bluuebunny/crossref_metadata_2025 huggingface dataset:
Building military learning organizations: many birds, one stone
Authors: Freeman Tyler E. , Calton Michele A.
Published: November 2020

Purpose

This paper aims to illustrate the need for context-adapted models of military learning organizations (LOs), identify challenges to building LOs in the military and discuss how maturing as an LO provides military organizations a competitive advantage.

Design/methodology/approach

This paper highlights the primarily industrial focus of existing literature, discusses a sample of nuanced challenges to building military LOs and posits potential benefits of military LOs future operational environment.

Findings

Building military LOs is an area of research that remains underdeveloped. Advancing LO theory requires researchers to consider context and the challenges organizations may encounter during efforts to build LOs.

Originality/value

This paper highlights gaps and alignment in LO theory to advance the argument that context-adapted approaches to building military LOs are needed.
COVID-19: risk prediction through nature inspired algorithm
Authors: Singh Narinder , Singh S.B. , Houssein Essam H. , Ahmad Muhammad
Published: November 2020

Purpose

The purpose of this study to investigate the effects and possible future prediction of COVID-19. The dataset considered in this study to investigate the effects and possible future prediction of COVID-19 is constrained as follows: age, gender, systolic blood pressure, HDL-cholesterol, diabetes and its medication, does the patient suffered from heart disease or took anti-cough agent food or sensitive to cough related issues and any other chronic kidney disease, physical contact with foreign returns and social distance for the prediction of the risk of COVID-19.

Design/methodology/approach

This work implemented a meta-heuristic algorithm on the aforementioned dataset for possible analysis of the risk of being infected with COVID-19. The authors proposed a simple yet effective Risk Prediction through Nature Inspired Hybrid Particle Swarm Optimization and Sine Cosine Algorithm (HPSOSCA), particle swarm optimization (PSO), and sine cosine algorithm (SCA) algorithms.

Findings

The simulated results on different cases discussed in the dataset section reveal which category of individuals may happen to have the disease and of what level. The experimental results reveal that the proposed model can predict the percentage of risk with an overall accuracy of 88.63%, sensitivity (87.23%), specificity (89.02%), precision (69.49%), recall (87.23%), f_measure (77.36%) and Gmean (88.12%) with 41 and 146 true positive and negative, 18 and 6 false positive and negative cases, respectively. The proposed model provides a quite stable prediction of risk for COVID-19 on different categories of individuals.

Originality/value

The work for the very first time developed a novel HPSOSCA model based on PSO and SCA for the prediction of COVID-19 disease. The convergence rate of the proposed model is too high as compared to the literature. It also produces a better accuracy in a computationally efficient fashion. The obtained outputs are as follows: accuracy (88.63%), sensitivity (87.23%), specificity (89.02%), precision (69.49%), recall (87.23%), f_measure (77.36%), Gmean (88.12%), Tp (41), Tn (146), Fb (18) and Fn (06). The recommendations to reduce disease outbreaks are as follow: to control this epidemic in various regions, it is important to appropriately manage patients suspected of having the disease, immediately identify and isolate the source of infection, cut off the transmission route and prevent viral transmission from these potential patients or virus carriers.
Bring it on Covid-19: being an older person in developing countries during a pandemic
Authors: Sattari Setayesh , Billore Soniya
Published: November 2020

Purpose

This study aims to explore the respective risk perception toward the Covid-19 pandemic among the elderly in two developing countries and their lifestyle change and adaptation behavior as a result of that.

Design/methodology/approach

In total, 22 in-depth interviews were conducted among people aged 60 to 85 in Iran and India. The interview guideline was based on two constructs inspired by the study of Gerhold (2020) – risk perception of the pandemic and change in lifestyle and adaptation to the pandemic situation.

Findings

The results showed that although the majority of the interviewees initially experienced fear and anxiety during the stay-at-home order and the pandemic situation at large, they quickly adapted to the new situation with behavioral and attitudinal changes in ways relevant to the new normal. The results confirmed the maturation hypothesis proposed by Knight et al. (2000).

Originality/value

This paper is an original study of the researchers and among the first contributing to the literature of the elderly studies in developing countries. It contributes to the knowledge required for future behavioral studies concerning the Covid-19 pandemic by evaluating the experiences, risk perception and adaptation approaches of the older people in India and Iran.
Museums working with older people in times of pandemic
Authors: Grácio Rita
Published: November 2020

Purpose

The purpose of this paper is to highlight some of the work with/for/about older people being undertaken by museums during the coronavirus disease (COVID-19) pandemic, thinking of museums as caregivers.

Design/methodology/approach

This paper reviews the responses from museums which work with older adults, in times of pandemic. It reviews how museums have addressed older people during the COVID-19 outbreak in the UK and Portugal. Two Portuguese maritime museums which have older adults as strategic audiences are selected and their Facebook webpage during the lockdown is analyzed.

Findings

Museums were committed to delivering online the work they have been doing offline, not without limitations. The digital turn in times of pandemic draw attention to inequalities regarding visitors who has access and literacy to engage with the digital museum as well as museums themselves. Unlike in the UK, in the two maritime museums, there were no specific programmes targeting older people – except for COVID-19 messages. However, older adults are presented online as active and as experts on maritime issues, representing empowering versions of ageing, either online or offline.

