bluuebunny/crossref_metadata_2025 huggingface dataset:
Facts or gut feelings: analysis of external pricing antecedents for SMEs in Germany
Authors: Achterberg Lars Hendrik , Omar Maktoba , Ambituuni Ambisisis , Roll Oliver
Published: May 2018

Purpose

The purpose of this paper is to analyse the external antecedents of pricing information acquisition in an integrative manner. The study develops understanding of determinants of information acquisition as a crucial prerequisite of successful pricing strategies within German small and medium enterprises (SMEs).

Design/methodology/approach

A large scale survey of sampled 2,542 SMEs was conducted. A total of 220 questionnaires were completed, reflecting a response rate of 9 per cent. This was acceptable considering the sensitivity of pricing issues. A final sample of 173 usable questionnaires were obtained.

Findings

The result indicates that external antecedents of pricing information acquisition practices have a positive impact on SME pricing performance, and pricing performance is positively related to firm performance.

Practical implications

The study indicates that external antecedents of pricing information acquisition are strategic pricing capabilities, which should receive attention by SME managers.

Originality/value

This study bridges significant obstacle to knowledge generation and theory development of the important issues of pricing information acquisition in SMEs.
The epistemological structure of mobilities
Authors: Korstanje Maximiliano E.
Published: May 2018

Purpose

This paper aims to revolve around two problems which, though imagined as different, can be addressed altogether. On one hand, the advance of terrorism as a major threat to the tourism industry, while – on the other – we discuss the ontological nature of tourism as a rite of passage, which is vital to keep the political legitimacy of officialdom. At the time, paradoxically, social scientists shrug off tourism as a naïve commercial activity, while the main tourist destinations are being attacked by jihadism. This suggests the disinterest of ones associates to the interests of others.

Design/methodology/approach

The author holds the thesis that tourism derives from ancient institutions, which illuminated in the growth of Occident and the formation of hospitality. Capitalism hides the importance of tourism as a mere trivialization as a bit-player. However, a closer look reminds precisely the opposite. The recent attacks perpetrated at main destinations reveal tourism as an exemplary (symbolic) center of the West, a source of authority and power for the existing hierarchal order.

Findings

The issue captivates the attention of scholars, officials and policymakers, and at the same time, epistemologists of tourism receive a fresh novel debate regarding the origins of tourism.

Originality/value

It is a great paradox that tourism would be selected as a target for jihadism but at the same time a naïve activity for social scientists or at the least by the French tradition. Despite the partisan criticism exerted on tourism as an alienatory force, this work showed two important aspects, which merits to be discussed. At a closer look, tourism should be understood as “a rite of passage” whose function associates to the revitalization of those glitches happened during the cycles of production. Second, and most important, tourism accommodates those frustrations to prevent acts of separatism or the rise of extreme conflict among classes.
An empirical analysis of bank specific factors affecting interest rate of Ugandan banking financial institutions
Authors: Tumwine Sulait , Sejjaaka Samuel , Bbaale Edward , Kamukama Nixon
Published: May 2018

Purpose

The purpose of this paper is to investigate the effect of bank specific factors on interest rate in banking financial institutions (BFIs) of Uganda.

Design/methodology/approach

To analyze the effect, an OLS random effects regression estimate on a data set of 24 banks from 2008 to 2016 from Bank of Uganda Depository Corporation survey was carried out. Studied bank specific factors including liquidity, operational efficiency, credit risk, capitalization and lending ratio are considered.

Findings

The results indicate that liquidity, operational efficiency, capitalization and lending out ratio affect the interest rate while credit risk does not.

Research limitations/implications

The study has confirmed that bank specific factors influence interest rate and other factors such as industry-level and indirect macroeconomic indicators need to be explored. The differences in categories of banks on interest rate would be of importance. Finally, this study concentrated on banks in Uganda, future study would focus on the comparison of Ugandan banks with those of other countries in the East African Region.

Practical implications

Bank managers should invest in up-to-date technology to reduce operational costs and improve efficiency. Managers of bank should take interest on equity mobilization, because it constitutes a cheaper source of capital to finance asset used in operations and long-term needs of borrowers financing. Government should consider a legislation that provides incentives toward savings and reduction in tax for bank inputs.

Originality/value

This is the first study that investigates the effect of bank specific factors on interest rate in Uganda’s BFIs.
Phonological effects in visual word recognition: evidence from the processing of two types of Hebrew acronyms
Authors: Peleg Orna , Norman Tal , Bergerbest Dafna
Published: May 2018

To investigate phonological effects in visual word recognition, a visual lexical decision task was used in which the critical stimuli were two types of highly familiar Hebrew acronyms: ‘phonological’ acronyms that are conventionally pronounced as single words via letter‐to‐sound translation (ד"ש (d"ʃ) = /daʃ/), and ‘lexical’ acronyms that are conventionally pronounced according to their full multiword name (ת"א(t"ʔ) = /tel/ /aviv/). Thus, in the case of ‘phonological’ acronyms, phonological recoding may contribute to the recognition process, while in the case of ‘lexical’ acronyms, it may interfere ((ת"אt"ʔ) ≠ taʔ/). If familiar letter strings are accessed mainly orthographically, as assumed by dual route models, then no difference is expected between these two types of acronyms. Alternatively, if phonological recoding influences word recognition, then ‘phonological’ acronyms should be easier to recognise. Consistent with this latter interactive‐connectionist view, responses were faster and more accurate in the ‘phonological’ than in the ‘lexical’ condition.
Emotion, reflexivity and social change in the era of extreme fossil fuels
Authors: Davidson Debra J.
Published: May 2018

