bluuebunny/crossref_metadata_2025 huggingface dataset:
Organizational learning ambidexterity and openness, as determinants of SMEs' innovation performance
Authors: Tian Hongyun , Dogbe Courage Simon Kofi , Pomegbe Wisdom Wise Kwabla , Sarsah Sampson Ato , Otoo Charles Oduro Acheampong
Published: April 2020

Purpose

SMEs could achieve their innovation goals, either through exploitation, exploratory, or ambidextrous learning strategies. This study presents ambidexterity as a more effective and efficient strategy that offers superior innovation advantage to SMEs. We also present the role of openness in this relationship.

Design/methodology/approach

Empirical analysis was based on 388 SMEs in Ghana. Various validity and reliability checks were conducted before the presentation of the actual analysis, which was conducted using Ordinary Least Squares approach, run using SPSS (v. 20).

Findings

Findings indicate that although exploitative and exploratory learning strategies individually had a positive significant effect on SMEs' innovation performance, organizational learning ambidexterity was found to have a greater positive impact on innovation performance among SMEs. High levels of openness further boosted the effect of organizational learning ambidexterity on SMEs’ innovation performance.

Research limitations/implications

This study was conducted without recourse to some specific factors that could influence organizational learning ambidexterity among SMEs. Future studies should thus pay particular attention to the determinants of organizational learning ambidexterity among SMEs.

Practical implications

Innovation performance is very critical for the sustainability of firms, and SMEs in particular. Management of SMEs must therefore seek to simultaneously adopt both learning strategies, as that gives firms greater advantage, compared to the adoption of only one strategy.

Originality/value

The study demonstrates that organizational learning ambidexterity had a superior effect on SMEs' innovation performance. High levels of openness further boosted the effect of organizational learning ambidexterity on SMEs' innovation performance.
Towards innovative work behavior through knowledge management infrastructure capabilities
Authors: Anser Muhammad Khalid , Yousaf Zahid , Khan Adnan , Usman Muhammad
Published: April 2020

Purpose

This study proposed a model based on knowledge management infrastructure capabilities (KMICs) to explore that how functional flexibility (FF) and knowledge sharing (KS) plays a mediating role between KMIC and innovative work behavior (IWB) among production-line workers.

Design/methodology/approach

Data were collected from 894 workers through self-administered questionnaires from manufacturing businesses. The outcomes of the study revealed that KMIC has a significant and positive relationship with IWB. Second, FF and KS fully mediate between KMIC and IWB. Finally, the moderating role of KS between KMIC and FF was also supported by this study.

Findings

This study offers the empirical evidence on how to flourish the mechanism of FF and KS in manufacturing concerns. Additionally, some facts are also highlighted by this study that should be eloquent options for HR managers to understand the nexus of KMIC, KS and FF for enhancing the IWB among production-line workers. Moreover, this study contributed to noteworthy inferences for management by focusing on KMIC as a fundamental organizational level factor for IWB via KS and FF.

Originality/value

This is the first study in the which emphasis on KMIC for explaining IWB through employee FF and KS in settings such as manufacturing concern where the implementation of new working methods is necessary.
Dual-MRT lattice Boltzmann method combined with experimental measurements of nanofluid’s properties for analysis of fin-orientation effect on natural convection heat transfer
Authors: Wang Xiaodong , Ross David
Published: April 2020

Purpose

Natural convection heat transfer during free convection phenomenon in a cavity included with active fins and pipes is investigated. The influence of the orientation of fins on the heat transfer between heat source (i.e. hot fins) and heat sink (i.e. cold pipes) is investigated by using numerical and experimental techniques.

Design/methodology/approach

For the numerical simulations, the multiple relaxation time (MRT) thermal lattice Boltzmann method (LBM) is used. In this numerical approach, two separated distribution functions are used to solve the flow and temperature distributions within the computational domain. Furthermore, the local/volumetric second law analysis is used to show the impact of evaluated parameters on the heat transfer irreversibility. In addition, the dynamic viscosity and thermal conductivity of TiO2-water nanofluid are measured by using Brookfield viscometer and KD2 pro conductmeter, respectively.

Findings

The examined range of Rayleigh number is from 103 to 106, and the nanofluid samples are provided in 0, 20, 40, 60, 80 and 100 ppm.

Originality/value

The originality of this work is use of dual-MRT thermal LBM and experimental measurements of rheological/thermal properties of nanofluid for investigation of free convection problem for the considered application.
Development of renewable energy in the GCC region: status and challenges
Authors: Salim Abdalla Mahmoud , Alsyouf Imad
Published: April 2020

Purpose

The purpose of this paper is to assess the potential of renewable energy as an essential future energy source in the Gulf Cooperation Council (GCC) region. This paper summarizes the main projects and measures established to start the transition toward renewable energy. The opportunities and challenges for developing renewable energy projects have been discussed to reach a better understanding of the future of renewable energy in the region.

Design/methodology/approach

The paper provides a literature-based study on the status of the renewable energy sector in the GCC, including potentials, projects, targets and strategies. The opportunities and challenges of the development of renewable energy sources in the GCC region have been discussed based on the literature.

