bluuebunny/crossref_metadata_2025 huggingface dataset:
Do surges in foreign direct investment inflows lead to surges in economic growth? Evidence from developing countries
Authors: Sahu Jagadish Prasad
Published: September 2020

Purpose

The purpose of this paper is to examine whether surge in foreign direct investment (FDI) inflows leads to surge in economic growth in 52 developing countries for the period 1990-2014.

Design/methodology/approach

The author used a threshold approach to identify surge incidences in gross domestic product (GDP) per capita growth rates and FDI inflows (measured as percentage of GDP) for each country included in the sample. Three different criteria are used to identify surge instances. As a preliminary analysis the author used the probit and complementary log–log regression methods to estimate the likelihood of growth surge occurrence. To correct the potential endogeneity problem the author jointly estimated the growth surge and FDI surge equations using the recursive bivariate probit (RBP) regression.

Findings

The author found that East Asia and the Pacific region has highest rate of growth surge incidences followed by South Asia. The results suggest that surge in FDI inflows significantly increases the likelihood of growth surge. The finding is robust to alternative surge definitions and methods of estimation.

Practical implications

The analysis reveals that inbound FDI flow is a critical driver of economic growth in developing countries. Large FDI inflows matters for achieving rapid economic growth. Therefore developing countries should adopt favourable policies to attract more FDI. Policymakers should focus on improving the investment climate of the country to boost domestic investment and to attract larger amount of FDI into the economy.

Originality/value

To the best of the author’s knowledge this is the first study to examine whether surge in FDI inflows stimulates surge in economic growth in developing countries. The analysis reveals that FDI surge is a robust predictor of rapid economic growth in developing countries.
The plant endosphere world – bacterial life within plants
Authors: Compant Stéphane , Cambon Marine C. , Vacher Corinne , Mitter Birgit , Samad Abdul , Sessitsch Angela
Published: September 2020

The plant endosphere is colonized by complex microbial communities and microorganisms, which colonize the plant interior at least part of their lifetime and are termed endophytes. Their functions range from mutualism to pathogenicity. All plant organs and tissues are generally colonized by bacterial endophytes and their diversity and composition depend on the plant, the plant organ and its physiological conditions, the plant growth stage as well as on the environment. Plant‐associated microorganisms, and in particular endophytes, have lately received high attention, because of the increasing awareness of the importance of host‐associated microbiota for the functioning and performance of their host. Some endophyte functions are known from mostly lab assays, genome prediction and few metagenome analyses; however, we have limited understanding on in planta activities, particularly considering the diversity of micro‐environments and the dynamics of conditions. In our review, we present recent findings on endosphere environments, their physiological conditions and endophyte colonization. Furthermore, we discuss microbial functions, the interaction between endophytes and plants as well as methodological limitations of endophyte research. We also provide an outlook on needs of future research to improve our understanding on the role of microbiota colonizing the endosphere on plant traits and ecosystem functioning.
What Makes an Administrative Decision Unreasonable?
Authors: Dindjer Hasan
Published: September 2020

The nature of reasonableness review in administrative law has long been obscured behind vivid but uninformative descriptions. In recent years, courts and commentators have recognised that reasonableness review involves assessment of the weight and balance of reasons bearing on a decision. Yet by itself this idea is substantially incomplete, for there are many ways in which issues of weight might be relevant. Drawing on the theory of practical reason, this article offers a new account of the reasonableness standard that explains precisely how the weight of reasons matters. It shows, negatively, that several existing accounts are mistaken. Positively, it proposes that reasonableness be understood as a requirement of ‘relativised justification’: a decision must be justified relative to some eligible understanding of the balance of reasons. This account explains the standard's central features and yields a coherent, workable test for courts to apply.
Validation of the 4‐aminophenol color test for the differentiation of marijuana‐type and hemp‐type cannabis
Authors: Lewis Kenna , Wagner Rebecca , Rodriguez‐Cruz Sandra E. , Weaver Michael J. , Dumke Jonathan C.
Published: September 2020

The analysis of cannabis plant material submitted to seized‐drug laboratories was significantly affected by the signing of the Agricultural Improvement Act of 2018, which defined hemp and removed it from the definition of marijuana in the Controlled Substances Act. As a result, field law enforcement personnel and forensic laboratories now are in need of implementing new protocols that can distinguish between marijuana‐type and hemp‐type cannabis. Colorimetric tests provide a cost‐effective and efficient manner to presumptively identify materials prior to submission to a laboratory for analysis. This work presents the validation of the 4‐aminophenol (4‐AP) color test and demonstrates its utility for discriminating between marijuana‐type and hemp‐type cannabis (i.e., typification). Validation studies included the testing of numerous cannabinoid reference materials, household herbs, previously characterized cannabis plant samples, and real‐case samples. The 4‐AP test reliably produces a pink result when the level of Δ9‐tetrahydrocannabinol (THC) is approximately three times lower than the level of cannabidiol (CBD). A blue result is generated when the level of THC is approximately three times higher than that of CBD. Inconclusive results are observed when the levels of THC and CBD are within a factor of three from each other, demonstrating the limitations of the test under those scenarios.
Composition, source, and influencing factors of white spots formation in soybean paste
Authors: Min Shihao , Niu Chengtuo , Shan Wanxiang , Sun Weikang , Liu Chunfeng , Zheng Feiyun , Wang Jinjing , Li Qi
Published: September 2020