Reflexivity is an important sociological lens through which to examine the means by which people engage in actions that contribute to social reproduction or social elaboration. Reflexivity theorists have largely overlooked the central place of emotions in reflexive processing, however, thus missing opportunities to enhance our understanding of reflexivity by capitalizing on recent scholarship on emotions emanating from other fields of inquiry. This paper explores the role of emotion in reflexivity, with a qualitative analysis of social responses to hydraulic fracturing in Alberta, Canada, utilizing narrative analysis of long‐form interviews with rural landowners who have experienced direct impacts from hydraulic fracturing, and have attempted to voice their concerns in the public sphere. Based on interviews with a selection of two interview participants, the paper highlights the means by which emotions shape reflexivity in consequential ways, beginning with personal and highly individualized emotional responses to contingent situations, which then factor into the social interactions engaged in the pursuit of personal projects. The shared emotional context that emerges then plays a substantial role in shaping outcomes and their implications for social stasis or change. This study exemplifies the extent to which reflexive processing in response to breaches in the social order can be emotionally tumultuous affairs, constituting a significant personal toll that many may be unwilling to pay.
Relating Food Engineering to Cooking and Gastronomy
Authors: Aguilera José Miguel
Published: May 2018

Modern consumers are increasingly eating meals away from home and are concerned about food quality, taste, and health aspects. Food engineering (FE) has traditionally been associated with the industrial processing of foods; however, most underlying phenomena related to FE also take place in the kitchen during meal preparation. Although chemists have positively interacted with acclaimed chefs and physicists have used foods as materials to demonstrate some of their theories, this has not been always the case with food engineers. This review addresses areas that may broaden the vision of FE by interfacing with cooking and gastronomy. Examples are presented where food materials science may shed light on otherwise empirical gastronomic formulations and cooking techniques. A review of contributions in modeling of food processing reveals that they can also be adapted to events going on in pots and ovens, and that results can be made available in simple terms to cooks. Industrial technologies, traditional and emerging, may be adapted to expand the collection of culinary transformations, while novel equipment, digital technologies, and laboratory instruments are equipping the 21st‐century kitchens. FE should become a part of food innovation and entrepreneurship now being led by chefs. Finally, it is suggested that food engineers become integrated into gastronomy's concerns about safety, sustainability, nutrition, and a better food use.
Effects of Processing on Structure and Thermal Properties of Powdered Preterm Infant Formula
Authors: Sun Xiaomeng , Wang Cuina , Wang Hao , Guo Mingruo
Published: May 2018

Powdered infant formula is usually manufactured by ingredients mixing, homogenization, pasteurization, evaporation and spray drying. Effects of unit operations on the microstructure, thermal properties and other characteristics of preterm infant formula, fat (F), serum (S), and pellet (P) fractions on centrifugation were investigated using Scanning Electron Microscopy (SEM), Transmission Electron Microscopy (TEM), Differential Scanning Calorimetry (DSC), and Fourier Transform Infrared (FTIR) spectroscopy. After homogenization, particles which may be casein and denatured whey proteins were observed on the surface of F fraction in microstructure images. DSC results showed that the onset temperature of the second endothermic peak of F fraction shifted to higher temperature, and an endothermic transition appeared at 173.3 °C in P fraction. The ‐CH2 group corresponding to F fraction showed less intensity in FTIR spectrum after homogenization. Microstructure images for S and P fractions showed larger aggregates due to the pasteurization processing. Apparent exothermic transition in DSC curve occurred at 101.6 °C indicated whey protein aggregation. Spray drying resulted in some open areas in F fraction and lager aggregates in S fraction revealed by microstructure pictures. A new exothermic transition appeared at 93.6 °C in DSC curve of S fraction. Changes in amide I and amide II regions in FTIR spectra of samples resulted from pasteurization and spray drying indicated the changes in secondary structure of casein and whey proteins. All results indicated that homogenization, pasteurization, and spray drying exhibited pronounced impacts on the microstructure, thermal properties and structural characteristics of samples.

