Suction rectal biopsy (SRB) in Hirschsprung's Disease: Is a single macroscopically adequate sample sufficient?

Hirschsprung's Disease (HD) is a congenital disorder causing severe constipation in infants and children. Suction rectal biopsy (SRB) is the preferred technique for obtaining tissue samples for histopathological evaluation. In low-resource settings like Malaysia, cost-effective diagnostic approaches are necessary, making single sample SRB valuable. This study evaluates the diagnostic accuracy and sufficiency of a single macroscopically adequate sample in suction rectal biopsies for the histopathological confirmation of HD. We conducted a retrospective study of children who underwent suction rectal biopsies for the diagnosis of HD at Hospital Raja Perempuan Zainab II (HRPZII), Kota Bharu, Kelantan. A total of 68 patients were included in the study. The inadequacy rate for bedside SRB was 14%, comparable to current literature. Our study found no statistically significant association between sample inadequacy and gestational age, gender, birth weight, or weight at biopsy. Complication rates were 0%, consistent with literature reports. Calretinin staining, an additional technique, was performed in 23 biopsy episodes, with a 4.3% inadequacy rate, compared to 20% in specimens not subjected to calretinin staining. The cost of SRB almost doubled with each additional sample taken, significant in low-resource environments. In conclusion, single sample SRBs can be adequately diagnostic and cost-effective in low-resource settings, providing valuable insights for healthcare facilities in Malaysia and other developing countries. The use of adjunctive techniques such as calretinin staining may improve diagnostic accuracy while maintaining cost-effectiveness. Further prospective studies with larger sample sizes are needed to validate these findings.

Erratum to: Elephants also like coffee: Trends and drivers of human-elephant conflicts in coffee agroforestry landscapes of Kodagu, Western Ghats, India.

Kodagu district produces 2% of the world's coffee, in complex, multistoried agroforestry systems. The forests of the district harbour a large population of the Asian elephant (Elephas maximus). The combined effects of high elephant density and major landscape changes due to the expansion of coffee cultivation are the cause of human-elephant conflicts (HEC). Mitigation strategies, including electric fences and compensation schemes implemented by the Forest Department have met with limited success. Building on previous studies in the area, we assessed current spatial and temporal trends of conflict, analysed local stakeholders' perceptions and identified factors driving elephants into the estates. Our study, initiated in May 2007, shows that the intensity of HEC has increased over the last 10 years, exhibiting new seasonal patterns. Conflict maps and the lack of correlation between physical features of the coffee plantations and elephant visits suggest elephants move along corridors between the eastern and western forests of the district, opportunistically foraging when crossing the plantations. Dung analyses indicate elephants have selectively included ripe coffee berries in their diet. This is, to our knowledge, the first report of wild elephants feeding on coffee berries. If this new behaviour spreads through the population, it will compound an already severe conflict situation. The behavioural plasticity, the multiplicity of stakeholders involved, the difficulty in defining the problem and the limits of technical solutions already proposed suggest that HEC in Kodagu has the ingredients of a "wicked" problem whose resolution will require more shared understanding and problem solving work amongst the stakeholders.

Elephants also like coffee: trends and drivers of human-elephant conflicts in coffee agroforestry landscapes of Kodagu, Western Ghats, India.

Kodagu district produces 2% of the world's coffee, in complex, multistoried agroforestry systems. The forests of the district harbour a large population of the Asian elephant (Elephas maximus). The combined effects of high elephant density and major landscape changes due to the expansion of coffee cultivation are the cause of human-elephant conflicts (HEC). Mitigation strategies, including electric fences and compensation schemes implemented by the Forest Department have met with limited success. Building on previous studies in the area, we assessed current spatial and temporal trends of conflict, analysed local stakeholders' perceptions and identified factors driving elephants into the estates. Our study, initiated in May 2007, shows that the intensity of HEC has increased over the last 10 years, exhibiting new seasonal patterns. Conflict maps and the lack of correlation between physical features of the coffee plantations and elephant visits suggest elephants move along corridors between the eastern and western forests of the district, opportunistically foraging when crossing the plantations. Dung analyses indicate elephants have selectively included ripe coffee berries in their diet. This is, to our knowledge, the first report of wild elephants feeding on coffee berries. If this new behaviour spreads through the population, it will compound an already severe conflict situation. The behavioural plasticity, the multiplicity of stakeholders involved, the difficulty in defining the problem and the limits of technical solutions already proposed suggest that HEC in Kodagu has the ingredients of a "wicked" problem whose resolution will require more shared understanding and problem solving work amongst the stakeholders.

Illness narratives and chronic patients' sustainable employability: The impact of positive work stories.

