bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring the information practices of lawyers
Authors: Bronstein Jenny , Solomon Yosef
Published: June 2021

Purpose

This study examines the information practices of Israeli lawyers highlighting the central role that information plays in professional communities of practice. Examining the information practices of lawyers characterizes the information behavior of this community of practice.

Design/methodology/approach

Information practices are those recurrent practices related to actively seeking information for a variety of sources socially and contextually situated within members of a professional community. Twenty semi-structured interviews were carried out with lawyers in Israel that investigated the different ways by which lawyers interact with information in their professional work. Data collected in the interviews were analyzed using a grounded theory approach.

Findings

Findings from the content analysis of the interviews revealed three main themes: information assimilation, networking and self-promotion and content creation that encompass a wide variety of information practices related to seeking information related to a case, preparing and presenting a case, providing support for the client, collaborating with other members of the professional community and promoting their professional practice.

Originality/value

This study provides an innovating perspective of the ways by which an information-rich community of practice engages with information, solves problems, build social connections and creates new content.
Insight in cultural change during organizational transformation: a case study
Authors: Smit Wouter
Published: June 2021

Purpose

The purpose of this case study is to gain insight into how a cultural change process develops as a result of organizational transformation.

Design/methodology/approach

This case study employs an ethnographic and longitudinal research design. The transformation period of the organization is described by means of desk research and interviews with the management. Simultaneously, the cultural change process is described following four organizational mindset analyses.

Findings

This paper supports the theoretical assumption that culture changes as a reaction to transformation. However, in this case study, culture is also proven to be proactive, in that it emerged a year before the actual transformation was carried out. It is believed that the announcement of the new transformation caused a shift in the organizational mindset, enabling its members to deal with a situation of high uncertainty and stress. Whether the cultural change process in reaction to the transformation will evolve into a new sustainable cultural equilibrium could not yet be determined.

Originality/value

This study has contributed to comprehending the relationship between transformation and the process of cultural change. Cultural change is not solely a reaction to transformation. It can also be proactive in that it emerges before the transformation is carried out. That makes cultural change both proactive and reactive in relation to transformation, an insight that, as such, has not yet been discussed in the cultural theory.
The short-term bias in policy programs for small business: exploring discontinuation of a successful growth program
Authors: Bager Torben Eli
Published: June 2021

Purpose

When a successful policy intervention for small firm growth is ending, a continuation decision may be relevant. However, immediately after program termination, solid analysis of the growth of the treated firms in comparison with similar firms cannot be produced, so decision makers rely on less valid data. Moreover, the decision process is challenging because many players, alternative programs, decision levels and financial sources tend to be part of the process. In such a complex and volatile policy environment, successful programs may well be discontinued despite a clear continuation need. The purpose of the paper is to explore this weakness.

Design/methodology/approach

The paper identifies four fundamental principles that are conducive for a rational continuation choice: “additionality,” “substitution,” “need” and “success”. It argues that if these principles are fulfilled, the rational choice would be to continue the program. To demonstrate that this rational outcome does not always happen in practice, an extreme case fulfilling the four principles well was selected.

Findings

The program aimed to enhance growth in small firms through manager training. It encompassed about 700 growth-oriented small firms in three years and was comprehensively evaluated after program termination. This evaluation demonstrated a high success rate of the program in all respects, including in terms of achieved growth compared to a control group of similar firms.

Originality/value

This discontinuation case suggests that non-rational reasoning plays a significant role in contemporary complex and volatile policy environments, which again points to a need for reform in this policy area.
Strategy consensus and social practice: a perspective from public sector managers
Authors: Almansour Jarrah , Obembe Demola
Published: June 2021

Purpose

The purpose of this paper is to investigate consensus formation among the top and middle managers during the strategy process. Specifically, the paper seeks to gain insight into the role of strategic consensus during the transition between strategy formulation and implementation.

Design/methodology/approach

Adopting a social practice perspective and a single case study approach, we undertook semi-structured interviews of twenty-seven managers working in a Kuwaiti Ministry. Data collected were analyzed using thematic analysis.

Findings

We found that social interaction among individuals with similar characteristics and shared understanding fosters consensus. Factors such as alignment of strategic priorities, managerial flux and centralized control contribute to the extent to which strategic consensus is achievable. Additionally, managerial turnover and lack of empowerment hamper the development of shared understanding. Finally, that consensus on strategy content is insufficient for effective intergroup communications.

Originality/value

The research contributes to the strategic consensus literature from a social practice perspective as it provides new insights into the dynamics between top managers and middle managers. Significantly, it highlights the importance and need for common understanding, as well as communications prioritization among managers for consensus development and successful implementation of organization strategy.
Diverse effects of team diversity: a review and framework of surface and deep-level diversity
Authors: Jansen Alana E. , Searle Ben J.
Published: June 2021

Purpose

While diversification within organisations is seen by many to be a strategic move, there is conflicting evidence about what makes diverse teams successful. The purpose of this paper is to highlight a range of complex, and in some cases contradictory, research contributions towards several key areas of diversity within teams, and to propose a framework for integrating existing approaches and clarifying inconsistencies in this domain.

