bluuebunny/crossref_metadata_2025 huggingface dataset:
A study of treatment preference for diarrhea among Tengger people in Pasuruan, East Java, Indonesia
Authors: Pratama Antonius Nugraha Widhi , Ningsih Lutfia Wildatul Cahya , Rachmawati Ema , Triatmoko Bawon , Tan Elizabeth Yu , Nugraha Ari Satia
Published: September 2020

Purpose

This study aims to describe the treatment preference, especially in relation to traditional medicine, modern health care and a combination of both, in diarrheal cases among the Tengger ethnic minority group.

Design/methodology/approach

A cross-sectional survey was conducted in all eight villages of Tosari District, Pasuruan Regency, East Java Province. Tengger people were major resident in the area for generations. Convenience sampling and a face-validated structured questionnaire were used to recruit and face-to-face interview 377 Tengger people.

Findings

The study found that modern health care was the dominant preference (52%, n = 196) selected by Tengger people when they have an episode of diarrhea, compared to traditional medicines and mixed approach. Most respondents opted to visit one facility or to stay at home (64.3%, n = 242). Statistical significant relationships were found between treatment choice and age (p < 0.001), sex (p < 0.001), religion (p = 0.011), distance (p < 0.001), educational background (p < 0.001) and job (p < 0.001). A clear pattern between treatment choice and age was revealed with younger groups tended to choose modern health care, while older groups more preferred the traditional approach.

Practical implications

This work could provide an insight that when the young Tengger people are having uncomplicated and common health illness, such as diarrhea, they tend to use modern treatment approach.

Originality/value

This study fulfilled an identified need to explore the trend of treatment approach across generations in the Tengger society as a model of the minor ethnic group in Indonesia.
Emotional problems and intellectual disability: comparing groups with and without forensic involvement
Authors: Craven Rachel , Shelton Lyn
Published: September 2020

Purpose

Individuals with intellectual disability (ID) are known to experience increased emotional and behavioural concerns. The study aims to assess whether detained ID patients with a forensic history (IDPF) have increased difficulty managing their impulse control in comparison to detained ID patients without a forensic history (IDP). Using the externalising behaviour problems (EBP) subscale of the EPS, the study aims to compare the differences between the IDFP and IDP groups.

Design/methodology/approach

A total of 60 patients with ID detained under the Mental Health Act 1983 (Revised 2007) were assessed using the behaviour rating scale of the EPS. The outcome scores of the EBP were used to examine any observed differences between the scores of forensically involved patients [n= 34] and those without a forensic history [n= 26]. It was hypothesised that patients with a forensic history would display higher scoring on externalised behavioural problems (EBP) than patients without such a history.

Findings

Non-parametric testing revealed that there were no significant differences in EBP scoring between the two sample groups. These findings indicate that, for patients in the present study, no differences were detected in the presentation of these two distinct groups. In fact, with the exception of the verbal aggression subscale of the EBP, the other three subscales (physical aggression, non-compliance and hyperactivity) show that actually the IDP group displayed the higher ranked means in these subscales when compared with the forensically involved group.

Originality/value

These results indicate possible increased treatment needs within the IDP group and question whether offending history is necessarily a reliable predictor of ongoing hostility and behavioural concerns within similar inpatient services.
How to measure and manage the UK Government’s major project portfolio
Authors: Bourne Michael , Anker David , Chambers Glen , Torjai Laszlo
Published: September 2020

Purpose

The purpose of this paper is to stimulate changes to the way performance data is used to improve performance taking the government’s use of project data as an example.

Design/methodology/approach

This paper uses systems theory to review the way the government’s major projects portfolio should be analysed.

Findings

This paper concludes that broader engagement in the analytics process should be considered as a way of improving insights and learning from reviews. The paper suggests that report alone has limited value.

Research limitations/implications

By taking a systems approach, this study raises questions about the methods used to manage data analysis and system improvements. Systems thinking is a useful tool to consider applications such as the performance of the government’s project portfolio, but there are many other approaches that can be applied.

Practical implications

This study makes very specific recommendations around the roles and responsibilities of people and teams at different levels in the system. Roles and activities are described together with recommendations about interfering in and overreaching these roles and activities.

Originality/value

This paper synthesises a number of systems approaches together with a view of why “we measure” to create a framework for analysing approaches to performance improvement. The practical application provided here gives insights into how these approaches can be used in real-life contexts.
Understanding liaison psychiatry commissioning: an observational study
Authors: Fossey Matt , Godier-McBard Lauren , Guthrie Elspeth A. , Hewison Jenny , Trigwell Peter , Smith Chris J. , House Allan O.
Published: September 2020

Purpose

The purpose of this paper is to explore the challenges that are experienced by staff responsible for commissioning liaison psychiatry services and to establish if these are shared by other health professionals.

Design/methodology/approach

Using a mixed-methods design, the findings from a mental health commissioner workshop (n = 12) were used to construct a survey that was distributed to health care professionals using an opportunistic framework (n = 98).

Findings

Four key themes emerged from the workshop, which was tested using the survey. The importance of secure funding; a better understanding of health care systems and pathways; partnership working and co-production and; access to mental health clinical information in general hospitals. There was broad convergence between commissioners, mental health clinicians and managers, except in relation to gathering and sharing of data. This suggests that poor communication between professionals is of concern.

