bluuebunny/crossref_metadata_2025 huggingface dataset:
Ambulatory surgery for cancer patients: current controversies and concerns
Authors: Guerra-Londono Carlos E. , Kim Daniel , Ramirez Manotas Maria F.
Published: August 2021

Purpose of review

This review aims to describe the main concerns and controversies of ambulatory surgery in cancer patients while providing an overview of ambulatory cancer anaesthesia.

Recent findings

Cancer patients can undergo a variety of ambulatory surgeries. The introduction of robotic approach and the implementation of enhanced recovery programmes have allowed patients to avoid hospital admissions after more complex or invasive surgeries. In this context, the anaesthesiologist plays a key role in ensuring that the ambulatory surgical centre or the hospital-based ambulatory department is equipped for the perioperative challenges of the cancer population. Cancer patients tend to be older and with more comorbidities than the general population. In addition, these individuals may suffer from chronic conditions solely because of the cancer itself, or the treatment. Consequently, frailty is not uncommon and should be screened on a routine basis. Regional analgesia plays a key role in the provision of opioid-sparing multimodal analgesia.

Neither regional anaesthesia or general anaesthesia have proven to affect the long-term oncological outcomes of cancer patients undergoing ambulatory surgery. In addition, there is insufficient evidence to suggest the use of total intravenous anaesthesia or inhalational anaesthesia over the other to decrease cancer recurrence.
The Impact of Surgical Approaches for Isolated Acetabulum Fracture on Sexual Functions: A Prospective Study
Authors: Yavuz Ibrahim Alper , Aykanat Can , Senel Cagdas , Inci Fatih , Ceyhan Erman , Aslan Yılmaz , Tuncel Altug , Yildirim Ahmet Ozgur
Published: August 2021

Objectives:

To investigate the effects of surgical modalities for isolated acetabular fractures on the sexual functions of patients and their partners.

Design:

Prospective.

Setting:

Level I trauma centre.

Patients/Participants:

Sixty-five patients who had undergone open reduction and internal fixation because of isolated acetabular fractures who were sexually active before, together with their partners.

Intervention:

Patients operated on for isolated acetabular fractures were divided into 3 groups according to surgical approaches: the Kocher–Langenbeck approach (n = 36), ilioinguinal approach (n = 16), and modified Stoppa approach (n = 13).

Main Outcome Measurements:

Sexual functions of patients and their partners were evaluated with the 5-item version of the International Index of Erectile Function score and Female Sexual Function Index score preoperatively and at the postoperative first year after the rehabilitation period.

Results:

The mean age of the patients was 41.8 ± 13.0 (18–69) years. In male patients, the mean 5-item version of the International Index of Erectile Function score had changed from 24.3 to 20.0 at the postoperative first year and the decrease in sexual function scores was less with the Kocher–Langenbeck approach. In female patients, the Female Sexual Function Index scores had decreased statistically significantly from 24.9 to 18.3 at the postoperative first year, but there was no statistically significant difference between surgical groups. Both male and female patients' partners' sexual function scores were also decreased at the postoperative first year.

Conclusions:

As a result of our study, it was observed that the posterior approach is more advantageous than anterior approaches in preserving the sexual functions of male patients in acetabular fracture surgery. However, the surgical approach did not affect the sexual functions of female patients.

Level of Evidence:

Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
Pediatric and Adolescent Fractures of the Acetabulum Treated With ORIF: What Are Their Functional Outcomes?
Authors: Southam Brendan R. , Schumaier Adam , Ramalingam Wendy , Avilucea Frank , Rice Denning Jaime , Whitlock Patrick W. , Archdeacon Michael T.
Published: August 2021

Objectives:

To evaluate the functional outcomes of pediatric and adolescent patients (<18 year old) who sustained acetabulum fractures that were treated with open reduction internal fixation (ORIF).

Design:

Retrospective cohort.

Setting:

Level 1 trauma center.

Patients:

Thirty-four pediatric and adolescent patients underwent acetabulum fracture ORIF between 2001 and 2018. Of the operatively treated patients, 21 patients had sufficient follow-up (>6 months), one died after fixation secondary to other traumatic injuries, and 12 patients were lost to follow-up.

Intervention:

Acetabulum fracture ORIF.

Main Outcome Measurement:

The SF-36 Health Survey and Short Musculoskeletal Functional Assessment (SMFA) were compared with population norms. The modified Merle d'Aubigné clinical hip score, Matta radiologic outcome, and postoperative complications were also documented.

Results:

Functional outcome data were available at a mean of 5 years 2 months. Mean SF-36 scores were 44.8 and 50.1 for the physical component score and mental component scores, respectively, which did not differ significantly from US population norms (physical component score mean: 50, P = 0.061 and mental component score mean: 50, P = 0.973). Furthermore, the mean SMFA Bother Index score was 18.6, which is not significantly different from the population norm mean of 13.8 (P = 0.268). However, the function index mean was 31.9, which was significantly worse than the population norm mean of 12.7 (P = 0.001). Two patients with a delayed reduction (>6 hours) of an acetabulum fracture dislocation had poor outcomes related to the development of avascular necrosis and post-traumatic osteoarthritis.

