bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of perceived work–life balance between work overload and career commitment
Authors: Poulose Shobitha , Dhal Manoranjan
Published: March 2020

Purpose

The purpose of the study is to examine the mediating effect of perceived work–life balance (WLB) between work overload and career commitment among law enforcement officers in India. The study also explores whether satisfaction with organizational WLB strategies moderates the relationship between work overload and perceived WLB.

Design/methodology/approach

This research is based on a sample of 819 law enforcement officers through a structured questionnaire based data collection. The reliability coefficient of the scales varied between 0.86 and 0.94. The study adopted a hierarchical multiple regression analysis to test the hypotheses.

Findings

The result supported the mediating role of perceived WLB in the relationship between work overload and career commitment. It also demonstrated that the impact of work overload on perceived WLB would be diminished among employees having high levels of satisfaction on organizational WLB strategies.

Practical implications

The research findings have significant policy implications for the organization under study and a reference for many others with deteriorating WLB to amend the existing policy or formulate new measures.

Originality/value

The present study expands the scant literature on the mediating role of perceived WLB between work overload and career commitment. The study also furthers the literature by exploring the moderating roles of WLB strategies between work overload and perceived WLB.
Creating institutional disruption: an alternative method to study institutions
Authors: Gidley Devon
Published: March 2020

Purpose

This paper develops a new method to study institutions based on institutional work theory. Institutional disruption is intentionally utilized to explore the taken-for-granted foundations of social institutions. The paper outlines the method and considerations.

Design/methodology/approach

Taking inspiration from ethnomethodological breaches, the paper outlines the steps in the new method called researcher initiated institutional disruption (RIID). The four steps are identifying the institution, identifying the institutional actors, selecting the disruption type and disrupting the institution to gather data (action and reaction). RIID utilizes three types of institutional disruption: undermining assumptions and beliefs, resistance and issue raising.

Findings

The new method complements traditional field methods, such as observation, by showing how a researcher can deliberately make taken-for-granted institutional features visible. The paper finds that RIID offers the opportunity to gather different data, but it is not appropriate for every study and carries potential consequences in the field.

Originality/value

This paper contributes to the literature by outlining an innovative use of theory as method. The approach has not previously been detailed and offers the potential to access previously inaccessible research questions, data and theoretical insights.
From automats to algorithms: the automation of services using artificial intelligence
Authors: Meyer Chris , Cohen David , Nair Sudhir
Published: March 2020

Purpose

The paper aims to fill this gap by positing a framework that considers the service automation decision as a matter of knowledge management: a choice between human resident and codified knowledge assets.

Design/methodology/approach

The paper is a conceptual paper, grounded in the knowledge-based view.

Findings

The paper uses the information processing theory, which argues that the level of uncertainty in a process should dictate the type of knowledge deployed, as the contingency for the automation choice, and customer interaction uncertainty as the driver of that contingency. From these ideas, propositions are generated relating customer interaction uncertainty and service automation. Further implications for artificial intelligence (AI) are also explored.

Originality/value

The framework illuminates and informs the strategic choices regarding service automation, including the use of AI in professional services, a timely and highly important topic. It offers a valuable model for practitioners and contributes to the academic literature by pointing the way for future directions for scholarly research.
Mortality after Severe Sepsis and Septic Shock in Swedish Intensive Care Units 2008‐2016—A nationwide observational study
Authors: Strandberg Gunnar , Walther Sten , Agvald Öhman Christina , Lipcsey Miklós
Published: March 2020

Background

Recent studies have reported substantially decreased hospital mortality for sepsis, but data are scarcer on outcomes after hospital discharge. We studied mortality up to 1 year in Swedish intensive care unit (ICU) patients with and without sepsis.

Methods

Demographic and medical data for all registered adult general ICU patients admitted between 01‐01‐2008 and 30‐09‐2016 were retrieved from the Swedish Intensive Care Registry and linked with the National Patient Register for comorbidity data and the Cause of Death Register for death dates. The population was divided in two cohorts; (a) Patients with a diagnosis of severe sepsis or septic shock and (b) All other ICU patients. Crude yearly mortality was calculated, and logistic regression was used to analyse predictors of mortality.

Results

28 886 sepsis and 221 941 nonsepsis ICU patients were identified. In the sepsis cohort, in 2008 unadjusted mortality was 32.6% at hospital discharge, 32.7% at 30 days, 39% at 90 days and 46.8% at 365 days. In 2016, mortality was 30.5% at hospital discharge, 31.9% at 30 days and 38% at 90 days. Mortality at 365 days was 45.3% in 2015. Corresponding nonsepsis mortality was 15.4%, 16.2%, 20% and 26% in 2008 and 15.6%, 17.1%, 20.7% and 26.7% in 2016/2015. No consistent decrease in odds of mortality was seen in the adjusted analysis.

Conclusions

Mortality in severe sepsis and septic shock is high, with more than one in three patients not surviving three months after ICU admission, and adjusted mortality has not decreased convincingly in Sweden 2008‐2016.

