bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors that affect health‐care workers’ practices of medication administration to aged care residents with swallowing difficulties: An Australia‐wide survey study
Authors: Sefidani Forough Aida , Lau Esther T. L. , Steadman Kathryn J. , Kyle Greg J. , Cichero Julie A. Y. , Serrano Santos Jose Manuel , Nissen Lisa M.
Published: September 2020

Objectives

To understand the barriers and facilitators of medication administration to aged care residents with swallowing difficulties.

Methods

Health‐care workers in aged care facilities across Australia involved in medication administration to residents completed an online survey.

Results

Of 355 respondents, 90.9% reported ‘everyday’ encounters with residents with swallowing difficulties and 94.1% modified medications to facilitate administration. Time constraints (63.4%) and workload (69.0%) were common barriers. Only 39.0% believed swallowing abilities are considered at the prescribing stage. Pill size (95.8%), polypharmacy (75.2%) and lack of alternative formulations (74.9%) contributed to these challenges. Support from other health‐care professionals (91.5%) and training (85.9%) were the most favoured facilitators.

Conclusion

Health‐care workers are faced with various challenges when caring for residents with swallowing difficulties. Promoting multidisciplinary collaborations, provision of training and medication review services, and improving skill mix and staffing composition in aged care facilities are needed to address these challenges.
Rapid uptake of early medical abortions in the Northern Territory: A family planning‐based model
Authors: Murdoch Jacqueline , Thompson Kirsten , Belton Suzanne
Published: September 2020

Background

Abortion law reform does not necessarily translate into services, especially for those in regional areas. Although abortion has been legal in the Northern Territory (NT) since 1974, prior to 2017 legislation change, early medical abortions (EMAs) were effectively prohibited in primary care. In July 2017, Family Planning Welfare Association of the Northern Territory (FPNT) was awarded funding to provide EMAs free of charge for Medicare eligible clients.

Aims

To describe the demographics and clinical outcomes of clients accessing the EMA service in the first 12 months after legislation change.

Materials and Methods

Retrospective audit of FPNT’s Unplanned Pregnancy Database from 1 July 2017 to 30 June 2018 and analysis of the NT Government’s Termination of Pregnancy 12 Month Data Report.

Results

Of 742 abortions in the NT in the first 12 months after legislation change, 426 were EMAs prescribed at FPNT. Eleven percent of these (47/426) were for Aboriginal or Torres Strait Islander women and 15% (64/426) were for women from Remote or Very Remote Australia. Outcomes were definitively documented for 326 (77%); 5% of these required further misoprostol and 99% had a complete abortion without surgical intervention. Eighty‐six percent (281/326) commenced effective hormonal contraception following their EMA.

Conclusions

Providing funding to a Family Planning service was effective in devolving the majority of abortions from tertiary to primary healthcare and increasing the use of effective contraception. Some women remain under‐represented, particularly women from more remote areas of the NT. Further work is required to ensure equity of access to services for these women.
Provision of assisted reproductive technologies (ART) to Aboriginal and Torres Strait Islander peoples: Limited engagement in an online survey of Medical Directors of ART services
Authors: Gilbert Emily W. , Boyle Jacqueline A. , Campbell Sandra K. , Rumbold Alice R.
Published: September 2020

Current knowledge about infertility and access to infertility treatment among Aboriginal and Torres Strait Islander peoples is extremely limited. We conducted an online survey of Medical Directors of registered ART providers in Australia (n = 59) to obtain preliminary information on this topic. Six (10%) Directors responded; only two reported routinely collecting the Aboriginal and Torres Strait Islander status of clients. While the low response rate prevents generalising the findings, the poor engagement may indicate gaps in awareness of fertility issues for this group. This warrants further investigation, to understand whether Aboriginal and Torres Strait Islander people are appropriately accessing infertility care.
Evaluation of the Spring Seedling Project—Zhaotong Program: A study of a novel continuing medical education program for rural doctors in China
Authors: Gu Jie , Zhu Shanzhu , Chen Taojian , Tang Juntao , Pan Zhigang , Gong Jian , Shou Juan , Yang Hua , Du Zhaohui
Published: September 2020

Objective

To evaluate the effectiveness of the Spring Seedling Project‐Zhaotong program, a novel continuing medical education program, to improve the knowledge and skills of rural doctors in China.

Design

An uncontrolled single‐group pre‐ and post‐intervention design based on quantitative and qualitative methods.

Setting

Zhaotong is a prefecture‐level city located in Yunnan, China.

Participants

A total of 1866 country doctors practising in Zhaotong were enrolled.

Interventions

The Zhaotong program consisted of three stages: remote education, workshops conducted in Zhaotong and field training in Shanghai.

Main outcome measures

The effectiveness of the remote education and Zhaotong workshop stages was assessed based on differences between pre‐ and post‐training test scores. Qualitative comments were collected to assess the experience of country doctors following the Shanghai field training stage.

Results

In total, 1866 country doctors (46.9% males; mean age: 38.2 ± 9.2 years) participated in the program. The average score of the post‐training test was higher than that of the pre‐training test, both online (P < .001) and offline (P < .001). In regard to the Zhaotong workshops, with the exception of incisions/suturing, the average scores of cardiopulmonary resuscitation, gynaecological examinations and child growth/development were improved after training (P < .001). Qualitative analysis showed that Shanghai field training enhanced understanding of general practice, with the majority of country doctors indicating that they would apply what they learned in daily practice.

