bluuebunny/crossref_metadata_2025 huggingface dataset:
The burden of atherosclerosis in Portugal
Authors: Costa João , Alarcão Joana , Araujo Francisco , Ascenção Raquel , Caldeira Daniel , Fiorentino Francesca , Gil Victor , Gouveia Miguel , Lourenço Francisco , Mello e Silva Alberto , Sampaio Filipa , Vaz Carneiro António , Borges Margarida
Published: August 2020

Aims

This article sought to estimate the burden of disease attributable to atherosclerosis in mainland Portugal in 2016.

Methods and results

The burden of atherosclerosis was measured in disability-adjusted life years following the latest 2010 Global Burden of Disease (GBD) methodology. Disability-adjusted life years were estimated as the sum of years of life lost (YLL) with years lived with disability (YLD). The following clinical manifestations of atherosclerosis were included: ischaemic heart disease (IHD) (including acute myocardial infarction, stable angina, and ischaemic heart failure), ischaemic cerebrovascular disease (ICVD), and peripheral arterial disease (PAD). Years of life lost were estimated based on all-cause mortality data for the Portuguese population and mortality due to IHD, ICVD, and PAD for the year 2016 sourced from national statistics. Standard life expectancy was sourced from the GBD study. Years lived with disability corresponded to the product of the number of prevalent cases by an average disability weight for all possible combinations of disease. Prevalence data for the different clinical manifestations of atherosclerosis were sourced from epidemiological studies. Disability weights were sourced from the published literature. In 2016, 15 123 deaths were attributable to atherosclerosis, which corresponded to 14.3% of overall mortality in mainland Portugal. Disability-adjusted life years totalled 260 943, 75% due to premature death (196 438 YLL) and 25% due to disability (64 505 YLD).

Conclusion

Atherosclerosis entails a high disease burden to society. A large part of this burden would be avoidable if evidence-based effective and cost-effective interventions targeting known risk factors, from prevention to treatment, were implemented.
Continuity and Change: Strategy and Technology in the Royal Navy, 1890–1918
Authors: Morgan-Owen David G
Published: August 2020

This article presents a new interpretation of the relationship between technology and warfare at sea before and during the First World War. It challenges existing accounts which view technological innovations as the primary driver of naval strategy during this period, and argues for a more contingent, incremental and contextualised approach to the relationship between technology and strategy. It illustrates these points with a specific example: the highly controversial topic of the Royal Navy’s so-called ‘Battle Cruisers’, three of which suffered catastrophic explosions at the Battle of Jutland in 1916. In doing so it forwards a new interpretation of British naval policy between 1890 and 1918, the Anglo-German naval arms race, and elements of the First World War at sea.
ACE inhibitor-induced small bowel angioedema, mimicking an acute abdomen
Authors: Parreira Rafaela , Amaral Rui , Amaral Luís , Elói Teresa , Leite Maria Inês , Medeiros Armando
Published: August 2020

Angiotensin-converting enzyme (ACE) inhibitors are the leading cause of drug-induced angioedema, being the face, tongue, lips and upper airway the most affected ones. We describe a case of a 32-year-old white female with angioedema of small intestine after 1 month of perindopril therapy. The patient presented severe abdominal pain, nausea and vomiting. Laboratory analyses revealed mild leukocytosis and abdominal computed tomography (CT) showed unspecific findings, including segmental jejunal wall thickening without obstruction and ascites. Regarding the clinical findings, similar to an acute abdomen with no clear cause, the patient underwent an emergency laparoscopy that excluded other pathological features. The symptoms recurred 1 month after and the CT scan revealed the same pattern. Perindopril was stopped and the patient improved, concluding that ACE inhibitor-induced visceral angioedema was responsible for this clinical presentation.
Workforce Planning for Embedded Mental Health Care in the U.S. Navy
Authors: Millegan Jeffrey , Lippy Robert , De La Rosa Gabriel , Swayze Michael , Murray Thomas , Hucles Katherine , Webb-Murphy Jennifer , Bhakta Jagruti , Delaney Eileen , Pauli Ingrid , Buenviaje Bernardo
Published: August 2020

Introduction

Embedding mental health providers directly into operational units provides opportunities for holistic individual and population focused mental health support. To effectively provide clinical mental health care to a large number of Sailors and Marines while supporting the larger command, it is crucial to arrive at an optimal number of mental health (MH) care staff. In response to an increasing demand for MH care by operational units distributed globally, the U.S. Navy (USN) critically analyzed the current MH staffing levels, estimated future demand for MH care providers, and evaluated several staffing options. The following article illustrates a case study of workforce planning for the USN’s embedded MH delivery model.

Materials and methods

Several existing data sources were used to calculate current number of MH care staff across all USN platforms and to estimate demand for MH care. An open source Linear Programming application was used to estimate staffing solutions that meet business requirements in the most efficient manner possible.

Results

Results suggested different conclusions for embedded mental health staffing across USN communities. Depending on existing staffing levels and the number of Sailors or Marines anticipated to require care, the Linear Programming algorithm estimated needed staffing levels to address demand.