Findings

The paper shows that the GCC countries have begun to adopt a more proactive approach toward renewable energy, while the reorientation of strategies and plans for renewable energy is evolving in these countries. All of the GCC countries focus on solar and wind energies and plan to invest in waste-to-energy (WtE), while only Saudi Arabia is interested in going for geothermal.

Originality/value

The paper contributes to the provision of an extensive literature review on the development of renewable energy in the GCC countries. It provides an updated and comprehensive overview of the region’s renewable energy potential and highlights the main renewable energy strategies and targets. This paper targets regional decision-makers as well as multilateral stakeholders to formulate a set of recommendations to promote renewable energy deployment and improve industrial capabilities.
Reducing referral leakage: an analysis of health-care referrals in a service ecosystem
Authors: O’Connor Genevieve Elizabeth , Cook Laurel Aynne
Published: April 2020

Purpose

The purpose of this paper is to address a critical problem for health-care organizations: patient referral leakage. This paper explores the nature of patient referrals by examining how health-care providers’ breadth and depth of connectivity within a hospital network and identification with each other influence the likelihood of future patient referrals.

Design/methodology/approach

The data was collected by using a multi-sourced data set from the health-care industry. The proposed model was tested by using logistic regression to determine the likelihood of a primary care physician’s (PCP) referral to a specialist within a hospital network.

Findings

A model linking provider connectivity to examine co-creation practices in the form of patient referrals is tested. Results indicate that patient referrals are multidimensional. A PCP’s likelihood to refer to a specialist within the hospital network is influenced by the breadth and depth of connectivity of each provider.

Research limitations/implications

This investigation extends service ecosystems to patients, health-care providers and hospital organizations, making it the first to explore how different degrees of connectivity (breadth of referral partners and depth of exchange) between and among health-care providers influence the likelihood of future patient referrals. Findings complement extant literature on service ecosystems by empirically showing that provider relationships are interdependent and rely on the mutual coordination of benefits within the entire health-care organization and network.

Practical implications

Managers and health-care professionals can use the framework to build and strengthen relational ties/alliances within a service organization. An ecosystems perspective reduces patient referral leakage through enhanced organizational performance, competitive advantage and continuity of care.

Originality/value

The authors offer a novel view of referral relationships using hard-to-access proprietary data. Moreover, this study responds to the need for transformative service research by offering service researchers and policymakers a means to enhance consumer well-being. The main contribution of this study is a framework to gain a better understanding of patient referral relationships between employees (i.e., health-care providers) in an organization, thereby affording an opportunity to bolster operational efficiencies, improve clinical outcomes and strengthen referral pathways. By viewing health-care networks through a service ecosystems perspective, contextual boundaries and the relative power of relationships are also identified. The novel use of rarely available hospital data in this setting helps explain how patient leakage compromises the health of the ecosystem and its members.
Wellness tourism: a perspective article
Authors: Kazakov Sergey , Oyner Olga
Published: April 2020

Purpose

This paper aims to examine the development and significant contributions in a growing array of relevant publications spanning from 1946 to date and discuss future developments of the wellness tourism topic until the year 2095.

Design/methodology/approach

This perspective study traces down the wellness tourism evolution research by re-viewing and analysing an extant body of the relevant literature over the last 75 years. This paper builds a rigorous perspective review by examination of publications derived from several scientific domains, including tourism, medicine, economics and social sciences.

Findings

As a result of this study, wellness tourism can be attributed as a profuse and proliferating research stream in the recent 75 years. Its relevance to significant aspects of life, such as health and also due to effects on human, social, and economic well-being, drives its proliferation. The paper anticipates the relevance and topicality of wellness tourism studies for academic research in the next 75 years.

Originality/value

This paper contributes to the theory by addressing the ambiguous nature of wellness tourism, recapping the debate on the most debated research questions, and revealing the perspectives for future research in this area.
Farm Size, Technology Adoption and Agricultural Trade Reform: Evidence from Canada
Authors: Brown W. Mark , Ferguson Shon M. , Viju‐Miljusevic Crina
Published: April 2020

Using detailed census data covering over 30,000 farms in Alberta, Saskatchewan and Manitoba, Canada, we document the vast and increasing farm size heterogeneity, and analyse the role of farm size in adapting to the removal of an export subsidy in 1995. Consistent with the Alchian‐Allen hypothesis, the increase in per‐unit trade costs due to the reform was associated with farms of all sizes shifting their production of crops from low value wheat to higher value canola. We find that switching to new labour‐saving tillage technologies and away from summerfallow in response to the large negative shock to grain prices caused by the reform varied across the farm size distribution. We develop a theory of heterogenous farms and technology adoption that can explain our findings.
Opportunistic bowel infection after corticosteroid dosage tapering in a stage IV lung cancer patient with tislelizumab‐related colitis
Authors: Ni Jun , Zhang Xiaotong , Zhang Li
Published: April 2020