Conclusion

This study introduced an comprehensive form of continuing medical education for rural doctors in Zhaotong and proved the effectiveness of this program and also provided a reference point for the future development of continuing medical education.
Rethinking access for minority segments in rural health: An LGBTQI+ perspective
Authors: Lewis Clifford
Published: September 2020

This paper nuances the notion of access when considering minority segments and their use of health care services in rural communities. It argues that access needs to be considered as both the availability and the perceived ability to use a service without fear of retribution. By taking such a stance, this paper addresses the inequality in LGBTQI+ care in rural communities. It claims equitable care can only be achieved if the appropriate environment is created where individuals can disclose their identity and seek appropriate treatment. Given the complexity surrounding rural communities, their prevailing culture and perceptions, as well as stigmas and poor health outcome, a multilevel approach is taken to identify implications. It is argued that to address the individual and systemic barriers to equitable health care, a human rights‐centred approach to health needs to be adopted considering the individual, the community and the health system.
Quality assessment of a screening algorithm for diabetic retinopathy: prolongation of screening intervals with minimal effect of HbA1c and arterial hypertension on the length of intervals
Authors: Byberg Stine , Vistisen Dorte , Jørgensen Marit Eika , Diaz Lars Jorge , Valerius Marianne , Hajari Javad Nouri , Lund‐Andersen Henrik
Published: September 2020

Purpose

At Steno Diabetes Center Copenhagen (SDCC), diabetic retinopathy (DR) screening intervals are based on quantification of retinal lesions. Screening intervals are, for the milder forms of DR, prolonged to 2–3 years. The purpose of the present study was to evaluate the effect of the prolongation on developing unexpected events and to evaluate the effect of HbA1c and arterial hypertension.

Methods

We assessed 18 972 screening intervals from 6000 patients from 1/1‐2003 to 1/5‐2017 for occurrence of unexpected events, defined as: (1) DR progression requiring treatment, at the following screening date, and (2) DR‐related hospital contact within the planned interval. We modelled the effect of several risk factors for developing unexpected events in a Cox regression. Furthermore, we assessed the risk of unexpected events in a logistic regression analysis using cubic splines to model the effect of HbA1c, stratified by arterial hypertension status.

Results

16 283 (86%) intervals followed the planned interval and among those, only 86 (0.5%) experienced unexpected events. Intervals of dysregulated patients (86% of all intervals) did not experience more unexpected events, compared with well‐regulated patient intervals (Hazard Ratio: 1.12, 95% CI: 0.55–2.27). We found a nonlinear effect of HbA1c on the risk of unexpected events which peaked around HbA1c levels of 80 mmol/mol. Having arterial hypertension slightly increased the risk of unexpected events.

Conclusions

The present study supports the validity of the current algorithm. We found no increased risk of unexpected events among dysregulated intervals but a nonlinear effect of HbA1c. Age, diabetes duration and diabetes type were significantly associated with unexpected events.
Past 12‐month history of single and multiple suicide attempts among a national sample of school‐going adolescents in Tonga
Authors: Pengpid Supa , Peltzer Karl
Published: September 2020

Introduction

Suicide attempt may be common among adolescents. Less is known about this in the Pacific Island country, Tonga. Therefore, this analysis estimated the frequency of suicide attempts as well as its associated factors among adolescents in Tonga.

Method

Cross‐sectional data of 3333 adolescents (median age = 14 years) that took part in the “2017 Tonga Global School‐Based Student Health Survey (GSHS)” were analyzed.

Results

Almost one in seven students (16.5%) had attempted suicide in the past year (8.8% once and 7.7% more than once). Female sex, loneliness, having no close friends, often bullied, frequently in a physical fight, frequently truant from school, ever amphetamine use, and past‐month tobacco use were associated with ≥2 suicide attempts. Multiple suicide attempts increased with an increase in psychosocial distress, health risk behaviors, and social‐environmental factors.

Conclusion

Almost one in seven students attempted suicide in the past year and several risk variables were found.
Does CSR make better citizens? The influence of employee CSR programs on employee societal citizenship behavior outside of work
Authors: Lewin Lisa D. , Warren Danielle E. , AlSuwaidi Mohammed
Published: September 2020

While corporate social responsibility (CSR) is expected to benefit the firm and attract employees, few have examined the effects of CSR on employees outside of work. Extending the organizational citizenship literature, we conceptualize employee engagement in CSR at work and outside of work as a form of “societal citizenship behavior.” Across two studies of working adults, we examine the relationship between identification with an employer that engages in CSR and different forms of employee societal citizenship behaviors (e.g., donations, volunteering) outside of work. In Study 1 (N = 430 employees), we focus upon CSR donation programs and find that identification with an employer that engages in CSR and participating in employer CSR donation programs affect employee citizenship behavior (donations) outside of work. In Study 2 (N = 285 employees), we examine a broader set of citizenship behaviors inside and outside of work and find the relationships hold. Identification with an employer that engages in CSR relates positively to citizenship behavior at work and outside of work. In total, our study results suggest that employer CSR affects employee citizenship behaviors outside of work. We end with directions for future research.
Impact of enantiomer‐specific changes in pharmacokinetics between infants and adults on the target concentration of racemic ketorolac: A pooled analysis
Authors: Cloesmeijer Michael E. , van Esdonk Michiel J. , Lynn Anne M. , Smits Anne , Tibboel Dick , Daali Youssef , Olkkola Klaus T. , Allegaert Karel , Mian Paola
Published: September 2020

Aims

Ketorolac is a nonsteroidal anti‐inflammatory racemic drug with analgesic effects only attributed to its S‐enantiomer. The aim of this study is to quantify enantiomer‐specific maturational pharmacokinetics (PK) of ketorolac and investigate if the contribution of both enantiomers to the total ketorolac concentration remains equal between infants and adults or if a change in target racemic concentration should be considered when applied to infants.

