bluuebunny/crossref_metadata_2025 huggingface dataset:
Clarifying the interface between respectful leadership and intention to stay
Authors: Enwereuzor Ibeawuchi K. , Ugwu Lawrence E.
Published: January 2021

Purpose

Considering that leaders play an important role in influencing the work environment and experiences of subordinates as well as the fact that employees like to be respected, the purpose of the current study was to explore supportive supervisor relations as a mediator of the relationship between respectful leadership and intention to stay.

Design/methodology/approach

Data were collected from 389 hospital nurses based on authors' personal networks at three measurement points. This was done to avoid problems associated with collecting data for predictor and criterion variables from the same source at the same time. The direct and indirect effects were tested with ordinary least squares regression-based path analysis.

Findings

Respectful leadership was found to be positively related to both supportive supervisor relations and intention to stay. In addition, supportive supervisor relations had a positive relationship with intention to stay. Finally, the relationship between respectful leadership and intention to stay was mediated by supportive supervisor relations.

Research limitations/implications

The sample were drawn from nurses only in a particularly region of a country and differences may exist among other occupational groups and geographical areas of the country in the way they perceive their leaders' behavior.

Practical implications

Management of health facilities can utilize information from annual reviews and feedback from subordinates as performance evaluation criteria for rewarding leaders who treat their subordinates respectfully. However, leaders who are disrespectful toward their subordinates could be identified and subjected to mandatory training on respectful leadership.

Originality/value

The current study extends the present state of research on the impact exerted by respectful leadership in an organizational context never examined heretofore; that is, health care context. This is also the first study linking respectful leadership, supportive supervisor relations and intention to stay in unison in a single study.
Attitudes toward femvertising in the Middle East: the case of Lebanon
Authors: Elhajjar Samer
Published: January 2021

Purpose

The purpose of this paper is to offer a clear understanding of the use of femvertising in Lebanon and its effects on consumers in general.

Design/methodology/approach

Data was collected using an online survey questionnaire, administered to a random sample of 318 individuals. Structural equation modeling (SEM) was used to test the hypotheses.

Findings

Lebanese people positively perceive the implication of women empowerment in advertisement. Gender, trust in ads, support of women’s rights and feminist self-identification, all have an impact on consumer behavior toward femvertising. However, the educational level and age do not affect the attitudes toward femvertising.

Practical implications

The practical contributions of our research derive from the importance of our findings on the uniqueness of the knowledge and information in the Middle East region. The importance of increasing knowledge of gender roles and Marketing in the Middle East is highly related to the gender dynamics embedded within broader globalization debates.

Originality/value

While studies have been extensive on the utilization of femvertising as a marketing strategy, the contexts under which these studies have been published, are mainly focused in the West. Hence, the Middle East in general and Lebanon, in particular, has witnessed no comprehensive and serious research on the subject. Consequently, this study is considered important and a major step toward establishing a theoretical base and underpinnings on the subject of utilization of femvertising in brands’ marketing strategies.
Ambidexterity in Agile software development: a conceptual paper
Authors: Lindskog Carin , Magnusson Monika
Published: January 2021

Purpose

The purpose of this study is to apply the concept of organizational ambidexterity as a conceptual lens to increase the understanding of tensions between exploitation (continuity) and exploration (change) in Agile software development (ASD) project teams, and particularly the balancing (ambidextrous) strategies utilized.

Design/methodology/approach

A conceptual framework was constructed from interdisciplinary sources on ambidexterity. A literature review of publications on ambidexterity in ASD was then performed, and the results from the selected publications were classified according to an extension of the conceptual framework.

Findings

Contextual ambidexterity in ASD is affected by the four basic coherent concepts: time, task, team and transition. The study found that most ambidextrous factors and strategies were task and team-related. In addition, a mixture of hard (performance) strategies and soft (social) strategies is needed in order for people/teams to (be able to) become ambidextrous.

Practical implications

To provide a better understanding of ASD, it is important to identify a broader set of ambidextrous factors and strategies that can impact ASD project teams. The expanded conceptual framework can serve as a basis for future empirical research and provide insights to practitioners on how to strengthen ambidexterity in ASD projects.

Originality/value

The contribution is of great importance for ASD research and practice, as ASD methods are a popular method for managing projects within ASD and in other nonsoftware organizations. In addition, as more and more organizations struggle to deal with rapidly changing environments, interest in the phenomena of paradoxical tensions and the strategy (ambidexterity) to deal with these tensions increase.
Human capital, cultural distance and staffing localization
Authors: Ando Naoki
Published: January 2021

Purpose

This study aims to explore how a change in the staffing configuration of foreign subsidiaries affects subsidiary performance by focusing on staffing localization.

Design/methodology/approach

The relationship between localization and subsidiary performance is analyzed from the perspective of human capital. Hypotheses are tested using a panel data set of foreign direct investment by Japanese multinational enterprises.

Findings

The analysis demonstrates that localization has a positive effect on subsidiary performance when subsidiaries can access a pool of competent local managers in the host country. It also shows that when competent local managers are highly available, localization has a positive effect on subsidiary performance under high cultural distance. In comparison, when the availability of competent local managers is limited and cultural distance is high, localization has a negative effect on subsidiary performance.

