bluuebunny/crossref_metadata_2025 huggingface dataset:
Information technology and knowledge sharing for better health care: an emerging economy context
Authors: Turulja Lejla , Cinjarevic Merima , Veselinovic Ljiljan
Published: September 2020

Purpose

The present study aims to explore “what” type of knowledge is shared, “how” it is shared and what information and communication tools are used to share knowledge among health-care professionals in the context of emerging “digital laggard” country in the South-Eastern European region (i.e. Bosnia and Herzegovina [B&H]).

Design/methodology/approach

This study applies the qualitative research methodology and thematic analysis for collecting, analysing and interpreting data. Primary data is collected using semi-structured interviews (n = 9). Key informants are employees of the main primary health-care institution in the capital of B&H.

Findings

The results indicate that knowledge sharing among primary health-care practitioners is the interplay of formal and informal exchange of knowledge, facilitated by both traditional communication media (face-to-face interaction) and ICT-based tools. In regards to ICT tools, our findings suggest that instant messing applications (predominantly Viber) are viewed as common media for sharing tacit knowledge within a community of practice.

Research limitations/implications

This study is limited to one emerging digital laggard country; thus, future research regarding ICT-based knowledge sharing in other emerging digital laggard countries is welcomed.

Originality/value

In the context of “digital laggard”, societies, informal, spontaneous and dynamic system of social interactions can be a successful substitute for ICT-based formalised and structured system of knowledge sharing.
Volatility and dependence structures of Latin American stock markets
Authors: Cardoso Guilherme , Ribeiro Karem , Carvalho Luciano
Published: September 2020

Purpose

Risk management has been crucial to investors and regulators for pursuing market diversification opportunities and developing strategies to ensure market stability. This study examines the dependence structures of volatility, related to co-movements and macroeconomic effects, among Latin American stock markets and the risk–return spectrum benefits in the Latin American market using time-varying returns and volatility forecasts within a multivariate structure.

Design/methodology/approach

The sample comprised the largest stock markets in Latin America during the period from January 2000 to December 2017 and copulas and multivariate models were applied.

Findings

The results indicated that the copula with the best fit for modeling the dependence structure of the markets was symmetric Joe-Clayton with time-varying parameters. The dependence volatility structure was higher in the positive (upper tail) than in the negative (lower tail) returns, which may indicate that the Latin American markets had diversification benefits during downturns. Evidence of market coupling was found during times of the global crisis (subprime crisis) in Latin America. The presence of monetary and temporal effects over the dependence structures suggests that investors may obtain gains in a multivariate structure with copula distributions.

Originality/value

The findings will be of interest to researchers and practitioners for several reasons. First, this study contributes to the growing literature on the relationship between market dependence and volatility. Second, it indicates that the Latin American markets may present diversification advantages during downturns. Third, it informs the influence of macroeconomic effects on Latin American markets. The models that included the nonnormal and asymmetric characteristics of the financial market yielded better results in terms of less information loss and data adherence.
La diffusion des TIC ameliore‐t‐elle qualitativement les institutions politiques en Afrique?
Authors: Avom Désiré , Eyike Mbongo Louis de Berquin
Published: September 2020

This paper empirically analyses the impact of the diffusion of information and communication technology (ICT) on the quality of institutions simultaneously captured by democracy and corruption in a few African countries. To do so, we specify a panel Tobit model in which democracy is measured by the Institutional Quality Index proposed by the ICRG, while corruption is approximated by the Corruption Control Index. Our model is estimated on a sample of 40 African countries over the period 1995–2018. Overall, the main results show that ICT diffusion significantly improves the quality of democracy and reduces the propensity to corruption in the sample countries. We suggest strengthening the rule of law to increase the quality of democracy, a source of positive externalities on corruption.
Nonresident holdings of domestic debt in Nigeria: Internal or external driven?
Authors: Hosny Amr
Published: September 2020

This paper studies the drivers of nonresident holdings of local currency debt in Nigeria. Using data over 2007M1–2019M1, we show that, on average, global factors (global interest rates, oil prices) seem to carry more weight than domestic factors (treasury bills rate and domestic risk) in foreign portfolio investors’ decisions in Nigeria. Specifically, we show that foreign participation is, in the long run, positively correlated with oil prices and profitable rates of return on local‐currency instruments, but negatively correlated with exchange rate depreciation pressures. In the short run, oil prices, opportunity cost of funds and perception of Nigeria‐specific risks also play a role. These results highlight the volatile short‐term nature of such flows and call for a package of policy reforms to attract longer‐term direct investments.
Educational Goods: Values, Evidence, and Decision-Making—A Summary
Authors: Brighouse Harry , Ladd Helen F , Loeb Susanna , Swift Adam
Published: September 2020

This is a brief summary of the book Educational Goods: Values, Evidence, and Decision-Making by Harry Brighouse, Helen F. Ladd, Susanna Loeb and Adam Swift. It provides the introduction to the present symposium on this book, which includes the ensuing contributions from Carey Bagelman, Randall Curren, Michael Hand, John Tillson and Winston Thompson, followed by a response from the authors.
Handling biological sequences in R with the bioseq package
Authors: Keck François
Published: September 2020

With the democratization of molecular biology, more and more ecologists are required to analyse complex datasets including biological sequences.

I present the R package bioseq, a comprehensive toolset to handle biological sequences in R. The package implements three classes to work with DNA, RNA and amino acid sequences. Biological sequences are stored as simple vectors of character strings with restricted alphabets. This storage mode makes it easy to work with dataframes.