Practical Application

Preterm infant formula is an important dairy food for preborn infants. Our results indicate that unit operations especially homogenization, pasteurization, and spray drying during the processing have the most impacts on the microstructure, thermal properties and other characteristics of infant formula. This work provides further understanding of component interactions during the processing of infant formula and theoretical basis for the production of dairy food.
Intralobar pulmonary sequestration originating from the intercostal arteries treated with surgical resection
Authors: Li Xin , Du Hui , Rehman Mujeeb ur , Dong Ming , Liu Minghui , Liu Hongyu , Chen Jun
Published: May 2018

Intralobar pulmonary sequestration originating from the intercostal arteries is rarely reported. Herein, we report an unusual case of a 56‐year‐old male patient with intralobar pulmonary sequestration supplied from the intercostal arteries on the left lower lobe who presented after a month of a repeated cough and massive hemoptysis. Although transcatheter arterial embolization was performed three times, the patient's symptoms were not relieved. A left lower lobectomy was performed with video‐assisted thoracic surgery. At the six‐month follow‐up after surgery, the patient had recovered well without any hemoptysis. Therefore, surgical resection with lobectomy may be a better alternative to transcatheter arterial embolization for the treatment of intralobar pulmonary sequestrations arising from the intercostal arteries. To our knowledge, this is the second reported case of intralobar pulmonary sequestration arising from the intercostal arteries.
Understanding the development of a regulated market approach to new psychoactive substances (NPS) in New Zealand using Punctuated Equilibrium Theory
Authors: Rychert Marta , Wilkins Chris
Published: May 2018

Background and aims

The short‐lived regulated legal market for new psychoactive substances (NPS) in New Zealand marked a radical departure from the traditional prohibition‐based approach to drugs. This paper aimed to enhance understanding of this policy change using Punctuated Equilibrium Theory (PET).

Methods

The analysis draws on 3 years of evaluative research, including interviews with key stakeholders, analysis of legislation and policy documents and academic and grey literature.

Results

The reframing of the NPS issue from one of drug control to the need for stricter market regulation was achieved by the efforts of strategic policy entrepreneurs, including the legal high industry, drug law reform advocates, influential politicians and an independent legal advisory institution. This reframing was aided by the perceived saliency of the NPS problem and ineffectiveness of previous prohibition‐based responses. In the absence of any political opposition to the regulatory approach, the Psychoactive Substances Act rapidly progressed through the Parliament. However, once the interim legal market was established, portrayal of the issues shifted away from experts and lobbyists to critique from local communities, local government, animal rights activists and the media, who viewed the new regime as a source of social and health problems. The mobilization of criticism (‘Schattschneider mobilization’) drew on ideas of animal welfare and community safety. With a looming national election, the government responded by ending the interim market with the urgent passage of amendment legislation.

Conclusions

Punctuated Equilibrium Theory (PET) helps explain how New Zealand's Psychoactive Substances Act (PSA) policy first emerged on the political agenda and how the initial positive tone of expert support for reform shifted to a tide of popular criticism during the interim regime. However, with its emphasis on explaining agenda‐setting, PET does not account for the legislative design shortcomings of the PSA.
Comparison of endoscopic and percutaneous drainage of symptomatic necrotic collections in acute necrotizing pancreatitis
Authors: Woo Shanan , Walklin Ryan , Ackermann Travis , Lo Sheng Wei , Shilton Hamish , Pilgrim Charles , Evans Peter , Burnes James , Croagh Daniel
Published: May 2018

Introduction

Primary endoscopic and percutaneous drainage for pancreatic necrotic collections is increasingly used. We aim to compare the relative effectiveness of both modalities in reducing the duration and severity of illness by measuring their effects on systemic inflammatory response syndrome (SIRS).

Methods

We retrospectively reviewed all cases of endoscopic and percutaneous drainage for pancreatic necrotic collections performed in 2011–2016 at two hospitals. We assessed the post‐procedure length of hospital stay, reduction in C‐reactive protein levels, resolution of SIRS, the complication rates, and the number of procedures required for resolution.

Results

Thirty‐two patients were identified and 57 cases (36 endoscopic, 21 percutaneous) were included. There was no significant difference in C‐reactive protein reduction between endoscopic and percutaneous drainage (69.5% vs 68.8%, P = 0.224). Resolution of SIRS was defined as the post‐procedure normalization of white cell count (endoscopic vs percutaneous: 70.4% vs 64.3%, P = 0.477), temperature (endoscopic vs percutaneous: 93.3% vs 60.0%, P = 0.064), heart rate (endoscopic vs percutaneous: 56.0% vs 11.1%, P = 0.0234), and respiratory rate (endoscopic vs percutaneous: 83.3% vs 0.0%, P = 0.00339). Post‐procedure length of hospital stay was 27 days with endoscopic drainage and 46 days with percutaneous drainage (P = 0.0183).

Conclusion

Endoscopic drainage was associated with a shorter post‐procedure length of hospital stay and a greater rate of normalization of SIRS parameters than percutaneous drainage, although only the effects on heart rate and respiratory rate reached statistical significance. Further studies are needed to establish which primary drainage modality is superior for pancreatic necrotic collections.
The effect of high pre‐slaughter environmental temperature on meat quality traits of Italian autochthonous pig Suino Nero Lucano
Authors: Simonetti Amalia , Perna Annamaria , Giudice Roberto , Cappuccio Angelo , Gambacorta Emilio
Published: May 2018

