bluuebunny/crossref_metadata_2025 huggingface dataset:
Presenting women as sexual objects in marketing communications
Authors: Alam Md. Mahmudul , Aliyu Ahmed , Shahriar Shawon Muhammad
Published: May 2019

Purpose

In the current information age, when the attention spans of most people have become very short, marketers are facings serious challenges to grab the attention of their target audience effectively and fruitfully. From street corner to bedroom, virtually every perceivable location of human traces are littered with activity of marketers, whether they are small or large in scale or the recipients of their information understand the message properly. Studying consumers’ acceptance of the main ethical issues in communication, mainly in advertising, has recently been receiving much attention from scholars. Therefore, to grab the attention of people in the increasing competitive environment, advertisers have resorted to using what they feel can quickly attract the audience. For example, the attachment of attractive women with their physical natural endowments presented in explicit sexually appealing postures to products/services that have no linkage with women. These practices have raised some moral and ethical questions within the society. Therefore, this study aims to focus on discussing marketing communication through presenting women as a sexual object from the morality, ethics and religious perspectives.

Design/methodology/approach

This is a descriptive study based on the systematic literature review. Initially, this paper discusses the ethical issues of using women and sexual appeals in the process of marketing communication, as well as the current level of practices in the industry. Then, it discusses the consequences and dimensions of the issues from different types of ethical grounds. Finally, it provides recommendations with the objective of finding a common ground from business and social perspectives. It also mentions the scopes of further research, which could lead the secular world to modify their moral values and come closer to the norms of other civilized societies.

Findings

The position of the paper takes is that considering the negative effects of the prevalent advertising in society, the practice falls short of human moral values; as a result, it is considered unethical.

Originality/value

This review paper examines the ethical implication of using women as marketing tools from the perspectives of morality, business and Islamic principles that will help business groups, as well as the whole religious community, especially Muslims.
Role of social networking platforms as tool for enhancing the service quality and purchase intention of customers in Islamic country
Authors: Naeem Muhammad
Published: May 2019

Purpose

Customers are increasingly focused to find reviews, discussions and feedbacks on social media related to particular services in which they are interested. This paper aims to find which social networking platforms are more frequently used to provide reviews related to services, and based on these reviews, how service providing organizations can enhance the level of service quality and purchase intention of customers.

Design/methodology/approach

The research approach for this study is based on interpretivism assumptions and qualitative research design. The semi-structured and non-directive interviews were conducted to collect data from customers and marketing team of internet service provider and banking organization. These selected organizations have major shares in markets and a large number of customers. The participants were selected based on purposive sampling technique and their contribution in services-related discussion on social networking platforms.

Findings

Findings of this research highlighted that social networking platforms such as official Facebook page of selected service providing organizations, closed public discussion groups on Facebook, WhatsApp groups of family and friends and YouTube videos comment section are more frequently used to create service reviews and purchase intention of customers. Above all, results also reveal that customers are more frequently used Facebook discussion groups (public or private) for generating services reviews for selected bank and internet service provider.

Research limitations/implications

The effective and efficient use of these social networking platforms can enhance interactive communication, services reviews, feedbacks, intention to purchase, social influence, social trust and services quality. Furthermore, social media platforms required lower level of advertisement cost and offered huge amount of enquires, discussions, transactions, word of mouth, services stories and interactions of consumers.

Originality/value

There is rare research available on how and which social networking applications can enhance the level of service quality of services sector organizations especially in the context of Islamic countries. Most of the available literature has been investigated the link of social media and traditional marketing related constructs. This research is exploratory in nature because it investigates under-researched issue regarding the use of social networking applications to enhance the level of service quality and purchase intention of customers.
The Chinese plan for football development: a perspective from innovation theory
Authors: Junior Emanuel Leite , Rodrigues Carlos
Published: May 2019

Purpose

The purpose of this paper is to report a critical analysis of the plan recently launched by the Chinese Government for the development of the football industry in China. The analysis encompasses the impact exerted by the new policy instrument on the Eurocentric trend that configured the power relations in the football realm, as well as the challenges raised by barriers deeply rooted in culture that Chinese authorities should face in order to foster pervasive change and thus create the conditions for success.

Design/methodology/approach

The analysis of the policy document has been carried out under the light of the theory of innovation, namely, the contributions of Peter Drucker, who looks at innovation as a means to foster change in the social and economic environment, inducing new patterns of behaviour and creating new habits. This theoretical framework provides ground to the analytical endeavour because the Chinese plan for football development presents the overall goal of shifting the habits of sporting practice and consumption.

Findings

The first and most visible “innovative” effect of the policy took the form of a shock provoking an unprecedented change in the geopolitics of football and the inherent disturbance in the traditional Eurocentric structure of football power relations. At the domestic level, the Chinese Government is assuming the “educating” role in order to change behaviour and habits, that is, to ensure the transformative power necessary to overcome barriers deeply rooted in culture. Accordingly, rather than the availability of financial resources, the capacity to materialise this pervasive switch in behaviour and habits in terms of football practice and consumption is the major challenge, the one of a social innovation endeavour.