The package includes a collection of functions to perform basic editing operations on sequences and biological conversion among classes. The package can read and convert data from and to several formats. Thus, users can benefit from the richness of the R environment to perform advanced biological sequence analysis.

The bioseq package is a free software intended to be of significant value to researchers who need a simple and solid framework to analyse biological sequence data in R.
Effect of tranexamic acid on markers of inflammation in children undergoing craniofacial surgery
Authors: Fenger‐Eriksen Christian , Rasmussen Mads , Juul Niels , Krog Jan , Hvas Anne‐Mette
Published: September 2020

Background

Tranexamic acid (TXA) reduces blood loss and transfusion requirements during craniosynostosis surgery in small children. Possible interaction from TXA on the inflammatory system is unknown.

Objective

To evaluate the effect of TXA on a wide range of inflammatory markers in children receiving TXA in a randomized, blinded, and placebo controlled study design.

Methods

Thirty children undergoing craniosynostosis surgery with significant blood loss received TXA (bolus dose of 10 mg kg−1 followed by 8 hours continuous infusion of 3 mg kg−1 h−1) or placebo in a randomized, double‐blinded study design. Using a new proximity extension assays employing a panel of inflammatory biomarkers samples was used for analysis of blood samples obtained pre‐operatively, 4 and 24 hours after operation.

Results

Ninety‐two inflammatory parameters were measured. TXA did not affect any of the measured parameters as compared with placebo. Among 34 of the 92 pro‐ and antiinflammatory parameters investigated changes were observed between pre‐operative, 4 or 24 hours, respectively, reflecting immune activation during surgical stress.

Conclusion

TXA administration in a low‐dose regimen including bolus followed by 8 hours infusion during craniosynostosis surgery did not change any of 92 inflammatory markers as compared with placebo.
Evaluation of the factors related to difficult ultrasound‐guided radial artery catheterization in small children: A prospective observational study
Authors: Jung Oh Eun , Jin Min Jeong , Su Kim Chung , Yun Hwang Ji , Gook Joonhee , Lee Jong‐Hwan
Published: September 2020

Background

Although ultrasound guidance has significantly improved the success rate of radial artery catheterization, the failure rate in children is still high. For the further improvement of success rate, we prospectively evaluated the factors that make ultrasound‐guided radial artery catheterization difficult in children under two years old.

Methods

From October 2018 to September 2019, patients who required radial artery catheterization for surgery were enrolled. After collecting the anatomical characteristics of the radial artery using ultrasound at the puncture site, ultrasound‐guided radial artery catheterization was performed by one experienced anaesthesiologist. The primary outcome was to identify the factors related to the first attempt failure. The factors associated with the total duration of the procedure until success were also evaluated.

Results

A total of 183 children were included in the analysis. A radial artery cross‐sectional area of ≤1 mm2 (odds ratio [OR] = 5.26; 95% confidence interval [CI], 2.48‐11.18; P < .0001) and the presence of an anomalous radial artery branch (OR = 3.37; 95% CI, 1.43‐7.95; P = .005) were independent predictors of first‐attempt failure during ultrasound‐guided radial artery catheterization. The total procedure time was also negatively associated with the small cross‐sectional area (P < .001).

Conclusions

A cross‐sectional area of ≤ 1 mm2 and the presence of an anomalous branch of radial artery significantly increased the difficulty of ultrasound‐guided radial artery catheterization in children under two years old. In patients of these ages, pre‐procedural ultrasound scanning to find an optimal site for catheterization may increase the first‐attempt success rate although further studies are needed to verify our results.

Trial Registration

Clinical Research Information Service (https://crits.nih.go.kr, October 6, 2018 [KCT0003239]; Principle investigator: Jong‐Hwan Lee).
Prospective Study Examining the Effects of Extreme Drinking on Brain Structure in Emerging Adults
Authors: Hua Jessica P. Y. , Sher Kenneth J. , Boness Cassandra L. , Trela Constantine J. , McDowell Yoanna E. , Merrill Anne M. , Piasecki Thomas M. , Kerns John G.
Published: September 2020

Background

Emerging adulthood is a critical neurodevelopment period in which extreme drinking has a potentially pronounced neurotoxic effect. Therefore, extreme drinking, even a single episode, could be particularly harmful to the developing brain’s structure. Relatedly, heavy alcohol use in emerging adults has been associated with structural brain damage, especially in the corpus callosum. However, it is unclear whether and how much a single extreme drinking episode would affect brain morphometry.

Methods

For the first time in the literature, the current study prospectively examined the impact of an extreme drinking episode (i.e., twenty‐first birthday celebration) on the brain morphometry of emerging adults immediately following their birthday celebration (n = 50) and approximately 5 weeks post–birthday celebration (n = 29).

Results

We found evidence that a single extreme drinking episode was associated with structural changes immediately post–birthday celebration. Specifically, higher twenty‐first birthday estimated blood‐alcohol concentration was associated with decreased volume of the posterior and central corpus callosum immediately post–birthday celebration. This extreme drinking episode was not associated with further structural changes, or recovery, 5 weeks post–twenty‐first birthday celebration.

