bluuebunny/crossref_metadata_2025 huggingface dataset:
Structural Transformation and Productivity Growth in Cameroon
Authors: Avom Désiré , Malah Kuete Yselle Flora
Published: January 2023

The object of this paper is to evaluate the contribution of structural transformation to the labour productivity growth in Cameroon over the period 1965 to 2015. To do this, we use a growth decomposition technique following the work of McMillan and Rodrik (2011) and De Vries et al. (2015). Our results show that structural transformation, viewed as a progressive reallocation of the workforce from sectors with low productivity to those with high productivity, has contributed little to the increase in labour productivity growth. It is actually the within component that seems to explain most of the productivity gains, while the between component that characterizes structural transformation has been rather weak. Even more, the dynamic share of this structural transformation was negative throughout the period covered by the study. Econometric estimates make it possible to identify economic growth (approximated by the GDP per capita), trade openness, exchange rate depreciation and the quality of the institutions, particularly the decrease of corruption, as factors having affected structural transformation and on which Cameroon should act with appropriate economic policies.
The CFA Franc
Authors: Ajab Amin Aloysius
Published: January 2023

The chapter briefly traces the evolution of the Franc CFA Zone- a monetary union, which is one of the world’s longest surviving currency arrangement. It examines the implication of the four main principles of the monetary arrangements with the advantages and costs. It looks at the membership in CEMAC especially on how the agreement has impacted the financial sector and consequently CEMAC’s economy. The CEMAC’s economy is oil dominated and oil price shocks influence the region’s economic performance. The impact is seen in region’s limited intraregional trade, weak financial development and low private sector financing. The chapter, therefore, assesses the financial sector of the zone, and analyses the role of financial sector on the growth of the private sector and economic expansion. The results of the estimated model show the importance of the financial sector to the private sector. The chapter concludes that the weak financial sector/system of the CFA franc zone has hindered the economic expansion because of the limited private sector financing. Hence, economic diversification and financial development is essential in the regional economic expansion.
Determinants of the Performance of the Education System
Authors: Noumba Issidor
Published: January 2023

Education is a top priority for the Cameroonian government, as reflected in frequent institutional reforms implemented over time in this strategic sector to improve its performance. In this context, the objective of this study is to investigate the effect of institutions on primary and secondary school enrolment, controlling for other key variables. Data used are from the World Bank, the Center for Global Peace, and the Cameroonian government. A standard education production function is specified and estimated using the SURE method. The adopted methodology led to some interesting results. i) There is some heterogeneity in the effect of institutions on the performance of the education system. Indeed, institutional factors seem to have had a positive and significant effect on primary school enrolment and no effect on secondary school enrolment. ii) The same heterogeneity is observed in the effect of public spending on education as a share of GDP, which appears to be positive and significant on primary school enrolment and not on secondary school enrolment. iii) High level of GDP growth rate would not be a necessary and sufficient condition for improving the Cameroonian education system performance. Therefore, the Government should do more to reduce political instability, corruption and improve good governance to boost the performance of the education system. An effective health policy would also help to achieve the same goal.
When Kamerun Will Awaken…
Authors: Etounga-Manguelle Daniel
Published: January 2023

Endowed by its history and geography with considerable assets for its development, the country initially called Kamerun, which was a German protectorate from 1884 to 1918, before being placed under a mandate of French and English trusteeship from 1918 to 1960, is today at a crossroads. For since 2016 (with the eruption of an armed rebellion in the country’s English-speaking regions), it has been subjected to a sociopolitical crisis that endangers its state institutions and threatens its national integrity and its survival as a flagship nation with its rich and diverse history. This chapter sums up the challenges of the new sociopolitical situation of the country, whose economy shows a great deal of resilience, despite the gravity of the ills that weigh it down. These ills are due essentially to poor governance and lack of leadership. But the current daunting challenges facing Cameroon do not in any way mortgage its future when the country, reconciled with itself, will awaken and shine with all its radiance.
Cameroon’s Labor Market Dynamics and Prospects
Authors: Housseini Bouba , Boudarbat Brahim
Published: January 2023

Cameroon has experienced substantive economic growth in the past two decades between 2001 and 2019, but this growth has not been inclusive enough to provide jobs to hundreds of thousands of new Cameroonian job-seekers entering the market every year. This chapter provides a comprehensive assessment of the Cameroon’s labour market, with a focus on the dynamics and patterns of key labour market indicators and factors affecting the performance in the labour market. Our analysis uses both macro- and micro-economic approaches and combines country-level times-series data from the World Bank World Development Indicators (WDI) and household survey data (ECAM) produced by the Cameroon’s National Institute of Statistics. In terms of findings, first we observe an overall limited increase of the capacity of the Cameroonian economy to absorb its labour force, with a fluctuating pattern over time. Second, we show that the positive dynamics observed in labour force participation, employment and unemployment actually hide the precarity of jobs and poor working conditions prevailing in the country. Third, our results reveal that significant gaps persist across different groups of the population in terms of labour market outcomes, and women, youth, low-educated people, and population of northern regions of the country are the most affected groups by the scarcity of formal and decent jobs. Finally, our analysis also corroborates previous findings of the literature showing that gender, education, area of residence, and economic sector of employment are key drivers of the labour market outcomes in Cameroon. From a policy perspective, we argue that to mitigate the growing demographic pressure in Cameroon’s labour market and convert it into a demographic dividend, there is a need to accelerate the structural transformation of the Cameroonian economy, invest more in education and human capital, and therefore set up conditions for extensive job creation in more formal and more productive sectors. Additionally, targeted economic policies aiming to formalize the labour market, expand social protection programs, especially for women and youth, would help improving employment and earning prospects for the growing and young Cameroonian population.
‘In the Future, as Robots Become More Widespread’
Authors: Parviainen Jaana , Koski Anne
Published: January 2023