Originality/value

Using human capital theory, this study theorizes how localization, which is a change in the configuration of human capital toward a reliance on local-specific human capital, enhances subsidiary-specific advantages. It introduces the effects of changes in the configuration of human capital over time, into studies on subsidiary staffing. In addition, from a different viewpoint than previous studies, this study proposes one possible path where human capital leads to organizational performance. Specifically, it shows that a change in the configuration of human capital affects subsidiary-specific advantages, which eventually impacts subsidiary performance.
Optimized spaghetti pasta from amaranth, partially deoiled sesame and modified sorghum starch composite: bioactive, nutritional and physico-functional characterization
Authors: Fasuan Temitope Omolayo , Anyiam Cynthia Chioma , Ojokoh Linda Obianuju , Chima Judith Uchenna , Olagunju Titilope Modupe , Okpara Kingsley Osita , Asadu Kenneth Chigozie
Published: January 2021

Purpose

Pasta is popularly consumed in developed and developing countries. Many low-income homes that could not afford protein-rich foods consumed pasta without further supplements as a meal. However, pasta is deficient in protein and some other health-promoting substances. Deoiled sesame and amaranth flours are rich in protein, minerals, amino acids, antioxidants and many non-nutrient-based health benefits. Formulating a nutrient-dense pasta product (spaghetti) would reduce protein-energy malnutrition (PEM) and improve the health status of pasta consumers. This study aims to investigate some bioactive, nutrients and non-nutrient components of developed and optimized spaghetti pasta from deoiled sesame, amaranth and modified sorghum starch blend.

Design/methodology/approach

Amaranth, sorghum and sesame grains were sorted, wet-cleaned and dried. Sesame grain was roasted while starch was extracted from sorghum grain. The innate starch was modified by heat-moisture treatment. The prepared grains and starch were milled into flours and formulated into different flour mixtures using the Box-Behnken design of response surface methodology and the process was modeled and optimized. The flour mixtures were made into spaghetti pasta. Proximate, mineral, amino acids, biological value, protein efficiency ration, phytochemical, antioxidant activity, physico-functional and sensory properties of the formulated spaghetti were evaluated using standard procedures.

Findings

An optimal mixture of deoiled sesame (31.12g/100g), amaranth (56.56g/100g) and modified sorghum starch (12.32g/100g) were established, which yielded protein (25.79g/100g), appearance (96.65%), taste (94.57%) and acceptability index (97.37%). The spaghetti was significantly (p-values ranged from 0.001 to 0.018) superior in protein, ash, fat, fiber, calcium, magnesium, zinc, alkaloids, total phenolic, flavonoids, 2,2-diphenyl-1-picryl-hydrazl (DPPH) and ferric ion reducing antioxidant power (FRAP) relative to the control (100% wheat flour). Amino acid showed that the product is rich in histidine, isoleucine, phenylalanine and threonine. The high essential amino acid index of the product indicated that it is a good protein source. The spaghetti was significantly (p-values ranged from 0.001 to 0.021) superior in aroma, taste and acceptability index relative to the control.

Originality/value

This study showed the feasibility of developing spaghetti pasta from deoiled sesame, amaranth grains and modified sorghum starch. The production process described in this study is scalable; and the process could be applied on a small scale for the development of self-entrepreneurs and industrially. The high protein content of the product indicated that it could be used to reduce PEM in developing countries.
Critical stress factors influencing architecture students in Turkey: a structural equation modelling approach
Authors: Gümüşburun Ayalp Gülden , Çivici Tülay
Published: January 2021

Purpose

Presently, there are two main classification of architectural courses in the curriculum: lecture courses and design studios. Owing to the duality between design studios and lecture courses, architectural education includes a highly stressful learning environment. In addition to this dualism, architecture students also cope with their lives in universities and different types of stressors similar to all university students. Therefore, this study aims to determine the critical stress factors that affect architecture students studying in Turkey.

Design/methodology/approach

The reasons for a stressful architecture learning environment were examined using a questionnaire distributed among architecture students, and face-to-face surveys were conducted. The obtained data were analysed statistically using SPSS 22 and LISREL 8.7 software. Correlation analysis, exploratory and confirmatory analysis and structural equation modelling of the relationships between the stressors and stress factors and the impacts (perceived stress) were performed, and a structural model was developed.

Findings

A total of 11 critical factors affecting architecture students’ stress levels were determined; academic inadequacy, unusual assessments and evaluation techniques of courses and intensive academic schedule were the most critical stressors. Based on these factors, necessary solutions and recommendations were offered, which are expected to decrease architecture students’ stress levels and encourage other similar studies.

Originality/value

There is limited research that provides insights into the factors that cause stress to architecture students; only literature reviews and surveys are currently available. Unlike these, this study presents a structural equation model for critical stress factors via a confirmatory factor analysis.
A novel method of bead modeling and control for wire and arc additive manufacturing
Authors: Tang Shangyong , Wang Guilan , Song Hao , Li Runsheng , Zhang Haiou
Published: January 2021

Purpose

Modeling and control of bead geometry in wire and arc additive manufacturing is significant as it affects the whole manufacturing process. The purpose of this paper is to establish an efficient model to control the bead geometry with fewer experiments in wire and arc additive manufacturing (WAAM).

