bluuebunny/crossref_metadata_2025 huggingface dataset:
Sasta Bhojan Sewa: the pricing dilemma
Authors: Kaur Harsimar , Narayanamurthy Gopalakrishnan
Published: February 2021

Learning outcomes

After studying this case, students should be able to: understand the process of opportunity identification for forming social enterprises (knowledge), discuss various concepts related to social entrepreneurship and not-for-profit firms (comprehension), apply tools to differentiate between social and commercial enterprises (application), analyze the role of environmental factors like culture in influencing business (analysis) and develop decision-making skills by critically evaluating the options (evaluation).

Case overview/synopsis

Sasta Bhojan Sewa (SBS) was one of the key projects of Parupkar Sewa Society. The social venture initiated by Jaswinder Singh, a young resident of Ambala (a small town in Haryana, India), got registered as a not-for-profit society in the year 2018. Mr. Singh initiated various social welfare projects since the year 2006 when he got inspired from the history of Sikh Gurus. As years passed, he was able to employ more and more people. This led to the development of a social venture, which had 33 employees at the end of the year 2019. The society was running seven major projects with the help of dasvandh (donations). Project SBS was about providing home-like hygienic meals to people at merely INR10. There were 11 canteens in Ambala city and cantonment, which were being run under that project. Around 1,500 people were eating daily in those canteens, out of which around 70–80 people were not able to pay even INR10. The project had employed 30 people. The salaries of the staff and other operating expenses like liquid petroleum gas (LPG) expense, transportation cost and electricity were met through dasvandh (donations) from the local households. When the project was initiated, the cost of preparing a meal was INR10, but by the end of 2019, the cost went up to INR12 per meal due to food inflation. The meal was still being sold at INR10 at a loss of INR2 per meal. On December 28, 2019, as founder of the society, Mr. Singh was thinking of raising the selling price to INR12 per meal, which had to be implemented on January 01, 2020 but he was doubtful in doing so. He thought increasing the price might defeat the purpose of starting SBS as he was reflecting on how poor people were and how each rupee mattered to them. He was also considering that it might affect the goodwill of the society that was known for selling food at an extremely low price. By using the example of SBS, we explain various concepts of not-for-profit social enterprises like opportunity identification, key drivers, business model canvas and environmental effects in this teaching note. The teaching note also provides cost–benefit analysis of the available options to facilitate effective decision-making.

Complexity academic level

Undergraduate and graduate-level business programs.

Supplementary materials

Teaching notes are available for educators only.

Subject code

CSS 3: Entrepreneurship.
An examination of house price bubble in the real estate sector: the case of a small island economy – Fiji
Authors: Khan Mohsin , Singh Rup , Patel Arvind , Jain Devendra Kumar
Published: February 2021

Purpose

This paper aims to assess the equilibrium house price in the city of Suva (Fiji) and to analyse the house price bubble in the Fiji housing market.

Design/methodology/approach

This paper adopts a time series approach to determine the presence of house price bubbles in Fiji over the period from 1988 to 2018.

Findings

The findings suggest that real income, land cost, building material price, inflation rate, volatility, household size and wealth have a positive impact on house prices, whereas user cost of capital and political disturbances have a negative impact. The findings further indicate that the Fijis’ housing market does not constitute any house price bubble.

Practical implications

This paper draws policy implications for a small developing state (Fiji) and other similar economies.

Originality/value

The price bubble in the Fiji housing market is analysed for the first time. This paper develops a comprehensive empirical approach to assess the equilibrium-housing price in Fiji.
Alterations in the gut microbiome and metabolic profile in rats acclimated to high environmental temperature
Authors: Cao Yang , Liu Ying , Dong Qingyang , Wang Tao , Niu Chao
Published: February 2021

Heat acclimation (HA) is the best strategy to improve heat stress tolerance by inducing positive physiological adaptations. Evidence indicates that the gut microbiome plays a fundamental role in the development of HA, and modulation of gut microbiota can improve tolerance to heat exposure and decrease the risks of heat illness. In this study, for the first time, we applied 16S rRNA gene sequencing and untargeted liquid chromatography–mass spectrometry (LC‐MS) metabolomics to explore variations in the gut microbiome and faecal metabolic profiles in rats after HA. The gut microbiota of HA subjects exhibited higher diversity and richer microbes. HA altered the gut microbiota composition with significant increases in the genera Lactobacillus (a major probiotic) and Oscillospira alongside significant decreases in the genera Blautia and Allobaculum. The faecal metabolome was also significantly changed after HA, and among the 13 perturbed metabolites, (S)‐AL 8810 and celastrol were increased. Moreover, the two increased genera were positively correlated with the two upregulated metabolites and negatively correlated with the other 11 downregulated metabolites, while the correlations between the two decreased genera and the upregulated/downregulated metabolites were completely contrary. In summary, both the structure of the gut microbiome community and the faecal metabolome were improved after 28 days of HA. These findings provide novel insights regarding the improvement of the gut microbiome and its functions as a potential mechanism by which HA confers protection against heat stress.
Heritability of ethanol consumption and pharmacokinetics in a genetically diverse panel of collaborative cross mouse strains and their inbred founders
Authors: Bagley Jared R. , Chesler Elissa J. , Philip Vivek M. ,   Center for the Systems Genetics of Addiction, Jentsch James D.
Published: February 2021

Background

Interindividual variation in voluntary ethanol consumption and ethanol response is partially influenced by genetic variation. Discovery of the genes and allelic variants that affect these phenotypes may clarify the etiology and pathophysiology of problematic alcohol use, including alcohol use disorder. Genetically diverse mouse populations, which demonstrate heritable variation in ethanol consumption, can be utilized to discover the genes and gene networks that influence this trait. The Collaborative Cross (CC) recombinant inbred strains, Diversity Outbred (DO) population and their 8 founder strains are complementary mouse resources that capture substantial genetic diversity and can demonstrate expansive phenotypic variation in heritable traits. These populations may be utilized to discover candidate genes and gene networks that moderate ethanol consumption and other ethanol‐related traits.

