bluuebunny/crossref_metadata_2025 huggingface dataset:
Updates on HIV nonoccupational postexposure prophylaxis
Authors: Koyama Atsuko , Middlebrooks Lauren , Bullock Adam
Published: April 2019

Purpose of review

Adolescents and young adults continue to contribute to new HIV infections despite improved antiretroviral regimens and HIV preexposure and postexposure prophylaxis (PrEP and PEP). Knowledge about nonoccupational HIV PEP (nPEP) is relevant and important for all pediatricians as adolescents present under a variety of circumstances disclosing past sexual activity.

Recent findings

nPEP is effective in preventing HIV infection, and newer regimens have been shown to increase compliance amongst users, have less side effects, and lead to less HIV resistance. Yet, research on physician prescription practices shows a lack of knowledge regarding appropriate HIV nPEP medication regimens, dosing, and follow-up recommendations. Updated national guidelines are available to providers who may be unfamiliar with indications and drug regimens for nPEP. Studies also provide different strategies to increase nPEP use and compliance among patients as well as ways to increase provider awareness of appropriate nPEP prescription.

Research of HIV nPEP shows that it is effective when used correctly, but there needs to be increased education and awareness to increase provider prescription and patient use as well as institutional changes to help patients complete the full course of medication.
Hopelessness and Other Depressive Symptoms in Adults 70 Years and Older as Predictors of All-Cause Mortality Within 3 Months After Acute Hospitalization: The Hospital-ADL Study
Authors: Reichardt Lucienne A. , Nederveen Floor E. , van Seben Rosanne , Aarden Jesse J. , van der Schaaf Marike , Engelbert Raoul H. H. , van der Esch Martin , Henstra Marieke J. , Twisk Jos W.R. , Bosch Jos A. , Buurman Bianca M.
Published: April 2019

Objective

Depression among older adults predicts mortality after acute hospitalization. Depression is highly heterogeneous in its presentation of symptoms, whereas individual symptoms may differ in predictive value. This study aimed to investigate the prevalence of individual cognitive-affective depressive symptoms during acute hospitalization and investigate the predictive value of both overall and individual cognitive-affective depressive symptoms for mortality between admission up to 3-month postdischarge among older patients.

Methods

A prospective multicenter cohort study enrolled 401 acutely hospitalized patients 70 years and older (Hospitalization-Associated Disability and impact on daily Life Study). The predictive value of depressive symptoms, assessed using the Geriatric Depression Scale 15, during acute hospitalization on mortality was analyzed with multiple logistic regression.

Results

The analytic sample included 398 patients (M (SD) = 79.6 (6.6) years; 51% men). Results showed that 9.3% of participants died within 3 months, with symptoms of apathy being most frequently reported. The depression total score during hospitalization was associated with increased mortality risk (admission: odds ratio [OR] = 1.2, 95% confidence interval [CI] = 1.2–1.3; discharge: OR = 1.2, 95% CI = 1.2–1.4). Stepwise multiple logistic regression analyses yielded the finding that feelings of hopelessness during acute hospitalization were a strong unique predictor of mortality (admission: OR = 3.6, 95% CI = 1.8–7.4; discharge: OR = 5.7, 95% CI = 2.5–13.1). These associations were robust to adjustment for demographic factors, somatic symptoms, and medical comorbidities.

Conclusions

Symptoms of apathy were most frequently reported in response to acute hospitalization. However, feelings of hopelessness about their situation were the strongest cognitive-affective predictor of mortality. These results imply that this item is important in identifying patients who are in the last phase of their lives and for whom palliative care may be important.
Asymptomatic Prostate Cancer Brain Metastases on 68Ga-PSMA PET/CT
Authors: Yin Charlotte , Ho Bao , Chan Lyn , Emmett Louise
Published: April 2019

Brain metastases from prostate cancer are rare and occur at a late stage in the natural history of the disease. Men usually present with neurological manifestations. We present a 66-year-old asymptomatic man who had incidental brain metastases detected on 68Ga-PSMA PET/CT, which was later confirmed on biopsy to be prostate adenocarcinoma. With newer androgen deprivation agents and improved imaging capabilities increasing the mean survival and thus the incidence of brain metastases from prostate cancer, it is important to consider this important differential not only in men who display neurological symptoms but also in men who are asymptomatic.
EnsurePlus as an Alternative to the Standardized Egg Gastric-Emptying Meal
Authors: Solnes Lilja B. , Sheikhbahaei Sara , Ziessman Harvey A.
Published: April 2019

Objectives

The purpose of this study was to establish normal gastric-emptying values for EnsurePlus in healthy subjects and to determine whether it is an acceptable alternative to the recommended standardized 99mTc–sulfur colloid egg meal.

Methods

Twenty-one healthy subjects underwent gastric-emptying scintigraphy with 111In-DTPA EnsurePlus. Normal gastric emptying values were established for 1, 2, 3, and 4 hours after meal ingestion. The gastric-emptying results were compared with another group of normal subjects (n = 18) who ingested the standardized egg meal.