Research limitations/implications

There were a small number of survey respondents (n = 98). The sampling used an opportunistic framework that targeted commissioner and clinician forums. Using an opportunistic framework, the sample may not be representative. Additionally, multiple pairwise comparisons were conducted during the analysis of the survey responses, increasing the risk that significant results were found by chance.

Practical implications

A number of steps were identified that could be applied in practice. These mainly related to the importance of collecting and communicating data and co-production with commissioners in the design, development and monitoring of liaison psychiatry services.

Originality/value

This is the first study that has specifically considered the challenges associated with the commissioning of liaison psychiatry services.
Parent engagement in perinatal mortality reviews: an online survey of clinicians from six high‐income countries
Authors: Boyle FM , Horey D , Siassakos D , Burden C , Bakhbakhi D , Silver RM , Flenady V
Published: September 2020

Objective

Parent engagement in perinatal mortality review meetings following stillbirth may benefit parents and improve patient safety. We investigated perinatal mortality review meeting practices, including the extent of parent engagement, based on self‐reports from healthcare professionals from maternity care facilities in six high‐income countries.

Design

Cross‐sectional online survey.

Setting

Australia, Canada, Ireland, New Zealand, UK and USA.

Population

A total of 1104 healthcare professionals, comprising mainly obstetricians, gynaecologists, midwives and nurses.

Methods

Data were drawn from responses to a survey covering stillbirth‐related topics. Open‐ and closed‐items that focused on ‘Data quality on causes of stillbirth’ were analysed.

Main outcome measures

Healthcare professionals’ self‐reported practices around perinatal mortality review meetings following stillbirth.

Results

Most clinicians (81.0%) were aware of regular audit meetings to review stillbirth at their maternity facility, although this was true for only 35.5% of US respondents. For the 854 respondents whose facility held regular meetings, less than a third (31.1%) reported some form of parent engagement, and this was usually in the form of one‐way post‐meeting feedback. Across all six countries, only 17.1% of respondents described an explicit approach where parents provided input, received feedback and were represented at meetings.

Conclusions

We found no established practice of involving parents in the perinatal mortality review process in six high‐income countries. Parent engagement may hold the key to important lessons for stillbirth prevention and care. Further understanding of approaches, barriers and enablers is warranted.

Tweetable abstract

Parent engagement in mortality review after stillbirth is rare, based on data from six countries. We need to understand the barriers.
Between governance‐driven democratisation and democracy‐driven governance: Explaining changes in participatory governance in the case of Barcelona
Authors: BUA ADRIAN , BUSSU SONIA
Published: September 2020

Scholars of participatory democracy have long noted dynamic interactions and transformations within and between political spaces that can foster (de)democratisation. At the heart of this dynamism lie (a) the processes through which top‐down “closed” spaces can create opportunities for rupture and democratic challenges and (b) vice‐versa, the mechanisms through which bottom‐up, open spaces can be co‐opted through institutionalisation. This paper seeks to unpick dynamic interactions between different spaces of participation by looking specifically at two forms of participatory governance, or participatory forms of political decision making used to improve the quality of democracy. First, Mark Warren's concept of ‘governance‐driven democratization’ describes top‐down and technocratic participatory governance aiming to produce better policies in response to bureaucratic rationales. Second, we introduce a new concept, democracy‐driven governance, to refer to efforts by social movements to invent new, and reclaim and transform existing, spaces of participatory governance and shape them to respond to citizens’ demands. The paper defines these concepts and argues that they co‐exist and interact in dynamic fashion; it draws on an analysis of case study literature on participatory governance in Barcelona to illuminate this relationship. Finally, the paper relates the theoretical framework to the case study by making propositions as to the structural and agential drivers of shifts in participatory governance.
Estimating population density of Nicrophorus quadripunctatus (Coleoptera: Silphidae) in Korea
Authors: Kim Do‐Sung , Cho Young‐Bok , Han Yong‐Gu
Published: September 2020

Estimating the population density of organisms is of great concern to ecologists and much effort has been put into making accurate assessment of population levels in nature. We evaluated the trapping web (TW) method for the determination of the density of species of burying beetles. We found eight and six species of burying beetles at Beopjusa and Ssanggok‐ri areas, respectively. Most of the species population comprised Nicrophorus quadripunctatus, with densities of 65 and 195 per ha for Beopjusa and Ssanggok‐ri areas, respectively. Moreover, the flight intercept trap (FIT) method from 2003 to 2007 also revealed the same trend: Beopjusa temple (2928) to Ssanggok‐ri (5835). However, the differences in number of individuals were probably due to the differences in the methods and the length of the trapping period. The populations of N. quadripunctatus exist as metapopulations, making accurate assessment of the population densities extremely difficult. We hypothesized that the TW method could accurately estimate population densities extrapolated from patch population size per area.
Toxoplasma gondii α‐amylase deletion mutant is a promising vaccine against acute and chronic toxoplasmosis
Authors: Yang Jing , Yang Chenghang , Qian Jiahui , Li Facai , Zhao Junlong , Fang Rui
Published: September 2020

