws on the challenges when using user types within gamified persuasive systems by highlighting the impact and the importance of considering existing energy saving behaviors (RQ2), which has not been addressed so far.
Intellectual capital, knowledge sharing and equity crowdfunding
Authors: Vrontis Demetris , Christofi Michael , Battisti Enrico , Graziano Elvira Anna
Published: June 2020

Purpose

This paper explores knowledge sharing (KS) and intellectual capital (IC) impacts on the success rate of equity crowdfunding (EC) campaigns in the Italian market, which represents a new model for financing entrepreneurial initiatives.

Design/methodology/approach

The relation between KS, IC and the success rate of EC campaigns is analysed with a panel regression that measures IC through the value added intellectual coefficient. Social network analysis is used to measure KS in the users' network on Twitter for EC campaigning. Specifically, the authors consider the information users exchange on social networks as a proxy of KS and identify the hubs influencing information dissemination, the size and strength of networks for each EC campaign. Finally, the success rate of EC campaigns is a ratio of the number of positive campaigns to the total number of campaigns for each platform.

Findings

The success rate of EC campaigns is positively related to IC and significantly and positively related to the number of connections the EC platforms have.

Practical implications

The positive relationship between the hub role of social network platforms and the success of EC campaigns provides an important signal to crowdfunding operators. As more potential investors focus on an EC campaign, a bandwagon effect could involve uninformed investors. This result is crucial in order to better understand how social media activity affects crowdfunding success.

Originality/value

Although the literature has examined the impact of KS on general firm performance and the mediating role of intellectual capital, no prior studies have examined the impacts of KS and IC on the success rate of EC campaigns in a specific market.
Autochthonous management knowledge/knowledge management in Africa
Authors: Zoogah David B. , Gomes Emanuel , Cunha Miguel Pina
Published: June 2020

Purpose

There is a growing desire for more scientific and technical knowledge regarding Africa. This is because Africa has the potential and opportunity to generate impactful research. However, this potential is not optimized because of several constraints, including the lack of systematic reviews and models of knowledge management and paradoxical trends in Africa. The purpose of this paper is to review studies on knowledge management and associated paradoxes in Africa and a paradox-conscious African knowledge management model. The autochthonous African model that the authors propose has implications for global knowledge management.

Design/methodology/approach

The authors review studies on knowledge management and paradoxes on Africa.

Findings

The authors propose a model and identify 12 paradoxes broadly categorized as industrial, political and social.

Practical implications

The paradoxical tensions characteristic of Africa may be considered integral to business and policy rather than local expressions to be solved through international “best practice.”

Originality/value

The model this paper propose enables theoretical and empirical studies of knowledge management sensitive to the paradoxical tensions associated with autochthonous management knowledge and autochthonous knowledge management.
Managing meanings, coaching virtues and mediating rhetoric
Authors: Rutten Kris , Flory Marja
Published: June 2020

Purpose

The purpose of this article is to present and revisit the role of rhetoric and narratives in management research and practice.

Design/methodology/approach

The authors revisit the insights from previous work on the role of rhetoric and narratives in management research and introduce new perspectives based on the original contributions included in this special issue.

Findings

There is an ongoing need to stress the importance of narrative and rhetorical perspectives in management research, specifically for exploring the managing of meanings, the coaching of virtues and the mediating of rhetoric.

Originality/value

The paper revisits and provides new insights on the role of rhetoric and narratives in management research and emphasizes the interrelationship between both, specifically by focusing on the conceptual framework of Kenneth Burke, whose work can be situated at the intersection of rhetoric and narrative.
Parliamentary Prorogation in Comparative Context
Authors: Schleiter Petra , Fleming Thomas G.
Published: June 2020

This paper examines the power to prorogue (or suspend) Parliament following the 2019 prorogation controversy in the UK. We outline the legal basis of prerogative‐based prorogation, survey its uses in the UK and other Westminster systems, and compare it with equivalent rules in other European parliamentary democracies. The comparative perspective highlights the outlier status of the UK among comparable European democracies. In the UK, the absence of explicit legal limits on the use of prorogation gives the executive exceptional scope to employ the power for political purposes to sidestep Parliament. We conclude by discussing the implications of these findings for current discussions about the desirability of reforming the UK’s prorogation rules and placing express legal limits on the executive’s power.
Techniques, perspectives, and challenges of bioactive peptide generation: A comprehensive systematic review
Authors: Barati Meisam , Javanmardi Fardin , Mousavi Jazayeri Seyed Mohammad Hosein , Jabbari Masoumeh , Rahmani Jamal , Barati Farzaneh , Nickho Hamid , Davoodi Sayed Hossein , Roshanravan Neda , Mousavi Khaneghah Amin
Published: June 2020