The aim of the present study was to evaluate the effect of high pre‐slaughter environmental temperature on meat (Longissimus lumborum muscle) quality traits of Italian autochthonous pigs Suino Nero Lucano (SNL). High pre‐slaughter environmental temperature influenced the meat quality of autochthonous pigs. In particular, the meat from SNL pigs exposed to heat stress (H) showed significantly lower pH values at 24 and 48 hr post mortem, haem iron content and redness (a*) value, and a significantly higher shear force, drip loss and lightness (L*) values, compared to meat from SNL pigs reared under comfortable environmental temperature (C). Moreover, H meat showed a significant reduction of vitamin A, vitamin E, creatine and carnosine content, compared to C meat. Despite this, no pale‐soft‐exudative pork was found in our study, and no significant difference was detected between two studied groups for intramuscular fat and protein content of meat. In addition, despite the meat from SNL pigs exposed to heat stress has suffered a qualitative decrease, it showed a good endogenous antioxidants content.
Moderate correlation between systemic IL‐6 responses and CRP with trough concentrations of voriconazole
Authors: Vreugdenhil Bas , van der Velden Walter J. F. M. , Feuth Ton , Kox Matthijs , Pickkers Peter , van de Veerdonk Frank L. , Blijlevens Nicole M. A. , Brüggemann Roger J. M.
Published: May 2018

Aims

Voriconazole (VCZ) exhibits wide intrapatient pharmacokinetic variability, which is disadvantageous because of its narrow therapeutic range. A considerable part of this variation remains unexplainable, despite extensive knowledge of this drug. It is hypothesized that inflammation has an impact on VCZ pharmacokinetics. In the present study, we investigated the correlation between VCZ trough concentrations and various cytokines.

Methods

A prospective single‐centre analysis was performed in adult haematology patients receiving VCZ for possible, probable or proven invasive fungal disease. A linear mixed model was built to explore the contribution of each of the seven pro‐ and anti‐inflammatory cytokines to VCZ trough levels. The Akaike information criterion (AIC) was used to determine the model that fitted the best.

Results

Twenty‐two patients, with a total of 143 combined samples of VCZ trough levels and cytokines, were included. A significant correlation (P < 0.005) was found between VCZ trough concentrations and interleukin (IL) 6, IL‐8 and C‐reactive protein (CRP). IL‐6 showed the lowest AIC, although differences with the other mediators were marginal.

Conclusion

VCZ trough concentrations correlate with IL‐6, IL‐8 and CRP levels but only moderately explain the variability in VCZ pharmacokinetics. Future prospective studies should be undertaken to confirm these findings, and incorporate the data obtained into pharmacokinetic models, to refine the predictive behaviour.
High exposure compared with standard exposure to metoclopramide associated with a higher risk of parkinsonism: a nationwide population‐based cohort study
Authors: Tsai Shin‐Chia , Sheu Shiow‐Yunn , Chien Li‐Nien , Lee Hsin‐Chien , Yuan Eunice Jia‐Shiow , Yuan Rey‐Yue
Published: May 2018

Aims

We conducted a cohort study utilizing a nationwide health insurance database to assess the European Medicines Agency's restrictions on using metoclopramide and its association with the risk of parkinsonism.

Methods

New oral metoclopramide users aged ≥20 years, and age‐ and gender‐matched non‐users were recruited between 2001 and 2011. Users were divided into high‐exposure (dose >30 mg day–1 and/or duration >5 days) and standard‐exposure (dose ≤30 mg day–1 and duration ≤5 days) groups. The adjusted hazard ratio (aHR) with 95% confidence interval (CI) estimated the risk of parkinsonism.

Results

During a 1‐year period, 122 of 218 931 (0.06%) users of metoclopramide vs. 56 of 218 931 (0.03%) non‐users developed parkinsonism (P < 0.001). Among the 122 cases of parkinsonism in users, 64 (0.04%) were from 168 566 standard‐exposure users and 58 (0.12%) from 50 365 high‐exposure users. Compared with non‐users, the risk of parkinsonism was higher in users (aHR 2.16; 95% CI 1.54, 3.02), including standard‐exposure (aHR 1.73; 95% CI 1.11, 2.70), and high‐exposure (aHR 3.15; 95% CI 1.78, 5.57) users. High‐exposure users had a higher risk of parkinsonism than standard‐exposure users (aHR 1.83; 95% CI 1.28, 2.63). Within the high‐exposure group, 45 233 of 50 365 (89.81%) users and 55 of 58 (94.83%) parkinsonism were from long‐duration exposure; 5 132 of 50 365 (10.19%) users and 3 of 58 (5.17%) parkinsonism were from high‐dose exposure and long‐duration + high‐dose exposure.

Conclusions

The risk of parkinsonism in metoclopramide users, although extremely low (0.06%), is 2.16‐fold greater than in non‐users. High‐exposure users have a 1.83‐fold higher risk than standard‐exposure users. As users in high‐exposure group had a higher risk of parkinsonism than in standard‐exposure group, and the majority of users and parkinsonism in high‐exposure group were from long‐duration exposure; thus, physician are advised to avoid prescribing metoclopramide for >5 days, even if the daily dose is ≤30 mg.
Appropriateness of oral anticoagulant therapy prescription and its associated factors in hospitalized older people with atrial fibrillation
Authors: Franchi Carlotta , Antoniazzi Stefania , Proietti Marco , Nobili Alessandro , Mannucci Pier Mannuccio ,   on behalf of the SIM‐AF Collaborators
Published: May 2018

Aims

Although oral anticoagulants (OACs) are effective in preventing stroke in older people with atrial fibrillation (AF), they are often underused in this particularly high‐risk population. The aim of the present study was to assess the appropriateness of OAC prescription and its associated factors in hospitalized patients aged 65 years or older.