White spots are commonly found in bean‐based fermented food, which will significantly lower the product quality. This study aimed to analyze the composition of white spots and further reveal the source and influencing factors of white spots in bean‐based fermented food using soybean paste as study model. The results showed that white spots were mainly composed of 40.96% free tyrosine and 37.94% tyrosine in combination form. During soybean paste fermentation, tyrosine was found to be produced by the actions of proteolytic enzymes secreted by Aspergillus oryzae 3.042 instead of the microbial metabolism and the excessive accumulation of tyrosine in soybean paste led to the formation of white spots. Among all influencing factors, high temperature treatment favored the formation of white spots. The existence of soy peptone and phenylalanine would postpone the precipitation of tyrosine while promoting the aggregation of the tyrosine precipitation. Field emission scanning electron microscope analysis showed that tyrosine would accumulate around the soybean protein particles and treatment at 120 °C would disrupt the structure of tyrosine–protein complex. Based on the above results, we proposed that treatment of soybean paste at temperature lower than 80 °C was the current practically applicable method to control the formation of white spots in soybean paste.

Practical Application

This study developed a new idea to understand the composition and formation of white spots in soybean paste, which would provide guidance for prevention and control of white spots during the production of soybean paste for manufacturers and researchers.
Unravelling ties in the nitrogen network: Polyamines and nitric oxide emerging as essential players in signalling roadway
Authors: Recalde Laura , Gómez Mansur Nabila M. , Cabrera Andrea V. , Matayoshi Carolina L. , Gallego Susana M. , Groppa María D. , Benavides María P.
Published: September 2020

Nitrogen (N) is a central mineral nutrient essential for plant development and growth. It is usually scarcely found in soils, so the knowledge of the overall plant N metabolism deserves substantial attention. Polyamines (PAs) are N‐containing low‐molecular‐weight compounds of polycationic nature involved in essential processes all throughout the life of plants whereas nitric oxide (NO) is a gaseous free radical involved in signalling cascades related to many physiological events. PAs and NO share signalling functions and interact with each other in several biological functions, mainly in stress responses. Biosynthesis pathways of PAs and NO are overlapped; PAs induce NO formation, but it is still not completely defined whether PAs act as substrates, cofactors, or signals for promoting NO synthesis and also, which are the mechanisms involved in NO regulation of PAs metabolism. Polyamine levels are of vital importance in the regulation of the network of N‐metabolising pathways in plants, as they are components of the core of the overall N metabolism. In light of the importance of improving the efficiency of N uptake and distribution, it is time to elucidate the intricate relationship among N as a nutrient with PAs and NO as emerging signalling molecules. The close cooperation among these players in the whole N metabolism is an interesting target for the development of biotechnological tools for sustainable agriculture.
Dermoscopic features of port‐wine stains: A study of 264 cases
Authors: Huang Yuanbo , Yang Jun , Li Zhongming , Zhang Lichao , Sun Li , Bi Mingye , Wang Lei
Published: September 2020

Background

Port‐wine stains (PWS) occur in 0.3–0.5% of the population. However, the dermoscopic features of PWS have not been systematically studied.

Methods

Dermoscopic images of 264 cases with PWS were retrospectively analysed.

Results

Linear vessels were the most frequent dermoscopic features of PWS (42.0%). Other dermoscopic features were reticular vessels (28.0%), sausage‐like vessels (13.6%), dots or globules vessels (9.1%) and mixed vessels (7.2%). Nonvascular morphology comprised white circles (13.6%) and whitish veil (38.3%). Sausage‐like vessels and whitish veil were mainly present in the thickened type and in those with PWS aged ≥18 years; mixed vessels were mainly present in purple type of PWS. Dermoscopic features showed no significant difference between lesions located on different facial areas (V1, V2 and V3). Dots or globular vessels were more common in non‐facial lesions (P < 0.0001). White circles were only found in the facial lesions, and the frequency of white circles and whitish veil was higher in the treated group than in the untreated group (P = 0.004 and P = 0.04, respectively). The frequency of white circles was significantly higher in the prior treated group than in the untreated group (P < 0.0001).

Conclusion

There are various of dermoscopic features of PWS. The dermoscopic features of patients with PWS may correlate with age, subtype, location, prior treatment history and pulsed dye laser (PDL) resistance.
The safety of paediatric surgery between COVID‐19 surges: an observational study
Authors: Okonkwo I. N. C. , Howie A. , Parry C. , Shelton C. L. , Cobley S. , Craig R. , Permall N. , El‐Sheikha S. H. , Herbert N. , Arnold P.
Published: September 2020

