bluuebunny/crossref_metadata_2025 huggingface dataset:
Health insurance sector in India: an analysis of its performance
Authors: Dutta Madan Mohan
Published: November 2020

Purpose

Health insurance is one of the major contributors of growth of general insurance industry in India. It alone accounts for around 29% of total general insurance premium income earned in India. The growth of this sector is important from the perspective of overall growth of general insurance Industry. At the same time, problems in this sector are also many which are affecting its performance.

Design/methodology/approach

The paper provides an understanding on performance of health insurance sector in India. This study attempts to find out how much claims and commission and management expenses it has to incur to earn certain amount of premium. Methodology used for the study is regression analysis to establish relationship between dependent variable (Profit/Loss) and independent variable (Health Insurance Premium earned).

Findings

Findings of the study indicate that there is significant relationship between earned premium and underwriting loss. There has been increase of premium earnings which instead of increasing profit for the sector in fact has increased underwriting loss over the years. The earnings of the sector is growing at compounded annual growth rate of 27% still it is unable to earn underwriting profit.

Originality/value

This study is self-driven based on secondary data obtained from insurance regulatory and development authority site.
Patterns in intraspecific variation in root traits are species‐specific along an elevation gradient
Authors: Weemstra Monique , Freschet Grégoire T. , Stokes Alexia , Roumet Catherine
Published: November 2020

Intraspecific trait variation is an important driver of plant performance in different environments. Although roots acquire essential resources that vary with the environment, most studies have focused on intraspecific variation in leaf traits, and research on roots is often restricted to a few species. It remains largely unclear how and to what extent root traits vary with the environment and whether general intraspecific patterns exist across species.

We compared intraspecific variation in specific root length (SRL), root diameter, root tissue density (RTD) and root branching density of 11 species along a 1,000 m elevation gradient in the French Alps. We tested (a) the extent of intraspecific versus interspecific root trait variation along the gradient, (b) whether intraspecific trait patterns with elevation were consistent among species and (c) whether environmental variables better explained intraspecific variation in root traits than elevation. Specifically, we hypothesised that within a species, root trait values would adjust to enhance resource acquisition (either through an increase in SRL or root diameter, and/or in branching density) and/or conservation (increased RTD) at higher elevations.

Species identity explained most of the overall variation in root traits. Elevation explained only a minor proportion of intraspecific root trait variation, which was larger within than between elevations. Also, trait relationships with elevation rarely agreed with our hypotheses, varied strongly across species and were often differently related to environmental variation. Generally, climate, soil and vegetation properties better explained intraspecific root variation than elevation, but these relationships were highly species‐dependent.

Along complex environmental gradients where multiple properties simultaneously change, roots of different species vary in different ways, leading to species‐specific patterns in intraspecific root trait variation. The lack of support for our hypotheses may be caused by the multiple interactions between environmental properties, small‐scale soil heterogeneity, species phylogeny and changing plant–plant interactions. Our findings suggest that, to enhance our understanding of the effects of environmental change on plant performance, we need to better integrate the multiple dimensions of plant responses to change and measure a broader set of root traits and environmental variables.

A free Plain Language Summary can be found within the Supporting Information of this article.
A workflow for multimineralogic carbonate rock physics modelling in a Bayesian framework: Brazilian pre‐salt reservoir case study
Authors: Dias Jonatan , Lopez Jorge L. , Velloso Raquel , Perosi Fabio
Published: November 2020

We develop a workflow to estimate elastic attributes ( and ) of Pre‐Salt carbonate reservoirs using the Xu and Payne rock physics model in a depth‐variant multimineralogic fashion and apply it to one calibration and four extrapolation wells in a field in the Brazilian Santos Basin. Some of the parameters were stochastically simulated in a Bayesian framework to handle the model non‐uniqueness. Nuclear magnetic resonance porosity and mineralogic logs and x‐ray powder diffraction data from the studied wells and literature reference values were used for elastic solid media and dual‐porosity network modelling, bringing geological reasoning to the proposed workflow. Using rock physics templates, we improved our understanding of the reservoir petroelastic trends and devised alternative model parameterizations. Since the model was parameterized in a multimineralogic fashion with depth‐variant mineralogic information (e.g. volumes of carbonate, quartz and clay) as input, we improved elastic attribute estimations within the reservoir, increasing the model predictive power, compared to the common practice of allowing only porosity to vary with depth and representing the matrix properties by a depth‐invariant homogeneous or mixed mineral. We also investigated the workflow robustness and non‐uniqueness by studying its dependence on the choice of calibration well.
What drives biodiversity patterns? Using long‐term multidisciplinary data to discern centennial‐scale change
Authors: Woodbridge Jessie , Fyfe Ralph , Smith David , Pelling Ruth , de Vareilles Anne , Batchelor Robert , Bevan Andrew , Davies Althea L.
Published: November 2020

Biodiversity plays an important role in ecosystem functioning, habitat recovery following disturbance and resilience to global environmental change. Long‐term ecological records can be used to explore biodiversity patterns and trends over centennial to multi‐millennial time‐scales across broad regions. Fossil pollen grains preserved in sediment over millennia reflect palynological richness and diversity, which relates to changes in landscape diversity. Other long‐term environmental data, such as fossil insects, palaeoclimate and archaeologically inferred palaeodemographic (population) data, hold potential to address questions about the drivers and consequences of diversity change when combined with fossil pollen records.