Individuals with inhibited immunity may develop lethal toxoplasmosis; thus, a safe and effective vaccine is urged to be developed. Toxoplasma gondii (T. gondii) α‐amylase (α‐AMY) is one of the enzymes responsible for starch digestion. In the present study, we first generated a ME49Δα‐amy mutant and discovered that loss of α‐AMY robustly grew in vitro but contributed to significant virulence attenuation in vivo. Therefore, we established a mouse model to explore the protective immunity of Δα‐amy mutant against acute and chronic toxoplasmosis. The results indicated that the survival rates of short‐term or long‐term immunized mice re‐infected with the tachyzoites of multiple T. gondii strains were nearly 100%. ME49Δα‐amy not only could provide protective immunity against tachyzoites infection but also could resist the infection of tissue cysts. Furthermore, we detected that ME49Δα‐amy vaccination could effectively eliminate the proliferation of parasites in mice and prevent the formation of cysts. The significant increases of Th1‐type cytokines, Th2‐type cytokines and specific total IgG and IgG subclasses (IgG2a and IgG1) confirmed efficiency of a combination of cellular and humoral immunity against infection. In conclusion, ME49Δα‐amy attenuated strain can produce strong immune responses to provide efficient protection against toxoplasmosis, which signifies that ME49Δα‐amy mutant may be a potential vaccine candidate.
Application of a New Species‐Richness Based Flow Ecology Framework for Assessing Flow Reduction Effects on Aquatic Communities
Authors: Rapp Jennifer L. , Burgholzer Robert , Kleiner Joseph , Scott Durelle , Passero Elaina M.
Published: September 2020

Water‐resources managers are challenged with maintaining a balance among beneficial uses throughout river networks and need robust means of assessing potential risks to aquatic life resulting from flow alterations. This study generated ecological limit functions from species‐streamflow relations to quantify potential fish richness response to flow alteration and compared results to currently accepted streamflow management guidelines. Modeled responses of absolute richness change were watershed specific and varied among sample sets derived from hydrologic unit classifications of different sizes (large HUC 6 basins to regional scale HUC 8). With a 20% flow reduction, 10% of HUC 8 predicted a richness decrease in one or more taxa. While absolute richness change was consistent across streams within a HUC, percent richness change was stream size dependent. Comparisons with Instream Flow Incremental Methodology habitat models predicted habitat loss greater than percent richness change; however, predictions for habitat and richness decreased similarly as stream size decreased. Watershed‐specific responses from flow reductions could allow water‐resources management decisions to be made locally based on the predicted richness change for certain sized streams. Quantitative results highlight the utility of a richness‐based framework for generating watershed‐specific risk assessments that validate and inform currently employed water‐resources management practices.
England SimSmoke: the impact of nicotine vaping on smoking prevalence and smoking‐attributable deaths in England
Authors: Levy David T. , Sánchez‐Romero Luz María , Li Yameng , Yuan Zhe , Travis Nargiz , Jarvis Martin J. , Brown Jamie , McNeill Ann
Published: September 2020

Background and Aims

Whereas the use of nicotine vaping products (NVPs) is widespread, their impact on smoking prevalence is controversial. This study considered the potential impact of NVPs on smoking prevalence in England.

Design

Indirect simulation model. The England SimSmoke model is validated through 2012, before NVP use became more widely used by smokers. Because information on NVP‐related transitions is limited, an indirect method is used; the difference in observed smoking prevalence (reflecting NVPs) is compared with a 2012–2019 counterfactual No‐NVP scenario (without NVPs) to estimate the impact of NVPs on smoking and smoking‐attributable deaths.

Setting

England, 2000–2019.

Participants

Nationally representative sample of population.

Measurements

England's population, mortality rates and smoking prevalence estimates from three national surveys and tobacco control policies.

Findings

Between 2000 and 2012, SimSmoke projected a decline in age 18+ smoking prevalence of 23.5% in men and 27.0% in women. These projections, as well as those by specific age groups, were generally consistent with findings from the three national surveys. Comparing 2012–2019 relative reduction in age 18+ prevalence from the Annual Population Survey (males, 27.5%) with the model‐predicted No‐NVP reduction (males, 7.3%), the implied NVP‐attributable relative reduction in adult smoking prevalence was 20.2% (95% CI, 18.8%–22.0%) for males and 20.4% (18.7%–22.2%) for females. The NVP‐attributable reduction was 27.2% (22.8%–31.6%) for males and 31.7% (27.4%–36.5%) for females ages 18–24 and 18.6% (15.2%–21.8%) for males and 15.0% (11.1%–18.8%) for females ages 25–34, with similar reductions for ages 35+. The implied reduction in smoking prevalence between 2012 and 2019 equates to 165 660 (132 453–199 501) averted deaths by 2052. Other surveys yielded smaller, but relatively consistent results.