Immune checkpoint inhibitors, the new standard in cancer therapy, present durable responses in numerous solid tumors and hematologic malignancies, as well as resulting in an increased incidence of immune‐related adverse events (irAEs). Diarrhea is a common irAE, with an incidence rate of approximately 10% to 13%. It is important to distinguish between diarrhea symptomatic of an infection, which is the main differential diagnosis, and immune‐related diarrhea. Here, we report a case of an advanced lung cancer patient who presented with diarrhea as a result of treatment with tislelizumab, a novel PD‐1 inhibitor. Although the patient initially responded to corticosteroid treatment, diarrhea recurred upon dosage tapering, and eventually improved on treatment with ganciclovir and vancomycin. Therefore, clinicians must remain highly vigilant against infection and carefully distinguish symptoms of infection from irAEs by performing repeated blood or fecal examinations for pathogens, colonoscopy, and biopsy.
Comparison of short‐term outcomes following minimally invasive versus open Sweet esophagectomy for Siewert type II adenocarcinoma of the esophagogastric junction
Authors: Sun Xiaohui , Wang Gaoxiang , Liu Changqing , Xiong Ran , Wu Hanran , Xie Mingran , Xu Shibin
Published: April 2020

Background

Surgical resection is still the main treatment option for patients with resectable Siewert type II adenocarcinoma of the esophagogastric junction (AEG). This retrospective study evaluated the significance of minimally invasive Sweet esophagectomy (MISE) for the treatment of Siewert type II AEG.

Methods

We retrospectively evaluated 174 patients with Siewert type II AEG who received a Sweet esophagectomy in our center between October 2013 and September 2017. Of these patients, 73 underwent MISE and 101 underwent open Sweet esophagectomy (OSE). The clinicopathologic factors, operational factors and postoperative complications were compared.

Results

The two groups were similar in terms of age, sex, American Society of Anesthesiologists grade, preoperative staging and incidence of comorbidities (P > 0.05). Relative to the OSE approach, the MISE approach was associated with a significant decrease in surgical blood loss (P < 0.001), chest tube duration (P = 0.003) and postoperative admission duration (P = 0.002). The minimally invasive approach was associated with significantly less total morbidity and fewer respiratory complications than the open approach (P = 0.015 and P = 0.016, respectively). Relative to the open approach, the MISE approach was associated with a significant increase in the number of total lymph nodes removed and the locations of the total lymph nodes removed (P < 0.001 and P < 0.001, respectively).

Conclusions

Our MISE technique can be safely and effectively performed for intrathoracic anastomosis with favorable early outcomes.
Status of mammals on Groote Eylandt: Safe haven or slow burn?
Authors: Heiniger Jaime , Davies Hugh F , Gillespie Graeme R.
Published: April 2020

Native mammals across northern Australia have suffered severe decline, with feral cats (Felis catus), introduced herbivores and changed fire regimes being implicated as drivers. However, uncertainty surrounding the relative contribution of each of these threats, and the interactions between them, is limiting the development of effective management strategies. The absence of introduced herbivores and cane toads (Rhinella marina) on Groote Eylandt, Northern Territory, provides an opportunity to evaluate some hypothesised threats in isolation of others. We used camera traps to investigate the correlates of native mammal distribution and abundance at 112 lowland savanna sites across Groote Eylandt. Two large grids of camera traps were also deployed to obtain estimates of feral cat density. We hypothesised that native mammal populations would be negatively associated with feral cat occupancy as well as frequent, large fires. Native mammal site‐occupancy on Groote Eylandt was generally higher compared to mainland Northern Territory. Feral cats were infrequently detected, precluding both an estimate of feral cat density and an evaluation of the relationship between feral cats and native mammals. We found no evidence that native mammal site‐occupancy or relative abundance is negatively associated with frequent, large fires. The relatively healthy state of native mammal populations on Groote Eylandt is likely due to the low density of feral cats, the benign fire regime and the absence of large introduced herbivores and cane toads. However, due to a lack of historical data, the current state of mammals should not be taken as evidence that these populations are safe from decline. This study highlights that the apparent resilience of mammal populations is a result of complex interactions between factors that vary substantially across the landscape. Caution is therefore required when making broad inferences about the drivers of mammal decline from studies that are spatially and temporally limited.
The Market Gardens of Dark Dragon Ridge, New South Wales, Australia, 1876–1930
Authors: Gibson Peter
Published: April 2020

Long neglected within Eurocentric histories of Australian agriculture, a clearer view of Chinese market gardening in Australia has been emerging over recent decades. As a contribution to this ongoing work, this paper explores Chinese market gardens in Wollongong (known as Dark Dragon Ridge in Chinese), 70 km south of Sydney, between 1876 and 1930. Using a microhistorical framework with an emphasis on business and labour, and guided chiefly by gardeners' own accounts of their activities, I offer new insights into Chinese market gardening. This approach can, I conclude, markedly enhance understanding of this aspect of Australia's past.
Parent‐related factors influencing antibiotic use in a paediatric population: A qualitative study in Spain
Authors: Souto‐López Laura , Vazquez‐Cancela Olalla , Vazquez‐Lago Juan M. , López‐Durán Ana , Figueiras Adolfo
Published: April 2020

Aim

To explore the parent‐related factors underlying antibiotic misuse/overuse and their implication in the development of resistance in the paediatric population.

Methods

Qualitative study using the focus group (FG) method in Galicia (Spain). FG sessions were conducted with the parents, 27 mothers and three fathers, of children under 12 years old. A discussion topic guide was developed to lead the sessions, which were then transcribed by the researcher and independently interpreted by two researchers working separately. The grounded theory approach was used.