Conclusion

The current project represents the first systematic workforce planning initiative designed to help staff the USN’s global demand for community focused MH care. The results of this project have identified areas where additional embedded mental health resources should be made available. By systematically documenting all services and capabilities and carefully examining the operational demands of each community, the current solution was able to identify precisely what type of MH resources should be allocated to a given community.
Rojak: An Ethnographic Exploration of Pluralism and Music Therapy in Post-British-Colonial Malaysia
Authors: Low Ming Yuan , Kuek Ser Sheen Tse , Kalsi Gurpreet Kaur
Published: August 2020

The purpose of this discursive exploration that is influenced by ethnography and autoethnography is to present how Western-based music therapy intersects with the pluralistic healthcare culture in Malaysia. We will first be situating music therapy as a Eurocentric-based healthcare practice. We will then introduce the history of Malaysia and healthcare culture through a pluralistic lens, drawing inspiration from a popular Malaysian street food—rojak, a form of salad. We use rojak as an analogy to honor Malaysia’s food culture while drawing similarities between the diverse flavors and textures between the distinct components of rojak, with the unique pluralism that exists throughout Malaysian culture and healthcare practices. Through this rojak pluralist lens, we will share several unique Malaysian vignettes to explore the different ways we consider Eurocentric music therapy as a potentially colonial practice, ranging from postcolonial theory perspective to a pragmatic, inclusive perspective. As Malaysia has maintained its pluralistic culture as a uniquely multiracial Asian country despite the lengthy history of colonization, we offer these Malaysian, post-British-colonial music therapy vignettes in this article.
Diet and risk of visual impairment: a review of dietary factors and risk of common causes of visual impairment
Authors: Broadhead Geoffrey K , Hong Thomas , Bahrami Bobak , Flood Victoria , Liew Gerald , Chang Andrew A
Published: August 2020

Age-related macular degeneration, diabetic retinopathy, cataract, and glaucoma remain the leading causes of visual impairment in developed nations, resulting in a substantial treatment burden on sufferers and health care systems. Despite significant advances in diagnostic testing and therapeutics, population-based strategies to reduce the burden of these diseases remain limited. However, there is some evidence that these diseases may share overlapping risk factors, particularly in regard to dietary intake and antioxidant status, and it is thus possible that dietary modification may reduce both the prevalence and severity of these conditions. In particular, dietary intake of green leafy vegetables, hyperglycemia/glycemia index, and omega-3 fatty acid intake, as well as overall dietary patterns, may affect risk of one or more of these conditions. In this review, we analyse the evidence for dietary intake and the association with these conditions, and provide insights into possible modifications that may thus simultaneously reduce the risk of visual impairment from multiple causes, including improving dietary intake of green leafy vegetables and reducing dietary glycemic index, both of which have been associated with a decreased risk of multiple causes of visual impairment.
Hydrogen recombination near-infrared line mapping of Centaurus A with IRSF/SIRIUS
Authors: Katayama Risako , Kaneda Hidehiro , Kokusho Takuma , Morihana Kumiko , Suzuki Toyoaki , Oyabu Shinki , Yamagishi Mitsuyoshi , Tsuchikawa Takuro
Published: August 2020

Centaurus A (Cen A) is one of the most famous galaxies hosting an active galactic nucleus (AGN), where the interaction between AGN activities and surrounding interstellar and intergalactic media has been investigated. Recent studies reported detections of Hα emission from clouds in the galactic halo toward the northeast and southwest of the nucleus of Cen A, suggesting that AGN jets may have triggered star formation there. We performed near-infrared line mapping of Cen A with the IRSF 1.4 m telescope, using the narrow-band filter tuned for Paβ, from which we find that Paβ emission is not detected significantly from either of the northeast or southwest regions. The upper limit of the Paβ/Hα ratio in the northeast region is compatible with that expected for a typical H ii region, in line with the scenario that AGNs have triggered star formation there. On the other hand, the upper limit of Paβ/Hα in the southwest region is significantly lower than that expected for a typical H ii region. A possible explanation of the low Paβ/Hα ratio in the southwest region is the scattering of Hα and Paβ photons from the center of Cen A by dust grains in the halo clouds. From the upper limit of Paβ/Hα in the southwest region, we obtain constraints on the dust size distribution, which is found to be compatible with those seen in the interstellar medium of our Galaxy.
Cardiometabolic risk factors associated with educational level in older people: comparison between Norway and Brazil
Authors: Rodrigues J A L , Stenvold D , Almeida M L , Sobrinho A C S , Rodrigues G S , Júnior C R Bueno
Published: August 2020

Background

The non-communicable diseases are the major causes of death both worldwide and in high-income countries such as Norway. Understanding whether policy programs affect the health of older adults, especially considering different realities, is crucial. We aimed to analyse cardiometabolic risk factors associated with educational level in elderly people from Norway and Brazil.

Methods

A total of 555 elderly people recruited from Trondheim, Norway (n = 310, age 70.7 ± 0.8 years, body mass index (BMI) 26.2 ± 3.9 kg/m2) and from Ribeirao Preto, Brazil (n = 245, age 64.1 ± 8.1 years, BMI 28.2 ± 5.5 kg/m2). All analyses were adjusted for age and sex, considering country as an independent variable. The significance level considered was P < 0.05.

Results

Brazilian people presented a higher incidence of overweight and higher waist circumference (WC) compared to Norwegian (28.2 ± 5.5 kg/m2 and 97.0 ± 14.7 cm versus 26.4 ± 3.9 kg/m2 and 92.1 ± 11.2 cm, respectively). When classified by education level, Brazilians presented higher values for BMI, WC and triglycerides (TG) than Norwegians with the same level of education (incomplete higher education), while Norwegians presented higher values for systolic blood pressure (SBP), cholesterol total (CT), high-density lipoprotein (HDL)-cholesterol, LDL-cholesterol and handgrip strength.