Trial Registration: The study was registered prospectively, ClinicalTrials.gov ID: NCT03489447.
A review of literature supporting the development of practice guidelines for teledermatology in Australia
Authors: Abbott Lisa M , Miller Robert , Janda Monika , Bennett Haley , Taylor Monica L , Arnold Chris , Shumack Stephen , Soyer H Peter , Caffery Liam J
Published: March 2020

Despite the potential of teledermatology to increase access to dermatology services and improve patient care, it is not widely practised in Australia. In an effort to increase uptake of teledermatology, Australian‐specific practice guidelines for teledermatology are being developed by the Australasian College of Dermatologist. This paper reports finding from literature reviews that were undertaken to inform the development of these guidelines. Results cover the following sections: Modalities of teledermatology; Patient selection and consent; Imaging; Quality and safety; Privacy and security; Communication; and Documentation and retention. The document educates providers about the benefits and limitations of telehealth while articulating how to enhance patient care and reduce risk when practicing teledermatology.
Exposing Necroburbia: Suburban Relocation, Necropolitics, and Violent Geographies in Manila
Authors: Ortega Arnisson Andre C.
Published: March 2020

When accumulation in southern cities entails the dispossession of informal settlers, where do they go and what spatialities emerge out of their dispossession? In Manila, this occurs through a violent form of suburbanisation. To make way for modern and investment‐friendly spaces, informal settlers are exiled to relocation sites in the suburban fringe. This process of accumulation by suburban relocation engenders necroburbia, a dystopic suburban periphery constituted by distant relocation sites where evicted settlers are subjected into violent and asphyxiating everyday geographies. It serves as a spatial fix to enable metropolitan accumulation. Drawing on Achilles Mbembe’s notion of necropolitics, I expose necroburbia as a deceptive and violent space, produced through three spatialities: (1) demolition; (2) relocation; (3) necro‐suburbanisms, or everyday ways of necropolitical living. These processes illustrate how urban fantasies of growth in cities like Manila are predicated upon necropolitical realities rendering informal settlers as expendable populations, deserving of everyday brutalities.
Novel exomic rare variants associated with venous thrombosis
Authors: Deguchi Hiroshi , Shukla Meenal , Hayat Mohammed , Torkamani Ali , Elias Darlene J. , Griffin John H.
Published: March 2020

Exomic rare variant polymorphisms (c. 300 000) were analysed in the Scripps Venous Thrombosis (VTE) registry (subjects aged <55 years). Besides coagulation factor V (F5) single nucleotide polymorphisms (SNPs), family with sequence similarity 134, member B (FAM134B; rs78314670, Arg127Cys) and myosin heavy chain 8 (MYH8; rs111567318, Glu1838Ala) SNPs were associated with recurrent VTE (n = 34 cases) (false discovery rate‐adjusted P < 0·05). FAM134B (rs78314670) was associated with low plasma levels of anticoagulant glucosylceramide. Analysis of 50 chr17p13.1 MYH rare SNPs (clustered skeletal myosin heavy chain genes) using collapsing methods was associated with recurrent VTE (P = 2·70 ×10−16). When intravenously injected, skeletal muscle myosin was pro‐coagulant in a haemophilia mouse tail bleeding model. Thus, FAM134B and MYH genetic variants are plausibly linked to VTE risk.
Three strategies for doing narrative resistance: Navigating between master narratives
Authors: Hochman Yael , Spector‐Mersel Gabriela
Published: March 2020

Narrative psychology emphasizes the role of culture in shaping identities. Less attention has been paid to how individuals resist culture. Specifically, two aspects have remained understudied: the diverse forms of doing narrative resistance and the navigation between different types of master narratives involved in the process. The present study aimed to fill these gaps by examining the personal stories of former residents of Yamit, an Israeli region in the Sinai Peninsula that was evacuated following the peace agreement between Israel and Egypt. Holistic narrative analysis of the personal stories revealed three strategies of resisting the episodic master narrative of Yamit established in Israeli society – explicit debate, implicit debate, and neutralization – which differ in the relative weight of my/our story and the story about us. To remain within the Israeli consensus, resistance to the episodic master narrative was intertwined with appropriation of the Zionist foundational master narrative. The study demonstrates that narrative resistance can take diverse forms and simultaneously involve compliance with and resistance to different types of master narratives. Investigating these two findings offers a nuanced understanding of counter‐narratives as multifaceted, illuminating the complex relationships between personal stories and culture.
Patient‐reported outcomes in a phase 2 study comparing atezolizumab alone or with bevacizumab vs sunitinib in previously untreated metastatic renal cell carcinoma
Authors: Pal Sumanta K. , McDermott David F. , Atkins Michael B. , Escudier Bernard , Rini Brian I. , Motzer Robert J. , Fong Lawrence , Joseph Richard W. , Oudard Stephane , Ravaud Alain , Bracarda Sergio , Suárez Cristina , Lam Elaine T. , Choueiri Toni K. , Ding Beiying , Quach Caroleen , Hashimoto Kenji , Schiff Christina , Piault‐Louis Elisabeth , Powles Thomas
Published: March 2020

Objective

To evaluate patient‐reported outcome (PRO) data from the IMmotion150 study. The phase 2 IMmotion150 study showed improved progression‐free survival with atezolizumab plus bevacizumab vs sunitinib in patients with programmed death‐ligand 1 (PD‐L1)+ tumours and suggested activity of atezolizumab monotherapy in previously untreated metastatic renal cell carcinoma (mRCC).