Due to the digestible refractory and absorbable structures of bioactive peptides (BPs), they could induce notable biological impacts on the living organism. In this regard, the current study was devoted to providing an overview regarding the available methods for BPs generation by the aid of a systematic review conducted on the published articles up to April 2019. In this context, the PubMed and Scopus databases were screened to retrieve the related publications. According to the results, although the characterization of BPs mainly has been performed using enzymatic and microbial in‐vitro methods, they cannot be considered as suitable techniques for further stimulation of digestion in the gastrointestinal tract. Therefore, new approaches for both in‐vivo and in‐silico methods for BPs identification should be developed to overcome the obstacles that belonged to the current methods. The purpose of this review was to compile the recent analytical methods applied for studying various aspects of food‐derived biopeptides, and emphasizing generation at in vitro, in vivo, and in silico.
Emergency department: A sociological perspective
Authors: Grace Samuel G
Published: June 2020

As a complex space that can be interpreted on individual, societal and systemic levels, there is a need for analysis of emergency medicine that transcends the biomedical paradigm to explore its sociological influences. The ED is a social structure of different roles, responsibilities and relationships that can be analysed through observation of the different institutionalised activities which highlight the hierarchies and culturally influenced interactions taking place between actors. Institutionalised activities that provide insight into the social structure of the ED include deference to doctors by patients in the context of environmental chaos, segregated handover of information and discharge‐oriented patient care that de‐emphasises the impact of social background.
Cost–benefit analysis of retrospectively identifying missed compensable billings in the emergency department
Authors: Lim Andy , Lim Alvin
Published: June 2020

Objective

The aim of the present study was to perform a cost–benefit analysis of retrospectively identifying missed compensable billings in a public Australian ED.

Methods

A retrospective review of patients who were eligible for billing from the period of 1 April 2018 to 31 January 2019 was undertaken. Individual patient files were examined and reconciliated with the historical billing record and any discrepancies identified. Financial modelling with Vose ModelRisk and R Studio v1.2.5033 was employed to estimate future benefits of such a strategy. Uncertainty analyses included variation in wage cost (AU$0–200/h), discount rate (3–10%), presentation growth rate, percentage compensable, benefit recovered/patient, percentage recoverable and cost per patient.

Results

A total of 76 523 patients presented during this time. Of these, 2737 patients were deemed compensable. A total of 740 undocumented billing items were identified with an estimated Medicare Benefits Schedule value of $59 870 and an Australian Medical Association value of $152 400. The net present value (NPV) of this identified cash flow stream in perpetuity was $1 436 892 (Medicare Benefits Schedule) and $3 657 600 (Australian Medical Association) (i.e. the total value of recovering this amount of money each year indefinitely, corrected for the time value of money). The positive NPV was maintained with sensitivity analysis.

Conclusion

All scenarios examined led to a positive NPV favouring retrospectively identifying missed compensable billings.
Identification of putative olfactory genes in newly hatched larvae of a Coleopteran ectoparasitoid Dastarcus helophoroides (Fairmaire) (Coleoptera: Bothrideridae) by transcriptome analysis
Authors: Li Xiaojuan , Dong Guangping , Fang Jianmin , Liu Hongjian , Guo Wanlin , Yin Huayang
Published: June 2020

Dastarcus helophoroides (Fairmaire) (Coleoptera: Bothrideridae) is an effective ectoparasitoid of pine sawyer beetle Monochamus alternatus Hope (Coleoptera: Cerambycidae) which is the major median insect for transmission of pine wood nematode, Bursaphelenchus xylophilus (Steiner et Buhrer) Nickle (Aphelenchida: Parasitaphelenchidae). A sensitive and acute olfactory system is extremely essential for newly hatched larva of D. helophoroides to forage for a host. Therefore, we established the transcriptome of newly hatched D. helophoroides larvae and characterized the expression profiles of olfactory genes. We identified 20 transcripts encoding putative odorant binding proteins (OBPs), 11 putative chemosensory proteins (CSPs), 9 putative odorant receptors (ORs), 11 putative ionotropic receptors (IRs), 7 putative gustatory receptors (GRs) and 4 putative sensory neuron membrane proteins (SNMPs) olfactory genes from the transcriptome of newly hatched D. helophoroides larvae. According to the phylogenetic analysis, 3 OBPs (DhelOBP6, DhelOBP14 and DhelOBP19), 1 CSP (DhelCSP11), 1 OR (DhelOrco1), 3 IRs (DhelIR3, DhelIR6 and DhelIR8), 3 GRs (DhelGR2, DhelGR4 and DhelGR5) and 2 SNMPs (DhelSNMP1 and DhelSNMP3) had high similarities with reported Coleopteran species. The highest expressed olfactory gene was DhelCSP3, followed by DhelOBP8 and DhelCSP2. The expression levels of the majority of OR, IR, GR and SNMP genes were low. These results indicate that CSPs and OBPs may play important roles in the olfactory recognition process in newly hatched D. helophoroides larvae. The findings from the present study are helpful in unraveling the profound mystery between D. helophoroides and M. alternatus, as well as improving the parasitism efficiency of D. helophoroides larvae.
Preoperative high‐dose Steroids in Total Knee and Hip Arthroplasty – Protocols for three randomized controlled trials
Authors: Nielsen Niklas I. , Kehlet Henrik , Gromov Kirill , Troelsen Anders , Husted Henrik , Varnum Claus , Kjærsgaard‐Andersen Per , Rasmussen Lasse E. , Mandøe Hans , Foss Nicolai B.
Published: June 2020