Conclusions

Both nationalities presented important cardiometabolic risk factors. However, when considering a low level of education, the Brazilian elderly people presented more cardiometabolic risk factors than Norwegians.
ON THE MORITA REDUCED VERSIONS OF SKEW GROUP ALGEBRAS OF PATH ALGEBRAS
Authors: Le Meur Patrick
Published: August 2020

Let $R$ be the skew group algebra of a finite group acting on the path algebra of a quiver. This article develops both theoretical and practical methods to do computations in the Morita-reduced algebra associated to $R$. Reiten and Riedtmann proved that there exists an idempotent $e$ of $R$ such that the algebra $eRe$ is both Morita equivalent to $R$ and isomorphic to the path algebra of some quiver, which was described by Demonet. This article gives explicit formulas for the decomposition of any element of $eRe$ as a linear combination of paths in the quiver described by Demonet. This is done by expressing appropriate compositions and pairings in a suitable monoidal category, which takes into account the representation theory of the finite group.
Tokenomics: Dynamic Adoption and Valuation
Authors: Cong Lin William , Li Ye , Wang Neng
Published: August 2020

We develop a dynamic asset pricing model of cryptocurrencies/tokens that allow users to conduct peer-to-peer transactions on digital platforms. The equilibrium price of tokens is determined by aggregating heterogeneous users’ transactional demand, rather than discounting cash flows as is done in standard valuations models. Endogenous platform adoption builds on user network externality and exhibits an $S$-curve: it starts slow, becomes volatile, and eventually tapers off. The introduction of tokens lowers users’ transaction costs on the platform by allowing users to capitalize on platform growth. The resultant intertemporal feedback between user adoption and token price accelerates adoption and dampens user-base volatility.
Discharge and Readmission to the Pediatric Cardiac ICU in Pediatric Patients With Durable Ventricular Assist Devices
Authors: Chacko Jacob J. , Pidborochynski Tara , Buchholz Holger , Freed Darren H. , Al-Aklabi Mohammed , Anand Vijay , Holinski Paula , Conway Jennifer
Published: August 2020

Objectives:

Pediatric patients implanted with a durable ventricular assist device are initially managed in the pediatric cardiac ICU but are eligible for discharge to the ward. Our objectives were to characterize discharge and readmission of ventricular assist device patients to the pediatric cardiac ICU, identify risk factors for readmission, and determine whether discharge or readmission is associated with mortality.

Design:

Retrospective study.

Setting:

Stollery Children’s Hospital.

Patients:

Patients implanted with a durable ventricular assist device at less than 18 years old between 2005 and 2016.

Interventions:

None.

Measurements and Main Results:

There were 44 patients who underwent ventricular assist device implantation at a median age of 3.7 years (interquartile range, 0.6–9.0 yr), with the most common etiology being noncongenital heart disease (76.7%). Median time of total ventricular assist device support was 110.0 days (interquartile range, 42.3–212.3 d) with the median index pediatric cardiac ICU stay being 34.0 days (interquartile range, 19.8–81.0 d). Thirty patients (68.0%) were discharged to the ward with 18 (60.0%) having at least one readmission. The median time to first readmission was 18.0 days (interquartile range, 14.8–109.8 d) with a median of two readmissions per patient (interquartile range, 1.0–3.0). The most common reason for readmission was pump thrombosis (30.4%), followed by neurologic dysfunction (23.9%). There were no statistically significant pre- or post-implant factors associated with readmission, and readmission was not associated with mortality (p = 0.600). Univariate Kaplan-Meier survival analysis indicated that use of pre-implant extracorporeal membrane oxygenation, post-implant continuous renal replacement therapy, as well as failure to be discharged from the index pediatric cardiac ICU stay were associated with mortality.

Conclusions:

Readmissions to the pediatric cardiac ICU occurred in 60.0% of pediatric patients on durable ventricular assist devices with the first readmission occurring within a month of discharge from the index pediatric cardiac ICU stay. While readmission was not associated with mortality, lack of discharge from index pediatric cardiac ICU stay was likely due to a worse pre-implant clinical status.
Eliminating Catheter-Associated Urinary Tract Infections in a Pediatric Cardiac ICU
Authors: Bigelow Amee M. , Koh Wonshill , Kinstler Angela , Conn Sandy M. , Geiser Lyndsey , Wright Carvey C. , LaMantia Susan P. , France Ashton , Cooper David S.
Published: August 2020

Objectives:

To eliminate catheter-associated urinary tract infections in a pediatric cardiac ICU.

Design:

Quality improvement methodology.

Setting:

Twenty-five bed cardiac ICU in a quaternary freestanding children’s hospital.

Patients:

All patients with an indwelling urinary catheter admitted to the cardiac ICU.

Interventions:

Catheter-associated urinary tract infection was defined according to National Healthcare Safety Network criteria. Failure modes and effects analysis and Pareto charts were used to determine etiology of process failures. We implemented a team-based multi-interventional approach in 2012 using the Model for Improvement, which included as follows: 1) establish indications for inserting and/or maintaining bladder catheterization, 2) standardization of maintenance care for the indwelling urinary catheters, 3) protocol for management of the leaking urinary catheters, 4) incorporation of urinary catheter days and prompts for removal in daily rounds, and 5) review of all cases of prolonged indwelling urinary catheter use (> 3 d). Process control charts were used to evaluate change.