Results

The mean (95% upper reference limit) percentages for gastric retention for EnsurePlus were as follows: 69.9% (87.1%) at 1 hour, 35.1% (64.3%) at 2 hours, 13.5% (23.2%) at 3, and 8.9% (13.5%) at 4 hours. There were time-related differences in the gastric emptying of the EnsurePlus compared with the egg meal. In the first and second hours, there were no difference between EnsurePlus and the egg meal in terms of percentage retention (P = 0.92 at 1 hour, P = 0.05 at 2 hours). However, at 3 and 4 hours after meal ingestion, the mean percentage gastric retention of the EnsurePlus was significantly higher than the egg meal (P < 0.001).

Conclusion

EnsurePlus is a good and acceptable alternative to the standardized egg meal.
Incidental Uptake in Benign Gynecomastia on 68Ga-DOTATATE PET/CT
Authors: Pandika Veska , Covington Matthew F.
Published: April 2019

A 54-year-old man with mesenteric carcinoid tumor metastatic to the liver completed staging 68Ga-DOTATATE PET/CT demonstrating uptake in multiple hepatic lesions consistent with liver metastases with additional asymmetric increased uptake in the right greater than the left breast. Subsequent bilateral diagnostic mammogram revealed benign right greater than left gynecomastia without suspicious underlying mass. With Food and Drug Administration approval of 68Ga-DOTATATE and the increased use of this analog in neuroendocrine tumor imaging, this case illustrates a relevant example of uptake that can potentially mimic malignancy.
Association between operating room access and mortality for life-threatening general surgery emergencies
Authors: Daniel Vijaya T. , Rushing Amy P. , Ingraham Angela M. , Ricci Kevin B. , Paredes Anghela Z. , Diaz Adrian , Ayturk M. Didem , Baselice Holly E. , Strassels Scott A. , Santry Heena P.
Published: April 2019

BACKGROUND

Few diseases truly require emergency surgery today. We investigated the relationship between access to operating room (OR) and outcomes for patients with life-threatening emergency general surgery (LT-EGS) diseases at US hospitals.

METHODS

In 2015, we surveyed 2,811 US hospitals on EGS practices, including how OR access is assured (e.g., OR staffing, block time). There were 1,690 (60%) hospitals that responded. We anonymously linked survey data to 2015 Statewide Inpatient Sample data (17 states) using American Hospital Association identifiers. Adults admitted with life-threatening diagnoses (e.g., necrotizing fasciitis, perforated viscus) who underwent operative intervention the same calendar day as hospital admission were included. Primary outcome was in-hospital mortality. Univariate and multivariable regression analyses, clustered by treating hospital and adjusted for patient factors, were performed to examine hospital-level OR access variables.

RESULTS

Overall, 3,620 patients were admitted with LT-EGS diseases. The median age was 63 years (interquartile range, 51–75), with half having three or more comorbidities (50%). Thirty-four percent had one or more major systemic complication, and 5% died. The majority got care at hospitals with less than 1 day of EGS block time but with policies to ensure emergency access to the OR. After adjusting for age, sex, race, insurance status, comorbidities, systemic complications, and surgical complications, we found that less presence of an in-house EGS surgeon, compared with around the clock, was associated with increased mortality (rarely/never in-house surgeon: odds ratio, 2.4; 95% confidence interval [CI],1.1–5.3; sometimes in-house surgeon: odds ratio, 1.6; 95% CI, 1.1–2.3). In addition, after controlling for other factors, on-call overnight recovery room nurse, compared with in-house, was associated with an increased mortality (odds ratio, 2.2; 95% CI, 1.5–3.1).

CONCLUSION

Round-the-clock availability of personnel, specifically emergency general surgeons and recovery room nurses, is associated with decreased mortality. These findings have implications for the creation of EGS patient triage criteria and Acute Care Surgery Centers of Excellence.

LEVEL OF EVIDENCE

Therapeutic, level III.
How much do calcitonin gene-related peptide monoclonal antibodies improve the quality of life in migraine? A patient's perspective
Authors: Torres-Ferrus Marta , Alpuente Alicia , Pozo-Rosich Patricia
Published: April 2019

Purpose of review

Migraine is a prevalent and extremely disabling brain disorder, with an impact on the individual, family, workplace and society. This review focuses on describing Calcitonin Gene Related Peptide Monoclonal Antibodies (CGRP-mABs) efficacy on improving the quality of life (QoL) and decreasing the disability and impact of migraine measured with patient related outcomes (PROs), on patients who participated in clinical trials with erenumab, fremanezumab, galcanezumab and eptinezumab. The goal is to better reflect the effect of these preventive migraine treatments in the daily life of our patients.

Recent findings

CGRP-mABs have been approved by the Food and Drug Administration's (FDA) and European Medicines Agency (EMA) as the first migraine specific treatment for the prevention of migraine. In clinical trials, CGRP-mABs have proven to achieve their primary endpoint which is to reduce the number of headache days, and also have shown to have an impact on disability, QoL and workplace productivity.