Despite the ongoing coronavirus disease 2019 (COVID‐19) pandemic, elective paediatric surgery must continue safely through the first, second and subsequent waves of disease. This study presents outcome data from a children's hospital in north‐west England, the region with the highest prevalence of COVID‐19 in England. Children and young people undergoing elective surgery isolated within their household for 14 days, then presented for real‐time reverse transcriptase polymerase chain reaction testing for severe acute respiratory syndrome coronavirus disease‐2 (SARS‐CoV‐2) within 72 h of their procedure (or rapid testing within 24 h in high‐risk cases), and completed a screening questionnaire on admission. Planned surgery resumed on 26 May 2020; in the four subsequent weeks, there were 197 patients for emergency and 501 for elective procedures. A total of 488 out of 501 (97.4%) elective admissions proceeded, representing a 2.6% COVID‐19‐related cancellation rate. There was no difference in the incidence of SARS‐CoV‐2 among children and young people who had or had not isolated for 14 days (p > 0.99). One out of 685 (0.1%) children who had surgery re‐presented to the hospital with symptoms potentially consistent with SARS‐CoV‐2 within 14 days of surgery. Outcomes were similar to those in the same time period in 2019 for length of stay (p = 1.0); unplanned critical care admissions (p = 0.59); and 14‐day hospital re‐admission (p = 0.17). However, the current cohort were younger (p = 0.037); of increased complexity (p < 0.001) and underwent more complex surgery (p < 0.001). The combined use of household self‐isolation, testing and screening questionnaires has allowed the re‐initiation of elective paediatric surgery at high volume while maintaining pre‐COVID‐19 outcomes in children and young people undergoing surgery. This may provide a model for addressing the ongoing challenges posed by COVID‐19, as well as future pandemics.
Accuracy of postpartum hemorrhage coding in the Swedish Pregnancy Register
Authors: Ladfors Linnea V. , Muraca Giulia M. , Butwick Alexander , Edgren Gustaf , Stephansson Olof
Published: September 2020

Introduction

Postpartum hemorrhage (PPH) is recognized as a leading cause of obstetric morbidity and mortality. Population‐wide studies have used International Classification of Diseases (ICD) diagnostic codes to track and report the prevalence of PPH. Although the 10th revision (ICD‐10) was introduced in Sweden in 1997, the accuracy of ICD‐10 codes for PPH is not known. Thus, the aim was to determine the accuracy of diagnostic coding for PPH in the Swedish Pregnancy Register.

Material and methods

We performed a retrospective cohort study of 609 807 deliveries in Sweden between 2014 and 2019. Information on ICD‐10 codes for PPH and estimated blood loss were extracted from the Swedish Pregnancy Register. Using an estimated blood loss >1000 mL as the reference standard, we evaluated the diagnostic accuracy of ICD‐10 codes for PPH by estimating sensitivity, specificity, positive predictive value and negative predictive value with exact binomial 95% confidence intervals (CIs). In our secondary analysis, we assessed the ICD‐10 coding accuracy for severe PPH, defined as an estimated blood loss >1000 mL and transfusion of at least 1 unit of red blood cells registered in the Scandinavian Donations and Transfusion database.

Results

Of the 609 807 deliveries, 43 312 (7.1%) had an ICD‐10 code for PPH and 45 071 (7.4%) had an estimated blood loss >1000 mL. The ICD codes had a sensitivity of 88.5% (95% CI 88.2‐88.7), specificity of 99.4% (95% CI 99.4‐99.4), positive predictive value of 92.0% (95% CI 91.8‐92.3) and negative predictive value of 99.1% (95% CI 99.1‐99.1). In our secondary analysis, on deliveries with severe PPH, the sensitivity for an ICD code was 91.3% (95% CI 90.7‐91.9), whereas specificity was 83.5% (95% CI 82.3‐84.6).

Conclusions

Our findings indicate that ICD‐10 codes for PPH in Sweden have moderately high sensitivity and excellent specificity. These results suggest that PPH diagnostic codes in medical records and linked pregnancy and birth registers can be used for research, quality improvement and reporting PPH prevalence in Sweden.
Ramucirumab or placebo plus erlotinib in EGFR‐mutated, metastatic non‐small‐cell lung cancer: East Asian subset of RELAY
Authors: Nishio Makoto , Seto Takashi , Reck Martin , Garon Edward B. , Chiu Chao‐Hua , Yoh Kiyotaka , Imamura Fumio , Park Keunchil , Shih Jin‐Yuan , Visseren‐Grul Carla , Frimodt‐Moller Bente , Zimmermann Annamaria , Homma Gosuke , Enatsu Sotaro , Nakagawa Kazuhiko ,   RELAY Study Investigators
Published: September 2020

In the global phase III RELAY study, ramucirumab plus erlotinib (RAM + ERL) demonstrated superior progression‐free survival (PFS) to placebo plus erlotinib (PL + ERL) in untreated patients with epidermal growth factor receptor (EGFR) mutation‐positive metastatic non‐small‐cell lung cancer (NSCLC) (hazard ratio (HR) [95% CI]: 0.59 [0.46‐0.76]). This prespecified analysis assessed RAM + ERL efficacy and safety in the RELAY subset enrolled in East Asia (Japan, Taiwan, South Korea, Hong Kong). Randomized (1:1) patients received oral ERL (150 mg/d) plus intravenous RAM (10 mg/kg) or PL Q2W. Primary endpoint was PFS (investigator‐assessed). Key secondary endpoints included objective response rate (ORR), disease control rate (DCR), duration of response (DoR), overall survival (OS), and safety. Exploratory endpoints included biomarker analyses and time to second progression (PFS2). Median PFS was 19.4 vs 12.5 mo for RAM + ERL (n = 166) vs PL + ERL (n = 170) (HR: 0.636 [0.485‐0.833]; P = .0009). The 1‐y PFS rate was 72.4% vs 52.2%, respectively. PFS benefit was consistent in most subgroups, including by EGFR mutation (Ex19del, Ex21.L858R). ORR and DCR were similar in both arms, but median DoR was longer with RAM + ERL. OS and PFS2 were immature at data cut‐off (censoring rates, 81.2%‐84.3% and 64.1%‐70.5%, respectively). Grade ≥ 3 treatment‐emergent adverse events were more frequent with RAM + ERL (70.7%) than PL + ERL (49.4%). Adverse events leading to treatment discontinuation were similar in both arms (RAM + ERL, 13.3%; PL + ERL, 12.9%), as were post‐progression EGFR T790M mutation rates (43%; 50%). With superior PFS over PL + ERL and safety consistent with the overall RELAY population, RAM + ERL is a viable treatment option for EGFR‐mutated metastatic NSCLC in East Asia.
Clinical, functional and genetic characterization of 16 patients suffering from chronic granulomatous disease variants – identification of 11 novel mutations inCYBB
Authors: Mollin M , Beaumel S , Vigne B , Brault J , Roux-Buisson N , Rendu J , Barlogis V , Catho G , Dumeril C , Fouyssac F , Monnier D , Gandemer V , Revest M , Brion J-P , Bost-Bru C , Jeziorski E , Eitenschenck L , Jarrasse C , Drillon Haus S , Houachée-Chardin M , Hancart M , Michel G , Bertrand Y , Plantaz D , Kelecic J , Traberg R , Kainulainen L , Fauré J , Fieschi F , Stasia M J
Published: September 2020

