bluuebunny/crossref_metadata_2025 huggingface dataset:
Youth Vulnerability and the Challenge of Human Development in Africa
Authors: Michael Paul K.
Published: May 2020

This paper offers a philosophical response to an aspect of the youth question in Africa – the question of youth vulnerability and its consequences on the human development outcome. To achieve the desired goal, first, I stretch the concept of pathogenic vulnerability from being more than ordinarily vulnerable to being far more than ordinarily vulnerable. Second, I identify two elements of African cultural structure – primacy of community over the individual and the belief that elders always possess superior knowledge over the youth – that influence and restrict capacity/capabilities in African youth and therefore make their transition to adulthood defective. Consequently, the African youth is deprived of the special opportunity to develop, encounter and explore the various character options from which he/she learns, selects and forms her identity. Third, I argue that these restraints of capacity/capabilities make African youths far more than ordinarily vulnerable to human development outcome.
A new species of planthopper in the genus Agoo (Hemiptera: Fulgoroidea: Derbidae) from coquito palms (Astrocaryum alatum) in Costa Rica
Authors: BAHDER BRIAN W. , ECHAVARRIA MARCO A. ZUMBADO , BARRANTES EDWIN A. BARRANTES , KUNZ GERNOT , HELMICK ERICKA E. , BARTLETT CHARLES R.
Published: May 2020

An ongoing survey to document planthopper diversity on palms (Arecaceae) is being conducted in Costa Rica. During these efforts a new species of derbid planthopper belonging to the genus Agoo was found on Astrocaryum alatum Loomis in the Heredia province at La Selva Biological Station and is described here as Agoo luzdenia Bahder & Bartlett sp. n., bringing the genus to four described taxa—A. dahliana, A. luzdenia Bahder & Bartlett sp. n., A rubrimarginata, and A. xavieri. Sequence data for the cytochrome c oxidase subunit I (COI) and 18S genes was generated for the novel taxon and strongly supports its placement in the genus Agoo.
Revision of the Miltochrista obliquilinea species-group, with descriptions of four new species (Lepidoptera, Erebidae, Arctiinae, Lithosiini)
Authors: VOLYNKIN ANTON V. , SINGH NAVNEET , ČERNÝ KAREL , KIRTI JAGBIR SINGH , DATTA HARVINDER SINGH
Published: May 2020

The Miltochrista obliquilinea (Swinhoe, 1901) species-group is revised. Four new species are described: M. konta Volynkin, Černý & N. Singh, sp. n. (Thailand, Laos and Vietnam), M. adelfika Volynkin, N. Singh, Černý, Kirti & Datta, sp. n. (India, Myanmar, China, Thailand, Laos and Vietnam), M. stenovalva Volynkin, N. Singh, Černý, Kirti & Datta, sp. n. (India and Thailand) and M. lavides Volynkin, Černý & N. Singh, sp. n. (Malaysia, Thailand, Myanmar, Laos and Vietnam). The lectotype for Lyclene obliquilinea Swinhoe, 1901 is designated. Adults, male and female genitalia are illustrated.
Holomorphology and Neotype designation of Microperla geei Chu, with egg morphology of Microperla qinlinga Chen (Plecoptera: Peltoperlidae)
Authors: CHEN ZHI-TENG
Published: May 2020

A Neotype is designated for Microperla geei Chu, 1928. This species was recently collected from Tianmu Mountain, Hangzhou City, Zhejiang Province of southeastern China. The male, female, larva, and egg of M. geei are described and illustrated. Identity of the Microperla species described by Stark & Sivec (2000) is discussed. Egg morphology of M. qinlinga Chen, 2019 is also described and compared with congeners.
Mycomystes nigriventris sp. nov. (Coleoptera: Erotylidae: Tritomini) from South America, with insights into the genus Mycomystes Gorham
Authors: DE CASTRO PECCI-MADDALENA ITALO SALVATORE , LOPES-ANDRADE CRISTIANO
Published: May 2020

Mycomystes nigriventris sp. nov. (Erotylidae: Tritomini) is described from South and Southeast Brazil. Mycomystes was described by Gorham to include a single species, Mycomystes ferrugineus Gorham, from Mexico. Since Gorham’s description, no other species was included in Mycomystes and its morphological limits to Mycotretus remain unclear. The new species described here is placed in Mycomystes due its oval body, conspicuously dilated tibiae, mentum plate subpentagonal, with a rounded outline, and terminal maxillary palpomeres more greatly widened than the terminal labial palpomeres. Mycomystes nigriventris sp. nov. differs from M. ferrugineus in the black ventral coloration, elytral punctation with rows of punctures uniform longitudinally and not confluent, outer side of protibia lacking conspicuous angle, and distributed in Southeast and South Brazil, with M. ferrugineus restricted to the northern and M. nigriventris sp. nov. to the southern Neotropics. Similarities in body shape, morphology of mouthparts, and male and female terminalia between M. nigriventris sp. nov. and four species of Mycotretus, which may belong in Mycomystes, are discussed. The detailed description provided here, including potential characters for a phylogenetic approach, will help in subsequent studies on Mycomystes and Mycotretus.
Impact of Refractivity Profiles from a Proposed GNSS-RO Constellation on Tropical Cyclone Forecasts in a Global Modeling System
Authors: Mueller Michael J. , Kren Andrew C. , Cucurull Lidia , Casey Sean P. F. , Hoffman Ross N. , Atlas Robert , Peevey Tanya R.
Published: May 2020

