bluuebunny/crossref_metadata_2025 huggingface dataset:
Revisiting risk management in a time of crisis
Authors: Sheehan Norman T.
Published: October 2020

Purpose

The global pandemic provides boards and executives an opportunity to evaluate if their organizations’ risk management systems were up to the challenge. Organizational risk management systems act like the body’s immune system, protecting the organization from threats. Most organizations struggled to deal with the crisis caused by global pandemic, with some failing to survive. This paper reviews the risk management steps and then examines at why some organizational risk management systems may have failed to protect their organizations from harm.

Design/methodology/approach

This topic was inspired by discussions with executives and board members of organizations dealing with the pandemic. The paper was written based on their comments and was supplemented and contrasted with a review of risk management literature.

Findings

The paper reviews what risk responses are effective in coping with the global pandemic and then discusses how a risk tool, the risk-value curve, can help boards and executive determine the optimal level of risk for their organizations going forward.

Practical implications

Boards and executives can use the risk responses and risk tools reviewed to evaluate the quality of their risk management systems in light of the global pandemic.

Originality/value

The paper is one of the first to critically examine why some organizational risk management systems failed and proposes risk management tools to help organizations deal with the next global crisis.
Design and implementation of smart waste recycling bin for the household environment based on IoT
Authors: Harjoseputro Yulius , Julianto Eddy , Handarkho Yonathan Dri , Ritonga Yuriska Indriati Talenta
Published: October 2020

Purpose

This study aims to build a prototype of a smart waste recycling bin to transform organic waste into liquid fertilizer. The internet of things (IoT) was used as a base to develop this bin to offer a recycling system that convenient to the household.

Design/methodology/approach

In general, this system will integrate a microcontroller and several sensors that able to be controlled by a smartphone app to manage the decomposition process of organic waste in the bin. In the end, black-box testing was conducted to ensure all hardware and software that construct the system can perform well as expected.

Findings

All the validation testing reveals all the integration of hardware and software that constructs the smart bin satisfied the performance requirement except for the real-time clock sensor that implies the slight error for a few seconds compares to the actual time.

Originality/value

Different from the previous works, this study focused on the involvement of society to participate in the recycling garbage process by designing the smart waste recycling bin system that fits to locate in the household environment, which allows users to monitor the fertilizer making process using IoT technology.
Fosravuconazole to treat severe onychomycosis in the elderly
Authors: Noguchi Hiromitsu , Matsumoto Tadahiko , Kimura Utako , Hiruma Masataro , Kano Rui , Kubo Masahide , Fukushima Satoshi , Ihn Hironobu
Published: October 2020

Fosravuconazole is a novel oral antifungal drug developed in Japan and used to treat tinea unguium since 2018. Its excellent oral absorbability and systemic bioavailability has enabled short‐duration therapy of 3 months. Furthermore, no concomitant drugs are contraindicated due to the presence of the mild inhibitor of cytochrome P450 enzyme which is responsible for polypharmacy adverse effects. Therefore, it can be safely administrated to elderly patients. Elderly patients (≥65 years old) with severe onychomycosis (≥50% nail involvement) were treated with oral fosravuconazole 100 mg once daily for 12 weeks. The rate of involvement improved from 86.6% to 28.1% (P < 0.01). The efficacy (i.e. percentage of those rated as “improved” and better) and cure rate was 83.8% (31/37) and 29.7% (11/37), respectively. Furthermore, when focusing on the thin nail group (<3 mm), the efficacy and cure rate was 88.2% (15/17) and 58.8% (10/17), respectively. Although the serum γ‐glutamyltransferase levels increased in 21.6% (8/37), all patients recovered without any specific treatments.
Improved quality of life of patients with generalized pustular psoriasis in Japan: A cross‐sectional survey
Authors: Hayama Koremasa , Fujita Hideki , Iwatsuki Keiji , Terui Tadashi
Published: October 2020

Generalized pustular psoriasis (GPP) is a rare variant of psoriasis with severe clinical symptoms. However, the quality of life (QoL) of the patients is largely unknown. We conducted a nationwide cross‐sectional survey of Japanese GPP patients using the 36‐Item Short‐Form Health Survey version 2 (SF‐36v2) to elucidate patients’ QoL and how their QoL had changed over the last decade. We analyzed QoL data of 83 patients obtained from 2016 to 2019 (present group) and compared it with that of 105 patients collected in a previous survey conducted between 2003 and 2007 (past group). Although the QoL of the present patients was still largely impaired in comparison with the standard Japanese population, substantial improvement was found in some SF‐36v2 subscales including “general health”, “vitality”, “social functioning” and “mental health” as compared with that of the past group. Advances in treatment may contribute to this QoL improvement.
Widening the gap? The challenges for equitable music education in Scotland
Authors: Wilson Alastair , Hunter Katie , Moscardini Lio
Published: October 2020

