bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of entrepreneurial orientation variables on business performance in the SME industry context
Authors: Wahyuni Ni Made , Sara I Made
Published: February 2020

Purpose

The purpose of this study is to provide new practical and theoretical insights into how small and medium-sized enterprises (SMEs) adjust and further develop business competencies, innovations and performance by using market orientation, learning orientation behaviors and entrepreneurial orientation.

Design/methodology/approach

The data was collected from manufacturing SMEs of textile products that had a number of employees between 5 and 99 people in the province of Bali, Indonesia, in 2016. Bali province was chosen as a research location because Bali was one of the tourism centers in Indonesia and even in the world was considered suitable for this research. It was because it had textile product industries that contributed in the fulfillment of the needs of tourism clothing, national economy, the fulfillment of fashion needs and foreign exchange contributors from non-oil exports (Industry and Trade Service of Bali).

Findings

Based on the results of descriptive and inferential analysis that has been conducted, it can be concluded that the answer to the problems and objectives that have been determined is market orientation, learning orientation and entrepreneurial orientation affect business performance through knowledge competence and innovation directly and its influence is significantly positive. But market orientation, learning orientation and entrepreneurial orientation do not directly have a significant positive effect on innovation through knowledge competence. Market orientation, learning orientation and entrepreneurship orientation indirectly have a significant positive effect on business performance through knowledge and innovation competencies.

Originality/value

The lack of studies in the existing literature underscores the potential contribution of this subsequent study. The novelty of the research is first to develop a concept of learning orientation that is linked to competence of knowledge, which this link has not been much expressed in the context of industry SMEs; second, to build the concept of innovation development of small and medium-sized industry of textile industry based on market orientation by strengthening the mediation role of competence of knowledge.
A hybrid method for forecasting new product sales based on fuzzy clustering and deep learning
Authors: Yin Peng , Dou Guowei , Lin Xudong , Liu Liangliang
Published: February 2020

Purpose

The purpose of this paper is to solve the problem of low accuracy in new product demand forecasting caused by the absence of historical data and inadequate consideration of influencing factors.

Design/methodology/approach

A hybrid new product demand forecasting model combining clustering analysis and deep learning is proposed. Based on the product similarity measurement, the weight of product similarity attributes is realized by using the method of fuzzy clustering-rough set, which provides a basis for the acquisition and collation of historical sales data of similar products and the determination of product similarity. Then the prediction error of Bass model is adjusted based on similarity through a long short-term memory neural network model, where the influencing factors such as product differentiation, seasonality and sales time on demand forecasting are embedded. An empirical example is given to verify the validity and feasibility of the model.

Findings

The results emphasize the importance of considering short-term impacts when forecasting new product demand. The authors show that useful information can be mined from similar products in demand forecasting, where the seasonality, product selling cycles and sales dependencies have significant impacts on the new product demand. In addition, they find that even in the peak season of demand, if the selling period has nearly passed the growth cycle, the Bass model may overestimate the product demand, which may mislead the operational decisions if it is ignored.

Originality/value

This study is valuable for showing that with the incorporation of the evaluation method on product similarity, the forecasting model proposed in this paper achieves a higher accuracy in forecasting new product sales.
Leadership for integrated care: a case study
Authors: Kozlowska Olga , Seda Gombau Gemma , Rea Rustam
Published: February 2020

Purpose

Integration of health services involves multiple interdependent leaders acting at several levels of their organisation and across organisations. This paper aims to explore the complexities of leadership in an integrated care project and aims to understand what leadership arrangements are needed to enable service transformation.

Design/methodology/approach

This case study analysed system and organisational leadership in a project aiming to integrate primary and specialist care. To explore the former, the national policy documents and guidelines were reviewed. To explore the latter, the official documents from the transformation team meetings and interview data from 17 health-care professionals and commissioners were analysed using thematic analysis with the coding framework derived from the comprehensive and multilevel framework for change (Ferlie and Shortell, 2001).

Findings

Although integration was supported in the narratives of the system and organisational leaders, there were multiple challenges: insufficient support by the system level leadership for the local leadership, insufficient organisational support for (clinical) leadership within the transformation team and insufficient leadership within the transformation team because of disruptions caused by personnel changes, roles ambiguity, conflicting priorities and insufficient resources.

Practical implications

This study provides insights into the interdependencies of leadership across multiple levels and proposes steps to maximise the success of complex transformational projects.

Originality/value

This study’s practical findings are useful for those involved in the bottom-up integrated projects, especially the transformation teams’ members. The case study highlights the need for a toolkit enabling local leaders to operate effectively within the system and organisational leadership contexts.
Experiences of engaging in therapeutic storytelling
Authors: Aguilera Lucho , Reed Kirk , Goulding Josie
Published: February 2020

Purpose

The purpose of this study is to seek answer to the following question: Does participating in storytelling changes participants’ life experiences in their journey of recovery? The study explores participants’ experiences of engaging in a storytelling programme in a community mental health team in a large New Zealand city. The programme aims to provide a safe environment to support and increase participants’ engagement with services and the community. Currently, there is limited literature on consumer’s experiences of engaging in therapeutic storytelling programmes in the international or New Zealand context.