This study tests a model of Holocene palynological diversity change through a synthesis of pollen and insect records from across the British Isles along with palaeodemographic trends and palaeoclimate records. We demonstrate relationships between human population change, insect faunal group turnover, palynological diversity and climate trends through the Holocene.

Notable increases in population at the start of the British Neolithic (~6,000 calendar years before present [bp]) and Bronze Age (~4,200 bp) coincided with the loss of forests, increased agricultural activity and changes in insect faunal groups to species associated with human land use. Pollen diversity and evenness increased, most notably since the Bronze Age, as landscapes became more open and heterogeneous. However, regionally distinctive patterns are also evident within the context of these broad‐scale trends. Palynological diversity is correlated with population while diversity and population are correlated with some climate datasets during certain time periods (e.g. Greenland temperature in the mid‐late Holocene).

Synthesis. This study has demonstrated that early human societies contributed to shaping palynological diversity patterns over millennia within the context of broader climatic influences upon vegetation. The connections between population and palynological diversity become increasingly significant in the later Holocene, implying intensifying impacts of human activity, which may override climatic effects. Patterns of palynological diversity trends are regionally variable and do not always follow expected trajectories. To fully understand the long‐term drivers of biodiversity change on regionally relevant ecological and management scales, future research needs to focus on amalgamating diverse data types, along with multi‐community efforts to harmonise data across broad regions.
Work, Care and Gender during the COVID‐19 Crisis*
Authors: Hupkau Claudia , Petrongolo Barbara
Published: November 2020

We explore the effects of the COVID‐19 crisis and the associated restrictions to economic activity on paid and unpaid work for men and women in the United Kingdom. Using data from the COVID‐19 supplement of Understanding Society, we find evidence that labour market outcomes of men and women were roughly equally affected at the extensive margin, as measured by the incidence of job loss or furloughing. But, if anything, women suffered smaller losses at the intensive margin, experiencing slightly smaller changes in hours and earnings. Within the household, women provided on average a larger share of increased childcare needs, but in an important share of households fathers became the primary childcare providers. These distributional consequences of the pandemic may be important to understand its inequality legacy over the longer term.
Hippocampal volume and memory impairment after electroconvulsive therapy in patients with depression
Authors: Gbyl Krzysztof , Støttrup Mette Marie , Mitta Raghava Jayachandra , Xue Jie Song , Videbech Poul
Published: November 2020

Objective

Patients hesitate to consent to electroconvulsive therapy (ECT) because of the fear of memory impairment. The mechanisms underlying this impairment are unclear, but several observations suggest hippocampal alterations may be involved. We investigated whether ECT‐induced change in hippocampal volume correlates with memory impairment.

Methods

Using a 3 T MRI scanner, we acquired brain images and assessed cognitive performance in 22 severely depressed patients at three time points: (1) before ECT series, (2) within one week after the series, and (3) at six‐month follow‐up. The hippocampus was segmented into subregions using FreeSurfer. The dentate gyri (DG) were the primary regions of interest (ROIs) and major hippocampal subregions secondary ROIs. Cognitive performance was assessed using the Screen for Cognitive Impairment in Psychiatry and verbal memory using the Verbal Learning subtest. The linear mixed model and the repeated‐measures correlation were used for statistical analyses.

Results

ECT induced an increase in the right and left DG volume with co‐occurring worsening in verbal memory, and these changes were within‐patients negatively correlated (right DG,rrm = −0.85, df = 18,p = 0.0000002; left DG,rrm = −0.58, df = 18,p = 0.008). At a six‐month follow‐up, the volume of both DG decreased with a co‐occurring improvement in verbal memory, and these changes were negatively correlated in the right DG (rrm = −0.64, df = 15,p = 0.005). Volume increases in 14 secondary ROIs were also negatively correlated with memory impairment.

Conclusion

ECT‐related transient increases in the volume of major hippocampal subregions within‐patients are associated with memory impairment. Hippocampal alterations following ECT should be the focus in searching for causes of the cognitive side effects.
The association between cannabis use and testicular function in men: A systematic review and meta‐analysis
Authors: Belladelli Federico , Del Giudice Francesco , Kasman Alex , Kold Jensen Tina , Jørgensen Niels , Salonia Andrea , Eisenberg Michael L.
Published: November 2020

Objective

To evaluate the association between cannabis use and testicular function (as assessed through semen quality and serum hormone levels) in different populations.

Evidence Review

Systematic review and meta‐analysis of population‐based retrospective cohort studies. PRISMA guidelines were used for abstracting data and assessing data quality and validity. Data were pooled using a fixed‐effects or random‐effects model depending on the heterogeneity of studies included. Pooled risk ratio (RR) of having any sperm abnormality and testosterone, FSH, and LH standardized mean differences among male cannabis users and non‐users, and meta‐regression analysis according to age and year of publication.

