bluuebunny/crossref_metadata_2025 huggingface dataset:
Numerical study of unsteady boundary layer flow and heat transmission of a nano-fluid past a continuously stretching sheet immersed in porous media
Authors: Haider Sajjad , Syed Muhammad Imran , Li Yun-Zhang , Butt Adnan Saeed
Published: July 2019

Purpose

This paper aims to incorporate a numerical investigation of unsteady flow of nano-fluid near the boundary wall and heat transmission over a flat sheet in porous media under the assumption that sheet is continuously stretching. A comprehensive study is accomplished to probe the impacts of different physical parameters on heat transmission and fluid flow.

Design/methodology/approach

The problem is designed mathematically by using Navier–Stokes equations and corresponding equations are transmuted into non-dimensional form, which are reduced to local non-similarity equations. Implicit finite difference scheme is used to attain a non-similar solution for values of similarity variable ranging in [0,1]

Findings

The reduced Nusselt number is a decreasing function of each dimensionless number, while the reduced Sherwood number is an increasing function of each considered value of parameters Pr, Sc, Nb and Nt.

Originality value

Motivated by the industrial, technological and scientific importance, the objective of this study is to discuss the unsteady flow generated by linear stretching of the surface in Nano-fluid in a porous medium. However, the investigation of unsteady boundary layer flow and heat transfer of a Nano-fluid past a stretching surface immersed in a porous medium has not been discussed yet. Furthermore, finite difference scheme is used to solve the problem, and authenticate results are achieved which are in good agreement with published work.
Lesson study with music: a new way to expand the dialogic space of learning and teaching
Authors: Gruber Hubert
Published: July 2019

Purpose

The purpose of this paper is to show that lesson study by including elements from music and music education can sustainably expand and improve the dialogical space for teaching and learning in higher education, especially for primary and secondary teacher education students.

Design/methodology/approach

For the first time under the topic “Lesson Study: Music in Dialogue,” corresponding study programs were prepared at the University College of Teacher Education, Lower Austria. The data material from which answers to research questions can be generated are the “Didactic Design Pattern” and classical research lesson planning, observation and discussion instruments. Moreover, discussion protocols of the reflection meetings offered insights the participants gained through sharing their experience of a series of lesson study cycles including focussed collaboration between mentors, teachers, teacher education students and primary school pupils.

Findings

Within the lesson study groups, the space for cooperation and dialogue widened considerably and the interest in the work and expertise of each other increased. Based on the principles of a “community of practice,” this study shows the positive effects of professional collaboration on primary and secondary teacher education students and a lasting impact on their pupils’ learning. Thereby, the dialogical principle was found to play a central and important role. In connection with music- and art-related processes, previous limitations in teaching and learning with music can be exceeded for pupils, teacher education students and teachers.

Research limitations/implications

This study, therefore, provides new insights into questions of organization and implementation, as well as scientific and didactic support in professional learning communities.

Originality/value

So far, there has been little practitioner research through lesson study in the field of music education. In particular, lesson study enhancing the cooperation between music education and other subject areas through dialogical-integrative work has brought about knowledge and insights of great importance for the further development of an appropriate didactic approach in dialogic music education.
Cues for shaping purchase of local retail apparel clothing brands in an emerging economy
Authors: Zebal Mostaque A. , Jackson Faye Hall
Published: July 2019

Purpose

The purpose of this paper is to explore and identify the cues that shape the purchase of local retail apparel clothing brands in an emerging economy. The study further develops a conceptual framework for the cues that shape the purchase of local retail apparel clothing brands.

Design/methodology/approach

A focus group methodology is used for data collection from the local retail clothing consumers in Bangladesh. Data collected for this study were coded and categorized using inductive reasoning methods and similar responses were identified from a prepared data matrix. The results were presented in narrative while preserving the authenticity of participant response.

Findings

Three cues were identified that shape the purchase of local retail apparel clothing brands in Bangladesh. First, consumers buy local retail apparel clothing brands due to the product authenticity (product quality, product uniqueness, apparel fittings, apparel durability, color combination, attractive design, comfortability and reasonable price). Second, consumer cosmopolitanism (urbanization of people, migration and overseas travel, and access to cable television and international channels) positively related to the purchase of local retail apparel brands in Bangladesh. Third, consumer ethnocentrism (superiority of local made brands over imported foreign brands, moral obligation for purchasing local products and patriotism) is a contributory cue responsible for the success of local retail apparel clothing brands in Bangladesh.

Originality/value

This study is a first of its kind to significantly enrich the consumer behavior literature related to local retail apparel branded companies and their implications.
Glocalising university websites: culturally formatted Arab sentiments
Authors: Vadakepat Vanaja Menon , Menon Devaki Vadakepat
Published: July 2019

Purpose

Many researchers have addressed students as consumers and considered their online searches to choose a university as typical buying behaviour. The myriad features of digital information enable universities to conveniently and quickly reach educational markets at a relatively low cost. Consumers’ market choices can usefully be interpreted in terms of their cultural perceptions. To encourage Web viewers to make repeat visits to, and remain longer on, their websites, it is critical for international universities to understand local and regional viewers’ perceptions and preferences regarding non-text Web messages through the lens of culture. The purpose of the current study is to address the need for, and the challenge presented by, glocalising the text and non-text aspects of university websites by investigating Arab consumers’ perceptions of these websites.