Background

Patients undergoing total knee arthroplasty (TKA)/ total hip arthroplasty (THA) still experience moderate‐severe postoperative pain despite optimized pain management regimes. The patients already on opioid treatment and pain catastrophizers (PCs) have a higher risk of postoperative pain.

The use of preoperative intravenous high‐dose glucocorticoids decreases postoperative pain after TKA and THA, but optimal dose is yet to be found, and the effect on subpopulations at high pain risk is unknown.

Aim

To investigate the effect of a higher than previously used dose of glucocorticoids (dexamethasone (DXM)), administered intravenously before surgery, as part of standardized fast‐track regimen, on postoperative pain in TKA/THA subgroups.

Method

Three separate randomized, double‐blinded, controlled trials were planned to compare a new higher dose DXM (1 mg/kg) to the earlier used high‐dose DXM (0.3 mg/kg). Study 1: predicted Low Pain TKA; study 2: predicted High Pain Responder (HPR) TKA; study 3: predicted HPR THA. Predicted HPR groups consist of either PCs with PCS‐score of ≥ 21 and/or history of ongoing opioid‐treatment of 30 mg/day of morphine or equivalents > 30 days. In total, 408 patients were planned for inclusion (160 Low Pain TKA, 88 HPR TKA, 160 HPR THA).

Primary outcome

Pain upon ambulation in a 5‐meter walk test 24 hours after surgery. Secondary outcomes include use of analgesics, rescue‐opioids, antiemetics, cumulated pain, CRP, OR‐SDS, QoR‐15, quality of sleep, length of stay (LOS), reasons for hospitalization, readmission, morbidity, and mortality. Patients completed follow‐up on day 90. Recruiting commenced February 2019 and is expected to finish in September 2020.
Methadone‐related deaths among youth and young adults in Sweden 2006–15
Authors: Fugelstad Anna , Bremberg Sven , Hjelmström Peter , Thiblin Ingmar
Published: June 2020

Aims

To identify methadone‐related deaths and determine the prevalence among youth and young adults in Sweden 2006–15.

Design, Setting and Participants

National retrospective registry study comparing data from all forensic autopsy examinations and toxicology cases involving methadone during 2006–15 in individuals aged 15–29 years with police records, previous pharmaceutical prescriptions and health‐care episodes.

Measurements

Multinomial logistic regression. To assess the factors contributing to the deaths, we compared individuals with and without previous substance use treatment and opioid use‐related diagnoses with regard to previous opioid agonist treatment (OAT), psychiatric care and previous pain medication. To assess the circumstances of deaths, we analyzed the presence of other drugs and other factors at time of death.

Findings

We identified 269 methadone‐related deaths, and the rate increased during the study period. Seventy‐two (27%) cases had not previously received substance use treatment, 112 (42%) had received treatment but had no opioid use‐related diagnosis and 85 (32%) had received treatment and had an opioid use‐related diagnosis. In total, only 10 individuals had been prescribed methadone during the year before death. Prescriptions of benzodiazepines (60%), antidepressants (62%) and opioids for pain (22%) the year before death were common. Most deaths occurred during sleep with a time lag from ingestion of methadone.

Conclusion

Prescription opioid‐ and methadone‐related deaths increased in the group aged 15–29 years in Sweden between 2006 and 2015. Exposure to non‐prescribed methadone and prescribed benzodiazepines, antidepressants and opioids for pain appears to be common in drug‐related deaths in youth and young adults in Sweden.
LupinuspolyphyllusLindl. andRumex acetosellaL. effects on nutrient accumulation and microbial activity on tephra from the Puyehue–Cordón Caulle eruption (2011)
Authors: Ferreiro Nicolás , Satti Patricia , Castán Elisa , Álvarez Soria Luciano , Mazzarino María Julia
Published: June 2020