Methods

Data were pooled from 5 different studies in adults, children and infants, with 1020 plasma concentrations following single intravenous ketorolac administration. An allometry‐based enantiomer‐specific population PK model was developed with NONMEM 7.3. Simulations were performed in typical adults and infants to investigate differences in S‐ and R‐ketorolac exposure.

Results

S‐ and R‐ketorolac PK were best described with a 3‐ and a 2‐compartment model, respectively. The allometry‐based PK parameters accounted for changes between populations. No maturation function of ketorolac clearance could be identified. All model parameters were estimated with adequate precision (relative standard error <50%). Single dose simulations showed that a previously established analgesic concentration at half maximal effect in adults of 0.37 mg/L, had a mean S‐ketorolac concentration of 0.057 mg/L, but a mean S‐ketorolac concentration of 0.046 mg/L in infants. To match the effective adult S‐ketorolac‐concentration (0.057 mg/L) in typical infants, the EC50‐racemic should be increased to 0.41 mg/L.

Conclusion

Enantiomer‐specific changes in ketorolac PK yield different concentrations and S‐ and R‐ketorolac ratios between infants and adults at identical racemic concentrations. These PK findings should be considered when studies on maturational pharmacodynamics are considered.
Placental disposition of eculizumab, C5 and C5‐eculizumab in two pregnancies of a woman with paroxysmal nocturnal haemoglobinuria
Authors: Eliesen Gaby A.M. , van Drongelen Joris , van den Broek Petra H.H. , Sarlea Andrei , van der Heijden Olivier W.H. , Langemeijer Saskia , Greupink Rick , Volokhina Elena B. , Russel Frans G.M.
Published: September 2020

Eculizumab is known to cross the placenta to a limited degree, but recently therapeutic drug levels in cord blood were found in a single case. We report maternal, cord and placental levels of unbound eculizumab, C5 and C5‐eculizumab in two pregnancies of a paroxysmal nocturnal haemoglobinuria patient who received 900 mg eculizumab every 2 weeks. In both pregnancies, cord blood concentrations of unbound eculizumab were below 4 μg/mL, while C5‐eculizumab levels were 22 and 26 μg/mL, suggesting that a considerable fraction of C5 was blocked in the newborn. Concentrations in each placenta of unbound eculizumab were 41 ± 3 and 45 ± 4 μg/g tissue, of C5‐eculizumab 19 ± 2 and 32 ± 3 μg/g, and of C5 20 ± 3 and 30 ± 2 μg/g (mean ± SD, in three tissue samples per placenta). Placental levels of unbound eculizumab were higher than those of C5‐eculizumab complexes, while maternal concentrations were approximately equal, suggesting selective transport of unbound eculizumab across the placenta.
Safety, pharmacokinetics and pharmacodynamics of BI 705564, a highly selective, covalent inhibitor of Bruton's tyrosine kinase, in Phase I clinical trials in healthy volunteers
Authors: Litzenburger Tobias , Steffgen Jürgen , Benediktus Ewald , Müller Fabian , Schultz Armin , Klein Elliott , Ramanujam Meera , Harcken Christian , Gupta Alpana , Wu Jing , Wiebe Sabrina , Li Xiujiang , Flack Mary , Padula Steven J. , Visvanathan Sudha , Hünnemeyer Andreas , Hui Jianan
Published: September 2020

Aims

To evaluate the safety, pharmacokinetics and pharmacodynamics of single‐ and multiple‐rising doses (MRDs) of BI 705564 and establish proof of mechanism.

Methods

BI 705564 was studied in 2 placebo‐controlled, Phase I clinical trials testing single‐rising doses (1–160 mg) and MRDs (1–80 mg) of BI 705564 over 14 days in healthy male volunteers. Blood samples were analysed for BI 705564 plasma concentration, Bruton's tyrosine kinase (BTK) target occupancy (TO) and CD69 expression in B cells stimulated ex vivo. A substudy was conducted in allergic, otherwise healthy, MRD participants. Safety was assessed in both studies.

Results

All doses of BI 705564 were well tolerated. Geometric mean BI 705564 plasma terminal half‐life ranged from 10.1 to 16.9 hours across tested doses, with no relevant accumulation after multiple dosing. Doses ≥20 mg resulted in ≥85% average TO that was maintained for ≥48 hours after single‐dose administration. Functional effects of BTK signalling were demonstrated by dose‐dependent inhibition of CD69 expression. In allergic participants, BI 705564 treatment showed a trend in wheal size reduction in a skin prick test and complete inhibition of basophil activation. Mild bleeding‐related adverse events were observed with BI 705564; bleeding time increased in 1/12 participants (8.3%) who received placebo vs 26/48 (54.2%) treated with BI 705564.