Originality/value

This paper reviewed and illustrated with empirical examples from the UK and Portugal how museums are addressing older adults during the COVID-19 pandemic, contributing to the wider debate on the role of arts, culture and cultural heritage for the well-being of older adults.
Sex‐specific plasticity across generations II: Grandpaternal effects are lineage specific and sex specific
Authors: Hellmann Jennifer K. , Carlson Erika R. , Bell Alison M.
Published: November 2020

Transgenerational plasticity (TGP) occurs when the environment encountered by one generation (F0) alters the phenotypes of one or more future generations (e.g. F1 and F2). Sex selective TGP, via specific lineages or to only male or female descendants, has been underexplored in natural systems, and may be adaptive if it allows past generations to fine‐tune the phenotypes of future generations in response to sex‐specific life‐history strategies.

We sought to understand if exposing males to predation risk can influence grandoffspring via sperm in three‐spined sticklebackGasterosteus aculeatus. We specifically tested the hypothesis that grandparental effects are transmitted in a sex‐specific way down the male lineage, from paternal grandfathers to F2 males.

We reared F1 offspring of unexposed and predator‐exposed F0 males under ‘control’ conditions and used them to generate F2s with control grandfathers, a predator‐exposed maternal grandfather (i.e. predator‐exposed F0 males to F1 daughters to F2s), a predator‐exposed paternal grandfather (i.e. predator‐exposed F0 males to F1 sons to F2s) or two predator‐exposed grandfathers. We then assayed male and female F2s for a variety of traits related to antipredator defence.

We found little evidence that transgenerational effects were mediated to only male descendants via the paternal lineage. Instead, grandpaternal effects depended on lineage and were mediated largely across sexes, from F1 males to F2 females and from F1 females to F2 males. When their paternal grandfather was exposed to predation risk, female F2s were heavier and showed a reduced change in behaviour in response to a simulated predator attack relative to grandoffspring of control, unexposed grandparents. In contrast, male F2s showed reduced antipredator behaviour when their maternal grandfather was exposed to predation risk. However, these patterns were only evident when one grandfather, but not both grandfathers, was exposed to predation risk, suggesting the potential for non‐additive interactions across lineages.

If sex‐specific and lineage effects are common, then grandparental effects are likely underestimated in the literature. These results draw attention to the importance of sex‐selective inheritance of environmental effects and raise new questions about the proximate and ultimate causes of selective transmission across generations.
Practice‐site‐level measures of primary care comprehensiveness and their associations with patient outcomes
Authors: O’Malley Ann S. , Rich Eugene C. , Shang Lisa , Rose Tyler , Ghosh Arkadipta , Poznyak Dmitriy , Peikes Deborah , Niedzwiecki Matt
Published: November 2020

Objectives

To develop twopractice‐site‐levelmeasures of comprehensiveness and examine their associations with patient outcomes, and how their performance differs from physician‐level measures.

Data Sources

Medicare fee‐for‐service claims.

Study Design

We calculated practice‐site‐level comprehensiveness measures (new problem managementandinvolvement in patient conditions) across 5286 primary care physicians (PCPs) at 1339 practices in the Comprehensive Primary Care initiative evaluation in 2013. We assessed their associations with practices’ attributed beneficiaries’ 2014 total Medicare expenditures, hospitalization rates, ED visit rates. We also examined variation in PCPs’ comprehensiveness across PCPs within practices versus between primary care practices. Finally, we compared associations of practice‐site and PCP‐level measures with outcomes.

Principal Findings

The measures had good variation across primary care practices, strong validity, and high reliability. Receiving primary care from a practice at the 75th versus 25th percentile on theinvolvement in patient conditionsmeasure was associated with $21.93 (2.8%) lower total Medicare expenditures per beneficiary per month (P < .01). Receiving primary care from a practice at the 75th versus 25th percentile on thenew problem managementmeasure was associated with $14.77 (1.9%) lower total Medicare expenditures per beneficiary per month (P < .05); 8.84 (3.0%) fewer hospitalizations (P < .001), and 21.27 (3.1%) fewer ED visits per thousand beneficiaries per year (P < .01). PCP comprehensiveness varied more within than between practices.

Conclusions

More comprehensive primary care practices had lower Medicare FFS expenditures, hospitalization, and ED visit rates. Both PCP and practice‐site level comprehensiveness measures had strong construct and predictive validity; PCP‐level measures were more precise.
Measuring physician practice site characteristics: A comparison of data from SK&A and a practice site survey
Authors: Maurer Kristin A. , Blue Laura , Orzol Sean , Morrison Hensleigh Nikkilyn , Peikes Deborah
Published: November 2020

Objective

To evaluate the comparability of commercially available practice site data from SK&A with survey data to understand the implications of using SK&A data for health services research.

Data sources

Responses to the Comprehensive Primary Care Plus (CPC+) Practice Survey and SK&A data.

Study design

Comparison of CPC + Practice Survey responses to SK&A information for 2698 primary care practice sites.

Data collection

CPC + Practice Survey data collected through a web‐only survey from April through September 2017, and SK&A data purchased in November 2016.

Principal findings

Information was similar across data sources, although some discrepancies were common. For example, 56% of practice sites had differences in the reported number of practitioners, and larger sites tended to have larger differences. Among practice sites with 1 practitioner in the survey, only 1.3% had a difference of 3 or more practitioners between the data sources, whereas 63% of practice sites with 11 or more practitioners had a difference of 3 or more practitioners.