Design/methodology/approach

The sampling frame comprised 200 residents from the Emirate of Abu Dhabi, including 100 high school students and 100 stakeholders, with equal proportions of Arabs and non-Arabs. Illustrations and images were used in the questionnaire to collect respondents’ perceptions about university websites from a cultural perspective.

Findings

This study identifies a need to glocalise the non-text and website messages of international universities that are aiming to penetrate educational markets in the Emirates.

Research limitations/implications

This study clearly identifies the segment that is most receptive to a “glocalised” website communication strategy of international universities: Arab students, aged 16 or above, and educated stakeholders, expect to view academic information on websites, as do viewers everywhere, but prefer this information to reflect the values and traditions of Arab culture.

Originality/value

The increasing inflow of students from the Gulf region to the United Arab Emirates, instead of their usual choice of European or Western educational destinations, has motivated international universities to envisage the Emirates as a location for their campus expansions. An understanding of the approaches of Arab viewers to the websites of international universities through the lens of culture is essential for bridging the literature gaps that currently persist in the area of digital promotion and social marketing.
Breadth and frequency of marketing metric reporting and firm performance in the Middle East
Authors: Sailors John J.
Published: July 2019

Purpose

The purpose of this paper is to explore a host of issues related to the use of marketing metrics and firm performance in the context of the Middle East. Specifically, it seeks to explore which marketing metrics relate to perceived performance, to understand how frequency of metric reporting impacts perceived performance, to identify the impact that marketing dashboards have on perceived firm performance and to analyze how measurement ability relates to perceived performance.

Design/methodology/approach

This paper used an online survey administered to marketing managers at firms located in the Middle East. A total of 55 participants provided usable data. Participants provided the frequency at which 71 different marketing metrics are reported by their firms and their assessments of the firm’s performance with respect to sales growth, market share growth, and profitability. In addition, they indicated whether or not a marketing dashboard was used to report these metrics, and if so, how long ago the dashboard had been implemented. They also assessed their firm’s holistic ability to measure and use metrics compared to their competition.

Findings

As expected, marketers in the Middle East found the marketing metrics examined to vary in their usefulness as judged by their relationship to perceived performance. For those metrics that were perceived to be useful, their utility tended to peak at a moderate level of reporting frequency. These findings also varied by the type of performance considered. The use a marketing metric dashboard did not relate to perceived performance, but the frequency with which the dashboards were reported was found to have a negative linear relationship to perceived performance. Overall, the more capable respondents judged their firms to be with respect to measuring and reporting metrics, the higher their perceived performance.

Practical implications

This paper offers new insights into the usefulness of a wide variety of marketing metrics to marketers in the Middle East. It also provides guidance on the ideal reporting frequency for those metrics. The findings suggest that marketers in the Middle East should focus on reporting key metrics at an appropriate frequency, regardless of whether or not a dashboard format is used. If a dashboard is used, the results of this paper suggest that care should be taken that it not be reported too frequently.

Originality/value

This paper contributes to our understanding of how marketing metrics relate to performance. As the first such study undertaken in the context of Middle Eastern marketers, it represents an important replication and extension of previous findings in other contexts.
Accruals quality, financial constraints, and corporate cash holdings
Authors: Mansali Hatem , Derouiche Imen , Jemai Karima
Published: July 2019

Purpose

The purpose of this paper is to examine how information asymmetry driven by earnings quality affects corporate cash holdings. It also investigates the role that financial constraints play in this effect.

Design/methodology/approach

The paper examines a large sample of 6,501 observations of 741 firms listed on Euronext Paris over the period 2000–2015. Earnings quality is computed using the Jones model performance-matched discretionary accruals developed by Kothari et al. (2005): the larger the absolute value of discretionary accruals, the lower the accruals quality.

Findings

The study finds that firms with poor accruals quality hold more cash and that cash holdings in firms of low reporting quality are higher under financial constraints. These results indicate that firms tend to increase their cash reserves in the presence of high information asymmetry which is notably driven by low accounting quality. The findings also suggest that information asymmetry associated with low reporting quality is greater when firms also have strong financial constraints. The study’s conclusions are consistent with the precautionary motive for cash holdings.

Practical implications

The results would enhance practitioners’ awareness of the importance of accounting choices in the management of cash policies. It would also give researchers an incentive to further explore how these policies are influenced by the precautionary behavior of managers.

