bluuebunny/crossref_metadata_2025 huggingface dataset:
Occupational therapy, cancer, and occupation‐centred practice: impact of training in the model of human occupation
Authors: Bowyer Patricia , Muñoz Lauro , Tiongco Cynthia Gorter , Tkach Melanie Morriss , Moore Cary C. , Burton Brittney , Lim Daisy
Published: August 2020

Introduction

This study examined the influence of training in an occupation‐centred model on the practice of occupational therapists working in a cancer hospital. There is an increased need for occupation‐based rehabilitation services for individuals with and surviving cancer. Incorporating an occupation‐centred model into practice has unique challenges for occupational therapists working in oncology settings. Utilizing an occupation‐centred model of practice may influence the therapeutic reasoning of occupational therapists.

Methods

A generic qualitative inquiry (Patton, 2015) was used to examine therapeutic reasoning as related to post‐professional training in a specific occupation‐centred model, the Model of Human Occupation (MOHO). Initially, ten occupational therapists with various levels of experience, working across populations in a large cancer centre completed a training session about the MOHO. This was followed by participation in monthly focus groups with an emphasis on the use of MOHO in daily practice (Taylor, 2017). Focus group sessions were video recorded and transcribed. The transcripts were then analysed using open coding and theme generation (Patton, 2015).

Results

Three major themes were extracted from the data during the thematic analysis: understanding and using MOHO language; challenges in incorporating a conceptual model of occupation‐centred practice in an oncology setting; and therapeutic reasoning implications. Patterns in the themes indicated a progression from learning the model, to applying the model, to reflection on practice.

Conclusion

Post‐professional training in an occupation‐based model influenced the therapeutic reasoning and practice of occupational therapists in an oncology setting.
Control of pathogenic and spoilage bacteria in meat and meat products by high pressure: Challenges and future perspectives
Authors: Li Hui , Sun Xiaohong , Liao Xiaojun , Gänzle Michael
Published: August 2020

High‐pressure processing is among the most widely used nonthermal intervention to reduce pathogenic and spoilage bacteria in meat and meat products. However, resistance of pathogenic bacteria strains in meats at the current maximum commercial equipment of 600 MPa questions the ability of inactivation by its application in meats. Pathogens including Escherichia coli, Listeria, and Salmonelle, and spoilage microbiota including lactic acid bacteria dominate in raw meat, ready‐to‐eat, and packaged meat products. Improved understanding on the mechanisms of the pressure resistance is needed for optimizing the conditions of pressure treatment to effectively decontaminate harmful bacteria. Effective control of the pressure‐resistant pathogens and spoilage organisms in meats can be realized by the combination of high pressure with application of mild temperature and/or other hurdles including antimicrobial agents and/or competitive microbiota. This review summarized applications, mechanisms, and challenges of high pressure on meats from the perspective of microbiology, which are important for improving the understanding and optimizing the conditions of pressure treatment in the future.
Where have our patients gone? The impact of COVID‐19 on stroke imaging and intervention at an Australian stroke center
Authors: Amukotuwa Shalini A , Bammer Roland , Maingard Julian
Published: August 2020

Introduction

Australia has fortunately had a low prevalence coronavirus disease 2019 (COVID‐19), and our healthcare system has not been overwhelmed. We aimed to determine whether, despite this, a decline in acute stroke presentations, imaging and intervention occurred during the pandemic at a busy stroke centre.

Methods

The number of ‘code stroke’ activations, multimodal CTs and endovascular clot retrievals (ECRs) performed during the pandemic period (3/1/2020–5/10/2020) at a large comprehensive stroke centre was compared against the pre‐pandemic period (3/1/2019–1/31/2019) using Z‐statistics. Year‐on‐year comparison of the number of patients with large vessel occlusions (LVOs) and ECRs performed per month was also made.

Results

The number of ‘code stroke’ activations and patients undergoing multimodal CT per month decreased significantly (P < 0.0025) following lockdown on 29th March. The number of ECRs also decreased (P = 0.165). The nadir in the weekly number of CTs coincided with lockdown and the peak of new COVID‐19 cases. The number of patients with LVOs and ECRs increased by 15% and 14%, respectively, in March but decreased by 55% and 48%, respectively, in April.

Conclusions

The significant decrease in volume of ‘code stroke’ activations and acute stroke imaging following lockdown was accompanied by a concomitant decrease in patients with LVOs and ECRs. The decrease in imaging was therefore not driven purely by patients with mild strokes and stroke mimics, but also included those with severe strokes. Since Australia had a low prevalence of COVID‐19, this observed decrease cannot be attributed to hospital congestion and is instead likely driven by patient fear.
Law, Language, and a Nonsovereign Caribbean
Authors: Cabatingan Lee
Published: August 2020

This article argues that the Caribbean Court of Justice (CCJ), a tribunal serving twelve independent primarily Anglophone Caribbean states, uses a variety of linguistic techniques in its pursuit of a regional future. Created upon a complicated (post)colonial landscape and charged with resolving the nonsovereignty of its member states, which, for the most part, continue to utilize the United Kingdom's Privy Council for their final court of appeal, the CCJ does not view sovereignty as a solution. Instead, as I demonstrate through several examples of the Court's use of, talk about, and abstention from language, the CCJ's judges and employees seek to constitute a yet‐to‐be‐fully‐defined nonsovereign region that carves out a Caribbean people, pointedly rejects ongoing British legacies and logics, refuses to adopt the legal practices associated with sovereignty, and strives to remain untethered to either nation‐state or suprastate. [law, language, sovereignty, region, Caribbean]
Full‐field electroretinography in age‐related macular degeneration: an overall retinal response
Authors: Forshaw Thomas Richard Johansen , Kjær Troels Wesenberg , Andréasson Sten , Sørensen Torben Lykke
Published: August 2020