Conclusions

Discrepancies between data sources could reflect differences of interpretation when defining practice site characteristics, changes over time in those characteristics, or data errors in either SK&A or the survey. Researchers using SK&A data should consider possible ramifications for their studies.
Clinicopathological features and prognostic implications of ASCL1 expression in surgically resected small cell lung cancer
Authors: Wei Jiacong , Liu Li , Guo Yiying , Zhang Jinyao , Wang Xin , Dong Jiyan , Xing Puyuan , Ying Jianming , Yang Lin , Li Junling
Published: November 2020

Background

Small cell lung cancer (SCLC) is one of the most aggressive lung cancers. Treatment of SCLC has remained unchanged during the past decades. Preclinical studies have revealed ASCL1 as a transcription regulator in the neuroendocrine (NE) differentiation and carcinogenesis of SCLC. However, there are few studies on correlation of ASCL1 expression and clinicopathological factors in resected SCLCs. Here, we aimed to analyze the ASCL1 expression of SCLC and investigate its associations with clinicopathological factors and survival.

Methods

A total of 247 surgically resected pure SCLC specimens were included in this retrospective study, all of which were processed using tissue microarrays for immunohistochemistry analysis of ASCL1. A total of 48 of 247 cases were tested by NanoString for mRNA expression analysis on 50 SCLC related genes. Statistical analysis was performed using R studio and SPSS software.

Results

NE scores of 48 pure SCLC specimens were calculated by analyzing 50 preselected genes. A significant correlation between NE score with both ASCL1 mRNA expression and ASCL1 protein expression were observed. For the entire cohort of 247 patients, ASCL1 was highly expressed in 42.5% of pure SCLC patients according to IHC results. Significant differences were observed between ASCL1 high and low expression groups in variables including staging, lymph node metastasis, nerve invasion and overall survival.

Conclusions

In limited staged pure SCLC, ASCL1 expression was positively correlated with NE signature, pTNM stage, nerve invasion and OS. ASCL1 may therefore serve as a potential biomarker to predict prognosis as well as in the selection of patients for therapies targeting ASCL1‐regulated downstream molecules.
Determining the optimal antibiotic regimen for chorioamnionitis: A systematic review and meta‐analysis
Authors: Alrowaily Nouf , D'Souza Rohan , Dong Susan , Chowdhury Soneya , Ryu Michelle , Ronzoni Stefania
Published: November 2020

Introduction

To evaluate the effect of antibiotic regimens for chorioamnionitis on maternal and neonatal outcomes.

Material and methods

We conducted a systematic review, wherein we searched six bibliographic databases until June 2020 and included randomized clinical trials describing antibiotic regimens for treating chorioamnionitis. Risk of bias was assessed using the Cochrane Risk of Bias tool V2.0. Random‐effects meta‐analysis was performed and results were presented as risk ratio (RR) and mean differences (MD) with 95% CI.

Results

Fourteen trials at low‐to‐high risk of bias were included. Three trials (n = 244), comparing different intrapartum antibiotic regimens, showed no difference in outcomes except for lower composite maternal morbidity (endometritis, pneumonia, sepsis, blood transfusion, and ileus) with ampicillin/sulbactam vs ampicillin/gentamicin in one study (0/43 vs 6/49, P = .03). Three trials (n = 295) comparing different doses of intrapartum antibiotics showed no differences in maternal and neonatal outcomes, although one study showed a shorter duration of antibiotic treatment in the experimental arm (4 mg/kg gentamicin q24h + 1200 mg clindamycin q12h) vs conventional arm (1.33 mg/kg gentamicin + 800 mg clindamycin q8h) (48.0 ± 36 hours vs 55.2 ± 48 hours, P = .04). Four trials (n = 484) comparing postpartum antibiotics vs no antibiotics showed no difference in outcomes except for a shorter hospital stay (two studies, MD −7.90 hours, 95% CI −13.52 to −2.27 hours). Three trials (n = 447) comparing single vs multiple doses of postpartum antibiotics showed shorter hospital stay [MD −19.14 hours, 95% CI −29.88 to −8.41 hours), but no differences in treatment failure (RR 1.73, 95% CI 0.69‐4.30) or total antibiotic dose (MD −9.24, 95% CI −19.49 to 1.01). One trial (n = 48) comparing intrapartum vs postpartum initiation of treatment found benefits to intrapartum (vs postpartum) initiation of antibiotics, in terms of postpartum maternal hospital stay (MD −24 hours, 95% CI −45.56 to −1.44 hours), neonatal hospital stay (MD −45.6 hours, −93.84 to −11.76 hours), and neonatal pneumonia or sepsis (RR 0.06, 95% CI 0.00‐0.95).

Conclusions

Upon diagnosis of chorioamnionitis, there is limited evidence to recommend the prompt initiation of intrapartum antibiotics, and to consider a single dose of postpartum antibiotics over multiple doses or no treatment. Well‐designed trials using standard definitions of chorioamnionitis, outcome measures, and newer antibiotics are required to inform clinical practice with regard to the preferred antibiotic regimen, dose, and duration to optimize maternal and neonatal outcomes.
Maternal pre‐pregnancy overweight and infertility in sons and daughters: A cohort study
Authors: Arendt Linn H. , Høyer Birgit B. , Kreilgaard Anne F. , Bech Bodil H. , Toft Gunnar , Hougaard Karin S. , Bonde Jens P. , Olsen Jørn , Ramlau‐Hansen Cecilia H.
Published: November 2020

Introduction

Overweight and obesity in pregnancy is increasing worldwide and may harm the developing fetus, including its future reproductive health. We therefore studied the association between in utero exposure to maternal overweight and obesity and infertility in adulthood. No studies have previously assessed this association.