This study investigated the capacity ofLupinus polyphyllus(Leguminosae) andRumex acetosella(Polygonaceae) to promote nutrient accumulation and microbial activity on tephra from the volcanic eruption of the Chilean Puyehue–Cordon Caulle complex (Northern Patagonia) in June 2011. In December 2015, February 2016 and September 2016, we sampled (1) barren substrate (‘Barren’), (2) substrate underR. acetosella(‘R. ac. substrate’), (3) substrate underL. polyphyllus(‘L. po. substrate’), (4)R. acetosellarhizosphere substrate (‘R. ac. rhizosphere’) and (5)L. polyphyllusrhizosphere substrate (‘L. po. rhizosphere’) (n = 5). Soil properties (moisture, pH, electrical conductivity, organic C, available P, inorganic N and total N) and microbial activity (enzymatic activities) were assessed. ‘Barren’ presented the lowest moisture, organic C, total N and enzymatic activities. ‘R. ac. substrate’ and ‘L. po. substrate’ showed similar levels of organic C (0.23–0.30 g kg−1), and however,R. acetosellawas associated with lower inorganic N (‘R. ac. substrate’ = 0.7 and ‘L. po. substrate’ = 2.3 mg kg−1) whileL. polyphyllustended to promote higher total N, especially in the rhizosphere (‘R. ac. rhizosphere’ = 0.19 and ‘L. po. rhizosphere’ = 0.34 g kg−1). ‘L. po. substrate’ and ‘L. po. rhizosphere’ presented the highest enzymatic activities. After five years,L. polyphyllusandR. acetosellahave increased tephra organic C, total N and microbial activity, and however,L. polyphyllushas maintained the best substrate N availability.

Abstract in Spanish is available with online material.
Genomic testing and counseling: The contribution of next‐generation sequencing to epilepsy genetics
Authors: Alsubaie Lamia , Aloraini Taghrid , Amoudi Manal , Swaid Abdulrahman , Eyiad Wafaa , Al Mutairi Fuad , Ababneh Farouq , Alrifai Muhammad Talal , Baarmah Duaa , Altwaijri Waleed , Alotaibi Naser , Harthi Ashraf , Rumayyan Ahmad , Alanazi Ali , Qrimli Mohammad , Alfadhel Majid , Alfares Ahmed
Published: June 2020

Introduction

Currently, next‐generation sequencing (NGS) technology is more accessible and available to detect the genetic causation of diseases. Though NGS technology benefited some clinical phenotypes, for some clinical diagnoses such as seizures and epileptic disorders, adaptation occurred slowly. The genetic diagnosis was mainly based on epilepsy gene panels and not on whole exome and/or genome sequencing.

Method

We retrospectively analyzed 420 index cases, referred for NGS over a period of 18 months, to investigate the challenges in diagnosing epilepsy.

Result

Of the 420 cases, 65 (15%) were referred due to epilepsy with one third having a positive family history. The result of the NGS was 14 positive cases (21.5%), 16 inconclusive cases (24%), and 35 (53%) negative cases. No gene has been detected twice in the inconclusive and positive groups. Comparative genomic hybridization has been performed for all 30 NGS negative cases and four cases with pathogenic variants (deletion in 15q11.213.1, deletion of 2p16.3, deletion in Xq22.1, and deletion in 17p13.3) were identified.

Conclusion

These findings have implications for our understanding of the approach to genetic testing and counseling of patients affected with seizures and epilepsy disorders. The overall diagnostic yield of exome/genome sequencing in our cohort was 23%. The main characteristic is genetic heterogeneity, supporting NGS technology as a suitable testing approach for seizures and epilepsy disorders. Genetic counseling for newly identified disease‐causing variants depends on the pedigree interpretation, within the context of disease penetrance and variable expressivity.
Above‐ground biomass and vegetation attributes in the forest‐savannah mosaic of Togo, West Africa
Authors: Atsri Honam Komina , Kokou Kouami , Abotsi Komla Elikplim , Kokutse Adzo Dzifa , Cuni‐Sanchez Aida
Published: June 2020

Despite the increasing interest in the role of African savannah and woodlands on the global carbon cycle, little is known about the above‐ground biomass (AGB) and the factors affecting it in these ecosystems in West Africa. We estimated AGB in different vegetation types of a forest–savannah mosaic in Togo, and we investigated the relationship between AGB, structural and diversity attributes. We also assessed the effects of using the ≥5 or ≥10 cm diameter threshold on AGB estimates. We sampled tree diameter, height and species of all trees ≥5 cm diameter following standardised protocols in 160 plots of 50 × 20 m (50 × 10 m for riparian). Above‐ground biomass (AGB) (all trees ≥5 cm diameter) ranged from 6.2 Mg/ha in shrub savannah to 292 Mg/ha in riparian forest and showed significant differences between vegetation types. Differences in AGB were related to structural attributes, with little influence of diversity attributes. The effects of minimum tree diameter size (5 or 10 cm) on AGB estimates were negligible. At a landscape level, closed‐canopy and open forests stored important quantities of carbon. We highlight the importance of the forest–savannah mosaic as a large carbon pool, which could be released if converted to another land cover type.
Revolutionary Fossils, Ancient Biomolecules, and Reflections in Ethics and Decolonization: Paleoanthropology in 2019
Authors: Schroeder Lauren
Published: June 2020