Exposure to and potential to engage in music is now very different for children and young people from more middle‐class and affluent backgrounds compared to those from working‐class or poor households. Middle‐class children and young people have access to opportunities to learn an instrument and engage in performance, predominantly for intrinsic reward and on occasion as the basis of a future career. Children and young people from more working class or poor backgrounds are more likely to be excluded from these opportunities and are less likely to take advantage of opportunities within the wider world of music industries. This research draws on in depth case studies of three local authorities in Scotland to reveal the ways in which local provision for music education is largely being reshaped by economic factors and restraints. Drawing on aspects of critical theory it discusses the ways in which economic‐based decisions are interacting with the dominant social and cultural values to influence provision. It makes the argument that in an era of austerity the social and cultural values of the middle class are dominant and effectively increasing inequality in access to music. Children and young people from poor or working class households are increasingly excluded from opportunities to engage with formal music provision.
Spirits out of place: relational landscapes and environmental change in East Kalimantan, Indonesia
Authors: Herrmans Isabell
Published: October 2020

This article examines interaction with spirits among the Luangan, a group of shifting cultivators in Indonesian Borneo. Through examples of different forms of Luangan spirit interaction, it interrogates the relationship between the spirit world and the natural environment, with special reference to what happens when the latter undergoes dramatic change. Inspired by Eduardo Kohn's understanding of how the spirit world is semiotically embedded within the rainforest environment, I explore how relations with nonhumans reflect historical and ongoing experiences of life and sociality in the forest and human domain, while superimposing a virtual relational landscape upon the natural landscape. It is proposed that spirit communication offers a means of refiguring human lives and alleviating debilitation, and that recurrent rituals enable Luangans to virtually maintain relations with unseen beings of the local environment, even where it has been thoroughly transformed through oil palm cultivation.
Understanding the social and cultural bases of Brexit*
Authors: Chan Tak Wing , Henderson Morag , Sironi Maria , Kawalerowicz Juta
Published: October 2020

We use data from a large scale and nationally representative survey to evaluate two narratives about the social bases of Brexit. The first narrative sees Brexit as a revolt of the economically left‐behinds. The second narrative attributes Brexit to the resurgence of an English nationalism. There is some, albeit not always consistent, evidence that people in relative poverty or those living in areas that have seen greater Chinese import penetration are slightly more pro‐Leave. People living in economically deprived neighborhoods are not more pro‐Brexit. Using the Weberian class–status distinction, it is social status, not social class, which stratifies Brexit support. Individuals for whom being British is important are more pro‐Leave. But those who see themselves as British rather than English, and those reporting omnivorous cultural consumption are less supportive of Brexit. Overall, there is empirical support for both narratives. But the weight of the evidence suggests a strong cultural dimension in Brexit support.
Severe acute respiratory syndrome coronavirus‐2 infection and the gut–liver axis
Authors: Mohandas Sundhar , Vairappan Balasubramaniyan
Published: October 2020

Patients affected by coronavirus disease 2019 (COVID‐19), which is caused by severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) infection, manifest various gastrointestinal and hepatic abnormalities alongside respiratory disorders. The identification of this virus in the feces of more than 50% of infected individuals indicates the possibility of viral shedding and fecal‐to‐oral transmission. Preliminary reports have also identified alterations in the intestinal microbiota profile in infected individuals. Moreover, COVID‐19 patients manifest various degrees of liver injury characterized by alterations in liver enzymes. Digestive symptoms and liver abnormalities correlate with disease severity, the incidence of critical outcomes and patient's recovery. However, the pathogenic mechanisms behind COVID‐19‐induced abnormalities in the gut–liver axis seem to be multifactorial in origin. This review compiles current knowledge sourced from preclinical and clinical research and summarizes gastrointestinal and hepatic dysfunctions observed following SARS‐CoV‐2 infection, and also explores the possible mechanisms generating abnormalities in the gut–liver axis. Furthermore, this review sheds light on possible therapeutic targets against these disorders.
Market Reactions to Central Bank Interest Rate Changes: Evidence from the Chinese Stock Market*
Authors: Hu Jun , Jiang George J. , Pan Guanzhong
Published: October 2020

Contrary to theoretical expectations and empirical evidence in developed markets, the Chinese stock market reacts positively (negatively) to interest rate increases (cuts) by the central bank. During the period from January 1996 to December 2016, the Shanghai Composite Index had an average abnormal return of 1.07% (−1.85%) in reaction to interest rate increases (cuts) over the two‐day announcement window. We further demonstrate that short‐term market reactions are transitory and have no permanent effect. Finally, we reveal that short‐term market reactions cannot be explained by market frictions or information uncertainty. Rather, such reactions are likely driven by investor sentiment.
IL1B triggers inflammatory cytokine production in bovine oviduct epithelial cells and induces neutrophil accumulation via CCL2
Authors: Nakamura Yuki , Aihara Riho , Iwata Hisataka , Kuwayama Takehito , Shirasuna Koumei
Published: October 2020

Problem

The oviduct is essential for reproduction. We previously showed that oviduct epithelial cells (OECs) isolated from aged cows expressed higher levels of inflammatory cytokines, including interleukin (IL) 1A and IL1B. In addition, aging is associated with tissue dysfunction and cellular senescence via a senescence‐associated secretory phenotype (SASP) and immune cell accumulation. We investigated whether IL1A or IL1B causes SASP production, cellular senescence, and inflammatory responses in bovine OECs.