Methods

We characterized ethanol consumption, preference, and pharmacokinetics in the 8 founder strains and 10 CC strains in 12‐hour drinking sessions during the dark phase of the circadian cycle.

Results

Ethanol consumption was substantially heritable, both early in ethanol access and over a chronic intermittent access schedule. Ethanol pharmacokinetics were also heritable; however, no association between strain‐level ethanol consumption and pharmacokinetics was detected. The PWK/PhJ strain was the highest drinking strain, with consumption substantially exceeding that of the C57BL/6J strain, which is commonly used as a model of “high” or “binge” drinking. Notably, we found strong evidence that sex moderated genetic effects on voluntary ethanol drinking.

Conclusions

Collectively, this research serves as a foundation for expanded genetic study of ethanol consumption in the CC/DO and related populations. Moreover, we identified reference strains with extreme consumption phenotypes that effectively represent polygenic models of excessive ethanol use.
Effect of 15‐year sward management on vertical distribution of plant functional groups in a semi‐natural perennial grassland of central Europe
Authors: Kassahun Teowdroes , Pavlů Klára , Pavlů Vilém V. , Pavlů Lenka , Blažek Petr
Published: February 2021

Aims

The nutrient concentration in herbage and biomass productivity analyses are dependent on the vertical distribution of different sward layers where the sampling is done. Notably, a majority of studies indicate clipping biomass to the ground level without any consideration of the vertical distribution. This study examined the effect of cutting and grazing intensities on the vertical distribution of plant functional groups.

Location

Oldřichov Grazing Experiment, northern Czechia.

Methods

During a 15‐year experiment: (a) intensive and (b) extensive grazing without cutting; (c) cutting in June followed by intensive and (d) extensive grazing; and (e) undefoliated treatment were applied throughout the vegetation season. Biomass data were collected at two layers in the sward (below and above 3 cm) and separated into five functional groups. Biomass data were analysed to examine the succession and effects of treatments on vertical distribution of functional groups.

Results

Treatment effects were differentiated after 2–3 years from the introduction of management, but the composition of functional groups fluctuated over time. Treatments significantly affected total biomass of all functional groups and the vertical distribution within swards of most groups. Particularly intensive grazing significantly decreased the total biomass of graminoids, forbs, and dead biomass in favour of legumes (which increased). This led to a shift in the relative biomass distribution from the upper sward layer to the lower layer for most functional groups except for legumes and mosses.

Conclusion

The high proportion of dead biomass in the lower sward layer suggests the need for a methodological approach that considers clipping of biomass only above 3 cm when sampling for productivity and forage quality analysis. This approach would avoid including biomass from below 3 cm or the lower layer, which would be ungrazed by cattle. Many previous studies may have reported a distorted or inflated value in herbage productivity or forage quality results.
Multiple sclerosis limited to spinal cord lesions
Authors: Takeuchi Wataru , Fujimori Juichi , Nakashima Ichiro
Published: February 2021

Objectives

A recent Asian study proposed a phenotype of “pure spinal multiple sclerosis.” Thus, we tried to identify cases of myelitis that can fulfil the 2017 McDonald criteria with minimum or no brain lesions.

Methods

In our consecutive cases, we explored patients who presented with recurrent or monophasic short‐segment partial myelitis, positive cerebrospinal fluid oligoclonal bands and no more than a single asymptomatic periventricular lesion <10 mm on brain magnetic resonance imaging.

Results

A total of six patients (1 men and 5 women) were identified. All six patients could fulfil the 2017 McDonald criteria. The patients primarily presented disturbance of superficial sensation, whereas fewer presented motor symptoms or disturbance in deep sensation. No pathological brain atrophy or brainstem, cerebellar, or optic nerve lesions were observed. The sequelae were mild, and no patients showed a progressive disease course.