Results

Nine studies were evaluated which included 4014 men with semen data and 4787 with hormonal data. Overall among 1158 cannabis users, 44.9% had impaired semen parameters, compared with 24.5% of the 2856 non‐users. The relative risk among cannabis users for any abnormal semen parameter was 1.159 (95% CI: 0.840; 1.599, P = 0.369). The standardized mean difference between user and non‐user testosterone levels was −0.139 (95% CI: −0.413; 0.134, P = 0.318). For FSH, the standardized mean difference estimate was −0.142 (95% CI: −0.243; −0.0425, P = 0.005), while for LH the standardized mean difference estimate was −0.318 (95% CI: −0.810‐0.175; P = 0.206).

Conclusions

The current evidence does not suggest clinically significant associations between cannabis use and testicular function. However, we cannot exclude an effect of cannabis because of the limited and heterogeneous studies. Additionally, well‐designed studies will be needed to define the association between cannabis use and the male reproductive system.
Ultrasound in the prediction of birthweight discordance in dichorionic twins
Authors: Lei Ting , Zheng Ju , Papageorghiou Aris T. , Feng Jie‐Ling , Lin Mei‐Fang , Zhang Fan , Xie Hong‐Ning
Published: November 2020

Introduction

Large birthweight discrepancy has been identified as a risk factor for perinatal morbidity and mortality in twin pregnancies. However, it remains unclear whether such discordance can be predicted by various biological indices with specific cut‐off values, and how these depend on the gestational age. We aimed to determine the most effective way to predict large birthweight discordance at various gestational ages.

Material and methods

A retrospective cohort study of dichorionic twins, live‐born between 2008 and 2018, was conducted. Discordances in biparietal diameter, head circumference, humerus and femur length, abdominal circumference, and estimated fetal weight were calculated—([larger twin − smaller twin] / larger twin) × 100%—and compared between those with and without a large birthweight discordance (≥20%). Receiver operating characteristic curves were constructed to analyze the predictive characteristics of each parameter.

Results

Of 598 dichorionic twin pregnancies included, 83 (13.9%) had a birthweight discordance ≥20%. Group differences in biparietal diameter and head circumference discordance were the earliest to emerge (before 20 weeks of gestation), but became insignificant after 36 weeks, followed by humerus and femur length, estimated fetal weight discordance (after 20 weeks), and abdominal circumference discordance (after 28 weeks). The best predictors (with cut‐off values) were discordance in biparietal diameter ≥7.8% at <20 weeks, head circumference ≥4.5% at 20‐23+6 weeks, humerus length ≥4.5% at 24‐27+6 weeks, and estimated fetal weight discordance (≥11.6% at 28‐31+6 weeks, ≥10.5% at 32‐35+6 weeks, and ≥15.0% ≥36 weeks), with sensitivity and specificity of 52%‐77% and 69%‐82%, respectively.

Conclusions

Different predictors and cut‐off values may be useful for predicting large inter‐twin birthweight discordance in dichorionic twins at different gestational ages. It is more accurate to use biparietal diameter and head circumference discordance in the early second trimester, humerus length discordance in the late second trimester, and estimated fetal weight discordance in the third trimester.
Altered colonic motility is associated with low anterior resection syndrome
Authors: Keane Celia , Paskaranandavadivel Nira , Vather Ryash , Rowbotham David , Arkwright John , Dinning Phil , Bissett Ian , O’Grady Greg
Published: November 2020

Aim

Patients frequently suffer from low anterior resection syndrome (LARS) after distal colorectal resection. The pathophysiology of LARS has not been clearly elucidated. We hypothesized that rectosigmoid resection could impair motility patterns in the distal colon, such as the rectosigmoid brake, which contribute to control of stool form and frequency.

Method

High‐resolution colonic manometry was performed in patients who had previously undergone distal colorectal resection (mean 6.8 years after resection) and non‐operative controls before and after a standardized meal. Symptoms were assessed using the LARS score. Propagating contractions were compared between patients with and without LARS, and controls.

Results

Data were analysed from 23 patients (11 no‐LARS; 12 LARS) and nine controls. All groups demonstrated a significant meal response. LARS patients had fewer post‐prandial antegrade propagating contractions than controls (P = 0.028), and fewer retrograde propagating contractions both pre‐ (P = 0.005) and post‐prandially (P = 0.004). Post‐prandially, the LARS group had a significantly lower percentage of propagating contractions that met the criteria for the cyclic motor pattern compared to the control group (26% vs. 58%; P = 0.009). There were significant differences in antegrade and retrograde amplitude (P = 0.049; P = 0.018) and distance of propagation (P = 0.003; P = 0.002) post‐prandially between LARS patients and controls.

Conclusion

Rectosigmoid resection alters the meal response following anterior resection, including impairment of the rectosigmoid brake cyclic motor pattern. These findings help to quantify the impaired functional motility after rectosigmoid resection and offer new insights into the mechanisms of LARS.
EB (Epidermolysis bullosa)‐Haus Austria: Pionierarbeit für die Betreuung von Patienten mit seltenen Erkrankungen
Authors: Prodinger Christine , Laimer Martin , Bauer Johann W , Hintner Helmut
Published: November 2020

