bluuebunny/crossref_metadata_2025 huggingface dataset:
Cholescintigraphy may have a role in selecting patients with biliary dyskinesia for cholecystectomy: a systematic review
Authors: Alhayo Sam , Eslick Guy D. , Cox Michael R.
Published: June 2020

Background

Patients with typical biliary pain, no gallstones on ultrasound and low gallbladder ejection fraction (GBEF) on cholescintigraphy (gallbladder dyskinesia) may be considered for a laparoscopic cholecystectomy. However, some studies have suggested that symptoms alone are an adequate indication for laparoscopic cholecystectomy. The aim was to determine the role of cholescintigraphy in predicting outcomes of cholecystectomy in patients with typical and atypical biliary symptoms and normal biliary ultrasound.

Methods

Meta‐analysis using Preferred Items for Systematic reviews and Meta‐Analysis (PRISMA) guidelines of published literature using several electronic databases.

Results

Twenty‐four articles were selected with a total of 1710 patients. The majority (n = 1633, 94.4%) of patients had typical biliary symptoms. A total of 1047 patients with typical symptoms and a reduced GBEF had a cholecystectomy with 852 (81.4%) having complete resolution of symptoms. A total of 148 with typical symptoms and normal GBEF had a cholecystectomy with 103 (69.5%) having complete resolution, which was significantly less than those with a reduced GBEF (odds ratio 1.65, confidence interval 1.08–2.05, P = 0.01). Forty‐five patients with atypical symptoms and a reduced GBEF had a cholecystectomy with 31 (68.9%) having complete resolution of symptoms, which is significantly lower than those with typical symptoms (odds ratio 1.97, confidence interval 0.95–3.90, P = 0.05).

Conclusion

Cholescintigraphy improved the predication of outcome of cholecystectomy in biliary dyskinesia by 10%. However, the presence of typical symptoms does predict an effective response in 70% of patients. Atypical symptoms predict a poorer response.
Gastrointestinal involvement in childhood vasculitides
Authors: Trapani Sandra , Rubino Chiara , Indolfi Giuseppe
Published: June 2020

Aim

The aim of this narrative review was to provide a comprehensive summary of the characteristics of gastrointestinal (GI) involvement in the most common paediatric primary vasculitides.

Methods

We used PubMed to primarily identify papers, reviews, case series and editorials published in English from 2000 until 31 January 2020. Based on this, we report the prevalence, clinical manifestations, diagnostic approaches and management of GI involvement in each vasculitis.

Results

Vasculitides are inflammatory blood vessel diseases, and the majority can affect the GI system with vascular, GI tract or solid organ involvement. GI involvement can sometimes complicate and delay the correct diagnosis. Clinical findings are usually nonspecific symptoms, such as fever, abdominal pain, nausea, vomiting and diarrhoea. Bleeding should alert paediatricians to the possibility of severe complicated vasculitis. Diagnosis relies mostly on imaging. If it goes unrecognised, GI involvement in paediatric vasculitis is a serious cause of morbidity and even mortality, related to bowel ischaemia and perforation. Treatment of GI symptoms depends on the type of vasculitis and usually involves high‐dose steroids and immunosuppressants.

Conclusion

GI manifestations in the most common paediatric primary vasculitides were usually nonspecific, diagnosis mostly relied on imaging, and treatment usually involved high‐dose corticosteroids and immunosuppressants.
Pathophysiological mechanisms explaining poor clinical outcome of older cancer patients with low skeletal muscle mass
Authors: Looijaard Stéphanie M. L. M. , te Lintel Hekkert Miriam L. , Wüst Rob C. I. , Otten René H. J. , Meskers Carel G. M. , Maier Andrea B.
Published: June 2020

Low skeletal muscle mass is highly prevalent in older cancer patients and affects 5% to 89% depending on the type and stage of cancer. Low skeletal muscle mass is associated with poor clinical outcomes such as post‐operative complications, chemotherapy toxicity and mortality in older cancer patients. Little is known about the mediating pathophysiological mechanisms. In this review, we summarize proposed pathophysiological mechanisms underlying the association between low skeletal muscle mass and poor clinical outcomes in older cancer patients including a) systemic inflammation; b) insulin‐dependent glucose handling; c) mitochondrial function; d) protein status and; e) pharmacokinetics of anticancer drugs. The mechanisms of altered myokine balance negatively affecting the innate and adaptive immune system, and altered pharmacokinetics of anticancer drugs leading to a relative overdosage of anticancer drugs are best‐substantiated. The effects of glucose intolerance and circulating mitochondrial DNA as a consequence of low skeletal muscle mass are topics of interest for future research. Restoring myokine balance through physical exercise, exercise mimetics, neuro‐muscular activation and adapting anticancer drug dosing on skeletal muscle mass could be targeted approaches to improve clinical outcomes in older cancer patients with low skeletal muscle mass.
How Much Time Do We Need? Time and Psychoanalytic Psychotherapy in CAMHS
Authors: Bent‐Hazelwood Jo
Published: June 2020