Design/methodology/approach

A literature review was conducted to explore several key areas of surface and deep-level diversity in teams, with the discussion included in this paper highlighting many of the inconsistencies and complexities associated with this research domain.

Findings

This review highlights the need for future research to look at the effects of surface and deep-level diversity simultaneously, over time, across multiple levels and with a broad range of contextual moderators, to examine their impact on a range of outcomes.

Originality/value

In order to account for the complexities within diversity research, the authors propose the use of the job demands-resources (JDR) model which suggests possible explanations for inconsistent findings and bridges the gap between commonly used theoretical perspectives.
The potential of metal epoxy composite (MEC) as hybrid mold inserts in rapid tooling application: a review
Authors: Hussin Radhwan Bin , Sharif Safian Bin , Abd Rahim Shayfull Zamree Bin , Suhaimi Mohd Azlan Bin , Bin Mohd Khushairi Mohd Tanwyn , Abdellah EL-Hadj Abdellah , Shuaib Norshah Afizi Bin
Published: June 2021

Purpose

Rapid tooling (RT) integrated with additive manufacturing technologies have been implemented in various sectors of the RT industry in recent years with various kinds of prototype applications, especially in the development of new products. The purpose of this study is to analyze the current application trends of RT techniques in producing hybrid mold inserts.

Design/methodology/approach

The direct and indirect RT techniques discussed in this paper are aimed at developing a hybrid mold insert using metal epoxy composite (MEC) in increasing the speed of tooling development and performance. An extensive review of the suitable development approach of hybrid mold inserts, material preparation and filler effect on physical and mechanical properties has been conducted.

Findings

Latest research studies indicate that it is possible to develop a hybrid material through the combination of different shapes/sizes of filler particles and it is expected to improve the compressive strength, thermal conductivity and consequently increasing the hybrid mold performance (cooling time and a number of molding cycles).

Research limitations/implications

The number of research studies on RT for hybrid mold inserts is still lacking as compared to research studies on conventional manufacturing technology. One of the significant limitations is on the ways to improve physical and mechanical properties due to the limited type, size and shape of materials that are currently available.

Originality/value

This review presents the related information and highlights the current gaps related to this field of study. In addition, it appraises the new formulation of MEC materials for the hybrid mold inserts in injection molding application and RT for non-metal products.
Different community assembly of ground beetles and spiders in subalpine forests and alpine scoria deserts of a young volcano, Mt. Fuji
Authors: Ohwaki Atsushi , Tanikawa Akio , Kishimoto Toshio , Maeda Saki , Kitahara Masahiko
Published: June 2021

While the colonization processes of arthropods in new volcanoes have attracted our attention, the arthropod assembly process in sites where vegetation reaches climax forests after the Holocene catastrophic eruption is unknown. In this study, ground beetles and spiders were investigated using pitfall traps in 12 sites from the subalpine and alpine areas of Mt. Fuji, which were shaped about 2300 years ago and where undisturbed subalpine climax forests and alpine deserts are formed. We examined how elevation, canopy and forest floor vegetation affected turnover and nestedness structure of these assemblages. The alpine desert and subalpine forest comprised different species for both beetles and spiders. The species from the alpine desert seemed to have high dispersal ability. In the subalpine forest, the beetle assemblage found at higher elevations was a subset of those at lower elevations. This nested structure was generated by the expansion of flightless species from montane forests to subalpine forests. Species tolerance to harsh weather conditions may decide the upper elevational limit. The spider assemblage was affected by forest floor vegetation, where species turnover was observed between different floor types. Subalpine spiders included both species expanding from the montane area and those probably colonizing from distant subalpine areas by ballooning. These results suggest that the assembly process differed between alpine and subalpine areas, and also between different taxa particularly in subalpine forests. Examining the genetic relationship between Mt. Fuji populations and possible source populations in other mountains will elucidate the detailed community assembly process in Mt. Fuji.
Psychiatric and legal considerations in cases of Fetal Abduction by Maternal Evisceration
Authors: Welner Michael , Burgess Ann , O’Malley Kate Y.
Published: June 2021

Fifteen cases of Fetal Abduction by Maternal Evisceration (FAMAE) reported to the National Center for Missing and Exploited Children during 1987–2011 outline the findings from a review of the forensic psychiatric considerations and legal course of each of the cases. Most offenders confessed to law enforcement within a short time of being placed under arrest in statements reflecting a continued effort to manage impressions and minimize culpability. Psychiatric assessment is invariably central to the legal disposition of FAMAE cases, as the defendant's goal is to diminish the perception of culpability/criminal responsibility and mitigate sentencing. Of those sentenced in the United States, nine defendants received life without parole, two received the death penalty (one executed), and one received a minimum of 30 years. Two abductors committed suicide and were not sentenced. Proffered diagnoses at trial included psychogenic amnesia, pseudocyesis, dissociative disorder, and delusional disorder; however, these rarely stood up to court scrutiny. Psychiatric experts showed the greatest variance in diagnosis over what to call the feigned pregnancy. In addition to delusional disorder and dissociative disorder, pseudocyesis, factitious disorder/pregnancy, pseudopregnancy, schizophrenia, and PTSD were among the various diagnoses proposed. A differential diagnosis for many FAMAE offenders may also include borderline personality disorder. Future research accounting for those women claiming false pregnancy who do not become homicidal will clarify whether FAMAE is the extreme endpoint of a fertility identity disorder.
First morphological description on the immature stages of the genus Acoptolabrus (Coleoptera; Carabidae) from Korea
Authors: Kwon Taeyeong , Choi Jong Bong , Park Jong Kyun
Published: June 2021

