bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neurological examination
Authors: Kirk Andrew 
Published: October 2020

The clinical examination is an important part of any patient consultation. After the primary survey and taking the patient history, a more in-depth examination is sometimes required to aid making a working diagnosis and help negate other differential diagnoses. The extent of this depends on the stability of the patient and may not be possible in time-critical circumstances. However, clinical examination is an increasing part of paramedic practice owing to the continued expansion of the scope of the paramedic role in both urgent and emergency care. Education on clinical examination concerning each of the main body systems is now an integral part of undergraduate paramedic curricula. This clinical examination series provides a step-by-step overview for each of the main body systems. Continuing professional development (CPD) is an essential requirement for all clinicians to maintain and to demonstrate that they are staying up to date and advancing in their roles. This series gives an overview of each type of examination to support students, newly qualified paramedics and paramedics wishing to use these articles as a CPD development activity and an aide-memoire for clinical practice. This article, which explores the the neurological examination, gives an overview of initial examination considerations, and assessment of the upper limbs.
Alcohol/substance use and occupational/post-traumatic stress in paramedics
Authors: Hichisson Andrew David , Corkery John Martin 
Published: October 2020

Background: Paramedics work in high-pressure environments and experience traumatic events, which contribute to high levels of occupational and post-traumatic stress. Such stress can result in alcohol and substance misuse in other health professionals, but this relationship has not been examined in paramedics. This review is the first exploration of the literature on this. Methods: A systematic literature review was conducted using PRISMA guidelines, with databases searched using terms relevant to paramedics and alcohol/substance use. Studies were analysed using descriptive statistics for quantitative data and thematic analysis for qualitative information. Findings: Eleven studies were identified. Nine studies examined alcohol use; seven examined substance use; five examined both. Alcohol and smoking may be linked to occupational stress. Conclusions: The nature and extent of alcohol and substance use in relation to occupational and post-traumatic stress among paramedics need further investigation to facilitate advice and support.
Clashes Among Founding Partners: How Entrepreneurs Overcome Conflicts?
Authors: Sarfati Gilberto Sarfati Gilberto , Martins Thomaz , Abrahão Gabriel Akel 
Published: October 2020

Objective: Conflicts have negative impacts on organizational performance and can lead to company mortality. The GVentures Accelerator, from the School of Business Administration of São Paulo (EAESP-FGV) identified that several startups that failed during and after the acceleration process had conflicts among the founding partners. This work aims to understand why some entrepreneurial teams in a pre-seed stage are able to overcome conflicts while others are not Methodology: We conducted a case study of 9 accelerated startups using in-depth interviews with 20 founding partners, and the interviews were followed by the codification and analysis of the cases with support from the manager responsible for the accelerator.Results: The research concludes that operational conflicts that escalate to affective conflicts due to disagreements in the process of giving and receiving feedback and/or mistrust between partners can lead to the dissolution of a company. On the other hand, founding members, even if they experience affective conflicts, are able to overcome the problems using the strategies of taking a step aside, giving in and putting their egos aside. It was also identified that the acceleration process tends to exacerbate the operational conflicts between founding partners.Theoretical/methodological contributions: The research contributes to the literature about founding teams by pointing out that operational conflict does not necessarily lead to the dissolution of the organization or closing the business, but operational conflicts that intensify to affective conflicts due to disagreements in the process of giving and receiving feedback and/or distrust among partners can lead to the dissolution of the organizationRelevance/originality: Founding teams are the backbone of any company. In spite of several articles discussing team conflict little is known about why some entrepreneurial team are able to overcome conflicts while other not. Moreover, also little is known about the role accelerators play in these conflicts.Social/management contribution: The conclusions about the strategies for managing founding team conflicts: taking a step aside, giving in and putting their egos aside; may be very useful for both entrepreneurs and accelerators’ management team in dealing with conflicts among founders.
Autoantibodies Toward ATP4A and ATP4B Subunits of Gastric Proton Pump H+,K+-ATPase Are Reliable Serological Pre-endoscopic Markers of Corpus Atrophic Gastritis
Authors: Lahner Edith , Marzinotto Ilaria , Lampasona Vito , Dottori Ludovica , Bazzigaluppi Elena , Brigatti Cristina , Secchi Massimiliano , Piemonti Lorenzo , Conti Laura , Pilozzi Emanuela , Davidson Howard W. , Wenzlau Janet M. , Annibale Bruno 
Published: October 2020