CGRP-mABs have an impact on the disability, QoL, workplace productivity and global impression of improvement of migraine, which will translate into changes in the real world of migraine patients who are treated with CGRP-mABs.
Age and the risks of high-efficacy disease modifying drugs in multiple sclerosis
Authors: Schweitzer Finja , Laurent Sarah , Fink Gereon R. , Barnett Michael H. , Reddel Stephen , Hartung Hans-Peter , Warnke Clemens
Published: April 2019

Purpose of review

A variety of high-efficacy disease-modifying therapies (DMTs) are available for the treatment of multiple sclerosis (MS). After evaluation and approval by regulatory agencies, DMTs are likely to be administered to patients whose characteristics differ from those enrolled in clinical trials. This may contribute to the emergence of unexpected adverse events observed in the real-world setting. Higher age may be a relevant factor that could change the benefit–risk balance of DMTs, as it may associate with lower efficiency and higher frequency of adverse events.

Recent findings

The absolute and relative number of patients with MS who reach the age of 55 and higher increases. Growing evidence demonstrates lower efficacy of DMTs in older persons with MS. Specific risks during DMTs for MS, such as the risk of developing progressive multifocal leukoencephalopathy (PML) or the outcome following PML, have been associated with age. It is hypothesized that age-related and therapy-induced alterations to the immune system may have (super)additive effects, resulting in an acceleration of physiological immunosenescence and inflamm-aging.

In this article, we review the risks of high-efficacy DMTs in MS with a specific focus on age-related efficacy and risks, including opportunistic infections, malignancies, and autoimmune reactions.
The antenna spacetime system theory of wireless communications
Authors: Mikki Said
Published: April 2019

A general deterministic spacetime system theory of antennas suitable for the analysis and design of wireless communication links is rigorously developed using the recently introduced antenna current Green's function formalism. We provide the first complete derivation of the antenna spatio-temporal response to a delta source using only electromagnetic Green's functions, effectively eliminating all field and current distributions in the final expressions. While the theory works well in both space and time, it puts into sharper focus how the spatio-temporal structure of electromagnetic processes imposes restrictions on the signal processing capabilities of antenna systems by constraining the allowable mathematical form of the effective impulse response of the global wireless communication link. It is shown that the antenna current Green's functions of both the receive and transmit terminals, plus the propagation environment Green's functions, are the only quantities needed to obtain the single input–single output link response function in closed form. One of the results deduced from the theory is that an exact impulse response cannot be ascribed to an arbitrary antenna in general, but may be approximated for many applications. The theory can be deployed for future antenna systems research to boost up spectral efficiency (without increasing physical bandwidth) by directly incorporating electromagnetic knowledge into the design of the communication system's signal processing functions.
Compensatory responses can alter the form of the biodiversity–function relation curve
Authors: Thomsen Matthias S. , Godbold Jasmin A. , Garcia Clement , Bolam Stefan G. , Parker Ruth , Solan Martin
Published: April 2019

There is now strong evidence that ecosystem properties are influenced by alterations in biodiversity. The consensus that has emerged from over two decades of research is that the form of the biodiversity–functioning relationship follows a saturating curve. However, the foundation from which these conclusions are drawn mostly stems from empirical investigations that have not accounted for post-extinction changes in community composition and structure, or how surviving species respond to new circumstances and modify their contribution to functioning. Here, we use marine sediment-dwelling invertebrate communities to experimentally assess whether post-extinction compensatory mechanisms (simulated by increasing species biomass) have the potential to alter biodiversity–ecosystem function relations. Consistent with recent numerical simulations, we find that the form of the biodiversity–function curve is dependent on whether or not compensatory responses are present, the cause and extent of extinction, and species density. When species losses are combined with the compensatory responses of surviving species, both community composition, dominance structure, and the pool and relative expression of functionally important traits change and affect species interactions and behaviour. These observations emphasize the importance of post-extinction community composition in determining the stability of ecosystem functioning following extinction. Our results caution against the use of the generalized biodiversity–function curve when generating probabilistic estimates of post-extinction ecosystem properties for practical application.
Channel catfish use higher coordination to capture prey than to swallow
Authors: Olsen Aaron M. , Hernández L. Patricia , Camp Ariel L. , Brainerd Elizabeth L.
Published: April 2019

When animals move they must coordinate motion among multiple parts of the musculoskeletal system. Different behaviours exhibit different patterns of coordination, however, it remains unclear what general principles determine the coordination pattern for a particular behaviour. One hypothesis is that speed determines coordination patterns as a result of differences in voluntary versus involuntary control. An alternative hypothesis is that the nature of the behavioural task determines patterns of coordination. Suction-feeding fishes have highly kinetic skulls and must coordinate the motions of over a dozen skeletal elements to draw fluid and prey into the mouth. We used a dataset of intracranial motions at five cranial joints in channel catfish (Ictalurus punctatus), collected using X-ray reconstruction of moving morphology, to test whether speed or task best explained patterns of coordination. We found that motions were significantly more coordinated (by 20–29%) during prey capture than during prey transport, supporting the hypothesis that the nature of the task determines coordination patterns. We found no significant difference in coordination between low- and high-speed motions. We speculate that capture is more coordinated to create a single fluid flow into the mouth while transport is less coordinated so that the cranial elements can independently generate multiple flows to reposition prey. Our results demonstrate the benefits of both higher and lower coordination in animal behaviours and the potential of motion analysis to elucidate motor tasks.
A dynamical model of the laminar BOLD response
Authors: Havlicek Martin , Uludag Kamil
Published: April 2019