Most species of the genus Acoptolabrus are considerably rare and have a beautiful body color, making them interesting for collectors. Among the subspecies, A. mirabilissimus mirabilissimus is designated legally as an endangered species in Korea. However, studies on the adults and their immature stages remain limited. Thus, this study was carried out to identify the morphological characteristics of the larval stages. The larvae were obtained by captive breeding adult A. m. sangjuensis, a subspecies closely related to the protected subspecies, and examining them for external characteristics. Further, morphological descriptions and diagnostic characters of each stage of the larvae were provided, including their adult photos.
Single‐molecule long‐read sequencing reveals extensive genomic and transcriptomic variation between maize and its wild relative teosinte (Zea mays ssp. parviglumis)
Authors: Li Zhao , Han Linqian , Luo Zi , Li Lin
Published: June 2021

Teosinte (Zea mays ssp. parviglumis), the wild progenitor of maize (Zea mays L.), is an important germplasm resource for improvement of modern maize lines. However, we have limited genetic and genomic information about teosinte and lack state‐of‐the‐art tools to annotate transcriptomes assembled by single‐molecule long‐read sequencing without a reference genome. Here, we employed single‐molecule long‐read sequencing of cDNA libraries from five tissues of the teosinte inbred line TIL11 and identified 70,044 nonredundant transcript isoforms. We devised a state‐of‐the‐art, machine learning‐based bioinformatics pipeline DenovoAS_Finder to annotate the TIL11 transcriptome without a complete reference genome with an accuracy of up to 91%, providing a robust gene classifier of complex genomes. Additionally, we constructed a draft TIL11 genome with 16,633 high‐quality contigs and a N50 of 112 kb by Nanopore sequencing. Genes from families that expanded from teosinte to maize were significantly enriched in the gene ontology (GO) term “RNA modification pathway” and had more transcript isoforms in TIL11 than in the maize inbred line B73. Genes showed collinearity between TIL11 and B73, and intergenic regions were extensively altered by transposable elements. Our study furthers the understanding of maize domestication and provides a resource for the utilization of wild germplasm in maize breeding.
Non‐Movement as Latent Political Engagement and War of Position: Islamist Spatial Strategy in an Indian State
Authors: C Shayju
Published: June 2021

This article looks at the relation between ideology and the practice of politics concerning the peculiarities of the social context. By comparing the non‐movement in the Middle East, this article argues that the Jamaat‐e‐Islami is establishing a war of position to operate safely in secular democratic countries by preparing the support base for future action through a latent political engagement. This article deals with the aspects of political mobilisation and political sociology and emerged out of an ethnographic study. This article argues that the appropriation of methods suitable for working within secular political systems does not imply that the Islamist ideology and politics are secularised.
Labour Rights from Labour Wrongs? Transnational Compensation and the Spatial Politics of Labour Rights after Bangladesh’s Rana Plaza Garment Factory Collapse
Authors: Prentice Rebecca
Published: June 2021

The collapse of the Rana Plaza garment factory building in Bangladesh, which resulted in the loss of at least 1134 lives and injuries to hundreds more, exposed the brutality of a global production system in which labour rights have become privatised, circumscribed, and deterritorialised. Unprecedented for an incident of its kind, affected families received $30 million in “compensation” from global apparel companies through the Rana Plaza Arrangement, a voluntary initiative overseen by the International Labour Organization (ILO). This article situates the Arrangement in debates over labour rights in global supply chains, presenting it as a hybrid mechanism that recognises workers’ right to compensation for injury or death but relies on the voluntarism of corporate social responsibility for funding. Exploring the complex role of neoliberal regulation in reproducing geographies of uneven development, I show how a transnational initiative can restrict labour rights even as it attempts to expand such rights.
Mirtazapine use may increase the risk of hypothyroxinaemia in patients affected by major depressive disorder
Authors: Zhao Ying , Wang Na , Wen Shi Wu , Li Mingcan , Yuan Yuan , Retnakaran Ravi , Hao Wei , Zhang Ruiling , Zhai Desheng
Published: June 2021

Aims

Hypothyroxinaemia could be easily neglected if attention is paid only to patients with elevated thyroid‐stimulating hormone. We aimed to assess the association between mirtazapine use and hypothyroxinaemia in patients affected by major depressive disorder.