Material and methods

We performed a cohort study with 9232 adult sons and daughters whose mothers were enrolled in the Danish Healthy Habits for Two cohort during pregnancy in 1984‐87. Participants were sons and daughters followed in the Danish In‐Vitro‐Fertilization‐Register and Danish National Patient Register until February 2018 for diagnoses of infertility.

Results

In total, 1203 (13%) sons and daughters were born to mothers with a body mass index (BMI) >25 kg/m2; 871 (9.4%) of the participants were identified as being infertile during follow‐up. Sons of overweight mothers had slightly increased odds of infertility compared with sons of mothers with normal body weight (BMI 18.5‐24.9 kg/m2, adjusted odds ratio 1.4, 95% confidence interval [CI] 1.0‐1.9). Cubic spline analyses with continuous BMI levels showed increasing odds with higher levels of BMI; however, for BMI >29 kg/m2 the confidence intervals were too wide to draw conclusions. No association between maternal overweight and infertility was found among daughters (adjusted odds ratio 0.9, 95% CI 0.7‐1.2)).

Conclusions

Sons born to overweight mothers had higher odds of infertility compared with sons of normal weight mothers. No association between maternal overweight and infertility was observed in daughters. Prevention of overweight during pregnancy may be an important tool to preserve fecundity in future generations.
Strabismus in chronic progressive external ophthalmoplegia
Authors: Kim Ji Yeon , Yang Hee Kyung , Kim Namju , Kim Man Jin , Cho Sung Im , Seong Moon‐Woo , Park Sung Sup , Hwang Jeong‐Min
Published: November 2020

Purpose

To elucidate the patterns of strabismus and ophthalmoplegia associated with chronic progressive external ophthalmoplegia (CPEO) confirmed by mitochondrial DNA (mtDNA) deletions in Asians.

Methods

A total of 10 patients confirmed to have mtDNA deletion associated with CPEO were included. Long‐range PCR encompassing the entire mtDNA was carried out. In the cases with mtDNA deletion, the exact deletion ranges of mtDNA were identified by sequencing. A full ophthalmologic examination including prism and alternate cover test in the primary position, evaluation of ductions and versions, and binocularity was performed in 10 patients with confirmed mtDNA deletions associated with CPEO.

Results

All of the patients showed ophthalmoplegia as well as ptosis, even after eyelid surgeries. Ophthalmoplegia was symmetric between both eyes in nine patients (90%) while one patient (10%) showed asymmetric ophthalmoplegia with esotropia and left hypotropia. Among the nine patients with symmetric involvement, four patients (44%) showed exotropia, three (33%) had exotropia with vertical deviation, and the remaining two patients (22%) showed orthotropia. Five out of 10 patients (50%) complained of diplopia associated with strabismus, four of whom (80%) had vertical deviation. Three out of five patients (60%) without diplopia showed exotropia of 20 prism diopters (PD) to 50 PD.

Conclusions

Exotropia with/without vertical deviation is the most common form of strabismus in Asian patients with CPEO and only one of them showed a small angle of esotropia. Ophthalmoplegia could be asymmetric in 10% of CPEO patients.
Increase in neuropeptide Y activity impairs social behaviour in association with glutamatergic dysregulation in diabetic mice
Authors: Ueda Daiki , Yonemochi Naomi , Kamata Tomohiro , Shibasaki Masahiro , Kamei Junzo , Waddington John L. , Ikeda Hiroko
Published: November 2020

Background and Purpose

Patients with diabetes mellitus are reported to show a raised prevalence of mental disorders, which may be reflected in impaired social interaction. However, the mechanisms underlying such impairment in diabetes are unknown.

Experimental Approach

The present study investigated whether social interaction is impaired in diabetic mice and whether central neuropeptide Y (NPY) and glutamatergic function are involved in such impairment.

Key Results

In the three‐chamber test, social novelty preference, but not sociability, was impaired in streptozotocin (STZ)‐induced diabetic mice. The mRNA level of NPY in the hypothalamus was increased in STZ‐induced diabetic mice. Injection of the NPY Y2 receptor agonist NPY 13‐36 into naïve mice impaired social novelty preference, but not sociability, and this effect was inhibited by the Y2 receptor antagonist BIIE 0246. BIIE 0246 also reversed the impairment of social novelty preference in STZ‐induced diabetic mice. Similarly, injection of the AMPA receptor agonist AMPA into naïve mice impaired social novelty preference, but not sociability, and this effect was inhibited by the AMPA receptor antagonist NBQX. Impairment of social novelty preference induced by NPY 13‐36 was inhibited by NBQX, whereas impairment of social novelty preference induced by AMPA was not inhibited by BIIE 0246. Finally, impairment of social novelty preference in STZ‐induced diabetic mice was reversed by NBQX.

Conclusion and Implications

These findings suggest that NPY neurons are activated in diabetic mice and that this may impair social novelty preference by promoting glutamatergic function through Y2 receptors.
Social capital and self‐reported oral health at baseline of the brazilian longitudinal study of aging
Authors: do Amaral Júnior Orlando Luiz , Menegazzo Gabriele Rissotto , Fagundes Maria Laura Braccini , Campagnol Patrícia Bastianello , Giordani Jessye Melgarejo do Amaral
Published: November 2020

Objectives

This cross‐sectional study aimed to estimate the association between the structural and cognitive dimensions of social capital and self‐reported oral health.