A global observing system simulation experiment (OSSE) was used to assess the potential impact of a proposed Global Navigation Satellite System (GNSS) radio occultation (RO) constellation on tropical cyclone (TC) track, maximum 10-m wind speed (Vmax), and integrated kinetic energy (IKE) forecasts. The OSSE system was based on the 7-km NASA nature run and simulated RO refractivity determined by the spatial distribution of observations from the original planned (i.e., including both equatorial and polar orbits) Constellation Observing System for Meteorology, Ionosphere, and Climate-2 (COSMIC-2). Data were assimilated using the NOAA operational weather analysis and forecasting system. Three experiments generated global TC track, Vmax, and IKE forecasts over 6 weeks of the North Atlantic hurricane season in the North Atlantic, east Pacific, and west Pacific basins. Confidence in our results was bolstered because track forecast errors were similar to those of official National Hurricane Center forecasts, and Vmax errors and IKE errors showed similar results. GNSS-RO assimilation did not significantly impact global track forecasts, but did slightly degrade Vmax and IKE forecasts in the first 30–60 h of lead time. Global forecast error statistics show adding or excluding explicit random errors to RO profiles made little difference to forecasts. There was large forecast-to-forecast variability in RO impact. For two cases studied in depth, track and Vmax improvements and degradations were traced backward through the previous 24 h of assimilation cycles. The largest Vmax degradation was traced to particularly good control analyses rather than poor analyses caused by GNSS-RO.
“The quietness of the place calmed my troubled mind”: The restorative potential of environments in an existential rehabilitation programme for patients with cancer
Authors: Roessler K. K. , Graven V. , la Cour K. , Hvidt N. C. , Rottmann N. , Hvidt E. Assing
Published: May 2020

In the following article, the restorative potential of the environment in a cancer rehabilitation programme is analysed and discussed. The programme was developed as a transdisciplinary cooperation of psychologists, theologians, philosophers, and artists. To investigate the importance of environments, six qualitative focus group interviews were performed with 36 Danish cancer patients (30 females; six males) who attended the programme either at The Danish Knowledge Centre for Rehabilitation and Palliative Care (REHPA), a former hospital building adapted for rehabilitation, or at Løgumkloster Refugium, an old monastery, used as a place for retreat. The data were analysed using a content analysis that took a psychodynamic and hermeneutic approach as its point of departure. Outcomes associated with the environment that enhanced the well-being of the patients were feelings: a) of being close to nature, b) of being protected, c) of the spirit of place, and d) of experiencing narratives of peace. Our programme supports the idea, that environments in which cancer rehabilitation takes place can trigger different emotions and fulfil different existential needs. Aesthetic, historical, and spiritual aspects of an environment can help individuals to respond to existential challenges and can induce hope. Our study contributes knowledge about the interplay between existential well-being and aspects of the environment.
Impostor Phenomenon and Psychological Well-Being: The Moderating Roles of John Henryism and School Racial Composition Among Black College Students
Authors: Bernard Donte L. , Jones Shawn C. T. , Volpe Vanessa V.
Published: May 2020

The impostor phenomenon (IP), or erroneous cognitions of intellectual incompetence, is a risk factor for poor psychological adjustment among Black emerging adults. Grounded in Lazarus and Folkman’s Stress and Coping Framework, the current study investigated John Henryism’s active coping and institutional racial composition as moderators of the association between IP and indicators of psychological well-being among 266 Black students (77% women; Mage = 19.87) attending predominately White institutions (PWIs) and historically Black colleges/universities (HBCUs). Hierarchical moderation regression analyses revealed that IP was associated with decreases in well-being indicators among students attending PWIs and HBCUs. Moreover, students who attended PWIs and reported higher levels of John Henryism (+1 SD) were most vulnerable to increases in social anxiety, particularly at higher levels of IP. Results suggest that the interaction between IP, John Henrysim, and institutional racial composition may negatively influence psychological well-being. We discuss how these findings can be used to inform clinical and educational practices to best support Black college students.
Prediction of Malignancy in Salivary Gland Tumors by a New Cytology Reporting System
Authors: Lee Doh Young , Song Seulki , Yang Seung Koo , Lee Min Hyung , Kim Ji Eun , Jung Young Ho , Kwon Tack-Kyun
Published: May 2020

Objectives:

The aim of this study was to analyze the risk of malignancy in salivary gland tumors on the basis of the Milan System for Reporting Salivary Gland Cytopathology.

Methods:

A retrospective review was performed of the charts of patients with salivary gland tumors in whom the final diagnosis was confirmed by surgical excision. Preoperative fine needle aspiration results were categorized according to the Milan System for Reporting Salivary Gland Cytopathology: non-diagnostic (category I), nonneoplastic (category II), atypia of undetermined significance (category III), neoplasm (category IV), suspicious for malignancy (category V), and malignant (category VI). Fine needle aspiration and final diagnosis were compared, and the risk of malignancy and operative/oncological outcomes were analyzed.

Results:

A total of 288 patients were enrolled in this study. Postoperative histopathologic salivary gland malignancies were found in 30 (10.4%) patients. Risk of malignancy was 7.1%, 0%, 48.0%, 4.8%, 88.7%, and 100% in categories I, II, III, IV, V, and VI, respectively. The most common malignant tumor in category III was salivary duct carcinoma (37.5%), followed by acinic cell carcinoma (25.0%), mucoepidermoid carcinoma (25.0%), and squamous cell carcinoma (12.5%). The 5-year survival rate of patients with malignant tumors showed no statistical difference between category III and category V/VI ( P = .140). Risk of malignancy was 88.9% and 100% in category V and VI, respectively.