The number of workers with a chronic disease is steadily growing in industrialized countries. To cope with and to give meaning to their illness, patients construct illness narratives, which are widely shared across patient societies, personal networks and the media. This study investigates the influence of these shared illness narratives on patient's working lives, by examining the impact of reading a positive work story versus negative work story on patients' sustainable employability. We expected that this relationship would be mediated by positive emotions and the extent to which the story enhanced awareness of desires future selves, and moderated by identification with story character. An online field experiment with 166 people with Inflammatory Bowel Disease in The Netherlands showed that while reading a positive story of a patient with the same condition significantly increased positive emotions, these emotions did not influence sustainable employability. However, reading a positive story was related to higher sustainable employability when patients became more aware of their desired possible future work selves. Finally, identification with the story character moderated the impact of story type on sustainable employability. This study showed that personal engagement with a positive work story of a fellow patient is related to higher sustainable employability. Findings can be helpful for health professionals to empower employees with a chronic disease.

Buffering the Breach: Examining the Three-Way Interaction Between Unit Climate Level, Strength, and Psychological Contract Breach.

Despite the wealth of research showing that psychological contract breach (PCB) has negative outcomes for individuals, knowledge about the influence of the social context in which breaches are experienced is still scarce. This is surprising, as scholars have argued that work climates, such as when unit members are generally highly committed, could buffer an individual's negative experiences at work. Yet, to date, the unit climate and PCB literatures have largely remained separated and our main goal is to integrate these fields. This is especially timely and relevant, because recent work in the unit climate literature indicates that merely looking at the average climate level might not be enough, because the climate's strength (i.e., the agreement or homogeneity within the unit) could also provide important social cues. Building on these recent advances, we develop and test a theoretical framework which links both climate concepts to PCB. More specifically, we hypothesized that especially when all unit members are highly and homogeneously committed, an employee would reframe their PCB in such a way that it would less adversely affect work engagement and turnover intentions. Using data from 1,272 employees across 36 healthcare units, multilevel structural path analyses supported this three-way interaction. By answering recent calls for more "social PCB research" and integrating the unit climate and PCB literatures, we aim to provide guidance to scholars and practitioners who want to understand in more depth the social context's influence on PCB.

How Do High-Performance Work Systems Affect Individual Outcomes: A Multilevel Perspective.

Research on high-performance work systems (HPWS) has suggested that a potential disconnection may exist between organizational-level HPWS and employee experienced HPWS. However, few studies have identified factors that are implied within such a relationship. Using a sample of 397 employees, 84 line managers, and 21 HR executives in China, we examined whether line managers' goal congruence can reduce the difference between organizational-level HPWS and employee experienced HPWS. Furthermore, this study also theorized and tested organization-based self-esteem (OBSE) as a mediator in the associations between employee experienced HPWS and job performance and job satisfaction. Using multilevel analyses, we found that line managers' goal congruence strengthened the relationship between organizational-level HPWS and employee experienced HPWS, such that the relationship was significant and positive when line managers' goal congruence was high, but a non-significant relationship when line managers' goal congruence was low. Moreover, employee experienced HPWS indirectly affected job performance and job satisfaction through the mechanism of OBSE beyond social exchange perspective.

HER2/neu negative salivary duct carcinoma of parotid: A case with forty months recurrence free follow up.

INTRODUCTION: Salivary duct carcinoma (SDC) is very rare, only 1-3% of all salivary gland tumors are reported as SDC. SDC predominantly occurs in elderly males, SCD is characterized by an aggressive clinical course of the disease with less than 60% five years survival from the day of initial diagnosis, lymph node metastasis and facial nerve involvement is common, the current literature lacks protocol regarding management of this entity and the advantage of adjuvant therapy has not been evaluated due to its rare occurrence. PRESENTATION OF CASE: We report patient with stage IV HER2/neu negative SDC successfully treated with surgery followed by adjuvant radiotherapy, patient is followed up for 40 months without evidence of recurrence or metastasis. DISCUSSION: SDC is reported to be similar to mammary duct carcinoma in clinical and immunohistologic typing, further it shows an association of expression of HER-2/neu and p53, with early local disease recurrence, distant metastasis and survival, however; current case was adequately followed up and reevaluated after 26 months, MRI did not show evidence of recurrence. CONCLUSION: SDC is a rare tumor and information on association of HER2/neu with survival is useful in further research on this tumor.

Saponins from Chenopodium album.

The isolation and spectral data of three saponins from the roots of Chenopodium album L. are reported. One of them is a seco-glycoside analogous to compounds that were previously found in species belonging to Caryophyllales.

Future time perspective and promotion focus as determinants of intraindividual change in work motivation.