Originality/value

The research reported in this paper provides an original and innovative approach to the analysis of a sports relevant public policy document, namely, because of the theoretical framework wrapping up the analytical endeavour.
‘Step by step, side by side’: the quest to create relational artistry through systemic practice within children’s social care
Authors: Partridge Karen , Dugmore Paul , Mahaffey Helen , Chidgey Mark , Owen James
Published: May 2019

This paper describes a quest towards relational artistry in the development of a systemic training programme in social care. As part of tiered delivery addressing staff at different levels in the workforce a systemic group supervision process was introduced, adapted from Proctor’s (1997) ‘Bells that Ring’ model. The paper describes the adaptation and delivery of the model through live supervision of senior practitioners by Systemic Mentors working in situ alongside the supervision groups. The project expanded in response to feedback leading to further initiatives to embed systemic ideas. These included a ‘systemic rucksack’ containing sets of cards to guide the supervision process. ‘Systemic champions’ went on to co‐produce and deliver workshops on key concepts for the whole workforce and to engage frontline workers and families in creating the next steps in the project.

Practitioner Points

Going step by step, taking a participative action learning approach to training in social care can maximise the potential effectiveness of training and help to embed systemic practice throughout the workforce

Getting alongside staff through live mentoring, using relational artistry, can enhance participation and learning in systemic group supervision

Relational Artistry can be described as a creative process of navigating through positioning and re‐positioning in the relational responsive flow of dialogue

A Systemic Rucksack, including a collection of cards describing systemic concepts and roles in the systemic group supervision process can enhance theory/practice links and trigger reflexivity
Exploring the neglected and hidden dimensions of large‐scale healthcare change
Authors: Jones Lorelei , Fraser Alec , Stewart Ellen
Published: May 2019

Forms of large‐scale change, such as the regiona l re‐distribution of clinical services, are an enduring reform orthodoxy in health systems of high‐income countries. The topic is of relevance and importance to medical sociology because of the way that large‐scale change significantly disrupts and transforms therapeutic landscapes, relationships and practices. In this paper we review the literature on large‐scale change. We find that the literature is dominated by competing forms of knowledge, such as health services research, and show how sociology can contribute new and critical perspectives and insights on what is for many people a troubling issue.
Clients expect nutrition care to be provided by personal trainers in Australia
Authors: Barnes Katelyn , Beach Bettina , Ball Lauren , Desbrow Ben
Published: May 2019

Aim

To describe client expectations and the experience of nutrition care provided by personal trainers and explore factors that influence expectations of nutrition care.

Methods

A cross‐sectional survey identified expectations of nutrition care provided by personal trainers. Likert scales explored expected nutrition care, nutrition knowledge of personal trainers and experiences of those who had received nutrition care from a personal trainer. Expectations were evaluated using descriptive statistics. Associations between expectations and participant characteristics were explored with Pearson chi‐squared tests.

Results

Six hundred twenty‐seven Australian residents participated (77% female; 16–74 years of age). Participants frequently expected personal trainers to be knowledgeable about and discuss general healthy eating, muscle gain and weight loss. Half of the participants expected personal trainers to discuss and be knowledgeable about nutrition for chronic disease. Of the 334 participants who had engaged a personal trainer, 98% received nutrition care. Half of these participants (n = 167) were satisfied with the nutrition care they received, and 40% reported positive dietary changes because of their personal trainers’ nutrition care. Tertiary education and perceived healthfulness of diet lowered expectations of nutrition care from personal trainers (P < 0.001). Engagement of a personal trainer did not influence expectations of nutrition discussions (P > 0.01) but increased expectations of personal trainer nutrition knowledge (P < 0.01).

Conclusions

Clients expect personal trainers to provide nutrition care. Client expectations may compel personal trainers to provide nutrition care beyond the recommended scope of practice. Strategies to manage client expectations, including awareness of the personal trainer scope of practice, are needed to ensure safe and effective nutrition care from personal trainers.
Precision medicine in primary sclerosing cholangitis
Authors: Maurice James B. , Thorburn Douglas
Published: May 2019

Primary sclerosing cholangitis is a rare, complex autoimmune disease in relatively young patients. There is currently no treatment for the disease, resulting in high rates of advanced liver disease leading to death or liver transplantation. However, advances have been made in our understanding of the pathophysiological mechanisms of the disease, particularly from breakthroughs in the underlying genetics. Moreover, large international collaborations have generated important clinical data that have given greater detail on the different disease phenotypes and natural history, generating new risk prediction models. As a result, drug development may be designed to target specific disease mechanisms at known points of the disease natural history. Therefore, more drugs are entering phase II and III development, giving hope that soon patient‐specific treatments may be available to treat this difficult disease.
Evaluation of risk factors for atherosclerosis using carotid ultrasonography in Japanese patients with rheumatoid arthritis
Authors: Yamamoto Hiroko , Nakajima Toshiki , Kawahara Rie , Nakabo Shuichiro , Hashimoto Motomu , Yamamoto Wataru , Masuda Izuru , Ito Hiromu , Mimori Tsuneyo , Fujii Yasutomo
Published: May 2019

Aim

Previous studies have reported that patients with rheumatoid arthritis (RA) have a higher risk of developing cardiovascular disease (CVD) than the general population. A major cause of CVD is atherosclerosis, which can be evaluated with carotid ultrasonography (US). As far as we know, there have been no large‐scale carotid artery US studies in Japanese patients with RA. The aim of this study was to identify the risk factors for atherosclerosis in Japanese patients with RA.