Conclusions:

A half of atypia of undetermined significance (category III) cases were malignant. Once diagnosed, the prognosis of malignant tumor in category III was similar with that in category V/VI.
SimTube: A National Simulation Training and Research Project
Authors: Wiet Gregory J. , Deutsch Ellen S. , Malekzadeh Sonya , Onwuka Amanda J. , Callender Nathan W. , Seidman Michael D. , Fried Marvin P.
Published: May 2020

Objective

To test the feasibility and impact of a simulation training program for myringotomy and tube (M&T) placement.

Study Design

Prospective randomized controlled.

Setting

Multi‐institutional.

Subjects and Methods

An M&T simulator was used to assess the impact of simulation training vs no simulation training on the rate of achieving competency. Novice trainees were assessed using posttest simulator Objective Structured Assessment of Technical Skills (OSATS) scores, OSATS score for initial intraoperative tube insertion, and number of procedures to obtain competency. The effect of simulation training was analyzed using χ2 tests, Wilcoxon‐Mann‐Whitney tests, and Cox proportional hazards regression.

Results

A total of 101 residents and 105 raters from 65 institutions were enrolled; however, just 63 residents had sufficient data to be analyzed due to substantial breaches in protocol. There was no difference in simulator pretest scores between intervention and control groups; however, the intervention group had better OSATS global scores on the simulator (17.4 vs 13.7, P =. 0003) and OSATS task scores on the simulator (4.5 vs 3.6, P =. 02). No difference in OSATS scores was observed during initial live surgery rating (P =. 73 and P =. 41). OSATS scores were predictive of the rate at which residents achieved competence in performing myringotomy; however, the intervention was not associated with subsequent OSATS scores during live surgeries (P =. 44 and P =. 91) or the rate of achieving competence (P =. 16).

Conclusions

A multi‐institutional simulation study is feasible. Novices trained using the M&T simulator achieved higher scores on simulator but not initial intraoperative OSATS, and they did not reach competency sooner than those not trained on the simulator.
Methodological Quality of Systematic Reviews and Meta‐analyses Published in High‐Impact Otolaryngology Journals
Authors: Martinez‐Monedero Rodrigo , Danielian Arman , Angajala Varun , Dinalo Jennifer E. , Kezirian Eric J.
Published: May 2020

Objective

To assess the methodological quality of intervention‐focused systematic reviews (SRs) and meta‐analyses (MAs) published in high‐impact otolaryngology journals.

Data Sources

Ovid Medline, Embase, and Cochrane Library.

Review Methods

A comprehensive search was performed for SR and MA citations from 2012 to 2017 in the 10 highest impact factor otolaryngology journals. Abstracts were screened to identify published manuscripts in which the authors indicated clearly that they were performing an SR or MA. Applying a modified typology of reviews, 4 reviewers characterized the review type as SR, MA, or another review type. A simplified version of the AMSTAR 2 (A MeaSurement Tool to Assess systematic Reviews 2) tool was used to assess the reporting and methodological quality of the SRs and MAs that were focused on interventions.

Results

Search and abstract screening generated 499 manuscripts that identified themselves as performing an SR or MA. A substantial number (85/499, 17%) were review types other than SRs or MAs, including 34 (7%) that were literature reviews. In total, 236 SRs and MAs focused on interventions. Over 50% of these SRs and MAs had weaknesses in at least 3 of the 16 items in the AMSTAR 2, and over 40% had weaknesses in at least 2 of the 7 critical domains. Ninety‐nine percent of SRs and MAs provided critically low confidence in the results of the reviews.

Conclusion

Intervention‐focused SRs and MAs published in high‐impact otolaryngology journals have important methodological limitations that diminish confidence in the results of these reviews.
Psychological Status as an Effect Modifier of the Association Between Sinonasal Instrument and Imaging Results
Authors: Zhou Allen S. , Prince Anthony A. , Maxfield Alice Z. , Shin Jennifer J.
Published: May 2020

Objective:

To determine whether psychological status is an effect modifier of the previously observed low discriminatory capacity of Sinonasal Outcome Test‐22 (SNOT‐22) scores for Lund‐Mackay computed tomography (CT) results.

Study Design:

Observational outcomes study.

Setting:

Tertiary care center.

Subjects and Methods:

We assessed patients presenting with chronic sinonasal complaints who underwent CT of the sinuses within 1 month of completing the SNOT‐22 instrument. SNOT‐22 overall and domain scores were calculated, as were Lund‐Mackay CT scores. The discriminatory capacity of SNOT‐22 scores for CT results was determined using the receiver‐operator characteristic area under the curve (ROC‐AUC). Patient‐Reported Outcome Measurement Information System (PROMIS) mental health T‐scores were assessed, and stratified analyses were used to test for effect modification by psychological status.

Results:

In stratified analyses, patients with better PROMIS mental health scores had SNOT‐22 overall (ROC‐AUC 0.96) and nasal domain scores (ROC‐AUC 0.97‐0.98) that were highly discriminatory for Lund‐Mackay scores, while those with worse mental health scores did not (ROC‐AUC 0.42‐0.55, P <. 007). Patients with better SNOT‐22 psychological domain scores also had nasal scores that discriminated among CT results significantly better than those with worse psychological domain scores (ROC‐AUC 0.65‐0.69 and 0.34‐0.35, respectively, P <. 013).