Conclusions

Overall, results suggest that a single episode of heavy drinking in emerging adulthood may be associated with immediate structural changes of the corpus callosum. Thus, emerging adulthood, which is characterized by high rates of extreme drinking, could be a critical period for targeted prevention and intervention.
In search of a dose–response relationship in SSRIs—a systematic review, meta‐analysis, and network meta‐analysis
Authors: Braun C. , Adams A. , Rink L. , Bschor T. , Kuhr K. , Baethge C.
Published: September 2020

Objective

Recent meta‐analyses on dose–response relationships of SSRIs are largely based on indirect evidence. We analyzed RCTs directly comparing different SSRI doses.

Method

Systematic literature search for RCTs. Two raters independently screened articles and extracted data. Across SSRIs, doses defined as low, medium, and high doses, based on drug manufacturers’ product monographs, were analyzed in pairwise random‐effects meta‐analyses and in a sensitivity network meta‐analysis with regard to differences in antidepressive efficacy (primary outcome). We also analyzed all direct comparisons of different dosages of specific SSRIs. (Prospero CRD42018081031).

Results

Out of 5333 articles screened, we included 33. Comparisons of dosage groups (low, medium, and high) resulted in only small and clinically non‐significant differences for SSRIs as a group, the strongest relating to medium vs low doses (SMD: −0.15 [95%‐CI: −0.28; −0.01) and not sustained in a sensitivity analysis. Among different doses of specific SSRIs, no statistically significant trend emerged for efficacy at higher doses, but 60 mg/day fluoxetine are statistically significantly inferior to 20 mg/day. Paroxetine results are inconclusive: 10 mg/day are inferior to higher doses, but 30 and 40 mg/day are inferior to 20 mg/day. Meaningful effects cannot be ruled out for certain drugs and dosages, often investigated in only one trial. Dropout rates increase with dose—particularly due to side effects. Network meta‐analyses supported our findings.

Conclusions

There is no conclusive level I or level II evidence of a clinically meaningful dose–response relationship of SSRIs as a group or of single substances. High SSRI doses are not recommended as routine treatment.
Relative contribution to the shark fin trade of Indo‐Pacific and Eastern Pacific pelagic thresher sharks
Authors: Cardeñosa D. , Fields A. T. , Shea S. K. H. , Feldheim K. A. , Chapman D. D.
Published: September 2020

Fins from highly mobile shark species entering large shark fin trade hubs can originate from various geographical locations and stocks. Tracing fins from internationally regulated species to their starting point in the supply chain can have important implications for the monitoring and enforcement of international laws intended to protect threatened shark species. Here we use pelagic thresher shark Alopias pelagicus fin samples (N = 86) collected during a 4‐year period (2014–2017), and phylogenetic analyses, using the cytochrome oxidase I (COI), to determine the relative contribution of this species to the two largest shark fin trade hubs in the world, Hong Kong and Guangzhou, mainland China. Our results suggest that the Eastern Pacific is a major starting point of the international supply chain of pelagic thresher shark fins, contributing 84.9% of the analyzed market‐derived fin samples. We suggest that capacity building investments are needed in Eastern Pacific countries to increase the efficiency of border control inspections and improve the enforcement of international trade regulations for this threatened shark species. Our study highlights the utility of combining population genetics data and large‐scale market surveys to trace wildlife products back to the starting point in the supply chain and support the assessment of emerging management and conservation measures for exploited sharks.
Revised guidelines for educational requirements for specialisation in endodontics in Australia and New Zealand (July 2020)
Authors: Rossi‐Fedele Giampiero , Damiani Fabrizio , Love Robert M , George Roy , Parashos Peter , Wu Morgan Cheng‐Yin , Friedlander Lara , Peters Ove A , Moule Alex J , Abbott Paul V
Published: September 2020

These revised guidelines developed by the Australian Society of Endodontology Inc. and the Australian and New Zealand Academy of Endodontists for educational requirements for specialisation in endodontics in Australia and New Zealand (version 2020) propose minimum criteria for training specialists in our field. The document contains a definition of endodontics and a description of the scope of endodontics. It proposes criteria for selection of the students and describes the proposed main features and a general outline of the education programme.
Walnut twig beetle landing rates differ between host and nonhost hardwood trees under the influence of aggregation pheromone in a northern California riparian forest
Authors: Homicz Crystal S. , Audley Jackson P. , Chen Yigen , Bostock Richard M. , Tauber Catherine A. , Seybold Steven J.
Published: September 2020

Host selection behaviour of the walnut twig beetle (WTB) among hardwood trees was investigated in a riparian forest in northern California by monitoring the landing rate of the beetle with sticky traps on branches baited with 3‐methyl‐2‐buten‐1‐ol, the male‐produced aggregation pheromone.

The assay was conducted over 7 days (22 May to 29 May 2017) and compared landing rates on branches of six nonhost species paired with northern California black walnut, Juglans hindsii (the host).

A total of 2242/1192 WTB were collected on branches of host/nonhost pairs, and more WTB landed on J. hindsii than on nonhosts in 42 of 58 instances. Female landing rate generally exceeded male landing rate, which underscores the influence of the male‐produced synthetic pheromone in this system.

Landing rates of WTB males, females, and the combined sexes on boxelder, Acer negundo, and valley oak, Quercus lobata, did not differ significantly from the landing rates on J. hindsii, suggesting that these two nonhost riparian hardwoods do not repel WTB (in the context of the aggregation pheromone).