Methods

The study subjects underwent physical examinations, laboratory tests and US examination, and answered a questionnaire about their lifestyle. Carotid US was performed to measure the maximum carotid intima media thickness (max cIMT) and to detect plaques.

Results

Atherosclerosis was detected in 238 patients (52%). Age, hypertension, and total/high‐density lipoprotein cholesterol ratio were positively related to max cIMT. Presence of plaques was related to age, Disease Activity Score of 28 joints—erythrocyte sedimentation rate (DAS28‐ESR), smoking, and any biological treatment. DAS28‐ESR correlated positively not with cIMT but with the development of plaques in our patients with low disease activity (average DAS28‐ESR of 2.7).

Conclusion

Disease Activity Score of 28 joints—erythrocyte sedimentation rate was related to the size and number of plaques, whereas only traditional risk factors were related to max cIMT. This indicated that the inflammatory conditions of RA could affect the formation of atherosclerotic plaques. For the management of CVD in patients with RA, it may be important to control not only traditional risk factors, but also RA disease activity.
Infection risks of rituximab versus non‐rituximab treatment for rheumatoid arthritis: A systematic review and meta‐analysis
Authors: Shi Yuhong , Wu Yanbin , Ren Yafei , Jiang Yanan , Chen Yiqiang
Published: May 2019

Objective

The aim of this study was to assess the differences in infection rates between rituximab (RTX) and non‐RTX treatment in patients with rheumatoid arthritis (RA).

Methods

A systematic review and meta‐analysis was conducted by searching databases of PubMed, MEDLINE, EMBASE, Web of Science and Cochrane Library through to June 2018. We included studies that compared RTX and non‐RTX treatment for patients with RA. Outcome measures were overall infections and serious infections between RTX and non‐RTX treatments.

Results

A total of 11 articles, including 9502 patients (4595 with RTX treatment and 4907 with non‐RTX treatment) met our inclusion criteria. The results demonstrated that RTX‐related all infections and serious infections in RA patients were 43.8% and 4.4%, respectively. Pooled analysis showed no significant differences between RTX and non‐RTX treatment groups in overall infections rate (43.3% vs 44.9%; odds ratio [OR] = 0.87; 95% CI = 0.70‐1.08) and serious infections rate (4.1% vs 4.6%; OR = 1.05; 95% CI = 0.84‐1.31). Subgroup analysis also showed no significant differences in overall infections between RTX versus placebo (OR = 0.98, 95% CI = 0.71‐1.33); RTX versus tumor necrosis factor inhibitors (TNFi) (OR = 0.47, 95% CI = 0.30‐1.73); RTX plus methotrexate (MTX) versus placebo plus MTX (OR = 0.98, 95% CI = 0.77‐1.24), and in serious infections between RTX versus placebo (OR = 1.06, 95% CI = 0.36‐3.07); RTX versus TNFi (OR = 1.25, 95% CI = 0.96‐1.63); RTX plus MTX versus placebo plus MTX (OR = 0.69, 95% CI = 0.39‐1.20).

Conclusion

In patients with RA, RTX treatment has no additional risks for infections over non‐RTX treatment.
The Process Performance of the WTO Trade Policy Review Mechanism: Peer‐Reviewing Reconsidered
Authors: Karlas Jan , Parízek Michal
Published: May 2019

This survey article provides the first comprehensive assessment of the functioning of the Trade Policy Review Mechanism (TPRM), the central monitoring platform of the World Trade Organization (WTO), over the first 20 years of the WTO's existence (1995–2014). Building on two large new datasets, we assess the performance of the Mechanism along three dimensions: (1) members’ participation rates in trade policy reviews (TPRs); (2) the coverage of trade flows through participation of states in relevant TPRs; and (3) the content of their input into the reviews. Descriptively, we identify a very prominent increase in members’ participation rates, but also a very high share of dyadic trade flows covered by the TPRs. In the most recent period, members accounting for up to 95 per cent of the imports into the reviewed state take part in the TPRs, on average. We also argue that the Mechanism provides space for substantial critical reviewing of members’ policies, especially in some areas such as agriculture. However, we also identify specific pitfalls of the Mechanism, especially in its excessive formalism and lack of interactive discussion.
Exposure to Stigma Elicits Negative Affect and Alcohol Craving Among Young Adult Sexual Minority Heavy Drinkers
Authors: Mereish Ethan H. , Miranda Robert
Published: May 2019

Background

Sexual orientation disparities in alcohol use disorder (AUD) are thought to be explained by stigma specific to sexual minorities. Despite the importance of negative affect and craving in addiction, research has yet to test the effects of stigma on affect and alcohol craving among sexual minorities. This laboratory study examined the effects of 3 novel mood inductions (stigma, general unpleasant, and neutral) on affect and alcohol craving among heavy‐drinking sexual minority young adults. We also paired these mood inductions with an established alcohol cue reactivity paradigm to explore the effects of stigma on cue‐elicited craving.