Purpose

Age‐related macular degeneration (AMD) is generally considered a disease of the macula. However, recent studies show peripheral retinal lesions are prevalent in patients with AMD, indicative of a disease process that is more widespread. Full‐field electroretinography (ffERG) measures an electrical response, not only from the macula, but from the entire retina. We wanted to study the ffERG response in eyes with AMD.

Methods

We performed full‐field electroretinography (RETI‐port/scan 21, Roland, Berlin) in 13 patients with early AMD, 25 patients with late AMD and 24 individuals without vitreoretinal disease as a control group. Dawson–Trick–Litzkow fibre electrodes were used. Statistical analysis was performed and a p‐value <0.05 was considered significant.

Results

After adjusting for multiple comparisons, both the light‐adapted 3.0 a‐wave implicit time (p < 0.001) and 30‐Hertz flicker peak time (p = 0.012) showed significant difference between patients with late AMD and individuals without vitreoretinal disease. There was a significant difference in the light‐adapted 3.0 a‐wave implicit time (p = 0.011) between patients with early AMD and the control group, but the difference in 30 Hz flicker peak time was not significant (p = 0.256).

Conclusion

The difference in cone function measured by light‐adapted 3.0 a‐wave implicit time and 30‐Hertz flicker peak time in early and late AMD when compared to healthy controls suggests a more diminished overall response when AMD has reached later stages.
Use of a physiologically based pharmacokinetic–pharmacodynamic model for initial dose prediction and escalation during a paediatric clinical trial
Authors: Johnson Trevor N. , Abduljalil Khaled , Nicolas Jean‐Marie , Muglia Pierandrea , Chanteux Hugues , Nicolai Johan , Gillent Eric , Cornet Miranda , Sciberras David
Published: August 2020

Aims

To build and verify a physiologically based pharmacokinetic (PBPK) model for radiprodil in adults and link this to a pharmacodynamic (PD) receptor occupancy (RO) model derived from in vitro data. Adapt this model to the paediatric population and predict starting and escalating doses in infants based on RO. Use the model to guide individualized dosing in a clinical trial in 2‐ to 14‐month‐old children with infantile spasms.

Methods

A PBPK model for radiprodil was developed to investigate the systemic exposure of the drug after oral administration in fasted and fed adults; this was then linked to RO via a PD model. The model was then expanded to include developmental physiology and ontogeny to predict escalating doses in infants that would result in a specific RO of 20, 40 and 60% based on average unbound concentration following a twice daily (b.i.d.) dosing regimen. Dose progression in the clinical trial was based on observed concentration–time data against PBPK predictions.

Results

For paediatric predictions, the elimination of radiprodil, based on experimental evidence, had no ontogeny. Predicted b.i.d. doses ranged from 0.04 mg/kg for 20% RO, 0.1 mg/kg for 40% RO to 0.21 mg/kg for 60% RO. For all infants recruited in the study, observed concentration–time data following the 0.04 mg/kg and subsequent doses were within the PBPK model predicted 5th and 95th percentiles.

Conclusion

To our knowledge, this is the first time a PBPK model linked to RO has been used to guide dose selection and escalation in the live phase of a paediatric clinical trial.
Surgical treatment of peri‐implantitis defects with two different xenograft granules: A randomized clinical pilot study
Authors: Polymeri Angeliki , Anssari‐Moin David , van der Horst Joyce , Wismeijer Daniel , Laine Marja L. , Loos Bruno G.
Published: August 2020

Objectives

To investigate whether xenograft EB (EndoBon) is non‐inferior to xenograft BO (Bio‐Oss) when used in reconstructive surgery of peri‐implant osseous defects.

Materials and methods

Dental patients with one implant each demonstrating peri‐implantitis were randomized to receive surgical debridement and defect fill with either BO or EB. Changes in bone level (BL) and intrabony defect depth (IDD) evaluated radiographically were the primary outcomes. The secondary outcomes included changes in probing pocket depth (PPD), bleeding on probing (BoP), and suppuration on probing (SoP). All outcomes were recorded before treatment and at 6 and 12 months post‐treatment.

Results

Twenty‐four patients (n = 11 BO,n = 13 EB) completed the study. Both groups demonstrated significant within‐group improvements in all clinical and radiographic parameters at 6 and 12 months (p ≤ .001). At 12 months, both groups presented with IDD reductions of 2.5–3.0 mm on average. The inter‐group differences were not statistically significant at all time points and for all the examined parameters (p > .05). While the radiographic defect fill in both groups exceeded > 1 mm and can be considered treatment success, successful treatment outcomes as defined by Consensus Reporting (no further bone loss, PPD ≤ 5 mm, no BOP, and no SoP) were identified in 2/11 (18%) BO and 0/13 (0%) EB individuals (Fisher's exact test,p = .199).