Conclusions

The identified phenotype of multiple sclerosis seems to be female dominant and presents a relatively mild clinical course without pathological brain atrophy.
Individual Differences in Reward‐Based Learning Predict Fluid Reasoning Abilities
Authors: Stocco Andrea , Prat Chantel S. , Graham Lauren K.
Published: February 2021

The ability to reason and problem‐solve in novel situations, as measured by the Raven's Advanced Progressive Matrices (RAPM), is highly predictive of both cognitive task performance and real‐world outcomes. Here we provide evidence that RAPM performance depends on the ability to reallocate attention in response to self‐generated feedback about progress. We propose that such an ability is underpinned by the basal ganglia nuclei, which are critically tied to both reward processing and cognitive control. This hypothesis was implemented in a neurocomputational model of the RAPM task, which was used to derive novel predictions at the behavioral and neural levels. These predictions were then verified in one neuroimaging and two behavioral experiments. Furthermore, an effective connectivity analysis of the neuroimaging data confirmed a role for the basal ganglia in modulating attention. Taken together, these results suggest that individual differences in a neural circuit related to reward processing underpin human fluid reasoning abilities.
Autoinflammatory syndromes
Authors: Meier‐Schiesser Barbara , French Lars E.
Published: February 2021

Autoinflammatory syndromes are a steadily growing group of inflammatory diseases caused by abnormal regulations of the innate immune system. The clinical presentation is multifaceted, but recurrent fever, skin involvement, joint inflammation and other systemic symptoms of inflammation are characteristic. In contrast to classic autoimmune diseases, autoantibodies or specific T cells are not involved in the pathogenesis. In fact, innate immunity plays the most important role in autoinflammation. While activation of the innate immune system is usually self‐limiting in healthy individuals, mutations and dysregulation can lead to chronic and excessive activation of innate immune responses and to the development of autoinflammatory diseases.
Long‐term (52‐week) efficacy and safety of dapagliflozin as an adjunct to insulin therapy in Japanese patients with type 1 diabetes: Subgroup analysis of the DEPICT‐2 study
Authors: Araki Eiichi , Mathieu Chantal , Shiraiwa Toshihiko , Maeda Hajime , Ikeda Hiroki , Thoren Fredrik , Arya Niki , Asano Michiko , Iqbal Nayyar
Published: February 2021

Aim

To examine the long‐term efficacy and safety of dapagliflozin, a sodium‐glucose co‐transporter‐2 (SGLT2) inhibitor used to treat type 1 diabetes, in the Japanese subpopulation of the DEPICT‐2 study.

Materials and Methods

Patients with type 1 diabetes were randomized to dapagliflozin 5 mg (n = 55), dapagliflozin 10 mg (n = 41) or placebo (n = 58) plus insulin for a 24‐week, double‐blind period followed by a 28‐week, single‐blind extension phase.

Results

From baseline to 24 weeks, dapagliflozin reduced HbA1c compared with placebo (mean change of −0.58% and −0.80% for 5 and 10 mg, respectively), and an HbA1c reduction was observed up to 52 weeks. Compared with placebo, dapagliflozin 5 and 10 mg increased the proportion of patients achieving HbA1c reductions of 0.5% or more without severe hypoglycaemia events and reduced glycaemic variability assessed via continuous glucose monitoring. Both dapagliflozin doses decreased body weight and total daily insulin dose at 24 weeks compared with placebo; these reductions were maintained up to 52 weeks. Diabetic ketoacidosis occurred in both dapagliflozin groups (one and two cases, respectively) but not with placebo.

Conclusions

Efficacy and safety results from the Japanese subpopulation of the DEPICT‐2 study were generally consistent with those from the overall population, indicating that long‐term dapagliflozin adjunct to insulin therapy improves glycaemic control without an increased risk of hypoglycaemia but with a risk of diabetic ketoacidosis in Japanese patients with type 1 diabetes.
Sex bias in admission to tertiary‐care centres for acute myocardial infarction and cardiogenic shock
Authors: Sambola Antonia , Elola Francisco Javier , Buera Irene , Fernández Cristina , Bernal José Luis , Ariza Albert , Brindis Ralph , Bueno Héctor , Rodríguez‐Padial Luis , Marín Francisco , Barrabés José Antonio , Hsia Renee , Anguita Manuel
Published: February 2021

Background

There are limited data on sex‐specific outcomes and management of cardiogenic shock complicating ST‐segment elevation myocardial infarction (CS‐STEMI). We investigated whether any sex bias exists in the admission to revascularization capable hospitals (RCH) or intensive cardiac care units (ICCU) and its impact on in‐hospital mortality.

Methods

We used the Spanish National Health System Minimum Basic Data from 2003 to 2015 to identify patients with CS‐STEMI. The primary outcome was sex differences in in‐hospital mortality.

Results

Among 340 490 STEMI patients, 20 262 (6%) had CS and 29.2% were female. CS incidence was higher in women than in men (7.9% vs 5.1%, P = .001). Women were older and had more hypertension and diabetes, and were less often admitted to RCH than men (from 58.7% in 2003 to 79.6% in 2015; and from 61.9% in 2003 to 85.3% in 2015; respectively, P = .01), and to ICCU centres (25.7% vs 29.2%, P = .001). Adjusted mortality was higher in women than men over time (from 79.5 ± 4.3% to 65.8 ± 6.5%; and from 67.8 ± 6% to 58.1 ± 6.5%; respectively, P < .001). ICCU availability was associated with higher use of Percutaneous coronary intervention (PCI) in women (46.8% to 67.2%; P < .001) but was even higher in men (54.8% to 77.4%; P < .001). In ICCU centres, adjusted mortality rates decreased in both sexes, but lower in women (from 74.9 ± 5.4% to 66.3 ± 6.6%) than in men (from 67.8 ± 6.0% to 58.1 ± 6.5%, P < .001). Female sex was an independent predictor of mortality (OR 1.18 95% CI 1.10‐1.27, P < .001).