Conclusions:

Psychological status is an effect modifier of the relationship between SNOT‐22 and Lund‐Mackay scores. SNOT‐22 scores were discriminatory for Lund‐Mackay CT results in patients with better psychological status, while they were nondiscriminatory in those with worse psychological status. When assessing the relationship between subjective and objective measures of chronic rhinosinusitis, accounting for effect modification may have practical utility.
Highly stretchable, smooth, and biodegradable hydrogel films based on chitosan as safety food packaging
Authors: El-Mekawy Rasha E , Elhady Heba A , Al-Shareef Hossa F
Published: May 2020

Intelligent food wrapping materials have sparked interest in preserving food from spoilage until it reaches to consumers. Sufficient moisture from the air can be picked up by the food to encourage microorganism’s growth. One of the most significant matters in food chemistry is bright packaging which enables the researchers to keep an eye on the quality of food. In the light of these factors, the researchers made long efforts to synthesize responsive-stimuli chitosan hydrogels from shrimp shell preparative chitosan which cross-linked with different weights of 1,6-diisocyanatohexane in refluxing 1% glacial acetic acid. Alternatively, the newly harvesting hydrogels were screened as meat and chicken smart packaging because they were soft, biodegradable, and flexible instead of plastic packaging that is nonbiodegradable and causes environmental pollution. The flexibility enabled hydrogels to be folded around the meat and chicken pieces. The synthesized hydrogels were confirmed by Fourier transform infrared spectroscopy, scanning electron microscopy, X-ray diffraction, and thermogravimetric analyses.
Role of the Rapid Response System in End-of-Life Care Decisions
Authors: Kim Jung Soo , Lee Man Jong , Park Mi Hwa , Park Jae Yoen , Kim Ah Jin
Published: May 2020

Purpose:

An important role of the rapid response system (RRS) is to provide opportunities for end-of-life care (EOLC) decisions to be appropriately operationalized. We investigated whether EOLC decisions were made after the RRS-recommended EOLC decision to the primary physician.

Materials and Methods:

We studied whether patients made EOLC decisions consistent with the rapid response team’s (RRT) recommendations, between January 1, 2017, and February 28, 2019. The primary outcome was the EOLC decision after the RRT’s recommendation to the primary physician. The secondary outcome was the mechanism of EOLC decision-making: through institutional do-not-resuscitate forms or the Korean legal forms of Life-Sustaining Treatment Plan (LSTP).

Results:

Korean LSTPs were used in 26 of the 58 patients who selected EOLC, from among the 75 patients for whom the RRS made an EOLC recommendation. Approximately 7.2% of EOLC decisions for inpatients were related to the RRT’s interventions in EOLC decisions. Patients who made EOLC decisions did not receive cardiopulmonary resuscitation, mechanical ventilation, or dialysis.

Conclusion:

The timely intervention of the RRS in EOLC facilitates an objective assessment of the patient’s medical conditions, the limitation of treatments that may be minimally beneficial to the patient, and the choice of a higher quality of care. The EOLC decision using the legal process defined in the relevant Korean Act has advantages, wherein patients can clarify their preference, the family can prioritize the patient’s preference for EOLC decisions, and physicians can make transparent EOLC decisions based on medical evidence and informed patient consent.
The good toxin: 10 years of experience with botulinum toxin A in the treatment of benign essential blepharospasm
Authors: Lai Kenneth KH , Kuk Andrew KT , Chan Edwin , Ko Simon TC
Published: May 2020

Purpose:

To describe the efficacy and safety of botulinum toxin A (Botox) in patients with benign essential blepharospasm.

Methods:

Retrospective review of operation, injection, and medical records.

Results:

Information of 29 patients (nine males) was reviewed, and the average age of benign essential blepharospasm onset was 59.1 years. The average number of injections per patient was 14.2 ± 8.2 (5–44) and the average follow-up was 75.8 ± 47.3 months (15–180). The average unit dose was 14.2 ± 8.2 (10–30) ipsilaterally in the patient’s first year and was 21.4 ± 5.0 (12.5–30) ipsilaterally in their last year (p = 0.00458). The average onset time was 3.8 ± 1.9 (1–7) days in a patient’s first year and was 3.6 ± 1.7 (2–7) days in their last year (p = 0.549). The average effective duration was 2.86 ± 1.1 months in a patient’s first year and was 2.53 ± 0.9 in their final year (p = 0.187). The Subjective Spasm Alleviation Scale was 1.72 ± 0.4 at the first year and was 1.79 ± 0.5 in the last year (p = 0.187). Ten (34.5%) patients with eyelid disease had surgical correction. The Subjective Spasm Alleviation Scale was 1.50 ± 0.5 before and was 2.0 ± 0 six months after the operation (p = 0.0268). Post-injection complications were experienced in eight (27.6%) patients. The most common complication was ptosis (n = 7), followed by diplopia (n = 1), dry eye (n = 1), and tearing (n = 1). No life-threatening complication was reported.

Conclusion:

Botox was a safe and effective treatment in benign essential blepharospasm which required an increased dosage over time. Ptosis was the most common complication and no life-threatening condition was reported. Surgical correction of those with eyelid diseases showed subjective improvement of subsequent Botox treatment.
Optical coherence tomography angiography markers associated with treatment response in neovascular age-related macular degeneration
Authors: Ozdemir Zeydanli Ece , Gurelik Gokhan
Published: May 2020

Purpose:

To investigate whether qualitative and quantitative features of choroidal neovascular membranes are associated with anti-vascular endothelial growth factor treatment response in patients with neovascular age-related macular degeneration.