Conclusion:

In this small cohort, 86% (18/21) of these patients had a favorable functional outcome with the exception of the SMFA Functional Index that was significantly less than population norms. Although long-term follow-up is needed, we advocate for operative management of pediatric and adolescent acetabulum fractures when adult displacement and instability criteria are present.

Level of Evidence:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Tibial Shaft and Pilon Fractures With Associated Syndesmotic Injury: A Matched Cohort Assessment
Authors: Purcell Kevin F. , Bergin Patrick F. , Russell George V. , Graves Matt L. , Jones LaRita C. , Spitler Clay A.
Published: August 2021

Objective:

To determine the outcomes of pilon and tibial shaft fractures with syndesmotic injuries compared with similar fractures without syndesmotic injury.

Design:

Retrospective case–control study.

Setting:

Level 1 trauma center.

Patients/Participants:

All patients over a 5-year period (2012–2017) with tibial shaft or pilon fractures with a concomitant syndesmotic injury and a control group without a syndesmotic injury matched for age, OTA/AO fracture classification, and Gustilo–Anderson open fracture classification.

Intervention:

Preoperative or intraoperative diagnosis of syndesmotic injury with reduction and fixation of both fracture and syndesmosis.

Main Outcome Measurement:

Rates of deep infection, nonunion, unplanned reoperation, and amputation in patients with a combined syndesmotic injury and tibial shaft or pilon fracture versus those without a syndesmotic injury.

Results:

A total of 30 patients, including 15 tibial shaft and 15 pilon fractures, were found to have associated syndesmotic injuries. The matched control group comprised 60 patients. The incidence of syndesmotic injury in all tibial shaft fractures was 2.3% and in all pilon fractures was 3.4%. The syndesmotic injury group had more neurologic injuries (23.3% vs. 8.3% P = 0.02), more vascular injuries not requiring repair (30% vs. 15%, P = 0.13), and a higher rate compartment syndrome (6.7% vs. 0%, P = 0.063). Segmental fibula fracture was significantly more common in patients with a syndesmotic injury (36.7% vs. 13.3%, P = 0.04). Fifty percent of the syndesmotic injury group underwent an unplanned reoperation with significantly more unplanned reoperations (50% vs. 27.5%, P = 0.04). The syndesmotic group had a significantly higher deep infection rate (26.7% vs. 8.3% P = 0.047) and higher rate of amputation (26.7% vs. 3.3% P = 0.002) while the nonunion rate was similar (17.4% vs. 16.7% P = 0.85).

Conclusions:

Although syndesmotic injuries with tibial shaft or pilon fractures are rare, they are a marker of a potentially limb-threatening injury. Limbs with this combined injury are at increased risk of deep infection, unplanned reoperation, and amputation. The presence of a segmental fibula fracture should raise clinical suspicion to evaluate for syndesmotic injury.

Level of Evidence:

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Are internal lengthening devices effective and associated with less complications compared to other lengthening devices? A systematic review and meta-analysis
Authors: Rehan Youssef Aliaa , Gumaa Mohammed , Hosny Gamal A.
Published: August 2021

Internal lengthening devices became more popular than external fixators. This was attributed to their effectiveness and lower complication rates. However, this is an assumption that is not on the basis of solid scientific evidence. Therefore, this study systematically reviewed the quality and strength of evidence supporting femoral internal lengthening devices' effectiveness and their associated complications. Six electronic databases (PubMed, Cochrane, Sage, Embase, Web of Science and Scopus) were searched from inception until 20 June 2020. Further, all included articles' bibliographies were searched manually. After screening of retrieved articles, five studies were eligible for qualitative and quantitative synthesis. Studies were assessed by two independent assessors using a modified ‘assessment of the methodological quality both of randomized and nonrandomized studies of health care interventions’. Further, meta-analysis was conducted to compare the procedure’s effectiveness, in terms of healing index and major complications incidence. Our findings showed internal validity as the major source of bias whereas external validity was the least. For healing index, there is limited evidence that internal lengthening devices lower healing index by 0.45 months/cm (95% CI, −0.62 to −0.28; P < 0.01) compared to LON/external fixators. The incidence of major complications, that were directly related to the procedures, did not differ between internal lengthening devices and other fixators (risk ratio=0.97; 95% CI, 0.39–2.44; P < 0.95). This review provides evidence that supports lower healing index and similar complications associated with internal lengthening devices compared to other procedures of femoral lengthening. However, the evidence is very limited to draw a solid conclusion.
Severe adverse cutaneous reactions induced by gefitinib combined with antihypertensive and antihyperlipidemic drugs in lung cancer: a case report
Authors: Shen Xiao , Fan Guorong , Liu Gaolin , Wang Fan , Li Qi , Liu Xinyan , Zhu Hong , Zhu Ying , Lu Jiguang , Wang Shuowen
Published: August 2021

