bluuebunny/crossref_metadata_2025 huggingface dataset:
Attracting and managing talent, how are the top three hotel companies in India doing it?
Authors: Sen Kakoli , Bhattacharya Arunangshu
Published: September 2019

Purpose

Global business travel spending reached a record breaking $1.2tn in 2015 (Bureau of Labor Statistics, 2016) and the average Indian traveling is now at a phenomenal high for both business and leisure travel. In this context, the paper aims to investigate how the top hotels in India are addressing the issue of human resource shortages and training and how they are preparing for the future when the market, the customer profile and employee expectations are undergoing a major change. In essence, brand loyalty could be minimal and competition intense.

Design/methodology/approach

This paper adopts a case study approach and reviews how participating hotels are addressing their talent attraction and retention issues and differentiating their people management processes.

Findings

The processes used by top hotel companies provide an overview as to how they manage people and how they will need to innovate to assess progress of the measures and initiatives they are taking. They will also have to be more global in their approach.

Originality/value

The findings will be of interest to managers who are responsible for hiring and managing employees. The study also has implications for policymakers and higher education institutions in relation to managing skill shortages that exist in the hotel industry.
The tourism and hospitality industry in India: emerging issues for the next decade
Authors: Sanjeev Gunjan M. , Birdie Arvind K.
Published: September 2019

Purpose

This paper aims to introduce the theme issue and strategic question: What should Indian tourism and hospitality managers focus on to stay competitive in the coming decade? It also presents an overview of recent developments in the tourism and hospitality industry and presents some statistics and trends relating to prospects for the tourism and hospitality industry in India.

Design/methodology/approach

Emerging trends emanate from various official reports and expert views. The paper also highlights key issues and areas for investigation by the theme issue contributors.

Findings

Strong growth is predicted for the tourism and hospitality industry and some of the underpinning issues that will influence competitiveness are the role of social media, business model innovations, risk management, talent management, valuation models, the influence of information technology, employee loyalty and design thinking in hospitality higher education.

Practical implications

Given the expansion occurring in the domestic market in India and the involvement of international operators in the Indian environment, this paper will be of interest to practitioners with an interest in the emerging opportunities and challenging issues related in this dynamic marketplace.

Originality/value

This introductory paper captures the essence of the prevailing trends in the tourism and hospitality industry as a starting point for this theme issue.
Resilience and regime shifts: Do novel communities impede ecological recovery in a historically metal‐contaminated stream?
Authors: Wolff Brian A. , Duggan Sam B. , Clements William H.
Published: September 2019

Novel communities that result from exposure to contaminants and other anthropogenic stressors often persist in ecosystems that have experienced regime shifts. Because these systems may not return to pre‐disturbance conditions after removal of a stressor, understanding the ecological consequences of regime shifts has important implications for how restoration success is defined. Long‐term observational studies can potentially identify regime shifts in disturbed ecosystems; however, experimental approaches may be necessary to demonstrate their ecological consequences.

We report results of a long‐term (28 years) observational study and a series of stream mesocosm experiments that investigated a regime shift in a mining‐contaminated watershed. We tested the hypothesis that establishment of a novel, metal‐tolerant macroinvertebrate community in a previously contaminated stream impeded recovery of sensitive species, despite significant improvements in water quality over the past two decades.

We observed significant improvements in abundance and species richness, but differences in community composition and trophic structure persisted downstream from a former source of metal contamination. These downstream communities were dominated by large, metal‐tolerant caddisflies that likely impeded colonization by metal‐sensitive groups (e.g. grazing mayflies). Mesocosm experiments conducted with reference and downstream communities demonstrated that novel communities retained their tolerance to metals, but were significantly more sensitive to other stressors. We suggest that the failure of downstream communities to recover represented a contaminant‐induced regime shift that resulted from the sustained dominance of metal‐tolerant species.

Synthesis and applications. Restoration ecologists generally consider increased species diversity or abundance of recreationally important species as indicators of restoration success. However, few stream restoration projects have quantified ecological resilience, and none have included a significant experimental component. Our research is the first to experimentally demonstrate that novel communities in a stream recovering from historical metal pollution have lower resilience to other (e.g. non‐metal) stressors. These results have important implications for how restoration success is defined. In systems where the return to pre‐disturbance conditions is unlikely, a better understanding of the ecological resilience of novel communities may be critical for assessing restoration success. We suggest that resilience to novel stressors is an important indicator of restoration effectiveness that may be applicable in other aquatic ecosystems.
Perceptions of occupational therapy threshold concepts by students in role‐emerging placements in schools: A qualitative investigation
Authors: Kaelin Vera C. , Dancza Karina
Published: September 2019

Introduction

Traversing threshold concepts has been identified as crucial in becoming an occupational therapist. To support this learning, previous research has emphasised the value of students engaging in practice‐based learning, accompanying reflection, and a curriculum which makes threshold concepts explicit to students. Role‐emerging placements form part of students’ practice‐based learning in many universities and could offer a valuable opportunity for students to learn threshold concepts. Understanding the value of threshold concepts to enhance role‐emerging placement learning from both the students’ and educators’ perspectives warrants further research. The aim of this study was to examine how occupational therapy students on role‐emerging placements in school settings experienced applying threshold concepts and how it impacted on their learning.