Originality/value

This paper is the first work to investigate the effect of accruals quality on corporate cash holdings in the French equity market, which typically has a poor information environment resulting in high information asymmetry. Moreover, the role of financial constraints in this effect has not yet been explored.
Factors related to hospital utilisation for people living with schizophrenia: Examining Allen’s Cognitive Level Scores, recommended supports and routinely collected variables
Authors: Stewart Kylie , Hancock Nicola , Stancliffe Roger J.
Published: July 2019

Introduction

Australian occupational therapists working on mental health inpatient wards are often requested to assess a person’s function and, based on that assessment, recommend the best support environments for that person post‐discharge. The Allen Cognitive Level Screen (ACLS) is a tool used by some therapists to screen cognitive functioning as a basis with which to make support recommendations. There is limited examination of the outcomes for people post‐discharge if the ACLS score‐based support recommendations are followed.

Method

A retrospective cohort design involved quantitative analysis of archival data for 150 adult (18–65 years old) consumers with a primary diagnosis of schizophrenia and an ACLS completed pre‐discharge. Data up to 12 months post‐discharge from hospital were studied. Outcomes examined included re‐presentations or readmission to hospital, length of time in community prior to re‐presentation and length of stay in hospital if readmitted.

Results

Being younger, male, receiving formal supports, having a drug and alcohol disorder comorbidity, living in public housing and having a lower cognitive level as measured by the ACLS were significant univariate factors associated with higher hospital utilisation for one or more of the outcome variables. Multivariate analyses revealed fewer significant relationships, with being younger and receiving formal supports significantly associated with greater likelihood of return to hospital.

Conclusion

This research contributes to evidence of the complexity of living with schizophrenia in the community and supporting people to stay out of hospital. More research regarding how the ACLS score‐aligned support recommendations are carried out and the impact on hospital utilisation is needed in order to enhance occupational therapists confidence in their use and prescription.
Atlantis: A spatially explicit end‐to‐end marine ecosystem model with dynamically integrated physics, ecology and socio‐economic modules
Authors: Audzijonyte Asta , Pethybridge Heidi , Porobic Javier , Gorton Rebecca , Kaplan Isaac , Fulton Elizabeth A.
Published: July 2019

Marine ecosystem management is increasingly expected to take into account a wide range of ecological and socio‐economic factors. Decision‐making is helped by end‐to‐end ecosystem models that allow exploration of alternative management scenarios given a complex range of interacting factors.

We present Atlantis – a spatially structured largely deterministic end‐to‐end marine ecosystem model written in C, available for all major operating systems, based on dynamically interacting physics, biology, fisheries, management, assessment and economics submodels. A detailed installation guide and example application files are also provided.

One of the main features of Atlantis is its modularity. At the simplest level Atlantis can have uniform forcing of oceanographic processes, a single primary producer and a consumer. At the most complex level, Atlantis can be used with a range of environmentally driven ecological responses, complex and habitat‐dependent food web, dynamic assessment, management and fishing effort driven by market forces and human behaviour. The combination chosen should be guided by the available data and the questions to be answered.

Atlantis provides a large and customizable list of output files and summary statistics that can be analysed and plotted using a number of dedicated r packages.

When applying the Atlantis package, the users should be aware of the caveats associated with complex models, such as parameter and structural model uncertainty and challenges interpreting interactions of multiple processes.
Noninvasive long‐term ECG monitoring vs. loop recorder implantation for the atrial fibrillation management
Authors: Mamchur Sergey E. , Khomenko Egor A. , Chichkova Tatiana Y. , Romanova Maria P. , Evtushenko Veronika V. , Polikutina Olga M.
Published: July 2019

Objective

The objective of the study was to estimate the efficacy of a noninvasive ambulatory ECG monitoring (NIAM) in comparison with implantable loop recorder (ILR) in patients with atrial fibrillation (AF).

Methods

Thirty‐two patients 58 [47; 73] years of age with AF were included in the study. Patients were randomized into two groups: in group I (n = 15), “Reveal XT” ILR was used for invasive ECG monitoring up to 3 months; in group II (n = 17), “Spyder” device was used for NIAM up to 14 days.

Results

In both groups, at least one AF episode was detected during 14 days of monitoring. The overall count of AF episodes was 25 in NIAM group and 28 in ILR group. The mean time between AF start and its registration by a physician was 8 hr in NIAM group and 20 hr in ILR group (p = .005). The diagnostic value parameters of NIAM were as follows: sensitivity—80.1%, specificity—73.1%; positive predictive value—74.1%; and negative predictive value—79.2%. The same parameters in ILR group were comparable with NIAM: sensitivity—78.6%; specificity—69%; positive predictive value—71%; and negative predictive value—77%. At the same time, continued monitoring with ILR for longer than two weeks did not lead to a significant change in the sensitivity and specificity of the method.

Conclusion

In patients with paroxysmal AF, the diagnostic value of both NIAM and ILR is comparable. An increase in the duration of ECG monitoring for longer than two weeks does not provide additional diagnostic information.
A scoping review of parental experiences caring for their hospitalised medically fragile infants
Authors: Mackay Lyndsay J. , Benzies Karen M. , Barnard Chantelle , Hayden K Alix
Published: July 2019

Aim

To synthesise and summarise evidence from published research articles regarding parental experiences caring for their hospitalised medically fragile infant.