Significantly fewer WTB landed on Oregon ash, Fraxinus latifolia, river red gum, Eucalyptus camaldulensis, Fremont cottonwood, Populus fremontii, and red willow, Salix laevigata, than on J. hindsii, which suggests that these four nonhosts may repel one or both sexes of WTB in the context of the aggregation pheromone. Future analysis of the volatiles from these four hardwood species may lead to the discovery of semiochemical repellents for WTB.
Slight volume changes in the duck lung do not imply a fundamental change in the structure of the parenchyma
Authors: Makanya Andrew N. , Kavoi Boniface M. , Kihurani David O.
Published: September 2020

Slight changes in lung volume have previously been reported in ducks. We studied the functional structure of the lung of the domestic duck using classical anatomical techniques as well as ultrasound monitoring to unravel the causes of such changes. Later dorsal and medioventral secondary bronchi were superficially positioned and covered with a thin transparent and collapsible membrane, internally lined with a cuboidal to squamous epithelium. The lung parenchyma was rigid, with atria well supported by septa containing smooth muscles, interparabronchial septa reinforced by collagen fibres, and blood capillaries supported by epithelial plates. On ultrasound monitoring, an outward and inward movement of the lung surface during inspiration and expiration, respectively, was evident at the region where the airways were covered by the thin membranes. The movements plausibly facilitated air movement in the lung just like the air sacs. We conclude that volume changes in the duck lung occur due to a slight morphological adaptation rather than a change in the archetypical design of the avian lung parenchyma.
Association of variants inPTPN22,CTLA‐4,IL2‐RA, andINSgenes with type 1 diabetes in Emiratis
Authors: Sharma Charu , R. Ali Bassam , Osman Wael , Afandi Bachar , Aburawi Elhadi H. , Beshyah Salem A , Al‐Mahayri Zeina , Al‐Rifai Rami H. , Al Yafei Zain , ElGhazali Gehad , Alkaabi Juma
Published: September 2020

Type 1 diabetes (T1D) is a chronic autoimmune disease with a complex interrelation of genetic and environmental factors. Genetic studies have reported HLA and non‐HLA loci as significant contributors to T1D. However, the genetic basis of T1D among Emiratis is unexplored. This study aims to determine the contribution of four genesPTPN22,CTLA‐4,IL2‐RA, andINSto T1D risk among Emiratis. The association between variants inPTPN22(rs2476601, rs1310182),CTLA‐4(rs11571316, rs231775, rs3087243, rs1427676, and rs231727),IL2‐RA(rs7090530), andINS(rs7111341) with T1D was tested in 310 Emiratis (139 T1D patients and 171 controls). A significant association was found at rs1310182, and rs2476601 both inPTPN22, rs3087243, and rs231775 both inCTLA‐4, and rs12251307 inIL2‐RA. Moreover, a haplotype constituted from GG and AG genotypes at rs231727 and rs231775, respectively, inCTLA‐4was significantly associated with an increased T1D risk. The cumulative effects of risk alleles for all significantly associated SNPs showed 11.8 higher relative risk for T1D for those who carry 5–6 compared to 0–1 risk alleles. This study illustrated thatPTPN22, CTLA‐4, andIL2‐RAgene variants could confer risk alleles for T1D among the Emirati population.
Impact of COVID‐19 on cancer patients: A review
Authors: Cavalcanti Iago Dillion Lima , Soares José Cleberson Santos
Published: September 2020

To inform about the impact of COVID‐19 on cancer patients, a literature review was carried out, using the descriptors “COVID‐19,” “SARS‐CoV‐2,” “Oncology,” and “Coronavirus,” in the Pubmed, Sciencedirect, and Scifinder databases. Fifty‐three articles were included after analyzing the inclusion and exclusion criteria, being divided into five sessions: Epidemiological aspects of COVID‐19; Pathophysiology of COVID‐19; Clinical aspects of cancer patients; Risks to cancer patients infected with COVID‐19; and Care for cancer patients amid a pandemic. The cancer patient has a weakened immune system, due to characteristics specific to the development of cancer or even chemotherapy, leaving these patients more susceptible to infections by COVID‐19. Thus, the development of protection plans for cancer patients should be encouraged, reducing the exposure of these patients to the SARS‐CoV‐2 virus, contributing to the maintenance of the health of the cancer patient, and avoiding possible therapeutic complications that can lead the patient to death.
Exploring the association between climate change concern and mitigation behaviour between societies: A person‐context interaction approach
Authors: Chan Hoi‐Wing , Tam Kim‐Pong
Published: September 2020

Despite the global scale of climate change, research comparing people’s behavioural expression of their concern for the problem across societies is lacking. The present investigation adopts a person‐context interaction approach to provide such a comparison and demonstrates the influences of societal‐level factors. We propose that some sociocultural contexts tend to be more agentic, allowing people to express their internal attributes, including climate change concern, whereas some contexts tend to be more restrictive, hindering people from doing so. With two international datasets, we observed that the association between climate change concern and mitigation behaviour was stronger among societies with higher levels of self‐expression affordance (indicated by lower levels of disease threat and higher levels of governance quality, economic development, and individualism). These results indicate the importance of considering not only individual‐level determinants but also societal‐level factors in the study of people’s behavioural response to climate change. They also offer insights into how environmental practitioners and decision makers can promote mitigation behaviour.
Detection rates of missing microsurgical needles using intra‐operative imaging
Authors: McCombe Alistair , Heald Alicia , Wagels Michael
Published: September 2020

Background

Unintentional retention of foreign bodies in surgery is uncommon but potentially serious. Published data regarding the consequence of retained surgical needles is sparse. We aimed to characterize lost surgical needles at our institution. Secondarily, we aimed to determine whether or not retained microsurgical needles can be reliably detected.