In the near future, workforces will increasingly consist of older workers. At the same time, research has demonstrated that work-related growth motives decrease with age. Although this finding is consistent with life span theories, such as the selection optimization and compensation (SOC) model, we know relatively little about the process variables that bring about this change in work motivation. Therefore, we use a 4-wave study design to examine the mediating role of future time perspective and promotion focus in the negative association between age and work-related growth motives. Consistent with the SOC model, we found that future time perspective was negatively associated with age, which, in turn, was associated with lower promotion focus, lower work-related growth motive strength, and lower motivation to continue working. These findings have important theoretical implications for the literature on aging and work motivation, and practical implications for how to motivate older workers.

How does fiction reading influence empathy? An experimental investigation on the role of emotional transportation.

The current study investigated whether fiction experiences change empathy of the reader. Based on transportation theory, it was predicted that when people read fiction, and they are emotionally transported into the story, they become more empathic. Two experiments showed that empathy was influenced over a period of one week for people who read a fictional story, but only when they were emotionally transported into the story. No transportation led to lower empathy in both studies, while study 1 showed that high transportation led to higher empathy among fiction readers. These effects were not found for people in the control condition where people read non-fiction. The study showed that fiction influences empathy of the reader, but only under the condition of low or high emotional transportation into the story.

The effects of a high fibre, low fat and low sodium dietary regime on diabetic hypertensive patients of different ethnic groups.

Fifty-three diabetic patients with mild hypertension were allocated to a treatment diet with a high fibre, low fat and low sodium dietary regime or a control diet. After a 1-month treatment period, the modified-diet treated group (n = 35) showed a highly significant reduction in mean diastolic blood pressure (P less than 0.001) accompanied by significant reduction in urinary sodium excretion (P less than 0.01). The mean values of diastolic pressure (P less than 0.05) and urinary sodium/potassium ratio (P less than 0.01) were also significantly reduced at 1 month compared to control. White (n = 16) and West Indian (n = 10) diabetic hypertensive patients demonstrated a similar significant hypotensive response (P less than 0.05 and less than 0.01 respectively) with reduction in urinary sodium excretion to the modified diet. In contrast, Asian patients demonstrated no significant changes. Treatment of hypertension in diabetic subjects with a high fibre, low fat and low sodium dietary regimen may have a hypotensive response after a period of 1 month and there is a similar response in both black and white ethnic groups. Further observation of these patients will determine long-term response and compliance.

A controlled trial of a high fibre, low fat and low sodium diet for mild hypertension in Type 2 (non-insulin-dependent) diabetic patients.

Fifty hypertensive Type 2 (non-insulin-dependent) diabetic patients were allocated, in a controlled trial, to a treatment diet of high fibre, low fat and low sodium composition, or to a control diet by the hospital dietitian. After 3 months treatment, the modified diet-treated group showed a highly significant reduction in mean systolic (180.5 +/- 19.0 to 165.0 +/- 20.7 mmHg) and diastolic blood pressure (96.6 +/- 9.3 to 88.0 +/- 10.5 mmHg), accompanied by significant reductions in urinary sodium excretion (183.0 +/- 62.1 to 121.7 +/- 65.8 mmol/day) glycosylated haemoglobin (12.4 +/- 3.1 to 10.5 +/- 2.9%), weight (74.6 +/- 13.5 to 71.7 +/- 12.1 kg) and serum triglyceride levels (p less than 0.05). The mean values of diastolic pressure (p less than 0.01), urinary sodium/potassium ratio (p less than 0.001), urinary potassium (p less than 0.01) was significantly reduced at 3 months compared to control. No changes in serum HDL-cholesterol levels were observed. The number of patients with normal blood pressure at 3 months was greater in the modified diet-treated group (ten versus five). Treatment of mild hypertension in diabetic subjects with this form of dietary regimen has a hypotensive response, with improvement in glycaemic control and no side effects. This modified diet may be an attractive alternative to anti-hypertensive drug therapy as a first line treatment.

Transient musical hallucinosis of central origin: a review and clinical study.

A 52 year old, right handed, hearing impaired woman was admitted with headache and neck stiffness. The only neuropsychological symptom was transient auditory perceptions in the left ear, which were musical, seemed familiar and were not influenced by verbal communication. CT and MRI showed a right subarachnoid haemorrhage, while brainstem auditory evoked potentials failed to reveal a brainstem lesion. In patients with organic cerebral disease, unilateral auditory hallucinations (AHs) may indicate a lesion in the contralateral hemisphere. However, according to this review the type of AHs (verbal versus musical) is not consistently associated with a cerebral lesion on either side.