This chapter discusses imaginary technologies that do not exist yet but are expected to be implemented in clinical work in the near future. Adopting a phenomenological view on the politics of organizational time, we illuminate how the rhetoric of futurity and protentional anticipation dominate managerial acts in healthcare organizations. This future-oriented management includes strategies of risk assessment, investments in emerging technologies, and other actions to reduce external uncertainty and move towards an enhanced capacity to cope with potential challenges. However, we suggest that potentially harmful consequences of emerging technologies cannot be established reliably in advance by investigation, experiments, and risk assessments. The phenomenological notion of embodied information infrastructure allows us to consider how visions of complex technologies intertwine with clinical practices in healthcare professionals’ work. We use two examples of imaginary technologies—automated decision-making systems and care robotics—to concretize how the line between imaginary technologies and existing technologies becomes increasingly volatile in healthcare organizations.
Is the Phenomenal Difference of the Entrepreneurial Event Opening on Its Repetition?
Authors: Deroy Xavier
Published: January 2023

Entrepreneurs have immanent perceptions that observers can only perceive retrospectively. This chapter relies on neo-phenomenologist philosophers to better understand how the entrepreneurial event can be reconsidered through the lenses of phenomenology. After considering the main features of the event as defined by some of these philosophers, we advance (a) that structuration and subjectivity echo (b) the private and public dimensions. These dimensions are at the core of the entrepreneurial event when organizing is at stake. In so doing we reappraise the dominant theories of the event in organization studies. While underlining the interest of phenomenology for organization theory, the phenomenon of the entrepreneurial event opens new avenues for research.
Tuning into Things
Authors: Cnossen Boukje
Published: January 2023

This chapter introduces a specific phenomenological approach in a suggestion to sense organizing as a productive encounter between a place and its potential futures. In particular, it draws on the work of the anthropologist Kathleen Stewart to propose a ‘sensing’ approach to tune in to the role of place in the emergence of an alternative urban community of entrepreneurs and activists. While the field of management and organization studies (MOS) has been experiencing a very vibrant spatial turn, so far scholarship in this area has been focusing mostly on the ‘here and now’ of spaces and places. This has a lot to do with the specific epistemological commitments of MOS, including a realist focus in the field of organizational ethnography. This chapter suggests that a focus on what can be seen only goes so far, and that research on new or emergent organizations needs tools in order to sense the not-yet-there, and that this requires an affective attention that moves beyond the visual. The case presented, based on a field visit to an alternative urban community in the midst of the Covid-19 pandemic, offers insights into how such early-stage organizing can be seen sensed through an attention to things in a certain place, and how they are named and cared for.
Squatters and the Willing Suspension of Disbelief
Authors: Peiro Mickael
Published: January 2023

This chapter tells the story of the Occupied Theatre, the occupation of a former theatre and cinema by activists, which serves as a counterplace that represents ‘a kind of contestation of space that is both mythical and real’ (Foucault, 1984: 4) and allows ‘perception in the present of the unknown possible’ (Busquet, 2012: 6). When the place is not used for spectacular ends, it (re)becomes a living space in which occupants sleep, eat, talk, cook and play. It is during these daily moments that it is possible to observe the multiplicity of the inhabitants’ lives as well as the diversity of their temporality. This chapter focuses on phenomenological approaches by mobilizing the concept of the willing suspension of disbelief (Coleridge, 1817) to demonstrate the capacity of the occupants to produce their own reality and the capacity of the researcher, embedded in an ethnographic methodology, to accept the need to put aside his beliefs for the duration of the story in order to experience the characters’ emotions and to grasp aspects of their ‘real’ world. It is structured in three parts: first, it considers the capacity of the actors to produce new social relations, then it addresses the possibility for the ethnographer to observe those relations, and, finally, it focuses on the co-construction of new imaginaries.
Deconstructing the Clinical Hierarchy
Authors: Swanson Jae
Published: January 2023