Methods

An epistemological position of social constructionism and a qualitative research design was used. This included semi‐structured focus group interviews and reflective logs that enabled exploration of 13 student’s and one supervisor’s perspectives of learning during the placement. Template analysis was used to analyse the data.

Results

Students spoke of their learning of the threshold concepts of client‐centredness, occupation, and understanding and applying occupational therapy theory in practice. These are expressed within the three emergent themes; ‘curriculum supports in placement’, ‘uncertainty when applying their own knowledge’, and ‘placement context and expectations’.

Conclusion

Results suggest that learning happens within the liminal spaces which occurred from an intersection with the threshold concepts, the curriculum, knowledge generation and use, and the context and expectations of the role‐emerging placement. Engaging with uncertainty may be considered a vital part of this process and something which should be valued.
Food Consumer Behavior and Salmonella Exposure Self‐Perception in the Central Region of Mexico
Authors: Godínez‐Oviedo Angélica , Sampedro Parra Fernando , Machuca Vergara Jessica J. , Gutiérrez González Porfirio , Hernández Iturriaga Montserrat
Published: September 2019

In Mexico, there is limited information regarding food consumer behaviors at home. The knowledge of food consumption and food handling practices can help to determine more realistically the exposure to different hazards, such as Salmonella spp. on the population. The main goal of this study was to characterize the food consumption habits of five food groups (fruits and vegetables, fresh meat, dairy products, processed meat products, and seafood), food handling practices, and Salmonella exposure self‐perception of the population of the central region of Mexico using an online survey. A total of 1,199 surveys were analyzed. The group of fruits and vegetables is the most consumed and one of the most related to the consumer self‐perception of suffering from salmonellosis. Mexican consumers regularly use refrigeration as the principal food storage method for the five food groups (42.2% to 90.8%), and generally, they store the products between 2 and 3 days (26.5% to 38.1%). A total of 86.4% of consumers reported that they always wash their hands prior to food preparation. A total of 16.9% and 13.0% use the same cutting board and knife, respectively, to cut more than one product without applying sanitization. Men, people between 20 and 24 years, and people between 60 and 64 years, had the highest risk food handling practices at home. Finally, age (P < 0.0001), education level (P = 0.0004), and suffering from gastrointestinal diseases (P = 0.0005) showed significant effects with self‐perception of having salmonellosis.

Practical Application

Data presented in this study could be used in future risk and exposure assessment research to evaluate the public health risk from the consumption of contaminated food. In addition, it could be used by government agencies to design education campaigns in food safety area.
The roles of energy markets and environmental regulation in reducing coal‐fired plant profits and electricity sector emissions
Authors: Linn Joshua , McCormack Kristen
Published: September 2019

Between 2005 and 2015, US electricity sector emissions of nitrogen oxides and sulfur dioxide, which harm human health and the environment, declined by two thirds, and many coal‐fired power plants became unprofitable and retired. Intense public controversy has focused on these changes, but the literature has not identified their underlying causes. Using a new electricity sector model of the US eastern interconnection that accurately reproduces unit operation, emissions, and retirement, we find that electricity consumption and natural gas prices account for nearly all the coal plant profitability declines and resulting retirements. Environmental regulations had little effect on these outcomes.
Modeling strategies and evaluating success during repatriations of elusive and endangered species
Authors: Folt B. , McGowan C. P. , Steen D. A. , Piccolomini S. , Hoffman M. , Godwin J. C. , Guyer C.
Published: September 2019

Wildlife repatriation is an important tool to decrease extinction risk for imperiled species, but successful repatriations require significant time, resources and planning. Because repatriations can be long and expensive processes, clear release strategies and monitoring programs are essential to efficiently use resources and evaluate success. However, monitoring can be challenging and surrounded by significant uncertainty, particularly for secretive species with extremely low detection probability. Here, we simulated how alternative repatriation strategies influence repatriation success for the eastern indigo snake Drymarchon couperi, a federally‐Threatened species that is currently being repatriated in Alabama and Florida. Critically, we demonstrate how observed population growth can differ from true population growth when detection probabilities are low and mark‐recapture analyses are not an option. Specifically, we built a stochastic stage‐based population model to predict population growth and extinction risk under different release strategies and use information from ongoing repatriations to predict success and guide future releases. Because D.  couperi is difficult to monitor, we modeled how detection probability influenced perceptions of abundance and population growth by monitoring programs. Simulated repatriation strategies releasing older, head‐started snakes in greater abundance and frequency created wild populations with decreased extinction risk relative to scenarios releasing fewer and younger snakes less frequently. Ongoing repatriations currently have a 0.23 (Alabama) and 0.61 (Florida) probability of quasi‐extinction, but extinction risk decreased to 0.07 and 0.10 at sites upon achieving the targeted number of releases. Abundances observed under realistic detection thresholds for D.  couperi did not always predict true population growth; specifically, we demonstrate that monitoring programs during repatriations of secretive species may indicate that efforts have been unsuccessful when populations are actually growing. Overall, our modeling framework informs release strategies to maximize repatriation success while demonstrating the need to consider how detection processes influence assessment of success during conservation interventions.
Competitive effects and responses of the invasive grass Eragrostis plana in Río de la Plata grasslands
Authors: Guido Anaclara , Hoss Daniela , Pillar Valério D.
Published: September 2019