The author considers what seem to be norms and values concerning session frequency and length of treatment in ‘traditional’ and current child and adolescent psychotherapy practice, and the impact of training expectations and models of training on identity and status as a child and adolescent psychotherapist. In the UK National Health Service, there is pressure to do more in less time: the norm is once‐weekly work. Such an expectation does not sit comfortably with psychoanalytic theory and training, which remains rooted in higher frequency, longer‐term cases. For trainees, this can lead to feelings of fraudulence and questioning whether less frequent therapies imply that the work is not psychoanalysis. The author explores, through a literature review, a case study and research material, how one might acknowledge the tension between these conflicting values about time; how psychoanalytic work in all its forms might be valued and be valuable for patients; and urges the need to feedback clinical experience into training structures and ongoing learning.
The deglaciation of the western sector of the Irish Ice Sheet from the inner continental shelf to its terrestrial margin
Authors: Roberts David H. , Ó Cofaigh Colm , Ballantyne Colin K. , Burke Matthew , Chiverrell Richard C. , Evans David J. A. , Clark Chris D. , Duller Geoff A. T. , Ely Jeremy , Fabel Derek , Small David , Smedley Rachel K. , Callard S. Louise
Published: June 2020

This paper provides a new deglacial chronology for retreat of the Irish Ice Sheet from the continental shelf of western Ireland to the adjoining coastline, a region where the timing and drivers of ice recession have never been fully constrained. Previous work suggests maximum ice‐sheet extent on the outer western continental shelf occurred at ~26–24 cal. ka BP with the initial retreat of the ice marked by the production of grounding‐zone wedges between 23–21.1 cal. ka BP. However, the timing and rate of ice‐sheet retreat from the inner continental shelf to the present coast are largely unknown. This paper reports 31 new terrestrial cosmogenic nuclide (TCN) ages from erratics and ice‐moulded bedrock and three new optically stimulated luminescence (OSL) ages on deglacial outwash. The TCN data constrain deglaciation of the near coast (Aran Islands) to ~19.5–18.5 ka. This infers ice retreated rapidly from the mid‐shelf after 21 ka, but the combined effects of bathymetric shallowing and pinning acted to stabilize the ice at the Aran Islands. However, marginal stability was short‐lived, with multiple coastal sites along the Connemara/Galway coasts demonstrating ice recession under terrestrial conditions by 18.2–17. ka. This pattern of retreat continued as ice retreated eastward through inner Galway Bay by 16.5 ka. South of Galway, the Kilkee–Kilrush Moraine Complex and Scattery Island moraines point to late stage re‐advances of the ice sheet into southern County Clare ~14.1–13.3 ka, but the large errors associated with the OSL ages make correlation with other regional re‐advances difficult. It seems more likely that these moraines are the product of regional ice lobes adjusting to internal ice‐sheet dynamics during deglaciation in the time window 17–16 ka.
Rapid Late Pleistocene climate change reconstructed from a lacustrine ostracod record in central Italy (Lake Trasimeno, Umbria)
Authors: Marchegiano Marta , Horne David J. , Gliozzi Elsa , Francke Alexander , Wagner Bernd , Ariztegui Daniel
Published: June 2020

This study presents, for the first time, a detailed quantitative reconstruction of winter (January) and summer (July) palaeotemperatures from the Late Pleistocene to Holocene transition in central Italy based on ostracod assemblages in an 8.59‐m‐long sediment core retrieved in Lake Trasimeno. Of 19 ostracod species recovered, 13 were calibrated according to their living temperature ranges, enabling us to reconstruct mean January and July temperature ranges using the mutual ostracod temperature range (MOTR) method. The occurrences of Cytheromorpha fuscata and Limnocythere suessenbornensis from 44 000 to 25 500 cal. a BP showed mean January temperatures at least 7 °C colder and mean July temperature at least 1 °C cooler in some intervals compared to present‐day temperatures. Comparison of the MOTR‐derived January minima curve with a Greenland oxygen isotope record (NGRIP) shows a remarkable correlation of warmer Greenland Interstadial and the colder Greenland Stadial events with clear peaks and troughs in the MOTR signal. These correlations were tested successfully by tuning the MOTR curve to the NGRIP record, resulting in an improved age‐depth model combining radiocarbon ages with MOTR tie points. The results demonstrate that a record of rapid climate change in the North Atlantic region is archived in lacustrine ostracod assemblages in central Italy.
The experiences of immigrant entrepreneurs in a medium‐sized Canadian city: The case of St. John's, Newfoundland and Labrador, Canada
Authors: Graham Nelson , Pottie‐Sherman Yolande
Published: June 2020

There is growing interest in the dynamics of immigrant entrepreneurship in non‐traditional immigrant gateway cities in Canada. Encouraging immigrant businesses is a particularly pressing imperative for Atlantic Canada's small and medium‐sized cities, which struggle with aging labour markets, youth out‐migration, and difficulty attracting and retaining newcomers. Recent research on immigrant entrepreneurship highlights the geography of entrepreneurial benefits and challenges across Canadian cities. Our study contributes to this field by examining the experiences of immigrant entrepreneurs on the “edge”—working in Canada's easternmost city, St. John's, Newfoundland and Labrador. Our findings are based on 28 interviews conducted with immigrant entrepreneurs and key informants in St. John's. As a remote, peripheral city within Canada with a small immigrant population and an economy intimately tied to booms and busts in global oil markets, we found that St. John's presents a distinct set of challenges for immigrant entrepreneurs. Yet, a recent rush to encourage a start‐up ecosystem—through a university‐based incubator program and new provincial nominee streams—is also creating new opportunities for self‐employment and shifting the terrain of support towards white‐collar businesses. Ultimately, this study highlights the variegated experiences of a diverse set of immigrant entrepreneurs in St. John's.
Effects of dipeptidyl peptidase‐4 inhibitor linagliptin versus sulphonylurea glimepiride on systemic haemodynamics in overweight patients with type 2 diabetes: A secondary analysis of an 8‐week, randomized, controlled, double‐blind trial
Authors: Kraaijenhof Jordan , Muskiet Marcel H. A. , Tonneijck Lennart , Ouwens D. Margriet , Kramer Mark H. H. , van Raalte Daniël H. , Smits Mark M.
Published: June 2020