Design/methodology/approach

Following ethical approval, eight adult participants were recruited to the study. Data were collected through semi-structured interviews and analysed using the six-phase process of thematic analysis, developed by Braun and Clarke.

Findings

Three main themes emerged from the data. The first theme, breaking barriers, was described by participants as to how they overcame barriers. The second theme, creating positive memories, uncovered the positive experiences that participants gained from the programme. The final theme, becoming a new person, described some of the transformative experiences that emerged through participation in the programme.

Originality/value

This is the first qualitative study in the New Zealand context that has explored the value of a storytelling programme from a consumer’s perspective. The findings suggest that participating in a storytelling programme can contribute to a participant’s journey of recovery; the use of myths, legends and group work is fundamental to those from collective cultures with oral traditions. The ongoing value of storytelling as a therapeutic tool requires further research and the development of a clearer evidence base to inform practice.
Stakeholder orientation’s contribution to firm performance
Authors: Vaitoonkiat Ekawee , Charoensukmongkol Peerayuth
Published: February 2020

Purpose

This study aims to investigate stakeholder orientation’s influence on firm’s performance and analyze four types of stakeholder orientations: customer, competitor, employee and shareholder. Moreover, this research extended the previous literature by examining perceived market uncertainty’s moderating effect, which can influence the effects of the orientation to all four stakeholder groups’ effects on firm performance.

Design/methodology/approach

The study collected questionnaire data from 370 small and medium-sized enterprises in the steel fabrication industry in Thailand, and hierarchical regression analysis was used to test the hypotheses.

Findings

The results of the main effect analysis indicated that customer, competitor and employee orientation affected firm’s performance positively and significantly; however, the analysis did not support shareholder orientation’s significant contribution. Moreover, the analysis of the moderating effect showed that perceived market uncertainty moderated customer and competitor orientation’s effect on firm’s performance positively and significantly. However, perceived market uncertainty moderated employee and shareholder orientation’s effects on firm’s performance negatively and significantly.

Originality/value

This study advances prior research by showing that stakeholder orientation’s role in firms’ performance may be contingent on the nature of market conditions that firms experience. In particular, this research demonstrated that not all aspects of stakeholder orientation may be beneficial for firms to maintain high performance under high market uncertainty.
The benefits of executive coaching: voices from the C-suite
Authors: Longenecker Clinton , McCartney Mike
Published: February 2020

Purpose

The purpose of this paper is to provide readers with research findings based on qualitative data that describe the benefits of executive coaching from a sample of 70 senior business executives, all of whom have a personal executive coach. In addition, the paper provides readers with specific questions concerning their organizations’ approach to executive leadership development and the application of these potential benefits to their enterprise.

Design/methodology/approach

The findings of this study are based on personal interviews with 30 executives and ten four-person focus groups in which both sets of participants were asked to describe personal and organizational benefits associated with their experiences in using executive coaches.

Findings

Interviews and focus group findings converged around a number of benefits associated with effective executive coaching. These benefits included improved executive focus, better alignment of key leadership behaviors, candid and ongoing feedback, accountability for appropriate leader behaviors, improved emotional intelligence and ego control and personal support and encouragement, among others.

Research limitations/implications

This qualitative study provides empirical evidence of the benefits of executive coaching from the perspective of senior business leaders. These findings provide researchers with specific criteria that can be tested and measured on a larger scale. The primary limitation of the study is the small sample size of only 70 executives.

Practical implications

The findings of this research provide a compelling set of benefit trends that individual executives, boards of directors and organizations need to consider in the development of their senior leaders. Specific questions are included to guide practitioner’s thinking concerning executive coaching and its role in their organizations.

Social implications

These findings make a compelling case that senior leaders can become more effective and can experience great benefits when they properly make use of an effective executive coach. The development of senior leaders using this tool can have a powerful impact on organizational performance and organization’s culture.

Originality/value

A review of the literature will reveal that anecdotal evidence abounds, but there is limited empirical research chronicling the true benefits of executive coaching.
The moderating effect of industry clockspeed on Lean Manufacturing implementation in Zimbabwe
Authors: Maware Catherine , Adetunji Olufemi
Published: February 2020

Purpose

The purpose of this paper is to analyze the moderating impact of industry clockspeed (IC) on the relationship between Lean Manufacturing (LM) practices and operational performance. A model for evaluating the impact of LM is developed and the moderating effect of IC is taken into consideration as a fundamental variable that affects the causal relationship between LM practices and operational performance.

Design/methodology/approach

A structural equation model was proposed and investigated across two groups based on IC level (Group 1: low IC and Group 2: high IC). A structured survey questionnaire was used to collect empirical data from 600 companies listed by the Confederation of Zimbabwean Industries. A total of 214 usable questionnaires were obtained giving a response rate of 35.6 percent. The data were analyzed using Smart PLS 3 and SPSS version 25.