The ability of an invasive species to establish is mostly determined by its biotic interactions with native species from the recipient community. Here, we evaluate the competitive effects and responses of the invasive Eragrostis plana when interacting with native species, in order to identify possible mechanisms driving invasion in Río de la Plata grasslands. A pairwise competition experiment was performed consisting of treatments that varied in the identity of neighbour plant species: (i) control (no interaction); (ii) intraspecific interaction; (iii) interspecific interaction between native and invasive species; and (iv) interspecific interaction between two co‐occurring native species. Data analysis was separated into the effect of E. plana on the performance of three native perennial grasses (target species: Aristida laevis, Eragrostis neesii and Paspalum notatum) and the response of E. plana to natives (target species: E. plana). Separately for each target species, components of plant performance were compared between neighbouring species treatments. We found that the strength of competitive interactions depended on both target and neighbour species identity. Regarding natives, interspecific competition was stronger than intraspecific. Native species showed distinctive responses to whether the neighbour was the invasive or a co‐occurring native (Eragrostis lugens). Competition between E. plana and native species was stronger than between co‐occurring natives. We demonstrated E. plana had a greater negative effect on native's species performance than the native congener E. lugens. Regarding E. plana, intraspecific competition was stronger than interspecific, and its response was positive or neutral when interacting with natives, suggesting its high tolerance to grow in competition with neighbours. We conclude E. plana's negative effects on native species performance, and its positive or neutral responses to neighbouring native plants demonstrate its strong competitive ability in the recipient community. This may explain its invasion success in southern Brazil and in the encompassing Río de la Plata grasslands.

Abstract in Spanish is available with online material.
Body wall defects and amniotic band syndrome in pig (Sus scrofa domesticus)
Authors: Martín‐Alguacil Nieves , Avedillo Luis
Published: September 2019

The amniotic band syndrome is a congenital condition. It is characterized by the presence of fibrous amniotic bands that may entangle or entrap different foetal parts in utero, resulting in deformation, malformation or disruption. We report on a female piglet presenting amniotic band adherences in the right abdominal flank, several body wall defects (gastroschisis, abdominoschisis with omphalocele), severe scoliosis, anomalous umbilical cord with single umbilical artery, anal atresia, anomalous liver and absent gall bladder, hypoplastic genitalia, ankylosis and arthrogryposis in pelvic limbs, and bilateral patellar agenesia. The ethiopatogenia is discussed, as well as the comparative and embryological implications.
The tongue of Leopard Gecko (Eublepharis macularius): LM, SEM and confocal laser study
Authors: Abbate Francesco , Guerrera Maria Cristina , Levanti Maria , Laurà Rosaria , Montalbano Giuseppe , Cavallaro Mauro , Germanà Antonino
Published: September 2019

The leopard gecko is a crepuscular and insectivorous reptile. The role of the tongue in this reptile is fundamental for the prey capture and ingestion and is not related with eyes cleaning as usual in other geckos. The elongated tongue can be divided into a foretongue with a slightly bifurcated apex and a hindtongue. Scanning electron microscopy demonstrated that several different papillae are present on the dorsal surface, foliate and dome‐shaped in the foretongue, becoming thicker and stouter with reduced interpapillary spaces in the lateral parts. The hindtongue is characterised by wide foliate papillae with indented margins and deep fissures of the mucosa. Light microscopy showed the presence of a stratified slightly keratinized squamous epithelium in the apex of the foretongue, a stratified non‐keratinized squamous epithelium in the fore and in the hindtongue. In the foretongue, numerous muciparous caliciform cells were observed. Moreover, the presence of taste buds on the tongue ventral surface was demonstrated for the first time in this species and the confocal laser study revealed a strong immunoreactivity for the S‐100 protein in the sensory cells. Therefore, the results obtained could give a contribution to the knowledge of the tongue anatomy and are a basis for eventual further studies regarding the feeding habits in a reptile become a popular pet.
Gill epithelium of an angler catfish, Chaca chaca (Siluriformes, Chacidae): Enzyme and glycoprotein histochemistry
Authors: Mistri Arup , Kumari Usha , Mittal Swati , Mittal Ajay Kumar
Published: September 2019

