bluuebunny/crossref_metadata_2025 huggingface dataset:
The suffering of refugees in Ghassan Kanafani’s “The Child Goes to the Camp”: a critical appraisal
Authors: Abdel Meguid Rania Mohammed Abdel
Published: February 2021

Purpose

This paper aims to present a critical appraisal of Ghassan Kanafani’s short story “The Child Goes to the Camp” using the Appraisal Theory proposed by Martin and Rose (2007) in an attempt to investigate the predicament of the Palestinians who were forced to flee their country and live in refugee camps as well as the various effects refugee life had on them.

Design/methodology/approach

Using the Appraisal Theory, and with a special focus on the categories of Attitude and Graduation, the paper aims to shed light on the plight of refugees through revealing the narrator’s suffering in a refugee camp where the most important virtue becomes remaining alive.

Findings

Analysing the story using the Appraisal Theory reveals the impact refugee life has left on the narrator and his family. This story serves as a warning for the world of the suffering refugees have to endure when they are forced to flee their war-torn countries.

Originality/value

Although Kanafani’ resistance literature has been studied extensively, his short stories have not received much scholarly attention. In addition, his works have not been subject to linguistic analysis. This study presents an appraisal analysis of Kanafani’s “The Child Goes to the Camp” in an attempt to investigate how the author’s linguistic choices are key to highlighting the suffering of the Palestinians, especially children, in refugee camps.
Real-time polling to help corral university-learners' wandering minds
Authors: Price Trevor John
Published: February 2021

Purpose

This research investigates the use of real-time online polling to enhance university teaching and learning.

Design/methodology/approach

Using a case study and employing action research, this work shows how polling can improve professional practice, learner engagement and teaching performance.

Findings

Incorporating the right type of online real-time polling into lessons is a professional challenge and can be hard work for teachers but has overriding benefits.

Research limitations/implications

This research reports one lecturer's experiences within two UK universities, limited to location, variety of students and lecturer technical capability. The research implications are that online polling, especially in different learning environments, is needed. Previous research is outdated or limited to real-time polling for teaching and learning during physical classes. There are research opportunities therefore in the use of polling before, during and after class.

Practical implications

This research finds that the field of online polling needs to be seen as a modern teaching tool that now uses students' personal technology for easier use by students and teachers: it is more than the use of archaic “clickers” which were extra classroom items to be bought and maintained. Also, online polling, before, during and after classes, can be employed usefully and have validity within teachers' toolboxes. This paper shows how such polls can be successfully deployed.

Originality/value

Whilst there are previous reports of polling undertaken within teaching and learning events, this paper builds upon those experiences and boosts collective understanding about the use of polling as a way to improve professional practice and increase learning.
The perfect storm in the midst of a pandemic: the use of information within an institution's concurrent crises
Authors: R Slagle Derek , McIntyre J.J. , Chatham-Carpenter April , Reed Heather Ann
Published: February 2021

Purpose

The purpose of this study is to examine the types of information that were shared by the institution, and faculty/staff responses to the information shared, with the goal of providing recommendations for other institutions facing concurrent crises.

Design/methodology/approach

This mixed-methods case study examines a public university's experiences managing the Covid-19 pandemic crisis while simultaneously navigating financial challenges that had been building over time. Using data from university-wide mediated communications and a survey of on-campus stakeholders during the Covid-19 pandemic and university retrenchment process, this paper explores institutional communication, stakeholder response to organizational communication and faculty/staff reactions to information in the midst of concurrent crises.

Findings

The study found that the university used instructing and advising information within its messages from its top administrator but fell short of incorporating empathy for its stakeholders in its initial responses.

Research limitations/implications

Using the situational crisis communication theory (Coombs, 2019), which recommends the use of an ethical base response to crises, implications are provided for other organizations facing concurrent crises during the Covid-19 pandemic, to also incorporate empathy in their messages to stakeholders whose livelihoods are being affected, across multiple platforms.

Originality/value

Weathering the Covid-19 pandemic and long-term financial pitfalls have proven to be a disruptive phenomenon for higher education institutions. This research expands understanding of institutional communication and stakeholder reactions in a higher education institution facing both the Covid-19 crisis and a retrenchment.

Peer review

The peer-review history for this article is available at:https://publons.com/publon/10.1108/OIR-09-2020-0415.
Patterns of black and white hysterectomy incidence among reproductive aged women
Authors: Gartner Danielle R. , Delamater Paul L. , Hummer Robert A. , Lund Jennifer L. , Pence Brian W. , Robinson Whitney R.
Published: February 2021

Objective

To investigate the intersection of race and economic context in treatment with hysterectomy among reproductive aged women with noncancerous gynecologic conditions.

Data Sources

We combined administrative billing records of inpatient and outpatient hysterectomy procedures (N = 28 301) occurring in North Carolina between 2011 and 2014 with census data to calculate county‐level hysterectomy rates.

Study Design

Spatial analysis techniques examined the distribution of black and white hysterectomy rates across counties, and county‐level black and white rate differences were compared across economic contexts.

Data Collection/Extraction

We restricted to those of premenopausal age identifying as non‐Hispanic black or white, undergoing hysterectomy for nonemergent causes (N = 28 301 procedures).