Findings

The results revealed that LM practices directly and positively affected operational performance and IC had a positive moderation effect on the relationship between LM practices and operational performance. The results indicated that the structural equation model remained invariant across the groups. This showed that IC had a moderating effect on the relationship between LM practices and operational performance for both low IC and high IC industries.

Originality/value

The study analyzed the moderating effect of IC in Zimbabwean industries. The study will provide further evidence to managers on the impact of LM practices on operational performance in developing countries.
An information-based approach to organizational change management
Authors: Freeburg Darin
Published: February 2020

Purpose

Though information dissemination is widely viewed within organizations as an outdated method for initiating behavior change, this study aims to suggest that it can still be effective if done strategically. The study proposes and implements the knowing model, which suggests that an individual must be aware of information about a target behavior change, integrate that information as knowledge, and be motivated to act on that knowledge. The study highlights several barriers and strategies for overcoming those barriers.

Design/methodology/approach

The model was implemented in a case study within a religious organization that wanted to increase giving behavior. Leadership and members engaged in several focus groups both before and after a three-month information campaign.

Findings

Results show that members had a better understanding of the target behavior, a gradual shift in beliefs about the target behavior, and an increase in perceived susceptibility to consequences related to inaction. As a result, members and leadership indicated an increase in giving behavior in unexpected and beneficial ways.

Originality/value

The knowing model is a low-resource approach useful as a first step in change management. It is helpful when organizations acknowledge the need for change in a given area without knowing how that change should look.
Does political self-disclosure in social media hamper tacit knowledge sharing in the workplace?
Authors: Yudhistira Diaz Satriavi , Sushandoyo Dedy
Published: February 2020

Purpose

The purpose of this is to explore recipients’ reactions to co-workers’ political self-disclosure on social media and their willingness to share tacit knowledge with the disclosers. The paper aims to understand whether political self-disclosure with dissimilar value and negative valence hampers tacit knowledge sharing among co-workers in a workplace setting.

Design/methodology/approach

This study applies an online survey combined with the experimental vignette methodology approach to collect respondent data. Further, the study uses the partial least squares-structural equation modelling method to analyse the 144 collected responses.

Findings

This study suggests that perceived content negativity towards co-workers’ political self-disclosure has a weak and significant indirect effect on recipients’ willingness to share tacit knowledge, and that perceived value dissimilarity has an insignificant indirect effect on recipients’ willingness to share tacit knowledge.

Research limitations/implications

This study is a cross-sectional research that was conducted at a public organisation, with a limited number of samples and non-probabilistic sampling method. Thus, the results of this study may be subject to bias, and the generalizability of the findings should be taken into consideration.

Practical implications

Although this study shows that political self-disclosure does not likely affect tacit knowledge sharing, senior management of an organisation is encouraged to educate their employees about the potential consequences of self-political disclosure embedded in information employees post in social media. The posted information may attract positive or negative perceptions from the recipient to the discloser. Therefore employees are expected to use social media properly and minimise the possibility of posting something that might trigger a negative perception or emotion from their co-workers.

Originality/value

Sharing topics related to political self-disclosure on social media potentially hampers tacit knowledge sharing in organisations and is relatively rare in the knowledge management literature. In particular, the existing literature bases its studies on private sector organisations. Furthermore, the empirical evidence of this study is based on an Indonesian public sector organisation, which is also relatively rare in the literature.
Risk of insulin resistance with statin therapy in individuals without dyslipidemia: A propensity‐matched analysis in a registry population
Authors: Hyun Myung Han , Jang Jae Won , Choi Byoung Geol , Na Jin Oh , Choi Cheol Ung , Kim Jin Won , Kim Eung Ju , Rha Seung‐Woon , Park Chang Gyu , Lee Eunmi , Seo Hong Seog
Published: February 2020

Several studies suggest the higher vulnerability of individuals with lower low‐density lipoprotein cholesterol (LDL‐C) levels to diabetes mellitus. However, the discordance between high and low baseline LDL‐C levels shown by statin‐induced insulin resistance is not fully understood. This study aimed to explore the relationship between baseline LDL‐C levels and the risk of statin‐induced insulin resistance during statin therapy. In total, 2660 (451 with dyslipidemia and 2209 without dyslipidemia) consecutive patients were enrolled. Their baseline clinical data were adjusted using a propensity score matching analysis, using the logistic regression model. Insulin resistance index was based on the homeostatic model assessment‐insulin resistance (HOMA‐IR) and was monitored for a median of 2 years. Among the individuals who received statin therapy, those with and without dyslipidemia showed significantly decreased LDL‐C levels (all P < .0001) and significantly increased fasting plasma insulin levels (Δ = +24.1%, P = .0230; Δ = +30.1%, P < .0001); however, their glycated haemoglobin A1c and fasting blood glucose levels did not change (all P > .05). Although HOMA‐IR was positively associated with statin therapy in individuals with and without dyslipidemia, statistically significant difference during follow‐ups was observed only in individuals without dyslipidemia (Δ = +15.6%, P = .1609; Δ = 24.0%; P = .0001). Insulin resistance was higher in statin users without baseline dyslipidemia than in those with dyslipidemia. Thus, statin therapy could increase the risk of statin‐induced insulin resistance in individuals with normal baseline cholesterol levels.
Wheat germ agglutinin is a biomarker of whole grain content in wheat flour and pasta
Authors: Killilea David W. , McQueen Rebecca , Abegania Judi R.
Published: February 2020