Methods

We conducted a retrospective cohort study in the Second Affiliated Hospital of Xinxiang Medical University between January 2016 and December 2018. Patients affected by major depression disorder and admitted to the hospital for treatment during the study period and who had thyroid tests at admission and after treatment were included. Mirtazapine use during hospitalization was the exposure measure and newly developed hypothyroxinaemia was as the primary outcome and structure parameters of thyroid homeostasis were the secondary outcomes of this study. Log‐binomial model was used to estimate the association between mirtazapine use and hypothyroxinaemia, after adjusting for potential confounding factors.

Results

A total of 220 eligible patients were included in the final analysis. The incidence of hypothyroxinaemia in patients who used mirtazapine was higher (37.5%) than those patients who did not use (19.7%). The relative risk of developing hypothyroxinaemia was 1.70 (95% confidence interval: 1.21–2.43) for mirtazapine use, after adjusting for confounding factors. The degree of reduction in thyroid feedback quantile‐based index in mirtazapine group was significantly greater than that in nonmirtazapine group.

Conclusion

Mirtazapine use was associated with the increased risk of developing hypothyroxinaemia. The underlying mechanism may be involved the changed central set point of thyroid homeostasis, in which pituitary was in a possibly impaired sensitivity to the lower level of thyroid hormones.
Seeking and avoiding contact with Muslims at a Hijab Stall: Evidence for multilayer, multi‐determined solidarity, courage, apathy, and moral outrage
Authors: Paolini Stefania , Azam Fatima , Harwood Jake , Mackiewicz Matylda , Hewstone Miles
Published: June 2021

Intergroup contact is key to social cohesion, yet psychological barriers block engagement with diversity even when contact opportunities are abundant. We lack an advanced understanding of contact seeking because intergroup contact is often an independent variable in research, and studies on contact seeking have favoured experimental probing of selected factors or measured only broad behavioural intentions. This research carried out the first ecological tests of a novel multilayer‐multivariate framework to contact seeking/avoiding. These tests were centred on a Muslim‐led community contact‐based initiative with visible support from local authorities following a terrorist attack. Non‐Muslim Australian women (N = 1,347) contributed field data on their situated contact motivations, choices, and attendance at an intercultural educational stall; many (N = 559) completed a profiling test battery. Among those who responded to the initiative invite, the rate of taking up the high‐salience contact opportunity in this heated setting was high and reflected multiple approach/avoidance motivations. Contact seeking/avoiding was not just allophilia/prejudice; it presented as new typologies of politicized solidarity, courage, apathy, and moral outrage. While intergroup predictors were significant across all profiling analyses, intrapersonal and interpersonal predictors also regularly contributed to explain variance in non‐Muslims’ contact motivations and choices, confirming their multilayer‐multivariate nature.
Prostate cancer in transgender women: what does a urologist need to know?
Authors: Bertoncelli Tanaka Mariana , Sahota Kirpal , Burn James , Falconer Alison , Winkler Mathias , Ahmed Hashim U. , Rashid Tina G. ,   the Gender Research Collaborative
Published: June 2021

Objective

To review of the existing literature, current guidelines and standard of practice related to prostate cancer in transgender women, as the transgender population share many of the same healthcare needs as their cisgender counterparts, but may have additional specialist needs.

Materials and methods

We performed a non‐systematic review of the literature, current guidelines and standard of practice related to prostate cancer in transgender women.

Results

Our search revealed 10 case reports of prostate cancer in transgender women, four specialist opinion papers, six cohort studies, and four systematic reviews. The information in these publications were assimilated to produce a review of prostate cancer in transgender women.

Conclusion

The risk of prostate cancer in transgender women who are not on gender‐affirming hormone therapy (GAHT) or who have not had gender‐affirming surgery (GAS) and gender non‐conforming individuals (who may never commence GAHT or have GAS) is the same as that in the cis male population. In these patients, healthcare professionals need to be able to discuss screening, diagnostic and treatment options considering future wishes for gender‐affirming treatment. Prostate cancer incidence in transgender women on GAHT or following GAS is lower than age‐matched cis‐male counterparts, but diagnosis and treatment is more nuanced. The present review discusses the existing literature about development and incidence of prostate cancer in this population, and makes recommendations about screening, the usefulness of diagnostic tools e.g. prostate‐specific antigen and magnetic resonance imaging, and considerations when formulating treatment. Potential directions for future research are discussed, which will hopefully lead to development of robust evidence‐based guidelines for the diagnosis and management of prostate cancer in transgender women.
The mitochondrial permeability transition pore: an evolving concept critical for cell life and death
Authors: Morciano Giampaolo , Naumova Natalia , Koprowski Piotr , Valente Sara , Sardão Vilma A. , Potes Yaiza , Rimessi Alessandro , Wieckowski Mariusz R. , Oliveira Paulo J.
Published: June 2021