Over the past few decades, paleoanthropology has undergone a transformative shift away from studies focused solely on traditional assessments of skeletal anatomy. Prior to this shift, a review highlighting a year of research may have primarily consisted of a description of new fossil discoveries; in 2019, however, this review also incorporates novel subject matters such as ancient DNA, paleoproteomics, and studies applying a wide array of new analytical methods and theoretical frameworks to paleoanthropological questions. Through these new advances, the nonlinearity and complexity of hominin evolution has been illuminated, emphasizing the importance of interdisciplinary work in progressing the field. In addition, similar to the broader discipline of biological anthropology, the topic of decolonization has been reflected on and discussed. Further, researchers in paleoanthropology are grappling with important issues related to open access and data sharing. In light of this widening scope, this review centers on a collection of studies that focus on five key themes: (1) new discoveries; (2) data sharing and ethics; (3) human origins research; (4) paleogenomics, and new advancements in paleoproteomics; and (5) introspection on a colonial history. Paleoanthropology is coming of age, and in 2019 especially, published research has been reflective of this. [Evolutionary anthropology; human evolution; year in review; human origins]
The effect of dexmedetomidine on postoperative behaviour change in children: a randomised controlled trial
Authors: Lee‐Archer P. F. , von Ungern‐Sternberg B. S. , Reade M. , Betts M. , Haenke D. , Keys A. , Rance T. , Gibbons K. , Long D.
Published: June 2020

Children may develop changes in their behaviour following general anaesthesia. Some examples of negative behaviour include temper tantrums and nightmares, as well as sleep and eating disorders. The aim of this study was to determine whether dexmedetomidine reduces the incidence of negative behaviour change after anaesthesia for day case surgery in children aged two to seven years. Children were randomly allocated to one of three groups: a premedication group received 2 μg.kg-1 intranasal dexmedetomidine; an intra‐operative group received 1 μg.kg-1 intravenous dexmedetomidine; and a control group. The primary outcome was the incidence of negative behaviour on postoperative day 3 using the Post‐Hospitalisation Behaviour Questionnaire for Ambulatory Surgery (PHBQ‐AS) and the Strength and Difficulties Questionnaire (SDQ). Secondary outcomes included: the incidence of negative behaviour on postoperative days 14 and 28; anxiety at induction; emergence delirium; pain; length of recovery and hospital stay; and any adverse events. The data for 247 patients were analysed. Negative behaviour change on postoperative day 3 was similar between all three groups when measured with the PHBQ‐AS (47%, 44% and 51% respectively; adjusted p=0.99) and the SDQ (median scores 7.5, 6.0 and 8.0 respectively; adjusted p=0.99). The incidence of negative behaviour in the group who received dexmedetomidine intra‐operatively was less at postoperative day 28 (15% compared with 36% in the dexmedetomidine premedication group and 41% in the control group, p<0.001). We conclude that dexmedetomidine does not reduce the incidence of negative behaviour on postoperative day 3 in two to seven‐year olds having day case procedures. [Correction added 15 January 2021, after first online publication: In original published version, there was a dosage error in the Summary section, which specified mg instead of μg; this version corrects the error].
Resilience strategies to manage psychological distress among healthcare workers during the COVID‐19 pandemic: a narrative review
Authors: Heath C. , Sommerfield A. , von Ungern‐Sternberg B. S.
Published: June 2020

The COVID‐19 pandemic marks an extraordinary global public health crisis unseen in the last century, with its rapid spread worldwide and associated mortality burden. The longevity of the crisis and disruption to normality is unknown. With COVID‐19 set to be a chronic health crisis, clinicians will be required to maintain a state of high alert for an extended period. The support received before and during an incident is likely to influence whether clinicians experience psychological growth or injury. An abundance of information is emerging on disease epidemiology, pathogenesis and infection control prevention. However, literature on interventions for supporting the psychological well‐being of healthcare workers during disease outbreaks is limited. This article summarises the available management strategies to increase resilience in healthcare workers during the COVID‐19 pandemic and beyond. It focuses on self‐care and organisational justice. It highlights various individual as well as organisational strategies. With the success of slowing disease spread in many countries to date, and reduced work‐load due to limitations on elective surgery in many institutions, there is more time and opportunity to be pro‐active in implementing measures to mitigate or minimise potential adverse psychological effects and improve, restore and preserve the well‐being of the workforce now and for years to come. The purpose of this review is to review available literature on strategies for minimising the psychological impact of the COVID‐19 pandemic on clinicians and to identify pro‐active holistic approaches which may be beneficial for healthcare workers both for the current crisis and into the future.
Endophthalmitis after strabismus surgery: incidence and outcome in relation to age, operated eye muscle, surgical technique, scleral perforation and immune state
Authors: Simonsz Huibert J. , Rutar Tina , Kraft Stephen , Thiadens Alberta A.H.J. , Batstra Manou R. , Verdijk Robert M. , Loeffler Karin U. , Kommerell Guntram ,   the Endophthalmitis‐after‐Strabismus‐Surgery Reporting Group
Published: June 2020

Purpose

Identify risk factors for endophthalmitis after strabismus surgery (EASS) and relate these to incidence and outcome.