Methods

We searched four electronic databases in April 2018 using three main concepts individually and in combination: infant, medically fragile, parents. We examined articles about experiences of parents caring for the medically fragile infant in a hospital setting. We conducted thematic analysis on the 34 included articles.

Results

Parents experienced high rates of depressive symptoms, depression, stress, anxiety, distress and post traumatic stress. Parent‐infant interactions were disrupted. Parents experienced loss and worry in response to the diagnosis of their infant, which altered or delayed parental role attainment. Supports and coping were key for parents to manage their stress.

Conclusion

Parents of medically fragile infants experience multiple stressors, elevated levels of mental health difficulties, trouble attaining their parental role and often struggle to cope. Development of interventional research is needed to test targeted strategies aimed at reducing parental stress and mental health difficulties. Interventions should include: screening for parental mental health, psychological support, healthcare professional education, strategies to enhance parent‐infant interactions and improved relationship competencies among healthcare professionals.
Mandating Work: A Social Psychological Analysis of Rising Neoliberalism in U.S. Public Assistance Programs
Authors: Bullock Heather E. , Twose Gabriel H. J. , Hamilton Veronica M.
Published: July 2019

Aligning with key neoliberal values of self‐sufficiency, privatization, free market capitalism, and limited state support, the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), popularly referred to as “welfare reform,” ushered in new restrictions on the receipt of public assistance (e.g., work requirements and time limits). Despite considerable debate regarding PRWORA's success and limited evidence that work requirements are effective, the neoliberal emphasis on work that informed welfare reform is increasingly being extended to other U.S. safety net programs. This analysis critically interrogates the current neoliberal push to extend and/or expand work requirements to the Supplemental Nutrition Assistance Program and Medicaid. Examining the neoliberal politics and ideology that undergirds U.S. welfare policy and legitimizes restrictive work requirements, we examine the cultural construction of work as redemptive, the covert and overt functions of work requirements, and the damaging consequences of shifting societal obligation from the state to individuals. In doing so, we draw attention to who is harmed by and who benefits from “welfare reform.” We also consider how psychological research can be leveraged to challenge restrictive welfare policies and the further spread of neoliberal work mandates.
Sophisticated but Scared: The Effects of Political Sophistication, Right‐Wing Authoritarianism, and Threat on Civil Liberty Restrictions
Authors: Carriere Kevin R. , Hendricks Margaret J. , Moghaddam Fathali M.
Published: July 2019

Despite the widely ratifiedUnited Nations Declaration of Human Rights, support for civil liberties is easily eroded in times of threat. Understanding which factors moderate the relationship between threat and support for civil liberties is critical, yet remains relatively unexplored. In this study, we test a double moderation model in which support for the restriction of civil liberties in the face of threat is moderated by both right‐wing authoritarianism and political sophistication. In a national representative dataset (N= 12,507), those low on right‐wing authoritarianism became more like their high right‐wing authoritarian peers in the face of threat. Also, those more sophisticated about political issues were less supportive of restrictions on civil liberties, but only when threat was low. We tested this model on both restrictions for the in‐group, in terms of being wiretapped, and for the out‐group, in terms of torturing suspected terrorists. Our results suggest that increasing political sophistication may have desirable consequences when considering the outcomes for in‐group members, and we argue for increased efforts to expand the in‐group we seek to protect.
Transgender Expressions and Psychosis: Towards an Ethics of Sexual Difference
Authors: Gherovici Patricia
Published: July 2019

Psychoanalysis has a regrettable history of pathologizing non‐normative expressions of gender and sexuality; this tendency is even more prevalent with analysands who identify as trans. However, this has not been Jacques Lacan's position. In order to flesh out Lacan's complex intervention in the domain of transsexualism and to show his nuanced position that has often been misinterpreted, I will discuss three of his clinical interventions with patients presenting ‘transgender expressions’. Examining Lacan's work, I propose moving towards a differential clinic, a clinic where the diagnosis preserves the subjectivity of the patient and is a tool in the direction of the treatment and not a label. This type of structural diagnosis is not standardized but decided case by case, based on the particulars of each treatment.
miR‐640 aggravates intervertebral disc degeneration via NF‐κB and WNT signalling pathway
Authors: Dong Wengang , Liu Jun , Lv Yang , Wang Fei , Liu Tao , Sun Siguo , Liao Bo , Shu Zhen , Qian Jixian
Published: July 2019

Objectives

Low back pain becomes a common orthopaedic disease today. It is mainly induced by the degeneration of the intervertebral disc. In this study, we tried to reveal the pathogenesis of the degeneration and the relative therapeutic strategy, which are still elusive.

Materials and Methods

We collected 15 degenerative intervertebral tissues and five healthy donors. Nucleus pulposus and annulus fibrosus cells were subcultured. miR‐640 expression was determined by qPCR. Computer analysis and luciferase reporter assay were used to confirm miR‐640 target genes. Immunohistochemical and immunocytochemical staining was used to trace the proinflammatory cytokines and key transductor of signalling pathways. We also used β‐galactosidase staining, flow cytometry, and cell viability assay to monitor the degenerative index.