Methods:

A total of 41 eyes were included in this cross-sectional observational study and divided into “good responders” and “poor responders” based on the long-term functional changes, frequency of recurrent choroidal neovascular activity, and injection need. Enface optical coherence tomography angiography images were obtained and qualitative features of choroidal neovascular membranes were described based on vessel network density. Then, quantitative measurements including vessel area, vessel length, junction density, and lacunarity were calculated using validated software (ImageJ and AngioTool). Chi-square tests, t-test, or Mann–Whitney U tests were used for group comparisons, and intraclass correlation coefficients were calculated for reliability assessment of quantitative analyses.

Results:

Twenty-two eyes treated by a median of 9 (3–24) anti-vascular endothelial growth factor injections at a median follow-up of 41 (12–89) months were categorized as good responders, 19 treated by a median of 26 (11–46) injections at a median follow-up of 44.5 (12–84) months as poor responders. Good responder group mostly had loose network (45.5%), and poor responders mostly had dense network (47.7%). The difference was not statistically significant (p = 0.25). The size of the lesion was 2.7 times greater at baseline (p = 0.04) and 1.7 times greater at final examination in the poor responder group (p = 0.04). Lacunarity index, showing lesion heterogeneity, was higher in good responders (p = 0.018) than poor responders. Other quantitative vascular features did not significantly differ between the groups (p > 0.05).

Conclusion:

Long-term remodeling of chronically treated choroidal neovascular may be non-invasively and reproducibly investigated using optical coherence tomography angiography. Quantitative analysis and lacunarity index, in particular, may be used as a measure of vessel maturation and guide treatment strategies in neovascular age-related macular degeneration.
Successful Treatment of Bronchial Artery Aneurysms Associated With Racemose Hemangioma by Combined Therapy of Transcatheter Bronchial Artery Embolization and Thoracic Endovascular Aortic Repair
Authors: Kano Masaki , Nishibe Toshiya , Iwahashi Toru , Fujiyoshi Toshiki , Otaka Jun , Saguchi Toru , Ogino Hitoshi
Published: May 2020

A 70-year-old man was referred to our hospital for an abnormal chest shadow. Enhanced computed tomography (CT) revealed 2-humped bronchial artery aneurysms (BAAs) associated with racemose hemangioma. The combined therapy of transcatheter bronchial artery embolization and thoracic endovascular aortic repair was performed. Postoperative CT confirmed the complete exclusion of the aneurysms with no evidence of an endoleak. Our result suggests that this combined therapy is a safe and effective treatment for BAA.
Artifacts in Diagnostic Ultrasonography
Authors: Oglat Ammar A. , Alshipli Marwan , Sayah Mohannad Adel , Ahmad Muntaser S.
Published: May 2020

In this review, the ultrasound (US) artifacts features such as propagation path, velocity, attenuation, multiple echoes, and resolution are explained. The main restrictions of an axial and lateral resolution are artifacts. However, failure to fix them lead to the lack of details, and adjacent neighboring objects may be observed as one image. This article describes an essential law to control wave movement, and the US artifacts are formed. Thus, it is substantial for the radiologist and sonographer to differentiate between the artifacts and abnormal signs during the diagnostic procedure. Furthermore, the use of enhancing and shadowing artifacts in determining the nature of masses was explained. The comet tail, attenuation, mirror image, refraction, speed displacement, side lobe, and beam width artifacts happened typically in clinical (in-vivo) practice were also discussed. Finally, an estimation and evaluation of these artifacts are necessary to increase the accuracy in diagnosis.
(Un)settling the precedent: Contrasting institutionalisation dynamics in the spitzenkandidaten procedure of 2014 and 2019
Authors: Heidbreder Eva G. , Schade Daniel
Published: May 2020

The article analyses the application of the spitzenkandidaten procedure as instances of a larger institution building process in which the European Parliament and the European Council try to enact competing rules. The Treaty of Lisbon introduced a new clause on how to appoint the Commission President. While in 2014 the European Parliament successfully realised its interpretation according to which the winning spitzenkandidat became Commission President, in 2019 the Council succeeded in deciding not only who would take the Commission presidency but also other key positions. We consider both appointments as cases of decision-making in a natural arena that lack stable institutions about how to appoint the Commission president. Accordingly, the single decisions pended on the case-specific strategic use of resources. While the analysis of the two single cases does not allow us to predict what the institutional rules for future appointments will be, we can identify key resources and strategies that will determine how the institutional rules will be shaped in the elections to come and thus further the understanding of the institutionalisation in the making.
How Communication “Failed” or “Saved the Day”: Counterfactual Accounts of Medical Errors
Authors: Street Richard L , Petrocelli John V , Amroze Azraa , Bergelt Corinna , Murphy Margaret , Wieting J Michael , Mazor Kathleen M
Published: May 2020

Communication breakdowns among clinicians, patients, and family members can lead to medical errors, yet effective communication may prevent such mistakes. This investigation examined patients’ and family members’ experiences where they believed communication failures contributed to medical errors or where effective communication prevented a medical error (“close calls”). The study conducted a thematic analysis of open-ended responses to an online survey of patients’ and family members’ past experiences with medical errors or close calls. Of the 93 respondents, 56 (60%) provided stories of medical errors, and the remaining described close calls. Two predominant themes emerged in medical error stories that were attributed to health care providers—information inadequacy (eg, delayed, inaccurate) and not listening to or being dismissive of a patient’s or family member’s concerns. In stories of close calls, a patient’s or family member’s proactive communication (eg, being assertive, persistent) most often “saved the day.” The findings highlight the importance of encouraging active patient/family involvement in a patient’s medical care to prevent errors and of improving systems to provide meaningful information in a timely manner.
Serine hydroxymethyltransferase localised in the endoplasmic reticulum plays a role in scavenging H2O2 to enhance rice chilling tolerance
Authors: Fang Changxun , Zhang Pengli , Li Lanlan , Yang Luke , Mu Dan , Yan Xue , Li Zhong , Lin Wenxiong
Published: May 2020

Background

Rice is a chilling-sensitive crop that would suffer serious damage from low temperatures. Overexpression of the Lsi1 gene (Lsi1-OX) in rice enhances its chilling tolerance. This study revealed that a serine hydroxymethyltransferase (OsSHMT) mainly localised in the endoplasmic reticulum (ER) is involved in increasing tolerance to chilling.