Die Versorgung von Patienten mit Epidermolysis bullosa (EB) stellt angesichts der Seltenheit, der Heterogenität und Komplexität der Erkrankungsgruppe eine besondere Herausforderung dar. Die primäre und sekundäre Beteiligung zahlreicher extrakutaner Organsysteme führt zudem zu erheblicher Morbidität und Mortalität. Um diese besser zu bewältigen, sind spezialisierte Behandlungszentren von Nöten, die eine individuelle, interdisziplinär akkordierte Betreuung nach aktuellem medizinischen Standard sowie Zugang zu innovativen Therapiemöglichkeiten gewährleisten. Mit diesem Ziel wurde 2005 das EB‐Haus Austria gegründet, das 2017 zum ersten österreichischen Expertisezentrum für Genodermatosen mit Schwerpunkt auf EB designiert wurde und auch als Mitglied in das Europäische Referenznetzwerk für seltene Hauterkrankungen (ERN Skin) aufgenommen wurde. Die Säulen dieser Institution (Ambulanz, Forschungseinheit, Akademie, Klinisches Studienzentrum) betreiben einen regen Austausch untereinander, mit zahlreichen nationalen sowie internationalen klinischen und wissenschaftlichen Partnern, wie auch insbesondere mit Patienten und deren Angehörige über die Selbsthilfegruppe DEBRA Austria. Die Entwicklung des EB‐Hauses Austria als Referenzzentrum war über weite Strecken von Pionierarbeit gekennzeichnet, die wegbereitend für die Optimierung der Betreuung vergleichbarer Erkrankungen sowie allgemeiner Versorgungsstrukturen sein kann.
Das subkutane weiße Fettgewebe: die unterste Etage der immunologischen Hautbarriere
Authors: Brüggen Marie‐Charlotte , Stingl Georg
Published: November 2020

Die äußere Begrenzung des Körpers von Säugetieren, die Haut, besteht aus drei Schichten, Epidermis, Dermis und subkutanem weissem Fettgewebe (subcutaneous white adipose tissue, SWAT). Während die Epidermis und Dermis hinsichtlich ihrer Funktion als «Immunbarriere» eingehend charakterisiert sind, ist über das SWAT nur wenig bekannt. SWAT des Menschen setzt sich aus Läppchen zusammen, die vor allem aus Adipozyten bestehen und durch vaskularisierte Bindegewebssepten unterteilt und voneinander getrennt werden. Eine immun‐phänotypische Untersuchung von durch Fettabsaugung gewonnenem SWAT zeigte, dass gesundes SWAT keine Entzündungszeichen aufweist, jedoch Immunzellen beherbergt.  Im Unterschied zur restlichen Haut handelt es sich dabei hauptsächlich um Makrophagen und, in geringerem Maße, T‐ Lymphozyten, deren Phänotyp darauf hinweist, dass ihnen primär anti‐inflammatorische und regulierende Funktionen zukommen. SWAT besitzt also nicht nur eine mechanische, sondern möglicherweise auch immunologische Schutzfunktion, die darin besteht, überschießende Immun‐ sowie Entzündungsreaktionen zu verhindern oder zumindest abzumildern.
Application of lung ultrasonography in critically ill patients with COVID‐19
Authors: Li Shuo , Qu Ya‐Li , Tu Mu‐Qin , Guo Li‐Yan , Zhang Qi‐Li , Lv Chao‐Yang , Guo Rui‐Jun
Published: November 2020

Purpose

Lung ultrasonography (LU) is useful to assess lung lesions and variations at bedside. To investigate the results of LU in severe and critical patients with coronavirus disease 2019 (COVID‐19), we performed a single‐institution study to evaluate the related lung lesions and variations, and prophylactic strategies, in a large referral and treatment center.

Methods

We included 91 adult patients with severe and critical COVID‐19, namely 62 males and 29 females, with an average age of 59 ± 11 years, who underwent LU. We collected the following patient information: sex, age, days in hospital, and days in ICU. In the ultrasound examinations, we recorded the presence of discrete B lines, confluent B lines, consolidation, pleural thickening, pleural effusion, and pneumothorax (PTX).

Results

Among the 91 severe and critical patients, 59 cases had scattered B lines, 56 cases had confluent B lines, 58 cases had alveolar‐interstitial syndrome (AIS), 48 cases had lung consolidation, six cases had pleural thickening, 39 cases had pleural effusion (average depth of the pleural effusion: 1.0 ± 1.5 cm), and 20 patients developed PTX. In the Cox multivariate analysis, there were significant differences in age, hospitalization days, ICU days, and lung consolidation.

Conclusion

Lung ultrasonography performed at the bedside can detect lung diseases, such as B lines, PTX, pulmonary edema, lung consolidation, pleural effusion, and variations of these findings. Our findings support the use of LU and measurements for estimating factors, and monitoring response to therapy in severe and critical COVID‐19 patients.
RSDB: an easy to deploy open‐source web platform for remote sensing raster and point cloud data management, exploration and processing
Authors: Wöllauer Stephan , Zeuss Dirk , Magdon Paul , Nauss Thomas
Published: November 2020

Monitoring biodiversity and its change over space and time is a key challenge for ecological research. Utilizing remote sensing data in ecological research has been shown to be a powerful complement to labor‐intensive field work to derive area‐wide biodiversity indices, which can also capture larger spatiotemporal areas. However, preprocessing different types of remote sensing data for specific studies often requires extensive computational skills as the algorithms for creating final data products are scattered across the literature.