In this review, we summarize current knowledge of perhaps one of the most intriguing phenomena in cell biology: the mitochondrial permeability transition pore (mPTP). This phenomenon, which was initially observed as a sudden loss of inner mitochondrial membrane impermeability caused by excessive calcium, has been studied for almost 50 years, and still no definitive answer has been provided regarding its mechanisms. From its initial consideration as an in vitro artifact to the current notion that the mPTP is a phenomenon with physiological and pathological implications, a long road has been travelled. We here summarize the role of mitochondria in cytosolic calcium control and the evolving concepts regarding the mitochondrial permeability transition (mPT) and the mPTP. We show how the evolving mPTP models and mechanisms, which involve many proposed mitochondrial protein components, have arisen from methodological advances and more complex biological models. We describe how scientific progress and methodological advances have allowed milestone discoveries on mPTP regulation and composition and its recognition as a valid target for drug development and a critical component of mitochondrial biology.
The importance of considering age when quantifying wild animals’ welfare
Authors: Hecht Luke
Published: June 2021

Wild animals experience different challenges and opportunities as they mature, and this variety of experiences can lead to different levels of welfare characterizing the day‐to‐day lives of individuals of different ages. At the same time, most wild animals who are born do not survive to adulthood. Individuals who die as juveniles do not simply experience a homogeneous fraction of the lifetimes of older members of their species; rather, their truncated lives may be characterized by very different levels of welfare. Here, I propose the concept of welfare expectancy as a framework for quantifying wild animal welfare at a population level, given individual‐level data on average welfare with respect to age. This concept fits conveniently alongside methods of analysis already used in population ecology, such as demographic sensitivity analysis, and is applicable to evaluating the welfare consequences of human interventions and natural pressures that disproportionately affect individuals of different ages. In order to understand better and improve the state of wild animal welfare, more attention should be directed towards young animals and the particular challenges they face.
Coping with cystic fibrosis: An analysis from the sibling's point of view
Authors: Milo Francesco , Ranocchiari Silvia , Lucidi Vincenzina , Tabarini Paola
Published: June 2021

Background

Cystic fibrosis (CF) is a chronic, life‐threatening condition that results in life‐long morbidity and premature mortality. CF has a significant impact on healthy siblings' adaptation and well‐being. Siblings of patients with a chronic disease may experience psychological difficulties, such as anxiety, depression symptoms and troubles in adaptation. This study aimed to explore the participants' experiences of growing up with a CF patient diagnosed at a paediatric age and their adaptation strategies.

Methods

We enrolled eight CF siblings (adolescents and young adults) in a 6‐month focus group sessions programme. Each session had two phases (psychoeducational and experiential). Transcripts were analysed and grouped through grounded theory analysis to elaborate on data‐driven theory.

Results

We identified 14 subthemes by which the raw data could be organized. All the subthemes were gathered together according to the axial coding process into six themes (illness, changes, communication, avoidance, normalization, and protection and care). We then grouped the six themes into two main themes (‘Growing up with a CF brother or sister’ and ‘Finding the right distance’) and conceptualized the grounded theory ‘Keeping the right distance’. The participants described the evolving process of maintaining a balance between the illness of their brother or sister, family organization and their own needs.

Conclusions

Knowing siblings' experiences and their common strategies to deal with the experience of having a brother or sister with a chronic health condition may be useful to ensure more tailored and specific interventions.
Mothers’ Depressive Symptoms and Children’s Internalizing and Externalizing Behaviors: Examining Reciprocal Trait‐State Effects from Age 2 to 15
Authors: Yan Ni , Liu Yuan , Ansari Arya , Li Keman , Li Xile
Published: June 2021

Using a large sample from the National Institute of Child Health and Development Study of Early Child Care and Youth Development (N = 1,178, 51% were male and 80% were White), the random intercept cross‐lagged panel model was employed to unpack the trait and state aspects in the relations between mothers’ depressive symptoms and children’s behavioral problems from age 2 to 15. The transactional predictions among mothers’ depressive symptoms and children’s behavioral problems were largely attributed to their correlations at the underlying trait level (rs = .458–.528). At the state level, the mutual influences among mothers’ depressive symptoms and children’s behavior problems occurred more often during periods of transition. With that said, the child effects hypothesis was not supported.
Antitumour necrosis factor therapy is associated with de novo Crohn’s disease after ileal pouch‐anal anastomosis
Authors: Truong Adam , Zaghiyan Karen N. , Mirocha James , Melmed Gil Y. , McGovern Dermot P. B. , Syal Gaurav , Ha Christina Y. , Targan Stephan R. , Fleshner Phillip R.
Published: June 2021

Aim

Tumour necrosis factor inhibitors (TNFi) have revolutionized the management of moderate to severe ulcerative colitis (UC) since their approval for UC in 2005. However, many patients ultimately require surgery with ileal pouch‐anal anastomosis (IPAA). Development of de novo Crohn's disease (CD) following IPAA is an increasingly common and devastating complication, sometimes progressing to pouch failure. The aim of this study was to evaluate the association of preoperative TNFi exposure and the development of de novo CD after IPAA.

Method

A prospective single‐centre inflammatory bowel disease (IBD) registry was searched for consecutive patients with UC undergoing IPAA during a 25‐year period ending July 2018. Patients with preoperative CD or IBD‐unclassified were excluded. De novo CD was diagnosed upon endoscopic evidence of five or more mucosal ulcers proximal to the ileal pouch any time after surgery and/or pouch fistula occurring more than three months after ileostomy closure.