Chronic granulomatous disease (CGD) is a rare inherited disorder in which phagocytes lack nicotinamide adenine dinucleotide phosphate (NADPH) oxidase activity. The most common form is the X-linked CGD (X91-CGD), caused by mutations in the CYBB gene. Clinical, functional and genetic characterizations of 16 CGD cases of male patients and their relatives were performed. We classified them as suffering from different variants of CGD (X910, X91− or X91+), according to NADPH oxidase 2 (NOX2) expression and NADPH oxidase activity in neutrophils. Eleven mutations were novel (nine X910-CGD and two X91−-CGD). One X910-CGD was due to a new and extremely rare double missense mutation Thr208Arg-Thr503Ile. We investigated the pathological impact of each single mutation using stable transfection of each mutated cDNA in the NOX2 knock-out PLB-985 cell line. Both mutations leading to X91−-CGD were also novel; one deletion, c.-67delT, was localized in the promoter region of CYBB; the second c.253-1879A>G mutation activates a splicing donor site, which unveils a cryptic acceptor site leading to the inclusion of a 124-nucleotide pseudo-exon between exons 3 and 4 and responsible for the partial loss of NOX2 expression. Both X91−-CGD mutations were characterized by a low cytochrome b558 expression and a faint NADPH oxidase activity. The functional impact of new missense mutations is discussed in the context of a new three-dimensional model of the dehydrogenase domain of NOX2. Our study demonstrates that low NADPH oxidase activity found in both X91−-CGD patients correlates with mild clinical forms of CGD, whereas X910-CGD and X91+-CGD cases remain the most clinically severe forms.
Subjective expectations regarding longevity and future health: a cross‐sectional survey among patients with Crohn's disease
Authors: Péntek M. , Gulácsi L. , Herszényi L. , Banai J. , Palatka K. , Lakatos P. L. , Brodszky V. , Rencz F.
Published: September 2020

Aim

The aim was to explore the subjective health expectations (sHE) of patients with Crohn's disease (CD) for both the near future and the elderly.

Method

A cross‐sectional survey was performed in four gastroenterology centres in Hungary. Consecutive outpatients with CD with age ≥ 18 were recruited. Socio‐demographic and disease characteristics were recorded and the Crohn's Disease Activity Index (CDAI), Perianal Disease Activity Index, Patients' Global Assessment (PGA) and current pain visual analogue scale (VAS) were assessed. Subjective life expectancy (sLE) was explored and compared to statistical life expectancy. Current health and sHE for 1 year ahead and for ages 60/70/80/90 were assessed using the descriptive system of the EQ‐5D‐3L.

Results

In all, 206 patients (54.9% men) with a mean age of 34.7 (SD 10.5 years) and disease duration of 10.5 (SD 6.3) years were studied. The CDAI score was 110.5 (SD 77.0) and 66% were treated by biologic drugs. Mean current EQ‐5D‐3L score was 0.80 (SD 0.17) and patients expected a 0.05 (SD 0.15) improvement within a year (P < 0.05). For ages 60/70/80/90, a mean EQ‐5D‐3L score of 0.59, 0.38, 0.10 and −0.12 respectively was provisioned. Age, current health status, sLE, PGA and pain VAS showed significant correlation with both 1‐year and older age sHE (P < 0.05). Long‐term sHE and sLE were negatively affected by the presence of extraintestinal manifestations but not by previous CD‐related surgery.

Conclusion

Patients with CD expect severe deterioration in health in later life. Given that unrealistic sHE may affect patients' current quality of life and health behaviour, we encourage physicians to explore and consider CD patients' sHE in clinical care.
Long‐term outcome of sacral nerve stimulation for faecal incontinence
Authors: Leo C. A. , Thomas G. P. , Bradshaw E. , Karki S. , Hodgkinson J. D. , Murphy J. , Vaizey C. J.
Published: September 2020

Aim

Sacral nerve stimulation (SNS) is a minimally invasive treatment for faecal incontinence (FI). We report our experience of patients who have undergone SNS for FI with a minimum of 5 years’ follow‐up. This is a single centre prospective observational study with the aim to assess the long‐term function of SNS.