Measurements and Main Results:

From 2011 to 2018, we showed an early and sustained improvement in catheter-associated urinary tract infection prevention standards compliance from 44% to 96% (52% improvement). These interventions showed a reduction and then elimination of catheter-associated urinary tract infections from January 2012 to the present day, despite fluctuations in total indwelling urinary catheter days.

Conclusions:

Utilization of quality improvement methodology allowed us to identify components of care that contributed to catheter-associated urinary tract infections. After addressing these issues, we noted a substantial reduction and then elimination of catheter-associated urinary tract infections in our pediatric cardiac ICU. Widely disseminating these interventions across multiple pediatric hospitals to determine the ability to achieve similar results are important next steps.
Treatment of Divided Eyelid Nevus With Orbicularis Oculi Myocutaneous Flap
Authors: Liu Jian , Sun Jiaming , Wang Zhenxing , Guo Liang , Guo Nengqiang
Published: August 2020

Background

Divided eyelid nevus is a rare congenital dermatological abnormality associated with several functional and aesthetic problems. Reconstruction of periorbital defects after resection of the lesions has been an intractable challenge. Also, plastic surgeons are still in the exploration stage regarding the treatment of this disease, because the knowledge about it has only been derived from random case reports and series.

Objective

To evaluate the postoperative effect of advanced orbicularis oculi myocutaneous (OOMC) flap for the treatment of divided eyelid nevus and present our experiences using this technique in our department.

Methods

A retrospective study was performed on 17 patients who had undergone treatment of divided eyelid nevus with OOMC flap between December 2012 and January 2018. All patients were treated with advanced OOMC flap. In some cases, flap thinning surgery and/or blepharoplasty was performed in the second stage for symmetry and aesthetic purposes.

Results

Seventeen patients, aged between 1 and 33 years, were operated. During a follow-up period ranging from 10 to 80 months, all the flaps were viable, and no serious complications were recorded except for partial cilia loss in 6 cases. Four cases developed slightly bloated flap, but after surgical revision by performing flap thinning surgery or/and blepharoplasty in the second stage, they achieved an even better aesthetic reconstruction. Except for the above 4 cases, the other patients stated that no further revision was needed.

Conclusions

The OOMC flap is an excellent method for the treatment of divided eyelid nevus, resulting in high functional and aesthetic reconstruction. In some cases, blepharoplasty can be performed in the second stage, which improves the aesthetic outcomes.
Enhancement of microwave absorption bandwidth of MXene nanocomposites through macroscopic design
Authors: Bora Pritom J. , Suresh Kumar T. R. , Tan Daniel Q.
Published: August 2020

MXene, the new family of two-dimensional materials having numerous nanoscale layers, is being considered as a novel microwave absorption material. However, MXene/functionalized MXene-loaded polymer nanocomposites exhibit narrow reflection loss (RL) bandwidth (RL less than or equal to −10 dB). In order to enhance the microwave absorption bandwidth of MXene hybrid-matrix materials, for the first time, macroscopic design approach is carried out for TiO
2
-Ti
3
C
2
T
x
MXene and Fe
3
O
4
@TiO
2
-Ti
3
C
2
T
x
MXene hybrids through simulation. The simulated results indicate that use of pyramidal meta structure of MXene can significantly tune the RL bandwidth. For optimized MXene hybrid-matrix materials pyramid pattern, the bandwidth enhances to 3–18 GHz. Experimental RL value well matched with the simulated RL. On the other hand, the optimized Fe
3
O
4
@TiO
2
-Ti
3
C
2
T
x
hybrid exhibits two specific absorption bandwidths (minimum RL value - −47 dB). Compared with other two-dimensional nanocomposites such as graphene or Fe
3
O
4
-graphene, MXene hybrid-matrix materials show better microwave absorption bandwidth in macroscopic pattern.
Modelling cytoskeletal transport by clusters of non-processive molecular motors with limited binding sites
Authors: Rueangkham Naruemon , Estabrook Ian D. , Hawkins Rhoda J.
Published: August 2020

Molecular motors are responsible for intracellular transport of a variety of biological cargo. We consider the collective behaviour of a finite number of motors attached on a cargo. We extend previous analytical work on processive motors to the case of non-processive motors, which stochastically bind on and off cytoskeletal filaments with a limited number of binding sites available. Physically, motors attached to a cargo cannot bind anywhere along the filaments, so the number of accessible binding sites on the filament should be limited. Thus, we analytically study the distribution and the velocity of a cluster of non-processive motors with limited number of binding sites. To validate our analytical results and to go beyond the level of detail possible analytically, we perform Monte Carlo latticed based stochastic simulations. In particular, in our simulations, we include sequence preservation of motors performing stepping and binding obeying a simple exclusion process. We find that limiting the number of binding sites reduces the probability of non-processive motors binding but has a relatively small effect on force–velocity relations. Our analytical and stochastic simulation results compare well to published data from
in vitro
and
in vivo
experiments.
Combining derivative and synchronous approaches for simultaneous spectrofluorimetric determination of terbinafine and itraconazole
Authors: Elmansi Heba , Roshdy Aya , Shalan Shereen , El-Brashy Amina
Published: August 2020