Conclusions

Within the limitations of this pilot study, the application of xenograft EB showed to be non‐inferior to xenograft BO when used in reconstructive surgery of peri‐implant osseous defects.
A Dynamic Quantitative Systems Pharmacology Model of Inflammatory Bowel Disease: Part 2 – Application to Current Therapies in Crohn’s Disease
Authors: Rogers Katharine V. , Martin Steven W. , Bhattacharya Indranil , Singh Ravi Shankar Prasad , Nayak Satyaprakash
Published: August 2020

Inflammatory bowel disease (IBD) is a heterogeneic disease with a variety of treatments targeting different mechanisms. A multistate, mechanistic, mathematical model of IBD was developed in part 1 of this two‐part article series. In this paper, application of the model to predict response of key clinical biomarkers following different treatment options for Crohn’s disease was explored. Five therapies, representing four different mechanisms of action, were simulated in the model and longitudinal profiles of key clinical markers, C‐reactive protein and fecal calprotectin were compared with clinical observations. Model simulations provided an accurate match with both central tendency and variability observed in biomarker profiles. We also applied the model to predict biomarker and clinical response in an experimental, combination therapy of existing therapeutic options and provide possible mechanistic basis for the increased response. Overall, we present a validated, modular, mechanistic model construct, which can be applied to explore key biomarkers and clinical outcomes in IBD.
Berufsbedingte Allergie gegen Phytase: Fallserie von acht Produktionsmitarbeitern, die Futtermittelzusatzstoffen ausgesetzt waren
Authors: Kuske Marvin , Berndt Katja , Spornraft‐Ragaller Petra , Neumeister Volker , Raulf Monika , Sander Ingrid , Koschel Dirk , Bickhardt Jakob , Beissert Stefan , Bauer Andrea
Published: August 2020

Hintergrund

In der landwirtschaftlichen Fleischproduktion ist der Zusatz von Enzymen wie Phytase zu Tierfutter weit verbreitet, aber es gibt nur wenig Bewusstsein über das allergene Potenzial und die Gesundheitsrisiken dieser Pilzenzyme.

Patienten und Methoden

Wir berichten über acht Patienten, die in einem Betrieb arbeiten, der Phytase‐Granulat herstellt. Alle Patienten litten an einer berufsbedingten Rhinitis, die sechs Monate nach Beginn der Exposition gegenüber Phytase‐Staub auftrat. Asthmatische Symptome und Kontakturtikaria traten ebenfalls auf. Anhand von Prick‐, Epikutan‐ und Basophilenaktivierungstests, die mit dem Fabrikprodukt durchgeführt wurden, konnten wir eine Sensibilisierung gegen Phytase nachweisen. Außerdem wurden die IgE‐ und IgG‐Antikörper gegen Phytase bestimmt.

Ergebnisse

Sieben der acht Patienten zeigten im Pricktest eine positive Reaktion auf Phytase. Bei vier der acht Patienten wurde Phytase‐spezifisches IgE und bei sechs der acht Patienten Phytase‐spezifisches IgG nachgewiesen. Während der Basophilenaktivierungstest bei vier von sieben Patienten positiv ausfiel, war der Epikutantest bei allen getesteten Patienten negativ. Die Versetzung an einen anderen Arbeitsplatz ohne Exposition gegenüber Phytase führte zur vollständigen Rückbildung der Symptome.

Schlussfolgerungen

Enzyme von Schimmelpilzen wie Phytase sind hochwirksame Berufsallergene. Zum Gesundheitsschutz der Beschäftigten ist die konsequente Umsetzung von Arbeitsschutzmaßnahmen essentiell.
Unraveling biogeochemical phosphorus dynamics in hyperarid Mars‐analogue soils using stable oxygen isotopes in phosphate
Authors: Shen Jianxun , Smith Andrew C. , Claire Mark W. , Zerkle Aubrey L.
Published: August 2020

With annual precipitation less than 20 mm and extreme UV intensity, the Atacama Desert in northern Chile has long been utilized as an analogue for recent Mars. In these hyperarid environments, water and biomass are extremely limited, and thus, it becomes difficult to generate a full picture of biogeochemical phosphate‐water dynamics. To address this problem, we sampled soils from five Atacama study sites and conducted three main analyses—stable oxygen isotopes in phosphate, enzyme pathway predictions, and cell culture experiments. We found that high sedimentation rates decrease the relative size of the organic phosphorus pool, which appears to hinder extremophiles. Phosphoenzyme and pathway prediction analyses imply that inorganic pyrophosphatase is the most likely catalytic agent to cycle P in these environments, and this process will rapidly overtake other P utilization strategies. In these soils, the biogenic δ18O signatures of the soil phosphate (δ18OPO4) can slowly overprint lithogenic δ18OPO4values over a timescale of tens to hundreds of millions of years when annual precipitation is more than 10 mm. The δ18OPO4of calcium‐bound phosphate minerals seems to preserve the δ18O signature of the water used for biogeochemical P cycling, pointing toward sporadic rainfall and gypsum hydration water as key moisture sources. Where precipitation is less than 2 mm, biological cycling is restricted and bedrock δ18OPO4values are preserved. This study demonstrates the utility of δ18OPO4values as indicative of biogeochemical cycling and hydrodynamics in an extremely dry Mars‐analogue environment.
Do collective bargaining institutions crowd out discussion and implementation of firm‐related training programs? Evidence from Japan
Authors: Kambayashi Ryo , Kato Takao
Published: August 2020