Methods

Sexual minority participants (N = 20; 55% female), aged 18 to 27 years (M = 21.80, standard deviation = 2.65), were recruited from the community. Participants completed 3 mood induction and cue reactivity trials counterbalanced over 3 visits on different days: stigma, general unpleasant, and neutral mood inductions. A structured interview assessed criteria for DSM‐5 AUD, and self‐report measures assessed lifetime adverse experiences.

Results

Most participants met criteria for past‐year AUD (75%). Exposure to stigma produced more negative affect and greater alcohol craving than the neutral and general unpleasant mood induction conditions. The general unpleasant mood induction did not predict greater alcohol craving than the neutral mood induction. Stigma enhanced alcohol cue reactivity effects, as measured with a single‐item craving measure, compared to the general unpleasant mood condition, and this effect remained significant while controlling for covariates.

Conclusions

Findings are the first to demonstrate how stigma uniquely predicts negative affect and alcohol craving among sexual minorities. This study suggests that being exposed to stigma, specifically heterosexism, elicits negative mood and alcohol craving among sexual minority young adults who are heavy drinkers.
Genome‐wide gene expression in a pharmacological hormonal transition model and its relation to depressive symptoms
Authors: Mehta D. , Rex‐Haffner M. , Søndergaard H. B. , Pinborg A. , Binder E. B. , Frokjaer V. G.
Published: May 2019

Objectives

Sensitivity to sex‐steroid hormone fluctuations may increase risk for perinatal depression. We aimed to identify genome‐wide biological profiles in women demonstrating sensitivity to pharmacological sex‐hormone manipulation with gonadotrophin‐releasing hormone agonist (GnRHa).

Methods

Longitudinal gene expression (Illumina Human HT12.v4) and DNA methylation data (Infinium HumanMethylation450K BeadChip) from 60 women (30 GnRHa, 30 placebo) were generated (Trial ID: NCT02661789). Differences between baseline and two follow‐up points (initial stimulation‐ and subsequent early suppression phase) in the biphasic ovarian hormone response to GnRHa were assessed using linear mixed effects models.

Results

Genome‐wide analysis revealed 588 probes differentially expressed from GnRHa intervention to first stimulatory phase follow‐up (intervention group × time) after 10% fdr multiple testing correction. Of these, 54% genes were also significantly associated with estradiol changes over time (proxy for GnRHa response magnitude), 9.5% were associated with changes in depressive symptoms, and 38% were associated with changes in neocortical serotonin transporter binding. The genes were implicated in TGF beta signaling, adipogenesis, regulation of actin cytoskeleton, and focal adhesion pathways and enriched for DNA methylation changes (P = 0.006).

Conclusions

These findings point toward an altered peripheral blood transcriptomic landscape in a pharmacological model of sex‐hormone‐induced depressive symptoms.
Associations between nucleus accumbens structural connectivity, brain function, and initiation of binge drinking
Authors: Morales Angelica M. , Jones Scott A. , Harman Gareth , Patching‐Bunch Jessica , Nagel Bonnie J.
Published: May 2019

Adolescent alcohol use is associated with increased risk for alcohol use disorders later in life; therefore, identifying biomarkers for initiation of heavy alcohol use, such as individual differences in the development of white‐matter microstructure, may inform prevention strategies that improve public health. This prospective cohort study included 40 adolescents, ages 14 and 15, without substantial history of alcohol or drug use at baseline. Fractional anisotropy (FA), an index of white‐matter microstructure, was assessed in pathways connecting the nucleus accumbens (NAcc) to the rest of the brain using diffusion tensor imaging. Path analyses were conducted voxel‐wise within these pathways to examine direct effects of premorbid FA on number of months between baseline assessment and the onset of binge drinking and indirect effects mediated by NAcc activation during decision making assessed using functional magnetic resonance imaging. Adolescents with lower premorbid accumbofrontal FA began binge drinking sooner, an effect which was mediated by greater NAcc activation during decision making involving greater levels of risk and reward (P < .05 corrected). An additional direct effect of FA on duration to onset of binge drinking was observed in white matter near the ventral pallidum, as adolescents with lower premorbid FA in this region began binge drinking sooner (P < .05 corrected). Findings suggest that delayed maturation of prefrontal white matter is associated with less top‐down control over striatal sensitivity to reward. These factors, along with individual differences in white matter proximal to ventral pallidum, may represent premorbid risk factors for earlier initiation of heavy alcohol use.
Methamphetamine acutely alters frontostriatal resting state functional connectivity in healthy young adults
Authors: Weafer Jessica , Van Hedger Kathryne , Keedy Sarah K. , Nwaokolo Nkemdilim , de Wit Harriet
Published: May 2019