Methods

Data were obtained from the retrospective phase of Simulation‐based Technologies to Improve the Appropriate Use of Oral Anticoagulants in Hospitalized Elderly Patients With Atrial Fibrillation (SIM‐AF) study, held in 32 Italian internal medicine and geriatric wards. The appropriateness of OAC prescription was assessed, grouping patients in those who were and were not prescribed OACs at hospital discharge. Multivariable logistic regression was used to establish factors independently associated with the appropriateness of OAC prescription.

Results

A total of 328 patients were included in the retrospective phase of the study. Of these, almost 44% (N = 143) were inappropriately prescribed OACs, being mainly underprescribed or prescribed an inappropriate antithrombotic drug (N = 88). Among the patients prescribed OACs (N = 221), errors in the prescribed doses were the most frequent cause of inappropriate use (N = 55). Factors associated with a higher degree of patient frailty were inversely associated with the appropriateness of OAC prescription.

Conclusions

In hospitalized older patients with AF, there is still a high prevalence of inappropriate OAC prescribing. Characteristics usually related to frailty are associated with the inappropriate prescribing. These findings point to the need for targeted interventions designed for internists and geriatricians, aimed at improving the appropriate prescribing of OACs in this complex and high‐risk population.
Designing serious games for special user groups—design for somebody approach
Authors: Merilampi Sari , Koivisto Antti , Sirkka Andrew
Published: May 2018

This paper presents the Design for Somebody (DfS) philosophy targeted to iterative, user‐oriented development of solutions for special user groups. In this article, the DfS is discussed using a game development context. The paper gives concrete examples how the DfS can be used in developing motivating serious games. The paper presents three games which can be adjusted according to the user's abilities. The aim is to generate personalized means to enable and motivate physical, cognitive and social skill development. The development process of the three games is described in order to clarify the DfS approach and the features which are of key importance in game development for special user groups. Authentic user experiences are also presented and discussed. The user experiences and the suitability of the games were investigated through interviews and observations in game test events. The main findings in general indicated the usefulness of the DfS principles and the great interest and positive experiences in special user groups. The findings encourage further research and development of serious games for these target groups.
Anticipatory versus reactive spatial attentional bias to threat
Authors: Gladwin Thomas E. , Möbius Martin , McLoughlin Shane , Tyndall Ian
Published: May 2018

Dot‐probe or visual probe tasks (VPTs) are used extensively to measure attentional biases. A novel variant termed the cued VPT (cVPT) was developed to focus on the anticipatory component of attentional bias. This study aimed to establish an anticipatory attentional bias to threat using the cVPT and compare its split‐half reliability with a typical dot‐probe task. A total of 120 students performed the cVPT task and dot‐probe tasks. Essentially, the cVPT uses cues that predict the location of pictorial threatening stimuli, but on trials on which probe stimuli are presented the pictures do not appear. Hence, actual presentation of emotional stimuli did not affect responses. The reliability of the cVPT was higher at most cue–stimulus intervals and was .56 overall. A clear anticipatory attentional bias was found. In conclusion, the cVPT may be of methodological and theoretical interest. Using visually neutral predictive cues may remove sources of noise that negatively impact reliability. Predictive cues are able to bias response selection, suggesting a role of predicted outcomes in automatic processes.
High voice pitch mitigates the aversiveness of antisocial cues in men's speech
Authors: O'Connor Jillian J. M. , Barclay Pat
Published: May 2018

Speech contains both explicit social information in semantic content and implicit cues to social behaviour and mate quality in voice pitch. Voice pitch has been demonstrated to have pervasive effects on social perceptions, but few studies have examined these perceptions in the context of meaningful speech. Here, we examined whether male voice pitch interacted with socially relevant cues in speech to influence listeners’ perceptions of trustworthiness and attractiveness. We artificially manipulated men's voices to be higher and lower in pitch when speaking words that were either prosocial or antisocial in nature. In Study 1, we found that listeners perceived lower‐pitched voices as more trustworthy and attractive in the context of prosocial words than in the context of antisocial words. In Study 2, we found evidence that suggests this effect was driven by stronger preferences for higher‐pitched voices in the context of antisocial cues, as voice pitch preferences were not significantly different in the context of prosocial cues. These findings suggest that higher male voice pitch may ameliorate the negative effects of antisocial speech content and that listeners may be particularly avoidant of those who express multiple cues to antisociality across modalities.
Cluster analysis of multiple chronic conditions associated with urinary incontinence among women in the USA
Authors: Markland Alayne D. , Vaughan Camille P. , Okosun Ike S. , Goode Patricia S. , Burgio Kathryn L. , Johnson Theodore M.
Published: May 2018

Objective

To identify patterns of prevalent chronic medical conditions among women with urinary incontinence (UI).