Results

The study cohort consisted of 400 patients with a median follow‐up of 44.0 (IQR 11–113) months. Sixty‐two (16%) patients developed de novo CD 28.0 (IQR 6–67) months following ileostomy closure. Survival analysis of TNFi era patients revealed a significant increase in de novo CD risk in those with preoperative TNFi exposure. Multivariable proportional hazards modelling revealed two independent predictors for de novo CD development: older age was protective (HR 0.89 per 5‐year increase; P = 0.009) and preoperative TNFi exposure was hazardous (HR 2.10; P = 0.011).

Conclusion

This prospective study is the first to suggest an association between preoperative TNFi exposure and the development of de novo CD.
Minimal access rectal cancer surgery: an observational study of patient outcomes from a district general hospital with over a decade of experience with robotic rectal cancer surgery
Authors: Tilney Henry S. , Huddy Jeremy R. , Nizar A. Shiyam , Smith Ralph , Gudgeon A. Mark
Published: June 2021

Aim

Robotic surgery for colorectal cancer has become established more slowly than in other specialities. The aim of this study was to assess the risks and benefits of the use of robotic rectal cancer surgery in comparison with laparoscopic surgery within the confines of a subspecialist rectal cancer service in a district general hospital.

Method

Outcomes from consecutive patients undergoing minimal access rectal cancer surgery between July 2008 and January 2020 were analysed. Comparisons were made between short‐term outcomes including conversion rates, anastomotic leakage and pathological outcomes as well as long‐term survival and cancer recurrence.

Results

A total of 337 patients were included in the analysis, 204 (60.5%) of whom underwent robotic surgery. Demographic characteristics and use of neoadjuvant chemoradiotherapy were similar between groups. However, patients having robotic surgery had significantly lower tumours than in the laparoscopic group (7.6 cm vs. 9.8 cm, p = 0.003). Conversion to open surgery in the robotic group was significantly less likely (9.8% vs. 22.6%, p = 0.001). Operative mortality, clinical leakage and major complications were similar between groups. While asymptomatic ‘radiological’ leaks were significantly more common following robotic surgery (13.7% vs. 5.3%, p = 0.017) this did not affect the long‐term stoma closure rate. Pathological outcomes were similar with the exception of shorter mean distal resection margins (25.9 mm vs. 32.8 mm, p = 0.001) for the robotic group of patients. There was no statistical difference in 5‐year survival between groups (78.7% robotic vs. 85.4% laparoscopic, p = 0.263) nor local recurrence (2.0% robotic vs. 3.8% laparoscopic, p = 0.253).

Conclusions

These results illustrate how the selective use of robotic surgery by a dedicated rectal cancer team can achieve low rates of cancer recurrence and low permanent stoma rates.
Appendiceal pseudomyxoma peritonei: predictors of recurrence and iterative surgery
Authors: Kong Joseph C. , Flood Michael P. , Guerra Glen R. , Liesegang Amanda , Wong Wen J. , Mitchell Catherine , Warrier Satish K. , Naidu Sanjeev , Meade Brian , Lutton Nicholas , Heriot Alexander G.
Published: June 2021

Aim

Appendiceal pseudomyxoma peritonei (PMP) is a rare entity, with recurrence rates up to 26% despite optimal cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). Evidence specific to PMP originating from non‐infiltrative appendiceal mucinous neoplasms (low grade ‐ LAMN and high grade ‐ HAMN) is lacking. The aim of this study was to identify patterns of recurrence and predictive factors for patients appropriate for iterative surgery.

Method

A bi‐institutional retrospective analysis was performed on patients undergoing complete cytoreduction and HIPEC for PMP derived from perforated LAMN or HAMN. Multivariate logistic regression was performed to identify independent predictors for re‐do CRS. Five‐year overall survival (OS) was stratified according to surgical intervention, and 5‐year disease‐free survival (DFS) was stratified according to histological PMP grade. Cox regression analysis was performed to identify independent predictors for OS and DFS.

Results

Sixty of 239 (25.1%) patients developed peritoneal recurrence between 2007 and 2020. The median time to recurrence was 20.7 months. The risk of disease recurrence was highest with high‐grade PMP (P <0.001) and increasing PCI (P <0.001). Patients with high‐grade histology from their index procedure and aged over 60 years were less likely to be offered iterative surgery on multivariate analysis. Patients who underwent iterative CRS and HIPEC had a 5‐year survival of 100%.