Results

Five FG sessions were conducted. The principal factor detected among parents was fear, associated with the perception of poor parent‐paediatrician communication. This factor was related to the following behaviours: (a) pressure on physicians; (b) lack of adherence to treatment; and (c) search for other ways of accessing antibiotics. No group highlighted antibiotic resistance as posing a real problem. All groups considered certain external agents to be responsible for such resistance. Four groups also acknowledged that patient behaviour can influence antibiotic resistance.

Conclusion

Our study points to poor communication between the healthcare system and the population. Identifying the factors underlying the problem enables more efficient, tailor‐made interventions to be designed for the purpose of improving antibiotic use and resistance.
Patterns and clinical correlates of lifetime alcohol consumption in women and men with bipolar disorder: Findings from the UK Bipolar Disorder Research Network
Authors: Gordon‐Smith Katherine , Lewis Katie J. S. , Vallejo Auñón Fransico M. , Di Florio Arianna , Perry Amy , Craddock Nick , Jones Ian , Jones Lisa
Published: April 2020

Objectives

Despite previous literature on comorbid alcohol use disorders (AUDs) in bipolar disorder (BD), little is known about patterns of alcohol use more widely in this population. We have examined lifetime heaviest average weekly alcohol consumption levels in a large well‐characterised UK sample including lifetime clinical correlates of increasing levels of alcohol use.

Methods

Participants were 1203 women and 673 men with bipolar I disorder interviewed by semi‐structured interview who had consumed alcohol regularly at any point in their life.

Results

Over half of both women (52.3%) and men (73.6%) had regularly consumed over double the current UK recommended guideline for alcohol consumption. In women and men increasing levels of lifetime alcohol consumption were significantly associated with the presence of suicide attempts (women: OR 1.82, P < .001; men: OR 1.48, P = .005) and rapid cycling (women: OR 1.89, P < .001; men: OR 1.88, P < .001). In women only, increasing levels of alcohol consumption were significantly associated with more episodes of depression (OR 1.35, P < .001) and mania (OR 1.30, P < .004) per illness year, less impairment in functioning during the worst episode of mania (OR 1.02, P < .001), fewer psychiatric admissions (OR 0.51, P < .001), comorbid panic disorder (OR 2.16, P < .001) and eating disorder (OR 2.37, P < .001).

Conclusions

Our results highlight the clinical importance of obtaining detailed information on levels of alcohol consumption among patients with BD. Increased levels of alcohol use, not necessarily reaching criteria for AUD, may be helpful in predicting BD illness course, in particular eating disorders comorbidity in women.
Applicability and reproducibility of acute myeloid leukaemia stem cell assessment in a multi‐centre setting
Authors: Hanekamp Diana , Snel Alexander N. , Kelder Angèle , Scholten Willemijn J. , Khan Naeem , Metzner Marlen , Irno‐Consalvo Maria , Sugita Mayumi , de Jong Anja , Oude Alink Sjoerd , Eidhof Harrie , Wilhelm Miriam , Feuring‐Buske Michaela , Slomp Jennichjen , van der Velden Vincent H. J. , Sonneveld Edwin , Guzman Monica , Roboz Gail J. , Buccisano Francesco , Vyas Paresh , Freeman Sylvie , Bachas Costa , Ossenkoppele Gert J. , Schuurhuis Gerrit J. , Cloos Jacqueline
Published: April 2020

Leukaemic stem cells (LSC) have been experimentally defined as the leukaemia‐propagating population and are thought to be the cellular reservoir of relapse in acute myeloid leukaemia (AML). Therefore, LSC measurements are warranted to facilitate accurate risk stratification. Previously, we published the composition of a one‐tube flow cytometric assay, characterised by the presence of 13 important membrane markers for LSC detection. Here we present the validation experiments of the assay in several large AML research centres, both in Europe and the United States. Variability within instruments and sample processing showed high correlations between different instruments (Rpearson > 0·91, P < 0·001). Multi‐centre testing introduced variation in reported LSC percentages but was found to be below the clinical relevant threshold. Clear gating protocols resulted in all laboratories being able to perform LSC assessment of the validation set. Participating centres were nearly unanimously able to distinguish LSChigh (>0·03% LSC) from LSClow (<0·03% LSC) despite inter‐laboratory variation in reported LSC percentages. This study proves that the LSC assay is highly reproducible. These results together with the high prognostic impact of LSC load at diagnosis in AML patients render the one‐tube LSC assessment a good marker for future risk classification.
Pathology, diagnostics, and classification of medulloblastoma
Authors: Orr Brent A.
Published: April 2020