Patients and methods

Patients with previously untreated mRCC were randomised to atezolizumab 1200 mg intravenously (i.v.) every 3 weeks (n = 103), the atezolizumab regimen plus bevacizumab 15 mg/kg i.v. every 3 weeks (n = 101), or sunitinib 50 mg orally daily (4 weeks on, 2 weeks off; n = 101). The MD Anderson Symptom Inventory (MDASI) and Brief Fatigue Inventory (BFI) were administered on days 1 and 22 of each 6‐week cycle. Time to deterioration (TTD), change from baseline in MDASI core and RCC symptom severity, interference with daily life, and BFI fatigue severity and interference scores were reported for all comers. The TTD was the first ≥2‐point score increase over baseline. Absolute effect size ≥0.2 suggested a clinically important difference with checkpoint inhibitor therapy vs sunitinib.

Results

Completion rates were >90% at baseline and ≥80% at most visits. Delayed TTD in core and RCC symptoms, symptom interference, fatigue, and fatigue‐related interference was observed with atezolizumab (both alone and in combination) vs sunitinib. Improved TTD (hazard ratio [HR], 95% confidence interval [CI]) was more pronounced with atezolizumab monotherapy: core symptoms, 0.39 (0.22–0.71); RCC symptoms, 0.22 (0.12–0.41); and symptom interference, 0.36 (0.22–0.58). Change from baseline by visit, evaluated by the MDASI, also showed a trend favouring atezolizumab monotherapy vs sunitinib. Small sample sizes may have limited the ability to draw definitive conclusions.

Conclusion

PROs suggested that atezolizumab alone or with bevacizumab maintained daily function compared with sunitinib. Notably, symptoms were least severe with atezolizumab alone vs sunitinib (IMmotion150; ClinicalTrials.gov Identifier: NCT01984242).
Exendin‐4, a GLP‐1 receptor agonist regulates retinal capillary tone and restores microvascular patency after ischaemia–reperfusion injury
Authors: Zhai Ruyi , Xu Huan , Hu Fangyuan , Wu Jihong , Kong Xiangmei , Sun Xinghuai
Published: March 2020

Background and Purpose

The aim of this study is to investigate the vasorelaxant effect of exendin‐4, a GLP‐1 receptor agonist on retinal capillaries under normal and ischaemia–reperfusion (I/R) conditions.

Experimental Approach

Capillary diameters in the whole‐mounted retina were directly observed using infrared differential interference contrast microscopy. A model of retinal I/R was established inraats,using high perfusion pressure in an anterior chamber. To assess the effects of exendin‐4, it was administered through subcutaneous injection, intravitreal injection, or eye drops. The underlying mechanism was explored by immunofluorescence, qPCR, and capillary western blots.

Key Results

Immunofluorescence staining showed that GLP‐1 receptors were expressed in endothelial cells of retinal capillaries. Exendin‐4 relaxed the capillaries precontracted by noradrenaline, an effect abolished by denuding endothelium with CHAPS and inhibited by GLP‐1 receptor antagonist exendin‐9‐39, endothelial NOS (eNOS) inhibitor l‐NAME, and the guanylate cyclase blocker ODQ but not by a COX inhibitor, indomethacin. Retinal capillaries were constricted in I/R injury, an effect reversed by perfusion of exendin‐4. Expression of PI3K and Akt, phosphorylation level of eNOS and NO production after I/R were lower than that in the normal control group. Administration of exendin‐4 improved the changes.

Conclusion and Implications

Exendin‐4 can restore injured microvascular patency in I/R. Exendin‐4 may regulate retinal capillaries through the GLP‐1 receptor‐PI3K/Akt‐eNOS/NO‐cGMP pathway. Therefore, exendin‐4 may be an effective treatment for improving tissue perfusion in I/R‐related conditions.
Anti‐nodal/paranodal antibodies in human demyelinating disorders
Authors: Ogata Hidenori
Published: March 2020

Anti‐nodal/paranodal antibodies have been reported in human demyelinating disorders. Anti‐nodal protein antibodies, namely, anti‐neurofascin (NF) 186 antibodies and antibodies against paranodal proteins, such as NF155, contactin 1 (CNTN1), and contactin‐associated protein 1 (CASPR1), are found in subsets of chronic inflammatory demyelinating polyneuropathy (CIDP). In particular, CIDP patients with IgG4 anti‐NF155 antibodies and those with IgG4 anti‐CNTN1 antibodies commonly show sensory ataxia, severe demyelination on nerve conduction studies, very high cerebrospinal (CSF) protein levels and poor response to intravenous immunoglobulin. However, younger age at onset, higher frequency of tremor, and nerve root hypertrophy are characteristic of anti‐NF155 antibody–positive CIDP, whereas anti‐CNTN1 antibody–positive CIDP is characterized by higher age at onset, early axonal damage, subacute aggressive course, and concurrence of membranous nephropathy. Interestingly, anti‐NF155 antibody–positive CIDP occasionally accompanies central nervous system lesions suggestive of demyelination. Such cases are termed combined central and peripheral demyelination. Both CIDP with anti‐NF155 antibodies and CIDP with anti‐CNTN1 antibodies usually demonstrate detachment of terminal loops from the axolemma at the node of Ranvier in biopsied sural nerves. IgG4 in vivo is monovalent and bispecific and lacks complement‐binding capability; therefore, IgG4 autoantibodies can only interfere with protein–protein interactions. This property of IgG4 explains the sural nerve pathology but the reasons behind nerve root hypertrophy and CSF protein increase are not known. Recently, we found significant elevation of both Th1 and Th2 cytokines in CSF from anti‐NF155 antibody–positive CIDP patients, indicating T‐cell involvement in this condition.
Novel animal model of multiple sclerosis: The glial connexin gap junction as an environmental tuner for neuroinflammation
Authors: Yamasaki Ryo
Published: March 2020