A series of histochemical techniques have been employed to localize alkaline phosphatase, acid phosphatase, non‐specific esterase, catalase and peroxidase; and to visualize and characterize glycoprotein (GPs) moieties in the epithelium of gill arch, gill filaments and secondary lamellae of an angler catfish Chaca chaca. The epithelium of gill arch and gill filament shows strong alkaline phosphatase activity in the deeper layer epithelial cells; strong non‐specific esterase activities in the outer layer epithelial cells; and weak acid phosphatase activity throughout the epithelium. The activity of these enzymes in the secondary lamellae is weak. The catalase and peroxidase show strong activities in the blood cells of the secondary lamellae. Various classes of GPs have been identified and characterized in the mucous secretions of the gill epithelium of C. chaca. These include—GPs with oxidizable vicinal diols, GPs with sialic acid residues without O‐acyl substitution and GPs with O‐sulphate esters. The functional significance of different enzymes in gill epithelium and the GPs in the mucus secreted on the surface has been discussed with the physiology of the gills in relation to the characteristic habit and habitat of the fish.
Mediterranean fever (MEFV) gene profile and a novel missense mutation (P313H) in Iranian Azari‐Turkish patients
Authors: Rostamizadeh Leila , Vahedi Leila , Bahavarnia Seied Rafi , Alipour Shahriar , Abolhasani Somayeh , Khabazi Alireza , Sakhinia Ebrahim
Published: September 2019

Background

Familial Mediterranean fever (FMF) is common in Azari‐Turkish people, one of the biggest ethnic groups in Iran. In this study, we sought to investigate the mutation spectrum of the MEFV gene and any genotype–phenotype correlations.

Methods and materials

400 unrelated Azari‐Turkish FMF patients were analyzed in this study. Mutations in exons 2, 3, 5, and 10 of the MEFV gene were investigated using direct Sanger sequencing, and their correlations with the clinical features of the patients were analyzed.

Results

At least one mutation was detected in 248 (62%) patients. The most common mutations were M694V (26.25%) and E148Q (24.75%), respectively. Abdominal pain (65.2%) and fever 204 (51%) were the most frequent clinical problems in all subjects. The analysis recognized a novel missense mutation in the coding region of the MEFV gene, named P313H, which is the first report of a new mutation in exon 2 of the MEFV gene in an Azari‐Turkish family.

Conclusion

Genotype–phenotype correlations obtained from this study would be helpful in the diagnosis and management of FMF patients in clinical situations. This novel missense mutation may provide useful evidence for further studies of FMF pathogenesis.
GJB2‐related hearing loss in central Iran: Review of the spectrum and frequency of gene mutations
Authors: Koohiyan Mahbobeh , Koohian Farideh , Azadegan‐Dehkordi Fatemeh
Published: September 2019

Mutations in the GJB2 gene are a main cause of autosomal‐recessive nonsyndromic hearing loss (ARNSHL) in many populations. Previous studies have estimated the average frequency of GJB2 mutations to be ∼16% in Iran, but would vary among different ethnic groups. Here, we have taken together and reviewed results from our two previous publications and data from searching other published mutation reports to provide a comprehensive collection of data for GJB2 mutations and HL in central Iran. In all, 332 unrelated families were included and analyzed for the prevalence and type of the GJB2 gene mutations. In total, the frequency of GJB2 mutations was found to be 16% in the central provinces, which is significantly higher than those identified in southern populations of Iran. Also, c.35delG was the most frequent mutation in the related population. The present study suggests that mutations in the GJB2 gene, especially c.35delG, are important causes of HL in central Iran and can be used as a basis of genetic counseling and clinical guidelines in this region.
Long‐term patient‐reported outcomes after laparoscopic Burch colposuspension
Authors: Conrad Dean H. , Pacquee Stefaan , Saar Tal D. , Walsh Caroline , Chou Danny , Rosen David , Cario Gregory M.
Published: September 2019

Background

The negative media attention surrounding vaginal mesh procedures has seen a rise in demand for minimally invasive non‐mesh options for the treatment of stress urinary incontinence (SUI). The laparoscopic Burch colposuspension (LBC) is a non‐mesh alternative to synthetic midurethral slings (MUS) with similar short‐term outcomes. However, long‐term outcomes are not well established.

Aims

To evaluate the long‐term outcomes of LBC for treatment of SUI in women.

Material and Methods

One hundred and fifty‐one cases of LBC were performed by a single surgeon over two private hospital settings between January 2010 and January 2016. Follow‐up subjective outcomes were obtained in 137 cases (90.7%) utilising standardised questionnaires. Primary outcome was successful treatment of SUI, defined as subjective cure or significant improvement of stress incontinence symptoms. Secondary outcomes included new‐onset or worsened symptoms of overactive bladder (OAB), voiding dysfunction, prolapse, and perioperative complications.

Results

One hundred and thirty‐seven patients were analysed with a mean follow‐up of 50.6 months (range: 13–89 months). Primary outcome of successful treatment was achieved in 90.5% of women. New‐onset or worsened symptoms of OAB was reported in 10.2%, with a further 8.8% of women experiencing symptomatic voiding dysfunction. Sixteen patients (11.7%) reported new‐onset or worsening symptoms of prolapse. There were no major surgical complications.

Conclusions

LBC is a safe and effective long‐term treatment for SUI, with low failure rates and minimal adverse outcomes. It is a suitable alternative for women with contraindications to mesh or those having concomitant laparoscopic procedures.
Maternal mortality at the National Referral Hospital in Honiara, Solomon Islands over a five‐year period
Authors: De Silva Manarangi , Panisi Leeanne , Maepioh Anita , Mitchell Rebecca , Lindquist Anthea , Tong Stephen , Hastie Roxanne
Published: September 2019

Background

The Solomon Islands is a developing country facing significant barriers to the provision of quality antenatal and obstetric care. The maternal mortality rate is 114/100 000 live births, ranking the Solomon Islands 113th globally. Investigating maternal mortality may yield valuable insight into improving these numbers.