The paper empirically examines labor‐management communication concerning in‐house training programs and its relation to the actual on‐ and off‐the‐job training policy and wage structure. Using governmental datasets from Japan, we study how different labor‐management communication institutions may affect the training interests of employers and employees differently. We classify these institutions in terms of whether they have a legal (i.e. statutory) foundation (‘de jure’) or not (‘de facto’). We find that collective bargaining, with legal grounds, may crowd out employees’ willingness to communicate about training. However, the existence of ‘de facto’ communication channels such as joint labor‐management councils or shop floor committees is positively correlated with both on‐ and off‐the‐job of training. At the same time, the existence of unions is positively correlated with the steepness of wage profiles for mid‐career workers, which is consistent with the fact that employers and employees assume a long‐term relationship. Thus, we show that a multi‐tiered structure of labor‐management communication, together with a long‐term orientation toward the employment relationship, contributes to strengthen employees’ voice in training matters.
One‐surgeon basketing technique for stone extraction during flexible ureteroscopy for urolithiasis: A comparison between novice and expert surgeons
Authors: Anan Go , Komatsu Kenji , Hatakeyama Shingo , Iwamura Hiromichi , Kohada Yuki , Mikami Jotaro , Ito Jun , Kaiho Yasuhiro , Shimbo Masaki , Endo Fumiyasu , Yoneyama Takahiro , Hashimoto Yasuhiro , Ohyama Chikara , Hattori Kazunori , Sato Makoto
Published: August 2020

Objective

To determine the safety and efficacy of the one‐surgeon basketing technique for stone extraction during flexible ureteroscopy when carried out by novice surgeons under instructor guidance.

Methods

We retrospectively compared perioperative results, complications and the “stone‐free” rate (defined as ≤2 mm fragments on kidney–ureter–bladder imaging 1 month after flexible ureteroscopy) between experienced (group A, n = 50) and novice (group B, n = 50) surgeons using the one‐surgeon basketing technique.

Results

Baseline patients’ characteristics were similar between the two groups. There were no significant differences between groups A and B in operative time (mean 76 min vs 85 min, P = 0.46), stone‐free rate (98% vs 92%, P = 0.36), postoperative fever events (4% vs 4%, P = 1.00) and postoperative hospital stay (24 h vs 24 h, P = 1.00). Clavien–Dindo grade IIIa complications (ureter injury) were only observed in two cases (4%) in group B.

Conclusions

The one‐surgeon basketing technique for the extraction of stone fragments during flexible ureteroscopy might be safely and effectively carried out by surgeons with no prior experience under proper guidance.
A multistage combined approach to promote diabetic wound healing in COVID‐19 era
Authors: Grande Raffaele , Fiori Giulia , Russo Giulia , Fioramonti Paolo , Campagnol Monica , di Marzo Luca
Published: August 2020

When diabetes mellitus is not properly controlled with drugs and a healthy lifestyle, it exposes patients with advanced peripheral arterial disease or critical limb ischaemia (CLI) to the most serious complications, in particular lower limb ulcers. Surgical or endovascular treatments represent the first line of intervention; in addition, the adequate management of ulcers can guarantee not only a faster wound healing but also the improvement of the patient's prognosis. To speed up this process, negative pressure wound therapy (NPWT), platelet‐rich plasma (PRP), and other advanced moist wound dressing have been proposed. During Coronavirus disease 2019 (COVID‐19) pandemic, many patients with CLI and diabetes mellitus had difficult access to advanced treatments with a significant reduction in life expectancy. We report the cases of patients with non‐healing ulcers and CLI treated with an empiric multistage approach after successful endovascular revascularisation; the postoperative course was eventful in all patients, and foot ulcers are currently in an advanced state of healing. The association between adequate revascularisation, systemic anti‐inflammatory, and antibiotic therapy with the multistage advanced medications ensures healing of ulcers, limb salvage, and improvement of patient prognosis.
Nursing staff participation in end‐of‐life nutrition and hydration decision‐making in a nursing home: A qualitative study
Authors: Firnhaber Gina C. , Roberson Donna W. , Kolasa Kathryn M.
Published: August 2020

Aim

To better understand the participation of nursing staff in end‐of‐life nutrition and hydration decision‐making in an American nursing home.

Design

A qualitative exploration with ethnographic focus.

Methods

In April 2017, in‐person, semi‐structured interviews were performed with 19 nursing staff members in a nursing home located in the south‐eastern United States. Additional information was gathered through participant observation during interviews and review of organizational and regulatory policies. Transcripts were coded and analysed using qualitative methods described by Roper and Shapira (2000).

Results

Three primary themes relating to nursing staff participation in end‐of‐life nutrition and hydration decision‐making were identified: (a) Formal decision‐making: decisions made and implemented by persons with the authority to make legal and binding care decisions in the nursing home setting; (b) Informal decision‐making: decisions not requiring medical orders; and (c) Influential factors: factors that influence actions of nursing staff.

Conclusion

A variety of factors have an impact on nursing staff participation in end‐of‐life nutrition and hydration decision‐making. Participation is closely aligned with the type of decision, whether formal or informal, and role, whether Certified Nursing Assistant/Aide, Licensed Practical/Vocational Nurse, or Registered Nurse.