Conclusions

Women with CS‐STEMI were less referred to tertiary‐care centres and had a higher adjusted in‐hospital mortality than men.
Thickness change and deformation of custom‐made mouthguards after two years of use by Bangladeshi field hockey players
Authors: Hayashi Kairi , Chowdhury Ruman Uddin , Chowdhury Nafees Uddin , Shrestha Abhishekhi , Pradhan Ishan , Shahrin Sharika , Toyoshima Yukako , Tanabe Gen , Yoshida Yuriko , Togawa Kaito , Churei Hiroshi , Ueno Toshiaki
Published: February 2021

Background/Aim

Sports mouthguards are effective devices that prevent dental trauma in sports activities. Players should change mouthguards on a regular basis because of thickness reduction and shape deformation. However, there is no guidance regarding the best timing to change mouthguards. The aims of this study were to analyze the thickness change and deformation of mouthguards after 2 years of use in Bangladesh field hockey players and to consider appropriate evaluation criteria.

Material and Methods

Fifty‐seven field hockey players belonging to the Bangladesh Sports Education Institute participated in this study. Participants were provided with double‐layered mouthguards made of polyolefin‐based material using a vacuum‐forming machine. Mouthguards were fabricated using 2‐mm‐thick sheet as the first layer and 3‐mm‐thick sheet as the second layer. Players used the mouthguards for 2 years. Before and after using the mouthguards, the thicknesses of nine areas were measured. In addition, the lengths of five areas were used to analyze shape deformation.

Results

After 2 years, the thicknesses of all measured areas had significantly reduced, and the lengths had significantly increased. Thickness reduction of the posterior‐occlusal and anterior‐incisal areas and deformation of the posterior‐buccal and posterior‐palatal areas were significantly larger than those in other measured areas.

Conclusions

Mouthguards should be changed on a regular basis to minimize thickness reduction and deformation. Occlusal and incisal thickness and length of the buccal‐posterior area and the palatal‐posterior area are factors to be considered in establishing guidelines regarding the timing of mouthguard change.
Pairing status moderates both the production of and responses to anti‐parasitic referential alarm calls in male yellow warblers
Authors: Lawson Shelby L. , Enos Janice K. , Mendes Niko C. , Gill Sharon A. , Hauber Mark E.
Published: February 2021

Defending offspring incurs temporal and energetic costs and can be dangerous for the parents. Accordingly, the intensity of this costly behavior should reflect the perceived risk to the reproductive output. When facing costly brood parasitism by brown‐headed cowbirds (Molothrus ater), where cowbirds lay eggs in heterospecific nests and cause the hosts to care for their young, yellow warblers (Setophaga petechia) use referential “seet” calls to warn their mates of the parasitic danger. Yellow warblers of both sexes produce this call only in response to cowbirds or seet‐calling conspecifics. Seet calls are mainly produced during the laying and incubation stages of breeding, when risk of brood parasitism is highest, rather than during the nestling stage. On the other hand, general alarm calls (chips) are produced throughout the nesting cycle and are also used in conspecific interactions unrelated to nesting. We hypothesized that context shapes responses prior to breeding as well, such that yellow warblers without a mate and active nest would be less likely to respond to playbacks that simulate brood parasitism risk. To test this hypothesis, we presented playbacks of two nest threats, cowbirds (brood parasite) and blue jays (Cyanocitta cristata; nest predator), on territories of unmated male warblers (unpaired) and male warblers with a known mate (paired). We found that unpaired males were unresponsive toward playbacks indicating nest threats, whereas paired males were significantly more aggressive and vocal toward these playbacks compared to control playbacks. However, both paired and unpaired males were vocally responsive toward chip calls, which are informative for males regardless of pairing status. Male yellow warblers appear to adjust their responses during the earliest stages of breeding depending on the contextual relevance of specific threat stimuli, and together with prior studies, our work further supports that referential seet calls are associated with stage‐specific risk of brood parasitism.
Allosteric coupling and biased agonism in G protein‐coupled receptors
Authors: Bock Andreas , Bermudez Marcel
Published: February 2021

G protein‐coupled receptors (GPCRs) are essential cell membrane signaling molecules and represent the most important class of drug targets. Some signaling pathways downstream of a GPCR may be responsible for drug adverse effects, while others mediate therapeutic efficacy. Biased ligands preferentially activate only a subset of all GPCR signaling pathways. They hold great potential to become next‐generation GPCR drugs with less side effects due to their potential to exclusively activate desired signaling pathways. However, the molecular basis of biased agonism is poorly understood. GPCR activation occurs through allosteric coupling, the propagation of conformational changes from the extracellular ligand‐binding pocket to the intracellular G protein‐binding interface. Comparison of GPCR structures in complex with G proteins or β‐arrestin reveals that intracellular transducer coupling results in closure of the ligand‐binding pocket trapping the agonist inside its binding site. Allosteric coupling appears to be transducer‐specific offering the possibility of harnessing this mechanism for the design of biased ligands. Here, we review the biochemical, pharmacological, structural, and biophysical evidence for allosteric coupling and delineate that biased agonism should be a consequence of preferential allosteric coupling from the ligand‐binding pocket to one transducer‐binding site. As transducer binding leads to large structural rearrangements in the extracellular ligand‐binding pocket, we survey biased ligands with an extended binding mode that interact with extracellular receptor domains. We propose that biased ligands use ligand‐specific triggers inside the binding pocket that are relayed through preferential allosteric coupling to a specific transducer, eventually leading to biased signaling.
Spatiotemporal evolution of production cooperation between China and Central and Eastern European countries: An analysis based on the input–output technique
Authors: Zheng Zhi , Song Zhouying , Ji Qidi , Xiong Wei
Published: February 2021

