bluuebunny/crossref_metadata_2025 huggingface dataset:
Observed without Sympathy: Adam Smith on Inequality and Spectatorship
Authors: Collins Kristen R.
Published: August 2020

Responding to socioeconomic inequality and the decline of political participation, theorists of “audience democracy” emphasize citizens’ spectatorship of political leaders but neglect how citizens experience being watched themselves. I turn to Adam Smith's arguments about the effects of inequality on spectatorship, highlighting his criticisms of the public's disdain for people living in poverty. By comparing Smith's arguments about misperceptions of people living in poverty to his discussions of an innocent man accused of a crime, I show how mistaken spectators demoralize even morally judicious individuals. I also expand on an example of unjust censure that Smith suggests but does not discuss in detail: the social shame directed at a survivor of rape. I conclude by using Smith's insights to reflect on the social and interpersonal dynamics of surveillance that render contemporary welfare programs degrading for many participants and help transform socioeconomic inequality into political inequality.
Acute small bowel obstruction: one‐year retrospective study of admissions to inner city Royal Perth Hospital
Authors: Cengarle Alessandro , Weber Dieter G. , Taib Adnan G.
Published: August 2020

Background

Analyse admissions to Royal Perth Hospital (RPH) with acute small bowel obstruction (SBO), and identify trends between outcomes and management.

Methods

Retrospective, single‐centre review of patients admitted to RPH with acute SBO, between May 2017 and May 2018.

Results

A total of 251 admissions met inclusion criteria. Increasing age correlated with increasing total length of stay (LOS) (r = 0.134, P = 0.033) and post‐operative LOS (r = 0.349, P < 0.0001). Increasing age led to poorer outcomes (P < 0.0001). Diagnoses were most commonly adhesions (167/251 = 66.5%), hernias (47/251 = 18.7%) and inflammatory bowel diseases (11/251 = 4.4%).

Operation rate for adhesional SBO was 24.6% (41/167) and non‐adhesional SBO 54.8% (46/84). Median total LOS for operative versus conservative management was 9 days (interquartile range (IQR) 8) versus 3 days (IQR 3) (P < 0.0001). Median time to surgery was 1 day (IQR 2). Increased time from admission to theatre led to increasing post‐operative LOS (r = 0.398, P = 0.0013). Median post‐operative LOS for bowel resection versus no resection was 9 days (IQR 4.5) versus 6 days (IQR 4) (P = 0.0128).

Of 101, 81 (80.2%) adhesional SBO resolved non‐operatively after receiving Gastrografin, compared to 45 of 66 (68.2%) of those who did not (P = 0.07). It did not significantly alter total or post‐operative LOS (P = 0.65 and P = 0.96), patient outcome (P = 0.26), or need for bowel resection (P = 0.63).

Conclusions

Operative management, bowel resection, older age and increasing time from admission to surgery increase LOS. Trial of Gastrografin in non‐operative management of adhesion type small bowel obstructions does not significantly affect outcomes but tends to reduce operative rates.
Emergency cerclage in singleton pregnancies with painless cervical dilatation: A meta‐analysis
Authors: Chatzakis Christos , Efthymiou Athina , Sotiriadis Alexandros , Makrydimas George
Published: August 2020

Introduction

Emergency cerclage is the most common active intervention in pregnant women with cervical insufficiency. This meta‐analysis aimed to compare the effectiveness of emergency cerclage vs expectant management on maternal and perinatal outcomes, and to assess the current status of evidence.

Material and methods

A search was conducted from 1 June 2019 until 1 September 2019 and eligible studies were identified in the MEDLINE, Scopus, Cochrane and US clinical trials registry without limitations concerning the publication dates and languages. Randomized controlled trials (RCTs), non‐RCTs and observational studies comparing emergency cerclage with no cerclage/expectant management, in women presenting with painless cervical dilatation were included.

Results

The electronic search yielded 3607 potential studies, of which 38 were fully reviewed and 12 observational studies (1021 participants) were included. Cerclage was superior to expectant management for the primary outcomes of preterm birth before 28 and 32 gestational weeks, OR 0.25 (95% CI 0.16‐0.39, five studies, N = 392, I2 = 41%, low quality) and 0.08 (95% CI 0.02‐0.29, four studies, N = 176, I2 = 51%, low quality), respectively. Cerclage was also superior to expectant management for the secondary outcomes of fetal loss OR 0.26 (95% CI 0.12‐0.56, 8 studies, N = 455, I2 = 46%, very low‐quality), pregnancy prolongation in days mean difference 47.45 (95% CI 39.89‐55.0, 12 studies, N = 1027 I2 = 86%, very low quality), gestational age at birth in weeks mean difference 5.68 (95% CI 4.69‐6.67, 9 studies, N = 892, I2 = 73%, very low quality), admission to neonatal intensive care OR 0.21 (95% CI 0.07‐0.70, two studies, N = 79, I2 = 36%, very low quality) and neonatal death OR 0.12 (95% CI 0.04‐0.34, five studies, N = 130, I2 = 0%, very low quality). There were no differences between cerclage and expectant management concerning premature rupture of membranes during or after the procedure OR 0.68 (95% CI 0.31‐1.48, two studies, N = 155, I2 = 85%, very low quality) and chorioamnionitis OR 1.14 (95% CI 0.31‐4.25, three studies, N = 88, I2 = 33%, very low quality).