INTRODUCTION:
Noninvasive assessment of corpus atrophic gastritis (CAG), a condition at increased risk of gastric cancer, is based on the measurement of pepsinogens, gastrin, and Helicobacter pylori antibodies. Parietal cell autoantibodies (PCAs) against the gastric proton pump (ATP4) are potential serological biomarkers of CAG. The purpose of this study was to compare the diagnostic performance of PCA and pepsinogen I tests in patients with clinical suspicion of CAG with the histopathological evaluation of gastric biopsies as reference standard.

METHODS:
A prospective case-finding study was performed on 218 naive adult patients (131 women, median age 65 years) who underwent gastric biopsies to confirm/exclude CAG. Patients with histopathological CAG were defined as cases, conversely as controls. Autoantibodies against the individual alpha (ATP4A) and beta (ATP4B) subunits of ATP4 were measured by luciferase immunoprecipitation, and global PCA and pepsinogen I by enzyme-linked immunosorbent assay.

RESULTS:
Histopathology classified 107 subjects (49%) as cases (CAG+, autoimmune 81.2%, and multifocal extensive 18.8%) and 111 subjects (51%) as controls (CAG−). In cases, ATP4A, ATP4B, and PCA titers were increased compared with controls, whereas pepsinogen I was reduced (P < 0.0001 for all). ATP4B, ATP4A, and pepsinogen I tests showed sensitivities of 77%, 75%, and 73% and specificities of 88%, 88%, and 80%, respectively. The receiver operating characteristic (ROC) area under the ROC curve (AUC) of these serological biomarkers confirmed their ability to discriminate cases from controls (ATP4B = 0.838, ATP4A = 0.826, pepsinogen I = 0.775, and PCA = 0.805), whereas the partial ROC-pAUC90 analysis showed that the ATP4B test had the best diagnostic performance (P = 0.008 vs ATP4; P = 0.0002 vs pepsinogen I). The presence of autoimmune or extensive gastritis was not significantly different between ATP4B positive or negative cases (P = 0.217).

DISCUSSION:
PCAs are promising serological biomarkers for the identification of CAG in high-risk individuals, particularly in an autoimmune pattern but also in an extensive-multifocal atrophy pattern.
Determinants of Pouch-Related Symptoms, a Common Outcome of Patients With Adenomatous Polyposis Undergoing Ileoanal Pouch Surgery
Authors: Gilad Ophir , Gluck N. , Brazowski E. , Kariv R. , Rosner G. , Strul H. 
Published: October 2020

INTRODUCTION:
Total proctocolectomy with ileal pouch anal anastomosis (IPAA) is performed in patients with adenomatous polyposis syndromes (APSs). Data regarding pouch outcomes in APS are scarce. The purposes of this study were to determine the prevalence of pouch-related symptoms in patients with APS and to identify the contributing factors.

METHODS:
This is a prospective cohort study. Demographic, surgical, and clinical data were collected. Endoscopy was performed, and biopsies from the terminal ileum, pouch, and cuff were obtained in all patients and reviewed by a dedicated pathologist.