Aim

To determine the glucose‐independent effect of the dipeptidyl peptidase‐4 (DPP‐4) inhibitor linagliptin versus the sulphonylurea glimepiride on systemic haemodynamics in the fasting and postprandial state in patients with type 2 diabetes (T2D).

Materials and Methods

In this prespecified secondary analysis of a phase IV, double‐blind trial, 46 metformin‐treated, overweight patients with T2D were included and randomly assigned (1:1) to once‐daily linagliptin (5 mg) or glimepiride (1 mg) for 8 weeks. In a sub‐study involving 26 patients, systemic haemodynamics were also assessed following a standardized liquid meal (Nutridrink Yoghurt style). Systemic haemodynamics (oscillometric device and finger photoplethysmography), arterial stiffness (applanation tonometry) and cardiac sympathovagal balance (heart rate variability [HRV]) were measured in the fasting state and repetitively following the meal. Ewing tests were performed in the fasting state.

Results

From baseline to week 8, linagliptin compared with glimepiride did not affect systemic haemodynamics, arterial stiffness or HRV in the fasting state. Linagliptin increased parasympathetic nervous activity, as measured by the Valsalva manoeuvre (P = .021) and deep breathing test (P = .027) compared with glimepiride. Postprandially, systolic blood pressure (SBP) dropped an average of 7.6 ± 1.6 mmHg. Linagliptin reduced this decrease to 0.7 ± 2.3 mmHg, which was significant to glimepiride (P = .010).

Conclusions

When compared with glimepiride, linagliptin does not affect fasting blood pressure. However, linagliptin blunted the postprandial drop in SBP, which could benefit patients with postprandial hypotension.
The influence of affective state on sensory and emotional perception: Application of the Sense’n Feel™ method
Authors: Rochet Marion , El‐Hage Wissam , Dreyfuss Lise , Atanasova Boriana
Published: June 2020

Emotions play a key role in our daily life through their control over our thoughts and behaviors. While it is commonly accepted that depressive patients have emotional perception disorders, it is important to know how these disorders affect patients’ sensory perception to develop products to provide them with better support. In this study, we first examined the existence of modifications in the emotional perception of subjects with minor depressive symptoms (MDS, n = 80) compared with healthy controls (HC, n = 80) using a nonverbal method based on pictures to measure projected emotions and personality traits: the Sense'n Feel™ method. The investigated stimuli were two unpleasant and two pleasant odors and one pleasant food product: a madeleine. Second, we investigated the hedonic, familiarity and intensity olfactory perceptions of the subjects using the same stimuli. No significant difference was found in any olfactory qualities between the two groups. Concerning the pleasant olfactory stimuli, however, we did note that the MDS subjects had a significantly lower score for the positive emotion of joy/happiness than the controls. Additionally, the MDS group's attribution of some positive personality traits for the three pleasant stimuli was significantly weaker than that in the HC group. These results could be explained by the affective state of the MDS subjects; they were more anxious and more alexithymic compared with the controls. Further research is needed to validate our study in clinically depressed individuals and to determine whether the modifications of the emotional olfactory perception are due to the disease and/or to neuropsychological alterations.
Plasticity in oligodendrocyte lineage progression: An OPC puzzle on our nerves
Authors: Craig Georgina A. , Yoo SangWon , Du Tian Y. , Xiao Junhua
Published: June 2020

Myelin deposition in the central nervous system has been shown to be responsive to experience, with sensory enrichment increasing myelination and sensory or social deprivation decreasing myelination. This process is referred to as “adaptive myelination” or “myelin plasticity” and signifies an essential component of new learning. However, whether these experience‐driven adaptations are driven by (a) underlying changes in the generation of myelinating cells, (b) altered interactions between myelin sheath and axon, or (c) a combination of the above remains unclear. It has been suggested that myelination largely follows an “innate” and automatic programme, allowing for a predictable pattern of central nervous system myelin deposition over time. Adaptive myelination is thought to account for more nuanced alterations that do not dramatically shift this pattern, but ultimately drive functional responses. This makes the study of myelin plasticity particularly difficult, as it necessitates being able to clearly and specifically draw boundaries between the innate and adaptive programme. Thus, the field requires a holistic understanding of the remit of innate myelin development, prior to investigation of adaptive myelination. This review will collate literature regarding different aspects of oligodendrocyte and myelin development (namely, oligodendrocyte proliferation, differentiation, death and myelin sheath formation) in an innate context, before discussing how these parameters are proposed to change under adaptive conditions. It is the hope that this review will highlight the need for a comprehensive and integrated approach towards studying both innate and adaptive forms of myelination.
SARS‐CoV‐2 and Guillain–Barré syndrome: AIDP variant with a favourable outcome
Authors: Lascano A. M. , Epiney J.‐B. , Coen M. , Serratrice J. , Bernard‐Valnet R. , Lalive P. H. , Kuntzer T. , Hübers A.
Published: June 2020

Background and purpose

The spectrum of COVID‐19, caused by severe acute respiratory syndrome coronavirus 2 infection (SARS‐CoV‐2), includes different neurologic manifestations of the central and peripheral nervous system.