Conclusions

Emergency cerclage in pregnant women with painless cervical dilatation seems to decrease preterm births, prolong the pregnancy, and decrease the neonatal deaths and fetal losses, but does not increase the risk of chorioamnionitis and premature rupture of membranes. Despite the extremely favorable estimates for cerclage, the results should be viewed with caution because, as a result of the lack of randomized control trials, the quality of evidence is low to very low.
Investigation into white spots in the carapace of a moribund mud crab (Scylla serrata) from a white spot syndrome virus (WSSV) positive zone in Moreton Bay, Australia
Authors: Diggles BK , Chong RSM , Hawkins K‐A , Underwood DJ , Genge B , Driver L , Kistler C
Published: August 2020

Background

A freshly deceased mud crab (Scylla serrata) exhibiting multiple white spots under the carapace was found in Pumicestone Passage, northern Moreton Bay in May 2018. This crab was taken from within a biosecurity zone established due to a recent incursion of White Spot Syndrome Virus (WSSV) into populations of wild penaeids (Penaeus spp., Metapenaeus spp.) and crabs (Thalamita crenata) in the area. Because grossly visible white spots have been previously observed under the carapace of moribund S. serrata with white spot disease (WSD) in India, an investigation into the cause of death was undertaken.

Case report

The affected S. serrata was negative for WSSV DNA when gill samples were tested by real‐time PCR. Histopathology found no evidence of WSD lesions in the form of basophilic hypertrophied intranuclear inclusions in any tissues of ectodermal or mesodermal origin. Histopathology of the affected carapace showed that the white spots consisted of multiple lighter coloured foci in the exocuticle formed from concentric crystalline‐like rings, which extended into the endocuticle. These were interpreted as evidence of mineral mobilisation within the carapace during the pre‐moult (D1 or D2) stage of the moult cycle. The cause of death in this case therefore may have been due to moult‐related complications.

Conclusion

These observations confirm that formation of grossly visible white spots under the carapace of S. serrata are not pathognomonic for infection with WSSV. Similar observations in previous studies where WSSV was detected by PCR in this same host may have been incidental findings.
Sarcopenia and high NLR are associated with the development of hyperprogressive disease after second-line pembrolizumab in patients with non-small-cell lung cancer
Authors: Petrova M P , Donev I S , Radanova M A , Eneva M I , Dimitrova E G , Valchev G N , Minchev V T , Taushanova M S , Boneva M V , Karanikolova T S , Gencheva R B , Zhbantov G A , Ivanova A I , Timcheva C V , Pavlov B P , Megdanova V G , Robev B S , Conev N V
Published: August 2020

The aim of this multi-center retrospective study was to evaluate the incidence of hyperprogressive disease (HPD) after second-line treatment with pembrolizumab in patients (n = 167) with metastatic non-small-cell lung cancer (NSCLC) whose tumors expressed programmed cell death ligand 1 (PD-L1) in ≥ 1% and to search for hematological and imaging biomarkers associated with its development. Prior to chemotherapy, neutrophil : lymphocyte ratio (NLR1) and platelet : lymphocyte ratio (PLR1), and prior to immunotherapy, NLR2 and PLR2 were retrospectively analyzed. The psoas major muscle area (PMMA) was calculated at the L3 position on computed tomography before chemotherapy (PMMA1) and before immunotherapy (PMMA2) (n = 112). Patients with ∆PMMA (1-PMMA2/PMMA1) × 100 ≥ 10% were considered to have sarcopenia (low muscle mass). After treatment with pembrolizumab on the first computerized tomography (CT) scan evaluation, patients were subdivided as follows as: hyperprogressors (HPs), progressors (Ps), non-progressors (NPs) and pseudoprogressors (PPs). HPs had significantly higher ∆PMMA levels, NLR2 and PLR2 than the other patients. Moreover, in multinomial logistic regression analysis, higher levels of ∆PMMA were associated with a decreased likelihood of being a P [odds ratio (OR) = 0·81; 95% confidence interval (CI) = 0·65–0·99; P = 0·047] or an NP (OR = 0·76; 95% CI = 0·62–0·94; P = 0·012) versus an HP. Higher NLRs tended to decrease the likelihood of being a P versus an HP (OR = 0·66; 95% CI = 0·42–1·06; P = 0·09) and significantly decreased the likelihood of being an NP versus an HP (OR = 0·44; 95% CI = 0·28–0·69; P < 0·0001). Our data suggest that a high pre-immunotherapy NLR2 and the presence of sarcopenia are potential risk factors for the development of HPD.
ECONOMIC FREEDOM AND THE ECONOMIC CONSEQUENCES OF THE 1918 PANDEMIC
Authors: Geloso Vincent , Bologna Pavlik Jamie
Published: August 2020

The 1918 flu pandemic constituted an exogenous shock on economic activity. In this paper, we condition the economic importance of these shocks on the level of economic freedom measured by the Historical Index of Economic Liberty project to test whether freer economies fared better. Our argument is that higher levels of economic freedom meant a greater ability to adjust to shocks by reducing frictions in the reallocation of resources and the reorganization of economic activity. We find that higher levels of economic freedom mitigated the pandemic's effect. We link this finding with the literature on economic freedom and crises. (JEL I15, N10, N30)
Adaptive weighted dynamic differential evolution algorithm for emergency material allocation and scheduling
Authors: Wang Tiejun , Wu Kaijun , Du Tiaotiao , Cheng Xiaochun
Published: August 2020