Conclusion

BI 705564 showed efficient target engagement through durable TO and inhibition of ex vivo B‐cell activation, and proof of mechanism through effects on allergic skin responses. Mild bleeding‐related adverse events were probably related to inhibition of platelet aggregation by BTK inhibition.
The Character Echo as a Symbol of the Absent Female Voice in Psychoanalytic Literatures
Authors: Savery Donna Christina
Published: September 2020

Echoism is a phenomenon observed most often in those who find themselves in repeated relationships with narcissistic partners, or who are recovering from narcissistic parenting. I have, over the course of seven years, carried out work with patients who have come to identify themselves as echoistic, or who have echoistic traits that may predispose them to seeking out, often unconsciously, relationships with narcissists, resulting in what I call an echoistic‐narcissistic complex. I return to the myth of Echo and Narcissus, as it is found in the work of Ovid, and consider the roles and feelings of the character Echo, in much the same way as Näcke and Ellis used the same myth to provide understanding from the presentation of Narcissus, for the condition Narcissismus, which later became widely known as narcissism. This paper questions why the character Echo has been largely ignored in psychoanalytic theory, and discusses how her clinical counterpart the echoist is prone to being missed, silenced and even mistaken for a narcissist.
Current status and future outlook for patient‐derived cancer models from a rare cancer research perspective
Authors: Kondo Tadashi
Published: September 2020

Rare cancers are a group of approximately 200 malignancies with extremely low incidences and with a wide variety of genotypes and phenotypes. Collectively, they are more common than any single malignancy. However, given the small numbers of individuals diagnosed with rare cancers, it is difficult to design clinical trials with sufficient patient numbers. Therefore, few effective anticancer drugs have been developed, and evidence‐based medicine is not always feasible for rare cancers. Consequently, their clinical outcomes are generally poorer. Cancer research requires adequate models that faithfully recapitulate molecular features and reproduce treatment responses of the original tumors. Such models allow us to focus on more efficacious drugs in the clinical studies. For rare cancers, patient‐derived cancer models are particularly important because the enrollment of sufficient patients is rarely attainable within a reasonable period of time. However, extremely few models are available for rare cancers. For example, cell lines and xenografts are available for only a limited number of histological subtypes of sarcomas; therefore, most sarcoma research is performed without such models, and a lack of adequate cancer models causes a lag in therapeutic development. The establishment of novel rare cancer models will dramatically facilitate rare cancer research and treatment development in the near future. This review focuses on the status of patient‐derived rare cancer models and discusses their pivotal problems and possibilities, using sarcomas as a representative rare cancer type. Multi‐institutional collaboration will help address the scarcity of patient‐derived rare cancer models.
A randomized, placebo‐controlled trial evaluating effects of lebrikizumab on airway eosinophilic inflammation and remodelling in uncontrolled asthma (CLAVIER)
Authors: Austin Cary D. , Gonzalez Edick Melissa , Ferrando Ronald E. , Solon Margaret , Baca Miriam , Mesh Kathryn , Bradding Peter , Gauvreau Gail M. , Sumino Kaharu , FitzGerald J. Mark , Israel Elliot , Bjermer Lief , Bourdin Arnaud , Arron Joseph R. , Choy David F. , Olsson Julie K. , Abreu Francis , Howard Monet , Wong Kit , Cai Fang , Peng Kun , Putnam Wendy S. , Holweg Cécile T.J. , Matthews John G. , Kraft Monica , Woodruff Prescott G. ,   the CLAVIER Investigators
Published: September 2020

Background

The anti‐interleukin 13 (IL‐13) monoclonal antibody lebrikizumab improves lung function in patients with moderate‐to‐severe uncontrolled asthma, but its effects on airway inflammation and remodelling are unknown. CLAVIER was designed to assess lebrikizumab's effect on eosinophilic inflammation and remodelling.

Objective

To report safety and efficacy results from enrolled participants with available data from CLAVIER.

Methods

We performed bronchoscopy on patients with uncontrolled asthma before and after 12 weeks of randomized double‐blinded treatment with lebrikizumab (n = 31) or placebo (n = 33). The pre‐specified primary end‐point was relative change in airway subepithelial eosinophils per mm2 of basement membrane (cells/mm2). Pre‐specified secondary and exploratory outcomes included change in IL‐13‐associated biomarkers and measures of airway remodelling.

Results

There was a baseline imbalance in tissue eosinophils and high variability between treatment groups. There was no discernible change in adjusted mean subepithelial eosinophils/mm2 in response to lebrikizumab (95% CI, −82.5%, 97.5%). As previously observed, FEV1 increased after lebrikizumab treatment. Moreover, subepithelial collagen thickness decreased 21.5% after lebrikizumab treatment (95% CI, −32.9%, −10.2%), and fractional exhaled nitric oxide, CCL26 and SERPINB2 mRNA expression in bronchial tissues also reduced. Lebrikizumab was well tolerated, with a safety profile consistent with other lebrikizumab asthma studies.

Conclusions & Clinical Relevance

We did not observe reduced tissue eosinophil numbers in association with lebrikizumab treatment. However, in pre‐specified exploratory analyses, lebrikizumab treatment was associated with reduced degree of subepithelial fibrosis, a feature of airway remodelling, as well as improved lung function and reduced key pharmacodynamic biomarkers in bronchial tissues. These results reinforce the importance of IL‐13 in airway pathobiology and suggest that neutralization of IL‐13 may reduce asthmatic airway remodelling.

Clinical Trial Registration: NCT02099656.
Gamma Knife radiosurgery for acromegaly: Evaluating the role of the biological effective dose associated with endocrine remission in a series of 42 consecutive cases
Authors: Balossier Anne , Tuleasca Constantin , Cortet‐Rudelli Christine , Soto‐Ares Gustavo , Levivier Marc , Assaker Richard , Reyns Nicolas
Published: September 2020

Introduction

Stereotactic radiosurgery (SRS) is a valuable treatment option for persistent and/or recurrent acromegaly secondary to growth hormone (GH) secreting pituitary adenoma (PA). Here, we assess the role of biological effective dose (BED) received by PA treated with SRS in relation with endocrine remission.