Our remote sensing database (RSDB, ) serves as an integrative storage, management and processing solution for several types of remote sensing data. Transparent data processing capabilities for more than 200 biodiversity‐related indices are included and can be used to calculate ready‐to‐use data products for a variety of ecological studies. These data products, for example, leaf area, vertical distribution of biomass and foliage height derived from light detection and ranging (LiDAR) point clouds, are individually calculated for user‐specified study areas and can serve as proxies for ecological variables, such as the availability of resources or habitat heterogeneity.

The primary RSDB user interface is web browser based on management, exploration, visualization and product processing capabilities. The RSDB stores data in layers that are discoverable by textual metadata and mapping on overview maps. Individual data layers can be explored using interactive maps and 3‐D visualizations. We additionally provide a seamless connection of the RSDB's functionality with the R environment through our accompanying R package for scripting and advanced processing tasks.

We designed the RSDB to be an easily accessible solution for on‐demand processing of comprehensive biodiversity indices. To date, the RSDB has been used and tested in several studies, and we are convinced that it will continue to facilitate biodiversity monitoring via its application to ecological research.
Soil element coupling is driven by ecological context and atomic mass
Authors: Ochoa‐Hueso Raúl , Plaza César , Moreno‐Jiménez Eduardo , Delgado‐Baquerizo Manuel
Published: November 2020

The biogeochemical cycling of multiple soil elements is fundamental for life on Earth. Here, we conducted a global field survey across 16 chronosequences from contrasting biomes with soil ages ranging from centuries to millions of years. For this, we collected and analysed 435 topsoil samples (0–10 cm) from 87 locations. We showed that high levels of topsoil element coupling, defined as the average correlation among nineteen soil elements, are maintained over geological timescales globally. Cross‐biome changes in plant biodiversity, soil microbial structure, weathering, soil pH and texture, and mineral‐free unprotected organic matter content largely controlled multi‐element coupling. Moreover, elements with heavier atomic mass were naturally more decoupled and unpredictable in space than those with lighter mass. Only the coupling of carbon, nitrogen and phosphorus, which are essential to life on Earth, deviated from this predictable pattern, suggesting that this anomaly may be an undeniable fingerprint of life in terrestrial soils.
From cell surface to signalling and back: the life of the mammalian FSH receptor
Authors: Banerjee Antara A. , Joseph Shaini , Mahale Smita D.
Published: November 2020

Follicle‐stimulating hormone receptor (FSHR) is a class A G protein‐coupled receptor that belongs to the subfamily of glycoprotein hormone receptors (GPHRs). The interaction of FSH with FSHR triggers downstream signaling pathways that play a central role in mammalian reproduction, such as folliculogenesis in females and the maintenance of spermatogenesis in males. This warrants a detailed investigation into FSHR, from its genesis, to the post‐translational modifications that enable it to become functionally competent, followed by its trafficking to the cell membrane. Subsequently, FSH‐stimulated Gsuncoupling and transduction of G protein‐mediated signaling pathways takes place, after which the receptor undergoes β‐arrestin‐mediated internalization and may trigger other noncanonical signaling pathways. The majority of the FSH–FSHR complexes are recycled back to the cell surface and only a small proportion are routed to lysosomal degradation pathways, thus completing the lifecycle of the FSH receptor. Information about important epitopes and aspects of FSH receptor function has been gleaned from a number of sources, including structure–function studies on both naturally occurring and induced mutations, single nucleotide polymorphisms, peptides and antipeptide antibodies corresponding to predicted functional residues, X‐ray crystallography analysis and high resolution imaging studies, in addition to the information available for the other GPHRs. In this review, we have traversed through the life cycle of the FSH receptor and discuss the reproductive pathophysiologies that could result from an impairment in receptor function, as may arise from defects during its journey from its birth to its degradation. Moreover, the unresolved questions and challenges that require exploration have been highlighted.
‘A journal with ambitions’: Health Libraries Review and Shane Godbolt
Authors: Morgan Peter
Published: November 2020

In 1978, the UK Library Association's newly formed Medical, Health and Welfare Libraries Group decided to establish a newsletter for its members. This paper sets out to describe how that newsletter evolved into Health Libraries Review (subsequently Health Information and Libraries Journal) and became the premier European journal for health‐care information professionals. Drawing on both published accounts and personal reminiscences, it focuses on the role played by Shane Godbolt as the Review's founding editor. It analyses and discusses the factors that influenced her work, and concludes by summarising the lasting importance of her achievements as editor.
Fashioning the future: Shane Godbolt’s leadership of the NHS regional library and information service in North Thames and London 1992‐2003
Authors: Osborn Richard M.
Published: November 2020

This paper reviews Shane Godbolt’s work as the National Health Service (NHS) Regional Librarian in North Thames and London between 1992 and 2003. It was a challenging time for both the NHS and the world of health care librarianship, and this article describes how the opportunities presented by continual organisational change and new ways of working were fully grasped by Shane and her colleagues to move library and information services forward in the capital, working in partnership with NHS partners and Higher Education – and laying the foundations for today’s NHS library and knowledge service.
Differences between Stevens‐Johnson syndrome versus toxic epidermal necrolysis
Authors: Nowsheen Somaira , Lehman Julia S. , el‐Azhary Rokea A.
Published: November 2020

Background

To retrospectively review the outcomes of two rare cutaneous diseases, Stevens‐Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), and to question the practice of averaging the mortality rate on the assumption that they are one disease.