In this study, determination of terbinafine and itraconazole down to biological concentration level has been carried out. The determination is based on increasing the selectivity of the spectrofluorimetric technique by combining both derivative and synchronous spectrofluorometric approaches, which permits successful estimation of terbinafine at 257 nm and itraconazole at 319 nm in the presence of each other at Δ
λ
of 60 nm. International Conference on Harmonization validation guidelines were followed to fully validate the method, and linearity was obtained for the two drugs over the range of 0.1–0.7 µg ml
−1
for terbinafine and 0.5–4.0 µg ml
−1
for itraconazole. Application of the method was successfully carried out in the commercial tablets with good agreement with the comparison spectrofluorometric methods. As the detection limits were down to 0.013 and 0.1 µg ml
−1
and quantitation limits were 0.04 and 0.032 µg ml
−1
for terbinafine and itraconazole, respectively; the
in vitro
determination of terbinafine and itraconazole in spiked plasma samples was applicable. The percentage recoveries in biological samples were 97.17 ± 4.54 and 98.75 ± 2.25 for terbinafine and itraconazole, respectively. Water was used as the optimum diluting solvent in the proposed methodology which adds an eco-friendly merit.
Hydrodynamics of a twisting slender swimmer
Authors: Iosilevskii Gil , Rashkovsky Alexander
Published: August 2020

Sea snakes propel themselves by lateral deformation waves moving backwards along their bodies faster than they swim. In contrast to typical anguilliform swimmers, however, their swimming is characterized by exaggerated torsional waves that lead the lateral ones. The effect of torsional waves on hydrodynamic forces generated by an anguilliform swimmer is the subject matter of this study. The forces, and the power needed to sustain them, are found analytically using the framework of the slender (elongated) body theory. It is shown that combinations of torsional waves and angle of attack can generate both thrust and lift, whereas combinations of torsional and lateral waves can generate lift of the same magnitude as thrust. Generation of lift comes at a price of increasing tail amplitude, but otherwise carries practically no energetic penalty.
A rare octacoordinated mononuclear iron(III) spin-crossover compound: synthesis, crystal structure and magnetic properties
Authors: Hao Xiaoyun , Cao Tong , Dou Yong , Yang Lu , Zhou Zhen , Zhang Daopeng , Hao Hongguo
Published: August 2020

The chemistry of transition-metal complexes with unusually high coordination numbers has been of interest because of their application in catalytic and biological systems. Deprotonation of the ionogenic tetradentate ligand 6,6′-bis(1H-tetrazol-5-yl)-2,2′-bipyridine [H2bipy(ttr)2] in the presence of iron(III) and tetra-n-butylammonium bromide, [n-Bu4N]Br, in solution resulted in the synthesis of a rare octacoordinated anionic mononuclear complex, tetra-n-butylammonium bis[6,6′-bis(tetrazol-1-id-5-yl)-2,2′-bipyridine]iron(III) methanol hemisolvate dihydrate, (C16H36N)[Fe(C12H6N10)2]·0.5CH3OH·2H2O or [n-Bu4N][Fe{bipy(ttr)2}2]·0.5CH3OH·2H2O (1), which has been structurally characterized by elemental analysis, powder X-ray diffraction (PXRD) and single-crystal X-ray diffraction. In 1, the coordination sphere of the iron(III) ion is a distorted bis-disphenoid dodecahedron, in which the eight coordination positions are occupied by eight N atoms from two independent tetradentate [bipy(ttr)2]2− anionic ligands, therefore forming the anionic [Fe{bipy(ttr)2}2]− unit, with the negative charge balanced by a free [n-Bu4N]+ cation. An investigation of the magnetic properties of 1 revealed a gradual incomplete spin-crossover behaviour below 150 K.
Market structure, institutional quality and bank capital ratios: evidence from developing countries
Authors: Etudaiye-Muhtar Oyebola Fatima , Abdul-Baki Zayyad
Published: August 2020

Purpose

This paper investigates the role of market structure and institutional quality in determining bank capital ratios in developing economies.

Design/methodology/approach

The generalised methods of moment technique is used to control for auto-correlation and endogeneity in a sample of 79 publicly listed commercial banks. The study period is between 2000 and 2016.

Findings

Results show that market structure (proxied with bank competition) as well as institutional quality (regulatory quality) lowers bank capital in the sampled banks. This suggests that banks operating in less competitive markets with good regulatory quality do not need to engage in excessive risk-taking activities that would necessitate holding increased level of capital. Furthermore, the interaction of competition and regulatory quality reinforces the main findings, suggesting the importance of the two variables in determining bank capital ratio.

Research limitations/implications

Research has limitation in that the study investigated publicly listed commercial banks, the findings may not be applicable to non-listed banks.

Practical implications

Taking into cognisance the developing nature of the banking system in Africa, the findings from this study imply that the maintenance of an improved regulatory quality in an environment where healthy competition exists would encourage banks to hold capital ratios appropriate for their level of banking activities, that is, the banks would not engage in excessive risk-taking activities.

Originality/value

This is one of the first papers that examine the effect of market structure and institutional quality on bank capital ratios in developing countries that have bank-based financial systems.
Challenges of identifying and monitoring politically exposed persons (PEPs) in Latin America
Authors: Clavijo Suntura Joel Harry , Rosero Rosero Piedad Maribel , Aragón Cuamacás Gloria Esperanza
Published: August 2020

Purpose

The purpose of this paper is to analyze politically exposed persons (PEPs) according to Financial Action Task Force (FATF) Recommendations and assess the identification process followed by financial institutions to create a harmonized regional model for PEPs identification in Latin America.