Principal Findings

County‐level hysterectomy rates were spatially patterned (Moran's I, P < .05) and similarly so for black and white women (LISA, P < .005). The black‐white difference in hysterectomy rates was the largest in the high economic tier counties (22/10 000 person‐years [PY], P < .05) and smallest in the mid and low economic tier counties (11/10 000 PY, P > .05 and 10/10 000 PY, P > .05, respectively).

Conclusion

Socioeconomic context is important to understand, particularly for black‐white disparities in hysterectomy. Efforts should be made to understand the causes of higher rates of hysterectomy among blacks than whites, especially in counties in the highest economic tier.
Genetic characteristics and phylogeography of the habitat generalist mayfly Ecdyonurus yoshidae (Ephemeroptera: Heptageniidae) in the Japanese archipelago
Authors: Kaneko Hiroaki , Ishiwata Shin‐ichi , Bae Yeon Jae , Takamura‐Enya Takeji
Published: February 2021

Because of their early divergence in insect evolution, unique aquatic larval stage, and low dispersal ability, many mayfly species exhibit genetic structures that accurately reflect geological history and paleoclimatic changes. The present study investigated the genetic characteristics of Ecdyonurus yoshidae Takahashi (Ephemeroptera: Heptageniidae), a mayfly that inhabits a variety of freshwater habitats in Japan. Mitochondrial cytochrome c oxidase subunit I (COI) and 16S ribosomal RNA (16S rRNA) gene sequences were generated from 209 mayfly specimens that were collected from 109 sites in Japan. A total of 145 haplotypes were detected, and nine of the lineages exhibited geographical regionality, with one lineage being endemic to Lake Biwa. The haplotype network was “bottleneck type” and included both star‐like structures and missing (or unobserved) haplotypes. Together, the haplotype network and FST values indicated that the Fukuejima Island group (Clade I) was genetically distinct from groups on the island of Kyushu, which is separated from Fukuejima Island by the Gotonada Sea. The common ancestor of E. yoshidae lineages in Japan was estimated to have diverged 1.14 mega‐annum (Ma) (95% highest posterior density interval, 0.55–1.78 Ma), and more regional genetic diversities were generated during the Middle to Late Pleistocene. Genetically distinct lineages of eastern and western Japan were separated by the Kinki Triangle region in central Japan. The genetic diversity of the habitat generalist E. yoshidae increased during the Middle and Late Pleistocene, when crustal movement and climate change in the Japanese archipelago occurred simultaneously.
Development of a new low‐cost device to measure calcium carbonate content, reactive surface area in solid samples and dissolved inorganic carbon content in water samples
Authors: Lopez‐Canfin Clément , Lázaro Roberto , Sánchez‐Cañete Enrique P.
Published: February 2021

Estimates of soil carbonate dynamics are still very scarce, despite their importance in the global carbon budget. Geochemical models used to estimate carbonate precipitation–dissolution rates require important inputs including carbonate content and calcite reactive surface area in soil as well as dissolved inorganic carbon (DIC) content in soil solution. However, most methods currently available to accurately measure these parameters can be time‐consuming and/or often require expensive laboratory equipment.

To tackle this problem, we aimed to develop a sensitive device to measure these variables at low cost and with little time investment. By taking advantage of the recent development of low‐cost CO2 sensors and microcontrollers, a low‐cost and easy‐to‐mount analyzer was developed based on direct measurements of CO2 evolved during an acidic reaction.

The new instrument proved to be sensitive, accurate, precise and able to quickly perform the analyses. It was therefore used in a pilot experiment on the inorganic component of CO2 flows from crusted semi‐arid soils, and to evaluate the variation in DIC content through a spring‐cave‐downstream river water continuum.

The device could facilitate these analyses for scientists from different fields since it can potentially analyse any solid or aqueous sample.
Conceptual development and validation of the nursing diagnosis “Disturbed thought process”
Authors: Escalada‐Hernández Paula , Marín‐Fernández Blanca
Published: February 2021

Purpose

To validate the content of the nursing diagnosis proposal Disturbed thought process.

Methods

With an exploratory and descriptive design, the content validation for each component of the diagnosis proposal was pursued, based on a previous broad conceptual work, through consulting experts, applying Fehring's Diagnosis Content Validation Model. The modified Delphi technique was used by sending out three rounds of questionnaires electronically to seek consensus among the experts.

Findings

The nursing diagnosis version validated in this study includes the diagnosis label Disturbed thought process, the corresponding definition, 15 defining characteristics, and 13 related factors. The resulting diagnosis total Diagnosis Content Validation score was 0.99, implying its content validation.

Conclusions

The validated diagnosis proposal describes a human response for which nursing professionals can autonomously assess and prescribe interventions leading to improvement of this health problem and/or alleviate its consequences, preserving the patient's autonomy and helping them to address their situation. It will be included in the next edition of the nursing diagnosis classification NANDA‐I 2021–2023.

Implications for Nursing Practice

The results of this study will help nursing professionals reduce the potential impact among patients who suffer from an alteration in cognitive functioning in its executive function dimension, as the validated diagnosis proposal will make it possible to identify and report this problem precisely.
Association between a delay in driving licensure and driving while impaired and riding with an impaired driver among emerging adults
Authors: Vaca Federico E. , Li Kaigang , Haynie Denise L. , Simons‐Morton Bruce , Romano Eduardo , Fell James C.
Published: February 2021

Background

Teens who delay driving licensure may not be subject to graduated driver licensing restrictions that are known to reduce crash risk. We explored the association of delay in licensure with driving while impaired (DWI) and riding with an impaired driver (RWI) among emerging adults.