This chapter investigates an open songwriting group with LGBTQIA+ youth. As a white queer and nonbinary music therapist, I describe my work with a group of LGBTQIA+ youth who were predominantly Black. Sessions were influenced by queer theory and anti-oppressive approaches to music therapy. The dominance of white supremacist ideals of clinical hierarchy in music therapy are challenged. Queering community music therapy is proposed and realized through songwriting and the theoretical lens through which the group was studied. Narratives of group artists and descriptions of the final showcase performance allow the reader an opportunity to gain a comprehensive understanding of the group. Questions are posed for music therapy challenging the hierarchy central to contemporary clinical practice, status quo, and a readiness to embrace the values of queer and trans music therapy.
Managing Uncertainty with Ambidexterity
Authors: Barbour Jennifer P. , Collins Catherine , Gibson Cristina B.
Published: January 2023

Uncertainty exogenous to organizations is pervasive, and yet espoused to have a negative impact on employee well-being. This chapter explores whether organizational ambidexterity might help mitigate the influence of exogenous uncertainty on employee well-being. Specifically, the job demands-resources theory is utilized to unpack how ambidexterity may be viewed as a “resource” to mitigate and/or potentially even a “demand” that exacerbates the negative impact of exogenous uncertainty on employee well-being. These rival hypotheses are explored in a field study (N = 540), and then an experiment (N = 160). The consistent finding was that exogenous uncertainty was experienced as a demand that exacerbates the negative effect of uncertainty on well-being. Thus it is revealed that organizational ambidexterity has the unanticipated consequence of amplifying a negative relationship between exogenous uncertainty and employee well-being, adding to the burden employees feel in coping with the unknown. Implications for managing exogenous uncertainty for employees’ well-being are unpacked, and future research is advocated. This ranges from organizational-level strategies with how organizational systems are embedded, at the individual level with employees’ taking agency, and taking into account the individual differences that predispose individuals to react differently.
Popular Culture and Human Mating
Authors: Salmon Catherine A. , Burch Rebecca L.
Published: January 2023

The products of popular culture, including pornography and romance, can be viewed as artifacts of human sexual psychology. In other words, popular culture can be examined as data in testing theories about human psychological adaptations in the same way as archaeological artifacts can be used by anthropologists to test hypotheses about human evolution. From a methodological standpoint, there are clear benefits to this approach (as opposed to surveys, for example) in that such unobtrusive measures do not require the cooperation of participants, or their honesty or self-awareness, and it does not influence the participant response. Additionally, media outlets can provide much larger samples reporting actual use. In this chapter, we will examine how the products of popular culture illuminate our understanding of male and female sexual desires with a particular emphasis on the appeal of mythology, pornography, and various forms of romance (from romance novels to Bollywood, erotica, and slash). Not only are there differences and overlap in mass media marketed to men and women but also in the media they create themselves. These differences not only inform researchers regarding what men and women desire, but also where more research needs to be conducted.
The Logic of Physical Attractiveness
Authors: Lewis David M. G. , Evans Kortnee C. , Al-Shawaf Laith
Published: January 2023

Attractiveness is a perception produced by psychological mechanisms in the mind of the perceiver. Understanding attractiveness therefore requires an understanding of these mechanisms. This includes the selection pressures that shaped them and their resulting information-processing architecture, including the cues they attend to and the context-dependent manner in which they respond to those cues. We review a diverse array of fitness-relevant cues along with evidence that the human mind processes these cues when making attractiveness judgments. For some of these cues, there is unequivocal evidence that the cue influences attractiveness judgments, but exactly why attractiveness-assessment mechanisms track that cue is an area of current debate. Another area of active inquiry is when these cues influence attractiveness judgments: because the fitness costs and benefits associated with these cues would have varied across contexts, selection should have shaped attractiveness-assessment mechanisms to be sensitive to contextual variables. As a consequence of this context-sensitive design, these mechanisms, despite being universal, should produce attractiveness assessments that vary systematically and predictably across contexts. We review evidence indicating that this is how human perception of attractiveness works, and highlight the need for more comprehensive and systematic investigations into contextual variation in human standards of attractiveness. We conclude by identifying limitations on existing evolutionary research on attractiveness, and provide concrete suggestions for how future work can address these issues.
Mate Competition between the Sexes
Authors: Semenyna Scott W. , Gómez Jiménez Francisco R. , Vasey Paul L.
Published: January 2023

Darwinian sexual selection has been the dominant framework for understanding mate competition, which usually involves intrasexual competition for opposite-sex partners. This expected dynamic can become more complicated in any species that shows an appreciable rate of bisexual behavior. Specifically, intersexual mate competition is possible any time opposite-sex individuals engage in romantic/sexual competition over the same target. We review historical and ethnographic evidence that intersexual mate competition occurs among humans. Going further, we describe data from two different non-Western cultures—Samoa and the Istmo Zapotec (Oaxaca, Mexico). These data show that competitions to acquire and maintain sexual relationships with men occur between women and feminine same-sex attracted males. This intersexual mate competition most commonly involved feminine males attempting to mate-poach partnered men from their relationships with women. Using participant stories to complement mixed-methods data, we illustrate how these competitions typically involved feminine males attempting to entice the target man, whereas women engaged in mate-guarding and emotionally punitive behaviors. Although intersexual mate competition is unlikely to be found in most species, or across all human cultures, our data show that intersexual mate competition can ensue when males and females prefer the same sexual partners, who themselves behave in a bisexual manner.
International Law, International Institutions, and the Pursuit of Peace
Authors: Gittings John
Published: January 2023