When consumed as whole grain, wheat has a high nutrient density that contributes to a healthy diet. Yet, products labeled as whole wheat can still contain a substantial amount of refined grain leading to the confusion for consumers, so a method was designed to determine the whole grain status within wheat‐based foods. Wheat germ agglutinin (WGA), a lectin found in the germ tissue of wheat kernels, was evaluated as a biomarker of whole grain wheat. WGA content strongly correlated with the percentage of whole wheat within premade mixtures of whole and refined (white) flours. Then, commercial flours labeled as whole wheat were tested for WGA content and found to contain up to 40% less WGA compared to a whole grain standard. Commercial pasta products labeled as whole wheat were also tested for WGA content and found to contain up to 90% less WGA compared to a whole grain standard. The differences in WGA content were not likely due to varietal differences alone, as the WGA content in common varieties used in domestic wheat flour production varied less than 25%. The levels of other constituents in wheat kernels, including starch, mineral, phytate, and total protein, were not different among the commercial whole wheat flours and pasta products. WGA is a unique biomarker that can identify wheat products with the highest whole grain content.

Practical Abstract

Whole grain wheat has a high nutrient density that can be part of a healthy diet, but products labeled as whole wheat can still contain some refined grain. Wheat germ agglutinin (WGA) was tested as a biomarker to measure whole grain status in wheat‐based foods and revealed that some commercial whole wheat flour and pasta contained unexpectedly lower levels of the WGA biomarker compared to a whole grain standard. WGA may therefore be a useful way to test for whole grain wheat content.
Consumer attitudes toward entomophagy before and after evaluating cricket (Acheta domesticus)‐based protein powders
Authors: Barton Alanah , Richardson Connor D. , McSweeney Matthew B.
Published: February 2020

In recent years, the use of insects in food products has increased. Insects are a sustainable ingredient that is high in protein. However, consumption in Western countries is low, and this may be due to poor sensory qualities, expense, availability, and food neophobia. The objectives of this study were to determine Atlantic Canadian consumers’ attitudes toward entomophagy and to assess consumers’ perception of cricket‐based protein powders. There were two phases to this study: in phase one, participants (n = 107) completed a survey about their attitudes toward consuming insects (Specific Beliefs and Attitudes about Insect Consumption Scale created by Ruby, Rozin, & Chan 2015), and in the second phase, participants (n = 102) were asked to evaluate four different protein powders (two contained crickets) using 9‐point hedonic scales and a CATA questionnaire. Then, the participants were again asked to complete the aforementioned survey. Before consuming cricket protein powder, most participants thought that insects were a sustainable protein source, but also thought that the consumption of insects was undesirable. However, after consuming cricket protein powder, the participants were willing to buy cricket powder and were willing to recommend it to their friends. For insect consumption to become acceptable in the Western world, it will need to be integrated slowly to reduce consumers’ fear and negative attitudes. Protein powders are consumed by many people in the Western world and are an excellent candidate to allow for the integration of insects into their diets.

Practical Application

This study demonstrated that consumers in Atlantic Canada are more willing to eat insects after having tried them in protein powders. Additionally, protein powders represent a familiar context for consumers and allow for the acceptable integration of cricket powder. Consumers are willing to buy and recommend crickets to their friends after consuming them (in a processed form); however, they still have concerns that insects may carry harmful microbes and toxins.
Centers for Disease Control and Prevention Recommendations for Hepatitis C Testing: The Need to Adopt Universal Screening in an Appalachian Emergency Department
Authors: Wojcik Elena M. , Sharon Melinda J. , Davis Stephen M. , Lander Owen M. , Burrell Carmen N.
Published: February 2020

Background

The Centers for Disease Control and Prevention recommends screening baby boomers and high‐risk patients for hepatitis C virus (HCV); however, the incidence of HCV is rapidly increasing among younger populations, and screening is limited by access to care and risk factor assessment. The purpose of this study was to evaluate characteristics of HCV antibody‐positive (Ab+) and ribonucleic acid (RNA)‐confirmed‐positive patients identified via two screening models in an Appalachian emergency department (ED).

Methods

This was a retrospective cohort study of patients who screened HCV Ab+ in the ED from January 1 to October 31, 2018. Data were extracted, and comparative analyses were conducted between the risk‐based and the universal screening models.