High-resolution functional magnetic resonance imaging (fMRI) using blood oxygenation dependent level-dependent (BOLD) signal is an increasingly popular tool to non-invasively examine neuronal processes at the mesoscopic level. However, as the BOLD signal stems from hemodynamic changes, its temporal and spatial properties do not match those of the underlying neuronal activity. In particular, the laminar BOLD response (LBR), commonly measured with gradient-echo (GE) MRI sequence, is confounded by non-local changes in deoxygenated hemoglobin and cerebral blood volume propagated within intracortical ascending veins, leading to a unidirectional blurring of the neuronal activity distribution towards the cortical surface. Here, we present a new cortical depth-dependent model of the BOLD response based on the principle of mass conservation, which takes the effect of ascending (and pial) veins on the cortical BOLD responses explicitly into account. It can be used to dynamically model cortical depth profiles of the BOLD signal as a function of various baseline- and activity-related physiological parameters for any spatiotemporal distribution of neuronal changes. We demonstrate that the commonly observed spatial increase of LBR is mainly due to baseline blood volume increase towards the surface. In contrast, an occasionally observed local maximum in the LBR (i.e. the so-called “bump”) is mainly due to spatially inhomogeneous neuronal changes rather than locally higher baseline blood volume. In addition, we show that the GE-BOLD signal laminar point-spread functions, representing the signal leakage towards the surface, depend on several physiological parameters and on the level of neuronal activity. Furthermore, even in the case of simultaneous neuronal changes at each depth, inter-laminar delays of LBR transients are present due to the ascending vein. In summary, the model provides a conceptual framework for the biophysical interpretation of common experimental observations in high-resolution fMRI data. In the future, the model will allow for deconvolution of the spatiotemporal hemodynamic bias of the LBR and provide an estimate of the underlying laminar excitatory and inhibitory neuronal activity.
Identification of Gly/NMDAR Antagonist from Chromolaena odorata’s Derived Phytoconstituents using Induced Fit Docking Approach
Authors: David Temitope Israel , Omotuyi Olaposi Idowu. , Agboola Olalekan David , Okonkwo Dominic Chinedu , Adelakun Niyi Samuel
Published: April 2019

The ionotropic activation of N-methyl-D-aspartic acid (NMDA) plays a significant role in different type of neurodegenerative disease, as it is a tetramer with two Glycine binding subunit and two glutamate subunits. NMDA receptor can be inhibited by either blocking of the glycine site or glutamate site. Previously reported inhibitors of NMDA receptor focus on the inhibition of the glutamate subunit, which was reported to be associated with side effects such as ataxia, memory deficits, neurotoxicity. Therefore, different compounds with antagonistic effect are been explored on Gly/NMDA site. Glide XP docking was employed in screening phyto-constituent of Chromolaena odorata against Gly/NMDA receptor for hit compounds with antagonistic properties. The hit compounds were further subjected to Induced fit docking (IFD) and lipinski rule of five. The final selection was based on Rigid XP docking score using co-crystallized ligand as threshold docking score, interaction with receptor site residues, and IFD score. Ferulic acid, caffeic acid and scutellarein recorded binding affinity of −8.752Kcal/mol, 10.004 Kcal/mol and - 9.096 Kcal/mol respectively, which is higher than the binding affinity of co-crystallized ligand. Induced fit score obtained were −614.38, −614.03 and −616.31 for ferulic acid, caffeic acid and scutellarein respectively. The Adme properties of the phyto-constituent indicated that the compounds are drug-like in nature.
Quantifying the individual auditory and visual brain response in 7- month-old infants watching a brief cartoon movie
Authors: Jessen Sarah , Fiedler Lorenz , Münte Thomas F. , Obleser Jonas
Published: April 2019

Abstract

Electroencephalography (EEG) continues to be the most popular method to investigate cognitive brain mechanisms in young children and infants. Most infant studies rely on the well-established and easy-to-use event-related brain potential (ERP). As a severe disadvantage, ERP computation requires a large number of repetitions of items from the same stimulus-category, compromising both ERPs’ reliability and their ecological validity in infant research. We here explore a way to investigate infant continuous EEG responses to an ongoing, engaging signal (i.e., “neural tracking”) by using multivariate temporal response functions (mTRFs), an approach increasingly popular in adult-EEG research. N=52 infants watched a 5-min episode of an age-appropriate cartoon while the EEG signal was recorded. We estimated and validated forward encoding models of auditory-envelope and visual-motion features. We compared individual and group-based (‘generic’) models of the infant brain response to comparison data from N=28 adults. The generic model yielded clearly defined response functions for both, the auditory and the motion regressor. Importantly, this response profile was present also on an individual level, albeit with lower precision of the estimate but above-chance predictive accuracy for the modelled individual brain responses. In sum, we demonstrate that mTRFs are a feasible way of analyzing continuous EEG responses in infants. We observe robust response estimates both across and within participants from only five minutes of recorded EEG signal. Our results open ways for incorporating more engaging and more ecologically valid stimulus materials when probing cognitive, perceptual, and affective processes in infants and young children.
Do low gasoline prices cause more traffic fatalities in the 50 states of the USA? The importance of other factors
Authors: Hammoudeh Shawkat , Yoon Seong-Min , Kutan Ali
Published: April 2019

Purpose

Motivated by the news media and a lack of comprehensive research on the USA, the purpose of this paper is to examine the relationship between changes in road fatalities and gasoline prices, per capita disposable personal income, alcohol consumption per adult, blood alcohol concentration (BAC) limits and gender.