Design/methodology/approach

A multi-sensor system is established to monitor the process parameters and measure the bead geometry information. A dynamic parameters experimental method is proposed for rapid modeling without dozens of experiments. A deep learning method is used for bead modeling and control. To adaptively control the bead geometry in real-time, a closed-loop control system was developed based on the bead model and in situ monitoring.

Findings

A series of experiments were conducted to train, test and verify the feasibility of the method and system, and the results showed that the proposed method can build the bead model rapidly with high precision, and the closed-loop system can control the forming geometry adaptively.

Originality/value

The proposed modeling method is novel as the experiment number is reduced. The dynamic parameters experimental method is effective with high precision. The closed-loop control system can control the bead geometry in real-time. The forming accuracy is elevated.
Thermal performance analysis of a Solar parabolic dish concentrator system with modified cavity receiver
Authors: Kumar Varinder , Bopche Santosh
Published: January 2021

Purpose

This paper aims to present the numerical models and experimental outcomes pertain to the performance of the parabolic dish concentrator system with a modified cavity-type receiver (hemispherical-shaped).

Design/methodology/approach

The numerical models were evolved based on two types of boundary conditions; isothermal receiver surface and non-isothermal receiver surface. For validation of the numerical models with experimental results, three statistical terms were used: mean of absolute deviation, R2 and root mean square error.

Findings

The thermal efficiency of the receiver values obtained using the numerical model with a non-isothermal receiver surface found agreeing well with experimental results. The numerical model with non-isothermal surface boundary condition exhibited more accurate results as compared to that with isothermal surface boundary condition. The receiver heat loss analysis based on the experimental outcomes is also carried out to estimate the contributions of various modes of heat transfer. The losses by radiation, convection and conduction contribute about 27.47%, 70.89% and 1.83%, in the total receiver loss, respectively.

Practical implications

An empirical correlation based on experimental data is also presented to anticipate the effect of studied parameters on the receiver collection efficiency. The anticipations may help to adopt the technology for practical use.

Social implications

The developed models would help to design and anticipating the performance of the dish concentrator system with a modified cavity receiver that may be used for applications e.g. power generation, water heating, air-conditioning, solar cooking, solar drying, energy storage, etc.

Originality/value

The originality of this manuscript comprising presenting a differential-mathematical analysis/modeling of hemispherical shaped modified cavity receiver with non-uniform surface temperature boundary condition. It can estimate the variation of temperature of heat transfer fluid (water) along with the receiver height, by taking into account the receiver cavity losses by means of radiation and convection modes. The model also considers the radiative heat exchange among the internal ring-surface elements of the cavity.
Root exudates increase soil respiration and alter microbial community structure in alpine permafrost and active layer soils
Authors: Adamczyk Magdalene , Rüthi Joel , Frey Beat
Published: January 2021

Due to climate warming, alpine ecosystems are changing rapidly. Ongoing upward migrations of plants and thus an increase of easily decomposable substrates will strongly affect the soil microbiome. To understand how belowground communities will respond to such changes, we set up an incubation experiment with permafrost and active soil layers from northern (NW) and southern (SE) slopes of a mountain ridge on Muot da Barba Peider in the Swiss Alps and incubated them with or without artificial root exudates (AREs) at two temperatures, 4°C or 15°C. The addition of AREs resulted in elevated respiration across all soil types. Bacterial and fungal alpha diversity decreased significantly, coinciding with strong shifts in microbial community structure in ARE‐treated soils. These shifts in bacterial community structure were driven by an increased abundance of fast‐growing copiotrophic taxa. Fungal communities were predominantly affected by AREs in SE active layer soils and shifted towards fast‐growing opportunistic yeast. In contrast, in the colder NW facing active layer and permafrost soils fungal communities were more influenced by temperature changes. These findings demonstrate the sensitivity of soil microbial communities in high alpine ecosystems to climate change and how shifts in these communities may lead to functional changes impacting biogeochemical processes.
Youth agripreneurship in the horticultural value‐chain: The case of small‐scale mango farmers in Southern Ghana
Authors: Akrong Rexford , Mbogoh Stephen G. , Irungu Patrick
Published: January 2021

Development partners are promoting youth entrepreneurship in agriculture (agripreneurship) in sub‐Saharan Africa. While youth engagement in food crop production and marketing has received a lot of attention on both policy and academic fronts, the low level of involvement of youth in the horticultural value‐chain has received little attention. To this end, this study assessed the factors that influence participation of youth in the horticultural value‐chain. Using the multistage sampling technique, data were collected from 224 mango‐producing households in southern Ghana. The data were analyzed using descriptive statistics and the binary logit model. The study found that there exist differences between the youth and older farmers in terms of socioeconomic factors including education, household size, and income, and institutional support services including certification, credit, extension services and group membership. The results of the econometric model revealed that age, education, and access to credit and extension services motivate youth participation in agriculture. Access to credit and ownership of motorized transport encouraged participation of older farmers in high value markets. The study recommends that development partners provide credit facilities and capacity development through agricultural training and extension services to enhance youth participation in high value markets.
Where are children seen in Australian emergency departments? Implications for research efforts
Authors: Lim Jolene CJ , Borland Meredith L , Middleton Paul M , Moore Katie , Shetty Amith , Babl Franz E , Lee Robert S , Acworth Jason , Wilson Catherine , Than Martin , Craig Simon ,   ACEM EDEN and the PREDICT Network
Published: January 2021