Method of Study

The OECs were isolated from bovine oviducts from young (mean 50.3 months) and aged cows (mean 157.0 months) and cultured.

Results

Treatment with IL1A or IL1B induced SASP production (IL8, IL6, TNFA, and CCL2) and mRNA expression of cell adhesion molecules in bovine OECs, but both IL1s did not induce cellular senescence in OECs and migration of polymorphonuclear neutrophils (PMNs). Cultured medium of OECs treated with IL1s, especially IL1B, dramatically induced PMN migration. Treatment with the CCL2 inhibitor, but not IL8 or its receptor CXCR2 inhibitors, significantly reduced immune cell migration in IL1B‐treated OEC‐cultured medium. Treatment with IL1B increased PMN adhesion to OECs, resulting in further SASP production in OECs due to a PMN‐OEC interaction.

Conclusion

We suggest that senescence‐associated IL1s cause SASP production in bovine OECs and CCL2 induced by IL1B is essential for the migration of immune cells to OECs. Specifically, IL1B regulates PMN migration and adhesion to bovine OECs, and PMNs accelerate inflammatory cytokine production from bovine OECs via a direct interaction. These phenomena may contribute to chronic oviductal inflammation, resulting in subfertility.
Knowing minds: Linking early perspective taking and later metacognitive insight
Authors: Kloo Daniela , Sodian Beate , Kristen‐Antonow Susanne , Kim Sunae , Paulus Markus
Published: October 2020

Recent metacognitive research using a partial knowledge task indicates that a firm understanding of ‘knowing about knowing’ develops surprisingly late, at around 6 years of age. To reveal the mechanisms subserving this development, the partial knowledge task was used in a longitudinal study with 67 children (33 girls) as an outcome measure at 5;9 (years;months). In addition, first‐ and second‐order false belief was assessed at 4;2, 5;0, and 5;9. At 2;6, perspective taking and executive abilities were evaluated. Metacognition at 5;9 was correlated with earlier theory of mind and perspective taking – even when verbal intelligence and executive abilities were partialled out. This highlights the importance of perspective taking for the development of an understanding of one’s own mind.
Chronic pain in the time of COVID‐19: Stress aftermath and central sensitization
Authors: Serrano‐Ibáñez Elena R. , Esteve Rosa , Ramírez‐Maestre Carmen , Ruiz‐Párraga Gema T. , López‐Martínez Alicia E.
Published: October 2020

Objectives

The COVID‐19 crisis is a significant stressor worldwide. The physical and emotional condition of individuals with pain sensitization syndromes who are experiencing the pandemic may worsen. This study investigated the contribution of life changes due to the coronavirus to emotional distress in individuals with a diagnosis of chronic central sensitization pain and tested whether the associations between level of pain and sensitization were independent of or mediated by emotional distress.

Methods

Spanish individuals with chronic pain (N = 362) completed an online survey on direct or indirect exposure to the consequences of COVID‐19, pain intensity, and emotional distress. They also completed central sensitization questionnaires.

Results

An association was found between changes in daily routines and pain intensity, emotional distress, and sensitization scores. Correlations were found between emotional distress, sensitization, and pain intensity. Significant predictors of emotional distress were age, difficulty in receiving medical care, changes in daily routines, and diminished social support. Emotional distress did not mediate the association between sensitization and pain intensity.

Conclusion

Due to the COVID‐19 situation, individuals with central sensitization pain syndromes may be at higher risk of developing psychological distress. Interdisciplinary interventions involving psychologists are urgently needed to provide this population with appropriate health care.
Resilience during uncertainty? Greater social connectedness during COVID‐19 lockdown is associated with reduced distress and fatigue
Authors: Nitschke Jonas P. , Forbes Paul A. G. , Ali Nida , Cutler Jo , Apps Matthew A. J. , Lockwood Patricia L. , Lamm Claus
Published: October 2020

Background

Social connections are crucial for our health and well‐being. This is especially true during times of high uncertainty and distress, such as during the COVID‐19 lockdown. This period was characterized by unprecedented physical distancing (often communicated as social distancing) measures resulting in significant changes to people’s usual social lives. Given the potential effects of this disruption on people’s well‐being, it is crucial to identify factors which are associated with negative health outcomes, and conversely, those that promote resilience during times of adversity.

Aims

We examined the relationship between individuals’ levels of social connectedness during lockdown and self‐reported stress, worry, and fatigue. Method: Survey data were collected from 981 individuals in a representative sample of Austrian citizens. Data collection occurred during the last week of a six‐week nationwide lockdown due to the COVID‐19 pandemic. The final sample consisted of 902 participants. Participants were asked to complete validated questionnaires to assess levels of social connectedness as well as measures of perceived stress, worry—both general and COVID‐19 specific—and symptoms of fatigue during the previous two weeks.