Results

Overall, 444 patients screened HCV Ab+, with a median age of 39 years. From January to May 2018, the risk factor model identified 126 HCV Ab+ patients out of 3,014 screened (4%), whereas from June to October 2018, the universal model identified 318 HCV Ab+ patients out of 5,407 screened (6%; p < 0.001). A consistently large proportion of diagnoses were new (71%). There was no statistically significant decrease between the RNA‐confirmed‐positive patients during the risk factor model (76, 60%) and universal model (186, 58%) time periods (p = 0.72). The models had high rates of reported intravenous drug use, and the universal screening adoption was modest at 33%.

Conclusion

This study was the first to present characteristics of HCV Ab+ and RNA‐confirmed‐positive patients identified during the transition to a universal screening model in an Appalachian ED. Most diagnoses were new regardless of screening model, but more patients screened HCV Ab+, and a similar proportion were RNA‐confirmed‐positive, under the universal model. Given that adoption of universal screening was modest, and risk factors remained similar, future research should investigate how to more effectively implement a universal screening model on a wider scale to identify early infections.
Micro Impacts of a Macro‐Level Trading Partnership: Effects of China’s Belt and Road Initiative in Pakistan
Authors: Niazi Komal , Shoaib Muhammad , Qiulian Song
Published: February 2020

Trade and investment lead to economic development of regions and nations. Economists focus on the benefits derived from these activities, but there are also costs, many of which go unnoticed in studies that examine the aggregate effects of projects. This article examines the effects on one village in Pakistan of the construction of two coal‐fired power plants that are elements in the China‐Pakistan Economic Corridor (CPEC), which is the largest component of China’s Belt and Road Initiative to develop Asia. Although the newly produced roads and electric power from CPEC will help solve the macro‐level problems of Pakistani development, the local residents who are displaced from their farmland to make construction possible fare badly. Losing their farms has not only meant being forced to take jobs that pay much less than agriculture. It has also fractured the social ties that bind together the local community and provide residents with self‐respect. The effects have been particularly harmful to the status of women. Viewed as a microcosm of the costs of trade and investment, the village of Qadirabad is a symbol of how well‐meaning projects contribute to the deterioration of small‐scale communities and the growth of urban slums around the world.
Liquefied Natural Gas: Redefining Nature, Restructuring Geopolitics, Returning to the Periphery?
Authors: Ciccantell Paul S.
Published: February 2020

The liquefied natural gas (LNG) industry began as a means of making use of natural gas resources in socially remote regions and of natural gas associated with oil production. Natural gas was transformed from a waste product into LNG that could be moved thousands of miles to market, redefining “waste” as a valuable raw material. As the newest large‐scale LNG exporter, the United States entered the LNG industry based on another redefinition of nature: the extraction of natural gas previously economically and technologically inaccessible in shale formations. Hydraulic fracturing and new drilling technologies have created reserves of natural gas that are driving down prices with excess production and provoking a search for new markets via LNG exports. Liquefied natural gas is reshaping economies, communities, industries, and ecosystems in the United States and in other parts of the world.

This article analyzes the role of the LNG industry with a particular focus on the economic and geopolitical consequences for the United States. The United States is returning to its historical role of energy exporter. Some view the return to this role as an economic and geopolitical boon that will enhance the U.S. economy and the nation’s global standing. A contrasting interpretation sees the United States sliding into the extractive periphery, serving the energy demands of a growing China, much like the United States once did for Europe and especially Great Britain. This view condemns what it views as the exploitation of U.S. natural resources to meet China’s energy needs while leaving large areas of the United States with depleted resources, damaged ecosystems, and disrupted communities.
Radical Trade Reform: From Industrial to Ecological Civilization
Authors: Huang Yi , Tian Shuying
Published: February 2020

All theories of international trade that are based on the paradigm of industrial civilization are becoming obsolete. The premises behind the principle of comparative advantage, which developed in the historical context of the early 19th century, are disappearing. Uncertainties about the future of fossil fuels, conflicts between rich and poor, global ecological fragility, and many other symptoms of system failure have revealed the flaws of industrial civilization and international trade. We examine the history of trade theory within the framework of industrial civilization. We then propose the transition to an ecological civilization, which will restore the diversity of cultures by moving away from the homogeneous world culture that globalization has begun to create. Under the conditions of ecological civilization, international trade will serve the human need to exchange the surplus of each society and to communicate with other cultures. It will cease to be a system of debt and dependence that threatens the sovereignty of most nations today.
Diagnostic accuracy of repeat placental growth factor measurements in women with suspected preeclampsia: A case series study
Authors: Duhig Kate E. , Webster Louise M. , Sharp Andrew , Gill Carolyn , Seed Paul T. , Shennan Andrew H. , Myers Jenny E. , Chappell Lucy C.
Published: February 2020

Introduction

Preeclampsia affects about 3% of singleton pregnancies and is characterized by placental dysfunction. It is associated with significant maternal and perinatal morbidity and mortality. The diagnosis of preeclampsia remains a challenge, and the clinical course can develop for weeks before a diagnosis is confirmed. National guidelines have approved placental growth factor (PlGF) testing to rule out suspected preeclampsia, but the utility of repeated PlGF measurement is unknown. The aim of this case series analysis was to evaluate the test performance of repeated PlGF sampling in women presenting with suspected preeclampsia, and to describe relevant clinical outcomes.