Objective

With most paediatric emergency research in Australia conducted at tertiary EDs, it is important to understand how presentations differ between those at tertiary paediatric EDs and all other EDs.

Methods

Retrospective epidemiological study assessing paediatric case‐mix and time‐based performance metrics (aged 0–14 years) obtained from a national health service minimum dataset for the 2017–2018 financial year, comparing tertiary paediatric EDs and all other EDs. We defined a ‘major tertiary paediatric hospital’ as one which was accredited for training in both paediatric emergency medicine and paediatric intensive care.

Results

Of the 1 695 854 paediatric ED presentations, 23.8% were seen in nine major metropolitan tertiary paediatric hospitals. Reasons for presentations were more distinctive between cohorts among children aged 10–14 years, where psychiatric illness (5.2% vs 2.5%) and neurological illness (4.5% vs 2.5%) were more commonly seen in major tertiary paediatric EDs. Australian Indigenous children were significantly less likely to present to tertiary paediatric EDs (3.0%), compared with other EDs (9.7%) (odds ratio 0.27, 95% confidence interval 0.26–0.27). While median waiting times were longer in major tertiary paediatric EDs (28 min [interquartile range 11–65]) than in other EDs (20 min [interquartile range 8–48], P < 0.001), patients were also less likely to leave without being seen (5.5% in tertiary paediatric EDs vs 6.9% in other EDs; odds ratio 0.80, 95% confidence interval 0.78–0.81).

Conclusions

The present study identified key areas of difference in paediatric presentations between tertiary paediatric EDs and other EDs. It is vital to broaden paediatric ED research beyond tertiary paediatric centres, to ensure relevance and generalisability.
Role of sirtuins in bone biology: Potential implications for novel therapeutic strategies for osteoporosis
Authors: Li Qiangqiang , Cheng Jack Chun‐yiu , Jiang Qing , Lee Wayne Yuk‐wai
Published: January 2021

The decline in bone mass and bone strength and musculoskeletal problems associated with aging constitute a major challenge for affected individuals and the healthcare system globally. Sirtuins 1‐7 (SIRT1‐SIRT7) are a family of nicotinamide adenine dinucleotide‐dependent deacetylases with remarkable abilities to promote longevity and counteract age‐related diseases. Sirtuin knockout and transgenic models have provided novel insights into the function and signaling of these proteins in bone homeostasis. Studies have revealed that sirtuins play a critical role in normal skeletal development and homeostasis through their direct action on bone cells and that their dysregulation might contribute to different bone diseases. Preclinical studies have demonstrated that mice treated with sirtuin agonists show protection against age‐related, postmenopausal, and immobilization‐induced osteoporosis. These findings suggest that sirtuins could be potential targets for the modulation of the imbalance in bone remodeling and treatment of osteoporosis and other bone disorders. The aim of this review was to provide a comprehensive updated review of the current knowledge on sirtuin biology, focusing specifically on their roles in bone homeostasis and osteoporosis, and potential pharmacological interventions targeting sirtuins for the treatment of osteoporosis.
For better or for worse? A pre–post exploration of the impact of the COVID‐19 lockdown on cannabis users
Authors: Cousijn Janna , Kuhns Lauren , Larsen Helle , Kroon Emese
Published: January 2021

Background and aims

Lockdown measures aimed at limiting the number of infections and deaths from the coronavirus disease 2019 (COVID‐19) have introduced substantial psychosocial stressors in everyday life. We aimed to investigate the influence of the Dutch lockdown on cannabis use and cannabis use disorder (CUD) and investigate relations with change in mental wellbeing and experienced psychosocial stressors during the lockdown.

Design

Explorative longitudinal baseline‐, pre‐ and during lockdown survey study.

Setting

The Netherlands, on‐line between January 2019 and May 2020.

Participants

Community sample of 120 monthly to daily cannabis users and reference group of 63 non‐using controls.

Measurements

Change in cannabis use and CUD symptom severity from baseline to pre‐ to post‐lockdown. Change in cannabis use motives, mental health, quality of social relationships and job status from pre‐ to post‐lockdown.

Findings

In cannabis users, lockdown related to increased cannabis use [B = 1.96, 95% confidence interval (CI) = 0.26–3.66, P = 0.024], but not CUD symptom severity. Cannabis users experienced 30% job loss and increased loneliness [P < 0.001, Bayes factor (BF)10 > 100], while contact with partners (P = 0.005, BF10= 8.21) and families improved (P < 0.001, BF10 = 19.73), with no differences between cannabis users and control. Generally, mental health problems (all Ps > 0.277, all BF10 < 0.139) did not change, but individual differences were significant and severity of cannabis use pre‐lockdown, COVID‐19‐related worries, change in anxiety, expansion motives, social motives and family contact all uniquely related to variance in change in cannabis use or CUD.