Results

miR‐640 overexpressed in patients derived degenerative nucleus pulposus tissues and cells. The inflammatory environment promoted miR‐640 expression via NF‐κB signalling pathway. In addition, miR‐640 targeted to LRP1 and enhances NF‐κB signal activity, which built a positive feedback loop. miR‐640 inhibited the expression of β‐catenin and EP300, therefore, restrained WNT signal and induced the degeneration in nucleus pulposus cells. miR‐640 inhibitor treatment exhibited the effects of anti‐inflammation, reverse WNT signalling pathway exhaustion, and remission of degenerative characteristics in vitro.

Conclusions

miR‐640 plays an important role in the degeneration of intervertebral disc and the relative inflammatory microenvironment. It is a promising potential therapeutic target for the low back pain biotherapy.
Social influence and forest habitat conservation: Experimental evidence from Vermont's maple producers
Authors: Byerly Hilary , D'Amato Anthony W. , Hagenbuch Steve , Fisher Brendan
Published: July 2019

Working landscapes can provide biodiversity and ecosystem services. Many voluntary conservation programs ask those who manage working lands—farmers, ranchers, and forest landowners—to steward their resources in ways that maintain or increase these benefits. While research on landowners suggests the importance of social influence in management decisions, few studies have tested whether providing information about the behavior and opinions of others affects decisions related to private land and forest management, stewardship, or conservation. Using a randomized controlled trial design, we mailed three versions of a solicitation letter for a bird habitat conservation program to 967 individuals who manage forests to produce maple syrup. Maple producers who were messaged about recognition for participation were as likely to ask for more information about the program as those who received only a control message that described the program. Providing information about the participation of others had a negative effect on the number of producers requesting information compared to the control. These results highlight the importance of context in using social influence to change land manager behavior. Findings are relevant to conservation researchers and practitioners, offering applications of behavioral science to improve biodiversity and ecosystem service outcomes on private lands.
Reducing the burden of childhood cerebral visual impairment: another step forward
Authors: Williams Cathy
Published: July 2019

This commentary is on the original articles by Vancleef et al. on pages 111‐117 of this issue and on pages 118‐124 of this issue.
Objective quantification of vitreous haze on optical coherence tomography scans: no evidence for relationship between uveitis and inflammation in multiple sclerosis
Authors: Coric D. , Ometto G. , Montesano G. , Keane P. A. , Balk L. J. , Uitdehaag B. M. J. , Petzold A. , Crabb D. P. , Denniston A. K.
Published: July 2019

Background and purpose

The occurrence of intermediate uveitis, which is characterized by the presence of vitreous haze (VH), in patients with multiple sclerosis (MS) may be a sign of coexistent inflammatory central nervous system (CNS) disease activity. Using an automated algorithm to quantify VH on optical coherence tomography (OCT) scans, the aim was to investigate whether VH in MS patients is associated with signs of inflammatory CNS disease activity.

Methods

Vitreous haze was quantified on OCT macular volume scans of 290 MS patients and 85 healthy controls (HCs). The relationship between VH and clinical, retinal OCT and magnetic resonance imaging parameters of inflammatory disease activity was investigated using generalized estimating equations.

Results

Mean VH scores did not differ between patients and HCs (P = 0.629). Six patients (2.1%) showed values higher than the highest of the controls by HCs. VH scores did not differ between the different disease types or between eyes with and without a history of optic neuritis (P = 0.132). VH was not associated with inner nuclear layer volume on OCT (P = 0.233), cerebral T2 lesion load on magnetic resonance imaging (P = 0.416) or the development of new relapses (P = 0.205).

Conclusion

In this study, OCT‐based automated VH estimation did not detect increased vitreous inflammation in MS patients compared to HCs and did not find an association with CNS inflammatory burden.
Geriatric Nutritional Risk Index, a predictive assessment tool, for postoperative complications after abdominal surgery: A prospective multicenter cohort study
Authors: Hanada Masatoshi , Yamauchi Kouta , Miyazaki Shinjiro , Hirasawa Jun , Oyama Yohei , Yanagita Yorihide , Takahata Hideaki , Kozu Ryo
Published: July 2019

Aim

Patients awaiting abdominal surgery are often malnourished, which puts them at a high risk of postoperative complications. The aim of the present study was to investigate the effects of preoperative nutritional status using the Geriatric Nutritional Risk Index (GNRI) on postoperative complications and the course of recovery for patients undergoing abdominal surgery.

Methods

In this prospective multicenter cohort study, we enrolled patients awaiting abdominal surgery from November 2015 to December 2017. The characteristics of patients and postoperative complications were compared between participants (median age 71 years; interquartile range 66–78 years) with low GNRI (<98) values and high GNRI (≥98) values. Multivariate logistic regression was carried out to identify postoperative complications‐related factors.