Medulloblastoma (MB) is the most common CNS embryonal tumor. While the overall cure rate is around 70%, patients with high‐risk disease continue to have poor outcome and experience long‐term morbidity. MB is among the tumors for which diagnosis, risk stratification, and clinical management has shown the most rapid advancement. These advances are largely due to technological improvements in diagnosis and risk stratification which now integrate histomorphologic classification and molecular classification. MB stands as a prototype for other solid tumors in how to effectively integrate morphology and genomic data to stratify clinicopathologic risk and aid design of innovative clinical trials for precision medicine. This review explores the current diagnostic and classification of MB in modern neuropathology laboratories.
Tectono‐sedimentary evolution of Jurassic–Cretaceous diapiric structures: Miravete anticline, Maestrat Basin, Spain
Authors: Vergés Jaume , Poprawski Yohann , Almar Ylènia , Drzewiecki Peter A. , Moragas Mar , Bover‐Arnal Telm , Macchiavelli Chiara , Wright Wayne , Messager Grégoire , Embry Jean‐Christophe , Hunt David
Published: April 2020

Integration of extensive fieldwork, remote sensing mapping and 3D models from high‐quality drone photographs relates tectonics and sedimentation to define the Jurassic–early Albian diapiric evolution of the N–S Miravete anticline, the NW‐SE Castel de Cabra anticline and the NW‐SE Cañada Vellida ridge in the Maestrat Basin (Iberian Ranges, Spain). The pre shortening diapiric structures are defined by well‐exposed and unambiguous halokinetic geometries such as hooks and flaps, salt walls and collapse normal faults. These were developed on Triassic salt‐bearing deposits, previously misinterpreted because they were hidden and overprinted by the Alpine shortening. The Miravete anticline grew during the Jurassic and Early Cretaceous and was rejuvenated during Cenozoic shortening. Its evolution is separated into four halokinetic stages, including the latest Alpine compression. Regionally, the well‐exposed Castel de Cabra salt anticline and Cañada Vellida salt wall confirm the widespread Jurassic and Early Cretaceous diapiric evolution of the Maestrat Basin. The NE flank of the Cañada Vellida salt wall is characterized by hook patterns and by a 500‐m‐long thin Upper Jurassic carbonates defining an upturned flap, inferred as the roof of the salt wall before NE‐directed salt extrusion. A regional E‐W cross section through the Ababuj, Miravete and Cañada‐Benatanduz anticlines shows typical geometries of salt‐related rift basins, partly decoupled from basement faults. These structures could form a broader diapiric region still to be investigated. In this section, the Camarillas and Fortanete minibasins displayed well‐developed bowl geometries at the onset of shortening. The most active period of diapiric growth in the Maestrat Basin occurred during the Early Cretaceous, which is also recorded in the Eastern Betics, Asturias and Basque‐Cantabrian basins. This period coincides with the peak of eastward drift of the Iberian microplate, with speeds of 20 mm/year. The transtensional regime is interpreted to have played a role in diapiric development.
Leave it in the ground? Oil sands development under carbon pricing
Authors: Bošković Branko , Leach Andrew
Published: April 2020

We evaluate the impact of internalizing the carbon emissions externality on new oil sands projects. Using data from recent oil sands projects and estimates of both the social costs of carbon and carbon prices consistent with meeting global climate change targets, we estimate the potential impact of action on climate change on the economic viability of oil sands investments. Our results indicate that oil sands are a marginal resource before they incur any carbon costs. Incorporating carbon costs, we find that the viability of oil sands depends on the coverage of carbon pricing across the life cycle emissions from oil sands and on the equilibrium incidence of carbon prices on producers. We show an important interaction between resource royalties and carbon charges that implies that the impact carbon pricing depends on not only the stringency and coverage of the carbon price but also its point of application of a carbon price. Finally, we explore the potential for technological change to mitigate the impacts of carbon pricing on oil sands investment viability.
Alcohol labelling rules in free trade agreements: Advancing the industry's interests at the expense of the public's health
Authors: Gleeson Deborah , O'Brien Paula
Published: April 2020

Introduction and Aims

The Trans‐Pacific Partnership Agreement (TPP) included novel rules for wine and spirits requiring parties to allow wine and spirits importers to display information required by the importing country on a supplementary label rather than on the standard label. Since the TPP negotiations concluded, alcohol‐specific supplementary labelling rules have begun to appear in other trade agreements. The aim of this paper was to map the new instruments containing these rules and examine developments in the rules with implications for health information on alcohol containers.

Design and Methods

Trade agreements signed after the TPP negotiations concluded were retrieved and searched for alcohol‐specific labelling provisions. A legal analysis of these provisions and related exceptions was undertaken.

Results

Supplementary labelling rules similar or identical to those in the TPP have been included in five subsequent trade agreements. The United States–Mexico–Canada Agreement also includes several additional provisions about alcohol labelling. Exceptions in the agreements provide some space for governments to defend labelling measure that might otherwise breach the rules, in the event of a dispute.

Discussion and Conclusions

By securing these rules, the alcohol industry is better positioned to claim the space on the standard label as industry ‘real estate’ and to oppose mandatory health information incorporated into the standard labelling. These risks can be mitigated by stemming the adoption of supplementary labelling rules in further trade agreements; clarifying the text of agreements and ensuring that regulators understand that the rules do not prevent the use of ‘best‐practice’ warning labels.
Safety of dapagliflozin in a broad population of patients with type 2 diabetes: Analyses from the DECLARE‐TIMI 58 study
Authors: Cahn Avivit , Raz Itamar , Bonaca Marc , Mosenzon Ofri , Murphy Sabina A. , Yanuv Ilan , Rozenberg Aliza , Wilding John P. H. , Bhatt Deepak L. , McGuire Darren K. , Gause‐Nilsson Ingrid A. M. , Fredriksson Martin , Johansson Peter A. , Jermendy Gyorgy , Hadjadj Samy , Langkilde Anna Maria , Sabatine Marc S. , Wiviott Stephen D. , Leiter Lawrence A.
Published: April 2020

Aims

To evaluate comprehensively the safety of dapagliflozin in patients with type 2 diabetes (T2DM), with emphasis placed on potential safety concerns related to the sodium‐glucose co‐transporter‐2 inhibitor class.