Methods

This study conducted individual assessments of 9,365 individuals aged 50 years or older from Brazil. Four individual variables based on structural and cognitive dimensions of social capital were assessed. We used hierarchical Poisson regression models to estimate the prevalence ratio of self‐reported oral health with individual structural and cognitive social capital variables adjusted for associated factors.

Results

Cognitive social capital was associated with self‐reported oral health. Individuals who reported lack of neighbourhood trust and not having friends presented 14% (RP: 1.14; 95% CI: 1.07‐1.21) and 9% (RP: 1.09; 95% CI: 1.01‐1.19), respectively, higher prevalence of poor self‐reported oral health, relative to those who trust in their neighbourhood and reported having friends.

Conclusion

The cognitive dimension of social capital may be linked with self‐reported oral health. Therefore, social capital can be stimulated in the context of social policies as its encouragement can be an efficient tool for improving individuals’ health and, consequently, the oral health of the older people.
Prognosis after acute exacerbation in patients with interstitial lung disease other than idiopathic pulmonary fibrosis
Authors: Miyashita Koichi , Kono Masato , Saito Go , Koyanagi Yu , Tsutsumi Akari , Kobayashi Takeshi , Miki Yoshihiro , Hashimoto Dai , Nakamura Yutaro , Suda Takafumi , Nakamura Hidenori
Published: November 2020

Background

Acute exacerbation (AE) is recognized as a life‐threatening condition with acute respiratory worsening in idiopathic pulmonary fibrosis (IPF). AE also occurs in fibrotic interstitial lung disease (ILD) other than IPF, including other types of idiopathic interstitial pneumonias (IIPs), ILD associated with collagen vascular disease (CVD–ILD), and chronic hypersensitivity pneumonia (CHP). However, the clinical impact after AE in those patients is still unclear.

Methods

A retrospective review of 174 consecutive first‐episodes with AE of ILD in our institution from 2002 to 2016 was performed. AE was defined according to the revised definition and diagnostic criteria proposed by an international working group in 2016. Clinical characteristics, 90‐day survival, and the requirement of long‐term oxygen therapy (LTOT) after AE were evaluated in each underlying ILD.

Results

There were 102 patients with AE of IPF (AE–IPF) and 72 with AE of ILD other than IPF, including non‐IPF IIPs (n = 29) and secondary ILD (n = 43) [CVD–ILD (n = 39), CHP (n = 4)]. In CVD–ILD, rheumatoid arthritis (n = 17) was most common. The 90‐day mortality after AE was 57% in IPF, 29% in non‐IPF IIPs, and 33% in secondary ILD. After AE, ILD other than IPF had a significantly better survival rate than IPF (P < 0.001). Among survivors, the rates of patients requiring LTOT after AE were 63% in IPF, 35% in non‐IPF IIPs, and 46% in secondary ILD, respectively.

Conclusions

AE of ILD other than IPF might have a better prognosis than AE–IPF, but both are fatal conditions that cause chronic respiratory failure.
The economic impact of increased length of stay associated with surgical site infections in liver transplantation on Canadian healthcare costs
Authors: Natori Yoichiro , Vu James , Chow Edwin , Guirguis Micheal , Husain Shahid , Kumar Deepali , Humar Atul , Grant David , Rotstein Coleman
Published: November 2020

Background

Complications after liver transplantation cause additional healthcare costs. The objective of this study was to contrast the length of stay (LOS) costs for recipients with and without surgical site infections (SSIs).

Methods

This retrospective observational cohort study was conducted at a transplant center in Canada, between February 2011 and August 2014. The difference in the LOS costs was assessed by the Mann–Whitney U test, while multiple linear regression analysis was used to identify the variables that may have impacted on the costs.

Results

Two hundred and twenty‐nine liver transplant recipients were enrolled. Thirty‐six recipients developed SSIs (36/229, 15.7%). The median LOS costs in recipients with and without SSIs were $39,456 Canadian dollars (interquartile range $25,696‐ 59,722) and $31,084 Canadian dollars (interquartile range $22,712‐49 610), respectively (p = .072). There was a trend that the costs were higher for those recipients with versus those without SSIs (p = .088). Transfusion of ≥ 5 units of red cells and dialysis before transplantation impacted on cost.

Conclusion

There was a trend for higher healthcare facility costs for recipients with SSIs. Red cell transfusions and greater dialysis use before transplant were factors associated with the cost. Implementation of cost reduction strategies targeting high‐cost recipients is necessary.
The impact of COVID‐19 in the management of AL amyloidosis and Immunoglobulin Deposition Disease: A single‐center experience
Authors: Lee Holly , Tay Jason , Duggan Peter , McCulloch Sylvia , Neri Paola , Bahlis Nizar J. , Jimenez‐Zepeda Victor H.
Published: November 2020

Introduction

Patients with AL amyloidosis and immunoglobulin deposition diseases (IDD) are vulnerable during the COVID‐19 pandemic due to the immune compromise from the plasma cell disorder and therapy‐related immune defects. We describe a local experience in providing care for patients with AL amyloidosis and IDD.

Method

Patient treatment and disease status since the beginning of the pandemic on March 11, 2020, as declared by WHO, were collected and analyzed.