Methods

From March through April 2020, in two university hospitals located in western Switzerland, we examined three patients with Guillain–Barré syndrome (GBS) following SARS‐CoV‐2.

Results

These cases were characterized by a primary demyelinating electrophysiological pattern (Acute inflammatory demyelinating polyneuropathy or AIDP) and a less severe disease course compared to recently published case series. Clinical improvement was observed in all patients at week five. One patient was discharged from hospital after full recovery with persistence of minor neurological signs (areflexia). Two of the three patients remained hospitalized: one was able to walk and the other could stand up with assistance.

Conclusions

We report three cases of typical GBS (AIDP) occurring after SARS‐CoV‐2 infection and presenting with a favourable clinical course. Given the interval between COVID‐19‐related symptoms and neurological manifestations (mean of 15 days) we postulate a secondary immune‐mediated mechanism rather than direct viral damage.
Predictors of prostate‐specific antigen testing in men aged ≥55 years: A cross‐sectional study based on patient‐reported outcomes
Authors: Leong Joon Yau , Chandrasekar Thenappan , Berlin Alejandro , Klaassen Zachary , Wallis Christopher JD , Ahmad Ardalan E , Herrera‐Caceres Jaime O , Perlis Nathan , Fleshner Neil E , Goldberg Hanan
Published: June 2020

Objectives

To examine the predictors of prostate‐specific antigen discussion with a physician and prostate‐specific antigen testing in men aged ≥55 years.

Methods

Utilizing the USA Health Information National Trends Survey, 4th Ed., a cross‐sectional study from 2011 to 2014 was carried out to analyze the factors predicting prostate‐specific antigen testing and discussion in men ≥55 years. Associations between each covariate and prostate‐specific antigen discussion/testing were determined. Multivariable logistic regression models were used to determine clinically relevant predictors of prostate‐specific antigen discussion/testing. Due to multiple comparisons, the Bonferroni correction was used.

Results

A total of 2731 men included in the Health Information National Trends Survey were analyzed. Several socioeconomic parameters were found to increase the likelihood of men aged ≥55 years to undergo prostate‐specific antigen testing: living with a spouse, a higher level of education (college graduate or above), a higher income (>$50 000 annually) and previous history of any cancer. In contrast, current smokers were less likely to undergo prostate‐specific antigen testing. Having a prostate‐specific antigen discussion with a physician was more likely for men surveyed in 2014, for men who were living with a spouse, who had a higher annual income (>$50 000 annually) and those with a history of any cancer.

Conclusions

Significant inequalities in prostate‐specific antigen testing and discussion exist among men in the USA, mainly driven by socioeconomic factors. Ideally, prostate‐specific antigen testing and discussion should be based on relevant clinical factors with a shared decision‐making approach for every man. Therefore, a better understanding of the socioeconomic factors influencing prostate‐specific antigen testing/discussions can inform strategies to reduce existing gaps in care.
The green factor: Unpacking green job growth
Authors: SOFRONIOU Nick , ANDERSON Pauline
Published: June 2020

Drawing on data from the Labour Force Survey of the United Kingdom (2011–14), this article estimates the number of green jobs in Scotland and identifies change over time, using a methodological framework that can be applied to any region, based on ISCO‐08 and O*NET. The findings highlight the value of charting changes in green jobs based on inclusive rather than “purist” definitions to better capture the broader impact of greening on jobs. The findings also indicate a need for greater analytical attention to issues of green job quality and inclusive green job growth.
Nasal vaccination of β7 integrin‐deficient mice retains elevated IgA immunity
Authors: Maślanka Tomasz , Clapp Beata , Hoffman Carol , Robison Amanda , Gregorczyk Izabela , Pascual David W
Published: June 2020

Understanding the migration of lymphocytes to nonintestinal mucosal sites is fundamental to developing mucosal vaccination strategies. Studies have shown that nasal and oral immunization with cholera toxin (CT) stimulates, in addition to α4β7+, the induction of αE (CD103)β7+ B cells. To determine the extent to which αE‐associated β7 contributes to antigen (Ag)‐specific immunoglobulin (Ig)A responses in the upper respiratory tract, nasal CT vaccination was performed in wild‐type (wt) and β7−/− mice. At 16 days postprimary immunization, upper respiratory tract IgA responses were greater in β7−/− mice than in wt mice. IgA induction by distal β7−/− Peyer’s patches, mesenteric lymph nodes and small intestinal lamina propria was minimal, in contrast to elevated gut IgA responses in wt mice. By 42 days postprimary immunization, β7−/− gut IgA responses were restored, and upper respiratory tract Ag‐specific IgA responses were equivalent to those of wt mice. Examination of homing receptor expression and cell‐sorting experiments revealed that β7−/− mice have increased usage of β1 and αE integrins by upper respiratory tract B cells, suggesting that alternative integrins can facilitate lymphocyte migration to the upper respiratory tract, especially in the absence of β7.
The importance of immunity in the development of reliable animal models for psoriasis and atopic dermatitis
Authors: Guerrero‐Aspizua Sara , Carretero Marta , Conti Claudio J , Del Río Marcela
Published: June 2020