Method

All patients implanted with SNS were identified from our prospective database. The date of implantation, first and last clinic follow‐up, surgical complications and St Mark's incontinence scores were abstracted and analysed.

Results

From 1996 to 2014, 381 patients were considered for SNS. Of these, 256 patients met the study inclusion criteria. Median age at implantation was 52 years (range 18–81). The ratio of women to men was 205:51. Indications were urge FI (25%), passive FI (17.9%) and mixed FI (57%). The median of the incontinence score at baseline was 19/24 and this improved to 7/24 at the 6‐month follow‐up. Of the total cohort, 235 patients received a medium‐term follow‐up (median 110 months, range 12–270) with a median continence score of 10/24 which was also confirmed at the telephone long‐term follow‐up on 185 patients (132 months, range 60–276).

Conclusion

This study demonstrates that SNS is an effective treatment in the long term. SNS results in an improvement of validated scores for approximately 60% of patients; however, there is a significant reduction of efficacy over time due to underlying causes.
PRESCRIBED BURNS, SMOKE EXPOSURE, AND INFANT HEALTH
Authors: Jones Benjamin A. , Berrens Robert P.
Published: September 2020

Prescribed burning is used for reducing future wildfire risk; however, it creates smoke, which can affect human health. Using newly available high‐frequency daily data (2015–2017) on PM2.5 specifically attributed to smoke from prescribed burns in Georgia, USA, this analysis investigates infant health externalities connected to these burns. Cumulatively, over an average pregnancy, smoke from prescribed burns is associated with a 1.02 percentage point increase in instances of low birth weight and prematurity, each. For every $1 spent on prescribed burning, $0.43–$2.46 in state‐wide low birth weight and prematurity hospitalization costs are created. Various robustness and specification checks are performed.(JELQ23, Q53, Q51, I18, J13)
Moderating effect of illicit drug use on the relationship between sexual behaviours and prevalence of HIV or sexually transmitted infections
Authors: Chen Lian‐Yu , Wu Shang‐Chi , Ko Nai‐Ying
Published: September 2020

Introduction and Aims

We aimed to: (i) investigate sexual behaviours, substance use, HIV and sexually transmitted infections (STI) prevalence among a population of men who have sex with men (MSM) in Taiwan; and (ii) examine the moderating effects of substance use in the relationship of sexual behaviours and HIV and STI diagnosis.

Design and Methods

We used the Taiwan 2013 Internet MSM Sex Survey conducted cross‐sectionally online. We examined the association between sexual behaviours and HIV and STIs using logistic regression models. We then assessed the moderating effects of substance use between specific sexual behaviours and HIV and STI using interaction term.

Results

Among the 2020 MSM participants, 5.5% of them had reported having been diagnosed with HIV and 7.4% with STIs. Reporting having a sex partner found online, having unprotected anal sex with a casual male partner, alcohol and illicit drug use were all significantly associated with HIV and STI diagnosis. Those reporting having sex with partners found via mobile apps were more likely to report being HIV positive as a function of illicit drug use. A similar finding was evident for STIs. Interestingly, alcohol had no moderating effects in similar analyses.

Discussion and Conclusions

This study sheds light on future development of interventions that target at mobile apps which better integrate drug prevention and HIV prevention programs for the MSM population.
Efficacy and safety of cold forceps biopsy for diminutive pharyngeal neoplasms: Single‐center, prospective pilot study
Authors: Shimodate Yuichi , Itakura Junya , Sunami Tomohiko , Ueno Masayuki , Ishikawa Sho , Hira Daichi , Takayama Hiroshi , Sumiya Tomoki , Sue Masahiko , Takezawa Rio , Doi Akira , Nishimura Naoyuki , Mouri Hirokazu , Matsueda Kazuhiro , Yamamoto Hiroshi , Mizuno Motowo
Published: September 2020

Background

Management of diminutive pharyngeal neoplasms is controversial. Thus, we conducted a single‐center, prospective pilot study to investigate the efficacy and safety of endoscopic excision with cold forceps biopsy (CFB) of these lesions.

Patients and Methods

Thirty‐nine lesions endoscopically diagnosed with narrow‐band imaging as pharyngeal neoplasms of 3 mm or smaller were excised with CFB using jumbo biopsy forceps (cap diameter 2.8 mm, jaw volume 12.4 mm3). The primary outcome was endoscopically determined local remnant/recurrence rate 3 months after CFB. The secondary outcomes were histopathologically determined local remnant/recurrence rate; risk factors associated with the endoscopic remnant/recurrence; and incidence of intraoperative or delayed bleeding and other adverse events.

Results

Histological diagnosis of the 39 CFB‐excised lesions were: 11 high‐grade dysplasia (28.2%), 22 low‐grade dysplasia (56.4%), two basal cell hyperplasia (5.1%) and four atypical squamous epithelium (10.3%).Twenty‐seven patients (30 lesions) underwent follow‐up endoscopy 3 months after CFB; the endoscopic and pathological local remnant/recurrence rate was 20% (6/30; 95% confidence interval (CI), 7.7–36.6%) and 16.7% (5/30; 95% CI, 5.6–34.7%), respectively. Location of the lesion in the hypopharynx was a significant risk factor associated with the endoscopic local remnant/recurrence (P = 0.049). No significant adverse events occurred.