Results

Ninety‐six patients with AL amyloidosis and IDD were included. Four patients with IDD and 22 patients with systemic AL amyloidosis were receiving treatment during the pandemic. Since the pandemic, patients’ treatments were discontinued if they achieved VGPR or better postinduction. Seven patients discontinued all treatment after achieving VGPR, and others required treatment modifications. 28 patients have been tested for COVID‐19, and all tests have been negative. Three patients died since the pandemic, two from organ complications of systemic AL amyloidosis and one from an unrelated cause.

Conclusion

The management of AL amyloidosis and IDD must be individualized on the clinical characteristics, centers’ access to care under the pandemic restrictions, and the epidemiological aspects of the outbreak.
El desastre del Rana Plaza siete años después: Iniciativas transnacionales y proyecto de tratado
Authors: TREBILCOCK Anne
Published: November 2020

Se examinan iniciativas innovadoras de derecho laboral transnacional en respuesta al desastre del Rana Plaza (Bangladesh) en 2013. Respaldadas por la OIT, tuvieron gran éxito, pero fueron insuficientes para un cambio duradero en la industria de la confección: las prácticas de abastecimiento de las grandes marcas en la cadena mundial de suministro obstaculizan la inversión en seguridad y salud en el trabajo. El proyecto de tratado de las Naciones Unidas sobre las empresas y los derechos humanos podría mejorar la toma de responsabilidades dentro de una combinación inteligente y multinivel de mecanismos públicos y privados, pero convendría que reflejara la experiencia adquirida tras el desastre del Rana Plaza.
Revisiting an ancient legend: influence of the lunar cycle on occurrence of first‐ever unprovoked seizures
Authors: Wang Shuyu , Boston Ray , Lawn Nicholas , Seneviratne Udaya
Published: November 2020

Background

The mythical effect of the lunar cycle on seizures has been debated over time. Previously healthy individuals presenting with first‐ever seizures in whom investigations are negative often invoke questions about potential reasons including a full moon.

Aims

To determine whether there is a temporal relationship between the occurrence of the first‐ever unprovoked seizure and the lunar cycle.

Methods

We studied adults who presented with a first‐ever unprovoked seizure to two tertiary centres in Australia. Seizure onset time was obtained from the emergency department and ambulance documentations. We used Poisson regression modelling and incidence rate ratios (IRR) to determine whether seizures have a preponderance for a particular lunar phase. We performed further analysis on ‘first seizure epilepsy’ and ‘first seizure not epilepsy’ subgroups based on the International League Against Epilepsy criteria for a diagnosis of epilepsy after a single unprovoked seizure.

Results

We analysed 1710 patients (38% females; median age 39 years), of whom 18% had epileptiform abnormalities on electroencephalogram (EEG) and potentially epileptogenic lesions were detected on neuroimaging in 28%. Based on the EEG and imaging findings, 684 (40%) patients were categorised as ‘first seizure epilepsy’ and 1026 (60%) ‘first seizure not epilepsy’. The whole cohort and subgroup analysis demonstrated no significant difference in the seizure occurrence among the four lunar quarters.

Conclusions

First unprovoked seizures are not influenced by the lunar cycle. Patients pondering the cause of their first‐ever unprovoked seizure can be reassured that the full moon was not responsible.
Transnational fathers: New theoretical and conceptual challenges
Authors: Parke Ross D. , Cookston Jeffrey T.
Published: November 2020

We propose a transactional model of risk and resilience and ambiguous loss as theoretical guides to understanding transnational fathering. We also examine the risk and buffering conditions associated with each temporal aspect of the migrant journey of transnational fathers beginning with the initial decision to leave their country of origin to their process of resettlement in a destination country. In addition, we examine the effects of the absence of transnational fathers from their family on the fathers themselves, their partners, and their children. We critically explore the buffering effects of communication at a distance as a strategy for reducing the risks associated with the migration experience of transnational fathers and examine the buffering role of substitute caregivers in the home country as a means of reducing the risk associated with the absence of fathers on children. New directions for future work in this area are noted.
Recombinant Zoster Vaccine Is Efficacious and Safe in Frail Individuals
Authors: Curran Desmond , Kim Joon H. , Matthews Sean , Dessart Christophe , Levin Myron J. , Oostvogels Lidia , Riley Megan E. , Schmader Kenneth E. , Cunningham Anthony L. , McNeil Shelly A. , Schuind Anne E. , Andrew Melissa K. ,   Zoster‐064 Study Group
Published: November 2020

BACKGROUND/OBJECTIVES

Frail participants are often under‐represented in randomized trials, raising questions about outcomes of interventions in real‐world settings. Frailty is strongly associated with vulnerability to illness and adverse health outcomes. We studied the impact of frailty on recombinant zoster vaccine (RZV) clinical outcomes.

DESIGN/SETTING

Data from two previously conducted phase III randomized trials of RZV were pooled. These two parent trials were conducted concurrently at the same study sites using the same methods.

PARTICIPANTS/INTERVENTION

In the two parent studies, participants aged ≥50 years (ZOE‐50 study) and ≥70 years (ZOE‐70 study), respectively, were randomized 1:1 to receive two doses of RZV or placebo.

MEASUREMENTS

In the current ZOE‐Frailty study (NCT03563183), a frailty index was created using previously validated methods. Clinical outcomes assessed by frailty status included vaccine efficacy, immunogenicity, reactogenicity, and safety.