Impact

End‐of‐life nutrition and hydration decision‐making in nursing homes differs from decision‐making in other care settings and presents a challenge globally. Interventions that support the participation of nursing staff in end‐of‐life nutrition and hydration decision‐making have the potential to positively impact the experiences of residents and family members faced with these issues in the nursing home setting.
Refining interprofessional, outpatient transitions of care services to reduce hospital readmissions
Authors: Smith Jennifer N. , Zupec Jason , LaMar Sarah , Pontiggia Laura , Rhodes Corinne
Published: August 2020

Rationale, aims and objectives

Transitions of care between healthcare facilities are associated with increased risk of adverse events and hospital readmissions. Previous studies employing pharmacists in transitions of care showed reduced 30‐day readmissions, however, many were without an active comparator. There is no standardized approach to pharmacist involvement in transitions of care services, making it difficult to ascertain where pharmacist expertise is most meaningful. This paper aims to compare the 30‐day hospital readmissions between an interprofessional hospital discharge visit (iHDV) with physician and pharmacist involvement to a non‐interprofessional HDV (PHDV) without pharmacist involvement.

Method

This was a retrospective quality improvement initiative examining patients of two outpatient clinical practices within a large, academic medical centre. The primary analysis compared 30‐day hospital readmission rates for patients with a scheduled PHDV or iHDV within 30‐days of index hospital discharge date, regardless of attendance at the HDV. The secondary outcome compared 30‐day hospital readmission rates for patients who completed a PHDV or iHDV. Primary and secondary outcomes were evaluated using bivariate analysis and multivariate analysis by stepwise logistic regression, for both intention‐to‐treat (ITT) and per protocol (PP).

Results

This study found significantly lower 30‐day hospital readmissions for patients scheduled for a PHDV compared to an iHDV (16.7% vs 21.5%, P = .0230) in an unadjusted analysis, but no significant difference in adjusted analyses (P = .4856). Per‐protocol analysis found no significant difference in 30‐day hospital readmission rates between groups in unadjusted and adjusted analyses. Visit completion rates were significantly different between groups, with approximately twice as many PHDV group patients completing visits as compared to the iHDV group (74.1% vs 61.5%, P < .0001).

Conclusion

This study demonstrates an interprofessional clinic visit employing a clinical pharmacist in the post‐hospital discharge visit did not significantly reduce 30‐day hospital readmission rates compared to a post‐hospital discharge visit without pharmacist involvement.
A systematic assessment on COVID‐19 preparedness and transition strategy in Bangladesh
Authors: Biswas Raaj Kishore , Huq Samin , Afiaz Awan , Khan Hafiz T. A.
Published: August 2020

Rationale, aims, and objectives

The COVID‐19 pandemic of 2020 has overpowered the most advanced health systems worldwide with thousands of daily deaths. The current study conducted a situation analysis on the pandemic preparedness of Bangladesh and provided recommendations on the transition to the new reality and gradual restoration of normalcy.

Method

A complex adaptive system (CAS) framework was theorized based on four structural dimensions obtained from the crisis and complexity theory to help evaluate the health system of Bangladesh. Data sourced from published reports from the government, non‐governmental organizations, and mainstream media up to June 15, 2020 were used to conduct a qualitative analysis and visualize the spatial distribution of countrywide COVID‐19 cases.

Results

The findings suggested that Bangladesh severely lacked the preparedness to tackle the spread of COVID‐19 with both short‐ and long‐term implications for health, the economy, and good governance. Absence of planning and coordination, disproportionate resource allocations, challenged infrastructure, adherence to bureaucratic delay, lack of synchronized risk communication, failing leadership of concerned authorities, and incoherent decision‐making have led to a precarious situation that will have dire ramifications causing many uncertainties in the coming days.

Conclusions

Implementation of response protocols addressing the needs of the community and the stakeholders from the central level is urgently needed. The development of mechanisms for dynamic decision‐making based on regular feedback and long‐term planning for a smooth transition between the new reality and normalcy should also be urgently addressed in Bangladesh.
The use of extensively hydrolysed and amino acid feeds beyond cow’s milk allergy: a national survey
Authors: Meyer R. , Smith C. , Sealy L. , Mancell S. , Marino L. V.
Published: August 2020

Background

Extensively hydrolysed formulas (EHFs) and amino acid formulas (AAFs) with proven hypoallergenicity are used for children suffering from cow’s milk allergy, when breast milk is not available. However, these feeds are often used in other medical conditions where tolerance and absorption of whole protein is affected, frequently without assessment of efficacy. This practice survey assessed the use of these feeds in paediatric conditions other than cow’s milk allergy; aiming to describe the population, growth parameters and micronutrient status.

Methods

Four National Health Service tertiary paediatric centres participated in this practice survey. Inclusion: children between 0 and 18 years, consuming >25% of their estimated energy requirements of an EHF/AAF for any condition other than allergic disease. Anonymised data were collected: (i) descriptive information; (ii) indications; (iii) type and route of feeding; (iv) growth status and nutritional deficiencies; and (v) medication and vitamin and mineral supplementation.