Conclusions

An indirect method of simulation modelling indicates that substantial reductions in smoking prevalence occurred in England from 2012–2019 coinciding with the growth in nicotine vaping product use.
Gender and the dynamics of technology adoption: Empirical evidence from a household‐level panel data
Authors: Mishra Khushbu , Sam Abdoul G. , Diiro Gracious M. , Miranda Mario J.
Published: September 2020

Very few empirical studies account for the dynamic nature of the agricultural technology adoption decision and none of these explores if this dynamic nature depends on the gender of the decision maker. Using four waves of a household‐level Ugandan panel data, this is the first empirical analysis to account for self‐learning (one's own adoption experience) in explaining current adoption decision in a developing country context, and the first to study the interaction between self‐learning and gender. Technology adoption is defined as adoption of hybrid seed, inorganic fertilizer, or pesticides. Our results indicate that the dynamic panel data Probit model is superior to its static counterpart in the sense that self‐learning, captured by lagged technology adoption indicators, is by far the most important determinant of technology adoption. We also find a weaker impact of self‐learning for female‐headed households than male‐headed households. Female‐headed households face fewer learning opportunities, which produce a lower self‐learning impact in later periods, further exacerbating the gap in technology adoption among male‐ and female‐headed households.
Mechanization in land preparation and agricultural intensification: The case of rice farming in the Cote d'Ivoire
Authors: Mano Yukichi , Takahashi Kazushi , Otsuka Keijiro
Published: September 2020

It is critically important to intensify farming systems in sub‐Saharan Africa by disseminating improved agronomic practices and increasing the application of modern inputs. One of the region's problems is that proper land preparation is difficult due to the scarcity of draft animals and the underdevelopment of the tractor rental market. Our analysis of rice production in the Cote d'Ivoire reveals that farmers who use tractors in land preparation more intensively apply fertilizer and use more labor to carefully implement proper agronomic practices, thereby raising productivity. Thus, the diffusion of tractors appears to be key to the intensification of rice farming systems in sub‐Saharan Africa.
Long‐run impacts of trade shocks and export competitiveness: Evidence from the U.S. BSE event
Authors: Chen Chen‐Ti , Crespi John M. , Hahn William , Schulz Lee L. , Taha Fawzi
Published: September 2020

This paper examines how comparative advantages of major beef exporters changed following the 2003 bovine spongiform encephalopathy (BSE) outbreak, which significantly disrupted the U.S. beef trade until approximately 2007. Using longitudinal data on beef export values and constructed revealed comparative advantage measures, we show that while some measures of the long‐run impacts of BSE on U.S. beef export competitiveness have returned to pre‐2003 levels, the U.S.’s comparative advantage has not. We also examine a hypothetical scenario of no BSE event in 2003 and predict that in the absence of the BSE outbreak, the U.S. beef sector would have been increasingly more competitive by 2017 than it actually was. Long‐term trade competitiveness may not simply return to normal even after a short‐term disruption.
Hepatic ultrasonography in three breeds of healthy calves: Nellore, Curraleiro Pe‐duro and Pantaneiro
Authors: Lima Valesca Henrique , da Silva Nivan Antônio Alves , Rodrigues Milenna Karoline , da Silva Jéssica Alves , dos Santos Fabrício Carrião , Juliano Raquel Soares , Fioravanti Maria C. Soares , Borges Naida Cristina , da Cunha Paulo H. Jorge
Published: September 2020

An ultrasonography was performed in 21 healthy male calves of Nellore (n = 8), Curraleiro Pe‐duro (n = 7) and Pantaneiro (n = 6) breeds, between 8 and 12 months, with the objective to display information about size, position and ultrasonographic parenchymal patterns of the liver, in addition to the topography of the gallbladder, right kidney and major vessels. The measurements used were dorsal margin distance (DMD) and ventral margin distance (VMD) of the liver, viewable extension (VE) of the liver, the caudal vena cava (CVC), width (CVCW) and depth (CVCD) and the portal vein (PV), width (PVW) and depth (PVD). The measures DMD, VMD and VE were similar, and the organ’s longest visible extension was in 11th ICS. CVC was more frequently observed in the 11th and 10th ICS, despite being visible from the 12th to the 9th ICS in Nellore and still 8th ICS in Curraleiro Pe‐duro and Pantaneiro. CVCD was lower in the 10th and 9th ICS in Nellore. The PV presented higher observation frequency in the 10th ICS. The measures PVD and PVW were higher in Nellore in the 11th, 10th and 9th ICS. To our knowledge, this report is the first to document ultrasonographic findings in three healthy calves. Considering the three breeds, the results show no differences in the ultrasonographic features as regard to the measurements and visualization of the position, size and vasculature of the liver and there was no additional information about the topography of the gallbladder and the right kidney.
The impact of caffeine consumption on clinical symptoms in patients with bipolar disorder: A systematic review
Authors: Frigerio Sofia , Strawbridge Rebecca , Young Allan H.
Published: September 2020

Objectives

In healthy populations, caffeine appears to have beneficial effects on health; however, patients with bipolar disorder (BD) are routinely advised to limit caffeine use in psychoeducation programmes. We aimed to examine all literature reporting whether caffeine intake/withdrawal impacts the natural course of BD, in terms of clinical outcomes.

Methods

PubMed, Embase and PsycINFO were searched (up to 17/07/2020) and all studies reporting data on individuals with BD comparing a measure of caffeine use with illness severity (symptoms of mania, depression, psychosis, anxiety, sleep or suicidality) were included.