Methods

A retrospective chart review of all patients diagnosed with SJS and TEN by a dermatologist between January 1, 2000, and January 1, 2020, at our institution was performed. Seventy‐one patients were identified (21 pediatric and 50 adults). Pathology slides from 32 adult patients (64%) were evaluated by a blinded board‐certified dermatopathologist.

Results

Of the adult patients, 31 had SJS, two had SJS‐TEN overlap, and 17 had TEN. All 21 patients in the pediatric group were diagnosed with SJS mainly caused by Mycoplasma. Mortality rates were 6.5% for SJS among adults and 35.3% for TEN. Chemotherapy‐induced TEN is a trigger with 50% mortality.

Conclusions

SJS was more common in adults and pediatric cases than TEN (3:1) and had a much better prognosis and outcome. Combining and averaging the mortality rates of TEN and SJS are not advised as SJS is mainly a mucocutaneous disorder with good prognosis versus TEN, a systemic toxicity of multiple organs with deep skin detachment.
KIF2A regulates ovarian development via modulating cell cycle progression and vitollogenin levels
Authors: Gao H. , Zhang Y. , Li Y. , Lin X.
Published: November 2020

The kinesin superfamily of proteins (KIFs) are microtubule motor proteins that use the hydrolysis of ATP to power directional movement along microtubules. KIFs induce microtubule depolymerization to regulate the length and dynamics of microtubules in a variety of cell processes and structures, including the mitotic and meiotic spindles and centriole and interphase microtubules. KIF plays a significant role in the transport of organelles, protein complexes and mRNAs. The brown planthopper (Nilaparvata lugens) is a major insect pest in rice paddy fields. Ovarian development is regulated by multiple factors, including endocrine factors. The role of KIFs in brown planthopper ovarian development remains unknown. We found that downregulation of KIF2A significantly compromised the development and eclosion of the brown planthopper, delayed ovarian cell cycle progression, disrupted ovarian development, reduced the expression of MCM genes required for DNA replication and significantly reduced the number of nuclei in the follicles. We also found a significant reduction in Vg mRNA and protein levels. We conclude that downregulation of KIF2A disrupts the cell cycle progression of cells. Alternatively, the ovarian phenotype could be an indirect effect of a compromised trophic cord. In summary, KIF2A regulates ovarian development via modulating cell cycle progression and/or vitollogenin transportation.
Editorial: Biomarkers in precision medicine for mental illnesses
Authors: Peterson Bradley S.
Published: November 2020

Precision medicine and biomarker development have become the prevailing paradigm for mental health research. Despite its conceptual elegance and dominance as a research framework, precision medicine has a very limited track record of demonstrable success thus far for mental illnesses, due in varying degrees to the complexity of both the brain and the pathophysiology of mental illnesses, which limits our ability to develop, replicate, and validate biomarkers for use in enhancing clinical care for mental illnesses, especially in high‐risk and complex clinical populations. Research and funding priorities should integrate biomarker development and precision medicine interventions that target the robust behavioral, environmental, and social determinants that we know are important for population‐based mental health.
Assessing the Accessibility of Content for Geriatric Fellowship Programs
Authors: Maybee Camilla , Nguyen Nam Tran , Chan Melissa , Chan Emily , Wei Chapman , Quan Theodore , Wei Chaplin , Gu Alex , Roth Katalin E.
Published: November 2020

The information available on program websites concerning geriatric fellowships in internal medicine and family medicine is a crucial factor in generating applicants' interest in individual programs. Our study aimed to quantify the accessibility and quality of information available on accredited geriatric (family medicine and internal medicine) fellowship program websites and further analyze the implications of the results obtained. A list of geriatric (family medicine and internal medicine) fellowship programs was analyzed through quantified measures after being verified for accreditation. Certain criteria were evaluated for each of these programs, such as website accessibility and whether critical information was available on online program websites. These criteria were centered on academic, administrative, and application‐based factors. Hundred and fifty eight Family Medicine and Internal Medicine geriatric fellowship programs were identified in total, of which only 150 were accredited by the Accreditation Council for Graduate Medical Education and considered for analysis. Of these, 20 (13.33%) programs had website links that were nonfunctional and only 145 programs had websites at all. On programs' websites, information regarding aspects such as contact information—including phone number or email for the program—were lacking. Other information regarding past and current fellows, research, and curriculum were also generally lacking. Geriatric Fellowship websites in Family Medicine and Internal Medicine can gain better traction from those interested in applying for their programs by updating information more often and providing more and better information concerning critical aspects of the programs themselves online.
A case study investigating the role of the anterior temporal lobes in general semantics and semantics specific to persons, emotions and social conceptual knowledge
Authors: Foley Jennifer A. , Hyare Harpreet , Rees Jeremy H. , Caine Diana
Published: November 2020