Connexins, which comprise gap junctions (GJs) via homotypic/heterotypic oligomerization, act as channels to connect opposing cells, mainly in solid organs such as the skin, liver, heart, and central/peripheral nervous system. Connexins are synthesized in the endoplasmic reticulum, assembled in the Golgi apparatus as hexamers, and inserted into the cell membrane as hemichannels. These hemichannels are closed under normal conditions until they combine to form clusters and connect to neighboring cells via GJs in a head‐to‐head configuration. Opening of hemichannels, which depends on the intra‐ or extracellular environment, allows various bioactive molecules to enter into or be released from the host cells. Recent pathological studies on human demyelinating diseases have revealed alterations of connexin expression patterns in demyelinating lesions. To elucidate the molecular mechanisms of connexins in the pathomechanisms of inflammatory demyelination, we induced experimental autoimmune encephalomyelitis (EAE) in connexin 30 (Cx30)‐deficient mice, oligodendroglia‐specific Cx47‐ablated mice, and astroglia‐specific Cx43‐ablated mice. We found that both astroglial‐Cx30‐deficient mice and Cx43‐ablated mice showed amelioration of the clinical course of EAE, while oligodendroglial‐Cx47‐ablated mice showed aggravation. These findings indicate the distinct role of connexins expressed in different cell types and the substantial contribution of connexin‐mediated pathology to demyelinating disorders. The imbalance in connexin expression, which is caused by the inflammatory environment, results in an increase in hemichannels in glial cells. The release of proinflammatory molecules induced by the increase in hemichannels on activated glial cells is a crucial mechanism of demyelinating disorders.
Calculating pay in Swedish schools: Accounting, performativity, and misfires
Authors: Fırtın Cemil Eren , Kastberg Gustaf
Published: March 2020

This is a study of individual differentiated pay (IDP) for teachers in Sweden. We regard IDP as part of the observed accountingization of professional work. Our aim is to contribute to the understanding of accounting as a performative calculative device through the study of how performance is made an element of individual pay. As we sought to answer “How are merits and performance of professionals turned into a set IDP?” we observed the ways in which IDP had diverse performative consequences, which made the connection between performance and merit less influential in the process of setting wages. We contribute to the theorizing of accounting as a performative practice by introducing two propositions that indicate the importance of considering the extent to which accounting is turned into a dominant narrative and the extent to which the operations can be visualized in a relevant, stable manner. The propositions are the result of the approach to include visualizations as a focal dimension of performativity. The concept stresses the importance of recognizing the prerequisites of relevance and correspondence.
The Many Faces of Medication‐Overuse Headache in Clinical Practice
Authors: Vandenbussche Nicolas , Paemeleire Koen , Katsarava Zaza
Published: March 2020

The management of medication‐overuse headache (MOH) is multifaceted and headache experts have different views on the optimal strategy to tackle this type of secondary headache. The purpose of this review is to provide an overview of the literature on the management of MOH, and to highlight important considerations in the clinical evaluation of the MOH patient.

Managing MOH in clinical practice starts by evaluating the headache patient with medication overuse, determining the overused drug(s), assessing the impact of headaches on the patient and assessing comorbid conditions and disorders. Withdrawal of the overused medication is the cornerstone of treatment. An inpatient or outpatient setting is chosen based on the clinical profile of the patient. There is evidence for abrupt withdrawal combined with headache preventive treatment. Bridging therapy to bring relief to withdrawal headaches and/or symptoms should be offered. Education and motivational work through multidisciplinary assessment show benefits in sustaining withdrawal and preventing relapse.

Although the reversal of chronic headache after cessation of overused acute medication has been noticed worldwide, different aspects of the management of MOH, such as complete or gradual withdrawal, or preventive treatment with or without withdrawal are still debated.
Headaches Associated With Personal Protective Equipment – A Cross‐Sectional Study Among Frontline Healthcare Workers During COVID‐19
Authors: Ong Jonathan J.Y. , Bharatendu Chandra , Goh Yihui , Tang Jonathan Z.Y. , Sooi Kenneth W.X. , Tan Yi Lin , Tan Benjamin Y.Q. , Teoh Hock‐Luen , Ong Shi T. , Allen David M. , Sharma Vijay K.
Published: March 2020

Background

Coronavirus disease 2019 (COVID‐19) is an emerging infectious disease of pandemic proportions. Healthcare workers in Singapore working in high‐risk areas were mandated to wear personal protective equipment (PPE) such as N95 face mask and protective eyewear while attending to patients.

Objectives

We sought to determine the risk factors associated with the development of de novo PPE‐associated headaches as well as the perceived impact of these headaches on their personal health and work performance. The impact of COVID‐19 on pre‐existing headache disorders was also investigated.