Conclusions

While cannabis use among daily cannabis users in the Netherlands increased at the group level during the period of COVID‐19 lockdown, the effect of the first months of lockdown on cannabis use disorder severity and mental wellbeing varied significantly among individual daily cannabis users.
Fear of childbirth after medical vs surgical abortion. Population‐based register study from Finland
Authors: Kemppainen Venla , Niinimäki Maarit , Bloigu Aini , Saisto Terhi , Rouhe Hanna , Gissler Mika , Heikinheimo Oskari , Mentula Maarit
Published: January 2021

Introduction

To evaluate the effect of method of induced abortion and other abortion‐associated variables on the incidence of fear of childbirth in subsequent pregnancy.

Material and methods

This population‐based register study cohort includes all nulliparous women with their first pregnancy ending in an induced abortion in 2000‐2015 and subsequent pregnancy with live singleton delivery between 2000 and 2017 (n = 21 479). Data were derived from three national registers maintained by the Finnish Institute for Health and Welfare. We divided the study population in three cohorts: (a) medical and (b) surgical abortion during first trimester (≤84 days of gestation), and (c) medical abortion during second trimester (85‐168 days of gestation). Primary outcome measures were the incidence of registry‐identified fear of childbirth and cesarean delivery related to it.

Results

The overall incidence of fear of childbirth was 5.6% (n = 1209). Altogether, 19.2% (n = 4121) of women underwent cesarean delivery. The odds were elevated especially for elective cesarean delivery (odds ratio [OR] 9.30, 95% CI 7.95‐10.88, P < .001) in women with fear of childbirth. In multivariable analysis, the odds for fear of childbirth (adjusted OR [aOR] 0.80, 95% CI 0.68‐0.94) and cesarean delivery (aOR 0.66, 95% CI 0.84‐0.90) were decreased in women with a history of first‐trimester medical abortion compared with those with first‐trimester surgical abortion. Second‐trimester medical abortion had no effect on the odds for fear of childbirth (aOR 1.04, 95% CI 0.71‐1.50). Maternal age of 30‐39 years and interpregnancy interval over 2 years were additional risk factors for both fear of childbirth and cesarean delivery, but surgical evacuation of uterus after the abortion was not.

Conclusions

One first‐ or second‐trimester medical abortion does not increase the odds for fear of childbirth, and cesarean delivery related to it in subsequent pregnancy when compared with first‐trimester surgical abortion. Older maternal age and longer interpregnancy interval emerged as risk factors for fear of childbirth.
Cav3.1 t‐type calcium channel is critical for cell proliferation and survival in newly generated cells of the adult hippocampus
Authors: Yabuki Yasushi , Matsuo Kazuya , Yu Mengze , Xu Jing , Sakimura Kenji , Shioda Norifumi , Fukunaga Kohji
Published: January 2021

Aims

Adult hippocampal neurogenesis plays an important role in neuronal plasticity and maintenance in mammals. Low‐threshold voltage‐gated T‐type calcium channels produce calcium spikes that increase fast action potentials in newborn cells in the hippocampal dentate gyrus (DG); however, their role in adult hippocampal neurogenesis remains unclear. Here, we demonstrate impaired adult hippocampal neurogenesis in Cav3.1T‐type calcium channel knockout mice.

Methods and Results

Cav3.1T‐type calcium channel was predominantly localized in neuronal progenitor cells of the mouse hippocampal DG. By counting the number of 5‐bromo‐2′‐deoxyuridine‐labeled cells, decreased proliferation and survival of newly generated cells were observed in the adult hippocampal DG in Cav3.1 knockout mice as compared to wild‐type (WT) mice. Moreover, the degree of maturation of doublecortin‐positive cells in Cav3.1 knockout mice was lower than that in WT mice, suggesting that Cav3.1 deletion may impair neuronal differentiation. Consistent with impaired hippocampal neurogenesis, Cav3.1 knockout mice showed decreased social interaction. Reduced phosphorylation levels of calcium/calmodulin‐dependent protein kinase II and protein kinase B were closely associated with impaired hippocampal neurogenesis in Cav3.1 knockout mice. Moreover, the mRNA and protein expression levels of brain‐derived neurotrophic factor, important for neurogenesis, were significantly decreased in Cav3.1 knockout mice. Finally, gene ontology analysis revealed alterations in genes related to the promotion of cell death/apoptosis and suppression of cell proliferation/neuronal differentiation pathways, including Bdnf.