Methods

In the Dapagliflozin Effect on Cardiovascular Events – Thrombolysis in Myocardial Infarction 58 (DECLARE‐TIMI 58) study, 17 160 patients with T2DM were randomized to dapagliflozin or placebo and followed for a median of 4.2 years. Safety was evaluated in 17 143 patients receiving at least one dose of study drug.

Results

Acute kidney injury occurred less frequently with dapagliflozin, and adverse events suggestive of volume depletion were balanced between treatment groups, both irrespective of baseline estimated glomerular filtration rate, blood pressure, diuretic or loop diuretic use (interaction P values >0.05). Fractures and malignancies were balanced between the groups, irrespective of sex, diabetes duration or smoking (interaction P values >0.05) and fewer cases of bladder cancer occurred in the dapagliflozin versus the placebo group. Diabetic ketoacidosis was very rare, but more frequent with dapagliflozin versus placebo (27 vs. 12 patients with events; P = 0.02), yet signs, symptoms and contributing factors were similar in the two groups. Major hypoglycaemia occurred less frequently with dapagliflozin versus placebo, regardless of baseline use of either insulin or sulphonylureas (interaction P values >0.05). There were more adverse events of genital infections leading to discontinuation of study drug in the dapagliflozin versus the placebo group, but serious genital infections were few and balanced between treatment groups. Urinary tract infections, acute pyelonephritis and urosepsis were also balanced between treatment groups.

Conclusions

Dapagliflozin was well tolerated. The long duration and large number of patient‐years in DECLARE‐TIMI 58 comprehensively addressed previous safety questions, confirming the robust safety profile of dapagliflozin.
Why are Fiscal Multipliers Asymmetric? The Role of Credit Constraints
Authors: McManus Richard , Gulcin Ozkan F. , Trzeciakiewicz Dawid
Published: April 2020

Recent empirical evidence strongly points to the state dependence of fiscal multipliers that are larger in recessions than in expansions. Yet standard business cycle models face great difficulty in producing such asymmetric fiscal policy effects. By incorporating endogenously binding collateral constraints into a medium scale dynamic stochastic general equilibrium model, we find that fiscal effectiveness can vary substantially across the business cycle. The key to our framework is the state‐dependent nature of collateral constraints—binding in bad times while slack in good times, amplifying the effectiveness of fiscal policy and hence generating fiscal multipliers that are larger during recessions.
Impact of global longitudinal strain on left ventricular remodeling and clinical outcome in patients with ST‐segment elevation myocardial infarction (STEMI)
Authors: Tawfik Wael , El‐Sherif Amr , Bendary Ahmed , Mahros Mohammed , Salem Mohamed
Published: April 2020

Background

Predicting left ventricle (LV) remodeling is important for outcome prediction in patients with ST‐segment elevation myocardial infarction (STEMI). Novel echocardiographic techniques may be beneficial for those patients.

Objectives

We hypothesized that the semiautomated calculation of baseline global longitudinal strain (GLS) can predict LV remodeling and 6‐month clinical outcomes in these patients.

Methods

During the period from March to December 2018, 130 patients with successful reperfusion of STEMI were prospectively included. Within 48 hours, patients underwent a baseline GLS study with follow‐up study at 6 months. Patients were divided into two groups: group I: patients who showed adverse LV remodeling and group II: patients who did not. The endpoint was a composite of cardiovascular mortality, readmission due to heart failure, and urgent revascularization.

Results

The mean baseline GLS changed from −13.1 ± 3.5% for group I and −16.8 ± 3.1% for group II, to −10.2 ± 4.7% and −12.6 ± 3.1%, respectively, at 6‐month follow‐up. ROC analysis demonstrated a cutoff value of baseline GLS > −12.5% predicted LV remodeling with 64.5% sensitivity and 89% specificity (AUC 0.797, 95% CI 0.690‐0.904). Multivariate logistic regression analysis model using 6‐month MACEs occurrence as a dependent factor showed baseline GLS value> −12.5% to be the only significant independent predictor MACEs occurrence (OR 0.704, 95% CI 0.597‐0.829, P < .001). Linear regression analysis showed that for every point estimate deterioration of baseline GLS, there was a significant corresponding 2.55 mL increase in LVEDV at 6‐month follow‐up (CI −4.501 to −0.612, P = .01).