Methods

Ophthalmologists, who had operated, diagnosed or treated EASS, completed a case record form with 71 questions in six domains: Preoperative, Surgery, Perforation, Postoperative, Outcome and Experts’ opinion. To estimate the age‐specific incidence per number of strabismus operations in the Netherlands during 1994‐2013, the age distribution of Dutch cases was compared with the age‐specific rates of strabismus surgery in the Dutch Registry of Strabismus Operations and with population data. Exploratory data analysis was performed. The immune state was evaluated in six patients. Five enucleated eyes were studied histopathologically.

Results

None of the 26 patients (27 eyes with EASS) were between 9 and 65 years old, except for one patient with retinal haemorrhage followed by endophthalmitis. In the Netherlands during 1994‐2013, the rate of EASS was approximately one per 11 000 strabismus operations, but one per 4300 for children aged 0–3 and one per 1000 for patients 65 and older. Endophthalmitis was diagnosed on postoperative day 1–4 in children aged 0–3. In all 15 children aged 0–5, the 16 affected eyes were phthisical, eviscerated or enucleated. The involved eye muscle had been recessed in 25 of 27 cases. It was a medial rectus in 15 of 16 children aged 0–6. It was a lateral (6), inferior (2) or medial (1) rectus in elderly. Scleral perforation went unnoticed in all children (no record in three) and in two of seven elderly (no record in two). Histopathology showed transscleral scarring compatible with scleral perforation in four patients but, in a two‐year‐old girl who had EASS together with a transient medial rectus palsy, the sclera underneath the former suture tract was not perforated but did contain the long posterior ciliary artery.

Conclusions

Endophthalmitis after strabismus surgery (EASS) affects children and elderly, with a grave outcome in young children. It occurs after recession of the medial rectus muscle in children, and it may occur without scleral perforation. Age and perforation are key determinants that interact with other factors that determine the occurrence and fulminance of EASS.
Pigmentary retinopathy can indicate the presence of pathogenic LAMP2 variants even in somatic mosaic carriers with no additional signs of Danon disease
Authors: Kousal Bohdan , Majer Filip , Vlaskova Hana , Dvorakova Lenka , Piherova Lenka , Meliska Martin , Langrova Hana , Palecek Tomas , Kubanek Milos , Krebsova Alice , Gurka Jiri , Stara Veronika , Michaelides Michel , Kalina Tomas , Sikora Jakub , Liskova Petra
Published: June 2020

Purpose

Danon disease (DD) is a rare X‐linked disorder caused by pathogenic variants in LAMP2. DD primarily manifests as a severe cardiomyopathy. An early diagnosis is crucial for patient survival. The aim of the study was to determine the usefulness of ocular examination for identification of DD.

Methods

Detailed ocular examination in 10 patients with DD (3 males, 7 females) and a 45‐year‐old asymptomatic female somatic mosaic carrier of a LAMP2 disease‐causing variant.

Results

All patients with manifest cardiomyopathy had pigmentary retinopathy with altered autofluorescence and diffuse visual field loss. Best corrected visual acuity (BCVA) was decreased (<0.63) in 8 (40%) out of 20 eyes. The severity of retinal pathology increased with age, resulting in marked cone‐rod involvement overtime. Spectral‐domain optical coherence tomography in younger patients revealed focal loss of photoreceptors, disruption and deposition at the retinal pigment epithelium/Bruch's membrane layer (corresponding to areas of marked increased autofluorescence), and hyperreflective foci in the outer nuclear layer. Cystoid macular oedema was seen in one eye. In the asymptomatic female with somatic mosaicism, the BCVA was 1.0 bilaterally. An abnormal autofluorescence pattern in the left eye was present; while full‐field electroretinography was normal.

Conclusions

Detailed ocular examination may represent a sensitive and quick screening tool for the identification of carriers of LAMP2 pathogenic variants, even in somatic mosaicism. Hence, further investigation should be undertaken in all patients with pigmentary retinal dystrophy as it may be a sign of a life‐threatening disease.
The occurrence of optic disc haemorrhage in primary open‐angle glaucoma eyes with lower normal pressure and its relating factors
Authors: Sakata Rei , Yoshitomi Takeshi , Araie Makoto ,   for Lower Normal Pressure Glaucoma Study Members in Japan Glaucoma Society
Published: June 2020

Purpose

To report the occurrence probability of disc haemorrhage (DH) and risk factors for it in otherwise healthy Japanese normal‐tension glaucoma (NTG) patients who had lower normal intraocular pressure (IOP) and were followed without treatment for 5 years.