Conclusion

These results suggest that the Cav3.1T‐type calcium channel may be a key molecule required for cell proliferation, survival and neuronal differentiation in newly generated cells of the adult mouse hippocampus.
Spigelian hernia: Our total extraperitoneal approach and a systematic review of the literature
Authors: Cui Tracy Yu‐Shi , Law Tsz Ting , Ng Lily , Wong Kin Yuen
Published: January 2021

Introduction

Spigelian hernia is a rare lateral ventral hernia traditionally repaired through open incision with extensive dissection. Three laparoscopic techniques have been reported in the literature: intraperitoneal onlay mesh (IPOM), transabdominal preperitoneal (TAPP), and total extraperitoneal (TEP). TEP is less popular than the other approaches. We evaluated TEP's safety and effectiveness and compared different laparoscopic techniques.

Methods

All patients with Spigelian hernia who had undergone extended TEP (eTEP) repair with mesh in our center from January 2007 to February 2020 were studied. A three‐port technique with a preperitoneal space created by telescope at the midline was adopted. A systematic review on laparoscopic mesh repair was performed by searching for “Spigelian hernia” and “laparoscopic” from 1999 to 2019 in the MEDLINE database.

Results

Seven patients underwent eTEP repair for Spigelian hernia. Five presented with abdominal mass and underwent preoperative imaging. Two were diagnosed incidentally during TEP for inguinal hernia. The mean operative duration was 65 minutes (range, 40‐93 minutes). There were no open conversions or intraoperative complications. The mean length of hospital stay was 1.4 days (range, 1‐3 days). The mean follow‐up period was 44.3 months. One patient developed seroma. There was no recurrence or chronic pain. We identified 197 laparoscopic mesh repairs reported in 41 articles. IPOM (n = 91) was the most popular approach, followed by TAPP (n = 70) and TEP (n = 36). Laparoscopic mesh repair of Spigelian hernia is safe and offers excellent outcomes.

Conclusion

We found the eTEP approach safe and effective for Spigelian hernia repair. IPOM, TAPP, and TEP are comparable.
A case of single‐incision laparoscopic surgery for acute appendicitis with left ventricular assist device
Authors: Chinen Yoshinao , Ogino Takayuki , Fujino Shiki , Takahashi Hidekazu , Miyoshi Norikatsu , Uemura Mamoru , Yamamoto Hirofumi , Mizushima Tsunekazu , Doki Yuichiro , Eguchi Hidetoshi
Published: January 2021

A left ventricular assist device (LVAD) is used for patients with severe heart failure. We present a case of a 35‐year‐old man who had undergone LVAD implantation 2 years ago for dilated phase of hypertrophic cardiomyopathy. He had right lower abdominal pain and was diagnosed with acute appendicitis. Single‐incision laparoscopic surgery for appendicitis was performed. We incised approximately 3 cm of the umbilicus carefully because the driveline of LVAD was passing just caudal to the umbilicus. LVAD is only available for patients waiting for cardiac transplantation in Japan, and the number of patients with LVAD has been increasing. Adequate anticoagulant therapy is necessary because device thrombosis often causes fatal complications, but during emergency cases, the surgeons have to be cautious of bleeding and injury to the driveline of LVAD.
Debate: Giving prevention a chance to prove its worth in lowering common mental disorder prevalence: how long will it take?
Authors: Ormel Johan , VonKorff Michael
Published: January 2021

Large increases in treatment of Common Mental Disorders (CMD) have failed to reduce population prevalence and global burden. Preventive strategies are needed to lower CMD prevalence and burden. Giving prevention a real chance to prove its promise will require: (a) full embedment in social institutions; (b) long‐term structural funding; (c) targeting major CMD determinants early in life combining population‐level and individual‐level strategies; and, (d) integrated evaluation of short‐term and long‐term effects to guide implementation. Targeting life skills and resilience of children and parenting skills of their parents has the potential for long‐term benefits for multiple outcomes including well‐being, social, economic, and financial domains as well as mental health outcomes. However, the large investments may not occur without compelling proof of effectiveness, but evaluation of effectiveness cannot occur without long‐term, structural investments. Overcoming this impasse requires a paradigm shift. Randomized controlled trials of initial efficacy need to be supplemented by evaluation strategies for long‐term surveillance of community‐based programs that guide implementation while assessing long‐term effectiveness.
Expression of asporin reprograms cancer cells to acquire resistance to oxidative stress
Authors: Sasaki Yuto , Takagane Kurara , Konno Takumi , Itoh Go , Kuriyama Sei , Yanagihara Kazuyoshi , Yashiro Masakazu , Yamada Satoru , Murakami Shinya , Tanaka Masamitsu
Published: January 2021