Design/methodology/approach

This study employs both static and dynamic panel data models, making use of annual data over the 2000–2013 period collected from the 50 states of the USA and the consistent system GMM estimators of the parameters, to estimate the impact of these variables on fatalities per 100,000 persons and per 100,000 vehicles.

Findings

The results highlight the importance of gasoline prices in determining the level of road fatalities, underscoring that a 10 percent decrease in gasoline prices leads to a 248 increase in the total number of road fatalities, but with many more injuries. Increases in the female-to-total driver ratio have a greater significant positive impact on road fatalities where a 10 percent increase in this ratio increases road fatalities by 1,008 deaths. Increases in registered vehicles per capita also increase the number of fatalities. Other variables such as alcohol consumption per adult and BAC limits are not as important. Policy implications are also provided.

Research limitations/implications

The results of this study highlight the importance of gasoline prices in determining the number of road fatalities. This factor can be an effective policy measure by which policymakers can offset increases in fatalities due to further drastic declines in future gasoline prices. But the effects of the gasoline prices in determining the number of road fatalities are not as strong as the media would lead us to believe. The media ignores the impact of other factors on fatalities, which results in an overestimation of the impact of gasoline prices.

Originality/value

This study uses the panel data of 50 US states and the dynamic panel data model. In addition to gasoline price effects on the road fatalities, this study also considers other factors such as gender, gasoline taxes, per capita disposable personal income, per capita alcohol consumption, BAC limits and number of registered vehicles.
Quality of life and its predictors in Thai patients following multiple trauma
Authors: Saengniam Wilaiwan , Jitpanya Chanokporn
Published: April 2019

Purpose

The purpose of this paper is to describe the quality of life (QOL) and to examine factors predicting the QOL among the demographic characteristics, injury severity, effect on work, pain intensity, disability point, coping and resilience factors, in Thai patients following multiple injuries.

Design/methodology/approach

A cross-sectional research design was used. A total of multiple 106 trauma patients were obtained by simple random sampling. The patients were between 18 and 59 years of age, and had visited an outpatient clinic at one of three randomly selected tertiary hospitals in Metropolitan Bangkok, Thailand. Dependent variable was QOL measured by Trauma Outcome Profile (TOP) questionnaire. Independent variables were demographic and illness-related factors collected from patients’ medical records, coping measured by the Jalowiec Coping Scale, pain measured by the Chronic Pain Grade questionnaire (CPGQ) and resilience measured by the Connor-Davidson Resilience Scale (CD-RISC-10). Data were analyzed using descriptive statistics and multiple regression analysis.

Findings

Except for satisfaction, the other nine dimensions of the QOL in patients following traumatic injuries were poor. Pain intensity was the most influential factor predicting the QOL, but the patient’s resilience, emotional coping and disability points were also able to predict the QOL.

Originality/value

The TOP, CPGQ and CD-RISC-10 were translated into Thai and used in the current study for the first time. The results of the study revealed that the pain intensity, and the patient’s resilience and coping influenced the QOL more than other factors, such as the demographic data and injury severity.
The growth oxymoron: strategic execution
Authors: Connell Carol M. , Lemyze Christine
Published: April 2019

Purpose

The purpose of this paper is to present a viewpoint on aligning strategy and execution to produce superior business results.

Design/methodology/approach

The paper examines the long-term financials of the top ten growers to reveal companies that have continued to grow in good economic times and bad, including the Great Recession. While some companies dug deeper into their core businesses during the financial crisis, others continued to innovate.

Findings

Where companies continued to focus on strategy execution, they were rewarded, for example, Amazon’s compound annual growth rate for the ten-year period that included the financial crisis was 36.45 per cent; in the past three years, Amazon’s compound annual growth rate (CAGR) has been 56.76 per cent. Most of the top ten long-term growers are headed by the same founder/entrepreneur.

Research limitations/implications

Look beyond the past three years for models of successful strategy execution.

Practical implications

For long-term company leaders, entrepreneurs, or turnaround experts, strategic execution is no oxymoron, but a requirement for growth and, ultimately, their unique responsibility.

Social implications

The paper identifies three major focus areas for strategy teams and company leadership: 1. customer centricity and strategy execution; 2. learning from survivors; and 3. rethinking capabilities and talent.

Originality/value

As a professor of strategic management and as a consultant to organizations on strategy and marketing transformation, we have focused on the activities that are necessary for leaders to create effective strategy and to execute successfully. We have also been responsible for equipping the larger teams of strategy professionals (and future strategy professionals) who support these leaders with the approaches, the methods, and the tools necessary to plan effectively, to assess effectiveness, and to correct problems in strategy and execution. We bring that perspective to this viewpoint paper.
Technology innovations towards reducing hospitality human resource costs in Langkawi, Malaysia
Authors: Ahmad Rozila , Scott Noel
Published: April 2019

Purpose

Hotel labour costs in Malaysia are increasing. This paper aims to explore Langkawi hotel managers’ perceptions about reducing labour costs using various information and communication technology (ICT) innovations.