Methods

Data from the NEXT Generation Health Study, starting with 10th grade (2009–2010), were analyzed. The outcome variables were Wave 7 (W7) self‐reported DWI and RWI as dichotomous variables. The independent variable was delay in licensure. Covariates included sex, urbanicity, race/ethnicity, family structure, parent education, family affluence, teen’s highest education, minimum legal drinking age laws, and onset age of alcohol use. Descriptive analysis and logistic regressions were conducted.

Results

Of 2525 participants eligible for licensure, 887 reported a delay in licensure by 1–2 years (38.9%, weighted) and 1078 by > 2 years (30.3% weighted) across 7 waves. In W7, 23.5% (weighted and hereafter, 5.6% once, 17.8% ≥twice) of participants reported DWI and 32.42% (5.6% once, 25.4% ≥twice) reported RWI. Logistic regressions showed no overall significant association of delay in licensure with either W7 RWI or W7 DWI. However, in stratified analyses, among African American youth, delay in licensure was positively associated with DWI (OR = 2.41, p = 0.03) and RWI (OR = 2.72, p = 0.05). Among those with ≤ high school or lower education by W7, delayed licensure was positively associated with RWI (OR = 2.51, p < 0.01).

Conclusions

While in the overall sample, delayed licensure did not appear to be associated with DWI or RWI, our findings suggest that delayed licensure may be of concern to teen risk of DWI and RWI among African Americans and among those with lower educational attainment. Furthermore, as two‐thirds of youth delayed licensure, more research is needed to determine whether this is more of a positive (i.e., protective) factor by reducing their exposure to crash risk or a negative (i.e., risk) factor due to their missing important driver safety stages of graduated driver licensing.
Financial reporting and corporate innovation: a review of the international literature
Authors: Huang Hedy Jiaying , Habib Ahsan , Sun Sophia Li , Liu Ying , Guo Huiting
Published: February 2021

We synthesise the empirical studies on innovation in the accounting, finance, and corporate governance disciplines using Bushman and Smith’s corporate transparency framework as our theoretical lens. The review presents competing findings on the association between financial reporting and innovation. Most of the reviewed studies fail to address the critical question of how the financial reporting system affects the interactions among financial development, corporate governance and innovation. We suggest future research, ranging from enriching the theoretical perspectives to incorporating the future of innovation research in the COVID‐19 environment.
Tunnelling in asset‐injecting private placements: evidence from China
Authors: Zhang Weidong , Wang Jenny Jing , Luo Guomin , Sun Yanqi
Published: February 2021

Following the reform of shareholder structures in China, the country’s listed companies have seen a boom in asset injection using private equity placements. However, because of continuing weaknesses in corporate governance structures and accounting regulations on related‐party transactions, it is possible for controlling shareholders to ‘tunnel’ listed companies through unsound private placements. We find that manipulation of the discount rate offered in private placements, accompanied by earnings management behaviour, is used by controlling shareholders to ‘tunnel’ listed companies during the private placement and asset‐injecting process.
Molecular systematics and biogeography of an Australian soil‐burrowing cockroach with polymorphic males, Geoscapheus dilatatus (Blattodea: Blaberidae)
Authors: Beasley‐Hall Perry G , Rose Harley A , Bourguignon Thomas , Lo Nathan
Published: February 2021

An iconic group of arid‐adapted insects is the Australian soil‐burrowing cockroaches (Blaberidae: Geoscapheinae), large, wingless insects that evolved burrowing behaviour and associated forms in parallel from wood feeding ancestors in the subfamily Panesthiinae. A particularly problematic taxon within the Geoscapheinae is Geoscapheus dilatatus (Saussure, 1864), which might represent a species complex and whose delimitation has been complicated for decades by the species harbouring polymorphic males. Males can be divided into two main morphs: individuals possessing horn‐like protrusions on the anterior margin of the pronotum (‘tuberculate’) and those without these characters (‘non‐tuberculate’). A less common, third form consists of individuals that possess tubercles but are far larger than other tuberculate males and occur solely to the north of the species' distribution (‘atypical’ tuberculates). Here, we make use of whole mitochondrial genomes and nuclear ribosomal RNA data from individuals across the range of G. dilatatus to conduct the first phylogenetic analysis of this species to date. We recover all tuberculate males (including atypical forms) as monophyletic and the derived form of G. dilatatus, having evolved only once in this species, whereas non‐tuberculate forms are paraphyletic. Fossil‐calibrated molecular clock analysis revealed that the divergence between these two forms occurred during the late Miocene approximately 6.7 Mya, concurrent with an expansion of the continent's drier biomes. Environmental niche modelling suggests that tuberculate male forms are more climatically tolerant than their more restricted non‐tuberculate counterparts, and both forms' predicted fundamental niches are strongly limited by rainfall. Three species delimitation analyses implemented here failed to consistently delimit G. dilatatus beyond a single species. Ultimately, population genetic approaches paired with additional sampling will be necessary to determine these findings more concretely, but at present, we do not consider the results presented here sufficient to delimit G. dilatatus based on morphological differences found in the species' polymorphic males alone.
Health behaviour of women with Turner Syndrome
Authors: Santi Maristella , Flück Christa E. , Hauschild Michael , Kuhlmann Beatrice , Kuehni Claudia E. , Sommer Grit
Published: February 2021

Aim

This study assessed lifestyle‐related risk factors for cardiovascular disease in young women with Turner syndrome.