Asporin (ASPN), a small leucine‐rich proteoglycan expressed predominantly by cancer associated fibroblasts (CAFs), plays a pivotal role in tumor progression. ASPN is also expressed by some cancer cells, but its biological significance is unclear. Here, we investigated the effects of ASPN expression in gastric cancer cells. Overexpression of ASPN in 2 gastric cancer cell lines, HSC‐43 and 44As3, led to increased migration and invasion capacity, accompanied by induction of CD44 expression and activation of Rac1 and MMP9. ASPN expression increased resistance of HSC‐43 cells to oxidative stress by reducing the amount of mitochondrial reactive oxygen species. ASPN induced expression of the transcription factor HIF1α and upregulated lactate dehydrogenase A (LDHA) and PDH‐E1α, suggesting that ASPN reprograms HSC‐43 cells to undergo anaerobic glycolysis and suppresses ROS generation in mitochondria, which has been observed in another cell line HSC‐44PE. By contrast, 44As3 cells expressed high levels of HIF1α in response to oxidant stress and escaped apoptosis regardless of ASPN expression. Examination of xenografts in the gastric wall of ASPN–/– mice revealed that growth of HSC‐43 tumors with increased micro blood vessel density was significantly accelerated by ASPN; however, ASPN increased the invasion depth of both HSC‐43 and 44As3 tumors. These results suggest that ASPN has 2 distinct effects on cancer cells: HIF1α‐mediated resistance to oxidative stress via reprogramming of glucose metabolism, and activation of CD44‐Rac1 and MMP9 to promote cell migration and invasion. Therefore, ASPN may be a new therapeutic target in tumor fibroblasts and cancer cells in some gastric carcinomas.
Using sexual health and safety education to protect against child sexual abuse in residential care: The LINC model
Authors: McKibbin Gemma , Bornemisza Anna , Fried Ana , Humphreys Cathy , Smales Madelaine
Published: January 2021

Children and young people living in residential care are vulnerable to sexual abuse, and there is scant evidence about what sexuality education could help address this vulnerability. This paper explores the impact of thePower to Kids: Respecting Sexual Safetyprogramme, which involved capacity‐building workers to have ‘brave conversations’ with children and young people in residential care. The aim of the study was to capture the perceptions of workers about changes in their skill and confidence levels in relation to having brave conversations with children and young people and the impact of those conversations on children and young people. A mixed‐methods study was undertaken, involving multiple sets of interviews with 27 workers associated with four residential houses. The qualitative and quantitative data analysis showed that workers perceived the impact of the capacity building and brave conversations as strengthening protective factors available to children and young people vulnerable to sexual abuse. The research revealed the ‘LINC model’ as a viable approach to capacity‐building workers to educate children and young people in residential care about sexual health and safety. Workers perceived the enhancement of the following protective factors: stronger safe relationships, greater comfort disclosing abuse and improved knowledge of normal versus harmful sexual behaviour.
Generating and evaluating cross‐sectional synthetic electronic healthcare data: Preserving data utility and patient privacy
Authors: Wang Zhenchen , Myles Puja , Tucker Allan
Published: January 2021

Electronic healthcare record data have been used to study risk factors of disease, treatment effectiveness and safety, and to inform healthcare service planning. There has been increasing interest in utilizing these data for new purposes such as for machine learning to develop predictive algorithms to aid diagnostic and treatment decisions. Synthetic data could potentially be an alternative to real‐world data for these purposes as well as reveal any biases in the data used for algorithm development. This article discusses the key requirements of synthetic data for multiple purposes and proposes an approach to generate and evaluate synthetic data focused on, but not limited to, cross‐sectional healthcare data. To our knowledge, this is the first article to propose a framework to generate and evaluate synthetic healthcare data with the aim of simultaneously preserving the complexities of ground truth data in the synthetic data while also ensuring privacy. We include findings and new insights from synthetic datasets modeled on both the Indian liver patient dataset and UK primary care dataset to demonstrate the application of this framework under different scenarios.
Endometrial extracellular matrix rigidity and IFNτ ensure the establishment of early pregnancy through activation of YAP
Authors: Zhang Tao , Guo Shuai , Zhou Han , Wu Zhimin , Liu Junfeng , Qiu Changwei , Deng Ganzhen
Published: January 2021

Background

In mammals, early pregnancy is a critical vulnerable period during which complications may arise, including pregnancy failure. Establishment of a maternal endometrial acceptance phenotype is a prerequisite for semiheterogeneous embryo implantation, comprising the rate‐limiting step of early pregnancy.

Methods

Confocal fluorescence, immunohistochemistry and western blot for nuclear and cytoplasmic protein were used to examine the activation of yes‐associated protein (YAP) in uterine tissue and primary endometrial cells. The target binding between miR16a and YAP was verified by dual‐luciferase reporter gene assay. The mouse pregnancy model and pseudopregnancy model were used to investigate the role of YAP in the maternal uterus during early pregnancy in vivo.

Results

We showed that YAP translocates into the nucleus in the endometrium of cattle and mice during early pregnancy. Mechanistically, YAP acts as a mediator of ECM rigidity and cell density, which requires the actomyosin cytoskeleton and is partially dependent on the Hippo pathway. Furthermore, we found that the soluble factor IFNτ, which is a ruminant pregnancy recognition factor, also induced activation of YAP by reducing the expression of miR‐16a.

Conclusions

This study revealed that activation of YAP is necessary for early pregnancy in bovines because it induced cell proliferation and established an immunosuppressive local environment that allowed conceptus implantation into the uterine epithelium.
Prevalence of long‐term mechanical insufflation‐exsufflation in children with neurological conditions: a population‐based study
Authors: Hov Brit , Andersen Tiina , Toussaint Michel , Vollsæter Maria , Mikalsen Ingvild B , Indrekvam Solfrid , Hovland Vegard
Published: January 2021

Aim

To determine the prevalence of long‐term mechanical insufflation‐exsufflation (MI‐E) and concomitant mechanical ventilation in children with neurological conditions, with reported reasons behind the initiation of treatment.