Aim

The objective of this study was to review all cases of maternal mortality at the National Referral Hospital, Solomon Islands over a five‐year period.

Materials and methods

This was a retrospective review of maternal deaths occurring at the National Referral Hospital, Solomon Islands from 2013 to 2017. Data on maternal demographics, characteristics and cause of death were collected.

Results

There were 39 maternal deaths at the National Referral Hospital from 2013 to 2017. The maternal mortality rate of the National Referral Hospital (139/100 000) is higher than the national rate (114/100 000). Most deaths were direct, with 28% attributed to haemorrhage. Overall, 79% of the total maternal deaths had elements that may be considered preventable, with laboratory delays present in 54% and medication shortages present in 29% of cases.

Conclusion

Maternal mortality is high in the Solomon Islands, with many potentially preventable deaths occurring at the National Referral Hospital. Continued focus on improving data collection, access to resources, and training is vital to reduce maternal mortality in the Solomon Islands.
A brief update on the evidence supporting the treatment of infertility in polycystic ovary syndrome
Authors: Costello Michael F. , Misso Marie L. , Balen Adam , Boyle Jacqueline , Devoto Luigi , Garad Rhonda M. , Hart Roger , Johnson Louise , Jordan Cailin , Legro Richard S. , Norman Rob J. , Moran Lisa , Mocanu Edgar , Qiao Jie , Rodgers Ray J. , Rombauts Luk , Tassone Eliza C. , Thangaratinam Shakila , Vanky Eszter , Teede Helena J.
Published: September 2019

Background

Polycystic ovary syndrome (PCOS) is complex with reproductive, metabolic and psychological features. Infertility is a prevalent presenting feature of PCOS with approximately 75% of these women suffering infertility due to anovulation, making PCOS by far the most common cause of anovulatory infertility. Previous guidelines either lacked rigorous evidence‐based processes, did not engage consumer and international multidisciplinary perspectives, or were outdated.

Aims

This review paper aims to provide a brief update on the best available and most current research evidence supporting the treatment of PCOS which informed the recommendations in the assessment and treatment of infertility section of the international evidence‐based guideline on PCOS 2018.

Materials and Methods

International evidence‐based guideline development engaged professional societies and consumer organisations with multidisciplinary experts and women with PCOS directly involved at all stages.

Results

Lifestyle change alone is considered the first‐line treatment for the management of infertile anovulatory PCOS women who are overweight or obese. Letrozole should now be considered first‐line pharmacological treatment for ovulation induction to improve fertility outcomes. Clomiphene citrate alone and metformin alone could also be used as first‐line pharmacological therapy, although both are less effective than letrozole and metformin is less effective than clomiphene citrate in obese women. Gonadotrophins or laparoscopic ovarian surgery are usually second‐line ovulation induction therapies. In the absence of an absolute indication for in vitro fertilisation (IVF) / intracytoplasmic sperm injection, women with PCOS and anovulatory infertility could be offered IVF as third‐line therapy where first‐ or second‐line ovulation induction therapies have failed.

Conclusion

This review provides the best available evidence informing recommendations (along with clinical expertise and consumer preference) which provide clinicians with clear advice on best practice for the management of infertile women with PCOS.
Venous thromboembolism prophylaxis of the obese postpartum patient: A cross‐sectional study
Authors: Gilmartin Christine E. , Cutts Briony A. , Ismail Huda
Published: September 2019

Background

Obesity increases risk of venous thromboembolism (VTE) in obstetric patients regardless of delivery mode and for up to six weeks postpartum.

Aim

This study aimed to examine postpartum pharmacological VTE prophylaxis practices for obese women at an Australian tertiary referral hospital.

Materials and Methods

Medical records were retrieved for obese obstetric patients who delivered during May 2016–May 2017. Records were examined for demographic data, VTE risk factors, and LMWH (low‐molecular‐weight heparin) use. Due to lack of specific Australian or local guidelines, practice was evaluated using recommendations from the Royal College of Obstetricians and Gynaecologists (RCOG‐UK). Patients with BMI (body mass index) <30, incomplete/unavailable medical records, and those discharged from other health services were excluded.

Results

One hundred and eight postpartum patients (70 caesareans, 38 vaginal deliveries) with a BMI ≥ 30 kg/m2 were reviewed. Of these patients, 53 (49.1%) had a BMI ≥ 40 kg/m2. Ninety‐eight of 108 (90.7%) patients had ≥2 VTE risk factors including a BMI ≥ 30 kg/m2. One hundred and three of 108 (95.4%) patients were indicated for postpartum VTE prophylaxis with LMWH, and 77 of 103 (74.8%) patients received it. Three of five patients meeting criteria for ≥6 weeks of LMWH thromboprophylaxis had it prescribed. Of the 72 patients whose weight exceeded 90 kg and who also received LMWH, 32 (44.4%) were prescribed a weight‐adjusted dose.