Methods

In 2012, we sent a questionnaire to women with Turner syndrome aged ≥18 years and living in Switzerland with questions on socio‐demographic and medical data as well as health behaviour. We compared the reported lifestyle with that of women from the Swiss Health Survey 2012, a representative survey of the general population.

Results

Fifty‐seven per cent (45/79) of women with Turner syndrome answered the questionnaire (mean age: 24 years). Eighty per cent (36/45) had never smoked compared with 58% (1156/1972) of the general population (p < 0.01). Women with Turner syndrome engaged less often in binge drinking (34% vs. 71%) (p < 0.001), but consumed alcohol equally often as the general population (p = 0.327). They performed sports as often as the general population (p = 0.34), but only one quarter (11/45) of women with Turner syndrome adhered to official physical activity recommendations.

Conclusion

Although most women with Turner syndrome had a healthy lifestyle, only a minority had sufficient physical activity. Paediatricians should promote structured physical activity in girls with Turner syndrome from early childhood onwards to reduce their cardiovascular risk in adulthood and to increase long‐term health‐related quality of life.
Inter‐island relations in Oceania's archipelagos: Identity and everyday politics
Authors: Prinsen Gerard , Mawyer Alexander , Cholymay Margarita , Lotti Allison , Manuireva Ena , Muir Helen
Published: February 2021

Oceania includes sovereign states as well as overseas territories of metropolitan powers. In both cases, contemporary geopolitical borders are legacies of colonialism. As in many (de)colonised places, materialisations of spatially anchored social imaginaries and practices of self and otherness, play a role in the everyday politics of Oceania's communities and states. Notably, cultural intimacies (Herzfeld, 2016) in this region are also shaped by tensions between islands in an archipelagic unit. Characterised by plural identities, Oceania's communities must navigate solidarities within the colonial borders of unitary sovereign states or non‐sovereign island territories. Given this context, we ask whether spatially anchored identities within archipelagic contexts are politically engaged, playing a role in the politics of state (dis)cohesion across the region. This paper presents findings from 73 interviews across four pairs of Pacific islands – Wallis‐Futuna, Tahiti‐Mangareva, Rarotonga‐Manihiki, Pohnpei‐Chuuk – exploring how communities define their own identities and the identity of those on ‘the other island’. We find both sides in agreement on six complementary and rather respectful identities. We therefore suggest that while political tensions and calls for secession in archipelagos are real, it is unlikely that identity politics at this point in time inflames political break ups.
Flow cytometric immunophenotypic alterations of persistent clonal haematopoiesis in remission bone marrows of patients with NPM1‐mutated acute myeloid leukaemia
Authors: Loghavi Sanam , DiNardo Courtney D. , Furudate Ken , Takahashi Koichi , Tanaka Tomoyuki , Short Nicholas J. , Kadia Tapan , Konopleva Marina , Kanagal‐Shamanna Rashmi , Farnoud Noushin R. , Pierce Sherry , Khoury Joseph D. , Jorgensen Jeffrey L. , Patel Keyur P. , Daver Naval , Yilmaz Musa , Medeiros L. Jeffrey , Kantarjian Hagop , Ravandi Farhad , Wang Sa A.
Published: February 2021

Clonal haematopoiesis (CH) in patients with acute myeloid leukaemia (AML) may persist beyond attaining complete remission. From a consecutive cohort of 67 patients with nucleophosmin 1‐mutated (NPM1mut) AML, we identified 50 who achieved NPM1mut clearance and had parallel multicolour flow cytometry (MFC) and next generation sequencing (NGS). In total, 13 (26%) cleared all mutations, 37 (74%) had persistent CH frequently involving DNA methyltransferase 3α (DNMT3A,70%), tet methylcytosine dioxygenase 2 (TET2, 27%), isocitrate dehydrogenase 2 (IDH2, 19%) and IDH1 (11%). A small number (<1%) of aberrant CD34+ myeloblasts, but immunophenotypically different from original AML blasts [herein referred to as a pre‐leukaemic (PL) phenotype], was detected in 17 (49%) patients with CH, but not in any patients with complete clearance of all mutations (P = 0·0037). A PL phenotype was associated with higher mutation burden (P = 0·005). Persistent IDH2 and serine and arginine‐rich splicing factor 2 (SRSF2) mutations were exclusively observed in PL+ CH+ cases (P = 0·016). Persistent dysplasia was seen exclusively in cases with a PL+ phenotype (29% vs. none; P = 0·04). The PL+ phenotype did not correlate with age, intensity of induction therapy or relapse‐free survival. Post‐remission CH in the setting of NPM1mut clearance is common and may result in immunophenotypic changes in myeloid progenitors. It is important to not misinterpret these cells as AML measurable residual disease (MRD).
The dynamics, processes, mechanisms, and functioning of personality: An overview of the field
Authors: Kuper Niclas , Modersitzki Nick , Phan Le Vy , Rauthmann John F.
Published: February 2021