Conclusions

Cold forceps biopsy with jumbo biopsy forceps appears to be a safe and effective technique for excising diminutive pharyngeal neoplasms. Although small, the excised lesions may have a remarkably high frequency of high‐grade dysplasia. (Clinical trial registration number: UMIN000037980).
Thrombolysis and bridging therapy in patients with acute ischaemic stroke and Covid‐19
Authors: Cappellari M. , Zini A. , Sangalli D. , Cavallini A. , Reggiani M. , Sepe F. N. , Rifino N. , Giussani G. , Guidetti D. , Zedde M. , Marcheselli S. , Longoni M. , Beretta S. , Sidoti V. , Papurello D. M. , Giossi A. , Nencini P. , Plocco M. , Balestrino M. , Rota E. , Toni D.
Published: September 2020

Background and purpose

Comorbidity of acute ischaemic stroke with Covid‐19 is a challenging condition, potentially influencing the decision of whether to administer intravenous thrombolysis (IVT). We aimed to assess the 1‐month outcome in ischaemic stroke patients with Covid‐19 infection who received IVT alone or before thrombectomy (bridging therapy).

Methods

As a collaboration initiative promoted by the Italian Stroke Organization, all Italian stroke units (n = 190) were contacted and invited to participate in data collection on stroke patients with Covid‐19 who received IVT.

Results

Seventy‐five invited centers agreed to participate. Thirty patients received IVT alone and 17 received bridging therapy between 21 February 2020 and 30 April 2020 in 20 centers (n = 18, Northern Italy; n = 2, Central Italy). At 1 month, 14 (30.4%) patients died and 20 (62.5%) survivors had a modified Rankin Scale (mRS) score of 3 to 5. At 24 to 36 hours, asymptomatic intracerebral hemorrhage (ICH) was reported in eight (17.4%) patients and symptomatic ICH (sICH) in two (4.3%) patients. Causes of death were severe ischaemic stroke (n = 8), a new ischaemic stroke (n = 2), acute respiratory failure (n = 1), acute renal failure (n = 1), acute myocardial infarction (n = 1), and endocarditis (n = 1). In survivors with a 1‐month mRS score of 3 to 5, baseline glucose level was higher, whereas endovascular procedure time in cases of bridging therapy was longer. Baseline National Institutes of Health Stroke Scale glucose and creatinine levels were higher in patients who died.

Conclusions

Intravenous thrombolysis for patients with stroke and Covid‐19 was not a rare event in the most affected areas by pandemic, and rates of 1‐month unfavorable outcomes were high compared to previous data from the pre–Covid‐19 literature. However, risk of sICH was not increased.
Local adaptation to precipitation in the perennial grass Elymus elymoides: Trade‐offs between growth and drought resistance traits
Authors: Blumenthal Dana M. , LeCain Daniel R. , Porensky Lauren M. , Leger Elizabeth A. , Gaffney Rowan , Ocheltree Troy W. , Pilmanis Adrienne M.
Published: September 2020

Understanding local adaptation to climate is critical for managing ecosystems in the face of climate change. While there have been many provenance studies in trees, less is known about local adaptation in herbaceous species, including the perennial grasses that dominate arid and semiarid rangeland ecosystems. We used a common garden study to quantify variation in growth and drought resistance traits in 99 populations of Elymus elymoides from a broad geographic and climatic range in the western United States. Ecotypes from drier sites produced less biomass and smaller seeds, and had traits associated with greater drought resistance: small leaves with low osmotic potential and high integrated water use efficiency (δ13C). Seasonality also influenced plant traits. Plants from regions with relatively warm, wet summers had large seeds, large leaves, and low δ13C. Irrespective of climate, we also observed trade‐offs between biomass production and drought resistance traits. Together, these results suggest that much of the phenotypic variation among E. elymoides ecotypes represents local adaptation to differences in the amount and timing of water availability. In addition, ecotypes that grow rapidly may be less able to persist under dry conditions. Land managers may be able to use this variation to improve restoration success by seeding ecotypes with multiple drought resistance traits in areas with lower precipitation. The future success of this common rangeland species will likely depend on the use of tools such as seed transfer zones to match local variation in growth and drought resistance to predicted climatic conditions.
Evaluation of cervical radiographs in Dutch Warmblood horses, using a novel radiographic grading system for the cervical articular process joints
Authors: Crijns C. P. , Broeckx B. J. G.
Published: September 2020

Clinical and radiographic examination of the cervical spine has been of increasing interest in the prepurchase examination and clinical work‐up conducted for horses. The objective of this study was to describe a grading system useful for evaluating all the cervical articular process joints (cAPJs). Additionally, the findings of the cervical radiographs (occiput, cAPJ and intercentral joint space grading, intra‐ and intervertebral sagittal ratios, and intervertebral disc width measurements) were reported, and their association with clinical complaints in a large group of Dutch Warmblood horses (n = 598) were investigated. Significant associations were found between cAPJ radiographic grades and clinical complaints using the chi‐squared test (C2‐3 [P = 0.01], C5‐6 [P = 0.006], C6‐7 [P < 0.001], and C7‐T1 [P = 0.02]). Higher occiput grades were significantly associated with clinical complaints (chi‐squared test, P = 0.005). A large variability was found for intra‐ and intervertebral ratios and minimum intercentral joint space in the control group, but no significant association between intercentral joint space and clinical complaints was observed using the Kruskal–Wallis test followed by post hoc testing with the Wilcoxon rank sum test with a Bonferroni correction. The main limitations of this study were that only information regarding localisation was used for the statistical analyses, without any other details of the clinical complaints. Furthermore, clinical records were retrospectively reviewed, and a bias towards cervical findings in the clinical data recordings should be considered. It was concluded that knowledge of the distribution of the radiographic findings evaluated in this study and their associated clinical relevance can be useful in reaching a science‐based diagnosis in daily practice.
Net‐spinning caddisfly distribution in large regulated rivers
Authors: Metcalfe Anya N. , Muehlbauer Jeffrey D. , Kennedy Theodore A. , Yackulic Charles B. , Dibble Kimberly L. , Marks Jane C.
Published: September 2020