Methods

A prospective observational study. Normal‐tension glaucoma (NTG) patients with IOP consistently ≤15 mmHg without treatment were enrolled. The presence or absence of DH was checked semi‐annually on the fundus photographs by three independent observers, while patients were followed without treatment. Cox proportional hazards model taking inter‐eye correlation into consideration was adopted to identify risk factors for DH occurrence. The main outcomes were DH occurrence probability during 5‐year period and its risk factors.

Results

One hundred seventeen eyes of 90 patients with mean age of 54.1 years, mean deviation value of −3.6 decibels and mean IOP during follow‐up of 12.4 mmHg were included. Disc haemorrhage (DH) was observed at least once in 34 eyes and more than twice in 15 eyes during the follow‐up. The DH occurrence probability at 5 years was 31% (95% confidence interval: 21–40%), and lower myopic refraction (HR = 1.18; p = 0.018), higher IOP during follow‐up (HR = 1.35; p = 0.047) and presence of DH at baseline (HR = 4.19; p = 0.002) were its risk factors.

Conclusion

Disc haemorrhage (DH) occurrence probability of Japanese healthy NTG patients with mean IOP of 12.4 mmHg and no systemic and/or topical treatment was 31% at 5 years. Lower myopic refraction, higher IOP and its existence at baseline were its risk factors.
Drug‐drug interaction between warfarin and statins: A Danish cohort study
Authors: Engell Anna E. , Svendsen Andreas L.O. , Lind Bent S. , Andersen Christen L. , Andersen John S. , Willadsen Tora G. , Persson Frederik , Pottegård Anton
Published: June 2020

Initiation of statin treatment is suggested to increase the international normalised ratio (INR) among warfarin users. However, available data is limited and conflicting. We conducted a register‐based cohort study to evaluate the drug‐drug interaction between warfarin and statins.

By linking data on INR measurements and filled prescriptions, we identified warfarin users 2000‐2015 initiating simvastatin (n = 1363), atorvastatin (n = 165) or rosuvastatin (n = 23). Simvastatin initiation led to an increase in mean INR from 2.40 to 2.71, with INRs peaking after 4 weeks, corresponding to a mean change of 0.32 (95%CI 0.25‐0.38). High‐dose and low‐dose simvastatin led to comparable changes (mean change 0.33 vs 0.29). Initiation of atorvastatin and rosuvastatin lead to INR increases of 0.27 (95%CI 0.12‐0.42) and 0.30 (95%CI ‐0.09‐0.69).

In conclusion, initiation of simvastatin, atorvastatin or rosuvastatin among warfarin users led to a minor increase in INR. The magnitude of this change is for most patients likely of limited clinical relevance.
Low arginine vasopressin levels in patients with diabetes insipidus are not associated with anaemia
Authors: Winzeler Bettina , Morin Benedict , Refardt Julie , Imber Cornelia , Fenske Wiebke , Sailer Clara O. , Holbro Andreas , Christ‐Crain Mirjam
Published: June 2020

Objective

Arginine vasopressin (AVP) is released upon osmotic stimulation or hypovolaemia in order to maintain water balance. A recent study showed a role of AVP in haematopoiesis by stimulating red blood cell precursors, suggesting a higher risk of anaemia in patients with AVP deficiency.

The objective was to explore the effect of low AVP levels in patients with central diabetes insipidus (cDI) and primary polydipsia (PP) on haemoglobin and the prevalence of anaemia.

Methods

A total of 164 patients with either cDI (70, 43%) or PP (94, 57%) and 30 healthy volunteers from two prospective diagnostic studies performed in Switzerland, Germany and Brazil were studied. A standardized clinical and biochemical (eg copeptin, full blood count) assessment was performed. Haemoglobin and haematocrit levels and prevalence of anaemia (defined as haemoglobin values of <120 g/L in women and <130 g/L in men) were analysed.

Results

Mean copeptin values were 2.63 pmol/L (±1.08) and 3.91 pmol/L (±4.28) in patients with cDI and PP and 24.76 pmol/L (±5.75) in healthy volunteers, P = .02. The prevalence of anaemia was low in all participants with 7.1%, 2.2% and 10% in cDI, PP and in healthy volunteers, P = .15. Mean haemoglobin values were similar in all groups: 139 g/L (±15.85), 140 g/L (±13.16) and 139 g/L (±13.05) in patients with cDI, PP and healthy volunteers, P = .90, as were mean haematocrit values with 41% in all groups (P = .85).