Chronic use of methamphetamine impairs frontostriatal structure and function, which may result in increased incentive‐motivational responses to drug cues and decreased regulation of drug‐seeking behavior. However, less is known regarding how the drug affects these circuits after acute administration. The current study examined the effects of a single dose of methamphetamine on resting state frontostriatal functional connectivity in healthy volunteers. Participants (n = 22, 12 female) completed two sessions in which they received methamphetamine (20 mg) and placebo before a resting state scan during functional magnetic resonance imaging. Participants also provided self‐report measures of euphoria and stimulation at regular intervals. We conducted seed‐based voxelwise functional connectivity analyses using three bilateral striatal seed regions: nucleus accumbens (NAcc), caudate, and putamen and compared connectivity following methamphetamine versus placebo administration. Additionally, we conducted correlational analyses to assess if drug‐induced changes in functional connectivity were related to changes in subjective response. Methamphetamine increased NAcc functional connectivity with medial frontal regions (ie, orbitofrontal cortex, medial frontal gyrus, and superior frontal gyrus) and decreased NAcc functional connectivity with subgenual anterior cingulate cortex (ACC). Methamphetamine also increased functional connectivity between putamen and left inferior frontal gyrus (IFG), and individuals who displayed greater drug‐induced increase in connectivity reported less euphoria and stimulation. These findings provide important information regarding the effects of methamphetamine on brain function in nonaddicted individuals. Further studies will reveal whether such effects contribute to the abuse potential of the drug and whether they are related to the frontostriatal impairments observed after chronic methamphetamine use.
Going Deeper in Video‐Cued Multivocal Ethnographies
Authors: Hayashi Akiko
Published: May 2019

This article demonstrates how the original Preschool in Three Cultures method can be extended and modified. Modifications to the method include using videos not only as interviewing cues but also as data for microanalysis; conducting multiple return interviews with the same informants; re‐editing videos to draw more explicit attention to key issues in the research; and using videos shot in classrooms twelve years earlier as cues for interviewing teachers about how they have changed with experience.
Elevated serum interleukin‐32 levels in patients with endometriosis: A cross‐sectional study
Authors: Choi Young Sik , Kim Sinae , Oh Young Sang , Cho SiHyun , Hoon Kim Sung
Published: May 2019

Problem

Recently, interleukin (IL)‐32 has been suggested to be involved in the pathogenesis of endometriosis. The aim of this study was to investigate whether serum IL‐32 level might be used as a biomarker for diagnosis of endometriosis.

Method of study

We recruited the serum samples of 50 patients with histologically confirmed endometriosis and 35 controls. Enzyme‐linked immunosorbent assay was used to analyze the serum IL‐32, IL‐6, IL‐10, tumour necrosis factor (TNF)‐α, IL‐1β, and CA‐125 levels in patients with and without the disease and the diagnostic potentials of the cytokines were assessed using receiver operating characteristic curve and the area under the curve (AUC).

Results

Among evaluated cytokines, only serum IL‐32 levels showed significant differences between patients with and without endometriosis (1111.24 ± 149.59 vs 631.10 ± 120.23 ng/mL, P = 0.018, respectively). When the diagnostic power of serum IL‐32 was evaluated, the AUC was 0.638 (95% confidence interval (CI): 0.521‐0.766, P = 0.031). When serum IL‐32 levels were combined with serum CA‐125 levels, the AUC was increased to 0.749 (95% CI: 0.640‐0.858, P < 0.001) with sensitivity and specificity of 60.0% and 82.9% at cutoff value of 0.640, which led to detect 25 more cases of endometriosis than the use of serum CA 125 with the cutoff value of 35 IU/mL (36/50 vs 11/50, P < 0.001) without sacrificing the specificity of the marker.

Conclusion

Serum IL‐32 levels are elevated in patients with endometriosis, and with combination of serum CA‐125 levels, it may serve as a potential biomarker for endometriosis.
The impact of ganglion cell layer cysts in diabetic macular oedema treated with anti‐vascular endothelial growth factor
Authors: Ceklic Lala , Huf Wolfgang , Ebneter Andreas , Wolf Sebastian , Zinkernagel Martin S. , Munk Marion R.
Published: May 2019

Purpose

To investigate the prevalence and impact of ganglion cell layer cysts (GCLC) in patients with diabetic macular oedema (DME) under continuous anti‐vascular endothelial growth factor (VEGF) therapy.

Methods

The clinical findings and spectral domain optical coherence devices of baseline visits and follow‐up after 12–24 and 36 months of DME patients under continuous anti‐VEGF therapy were retrospectively collected and analysed for the impact of GCLC cysts. Previously established prognostic parameters were also assessed.

Results

A total of 110 eyes of 110 DME patients (mean age 64 ± 10 years) were included. At baseline, 17% eyes had GCLC. With GCLC, the best‐corrected visual acuity (BCVA) improvement was in mean 8.4 ± 2.4 Early‐Treatment‐Diabetic‐Retinopathy‐Study (ETDRS) letters less over the course of 36 months compared to the group lacking GCLC (p = 0.0009). Eyes with GCLC showed 68 ± 23.4 μm less central retinal thickness (CRT) decrease than eyes lacking GCLC (p < 0.0001). In the linear mixed effect models including external limiting membrane disruption, disintegration of inner retinal layer and epiretinal membrane, GCLC remained a statistical significant factor for the outcome parameter CRT, but missed statistical significance for BCVA.