RESULTS:
Fifty-one patients with APS after IPAA were followed. Twenty patients (39.2%) had pouch-related symptoms. Single-stage IPAA had better outcomes than 2-stage IPAA: fewer daily bowel movements (42.9% vs 13.8% with ≤5 daily bowel movement, P = 0.02), more solid consistency (52.4% vs 6.9%, P < 0.001), and less abdominal pain (19% vs 48.3%, P = 0.034). Younger age at IPAA (<20) was also associated with better outcomes: fewer daily bowel movement (58.3% vs 17.9% with ≤5 daily bowel movement, P = 0.011), less watery consistency (8.3% vs 53.8%, P = 0.005), and abdominal pain (8.3% vs 43.6%, P = 0.037). Eighteen patients (35.3%) had endoscopic signs of inflammation, and 22 patients (43.1%) had histologic signs of pouchitis. However, no correlation was found between symptoms and endoscopic or histologic findings. The median pouchitis disease activity index was low (2, interquartile range 1–4) and did not correlate with clinical symptoms.

DISCUSSION:
Pouch-related symptoms are common in patients with APS after IPAA. One-stage IPAA and younger age at surgery are associated with better clinical outcomes. However, symptoms do not correlate well with endoscopic or histologic findings or with pouchitis disease activity index and might be attributed to a functional pouch disorder.
Clinical Features and Genomic Characterization of Post-Colonoscopy Colorectal Cancer
Authors: Tanaka Hidenori , Urabe Yuji , Oka Shiro , Shimohara Yasutsugu , Nishimura Tomoyuki , Inagaki Katsuaki , Okamoto Yuki , Matsumoto Kenta , Yamashita Ken , Sumimoto Kyoku , Ninomiya Yuki , Yuge Ryo , Tanaka Shinji , Chayama Kazuaki 
Published: October 2020

INTRODUCTION:
Some colorectal cancers (CRCs) may be missed during colonoscopies. We aimed to determine the clinicopathological, biological, and genomic characteristics of post-colonoscopy CRCs (PCCRCs).

METHODS:
Of the 1,619 consecutive patients with 1,765 CRCs detected between 2008 and 2016, 63 patients with 67 PCCRCs, when colonoscopies were performed 6–60 months before diagnosis, were recruited. After excluding patients with inflammatory bowel disease, familial polyposis syndrome, CRCs that developed from diminutive adenomatous polyps, and recurrent CRCs after endoscopic resection, 32 patients with 34 PCCRCs were enrolled. The lesions' clinicopathological features, mismatch repair proteins (MMRs), and genomic alterations were investigated.

RESULTS:
The overall PCCRC-5y rate, rate of intramucosal (Tis) lesions, and rate of T1 or more deeply invasive cancers were 3.7% (66/1,764), 3.9% (32/820), and 3.6% (34/944), respectively. Thirty-three patients' MMRs were investigated; 7 (21%) exhibited deficient MMRs (dMMRs), comprising 4 with T2 or more deeply invasive cancers and 5 whose lesions were in the proximal colon. Twenty-three tumors' genomic mutations were investigated; PIK3CA had mutated in 5 of 6 T2 or more deeply invasive cancers, of which, 4 were located in the proximal colon. Two patients with dMMRs and BRAF

V600E
mutations had poor prognoses. Sixty-one percent (17/28) of the macroscopic type 0 lesions were superficial. All superficial Tis and T1 PCCRCs were detected <24 months after the negative colonoscopies. They were distributed throughout the colon and rectum.

DISCUSSION:
PCCRCs may be invasive cancers in the proximal colon that exhibit dMMRs and/or PIK3CA mutations or missed early CRCs especially superficial lesions.
L-Menthol for Gastrointestinal Endoscopy: A Systematic Review and Meta-Analysis
Authors: You Qiang , Li Lan , Chen Hongping , Chen Lin , Chen Xia , Liu Youping 
Published: October 2020

INTRODUCTION:
In randomized controlled trials, L-menthol inhibits gastrointestinal peristalsis during endoscopy. Our goal was to quantitatively synthesize the available evidence to evaluate the efficacy and safety of L-menthol for gastrointestinal endoscopy.