Psoriasis (PS) and atopic dermatitis (AD) are common inflammatory skin diseases characterized by an imbalance in specific T‐cell subsets, resulting in a specific cytokine profile in patients. Obtaining models closely resembling both pathologies along with a relevant clinical impact is crucial for the development of new therapies because of the high prevalence of these diseases. Single‐gene mouse models developed until now do not fully reflect the complexity of these disorders, in part not only because of inherent differences between mice and humans but also because of the multifactorial nature of these pathologies. The skin‐humanized mouse model developed by our group, based on a tissue engineering approach, has been used to test therapeutic strategies, although this methodology is still technically challenging and not widely available. The skin‐humanized mouse models for PS and AD reproduce human skin phenotypes, providing valuable tools for drug development and testing in the preclinical setting. The tissue engineering approach allows the development of personalized medicine, covering the broad genotypic spectrum of these pathologies. This review highlights the main differences between available murine models focusing on the tissue‐specific immunity of PS and AD. We discuss their contribution to unravel the complex pathophysiology of these diseases and to translate this knowledge into more accurate therapies.
Constructing continuity across the organisational culture boundary in a highly virtual work environment
Authors: Asatiani Aleksandre , Hämäläinen Julia , Penttinen Esko , Rossi Matti
Published: June 2020

While remote work allows organisations to offer their employees flexibility and harness global talent and markets for business growth, inability to rely on physical interactions between employees imposes challenges specific to operations in highly virtual work environments. Among these characteristic issues are challenges associated with organisational socialisation and organisational culture. Accordingly, an action design research project was carried out for building a socialisation substitute (an information artefact in the form of a digital organisational culture handbook) to support synthesis of symbolic and pragmatic components of organisational culture at case company Smartly.io, a highly virtual organisation experiencing rapid growth. The paper contributes to the literature on socialisation and organisational culture by demonstrating one approach to designing a surrogate for socialisation that acts as a conduit between the symbolic aspects of organisational culture (such as values) and the pragmatic ones (such as toolkits). The work contributes to organisational discontinuity theory also, via theory‐generating descriptive analysis of the process of building continuity across the organisational culture boundary through creation of an information artefact. The resulting artefact was found to deliver practical utility to the case company and encapsulate generalisable design principles for this building process.
Hybrid transvenous lead extraction during cardiac surgery for valvular endocarditis
Authors: Yildirim Yalin , Petersen Johannes , Tönnis Tobias , Reichenspurner Hermann , Pecha Simon
Published: June 2020

Introduction

In patients with endocarditis and cardiac implantable electronic devices (CIED), lead extraction is recommended according to current guidelines. In patients with short lead implant duration, lead extraction by manual traction might be sufficient for intraoperative lead removal. However, in patients with long implant duration, specialized extraction tools like laser or mechanical rotational sheaths are necessary. We report our experience with transvenous lead extraction during concomitant cardiac surgery for valvular endocarditis using mechanical rotational sheaths.

Methods and Results

Between December 2018 and April 2020, 12 patients were treated with transvenous lead extraction during open‐heart surgery using mechanical rotational sheaths. Cardiac surgery was performed due to mitral, aortic, or tricuspid valve endocarditis. All patient‐related and procedural data were collected, and in‐hospital outcome was analyzed retrospectively. Mean patients' age was 65.2 ± 16.4 years, and 75.0% were male. Nine atrial, 15 ventricular, and 2 coronary sinus leads had to be extracted. The mean time from initial lead implantation was 94.3 ± 39.7 months. Complete procedural success was achieved in all patients with no major but one minor complication (pocket hematoma) occurring during lead extraction. Four patients with pacemaker dependency received epicardial leads, seven patients were treated in a two‐step approach with endocardial leads, whereas one patient had no further CIED indication. No procedure‐related mortality was seen. In‐hospital survival was 91.7%.

Conclusions

Valvular endocarditis surgery in combination with lead extraction using mechanical rotational sheaths is safe and feasible. It results in a high procedural success rate with prompt infection control by immediate removal of all infected lead materials.
An Integrated Review of Uterine Activity Monitoring for Evaluating Labor Dystocia
Authors: Kissler Katherine J. , Lowe Nancy K. , Hernandez Teri L.
Published: June 2020

Introduction

Labor dystocia is the most common cause of cesarean birth in the United States, yet how dystocia develops during labor remains elusive. Uterine activity monitoring has significant potential for advancing our understanding of labor dystocia. While evaluating contraction frequency and amplitude is a common component of labor dystocia management, the literature describing the relationship between measures of uterine activity and labor dystocia is heterogeneous and has not been synthesized to identify the best methods for use in clinical investigation.

Methods

We conducted a literature search for original research exploring the relationship between uterine activity and labor dystocia published between 2000 and 2019. Included articles were critically reviewed and synthesized.