Methods

Forty‐two patients (minimum 6 months follow‐up) were included. Mean marginal dose was 27.7 (median 28, 20–35), and mean BED received by tumour was 193.1 Gy2.47 (median 199.7, 64.1–237.1). Based on the median values, we divided the patients in high tumour BED group (H‐BEDtm, 199.7–237.1 Gy2.47, n = 12) and low BED one (L‐ BEDtm, 64.1–199.7 Gy2.47, n = 10). The two groups did not differ by pretherapeutic IGF‐1 levels (p = .1) or by the prescribed dose (p = .6).

Results

Mean follow‐up period was 62.5 months (median 60.5, 9–127). Probability of IGF‐1 normalization was 65% at 3 years and 72.4% at 4 years, remaining stable until last follow‐up. Twenty‐two (52.4%) patients had complete endocrine remission in absence of any Somatostatin analogues. Actuarial rates were 33% at 3 years and 57.4% at 7 years, further remaining stable during follow‐up course. In univariate analysis, only statistically significant parameter was pretherapeutic serum IGF‐1 and IGF‐1 index (p = .01). Five patients (5/26, 19.3%) without previous hypopituitarism developed new pituitary insufficiency. H‐BEDtm was associated with higher rates of endocrine remission compared with L‐BEDtm, with actuarial probability of 70.2% versus 48.2% at 9 years, although this did not reach statistical significance (p > .05).

Conclusion

Our study confirms that SRS by Gamma Knife is safe and effective for GH‐secreting PA. Pretherapeutic serum levels of IGF‐1 were only statistically significant parameter for endocrine remission.
Flags and Shields: Muslim Socialities and Informal Livelihoods in Dar es Salaam
Authors: Kirby Benjamin
Published: September 2020

In this article, I explore entanglements of Muslim sociality and informal livelihoods in Dar es Salaam. I propose that Muslim practices of affiliation deserve to be counted among the ordinary strategies that urban majorities employ to navigate the city amidst conditions of uncertainty. Building on Stephan Lanz and Martijn Oosterbaan’s (2016) work on “entrepreneurial religion,” I draw on fifteen months of ethnographic research in Kariakoo, a super‐dense market district at the center of the city. The first part of my analysis explores associational life in Dar es Salaam, combining a historical overview with ethnographic description. I explore how urban actors use affiliations to football teams and political parties to generate livelihood opportunities and to secure protection. The second part of my analysis uses emic notions of “flags” (bendera) and “shields” (ngao) to demonstrate that Muslim modes of association operate in strikingly similar ways to those pertaining to football and politics. Engaging with the conceptual vocabularies of AbdouMaliq Simone and Erving Goffman, as well as recent debates about “everyday” and “lived Islam,” this article foregrounds the interplay between religious forms and neoliberal processes of informalization as they are unfolding in African cities and beyond.[Tanzania; Dar es Salaam; Urban Religion; Muslim Urbanism; Informal Economy; Associational Life.]
Physicians certified by the American Board of Obesity Medicine provide evidence‐based care
Authors: Gudzune Kimberly A. , Wickham Edmond P. , Schmidt Stacy L. , Stanford Fatima Cody
Published: September 2020

Our objective was to determine the clinical services offered by American Board of Obesity Medicine (ABOM) Diplomates and whether guideline concordant services varied by clinical practice attributes. We conducted a cross‐sectional analysis of the 2019 ABOM Diplomate survey (response rate 19.2%). Respondents (n = 494) self‐reported services offered: nutrition, exercise, mental health, minimally invasive bariatric procedures, perioperative bariatric surgical care and FDA‐approved anti‐obesity medications. We graded concordance of services offered with three evidence‐based obesity guidelines, and then conducted bivariate analyses comparing concordance by practice attributes. Most responding ABOM Diplomates offered nutrition (90.1%), exercise (67.8%) and mental health (76.7%). Few offered minimally invasive procedures (24.3%), and most provided perioperative surgical care (63.0%). Most (83.4%) prescribed FDA‐approved medications—typically both short‐ and long‐term agents (70.9%). Few Diplomates had low concordance with the American Heart Association/American College of Cardiology/The Obesity Society (AHA/ACC/TOS) guidelines (24.7%). Those who managed more obesity‐related conditions and endorsed AHA/ACC/TOS guideline use had higher concordance with these recommendations. No differences in guideline concordance existed by population, clinical effort or location. We found similar findings regarding concordance with ) American Association of Clinical Endocrinologists/American College of Endocrinology and Obesity Medicine Association guidelines. In conclusion, most responding ABOM Diplomates offer evidence‐based obesity medicine services. Clinicians may therefore have increased confidence in patient receipt of evidence‐based care when referring to an ABOM Diplomate.
More than a “monstrous obesity”! Time to overcome the “anti‐fat” bias
Authors: Palmese Francesco , Reggidori Nicola , Pappas Georgios , Gramenzi Annagiulia
Published: September 2020