The incidence of lung cancer is increasing yearly worldwide, and targeted medicines are the main choice for lung cancer patients. However, there has been no relevant research about the analysis and adjustment of drug combinations for cancer patients with hypertension and hyperlipidemia until now. Here, we reported a case of medicine adjustment for a patient of lung cancer with hypertension and hyperlipidemia. The patient was diagnosed as right lung adenocarcinoma with lymph node metastasis and continued taking gefitinib tablets to maintain therapeutic efficacy after the end of chemotherapy. Severe paronychia and a high plasma concentration of gefitinib were noticed when the patient visited the hospital for reexamination. The clinical pharmacist found that the patient took nifedipine sustained-release tablets and simvastatin tablets simultaneously, and these medicines were all substrates of CYP3A4. The clinical pharmacist suggested replacing the medicines for hypertension and hyperlipidemia with valsartan capsules (Diovan) and rosuvastatin calcium tablets (Crestor), respectively. The adverse cutaneous reactions were greatly relieved, and the plasma concentration of gefitinib was decreased when another reexamination was performed. Therapeutic drug monitoring was an important method in our case and provided valuable information to develop individualized treatment strategies. For cancer patients suffering from other diseases such as hypertension and hyperlipidemia, it is necessary to pay special attention to the drug–drug interactions and metabolic pathways among drug combinations.
Systematic analysis of the potential off-target activities of osimertinib by computational target fishing
Authors: Chen Shao-jun , Bi Yan-hua , Zhang Li-hua
Published: August 2021

Osimertinib is a third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor used to treat non-small cell lung cancer. However, its off-targets are obscure, and systematic analysis of off-target activities remains to be performed. Here, we identified the off-targets of osimertinib using PharmMapper and DRAR-CPI and analyzed the intersected targets using the GeneMANIA and DAVID servers. A drug-target-pathway network was constructed to visualize the associations. The results showed that osimertinib is associated with 31 off-targets, 40 Kyoto Encyclopedia of Genes and Genomes pathways, and 9 diseases. Network analysis revealed that the targets were involved in cancer and other physiological processes. In addition to EGFR, molecular docking analysis showed that seven proteins, namely Janus kinase 3, peroxisome proliferator-activated receptor alpha, renin, mitogen-activated protein kinases, lymphocyte-specific protein tyrosine kinase, cell division protein kinase 2 and proto-oncogene tyrosine-protein kinase Src, could also be potential targets of osimertinib. In conclusion, osimertinib is predicted to target multiple proteins and pathways, resulting in the formation of an action network via which it exerts systematic pharmacological effects.
Antibodies to EGF Receptor Family Members Can Upregulate Tumor Immunity
Authors: Dai Min , Yip Yuen Yee , Todaro George , Hellstrom Ingegerd , Hellstrom Karl E.
Published: August 2021

Immunologic mechanisms influence how a cancer patient responds to therapy. Monoclonal antibodies (mAbs) to the epidermal growth factor receptor are clinically approved, and a lung cancer vaccine inducing antibodies to epidermal growth factor (EGF) has some beneficial clinical effects. We tested the hypothesis that mAbs to epidermal growth factor receptor, EGF, and tumor growth factor alpha (TGF-α), in addition to any other effects, can facilitate the generation of a tumor-destructive immunologic response. Data from studies with mouse tumors showed that all 3 of these mAbs stimulated the in vitro generation of a Th1 response with tumor cells killed by spleen cells from mice with SW1 melanoma, B16 melanoma, or ID8 ovarian carcinoma. The mAb to TGF-α was most effective, and tumor lines releasing TGF-α were more sensitive than lines not releasing TGF-α. Stimulated by these findings we then performed pilot experiments in which mice with SW1 melanoma were injected with mAbs intraperitoneally or with a combination of the 2. A combination of anti-TGF-α and anti-PD-1 mAbs could cure mice with established tumor while single anti-TGF-α or anti-PD1 mAbs could not.
The intersection of drug interactions and adverse reactions in contemporary antiretroviral therapy
Authors: Nhean Salin , Tseng Alice , Back David
Published: August 2021

Purpose of review

Advances in antiretroviral therapy (ART) have transformed HIV infection into a chronic and manageable condition. The introduction of potent and more tolerable antiretrovirals (ARVs) with favorable pharmacokinetic profiles has changed the prevalence and nature of drug–drug interactions (DDIs). Here, we review the relevance of DDIs in the era of contemporary ART.

Recent findings

Management of DDIs remains an important challenge with modern ART, primarily due to increased polypharmacy in older persons living with HIV. Significant DDIs exist between boosted ARVs or older nonnucleoside reverse transcriptase inhibitors and comedications for chronic comorbidities (e.g., anticoagulants, antiplatelets, statins) or complex conditions (e.g., anticancer agents, immunosuppressants). Newer ARVs such as unboosted integrase inhibitors, doravirine, and fostemsavir have reduced DDI potential, but there are clinically relevant DDIs that warrant consideration. Potential consequences of DDIs include increased toxicity and/or reduced efficacy of ARVs and/or comedications. Management approaches include switching to an ARV with less DDI potential, changing comedications, or altering medication dosage or dosing frequency. Deprescribing strategies can reduce DDIs and polypharmacy, improve adherence, minimize unnecessary adverse effects, and prevent medication-related errors.