Methods

This is a cross‐sectional study among healthcare workers at our tertiary institution who were working in high‐risk hospital areas during COVID‐19. All respondents completed a self‐administered questionnaire.

Results

A total of 158 healthcare workers participated in the study. Majority [126/158 (77.8%)] were aged 21‐35 years. Participants included nurses [102/158 (64.6%)], doctors [51/158 (32.3%)], and paramedical staff [5/158 (3.2%)]. Pre‐existing primary headache diagnosis was present in about a third [46/158 (29.1%)] of respondents. Those based at the emergency department had higher average daily duration of combined PPE exposure compared to those working in isolation wards [7.0 (SD 2.2) vs 5.2 (SD 2.4) hours, P < .0001] or medical ICU [7.0 (SD 2.2) vs 2.2 (SD 0.41) hours, P < .0001]. Out of 158 respondents, 128 (81.0%) respondents developed de novo PPE‐associated headaches. A pre‐existing primary headache diagnosis (OR = 4.20, 95% CI 1.48‐15.40; P = .030) and combined PPE usage for >4 hours per day (OR 3.91, 95% CI 1.35‐11.31; P = .012) were independently associated with de novo PPE‐associated headaches. Since COVID‐19 outbreak, 42/46 (91.3%) of respondents with pre‐existing headache diagnosis either “agreed” or “strongly agreed” that the increased PPE usage had affected the control of their background headaches, which affected their level of work performance.

Conclusion

Most healthcare workers develop de novo PPE‐associated headaches or exacerbation of their pre‐existing headache disorders.
Producing co‐production: Reflections on the development of a complex intervention
Authors: Madden Mary , Morris Steph , Ogden Margaret , Lewis David , Stewart Duncan , McCambridge Jim
Published: March 2020

Background

Patient and public involvement and co‐production are widely used, but nevertheless contested concepts in applied health research. There is much confusion about what they are, how they might be undertaken and how they relate to each other. There are distinct challenges and particular gaps in public involvement in alcohol research, especially when the study focus is on health matters other than alcohol dependence.

Objective

To explore how patient and public involvement and co‐production have been interpreted and applied within a multi‐disciplinary research programme in the development of a complex intervention on alcohol and medicine use in community pharmacies.

Design

The paper presents the authors' critical reflection on a grounded example of how public involvement concepts have been translated into practice in the intervention development phase of a publicly funded research programme, noting its impact on the programme to date.

Discussion

Co‐production adds another layer of complexity in the development of a complex intervention. The research planning requirements for publicly funded research circumscribe the possibilities for co‐production, including impacting on the possibility of stability and continuity over time.
Immobilization of simulated waste into pure Gd2Zr2O7 pyrochlore without space occupancy design
Authors: Wu Jianjun , Luo Fen , Shu Xiaoyan , Chen Shunzhang , Wei Guilin , Li Bingsheng , Xie Yi , Yuan Wenqing , Yi Facheng , Lu Xirui
Published: March 2020

In this study, different molar ratios of Nd:Ce were directly mixed with prepared pure Gd2Zr2O7 powders without space occupancy design. Samples were obtained by performing sparking plasma sintering (SPS) at 1750°C for 5 minutes. X‐ray diffraction (XRD) results show that maximum solid solubility of simulated radionuclides can reach 50 mol%. In addition, all samples with the maximum solid solubility have high compactness, and all elements are evenly distributed on the surface of the samples. The samples show a better crystallization effect as the molar ratio of Nd:Ce increases. The maximum solid solubility increases from 42 mol% to 50 mol% when the amount of Nd2O3 reaches 66 mol%.
Assessment of the tidal effect on flood inundation in a low‐lying river basin under composite future scenarios
Authors: Yonehara Shin , Kawasaki Akiyuki
Published: March 2020

Large‐scale flooding causing widespread devastation is expected to increase in the low‐lying river basin of developing countries. Flood inundation occurring in deltaic environments are caused by both river runoff and tides. Furthermore, flood risk in deltas can be exacerbated by composite driving forces, such as future climate change, land‐use change, and sea‐level rise. Flood hazard maps have provided one way to visualize flood risk, and are generally created with future projection. However, existing hazard maps have not incorporated the tidal effect and have not assessed the impact of these three future driving factors simultaneously. Here we presented a method to quantify and visualize the tidal effect on flood inundation under current and future scenarios by coupling rainfall‐runoff and inundation models, and tide level data. We found simulations of the composite future scenario indicate a 1.27‐fold increase in the inundation area, with a two‐fold increase in the extent of the tidal effect for the case of a with any return period rainfall event. These achievements can be used to provide flood hazard maps that also visualize the tidal effect. This new information will enhance our understanding of flood risk in low‐lying areas and contribute further to disaster risk reduction.
Overview of guidance for endoscopy during the coronavirus disease 2019 pandemic
Authors: Lui Rashid N , Wong Sunny H , Sánchez‐Luna Sergio A , Pellino Gianluca , Bollipo Steven , Wong Mei‐Yin , Chiu Philip W Y , Sung Joseph J Y
Published: March 2020