Method

This was a population‐based, cross‐sectional study using Norwegian national registries and a questionnaire.

Results

In total, 114 of 19 264 children with a neurological condition had an MI‐E device. Seventy‐three of 103 eligible children (31 females, 42 males), median (min–max) age of 10 years 1 month (1y 5mo–17y 10mo), reported their MI‐E treatment initiation. Overall, 76% reported airway clearance as the main reason to start long‐term MI‐E. A prophylactic use was mainly reported by children with neuromuscular disorders (NMDs). Prevalence and age at initiation differed by diagnosis. In spinal muscular atrophy and muscular dystrophies, MI‐E use was reported in 34% and 7% of children, of whom 83% and 57% respectively received ventilator support. One‐third of the MI‐E users were children with central nervous system (CNS) conditions, such as cerebral palsy and degenerative disorders, and ventilator support was provided in 31%. The overall use of concomitant ventilatory support among the long‐term MI‐E users was 56%.

Interpretation

The prevalence of MI‐E in a neuropaediatric population was 6 per 1000, with two‐thirds having NMDs and one‐third having conditions of the CNS. The decision to initiate MI‐E in children with neurological conditions relies on clinical judgment.

What this paper adds

The prevalence and age at initiation of mechanical insufflation/exsufflation (MI‐E) differed between diagnoses.

MI‐E was most commonly used in spinal muscular atrophy, where it generally coincided with ventilatory support.

One‐third of MI‐E devices were given to children with central nervous system conditions, and one‐third also received ventilatory support.
Cardiovascular and renal safety of metformin in patients with diabetes and moderate or severe chronic kidney disease: Observations from the EXSCEL and SAVOR‐TIMI 53 cardiovascular outcomes trials
Authors: Clegg Lindsay E. , Jing Yankang , Penland Robert C. , Boulton David W. , Hernandez Adrian F. , Holman Rury R. , Vora Jiten
Published: January 2021

Aim

To provide evidence on the cardiovascular and renal safety of metformin in chronic kidney disease (CKD) stages 3 to 4.

Materials and Methods

This post hoc analysis compared participants with an estimated glomerular filtration rate (eGFR) of 15 to 59 mL/min/1.73m2 in the Exenatide Study of Cardiovascular Event Lowering (EXSCEL) and the Saxagliptin and Cardiovascular Outcomes in Patients With Type 2 Diabetes Mellitus (SAVOR‐TIMI 53) trials taking metformin, with those not exposed to metformin during these trials, using a propensity‐matching approach. Adjusted Cox proportional hazards models were used to assess risk of major adverse cardiovascular events (MACE) and all‐cause mortality (ACM). Metformin effect on eGFR slope was calculated using a mixed‐model repeated measures analysis, and the number of lactic acidosis events was tabulated.

Results

No strong trend for lower metformin doses with lower eGFR values was observed in either the EXSCEL or SAVOR‐TIMI 53 trials. In the 1745 metformin‐using participants matched to non‐metformin users, metformin had neutral effects on MACE (hazard ratio [HR] 0.91, 95% confidence interval [CI] 0.76–1.08; P = 0.28) and ACM (HR 0.86, 95% CI 0.70–1.07; P = 0.18), with no interaction by CKD stage, or with use of exenatide or saxagliptin. An improvement in eGFR slope was observed with metformin in the CKD stage 3B cohort in SAVOR‐TIMI 53, but not in other groups.

Conclusions

This analysis of participants with CKD stages 3 to 4 from two cardiovascular outcomes trials supports the cardiorenal safety of metformin, but does not suggest a consistent benefit on MACE, ACM, or eGFR slope across this population.
Clinician stakeholder experiences of a new youth mental health model in Australia: A qualitative study
Authors: Nash Louise , Isobel Sophie , Thomas Margaret , Nguyen Thao , van der Pol Renae
Published: January 2021

Aim

Late teens and early adulthood is the peak age of onset for mental disorders. Currently, there is a gap between primary mental health care and more intensive mental health services for young people in New South Wales (NSW), Australia. Two headspace Early Intervention Teams (hEITs) were developed to bridge this gap in Sydney Local Health District (SLHD), in Sydney, Australia. This study aims to explore clinician experiences of hEIT after the first 2 years of implementation.

Methods

Semistructured interviews were conducted with key clinicians working within hEIT or closely associated with hEIT. Nine interviews were conducted, transcribed and analysed using qualitative thematic analysis.

Results

Four themes were identified: (1) building a bridge between services, (2) filling a clinical gap, (3) service collaborations and their challenges and (4) difficulties of small team size.

Conclusions

There is evidence that clinicians value the service provided by hEIT. There are difficulties such as referral confusion, staff turnover and suggestions to increase staffing to improve the stability, skill diversity and viability of the service. Findings have implications for other collaborative youth mental health models.