Conclusion

GLS measurement can predict remodeling and adverse clinical events in STEMI patients.
Benefits of living underground: the case of parasite release in the antlionMyrmeleon timidus
Authors: Gálvez Dumas , Garrido Milagro , Gil Fermín , Fernández‐Marín Hermógenes
Published: April 2020

The omnipresence of pathogens makes them a strong selective pressure for most organisms, generating a variety of defensive responses to fight them. One mechanism by which organisms can release this pressure is avoidance of the pathogens in a spatial or temporal context. To date, only a few biological systems provide evidence that habitat selection can favour an escape from pathogens. An abiotic factor that varies across habitats and influences the evolution of host life history is humidity, which correlates positively with pathogen levels in the environment. Entomopathogenic fungi are abundant in soils and are obligate killers that require humidity for host infection. Antlions (Neuroptera: Myrmeleontidae) are typical soil‐dwelling insects that can live several years as larvae, buried in dry and fine substrates where they build their traps. This lifestyle may release them from selective pressure by entomopathogenic fungi. Here, we investigated whether living underground provides protection against the generalist entomopathogenic fungusBeauveria bassiana(Bals.‐Criv.) Vuill. in the antlionMyrmeleon timidusGerstaecker under low or high humidity in the environment. Individuals that were inoculated with the fungus showed greater survival rates when buried in dry sand compared to individuals that were kept half‐buried or without sand, with similar outcomes across humidity levels. Given that the diversity of antlions is higher in arid environments, this benefit obtained from pit‐building behaviour seems to be a coincidental by‐product of this foraging strategy, which would be particularly beneficial in environments where fungal pathogens are common.
Effect of fermentation on immunological properties of allergens from black carp (Mylopharyngodon piceus) sausages
Authors: Zhu Yidan , Gao Ling , Xie Guojin , Yang Fang , Gao Pei , Yu Dawei , Yu Peipei , Jiang Qixing , Xu Yanshun , Xia Wenshui
Published: April 2020

The increased fish consumption correlates with increased hypersensitive reactions, which can reduce consumer's living quality. Therefore, the reduction by fish allergens by new technologies is important. The aim of this study was to evaluate the effect of different starter cultures, fermentation process and additives used in fermentation on immunological properties of fish allergens. The results showed that fermentation with Lactobacillus plantarum reduced the IgG‐ and IgE‐binding capacity (39.71 ± 6.18% and 76.12 ± 4.73%, respectively) the most, compared with Staphylococcus xylosus and Saccharomyces cerevisiae, and the reduction rate was the highest atthe end of fermentation and an incubation concentration at 1.5% (v/w). A change in the NaCl content affected immunological properties of fish allergenic proteins during fermentation, while a change in glucose had less impact. In conclusion, fermentation can be used to reduce the immunological propertis of fish allergens due to structural changes in proteins caused by enzymatic hydrolysis, acidity or ion strength.
Mesurer ce qui importe et éclairer l'action: l'indicateur de progrès véritable au banc d'essai
Authors: BERIK Günseli
Published: April 2020

L'indicateur de progrès véritable (IPV) a été conçu pour estimer les performances économiques, évaluer les effets des propositions politiques et aborder les préoccupations d'aujourd‘hui en matière de bien‐être, ce que ne permet pas le PIB. Actuellement, l'IPV apparaît comme un tableau de bord pour suivre l‘évolution des variables qui le composent, mais ne permet pas d'analyse transnationale. Il sera calculable selon une méthodologie normalisée lorsque certains problèmes de données auront été résolus et qu'un consensus sera réalisé sur l'IPV 2.0. Mais c'est surtout le manque de volonté politique et de soutien institutionnel qui fait principalement obstacle à la généralisation de son utilisation.
Tape casting and characterizations of MgO ceramics
Authors: Chen Ching‐Fong , Baker Timothy J. , Synowicki Ron , Tegtmeier Eric L. , Forsyth Robert T. , Bissell Ashley L. , Orlowski Alex G. , Christopher James M. , Savrun Ender
Published: April 2020

We report a high density MgO ceramic substrate produced by the tape casting technology. The tape casting formulation and process produced a uniform tape free of cracking. Y2O3 and SiO2 were used as the sintering aid for the pressureless sintering of the green tape. X‐ray diffraction phase identification indicates that MgO is the main phase, while both Y2O3 and SiO2 sintering aids react with MgO to form MgY4Si3O13 as the second phase. Liquid phase sintering occurs in the temperature range from 1030°C to ~1500°C, which is confirmed by the simultaneous Thermal Gravitation Analysis/Differential Scanning Calorimeter (TGA/DSC) and the percent linear shrinkage and densification. A 96.5% theoretical density was achieved by presureless sintering at 1650°C for 2 hours, which was further increased to a fully dense structure using hot‐isostatic‐pressing(HIP) at 1650°C and 207 MPa in argon. Scanning electron microscopy (SEM) and energy dispersive(EDS) spectroscopic analysis on the HIP’ed sample show that MgY4Si3O13is located at the MgO grain boundary and the sample has a fully dense structure. The refractive indices and extinction coefficient were measured on the HIP’ed sample along with thermal properties and dielectric properties. Thermal diffusivity and heat capacity were measured to calculate the thermal conductivity.
Habitat suitability modelling to predict the spatial distribution of cold‐water coral communities affected by the Deepwater Horizon oil spill
Authors: Georgian Samuel E. , Kramer Kody , Saunders Miles , Shedd William , Roberts Harry , Lewis Christopher , Fisher Chuck , Cordes Erik
Published: April 2020

Aim

The Deepwater Horizon disaster resulted in the largest accidental marine oil spill in history and caused extensive injury to deep‐sea habitats, including cold‐water coral communities dominated by Paramuricea species. One of the primary difficulties in assessing the full extent of the injury to cold‐water coral ecosystems is the extreme paucity of observational data and the subsequent lack of knowledge of their distribution within the affected region. The aim of this study was to use habitat suitability modelling to estimate the number of potentially affected Paramuricea sp. corals across the northern Gulf of Mexico.