Despite frequent political interactions, economic cooperation between China and Central and Eastern Europe (CEE) countries has progressed quite slowly, raising the question of why the economic cooperation of China and CEE countries stagnates and how to promote sustainable bilateral cooperation. This study explored the spatiotemporal evolution of China–CEE production cooperation and the value‐added structure of bilateral exports by the long time‐sequenced multi‐region input–output table and methods of input–output technique. The results show that although the production cooperation intensity of China and CEE countries has been increasing in both directions, neither side currently comprises the main foreign production cooperation direction of each other, and the intensity of production cooperation remains low. From the perspective of value‐added structure, foreign value‐added accounts comprise the greatest proportion of exports from CEE countries to China, while a large part of China’s intermediate exports go to other European countries after being imported by CEE countries, which indicates that CEE countries have played an important role of the bridge between China and Europe. States are undoubtedly important in the promotion of global value chain connections. Governments should correctly identify their own advantageous industries in global value chains and focus on extending the industrial chain to formulate cooperation plans. Strengthening the value chain link with Western European countries through production cooperation and improving the capacity of value capture are important directions for China–CEE cooperation.
Ultrasound evaluation of joint damage and disease activity in adult patients with severe haemophilia A using the HEAD‐US system
Authors: Jiménez‐Yuste Víctor , de la Corte‐Rodríguez Hortensia , Álvarez‐Román María Teresa , Martín‐Salces Mónica , Querol Felipe , Bonanad Santiago , Mingot‐Castellano María Eva , Fernández‐Mosteirín Nuria , Canaro Mariana , Santamaría Amparo , Núñez Ramiro , García‐Frade Luis Javier , Martinoli Carlo , Kim Hae Kyung
Published: February 2021

Introduction

The Haemophilia Early Arthropathy Detection with Ultrasound (HEAD‐US) system and scoring scale has proven to be an accurate and time‐efficient imaging method for identifying joint damage in patients with haemophilia.

Aim

Observational, multicentre, cross‐sectional study conducted in 8 centres in Spain that assessed the joint status of adult patients with severe haemophilia A (SHA) using HEAD‐US.

Methods

Joint status of the elbow, knee and ankle was evaluated in adults with SHA receiving on‐demand (OD) treatment, or primary (PP), secondary (SP), tertiary (TP) or intermittent (IP) prophylaxis.

Results

Of the 95 patients enrolled, 87 received prophylaxis (6.3% PP, 38.9% SP, 43.2% TP and 3.2% IP). Mean age was 35.2 years, and 59% of patients had not undergone image testing in the last year. The HEAD‐US score was 0 in all joints in 6.3% of patients. The ankle was the most affected joint, regardless of treatment regimen. Patients receiving OD treatment, TP or IP had the overall worst scores, mainly in the ankles and elbows; a similar but milder profile was observed in patients on SP; and patients on PP had the best score in all joints.

Conclusion

Joint function may be effectively preserved in patients with SHA on PP, but OD treatment or later initiation of prophylaxis does not seem to prevent progression of arthropathy. Disease worsening was observed in patients OD, TP or IP, most often affecting ankles and elbows. Closer ultrasound imaging monitoring may improve management of these patients.
Comparison of laparoscopic pyelolithotomy and retrograde intrarenal surgery in the management of large renal pelvic stones
Authors: Cicek Mehmet Cagatay , Asi Tariq , Gunseren Kadir Omur , Kilicarslan Hakan
Published: February 2021

Background

To compare the clinical outcomes of laparoscopic pyelolithotomy (LP) and retrograde intrarenal surgery (RIRS) in the management of large renal pelvic stones.

Patients and methods

This study included patients who presented with a single renal pelvic stone sized ≥20 mm and who were treated primarily by LP or RIRS. The patients were grouped based on the surgical procedure they underwent. We retrospectively examined and compared the age, the longest axis, and the surface area of the stone, operation time, hospitalization time, complications, and stone‐free rates of the two groups.

Results

Of the 156 patients included in the study, 44 had LP, and 112 had RIRS. Patients who received LP (13 males, 31 females) had a median age of 54 (18‐79) years, while those who underwent RIRS (46 males, 66 females) had a median age of 54.5 (18‐79). Patients who received LP were found to have larger median stone size (30 mm vs 24 mm, P = .003), longer operation time (100 minutes vs 70 minutes, P = .007), lower complication rate (2% vs 8.9%, P = .063), longer median hospital stay (3 days vs 1 day, P < .001) and better stone‐free rate at the third month (90.9% vs 67.9%, P < .001).

Conclusion

LP is a safe and efficient procedure that could be used as an alternative to RIRS in managing large renal pelvic stones.
Effects of androgen deprivation therapy on cognitive functions in patients with metastatic prostate cancer: A multicentric, prospective study of the Society of Urological Surgery Andrology group
Authors: Cinar Onder , Turunc Tahsin , Kazaz Ilke Onur , Yildirim Omer , Deliktas Hasan , Cihan Ahmet , Gudeloglu Ahmet , Ure Iyimser , Deveci Serkan , Sahin Bahadir , Cinar Bilge Piri , Ozkara Hamdi
Published: February 2021

Aims of the study

The aim of this study was to investigate the impact of testosterone deficiency on cognitive functions in metastatic prostate cancer patients receiving androgen deprivation therapy (ADT).