This chapter charts the development over the past two centuries of effective international law and institutions to limit war and promote peace. The effort gained popular support in the nineteenth century, with the growth of peace societies leading to The Hague peace conferences (1899 and 1907), and the first agreements for rules of war and for arbitration of disputes. Though the First World War represented a defeat for peace campaigns, the League of Nations established a new framework for war prevention and disarmament. This led to the more comprehensive approach towards international peace and security set out in the United Nations Charter. Collective action for peace-keeping and, later, intervention for humanitarian purposes, would become enshrined in international law. By the twenty-first century, broader issues including the prevention of non-state aggression and genocide, and the threat posed by nuclear weapons, were being addressed. Peace advocacy and the activities of non-governmental organizations have played a significant role, but now face the challenge of formidable new risks.
Historical Political Economy
Authors: Jenkins Jeffery A. , Rubin Jared
Published: January 2023

This chapter defines what historical political economy (HPE) is and is not, classifies the major themes in the literature, assesses the relative strengths and weaknesses of the literature, and points to directions for future study. We view HPE as social scientific inquiry that highlights political causes or consequences of historical issues. HPE is different from conventional political economy in the emphasis placed on historical processes and context. While the authors view HPE in the most inclusive manner reasonable, they define it to exclude works that are either solely of contemporary importance or that use historical data without any historical context (e.g., long-run macroeconomic time series data). The future of HPE is bright, especially as more historical data from around the world become available via digitization. Consequently, the future frontier of the field likely falls outside of the United States, which is the concern of a disproportionate amount of the current literature.
Culture in Historical Political Economy
Authors: Lowes Sara
Published: January 2023

Culture—the set of socially transmitted values and beliefs held by individuals—has important implications for a wide variety of economic outcomes. The causes and consequences of culture have both been the subject of work in historical political economy (HPE). This chapter first outlines several theories on the origins, evolution, and transmission of culture. It then discusses various strategies for measuring culture. Finally, the chapter reviews recent research in HPE that explores the origins of variation in culture and the economic consequences of culture.
The Evolution of the Symbolic Sciences
Authors: Gontier Nathalie
Published: January 2023

Aspects of human symbolic evolution are studied by scholars active in a variety of fields and disciplines in the life and the behavioral sciences as well as the scientific-philosophical, sociological, anthropological, and linguistic sciences. These fields and disciplines all take on an evolutionary approach to the study of human symbolism, but scholars disagree in their theoretical and methodological attitudes. Theoretically, symbolism is defined differentially as knowledge, behavior, cognition, culture, language, or social group living. Methodologically, the diverse symbolic evolution sciences establish their teachings upon diverging evolutionary biological schools and paradigms. This chapter reviews past and current research fields in human symbolic evolution for how they differentially implement tenets of the major evolution schools that were discussed in the previous chapter. Traditional evolutionary epistemology and biosemiotics bring in a mesoevolutionary outlook by drawing on early Darwinism and evolutionary developmental biology movements that emphasize the role of the organism in evolution. Communication studies instead originally take on a microevolutionary perspective by investigating how units of information are transmitted across generations through time. Only later do they integrate studies on meaning-making at the organismal level. Sociobiology complements a microevolutionary with a macroevolutionary outlook by implementing population genetic approaches, typical of the Modern Synthesis, into studies on individual and group behavior. The new symbolic evolutionary sciences build upon these traditions and include disciplines such as evolutionary psychology, evolutionary linguistics, evolutionary anthropology, evolutionary archaeology, evolutionary sociology, and evolutionary economics. Originally centered on implementing Darwinian selection theory, these fields are now including ecological and evolutionary developmental biology as well as reticulate evolutionary paradigms. As diverse in outlook and scope as they are, no discipline holds a privileged position over the other and all have made valuable contributions to our understanding of human symbolic evolution.
IMPACT OF RETINAL FLUID-FREE MONTHS ON OUTCOMES IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION
Authors: Eichenbaum David , Brown David M. , Ip Michael , Khanani Arshad M. , Figueroa Marta S. , McAllister Ian L. , Laude Augustinus , B Guruprasad , Tang Shuhan , Gmeiner Benjamin , Clemens Andreas , Souied Eric
Published: January 2023

Purpose:

To assess the effect of the total number of fluid-free months after loading on visual and anatomical outcomes in neovascular age-related macular degeneration patients receiving anti–vascular endothelial growth factor therapy.