Conclusion

Chronic low AVP levels in patients with cDI and PP do not affect haemoglobin levels and prevalence of anaemia.
Comparative meta‐analysis of Kabuki syndrome with and without hyperinsulinaemic hypoglycaemia
Authors: Hoermann Henrike , El‐Rifai Omar , Schebek Martin , Lodefalk Maria , Brusgaard Klaus , Bachmann Nadine , Bergmann Carsten , Roeper Marcia , Welters Alena , Salimi Dafsari Roschan , Blankenstein Oliver , Mayatepek Ertan , Christesen Henrik , Meissner Thomas , Kummer Sebastian
Published: June 2020

Background and Objective

Kabuki syndrome (KS), caused by pathogenic variants in KMT2D or KDM6A, is associated with hyperinsulinaemic hypoglycaemia (HH) in 0.3%‐4% of patients. We characterized the clinical, biochemical and molecular data of children with KS and HH compared to children with KS without HH in a multicentre meta‐analysis.

Methods

Data of seven new and 17 already published children with KS and HH were compared to 373 recently published KS patients without HH regarding molecular and clinical characteristics.

Results

Seven new patients were identified with seven different pathogenic variants in KDM6A (n = 4) or KMT2D (n = 3). All presented with HH on the first day of life and were responsive to diazoxide. KS was diagnosed between 9 months and 14 years of age. In the meta‐analysis, 24 KS patients with HH had a significantly higher frequency of variants in KDM6A compared to 373 KS patients without HH (50% vs 11.5%, P < .001), and KDM6A‐KS was more likely to be associated with HH than KMT2D‐KS (21.8% vs. 3.5%, P < .001). Sex distribution and other phenotypic features did not differ between KS with and without HH.

Conclusion

The higher incidence of HH in KDM6A‐KS compared to KMT2D‐KS indicates that KDM6A loss of function variants predispose more specifically to beta cell dysfunction compared to KMT2D variants. As difficulties to assign syndromic characteristics to KS in early infancy often lead to delayed diagnosis, genetic testing for KS should be considered in children with HH, especially in the presence of other extrapancreatic/syndromic features.
Acceptance of a meal kit programme in an outpatient paediatric weight management clinic: A qualitative pilot study
Authors: Oberle Megan M. , Loth Katie A. , Schendel Anne , Fox Claudia K. , Gross Amy C.
Published: June 2020

Lack of food preparation knowledge, time to prepare meals and concerns about fruit and vegetable spoilage before consumption are the potential barriers to home cooking. These barriers may be addressed by meal kits (bundles of recipes and ingredients). We described home cooking barriers and evaluated acceptability of meal kits, using semi‐structured focus groups with caregivers and adolescent patients of an outpatient paediatric weight management clinic. One meal kit per family, containing non‐perishable food, a $20 gift card to a grocery store and recipes designed by clinic dietician for two meals, were given at clinic appointments. Two in‐person semi‐structured focus groups were conducted within 2 weeks of meal kit receipt. Four adolescent participants (75% female; 12.7 ± 0.9 years) and eight caregivers (88% female) participated in the focus groups. Four barriers to home cooking were identified: (a) healthy food cost, (b) preparation time, (c) food preparation knowledge and (d) picky eaters. Participants felt the meal kits addressed the time and lack of food preparation knowledge barriers to home cooking. A clinical meal kit programme was acceptable to a treatment‐seeking adolescent population with obesity and their caregivers.
Impaired dexamethasone resorption in two patients with pseudo‐Cushing after bariatric surgery: Implications for immunosuppressive treatment
Authors: Humpert Per M. , Samigullin Azat , Lindner Andre , Weihrauch Julia , Oikonomou Dimitrios , Metzner Cornelia , Böttcher Knut A. , Morcos Michael
Published: June 2020

Two cases of middle‐aged female patients treated by gastric bypass surgery for weight loss presented to our clinic for a follow‐up examination 3‐6 months after the surgical procedure (a mini gastric bypass and a modified single anastomosis sleeve‐ileostomy). In both patients increased ACTH levels and either high serum cortisol or an increased urinary cortisol excretion was apparent and triggered further endocrine testing. Serum cortisol could not be suppressed adequately by 2 and 4 mg dexamethasone in the standardized oral overnight suppression test while midnight salivary cortisol dropped well below the desired cut‐off. This led to the hypothesis of an impaired dexamethasone resorption and could be further substantiated by suppression of serum cortisol below the cut‐off by an intravenous dexamethasone application. The data presented point to an impairment of enteral synthetic corticosteroid resorption in patients after gastric bypass surgery and could be of importance for individuals in need for immunosuppressive treatment. In view of the growing number of bariatric procedures, pharmacokinetics of corticosteroids and other drugs should be tested in clinical trials.