Personality psychology has long focused on structural trait models, but it can also offer a rich understanding of the dynamics, processes, mechanisms, and functioning of individual differences or entire persons. The field of personality dynamics, which works towards such an understanding, has experienced a renaissance in the last two decades. This review article seeks to act as a primer of that field. It covers its historical roots, summarizes current research strands – along with their theoretical backbones and methodologies – in an accessible way, and sketches some considerations for the future. In doing so, we introduce relevant concepts, give an overview of different topics and phenomena subsumed under the broad umbrella term ‘dynamics’, and highlight the interdisciplinarity as well as applied relevance of the field. We hope this article can serve as a useful overview for scholars within and outside of personality psychology who are interested in the dynamic nature of human behaviour and experience.
Subsequent menstrual disorder after spontaneous menarche in Turner syndrome
Authors: Komura Naoko , Mabuchi Seiji , Sawada Kenjiro , Nishio Yukihiro , Kimura Tadashi , Komura Hiroko
Published: February 2021

Objective

Turner syndrome (TS) is a congenital disease characterized by delayed puberty, ovarian dysgenesis and short stature. Although most patients are diagnosed with primary amenorrhea, approximately 15‐20% of patients with TS are reported to have spontaneous menarche. However, little is known about their menstruation status after spontaneous menarche. In the current study, we investigated the menstrual abnormalities after spontaneous menarche in TS patients.

Design

Retrospective study.

Patients

This study included TS patients with spontaneous menarche at Osaka Police Hospital or Komura Women’s Clinic between April 2015 and December 2019.

Measurements

Data regarding the age of menarche, menstruation status and chromosomal karyotype were collected and retrospectively analyzed.

Results

Of 172 TS patients, 32 with spontaneous menarche were identified. The median age of menarche was 12 years old. Premature ovarian insufficiency (POI) after menarche was observed in 12 patients (37.5%) and the median age at menopause was 20 years old. The average period from spontaneous menarche to menopause in these patients was 5.1 years. Five patients (15.6%) had irregular menstruation and 15 (46.9%) had regular menstruation. When examined according to the structural abnormality of the X chromosome, all patients with structural abnormality of the X chromosome were diagnosed with POI after spontaneous menarche, and none with mosaic without structural abnormality were diagnosed with POI.

Conclusion

Approximately one‐third of TS patients with spontaneous menarche were diagnosed with POI after menarche for an average of 5.1 years. Counseling is required for TS patients and their parents, including information about menstrual abnormalities or fertility preservation.
In vitro evaluation of bioburden, three‐dimensional stability, and accuracy of surgical templates without metallic sleeves after routinely infection control activities
Authors: Tallarico Marco , Lumbau Aurea Immacolata , Park Chang‐Joo , Puddu Antonio , Sanseverino Franco , Amarena Rocco , Meloni Silvio Mario
Published: February 2021

Background

Surgical templates are classified as noncritical devices, and they do not need to be sterile.

Aim

Primary aim of this study was to assess the microbiological burden present on the surgical templates without metallic sleeves after disinfection. Furthermore, to evaluate trueness after disinfection and steam sterilization at 121°C/15 min, and over a 8‐week storage period. Finally, to assess their accuracy after in vitro implant placement simulation.

Materials and methods

Forty surgical templates were printed and divided in five groups of eight templates each. Groups A to C were disinfected with 0.5% Chlorhexidine Gluconate and 70% ethyl alcohol base solution for 15 min. Templates in the group D were steam sterilized at 121°C for 15 min, while, the templates in the group E were used as control. Implant simulation was performed in the group A. Outcome measures were determination of bioburden, trueness assessment using GOM Inspect Professional software, and accuracy evaluated thought the mean angular deviation of simulated implants.

Results

Total microbic charge measured as colony forming units (CFU) for sample, was 24.40 in the control group (group E; n = 8), and <4.40 in the test group (group C; n = 8), with a reduction of 84%. Colored representation from GOM inspection showed no differences after disinfection and implant simulation, disinfection alone, and steam sterilization, compared to the control group. A very small difference in the surface and volume dimensions was reported 1 month after templates fabrication. The mean roundness tolerances of the tested templates improved of 0.96 ± 0.56° (95% CI 0.57–1.35).

Conclusion

Surgical templates without metallic sleeves can be safely used after disinfection, demonstrating high level of accuracy, even when the surgical procedures should be postponed within a couple of weeks. Further in vivo study are needed to confirm these preliminary results.
‘Let's talk about sex’: a patient‐led survey on sexual function after colorectal and pelvic floor surgery
Authors: Dames Nicola B. , Squire Sarah E. , Devlin Anthony B. , Fish Rebecca , Bisset Carly Nichola , Tozer Phil ,   the Respondents to the Sex After Colorectal Surgery Survey
Published: February 2021

Aim

Discussions regarding sex after colorectal and pelvic floor surgery are often overlooked by clinicians. This is the first patient designed and delivered study to explore sexual function and practices after colorectal surgery. The aim was to explore the questions about sex that matter to patients and their partners following colorectal or pelvic floor surgery through a patient and public involvement survey. The results of this work will underpin the creation of a sex patient reported outcome measure.

Methods

An anonymous online survey tool (Survey Monkey™) was disseminated via social media (Twitter, Facebook). Thematic analysis was applied to 130 free text comments posted by participants to identify key themes.