Results

A higher transcription level of OsSHMT was detected in Lsi1-OX rice than in the wild type. Histone H1 and nucleic acid binding protein were found to bind to the promoter region of OsSHMT and regulate its expression, and the transcription levels of these proteins were also up-regulated in the Lsi1-OX rice. Moreover, OsSHMT interacts with ATP synthase subunit α, heat shock protein Hsp70, mitochondrial substrate carrier family protein, ascorbate peroxidase 1 and ATP synthase subunit β. Lsi1-encoded protein OsNIP2;1 also interacts with ATP synthase subunit β, and the coordination of these proteins appears to function in reducing reactive oxygen species, as the H2O2 content of transgenic OsSHMT Arabidopsis thaliana was lower than that of the non-transgenic line under chilling treatment.

Conclusions

Our results indicate that ER-localised OsSHMT plays a role in scavenging H2O2 to enhance the chilling tolerance of Lsi1-OX rice and that ATP synthase subunit β is an intermediate junction between OsNIP2;1 and OsSHMT.
Gastroesophageal reflux disease: prevalence and Extraesophageal manifestations among undergraduate students in South West Nigeria
Authors: Akinola Moses Ayodele , Oyedele Titus Ayodeji , Akande Kolawole Oluseyi , Oluyemi Olukayode Yinka , Salami Omotayo Felicia , Adesina Alaba Moses , Adebajo Adedeji David
Published: May 2020

Background

The reflux of noxious contents of the stomach may cause oesophageal and extra-oesophageal complications either by direct contact of aspirated gastric refluxate with the upper airway or by a vago-vagal reflex. This study aimed to determine the prevalence of gastroesophageal disease (GERD) and extraesophageal manifestations among undergraduate students in a tertiary institution in Nigeria.

Methods

This is a cross-sectional study involving undergraduate students in a private University in Nigeria. Study proforma had three parts. Part A consisted of self-administered questionnaire designed to obtain students biodata. Part B consisted of standard Carlsson-Dent questionnaire. A score of 4 and above on Carlsson- Dent questionnaire was considered diagnostic of gastroesophageal reflux symptoms (GERD). Thereafter those who had GERD were further questioned and examined for extra-oesophageal symptoms of GERD.

Results

The total number of the study participants was 647, out of which 212 (32.8%) had GERD. One hundred and forty-four (67.9%) and 86 (32.1%) females and male had GERD respectively (p = 0.13).

The extraesophageal symptoms found in those with GERD were, dysphagia, coated tongue, nocturnal cough, xerostomia, lump in the throat, asthma-like symptoms, recurrent sore throat, frequent throat clearing, halithosis and dental erosion among others.

Conclusion

GERD is common among this study population, with a prevalence rate of 32.8%. Only age showed significant predictor for GERD. Varying extra-oesophageal manifestations were found in those with GERD.
The prognostic value of IDO expression in solid tumors: a systematic review and meta-analysis
Authors: Wang Sen , Wu Jia , Shen Han , Wang Junjun
Published: May 2020

Background

Indoleamine 2,3-dioxygenase (IDO) is a rate-limiting enzyme in the metabolism of tryptophan into kynurenine. It is considered to be an immunosuppressive molecule that plays an important role in the development of tumors. However, the association between IDO and solid tumor prognosis remains unclear. Herein, we retrieved relevant published literature and analyzed the association between IDO expression and prognosis in solid tumors.

Methods

Studies related to IDO expression and tumor prognosis were retrieved using PMC, EMbase and web of science database. Overall survival (OS), time to tumor progression (TTP) and other data in each study were extracted. Hazard ratio (HR) was used for analysis and calculation, while heterogeneity and publication bias between studies were also analyzed.

Results

A total of 31 studies were included in this meta-analysis. Overall, high expression of IDO was significantly associated with poor OS (HR 1.92, 95% CI 1.52–2.43,P < 0.001) and TTP (HR 2.25 95% CI 1.58–3.22,P < 0.001). However, there was significant heterogeneity between studies on OS (I2 = 81.1%,P < 0.001) and TTP (I2 = 54.8%,P = 0.007). Subgroup analysis showed lower heterogeneity among prospective studies, studies of the same tumor type, and studies with follow-up periods longer than 45 months.

Conclusions

The high expression of IDO was significantly associated with the poor prognosis of solid tumors, suggesting that it can be used as a biomarker for tumor prognosis and as a potential target for tumor therapy.
Hyperfunction of CD4 CD25 regulatory T cells in de novo acute myeloid leukemia
Authors: Wan Yuling , Zhang Congxiao , Xu Yingxi , Wang Min , Rao Qing , Xing Haiyan , Tian Zheng , Tang Kejing , Mi Yingchang , Wang Ying , Wang Jianxiang
Published: May 2020

Background

Acute myeloid leukemia (AML) is a common hematopoietic malignancy that has a high relapse rate, and the number of regulatory T cells (Tregs) in AML patients is significantly increased. The aim of this study was to clarify the role of Tregs in the immune escape of acute myeloid leukemia.