The role of the anterior temporal lobes (ATLs) in semantic representation remains still much debated. Long thought to support domain‐general semantic processing, recent accounts have alternatively suggested that they may be preferentially involved in the processing of person‐related semantic knowledge. Several studies have supported such a distinction, but few have either examined both types of semantic processing together, or considered the role of potentially important confounding variables. Here, we address these issues by investigating both domain‐general and person‐specific semantic processing in a patient with focal ATL damage. The patient presents with dense anterograde and retrograde amnesia. Performance was impaired on tests of general semantic knowledge, but most striking deficits were for person‐related semantics, including recognition and identification, knowledge of emotions and social conceptual knowledge. This unique case provides compelling evidence that, in addition to the role in general semantic knowledge, the ATLs are critical for person‐related semantics.
First report of tamoxifen‐induced baboon syndrome
Authors: Mofarrah Ramin , Mofarrah Ramina , Kränke Birger , Rahmani Maziar , Jahani Amiri Kousar , Ghasemi Maryam , Jallab Naghmeh , Ghobadiaski Sueshianth , Rahmani Nazgol , Hashemi Narges
Published: November 2020

Background

Baboon syndrome is a rare, type IV hypersensitivity reaction causing a maculopapular rash. Tamoxifen is an antineoplastic agent, working as an estrogen receptor antagonist, also called a selective estrogen receptor modulator. A variety of rashes were reported with Tamoxifen use to‐date except baboon syndrome. The Tamoxifen‐induced baboon syndrome seems to be reversible, as discontinuation of the drug improves clinical outcomes.

Aim

Herein, we present the first case of Tamoxifen‐induced baboon syndrome which occurred 8 years after initiation of Tamoxifen use.

Patients

A 44‐year‐old woman presented with papulovesicular eruption on her body and erythema on her face for a duration of 6 months. There was no evidence of ocular or mucosal involvement. She was diagnosed with breast cancer and treated with tamoxifen 10 mg twice daily over the past 8 years. She was not taking other medications or over‐the‐counter supplements at the time of presentation. The patient underwent urgent skin biopsies of two lesions on her buttock and thigh. No organisms were seen on Gram stain. The patient's skin biopsy revealed extensive hyperorthokeratosis, minimal parakeratosis, hypergranulosis, and lichenoid interface dermatitis in the irregularly acanthotic epidermis supporting diagnosis of fixed drug eruption. Following a multidisciplinary discussion, the patient was diagnosed with baboon syndrome or symmetrical drug‐related intertriginous and flexural exanthema (SDRIFE) associated with Tamoxifen.

Results

Hence, Tamoxifen was immediately discontinued and treated with oral steroid along with topical agents. She showed improvement of clinical abnormalities within days after discontinuation of Tamoxifen.

Conclusions

Given the widespread use of Tamoxifen in the management of patients with breast cancer, it is important that healthcare professionals monitor for rare, however clinically significant, and potentially life‐threatening dermatological manifestations of Tamoxifen use, such as baboon syndrome.
Cold contact urticaria triggered by a permanent tattoo
Authors: Raison‐Peyron Nadia , Litovsky Julie , Huet Pascale , Dereure Olivier
Published: November 2020

Cold contact urticaria is an inducible urticaria triggered by exposure to cold air, liquids, or objects. Symptoms may range from mild, localized urticaria to genuine anaphylaxis particularly after extensive contact of large skin areas to cold. Treatment mainly requires a strict avoidance of cold exposure and the use of second‐generation H1 antihistamine. In most cases, it is not associated with any specific etiology although in rare cases it can be secondary to various associated diseases or triggered by a number of external factors. We present the observation of a 38‐year‐old woman for whom cold contact urticaria began on a recent tattoo area.
Lutheranism from Above and from Below: “Pastoral Professionals” and Trust within the Nordic State/Society Nexus
Authors: Thue Fredrik W.
Published: November 2020

The article points to the dispersion, democratization, and feminization of “pastoral” forms of power and authority since the mid‐19th century as a key to understanding the exceptionally high degree of social trust in the Nordic countries. Taking Norway as its central case, it argues that the Nordic welfare state has been shaped by an older, distinctively Lutheran–Pietist combination of educational forms of government from above and edifying popular self‐organization from below. This trust‐producing synthesis has been sustained by such “pastoral” professions as teaching, nursing, and social work, functioning as mediators between public welfare policies and the life world of citizens.
LDL cholesterol level as a risk factor for retinopathy and nephropathy in children and adults with type 1 diabetes mellitus: A nationwide cohort study
Authors: Rathsman B. , Haas J. , Persson M. , Ludvigsson J. , Svensson A.‐M. , Lind M. , Andersson Franko M. , Nyström T.
Published: November 2020

Background

Microvascular complications are common in people with diabetes, where poor glycaemic control is the major contributor. The aim of this study was to explore the association between elevated LDL cholesterol levels and the risk of retinopathy or nephropathy in young individuals with type 1 diabetes.

Methods

This was a nationwide observational population‐based cohort study, including all children and adults with a duration of type 1 diabetes of ≤ 10 years, identified in the Swedish National Diabetes Register between 1998 and 2017. We calculated the crude incidence rates with 95% confidence intervals (CIs) and used multivariable Cox regression to estimate crude and adjusted hazard ratios (HRs) of retinopathy or nephropathy in four LDL cholesterol categories: <2.6 (Reference), 2.6–3.4, 3.4–4.1 and > 4.1 mmol L−1.