Methods:

This post hoc analysis pooled patient-level data from the brolucizumab 6 mg (n = 718) and aflibercept 2 mg (n = 715) arms of the HAWK and HARRIER randomized clinical trials. Based on data from Weeks 12 to 96, patients were assigned to one of five categories based on fluid-free visits (FFVs; the total number of monthly visits at which they were observed to be without retinal fluid). Three definitions of “fluid-free” were explored based on the location of the fluid observed.

Results:

Patients allocated to Categories 4 (15–21 FFV) and 5 (22 FFV, always dry) consistently had the best visual and anatomical outcomes at Week 96, whereas patients allocated to Categories 1 (0 FFV, never dry) and 2 (1–7 FFV) consistently had the worst visual and anatomical outcomes. Variability in retinal thickness over time was lowest in Categories 4 and 5.

Conclusion:

Absence of retinal fluid at more visits after loading has a positive association with visual and anatomic outcomes in neovascular age-related macular degeneration patients, regardless of fluid type.
Can Mindfulness Buffer Against Negative Effects of Job Demands for Military and Police Personnel?
Authors: Krick Annika , Felfe Jörg , Klebe Laura
Published: January 2023

Objective

We examined buffering effects of mindfulness on the relationship between job demands and health (ie, strain, complaints, affect, general health) in high-risk professions with high levels of unavoidable stressors.

Methods

We analyzed cross-sectional and longitudinal data from military (n = 362) and police personnel (n = 359).

Results

Study 1 showed that mindfulness buffered the effect of job demands at time 1 on strain and negative affect at time 2. Study 2 showed that mindfulness mitigates the relationship between job demands and strain and health complaints. With higher mindfulness, negative effects of job demands were reduced. Additional analyses reveal which facets of mindfulness are mostly important.

Conclusions

Findings provide evidence for the buffering effects of mindfulness and showed that mindfulness buffers against job demands in work contexts with high levels of stress and risk and a male-oriented culture.
Double-edged roles of IFNγ in tumor elimination and immune escape
Authors: Chen Yueyue , Niu Ningning , Xue Jing
Published: January 2023

Interferon-gamma (IFNγ) is a pleiotropic cytokine implicated in tumor immune surveillance, with its antiproliferative, pro-apoptotic, and immune-provoking effects. Regarding the antitumor effects of IFNγ, IFNγ-dependent therapies have been proposed and have undergone many clinical trials for various cancer types but the outcomes were not satisfactory. Recent studies have suggested that cancer cells develop immune evasion strategies to escape from IFNγ-dependent immunosurveillance by various mechanisms. In this review, we summarize recent advances in the effects and molecular mechanisms of IFNγ on target cells, as well as potential immune escape mechanisms of tumor cells. Furthermore, we discuss how to target IFNγ signaling and overcome immune evasion to provide promising therapeutic strategies for the treatment of patients with cancer.
Prognostic parameters on baseline and interim [18F]FDG-PET/computed tomography in diffuse large B-cell lymphoma patients
Authors: Czibor Sándor , Carr Robert , Redondo Francisca , Auewarakul Chirayu U. , Cerci Juliano J. , Paez Diana , Fanti Stefano , Györke Tamás
Published: January 2023

Objective

2-[18F]fluoro-2-deoxy-d-glucose PET/computed tomography ([18F]FDG-PET/CT) is a widely used imaging method in the management of diffuse large B-cell lymphomas (DLBCL). Our aim was to investigate the prognostic performance of different PET biomarkers in a multicenter setting.

Methods

We investigated baseline volumetric values [metabolic tumor volume (MTV) and total lesion glycolysis (TLG), also normalized for body weight] segmented with three different methods [>SUV4 (glob4); 41% isocontour (41pc), and a gradient-based lesion growing algorithm (grad)] and interim parameters [Deauville score, maximal standardized uptake value (ΔSUVmax), modified qPET, and ratio PET (rPET)] alongside clinical parameters (stage, revised International Prognostic Index), using 24-month progression-free survival as the clinical endpoint. Receiver operating characteristics analyses were performed to define optimal cutoff points for the continuous PET parameters.

Results

A total of 107 diffuse large B-cell lymphoma patients were included (54 women; mean age: 53.7 years). MTV and TLG calculations showed good correlation among glob4, 41pc, and grad methods; however, optimal cutoff points were markedly different.

Significantly different PFS was observed between low- and high-risk groups according to baseline MTV, body weight-adjusted (bwa) MTV, TLG, bwaTLG, as well as interim parameters Deauville score, ΔSUVmax, mqPET, and rPET. Univariate Cox regression analyses showed hazard ratios (HRs) lowest for bwaMTVglob4 (HR = 2.3) and highest for rPET (HR = 9.09). In a multivariate Cox-regression model, rPET was shown to be an independent predictor of PFS (P = 0.041; HR = 9.15). Combined analysis showed that ΔSUVmax positive patients with high MTV formed a group with distinctly poor PFS (35.3%).