Methods

The frequencies of Tregs and the expression of PD-1, CXCR4 and CXCR7 were examined by flow cytometry. The expression of CTLA-4 and GITR was tested by MFI. Chemotaxis assays were performed to evaluate Treg migration. The concentrations of SDF-1α, IFN-γ and TNF-α were examined by ELISA. Coculture and crisscross coculture experiments were performed to examine Treg proliferation and apoptosis and the effect of regulatory B cells (Breg) conversion.

Results

The frequencies of Tregs in peripheral blood and bone marrow in AML patients were increased compared with those in healthy participants. AML Tregs had robust migration towards bone marrow due to increased expression of CXCR4. AML Treg-mediated immunosuppression of T cells was achieved through proliferation inhibition, apoptosis promotion and suppression of IFN-γ production in CD4+CD25− T cells. AML Bregs induced the conversion of CD4+CD25−T cells to Tregs.

Conclusion

In AML patients, the Breg conversion effect and robust CXCR4-induced migration led to Treg enrichment in bone marrow. AML Tregs downregulated the function of CD4+CD25− T cells, contributing to immune escape.
Normative values for circulating intestinal fatty acid binding protein and calprotectin across gestational ages
Authors: Shores Darla R. , Fundora Jennifer , Go Mitzi , Shakeel Fauzia , Brooks Sandra , Alaish Samuel M. , Yang Jun , Sodhi Chhinder P. , Hackam David J. , Everett Allen
Published: May 2020

Background

Necrotizing enterocolitis (NEC) is associated with significant morbidity and mortality. Serum biomarkers to aid diagnosis, such as intestinal fatty acid binding protein (IFABP) and calprotectin, are actively being investigated; however, the normative values of these markers among healthy premature and term infants remains unknown. We sought to identify normative values for the serum concentrations of IFABP and calprotectin across gestational (GA) and post-menstrual age.

Methods

We collected serum from infants (24–40 weeks GA) in the first week of life and at multiple time points in a sub-cohort of premature infants (24–29 weeks GA), excluding sepsis or known intestinal disease. IFABP and calprotectin were measured using ELISA. Groups were compared with descriptive statistics and mixed effects linear regression.

Results

One hundred twelve infants had specimens in the first week of life, and 19 premature infants had longitudinal specimens. IFABP concentration in the first week of life was low and did not differ across gestational ages. Longitudinally, IFABP increased 4% per day (P < 0.001). Calprotectin concentration in the first week of life was more variable. An inverse relationship between day of life and calprotectin level was found in the longitudinal cohort (P < 0.001).

Conclusions

Serum IFABP and calprotectin fluctuate over time. Infants had low levels of IFABP during the first week of life, independent of gestational age, and levels increased longitudinally in premature infants. Calprotectin levels generally declined over time. Normative data for infants is necessary to establish meaningful cut-off levels for clinical use.
Enteroviral and herpes simplex virus central nervous system infections in infants < 90 days old: a Paediatric Investigators’ Collaborative Network on Infections in Canada (PICNIC) study
Authors: Petel Dara , Barton Michelle , Renaud Christian , Ouchenir Lynda , Brophy Jason , Bowes Jennifer , Khan Sarah , Bitnun Ari , McDonald Jane , Boisvert Andrée-Anne , Ting Joseph , Roberts Ashley , Robinson Joan L.
Published: May 2020

Background

The relative contribution of viruses to central nervous system (CNS) infections in young infants is not clear. For viral CNS infections, there are limited data on features that suggest HSV etiology or on predictors of unfavorable outcome.

Methods

In this cross-sectional retrospective study, seven centers from the Pediatric Investigators Collaborative Network on Infections in Canada identified infants < 90 days of age with CNS infection proven to be due to enterovirus (EV) or herpes simplex virus (HSV) January 1, 2013 through December 31, 2014.

Results

Of 174 CNS infections with a proven etiology, EV accounted for 103 (59%) and HSV for 7 (4%). All HSV cases and 41 (40%) EV cases presented before 21 days of age. Four HSV cases (57%) and 5 EV cases (5%) had seizures. Three (43%) HSV and 23 (23%) EV cases lacked cerebrospinal fluid (CSF) pleocytosis. HSV cases were more likely to require ICU admission (p = 0.010), present with seizures (p = 0.031) and have extra-CNS disease (p < 0.001). Unfavorable outcome occurred in 12 cases (11% of all EV and HSV infections) but was more likely following HSV than EV infection (4 (57%) versus 8 (8%); p = 0.002).

Conclusions

Viruses accounted for approximately two-thirds of proven CNS infections in the first 90 days of life. Empiric therapy for HSV should be considered in suspected CNS infections in the first 21 days even in the absence of CSF pleocytosis unless CSF parameters are suggestive of bacterial meningitis. Neurodevelopmental follow-up should be considered in infants whose course of illness is complicated by seizures.
A concept analysis of children with complex health conditions: implications for research and practice
Authors: Azar Rima , Doucet Shelley , Horsman Amanda Rose , Charlton Patricia , Luke Alison , Nagel Daniel A. , Hyndman Nicky , Montelpare William J.
Published: May 2020

Background

This concept analysis aimed to clarify the meaning of “children with complex health conditions” and endorse a definition to inform future research, policy, and practice.

Methods

Using Walker and Avant’s (2011)‘s approach, we refined the search strategy with input from our team, including family representatives.