Results

Some 632 individuals completed the survey. Most respondents were women (80% n = 507), 49.5% (n = 312) were married and 14% (n = 87) identified as LGBT+ (lesbian, gay, bisexual and transgender +). Indications for surgery varied: 34% were treated for ulcerative colitis (n = 214); 31% Crohn's (n = 196); 17% (n = 109) cancer; and 17% (n = 110) for perianal fistula. For patients who had a stoma formed (85%, n = 540), over half (51%, n = 324) lived with their stoma for 1–5 years. Respondents reported substantial alterations to their preferences for sexual positions, sexual activity and body confidence following surgery. Most respondents indicated that they were not offered advice about sex by a healthcare professional.

Conclusions

The survey showed a substantial impact on the mechanics of sex following colorectal surgery. Few patients were offered preoperative information regarding sex, which has implications for informed consent. This study demonstrates a clear unmet need, voiced by patients, that open dialogue is necessary preoperatively to discuss sexual (dys)function.
The impact of WIC participation on tobacco use and alcohol consumption
Authors: Kasim M. Taha , Ukert Benjamin
Published: February 2021

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program provides food coupons and health benefits to foster in utero and postpartum development of the child. However, due to these benefits, households might reallocate income from food and healthcare services toward other goods. Utilizing data from the Pregnancy Risk Assessment Monitoring System, this article investigates the effects of participation in the WIC program on cigarette and alcohol consumption. Our results indicate that the program has no effect on prenatal smoking but increases postpartum cigarette consumption per day by 6%. WIC also has preventive benefits as it decreases prenatal alcohol consumption on the extensive and intensive margins.
A standardized approach to classifying melanocytic neoplasms? Comments on the MPATH‐Dx system
Authors: Clarke Loren E. , Hosler Gregory A.
Published: February 2021

The potential benefits and limitations of the MPATH‐Dx classification system for melanocytic neoplasms are presented and discussed.
Inpatient dermatology: Where are we headed? A nationwide population‐based study of Spain from 2006 to 2016
Authors: Cuenca‐Barrales Carlos , de Vega‐Martínez Marina , Descalzo‐Gallego Miguel Ángel , García‐Doval Ignacio
Published: February 2021

Background and objectives

Information about hospital admissions for skin diseases is restricted to studies describing admissions to single centers, to specific wards, or only for a few diagnoses, and there is no information about the outcomes between different wards. The aim of this research is to describe hospital admissions due to dermatological diseases.

Patients and methods

Cross‐sectional study of hospital discharges at Spanish hospitals. Discharges were assumed to be the same as admissions.

Results

519,440 discharges (1.1 % of total discharges) were identified. Most admissions (60.1 %) were done from emergency departments. Only 7 % of cases were admitted to dermatology wards. The most prevalent group was cellulitis and acute lymphangitis. Median age was 57 years, and men were more common. The median length of hospital stay was four days; 40,823 (7.9 %) cases required readmission. There were 13,558 (2.6 %) hospital deaths. After adjusted analysis (by age, sex and group of diagnosis), the OR of readmission was 1.49 (95 % CI: 1.42–1.57) times higher and length of stay was 0.22 (95 % CI: 0.15–0.29) days longer in non‐dermatology wards (P < 0.0001). From 2006–2016, admissions to dermatology wards decreased 38 %, while in non‐dermatology wards they increased 8 %.

Conclusions

A non‐negligible number of patients require dermatological inpatient management. This is mainly provided by non‐dermatologists. Some of our findings may indicate an improved overall care by dermatologists.
Closure of gastric perforations during endoluminal resection using a novel biodegradable collagen sol: A feasibility survival study on porcine model (with video)
Authors: Uraoka Toshio , Yunoki Shunji , Sasaki Motoki , Kinoshita Satoshi , Takatori Yusaku , Hirai Yuichiro , Narita Takefumi , Ramberan Hemchand , Shimoda Masayuki , Yahagi Naohisa
Published: February 2021

Objective

A prior study using porcine colon demonstrated the feasibility of a novel injectable, temperature?responsive, and biodegradable collagen sol (ICS) that transforms from a liquid to a gel state in response to body temperature for endoscopic closure of perforation during endoscopic resection (ER). This study aims to report the acute and survival outcomes of ICS for gastric perforations during ER.

Methods

In two experiments using nine live pigs under general anesthesia, four and six perforations (3‐5\xA0mm) were created using an electrosurgical knife in acute and survival experiments, respectively. ICS was delivered to the perforations using an endoscopic catheter. In Experiment 1, a leak test and histopathology were performed on all explanted stomachs after euthanization. In Experiment 2, perforation sites were assessed by gastroscopy and histopathology 7, 14 and 28\xA0days post?procedure.

Results

In Experiment 1, gastroscopy confirmed complete closure of the perforations with ICS and no evidence of leak. Subsequent histopathology revealed a fixation of collagen gel (CG) as a sealant agent at the perforation sites. There were no adverse effects related with ESD or the use of ICS. In Experiment 2, histopathology revealed a fixation of CG as a sealant agent, replacement with granulation tissue and no CG; and fibrotic tissue at 7, 14 and 28\xA0days, respectively.