RESULTS

Of 29,305 participants from the pooled ZOE‐50 and ZOE‐70 total vaccinated cohort, 92% were included in this study. Mean age was 68.8 years; 58.1% were women; 45.6% were pre‐frail and 11.3% frail. The percentage of frail participants increased with age from 5.7% aged 50–59 years to 22.7% aged ≥80 years. RZV vaccine efficacy against herpes zoster was >90% for all frailty subgroups (non‐frail: 95.8% (95% confidence interval = 91.6–98.2), pre‐frail: 90.4% (84.4–94.4), frail: 90.2% (75.4–97.0)). The RZV group demonstrated robust anti‐gE antibody and gE‐specific CD42+ responses, with mean concentrations remaining above pre‐vaccination levels at least 3 years post‐dose two, in all frailty subgroups. In the RZV group, the percentage of participants reporting solicited adverse events tended to decrease with increasing frailty.

CONCLUSION

The relatively nonrestrictive inclusion/exclusion criteria in the parent ZOE studies resulted in a range of participants that included frail and pre‐frail older adults. RZV significantly reduced the risk of herpes zoster across all frailty subgroups.
From Attention to Action: The Influence of Cognitive and Ideological Diversity in Top Management Teams on Business Model Innovation
Authors: Narayan Somendra , Sidhu Jatinder S. , Volberda Henk W.
Published: November 2020

As top management teams (TMTs) become progressively more diverse, an important question arises: how does greater TMT diversity affect a company’s ability to innovate its business model? To examine this, we draw on the upper‐echelons literature and on research on business models as activity systems to theorize that cognitive and ideological diversity in TMTs will affect teams’ attention to business model innovation (BMI) and companies’ BMI intensity. Analysis of longitudinal data from firms in the US printing and publishing industry provides support for the theory that, over time, TMT cognitive and ideological diversity have a positive influence on BMI. Whereas cognitive diversity expands TMT’s BMI attention‐scope, both cognitive and ideological diversity increase BMI intensity. However, too much ideological diversity has a negative effect. We furthermore find that TMT longevity moderates the effects of TMT diversity positively, suggesting that the benefit of diversity grows as team members work together longer as a team. We discuss the study’s contributions to the literature on diversity, BMI, and the upper echelons.
Elevated co2 has Differential Effects on Five Species of Microalgae from a Subtropical Freshwater Lake: Possible Implications for Phytoplankton Species Composition
Authors: Lines Thomas , Orr Philip , Beardall John
Published: November 2020

Rising atmospheric CO2 concentrations are predicted to have a significant impact on global phytoplankton populations. Of particular interest in freshwater systems are those species that produce toxins or impact water quality, though evidence for how these species, and many others, will respond is limited. This study investigated the effects of elevated CO2 (1,000 ppm) relative to current atmospheric CO2 partial pressures (400 ppm), on growth, cell size, carbon acquisition, and photophysiology of five freshwater phytoplankton species including a toxic cyanophyte, Raphidiopsis raciborskii, from Lake Wivenhoe, Australia. Effects of elevated CO2 on growth rate varied between species; notably growth rate was considerably higher for Staurastrum sp. and significantly lower for Stichococcus sp. with a trend to lower growth rate for R. raciborskii. Surface area to volume ratio was significantly lower with elevated CO2, for all species except Cyclotella sp. Timing of maximum cell concentrations of those genera studied in monoculture occurred in the lake in order of CO2 affinity when free CO2 concentrations dropped below air equilibrium. The results presented here suggest that as atmospheric levels of CO2 rise, R. raciborskii may become less of a problem to water quality, while some species of chlorophytes may become more dominant. This has implications for stakeholders of many freshwater systems.
The small regulatory RNA Lpr10 regulates the expression of RpoS in Legionella pneumophila
Authors: Saoud Joseph , Carrier Marie‐Claude , Massé Éric , Faucher Sébastien P.
Published: November 2020

Legionella pneumophila (Lp) is a waterborne bacterium able to infect human alveolar macrophages, causing Legionnaires’ disease. Lp can survive for several months in water, while searching for host cells to grow in, such as ciliates and amoeba. In Lp, the sigma factor RpoS is essential for survival in water. A previous transcriptomic study showed that RpoS positively regulates the small regulatory RNA Lpr10. In the present study, deletion of lpr10 results in an increased survival of Lp in water. Microarray analysis and RT‐qPCR revealed that Lpr10 negatively regulates the expression of RpoS in the postexponential phase. Electrophoretic mobility shift assay and in‐line probing showed that Lpr10 binds to a region upstream of the previously identified transcription start sites (TSS) of rpoS. A third putative transcription start site was identified by primer extension analysis, upstream of the Lpr10 binding site. In addition, nlpD TSS produces a polycistronic mRNA including the downstream gene rpoS, indicating a fourth TSS for rpoS. Our results suggest that the transcripts from the third and fourth TSS are negatively regulated by the Lpr10 sRNA. Therefore, we propose that Lpr10 is involved in a negative regulatory feedback loop to maintain expression of RpoS to an optimal level.
A case report of oral heterotopic gastrointestinal cysts (HGIC) and review of the literature
Authors: Bains Gursimran Kaur , Pilkington Richard , Stafford Joanna , Bhatia Sunil
Published: November 2020

Introduction

Heterotopic gastrointestinal mucosa (HGM) found within the oral cavity has been reported as a rare type of anomaly. It can result in the formation of oral heterotopic gastrointestinal cysts (HGIC) which are thought to be either duplication cysts (surrounded by a muscular wall) or choristomas/heterotopic cysts (no muscular wall). The exact aetiology is poorly understood; they are thought to arise from misplacement or sequestration of the endoderm from the primitive stomach into the anlage of the tongue/developing oral cavity.