Results

Of the 1678 records reviewed, 17 studies met inclusion criteria (10 case reports, 1 retrospective cohort study, 5 cross‐sectional studies, 1 interventional study). Most case reports described people with BD switching to manic, hypomanic or mixed states after consuming caffeine in variable amounts and/or whose serum lithium concentrations increased after reducing caffeine consumption. The interventional study found that caffeine may suppress lithium concentrations, while the retrospective cohort study reported that participants who drank coffee had more suicidality than non‐drinkers.

Conclusions

The literature examining clinical effects of caffeine in patients with BD is not conclusive. Acute increases in caffeine consumption may precede the occurrence of manic symptoms in patients with BD, potentially through a direct stimulant effect, affecting sleep patterns and/or the metabolism of lithium or other medications, although increases in caffeine intake could also be a consequence of an ongoing manic relapse or a prodromal sign. Further research is needed to determine whether caffeine use impacts the long‐term prognosis of BD.
Collective psychological ownership and the rise of reactionary counter‐movements defending the status quo
Authors: Selvanathan Hema Preya , Lickel Brian , Jetten Jolanda
Published: September 2020

Social movements pushing for social change are often met with reactionary counter‐movements that defend the status quo. The present research examined this interplay by focusing on the role of racial majority group members claiming collective psychological ownership. We examined collective ownership that stems from being native to the land and from being founders of the nation. Study 1 found that in Malaysia, the Malay majority group endorsed more native ownership than Chinese and Indian minorities, which in turn predicted greater threat in response to protests demanding electoral reforms and subsequently greater support for a reactionary pro‐government movement. Situated in the United States, Study 2 found that the more that White Americans endorsed founder ownership beliefs, the more they reported negative attitudes towards the Black Lives Matter protests, which in turn predicted more support for White nationalistic counter‐protests. This effect was stronger among White people compared to people of colour. Study 3 examined both founder and native ownership in Australia. Founder (but not native) ownership beliefs predicted more negative attitudes towards Invasion Day protests, which subsequently predicted more support for counter‐protests defending Australia Day celebrations. Implications of culture‐specific beliefs about collective ownership for social movement research are discussed.
Ancient life and moving fluids
Authors: Gibson Brandt M. , Furbish David J. , Rahman Imran A. , Schmeeckle Mark W. , Laflamme Marc , Darroch Simon A.F.
Published: September 2020

Over 3.7 billion years of Earth history, life has evolved complex adaptations to help navigate and interact with the fluid environment. Consequently, fluid dynamics has become a powerful tool for studying ancient fossils, providing insights into the palaeobiology and palaeoecology of extinct organisms from across the tree of life. In recent years, this approach has been extended to the Ediacara biota, an enigmatic assemblage of Neoproterozoic soft‐bodied organisms that represent the first major radiation of macroscopic eukaryotes. Reconstructing the ways in which Ediacaran organisms interacted with the fluids provides new insights into how these organisms fed, moved, and interacted within communities. Here, we provide an in‐depth review of fluid physics aimed at palaeobiologists, in which we dispel misconceptions related to the Reynolds number and associated flow conditions, and specify the governing equations of fluid dynamics. We then review recent advances in Ediacaran palaeobiology resulting from the application of computational fluid dynamics (CFD). We provide a worked example and account of best practice in CFD analyses of fossils, including the first large eddy simulation (LES) experiment performed on extinct organisms. Lastly, we identify key questions, barriers, and emerging techniques in fluid dynamics, which will not only allow us to understand the earliest animal ecosystems better, but will also help to develop new palaeobiological tools for studying ancient life.
Partisan politics and fiscal policy in the Canadian provinces
Authors: Haddow Rodney
Published: September 2020

This article evaluates the impact of partisanship on provincial fiscal policies over business‐ and electoral‐cycles between 1981 and 2016. There were partisan differences between left‐wing governments (the New Democratic Party and the Parti Québécois), on the one hand, and conservative ones, on the other. The evidence is particularly strong for business‐cycles, where left‐wing parties pursued much more countercyclical strategies than conservatives. In contrast, there was little difference between most Liberal administrations and conservative ones. Left‐wing fiscal policies nevertheless lost their distinctiveness during the last third of the study period. The article concludes by discussing possible explanations for this change.
Acute and chronic kidney disease after pediatric liver transplantation: An underestimated problem
Authors: Lacquaniti Antonio , Campo Susanna , Casuscelli Di Tocco Teresa , Rovito Stefania , Bucca Maurizio , Ragusa Antonino , Monardo Paolo
Published: September 2020