Conclusions

This study presents a novel method using ICS, demonstrating promising efficacy and safety profile for endoscopic closure of perforations during ER. Further studies are necessary before translating to clinical use.
The DAFNEplus programme for sustained type 1 diabetes self management: Intervention development using the Behaviour Change Wheel
Authors: Stanton‐Fay Stephanie H. , Hamilton Kathryn , Chadwick Paul M. , Lorencatto Fabiana , Gianfrancesco Carla , de Zoysa Nicole , Coates Elizabeth , Cooke Debbie , McBain Hayley , Heller Simon R. , Michie Susan ,   the DAFNEplus study group
Published: February 2021

Aims

Self‐management programmes for type 1 diabetes, such as the UK’s Dose Adjustment for Normal Eating (DAFNE), improve short‐term clinical outcomes but difficulties maintaining behavioural changes attenuate long‐term impact. This study used the Behaviour Change Wheel (BCW) framework to revise the DAFNE intervention to support sustained behaviour change.

Methods

A four‐step method was based on the BCW intervention development approach: (1) Identifying self‐management behaviours and barriers/enablers to maintain them via stakeholder consultation and evidence synthesis, and mapping barriers/enablers to the Capability, Opportunity, Motivation‐Behaviour (COM‐B) model. (2) Specifying behaviour change techniques (BCTs) in the existing DAFNE intervention using the Behaviour Change Techniques Taxonomy (BCTTv1). (3) Identifying additional BCTs to target the barriers/enablers using the BCW and BCTTv1. (4) Parallel stakeholder consultation to generate recommendations for intervention revision. Revised materials were co‐designed by stakeholders (diabetologists, psychologists, specialist nurses and dieticians).

Results

In all, 34 barriers and 5 enablers to sustaining self‐management post‐DAFNE were identified. The existing DAFNE intervention contained 24 BCTs, which partially addressed the enablers. In all, 27 BCTs were added, including ‘Habit formation’, ‘Credible source’ and ‘Conserving mental resources’. In total, 15 stakeholder‐agreed recommendations for content and delivery were incorporated into the final DAFNEplus intervention, comprising three co‐designed components: (1) face‐to‐face group learning course, (2) individual structured follow‐up sessions and (3) technological support, including blood glucose data management.

Conclusions

This method provided a systematic approach to specifying and revising a behaviour change intervention incorporating stakeholder input. The revised DAFNEplus intervention aims to support the maintenance of behavioural changes by targeting barriers and enablers to sustaining self‐management behaviours.
Reference‐dependent preferences, time inconsistency, and pay‐as‐you‐go pensions
Authors: Andersen Torben M. , Bhattacharya Joydeep , Liu Qing
Published: February 2021

The classic Aaron–Samuelson result argues that pay‐as‐you‐go (PAYG) pension schemes cannot coexist with higher‐return, private, retirement‐saving schemes. The ensuing literature shows if agents voluntarily undersave for retirement due to myopia or time‐inconsistency, then a paternalistic, rationale for PAYG pensions arises only if voluntary retirement saving is fully crowded out because of a binding borrowing constraint. This paper generalizes the discussion to the reference‐dependent utility setup of Kőszegi and Rabin (2009) where undersaving happens naturally. No borrowing constraint is imposed. We show it is possible to offer a non‐paternalistic, welfare rationale for return‐dominated, PAYG pensions to coexist with private, retirement saving.
Labor upgrading and export market opportunities: Evidence from Vietnam
Authors: Malesky Edmund J. , Mosley Layna
Published: February 2021

We explore and provide an empirical assessment of an important mechanism by which global markets can motivate labor‐related upgrading among developing country firms. New market opportunities, which result from exogenous shocks, can some producers to improve their treatment of workers. These improvements come because they are consistent with taking advantage of new opportunities. We focus specifically on how shifts in U.S. trade policy toward China in 2018 affect the willingness of foreign firms operating in Vietnam to engage in upgrading. Our analyses, based on surveys of firms in 2016, 2017, and 2018, suggest that firms respond significantly to changes in market opportunities, especially when they are primed to consider specific supply chain relationships. This market opportunity mechanism for upgrading contrasts with another widely used tool, in which developed country governments condition access to their markets upon improved human and labor rights outcomes. The former operates, in the short to medium term, at the firm level, while the latter seeks to effect change at the country level.
Rapid evolution promotes fluctuation‐dependent species coexistence
Authors: Yamamichi Masato , Letten Andrew D.
Published: February 2021

Recent studies have demonstrated that rapid contemporary evolution can play a significant role in regulating population dynamics on ecological timescales. Here we identify a previously unrecognised mode by which rapid evolution can promote species coexistence via temporal fluctuations and a trade‐off between competitive ability and the speed of adaptive evolution. We show that this interaction between rapid evolution and temporal fluctuations not only increases the range of coexistence conditions under a gleaner‐opportunist trade‐off (i.e. low minimum resource requirement [R*] vs. high maximum growth rate) but also yields stable coexistence in the absence of a classical gleaner‐opportunist trade‐off. Given the propensity for both oscillatory dynamics and different rates of adaptation between species (including rapid evolution and phenotypic plasticity) in the real world, we argue that this expansion of fluctuation‐dependent coexistence theory provides an important overlooked solution to the so‐called ‘paradox of the plankton’.
Towards a more precise – and accurate – view of eco‐evolution
Authors: Bassar Ronald D. , Coulson Tim , Travis Joseph , Reznick David N.
Published: February 2021