A 54‐years‐old woman complained of unintentional important body weight gain associated with abdominal bloating. For this reason, she had consulted many different diet and nutritional professionals, general practitioners and a gastroenterology specialist, but no one went beyond a simple diagnosis of “monstrous obesity”. At our hospital division, based on physical examination, a computed tomography (CT) of the abdomen and pelvis was performed. It showed a voluminous intraperitoneal mass occupying the most part of the abdomen. The patient underwent laparotomy with resection of the abdomino‐pelvic mass, originating from the left ovary, measuring 60 x 45 cm and weighing 46 kg. Histopathology examination revealed a tumor composed of three different areas, including a well‐differentiated adenocarcinoma of intestinal‐type. It is emblematic of a grotesque misdiagnosis generated by a non‐comprehensive patient assessment and consequently by a too quick judgement related to the "anti‐fat bias".
FOREIGN ENTRY LIBERALIZATION AND EXPORT QUALITY: EVIDENCE FROM CHINA
Authors: Hou Xinyu , Shi Yingying , Sun Puyang
Published: September 2020

This paper examines the impact of foreign entry deregulation in China on the export price and quality of manufacturing firms through input–output linkage. We create a unique dataset describing the extent of regulatory control over foreign entry across approximately 900 industries covering all primary, manufacturing and services sectors. Results suggest foreign entry deregulation encourages firms to improve product quality and increase export prices. Deregulation in the manufacturing sectors has more impact on downstream export price and quality, compared with services sectors. Moreover, firms having larger imported inputs benefit more from foreign entry deregulation. These effects are robust to alternative specifications. (JEL F1, D2, O2)
Exotic animal cafes are increasingly home to threatened biodiversity
Authors: McMillan Sharne E. , Dingle Caroline , Allcock John A. , Bonebrake Timothy C.
Published: September 2020

Exploitation of species for wildlife trade, including the demand for exotic pets (likely sourced from the wild or recent generations of captivity) is a major threat to biodiversity. Although not traditionally considered “pet keeping” countries, pet ownership is growing in Asia. Exotic animals are also appearing in cafes, which are growing in popularity and have the potential to impact wild populations by stimulating exotic pet trade. We identified 406 animal cafes across Asia, of which 27% housed exotic species, including mammals (e.g., otter, slow loris, meerkat), birds (e.g., owls, hawks, parrots), and reptiles (e.g., geckos, pythons, turtles). Of the 252 exotic species recorded, 46% were threatened either as classified by the IUCN Red List, having a decreasing population trend, and/or threatened by the pet trade. These results, alongside the alignment of cafe traits with recognized factors influencing exotic pet trade, demonstrate as yet unclear (but potentially dramatic) implications for conservation.
Machine colour constancy: a work in progress
Authors: Lecca Michela
Published: September 2020

The term “colour constancy” denotes the human capability to recognise an object as the same entity even if its colours change due to illumination. Implementing such a human capability is highly desirable in computer vision to retrieve, detect, recognise and track objects regardless of the illumination. Many efforts have been made in this direction, leading to several “machine colour constancy” (MCC) algorithms, that is, routines inspired by human colour constancy (HCC) that are aiming to achieve an image representation independent of the light and thus invariant against light changes. Different to HCC, which is subject to illusions and only partially removes illuminant effects, MCC pursues the implementation of a perfect, total removal of light effects from images. Such an implementation represents a major challenge and is therefore a focus of ongoing research. In fact, the currently available MCC algorithms only work under constrained domains. Therefore, a priori knowledge about the image content is needed to choose the most appropriate MCC procedure and to properly set its parameters. Here, we present the main common assumptions underlying most of MCC algorithms. Our work shows that two main issues should be addressed in the future to ensure MCC is more efficacious and useable: first, the lack of a reliable MCC algorithm operating without supervision in multiple scenarios; and second, the difficulty which any user encounters when choosing the MCC procedure most appropriate for a particular application.
COMACO, from snares to plowshares: A conservation and human wellbeing success story
Authors: Lewis Dale , Wilkie David S.
Published: September 2020

Community Markets for Conservation is a private sector, not‐for‐profit social enterprise in Zambia. It was established in 2003 to halt wildlife poaching and illegal tree cutting for charcoal by helping poor rural families to increase their food and income security through improved farming practices and marketing of value‐added agricultural commodities. COMACO supports 178,891 farmers in the Luangwa Valley, providing them with improved farming skills, seed loans, a premium price for their crop surplus, and a dividend if they comply with sustainable farming and wildlife, and forest conservation best practices. Maize yields using COMACO methods increased by 63% and net income was 37% higher than for farmers who purchased inorganic fertilizers. Between 2012 and 2018 the number of food secure families increased from 67–84%. Elephant poaching has declined in all but one COMACO district, poaching is now primarily conducted by nonlocal hunters, and leg‐hold snare detections by community game scouts have decreased significantly in COMACO areas. Increasing food and income security while reducing deforestation and unsustainable hunting for ~$US10 per farmer per year is cheap and can be replicated in Zambia and other nations in Africa.
Dyskeratosis congenita: ein Literaturüberblick
Authors: AlSabbagh Manahel Mahmood
Published: September 2020