Results

One hundred‐and‐ninety‐one children were included with a median age of 19 months (interquartile range 4–63]. Seventeen percent (33/191) were on AAFs and 83% (158/191) were on EHFs. The feeds were commonly used in cancer for 26% and in critical illness for 31%. The majority (73%) of children had enteral feeds via a nasogastric tube. Nutritional biomarkers were performed in 29% of children and 83% were on a vitamin or mineral supplement.

Conclusions

This practice survey found that EHFs and AAFs were used in a variety of medical conditions. Indications for feed choice varied, and evidence‐based research supporting the use was scarce. Awaiting further research, children on these types of feeds should have regular nutritional monitoring.
Work‐related stress and wellbeing among nurses: Testing a multi‐dimensional model
Authors: Vallone Federica , Smith Andrew Paul , Zurlo Maria Clelia
Published: August 2020

Aim

Basing on the Demands‐Resources and Individual‐Effects (DRIVE) Model developed by Mark and Smith in 2008, the study aims to propose and test a multi‐dimensional model that combines work characteristics, individual characteristics, and work–family interface dimensions as predictors of nurses' psychophysical health.

Methods

Self‐report questionnaires assessing work characteristics (effort; rewards; job demands; job control; social support), individual characteristics (socio‐demographic characteristics; coping strategies; Type A behavioral pattern; Type D personality), work–family interface dimensions (work–family interrole conflict; job and life satisfaction), and health outcomes (psychological disease; physical disease) were completed by 450 Italian nurses. Logistic regression analyses and Hayes' PROCESS tool were used to test the proposed model by exploring main, moderating and mediating hypotheses.

Results

Findings confirmed the proposed theoretical framework including work characteristics, individual characteristics, and work–family interface dimensions as significant predictors of nurses' psychophysical disease. Specific main, moderating and mediating effects were found, providing a wide set of multiple risks and protective factors.

Conclusions

The study allowed a broader understanding of nurses' work‐related stress process, providing a comprehensive tool for the assessment of occupational health and for the definition of tailored policies and interventions in public healthcare organizations to promote nurses' wellbeing.
Evaluation of the vestibular system with video head impulse test in pregnant women with hyperemesis gravidarum
Authors: Tulmaç Özlem B. , Kılıç Rahmi , Yaman Selen , Aktulum Fatma , Şimşek Gökçe , Erdinç Seval
Published: August 2020

Aim

We aimed to evaluate the semicircular canal functions of the vestibular system in pregnant women with hyperemesis gravidarum.

Methods

This is a prospective case–control study. Among pregnant women in their first trimester (<14. gestational weeks) who presented to our outpatient clinic, 36 patients diagnosed with hyperemesis gravidarum defined as persistent nausea and vomiting requiring intravenous hydration or loss of at least 5% of prepregnancy weight and 34 healthy pregnant without nausea and vomiting were included. Otorhinolaryngologic examination and video head impulse test (vHIT) was performed to all patients. Vestibular‐ocular reflex (VOR) gain and gain asymmetry were assessed between groups.

Results

The VOR gains in each semicircular canal did not differ between hyperemesis and control groups. Using a VOR gain cut‐off value of 0.8, the groups were compared in terms of the frequency of low values. In the hyperemesis group, abnormally low gain values of left anterior canal were more frequently observed than in the control group (32 [88.9%], 22 [64.7%], respectively, P = 0.01). In left anterior–right posterior (LARP) plane VOR gain asymmetry was higher in hyperemesis group (13.5 [1.0–71.0], 6.0 [0.0–35.0], P = 0.001). No significant gain asymmetry was detected between the groups in the other planes.

Conclusion

Semicircular canal functions were not abnormal globally in women with hyperemesis gravidarum. However, higher LARP plane asymmetry and low LA gain in women with hyperemesis suggests need for further research to clarify functional role of vestibular system on hyperemesis gravidarum.
Impact of obesity on surgical and oncologic outcomes in patients with endometrial cancer treated with a robotic approach
Authors: Kawai Eri , Benoit Louise , Hotton Judicael , Rance Bastien , Bonsang‐Kitzis Hélène , Lécuru Fabrice , Balaya Vincent , Ngô Charlotte
Published: August 2020

Aim

The surgical treatment of endometrial cancer (EC) can be more complicated in obese patients. Robotic surgery could simplify the surgical approach in these patients. The aim of our study was to compare the outcomes of robotic surgery in obese (body mass index ≥30 kg/m2) and nonobese patients.

Methods

We performed a retrospective study on patients with EC benefitting from a robotic approach in our institution. The primary outcome was the 5‐year overall survival (OS). We also assessed the 5‐year recurrence‐free survival (RFS), type of surgery, laparotomy conversion rate, adjuvant treatment and postoperative morbidity.

Results

We analyzed 175 consecutive patients with EC who underwent robotic surgery, 42 patients with obesity and 133 patients without. The median follow‐up length was 37 months [1–120]. The OS rate was 97% in the whole population and the RFS was 74%. Obesity did not impact prognosis. Laparotomy conversion rate was low in both groups (5% in patients with obesity vs 3%, P = 0.619). There were no significant differences in terms of postoperative complications (5 vs 9%, P = 0.738). There were significantly less pelvic lymphadenectomies in patients with obesity (5 vs 12%, P = 0.005). In the subgroup of patients with high‐risk EC, rate of lymphadenectomy and of adjuvant treatments did not differ between patients with or without obesity.