METHODS:
We comprehensively searched for relevant studies published up to January 2020 in PubMed, EMBASE, Web of Science, and Cochrane Library. The main outcomes consisted of the proportion of no peristalsis, proportion of no or mild peristalsis, adenoma detection rate, and adverse events.

RESULTS:
Eight randomized controlled trials analyzing 1,366 subjects were included. According to the pooled data, L-menthol significantly improved the proportion of no peristalsis (odds ratio [OR] = 6.51, 95% confidence interval [CI] = 4.94–8.57, P < 0.00001), and the proportion of no or mild peristalsis (OR = 7.89, 95% CI = 5.03–12.39, P < 0.00001) compared with the placebo, whereas it was not associated with an improvement in the adenoma detection rate (OR = 1.03, 95% CI = 0.54–1.99, P = 0.92). Adverse events did not differ significantly between the 2 groups (OR = 1.40, 95% CI = 0.75–2.59, P = 0.29).

DISCUSSION:
The findings of this study support the use of L-menthol to suppress gastrointestinal peristalsis during endoscopic procedure.
IFCC Interim Guidelines on Serological Testing of Antibodies against SARS-CoV-2
Authors: Bohn Mary Kathryn , Loh Tze Ping , Wang Cheng-Bin , Mueller Robert , Koch David , Sethi Sunil , Rawlinson William D. , Clementi Massimo , Erasmus Rajiv , Leportier Marc , Grimmler Matthias , Yuen KY , Mancini Nicasio , Kwon Gye Cheol , Menezes María Elizabeth , Patru Maria-Magdalena , Gramegna Maurizio , Singh Krishna , Najjar Osama , Ferrari Maurizio , Horvath Andrea R. , Lippi Giuseppe , Adeli Khosrow 
Published: October 2020

Abstract
Serological testing for the detection of antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is emerging as an important component of the clinical management of patients with coronavirus disease 2019 (COVID-19) as well as the epidemiological assessment of SARS-CoV-2 exposure worldwide. In addition to molecular testing for the detection of SARS-CoV-2 infection, clinical laboratories have also needed to increase testing capacity to include serological evaluation of patients with suspected or known COVID-19. While regulatory approved serological immunoassays are now widely available from diagnostic manufacturers globally, there is significant debate regarding the clinical utility of these tests, as well as their clinical and analytical performance requirements prior to application. This document by the International Federation for Clinical Chemistry and Laboratory Medicine (IFCC) Taskforce on COVID-19 provides interim guidance on: (A) clinical indications and target populations, (B) assay selection, (C) assay evaluation, and (D) test interpretation and limitations for serological testing of antibodies against SARS-CoV-2 infection. These evidence-based recommendations will provide practical guidance to clinical laboratories in the selection, verification, and implementation of serological assays and are of the utmost importance as we expand our pandemic response from initial case tracing and containment to mitigation strategies to minimize resurgence and further morbidity and mortality.
Pseudohypoparathyroidism type 1B (PHP1B), a rare disorder encountered in adolescence
Authors: Vlachopapadopoulou Elpis-Athina , Anagnostou Elli , Dikaiakou Eirini , Hanna Patrick , Tsolia Maria , Michalacos Stefanos , Linglart Agnès , Karavanaki Kyriaki 
Published: October 2020

Abstract

Objectives
The objective of this paper is to report a peculiar case of a patient with pseudohypoparathyroidism type 1b (PHP1B). Pseudohypoparathyroidism (PHP) refers to a group of disorders characterized by hypocalcemia, hyperphosphatemia, and elevated parathyroid hormone (PTH) concentrations as the result of end-organ unresponsiveness to PTH.

Case presentation
We present a 14-year-old boy, who was admitted with severe symptomatic hypocalcaemia, absence of dysmorphic features and Albright's hereditary osteodystrophy features. Laboratory investigations revealed markedly low serum calcium, high phosphate, markedly elevated PTH levels and vitamin D insufficiency, while magnesium, albumin, ALP and TSH were normal. The clinical and laboratory findings were consistent with PHP1B. Molecular analysis revealed loss of methylation at the AB DMR of the GNAS locus, confirming the diagnosis. Yet no STX16 deletion was detected.