Results

Across 11 identified studies, investigators employed 3 different techniques for monitoring uterine activity and 9 different measures were employed. Uterine activity measures, including Montevideo units, uterine electromyography power density spectrum and sample entropy, and the fall‐to‐rise ratio of contraction shape, detected patterns associated with labor dystocia or cesarean birth.

Discussion

The use of multiple regression with clinical covariates and a uterine activity measure increased the accuracy of predicting cesarean delivery. Uterine electromyography may be especially useful to evaluate labor dystocia phenotypes to differentiate uterine muscle fatigue from understimulation and lead to algorithms for increased precision in the diagnosis of labor dystocia and innovative approaches to treatment.
Manufacturing American Identity Among Immigrant Workers: Colorado Fuel & Iron Company at the Turn of the 20th Century
Authors: Messer Chris M. , Shriver Thomas E.
Published: June 2020

Extant research indicates that white racial framing is utilized to rationalize discrimination, but less work has examined how the white racial frame becomes filtered into institutional settings such as corporations and instilled within its programs and practices. This paper analyzes white racial framing in the Colorado Fuel & Iron Company during the early twentieth century as part of its effort to Americanize and control its racially diverse workforce. The company developed a special unit headed by a physician and proponent of eugenics to promote “social betterment.” Our findings show how dominant racial ideologies were embedded within the company's conceptualization of social betterment and how these ideas influenced corporate programs aimed at mollifying the workforce and increasing productivity. We discuss the implications of our research for future analyses of historically embedded racial framing.
Seasonal influenza vaccination for children with special risk medical conditions: Does policy meet practice?
Authors: Tuckerman Jane , Crawford Nigel W , Marshall Helen S
Published: June 2020

Aim

Ensuring children with special risk medical conditions (SRMC) are protected from influenza is important. The study objective was to describe influenza vaccination practices of medical professionals caring for children with SRMC and explore characteristics associated with a vaccine recommendation.

Methods

Design: Cross‐sectional survey. Setting/Participants: Treating paediatric specialists and general practitioners of children with confirmed SRMCs. Postal questionnaire administered from March to September 2018 (option for online response). Characteristics associated with providing a recommendation were explored using univariable and multivariable analyses.

Results

Overall response rate of 24.8% with the sample representative of the eligible population in terms of practice location and years practicing medicine. There was a higher response from females and sub‐specialists. Of the 198 completed survey responders, 97.8% were aware of the recommendation, yet only 38.4% reported they ‘always’ routinely recommended influenza vaccine and fewer (19.5%) were very confident in understanding all ‘medically at risk’ conditions. Medical professionals were more likely to provide a recommendation always or mostly, if they received annual influenza vaccination themselves (adjusted odds ratio (aOR) 3.96, confidence interval (CI) 1.12–14.03), had confidence in understanding all ‘medically at risk’ conditions (aOR 1.82, CI 1.04–3.17) and perceived ownership of the responsibility to provide the recommendation (aOR 7.35, CI 1.67–32.26). Regional practising medical professionals were less likely to provide a recommendation (aOR 0.25 CI 0.10–0.70).

Conclusions

We need to improve medical professionals' knowledge through reminders and access to consistent and concise information about what constitutes a SRMC. Increasing medical professionals' engagement in the influenza vaccination programme could also provide a sense of responsibility fostering provider endorsement.
Network valuation in financial systems
Authors: Barucca Paolo , Bardoscia Marco , Caccioli Fabio , D'Errico Marco , Visentin Gabriele , Caldarelli Guido , Battiston Stefano
Published: June 2020

We introduce a general model for the balance‐sheet consistent valuation of interbank claims within an interconnected financial system. Our model represents an extension of clearing models of interdependent liabilities to account for the presence of uncertainty on banks' external assets. At the same time, it also provides a natural extension of classic structural credit risk models to the case of an interconnected system. We characterize the existence and uniqueness of a valuation that maximizes individual and total equity values for all banks. We apply our model to the assessment of systemic risk and in particular for the case of stress testing. Further, we provide a fixed‐point algorithm to carry out the network valuation and the conditions for its convergence.
When there is No ZOPA: Mental Fatigue, Integrative Complexity, and Creative Agreement in Negotiations
Authors: Yao Jingjing , Zhang Zhi‐Xue , Liu Leigh Anne
Published: June 2020

How to reach a creative agreement in negotiations when the Zone of Possible Agreement (ZOPA) does not apparently exist? To answer this question, we drew on the cognitive flexibility theory and proposed a model predicting that negotiators’ mental fatigue would engender fewer creative agreements, and their integrative complexity acted as an underlying mechanism. Across four studies, we measured (Study 1) and manipulated (Studies 2–4) mental fatigue to test our hypotheses. We found that negotiation dyads with higher mental fatigue were less likely to display integrative complexity and hence less likely to reach creative agreements in negotiations without an apparent ZOPA. We also demonstrated that in this kind of negotiation, simply identifying additional issues or proposing packaging offers were not enough; negotiators need to do both to construct creative agreements. This research contributes to the literature of negotiation, creative problem‐solving, and the cognitive flexibility theory.
High‐resolution anorectal manometry in children with functional constipation with or without fecal incontinence
Authors: Alessandrella Annalisa , Turco Rossella , Russo Marina , Poziello Antonio , Miele Erasmo , Staiano Annamaria
Published: June 2020

Background

High‐resolution anorectal manometry (HR‐ARM) is expected to be better than conventional manometry. Our aim was to characterize HR‐ARM pressures in children with functional constipation (FC), with or without fecal incontinence (FI).