Methods

Reports of missing surgical needles at our institution were reviewed. Surgical needles of relevant sizes were scattered across an anthropomorphic model at representative anatomical locations. Fluoroscopic images of the field were acquired using two resolution settings. Medical staff in our department attempted to locate needles in these images.

Results

A total of 46 323 procedures were performed in the main theatres in the 2.5‐year period. Sixty‐two needles were reported as missing. No patient harm was documented. Needles of chord length 16 mm (5–0) or greater were always detected. High‐resolution fluoroscopy improves detection of needles with chord lengths of 9.3 (7–0) or 6.6 mm (9–0). Needles are consistently better detected in the lower limb for needles of chord length greater than 6.6 mm (9–0). Senior observers under ideal conditions can detect 7.1% of smaller needles.

Conclusion

When a needle is lost during surgery, consider the following before ordering fluoroscopy. Needles of chord length greater than 13 mm (6–0) should be reliably detected whilst 3.8 mm (10–0) needles will not. For sizes in between, ideal conditions for detection may include an operating field in the lower limb, high‐resolution fluoroscopy and a senior observer. It may not be necessary or cost effective to identify microsurgical needles with fluoroscopy.
Comparison of absorbable and permanent sutures for laparoscopic sacrocervicopexy: A randomized controlled trial
Authors: Tagliaferri Valeria , Ruggieri Stefania , Taccaliti Chiara , Gentile Cosimo , Didonna Teodora , D’asta Marco , Legge Francesco , Guida Piero , Scambia Giovanni , Guido Maurizio
Published: September 2020

Introduction

Pelvic organ prolapse is a common cause of morbidity and decreased quality of life among women and is treatable by laparoscopic sacrocolpopexy. Recent data suggest that absorbable sutures are a feasible and appealing option for mesh attachment given a potential decreased risk of complications related to mesh erosion. The aim of the present study was to demonstrate the non‐inferiority of absorbable sutures to permanent sutures for laparoscopic sacrocervicopexy.

Material and methods

We performed a randomized, single‐blinded, non‐inferiority trial comparing late‐absorbable sutures (group A) to non‐absorbable sutures (group B) for anterior and posterior vaginal mesh fixation during laparoscopic sacrocervicopexy at a single center in Italy. The primary outcome was prolapse correction at 12 months after surgery, defined as the absence of a pelvic organ prolapse leading edge reaching or extending below the level of the hymen and the absence of bulge symptoms. Secondary outcomes included intraoperative parameters, postoperative characteristics, and long‐term morbidity. Statistical analyses were performed using STATA version 16.

Results

A total of 150 patients with pelvic organ prolapse were prospectively randomized 1:1 into two groups (A or B). Baseline characteristics and intraoperative parameters including blood loss, operation time, and intraoperative complications were comparable between groups. The success rate was 100% in both groups and no differences in prolapse correction were observed. The rates of de novo urinary incontinence and persistent urinary incontinence were also similar between groups. The rate of mesh erosion at 12 months was 0% in group A and 4% in group B (P = .24).

Conclusions

Late absorbable sutures are non‐inferior to non‐absorbable sutures for laparoscopic sacrocervicopexy in terms of procedural success. Moreover we did not see any differences in terms of operative parameters, or intraoperative and postoperative characteristics, although the study was not powered to these outcomes.
The role of vision‐related problems in fatal road accidents in Finland
Authors: Wedenoja Juho , Kalsi Juhani , Salenius Salla , Parkkari Kalle , Kaarniranta Kai , Tervo Timo
Published: September 2020

Purpose

To evaluate the significance of vision‐related problems in fatal motor vehicle accidents (FMVAs) based on a systematic investigation process by multidisciplinary road accident investigation teams (RAITs).

Methods

Retrospective registry‐based study of all FMVAs during the years 2012–2016 in Finland in which driver causing the accident had a valid Finnish driving licence and the operated motor vehicle required having a driving licence.

Results

There were a total of 968 FMVAs. In only 1.3% of all the accidents, a vision‐related problem was considered to have contributed to the FMVA, while an observational failure of 23.6% was the leading cause of all the FMVAs.

Conclusions

Eye‐originating vision problems are rarely a causative risk for FMVAs in Finland. Making current visual standards more stringent would unlikely to be effective in FMVA prevention.
A randomised crossover trial of closed loop automated oxygen control in preterm, ventilated infants
Authors: Sturrock Sarah , Ambulkar Hemant , Williams Emma E. , Sweeney Samantha , Bednarczuk Nadja F. , Dassios Theodore , Greenough Anne
Published: September 2020

Aim

To determine whether closed loop automated oxygen control resulted in a reduction in the duration and severity of desaturation episodes and the number of blood gases and chest radiographs in preterm, ventilated infants.

Methods

Infants were studied on two consecutive days for 12 hours on each day. They were randomised to receive standard care (standard period) or standard care with a closed loop automated oxygen control system (automated oxygen control period) first.