Conclusion

Ganglion cell layer cysts (GCLC) seem to impact outcome in DME in patients receiving long‐term treatment. This prognostic factor warrants further evaluation in the context of already well‐established outcome parameters.
Vascular dysfunction in retinitis pigmentosa
Authors: Lang Matt , Harris Alon , Ciulla Thomas A. , Siesky Brent , Patel Pooja , Belamkar Aditya , Mathew Sunu , Verticchio Vercellin Alice C.
Published: May 2019

The relationship between ocular haemodynamics and retinitis pigmentosa (RP) has not been fully understood. Reductions in blood flow have been established in RP patients by a variety of studies; however, questions have yet to be answered regarding the role of vascular dysfunction in photoreceptors (PR) degeneration, the causes of vascular dysfunction in RP, as well as the diagnostic, prognostic and perhaps therapeutic potential of measuring ocular haemodynamics in RP patients. While significant evidence supports the theory that vascular dysfunction is associated with but not the cause of PR death in retinitis pigmentosa, evidence suggests that vascular abnormalities in the foveal and parafoveal regions may exacerbate cone cell loss. Additional evidence demonstrates that vascular dysfunction likely results from changes in metabolic demand due to death of PR cells in the retina. Detection and monitoring of ocular blood flow, retinal oxygen saturation, endothelin‐1 levels and vascular structural abnormalities could provide diagnostic, prognostic and therapeutic potential for patients with RP.
Non‐alcoholic steatohepatitis, but not simple steatosis, disturbs the functional homogeneity of the liver – a human galactose positron emission tomography study
Authors: Eriksen Peter Lykke , Thomsen Karen Louise , Larsen Lars Peter , Grønbæk Henning , Vilstrup Hendrik , Sørensen Michael
Published: May 2019

Background

The disease severity of non‐alcoholic fatty liver disease (NAFLD) and the distinction between simple steatosis and non‐alcoholic steatohepatitis (NASH) are based on the pathohistological presence of steatosis, inflammation, ballooning and fibrosis. However, little is known about the relation between such structural changes and the function of the afflicted liver.

Aims

To investigate in vivo effects of hepatic fat fraction, ballooning and fibrosis on regional and whole liver metabolic function assessed by galactose elimination in NASH and simple steatosis.

Methods

Twenty‐five biopsy‐proven, nondiabetic patients with NAFLD (13 NASH with low‐grade fibrosis, 12 simple steatosis with no fibrosis) underwent 2‐[18F]fluoro‐2‐deoxy‐d‐galactose positron emission tomography and magnetic resonance imaging‐derived proton density fat fraction of the liver. Nine healthy persons were included as controls.

Results

In the NASH patients, the standardised hepatic uptake of 2‐[18F]fluoro‐2‐deoxy‐d‐galactose was reduced to 13.5 (95% confidence interval, 12.1‐14.9) as compared with both simple steatosis and controls (16.4 (15.6‐17.1), P < 0.001). Thus, the NASH patients had reduced regional metabolic liver function. The liver fat fraction diluted the standardised uptake equally in NASH and simple steatosis but the fibrosis and ballooning of NASH were associated with a further decrease. Moreover, the NASH livers exhibited increased variation in their standardised uptake values (coefficient of variation 13.8% vs 11.6% in simple steatosis and 10.2% in controls, P = 0.02), reflecting an increased functional heterogeneity.

Conclusions

In NASH, the regional metabolic liver function was lower and more heterogeneous than in both simple steatosis and healthy controls. Thus, NASH disturbs the normal homogeneous metabolic function of the liver.
Hemi‐double stapling technique performed with a transorally inserted anvil for esophagojejunostomy in the surgical treatment of gastric cancer
Authors: Ishibashi Yuji , Oka Shinichi , Kanda Satoshi , Yube Yukinori , Kohira Yoshinori , Kaji Sanae , Egawa Hiroki , Jianzhong Wu , Zhang Shun , Fukunaga Tetsu
Published: May 2019

Introduction

A transorally inserted anvil has been developed to facilitate the creation of a stapled anastomosis without the need for a purse string to secure the anvil into place during laparoscopic total gastrectomy (LTG). We describe a hemi‐double stapling technique and application of a transorally inserted anvil for esophagojejunostomy during LTG, and we report the results of a retrospective study in which we examined the feasibility and safety of this method. We also describe the key technical details of the method.

Methods

Our anastomotic method has four chief features: (a) the esophagus is cut at a slant, and its left cut end is cut and punched for the hemi‐double stapling technique; (b) the anvil and circular stapler are connected, placing the distal jejunum in cranial traction; (c) a single layer of sutures is used to correct dog‐earing and overlapping, and these points are completely closed with Lembert sutures; and (d) the jejunal limb is fixed to the duodenal stump to prevent kinking of the jejunal limb and to decrease tension on the anastomosis.

Results

This method has been used in 53 patients thus far. LTG with Roux‐en‐Y reconstruction was successful in all patients, and there was no need for conversion to open surgery. The mean operative time was 313 minutes, and the mean blood loss was 106 mL. The mean postoperative hospital stay was 18 days. There was no anastomotic leakage or stenosis.