Methods

In this multicentric prospective study, 65 metastatic prostate cancer patients were evaluated. Demographic and clinical data were recorded. Cognitive functions were assessed using the Symbol Digit Modalities Test, the California Verbal Learning Test Second Edition, the Brief Visuospatial Memory Test—Revised, and the Trail Making Test. Depressive symptoms were assessed using the Beck Depression Inventory. Cognitive functions and depressive symptoms were recorded before the androgen deprivation therapy and at the 3‐ and 6‐month follow‐ups.

Results

At the basal cognitive assessment, the mean Symbol Digit Modalities Test, the California Verbal Learning Test Second Edition, the Brief Visuospatial Memory Test—Revised scores were 25.84 ± 17.54, 32.68 ± 10.60, and 17.63 ± 11.23, respectively, and the mean time for the Trail Making Test was 221.56 ± 92.44 seconds, and were similar at the 3‐month, and 6‐month controls (P > .05). The mean pretreatment, third and sixth month testosterone levels were 381.40 ± 157.53 ng/dL, 21.61 ± 9.09 ng/dL and 12.25 ± 6.45 ng/dL (P < .05), and the total PSA levels were 46.46 ± 37.83 ng/mL, 1.41 ± 3.31 ng/mL and 0.08 ± 0.14 ng/mL (P < .05), respectively.

Conclusion

The ADT in patients with metastatic prostate cancer does not affect patients’ cognitive functions and depressive symptoms. However, further prospective randomised studies with higher cohorts and longer follow‐up periods are needed.
Impact of high visceral adiposity index associated with metabolic syndrome on erectile function in sexually active men: Results of a cross‐sectional study
Authors: Bolat Mustafa Suat , Ozbek Mustafa Latif , Şahin Bekir , Yılmaz Merve , Kocamanoglu Fatih , Buyukalpelli Recep , Sunter Ahmet Tevfik , Asci Ramazan
Published: February 2021

Aims

Erectile dysfunction (ED) is a common condition affected by many factors. We aimed to show the impact of the metabolic syndrome (MeTS) on male sexual function based on visceral adiposity index (VAI).

Methods

Participants who met MeTS criteria (Group 1, n = 96) and did not meet MeTS criteria (Group 2, n = 189) were included in this cross‐sectional study. The MeTS diagnosis was made in the presence of at least 3 of the following criteria: fasting serum glucose level higher than 100 mg/dL, HDL cholesterol level below 40 mg/dL, triglyceride level higher than 150 mg/dL, waist circumference higher than 102 cm and blood pressure higher than 130/85 mmHg. Demographic data were recorded; biochemical and hormonal tests were measured. Erectile and other sexual function scores were recorded. The VAI was calculated using the [(Waist Circumference/39.68) + (1.88 × body mass index)] × triglyceride/1.03 × 1.31/HDL formula.

Results

Mean age, smoking volume, testosterone (T) and testosterone/estradiol (T/E2) ratios of the groups were similar (P > .05). The mean VAI was two‐fold higher in patients in Group 1 (P < .001) and erectile function score was lower in Group 1 than Group 2 (P = .001). Other sexual function scores were similar (P > .05). The METS was associated with an increased risk of ED (P = .001). Logistic regression analysis showed that each integer increase in the VAI was associated with a 1.4‐fold increased risk of ED (P < .001). Higher T values were associated with a better erectile function (P = .03). For the VAI = 4.33, receiver‐operating characteristic analysis showed a sensitivity of 89.6% and specificity of 57.7%.

Conclusion

Compared with non‐MeTS, the presence of MeTS has emerged as a risk factor for patients with ED with high VAI levels while the other sexual functions are preserved. Management of ED patients with MeTS should cover a comprehensive metabolic and endocrinological evaluation in addition to andrological work up.
Maintaining cultural identity: A systematic mixed studies review of cultural influences on the self‐care of African immigrants living with non‐communicable disease
Authors: Henry Osokpo Onome , James Richard , Riegel Barbara
Published: February 2021

Aim

To understand and identify cultural factors influencing the self‐care practices of African immigrants living with chronic illness in countries outside Africa.

Background

The influence of cultural factors on self‐care is relatively unexplored in African immigrants with non‐communicable diseases (NCDs).

Design

Systematic Mixed Studies review.

Data sources

PubMed, Psych Info, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Anthropology Plus and Sociological Abstract computerized databases. No limit was placed on publication date.

Review methods

Results‐based convergent design was used. The Mixed Method Appraisal Tool was used to evaluate the studies. Quantitative studies were synthesized narratively while qualitative studies were synthesized using thematic synthesis.

Results

We identified 251 articles and nine fulfilled our inclusion criteria. The studies were published between 2006 and 2019, with six qualitative and three quantitative studies. Studies were conducted in the United States, Australia, Sweden, the Netherlands and the United Kingdom. Most studies examined the influence of culture on self‐care of diabetes (n = 6), while the rest focused on hypertension (n = 3). Findings highlight that cultural norms and practices, non‐Western approaches to interpreting and managing illness, cultural connotations of health behaviours and structural challenges influencing self‐care. Cultural food preferences made adherence to prescribed diets challenging. Family support facilitated self‐care. Maintainingcultural identitywas both a driver and constraint to engaging in self‐care.