Results

Twenty‐four infants with a median gestational age of 25.7 (range 23.1‐32.6) weeks were studied at a median postconceptional age of 27.4 (range 24.3‐34.9) weeks. During the automated oxygen control period, there were fewer desaturations that lasted >30 seconds (P = .032) or >60 seconds (P = .002), infants spent a higher proportion of the time within their target SpO2 range during the automated oxygen control period (P < .001), and fewer manual adjustments were made to the inspired oxygen concentration (mean 0.58 vs mean 11.29) (P < .001). There were no significant differences in the number of blood gases (P = .872) or chest radiographs (P = .366) between the two periods.

Conclusion

Closed loop automated oxygen delivery resulted in fewer prolonged desaturations with more time spent in the targeted oxygen range.
Overview of rearing and testing conditions and a guide for optimizing Galleria mellonella breeding and use in the laboratory for scientific purposes
Authors: Pereira Monalessa Fábia , Rossi Ciro César
Published: September 2020

The greater wax moth Galleria mellonella is an increasingly popular and consolidated alternative infection model to assess microbial virulence and the effectiveness of antimicrobial compounds. The lack of G. mellonella suppliers aiming at scientific purposes and a lack of well‐established protocols for raising and testing these animals may impact results and reproducibility between different laboratories. In this review, we discuss the state of the art of rearing the larvae in situ, providing an overview of breeding and testing conditions commonly used and their influence on larval health and experiments results, from setting up the environment, providing the ideal diet, understanding the effects of pretreatments, choosing the best testing conditions, to exploring the most from the results obtained. Meanwhile, we guide the reader through the most practical ways of dealing with G. mellonella to achieve successful experiments.
East Asia expert opinion on treatment initiation for chronic hepatitis B
Authors: Kao Jia‐Horng , Hu Tsung‐Hui , Jia Jidong , Kurosaki Masayuki , Lim Young‐Suk , Lin Han‐Chieh , Sinn Dong Hyun , Tanaka Yasuhito , Wai‐Sun Wong Vincent , Yuen Man‐Fung
Published: September 2020

Background

Globally, chronic hepatitis B (CHB) is a major public health concern. Timely and effective management can prevent disease progression to cirrhosis and reduce the risk of hepatocellular carcinoma (HCC). Currently, there is no consensus on the clinical management of CHB in East Asia.

Aim

To establish an East Asia expert opinion on treatment initiation for CHB based on alanine aminotransferase (ALT) level, hepatitis B virus (HBV) deoxyribonucleic acid (DNA) level, cirrhosis and HCC risk scores.

Methods

A meeting was held online with a panel of 10 experts from East Asia to discuss ALT, HBV DNA, cirrhosis and HCC risk scores. Indications for CHB treatment in the latest international guidelines were reviewed. Consensus was summarised to provide recommendations on the initiation of treatment for CHB.

Results

Anti‐viral therapy is recommended for CHB patients with (a) HBV DNA ≥ 2000 IU/mL and ALT ≥ 1× upper limit of normal (ULN); (b) HBV DNA ≥ 2000 IU/mL, ALT < 1× ULN and ≥ F2 fibrosis and/or ≥ A2 necroinflammation occurs; (c) cirrhosis and detectable HBV DNA; or (d) HBV DNA ≥ 2000 IU/mL, ALT < 1× ULN and a family history of cirrhosis or HCC, extrahepatic manifestations or age > 40 years. Patients with cirrhosis and/or HCC should be treated regardless of ALT levels if HBV DNA level is detectable. Initiating anti‐viral therapy or close monitoring at 3‐month intervals is recommended for CHB patients with at least two HCC risk factors.

Conclusions

These expert recommendations will contribute to a new standard of daily clinical practice in East Asia.
Spices as the saviour? The complex vulnerabilities of three commodity crop booms and ethnic minority livelihoods in Yunnan's agrarian frontier
Authors: Zuo Zhenting , Langill Jennifer C. , Turner Sarah , Rousseau Jean‐François
Published: September 2020

Commodity crops are redefining land use and rural smallholder livelihoods across Asia. These crops often have boom‐bust cycles with important implications for the drivers of farmer entry into and exit from particular cash crop opportunities. This paper offers a comparative analysis of the boom‐bust processes of three popular spice crops cultivated in Yunnan Province, southwest China. Drawing from agrarian frontiers and rural livelihoods literature, we disentangle the vulnerability contexts associated with black cardamom, cinnamon and star anise production, finding that farmers cultivating these spices face a combination of interlocking forms of vulnerability. Despite the monetary potential that each crop offered during its ‘boom’, the associated environmental, economic and political vulnerabilities caused most farmers to exit their production, responding with myriad on‐farm and off‐farm diversification strategies. Using a multi‐sited ethnographic approach, we draw on 52 in‐depth interviews with ethnic minority cultivators, spice traders and local government officials to untangle the complexities associated with cash crop production in this agrarian frontier, the interwoven vulnerabilities that result in their ‘busts’ and the coping and adaptation strategies that smallholder farmers employ. Our findings underline the importance of disaggregating farmer vulnerabilities and the need for more nuanced policy responses to adequately support small‐scale farmers.
A marginal moment matching approach for fitting endemic‐epidemic models to underreported disease surveillance counts
Authors: Bracher Johannes , Held Leonhard
Published: September 2020