Results

In total, 11 024/12 350 (retinopathy/nephropathy, both cohorts, respectively) children and adults (median age 21 years, female 42%) were followed up to 28 years from diagnosis until end of study. Median duration of diabetes when entering the study was 6 and 7 years in the retinopathy and nephropathy cohort, respectively. Median LDL cholesterol was 2.4 mmol L−1, and median HbA1c level was 61 mmol mol−1 (7.7 %). After multivariable adjustment, the HRs (95% CI) for retinopathy in individuals with LDL cholesterol levels of 2.6–3.4, 3.4–4.1 or > 4.1 mmol L−1 were as follows: 1.13 (1.03–1.23), 1.16 (1.02–1.32) and 1.18 (0.99–1.41), compared with the reference. The corresponding numbers for nephropathy were as follows: 1.15 (0.96–1.32), 1.30 (1.03–1.65) and 1.41 (1.06–1.89).

Conclusions

Young individuals with type 1 diabetes exposed to high LDL cholesterol levels have an increased risk of retinopathy and nephropathy independent of glycaemia and other identified risk factors for vascular complications.
Integrating the study of personality and psychopathology in the context of gene‐environment correlations across development
Authors: Perlstein Samantha , Waller Rebecca
Published: November 2020

Objective

A key principle of individual differences research is that biological and environmental factors jointly influence personality and psychopathology. Genes and environments interact to influence the emergence and stability of both normal and abnormal behavior (i.e., genetic predisposition, X, is exacerbated or buffered under environmental conditions, Y, or vice versa), including by shaping the neural circuits underpinning behavior. The interplay of genes and environments is also reflected in various ways in which they are correlated (i.e., rGE). That is, the same genetic factors that give rise to personality or psychopathology also shape that person's environment.

Methods

In this review, we outline passive, evocative, and active rGE processes and review the findings of studies that have addressed rGE in relation to understanding individual differences in personality and psychopathology across development.

Results

Throughout, we evaluate the question of whether it is possible, not only to differentiate the person from their problems, but also to differentiate the person from their problems and their environment.

Conclusions

We provide recommendations for future research to model rGE and better inform our ability to study personality and psychopathology, while separating the influence of the environment.
Barriers to Disability Inclusion: Social Needs and Discrimination in Mexico
Authors: Martínez‐Martínez Oscar A. , Nikolova Silviya Pavlova , Coutiño‐Vázquez Brenda , Ramírez‐López Araceli
Published: November 2020

El artículo tiene como objetivo identificar las barreras a las que se enfrentan las personas con discapacidad, tanto en su vida diaria como en su entorno. Usando datos de la Encuesta Nacional de Discriminación 2017, aplicamos un modelo de regresión logit multinomial. Nuestros resultados revelan que las personas en situación de discapacidad tienen menos probabilidades de acceder a servicios sociales y oportunidades educativas y de participar plenamente en el trabajo; por lo tanto, perciben menores ingresos para cubrir sus necesidades básicas. Una de las principales barreras de esta población es el diseño de la infraestructura urbana, como son las calles y banquetas, así como la falta de transporte urbano adecuado, que facilite su transportación. De igual forma, nuestro estudio indica que este grupo vulnerable tiene dificultades para para cubrir gastos en cuidados, terapias y tratamientos. Por esa razón, realizar actividades básicas como bañarse, vestirse o comer, es difícil para ellos. Los hallazgos indican que perciben inseguridad económica y discriminación. Por ello, se hace necesario la generación de políticas inclusivas que mejoren significativamente el bienestar de las personas con discapacidad.
Estimation of the burden of tinea capitis among children in Africa
Authors: Bongomin Felix , Olum Ronald , Nsenga Lauryn , Namusobya Martha , Russell Laura , de Sousa Emma , Osaigbovo Iriagbonse Iyabo , Kwizera Richard , Baluku Joseph Baruch
Published: November 2020

Tinea capitis is a common and endemic dermatophytosis among school age children in Africa. However, the true burden of the disease is unknown in Africa. We aimed to estimate the burden of tinea capitis among children <18 years of age in Africa. A systematic review was performed using Embase, MEDLINE and the Cochrane Library of Systematic Reviews to identify articles on tinea capitis among children in Africa published between January 1990 and October 2020. The United Nation's Population data (2019) were used to identify the number of children at risk of tinea capitis in each African country. Using the pooled prevalence, the country‐specific and total burden of tinea capitis was calculated. Forty studies involving a total of 229,086 children from 17/54 African countries were identified and included in the analysis. The pooled prevalence of tinea capitis was 23% (95% CI, 17%–29%) mostly caused by Trichophyton species. With a population of 600 million (46%) children, the total number of cases of tinea capitis in Africa was estimated at 138.1 (95% CI, 102.0–174.1) million cases. Over 96% (132.6 million) cases occur in sub‐Saharan Africa alone. Nigeria and Ethiopia with the highest population of children contributed 16.4% (n = 98.7 million) and 8.5% (n = 52.2 million) of cases, respectively. Majority of the participants were primary school children with a mean age of 10 years. Cases are mostly diagnosed clinically. There was a large discrepancy between the clinical and mycological diagnosis. About one in every five children in Africa has tinea capitis making it one of the most common childhood conditions in the region. A precise quantification of the burden of this neglected tropical disease is required to inform clinical and public health intervention strategies.