Die Dyskeratosis congenita ist eine seltene Erbkrankheit, die hauptsächlich Männer betrifft und klinisch durch die klassische Trias retikuläre Hyperpigmentierung, Onychodystrophie und Leukoplakie gekennzeichnet ist. Sie erhöht das Risiko für maligne Erkrankungen und andere potenziell zum Tod führende Komplikationen wie Knochenmarksversagen, Lungen‐ und Lebererkrankungen. Mutationen in 19 Genen wurden mit der Dyskeratosis congenita assoziiert. Circa ein Fünftel der pathogenen Mutationen finden sich in DKC1, dem für Dyskerin kodierenden Gen. Die vorliegende Übersicht soll die klinischen und genetischen Aspekte der Erkrankung aufzeigen.
Evaluation of right ventricular dyssynchrony in patients with acute inferior myocardial infarction and its relation with mortality
Authors: Kanar Batur Gonenc , Tigen Mustafa Kursat , Sunbul Murat , Cincin Ahmet Altug , Gurel Emre , Sayar Nurten , Kepez Alper , Sadıc Beste Ozben
Published: September 2020

Purpose

The aim of this study was to evaluate right ventricle (RV) dyssynchrony and its relation with mortality using speckle‐tracking echocardiography (STE) in patients with acute inferior myocardial infarction (IMI).

Methods

One hundred and fifty‐eight consecutive patients with acute IMI treated with primary percutaneous coronary intervention, and 44 healthy subjects were included. RV myocardial involvement (RVMI) was defined as an elevation >1 mm in V1 or V4R and/or the presence of a culprit lesion at the proximal portion of the first RV marginal branch after reviewing coronary angiography. Patients were followed for 3 years to determine the cardiovascular mortality.

Results

Overall, 70 patients with IMI had RVMI. IMI patients had significantly higher RV peak systolic longitudinal strain dyssynchrony (PLSSD) index, lower peak longitudinal systolic strain (PLSS), longer time to PLSS, and time to PLSS differences compared to healthy controls while the patients with RVMI had significantly worse values compared to patients without RVMI and healthy controls. Twenty‐seven patients (17.1%) died within 2 years. RVMI was more prevalent in mortality group, and they had significantly higher RV PSSD index, whereas they had lower RV free wall PLSS and longer time to PLSS differences. Receiver operating characteristics (ROC) analysis revealed that a RV PLSSD index > 65 ms predicted mortality with a sensitivity of 88.9% and specificity of 71.8% in IMI patients.

Conclusions

Intra‐ and inter‐ventricular dyssynhcrony may develop in patients with acute IMI, especially in those with RV involvement, which might have a negative effect on the prognosis of these patients.
Structural change and misallocation: Firm‐level evidence from Poland*
Authors: Hagemejer Jan , Tyrowicz Joanna
Published: September 2020

Early transition literature linked a large number of firm failures with the inability to overcome the pre‐transition misallocation of resources, that is, the inadequate capital–labour ratio. We look at the link between misallocation and firm survival using a rich firm‐level dataset of over 1,600 manufacturing plants established in a centrally planned economy after 1945. Our duration models include the standard Olley–Pakes misallocation measures as well as a firm‐level measure of the counterfactual level of capital that takes into account the present‐day market allocation and productivity. We show that while privatization is positively related to firm survival, misallocation (a) was more of a firm‐level than sector‐level phenomenon and, more importantly, (b) it, in general, did not have a sizeable effect on the actual firm survival nor it had an impact on the outcome of privatization.
Assessing self‐reported clinical high risk symptoms: The psychometric properties of the polish version of the prodromal questionnaire‐brief and a proposal for an alternative approach to scoring
Authors: Starkowska Anna , Tyburski Ernest , Kucharska‐Mazur Jolanta , Mak Monika , Samochowiec Jerzy
Published: September 2020

Background

Psychotic‐like experiences (PLEs) might occur in the general population as low‐risk individual differences or prodromal features, requiring quick detection and early intervention. The aims of this study were to conduct a mini‐systematic review of the prognostic abilities of the Prodromal Questionnaire‐Brief (PQ‐B), describe the PLEs distribution for the first time in a Polish population, assess PQ‐B reliability and propose an innovative scoring approach based on cluster analysis.

Methods

Five hundred and twenty eight (334 female) adult volunteers underwent screening with the PQ‐B, 49% also underwent the early psychosis screening test PRIME, to verify the tests' psychometric properties, to compare the prognostic accuracy of the PQ‐B to the more restrictive PRIME, and to the detected types of possible diagnosis in the general population.

Results

Almost 70% of respondents met the prognostic criteria of the PQ‐B while only 30.6% met the PRIME criteria. Both tests proved reliable (α > .835) and valid (rho >.710; P < .001). A cluster analysis identified three different sub‐groups detected with the PQ‐B: healthy individuals without PLE; healthy with low‐distressing PLEs; and possibly prodromal subjects reporting less frequent but more distressing PLEs and no worries about their own mental state. Also in systematic reviews, authors of different adaptations have observed that the PQ‐B has too low specificity and postulated the need for higher cut‐offs.

Conclusion

Study provides evidence of good reliability and sensitivity of the PQ‐B in assessing PLEs among the general population, but emphasizes that straightforward quantitative scoring criteria are still unclear. A more qualitative approach might be useful for differentiating true prodromal subjects from clinically low‐risk individual differences.
Paradigms of Flexibility: A Systematic Review of Research on Workplace Flexibility
Authors: Bal P. Matthijs , Izak Michal
Published: September 2020