Conclusion

Hemi‐double stapling technique with a transorally inserted anvil for LTG can be performed safely and easily and safely. It can also product good outcomes.
Connecting knowledge spaces: Enabling cross‐community knowledge building through boundary objects
Authors: Yuan Guangji , Zhang Jianwei
Published: May 2019

A learning community works with a collective knowledge space where members contribute and interact with one another's ideas to advance their community's knowledge. This study aims to explore designs of collective knowledge space to support cross‐community interaction. A design experiment was conducted in four grade 5 classrooms with the support of Knowledge Forum over a school year. As students conducted focused inquiry and discourse within their own community, they reviewed productive threads of ideas and created “super notes” (idea thread syntheses) for cross‐community sharing and interaction. A set of “super notes” from previous classrooms studying human body systems was also posted in the cross‐community space. Qualitative analyses results showed that the students wrote and posted “super notes” to capture substantive idea progress and deepening questions that had emerged from their inquiry. Social network analysis of who had read whose “super notes” revealed extensive social interactions between the four classrooms as well as among the students within each classroom. Analysis of the classroom conversations that followed the “super notes” reading elaborated how students built on the insights gained from the cross‐classroom interactions to develop deeper understandings in their home classroom. Analyses of teacher interviews and observation data documented the teachers’ roles to contextualize the purpose of the cross‐classroom space, support “super notes” reading and writing, and scaffold cross‐classroom connection and conversation.

Practitioner Notes

What is already known about this topic

Students work with a collective knowledge space where they contribute and interact with one another's ideas to advance their community's knowledge.

Existing designs of collective knowledge spaces focus on supporting students’ interaction in individual classroom communities, which is often organized as relatively short inquiry activities lasting over a couple of weeks.

What this paper adds

A multilevel emergent interaction design for connecting the knowledge spaces of different communities.

Elaborated classroom processes and technology support for enabling knowledge building across classroom communities.

Implications for practice and/or policy

Teachers can facilitate collaborative knowledge building in each classroom and further create cross‐community connections for mutual learning and idea build‐on.

It is important to support student‐driven efforts to develop interconnected knowledge spaces in order to enable sustained knowledge building and deep inquiry across classrooms.
From tweeting to meeting: Expansive professional learning and the academic conference backchannel
Authors: Greenhow Christine , Li Jiahang , Mai Minhtuyen
Published: May 2019

As new technologies shape and are shaped by human practices, educators and researchers must consider the impact that participating in social media—to access, reflect upon, question, evaluate and disseminate scholarship—is having on their professional development and practices. This paper investigates how members of the educational research community use social media to advance professional learning and scholarship dissemination in online–offline networks. Specifically, we examine whether and how participating in the microblogging service, Twitter, as a conference backchannel, facilitated professional learning and participation in the annual meetings of American educational researchers in 2012 and 2016, respectively, and the nature of that participation. Insights from this paper will benefit educators of varying disciplines and experience levels interested in the changing nature of social media in education, scholarship, and professional learning ecologies.
The importance of determining circadian parameters in pharmacological studies
Authors: Gaspar Laetitia S. , Álvaro Ana Rita , Carmo‐Silva Sara , Mendes Alexandrina Ferreira , Relógio Angela , Cavadas Cláudia
Published: May 2019

In mammals, most molecular and cellular processes show circadian changes, leading to daily variations in physiology and ultimately in behaviour. Such daily variations induce a temporal coordination of processes that is essential to ensure homeostasis and health. Thus, it is of no surprise that pharmacokinetics (PK) and pharmacodynamics (PD) of many drugs are also subject to circadian variations, profoundly affecting their efficacy and tolerability. Understanding how circadian rhythms influence drug PK, PD, and toxicity might significantly improve treatment efficacy and decrease related side effects. Therefore, it is essential to take circadian variations into account and to determine circadian parameters in pharmacological studies, especially when drugs have a short half‐life or target rhythmic processes. This review provides an overview of the current knowledge on circadian rhythms and their relevance to the field of pharmacology. Methodologies to evaluate circadian rhythms in vitro, in rodent models and in humans, from experimental to computational approaches, are described and discussed. Lastly, we aim at alerting the scientific, medical, and regulatory communities to the relevance of the physiological time, as a key parameter to be considered when designing pharmacological studies. This will eventually lead to more successful preclinical and clinical trials and pave the way to a more personalized treatment to the benefit of the patients.
La transformation de l'offre de services de garde au Québec: une brèche dans la collectivisation du travail de reproduction sociale?
Authors: Mathieu Sophie
Published: May 2019

In 1997, the government of Québec instituted a low‐cost and universal childcare services program most commonly available through the “centres de la petite enfance (CPE)” (early chilldhood centers). Since 2003, this model is being slowly dismantled on account of an explosion in the number of commercial daycare centers and, since 2015, an adjustment of rates according to family revenues. This research article gathers scattered information about the childcare services offer changes in Québec to demonstrate that tearing down a section of the Québécois family policy lowers the collectivization of social reproductive work.
Predicting future distributions of lanternfish, a significant ecological resource within the Southern Ocean
Authors: Freer Jennifer J. , Tarling Geraint A. , Collins Martin A. , Partridge Julian C. , Genner Martin J.
Published: May 2019

Aim

Lanternfish (Myctophidae) are one of the most abundant and ecologically important families of pelagic teleosts, yet how these species will respond to climate change is unclear, especially within polar regions. The aim of this study was to predict the impact of climate change on the distribution of Southern Ocean lanternfish and to relate these predicted responses to species traits.

Location

Circumpolar, 35–75°S.