Methods

We present a rare case of a healthy 37‐year‐old Eastern European gentleman who was diagnosed with HGM of the anterior tongue. A systematic literature review method of PubMed, Embase and Medline was conducted.

Results

A systematic review of PubMed, Embase and Medline was conducted, revealing 68 reported cases in the English language. The age range was from newborn to 70 years old, 42/68 cases were reported in infants (1 year or less). Male:Female 1.3:1. Of these patients six reported previous surgery and three reported previous failed aspirations/incision and drainage. In infancy/childhood it usually presents with problems with feeding/swallowing.

Clinical Relevance

MRI T2 weighted imaging produces a high signal due to a well‐defined cyst like appearance with imaging appearances being the same in infants as to those in adult patients. The majority of these cases cause feeding and breathing issues in the infant. However, this lesion had remained asymptomatic for over 30 years before causing discomfort with swallowing. This case reveals that these lesions can remain asymptomatic before causing problems in later life and the clinician should be aware of having it as part of a differential diagnosis.
Initial goals, goal trajectories, and changes in perceived resolvability during serial arguments
Authors: Worley Timothy , Liu Esther , Vanderbilt Rachel
Published: November 2020

This study examined how dyadic patterns of goal importance during a serial argument interaction predict changes in perceptions of argument resolvability over the course of a specific episode. Seventy romantic couples engaged in a 7‐min discussion of a current serial argument and used a video‐assisted recall method to report their goals at each minute. Although arguers' initial goals did not predict changes in perceptions of resolvability, increases in a partner's endorsement of partner‐identity goals predicted increases in individuals' own perceptions of resolvability. Conversely, increases in a partner's endorsement of self‐identity goals predicted declines in individuals' perceived resolvability. Results suggest that trajectories of identity‐focused goals during serial argument episodes may shape the progress of argument perceptions toward or away from resolvability.
Revisiting clay‐sized mineral and elemental records of the silicate weathering history in the northern Tibetan Plateau during the late Cenozoic: The role of aeolian dust
Authors: Yang Yibo , Ye Chengcheng , Yang Rongsheng , Fang Xiaomin
Published: November 2020

Exceedingly strong aeolian dust activity has occurred in inland Asia. Comparisons of the late Cenozoic sedimentation rates between aeolian and fluvial‐lacustrine sequences around the northern Tibetan Plateau suggest that aeolian process has played an important role in the erosion, weathering and deposition of sediment. However, recognizing dust as an important source in fluvial‐lacustrine sequences is a vital but difficult task. Here, clay‐sized mineral and elemental records of regional silicate weathering histories are revisited during the period of Asian dust expansion at ~9–8 Ma. The aeolian dust input from the Tianshan‐Altay Orogens into the Jiuquan Basin is identified using the Th/Sc ratio while that from the Qilian Shan into the Xining Basin is identified based on inconsistent fine‐grained silicate weathering proxies. Our study suggests that the use of appropriate dust provenance tracers and recognition of wind transport‐induced changes in dust grain size and chemistry can provide useful aeolian dust discrimination approaches.
Association of TNF (rs1800629) promoter polymorphism and schistosomiasis with sub‐microscopic asymptomaticPlasmodium falciparuminfections in a schistosomiasis‐endemic area in Zimbabwe
Authors: Vengesai Arthur , Marume Amos , Midzi Herald , Kasambala Maritha , Naicker Thajasvarie , Mduluza Takafira
Published: November 2020

Objectives

Infection withPlasmodium falciparumparasites may result in a wide spectrum of symptoms ranging from asymptomatic to mild or severe. A number of factors are associated with this heterogeneous response toP. falciparuminfection. In the present study, associations of sub‐microscopic asymptomaticP. falciparumwithSchistosomaspecies and TNF (rs1800629) polymorphism were investigated.

Methods

361 clinically healthy primary school children were microscopically screened forS. haematobium,S. mansoniandP. falciparum. Sub‐microscopic asymptomaticP. falciparuminfections were determined by PCR. Genotypic profiles were identified using ARMS‐PCR. Logistic regression was used to assess the association of sub‐microscopic asymptomaticP. falciparumwithSchistosomaspecies and TNF (rs1800629) polymorphism.

Results

17.2% of the children were infected withS. mansoni, and 27.4% were infected withS. haematobium. Microscopic examination of thick smears detected only one child infected withP. falciparum. Based on PCR results, 46.1% were infected with sub‐microscopic asymptomaticP. falciparum. Children carrying heterozygous AG (OR: 16.964, 95% CI: 0.496–586.547) and homozygous GG (OR: 2.280, 95% CI: 0.111–46.796) genotypes of rs1800629 were associated with an increased likelihood of sub‐microscopic asymptomaticP. falciparuminfections compared with those carrying homozygous AA genotype. Children withoutS. haematobiuminfections (OR: 1.051, 95% CI: 0.146–8.985) andS. mansoni(OR: 2.658, 95% CI: 0.498–14.184) also had an increased likelihood (risk) of being infected with sub‐microscopic asymptomaticP. falciparumcompared with theSchistosoma‐infected groups. However, all the associations observed were not statistical significant.

Conclusion

No associations were observed between rs1800629 and schistosomiasis with sub‐microscopic asymptomaticP. falciparuminfections. This study also reports a high prevalence of sub‐microscopic asymptomaticP. falciparuminfection concomitant with low malaria transmission.