Over the past 15 years, the number of papers focused on ‘eco‐evo dynamics’ has increased exponentially (Figure 1). This pattern suggests the rapid growth of a new, integrative discipline. We argue this overstates the case. First, the terms ‘eco‐evo dynamics’ and ‘eco‐evo interactions’ are used too imprecisely. As a result, many studies that claim to describe eco‐evo dynamics are actually describing basic ecological or evolutionary processes. Second, these terms are often used as if the study of how ecological and evolutionary processes are intertwined is novel when, in fact, it is not. The result is confusion over what the term ‘eco‐evolution’ and its derivatives describe. We advocate a more precise definition of eco‐evolution that is more useful in efforts to understand and characterise the diversity of ecological and evolutionary processes and that focuses attention on the subset of those processes that occur only when ecological and evolutionary timescales are comparable.

Number of papers returned, by year, by a search in Web of Science with the term ‘eco‐evolutionary dynamics' as accessed on 7 January 2021.

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Can we use intraoperative high‐frequency oscillations to guide tumor‐related epilepsy surgery?
Authors: van Klink Nicole E. C. , Zweiphenning Willemiek J. E. M. , Ferrier Cyrille H. , Gosselaar Peter H. , Miller Kai J. , Aronica Eleonora , Braun Kees P. J. , Zijlmans Maeike
Published: February 2021

Objective

In people with low‐grade intrinsic brain tumors, an epileptic focus is often located close to the lesion. High‐frequency oscillations (HFOs) in electrocorticography (ECoG) might help to delineate this focus. We investigated the relationship between HFOs and low‐grade brain tumors and their potential value for tumor‐related epilepsy surgery.

Methods

We analyzed pre‐ and postresection intraoperative ECoG in 41 patients with refractory epilepsy and a low‐grade lesion. Electrodes were designated as overlying the tumor, adjacent resected tissue (peritumoral), or outside the resection bed using magnetic resonance imaging (MRI) and intraoperative photographs. We then used a semiautomated approach to detect HFOs as either ripples (80–250 Hz) or fast ripples (250–500 Hz).

Results

The rate of fast ripples was higher in electrodes covering tumor and peritumoral tissue than outside the resection (p = .04). Mesiotemporal tumors showed more ripples (p = .002), but not more fast ripples (p = .07), than superficial tumors. Rates of fast ripples were higher in glioma and extraventricular neurocytoma than in ganglioglioma or dysembryoplastic neuroepithelial tumor (DNET). The rate of ripples and fast ripples in postresection ECoG was not higher in patients with residual tumor tissue on MRI than those without. The rate of ripples in postresection ECoG was higher in patients with good than bad seizure outcome (p = .03). Fast ripples outside the resection and in post‐ECoG seem related to seizure recurrence.

Significance

Fast ripples in intraoperative ECoG can be used to help guide resection in tumor‐related epilepsy surgery. Preresection fast ripples occur predominantly in epileptogenic tumor and peritumoral tissue. Fast ripple rates are higher in glioma and extraventricular neurocytoma than in ganglioglioma and DNET.
Equine leptospirosis: Experimental challenge of Leptospira interrogans serovar Bratislava fails to establish infection in naïve horses
Authors: Zilch Tiago J. , Lee Jen‐Jie , Saleem Muhammad Zain , Zhang Hui , Cortese Victor , Voris Nathan , McDonough Sean P. , Divers Thomas J. , Chang Yung‐Fu
Published: February 2021

Background

Little information is available about experimental inoculation of leptospirosis in horses and the pathogenicity of Leptospira interrogans serovar Bratislava in this host.

Objectives

To determine the serological, clinical, pathological and haematological responses of horses to L. interrogans serovar Bratislava strain PigK151.

Study design

Randomised controlled in vivo experiment.

Methods

Ten seronegative female foals were divided into 2 groups, control (n = 4) and challenged (n = 6). The challenged group received 1 × 109 leptospires divided equally between topical ocular and intraperitoneal injections. Blood and urine samples were analysed. The temperature was recorded daily for the first 9 days, then weekly. Sera were tested by microscopic agglutination test (MAT). Automated complete blood count, differential and chemistry panel were performed. Histopathological analysis was performed on sections of liver, kidney, urinary bladder, uterine body and pineal gland. Sample culturing was performed from blood, urine, liver, kidney, reproductive tract and vitreous humour.

Results

No pyrexia was noted. PCR and culture were negative from all samples. Differences between groups were found in CBC, differential counts and serum biochemistry panel (or profile), suggesting that leptospiral challenge triggered an inflammatory response. No evidence of leptospirosis was found from histopathological analysis. All challenged foals developed a humoral response. The MAT allowed the confirmation of the infecting serovar at a later stage, but it also revealed cross‐reactive results that were further explained by genomic analysis.

Main limitations

This experimental challenge had two main limitations: (a) the results might have varied if another strain from the same serovar had been used and (b) the use of another route of infection and a higher bacterial dose might have achieved colonisation.

Conclusions

Based on these findings, it may suggest that L. interrogans serovar Bratislava is neither pathogenic nor host‐adapted serovar for horses, although these results might have varied if another strain from the same serovar had been used instead.