Location

Northern Gulf of Mexico.

Taxon

Cold‐water corals in the genus Paramuricea.

Methods

High‐resolution (12.5 m) models were built using the maximum entropy (Maxent) approach using remotely sensed data including seafloor topography, seismic reflectivity, temperature and the amount of productivity exported from the surface. Model outputs were used to estimate the number of potential coral sites in the northern Gulf of Mexico, delineated as areas with both high habitat suitability scores and the presence of hard substrate. The number of coral sites was further adjusted using a ground‐truthing procedure using autonomous underwater vehicle‐transect data.

Results

Across the entire study area in the northern Gulf of Mexico, there were 558 predicted coral sites, covering an area of 14.2 km2. Within a 2,291 km2 region shown to have been directly affected by the spill and subsequent oil plume, there were 66 predicted coral sites covering an area of 1.2 km2 with an average of 63 corals per site.

Main Conclusions

Our results indicate that the magnitude of injury stemming from the spill was likely far higher than previously known, and will help quantify the full extent of the losses incurred as well as prioritize disturbed areas for future research and restoration efforts.
Discordant phylogenetic endemism patterns in a recently diversified Brassicaceae lineage from the Atacama Desert: When choices in phylogenetics and species distribution information matter
Authors: Toro‐Núñez Oscar , Lira‐Noriega Andrés
Published: April 2020

Aim

Phylogenetic endemism (PE), which combines phylogenetic diversity (PD) and range size distributions of co‐occurring taxa, has become a useful approach for the identification of geographical hotspots using evolutionary history in conservation. However, potential limitations could preclude a general assessment of PE, especially in the presence of incongruent phylogenetic signals and the use of different estimates of species distribution at fine spatial scales. Here, we assess the utility of using PE in a recently diversified plant tribe.

Location

Atacama Desert, Argentina, Chile, and Peru.

Taxon

Schizopetalae tribe from the mustard plant family of Brassicaceae.

Methods

We assessed PD and PE to determine whether incongruent phylogenetic trees derived from nuclear and chloroplast DNA and different estimates of species distribution based on species distribution modelling (SDM) and minimum convex polygons (MCP) impact the location of PE hotspots.

Results

Results show negligible influence from discordant phylogenetic signal between gene trees on PE estimates. Instead, the choice of the summary of species' range (i.e. SDM or MCP) has greater influence on the location of PE hotspots.

Main conclusions

Despite the observed discrepancies, results of PE are sufficiently congruent to support the use of this index in conservation‐related analyses for the Atacama Desert flora. Nonetheless, further analyses are recommended to determine and contextualize the impacts of phylogenetic incongruence and species distributional estimates on PE, especially when other scenarios involving larger spatial and taxonomic sampling scales remain unexplored.
Short‐term and intermediate‐term performance and safety of left bundle branch pacing
Authors: Guo Jincun , Li Linlin , Meng Fanqi , Su Maolong , Huang Xinyi , Chen Simei , Li Qiang , Chang Dong , Cai Binni
Published: April 2020

Introduction

Left bundle branch pacing (LBBP) is a promising new method for patients with pacing indications. This study aims to evaluate the safety and feasibility of LBBP in a relatively longer time span.

Methods and Results

A total of 164 patients were recruited for LBBP in this study. Among these patients, 148 patients had pacing indications due to symptomatic bradycardia while the other 16 patients had indications for cardiac resynchronization therapy (CRT). LBBP was successful in 89.0% (146/164) of all recruited patients. Intracardiac and surface electrographic parameters and image data were documented during the LBBP procedure. The mean paced QRS duration (pQRSD) and the mean stimulus to left ventricular activation time (stim‐LVAT) was 106.0 ± 12.9 ms and 64.4 ± 13.7 ms respectively. Left bundle branch (LBB) potentials were recorded in 89 patients. Forty‐three of whom had sick sinus syndrome (SSS), and 46 had atrioventricular block (AVB). The presence of LBB potential was more common in patients with SSS (82.7% vs 57.5%, P = .002). No significant differences in pQRSD, stim‐LVAT, or capture threshold were detected between patient groups with or without LBB potential. Patients were followed up at 1 month, 3 months, 6 months, and 1 year after the procedure. Pacing parameters and the echocardiographic data remained stable within a mean follow‐up period of 8.6 ± 4.3 months. No serious complication caused by this procedure was found in this study.

Conclusions

Successful LBBP carried an aspect of short pQRSD and stim‐LVAT while the LBB potential was not the prerequisite and necessary feature. The LBBP procedure had a high success rate with satisfied and stable lead parameters during short and intermediate‐term observations.