Conclusions
It is possible that delSTX16- patients carry a defect in an element that controls the methylation both at the GNAS-A/B DMR and at the GNAS-AS2. This rare case emphasizes the need of individualized molecular analysis in PHP1B patients in order to elucidate the possible molecular defect.
Mechanisms and early patterns of dyslipidemia in pediatric type 1 and type 2 diabetes
Authors: Nwosu Benjamin Udoka , Villalobos-Ortiz Tony R. , Jasmin Gabrielle A. , Parajuli Sadichchha , Zitek-Morrison Emily , Barton Bruce A. 
Published: October 2020

Abstract

Objectives
The is no consensus on the early patterns of lipid-based cardiovascular disease (CVD) risk in youth with either type 1 diabetes (T1D) or type 2 diabetes (T2D). The aim was todetermine the differences in CVD risk, using lipid profiles, in children and adolescents with either T1D or T2D at the time of their first lipid assessment, after stratifying the T1D cohort into remitters and non-remitters based on their honeymoon history.

Methods
A cross-sectional study of 249 subjects consisting of 73 controls, 53 T2D subjects, and 123 T1D subjects stratified into remitters (n=44), and non-remitters (n=79). Partial clinical remission (PCR) was defined as insulin-dose adjusted HbA1c of ≤9. Pubertal status was determined by Tanner staging.

Results
After adjusting for age, sex, BMI, race, and pubertal status, T2D patients had significantly higher LDL-C compared to the controls (p=0.022), the remitters (p=0.029), but not the non-remitters (103.1 ± 5.9 mg/dL vs. 91.4 ± 4.2 mg/dL, p=0.49). Similarly, T2D patients had significantly higher non-HDL-C compared to the controls (p=0.006), the remitters (p=0.0002), but not the non-remitters (137.6 ± 7.1 mg/dL vs. 111.71 ± 5.0 mg/dL, p=0.053). Total cholesterol was also significantly higher in T2D patients compared to the controls (p=0.0005), the remitters (p=0.006) but not the non-remitters (183.5 ± 6.6 mg/dL vs. 166.2 ± 4.8 mg/dL, p=0.27).

Conclusions
Lack of the honeymoon phase in children and adolescents with T1D confers early and significantly increased lipid-based cardiovascular risk to these patients that is similar to the elevated cardiovascular risk seen in T2D.
Topological photonics: Where do we go from here?
Authors: Segev Mordechai , Bandres Miguel A. 
Published: October 2020

AbstractTopological photonics is currently one of the most active research areas in optics and also one of the spearheads of research in topological physics at large. We are now more than a decade after it started. Topological photonics has already proved itself as an excellent platform for experimenting with concepts imported from condensed matter physics. But more importantly, topological photonics has also triggered new fundamental ideas of its own and has offered exciting applications that could become real technologies in the near future.
The Impact of Neoliberalism on Civil Society and Nonprofit Advocacy
Authors: Alexander Jennifer , Fernandez Kandyce 
Published: October 2020

AbstractThe following manuscript employs critical inquiry to analyze the effects of neoliberalism on nonprofits in the U.S. and their capacity to engage in political advocacy and the production of meaning, a pivotal role for civil society institutions. Three false narratives of how nonprofits support democracy are presented followed by a discussion of how neoliberalism and the economization of the sector has delimited their capacity to fulfill their roles of engaging in emancipatory projects or social change. The manuscript concludes with a discussion of how nonprofits can reclaim civic space and empower citizens in a representative democracy.
Effect of strain, sex and slaughter weight on growth performance, carcass yield and quality of broiler meat
Authors: Ikusika Olusegun O. , Falowo Andrew B. , Mpendulo Conference T. , Zindove Titus J. , Okoh Anthony I. 
Published: October 2020