Management of DDIs requires close interdisciplinary collaboration from multiple healthcare disciplines (medicine, nursing, pharmacy) across a spectrum of care (community, outpatient, inpatient).
The molecular, electrophysiological, and structural changes in the vestibular nucleus during vestibular compensation: a narrative review
Authors: Wang Pengjun , Lu Wen , Li Yini , Shi Haibo , Yin Shankai
Published: August 2021

The vestibular system involves high-level sensory and cognitive processes, such as spatial perception, balance control, visual stability, and emotional control. Vestibular dysfunction can induce vertigo, blurred vision, postural imbalance, walking instability, and spatial discomfort, which causes serious damage to health. It has long been known that after peripheral vestibular lesion, vestibular dysfunction may spontaneously recover. This is known as vestibular compensation. However, at least 20% to 30% of patients with vestibular disorders cannot yield vestibular compensation and remain with vestibular dysfunction for the rest of their lives. The exploration of the biological characteristics and regulatory factors of the loss and reestablishment of vestibular function will establish a new understanding of the mechanism of vestibular compensation and provide new tools and strategies for promoting vestibular rehabilitation. We aim to comprehensively review the mechanism of vestibular compensation and discuss future directions in this field.
Ion channel-related hereditary hearing loss: a narrative review
Authors: Zheng Honglan , Cui Wanning , Yan Zhiqiang
Published: August 2021

Sensorineural hearing loss is the most common sensory deficit in humans, with an estimated prevalence of 1 in 500 newborns. Approximately half of childhood hearing loss is attributed to genetic factors and can be classified as syndromic or non-syndromic based on the inheritance pattern. The ion channel genes
KCNQ1
,
KCNE1
,
KCNQ4
,
P2RX2
,
TMC1
,
KCNJ10
, and
CACNA1D
have frequently been associated with genetic hearing loss. Because of the important roles these genes play in cochlear hair cell function and the auditory pathways, mutations in these genes that result in impaired ion channel function can lead to hereditary hearing loss. The main purpose of this review was to examine the latest research progress on the functional roles, inheritance pattern, gene expression, protein structure, clinical phenotypes, mouse models, and possible treatments of the most commonly studied ion channels associated with inherited deafness. A comprehensive summary could help highlight ion channels that should be investigated as potential drug targets for the treatment of inherited deafness.
Improvements of Frontotemporal Cerebral Blood Flow and Cognitive Functioning in Patients With First Episode of Schizophrenia Treated With Long-Acting Aripiprazole
Authors: Peitl Vjekoslav , Badžim Vivian A. , Šiško Markoš Ines , Rendulić Ana , Matešić Krunoslav , Karlović Dalibor
Published: August 2021

Purpose/Background

Frontal and temporal cerebral blood flow (CBF) changes are the most common impairments of CBF described in patients with schizophrenia. Those impairments have also been associated with cognitive deficits, a hallmark of schizophrenia. In light of that fact, treatment interventions should target cognitive deficits to prevent chronic disability. However, specific therapies targeting cognitive symptoms are very few and far between. One of the treatment possibilities is aripiprazole, because several studies reported its potential procognitive effects. The objective of this study was to investigate whether use of aripiprazole in its long-acting injectable formulation (ALAI), during a 3-month treatment, has beneficial effects on CBF and cognitive functioning in patients with first episode of schizophrenia.

Methods/Procedures

Single-photon emission computed tomography with technetium-99m hexamethylpropylene amine oxime was performed at 2 time points. Cognitive functions were assessed with a standardized test for cognitive functions, 5-KOG test, whereas severity of clinical symptoms was assessed with the Positive and Negative Syndrome Scale, both at the same 2 time points as single-photon emission computed tomography. Three-month treatment with ALAI was associated with improvement of several cognition indices and improvements of right-sided frontal and temporal CBF, as well as of clinical symptoms.

Findings/Results

Multivariate tests were used to test for the effects of ALAI treatment on cognitive functions, clinical presentation, and brain perfusion in a 3-month period. Multivariate model revealed statistical significance (F = 11.958, P < 0.001). Of 10 separate 5-KOG parameters, 3-month treatment with ALAI significantly influenced 4: undelayed recall, delayed recall, attention, and working memory—digit span forward. Finally, 3-month ALAI treatment significantly improved regional CBF in 2 of 4 investigated areas, both on the right side of the brain (frontally and temporally).

Implications/Conclusions

Results of this research showed that treatment with ALAI in patients with first episode of schizophrenia is associated with improved right-sided frontal and temporal CBF, as well as with improved symptoms, including cognition indices. Although we cannot confirm it directly, it is possible that improved frontotemporal CBF led to the improvement in cognition indices.
Longitudinal Changes in Spirometry in Deployed Air Force Firefighters
Authors: Berglund Andrew J. , Kim John , Walter Robert J. , McCann Edward T. , Morris Michael J.
Published: August 2021

Introduction:

Inhalational exposures are common among service members who deploy to southwest Asia. The objective of this study is to determine if deployed Air Force firefighters have any decline in spirometry related to deployment.

Methods:

This study is a retrospective chart review.

Results:

The database search identified 302 firefighters with documentation of two separate spirometry examinations. For deployed firefighters, mean change in forced expiratory volume at 1 second (FEV1) percent predicted was –1.01 ± 7.86, forced vital capacity (FVC) was –0.46 ± 10.26 predicted, and mid-expiratory flow (FEF25–75) was –0.13 ± 12.97. For firefighters who had never deployed, mean change in FEV1 percent predicted was +0.08 ± 7.09, FVC was +0.72 ± 7.75, and FEF25–75 was –0.66 ± 16.17.