Most of the world's large rivers are dammed for the purposes of water storage, flood control, and power production. Damming rivers fundamentally alters water temperature and flows in tailwater ecosystems, which in turn affects the presence and abundance of downstream biota.

We collaborated with more than 200 citizen scientists to collect 2,194 light trap samples across 2 years and more than 2,000 river km. Samples contained 16,222 net‐spinning caddisfly (Hydropsyche) individuals across six species. We used these data to model the distribution of Hydropsyche throughout the Colorado River Basin in the western U.S.A. to identify the roles of water temperature, flows, and species‐specific morphology in determining aquatic species distributions throughout a large arid watershed that has been heavily altered by damming.

We predicted that water temperatures would determine Hydropsyche presence and abundance to a greater extent than diel variation in river stage associated with hydropower production. Among many species, adult female Hydropsychids are morphologically adapted to swim to deep‐water oviposition sites. We predicted that the presence of this ability would negate the otherwise deleterious effects of high stage change on caddisfly egg mortality.

We found that distributions of the two most widespread species, Hydropsyche occidentalis and Hydropsyche oslari (92% of total Hydropsyche captured), were both predicted by water temperatures. However, we also found that the abundance of H. oslari decreased by as much as 10‐fold as diel stage change increased, despite the presence of female morphological adaptations for deep‐water oviposition. We found sexual dimorphism and evidence for deep‐water swimming adaptations in 5/6 species.

Our results show that net‐spinning caddisflies have species‐specific responses to environmental variation and suggest that environmental flows designed to reduce diel stage change and destabilise water temperatures may improve habitat quality for these ubiquitous and important aquatic insects.
Towards geographies of child protection
Authors: Disney Tom , Lloyd Jenny
Published: September 2020

The emergence of current and historic cases of child abuse across the globe has, in recent years, dominated the news, political agendas and popular discourse surrounding children. From serious case reviews to exploitation in post‐conflict zones, from sexual abuse of children by groups to trafficking of drugs across countries, the importance of protecting children is an increasing concern in many countries. Key to, and inherent in, all of these processes and phenomena are child protection systems, working in varying degrees of effectiveness. While geographic interest has touched upon many of these areas, the role of child protection systems, and the practitioners that work within these, do not explicitly feature within this work. In this article, we seek to develop an introduction to geographies of child protection, producing an initial critical review which points to future research avenues in this field. We adopt a Foucauldian approach and review four themes to illustrate the ways in which geographical approaches might yield important insights. Drawing primarily on England as a context, we consider the historical geographies and origins of child protection, relational practices in contemporary child protection, the impact of austerity and finally we consider what future directions might require a geographical approach.
The risk of rediscovery: fast population decline of the localized endemic Chilean stag beetle Sclerostomulus nitidus (Coleoptera: Lucanidae) suggests trade as a threat
Authors: Crespin Silvio J. , Barahona‐Segovia Rodrigo M.
Published: September 2020

Rediscovery should be a celebratory event, but caution must be taken when making it public. Collectible species previously thought to be extinct are generally rare, which continuously increases the commercial value every time an individual is collected until extinction.

This is the case with the recently rediscovered saproxylic beetle Sclerostomulus nitidus (Benesh, 1955), rediscovered in 2012, whose only known global population inhabits one sole mountain, Cerro Poqui, Chile.

We sampled 146 dead logs per year and found that abundance per log of Sclerostomulus nitidus decreased by 93% in a 5‐year period (2013–2018) and estimated the probability of finding at least one individual is likely to approach zero by 2030 following a linear trend.

Sclerostomulus nitidus is listed as Critically Endangered by Chilean Law due to restricted geographic range, but we propose a need for new IUCN Red Listing resulting from our observations of ongoing population size reduction and the projected probabilities of finding an individual.

While in the field, we witnessed ongoing collection and so present evidence of online trade of Sclerostomulus nitidus. Therefore, to complement the study of the ecology of S. nitidus, we suggest a focus on unifying national and international policies regarding traded or trafficked species.