Results

A total of 366 patients who underwent abdominal surgery were assessed. Patients in the low GNRI group had a significantly higher rate of postoperative complications (P = 0.01), and longer length of hospital stay compared with those in the high GNRI group (P < 0.01). Using multivariate analysis, low GNRI was found to be independently associated with postoperative complications (OR 2.50; P = 0.02) and activities of daily living on postoperative day 7 (OR 1.39; P = 0.03). Comorbidities, handgrip force for postoperative complications, age, preoperative chemotherapy and activities of daily living on postoperative day 7 were not independently associated.

Conclusions

Malnutrition indicated by the GNRI might be predictive of postoperative complications after abdominal surgery and the delay of postoperative course. Geriatr Gerontol Int 2019; 19: 924–929.
On‐clamp versus off‐clamp partial nephrectomy: Propensity score‐matched comparison of long‐term functional outcomes
Authors: Simone Giuseppe , Capitanio Umberto , Tuderti Gabriele , Presicce Fabrizio , Leonardo Costantino , Ferriero Mariaconsiglia , Misuraca Leonardo , Costantini Manuela , Larcher Alessandro , Minisola Francesco , Guaglianone Salvatore , Anceschi Umberto , Muttin Fabio , Nini Alessandro , Trevisani Francesco , Montorsi Francesco , Bertini Roberto , Gallucci Michele
Published: July 2019

Objectives

To compare long‐term functional outcomes of off‐clamp or on‐clamp partial nephrectomy patients of two high‐volume centers with cT1–2/N0 M0 renal tumors and baseline estimated glomerular filtration rate >60 mL/min.

Methods

A 3:1 propensity score‐matched analysis was used to select two homogeneous cohorts to compare off‐clamp versus on‐clamp partial nephrectomy. Joinpoint regression analysis was used to compare the 2–8‐year probabilities of estimated glomerular filtration rate modifications in both selected cohorts. The Kaplan–Meier method assessed the risk of developing a stage ≥3b chronic kidney disease during follow up. Multivariable analyses aimed to identify predictors of renal function deterioration. Perioperative complications and oncological outcomes were compared.

Results

Overall, 1073 patients were included (588 on‐clamp and 485 off‐clamp). After applying the propensity score‐matched analysis, the two cohorts of 157 on‐clamp and 472 off‐clamp patients did not differ for all covariates, except for warm ischemia time and last estimated glomerular filtration rate. At joinpoint analysis, the off‐clamp group showed higher probabilities of maintaining an unmodified estimated glomerular filtration rate (P = 0.02). The probability of developing a stage ≥3b chronic kidney disease was significantly higher (P < 0.001) in the on‐clamp cohort. At multivariable analysis, estimated glomerular filtration rate at discharge and off‐clamp approach were independent predictors of improved functional outcomes. Perioperative complications were comparable among the two cohorts (P = 0.67). There were not any statistically significant differences in terms of cancer‐specific survival (P = 0.26) and overall survival (P = 0.18).

Conclusions

Off‐clamp partial nephrectomy seems to offer a higher probability of maintaining 100% estimated glomerular filtration rate after surgery. In our cohort, patients undergoing on‐clamp partial nephrectomy presented a 7.3‐fold increased risk of developing a severe chronic kidney disease during follow up.
Beta‐elemene inhibits breast cancer metastasis through blocking pyruvate kinase M2 dimerization and nuclear translocation
Authors: Pan Yanhong , Wang Wei , Huang Shuai , Ni Wenting , Wei Zhonghong , Cao Yuzhu , Yu Suyun , Jia Qi , Wu Yuanyuan , Chai Chuan , Zheng Qian , Zhang Lei , Wang Aiyun , Sun Zhiguang , Huang Shile , Wang Shijun , Chen Wenxing , Lu Yin
Published: July 2019

Pyruvate kinase M2 (PKM2), playing a central role in regulating aerobic glycolysis, was considered as a promising target for cancer therapy. However, its role in cancer metastasis is rarely known. Here, we found a tight relationship between PKM2 and breast cancer metastasis, demonstrated by the findings that beta‐elemene (β‐elemene), an approved drug for complementary cancer therapy, exerted distinct anti‐metastatic activity dependent on PKM2. The results indicated that β‐elemene inhibited breast cancer cell migration, invasion in vitro as well as metastases in vivo. β‐Elemene further inhibited the process of aerobic glycolysis and decreased the utilization of glucose and the production of pyruvate and lactate through suppressing pyruvate kinase activity by modulating the transformation of dimeric and tetrameric forms of PKM2. Further analysis revealed that β‐elemene suppressed aerobic glycolysis by blocking PKM2 nuclear translocation and the expression of EGFR, GLUT1 and LDHA by influencing the expression of importin α5. Furthermore, the effect of β‐elemene on migration, invasion, PKM2 transformation, and nuclear translocation could be reversed in part by fructose‐1,6‐bisphosphate (FBP) and L‐cysteine. Taken together, tetrameric transformation and nuclear translocation of PKM2 are essential for cancer metastasis, and β‐elemene inhibited breast cancer metastasis via blocking aerobic glycolysis mediated by dimeric PKM2 transformation and nuclear translocation, being a promising anti‐metastatic agent from natural compounds.
Enhancing Student Learning in Removable Partial Denture Design by Using Virtual Three‐Dimensional Models Versus Traditional Two‐Dimensional Drawings: A Comparative Study
Authors: Mahrous Ahmed , Schneider Galen B. , Holloway Julie A. , Dawson Deborah V.
Published: July 2019