Results

Our results demonstrate that greater social connectedness during the lockdown period was associated with lower levels of perceived stress, as well as general and COVID‐19‐specific worries. Furthermore, we found a negative relationship between fatigue and social connectedness, which was mediated by feelings of stress, general worries, and COVID‐19‐specific worries—respectively, indicating that individuals with smaller network sizes, who were highly distressed during the pandemic, were also likely to report feeling more fatigued.

Conclusion

Our findings highlight the important role that social connections play in promoting resilience by buffering against negative physical and mental health outcomes, particularly in times of adversity in times of adversity.
Teaching creative geovisualization: Imagining the creative in/of GIS
Authors: Jung Jin‐Kyu
Published: October 2020

Creative geovisualization is situated at the intersection of geography, arts, and digital humanities with a particular emphasis on visualization and mapping that preserves, represents, and generates more authentic, contextual, and nuanced meanings of space and people with an artistic and humanistic perspective and approach. This is a creative expansion in critical GIS practices and a new alternative to traditionally science‐rooted approaches to GIS and mapping. Reflecting the experience of teaching a “creative geovisualization” course in an interdisciplinary curriculum, I demonstrate how critical and creative scholarship with mapping and geovisualization is introduced in the classroom and is illuminated in the students' creative practices. The class encompasses key epistemological and methodological groundings of creative geovisualization—including non‐representational theories; critical cartography and GIS; the convergence of geography, arts, and humanities; psychogeography; and qualitative and affective geovisualization. Empirical examples of students' works illustrate the blending of different modes of creative engagements with GIS and geovisualization and specific ways to work with various forms of embodied, relational, interpretive, and expressive geographies. GIS and mapping become creative as they continue evolving in process, and it is time that we deeply (re‐)imagine “the creative” in/of GIS in critical GIS pedagogies.
Living in limbo: Economic and social costs for refugees
Authors: Ukrayinchuk Nadiya , Havrylchyk Olena
Published: October 2020

Our paper tests the hypothesis that living in limbo could have negative consequences for the socio‐economic integration of refugees. We define limbo as a protracted period when asylum seekers are waiting for the decision concerning their permanent refugee status. Relying on the French survey of migrants, France's longitudinal survey of migrants (ELIPA), we measure integration by labour market participation, fluency in French, finding new French friends and studying. To account for the endogeneity of limbo, we instrument it with the administrative backlog. We find that living longer in limbo during the asylum‐seeking period slows down future integration of refugees, but results differ with respect to gender and educational attainment. While having lived longer in limbo slows down most aspects of socio‐economic integration for refugees with no degree or a high school degree, those with a bachelor's degree do not experience negative effects. Male refugees who had lived longer in limbo have a lower likelihood of being employed and studying in France, while similar females make fewer French friends.
Atrioventricular, ventriculoarterial discordance and Ebstein malformation of the tricuspid valve with severe regurgitation resulting in aortic atresia in a neonate
Authors: Karmegaraj Balaganesh , Ibrahim Syed , Razeen Mohamed , Naseeha Ayesha , Srimurugan Balaji
Published: October 2020

Aortic atresia is uncommonly associated with atrioventricular and ventriculoarterial discordance. Presence of severe regurgitation of Ebstein malformation of the tricuspid valve in this subset results in reduced aortic blood flow in‐utero. We report here a term neonate with this anomaly detected antenatally.
Utility of global longitudinal strain to detect significant coronary artery disease, its extent and severity in patients with stable ischemic heart disease
Authors: Biswas Kaushik , Mukherjee Anindya , Nandi Saumen , Khanra Dibbendhu , Sharma Ranjan Kumar , Maji Sujata
Published: October 2020

Background

Early changes in cardiac function due to ischemia may be detected by global longitudinal peak systolic strain (GLS). Till date, no Indian data exist regarding role of GLS in stable ischemic heart disease (SIHD) and data showing correlation of GLS and SYNTAX score (SS) is meager in world literature. Our aim was to ascertain the role of GLS in SIHD.

Methods

One hundred and seventeen subjects with angina and normal transthoracic echocardiogram (TTE) underwent strain echocardiography and coronary angiography (CAG).

Results

There was significant correlation between GLS and SS values (R2 = .686, P < .0001). The correlation was weaker yet significant in the low SS (<22) group (R2 = .491, P < .0001) and high SS (≥22) group (R2 = .602, P < .0001). The cutoff value of GLS to detect significant CAD was −16.5 (87.6% sensitivity, 85.7% specificity, P < .0001), to predict high SS was −13.5% (sensitivity 78.3%, specificity 87.9%, P < .0001) and to predict triple vessel disease (TVD) was −14.5 (95.7% sensitivity, 73.4% specificity, P < .0001). The agreement between GLS and CAG for detection of significant CAD was substantial (κ = 0. 676, P < .0001), similar to that between territorial strain and CAG in detecting LAD disease (κ = 0.688, P < .0001) while agreement between strain imaging and CAG for detecting number of vessels diseased was moderate (κ = 0.406, P < .0001).