Abstract
This study examined strain, sex and slaughter weight effect on performance, meat quality and yield of broiler chicken. One hundred and fifty-day-old chicks (broilers) were distributed randomly in a 3 × 2 × 4 factorial experiment, with 50 birds per strain (Ross, Aboaca and Anak) and 25 birds per sex. After trial, 32 birds per strain and 16 per sex were slaughtered at 4 different body weights (1,000, 1,500, 2,000, and 2,500 g) to determine carcass yield and meat quality. The results revealed significant strain and sex effect (P < 0.05) on growth performance of the broiler chicken. Ross strain had the highest feed intake (4883.25 g) and final body weight (2440.25 g) compared to Aboaca and Anak strains. Female broiler having heavier body weight (2431.66 g) and feed intake (4864.83 g) than the males for all strains. Aboaca birds had the highest carcass yields for all slaughter weight than Anak and Ross. The slaughter weight, irrespective sex and strains significantly influenced the carcass yield (P < 0.001) with birds slaughtered at 2,500 g having (P < 0.001) highest values compared to other slaughtered weights. As slaughter weight increases, cooking loss and thermal shortening decreases while water holding capacity and shear force values increases. Overall, Aboaca strain was considered to have best performances for production.
Relevanz als Praxis und die Praxis der Bildung. Zur Relevanz von Relevanztheorien
Authors: Stetter Manuel 
Published: October 2020

Zusammenfassung
Relevanz ist ein Grundproblem religiöser Bildung. Vor diesem Hintergrund fragt der Beitrag nach der Bedeutung von Relevanztheorien für die praktisch-theologische Forschung. Im Zentrum steht ein praxistheoretischer Zugang, erlaubt dieser doch, Relevanz als ein eminent materielles Phänomen zu bedenken und damit ein dringendes Desiderat etablierter Theorien der Relevanz zu bearbeiten. Dass sich daraus auch für die empirische Erkundung der Relevanz neue Perspektiven ergeben, zeigen Beispiele aus der aktuellen Unterrichtsforschung.
„Fridays for Future“ – Über Klimaschwan- kungen im öffentlichen Diskurs angesichts des Widerstandes junger Menschen gegen den Totalitarismus der Sachzwänge
Authors: Reuter Ingo 
Published: October 2020

Zusammenfassung
Seit Anfang 2019 hat sich die Klimaprotestbewegung Fridays For Future auch nach Deutschland ausgebreitet. Der Text thematisiert das Verhältnis zwischen der Institution Schule und streikenden Schülerinnen und Schülern, der medialen Vermittlung und Diskussion des Klimaprotests und der theologischen Rezeption des Geschehens. Hieraus ergeben sich Schlussfolgerungen, welche Bedeutung der Protest der jungen Menschen und die Rezeption der medialen Leitfiguren der FFF-Bewegung und ihrer Gegenspieler für die Religionspädagogik haben könnten.
Tierethik als interdisziplinäres Thema im Religions- und Biologieunterricht am Beispiel landwirtschaftlich genutzter Tiere
Authors: Tramowsky Nadine , Eichler Janine 
Published: October 2020

Zusammenfassung
Welchen Wert haben Tiere? Wie sollten Menschen mit Tieren in der Landwirtschaft umgehen? Zur Beantwortung dieser Fragen müssen Lernende ethisch argumentieren und biologisches, philosophisches oder theologisches Wissen heranziehen. Deshalb werden Vorstellungen von Lernenden und Schulbuchinhalte zu diesen tierethischen Problemfeldern verglichen und auf Lernchancen und -hürden überprüft. Anschließend werden didaktische Empfehlungen daraus abgeleitet. In den Moralvorstellungen der Lernenden wurden zahlreiche Moralmetaphern identifiziert, welche Rückschlüsse auf die Gestaltung von interdisziplinären Lernumgebungen erlauben.