Materials and Methods

We combined cross‐sectional data from the 2005–2006 to 2011–2012 US National Health and Nutrition Examination Surveys, and identified 3 800 women with UI and data on 12 chronic conditions. Types of UI included stress UI (SUI), urgency UI (UUI), and mixed stress and urgency UI (MUI). We categorized UI as mild, moderate or severe using validated measures. We performed a two‐step cluster analysis to identify patterns between clusters for UI type and severity. We explored associations between clusters by UI subtype and severity, controlling for age, education, race/ethnicity, parity, hysterectomy status and adiposity in weighted regression analyses.

Results

Eleven percent of women with UI had no chronic conditions. Among women with UI who had at least one additional condition, four distinct clusters were identified: (i) cardiovascular disease (CVD) risk‐younger; (ii) asthma‐predominant; (iii) CVD risk‐older; and (iv) multiple chronic conditions (MCC). In comparison to women with UI and no chronic diseases, women in the CVD risk‐younger (age 46.7 ± 15.8 years) cluster reported the highest rate of SUI and mild UI severity. In the asthma‐predominant cluster (age 51.5 ± 10.2 years), women had more SUI and MUI and more moderate UI severity. Women in the CVD risk‐older cluster (age 57.9 ± 13.4 years) had the highest rate of UUI, along with more severe UI. Women in the MCC cluster (age 61.0 ± 14.8 years) had the highest rates of MUI and the highest rate of moderate/severe UI.

Conclusions

Women with UI rarely have no additional chronic conditions. Four patterns of chronic conditions emerged with differences by UI type and severity. Identification of women with mild UI and modifiable conditions may inform future prevention efforts.
S100A8/A9 promotes parenchymal damage and renal fibrosis in obstructive nephropathy
Authors: Tammaro A , Florquin S , Brok M , Claessen N , Butter L M , Teske G J D , de Boer O J , Vogl T , Leemans J C , Dessing M C
Published: May 2018

Despite advances in our understanding of the mechanisms underlying the progression of chronic kidney disease and the development of fibrosis, only limited efficacious therapies exist. The calcium binding protein S100A8/A9 is a damage-associated molecular pattern which can activate Toll-like receptor (TLR)-4 or receptor for advanced glycation end-products (RAGE). Activation of these receptors is involved in the progression of renal fibrosis; however, the role of S100A8/A9 herein remains unknown. Therefore, we analysed S100A8/A9 expression in patients and mice with obstructive nephropathy and subjected wild-type and S100A9 knock-out mice lacking the heterodimer S100A8/A9 to unilateral ureteral obstruction (UUO). We found profound S100A8/A9 expression in granulocytes that infiltrated human and murine kidney, together with enhanced renal expression over time, following UUO. S100A9 KO mice were protected from UUO-induced renal fibrosis, independently of leucocyte infiltration and inflammation. Loss of S100A8/A9 protected tubular epithelial cells from UUO-induced apoptosis and critical epithelial–mesenchymal transition steps. In-vitro studies revealed S100A8/A9 as a novel mediator of epithelial cell injury through loss of cell polarity, cell cycle arrest and subsequent cell death. In conclusion, we demonstrate that S100A8/A9 mediates renal damage and fibrosis, presumably through loss of tubular epithelial cell contacts and irreversible damage. Suppression of S100A8/A9 could be a therapeutic strategy to halt renal fibrosis in patients with chronic kidney disease.
A phylogenetic study of krill (Crustacea: Euphausiacea) reveals new taxa and co‐evolution of morphological characters
Authors: Vereshchaka Alexander L. , Kulagin Dmitry N. , Lunina Anastasia A.
Published: May 2018

The first comprehensive phylogenetic study of Euphausiacea (all 86 valid species) is presented. It is based on four molecular markers and 168 morphological characters (including 58 characters of the petasma). Phylogenetic analyses support the monophyly and robustness of the families Bentheuphausidae and Euphausiidae and reveal three major clades for which we erect three new subfamilies: Thysanopodinae, Euphausiinae and Nematoscelinae. All genus‐level clades are statistically supported (except Thysanopoda in molecular analyses), deeply nested within the subfamily‐level clades, and encompass 14 new species groups. Copulatory structures have a major impact on tree topology in the morphological analysis, the removal of which resulted in only half the number of supported clades and genera. We revealed three groups of morphological characters, which are probably coupled with the same biological role and thus interlinked evolutionarily: (i) antennular peduncle and petasma (copulation); (ii) eyes and anterior thoracopods (feeding); and (iii) shape of carapace and pleon (defence). We analysed the evolutionary pathways of the clades into main oceanic biotopes and compared them with morphological adaptations most likely to be coupled with this process.
Distribution and protection of climatic refugia in North America
Authors: Michalak Julia L. , Lawler Joshua J. , Roberts David R. , Carroll Carlos
Published: May 2018