Conclusion

VTE prophylaxis practices using LMWH in obese postpartum patients, including weight‐adjusting doses and extended‐course prescribing, appear variable. Limited literature, recommendation discrepancies, and varied awareness of recommendations may be contributing factors. Further education and research regarding this high‐risk cohort are warranted.
Risk of preterm birth in the subsequent pregnancy following caesarean section at full cervical dilatation compared with mid‐cavity instrumental delivery
Authors: Wang Mandy , Kirby Adrienne , Gibbs Emma , Gidaszewski Beata , Khajehei Marjan , Chua Seng C.
Published: September 2019

Background

Expediting delivery in the second stage of labour often involves a choice between a caesarean section at full dilatation or mid‐cavity instrumental delivery. Accumulating evidence suggests that the mode of delivery may influence the risk of preterm birth in the subsequent pregnancy.

Aims

To directly compare first birth caesarean section at full dilatation with mid‐cavity instrumental delivery for the risk of preterm birth in the subsequent pregnancy (second birth). A further aim was to identify predictive factors associated with these index modes of delivery.

Materials and Methods

This is a retrospective cohort study involving three maternity hospitals in western Sydney over the period of 2006–2017. Inclusion criteria were nulliparous women with a singleton term cephalic first birth delivered by caesarean section at full dilatation or mid‐cavity instrumental delivery, and whose second birth also occurred under our care. Data were analysed separately for first and second births.

Results

There were 425 caesarean section at full dilatation and 874 mid‐cavity instrumental cases which met inclusion criteria. The risk of preterm birth in the second birth was 5.7% compared to 3.2%, respectively (risk ratio 1.76; 95% CI 1.04–3.00; P = 0.035). After excluding causes of preterm birth not related to previous mode of delivery, the risk of spontaneous preterm birth was 4.3% compared to 2.0%, respectively (risk ratio 2.18; 1.14–4.19; P = 0.019).

Conclusion

Caesarean section at full dilatation is associated with a significantly higher rate of preterm birth in the subsequent pregnancy compared to a mid‐cavity instrumental delivery. This should be considered in second‐stage mid‐cavity decision‐making.
Systematic review of enhanced recovery protocols for elective caesarean section versus conventional care
Authors: Ilyas Sajidah , Simmons Scott , Bampoe Sohail
Published: September 2019

Background

Enhanced recovery protocols for caesarean section have been introduced in many maternity units with the aim of improving clinical outcomes and improving service efficiency.

Aim

Our aim was to assess the available evidence for the efficacy of enhanced recovery protocols for elective caesarean section compared to conventional care.

Materials and Methods

A systematic review was performed through a search of MEDLINE, EMBASE, The Cochrane Database of Systematic Reviews and Cochrane Central Register of Controlled Trials Database.

Results

After screening 118 records and reviewing 38 articles, no studies met the inclusion criteria for this systematic review. However, from ten articles we were able to describe 29 individual interventions that are included in the enhanced recovery pathways of care for elective caesarean sections. Early reintroduction of fluids and food was the only intervention that was common to all pathways.

Conclusion

This review reveals that while the adoption of enhanced recovery pathways for caesarean sections is increasing, there remains a paucity of evidence in the published literature on outcomes. This is reflected in the significant heterogeneity of the individual components included in various pathways currently in practice. Furthermore, development of standardised outcome metrics is required to facilitate meaningful comparison of multiple interventions. Further well‐designed research is needed to properly assess the potential benefits of these interventions to improve maternal outcomes after obstetric surgery.
Allergic rhinitis and allergic sensitisation are still increasing among Danish adults
Authors: Leth‐Møller Katja Biering , Skaaby Tea , Linneberg Allan
Published: September 2019

Background

Only a limited number of studies have included objective measures of allergic sensitisation (such as skin‐prick test [SPT] and serum specific IgE [sIgE]) when studying time trends in allergic respiratory disease in adults within the current millennium.

Methods

Five health examination studies of random samples of individuals aged 18‐69 years resident in the Copenhagen region were conducted in 1990‐1991, 2006‐2008, 2010‐2011, 2012‐2015, and 2016‐2017. Allergic sensitisation was defined by sIgE (in 1990‐1991, 2006‐2008, and, 2012‐2015) or SPT (in 2006‐2008, 2010‐2011, and 2016‐2017) to at least one of the allergens: birch, grass, house dust mite, or cat. Allergic rhinitis was defined as sensitisation and self‐reported nasal symptoms.

Results

The age‐ and sex‐standardised prevalence of sIgE‐defined sensitisation increased from 16% in 1990‐1991, to 26% in 2006‐2008, and to 29% in 2012‐2015. The age‐ and sex‐standardised prevalence of SPT‐defined sensitisation increased from 27% in 2006‐2008, to 28% in 2010‐2011, and to 32% in 2016‐2017. Changes in sIgE‐defined and SPT‐defined allergic rhinitis showed similar increasing trends.