From its beginning in December 2019, the coronavirus disease 2019 outbreak has spread globally from Wuhan and is now declared a pandemic by the World Health Organization. The sheer scale and severity of this pandemic is unprecedented in the modern era. Although primarily a respiratory tract infection transmitted by direct contact and droplets, during aerosol‐generating procedures, there is a possibility of airborne transmission. In addition, emerging evidence suggests possible fecal–oral spread of the virus. Clinical departments that perform endoscopy are faced with daunting challenges during this pandemic. To date, multiple position statements and guidelines have been issued by various professional organizations to recommend practices in endoscopic procedures. This article aims to summarize and discuss available evidence for these practices, to provide guidance for endoscopy to enhance patient safety, avoid nosocomial outbreaks, protect healthcare personnel, and ensure rational use of personal protective equipment. Responses adapted to national recommendations and local infection control guidelines and tailored to the availability of medical resources are imminently needed to fight the coronavirus disease 2019 pandemic.
Association between myotonometric measurement of masseter muscle stiffness and maximum bite force in healthy elders
Authors: Hara Koji , Namiki Chizuru , Yamaguchi Kohei , Kobayashi Kenichiro , Saito Takayuki , Nakagawa Kazuharu , Ishii Miki , Okumura Takuma , Tohara Haruka
Published: March 2020

Background

Maximum bite force (MBF) is a common and useful index of masticatory function; it correlates with physical strength in elderly people. Palpation of stiffness in the masseter muscle during forceful biting has been considered to be associated with MBF. However, this assessment method relies on subjective judgments; no study has verified the relationship between MBF and quantitative measurements of masseter muscle stiffness (MMS).

Objective

We aimed to verify the association between masseter muscle myotonometric assessment results and MBF.

Methods

In total, 117 community‐dwelling >65‐year‐old individuals from the Tokyo metropolitan area were assessed. MMS on the dominant side during forceful biting was measured with a MyotonPRO device. Masseter muscle thickness (MMT) during rest and forceful biting was measured with an ultrasonic diagnostic apparatus, and the difference in MMT (DMMT) between the rest and forceful biting conditions was determined. MBF data were obtained with a pressure‐sensitive sheet and an associated device. To determine the independent variables affecting MBF and MMS, multivariate linear regression analyses with adjustments for age, sex and number of teeth were performed.

Results

The multivariate analysis revealed that MBF correlated with the number of teeth (β = .489, P < .001) and MMS (β = .259, P = .003) (R2 = .433). MMS correlated with MBF (β = .308, P = .003) and DMMT (β = .430, P < .001) (R2 = .326).

Conclusion

Masseter muscle stiffness possibly reflects a force generated by the masseter muscle during forceful biting. Therefore, MMS is effective to assess tooth loss as well as an index of masseter muscle strength when evaluating MBF.
Characteristic directions of two-dimensional biholomorphisms
Authors: López-Hernanz Lorena , Rosas Rudy
Published: March 2020

We prove that for each characteristic direction $[v]$ of a tangent to the identity diffeomorphism of order $k+1$ in $(\mathbb{C}^{2},0)$ there exist either an analytic curve of fixed points tangent to $[v]$ or $k$ parabolic manifolds where all the orbits are tangent to $[v]$, and that at least one of these parabolic manifolds is or contains a parabolic curve.
The A-to-Z of influenza infection
Authors: Wong Wei
Published: March 2020

Z-RNA produced by influenza virus stimulates necroptosis and activates neutrophils in infected tissue.
Rapid-Release Griffithsin Fibers for Dual Prevention of HSV-2 and HIV-1 Infections
Authors: Tyo Kevin M. , Lasnik Amanda B. , Zhang Longyun , Jenson Alfred B. , Fuqua Joshua L. , Palmer Kenneth E. , Steinbach-Rankins Jill M.
Published: March 2020

The biologic griffithsin (GRFT) has recently emerged as a candidate to safely prevent sexually transmitted infections (STIs), including human immunodeficiency virus type 1 (HIV-1) and herpes simplex virus 2 (HSV-2). However, to date, there are few delivery platforms that are available to effectively deliver biologics to the female reproductive tract (FRT). The goal of this work was to evaluate rapid-release polyethylene oxide (PEO), polyvinyl alcohol (PVA), and polyvinylpyrrolidone (PVP) fibers that incorporate GRFT in
in vitro
(HIV-1 and HSV-2) and
in vivo
(HSV-2) infection models.
Headwater Stream Microbial Diversity and Function across Agricultural and Urban Land Use Gradients
Authors: Laperriere Sarah M. , Hilderbrand Robert H. , Keller Stephen R. , Trott Regina , Santoro Alyson E.
Published: March 2020

Stream ecosystems are frequently impacted by changes in watershed land use, resulting in altered hydrology, increased pollutant and nutrient loads, and habitat degradation. Macroinvertebrates and fish are strongly affected by changes in stream conditions and are commonly used in biotic indices to assess ecosystem health. Similarly, microbes respond to environmental stressors, and changes in community composition alter key ecosystem processes. The response of microbes to habitat degradation and their role in global biogeochemical cycles provide an opportunity to use microbes as a monitoring tool. Here, we identify stream microbes that respond to watershed urbanization and agricultural development and demonstrate that microbial diversity and community structure can be used to assess stream conditions and ecosystem functioning.
Caseum: a Niche for Mycobacterium tuberculosis Drug-Tolerant Persisters
Authors: Sarathy Jansy P. , Dartois Véronique
Published: March 2020