Conclusion

Obese patients with EC can be safely treated with a robotic approach, with a low complication rate and similar oncological outcomes compared to nonobese patients.
With Greater Power Comes Greater Stress? Authority, Supervisor Support, and Work‐Family Strains
Authors: Badawy Philip J. , Schieman Scott
Published: August 2020

Objective

This study investigates how status gains in job authority over time are related to three work‐ and family‐related stressors: job pressure, role blurring, and work‐to‐family conflict.

Background

Family scholars have long been interested in identifying work conditions as sources of change and stress in family life. Sociologists have devoted much effort in understanding the consequences of stratification for stress exposure—especially for those individuals with status‐based disadvantages. The present study advances work–family research by shifting focus to the status‐based stress exposure of individuals who transition into higher status positions in the workplace.

Method

This study uses four waves of panel data from the Canadian Work, Stress, and Health Study from 2011 to 2017 (N = 8,240 observations in pooled analysis). We use fixed effects regression techniques to analyze this diverse sample of Canadian workers with multi‐item measures of focal variables.

Results

We find that increases in job authority are associated with increases in job pressure, role blurring, and work‐to‐family conflict. Moreover, we find that supervisor support is an effective workplace resource to alleviate some of the stress that comes with greater workplace power.

Conclusion

These findings highlight nuances embedded in the status boost of gaining greater authority in the workplace by revealing some of its downsides for work‐related pressures and strains in the work–family interface. We discuss the implications of these results for stratification and work–family stress research by integrating insights from the stress of higher status and job demands–resources models.
Leptomeningeal Enhancement on 3D‐FLAIR MRI in Multiple Sclerosis: Systematic Observations in Clinical Practice
Authors: Titelbaum David S. , Engisch Renate , Schwartz Eric D. , Napoli Salvatore Q. , Sloane Jacob A. , Samaan Soleil , Katz Joshua D. , Lathi Ellen S.
Published: August 2020

BACKGROUND AND PURPOSE

Meningeal inflammation is implicated in cortical demyelination and disability progression in multiple sclerosis (MS). Gadolinium (Gd)‐enhanced 3‐dimensional (3D) FLAIR (fluid‐attenuated inversion recovery) magnetic resonance imaging (MRI) can identify leptomeningeal enhancement (LME) in MS. Further characterization is needed to determine if LME is an imaging biomarker for meningeal inflammation. We sought to characterize the natural history of LME in the community setting, including persistence/resolution, effect of disease‐modifying therapy, scanner variability, timing of acquisition, and imaging pitfalls that may lead to misinterpretation.

METHODS

A total of 341 MRI exams with Gd‐enhanced 3D‐FLAIR were reviewed in MS and non‐MS patients to determine frequency of enhancement by MS subtype and association with therapy. A phantom was used to assess scanner variability. Two MS patients with seven LME were imaged at four postinjection time points to generate time‐intensity curves. Imaging pitfalls were compiled.

RESULTS

A total of 16.6% (40/241) of MS patients revealed LME compared to 8% (8/100) in non‐MS patients (P = .04). There was no association with MS subtype, therapy, or disease activity. Detection using General Electric's version of 3D‐FLAIR (29%) was greater than with Siemen's 3D‐FLAIR (12%) at 1.5T (Tesla) (P < .001). Lesions were generally stable but resolved in 2 patients following high‐dose steroids. LME kinetics were heterogeneous, even within patients, without uniform optimal time for acquisition. Enhancement curves exhibited three different variations, similar to the two‐compartment model. Imaging pitfalls included enhancements of uncertain biologic significance, cortical veins and anatomic structures, and imaging artifacts.

CONCLUSIONS

Awareness of LME characteristics, variability with imaging parameters, and imaging pitfalls will facilitate determining the potential role as an imaging biomarker for meningeal inflammation.
What's for Lunch? Investigating the Experiences, Perceptions, and Habits of Parents and School Lunches: A Scoping Review
Authors: O'Rourke Brianne , Shwed Alanna , Bruner Brenda , Ferguson Kristen
Published: August 2020

BACKGROUND

Research indicates home‐packed school lunches are lower in nutritional value compared with school‐provided meals. Due to the lack of a school lunch program, most of what Canadian children consume during the school day is determined by parents and caregivers through packed lunches. Despite this, little research has focused on the school lunch packing habits and attitudes of parents. The purpose of this scoping review was to improve understanding of parental perceptions, experiences, and habits with respect to home‐packed school lunches.

METHODS

We conducted a scoping review of peer‐reviewed and gray literature. We reviewed only studies published from January 2000 to January 2019 with a focus on parents' lunch packing habits for their school‐aged children.

RESULTS

The review included 7 studies, with articles from the United Kingdom, Australia, and Canada. The studies identified 6 themes influencing parental decisions regarding what to pack in their child's lunch—school environment, food as fuel, convenience, child's influence, cost, and the lunch experience.