Material and methods

Women who presented to maternity services with suspected preeclampsia between 20+0 and 36+6 weeks’ gestation who underwent repeat PlGF sampling with a minimum test interval of 7 days were assessed. The outcomes were delivery for preeclampsia within 14 days of sampling, the proportion changing PlGF categories, and time to delivery.

Results

In total, 289 women with suspected preeclampsia undergoing repeat PlGF sampling were included. PlGF <100 pg/mL had a high sensitivity (87.5%, 95% confidence interval [CI] 67.6%‐97.3%) and a negative predictive value (97.7%, 95% CI 93.5%‐99.5%) at the initial test (receiver operating characteristic [ROC] area 0.79, 95% CI 0.68‐0.89). Similar test performance was seen for PlGF <100 pg/mL when undertaken as a repeat test (sensitivity 90.7%, 95% CI 85.2%‐95.9%, negative predictive value 92.2%, 95% CI 85.3‐96.6%). Overall, 25.6% of women changed PlGF category between the first and second PlGF tests. For each PlGF category, determination of time to delivery was similar for first and second tests.

Conclusions

Repeat PlGF measurement demonstrates high negative predictive value for determining preeclampsia requiring delivery in 14 days. Repeat testing may be clinically useful to risk stratify women with ongoing symptoms of disease. Confirmation of the impact of these findings is required in further studies.
Spleen size improvement in advanced heart failure patients using a left ventricular assist device
Authors: Hiraiwa Hiroaki , Okumura Takahiro , Sawamura Akinori , Kondo Toru , Kazama Shingo , Kimura Yuki , Shibata Naoki , Arao Yoshihito , Oishi Hideo , Kato Hiroo , Kuwayama Tasuku , Yamaguchi Shogo , Furusawa Kenji , Morimoto Ryota , Murohara Toyoaki
Published: February 2020

The spleen has been recognized as an important organ that holds a reserve of 20% to 30% of the total blood volume. Spleen contraction and splenic volume reduction occur in patients with hypovolemic shock. However, the change in the spleen volume and the association between spleen size and hemodynamic parameters remain unclear in patients with advanced heart failure (HF) who need left ventricular assist device (LVAD) support. This study was performed to investigate the change in spleen size and the relationship between spleen size and hemodynamic parameters before and after LVAD implantation in patients with advanced HF. We enrolled 20 patients with advanced HF on LVAD support. All patients underwent right heart catheterization and computed tomography before and after LVAD implantation. The spleen size was measured by computed tomography volumetry. We excluded patients with a mean right atrial pressure (RAP) of <5 mm Hg because of the possibility of hypovolemia and those with a cardiac index of >2.2 L/min/m2 before LVAD implantation. The splenic volume significantly increased from 160.6 ± 46.9 mL before LVAD implantation to 224.6 ± 73.5 mL after LVAD implantation (P < .001). Before LVAD implantation, there was a significant negative correlation between spleen volume and systemic vascular resistance (SVR). After LVAD implantation, however, there were significant correlations between spleen volume and the cardiac index, RAP, and pulmonary capillary wedge pressure despite the absence of a significant correlation between spleen volume and SVR. Furthermore, one patient developed reworsening HF because of LVAD failure due to pump thrombosis. In this case, the splenic volume was 212 mL before LVAD implantation and increased to 418 mL after LVAD implantation, although it decreased to 227 mL after LVAD failure. The spleen size may change depending on hemodynamics in patients with advanced HF with LVAD support, reflecting sympathetic nerve activity and the systemic volume status.
Randomised trial showed no difference in behavioural symptoms between surgical methods treating paediatric obstructive sleep apnoea
Authors: Sjölander Isabella , Borgström Anna , Larsson Jan‐Olov , Smedje Hans , Friberg Danielle
Published: February 2020

Aim

Our previous randomised controlled trial of children with obstructive sleep apnoea (OSA) showed no significant differences between adenotonsillectomy (ATE) and adenotonsillotomy (ATT) in improving nocturnal respiration and quality of life after 1 year. The aim of this report was to evaluate the effects on behavioural symptoms using the Strengths and Difficulties Questionnaire (SDQ).

Methods

Children between 2 and 6 years with OSA were randomised to ATT or ATE. Parents, blinded to method, answered the SDQ while their child underwent polysomnography before and 1 year after surgery. Differences between the total SDQ scores were analysed between the treatment groups.

Results

The SDQ was filled out in 87% of the cases preoperatively, and in 86% postoperatively. At follow‐up, the mean total SDQ score was 9.6 SD ± 5.1 in the ATE group (n = 31), and 8.2 ± 6.7 in the ATT group (n = 37), P = .09. The mean total SDQ score for all was preoperatively 10.6 ± 5.0, and postoperatively 8.8 ± 6.0, P = .0002.