Conclusion:

There does not appear to be evidence that deployment causes a significant change in lung function as measured by spirometry.
18F-FDG PET and PET/CT for the evaluation of gastric signet ring cell carcinoma: a systematic review
Authors: Dondi Francesco , Albano Domenico , Giubbini Raffaele , Bertagna Francesco
Published: August 2021

Background

In the last years, 18F-fluorodeoxyglucose PET/computed tomography (18F-FDG PET/CT) has demonstrated its utility for the evaluation of gastric cancer; however, considering some histotypes such as gastric signet ring cell carcinoma (GSRCC) the results are limited. The aim of this review is to analyze the diagnostic performance of 18F-FDG PET and PET/CT for the assessment of GSRCC.

Methods

A wide literature search of the PubMed/MEDLINE, Scopus, Embase and Cochrane library databases was made to find relevant published articles about the diagnostic performance of 18F-FDG PET or PET/CT for the evaluation of GSRCC.

Results

The comprehensive computer literature search revealed 179 articles. On reviewing the titles and abstracts, 162 articles were excluded because the reported data were not within the field of interest. Nine studies were included in the review and references were also screened for additional articles. Finally, 26 articles were selected and retrieved in full-text version.

Conclusion

Despite some limitations affect our review, GSRCC seems to have low 18F-FDG uptake, and therefore 18F-FDG PET or PET/CT reveals impaired sensitivity for its evaluation. However, a correlation between 18F-FDG uptake and some clinico-pathologic features (such as stage, depth of invasion, size and presence of nodal metastasis) has been demonstrated. Besides, a possible prognostic role of PET/CT features is starting to emerge.
Short-Term Resorption of Grafted Bone After Split Calvarial Bone Grafting for an Occipital Skull Defect in a Patient With Multisystem Langerhans Cell Histiocytosis
Authors: Mizokami Masataka , Imanishi Masaya , Asato Hirotaka
Published: August 2021

Langerhans cell histiocytosis (LCH) is a rare disease in which LCH cells derived from myeloid dendritic cells proliferate and invade single or multiple systems. We have encountered a case of short-term resorption of the grafted bone after split calvarial bone grafting for an occipital skull defect in a 6-year-old girl with multisystem LCH in remission who was referred to our department for reconstructive surgery. We performed cranioplasty using a split calvarial bone graft. Two months after surgery, computed tomography scans revealed that most of the grafted bone had been resorbed. To our knowledge, there have been no such reports previously. There are 2 possible explanations for the resorption of an autologous bone graft in this patient. The first possibility is that the recipient site contained an active lesion and the second is that the bone resorption occurred because the bone graft was placed on the periosteum.
Biomarkers for the Early Diagnosis of Sepsis in Burns
Authors: Li Andrew T. , Moussa Anthony , Gus Eduardo , Paul Eldho , Yii Erwin , Romero Lorena , Lin Zhiliang Caleb , Padiglione Alexander , Lo Cheng Hean , Cleland Heather , Cheng Allen C.
Published: August 2021

Objective:

The aim of this study was to evaluate the diagnostic performance of all biomarkers studied to date for the early diagnosis of sepsis in hospitalized patients with burns.

Background:

Early clinical diagnosis of sepsis in burns patients is notoriously difficult due to the hypermetabolic nature of thermal injury. A considerable variety of biomarkers have been proposed as potentially useful adjuncts to assist with making a timely and accurate diagnosis.

Methods:

We searched Medline, Embase, Cochrane CENTRAL, Biosis Previews, Web of Science, and Medline In-Process to February 2020. We included diagnostic studies involving burns patients that assessed biomarkers against a reference sepsis definition of positive blood cultures or a combination of microbiologically proven infection with systemic inflammation and/or organ dysfunction. Pooled measures of diagnostic accuracy were derived for each biomarker using bivariate random-effects meta-analysis.

Results:

We included 28 studies evaluating 57 different biomarkers and incorporating 1517 participants. Procalcitonin was moderately sensitive (73%) and specific (75%) for sepsis in patients with burns. C-reactive protein was highly sensitive (86%) but poorly specific (54%). White blood cell count had poor sensitivity (47%) and moderate specificity (65%). All other biomarkers had insufficient studies to include in a meta-analysis, however brain natriuretic peptide, stroke volume index, tumor necrosis factor (TNF)-alpha, and cell-free DNA (on day 14 post-injury) showed the most promise in single studies. There was moderate to significant heterogeneity reflecting different study populations, sepsis definitions and test thresholds.

Conclusions:

The most widely studied biomarkers are poorly predictive for sepsis in burns patients. Brain natriuretic peptide, stroke volume index, TNF-alpha, and cell-free DNA showed promise in single studies and should be further evaluated. A standardized approach to the evaluation of diagnostic markers (including time of sampling, cut-offs, and outcomes) would be useful.
Assessing sustainability factors for rural sanitation coverage in Kenya, Zambia, Nepal, and Bhutan: A qualitative case study analysis
Authors: Sakas Zoe , Uwah Eberechukwu A. , Snyder Jedidiah S. , Garn Joshua V. , Freeman Matthew C.
Published: August 2021

BACKGROUND

Few countries are likely to achieve universal sanitation within the next decade as sustaining sanitation coverage remains a critical challenge. The purpose of this study is to investigate factors that may have supported or hindered sustainability of sanitation coverage 1-2 years after the completion of an integrated, area-wide sanitation program in four countries.