Caseum, the central necrotic material of tuberculous lesions, is a reservoir of drug-recalcitrant persisting mycobacteria. Caseum is found in closed nodules and in open cavities connecting with an airway. Several commonly accepted characteristics of caseum were established during the preantibiotic era, when autopsies of deceased tuberculosis (TB) patients were common but methodologies were limited. These pioneering studies generated concepts such as acidic pH, low oxygen tension, and paucity of nutrients being the drivers of nonreplication and persistence in caseum.
Touching the Surface: Diverse Roles for the Flagellar Membrane in Kinetoplastid Parasites
Authors: Kelly Felice D. , Sanchez Marco A. , Landfear Scott M.
Published: March 2020

While flagella have been studied extensively as motility organelles, with a focus on internal structures such as the axoneme, more recent research has illuminated the roles of the flagellar surface in a variety of biological processes. Parasitic protists of the order Kinetoplastida, which include trypanosomes and
Leishmania
species, provide a paradigm for probing the role of flagella in host-microbe interactions and illustrate that this interface between the flagellar surface and the host is of paramount importance.
Identification of the Neuroinvasive Pathogen Host Target, LamR, as an Endothelial Receptor for the Treponema pallidum Adhesin Tp0751
Authors: Lithgow Karen V. , Church Brigette , Gomez Alloysius , Tsao Emily , Houston Simon , Swayne Leigh Anne , Cameron Caroline E.
Published: March 2020

Syphilis is a sexually transmitted infection caused by the spirochete bacterium
Treponema pallidum
subsp.
pallidum.
The continued incidence of syphilis demonstrates that screening and treatment strategies are not sufficient to curb this infectious disease, and there is currently no vaccine available. Herein we demonstrate that the
T. pallidum
adhesin Tp0751 interacts with endothelial cells that line the lumen of human blood vessels through the 67-kDa laminin receptor (LamR). Importantly, LamR is also a receptor for meningitis-causing neuroinvasive bacterial pathogens such as
Neisseria meningitidis
,
Haemophilus influenzae
, and
Streptococcus pneumoniae
. Our findings enhance understanding of the Tp0751 adhesin and present the intriguing possibility that the molecular events of Tp0751-mediated treponemal dissemination may mimic the endothelial interaction strategies of other invasive pathogens.
Suspected adverse reaction to compounded preparations prescribed for weight loss: two cases of cerebral venous thrombosis
Authors: Mainoli Beatrice , Carvalho Dias Mariana , Canhão Patricia , Rosa Mário Miguel
Published: March 2020

We report two cases of cerebral venous thrombosis associated with the use of compounded preparations containing several active substances prescribed for weight loss. In both cases there is suspicion of additive/synergic interaction with oral contraceptives. The adverse drug reactions were considered serious, being life-threatening and causing hospitalisation for days.
Combating antibiotic resistance using guidelines and enhanced stewardship in Kenya: a protocol for an implementation science approach
Authors: Gitaka Jesse , Kamita Moses , Mureithi Dominic , Ndegwa Davies , Masika Moses , Omuse Geoffrey , Ngari Moses , Makokha Francis , Mwaura Peter , Mathai Ronald , Muregi Francis , Mwau Matilu
Published: March 2020

Introduction

Antimicrobial resistance (AMR) is a growing problem globally especially in Sub-Saharan Africa including Kenya. Without any intervention, lower/middle-income countries (LMICs) will be most affected due to already higher AMR levels compared with higher income countries and due to the far higher burden of diseases in the LMICs. Studies have consistently shown that inappropriate use of antimicrobials is the major driver of AMR. To address this challenge, hospitals are now implementing antibiotic stewardship programmes (ASPs), which have been shown to achieve reduced antibiotic usage, to decrease the prevalence of resistance and lead to significant economic benefits. However, the implementation of the guideline is highly dependent on the settings in which they are rolled out. This study, employing an implementation science approach, aims to address the knowledge gap in this area and provide critical data as well as practical experiences when using antibiotic guidelines and stewardship programmes in the public health sector. This will provide evidence of ASP performance and potentially contribute to the county, national and regional policies on antibiotics use.

Methods and analysis

The study will be conducted in three geographically diverse regions, each represented by two hospitals. A baseline study on antibiotic usage, resistance and de-escalation, duration of hospital stay, rates of readmission and costs will be carried out in the preimplementation phase. The intervention, that is, the use of antibiotic guidelines and ASPs will be instituted for 18 months using a stepwise implementation strategy that will facilitate learning and continuous improvement of stewardship activities and updating of guidelines to reflect the evolving antibiotic needs.

Ethics and dissemination

Approvals to carry out the study have been obtained from the National Commission for Science, Technology and Innovation and the Mount Kenya University Ethics Review Committee. The approvals from the two institutions were used to obtain permission to conduct the study at each of the participating hospitals. Study findings will be presented to policy stakeholders and published in peer-reviewed scientific journals. It is anticipated that the findings will inform the appropriate antibiotic use guidelines within our local context.
‘You have got a foreign body in there’: renal transplantation, unexpected mild-to-moderate distress and patients’ support needs: a qualitative study
Authors: Jones Janet , Damery Sarah , Allen Kerry , Nicholas Johann , Baharani Jyoti , Combes Gill
Published: March 2020

Objective

To explore why transplant patients experience unexpected mild-to-moderate distress and what support they may need.