Acute and chronic kidney injuries represent critical issues after liver transplantation (LTx), but whereas renal dysfunction in adult transplant patients is well documented, little is known about its prevalence in childhood. It is a challenge to accurately evaluate renal function in patients with liver disease, due to several confounding factors. Creatinine‐based equations estimating glomerular filtration rate, validated in nephropathic patients without hepatic issues, are frequently inaccurate in end‐stage liver disease, underestimating the real impact of renal disease. Moreover, whereas renal issues observed within 1 year from LTx were often related to acute injuries, kidney damage observed after 5‐7 years from LTx, is due to chronic, irreversible mechanisms. Most immunosuppression protocols are based on calcineurin inhibitors (CNIs) and corticosteroids, but mycophenolate mofetil or sirolimus could play significant roles, also in children. Early diagnosis and personalized treatment represent the bases of kidney disease management, in order to minimize its close relation with increased mortality. This review analyzed acute and chronic kidney damage after pediatric LTx, also discussing the impact of pre‐existent renal disease. The main immunosuppressant strategies have been reviewed, highlighting their impact on kidney function. Different methods assessing renal function were reported, with the potential application of new renal biomarkers.
Long‐term outcome of persons with diabetic and non‐diabetic neuro‐osteoarthropathy after foot correction using external fixation
Authors: Spraul A. M. S. , Schönbach A. M. , Müller N. , Müller U. A. , Koller A. , Spraul M.
Published: September 2020

Aim

Diabetic neuro‐osteoarthropathy (Charcot foot) is a serious form of diabetic foot syndrome, often leading to severe deformity of the foot and subsequently to ulcers and osteomyelitis. The aim of this retrospective study was to determine the success rate and long‐term outcomes for a Charcot foot operation using external fixation in 115 individuals who underwent surgery between July 2008 and December 2012.

Methods

Some 115 consecutive persons, 78 (68%) men and 37 (32%) women, were enrolled in this study. The eligibility criterion for this retrospective study was reconstructive foot surgery using a Hoffmann II external fixator in diabetic and non‐diabetic neuro‐osteoarthropathy. The main examination parameters in the follow‐up were walking ability, amputation and mortality. Average follow‐up was 5.7 (± 3.2) years.

Results

Ninety‐seven per cent of people were able to walk after the operation with bespoke shoes or an orthosis. At follow‐up, 77% were able to walk and 51% were fully mobile even outside the home. Subsequent amputations were performed in 29 individuals (26%), with 17 (15%) minor and 12 (11%) major amputations. Forty‐seven individuals died before follow‐up, the majority (53%) from cardiovascular events. Average survival time post surgery was 4.5 (± 2.9) years.

Conclusion

Reconstruction surgery using external fixation is a very useful method for maintaining walking ability in the case of conservatively non‐treatable diabetic and non‐diabetic neuro‐osteoarthropathy. Individuals with severe Charcot foot disease had a low rate of major amputations. Osteomyelitis was the main reason for major amputations.
Transthoracic echocardiographic findings in patients admitted with SARS‐CoV‐2 infection
Authors: Schott Jason P. , Mertens Amy N. , Bloomingdale Richard , O’Connell Thomas F. , Gallagher Michael J. , Dixon Simon , Abbas Amr E.
Published: September 2020

Introduction

Severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2)–infected patients commonly have elevated troponin and D‐dimer levels, but limited imaging exists to support most likely etiologies in efforts to avoid staff exposure. The purpose of this study was to report transthoracic echocardiographic (TTE) findings in SARS‐CoV‐2 patients with correlating troponin and D‐dimer levels.

Methods

We identified 66 SARS‐CoV‐2 patients (mean age 60 ± 15.7 years) admitted within a large, eight‐hospital healthcare system over a 6‐week period with a TTE performed. TTE readers were blinded to laboratory data with intra‐observer and inter‐observer analysis assessed.

Results

Sixty‐six of 1780 SARS‐CoV‐2 patients were included and represented a high‐risk population as 38 (57.6%) were ICU‐admitted, 47 (71.2%) had elevated D‐dimer, 41 (62.1%) had elevated troponin, and 25 (37.9%) died. Right ventricular (RV) dilation was present in 49 (74.2%) patients. The incidence and average D‐dimer elevation was similar between moderate/severe vs. mild/no RV dilation (69.6% vs 67.6%, P = 1.0; 3736 ± 2986 vs 4141 ± 3351 ng/mL, P = .679). Increased left ventricular (LV) wall thickness was present in 46 (69.7%) with similar incidence of elevated troponin and average troponin levels compared to normal wall thickness (66.7% vs 52.4%, P = .231; 0.88 ± 1.9 vs 1.36 ± 2.4 ng/mL, P = .772). LV dilation was rare (n = 6, 9.1%), as was newly reduced LV ejection fraction (n = 2, 3.0%).

Conclusion

TTE in SARS‐CoV‐2 patients is scarce, technically difficult, and reserved for high‐risk patients. RV dilation is common in SARS‐CoV‐2 but does not correlate with elevated D‐dimer levels. Increased LV wall thickness is common, while newly reduced LV ejection fraction is rare, and neither correlates with troponin levels.
Anxious arousal alters prefrontal cortical control of stopping
Authors: Roxburgh Ariel D. , White David J. , Cornwell Brian R.
Published: September 2020