Conclusion

Baseline MTV and TLG values and optimal cutoff points achieved with different segmentation methods varied markedly and showed a limited prognostic impact. Interim PET/CT parameters provided more accurate prognostic information with semiquantitative ‘Deauville-like’ parameters performing best in the present study.
Fecal Elastase in Preterm Infants to Predict Growth Outcomes
Authors: Holzapfel Lindsay F. , Hair Amy B. , Preidis Geoffrey A. , Halder Tripti , Yang Heeju , Unger Jana P. , Freedman Steven , Martin Camilia R.
Published: January 2023

Objectives:

Preterm infants are born functionally pancreatic insufficient with decreased pancreatic production of lipase and proteases. Developmental pancreatic insufficiency (PI) may contribute to reduced nutrient absorption and growth failure. We sought to determine longitudinal fecal elastase (ELA1) levels in a cohort of preterm infants and whether levels are associated with growth outcomes.

Methods:

Prospective observational study of 30 infants 24–34 weeks gestational age and birth weight ≤1250 g fed the exclusive human milk diet, consisting of human milk with human milk-based fortifier. ELA1 was quantified by ELISA during the first 2 weeks of life [Early; 7.5 ± 1.8 days of life (DOL)] and after attainment of full, fortified feedings (Late; 63.6 ± 24.1 DOL).

Results:

Early ELA1 levels were 192.2 ± 96.4 µg/g, and Late ELA1 levels were 268.0 ± 80.3 µg/g, 39.4% higher (P = 0.01). Infants with early PI (ELA1 < 200 µg/g) were more likely male and of lower gestational age, weight, length, and head circumference at birth. These variables, but not PI status, independently predicted somatic growth.

Conclusions:

Fecal ELA1 in preterm infants fed exclusive human milk diet increases with postnatal age. Although pancreatic function in preterm infants may serve as a biological contributor to early postnatal growth failure, additional studies using fecal ELA1 as a predictive biomarker for growth failure are needed in larger cohorts.
Protocol Biopsies in Pediatric Liver Transplantation Recipients Improve Graft Histology and Personalize Immunosuppression
Authors: Karbaum Eva , Weidemann Sören , Grabhorn Enke , Fischer Lutz , Herden Uta , Oh Jun , Briem-Richter Andrea , Krebs-Schmitt Dorothee
Published: January 2023

Objectives:

Protocol liver biopsies (PLBs) are part of the follow-up program at many pediatric liver transplant centers, but the impact on clinical decision-making and allograft histology following adjustments of immunosuppression (IS) after PLB has not been thoroughly analyzed.

Methods:

Following our previous single-center cohort study, we have now evaluated histological findings of 178 PLBs of 118 pediatric patients transplanted at our center between 1998 and 2017. In particular, we focused on the changes in allograft histology in the follow-up biopsy of a subgroup of 22 patients, in which the histologic findings led to an adjustment of immunosuppressive therapy. All biopsies of this sub-study group were reevaluated by an experienced pathologist.

Results:

The overall frequency and severity of fibrosis increased over time after orthotopic liver transplantation. Patients with donor-specific antibodies (DSAs) had a higher prevalence of fibrosis than DSA-negative patients. Graft inflammation decreased significantly after intensifying IS, but renal function needs to be monitored. A significant increase in fibrosis was detected in children with reduced IS.

Conclusion:

The adjustment of IS following PLBs has a significant impact on allograft histology. Since chronic inflammatory changes may lead to graft failure, adjustment of IS seems to be of major importance for the long-term outcome.
Pediatric Neurogastroenterology and Motility: Moving Rapidly Into the Future
Authors: Chanpong Atchariya , Thapar Nikhil
Published: January 2023

The field of pediatric neurogastroenterology and motility encompasses some of the most common and severe gastrointestinal (GI) disorders that affect children. GI motility disorders remain, in general, poorly understood, variably diagnosed, and inadequately treated. Although the field progressed relatively slowly over the last decades, the coming years will, no doubt, see it move into a prolific and dynamic era. With this review, we look forward to this brighter future for the field and highlight emerging areas that show promise and deserve focus in the coming years. This includes the role of early life programming and insult of the enteric neuromusculature as a key determinant of motility diseases and factors that are likely to be relevant in disease etiopathogenesis. We discuss several recent and futuristic developments and advancements in investigative and diagnostic tools as well as novel approaches that have been introduced in the management of GI motility disorders. These include targeted and personalized medicine in both pharmacological and multidisciplinary approaches as well as the emerging therapeutic options such as bioelectrical neuromodulation and regenerative medicine.
Severe Recurrent Nocturnal Hypoglycemia During Chemotherapy With 6-mercaptopurine in 2 Children With Acute Lymphoblastic Leukemia
Authors: Albiroty Khalil , Al Sabahi Amal
Published: January 2023