Design/methodology/approach

Semi-structured interviews were conducted with managers from 19 budget and boutique resorts on Langkawi Island, Malaysia. Qualitative data were recorded, transcribed and content analysed using latent coding.

Findings

All hotel managers reported using some form of ICT. The purpose for ICT adoption found was to increase productivity and efficiency. A hotel’s customer mix, the need of the organization and the technology budget available influenced the outcome of technological innovation. Langkawi hotels had successfully implemented Property Management Systems (PMSs), but self-check-in/out kiosks were not seen as important as they do not meet their customers’ service expectations.

Research limitations/implications

This study identifies some factors influencing uptake by hotels of technological innovations. This initial qualitative exploration of the technology adoption feasibility in Langkawi suggests that implementation to reduce labour cost is more likely for employee-operated devices rather than customer-operated devices.

Practical implications

This study contributes to the human resource (HR) management literature by providing insight into the reasons hotel managers introduce technology in a developing country context. Results suggests that hotels face challenges in reducing labour costs through technology. These insights may serve to guide policymakers and hotel managers in other developing countries that are planning to use technology to solve their HR issues. Luxury hotels can consider adopting ICT for back-of-the-house operations such as using a HR information system within the HR department and PMS for the hotel overall operation.

Social implications

These findings can increase the Malaysians awareness of ICT importance, especially in the hotel industry.

Originality/value

The Malaysian national minimum wage order policy was introduced in 2012. This policy has resulted in increased labour costs and suggests a need to adopt ICT. This paper is the first to examine the viewpoints of hotel practitioners as to the viability of this strategy. Whilst many studies on the adoption of ICT in the hotel industry focus on its impact on productivity and firm’s performance using quantitative methods, this study used qualitative methods to explore hotel managers’ perceptions on its feasibility to reduce dependence on labour.
Dietary habits in adult Japanese patients with atopic dermatitis
Authors: Ito Michiko , Morita Takashi , Okazaki Shizuka , Koto Mototaka , Ichikawa Yuri , Takayama Ryoko , Hoashi Toshihiko , Saeki Hidehisa , Kanda Naoko
Published: April 2019

Dietary habits can modulate the pathogenesis of atopic dermatitis. We evaluated these habits in adult Japanese patients with atopic dermatitis using a validated, brief‐type self‐administered diet history questionnaire and compared the results to those of age‐ and sex‐matched healthy controls. Patients with atopic dermatitis showed higher intakes of carbohydrate and potatoes and lower intakes of alcohol, niacin, meat and oils/fats compared with those of the healthy controls. The results of logistic regression analysis showed that the intake of alcohol was negatively associated with atopic dermatitis (odds ratio, 0.905; 95% confidence interval, 0.832–0.983; P = 0.0181). The intakes of vitamin B6 and fruit were positively correlated with the severity scoring of atopic dermatitis. Multiple regression analysis revealed that vitamin B6 intake was a predictor of the severity scoring of atopic dermatitis (β = 26.98508709, t = 2.3995292, P = 0.01933781). The intakes of vegetable fat, n‐6 polyunsaturated fatty acid, and confections were lower in the severe atopic dermatitis group (severity scoring of atopic dermatitis, ≥33) than those in the mild group. Atopic dermatitis is negatively associated with alcohol intake, and intake of vitamin B6 is a predictor of severity scoring of atopic dermatitis. The intake of n‐6 polyunsaturated fatty acid is lower in the severe atopic dermatitis group than that in the mild group. Further study is warranted on the relationships of these results with abnormal immune responses, impaired skin barrier or pruritus in atopic dermatitis.
The impact of tort reform on defensive medicine, quality of care, and physician supply: A systematic review
Authors: Agarwal Rajender , Gupta Ashutosh , Gupta Shweta
Published: April 2019

Objective

To evaluate the impact of tort reform on defensive medicine, quality of care, and physician supply.

Data Sources

Empirical, peer‐reviewed English‐language studies in the MEDLINE and HeinOnline databases that evaluated the association between tort reform and our study outcomes.

Study Design

We performed a systematic review in accordance with the PRISMA guidelines.

Data Collection/Extraction Methods

Title and abstract screening was followed by full‐text screening of relevant citations. We created evidence tables, grouped studies by outcome, and qualitatively compared the findings of included studies. We assigned a higher rating to study designs that controlled for unobservable sources of confounding.

Principal Findings

Thirty‐seven studies met screening criteria. Caps on damages, collateral‐source rule reform, and joint‐and‐several liability reform were the most common types of tort reform evaluated in the included studies. We found that caps on noneconomic damages were associated with a decrease in defensive medicine, increase in physician supply, and decrease in health care spending, but had no effect on quality of care. Other reform approaches did not have a clear or consistent impact on study outcomes.