METHODS

Between 2014 and 2018, the SSH4A approach was implemented in 15 countries in Africa and Asia, four of which are included in this qualitative study. We conducted focus group discussions and interviews with beneficiaries, implementors, and decision-makers to identify sustainability factors and used household survey data to characterize sub-national sanitation coverage throughout implementation, and 1-2 years after.

RESULTS

Our data revealed behavioral, contextual, and service delivery factors that were related to the sustainability of sanitation improvements. Service delivery factors included follow-up hygiene promotion, access to materials (e.g., plastic, cement), local government commitment post-implementation, functioning monitoring systems, uptake of the supply chain by private sector, capacity for innovation. Contextual and behavioral factors included poverty, soil type, road networks, social cohesion, desire for improved latrines, maintenance and cleaning, and knowledge of sanitation benefits.

DISCUSSION

The presence or absence of sustainability factors identified through this research may have implications on where certain programmatic approaches will work, and where adaptations may be required. Through comparing sustainability factors with sub-national slippage rates, we were able to illustrate how local service delivery systems may respond to barriers (e.g., poverty, lack of affordable sanitation options, changes in population density) and enablers (e.g., sufficient resource allocation, passionate leadership, social cohesion). Understanding the programmatic and contextual factors that either drive or hinder long-term sanitation coverage may allow for greater program impact through adapting implementation based on existing challenges in service delivery and context.
Rethinking symbiotic metabolism: trophic strategies in the microbiomes of different sponge species
Authors: Burgsdorf I , Sizikov S , Squatrito V , Britstein M , Slaby BM , Cerrano C , Handley KM , Steindler L
Published: August 2021

In this study we describe the major lithoheterotrophic and autotrophic processes in 21 microbial sponge-associated phyla using novel and existing genomic and transcriptomic datasets. We show that a single gene family, molybdenum-binding subunit of dehydrogenase (coxL), likely evolved to benefit both lithoheterotrophic and organoheterotrophic symbionts, through adaptation to different inorganic and organic substrates. We show the main microbial carbon fixation pathways in sponges are restricted to specialized symbiotic lineages within five phyla. We also propose that sponge symbionts, in particular Acidobacteria, are capable of assimilating carbon through anaplerotic processes. However, the presence of symbionts genomically capable of autotrophy does not inform on their actual contribution to light and dark carbon fixation. Using radioisotope assays we identified variability in the relative contributions of chemosynthesis to total carbon fixation in different sponge species. Furthermore, the symbiosis of sponges with two closely related Cyanobacteria results in outcomes that are not predictable by analysis of -omicsdata alone:CandidatusSynechococcus spongiarum contributes to the holobiont carbon budget by transfer of photosynthates, whileCandidatusSynechococcus feldmannii does not. Our results highlight the importance of combining sequencing data with physiology to gain a broader understanding of carbon metabolism within holobionts characterized by highly diverse microbiomes.
HIV-1 Mutants that Escape the Cytotoxic T-Lymphocytes are Defective in Viral DNA Integration
Authors: Balasubramaniam Muthukumar , Thapa Santosh , Davids Benem-Orom , Bryer Alex , Xu Chaoyi , Shi Jiong , Aiken Christopher , Pandhare Jui , Perilla Juan R. , Dash Chandravanu
Published: August 2021

ABSTRACT

HIV-1 replication is durably controlled in certain untreated HIV-1-infected individuals expressing particular human leukocyte antigens (HLA). These HLAs tag infected cells for elimination by presenting specific viral epitopes to CD8+ cytotoxic T-lymphocytes (CTL). In individuals expressing HLA-B27, CTLs primarily target the capsid protein (CA)-derived KK10 epitope. Selection of CA mutation R264K helps HIV-1 escape the CTL response but severely diminishes virus infectivity. Here we report that the R264K mutation-associated infectivity defect arises primarily from impaired viral DNA integration. Strikingly, selection of the compensatory CA mutation S173A or depletion of host cyclophilin A largely rescues the R264K-associated integration and infectivity defects. Collectively, our study reveals novel mechanistic insights into the fitness defect incurred by an HIV-1 variant escaping a CA-directed CTL response.
To draw or not to draw: understanding the temporal organization of drawing behaviour using fractal analyses
Authors: Beltzung Benjamin , Martinet Lison , MacIntosh Andrew J. J. , Meyer Xavier , Hosselet Jérôme , Pelé Marie , Sueur Cédric
Published: August 2021