CONCLUSIONS

The decisions that influence what is packed in a school lunch are complex and indicate the need for support. Parents, schools, districts, and government policymakers need to work collaboratively to improve the healthiness of home‐packed school lunches.
Thalamic and neocortical differences in the relationship between the time course of delta and sigma power during NREM sleep in humans
Authors: Sarasso Simone , Zubler Frederic , Pigorini Andrea , Sartori Ivana , Castana Laura , Nobili Lino
Published: August 2020

Sleep spindles and slow waves are the hallmarks of non‐rapid eye movement (NREM) sleep and are produced by the dynamic interplay between thalamic and cortical regions. Several studies in both human and animal models have focused their attention on the relationship between electroencephalographic (EEG) spindles and slow waves during NREM, using the power in the sigma and delta bands as a surrogate for the production of spindles and slow waves. A typical report is an overall inverse relationship between the time course of sigma and delta power as measured by a single correlation coefficient both within and across NREM episodes. Here we analysed stereotactically implanted intracerebral electrode (Stereo‐EEG [SEEG]) recordings during NREM simultaneously acquired from thalamic and from several neocortical sites in six neurosurgical patients. We investigated the relationship between the time course of delta and sigma power and found that, although at the cortical level it shows the expected inverse relationship, these two frequency bands follow a parallel time course at the thalamic level. Both these observations were consistent across patients and across different cortical as well as thalamic regions. These different temporal dynamics at the neocortical and thalamic level are discussed, considering classical as well as more recent interpretations of the neurophysiological determinants of sleep spindles and slow waves. These findings may also help understanding the regulatory mechanisms of these fundamental sleep EEG graphoelements across different brain compartments.
Binding Morality and Perceived Harm as Sources of Moral Regulation Law Support Among Political and Religious Conservatives
Authors: Silver Jasmine R.
Published: August 2020

Conservatives—both political and religious—are more likely than liberals to support laws regulating traditional or religious morality. The current study applies a moral psychological framework to argue that the association between conservatism and moral regulation law support can be explained in part by binding morality, or a moral orientation that privileges group needs above individual needs and includes concerns about absolutism, collectivism, and purity. Binding morality may directly promote support for moral regulation laws, which enforce traditional rules, discourage deviance, and require adherence to customs regarding bodily and spiritual purity. Binding morality may also indirectly promote support for moral regulation laws by motivating perceptions that “immoral” behaviors are harmful to innocent victims. I test these hypotheses using three analytic samples drawn from the General Social Survey (N = 3669, 7120, 369). Results show that, as expected, binding morality (especially purity) mediates the effects of political and religious conservatism on laws regulating pornography, marijuana, abortion, and euthanasia. Additional analyses exploring views about pornography show that binding morality (especially collectivism) is associated with perceptions of immorality as harmful, which in turn is associated with support for regulation.
Bradyarrhythmias in patients with COVID‐19: Marker of poor prognosis?
Authors: Chinitz Jason S. , Goyal Rajat , Harding Melissa , Veseli Granit , Gruberg Luis , Jadonath Ram , Maccaro Paul , Gandotra Puneet , Ong Lawrence , Epstein Laurence M.
Published: August 2020

Background

Despite descriptions of various cardiovascular manifestations in patients with coronavirus disease 2019 (COVID‐19), there is a paucity of reports of new onset bradyarrhythmias, and the clinical implications of these events are unknown.

Methods

Seven patients presented with or developed severe bradyarrhythmias requiring pacing support during the course of their COVID‐19 illness over a 6‐week period of peak COVID‐19 incidence. A retrospective review of their presentations and clinical course was performed.

Results

Symptomatic high‐degree heart block was present on initial presentation in three of seven patients (43%), and four patients developed sinus arrest or paroxysmal high‐degree atrioventricular block. No patients in this series demonstrated left ventricular systolic dysfunction or acute cardiac injury, whereas all patients had elevated inflammatory markers. In some patients, bradyarrhythmias occurred prior to the onset of respiratory symptoms. Death from complications of COVID‐19 infection occurred in 57% (4/7) patients during the initial hospitalization and in 71% (5/7) patients within 3 months of presentation.

Conclusions

Despite management of bradycardia with temporary (3/7) or permanent leadless pacemakers (4/7), there was a high rate of short‐term morbidity and death due to complications of COVID‐19. The association between new‐onset bradyarrhythmias and poor outcomes may influence management strategies for acutely ill patients with COVID‐19.
Genetic analysis and map‐based delimitation of a major locus qSS3 for seed size in soybean
Authors: Cui Baofeng , Chen Lei , Yang Yongqing , Liao Hong
Published: August 2020

Seed size is a major determinant of grain yield in soybean, however their genetic basis remains largely unknown. In order to delimit map‐based position of a major locus qSS3, we evaluated three mapping populations, including RILs, NILs and a sub‐F2 in three environments for six seed size‐related traits. For these traits, the kurtosis and skewness ranged between 0.0 and 1.16, while h2b ranged from 0.75 to 0.96, indicating that this RIL population is suitable for QTL analysis. QTL analysis identified 12 loci which consist of 30 significant QTLs with PVE% and LOD values of 6.6%–26.2% and 2.50–5.61, respectively. Among them, qSS3 was a major and stable locus explaining 7.3%–26.2% of the variation in 5 of the 6 traits, with the respective LOD values falling in the range of 2.72–5.61. Additionally, qSS3 effects were confirmed in NILs and delimited to an interval of ~1,126 kb containing 123 annotated genes. Overall, this study may assist efforts aiming to improve soybean seed traits by identifying valuable genetic resources which can be used in future MAS breeding programmes.