As flexibility has become a sine qua non of the contemporary workplace, we performed a critical review of its different uses and understandings in business and management research. Analyzing the literature on workplace flexibility in the period 1970–2018, using a four‐part conceptual framework, and on the basis of subsequent content analysis of 262 most relevant publications, we identify two axes of tension embedding scholarly work on flexibility: the flexibility of vs. flexibility for organizations and employees, and a favorability‐criticality tension. We further explain how internal divisions are attributable to three different paradigms of flexibility (two of which dominate), resulting from divergent sets of assumptions regarding: its target, rationale, approach to it, as well as methodologies involved in studying it. We propose a research agenda indicating the ways in which paradigmatic underpinnings of flexibility research may be further clarified and divisions between the paradigms made sense of.
Social cognition in cervical dystonia: phenotype and relationship to anxiety and depression
Authors: Ellement B. , Jasaui Y. , Kathol K. , Nosratmirshekarlou E. , Pringsheim T. , Sarna J. , Callahan B.L. , Martino D.
Published: September 2020

Background and purpose

Anxiety and depression are common disabling comorbidities in cervical dystonia (CD) and may predispose to social withdrawal and social cognitive impairments. The relationship between social cognition and depressive/anxiety symptoms in CD is under‐investigated.

Methods

Forty‐six CD patients (40 women; mean age ± SD, 55.57 ± 10.84 years) were administered the following social cognition battery: Affect Naming, Prosody Face and Pair Matching subtests from the Wechsler Adult Intelligence Scale IV and Wechsler Memory Scale IV (social perception), reality‐known and reality‐unknown false belief reasoning tasks (theory of mind), Empathy Quotient and Social Norms Questionnaire 22 (social behaviour), alongside the Benton Facial Recognition Task (non‐emotional facial discrimination). Alongside CD severity, the Hospital Anxiety and Depression Scale measured depressive/anxiety comorbid diagnostic status and severity, and the Liebowitz Social Anxiety Scale assessed social phobia. Social cognition tasks were standardized using published normative data and a cut‐off of z < −1.5 for impairment.

Results

More than 90% of our CD patients performed normally on social perception and social behaviour tests. Performance on impaired belief reasoning (theory of mind) was impaired in 10 of 46 (21.74%); five of 46 (10.87%) were impaired on the Empathy Quotient. Better performance on the Affect Naming task was associated with comorbid anxiety (η2 = 0.09, medium‐to‐large effect size) and greater anxiety, depression and social phobia severity. Worse performance on the Empathy Quotient was associated with comorbid depression (η2 = 0.11, medium‐to‐large effect size) and greater depression severity. CD patients had significantly more difficulties with fearful face identification (P < 0.001).

Conclusions

Greater social perception abilities in CD patients with more severe anxiety and depression suggest efficient modulation and self‐adaptation of social cognitive skills.
An unusual familial dementia associated with G131V PRNP mutation
Authors: Yetim E. , Gul T. , Basak A. N. , Saka E.
Published: September 2020

Background

Gerstmann‐Struassler‐Scheinker disease is one of the familial prion diseases secondary to mutations in the prion protein gene (PRNP). The clinical phenotype has a diverse spectrum and might show variation among cases with the same genotype. We report a patient with G131V mutation in the PRNP gene, who was initially considered to harbor familial Alzheimer’s disease, based on the family history, clinical presentation and imaging findings.

Methods

A case with a G131V mutation in the PRNP gene is described, and the literature is reviewed.

Results

A 35‐year‐old man presented with personality changes, behavioral disturbances and cognitive complaints. A similar clinical phenotype was reported in the patient’s father, a paternal uncle and a paternal aunt. In conjunction with the observation of mild cerebral atrophy on magnetic resonance imaging and hypometabolism in bilateral temporal and parietal lobes on positron‐emission tomography studies, the diagnosis was initially considered as familial Alzheimer’s disease. However, whole‐exome sequencing of the index patient, confirmed with Sanger sequencing in his father and uncle, revealed the presence of a heterozygous G131V variant in the PRNP gene.

Conclusion

To the best of our knowledge, this is the third report of a G131V mutation in the PRNP gene in the literature. Although ataxia and extrapyramidal findings accompanied dementia in patients reported in the previous literature, the members of the family in the present case primarily reported cognitive impairment, underscoring the importance of genetic evaluation in familial early‐onset dementia patients, regardless of clinical and imaging features suggestive of alternative pathologies.
Drosophilaparasitoids (Hymenoptera) ofJapan
Authors: Kimura Masahito T. , Mitsui Hideyuki
Published: September 2020

TheDrosophilaparasitoid system is an excellent model for the study of biological and ecological interactions. In Japan, extensive studies have been carried out onDrosophilaparasitoids since the early 2000s. Here we provide up‐to‐date information on their diversity, distributions, host use and reproductive mode. Until now, 45 wasp species have been recorded. In addition, four genetically distinct groups (tentatively assigned as “races”) have been found inGanaspis brasiliensis(Figitidae). Most of them are larvo‐pupal parasitoids belonging to the families Figitidae and Braconidae, and some are pupal parasitoids of the families Pteromalidae and Diapriidae. A species of Encyrtidae was also recorded. Their major hosts are indicated with information on the host's breeding sites. ExceptGanaspis xanthopodaand two races ofG. brasiliensisthat are distributed both in tropical and temperate regions, they are divided into tropical and temperate species. The tropical species are mainly distributed in Southeast Asia, and their distributions in Japan are restricted to the Ryukyu islands, particularly Iriomote‐jima. The temperate species have been recorded from the main islands of Japan and surrounding islands but not from the Ryukyu islands, except two braconid species,Asobara japonicaandPhaenocarpasp. TK1. Some of the temperate species have also been recorded from Korea, China, Europe and/or North America. Among the 45 Japanese parasitoid species, at least seven are assumed to be thelytokous.