Studies on drawing often focused on spatial aspects of the finished products. Here, the drawing behaviour was studied by analysing its intermittent process, between drawing (i.e. marking a surface) and interruption (i.e. a pause in the marking gesture). To assess how this intermittence develops with age, we collected finger-drawings on a touchscreen by 185 individuals (children and adults). We measured the temporal structure of each drawing sequence to determine its complexity. To do this, we applied temporal fractal estimators to each drawing time series before combining them in a Principal Component Analysis procedure. The youngest children (3 years-old) drew in a more stereotypical way with long-range dependence detected in their alternations between states. Among older children and adults, the complexity of drawing sequences increased showing a less predictable behaviour as their drawings become more detailed and figurative. This study improves our understanding of the temporal aspects of drawing behaviour, and contributes to an objective understanding of its ontogeny.
Grid-cell modules remain coordinated when neural activity is dissociated from external sensory cues
Authors: Waaga Torgeir , Agmon Haggai , Normand Valentin A. , Nagelhus Anne , Gardner Richard J. , Moser May-Britt , Moser Edvard I. , Burak Yoram
Published: August 2021

The representation of an animal’s position in the medial entorhinal cortex (MEC) is distributed across several modules of grid cells, each characterized by a distinct spatial scale. The population activity within each module is tightly coordinated and preserved across environments and behavioral states. Little is known, however, about the coordination of activity patterns across modules. We analyzed the joint activity patterns of hundreds of grid cells simultaneously recorded in animals that were foraging either in the light, when sensory cues could stabilize the representation, or in darkness, when such stabilization was disrupted. We found that the states of different grid modules are tightly coordinated, even in darkness, when the internal representation of position within the MEC deviates substantially from the true position of the animal. These findings suggest that internal brain mechanisms dynamically coordinate the representation of position in different modules, to ensure that grid cells jointly encode a coherent and smooth trajectory of the animal.
“I thought I lost my home”: resource loss, distress and recovery after the Manaro Voui volcanic disaster on Ambae Island
Authors: Clissold Rachel , McNamara Karen Elizabeth , Westoby Ross , Daniel Ladonna , Raynes Elizabeth , Licht Obed Viviane
Published: August 2021

Purpose

This paper builds on existing studies by drawing on Conservation of Resources theory to explore the losses, psychological impacts as well as recovery processes of the 2017/18 volcanic disaster on Ambae Island, Vanuatu.

Design/methodology/approach

This discussion is based on local perspectives and personal accounts collected through a series of eight semi-structured interviews (five males and three females).

Findings

The volcanic activity and subsequent displacement and evacuation led to significant resource loss which had a spiralling nature, causing psychological harm. Locals invested resources to recover and protect against future loss in diverse ways and, as resource gains were secured, experienced emotional relief. Key to recovery and healing included returning “home” after being displaced and reinvigorating cultural practices to re-establish cultural continuity, community and identity. Resource gains spiralled as people reconnected and regained a sense of place, optimism and the motivation to rebuild.

Originality/value

Numerous studies have drawn upon the Conservation of Resources (COR) theory to explore how resource loss can trigger psychological distress during environmental disasters; however, it has not been applied in Vanuatu, the most at-risk nation globally to natural hazards. This paper builds on existing studies by exploring personal accounts of resource loss, distress and recovery, and providing insights into resource spirals, caravans and passageways.
Is it all about perception? A sustainability viewpoint on psychological capital and life well-being of management graduates
Authors: M Nimmi P. , Joseph George , Donald William E.
Published: August 2021

Purpose

Well-being and employability are considered important indicators of a sustainable career that must be incorporated into the system at the beginning of a job. Hence, it is essential to explore the role of positive personal resources to improve young managers' well-being. The unending ambivalence in the academic environment and the job market is detrimental to management graduates' well-being. The study aims to look into the possible intervening methods to enhance the well-being of management students during difficult times.

Design/methodology/approach

A cross-sectional study was conducted among 212 management students from Kerala, India. Multi-stage random sampling was used to collect data. Structural equation modelling using IBM-AMOS was done to gain insights into the proposed relationships.

Findings

The results indicated that psychological capital had a significant impact on the well-being of management students. Both perceived employability and psychological capital are positively related to life well-being. And, perceived employability mediated the relationship between psychological capital and life well-being.

Research limitations/implications

The theoretical contribution comes from the application of the broaden-and-build theory and resource caravans from the conservation of resource theory as a theoretical framework to understand the positive impact of developing psychological capital among university students. The practical contribution comes from identifying a need for universities to make their campus climate more supportive of the non-academic needs of students by supporting them to become more self-reliant and enhance their positive psychological resources. Developing psychological resources of perceived employability and psychological capital is quintessential to enhance life well-being and career sustainability of early careers talent.

Originality/value

This study is one of the first attempts to discern how psychological capital leads to an accumulation of psychological resources and life well-being in university students and graduates offering opportunities for career sustainability.
An evaluation of a de-escalation conflict management training in a behavioral health hospital setting
Authors: Romain Dagenhardt Danielle , Heideman Amanda , Knoche Victoria , Freiburger Tina
Published: August 2021

Purpose

The purpose of this study is to evaluate a conflict management training that used a communication competence perspective. This addresses whether the training had an impact on role conflict, conflict resolution skills, horizontal violence, burnout, turnover intention and perceptions of consumers. It also assessed staff perceptions of the training.

Design/methodology/approach

A mixed-method analysis was used using survey data from multiple time points along with focus group interviews.

Findings

The program decreased role conflict, horizontal violence and burnout among direct-care workers, whereas feelings of safety and perceptions of workers’ ability to protect themselves and others in aggressive situations increased. Furthermore, staff felt the training was useful and increased feelings of safety and empowerment at the study.