Emergency material allocation and scheduling is a combination optimization problem, which is essentially a Non‐deterministic Polynomial (NP) problem. Aiming at the problems such as slow convergence, easy prematurely falling into local optimum, and parameter constraints to solve high‐dimensional and multi‐modal combination optimization problems, this article proposes an adaptive weighted dynamic differential evolution (AWDDE) algorithm. The algorithm uses a chaotic mapping strategy to initialize the population. By weighting the standard differential evolution (DE) mutation strategy, a new weighted mutation operator is proposed. The scaling factor and cross probability can be adaptively adjusted. A disturbance operator is introduced to randomly generate the perturbation mutation and to accelerate the premature individuals to jump out of the local optimum. The algorithm is applied to the problem of emergency material allocation and scheduling, and a two‐stage emergency material allocation and scheduling model is established. Compared with the standard DE algorithm and the chaos adaptive particle swarm algorithm, the results show that the AWDDE algorithm has the characteristics of stronger global optimization ability and faster convergence speed compared with other optimization algorithms, which provide assistance for smart cities research, including smart city services, applications, case studies, and policymaking considerations for emergency management.
Intraspecific variation in host plant traits mediates taxonomic and functional composition of local insect herbivore communities
Authors: Tielens Elske K. , Gruner Daniel S.
Published: August 2020

1. Host plant phenotypic traits affect the structure of the associated consumer community and mediate species interactions. Intraspecific variation in host traits is well documented, although a functional understanding of variable traits that drive herbivore community response is lacking. We address this gap by modelling the trait‐environment relationship using insect traits and host plant traits in a multilevel model.

2. We compare herbivore assemblages from the canopy of the phenotypically variable tree Metrosideros polymorpha on Hawai‘i Island. Multiple distinct varieties of M. polymorpha frequently co‐occur, with variation in morphological traits. Using this system, we identify host and insect traits that underlie patterns of herbivore abundance and quantify the strength of host‐insect trait interactions.

3. This work examines plant‐insect interactions at a community scale, across 36 herbivore species in three orders. We find that co‐occurring trees of varying phenotype support distinct communities. Leaf traits, including specific leaf area, trichome presence, and leaf nutrients, explain 46% of variation in insect communities. We find that feeding guild and nymphal life history are correlated with host plant traits, and we show that model predictions are improved by including the host and insect trait interaction.

4. This study demonstrates how insect herbivores traits influence community response to morphologically variable hosts. Environmental heterogeneity indirectly affected herbivore community structure via intraspecific variation in host plants, providing an important source of variation for maintaining diversity in the broader community.
Severity of summer drought as predictor for smolt recruitment in migratory brown trout (Salmo trutta)
Authors: Jespersen Henrik , Rasmussen Gorm , Pedersen Stig
Published: August 2020

The recruitment of anadromous brown trout smolt from a small Baltic stream, frequently exposed to summer drought, was quantified for 9 years, and the effect from drought on smolt number and age composition analysed. Drought was quantified by, (a) a newly developed index quantifying the severity of summer drought (Drought Severity Index—DSI—based on amount of precipitation, monthly mean temperature and number of hours with sun), and (b) the amount of precipitation. Both DSI and precipitation were measured 1 or 2 years prior to emigration. We found highly significant (negative) relations between DSI (1 year before emigration) and both the total number of smolt, and the number of age 1 smolt. In addition, precipitation was (positively) related to total number of smolt, but DSI proved to be a stronger predictor compared to precipitation. In addition to drought, our results support a negative influence from older parr on the survival of age 0 trout. Our results indicate that recruitment of brown trout smolt from streams, regularly affected by summer drought, may be predicted approx. 6 months before the actual emigration the following spring. This offers an opportunity for managers to adapt protective measures in accordance with local and temporal changes in recruitment.
Guillain–Barré syndrome associated with SARS‐CoV‐2 infection. A systematic review
Authors: De Sanctis P. , Doneddu P. E. , Viganò L. , Selmi C. , Nobile‐Orazio E.
Published: August 2020

Guillain‐Barré syndrome (GBS) incidence can increase during outbreaks of infectious illnesses. A few cases of GBS associated with coronavirus disease 2019 (COVID‐19) infection have been reported. The aim was to identify specific clinical features of GBS associated with COVID‐19. PubMed, Embase and Cochrane were searched from 1 November 2019 to 17 May 2020 and included all papers with full text in English, Spanish, French or Italian, reporting original data of patients with GBS and COVID‐19. Data were extracted according to a predefined protocol. A total of 18 patients reported in 14 papers were included in this review. All the patients were symptomatic for COVID‐19, with cough and fever as the most frequently reported symptoms. The interval between the onset of symptoms of COVID‐19 and the first symptoms of GBS ranged from −8 to 24 days (mean 9 days; median 10 days). Most of the patients had a typical GBS clinical form predominantly with a demyelinating electrophysiological subtype. Mechanical ventilation was necessary in eight (44%) patients. Two (11%) patients died. Published cases of GBS associated with COVID‐19 report a sensorimotor, predominantly demyelinating GBS with a typical clinical presentation. Clinical features and disease course seem similar to those observed in GBS related to other etiologies. These results should be interpreted with caution since only 18 cases have been heterogeneously reported so far.
Demyelinating Charcot–Marie–Tooth neuropathy associated with FBLN5 mutations
Authors: Safka Brozkova D. , Stojkovic T. , Haberlová J. , Mazanec R. , Windhager R. , Fernandes Rosenegger P. , Hacker S. , Züchner S. , Kochański A. , Leonard‐Louis S. , Francou B. , Latour P. , Senderek J. , Seeman P. , Auer‐Grumbach M.
Published: August 2020