Conclusion

Global longitudinal peak systolic strain must be conducted on subjects with angina and inconclusive electrocardiogram (ECG) findings to rule out significant CAD even if conventional TTE was normal. This may facilitate early diagnosis of CAD or sub‐clinical left ventricular systolic dysfunction (LVSD), preventive or treatment measures, and overall cost savings.
Using the MoBI motion capture system to rapidly and accurately localize EEG electrodes in anatomic space
Authors: Mazurek Kevin A. , Patelaki Eleni , Foxe John J. , Freedman Edward G.
Published: October 2020

During mobile brain/body imaging (MoBI) experiments, electroencephalography and motion capture systems are used in concert to record high temporal resolution neural activity and movement kinematics while participants perform demanding perceptual and cognitive tasks in a naturalistic environment. A typical MoBI setup involves positioning multi‐channel electrode caps based on anatomical fiducials as well as experimenter and participant intuition regarding the scalp midpoint location (i.e., Cz). Researchers often use the “template” electrode locations provided by the manufacturer, however, the “actual” electrode locations can vary based on each participant's head morphology. Accounting for differences in head morphologies could provide more accurate clinical diagnostic information when using MoBI to identify neurological deficits in patients with motor, sensory, or cognitive impairments. Here, we asked whether the existing motion capture system used in a MoBI setup could be easily adapted to improve spatial localization of electrodes across participants without requiring additional or specialized equipment that might impede clinical adoption. Using standard electrode configurations, infrared markers were placed on a subset of electrodes and anatomical fiducials, and the remaining electrode locations were estimated using spherical or ellipsoid models. We identified differences in event‐related potentials between “template” and “actual” electrode locations during a Go/No‐Go task (p < 9.8e–5) and an object‐manipulation task (p < 9.8e–5). Thus, the motion capture system already used in MoBI experiments can be effectively deployed to accurately register and quantify the neural activity. Improving the spatial localization without needing specialized hardware or additional setup time to the workflow has important real‐world implications for translating MoBI to clinical environments.
Haematogenous septic arthritis, physitis and osteomyelitis in foals: A tutorial review on pathogenesis, diagnosis, treatment and prognosis. Part 1
Authors: Lindegaard C. , van Galen G. , Aarsvold S. , Berg L. C. , Verwilghen D.
Published: October 2020

Haematogenous septic arthritis, physitis and osteomyelitis (SAPO) is a potentially debilitating or even life‐threatening disease entity encountered in foals of all ages between birth and approximately 7 months old. Correct, and complete, diagnosis and successful treatment require collaboration between specialties including medicine, anaesthesia, diagnostic imaging, surgery and rehabilitation services. However, in order to succeed, it is important that all specialties have an overall knowledge of all aspects of the disease complex. Therefore, the aim of this review is to give an overview of aetiology, presenting complaints, clinical findings, diagnostic imaging, treatment, rehabilitation and prognosis. Part one deals with all aspects of aetiology and how to make a diagnosis. Part two deals with all aspects of treatment, rehabilitation and prognosis.
Acute myeloid leukemia with mutated NPM1 mimics acute promyelocytic leukemia presentation
Authors: Arana Rosainz Manuel J. , Nguyen Nghia , Wahed Amer , Lelenwa Laura C. , Aakash Nfn , Schaefer Karen , Rios Adan , Kanaan Zeyad , Chen Lei
Published: October 2020

Objectives

To investigate clinicopathological and molecular features of NPM1‐mutated acute myeloid leukemia that presented with infrequent acute promyelocytic leukemia (APL)‐like phenotype and clinical presentation.

Methods

Cases with both de novo or secondary Acute Myeloid Leukemia (AML) were retrieved. Data from flow cytometry immunophenotyping, cytogenetics, molecular studies, and clinical presentation were analyzed.

Results

Cases presented with abnormal coagulation parameters and low platelets count; four of them showed a DIC index compatible with overt DIC. Two cases showed Auer rods. In all cases, immunophenotypes mimicked APL: blasts expressed CD33, CD13, and cytoplasmic MPO but did not express CD34, HLA‐DR, or CD11b. Notably, CD4 expression was observed in all cases. Neither t(15;17) nor PML/RARα gene rearrangement was detected. NPM1 gene mutation was identified in all cases. In four cases, TET2 or IDH2 co‐mutations were identified.

Conclusions

Our findings provide additional evidence of association between NPM1‐mutated AML with TET2 or IDH2 co‐mutations and the APL‐like immunophenotype. This AML subset was found to exist in both de novo and secondary AML. High WBC count and blasts with low to moderate side scatter and significant expression of CD4 are observed features that could assist in the differential diagnosis with APL. The occurrence of significant elevated D‐dimer levels, or even overt DIC observed at diagnosis in these cases could be relevant for this AML subtype.
Neutrophil‐to‐lymphocyte ratio, a critical predictor for assessment of disease severity in patients with COVID‐19
Authors: Liu Lei , Zheng Yaqiong , Cai Liping , Wu Wanlei , Tang Shi , Ding Yinjuan , Liu Wanbing , Kou Guomei , Xiong Zhou , Wang Shengdian , Zheng Shangen
Published: October 2020

Introduction

Monitoring of laboratory indicators is important for predicting changes in disease severity and clinical outcomes. We aimed to identify the critical predictors that can effectively assess the disease conditions of patients with COVID‐19 by analyzing the clinical characteristics and laboratory findings of patients with SARS‐CoV‐2 infection.