Conclusions

We conclude that traditional tort reform methods may not be sufficient for health reform and policy makers should evaluate and incorporate newer approaches.
Property rights integrity, tenure security and forestland rental market participation: Evidence from Jiangxi Province, China
Authors: Zhou Yuepeng , Shi Xiaoping , Ji Dengyan , Ma Xianlei , Chand Satish
Published: April 2019

The decentralization of property rights is the focus of the forest tenure reforms in several developing countries. In China, it was achieved by the launch of a new round of collective forest tenure reform beginning in 2003, which provided farmers with more integrated and secure forestland rights. Drawing on household data collected in Jiangxi province in 2011 and 2013, this paper examines the impacts of households’ recognition of property rights and improved tenure security on forestland rental activities. Our empirical results show that households with higher perceptions of more complete use rights and mortgage rights have a lower probability and intensity of renting‐in land, while households with lower expectations of future forestland redistribution or expropriation are more likely to rent in forestland and more of it. These results imply that the development of a forestland rental market leading to better forest management requires an integrated forestland management approach consisting of decentralization of property rights and village governance. In particular, the central government may further clarify the rights and obligations affiliated to forestland ownership, contractual rights, and management rights; while the village collective may shift from direct intervention in the integrity and security of forestland rights to the supervision and protection of decentralized forestland rights to increase efficiency from the decentralization of property rights.
Roots of the taxonomic impediment: Is the “integrativeness” a remedy?
Authors: VINARSKI Maxim V.
Published: April 2019

The use of the “integrative approach” for classification of organisms since its formal establishment in 2005 has become a recurrent theme of zoosystematics. A bibliometric survey of the publications on integrative taxonomy of animals, which is aimed at exploring the most popular areas of research and characterizing the practical systematists’ attitudes to this new approach, is presented. An analysis of 582 papers, which appeared between 2005 and 2017 in journals indexed by Scopus and the Web of Science Core Collection, has illustrated the gradual growth of the popularity of integrative taxonomy as well as some biases in the representation of higher taxa in “integrated” studies. It has been shown that the “integrative” papers have more chance of appearing in a top‐ranking journal and gain relatively more citations as compared with non‐integrative papers. The obtained results are discussed in the context of the “taxonomic impediment” problem thought to be a consequence of the institutional crisis of traditional taxonomy, which has been vividly debated over the past decades.
Early clear cell “sugar” lung cancer management: A case report and a brief literature review
Authors: Sjniari Marsela , Miele Evelina , Stati Valeria , Di Cristofano Claudio , Diso Daniele , Pecoraro Ylenia , Venuta Federico , Tomao Silverio , Spinelli Gian Paolo
Published: April 2019

A clear cell tumor is a histological entity that rarely originates outside of the kidney. We describe a rare case of a clear cell tumor of the lung, also known as “sugar cancer,” that occurred in a 74 year‐old male patient, and perform a brief literature review. This report highlights the importance of an adequate disease management team, including surgeons, oncologists, and pathologists, to identify the best therapeutic approach to improve survival rates and the quality of life of patients affected by this rare disease.
Iatrogenic subglottic tracheal stenosis after tracheostomy and endotracheal intubation: A cohort observational study of more severity in keloid phenotype
Authors: Chang Enqiang , Wu Lingzhi , Masters Joe , Lu Jie , Zhou Shengli , Zhao Wenli , Sun Mingyang , Meng Fanmin , Soo Chen Pac , Zhang Jiaqiang , Ma Daqing
Published: April 2019

Background

Tracheostomy and endotracheal intubation can result in subglottic tracheal stenosis, and predisposition to keloid scar formation can increase stenosis risk after tracheal injury. This study aims to compare the incidence and severity of subglottic tracheal stenosis in keloid and non‐keloid patients following iatrogenic tracheal injury, in particular tracheostomy.

Methods

From 2012 to 2017, 218 573 patients were intubated for surgery; 2276 patients received tracheostomy in People’s Hospital of Zhengzhou University, China. Among these patients, 133 patients, who developed tracheal stenosis after intubation and/or tracheostomy, were divided into keloid or non‐keloid groups; their Myer and Cotton grading of tracheal stenosis, time‐to‐onset of airway stenosis, and treatment outcome were assessed and compared.

Results

The percentages of high grade (Myer and Cotton grading III/IV) tracheal stenosis were higher among keloid patients than non‐keloid patients (intubation: 83.3% vs 25.7%; tracheostomy: 77.7% vs 33.3%). Time‐to‐onset of airway stenosis following intubation (tracheostomy) was 27 ± 5 (38 ± 13) and 41 ± 7 (82 ± 14) days for keloid and non‐keloid patients, respectively (P < 0.01). The incidence of tracheal stenosis is higher in keloid than non‐keloid subjects (19.4% vs 1.82%, P < 0.001). Keloid patients also required more frequent treatment (P < 0.01) of longer duration, yet cure rate was significantly lower (P < 0.01).