Background and purpose

Charcot–Marie–Tooth disease type 1 (CMT1) is a group of autosomal dominantly inherited demyelinating sensorimotor neuropathies. Symptoms usually start in the first to second decade and include distal muscle weakness and wasting, sensory disturbances and foot deformities. The most frequent cause is a duplication of PMP22 whilst point mutations in PMP22 and other genes are rare causes. Recently, FBLN5 mutations have been reported in CMT1 families.

Methods

Individuals with FBLN5‐associated CMT1 were compiled from clinical and research genetic testing laboratories. Clinical data were extracted from medical records or obtained during patients’ visits at our centres or primary care sites.

Results

Nineteen CMT1 families containing 38 carriers of three different FBLN5 missense variants were identified and a mutational hotspot at c.1117C>T (p.Arg373Cys) was confirmed. Compared to patients with the common PMP22 duplication, individuals with FBLN5 variants had a later age of diagnosis (third to fifth decade) and less severely reduced motor median nerve conduction velocities (around 31 m/s). The most frequent clinical presentations were prominent sensory disturbances and painful sensations, often as initial symptom and pronounced in the upper limbs, contrasting with rather mild to moderate motor deficits.

Conclusions

Our study confirms the relevance of FBLN5 mutations in CMT1. It is proposed to include FBLN5 in the genetic work‐up of individuals suspected with CMT1, particularly when diagnosis is established beyond the first and second decade and comparably moderate motor deficits contrast with early and marked sensory involvement. FBLN5‐associated CMT1 has a recognizable clinical phenotype and should be referred to as CMT1H according to the current classification scheme.
Exploding head syndrome: new observations
Authors: Hayreh S.S.
Published: August 2020

Background and purpose

The etiology of ‘exploding head syndrome’ (EHS) is currently highly controversial and its management is unknown. The object was to explore these.

Methods

This observational study describes my personal experience of EHS and discusses its implications.

Results

I experienced, while suffering from EHS, recurrent episodes of transient cardiac arrests due to sick sinus syndrome. Implantation of a cardiac pacemaker resulted in immediate, dramatic, permanent cessation of both cardiac arrest episodes and EHS. This has not been reported previously.

Conclusions

This striking temporal relationship indicates a possible association between EHS and sick sinus syndrome.
Multimodal neurometabolic investigation of the effects of zolpidem on leukoencephalopathy‐related apathy
Authors: Delorme C. , Adanyeguh I. , Bendetowicz D. , Le Ber I. , Ponchel A. , Kas A. , Habert M.‐O. , Mochel F.
Published: August 2020

Background and purpose

The symptomatic effect of zolpidem on apathy has been reported in neurological disorders such as strokes and post‐anoxic brain injuries, but not in white‐matter disease of the brain.

Methods

A 38‐year‐old patient presenting with severe apathy related to a genetic leukoencephalopathy but showing marked improvement of apathy after taking 10 mg of zolpidem was studied. To understand what may mediate such a clinical effect, a multimodal neurometabolic approach using 18F fluorodeoxyglucose positron emission tomography (FDG‐PET) and a dedicated magnetic resonance spectroscopy (MRS) sequence for gamma aminobutyric acid (GABA) and glutamine + glutamate metabolism was undertaken.

Results

Pre‐zolpidem FDG‐PET showed hypometabolism in the orbitofrontal cortex, dorsolateral cortex and basal ganglia compared to healthy controls. Post‐zolpidem, FDG‐PET displayed increased metabolism in the orbitofrontal cortex together with improvement in the emotional and auto‐activation domains of apathy. There was no improvement in the cognitive domain of apathy, and no change in metabolism in the dorsolateral frontal cortex. Post‐zolpidem, MRS showed increased GABA and glutamine + glutamate levels in the frontal cortex and pallidum.

Conclusion

Our multimodal neurometabolic study suggests that the effects of zolpidem on apathy are related to increased metabolism in the orbitofrontal cortex and basal ganglia secondary to GABA modulation. Zolpidem may improve apathy in other white‐matter disorders.
A Critical Exploration of Biological and Social Fathering Among Afro‐Caribbean Fathers
Authors: Green David S. , Chuang Susan S.
Published: August 2020

Objective

This research explores fathers' construction of fathering to expand knowledge on the behavioral, cognitive, and affective domains of father involvement, focusing on middle childhood in ethnic minority families.

Background

Fathers' contributions to children's development and socialization have received increasing attention since the 1970s. Although exploration of ethnic minority fathers has increased, the literature on ethnic and minority fathers is limited because insight into fathers living outside North America continues to be understudied.