Methods

All consecutive patients (n = 294) with confirmed SARS‐CoV‐2 infection admitted to the General Hospital of Central Theater Command of the PLA from February 6 to February 21, 2020, were enrolled. These patients were divided into the severe group and the nonsevere group according to disease severity during hospitalization.

Results

The median neutrophil‐to‐lymphocyte ratio (NLR) value of the severe patients was dramatically higher than that of the nonsevere patients (10.4 vs 2.6; P < .001). The NLR value equal to 5 was a boundary value worthy of reference, because more than 80% severe patients had an NLR value greater than 5 and over 80% nonsevere patients had an NLR value less than 5. The NLR value of these COVID‐19 patients was positively and respectively correlated with the values of C‐reactive protein (R = .5921, P < .001), lactate dehydrogenase (R = .4509, P < .001), procalcitonin (R = .5504, P < .001), fibrinogen (R = .4710, P < .001), and D‐dimers (R = .4425, P < .001). However, the NLR value was merely and positively correlated with the interleukin‐6 value (R = .3594, P < .05), but had no correlations with the values of interleukin‐10, interleukin‐4, interleukin‐17, interferon‐γ, and tumor necrosis factor‐α (P > .05).

Discussion

Neutrophil‐to‐lymphocyte ratio is a critical predictor for assessment of disease severity in patients with COVID‐19, and it has a close relation with the laboratory indicators related to disease conditions.
High‐P metamorphism of garnet–epidote–amphibole schists from the Yuli Belt, Eastern Taiwan: Evidence related to warm subduction
Authors: Huang Po‐Hung , Wei Chunjing , Zhang Jinrui
Published: October 2020

High‐P (HP) rocks exhumed from ancient subduction zones have been controversially argued to record much warmer geotherms than numerical modelling results. The Yuli belt in Eastern Taiwan was regarded as a mélange consisting of HP rock‐bearing tectonic blocks within metasediments (or in situ schists), witnessing the subduction of the South China Sea Plate beneath the Philippine Sea Plate and the subsequent collision during the period of 15–5 Ma. Two garnet–epidote–amphibole schist samples selected from the Tamayen block in the Yuli belt are investigated for their metamorphic evolution. The rocks comprise garnet and paragonite porphyroblasts in a foliated matrix consisting of amphibole, epidote, chlorite, quartz, albite and rutile. Large paragonite flakes crosscut clearly the main foliation, and in places develop narrow coronae of muscovite, albite or chlorite. Fine‐grained pargasite (Amp1) is the dominant variety of amphibole that defines the foliation, whereas a few coarser grains (Amp2) penetrate the foliation and both are further rimmed by a narrow light‐coloured amphibole (Amp3). Petrographic observation and phase equilibria modelling using thermocalc suggest three stages of metamorphic evolution for these rocks. The pre‐peak prograde to the peak‐stage evolution can be revealed from garnet zoning to occur in the mineral assemblages containing lawsonite and glaucophane which cannot be observed petrographically due to the post‐peak decompressional evolution. The peak conditions are constrained to be ~22 kbar/545℃ using the isopleths of the maximum pyrope and the corresponding grossular contents in P–T pseudosections. The post‐peak decompression includes three substages with different fluid behaviours: the first substage is dominated by lawsonite dehydration with the growth of paragonite; the second substage is marked by the decompressional path proceeding in fluid‐absent fields; and the third substage occurs when mineral assemblages become again saturated with water at 10–9 kbar or 12–10 kbar where glaucophane is metastably transformed into Amp1, followed by the growth of Amp2. The late‐retrograde stage is defined to be cooling with decompression on the basis of the growth of Amp3, the coronae around paragonite and the matrix albite. The peak P–T estimates for garnet–epidote–amphibole schists suggest a geotherm of ~7℃/km, much cooler than those in the previous researches in the Yuli belt, and well consistent with the results from numerical thermal modelling. We argue that HP rocks from ancient orogenic belts can robustly constrain the thermal structure of subduction zones if their peak P–T conditions as well as the post‐peak decompressional evolution are well recovered.
Racial/ethnic differences in holding a retirement saving motive: A decomposition analysis
Authors: Kim Kyoung Tae , Cho Soo Hyun , DeVaney Sharon A.
Published: October 2020

Establishing a retirement goal facilitates one's long‐term financial planning behavior. Yet, the portion of U.S. households who achieve this goal is relatively small. Further, the percentage is much lower among racial and ethnic minorities. This study investigates racial/ethnic disparities in motives for holding a retirement savings and contributing factors to explain the gaps. Results from the 2016 Survey of Consumer Finances (SCF) indicate that White respondents were more likely to hold a retirement saving motive than were other racial/ethnic groups, even after controlling for various socio‐economic characteristics. Decomposition analysis shows that homeownership, objective financial knowledge, planning horizon, and age were the most important determinants that explain the racial/ethnic gap in withholding a retirement saving motive. This study provides evidence in support of the importance of tailored educational interventions among racial/ethnic groups.
A paediatric logbook: Millstone or milestone?
Authors: Akhtar Ridha , Neo Elise YL , McDonald Jenny , Teo Stephen S S
Published: October 2020