Methods

We used MaxEnt ecological niche models to estimate the present and predict the future distributions of 10 biomass‐dominant lanternfish species throughout the region. Future conditions were simulated using eight climate models, in both stabilizing (RCP 4.5) and rising (RCP 8.5) emission scenarios, for the time periods 2006–2055 and 2050–2099. Species responses were then related to their realized thermal niche (i.e., thermal tolerance range), latitudinal preference and body size.

Results

Despite large variation between climate model simulations, all but one species are consistently predicted to undergo a poleward distribution shift. Species show contrasting projections relating to a gain or loss of suitable habitat which was best explained by their thermal niche. Overall, high‐latitude Antarctic species were found to have narrower thermal niches and a higher likelihood of losing habitat than sub‐Antarctic species.

Main conclusions

The direction of a species response was dependent on the interplay between physiology (realized thermal niche) and biogeography (latitudinal preference). Antarctic species with restricted thermal niches and limited available habitat in which to disperse will be the most vulnerable group of Southern Ocean lanternfish in the face of climate change. Predicted range shifts may alter the size structure of the myctophid community as smaller, sub‐Antarctic species reach further south. This could have implications for trophic interactions and thus the wider Southern Ocean ecosystem.
Effectiveness and safety of rivaroxaban and warfarin for prevention of major adverse cardiovascular or limb events in patients with non‐valvular atrial fibrillation and type 2 diabetes
Authors: Baker William L. , Beyer‐Westendorf Jan , Bunz Thomas J. , Eriksson Daniel , Meinecke Anna‐Katharina , Sood Nitesh A. , Coleman Craig I.
Published: May 2019

Aims

To assess the effectiveness and safety of rivaroxaban versus warfarin for the prevention of major adverse cardiovascular events (MACE) and major adverse limb events (MALE) in patients with type 2 diabetes (T2D) and non‐valvular atrial fibrillation (NVAF).

Materials and methods

Using MarketScan data from January 2012 to December 2017, we identified oral anticoagulant‐naïve patients with NVAF and comorbid T2D and ≥12 months of insurance coverage prior to rivaroxaban or warfarin initiation. Differences in baseline covariates between cohorts were adjusted for using inverse probability of treatment weights based on propensity scores (absolute standardized differences <0.1 achieved for all covariates after adjustment). Patients were followed until a MACE, MALE or major bleeding event, oral anticoagulant discontinuation/switch, insurance disenrolment or end of data availability. Hazard ratios (HRs) and 95% confidence intervals (CIs) comparing the cohorts were calculated using Cox regression.

Results

We identified 10 700 rivaroxaban users (24.1% received a reduced dose) and 13 946 warfarin users. The median (25%, 75% range) age was 70 (62, 79) years, CHA2DS2‐VASc score was 4 (3, 5) and duration of available follow‐up was 1.4 (0.6, 2.7) years. Eleven percent of patients had peripheral artery disease, 5.1% had coronary artery disease, and 5.1% had a prior MALE, at baseline. Rivaroxaban was associated with a 25% (95% CI 4‐41) reduced risk of MACE and a 63% (95% CI 35–79) reduced risk of MALE compared to warfarin. Major bleeding risk did not significantly differ between cohorts (HR 0.95).

Conclusions

Among patients with NVAF and T2D treated in routine practice, rivaroxaban was associated with lower risks of both MACE and MALE versus warfarin, with no significant difference in major bleeding.
Long‐term risk of cardiovascular disease in individuals with latent autoimmune diabetes in adults (UKPDS 85)
Authors: Maddaloni Ernesto , Coleman Ruth L. , Pozzilli Paolo , Holman Rury R.
Published: May 2019

Aims

Latent autoimmune diabetes in adults (LADA) is diagnosed in up to 12% of adults with clinically diagnosed type 2 diabetes (T2D). LADA tends to have healthier cardiovascular (CV) risk profiles than T2D, but it remains uncertain whether the risk of CV events differs between the two. We examined the risk of CV events in patients enrolled in the United Kingdom Prospective Diabetes Study (UKPDS) according to LADA status.

Materials and methods

Diabetes autoantibodies (AAb) were measured in 5062 UKPDS participants. The incidence of major adverse CV events (MACE), defined as CV death, non‐fatal myocardial infarction or non‐fatal stroke, was compared in those with LADA (≥1 AAb test positive) and those without LADA (AAb negative).

Results

There were 567 participants (11.2%) with LADA. Compared with participants with T2D, they were younger, with higher mean HbA1c and HDL‐cholesterol values, and with lower body mass index and total cholesterol and systolic blood pressure values (all P < 0.01). After a median (25th, 75th percentile) 17.3 (12.6–20.7) years of follow‐up, MACE occurred in 157 (17.4 per 1000 person‐years) participants with LADA and in 1544 (23.5 per 1000 person‐years) participants with T2D (HR, 0.73; 95% confidence interval [CI], 0.62–0.86; P < 0.001). However, after adjustment for confounders, this difference was no longer significant (HRadj, 0.90; 95% CI, 0.76–1.07; P = 0.22).

Conclusions

In adults thought to have newly diagnosed T2D, the long‐term risk of MACE was lower in those with LADA. However, this did not differ after adjustment for traditional CV risk factors, suggesting that measurement of AAb in addition to traditional CV risk factors will not aid in stratification of CV risk in clinically diagnosed T2D.