As evidenced by past climatic refugia, locations projected to harbor remnants of present‐day climates may serve as critical refugia for current biodiversity in the face of modern climate change. We mapped potential climatic refugia in the future across North America, defined as locations with increasingly rare climatic conditions. We identified these locations by tracking projected changes in the size and distribution of climate analogs over time. We used biologically derived thresholds to define analogs and tested the impacts of dispersal limitation with 4 distances to limit analog searches. We identified at most 12% of North America as potential climatic refugia. Refugia extent varied depending on the analog threshold, dispersal distance, and climate projection. However, in all cases refugia were concentrated at high elevations and in topographically complex regions. Refugia identified using different climate projections were largely nested, suggesting that identified refugia were relatively robust to climate‐projection selection. Existing conservation areas cover approximately 10% of North America and yet protected up to 25% of identified refugia, indicating that protected areas disproportionately include refugia. Refugia located at lower latitudes (≤40°N) and slightly lower elevations (approximately 2500 m) were more likely to be unprotected. Based on our results, a 23% expansion of the protected‐area network would be sufficient to protect the refugia present under all 3 climate projections we explored. We believe these refugia are high conservation priorities due to their potential to harbor rare species in the future. However, these locations are simultaneously highly vulnerable to climate change over the long term. These refugia contracted substantially between the 2050s and the 2080s, which supports the idea that the pace of climate change will strongly determine the availability and effectiveness of refugia for protecting today's biodiversity.
Heart transplant outcomes in patients with Chagas cardiomyopathy in the United States
Authors: Benatti Rodolfo D. , Al‐Kindi Sadeer G. , Bacal Fernando , Oliveira Guilherme H.
Published: May 2018

Background

Chagas cardiomyopathy (CC) is one of the chronic manifestations of Trypanosoma cruzi (T. cruzi) infection and is among the leading reasons for heart transplantation (HT) in Latin America. Chagas disease is also present in areas with large Hispanic communities in the United States. Our objective is to evaluate the outcomes of cardiac allograft recipients with the diagnosis of CC in the United States.

Methods and Results

We identified 25 adult patients with CC and 15 930 with idiopathic dilated cardiomyopathy (IDCMP) who underwent HT between 1987 and 2015. CC patients were mostly Hispanics, had lower mean pulmonary artery pressure (23 vs 29 mm Hg, P = .035) and lower BMI (24 vs 26, P = .007). Patients with CC were more likely to be supported with a total artificial heart (TAH) as bridge to transplant (P = .009). There were no statistical differences for overall mortality and graft survival between CC and IDCMP cardiac allograft recipients. Induction therapy and mycophenolate mofetil (MMF) use were associated with higher rate of infection in Chagas patients.

Conclusions

Heart transplantation recipients with CC diagnosis appear to have similar outcomes to IDCMP patients. Induction therapy and MMF use may be associated with higher risk of infection in CC patients who underwent transplantation.
Atypical cellular neurothekeoma: A potential diagnostic pitfall for benign and malignant spindle cell lesions in skin
Authors: Tran Patrick , McLemore Michael
Published: May 2018

Cellular neurothekeomas (CNTs) are rare, benign cutaneous tumors that arise primarily on the head and neck, with a slight female predominance. CNTs with atypical features have been described, including those with an infiltrative growth pattern. Although CNTs with atypical features are benign, recognition of this entity can pose diagnostic challenges. Here, we report a case of CNT with an unusual clinical presentation on the left second digit, and with atypical histological features including an infiltrative growth pattern, which could have been mistaken for features of malignancy.
An overview of take‐home naloxone programs in Australia
Authors: Dwyer Robyn , Olsen Anna , Fowlie Carrie , Gough Chris , van Beek Ingrid , Jauncey Marianne , Lintzeris Nicholas , Oh Grace , Dicka Jane , Fry Craig L. , Hayllar Jeremy , Lenton Simon
Published: May 2018

Introduction and Aims

Take‐home naloxone (THN) programs commenced in Australia in 2012 in the Australian Capital Territory and programs now operate in five Australian jurisdictions. The purpose of this paper is to record the progress of THN programs in Australia, to provide a resource for others wanting to start THN projects, and provide a tool for policy makers and others considering expansion of THN programs in this country and elsewhere.

Design and Methods

Key stakeholders with principal responsibility for identified THN programs operating in Australia provided descriptions of program development, implementation and characteristics. Short summaries of known THN programs from each jurisdiction are provided along with a table detailing program characteristics and outcomes.

Results

Data collected across current Australian THN programs suggest that to date over 2500 Australians at risk of overdose have been trained and provided naloxone. Evaluation data from four programs recorded 146 overdose reversals involving naloxone that was given by THN participants.

Discussion and Conclusions

Peer drug user groups currently play a central role in the development, delivery and scale‐up of THN in Australia. Health professionals who work with people who use illicit opioids are increasingly taking part as alcohol and other drug‐related health agencies have recognised the opportunity for THN provision through interactions with their clients. Australia has made rapid progress in removing regulatory barriers to naloxone since the initiation of the first THN program in 2012. However, logistical and economic barriers remain and further work is needed to expand access to this life‐saving medication.
Implications of the International Paediatric Multiple Sclerosis Study Group consensus criteria for paediatric acute disseminated encephalomyelitis: a nationwide validation study
Authors: Boesen Magnus S , Blinkenberg Morten , Koch‐Henriksen Nils , Thygesen Lau C , Uldall Peter V , Magyari Melinda , Born Alfred P
Published: May 2018

Aim

The International Paediatric Multiple Sclerosis Study Group (IPMSSG) has proposed criteria for acute disseminated encephalomyelitis (ADEM) not evaluated in clinical practice. Our objective was to assess epidemiological implications of the IPMSSG criteria for ADEM in a cohort study using prospectively collected data.