Methods

Children with diagnosis of FC, with or without FI, according to Rome‐IV criteria, were enrolled. All patients underwent HR‐ARM using 24‐channel water‐perfused catheter.

Results

Twenty‐nine consecutive children (M/F: 21/8; mean age ± SD: 9.5 ± 3.1 years; range 4‐15), of whom 21 affected by FC without FI (mean age ± SD: 9.3 ± 3.23 years) and 8 affected by FC with FI (mean age ± SD: 10.2 ± 3.08 years), were enrolled. No significant differences were found regard to gender and age. The analysis of HR‐ARM 3D plots demonstrated asymmetry of the anal canal, with higher pressures in distal halves. Comparing pressures between the two groups, we found lower values in FC with FI than in FC without FI group, with a statistically significance for maximum and mean resting pressures (P = .032 and P = .008, respectively). When evaluating our study population respect to asymptomatic children, we found lower resting pressures, lower maximum squeeze pressure, and higher rectoanal inhibitory reflex (RAIR) values.

Conclusions

Our data demonstrate that HR‐ARM pressures at rest and during squeezing in FC with FI children are lower than FC without FI subjects, particularly in anteroposterior quadrants. Compared to children without lower gastrointestinal symptoms, children with FC with or without FI show lower pressures and higher values of RAIR.
Eating behaviors in relation to gestational weight gain and postpartum weight retention: A systematic review
Authors: Bijlholt Margriet , Van Uytsel Hanne , Ameye Lieveke , Devlieger Roland , Bogaerts Annick
Published: June 2020

Preventing obesity is of utmost public health importance. This paper systematically reviews associations between eating behaviors and peripartum weight change. This knowledge is crucial in the development of interventions that reduce long‐term obesity, often triggered and boosted in the peripartum. Through MEDLINE, EMBASE, and Web of Science, we identified 20 studies that fulfilled inclusion criteria: studies on food cravings, disinhibition, restrained, external, emotional, uncontrolled, intuitive, or mindful eating in relation to gestational or postpartum weight among adult women. Higher gestational weight gain was associated with lower intuitive eating (in 3/3 studies) and higher restrained eating (in 4/11 studies), external eating (in 2/2 studies), emotional eating (in 3/4 studies), food cravings (in 3/3 studies), and disinhibition (in 1/3 studies). No association with uncontrolled eating was found (in one study). No studies on mindful eating and gestational weight were identified. Higher postpartum weight loss was associated with higher restrained (in 2/4 studies) and intuitive eating (in 1/1 study). No associations between postpartum weight and food cravings, disinhibition, and mindful eating were found. No studies on external, emotional and uncontrolled eating, and postpartum weight were identified. Concluding, certain eating behaviors might be related to peripartum weight change.
Patient and provider factors impacting referral for neonatal organ donation
Authors: Aghion Abigail , Hussey‐Gardner Brenda , Davis Natalie L. , Falck Alison J.
Published: June 2020

Background

As determination of brain death is infrequent in neonates, the AAP endorses donation after circulatory determination of death as an acceptable alternative. Despite this recommendation, neonatal organ donation is infrequent. Timely referral to OPOs is a vital first step in the organ donation process. The aim of this study was to identify patient and provider factors impacting timely referral for neonatal organ donation.

Methods

Medical records were reviewed for deaths occurring in a Level IV NICU from 2007 to 2017. Clinical and demographic factors, provider type, timing of OPO referral (before or after death), and outcome were assessed. Bivariate and multivariable logistic regression models were utilized to identify predictors of OPO referral characteristics.

Results

Between 2007 and 2017, 329 deaths occurred in the NICU or delivery room. Of the 265 infants meeting inclusion criteria, 96% had late referrals (after death) and were declined for organ donation. Frequency of timely referrals (before death) improved when OPO contact was by an attending neonatologist, when withdrawal of life support was planned, and with increasing birthweight, gestational age, and PMA. Factors associated with decreased OPO referral included male sex, lower weight at death, earlier PMA, and deaths occurring while receiving maximal intensive care support. No organs or tissues were donated.

Conclusions

This study is the first to report NICU referral patterns for organ donation. We found that timely provider referral of neonates to the OPO was rare. Exploration of provider knowledge will guide future educational interventions aimed to improve the referral process.
Development of prehospital assessment findings associated with massive transfusion
Authors: Wheeler Abigail R. , Cuenca Camaren , Fisher Andrew D. , April Michael D. , Shackelford Stacy A. , Schauer Steven G.
Published: June 2020

BACKGROUND

Massive transfusion is frequently a component of the resuscitation of combat casualties. Because blood supplies may be limited, activation of a walking blood bank and mobilization of necessary resources must occur in a timely fashion. The development of a risk prediction model to guide clinicians for early transfusion in the prehospital setting was sought.

STUDY DESIGN AND METHODS

This is a secondary analysis of a previously described data set from the Department of Defense Trauma Registry from January 2007 to August 2016 focusing on casualties undergoing massive transfusion. Serious injury was defined based on an Abbreviated Injury Scale score of 3 or greater by body region. The authors constructed multiple imputations of the model for risk prediction development. Efforts were made to internally validate the model.