Purpose

To compare the use of virtual 3D casts as an alternative to paper‐based exercises in preclinical removable partial denture (RPD) design in terms of student outcomes (as evidenced by exercise evaluation scores), as well as student attitudes related to the 2 formats. The first hypothesis of this study is that virtual 3D digital models in the exercise will result in better student outcomes as evidenced by the final exercise score compared to the 2D drawings. The second hypothesis is that virtual 3D digital models in the exercise will result in greater student acceptance compared to the 2D drawings.

Materials and Methods

Students were divided into 2 equal, randomly assigned groups Both groups were made to solve 2 exercises: a class II exercise and a class IV exercise. Group 1 received the first exercise (exercise #1) as a Kennedy class IV design exercise in virtual 3D and the second exercise (exercise #2) as a Kennedy class II design exercise in traditional format. Group 2 would receive the opposite exercise #1 as a Kennedy class IV in traditional format and exercise #2 as a Kennedy class II in virtual 3D format. Virtual 3D casts were made to be identical to the traditional exercises. Students were then asked to complete a short survey to assess their preferences. The Wilcoxon Rank Sum test was used to compare the distribution of scores of exercises using the virtual 3D format with the scores when students used the traditional 2D format. Preference comparisons for the 2 formats were accomplished using exact binomial tests.

Results

There was no difference in learning outcomes based on the distribution of student scores for either exercise independent of presentation format (p > 0.52). There was also no difference in individual student score between 2 identical exercises, independent of whether the exercise was using 3D virtual models or 2D drawings. A greater proportion of students agreed with the statements that favored the use of the virtual 3D models than disagreed with respect to all 7 questions asked, based upon the sign test (comparing agreement vs. disagreement with the statement, p < 0.0003 in all instances).

Conclusion

Despite there being no difference in learning outcomes (final scores), the students showed an overwhelming preference in having the virtual 3D casts part as part of the curriculum.
HCV reinfections after viral clearance among HIV‐positive patients with recent HCV infection in Taiwan
Authors: Huang Miao‐Hui , Chang Sui‐Yuan , Liu Chen‐Hua , Cheng Aristine , Su Li‐Hsin , Liu Wen‐Chun , Su Yi‐Ching , Sun Hsin‐Yun , Hung Chien‐Ching , Chang Shan‐Chwen
Published: July 2019

Background

Higher rates of hepatitis C virus (HCV) reinfection after viral clearance have been well described among HIV‐positive men who have sex with men (MSM) in Europe. The epidemiology of HCV reinfection, however, has rarely been investigated among HIV‐positive patients in Asia‐Pacific region.

Methods

We retrospectively identified HIV‐positive patients with recent HCV infection who had cleared their primary infection, either spontaneously or via treatment, between January 2011 and May 2018. All included patients were observed until 31 March 2019. HCV reinfection was defined as recurrent HCV viraemia after achieving viral clearance with anti‐HCV treatment or after spontaneous clearance.

Results

During the study period, 219 HIV‐positive patients (90.4% MSM) were diagnosed with recent HCV infection. Viral clearance with successful treatment was achieved in 108 patients (49.3%) and spontaneous clearance occurred in 20 (9.1%); of them, 18 (14.1%) acquired HCV reinfections, resulting in an incidence rate of 8.2 per 100 person‐years of follow‐up (95% CI 5.2‐13.1). With the adjusted Cox proportional hazards model, we found a higher reinfection risk in patients with syphilis (adjusted hazard ratio 10.3, 95% CI 1.4‐77.8, P = .023) compared to those without syphilis. HCV RNA testing, if performed only following syphilis and elevated aminotransferases, might miss 44.4% and 33.3% of HCV reinfections, respectively.

Conclusions

Similar to the findings in Europe, we observed a high incidence of HCV reinfection among HIV‐positive Taiwanese with recent HCV infection, which was significantly associated with syphilis. To identify HCV reinfections, annual HCV RNA testing should be instituted instead of testing driven by symptoms, syphilis or elevated aminotransferases.
Bayesian quantification of ecological determinants of outcrossing in natural plant populations: Computer simulations and the case study of biparental inbreeding in English yew
Authors: Chybicki Igor J. , Iszkuło Grzegorz , Suszka Jan
Published: July 2019