Method

This study employed a qualitative methodology from a social constructivist perspective and a bioecological model to contextualize fathering in Afro‐Jamaican families. Phenomenological thematic analysis (PTA) was used, focusing on 24 semistructured interviews from five biological and 19 biological and social Afro‐Jamaican fathers.

Results

Using Palkovitz's (1997) conceptualization of fathering, including behavioral, affective, and cognitive domains, phenomenological thematic analysis was extended to include the spiritual domain. Furthermore, fathers reported being engaged with their biological and social children in similar ways.

Conclusion

These findings highlight the need for researchers to explore both the universal and culturalized aspects of fathering in cultural contexts.

Implications

Fathers should be supported through social policies and program intervention to encourage fathers to be involved in children's lives in multiple ways.
Climate warming increases spring phenological differences among temperate trees
Authors: Geng Xiaojun , Fu Yongshuo H. , Hao Fanghua , Zhou Xuancheng , Zhang Xuan , Yin Guodong , Vitasse Yann , Piao Shilong , Niu Kechang , De Boeck Hans J. , Menzel Annette , Peñuelas Josep
Published: August 2020

Climate warming has substantially advanced spring leaf flushing, but winter chilling and photoperiod co‐determine the leaf flushing process in ways that vary among species. As a result, the interspecific differences in spring phenology (IDSP) are expected to change with climate warming, which may, in turn, induce negative or positive ecological consequences. However, the temporal change of IDSP at large spatiotemporal scales remains unclear. In this study, we analyzed long‐term in‐situ observations (1951–2016) of six, coexisting temperate tree species from 305 sites across Central Europe and found that phenological ranking did not change when comparing the rapidly warming period 1984–2016 to the marginally warming period 1951–1983. However, the advance of leaf flushing was significantly larger in early‐flushing species EFS (6.7 ± 0.3 days) than in late‐flushing species LFS (5.9 ± 0.2 days) between the two periods, indicating extended IDSP. This IDSP extension could not be explained by differences in temperature sensitivity between EFS and LFS; however, climatic warming‐induced heat accumulation effects on leaf flushing, which were linked to a greater heat requirement and higher photoperiod sensitivity in LFS, drove the shifts in IDSP. Continued climate warming is expected to further extend IDSP across temperate trees, with associated implications for ecosystem function.
Microbial macroecology: In search of mechanisms governing microbial biogeographic patterns
Authors: Xu Xiaofeng , Wang Nannan , Lipson David , Sinsabaugh Robert , Schimel Josh , He Liyuan , Soudzilovskaia Nadejda A. , Tedersoo Leho
Published: August 2020

Introduction

Rapidly advancing technologies and accumulating information about microbial communities across the globe allow the quantification of microbial properties and functions at a macro‐scale. These emerging microbial biogeographic patterns call for a practical macroecological approach to investigate their underlying mechanisms.

Aims

The primary aims of this paper are to review the advancements of microbial macroecology in seeking mechanisms governing microbial biogeographic patterns, and to further lay out a roadmap for microbial macroecology in 10 years.

Methods

We reviewed the progress of microbial macroecology and demonstrated the application of the microbial macroecological approach to microbial biogeographic patterns with three case studies.

Results

Microbial macroecology provides a platform for understanding microbial abundance, community structure, and functioning across space, time, and taxonomic hierarchy. It emphasizes the integral effects of environmental filtering, microbial responses, diversification, dispersal, and local extinction that drive the microbial biogeographic patterns. The microbial macroecological approach emphasizes the last two stages of the four‐stage scientific method applied to microbial ecology: (a) describing microbial traits across scales to reveal patterns, (b) mathematically representing these patterns, (c) developing and testing conceptual models to build a mechanistic understanding of these patterns from a macroecological perspective, (d) plugging the new knowledge into the theoretical advancements. Three case studies were used to demonstrate the microbial macroecological approach for understanding the global patterns of microbial biomass carbon, microbial composition (fungi : bacteria ratio), and microbial carbon use efficiency.

Conclusions

Microbial macroecology offers a platform for understanding the mechanisms that drive biogeographic patterns of microbial abundance, diversity and functions. It is likely that these patterns and mechanisms will be increasingly incorporated into predictive models that link climate, carbon dynamics, and biogeochemical processes. A roadmap is outlined for the growing microbial macroecology field; we expect significant progress will be made in five research directions over the next 10 years.
Is there anything Left? The politics of social spending in new democracies
Authors: Sirén Sebastian
Published: August 2020

The evolution of public social expenditures displays divergent patterns across non‐western countries. This exploratory article argues that in order to understand the domestic sources of this divergence, institutional and structural explanations should be complemented with an actor‐oriented perspective. Analyses of the role of party politics in non‐OECD democracies, through multivariate fixed‐effect regressions using data from 46 countries between 1995 and 2015, reveals a robust positive association between shifts towards Left party government and increases in total public social expenditures, also when controlling for structural and institutional factors. This association however seems potentially conditional on sufficient levels of economic growth. While indicating an impact of partisanship, further research is arguably needed regarding the origins, organization and policy outputs of parties in more recently democratized countries, as well as regarding the conditions under which the ideological orientation of parties in government are actually consequential.
Access to Migraine Treatments in Ontario, Canada: A Review of the Ontario Drug Benefit Program
Authors: Cape Susan
Published: August 2020

Background

This paper provides a critical review of the decision‐making process of the Ontario Ministry of Health and Long‐Term Care (MOHLTC) regarding which migraine treatment drugs will be covered under the Ontario Drug Benefit Formulary (ODB).