Logbooks are ubiquitous in undergraduate and postgraduate medical education. Here, two alumni who are in the early phase of their career, reflect on their experience in their undergraduate paediatric term and how this was shaped by their mandatory paediatric logbook.
Antimicrobial stewardship in children: Where to from here?
Authors: Fay Michael‐John , Bryant Penelope A.
Published: October 2020

Antimicrobial resistance (AMR) is an ever‐developing global threat and children are becoming increasingly affected. In addition to established antimicrobial stewardship (AMS) measures, it is important to recognise the need for a paediatric focus to manage the physiological and pathological differences unique to children. Most studies on paediatric AMS are drawn from resource‐rich, hospital settings. They support interventions including AMS programmes, bundled groups of interventions, guidelines and education initiatives. These must be tailored to specific institutions, populations and resources as translating interventions between these may not be effective. There are knowledge gaps in paediatric AMS, which pose challenges to designing both interventions and research in this area. These include quantifying antimicrobial consumption, defining AMS outcomes and understanding the development of AMR. Finding answers to fill these gaps needs urgent attention. There is also a need to think outside the box to improve AMS in children. Potential opportunities include intravenous antibiotics at home via hospital‐in‐the‐home programmes, earlier switching to oral antibiotics, repurposing old antibiotics and re‐evaluating children labelled as having antibiotic allergy. Using all of the possibilities available gives us the best chance of staying ahead of the relentless march of AMR in children.
Minimising Immunisation Pain of childhood vaccines: The MIP pilot study
Authors: Jenkins Narelle , Orsini Francesca , Elia Sonja , Perrett Kirsten
Published: October 2020

Aim

Pain associated with immunisations can result in distress and/or anxiety for children and parents. We assessed the feasibility and acceptability of two novel devices; Coolsense (cold) and Buzzy (vibration ± cooling pads) versus standard care to minimise pain during immunisations. We also evaluated compliance to the devices and parent's perception of the effectiveness of the devices/standard care for minimising pain during immunisation.

Design

Open label, pilot, randomised controlled trial (RCT).

Methods

Forty children aged 3.5 to 6 years attending an Immunisation Centre at The Royal Children's Hospital in Melbourne, Australia, were randomised (1:1:1:1) into four groups: (i) Coolsense plus standard care; (ii) Buzzy with cold plus standard care; (iii) Buzzy without cold plus standard care; and (iv) Standard care alone (distraction with bubbles).

Results and analysis

Recruitment was completed in 12 days. Seventy percent were compliant with Buzzy (±cold), 82% with Coolsense, and 60% with standard care. Buzzy (with cold) was identified as effective by 70% of parents, Coolsense by 64%, Buzzy without cold by 50% and standard care by 60%.

Conclusions

This pilot study demonstrated feasibility. A larger RCT is needed to provide definitive evidence to inform best practice for minimising immunisation pain in young children.
Relationship between patient understanding and timeliness of penicillin prophylaxis in rheumatic heart disease prevention programmes in American Samoa
Authors: Huang Jennifer H , Elkhal Callia , Eliapo‐Unutoa Ipuniuesea , Armsby Laurie R , Madriago Erin J
Published: October 2020

Aim

While mostly eradicated in developed nations, rheumatic heart disease (RHD) is still the leading cause of preventable cardiovascular disease in children. RHD and its antecedent acute rheumatic fever remain endemic in many low to middle income countries, as well as in vulnerable communities in wealthy ones. Evidence‐based interventions are particularly important in resource‐poor settings. We sought to determine if efforts directed at patient and family education impact degree of participation in community‐based prevention measures, and with short‐term disease progression.

Methods

We performed an observational, cross‐sectional study of children with RHD aged 5–19 years, along with their parents, in American Samoa. A survey was administered in November 2016 to assess patient and parent knowledge of RHD. Scores were compared to percent timeliness of penicillin prophylaxis via chart review.

Results

We collected a total of 70 surveys of child–parent dyads with a patient mean age of 14.28 years ±2.71. An increased knowledge score was predictive of increased penicillin compliance for both children (12.70% increase in compliance per 1‐unit increase in score (P = 0.0004)) and parents (10.10% increase in compliance per 1‐unit increase in score (P = 0.0012)).