Anxiety heightens vigilance and stimulus‐driven attention to the environment, which may in turn disrupt cognitive control processes such as response inhibition. How this unfolds at the neural level is unclear. Previous evidence implicates the right inferior frontal gyrus (IFG) as an important cortical node in both stimulus‐driven attention and inhibitory control. Here we used magnetoencephalography (MEG) to investigate the neural mechanisms involved in the relationship between threat‐induced anxiety and stopping during a stop‐signal task, where a visual go signal was occasionally followed by an auditory stop signal. Healthy individuals (N = 18) performed the task during the threat of unpredictable shocks and safety to modulate anxious arousal. Behaviorally, we observed that stopping was impaired during threat (i.e. slower estimated stop‐signal reaction times), indicating that anxious arousal weakens inhibitory control. MEG source analyses revealed that bilateral IFG and right dorsal prefrontal cortex showed increased beta‐band activity (14–30 Hz) to the stop signal that varied as a function of successful stopping during nonanxious (safe) conditions only. Moreover, peak beta‐band responses from right IFG were inversely correlated with stopping efficiency during nonanxious conditions. These findings support theoretical claims that beta oscillations function to maintain the current sensorimotor state, and that the lack of differential beta‐band activity in prefrontal cortices underlies anxiety‐related deficits in inhibitory control. We specifically argue that altered right IFG functioning might directly link impaired cognitive control to heightened stimulus‐driven responding in anxiety states.
Seizures with paroxysmal arousals in sleep‐related hypermotor epilepsy (SHE): Dissecting epilepsy from NREM parasomnias
Authors: Loddo Giuseppe , Baldassarri Lorenzo , Zenesini Corrado , Licchetta Laura , Bisulli Francesca , Cirignotta Fabio , Mondini Susanna , Tinuper Paolo , Provini Federica
Published: September 2020

Objective

Sleep‐related hypermotor epilepsy (SHE) is a focal epilepsy characterized by seizures occurring mostly during sleep, ranging from brief seizures with paroxysmal arousals (SPAs) to hyperkinetic seizures and ambulatory behaviors. SPAs are brief and stereotypic seizures representing the beginning of a major seizure. Distinguishing SPAs from disorders of arousal (DOAs) and their briefest episodes called simple arousal movements (SAMs) is difficult. We performed a characterization of SPAs and SAMs to identify video‐polysomnographic (VPSG) features that can contribute to the diagnosis of SHE or DOA.

Methods

Fifteen SHE, 30 DOA adult patients, and 15 healthy subjects underwent full‐night VPSG. Two neurologist experts in sleep disorders and epilepsy classified all the sleep‐related movements and episodes recorded. For each SPAs and SAMs, sleep stage at onset, duration, limb involvement, progression, and semiology have been identified.

Results

A total of 121 SPAs were recorded, emerging mostly during stage 1‐2 non–rapid eye movement (NREM) sleep (median duration: 5 seconds). At the beginning, the SPAs motor pattern was hyperkinetic in 78 cases (64%), involving more than three non‐contiguous or all body parts. The standard was a constant progression of movements during SPAs without any motor arrests. In DOA patients a total of 140 SAMs were recorded (median duration: 12 seconds) mostly emerging during stage 3 NREM sleep. In SAMs, we did not observe any tonic/dystonic or hypermotor patterns or stereotypy; motor arrest was present over the course of about half of the episodes. In comparison with both DOA and healthy subjects, SHE patients showed a higher number of sleep‐related movements per night and a reduction of sleep efficiency.

Significance

SPAs and SAMs present different semiological and clinical features. Their recognition could be useful to drive the diagnosis when major episodes are not recorded during VPSG in patients with a clear clinical history of SHE or DOA.
Managing the Risks of Schooling, Securing Middle‐Class Belonging: Russian, Palestinian, and Jewish Mothers in Israel
Authors: Golden Deborah , Erdreich Lauren , Roberman Sveta
Published: September 2020

A major sphere of action in which parents engage in the management of risk on behalf of their children—primarily through the gendered work of mothering—is that of education and schooling. This article explores the endeavors on the part of middle‐class Israeli mothers hailing from three social‐cultural groups—immigrants from the former Soviet Union, Palestinian Israelis, and Jewish Israelis—to manage the risks of schooling, as they perceive these to be. We ask: What do the women share, and how do they differ in their understandings of the failings of school and the risks attached? How do they choose to act in response to these perceived risks? In posing these questions, we seek to explore the ways in which the perception of risk, the experience of anxiety, and the navigation of schooling are shaped at the nexus of class, culture, and social positioning.
Spatial and temporal variability of soil N2O and CH4 fluxes along a degradation gradient in a palm swamp peat forest in the Peruvian Amazon
Authors: Hergoualc’h Kristell , Dezzeo Nelda , Verchot Louis V. , Martius Christopher , van Lent Jeffrey , del Aguila‐Pasquel Jhon , López Gonzales Mariela
Published: September 2020