Method

We identified all diagnosed cases of ADEM in Denmark between 2008 and 2015 from the Danish National Patient Register by International Classification of Diseases 10 codes assigned to acute demyelinating episodes, and we reviewed all medical records to validate ADEM.

Results

We found 52 children up to the age of 18 years with a verified clinical diagnosis of ADEM (incidence rate 0.54/100 000 person‐years; all had abnormal brain magnetic resonance imaging). Only 18 (35%) fulfilled the IPMSSG criteria regarding encephalopathy and polyfocal neurological deficits. Among all 52 children with ADEM, 33 per cent had clinical sequelae after a median follow‐up of 4 years 6 months (range: 10mo–8y 3mo). Surprisingly, none progressed to multiphasic ADEM or multiple sclerosis, but median age at end of follow‐up was only 10 years 9 months (range: 2y–24y 3mo).

Interpretation

Among 52 children with ADEM, none converted to multiphasic ADEM or multiple sclerosis (median follow‐up: 4y 6mo; range: 10mo–8y 3mo). Applying the IPMSSG criteria to all children with a diagnosis of ADEM leaves 65 per cent of the cases without a diagnosis and lowers the incidence rate of paediatric ADEM.

What this paper adds

The incidence of paediatric acute disseminated encephalomyelitis (ADEM) was 0.54 per 100 000 person‐years in children younger than 18 years.

Only 35 per cent of children with ADEM fulfilled the International Paediatric Study Group consensus criteria.

ADEM in clinical practice was primarily based on magnetic resonance imaging findings.

Paediatric neurologists diagnosed ADEM in the absence of encephalopathy.

None of the children with ADEM progressed to multiple sclerosis/multiphasic ADEM during follow‐up.
Helicobacter pylori shows asymmetric and polar cell divisome assembly associated with DNA replisome
Authors: Kamran Mohammad , Dubey Priyanka , Verma Vijay , Dasgupta Santanu , Dhar Suman K.
Published: May 2018

DNA replication and cell division are two fundamental processes in the life cycle of a cell. The majority of prokaryotic cells undergo division by means of binary fission in coordination with replication of the genome. Both processes, but especially their coordination, are poorly understood in Helicobacter pylori. Here, we studied the cell divisome assembly and the subsequent processes of membrane and peptidoglycan synthesis in the bacterium. To our surprise, we found the cell divisome assembly to be polar, which was well‐corroborated by the asymmetric membrane and peptidoglycan synthesis at the poles. The divisome components showed its assembly to be synchronous with that of the replisome and the two remained associated throughout the cell cycle, demonstrating a tight coordination among chromosome replication, segregation and cell division in H. pylori. To our knowledge, this is the first report where both DNA replication and cell division along with their possible association have been demonstrated for this pathogenic bacterium.
Where do we diagnose HIV infection? Monitoring new diagnoses made in nontraditional settings in England, Wales and Northern Ireland
Authors: Croxford S , Yin Z , Kall M , Burns F , Simmons R , Copas A , Ireland G , Kirwan P , Chau C , Delpech V
Published: May 2018

Objectives

The objectives of the study were to describe 10‐year trends in HIV diagnosis setting and to explore predictors of being diagnosed outside a sexual health clinic (SHC).

Methods

Analyses of national HIV surveillance data were restricted to adults (aged ≥ 15 years) diagnosed in 2005–2014 in England, Wales and Northern Ireland. Logistic regression identified factors associated with diagnosis outside an SHC (2011–2014).

Results

Between 2005 and 2014, 63 599 adults were newly diagnosed with HIV infection; 83% had a diagnosis setting reported. Most people were diagnosed in SHCs (69%) followed by: medical admissions/accident and emergency (A&E; 8.6%), general practice (6.4%), antenatal services (5.5%), out‐patient services (3.6%), infectious disease units (2.7%) and other settings (4.0%). The proportion of people diagnosed outside SHCs increased from 2005 to 2014, overall (from 27% to 32%, respectively) and among men who have sex with men (MSM) (from 14% to 21%) and black African men (from 25% to 37%) and women (from 39% to 52%) (all trend P < 0.001). Median CD4 increased across all settings, but was highest in SHCs (384 cells/μL) and lowest in medical admissions/A&E (94 cells/μL). Predictors of being diagnosed outside SHCs included: acquiring HIV through heterosexual contact [adjusted odds ratio (aOR) 1.99; 95% confidence interval (CI) 1.81–2.18] or injecting drug use (aOR: 3.28; 95% CI: 2.56–4.19; reference: MSM), being diagnosed late (< 350 cells/μL) (aOR: 2.55; 95% CI: 2.36–2.74; reference: diagnosed promptly) and being of older age at diagnosis (35–49 years: aOR: 1.60; 95% CI: 1.39–1.83; ≥ 50 years: aOR: 2.48; 95% CI: 2.13–2.88; reference: 15–24 years).

Conclusions

The proportion of HIV diagnoses made outside SHCs has increased over the past decade in line with evolving HIV testing guidelines. However, the rate of late diagnosis remains high, indicating that further expansion of testing is necessary, as many people may have had missed opportunities for earlier diagnosis.