Design/methodology/approach

FATF Recommendation No.12 states that financial institutions should identify PEPs. To do so, the latter uses either an internal identification system or an external database. Within this framework, the purpose of the research work is to determine whether the procedure adopted by the regulated entities complies with the requirements of the regulations. Both analytical and interpretative methods have been used for this purpose.

Findings

In accordance with FATF Recommendation No.12, national and foreign PEPs, as well as officials of relevant international organizations, close relatives and closest associates must be identified. This wide range of people forms an hybrid type of PEPs. Because of the lack of a harmonized identification policy, it is likely that some people who meet these conditions may not be spotted.

Originality/value

PEPs control success relies on accurate and prompt identification. Therefore, it is crucial to create an inter-state model of harmonized identification at a regional level in Latin America. It includes not only the participation of the obligated subjects but also the sector entities associated to the concerned economic activity.
The general peer: the public sphere in the age of profilicity (profile-based identity)
Authors: Moeller Hans-Georg
Published: August 2020

Purpose

The purpose of the paper is to outline the concept of the general peer in detail and to show its relation to the relevant social theories by Niklas Luhmann and Jürgen Habermas. It also aims at illustrating the concept with concrete examples from the academic system and the arts/mass media.

Design/methodology/approach

This paper introduces the concept of the “general peer” as an alternative to the concept of the “public sphere.” It situates the concept in the context of the concept of “profilicity” indicating a profile-based mode of identity.

Findings

The paper suggests that the concept of the general peer describes actually existing forms of the public better than the concept of the public sphere. It relates the general peer to second-order observation and functional differentiation prevalent in contemporary society.

Research limitations/implications

The paper suggests that the concept of the general peer denotes a significant element of the constitution of profile-based identity (profilicity) in contemporary society.

Practical implications

The concepts of the general peer and profilicity may be used to conduct empirical research on the constitution of identity and the curation of profiles in various social contexts.

Social implications

The paper can help understanding how to develop and assess profiles and their impact in contemporary social contexts.

Originality/value

The two concepts general peer and profilicity are theoretical innovations.
Understanding and managing uncertainty in health care: revisiting and advancing sociological contributions
Authors: Mackintosh Nicola , Armstrong Natalie
Published: August 2020

In this collection we revisit the enduring phenomenon of uncertainty in health care, and demonstrate how it still offers coherence and significance as an analytic concept. Through empirical studies of contemporary examples of health care related uncertainties and their management, our collection explores the different ways in which uncertainty may be articulated, enacted and experienced. The papers address a diverse range of healthcare contexts ‐ Alzheimer’s disease, neonatal surgery, cardiovascular disease prevention, cancer, addiction (use of alcohol and other drugs during pregnancy), mental health/disorders and medical education – and many tackle issues of contemporary relevance, such as an ageing population, and novel medical interventions and their sequelae. These empirical papers are complemented by a further theoretical contribution, which considers the role of ‘implicit normativity’ in masking and containing potential ethical uncertainty. By mapping themes across the collection, in this introduction we present a number of core analytical strands: (1) conceptualising uncertainty; (2) intersections of uncertainty with aspects of care; (3) managing uncertainty; and (4) structural constraints, economic austerity and uncertainty work. We reflect on the methodological and theoretical stances used to think sociologically about uncertainty in health care, and the strengths, silences and gaps we observe in the collection. We conclude by considering the implications of the insights gained for ‘synthesising certainty’ in practice and for future research in this area.
Molecular diversity of Extended‐spectrum β‐lactamase‐producing Escherichia coli from vultures in Canary Islands
Authors: Carvalho Isabel , Tejedor‐Junco María Teresa , González‐Martín Margarita , Corbera Juan Alberto , Suárez‐Pérez Alejandro , Silva Vanessa , Igrejas Gilberto , Torres Carmen , Poeta Patrícia
Published: August 2020

Antimicrobial resistance among isolates from wild animals is increasingly reported. Extended‐spectrum beta‐lactamase (ESBL)‐producing Enterobacteriaceae, and particularly Escherichia coli, have spread worldwide as one of the most common multidrug‐resistant organisms. The aim of this study was to determine the carriage rate of ESBL‐producing E. coli isolates and their genetic characteristics in wild vultures from the Canary Islands. Faecal samples were collected from 22 apparently healthy free‐ranging (wild) vulture chicks from Lanzarote and Fuerteventura (Canary Islands) during July 2019. They were seeded in MacConkey agar supplemented with cefotaxime (2 μg ml−1). Colonies with typical morphology of E. coli were identified by MALDI‐TOF‐MS. Antimicrobial susceptibility was done by disk diffusion. Phenotypic detection of ESBL was performed by double‐disk tests. The presence of blaCTX‐M, blaSHV, blaTEM, blaKPC and blaOXA‐48 genes, as well as mcr‐1 (colistin resistance), tetA/tetB and int1 gene, was tested by PCR/sequencing. Phylogenetic groups and multilocus sequence typing (MLST) were determined by PCR/sequencing. ESBL‐producing E. coli isolates were detected in 5/22 tested animals (22.7%), and all isolates (one/animal) carried blaCTX‐M genes: blaCTX‐M‐15 (n = 3) and blaCTX‐M‐55 (n = 2). ESBL‐positive isolates were ascribed to phylogenetic group D (two isolates), B1 (two isolates) and A (one isolate), and five sequence types were detected (ST/phylogenetic‐group/ESBL): ST515/B1/CTX‐M‐15, ST1290/A/CTX‐M‐15, ST38/D/CTX‐M‐15, ST457/D/CTX‐M‐55 and ST6448/B1/CTX‐M‐55; this suggests a genetic diversity among these isolates. Three CTX‐M‐15‐producing isolates contained the blaTEM gene and one the tetA gene. To our knowledge, this appears to be the first report of ESBL‐producing E. coli in vulture chicks from the Canary Islands.
Effectiveness of stereotactic body radiotherapy for portal vein tumor thrombosis in patients with hepatocellular carcinoma and underlying chronic liver disease
Authors: Choi Hoon Sik , Kang Ki Mun , Jeong Bae Kwon , Jeong Hojin , Lee Yun Hee , Ha In Bong , Song Jin Ho
Published: August 2020