Main Text

Under MOHLTC policy, triptans and OnabotulinumtoxinA are available to patients only through the Exceptional Access Program (EAP). This policy, and justifications for it, are examined with reference to clinical guidelines, patient experiences, and health policy literature. The contexts and consequences of compromised access are outlined. Improvements in access to these treatments are suggested by highlighting how a country with similar healthcare infrastructure – Australia – employs policies that more adequately meet the needs of migraine patients as they secure treatments.

Conclusions

Despite clinically significant gains in the discovery of safe and effective migraine‐specific treatments the ODB thus far has failed to align its practice with current clinical recommendations. This forces patients to rely heavily on medication that, while still effective for some, is potentially suboptimal. This review concludes it is prudent, at minimum, to follow clinical recommendations that advocate for the removal of triptans from EAP and recategorize them as Limited Use drugs. Ideally, moving them to a general benefit would further remove the barriers experienced by patients attempting to access this treatment.
High Prevalence of Headaches During Covid‐19 Infection: A Retrospective Cohort Study
Authors: Poncet‐Megemont Louis , Paris Pauline , Tronchere Amélie , Salazard Jean‐Pascal , Pereira Bruno , Dallel Radhouane , Aumeran Claire , Beytout Jean , Jacomet Christine , Laurichesse Henri , Lesens Olivier , Mrozek Natacha , Vidal Magali , Moisset Xavier
Published: August 2020

Objectives

To document the prevalence of new headaches in patients with Covid‐19 infection and the potential association with other neuro‐sensorial symptoms (anosmia and ageusia). The persistence of these symptoms 1 month after recovery was also documented.

Background

Headaches are a very common symptom of viral infections. Surprisingly, early Chinese studies reported a relatively low prevalence (12‐15%) of headaches associated with Covid‐19.

Methods

All the patients with laboratory‐confirmed or chest‐CT‐confirmed Covid‐19 infection, diagnosed between February 27th and April 15th, 2020 in the dedicated laboratory of Clermont‐Ferrand University Hospital were followed for 1 month after recovery.

Results

A total of 139 consecutive patients (mean [SD] age, 48.5 [15.3] years; 87 women [62.6%]) were interviewed 1 month after disappearance of fever and dyspnea (semi‐structured phone interview). Overall, 59.0% (82/139) of people with Covid‐19 had mild disease, 36.7% (51/139) had severe disease, and 4.3% (6/139) had critical illness. Eighty‐two (59.0%; 95% CI: 50.3 to 67.3) reported new headaches during the acute phase and 3.6% (5/139) had persistent headaches 1 month after fever and dyspnea remission. Anosmia and ageusia were also very common, occurring in 60.4% (84/139) and 58.3% (81/139) of the patients, respectively. These 2 symptoms persisted in 14.4% (20/139) and 11.5% (16/139) of Covid‐19 patients 1 month after recovery. Headaches were neither clearly associated with anosmia, nor with ageusia, and were not associated with disease severity (ie, requiring hospitalization or intensive care unit).

Conclusion

This specific study highlights the high prevalence of new headaches during Covid‐19 infection in French patients. Further studies are needed to refine the characterization of patients with Covid‐19‐associated headaches.
Scoping review of patients’ attitudes about their role and behaviours to ensure safe care at the direct care level
Authors: Duhn Lenora , Godfrey Christina , Medves Jennifer
Published: August 2020

Background

To improve harm prevention, patient engagement in safety at the direct care level is advocated. For patient safety to most effectively include patients, it is critical to reflect on existing evidence, to better position future research with implications for education and practice.

Methods

As part of a multi‐phase study, which included a qualitative descriptive study (Duhn & Medves, 2018), a scoping review about patient engagement in safety was conducted. The objective was to review papers about patients’ attitudes and behaviours concerning their involvement in ensuring their safe care. The databases searched included MEDLINE, CINAHL and EMBASE (year ending 2019).

Results

This review included 35 papers about “Patient Attitudes” and 125 papers about “Patient Behaviours”—indicative of growing global interest in this field. Several patterns emerged from the review, including that most investigators have focused on a particular dimension of harm prevention, such as asking about provider handwashing, and there is less known about patients’ opinions about their role in safety generally and how to actualize it in a way that is right for them. While patients may indicate favourable attitudes toward safety involvement generally, intention to act or actual behaviours may be quite different.