Mauritia flexuosa palm swamp, the prevailing Peruvian Amazon peatland ecosystem, is extensively threatened by degradation. The unsustainable practice of cutting whole palms for fruit extraction modifies forest's structure and composition and eventually alters peat‐derived greenhouse gas (GHG) emissions. We evaluated the spatiotemporal variability of soil N2O and CH4 fluxes and environmental controls along a palm swamp degradation gradient formed by one undegraded site (Intact), one moderately degraded site (mDeg) and one heavily degraded site (hDeg). Microscale variability differentiated hummocks supporting live or cut palms from surrounding hollows. Macroscale analysis considered structural changes in vegetation and soil microtopography as impacted by degradation. Variables were monitored monthly over 3 years to evaluate intra‐ and inter‐annual variability. Degradation induced microscale changes in N2O and CH4 emission trends and controls. Site‐scale average annual CH4 emissions were similar along the degradation gradient (225.6 ± 50.7, 160.5 ± 65.9 and 169.4 ± 20.7 kg C ha−1 year−1 at the Intact, mDeg and hDeg sites, respectively). Site‐scale average annual N2O emissions (kg N ha−1 year−1) were lower at the mDeg site (0.5 ± 0.1) than at the Intact (1.3 ± 0.6) and hDeg sites (1.1 ± 0.4), but the difference seemed linked to heterogeneous fluctuations in soil water‐filled pore space (WFPS) along the forest complex rather than to degradation. Monthly and annual emissions were mainly controlled by variations in WFPS, water table level (WT) and net nitrification for N2O; WT, air temperature and net nitrification for CH4. Site‐scale N2O emissions remained steady over years, whereas CH4 emissions rose exponentially with increased precipitation. While the minor impact of degradation on palm swamp peatland N2O and CH4 fluxes should be tested elsewhere, the evidenced large and variable CH4 emissions and significant N2O emissions call for improved modeling of GHG dynamics in tropical peatlands to test their response to climate changes.
Extraction and characterization of hydroxyapatite‐based materials from grey triggerfish skin and black scabbardfish bones
Authors: Ideia Pedro , Degli Esposti Lorenzo , Miguel Carla Caseiro , Adamiano Alessio , Iafisco Michele , Castilho Paula C.
Published: September 2020

The conversion of food industry by‐products to compounds with high added value is nowadays a significant topic, for social, environmental, and economic reasons. In this paper, calcium phosphate‐based materials were obtained from black scabbardfish (Aphanopus carbo) bones and grey triggerfish (Balistes capriscus) skin, which are two of the most abundant fish by‐products of Madeira Island. Different calcination temperatures between 400 and 1000°C were employed. Materials obtained from calcination of bones of black scabbard fish were composed by homogeneous mixtures of hydroxyapatite (Ca10(PO4)6(OH)2, HAp) and β‐tricalcium phosphate (β‐Ca3(PO4)2, β‐TCP). Because of the high biocompatibility of HAp and the good resorbability of β‐TCP, these natural biphasic materials could be very relevant in the field of biomaterials, as bone grafts. The ratio between HAp and β‐TCP in the biphasic compound was dependent on the calcination temperature. Differently, the material obtained from skin of grey triggerfish contained HAp as the main phase, together with small amounts of other mineral phases, such as halite and rhenanite, which are known to enhance osteogenesis when used as bone substitutes. In both cases, the increase of calcination temperature led to an increase in the particles size with a consequent decrease in their specific surface area. These results demonstrate that from the fish by‐products of the most consumed fishes in Madeira Island it is possible to obtain bioceramic materials with tunable composition and particle morphology, which could be promising materials for the biomedical field.
Effect of cooking temperature on texture and flavour binding of braised sauce porcine skin
Authors: Xu Chunyan , Wang Ying , Pan Daodong , Zhou Changyu , He Jun , Cao Jinxuan
Published: September 2020

To investigate the effect of cooking temperature (55, 65, 75, 85 and 95 °C) on texture and flavour binding of braised sauce porcine skin (BSPS), sensory acceptance, microstructure and flavour‐binding capacity were investigated during the processing of BSPS. Samples cooked at 85 and 95 °C showed better texture and aroma scores. Hardness and chewiness of BSPS were obviously improved at 85 and 95 °C than control group. Collagen structure was significantly destroyed over 85 °C. The porcine skin collagen heated at 85 and 95 °C showed relatively higher flavour‐binding capacity than other samples. The improvement of texture of BSPS was mainly attributed to the degradation of collagen. Higher aroma scores of BSPS were related to intense binding abilities with aroma compounds at 85 and 95 °C. Cooking at 85 or 95 °C could be an optimal cooking temperature for BSPS.
The East African highland cooking bananas ‘Matooke’ preferences of farmers and traders: Implications for variety development
Authors: Akankwasa Kenneth , Marimo Pricilla , Tumuhimbise Robooni , Asasira Moreen , Khakasa Elizabeth , Mpirirwe Innocent , Kleih Uli , Forsythe Lora , Fliedel Geneviève , Dufour Dominique , Nowakunda Kephas
Published: September 2020

‘Matooke’ is a staple food made from Highland cooking bananas in the Great Lakes region of East Africa. Genetic improvement of these bananas for resistance to pests and diseases has been a priority breeding objective. However, there is insufficient information on fruit quality characteristics that different users prefer, resulting in sub‐optimal adoption of new varieties. This study identified matooke characteristics preferred by farmers and traders, using survey data from 123 farmers, 14 focus group discussions and 40 traders. Gender differences were considered. The main characteristics that were found to drive variety preferences were agronomic (big bunch, big fruits) and quality (soft texture, good taste, good aroma, yellow food). There were minimal geographical and gender differences for trait preferences. Quality characteristics need to be defined in terms of physical–chemical underpinnings so that breeding programmes can apply accurate high‐throughput systems, thereby improving adoption and impact of new banana varieties.