Aim

Stereotactic‐body radiotherapy (SBRT) is a treatment option for portal vein tumor thrombosis (PVTT) in patients with hepatocellular carcinoma (HCC). Here, we report on our experience of treating PVTT using SBRT in patients with concomitant underlying chronic liver disease.

Methods

This study included 24 patients. The initial prescription dose was 45 Gy in three fractions in 17 (70.8%) patients, but it was modified in the remaining seven (29.2%) patients, with the dose ranging from 39 to 42 Gy in 3‐4 fractions. After SBRT, transarterial chemoembolization (TACE) was performed in 16 (66.7%) patients.

Results

Of the 24 patients, 2 (8.3%) showed complete response, while 11 (45.8%) showed partial response. After a median follow‐up of 8.4 months (range: 2.6‐56.5 months), the 1‐year overall survival (OS) and the median survival were 67.5% and 20.8 months, respectively. Both combined SBRT and TACE and grade ≥3 hepatic toxicity affected the 1‐year OS (SBRT alone vs SBRT + TACE: 14.6% vs 71.4%, P < .001; presence of hepatic toxicity vs absence: 0% vs 81.1%, P = .002).

Conclusions

Overall, SBRT, especially in combination with TACE, is an effective treatment for patients with HCC and PVTT. An optimal dose schedule must be followed to reduce hepatic toxicity while maintaining tumor response.
Long‐term safety and efficacy of lanreotide autogel in Japanese patients with neuroendocrine tumors: Final results of a phase II open‐label extension study
Authors: Ito Tetsuhide , Fujimori Nao , Honma Yoshitaka , Kudo Atsushi , Hijioka Susumu , Katsushima Shinji , Kimura Yasutoshi , Fukutomi Akira , Hisamatsu Seiichi , Nakajima Akihiro , Shimatsu Akira
Published: August 2020

Aim

The aim of this study was to describe the long‐term safety and efficacy of lanreotide in Japanese patients with neuroendocrine tumors.

Methods

The final analyses of a 48‐week open‐label phase II study (n = 32) and its extension study (n = 17) were conducted. Patients received 4‐weekly subcutaneous injections of lanreotide autogel 120 mg. Safety was evaluated by adverse events. Efficacy endpoints included tumor response by RECIST and change in tumor size. Post hoc analyses including tumor growth rate were performed.

Results

The median (range) of lanreotide exposure in the safety analysis set (n = 17) and efficacy analysis set (n = 28) were 151.4 (52–181) and 52.7 (12–181) weeks, respectively. Sixteen patients developed adverse drug reaction; of these, upper abdominal pain and urticaria were not reported before 48 weeks. No patient discontinued lanreotide or died from an adverse event. Two serious events of bile duct stones in one patient were drug‐related. Partial response was observed in 2 patients (7.1%; at 60 and 108 weeks), stable disease in 20 (71.4%) and progressive disease in 6 (21.4%). The mean of the greatest change from baseline in the sum of diameters of target lesions was −5.5%. The mean (standard deviation) tumor growth rate before treatment and from baseline to last observation was 25.3% (35.7%)/month and 6.4% (9.6%)/month, respectively.

Conclusion

Lanreotide treatment had an acceptable safety profile and was effective over long‐term treatment in Japanese patients with neuroendocrine tumors. No unexpected serious adverse events developed during prolonged use of lanreotide.
The changing paradigm of managing Merkel cell carcinoma in Australia: An expert commentary
Authors: Kok David L. , Wang Annie , Xu Wen , Chua Margaret S. T. , Guminski Alexander , Veness Michael , Howle Julie , Tothill Richard , Kichendasse Ganessan , Poulsen Michael , Sandhu Shahneen , Fogarty Gerald
Published: August 2020

Merkel cell carcinoma (MCC) is a highly aggressive neuroendocrine tumor of the skin with an estimated disease‐associated mortality of 15–33%. Australia has a higher incidence of MCC compared to the rest of the world, thought to be due to a higher ultraviolet index. The Australian MCC population is distinct from the MCC population of the Northern hemisphere, characterized by a predominantly viral negative etiology with high tumor mutational burden. The optimal management of MCC and the choice of treatment modality vary significantly across the world and even between institutions within Australia. Historically, the treatment for MCC has been resection followed by radiotherapy (RT), though definitive RT is an alternative treatment used commonly in Australia. The arrival of immune checkpoint inhibitors and the mounting evidence that MCC is a highly immunogenic disease is transforming the treatment landscape for MCC. Australia is playing a key role in the further development of treatment options for MCC with two upcoming Australian/New Zealand investigator‐initiated clinical trials that will explore the interplay of RT and immunotherapy in the treatment of early and late stage MCC.
C‐reactive protein trajectory in the first 48 hours predicts the need for intervention in conservative management of acute diverticulitis
Authors: Ahmadi Nima , Ravindran Praveen , Kim Taejun , Ayoubi Salah E. , Byrne Christopher M. , Young Christopher J.
Published: August 2020

Background

C‐reactive protein (CRP) is a useful marker for monitoring response to treatment in sepsis. The aim of this study was to examine the use of CRP trajectory in predicting the need for intervention in conservatively managed patients with acute diverticulitis (AD).