The mating system is a central parameter of plant biology because it shapes their ecological and evolutionary properties. Therefore, determining ecological variables that influence the mating system is important for a deeper understanding of the functioning of plant populations. Here, using old concepts and recent statistical developments, we propose a new statistical tool to make inferences about ecological determinants of outcrossing in natural plant populations. The method requires codominant genotypes of seeds collected from maternal plants within different locations. Using extensive computer simulations, we demonstrated that the method is robust to the issues expected for real‐world data, including the Wahlund effect, inbreeding and genotyping errors such as allele dropout and allele misclassification. Furthermore, we showed that the estimates of ecological effects and outcrossing rates can be severely biased if genotyping errors and genetic differentiation are not treated explicitly. Application of the new method to the case study of a dioecious tree (Taxus baccata) allowed revealing that female trees that grow in lower local densities have a greater tendency towards mating with relatives. Moreover, we also demonstrated that biparental inbreeding is higher in populations that are characterized by a longer mean distance between trees and a smaller mean trunk perimeter. We found these results to agree with both the theoretical predictions and the history of English yew.
Safety and efficacy of clonidine on postoperative vomiting and pain in pediatric ophthalmic surgery: A systematic review and meta‐analysis
Authors: Hsu Yuan‐Pin , Chu Karen Chia‐Wen , Bai Chyi‐Huey , Huang Chun‐Jen , Chen Chiehfeng , Hsu Chin‐Wang
Published: July 2019

Background

Postoperative vomiting and pain are common, unpleasant phenomena in pediatric patients undergoing ophthalmic surgery. Clonidine has antiemetic and analgesic properties and thus may be used as premedication to reduce postoperative vomiting and pain.

Aim

To assess whether clonidine premedication may safely decrease postoperative vomiting and postoperative pain in pediatric patients who received an ophthalmic surgery.

Methods

We systematically searched PubMed, EMBASE, Cochrane Library, and Scopus databases from their inception to September 2018. Randomized clinical trials comparing clonidine premedication with a placebo or an active comparator that investigated postoperative vomiting or postoperative pain in pediatric patients undergoing ophthalmic surgery were included. The primary outcome was postoperative vomiting. The secondary outcome was postoperative pain. We also evaluated the safety of clonidine premedication by tracking hemodynamic instability associated with its use.

Results

Ten studies with 979 patients were eligible for inclusion. Clonidine achieved a significantly lower incidence of postoperative vomiting within 6 hours postoperatively, 6‐24 hours postoperatively, and at the end of the study (risk difference: −0.15; 95% confidence interval: −0.32 to −0.05; risk difference: −0.15; 95% confidence interval: −0.29 to 0.01; and risk difference: −0.23; 95% confidence interval: −0.34 to −0.12, respectively) than placebo. For the subgroup of patients who received strabismus surgery, clonidine produced a lower incidence of postoperative vomiting than placebo (risk difference: −0.19; 95% confidence interval: −0.29 to −0.05). Compared to benzodiazepine, clonidine achieved a lower incidence of postoperative vomiting at the end of the study (risk difference: −0.19; 95% confidence interval: −0.31 to −0.07); the effect was only observed in patients receiving clonidine 4 μg/kg. Furthermore, children receiving clonidine had lower postoperative pain scores, lower analgesic requirements, and more of them were pain‐free compared to those who received a placebo. No patient using clonidine had any major hemodynamic instability.

Conclusion

Compared to placebo or benzodiazepine, clonidine premedication was effective in reducing postoperative vomiting in pediatric patients undergoing ophthalmic surgery. Clonidine premedication also provided more reduction in postoperative pain when compared to placebo. The use of clonidine premedication was not associated with adverse hemodynamic events.
We won't find what we don't look for: Identifying barriers and enablers of chronic wet cough in Aboriginal children
Authors: Laird Pamela , Walker Roz , Lane Mary , Chang Anne B. , Schultz André
Published: July 2019

Background and objective

Chronic lung disease is prevalent among Australian Aboriginal children. Chronic wet cough is an early marker of disease but often goes undetected. Currently, no studies have examined health practitioner knowledge of chronic wet cough. We set out to examine health practitioner knowledge of chronic wet cough and chronic lung disease in Aboriginal children and to identify barriers and enablers to effective management.

Method

A qualitative study, gathering data through individual semi‐structured, in‐depth interviews and focus groups to ascertain health practitioner knowledge about management of Aboriginal children with chronic wet cough in a regional Kimberley town and remote community.

Results

Thirty‐seven health practitioners participated. Key barriers identified were: (i) limited training in assessment and management of chronic wet cough; (ii) prioritization of acute presentations and competing complex chronic conditions; and (iii) normalization of cough in children by health practitioners. Key enablers were: (i) improving practitioners’ knowledge and expertise in managing chronic wet cough; and (ii) health system changes to facilitate longitudinal patient care, improved cultural competence, improved chronic disease management and post‐hospitalization follow‐up.

Conclusion

Key barriers to effective management of chronic wet cough are limited training in chronic wet cough management combined with competing complexities of both acute and chronic healthcare needs for Aboriginal families. Early detection and management of chronic wet cough in Aboriginal children can be facilitated through health practitioner training, access to standardized management guidelines and a service model that allows longitudinal patient follow‐up and resources to effectively prevent and manage chronic lung disease in children.
Improving electromagnetic navigation: One nodule at a time
Authors: Bessich Jamie L. , Sterman Daniel H.
Published: July 2019

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