Conclusions

Our study suggests that tracheostomized patients with keloid phenotype are more susceptibility to develop iatrogenic tracheal stenosis of greater severity and with poorer treatment outcome. Greater cautions may be required when performing tracheostomy in keloid subjects. More substantive analysis is warranted to establish keloid phenotype as a risk factor for tracheal stenosis.
Genome‐wide identification and comparison of mRNAs, lncRNAs and circRNAs in porcine intramuscular, subcutaneous, retroperitoneal and mesenteric adipose tissues
Authors: Liu X. , Wei S. , Deng S. , Li D. , Liu K. , Shan B. , Shao Y. , Wei W. , Chen J. , Zhang L.
Published: April 2019

Many types of RNAs, including messenger RNAs (mRNAs), long noncoding RNAs (lncRNAs) and circular RNAs (circRNAs), play crucial roles in regulating fat cell differentiation and tissue development. However, the expression profiles of these RNAs in different adipose tissues are still largely unknown. To shed light on this issue, we performed a transcriptome analysis of mRNAs, lncRNAs and circRNAs obtained from intramuscular adipose tissue, subcutaneous adipose tissue, retroperitoneal adipose tissue and mesenteric adipose tissue of Chinese Erhualian pigs. A number of differentially expressed mRNAs, lncRNAs and circRNAs were identified among the four adipose tissues. Tissue‐specific analysis indicated that circRNAs exhibited the highest tissue specificity among mRNAs, lncRNAs and circRNAs, whereas intramuscular adipose tissue had the most tissue‐specific genes among the four adipose tissues. Gene Ontology analysis showed that differentially expressed mRNAs among groups were involved mainly in lipid metabolism and immune inflammatory response processes. Furthermore, the co‐expression network construction of mRNAs–lncRNAs revealed that several important lncRNAs, such as MSTRG.426159 and MSTRG.604206, might associate with lipid metabolic process. Taken together, these data provide a genome‐wide resource of mRNAs, lncRNAs and circRNAs potentially involved in porcine fat metabolism, thus improving understanding of their function in diverse adipose tissues.
A nationwide cohort study of the incidence of microscopic colitis in Sweden
Authors: Bergman David , Clements Mark S. , Khalili Hamed , Agréus Lars , Hultcrantz Rolf , Ludvigsson Jonas F.
Published: April 2019

Background

Epidemiological studies of microscopic colitis have shown varying but increasing incidence rates.

Aim

To assess the incidence of microscopic colitis in Sweden.

Methods

Nationwide cohort study performed in 1995‐2015 based on biopsy reports. Age‐specific and age‐standardised incidence rates were calculated.

Results

We identified 13 844 patients with an incident diagnosis of microscopic colitis. Lymphocytic colitis (n = 9238) constituted 67% and collagenous colitis (n = 4606) 33% of microscopic colitis. The mean age at time of diagnosis of microscopic colitis was 60.2 years (58.6 for lymphocytic colitis, 63.3 for collagenous colitis). The lifetime risk of developing microscopic colitis was 0.87% in women (95% confidence interval, CI: 0.85‐0.88) and 0.35% in men (95% CI: 0.34‐0.36). From 2006, the overall incidence of microscopic colitis was approximately 10.5 cases per 100 000 person‐years (95% CI: 9.8‐11.3) with higher rates in women (72% of cases, incidence rate ratio = 2.4 (95% CI: 2.3‐2.5) and the elderly with increasing rates up to 75‐79 years. From 2006‐2015, there was a significant increase of 1% per year (P = 0.02) in the overall microscopic colitis incidence rate in women; the estimated annual percent change was similar, although not statistically significant, in men (P = 0.15).

Conclusions

In Sweden, the incidence of microscopic colitis is still increasing in women, although the rate appears to be stabilising. The incidence is particularly high in women and the elderly up to age 75‐79 years. Finally, across a lifetime, 1 in 115 females and 1 in 286 males are expected to be diagnosed with microscopic colitis and thus posing a considerable disease burden.
Differential protein profiles in duck meat during the early postmortem storage period
Authors: Zheng Nen‐Zhu , Zhu Zhi‐Ming , Xin Qing‐Wu , Zhang Zheng‐Hong , Miao Zhong‐Wei , Li Li , Zhang Lin‐Li , Wang Zheng‐Chao , Huang Yi‐Fan
Published: April 2019

The present study was designed to investigate proteomic differences in duck breast muscle during the early postmortem storage period. The meat quality was evaluated at 0 hr and 24 hr postmortem at 4°C in Pekin ducks, black Muscovy ducks and Mule ducks. Differentially expressed proteins were detected by two‐dimensional gel electrophoresis (2‐DE) and matrix‐assisted laser desorption ionization‐time‐of‐flight mass spectrometry (MALDI‐TOF/TOF MS) at 0 hr and 24 hr postmortem in the three duck breeds. The results showed that 53 proteins spots were differentially expressed at 0 hr and 24 hr postmortem at 4°C in Pekin ducks, 75 spots in black Muscovy ducks, and 72 spots in Mule ducks. A total of 30 (10 spots for each breed) were selected for identification by mass spectrometry. Seven proteins were identified in Pekin ducks, eight in black Muscovy ducks and seven in Mule ducks. Moreover, the above results obtained by 2‐DE and MALDI‐TOF/TOF MS were confirmed by western blotting. To our knowledge, this study is the first to provide insights into the protein profiles of ducks during postmortem storage and provides a better understanding of the biochemical processes that contribute to duck meat quality.