We reviewed the published and grey literature. We also interviewed 84 health, social, and educational stakeholders involved in the care of children with complex health conditions about their use/understanding of the concept.

Results

We provided model, borderline, related, and contrary cases for clarification purposes. We identified defining attributes that nuance the concept: (1) conditions and needs’ breadth; (2) uniqueness of each child/condition; (3) varying extent of severity over time; 4) developmental age; and (5) uniqueness of each family/context. Antecedents were chronic physical, mental, developmental, and/or behavioural condition(s). There were individual, family, and system consequences, including fragmented services.

Conclusions

Building on previous definitions, we proposed an iteration that acknowledges the conditions’ changing trajectories as involving one or more chronic condition(s), regardless of type(s), whose trajectories can change over time, requiring services across sectors/settings, oftentimes resulting in a lower quality of life. A strength of this paper is the integration of the stakeholders’/family’s voices into the development of the definition.
The effect of information on prostate cancer screening decision process: a discrete choice experiment
Authors: Charvin M. , Launoy G. , Berchi C.
Published: May 2020

Background

Prostate cancer screening is controversial because of uncertainty about its benefits and risks. The aim of this survey was to reveal preferences of men concerning prostate cancer screening and to test the effect of an informative video on these preferences.

Methods

A stated preferences questionnaire was sent by e-mail to men aged 50–75 with no history of prostate cancer. Half of them were randomly assigned to view an informative video. A discrete choice model was established to reveal men’s preferences for six prostate cancer screening characteristics: mortality by prostate cancer, number of false positive and false negative results, number of overdiagnosis, out-of-pocket costs and recommended frequency.

Results

A population-based sample composed by 1024 men filled in the entire questionnaire. Each attribute gave the expected sign except for overdiagnosis. The video seemed to increase the intention to abstain from prostate cancer screening.

Conclusions

The participants attached greater importance to a decrease in the number of false negatives and a reduction in prostate cancer mortality than to other risks such as the number of false positives and overdiagnosis. Further research is needed to help men make an informed choice regarding screening.
Impact of family physician integrated care program on decreasing utilization of emergency department visit and hospital admission: a population-based retrospective cohort study
Authors: Huang Po-Tsung , Kung Pei-Tseng , Kuo Wen-Yin , Tsai Wen-Chen
Published: May 2020

Background

Hospital admission and emergency department(ED) visits are a massive burden in medical expenditures. In 2003, the Taiwanese government developed Family Physician Integrated Care Program (FPIC) to increase the quality of primary care and decrease medical expenditures. This study’s goals were to determine whether FPIC decreased hospital admissions and ED visits and identify the factors influencing the outcomes.

Methods

This nationwide retrospective cohort study was conducted for the period between 2006 and 2013 by using data obtained from the Taiwan National Health Insurance Research Database. A total of 68,218 individuals were divided into those who joined FPIC and those who did not. We used propensity score matching at a ratio of 1:1 and logistic regression with the generalized estimating equation (GEE) model having a difference-in-difference design to investigate the effects of the FPIC policy on hospital admissions and ED visits in 7 years.

Results

Using logistic regression with the GEE model with the difference-in-difference design, we found no reduction in ED visits and hospital admissions between the two groups. The participants’ risk of hospital admissions increased in the first year after joining FPIC (OR: 1.11, 95% CI: 1.03–1.20, P < .05). However, participants who joined FPIC showed an 8% lower risk of hospital admissions in the sixth and seventh years after joining FPIC, compared with those who did not join FPIC (OR: 0.92, 95% CI: 0.85–1.00, P < .05).

Conclusions

FPIC in Taiwan could not decrease medical utilization initially but might reduce hospital admissions in the long term.
Litterfall production and associated carbon and nitrogen flux along exclosure chronosequence at Kewet district, central lowland of Ethiopia
Authors: Tesfay Fikrey , Kibret Kibebew , Gebrekirstos Aster , Hadgu Kiros Meles
Published: May 2020

Background

Litterfall input and associated nutrient flux are critically important in the restoration of soil in degraded landscapes through exclosures. This study was conducted to evaluate the effects of exclosure on seasonal litterfall production and nutrient content, and estimate annual C and N inputs to the soil in an age sequence at Kewet district, central lowland of Ethiopia. Leaf litterfall production was recorded by a 0.25 m2litter trap from a systematically laid line transects from 5, 15, and 20 years old exclosures and adjacent grazing land.

Results

Leaf litterfall input in the exclosures ranged from 37 g m−2in January (at the old exclosure) to 7.33 g m−2(at the young exclosure), and 3 g m−2in March at the grazing land. Litterfall input showed seasonal variation and peaked in the dry months. Mean monthly leaf litterfall production was significantly (p <0.05) higher (22 g m−2) in the old exclosure than the adjacent grazing land (9 g m−2). Total annual leaf litterfall ranged from 1073 kg ha−1(grazing land) to 2662 kg ha−1(old exclosure). There were no significant differences in leaf litterfall nutrients i.e., N, P, K, Ca, and Mg concentrations, except for C. The annual leaf litterfall associated C and N input ranged from 412 (grazing land) to 1025 (old exclosure) and 27 (middle age exclosure) to 68 kg ha−1(old exclosure), respectively. The positive change recorded in leaf litterfall production and associated C and N return is associated with restoration of vegetation.

Conclusions

Through well-managed area exclosure, leaf litterfall production in the degraded landscapes can reach the level of tropical dry lowland forest in about a decade. Further research on the contribution of dominant tree species in litter production along the age of exclosure is recommended to improve the effectiveness of rehabilitation of degraded lands.