Methods

A retrospective review of patients with AD who were managed conservatively was performed. They were divided into four groups based on CRP relative to the median at day 0 and 2: ‘Low rise’ (levels below median at day 0 and 2), ‘High rise’ (levels above median at day 0 and 2), ‘Rapid rise’ (levels below median at day 0 but above median at day 2) and ‘Decline’ (levels above median at day 0 but below median at day 2).

Results

Intervention was required in 64 of 456 (14%) with 30 (48%) of these performed after day 2 of admission. There were 150 patients (54%) in the ‘Low rise’, 76 (27%) in the ‘Decline’, 26 patients (9%) in the ‘Rapid rise’ and 25 patients (9%) in the ‘High rise’ groups. Within these groups 5%, 8%, 19% and 32% of patients required intervention (P = 0.001). On multivariate analysis, patients with a pelvic abscess were more likely to need intervention (odds ratio 19.1 (confidence interval 6.2–59.4), P < 0.0001).

Conclusion

The CRP trajectory during the initial 48 h of admission can predict the need for intervention in AD patients being managed conservatively. Patients with a ‘Rapid rise’ or ‘High rise’ in CRP from day 0 to 2 are more likely to need intervention.
Knowledge and attitudes of Australian livestock producers concerning biosecurity practices
Authors: Paquette CC , Schemann KA , Ward MP
Published: August 2020

Biosecurity risks are a major threat to the profitability of the industry as well as impacting human and animal health. Livestock producers play a crucial role in biosecurity as the first to notice changes in the health or productivity of their stock and are generally responsible for implementing protective measures. However, uptake of biosecurity measures by producers is variable. We critically appraised the current literature regarding biosecurity practices in Australian livestock industries and highlight aspects that are well understood as well as those where further research or information is needed. Findings from 12 cross‐sectional studies suggest that Australian producers' knowledge of biosecurity methods and importance might have a positive influence on their willingness to implement or incorporate biosecurity practices. There is moderate evidence supportive of biosecurity being well understood by livestock producers across Australia. Barriers to producers using biosecurity practices included lack of information or communication from agricultural, veterinary or government organisations. It was found that larger stock numbers were positively correlated with biosecurity implementation and that producers used veterinarians, government and industry agencies as resources for trusted information.
The low‐expression programming of 11β‐HSD2 mediates osteoporosis susceptibility induced by prenatal caffeine exposure in male offspring rats
Authors: Xiao Hao , Wu Zhixin , Li Bin , Shangguan Yangfan , Stoltz Jean‐François , Magdalou Jacques , Chen Liaobin , Wang Hui
Published: August 2020

Background and Purpose

Prenatal caffeine exposure (PCE) can cause developmental toxicity of long bones in offspring, but the long‐term effects and the underlying mechanism have not been fully clarified. Here, we investigated the effects of PCE peak bone mass accumulation and osteoporosis susceptibility in offspring and its intrauterine programming mechanism.

Experimental Approach

Pregnant Wistar rats were administrated intragastrically with saline or caffeine (120 mg·kg−1·day−1) on gestational days 9–20. The serum and bone samples were collected from the fetal and postnatal offspring for bone mass, genes expression and corticosterone analysis. Then, rat bone marrow mesenchymal stem cells (BMSCs) were treated with corticosterone in vitro to confirm the molecular mechanism.

Key Results

PCE caused fetal bone dysplasia in male and female offspring. In adulthood, PCE reduced peak bone mass and increased osteoporosis susceptibility in male offspring but not in females. Meanwhile, PCE only decreased the H3K9ac and expression levels of 11β‐hydroxysteroid dehydrogenase 2 (11β‐HSD2) before and after birth in the male offspring but not in the females. Moreover, the high level of corticosterone induced by PCE down‐regulated the H3K9ac and expression levels of 11β‐HSD2 through promoting glucocorticoid receptor (GR; NR3C1) into the nucleus of bone marrow mesenchymal stem cells (BMSCs) and recruiting histone deacetylase 11 (HDAC11) binding to 11β‐HSD2 promoter region, which further enhanced the effect of corticosterone on suppressing osteogenic function of BMSCs.

Conclusion and Implications

PCE caused osteoporosis susceptibility in male adult offspring, which attributed to the low‐functional programming of 11β‐HSD2 induced by corticosterone via GR/HDAC11 signalling.
How to face the unexpected: Identification and leadership in managing bricolage
Authors: Paolino Chiara
Published: August 2020

Drawing on identity theory, empowering leadership, and justice, this study investigates the link between organizational identification and bricolage, and the moderating role of leader's empowering style and interactional justice. Data were collected through a survey on 231 individuals in a media production company. Results supported the research model, illustrating that organizational identification positively predicts individual bricolage, and that the support from the leader, in the form of empowerment and interactive justice, makes this relationship stronger. Robustness checks were carried out, collecting additional longitudinal data from different industries with respect to the main study, and the supplementary analysis corroborated the research model.