Practical implications

These findings suggest that conflict management training may need additional refresher sessions. Administrative planning is also needed to ensure training of all staff is trained in an adequate timeframe.

Originality/value

These results, although positive, are somewhat time bound. Therefore, the content of training and knowledge dissemination of conflict management training need additional research to ensure best practices.
A study on the impact of digital tobacco logistics on tobacco supply chain performance: taking the tobacco industry in Guangxi as an example
Authors: Shen Xiaoping , Zhang Yeheng , Tang Yumei , Qin Yuanfu , Liu Nan , Yi Zelong
Published: August 2021

Purpose

This paper, with the tobacco industry as the background, establishes an indicator system for tobacco supply chain performance evaluation using the FAHP method.

Design/methodology/approach

Based on the relevant data of tobacco enterprises in Guangxi, the paper calculates the performance values of tobacco companies in various cities of Guangxi, and through the analysis of each indicator and the performance values of each city, the authors find that the improvement ability has a major impact on tobacco supply chain performance. Then, the paper establishes a system dynamics model to further demonstrate the impact of information digitalization on the performance of the tobacco supply chain in Guangxi, thus providing theoretical support for building digital tobacco logistics in Guangxi.

Findings

The findings of the study show that the performance of the tobacco supply chains in various cities of Guangxi is generally at the level of “Pass–Good,” which can barely meet the requirements of tobacco supply chain operation, but there is still plenty of room for improvement.

Originality/value

The authors show that digital and IT-based empowerment can maximize the performance of Guangxi's tobacco logistics performance.
An intercultural, interpersonal relationship development framework
Authors: Koponen Jonna , Julkunen Saara , Gabrielsson Mika , Pullins Ellen Bolman
Published: August 2021

Purpose

The purpose of this paper is to explore how business-to-business (B2B), intercultural, interpersonal salesperson–customer relationships develop using the lens of identity management theory (IMT; Imahori and Cupach, 2005).

Design/methodology/approach

The research uses qualitative semi-structured interviews on 18 targeted relationships with customers from another culture conducted with business-to-business salespeople.

Findings

The findings indicate that our respondents' relationships moved from trial toward enmeshment and on occasion toward the renegotiation phase, as described in IMT. In the case of low cultural diversity between salesperson and customer, the relationships reached the trial and enmeshment phase. In the case of high cultural diversity between salesperson and customer, the relationships on occasion evolved toward the renegotiation phase. Salespeople's cultural intelligence (CQ) facilitates the development of interpersonal, intercultural salesperson–customer relationships.

Originality/value

The authors transfer IMT from the personal relationship development arena to B2B intercultural, interpersonal relationships, address a gap in the literature in the understanding of salesperson–customer interpersonal relationships in different contexts and develop a theoretical model to understand intercultural, interpersonal salesperson–customer relationship development across different levels of cultural diversity.
Stolen at the pump: an empirical analysis of risk factors on gas pump skimmer fraud attacks
Authors: Belshaw Scott H. , Nodeland Brooke
Published: August 2021

Purpose

The purpose of this study is to examine the characteristics of gas stations where skimmer attacks occurred in a sample of Texas gas stations between 2019 and 2021. This paper seeks to contribute to the literature related to payment card fraud at the gas pump by providing one of the first examinations of the gas stations where gas pump skimming is known to have occurred.

Design/methodology/approach

Using data collected from a Texas state regulatory agency between 2021, the authors examine characteristics of gas stations where a gas pump skimming was detected.

Findings

Results suggest that the presence of a surveillance camera system was significantly related to gas pump skimmer detection for gas stations in both urban and rural areas. Europay chip readers were not present in any of the pumps where a skimmer attack was detected.

Originality/value

Gas pump skimming is a form of payment card fraud that costs upwards of US$11bn a year in the USA alone. Gas pump skimming occurs when electronic devices are illegally installed fuel pumps to capture data or record cardholders’ personal identification numbers. This is among the first studies to use data obtained from a state agency with specific information regarding each individual occurrence of gas pump skimming. As such, the paper makes a unique contribution by exploring specific characteristics of gas stations where skimming and ultimately payment card fraud, occurred.
Social media and entrepreneurship: exploring the impact of social media use of start-ups on their entrepreneurial orientation and opportunities
Authors: Troise Ciro , Dana Leo Paul , Tani Mario , Lee Kyung Young
Published: August 2021

Purpose

The aim of this paper is to investigate how social media use (SMU) affects the entrepreneurial orientation (EO) and entrepreneurial opportunities (EOP) of start-ups.

Design/methodology/approach

The hypothesis testing and analysis were conducted using the partial least squares approach to structural equation modeling (PLS-SEM).

Findings

The research shows that SMU has a strong positive impact on EOP, while it has no impact on start-ups' EO. Interestingly, the impact of SMU on EOP is stronger than the impact of EO on EOP.

Originality/value

The findings add new knowledge to the emerging research stream that focuses on SMU in the context of entrepreneurship and provides useful insights for both scholars and practitioners. In particular, the evidence suggests implications for stakeholders with regard to their firms' entrepreneurial activities. This research offers several possible avenues for future research.