Conclusion

There were no significant differences in SDQ scores between the groups at follow‐up, indicating that the more conservative ATT is a treatment option in paediatric OSA. The whole group of patients showed a significant improvement after surgery.
Gastrointestinal stromal tumor of the rectum resected by transanal total mesorectal excision after neoadjuvant imatinib treatment: A case report
Authors: Yano Takuya , Nakahara Masahiro , Okuda Hiroshi , Nishidate Toshihiko , Takemasa Ichiro , Fujimori Masahiko , Nakatsuka Hirofumi , Amano Hironobu , Ohdan Hideki , Noriyuki Toshio
Published: February 2020

This report describes the combination of a transanal total mesorectal excision (TaTME) and neoadjuvant therapy with Imatinib mesylate (IM) for a gastrointestinal stromal tumor (GIST) of the lower rectum. A 49‐year‐old man presented with a submucosal tumor with ulcer located 3 cm above the anal verge. Histopathologically, a biopsy showed spindle‐shape cells, positive for C‐kit and CD34, negative for smooth muscle actin, desmin and S‐100 protein. Genetically, this GIST had the mutation in KIT exon 11. IM (400 mg/d) was administered as neoadjuvant therapy for 80 days. The GIST shrank from 4.7 to 3.3 cm in diameter. Abdominal and transanal approach were started at the same time. The tumor was resected by TaTME successfully. The manometric pressure data and anal function were preserved before and after surgery. TaTME and neoadjuvant therapy with IM provide a treatment option which can preserve anal function for the lower rectal GIST.
Primary analysis of JUMP, a phase 3b, expanded‐access study evaluating the safety and efficacy of ruxolitinib in patients with myelofibrosis, including those with low platelet counts
Authors: Al‐Ali Haifa Kathrin , Griesshammer Martin , Foltz Lynda , Palumbo Giuseppe A. , Martino Bruno , Palandri Francesca , Liberati Anna Marina , le Coutre Philipp , García‐Hernández Carmen , Zaritskey Andrey , Tavares Renato , Gupta Vikas , Raanani Pia , Giraldo Pilar , Hänel Mathias , Damiani Daniela , Sacha Tomasz , Bouard Catherine , Paley Carole , Tiwari Ranjan , Mannelli Francesco , Vannucchi Alessandro M.
Published: February 2020

Ruxolitinib is a potent Janus kinase (JAK) 1/JAK2 inhibitor approved for the treatment of myelofibrosis (MF). Ruxolitinib was assessed in JUMP, a large (N = 2233), phase 3b, expanded‐access study in MF in countries without access to ruxolitinib outside a clinical trial, which included patients with low platelet counts (<100 × 109/l) and patients without splenomegaly – populations that have not been extensively studied. The most common adverse events (AEs) were anaemia and thrombocytopenia, but they rarely led to discontinuation (overall, 5·4%; low‐platelet cohort, 12·3%). As expected, rates of worsening thrombocytopenia were higher in the low‐platelet cohort (all grades, 73·2% vs. 53·5% overall); rates of anaemia were similar (all grades, 52·9% vs. 59·5%). Non‐haematologic AEs, including infections, were mainly grade 1/2. Overall, ruxolitinib led to meaningful reductions in spleen length and symptoms, including in patients with low platelet counts, and symptom improvements in patients without splenomegaly. In this trial, the largest study of ruxolitinib in patients with MF to date, the safety profile was consistent with previous reports, with no new safety concerns identified. This study confirms findings from the COMFORT studies and supports the use of ruxolitinib in patients with platelet counts of 50–100 × 109/l. (ClinicalTrials.gov identifier NCT01493414).
Pharmacological and genetic characterisation of the canine P2X4 receptor
Authors: Sophocleous Reece A. , Berg Tracey , Finol‐Urdaneta Rocio K. , Sluyter Vanessa , Keshiya Shikara , Bell Lachlan , Curtis Stephen J. , Curtis Belinda L. , Seavers Aine , Bartlett Rachael , Dowton Mark , Stokes Leanne , Ooi Lezanne , Sluyter Ronald
Published: February 2020

Background and Purpose

P2X4 receptors are emerging therapeutic targets for treating chronic pain and cardiovascular disease. Dogs are well‐recognised natural models of human disease, but information regarding P2X4 receptors in dogs is lacking. To aid the development and validation of P2X4 receptor ligands, we have characterised and compared canine and human P2X4 receptors.

Experimental Approach

Genomic DNA was extracted from whole blood samples from 101 randomly selected dogs and sequenced across the P2RX4 gene to identify potential missense variants. Recombinant canine and human P2X4 receptors tagged with Emerald GFP were expressed in 1321N1 and HEK293 cells and analysed by immunoblotting and confocal microscopy. In these cells, receptor pharmacology was characterised using nucleotide‐induced Fura‐2 AM measurements of intracellular Ca2+ and known P2X4 receptor antagonists. P2X4 receptor‐mediated inward currents in HEK293 cells were assessed by automated patch clamp.