Conclusion

The complex interplay of cultural and structural factors influences the willingness of Africans who have immigrated to a developed country to follow recommended self‐care practices. Considering these cultural norms and structural barriers can help to explain the self‐care behaviours of African immigrant populations.

Impact

Clinicians and policymakers who account for structural factors and integrate cultural factors into care facilities, treatment protocols and policy can be influential in promoting self‐care in African immigrant populations.
Childhood psychopathology mediates associations between childhood adversities and multiple health risk behaviours in adolescence: analysis using the ALSPAC birth cohort
Authors: Troy David , Russell Abigail , Kidger Judi , Wright Caroline
Published: February 2021

Background

Childhood adversity strongly predicts adolescent multiple health risk behaviours (MRBs) such as alcohol/tobacco use, self‐harm and physical inactivity, and both adversities and MRBs are associated with premature mortality and several chronic health conditions that are among the leading causes of death in adults. It is therefore important to understand the relationship between adversities and MRBs and what could mediate any association. The aim of this study was to explore whether childhood psychopathology mediates associations between adversities and MRBs.

Methods

Participants were young people in the Avon Longitudinal Study of Parents and Children (ALSPAC) (N = 5,799). Using structural equation modelling, we explored the associations between adversities before 9 years and MRBs at age 16 years. We also explored potential mediating pathways through dimensional psychopathology measured by the Strength and Difficulties Questionnaire subscales at age 12 years.

Results

There were strong positive associations between adversities and MRBs (β .25, 95% CI 0.20, 0.31, p < .001) suggesting that each additional adversity is associated with a 0.25 increase in number of MRBs out of 13 total risk behaviours. We found robust evidence of mediating pathways from adversities through conduct problems (β .05, 95% CI 0.03, 0.06, p < .001), hyperactivity/inattention (β .02, 95% CI 0.01, 0.03, p < .001) and peer relationship problems (β −.02, 95% CI −0.03, −0.02, p < .001) to MRBs.

Conclusions

Increased conduct problems and hyperactivity/inattention appear to partially explain the relationship between adversities and MRBs. Peer relationship problems also appear to reduce the association between adversities and MRBs, and further research is needed to understand how to encourage peer connectivity without increasing risk of MRBs. These results suggest that interventions aimed at reducing MRBs among those exposed to childhood adversities could focus on prevention of behavioural problems.
Editorial: fixed‐dose combination calcipotriol/betamethasone dipropionate foam in the treatment of patients with psoriasis
Authors: Lebwohl M. , Warren R.B.
Published: February 2021

Video abstract
Low‐Intervention Birth Suites Within a Community Hospital: An Innovative Approach to Perinatal Services
Authors: Javernick Julie A. , Dempsey Amy , DeLeon Betsy
Published: February 2021

Perinatal care leaders at a community hospital located in the Denver, Colorado metropolitan area searched for an innovative way to provide a low‐intervention option that promoted physiologic birth for women seeking intrapartum care. This reasonably priced project focused on the transformation of traditional labor and delivery rooms into birth suites and included installation of birth slings, full‐size beds with home‐like mattresses, new sleep sofas for the partners, and the removal of computer screens and electronic fetal monitors. In addition, the team wrote a specific birth suite policy, provided nurse education focused on intermittent auscultation and labor support techniques, and developed a birth suite curriculum for patient education. This innovative model of care demonstrated outcomes similar to those seen in community‐based birth centers and received positive feedback from families who labored and gave birth in these suites. In the instance when the birth suite is no longer the appropriate environment for intrapartum care secondary to risk factors, a woman's preference, or obstetric emergency management, this model allows for expeditious transfer of the woman or newborn to a location where an appropriate higher level of care can be provided. Converting 2 labor and delivery rooms to low‐intervention birth suites required minimal funding and enabled a community hospital in Colorado to expand its perinatal services to women who are seeking low‐intervention birth options that promote physiologic birth.
Rural and Urban Differences in COVID‐19 Prevention Behaviors
Authors: Callaghan Timothy , Lueck Jennifer A. , Trujillo Kristin Lunz , Ferdinand Alva O.
Published: February 2021

Purpose

To examine whether the adoption of COVID‐19‐related preventive health behaviors vary in rural versus urban communities of the United States while accounting for the influence of political ideology, demographic factors, and COVID‐19 experiences.

Methods

We rely on a representative survey of 5009 American adults collected from May 28 to June 8, 2020. We analyze the influence of rural status, political ideology, demographic factors, and COVID‐19 experiences on self‐reported adoption of 8 COVID‐19‐related preventive health behaviors.

Findings

Rural residents are significantly less likely to have worn a mask in public, sanitized their home or workplace with disinfectant, avoided dining at restaurants or bars, or worked from home. These findings, with the exception of dining out, are robust to the inclusion of measures accounting for political ideology, demographic factors, and COVID‐19 experiences.