Conclusion

This review, given its multi‐focus across the continuum of care, is the first of its kind based on existing literature. It provides an important international “mapping” of the initiatives that are underway to engage patients in different elements of safety and their viewpoints, and identifies the gaps that remain.
Clinicopathological and molecular analyses of linearly expanded epithelial cells with β‐catenin alterations, “β‐catenin signature”, in the normal fallopian tube
Authors: Koyama Kei , Maeda Daichi , Kito Masahiko , Tamura Daisuke , Kudo‐Asabe Yukitsugu , Katoh Hiroto , Ishikawa Shumpei , Nanjo Hiroshi , Terada Yukihiro , Goto Akiteru
Published: August 2020

Aims

Recent advances in next‐generation sequencing have made it clear that clonal expansion of cells harbouring driver gene mutations occurs in physiologically normal epithelium. Molecular analysis of tubal epithelium has been almost exclusively confined to the TP53 pathway, which is involved in serous carcinogenesis. Other oncogenic events have not been explored in detail. Here, we report the linear expansion of fallopian tubal epithelial cells exhibiting an altered β‐catenin profile (β‐catenin signature). Through molecular analyses, we determined the incidence and clinicopathological significance of β‐catenin signatures.

Methods and results

We evaluated 64 specimens of surgically removed bilateral fallopian tubes. Thirty‐three β‐catenin signatures were identified in 13 cases (20.3%); these patients were significantly younger than those without β‐catenin signatures (median ages of 44 and 57 years, respectively, P = 0.0317). No correlation between β‐catenin signature and any clinical factor was observed. CTNNB1 mutations were detected in three of eight β‐catenin signatures when tissues were microdissected and subjected to Sanger sequencing in two representative cases.

Conclusions

This is the first report of the CTNNB1 mutation in clusters of morphologically bland tubal epithelial cells. The results of this study indicate that β‐catenin signatures are common, and they may be a part of diverse molecular alterations occurring in normal tubal epithelium.
Influence of minimally invasive endodontic access cavities on root canal shaping and filling ability, pulp chamber cleaning and fracture resistance of extracted human mandibular incisors
Authors: Rover G. , de Lima C. O. , Belladonna F. G. , Garcia L. F. R. , Bortoluzzi E. A. , Silva E. J. N. L. , Teixeira C. S.
Published: August 2020

Aim

To evaluate the influence of the location and design of endodontic access cavities on root canal shaping and filling ability, pulp chamber cleaning and fracture resistance of extracted human mandibular incisors.

Methodology

After pre‐selection using periapical radiographs, forty extracted intact human mandibular incisors were scanned in a micro‐computed tomographic device. The teeth were matched based on similar anatomical features of the canals and assigned to four experimental groups (n = 10) according to the endodontic access cavity and root canal preparation protocol: traditional/TRUShape (T/TRU); traditional/MTwo (T/MT); minimally invasive/TRUShape (MI/TRU); and minimally invasive/MTwo (MI/MT). The samples were scanned after root canal instrumentation and filling procedures. The parameters evaluated were as follows: volume and area of the root canal, noninstrumented canal areas, canal transportation and centring ratio, accumulated hard tissue debris, voids in root canal fillings and remnants of root canal filling materials in the pulp chamber. After root canal filling and cavity restoration procedures, the samples were submitted to a fracture resistance test. Data were statistically analysed using Shapiro–Wilk, one‐way anova and Bonferroni tests with a significance level of 5% (α = 0.05).

Results

There was no difference regarding all parameters evaluated before and after root canal preparation (volume and area of the root canal, noninstrumented canal areas, canal transportation and centring ratio, and accumulated hard tissue debris) amongst the groups (P > 0.05). MI/TRU and MI/MT groups were associated with significantly more voids in root canal fillings when compared to the T/TRU and T/MT groups (P < 0.05). Percentage of root canal filling material remnants in the pulp chamber after cleaning procedures and mean fracture resistance values were not significantly different amongst the four experimental groups (P > 0.05).

Conclusions

The location and design of the endodontic access cavity did not impact on root canal preparation nor resistance to fracture of extracted mandibular incisors, regardless of the instrument used. Minimally invasive access cavities were associated with significantly more voids in root canal fillings.
Development of antimicrobial whey protein‐based film containing silver nanoparticles biosynthesised by Aspergillus Niger
Authors: Çağrı Mehmetoğlu Arzu , Sezer Elif , Erol Sümeyye
Published: August 2020

Applications of whey protein concentrate (WPC)‐based films have been limited in the food industry due to their poor mechanical properties. This research aims to evaluate the effect of silver nanoparticles (AgNPs) synthesised by Aspergillus niger on the mechanical and antimicrobial properties of WPC‐based films. The biosynthesised AgNPs solution was added into the WPC film formula at the concentration of 0, 0.25 and 1.25 mm. The film samples containing AgNPs inhibited the growth of Staphylococcus aureus, Escherichia coli O157:H7, Salmonella Enteritidis, Listeria monocytogenes, Williopsis saturnus or Aspergillus sydowii with zones of inhibition ranging from 13 to 19.7 mm. Incorporation of AgNPs improved tensile strength and water barrier properties of the films by 84% and 67%, respectively. However, per cent elongation at the break of the film decreased from 37% to 11% by the addition of 1.25 mm AgNPs. This work provides a protocol for preparing improved antimicrobial WPC films with AgNPs.
Liquidity risk and corporate bond yield spread: Evidence from China
Authors: Chen Yinghui , Jiang Lunan
Published: August 2020