Key Results

No P2RX4 missense variants were identified in any canine samples. Canine and human P2X4 receptors were localised primarily to lysosomal compartments. ATP was the primary agonist of canine P2X4 receptors with near identical efficacy and potency at human receptors. 2′(3′)‐O‐(4‐benzoylbenzoyl)‐ATP, but not ADP, was a partial agonist with reduced potency for canine P2X4 receptors compared to the human orthologues. Five antagonists inhibited canine P2X4 receptors, with 1‐(2,6‐dibromo‐4‐isopropyl‐phenyl)‐3‐(3‐pyridyl)urea displaying reduced sensitivity and potency at canine P2X4 receptors.

Conclusion and Implications

P2X4 receptors are highly conserved across dog pedigrees and display expression patterns and pharmacological profiles similar to human receptors, supporting validation and use of therapeutic agents for P2X4 receptor‐related disease onset and management in dogs and humans.
Exploring drivers of demand for child protection services in an English local authority
Authors: Hood Rick , Gorin Sarah , Goldacre Allie , Muleya Wilson , Bywaters Paul
Published: February 2020

This paper reports on an empirical study of child protection services in a local authority where rates of investigations and interventions rose to unprecedented levels during the course of a single year. The aim of the research was to explore explanations for this rise in demand among the providers of children's social care in the area. Using an interpretative qualitative design, a series of focus groups and interviews were carried out with practitioners and managers (n = 25) from statutory services and Early Help. The findings identified a combination of long‐term and short‐term drivers of demand. Long‐term factors emphasized the impact of rising levels of deprivation combined with cuts to community‐based services for children and young people. Short‐term factors ranged from a more proactive approach to child neglect to more effective multi‐agency partnerships and joint decision making. The interaction between these factors was found to be accentuating an underlying shift to “late intervention” across the sector. The findings are contextualized in relation to contemporary debates about the crisis of demand for children's social care and the complex relationship between prevention and protection.
Global reforestation and biodiversity conservation
Authors: Kemppinen Krista M.S. , Collins Pamela M. , Hole David G. , Wolf Christopher , Ripple William J. , Gerber Leah R.
Published: February 2020

The loss of forest is a leading cause of species extinction, and reforestation is 1 of 2 established interventions for reversing this loss. However, the role of reforestation for biodiversity conservation remains debated, and lacking is an assessment of the potential contribution that reforestation could make to biodiversity conservation globally. We conducted a spatial analysis of overlap between 1,550 forest‐obligate threatened species’ ranges and land that could be reforested after accounting for socioeconomic and ecological constraints. Reforestation on at least 43% (∼369 million ha) of reforestable area was predicted to potentially benefit threatened vertebrates. This is approximately 15% of the total area where threatened vertebrates occur. The greatest opportunities for conserving threatened vertebrate species are in the tropics, particularly Brazil and Indonesia. Although reforestation is not a substitute for forest conservation, and most of the area containing threatened vertebrates remains forested, our results highlight the need for global conservation strategies to recognize the potentially significant contribution that reforestation could make to biodiversity conservation. If implemented, reforestation of ∼369 million ha would also contribute substantially to climate‐change mitigation, offering a way to achieve multiple sustainability commitments at once. Countries must now work to overcome key barriers (e.g., unclear revenue streams, high transaction costs) to investment in reforestation.
Routine comprehensive Aspergillus screening of bronchoalveolar lavage samples in lung transplant recipients
Authors: Unterman Avraham , Izhakian Shimon , Geffen Yuval , Rosengarten Dror , Shtraichman Osnat , Pertzov Barak , Vainshelboim Baruch , Alon Hagar , Raviv Yael , Kramer Mordechai R.
Published: February 2020

Background

Invasive aspergillosis is a significant cause of morbidity and mortality in lung transplant recipients (LTRs). Early diagnosis may improve outcome, yet is challenging. We assessed the diagnostic yield of a routine, comprehensive, prospectively employed Aspergillus screening strategy in LTRs.

Methods

During a 6‐month period, all bronchoalveolar lavage (BAL) samples (including post‐transplant surveillance) obtained from LTRs at our center were routinely tested for Aspergillus PCR, galactomannan (GM), and fungal culture. Invasive aspergillosis (IA) was defined using EORTC/MSG and ISHLT criteria for proven and probable aspergillosis.

Results

Ninety‐five consecutive BAL samples were tested. PCR, GM, and fungal culture were positive in 28.4%, 30.6%, and 7.4%, respectively. Five cases of IA (two proven, three probable) were identified. Fungal culture failed to detect 40% of IA cases, which were detected by a positive PCR and/or GM. However, the majority of positive PCR samples represented colonization (59.3%). Sensitivity of PCR, GM, and culture for IA was 80%, 60%, and 60%, respectively, and specificity was 74%, 71%, and 96%.

Conclusions

In LTRs, a routine prospectively employed screening strategy in which all BAL samples were screened for Aspergillus PCR and GM, detected aspergillosis cases that were otherwise missed by a false‐negative fungal culture, but resulted in more cases of colonization being detected. Clinical judgment is thus warranted to avoid unnecessary treatment of colonization.