Mercaptopurine (6MP) and methotrexate are the cornerstones of maintenance therapy in pediatric patients with acute lymphoblastic leukemia. However, although bone marrow suppression and liver dysfunction are common side effects of these antimetabolites, 6MP-induced hypoglycemia during the maintenance phase is rare. Guidelines and international protocols are well established for the management of bone marrow suppression and liver dysfunction, but promptly identifying 6MP-induced hypoglycemia is the key to its control. Here we report 2 cases of leukemia that developed hypoglycemia during the maintenance phase. Both patients were boys younger than 6 years of age and both suffered symptomatic morning hypoglycemia induced by 6MP (which was diagnosed after excluding all other possible causes). Successful management included changing the time of 6MP administration from evening to morning. Other management options are also discussed.
The Development and Early Experience of a Destination Center of Excellence Program for Total Joint Arthroplasty
Authors: Pelkowski Jessica N. , Wilke Benjamin K. , Glabach Michelle R. , Bowman Jacki C. , Ortiguera Cedric J. , Blasser Kurt E. , Crowe Matthew M. , Sherman Courtney E. , Ledford Cameron K.
Published: January 2023

High-volume total joint arthroplasty centers are becoming designated as destination centers of excellence to ensure quality of care while containing costs. This study aimed to evaluate the surgical patient journey through a new destination center of excellence program, review acute perioperative course trajectories, and report clinical outcomes. Our institution developed and implemented a destination center of excellence program to integrate into the existing total joint arthroplasty practice. A retrospective record review and analysis were performed for the first 100 destination center of excellence total knee arthroplasties and total hip arthroplasties enrolled in the program to evaluate program efficacy at a minimum 1-year follow-up. The study initially screened 213 patients, of whom 100 (47%) met program criteria and completed surgery (67 total knee arthroplasties and 33 total hip arthroplasties). The complication rate was 2%, and five patients (7.5%) required manipulation under anesthesia for stiffness after total knee arthroplasty. Two reoperations were needed: a neurectomy after total knee arthroplasty and a revision after total hip arthroplasty. The early experience of a destination center of excellence program has been favorable, with low complication rates and excellent outcomes.
The Effect of a Multidimensional Home Rehabilitation Program for Post-Total Knee Arthroplasty Elderly Patients
Authors: Park Soo Ah , Jeong Younhee
Published: January 2023

Patients with total knee arthroplasty (TKA) experience pain, decreased muscle strength, and decreased knee function, resulting in increases in depression and decreased subjective well-being. A multidimensional home program may prevent these adverse events.

The aim of this study was to test the effect of a home rehabilitation program that included education, exercise, aroma massage, and phone counseling for post-TKA patients.

We used a randomized control group pretest/posttest design. Fifty-nine patients participated, with 29 in the experimental group and 30 in the control group. Pain, knee joint range of motion (ROM), quadriceps strength, depression, and subjective well-being were measured as outcome variables. Data were analyzed using repeated-measures analysis of variance and generalized estimating equations.

The experimental group showed significant improvement in knee pain, active ROM, muscle strength, depression, and subjective well-being with no significant between-groups difference in passive ROM.

The multidimensional home rehabilitation program can be an effective nursing intervention for physical and emotional recovery of patients with TKA.
Do Anisometropic Eyes Have Steeper Retinas Than Their Isometropic Counterparts?
Authors: Manoharan Manoj K. , Atchison David A. , Verkicharla Pavan K.
Published: January 2023

SIGNIFICANCE

Our findings suggest that retinal shapes of the eyes of anisometropes are not different from that of the eyes of isometropes with the same refractions.

PURPOSE

We investigated (a) intereye differences in relative peripheral eye lengths between isometropes and anisometropes and (b) if the retinal shape is different between isometropic and anisometropic eyes with the same central refraction.

METHODS

Central and peripheral eye lengths were determined along the horizontal meridian in 10° intervals out to ±30° using a noncontact biometer in 28 isometropes and 16 anisometropes. Retinal coordinates were estimated using these eye lengths and ray tracing. Retinal shape was determined in terms of vertex radius of curvature (R
v), asphericity (Q), and equivalent radius of curvature (R
Eq). Linear regression was determined for the R
Eq as functions of central refraction in a subset of isometropic and anisometropic eyes having the same refraction.

RESULTS

The differences in relative peripheral eye lengths between the two eyes of anisometropes were significantly greater than for isometropes at ±30° eccentricities. Higher myopic eyes of anisometropes had smaller R
v, more negative Q, and smaller R
Eq than the lower myopic eyes for both isometropes and anisometropes (mean ± standard error of the mean: R
v, 9.8 ± 0.5 vs. 11.7 ± 0.4 mm [P = .002]; Q, −1.1 ± 0.2 vs. −0.5 ± 0.2 [P = .03]; R
Eq, 11.5 ± 0.3 vs. 12.4 ± 0.2 mm [P = .01]). Intercepts and slopes of the linear regressions of R
Eq in anisometropes and their isometropic counterparts with the same refraction were not significantly different from each other (P > .05).