Count data are often subject to underreporting, especially in infectious disease surveillance. We propose an approximate maximum likelihood method to fit count time series models from the endemic‐epidemic class to underreported data. The approach is based on marginal moment matching where underreported processes are approximated through completely observed processes from the same class. Moreover, the form of the bias when underreporting is ignored or taken into account via multiplication factors is analyzed. Notably, we show that this leads to a downward bias in model‐based estimates of the effective reproductive number. A marginal moment matching approach can also be used to account for reporting intervals which are longer than the mean serial interval of a disease. The good performance of the proposed methodology is demonstrated in simulation studies. An extension to time‐varying parameters and reporting probabilities is discussed and applied in a case study on weekly rotavirus gastroenteritis counts in Berlin, Germany.
Combined administration of lauric acid and glucose improved cancer‐derived cardiac atrophy in a mouse cachexia model
Authors: Nukaga Shota , Mori Takuya , Miyagawa Yoshihiro , Fujiwara‐Tani Rina , Sasaki Takamitsu , Fujii Kiyomu , Mori Shiori , Goto Kei , Kishi Shingo , Nakashima Chie , Ohmori Hitoshi , Kawahara Isao , Luo Yi , Kuniyasu Hiroki
Published: September 2020

Cancer‐derived myocardial damage is an important cause of death in cancer patients. However, the development of dietary interventions for treating such damage has not been advanced. Here, we investigated the effect of dietary intervention with lauric acid (LAA) and glucose, which was effective against skeletal muscle sarcopenia in a mouse cachexia model, on myocardial damage. Treatment of H9c2 rat cardiomyoblasts with lauric acid promoted mitochondrial respiration and increased ATP production by Seahorse flux analysis, but did not increase oxidative stress. Glycolysis was also promoted by LAA. In contrast, mitochondrial respiration and ATP production were suppressed, and oxidative stress was increased in an in vitro cachexia model in which cardiomyoblasts were treated with mouse cachexia ascites. Ascites‐treated H9c2 cells with concurrent treatment with LAA and high glucose showed that mitochondrial respiration and glycolysis were promoted more than that of the control, and ATP was restored to the level of the control. Oxidative stress was also reduced by the combined treatment. In the mouse cachexia model, myocardiac atrophy and decreased levels of a marker of muscle maturity, SDS‐soluble MYL1, were observed. When LAA in CE‐2 diet was orally administered alone, no significant rescue was observed in the cancer‐derived myocardial disorder. In contrast, combined oral administration of LAA and glucose recovered myocardial atrophy and MYL1 to levels observed in the control without increase in the cancer weight. Therefore, it is suggested that dietary intervention using a combination of LAA and glucose for cancer cachexia might improve cancer‐derived myocardial damage.
Autophagy regulates levels of tumor suppressor enzyme protein phosphatase 6
Authors: Fujiwara Nobuyuki , Shibutani Shusaku , Sakai Yusuke , Watanabe Toshio , Kitabayashi Issay , Oshima Hiroko , Oshima Masanobu , Hoshida Hisashi , Akada Rinji , Usui Tatsuya , Ohama Takashi , Sato Koichi
Published: September 2020

Protein phosphatase 6 (PP6) is an essential serine/threonine protein phosphatase that acts as an important tumor suppressor. However, increased protein levels of PP6 have been observed in some cancer types, and they correlate with poor prognosis in glioblastoma. This raises a question about how PP6 protein levels are regulated in normal and transformed cells. In this study, we show that PP6 protein levels increase in response to pharmacologic and genetic inhibition of autophagy. PP6 associates with autophagic adaptor protein p62/SQSTM1 and is degraded in a p62‐dependent manner. Accordingly, protein levels of PP6 and p62 fluctuate in concert under different physiological and pathophysiological conditions. Our data reveal that PP6 is regulated by p62‐dependent autophagy and suggest that accumulation of PP6 protein in tumor tissues is caused at least partially by deficiency in autophagy.
Baseline levels of seminal reactive oxygen species predict improvements in sperm function following antioxidant therapy in men with infertility
Authors: Vessey Wayne , Saifi Shaghayegh , Sharma Aditi , McDonald Cassandra , Almeida Paula , Figueiredo Monica , Minhas Suks , Virmani Ashraf , Dhillo Waljit S. , Ramsay Jonathan W. , Jayasena Channa N.
Published: September 2020

Background

Poor sperm function is a major cause of infertility. There is no drug therapy to improve sperm function. Semen oxidative stress is a recently identified pathway for sperm damage. Commercial antioxidants such as L‐carnitine and acetyl‐L‐carnitine (LAL) are commonly self‐administered by infertile men. However, concerns have been raised whether inappropriate LAL therapy causes reductive stress‐mediated sperm damage. It is imperative to investigate whether: (1) LAL improves sperm function by reducing reactive oxidative species (ROS); (2) LAL has differential effects on sperm function between men with normal and elevated ROS.

Methods

A prospective cohort study of routine clinical practice was performed in infertile men with abnormal sperm quality. Changes in sperm function and semen ROS levels following three months of oral LAL therapy were compared between participants with baseline seminal normal ROS (≤10RLU/SEC/106sperm; n = 29) and High ROS (>10 RLU/SEC/106sperm; n = 15) levels measured using an established colorimetric‐luminol method.

Results

In normal ROS group, sperm function did not change following LAL therapy. In high ROS group, LAL therapy reduced semen ROS fivefold, increased sperm count by 50% (mean count in mill/ml: 21.5 + 7.2, baseline; 32.6 + 9.5, post‐treatment, P = .0005), and total and progressive sperm motility each by 30% (mean total sperm motility in % 29.8 + 5.0, baseline: 39.4 + 6.2, post‐treatment, P = .004; mean progressive sperm motility in % 23.1 + 4.6, baseline: 30.0 + 5.5, post‐treatment, P = .014 vs. baseline).