Conclusion

Iterative CRS and HIPEC is feasible in selected patients with recurrent PMP, displaying good oncological outcomes. Age, index histology and level of abdominal quadrant involvement are predictive of proceeding to re‐do surgery.
Safety, tolerability, and pharmacokinetics of oral baicalein tablets in healthy Chinese subjects: A single‐center, randomized, double‐blind, placebo‐controlled multiple‐ascending‐dose study
Authors: Li Lijun , Gao Hongzhi , Lou Kun , Luo Hongmei , Hao Sheng , Yuan Jing , Liu Zeyuan , Dong Ruihua
Published: June 2021

Baicalein is a biologically important flavonoid in extracted from the Scutellaria baicalensis Georgi, which can effectively inhibit the influenza virus. This study aimed to analyze the safety and pharmacokinetic (PK) characteristics of baicalein tablets in healthy Chinese subjects and provide more information for phase II clinical trials. In this multiple‐ascending‐dose placebo‐controlled trial, 36 healthy subjects were randomized to receive 200, 400, and 600 mg of baicalein tablet or placebo once daily on day 1 and day 10, 3 times daily on days 4–9. All groups were intended to produce safety and tolerability outcomes (lowest dose first). Blood and urine samples were collected from subjects in the 600 mg group for baicalein PK analysis. Our study had shown that Baicalein tablet was generally safe and well‐tolerated. All adverse events were mild and resolved without any intervention except one case of fever reported in the 600 mg group, which was considered as moderate but not related with baicalein as judged by the investigator. Oral baicalein tablets were rapidly absorbed with peak plasma levels being reached within 2 h after multiple administration. The highest urinary excretion of baicalein and its metabolites peaked in 2 h, followed by 12 h, with a double peak trend.
Patterns of drinking in Aboriginal and Torres Strait Islander peoples as self‐reported on the Grog Survey App: A representative urban and remote sample
Authors: Zheng Catherine , Conigrave James H. , Conigrave Katherine M. , Wilson Scott , Perry Jimmy , Chikritzhs Tanya N. , Fitts Michelle S. , Lee K. S. Kylie
Published: June 2021

Introduction

Measuring self‐reported alcohol use is challenging in any population, including when episodic drinking may be common. Drinking among Indigenous Australians has been shown to vary greatly within and between communities. However, most survey methods assume ‘regular’ patterns of drinking. National estimates have also been shown to underestimate alcohol use among this group. This paper describes drinking patterns in two representative community samples (urban and remote).

Methods

Indigenous Australians (aged 16+ years) in two South Australian sites were recruited to complete the Grog Survey App. The App is a validated, interactive tablet‐based survey tool, designed to help Indigenous Australians describe their drinking. Drinking patterns were described using medians and interquartile ranges; gender and remoteness were compared using Wilcoxon rank‐sum tests. Spearman correlations explored the relationship between drinking patterns and age. Logistic regressions tested if beverage or container preference differed by remoteness or gender.

Results

Three‐quarters of participants (77.0%, n = 597/775) were current drinkers. Median standard drinks per occasion was 7.8 (78 g), 1.3 drinking occasions per month (median). Three‐quarters of current drinkers (73.7%) reported a period without drinking (median: 60 days). Remote drinkers were more likely to drink beer. Improvised containers were used by 40.5% of drinkers.

Discussion and Conclusions

Episodic drinking with extended ‘dry’ periods and from non‐standard drinking containers was common in this representative sample of Indigenous Australians. The diversity of container use and beverage preference, by gender and remoteness, illustrates nuances in drinking patterns between communities. It shows the importance of community‐level data to inform local strategies addressing alcohol misuse.
Sensitivity, but to which environment? Individual differences in sensitivity to parents and peers show domain‐specific patterns and a negative genetic correlation
Authors: Markovitch Noam , Knafo‐Noam Ariel
Published: June 2021

The idea that individuals differ in their sensitivity to the environment's effects is a cornerstone of developmental science. It has been demonstrated repeatedly, for different kinds of stressors, outcomes, and sensitivity markers. However, almost no empirical work was done to examine whether environmental sensitivity is domain‐general (i.e., the same individuals are sensitive to different environmental contexts) or domain‐specific (i.e., different individuals are sensitive to different environmental contexts), despite its importance to understanding human development, learning, and behavior. To address this question, phenotypic sensitivity to parents and to peers were compared in 1313 11‐year‐old Israeli adolescent twins. We found that, (1) our phenotypic markers indeed moderate environmental influences, with a discriminant predictive utility, (2) adolescents who are sensitive to their parents are not necessarily sensitive to their peers, and (3) sensitivity to parents and sensitivity to peers have different etiologies and show a negative genetic correlation, indicating that adolescents carrying genetic markers for sensitivity to parents are less likely to carry genetic markers for sensitivity to peers. These findings suggest that environmental sensitivity shows domain‐specific patterns, as different individuals can be sensitive to different environments. We discuss the theoretical, empirical, and practical implications of domain‐specificity of environmental sensitivity.
Opsoclonus‐myoclonus in Aicardi‐Goutières syndrome
Authors: Alburaiky Salam , Dale Russell C , Crow Yanick J , Jones Hannah F , Wassmer Evangeline , Melki Isabelle , Boespflug‐Tanguy Odile , Do Cao Jeremy , Gras Domitille , Sharpe Cynthia
Published: June 2021

Aicardi‐Goutières syndrome (AGS) is a rare genetic neuroinflammatory disorder caused by abnormal upregulation of type 1 interferon signalling. Opsoclonus‐myoclonus syndrome is a rare autoimmune phenotype demonstrating a disturbance in the humoral immune response mostly seen in the context of paraneoplastic or postinfectious states, although its pathophysiology is incompletely understood. We report the first three children described with AGS demonstrating transient opsoclonus and myoclonus after irritability and/or developmental regression, suggesting a pathological association. We describe the presentation, clinical features, progress, cerebrospinal fluid (CSF) inflammatory markers, electroencephalogram (EEG), and magnetic resonance imaging (MRI) findings in these children. Two patients had developmental regression but demonstrated a positive response to JAK1/2 inhibition clinically and on serial examination of CSF inflammatory markers. These findings suggest that AGS should be considered in children presenting with opsoclonus‐myoclonus, and that the association between AGS and opsoclonus‐myoclonus further supports the role of immune dysregulation as causal in the rare neurological phenomenon opsoclonus and myoclonus.