This paper investigates the contribution of liquidity risk to Chinese corporate bond spreads. We calculate corporate bond spreads based on the full treasury yield curve and establish a set of liquidity measures of the Chinese corporate bonds. Our empirical study shows that liquidity premium accounts for a relatively smaller portion of corporate bond spread in China, although the market liquidity is low and corporate bond issuers are strictly pre‐screened. These findings are interesting, as the developed markets have better liquidity and less pre‐issuance restriction, and liquidity premium still explains a relatively larger portion of corporate bond spread. Besides, we also explore the determinants of Chinese corporate bond liquidity and default premiums.
Use of a novel silicone‐acrylic drape with negative pressure wound therapy in anatomically challenging wounds
Authors: Fernández Luis G. , Matthews Marc R. , Benton Carol , Buresch Rebecca , Sutherland Angela , Tillison Natalie , Brooks Jenny
Published: August 2020

Negative pressure wound therapy (NPWT) utilises a polyurethane drape with acrylic adhesive over foam dressings to create a seal. In anatomically challenging areas, ancillary products are frequently used. Additionally, health care providers are unable to reposition the drape once placed. A novel hybrid drape consisting of polyurethane film with acrylic adhesive and silicone perforated layer has been developed to allow for repositioning after initial placement and easy removal. This six‐patient case series evaluates the use of NPWT with hybrid drape over anatomically challenging wounds. Three males and three females were treated. Dressing changes occurred every 2 to 3 days. Drape application, repositioning, and ability to maintain a seal were evaluated. During application, the drape was repositioned 1 to 2 times without periwound skin irritation in 4/6 wounds. Prior to initial application, ancillary products were applied to help create a seal. However, by the second or third application, ancillary products were no longer used in 4/6 wounds. None of the dressing applications resulted in negative pressure seal leaks. In these patients, health care providers could reposition the hybrid drape after initial placement without periwound skin irritation and successfully create a negative pressure seal without ancillary products in anatomically challenging wound locations.
Collaborative care for the wearable cardioverter defibrillator patient: Getting the patient and medical team “vested and active”
Authors: Sears Samuel F. , Tripp Connor , Huber Nichelle L. , Khan Saleen , Nekkanti Rajasekhar , Burch Ashley E. , Pokorney Sean D.
Published: August 2020

Patients with a reduced ejection fraction of 35% or less and a history of myocardial infarction (MI) are at increased risk of sudden cardiac death (SCD). These patients have a class I indication for an implantable cardioverter‐defibrillator after allowing time for medical therapy optimization and potential cardiac recovery. The rates of SCD are highest in this “gap” period early after a cardiac event, and the wearable cardioverter‐defibrillator (WCD) is an intervention that can be used to protect against SCD during this time period. There has been a clinical trial that randomized patients with a reduced ejection fraction at the time of MI to a WCD versus control. Results of the trial showed no statistically significant difference in the primary endpoint of SCD. There are many intricacies to the interpretation of the trial, including the importance of patient adherence to WCD therapy, which is affected by the patient experience and psychological factors. Patients with a new cardiomyopathy are affected by a mix of psychological factors, including the feeling of safety and protection from a WCD contrasted by the WCD providing a reminder of awareness and fear of ventricular arrhythmias and SCD. Beyond the capabilities of a WCD to defibrillate a life‐threatening ventricular arrhythmia, the device can also provide activity and heart failure diagnostics monitoring. Patients need to be engaged in shared decision‐making conversations about a WCD, so that patients can make a decision based on their own values construct, ultimately increasing adherence among the patients that want a WCD.
Impedance, power, and current in radiofrequency ablation: Insights from technical, ex vivo, and clinical studies
Authors: Bourier Felix , Ramirez F. Daniel , Martin Claire A. , Vlachos Konstantinos , Frontera Antonio , Takigawa Masateru , Kitamura Takeshi , Lam Anna , Duchateau Josselin , Pambrun Thomas , Cheniti Ghassen , Derval Nicolas , Denis Arnaud , Sacher Frédéric , Hocini Mélèze , Haissaguerre Michel , Jais Pierre
Published: August 2020

Background

Radiofrequency (RF) power is routinely considered during RF application. In contrast, impedance has been relatively poorly studied, despite also influencing RF lesion creation. The aim of this study was to examine the influence of electric impedance on RF lesion characteristics and on clinical RF ablation parameters.

Methods and Results

In the first part of the study, power and impedance were systematically varied and the resulting current was calculated using custom‐made software. In the second part of the study, ablation lesions (n = 40) were analyzed in a porcine ex vivo model. RF applications were delivered in cardiac muscle preparations with systematically varied values of electric impedance using a contact force ablation catheter. In the third part of the study, n = 3378 clinical RF applications were analyzed, power, impedance, and current data were exported and correlated with clinical patient data. 20 ± 3 W/80 Ω, 30 ± 3 W/120 Ω, 40 ± 3 W/160 Ω, and 50 ± 3 W/200 Ω RF applications resulted in 498 ± 40, 499 ± 26, 500 ± 20, and 500 ± 16 mA RF current, which were not significantly different (p = .32). Ablation lesions were significantly different in depth and diameter when applied with the same power but different impedances (p < .01); lesion sizes decreased when increasing impedance. In clinical data, a large range of delivered current (e.g., 39–40 W: 530–754 mA) was measured, due to variations in impedance.

Conclusions

RF lesion creation is determined by current rather than by power. During clinical RF ablation procedures, impedance significantly influences current delivery and varies considerably between patients. Impedance and current are clinically relevant parameters that should be considered during RF ablation.