National policy might be up to speed, but international legislation regarding trading of wildlife, such as CITES, are outdated. Making national and international policy compatible would open possibilities for serious discussions with courier services regarding transparency and monitoring processes used to stop unfettered trading or trafficking to which recently rediscovered species are most vulnerable.
Inhibition of the NLRP3 inflammasome by HSP90 inhibitors
Authors: Nizami Sohaib , Arunasalam Kanisa , Green Jack , Cook James , Lawrence Catherine B. , Zarganes‐Tzitzikas Tryfon , Davis John B. , Di Daniel Elena , Brough David
Published: September 2020

Excessive and dysregulated inflammation is known to contribute to disease progression. HSP90 is an intracellular chaperone known to regulate inflammatory processes including the NLRP3 inflammasome and secretion of the pro‐inflammatory cytokine interleukin(IL)‐1β. Here, primarily using an in vitro inflammasome ASC speck assay, and an in vivo model of murine peritonitis, we tested the utility of HSP90 inhibitors as anti‐inflammatory molecules. We report that the HSP90 inhibitor EC144 effectively inhibited inflammatory processes including priming and activation of NLRP3 in vitro and in vivo. A specific inhibitor of the β HSP90 isoform was ineffective suggesting the importance of the α isoform in inflammatory signalling. EC144 inhibited IL‐1β and IL‐6 in vivo when administered orally, and was brain‐penetrant. These data suggest that HSP90 inhibitors may be useful for targeting inflammation in diverse diseases that are worsened by the presence of inflammation.
Characteristics and clinical outcomes for mental health patients admitted to a behavioural assessment unit: Implications for model of care and practice
Authors: Daniel Catherine , Mukaro Violet , Yap Celene Y. L. , C Knott Jonathan , Kelly Peter , Innes Andrew , Braitberg George , Gerdtz Marie
Published: September 2020

Behavioural assessment units (BAU) have been established in emergency departments (EDs) to provide short‐term observation, treatment, and care to people experiencing acute behavioural disturbance. A prospective observational study was conducted in a cohort of adult patients admitted to one BAU located within an ED (July–December 2017) to compare clinical characteristics, treatment outcomes, and use of restrictive interventions for those who received a specialist mental health (MH) assessment with those who did not. Of the 457 patients, 61.5% received a specialist MH assessment. This group had a lower acuity (Australasian Triage Score 10.4%; CI 0.2–2.0% vs 13.6%; CI 9.3–19.5%); more arrived with police (28.8%; CI 23.8–34.3 vs 5.1%; CI 2.7–9.4%); and were subjected to restrictive interventions while in the BAU. Security responses for unarmed threat (code grey) were higher (10.9%; CI 7.8–15.0% vs 4.4%; CI 2.3–8.5%), as was the use of chemical restraint (4.2%; CI 2.4–7.2 vs 0.0% CI 0.0 – 2.1%). Those requiring specialist MH assessment had a longer length of stay (12.7 vs 5.2 hours). Further development of the BAU model of care must include targeted, evidence‐based strategies to minimize the use of restrictive interventions and ensure timely access to acute mental health services.
On why the gender employment gap in Britain has stalled since the early 1990s
Authors: Razzu Giovanni , Singleton Carl , Mitchell Mark
Published: September 2020

Using over four decades of British micro data, this article looks at how the narrowing gender employment gap stalled in the early 1990s. Changes to the structure of employment between and within industry sectors impacted the gap at approximately constant rates throughout the period and do not account for the stall. Instead, changes to how women's likelihood of paid work was affected by their partners' characteristics explain most of the gap's shift in trend. Increases in women's employment when they had children or achieved higher qualifications continued to narrow the gap even after it had stalled overall.
Teen Suicide and Changing Cause‐of‐Death Certification, 1953–1987
Authors: Males Mike
Published: September 2020

ABSTRACT: This study examines whether the purported tripling in teenage suicides since the 1950s represents a real increase or is simply an artifact of the increased skill of medical examiners in distinguishing youth suicides from fatal accidents. This study examines firearms and poisoning deaths, which together account for 75% of all certified youth suicides, from 1953 through 1987, and concludes: (a) a past undercount of youth suicides is likely, (b) the increase in youth suicide that has occurred is less dramatic than reported and resembles increases in adult suicide, and (c) the suicide increase indicated among youths and adults occurred from 1964 to 1971 and has since stabilized.
Development of a silver-based dual-function antimicrobial laundry additive and textile coating for the decontamination of healthcare laundry
Authors: Owen L. , Laird K.
Published: September 2020

Aims

To repurpose a silver-based antimicrobial textile coating product (Micro-Fresh 1911) as a dual-function antimicrobial laundry additive and textile coating.

Methods and Results

Survival of Escherichia coli or Staphylococcus aureus type and clinical isolates in a domestic 40°C wash was assessed with and without soiling and biological detergent. Washing with 2% w/v silver additive (wash phase) reduced E. coli and S. aureus by 7·14–8·08 log10 and no cross-contamination was observed. Under dirty conditions, 0·5% silver additive in the rinse phase of a wash with biological detergent reduced E. coli and S. aureus by 7·98–8·40 log10 (0·00–1·42 log10 cross contamination). BS EN ISO 20645:2004 and BS EN ISO 20743:2013 methods were used to assess the antimicrobial activity of polycotton washed with 2% w/v silver additive against S. aureus and E. coli. The treated polycotton was antimicrobial against E. coli and S. aureus type and clinical isolates and remains active after at least one further wash cycle at 40 or 73°C.

Conclusions

The silver additive exhibits antimicrobial activity in a 40°C domestic wash, preventing cross contamination onto clean textiles and depositing an antimicrobial coating onto polycotton.

Significance and Impact of the Study

The survival of micro-organisms on healthcare uniforms during domestic laundering presents a potential risk of contaminating the home, cross-contamination of other clothing within the wash and transmitting potential pathogens back into healthcare settings via contaminated uniforms. Silver may be useful as an antimicrobial laundry additive to decontaminate healthcare laundry washed at low temperatures in domestic and industrial settings, to therefore reduce the potential risk of transmitting micro-organisms within the domestic and clinical environments.