What this paper adds

There is a phenotypic association between opsoclonus‐myoclonus syndrome and Aicardi‐Goutières syndrome.

There is clinical evidence of immune dysregulation in the pathogenesis of opsoclonus and myoclonus.
Same goals, different challenges: A systematic review of perspectives of people with diabetes and healthcare professionals on Type 2 diabetes care
Authors: Catapan Soraia de Camargo , Nair Uthara , Gray Len , Cristina Marino Calvo Maria , Bird Dominique , Janda Monika , Fatehi Farhad , Menon Anish , Russell Anthony
Published: June 2021

Aims

To identify the views of people with Type 2 diabetes (PWD) and healthcare professionals (HCP) about diabetes care.

Methods

A systematic review of qualitative studies reporting both groups’ views using thematic synthesis frameworked by the eHealth Enhanced Chronic Care Model was conducted.

Results

We searched six electronic databases between 2010 and 2020, identified 6999 studies and included 21. Thirty themes were identified with in general complementary views between PWD and HCP. PWD and HCP find lifestyle changes challenging and get frustrated when PWD struggle to achieve it. Good self‐management requires a trustful PWD–HCP relationship. Diabetes causes distress and often HCP focus on clinical aspects. They value diabetes education. PWD require broader, tailored, consistent and ongoing information, but HCPs do not have enough time for providing it. There is need for diabetes training for primary HCP. Shared decision making can mitigate PWD’s fears. Different sources of social support can influence PWD’s ability to self‐manage and PWD/HCP suggest online peer groups. PWD/HCP indicate lack of communication and collaboration between HCP. PWD’s and HCP’s views about quality in diabetes care differ. They believe that comprehensive, multidisciplinary and locally provided care can help to achieve better outcomes. They recognise digital health benefits, with room for personal interaction (PWD) and eHealth literacy improvements (HCP). Evidence‐based guidelines are important but can detract from personalised care.

Conclusion

We hypothesise that including PWD’s and HCP’s complementary views, multidisciplinary teams and digital tools in the redesign of Type 2 diabetes care can help with overcoming some of the challenges and achieving common goals.
Echocardiographic predictors of long‐term adverse cardiovascular outcomes in participants with and without diabetes mellitus: A follow‐up analysis of the Copenhagen City Heart Study
Authors: Özbek Burcu Tas , Modin Daniel , Møgelvang Rasmus , Jørgensen Peter Godsk , Jensen Magnus Thorsten , Schnohr Peter , Gislason Gunnar Hilmar , Biering‐Sørensen Tor
Published: June 2021

Background

Previous studies have identified several echocardiographic markers of cardiac dysfunction in participants with diabetes mellitus, including E/e’. However, previous studies have been limited by short follow‐up duration or low statistical power, and none have assessed whether echocardiographic predictors of adverse cardiovascular outcome differ between individuals with DM and individuals without DM.

Methods

A total of 1997 individuals from the general population without heart disease had an echocardiogram performed in 2001 to 2003. Diabetes was defined as HbA1c ≥6.5% (≥48 mmol/mol), non‐fasted blood glucose ≥11.1 mmol/L or the use of glucose lowering medication. The end‐point was a composite of heart failure (HF), ischemic heart disease (IHD) and cardiovascular death (CVD).

Results

At baseline, a total of 292 participants (15%) had diabetes. Median follow‐up time was 12.4 years (interquartile‐range: 9.8–12.8 years) and follow‐up was 100%. During follow‐up, 101 participants (35%) with diabetes and 281 participants without diabetes (16%) reached the composite end‐point. The prognostic value of E/e’ was significantly modified by diabetes (p for interaction: 0.003). In participants with diabetes, only E/e’ remained an independent predictor of outcome in a final multivariable model adjusted for clinical and echocardiographic parameters (HR 1.08, 95% CI 1.00–1.17, p = 0.0041, per 1 increase). In participants without diabetes, left ventricular mass index (LVMI), left ventricular ejection fraction (LVEF) and a’ remained independent predictors of outcome when adjusted for clinical and echocardiographic parameters. In individuals with diabetes, only E/e’ added incremental prognostic value to risk factors from the SCORE risk chart and the ACC/AHA Pooled Cohort Equation.

Conclusion

In individuals with diabetes from the general population, E/e’ is a stronger predictor of cardiovascular mortality and morbidity than in individuals without diabetes and contributes with incremental prognostic value in addition to established cardiovascular risk factors.