CONCLUSIONS

Higher myopic eyes of anisometropes had similar retina shapes along the horizontal meridian to those of isometropic eyes with the same refraction.
Fighting Myopia with Intermittent Nearwork Breaks: 20 Seconds Every 20 Minutes Might Not Be Enough Time
Authors: Pucker Andrew D. , Gawne Timothy J.
Published: January 2023

SIGNIFICANCE

Practitioners commonly prescribe the 20/20/20 rule with hopes that, if patients follow it, they will reduce their myopic progression. This clinical perspective provides evidence that 20-second break from nearwork every 20 minutes are not enough time to impact ocular growth.

The ongoing myopia epidemic is a major public health crisis. Although the correlation between nearwork tasks such as reading, computers, and smartphones and myopia development is controversial, multiple lines of research suggest that sustained nearwork contributes to myopia development. Clinicians have proposed that children should take short breaks from nearwork with a 20-second break every 20 minutes being a common suggestion. Animal model data do strongly support the idea that multiple short breaks across time can cancel out the effects of longer periods of myopia-promoting activities. However, the animal model data also suggest that repeated episodes of 20 seconds are ineffective at reducing myopia development and instead indicate that sustained breaks of 5 minutes or more every hour are needed to negate myopiagenic effects.
Satisfaction of individuals with partial-hand amputations after they were fitted with cosmetic silicone prostheses
Authors: Atallah Huthaifa , Qureshi Ahmad Zaheer , Msechu Zidikheri
Published: January 2023

Background:

Partial-hand amputations are the most common level of upper-limb amputations which can lead to cosmetic and functional problems. Partial-hand amputations can be acquired or congenital. Cosmetic silicone prostheses are used in the management of partial-hand amputation; however, a literature review shows that most of the studies are on the fabrication of prosthesis, and data remain deficient on the satisfaction of users with silicone prostheses.

Objectives:

To assess the satisfaction of individuals after they were fitted with cosmetic silicone prostheses for partial-hand amputations.

Study design:

Cross-sectional study.

Methods:

Fifty-four participants with partial-hand amputations and who received cosmetic silicone prostheses participated in the survey using the validated Arabic version of the Client Satisfaction with Device (CSD-Ar).

Results:

Nearly half of the participants were using their silicone prosthesis daily. Most of the patients reported satisfaction with durability and donning, whereas most of the patients were dissatisfied with comfort. The mean of CSD-Ar total score was 16.8 ± 4.7 of 32. The CSD-Ar total score was significantly associated with the side of amputation (p-value = 0.014) and usage of prosthesis (p-value < 0.001).

Conclusion:

The satisfaction of individuals with partial-hand amputations can be enhanced by fitting them with cosmetic silicone prostheses. However, these prostheses should meet certain criteria including fitting, weight, comfort, donning, appearance, durability, skin abrasion and irritation, and pain. Individuals' expectations and concerns should be considered as well.
Recycling Tenofovir in Second-line Antiretroviral Treatment With Dolutegravir: Outcomes and Viral Load Trajectories to 72 weeks
Authors: Keene Claire M. , Cassidy Tali , Zhao Ying , Griesel Rulan , Jackson Amanda , Sayed Kaneez , Omar Zaayid , Hill Andrew , Ngwenya Olina , Van Zyl Gert , Flowers Tracy , Goemaere Eric , Maartens Gary , Meintjes Graeme
Published: January 2023

Background:

Recycling tenofovir and lamivudine/emtricitabine with dolutegravir (TLD) after failure of non-nucleoside transcriptase inhibitor first-line antiretroviral therapy is more tolerable and scalable than dolutegravir plus optimized nucleoside reverse transcriptase inhibitors. Studies have demonstrated TLD's efficacy as second line, but long-term follow-up is limited.

Methods:

ARTIST is a single arm, prospective, interventional study conducted in Khayelitsha, South Africa, which switched 62 adults with 2 viral loads >1000 copies/mL from tenofovir, lamivudine/emtricitabine, and an non-nucleoside transcriptase inhibitor to TLD. We report efficacy to 72 weeks and, in a post hoc analysis, evaluated viral load trajectories of individuals with viremic episodes.

Results:

Virologic suppression was 86% [95% confidence interval (CI) 74 to 93], 74% (95% CI: 61 to 84), and 75% (95% CI: 63 to 86) <50 copies/mL and 95%, 84%, and 77% <400 copies/mL at week 24, 48, and 72, respectively, with 89% (50/56) resistant (Stanford score ≥15) to tenofovir and/or lamivudine preswitch. No participants developed integrase-inhibitor resistance. Of the 20 participants not suppressed at week 24 and/or 48, 2 developed virologic failure, 1 switched regimen (adverse event), 2 were lost to follow-up, 1 missed the visit, 1 transferred out, 9 resuppressed <50 copies/mL with enhanced adherence counseling, and 4 remained viremic (3 with <200 copies/mL) at week 72.

Conclusions:

Recycling NRTIs with dolutegravir was effective for most participants to 72 weeks. Most with viremia did not develop virologic failure and subsequently suppressed with enhanced adherence counseling or continued to have low-level viremia. No integrase-inhibitor resistance was detected despite low-level viremia in a minority of participants.