Conclusion

The prevalence of allergic sensitisation and allergic rhinitis increased in a general adult Danish population over the last three decades and has thus continued to increase in the current millennium.
Near‐infrared spectroscopy in the diagnosis of testicular torsion: valuable modality or waste of valuable time? A systematic review
Authors: Laher Abdullah , Swart Marlize , Honiball John , Perera Marlon , Lawrentschuk Nathan , Adam Ahmed
Published: September 2019

Background

Testicular torsion (TT) is a urological emergency that affects one in 4000 males younger than 25 years. Delays in the management of TT may result in testicular ischaemia, testicular necrosis, orchidectomy and infertility. This review assesses the validity of near‐infrared spectroscopy (NIRS) as a diagnostic tool in the assessment and diagnosis of TT.

Methods

A systematic search of Cochrane Database of Systematic Reviews, EMBASE, Google Scholar, PubMed, Scopus and Web of Science databases was performed in January 2019 using specific search terms. Selected studies were ranked and evaluated using the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines and the Quality Assessment of Diagnostic Accuracy Studies‐2 tool.

Results

A total of nine studies that included 253 subjects (88 animals and 165 humans) with a mean sample size of 28.1 (standard deviation 40.8) subjects were included. The mean difference in testicular tissue oxygen saturation between torsed and non‐torsed testes (Δ%StO2) were 45%, 42% (±5%), 26% and 5–18% in four animal studies and 2.0%, 3.0%, 6.7%, 6.8% and 23.0% in five human studies. The tissue oxygen saturation difference between contralateral healthy testes (controls) ranged from 1% to 10% in the five studies that alluded to this.

Conclusion

The current body of evidence does not support the use of NIRS in the work‐up of TT. Well‐designed clinical trials with large patient samples are required to determine whether NIRS may have some future role as a diagnostic modality in TT.
QUANTITATIVE STUDY ON THE IMPACT OF BRANCHLESS BANKING ON MICROFINANCE INSTITUTIONS
Authors: PRIOR Francesc , MORA Toni
Published: September 2019

In this study, we examined how implementing branchless banking partnerships (BBPs) can enable microfinance institutions to improve their efficiency by reducing cash handling and to expand its product offering to savings. We examined the case of Attawfiq Microfinance in Morocco, that implemented a BBP strategy named Low Income Banking (LIB) in order to achieve increased efficiency and expand its product offering to savings through the LIB account offering. We studied how the customers of Attawfiq used the LIB account for transactional and savings purposes by analysing a large database of sociodemographic factors of customers and payments data of microcredits for the period 2010–15 (554,541 customers). We included in our analysis, for the first time to our knowledge, not only the study of the correlations between a very extensive dataset of sociodemographic variables and the use of bank accounts in terms of transactions and savings, but also the study of microcredit data as explanatory variables. Our study concluded that the BBP model implemented (LIB) allowed Attawfiq Microfinance to improve its operating efficiency although it failed to achieve increased savings.
LTBP2 knockdown by siRNA reverses myocardial oxidative stress injury, fibrosis and remodelling during dilated cardiomyopathy
Authors: Pang Xue‐Feng , Lin Xue , Du Jian‐Jun , Zeng Ding‐Yin
Published: September 2019

Aim

Dilated cardiomyopathy (DCM) is characterised by left ventricular dilation and associated with systolic dysfunction. Recent evidence has reported the high expression of latent transforming growth factor beta binding protein 2 (LTBP2) in heart diseases, which may play a role in regulating multiple biological functions of myocardial cells. Thus, this study set out to investigate the molecular mechanism and effects of LTBP2 in myocardial oxidative stress injury, fibrosis and remodelling in a rat model of DCM, with the involvement of NF‐κB signalling pathway.

Methods

The rat model of DCM was treated with si‐LTBP2 and/or activator of NF‐κB signalling pathway to examine the haemodynamic indexes, cardiac functions, oxidative stress injury, fibrosis and remodelling. Moreover, in vitro experiments were conducted to verify the regulatory role of LTBP2 and NF‐κB signalling pathway in DCM.

Results

LTBP2 was up‐regulated in DCM rats. After LTBP2 was knocked down, haemodynamic indexes, HW/BW ratio, collagen volume fraction (CVF) level, positive expression of LTBP2, levels of reactive oxygen species (ROS), malondialdehyde (MDA), interleukin‐6 (IL‐6), tumour necrosis factor‐alpha (TNF‐α), tumour necrosis factor beta 1 (TGF‐β1) and brain natriuretic peptide (BNP) were all decreased. Meanwhile, levels of LTBP2, Col‐I, Col‐III, p65 and p52 were also reduced, while HW, BW and levels of SOD and TAOC were increased. In contrast, activation of NF‐κB signalling pathway reversed effects of LTBP2 gene silencing. These findings were confirmed by in vivo experiments.