Conclusions

We report for the first time that LAL only improves sperm quality in infertile men who have baseline high‐ROS levels prior to treatment. These data have important potential implications for couples with male infertility and their clinicians.
Artificial intelligence‐based detection of lymph node metastases by PET/CT predicts prostate cancer‐specific survival
Authors: Borrelli Pablo , Larsson Måns , Ulén Johannes , Enqvist Olof , Trägårdh Elin , Poulsen Mads Hvid , Mortensen Mike Allan , Kjölhede Henrik , Høilund‐Carlsen Poul Flemming , Edenbrandt Lars
Published: September 2020

Introduction

Lymph node metastases are a key prognostic factor in prostate cancer (PCa), but detecting lymph node lesions from PET/CT images is a subjective process resulting in inter‐reader variability. Artificial intelligence (AI)‐based methods can provide an objective image analysis. We aimed at developing and validating an AI‐based tool for detection of lymph node lesions.

Methods

A group of 399 patients with biopsy‐proven PCa who had undergone 18F‐choline PET/CT for staging prior to treatment were used to train (n = 319) and test (n = 80) the AI‐based tool. The tool consisted of convolutional neural networks using complete PET/CT scans as inputs. In the test set, the AI‐based lymph node detections were compared to those of two independent readers. The association with PCa‐specific survival was investigated.

Results

The AI‐based tool detected more lymph node lesions than Reader B (98 vs. 87/117; p = .045) using Reader A as reference. AI‐based tool and Reader A showed similar performance (90 vs. 87/111; p = .63) using Reader B as reference. The number of lymph node lesions detected by the AI‐based tool, PSA, and curative treatment was significantly associated with PCa‐specific survival.

Conclusion

This study shows the feasibility of using an AI‐based tool for automated and objective interpretation of PET/CT images that can provide assessments of lymph node lesions comparable with that of experienced readers and prognostic information in PCa patients.
Adenosine deaminase cutoff value when diagnosing tuberculous pleurisy in patients aged 40 years and older
Authors: Arpinar Yigitbas Burcu , Satici Celal , Kosar A. Filiz
Published: September 2020

Introduction

Tuberculous pleurisy (TBP) is one of the most common manifestations of extra‐pulmonary tuberculosis. In patients aged ≥40 years, a closed needle pleural biopsy is recommended with an adenosine deaminase (ADA) level of 40‐70 U/L. We aim to investigate whether the cutoff value of ADA and the cancer ratio in patients with TBP aged ≥40 years is different and determine the effects of both compounded biomarkers on diagnosing TBP.

Materials and Methods

Between 2009 and 2016, the ADA levels were measured in pleural effusions from patients who were admitted to the Chest disease clinic.

Results

Of the 196 patients included in the study, 104 were aged ≥40 years. A significant relationship was found between the serum LDH/pleural ADA (sLDH/pADA) ratio and ADA levels in patients aged >40 years (OR: 0.935 and OR: 1.085, respectively). The model using an ADA value ≥30 and an sLDH/pADA ratio <16 yielded a sensitivity of 94.25% (95% CI, 87.1‐98.10) in all patients and 69.23% (95% CI, 54.9‐81.28) in patients aged >40 years.

Conclusion

ADA and the sLDH/pADA ratio are simple, cost‐efficient, and obtain fast results and, therefore, are the preferred methods in TBP diagnosis. The diagnosis rate in the present study was 91% using ADA levels in combination with the sLDH/pADA ratio, both of which can be obtained only through thoracentesis.
Adenomatoid tumor of the skin: Differential diagnosis of an umbilical erythematous plaque
Authors: Ferreira Ingrid , De Lathouwer Olivier , Fierens Hugues , Theunis Anne , André Josette , de Saint Aubain Nicolas
Published: September 2020

Adenomatoid tumors are benign tumors of mesothelial origin that are usually encountered in the genital tract. Although they have been observed in other organs, the skin appears to be a very rare location, with only one case reported in the literature to our knowledge. We report a second case of an adenomatoid tumor, arising in the umbilicus of a 44‐year‐old woman. The patient presented with an 8‐month‐old erythematous and firm plaque under the umbilicus. A skin biopsy showed numerous microcystic spaces dissecting a fibrous stroma and lined by flattened to cuboidal cells with focal intraluminal papillary formation. This little‐known diagnosis constitutes a diagnostic pitfall for dermatopathologists and dermatologists, and could be misdiagnosed as other benign or malignant entities. Through this case report, a practical approach and diagnostic keys have been devised to avoid misdiagnosis and overtreatment.
Women's invisible work in disaster contexts: gender norms in speech on women's work after a forest fire in Sweden
Authors: Danielsson Erna , Eriksson Kerstin
Published: September 2020

The aim of this study is to investigate what women do in disaster situations and how both men and women perceive and discuss the work of women. These patterns were evidenced in the stories that were told following the largest forest fire in the modern history of Sweden in July 2014. The study is based on 31 retrospective interviews with volunteers involved in combating the forest fire and concentrates on stories about the supportive work of women during this disaster. The results indicate that women were praised when they followed traditional norms but were denigrated when they performed what were viewed as male‐coded tasks. The stories reveal norms concerning what a woman is and is not by focusing on women's age and clothing and by directly and indirectly questioning their abilities and authority. The norms are also rendered visible by the positive attention that women receive while describing doing what is expected of them.