Design

Qualitative study using individual in-depth interviews.

Setting

Four National Health Service (NHS) Trusts in the Midlands, UK.

Participants

Fifteen renal transplant patients meeting the criteria for mild-to-moderate distress from their responses to emotion thermometers.

Main outcome measures

Identification of the reasons for distress and support options acceptable to renal transplant patients.

Results

Three themes were interpreted from the data: ‘I am living with a “foreign body” inside me’, ‘why am I distressed?’ and ‘different patients want different support’. Following their transplant, participants felt that they should be happy and content, but this was often not the case. They described a range of feelings about their transplant, such as uncertainty about the lifespan of their new kidney, fear of transplant failure or fear of the donor having health conditions that may transfer to them. A few experienced survivors’ guilt when others they had met at the dialysis unit had not received a transplant or because someone had died to enable them to receive the transplant. No longer having regular contact with the renal unit made participants feel isolated. Some participants did not initially attribute the source of their distress to their transplant. Participants’ preferred support for their distress and their preferences about who should deliver it varied from peer support to seeing a psychologist.

Conclusions

Raising the issue of post-transplant mild-to-moderate distress with patients and encouraging them to think about and plan coping strategies pretransplant may prove beneficial for the patient and healthcare provider. Patients should be able to choose from a variety of support options.
UK palliative medicine trainees and multisource communication skills feedback: an educational tool?
Authors: Webber Katherine , Selman Rebecca
Published: March 2020

Background

Multisource feedback provides ratings of a trainee doctor’s performance from a range of assessors and enables 360 degree feedback on communication skills and team working behaviours. It is a tool used throughout palliative medicine training in the UK. There are limited data on the value of multisource feedback from a palliative medicine trainee perspective.

Aim

To study the views of palliative medicine trainees regarding multisource feedback as an educational tool to develop communication skills.

Design

A multimodal study encompassing a focus group and questionnaire mailed to all deanery palliative doctors.

Setting/participants

All palliative medicine trainees within a UK training deanery.

Results

Over half of responding trainees thought multisource feedback had little or no impact on their clinical practice. Improvements in delivery of multisource feedback to maximise learning were identified, including skilled feedback and facilitation by educational supervisors.

Conclusions

Despite multisource feedback currently having limited benefits, a number of recommendations are suggested to improve this.
Adjuvant intraperitoneal ceftriaxone in the treatment of septic peritonitis in horses
Authors: de Moura Alonso Juliana , dos Santos Rosa Gustavo , Santos Bruna , Guerra Simony , Ribeiro Márcio , Watanabe Marcos Jun , Alves A , Rodrigues Celso , Takahira Regina Kiomi , Hussni Carlos Alberto
Published: March 2020

Background

Intraperitoneal administration of ceftriaxone maintains therapeutic abdominal concentrations for 24 hours in healthy horses. Therefore, it is a possible treatment for septic peritonitis. The aim of this study was to evaluate the efficacy of ceftriaxone as an adjuvant treatment in horses with septic peritonitis.

Methods

Twenty‐six horses with clinical signs, sonography and/or laboratory findings of septic peritonitis were included. Peritoneal fluid was collected for microbiological culture and in vitro microbial sensitivity profile assessment. Daily intraperitoneal administration of ceftriaxone (25 mg/kg) was initiated with supportive and systemic antimicrobial treatment. The animals were divided into three groups: group 1—gastrointestinal tract injuries and abdominal surgery (excluding perforations/ruptures); group 2—not related to changes in the gastrointestinal tract; group 3—secondary to intestinal rupture and/or faeces contamination.

Results

The mean success rate of the treatment was 77 per cent (20/26 animals), with success rates of 84.6 per cent in group 1; 87.5 per cent, group 2; and 40 per cent, group 3.

Conclusions

This is the first study to report adjuvant intraperitoneal treatment ceftriaxone for septic peritonitis in horses and indicates that this treatment can successfully treat septic peritonitis in horses.
Animal models of necrotizing enterocolitis
Authors: Mendez Yomara Stephanie , Khan Faraz A , Perrier Gregory Van , Radulescu Andrei
Published: March 2020

Background

Necrotizing enterocolitis (NEC) is one of the leading causes of death in premature infants. To determine the factors present in the disease that lead to increased morbidity and mortality, manipulation of variables that are shown to have a positive response has been tested using various animal models. Testing and manipulation of these variables are unwarranted in humans due to regulatory health standards.

Methods

The purpose of this review is to provide an update to previous summaries that determine the significance of animal models in studying the mechanisms of NEC. A large variety of animal models including rats, mice, rabbits, piglets, nonhuman primates, and quails have been described in literature. We reviewed the reported animal models of NEC and examined the pros and cons of the various models as well as the scientific question addressed.

Results

The animals used in these experiments were subject to gavage feeding, hypoxia, hypothermia, oxygen perfusion, and other methods to induce the disease state. Each of these models has been utilized to show the effects of NEC on the premature, undeveloped gut in animals to find a correlation to the disease state present in humans. We found specific advantages and disadvantages for each model.

Conclusions

Recent advances in our understanding of NEC and the ongoing therapeutic strategy developments underscore the importance of animal models for this disease.