Conclusions

LTBP2 silencing can attenuate myocardial oxidative stress injury, myocardial fibrosis and myocardial remodelling in DCM rats by down‐regulating the NF‐κB signalling pathway.
Exploitation of two siderophore receptors, BauA and BfnH, for protection against Acinetobacter baumannii infection
Authors: Aghajani Zahra , Rasooli Iraj , Mousavi Gargari Seyed Latif
Published: September 2019

Iron uptake system is expressed in early stages of Acinetobacter baumannii infections under iron‐restricted conditions. This study is aimed at the evaluation of immuno‐protectivity of BfnH in comparison with BauA in both mature and selected fragmental proteins. The study was designed in single and combined forms of antigens. BfnH is presented in 3472 strains of A. baumannii with more than 97% identity. The preliminary immune‐informatics analysis of this protein indicated a region from the β‐barrel domain including exposed loops 2–5, with antigenic score comparable to that of BfnH. There was a significant rise in the specific IgG response in all test groups. The bacterial challenge with a lethal dose of A. baumannii demonstrated partial protection of whole proteins which coincides with a significant reduction in the bacterial population colonized in the main organs and an increase in the survival level. Passive immunization of the mice brought about 50% survival in the mice groups immunized with BfnH and with a combination of BfnH and BauA. The protectivity of siderophore receptors suggests their potential immunogenic role that could be considered as a component of multivalent subunit vaccine candidates against A. baumannii.
Modelling gastric emptying: A pharmacokinetic model simultaneously describing distribution of losartan and its active metabolite EXP‐3174
Authors: Karatza Eleni , Karalis Vangelis
Published: September 2019

Losartan presents multiple peaks in the concentration‐time profile. This characteristic can be attributed to gastric emptying, which is known to significantly affect the disposition of highly soluble and permeable compounds. The aim of this study was to develop a population pharmacokinetic model for losartan and its active metabolite (EXP‐3174) in order to describe the effect of gastric emptying on their disposition. Population pharmacokinetic analysis was performed using concentration‐time data derived from a crossover bioequivalence study in 31 volunteers after a single oral dose of 100 mg losartan potassium in the fasted state. Delay differential equations (DDEs) were explored for the description of losartan absorption and EXP‐3174 formation, since when solved they result in oscillatory behaviour. A two‐compartment model preceded by a pre‐absorption compartment (referring to small intestine) adequately described the observed concentration‐time profiles of losartan. In the final model, a sinusoidal equation was used for the description of gastric emptying in view of its simplicity, leading to enhanced stability of the model and its capacity to describe periodicity. In case of EXP‐3174, a one‐compartment model, with a delayed first‐order formation rate from losartan's central compartment, best described its disposition. Using the model developed, it was shown through simulations that changes in gastric emptying parameters lead to changes in the C‐t profiles of both compounds. In particular, plasma oscillations can be enhanced or completely suppressed, simply by changing parameters affecting gastric emptying.
MultinomialN‐mixture models for removal sampling
Authors: Haines Linda M.
Published: September 2019

Multinomial ‐mixture models are commonly used to fit data from a removal sampling protocol. If the mixing distribution is negative binomial, the distribution of the counts does not appear to have been identified, and practitioners approximate the requisite likelihood by placing an upper bound on the embedded infinite sum. In this paper, the distribution which underpins the multinomial ‐mixture model with a negative binomial mixing distribution is shown to belong to the broad class of multivariate negative binomial distributions. Specifically, the likelihood can be expressed in closed form as the product of conditional and marginal likelihoods and the information matrix shown to be block diagonal. As a consequence, the nature of the maximum likelihood estimates of the unknown parameters and their attendant standard errors can be examined and tests of the hypothesis of the Poisson against the negative binomial mixing distribution formulated. In addition, appropriate multinomial ‐mixture models for data sets which include zero site totals can also be constructed. Two illustrative examples are provided.
Generation and evaluation of a chimeric antibody against coxsackievirus and adenovirus receptor for cancer therapy
Authors: Sakamoto Shuichi , Inoue Hiroyuki , Kaneko Mika K. , Ogasawara Satoshi , Kajikawa Masunori , Urano Sakiko , Ohba Shun‐ichi , Kato Yukinari , Kawada Manabu
Published: September 2019

Coxsackievirus and adenovirus receptor (CAR) is a single‐pass transmembrane protein that is associated with adenoviral infection. CAR is involved in the formation of epithelial tight junctions and promotes tumor growth in some cancers. Previously, we developed mouse monoclonal antibodies against human CAR and found that one, mu6G10A, significantly inhibited tumor growth in xenografts of human cancer cells. Herein, we generated and characterized a mouse‐human chimeric anti‐CAR antibody (ch6G10A) from mu6G10A. ch6G10A had binding activity, inducing antibody‐dependent cellular cytotoxicity and complement‐dependent cytotoxicity, and in vivo anti‐tumor activity against CAR‐expressing prostate cancer DU‐145 cells. In addition, cancer tissue array analysis confirmed that CAR is highly expressed in neuroendocrine lung cancers including small cell lung cancer, and treatment with ch6G10A effectively inhibited in vivo subcutaneous tumor growth of NCI‐H69 small cell lung cancer cells in nude mice. Moreover, treatment with mu6G10A effectively inhibited both in vivo orthotopic tumor growth and distant metastatic formation in mouse xenograft models of a highly metastatic subline of human small cell lung cancer DMS273 cells. These results suggest that targeting therapy to CAR with a therapeutic antibody might be effective against several cancer types including small cell lung cancer.