RESULTS

Within the data set, there were 15540 patients, of which 1238 (7.9%) underwent massive transfusion. In the body region injury scale model, explosive injuries (odds ratio [OR], 3.78), serious extremity injuries (OR, 6.59), and tachycardia >120/min (OR, 5.61) were most strongly associated with receiving a massive transfusion. In the simplified model, major amputations (OR, 17.02), tourniquet application (OR, 6.66), and tachycardia >120 beats/min (OR, 8.72) were associated with massive transfusion. Both models had area under the curve receiver operating characteristic values of greater than 0.9 for the model and bootstrap forest analysis.

CONCLUSION

In the body region injury scale model, explosive mechanisms, serious extremity injuries, and tachycardia were most strongly associated with massive transfusion. In the simplified model, major amputations, tourniquet application, and tachycardia were most strongly associated.
Which is the preferred blood product for fibrinogen replacement in the bleeding patient with acquired hypofibrinogenemia—cryoprecipitate or fibrinogen concentrate?
Authors: Cushing Melissa M. , Haas Thorsten , Karkouti Keyvan , Callum Jeannie
Published: June 2020

The importance of the targeted treatment of acquired hypofibrinogenemia during hemorrhage with a concentrated fibrinogen product (either cryoprecipitate or fibrinogen concentrate) cannot be underestimated. Fibrinogen concentrate is a pathogen inactivated, pooled product that offers a highly purified single factor concentrate. Cryoprecipitate is a pooled product that comes with a spectrum of other coagulation factors which may further enhance (additional procoagulant effect) or even disturb (prothrombotic risk) hemostasis. The pros and cons of each product are discussed.
Cognitive and physical performance are well preserved following standard blood donation: A noninferiority, randomized clinical trial
Authors: Nadler Roy , Tsur Avishai M. , Lipsky Ari M. , Lending Gadi , Benov Avi , Ostffeld Ishai , Shinar Eilat , Yanovich Ran , Moser Asher , Levy Diana , Haiman Nikolai , Eliassen Hakon , Bader Tarif , Glassberg Elon , Chen Jacob
Published: June 2020

BACKGROUND

A walking blood bank (WBB) refers to the use of fellow combatants for battlefield blood donation. This requires pretesting combatants for infectious diseases and blood type. A fundamental prerequisite for this technique is that the donating soldier will suffer minimal physiological and mental impact. The purpose of the current study is to assess the effect of blood shedding on battlefield performance.

METHODS

This is a double‐blind randomized control trial. Forty Israel Defense Forces combatants volunteered for the study. Participants underwent baseline evaluation, including repeated measurement of vital signs, cognitive evaluation, physical evaluation, and a strenuous shooting test. Three weeks after the baseline evaluation, subjects were randomized to either blood donation or the control group. For blinding purposes, all subjects underwent venous catheterization for the duration of a blood donation. Repeated vital signs and function evaluation were then performed.

RESULTS

Thirty‐six patients were available for randomization. Baseline measurements were similar for both groups. Mean strenuous shooting score was 80.5 ± 9.5 for the control group and 82 ± 6.6 for the test group (p = 0.58). No clinically or statistically significant differences were found in tests designed to evaluate cognitive performance or physical functions. Vital signs taken multiple times were also similar between the test and control groups.

CONCLUSIONS

Executive, cognitive, and physical functions were well preserved after blood donation. This study supports the hypothesis that a WBB does not decrease donor combat performance. The categorical prohibition of physical exercise following blood donation might need to be reconsidered in both military and civilian populations.
Hemolytic markers following the transfusion of uncrossmatched, cold‐stored, low‐titer, group O+ whole blood in civilian trauma patients
Authors: Harrold Ian M. , Seheult Jansen N. , Alarcon Louis H. , Corcos Alain , Sperry Jason L. , Triulzi Darrell J. , Yazer Mark H.
Published: June 2020

BACKGROUND

Low‐titer group O whole blood (LTOWB) is increasingly being used in the civilian trauma setting, although there is a risk of hemolysis. This study evaluated the impact on hemolytic markers following the transfusion of 4 or more units of uncrossmatched LTOWB.

METHODS

Civilian adult trauma patients who received four or more units of leukoreduced group O+, low‐titer (<50 anti‐A and anti‐B), platelet‐replete uncrossmatched whole blood during their initial resuscitation and who survived for more than 24 hours after the transfusion were included in this retrospective study. Lactate dehydrogenase (LDH), total bilirubin, haptoglobin, potassium, and creatinine were evaluated on the day of LTOWB transfusion (Day 0) and the next 3 days. Blood product administration over the first 24 hours of admission was recorded.

RESULTS

There were 54 non–group O and 23 group O recipients of four or more LTOWB units. The median (interquartile range [IQR]) number of transfused LTOWB units was 4 (4‐5) and 4 (4‐4), respectively, the maximum number in both groups was eight. The non–group O patients received a median (IQR) volume of 1470 mL (1368‐2052) of ABO‐incompatible plasma. Comparing the non–group O to the group O recipients, there were no significant differences in the haptoglobin, LDH, total bilirubin, potassium, or creatinine concentrations at any of the time points. There were no reported transfusion reactions.

CONCLUSION

Receiving at least four LTOWB units was not associated with biochemical or clinical evidence of hemolysis.