Conclusions

Rural residents are significantly less likely to participate in several COVID‐19‐related preventive health behaviors. This reality could exacerbate existing disparities in health access and outcomes for rural Americans. Health messaging targeted at improving COVID‐19 preventive behavior adoption in rural America is warranted.
Naps not as effective as a night of sleep at dissipating sleep pressure
Authors: Tarokh Leila , Van Reen Eliza , Achermann Peter , Carskadon Mary A.
Published: February 2021

The two‐process model of sleep posits that two processes interact to regulate sleep and wake: a homeostatic (Process S) and a circadian process (Process C). Process S compensates for sleep loss by increasing sleep duration and intensity. Process C gates the timing of sleep/wake favouring sleep during the circadian night in humans. In this study, we examined whether taking six naps throughout a 24‐hr period would result in the same amount of dissipation of homeostatic pressure at the end of the day as a night of sleep, when time in bed is equivalent. Data from 46 participants (10−23 years; mean = 14.5 [± 2.9]; 25 females) were analysed. Slow‐wave energy, normalized to account for individual differences in slow‐wave activity, was used as a measure of sleep homeostasis. In the nap condition, slow‐wave energy of six naps distributed equally during a 24‐hr period was calculated. In the baseline condition, slow‐wave energy was measured after 9‐hr time in bed. A paired t‐test was used to compare nap and baseline conditions. A linear regression was used to examine whether slow‐wave energy varied as a function of age. Slow‐wave energy was greater during baseline than the nap condition (p < .001). No association between age and slow‐wave energy was found for baseline or nap conditions. Our findings indicate that multiple naps throughout the day are not as effective at dissipating sleep pressure as a night of sleep. This is likely due to the influence of the circadian system, which staves off sleep during certain times of the day.
The association between eating frequency with alertness and gastrointestinal complaints in nurses during the night shift
Authors: de Rijk Mariëlle G. , van Eekelen Alexander P. J. , Kaldenberg Elly , Boesveldt Sanne , te Woerd Wendy , Holwerda Tineke , Lansink Ceciel J. M. , Feskens Edith J. M. , de Vries Jeanne H. M.
Published: February 2021

We investigated the association of the number of eating occasions and energy intake with alertness and gastrointestinal (GI) complaints in nurses during their night shift. During this observational study we collected data on anthropometrics and demographics, eating frequency, energy intake, alertness and GI complaints in 118 healthy female nurses, aged 20 to 61 years. Nurses completed an alertness test (psychomotor vigilance task) during the night shift and a 24‐hr dietary recall and a questionnaire about GI complaints after the night shift. This was repeated three times, always on the first night shift in a night shift series. The number of eating occasions during the night shift was negatively associated with reaction times (β = −4.81 ms, 95% confidence interval [CI] −9.14 to −0.48; p = .030), and number of lapses (β = −0.04, 95% CI −0.07 to −0.00; p = .030). However, the number of eating occasions was not associated with subjective alertness and GI complaints. Energy intake during the night shift was not associated with objective or subjective alertness or with GI complaints. These associations were independent of caffeine intake, age, body mass index and dependence among the repeated measurements. The present study showed that eating frequency was positively associated with objectively measured alertness levels in female nurses during the night shift. The results need to be confirmed in an intervention study, where also timing, size and composition of the meal will be taken into account. In practice, optimising nutritional guidelines on these aspects could lead to faster responses, less (medical) errors, and a better wellbeing of night shift workers.
Evaluation of hypophysectomy for treatment of hypersomatotropism in 25 cats
Authors: van Bokhorst Kirsten L. , Galac Sara , Kooistra Hans S. , Valtolina Chiara , Fracassi Federico , Rosenberg Dan , Meij Björn P.
Published: February 2021

Background

Successful treatment of cats with hypersomatotropism by transsphenoidal hypophysectomy is described in small numbers of cats.

Objectives

To describe the endocrine profile, survival, and remission rates of hypersomatotropism and diabetes mellitus in a cohort of cats with hypersomatotropism that underwent hypophysectomy between 2008 and 2020.

Animals

Twenty‐five client‐owned cats with spontaneous hypersomatotropism.

Methods

Retrospective study. Diagnosis of hypersomatotropism was based on clinical signs, plasma insulin‐like growth factor‐1 (IGF‐1) concentration, and imaging of the pituitary gland. Growth hormone (GH) and IGF‐1 concentrations were measured repeatedly after surgery. Survival times were calculated based on follow‐up information from owners and referring veterinarians.

Results

Median postoperative hospital stay was 7 days (range, 3‐18 days). One cat died within 4 weeks of surgery. Median plasma GH concentration decreased significantly from 51.0 ng/mL (range, 5.0‐101.0 ng/mL) before surgery to 3.8 ng/mL (range, 0.6‐13.0 ng/mL) at 5 hours after surgery. Remission of hypersomatotropism, defined as normalization of plasma IGF‐1 concentration, occurred in 23/24 cats (median, 34 ng/mL; range, 14‐240 ng/mL) and 22/24 cats entered diabetic remission. Median survival time was 1347 days (95% confidence interval, 900‐1794 days; range, 11‐3180 days) and the overall 1‐, 2‐, and 3‐year all‐cause survival rates were 76%, 76%, and 52%, respectively.

Conclusions and Clinical Importance

This study shows the beneficial outcome of hypophysectomy in cats with hypersomatotropism, marked by low death rate and a high percentage of diabetic remission and definitive cure.