Conclusions

A clear relationship exists between patient and parent knowledge of RHD and timeliness of penicillin prophylaxis doses. This study was the first to link patient understanding of RHD to engagement with preventative measures.
Quasi‐maximum likelihood estimation of conditional autoregressive Wishart models
Authors: Asai Manabu , So Mike K. P.
Published: October 2020

In this article, we consider a quasi‐maximum likelihood (QML) estimation of conditional autoregressive Wishart models, which generalize the conditional autoregressive Wishart models by not restricting the conditional distribution of covariances to follow the Wishart distribution. Strong consistency is established under the existence of the expectation of the log of the determinant. Sufficient conditions for asymptotic normality of the QML estimator are derived. Monte Carlo experiments show an inefficiency caused by using non‐Wishart distributions, which are negligible for the sample size T = 500. We use the daily covariance matrix of the returns of the Nikkei 225 index and its futures for the QML estimation of the conditional autoregressive Wishart model. The results indicate its appropriateness for the QML estimation.
Sectoral allocation of foreign capital inflows and skilled‐unskilled wage inequality in a developing economy: A theoretical model
Authors: Ahuja Rashmi
Published: October 2020

We consider a small open developing economy using a 2 × 3 general equilibrium model with voluntary unemployment of skilled labor and involuntary unemployment of unskilled labor. It is assumed that there exists surplus unskilled labor in the developing economy and supply of skilled labor is a function of skilled wages. One sector is receiving foreign capital at the expense of another sector. We examined the impact of increasing total foreign capital inflows and sectoral allocation of foreign capital inflows on skilled‐unskilled wage inequality. Our findings suggest that wage inequality as well as employment of unskilled labor increases with increase in total foreign capital inflows, whereas wage inequality decreases with increase in foreign capital inflow into the low‐skilled sector with no change in total foreign capital inflows. Besides, it also indicates that the impact of increasing total foreign capital inflows along with changes in sectoral allocation of foreign capital inflows depends on a cutoff value which is a function of initial sectoral allocation of foreign capital into the two sectors. These results could be important for policymaking in the developing countries like India. Numerical examples have also been constructed to capture the extent of changes in wage inequality.
When I say… travelling concepts
Authors: Veen Mario , van der Tuin Iris
Published: October 2020

The authors use the concept of 'concept' to explain how we can improve interdisciplinary research in medical education by developing concepts into analytical tools.
Implementing longitudinal integrated curricula: Systematic review of barriers and facilitators
Authors: Hense Helene , Harst Lorenz , Küster Denise , Walther Felix , Schmitt Jochen
Published: October 2020

Purpose

The increase of longitudinal integrated curricula in medical schools worldwide represents the shift towards an outcome‐oriented education. This novel model allows comprehensive student‐patient interactions over time and integrates the educational content across disciplines. According to quantitative research, students, patients, doctors and communities benefit from this educational model in terms of participant satisfaction, learning outcomes and clinician recruitment. However, quantitative research does not provide detailed information on programme implementation processes. Therefore, this review aims to summarise facilitators and barriers of programme implementation reported in qualitative and mixed methods studies.

Method

The authors reviewed the literature about facilitators and barriers for the implementation of longitudinal integrated curricula in undergraduate medical education programmes. The systematic search was conducted in MEDLINE, Embase and PsycINFO on 2 December 2019. The authors used the CASP checklist for qualitative research for the critical appraisal and summarised the results across studies using thematic content analysis.

Results

The authors screened 1682 reports. Twenty studies examining 17 different curricula met the inclusion criteria. Most curricula were implemented in the United States (n = 6/17), Australia (n = 5/17) or Canada (n = 4/17). Programme implementation is facilitated and hampered by its educational components (eg continuity of supervision, safe learning environments), organisational structures (eg community involvement) and participating students' and staff’ motivation and personality. The critical appraisal revealed that several studies lacked transparent documentation and adequate reflection on the researcher‐participant relationship (n = 20/20), data collection instruments (n = 12/20) and recruitment strategy (n = 4/20).

Conclusions

The authors derived practical recommendations for the implementation of undergraduate, patient‐centred, integrated medical curricula. Programme managers need to define and communicate common objectives with all participants. They should clarify the implementation of the objectives in all processes in a transparent and structured manner. Considering reporting guidelines, future studies in this field should document more transparently the methods used to gain qualitative insights and the researchers' personal involvement.
Encouraging sustainable action in a food company: Impacting environmentally sustainable dietary and lifestyle behaviours using an in‐house Sustainability Toolkit and Challenge
Authors: Taibjee H. , Woodley L.
Published: October 2020

The need for more environmentally sustainable diets is clear and urgent; it is predicted that we will need two planets to feed the Earth’s population by 2050. Adopting more environmentally sustainable behaviours has become increasingly popular in the last decade, both at an individual and institutional level. However, whilst sustainability is now a mainstream issue, the perceived impracticalities that are attributed to more environmentally sustainable actions can act as a barrier to the widespread adoption of sustainable lifestyles and dietary behaviours in the general population. This study sought to observe the degree to which an in‐house Sustainability Toolkit and Sustainability Challenge can encourage the adoption of environmentally sustainable dietary and lifestyle behaviours by employees of a European food company. Eight employees participated in a successful pilot Sustainability Challenge, yielding greater feelings of empowerment and motivation in acting more sustainably. A full company rollout is now planned, and it is hoped that the Sustainability Toolkit and Sustainability Challenge will encourage current and future employees to adopt more environmentally sustainable lifestyles and dietary behaviours.