bluuebunny/crossref_metadata_2025 huggingface dataset:
P1544 Independent prognostic significance of non invasive left atrial stiffness in outpatients with heart failure and reduced ejection fraction
Authors: Bytyci I , Riccardo N , Bajraktari A , Mazzola M , Bajraktari G , Henein M , Dini F L
Published: January 2020

Background and Aim

Left atrial (LA) stiffness is an important marker of cardiac pump function, especially in patients with heart failure (HF) and preserved ejection fraction (HFpEF). The aim of this study was to evaluate the relationship between LA stiffness and cardiac events (CE) in HF patients with reduced ejection fraction (HFrEF).

Methods

This study included 136 consecutive HFrEF outpatients (mean age: 65 ± 11 years). A complete conventional and tissue Doppler imaging study was performed. The LA dimension and function were measured. Non invasive LA stiffness was calculated with the following formula: LA stiffness = E/e’ratio/LA strain. The cardiac events were HF hospitalization and cardiac death.

Results

During a median follow up of 55 ± 37 months, 51 patients had CE, they had higher NYHA functional class (p = 0.001), higher LV end-diastolic dimension (p = 0.001), higher LV end-systolic dimension (p = 0.04), lower EF (p < 0.001), higher E/A ratio (p = 0.01) and reduced TAPSE (p = 0.001) compared with patients without CE. LA volume index was higher (p = 0.001), LA strain was reduced and LA stiffness was increased in patients with CE compared to those without CE (p = 0.0001, p < 0.0001, respectively). LA stiffness exhibited the closest relationship with E/e’ ratio (r = 0.67, p < 0.001). Survival analyses showed that LA stiffness [HR: 4.026 (1.300–12.468), p = 0.001] was the most powerful independent predictor of cardiac events[C1] . On ROC curve analysis, a LA stiffness < 0.82% was 81% sensitive and 73% specific (AUC 0.81, p < 0.001) in predicting clinical events (Figure 1).

Conclusion

In this cohort of outpatients with HFrEF, LA stiffness proved the most important predictor of clinical outcome.

[C1]

Abstract P1544 Figure.
P1554 Assessment of functional mitral regurgitation with leg lift and exercise echocardiography using the average pixel intensity method
Authors: Kamoen V , El Haddad M , De Backer T , Timmermans F
Published: January 2020

Background

Dynamic changes in functional mitral regurgitation (FMR) during exercise echocardiography were shown to be of prognostic value. However grading of FMR is challenging, especially during exercise echocardiography and therefore questioning its applicability in clinical practice. We recently introduced and validated the Average Pixel Intensity (API) for grading MR based on the pixel intensity of the continuous wave Doppler signal. In the current study we investigate the use of the API method using leg lift and exercise echocardiography in FMR.

Methods

We prospectively included 50 heart failure patients (mean ejection fraction 36%) in sinus rhythm with different grades of pure, FMR. After assessment of FMR severity at rest, the same acquisitions were repeated during leg lift and exercise echocardiography. FMR was assessed using the API method, color Doppler and quantitative grading methods (proximal isovelocity surface area (PISA) and vena contracta width (VCW)).

Results

The API method could be performed in all patients (100%) with leg lift (n = 50) and in 94% of the patients undergoing exercise echocardiography (n = 44), which was more than PISA and VCW (p < 0.001).

During leg lift, there was a small but significant increase on visual color Doppler grading (grade 1.93 to 2.11 (p = 0.004); increase of FMR in 35% of patients, and no difference in 65%). For API, we found the same significant increase (93 to 101 au), however, API values showed increase of MR in 62% and decrease of FMR in 20%.

During exercise echocardiography, we found no differences in color Doppler grade and API in the overall cohort (p 0.252 and p 0.832, respectively), despite 62% of patients showing some degree of increase in API during leg lift. On multivariate analysis, no specific echo parameter could be identified as independent predictor of API increase.

Conclusions

The novel API method is highly feasible for assessing dynamic FMR and may be of added value for in this setting, allowing the detection of even small increments of FMR severity.

In the current study, we found only mild increases of FMR during exercise echocardiography. Leg lift testing however proved to be a simple and quick loading approach that induced a significant rise in FMR compared to exercise echocardiography. The prognostic relevance of the findings during leg lift remains to be determined.
P1557 Predictive significance of right ventricle dysfunction on clinical outcome in patients with HFpEF
Authors: Skidan V I , Rosseykin E V , Pavlyukova E N , Nartsissova G P
Published: January 2020

Background

the volume and function of the right ventricle (RV) are the parameters that determine the echo predictive factors of mortality and reduce hospitalizations in patients with heart failure (HF) with reduced ejection fraction (HFrEF). In the concept of the mechanism of the contraction of the heart the global RV ejection fraction consist of combined longitudinal, radial and anteroposterior displacement of the RV walls. RV pump function realized by shortening of the longitudinal axis with the traction of the tricuspid annulus towards the apex; inward movement of the RV free wall; bulging of the interventricular septum into the RV and stretching the free wall over the septum. In case of HFpEF the longitudinal mechanism of RV reduction is more sensitive than others. Longitudinal strain of RV free wall (RVFWS) and 3DRVEF has been proposed as a more accurate and sensitive tool to evaluate RV function in longitudinal displacement of patients with HFpEF. Methods and Results—A total of 73 patients with HFpEF (age, from 26 to 77 years; the clinical manifestations of HFpEF corresponded to NYHA III in 52 patients (71%), NYHA IV in 21 patients (29%); LV EF ≤ 35%) with preserved TAPSE (≤15 mm) underwent RV function assessment using 4DETomTec, speckle-tracking TTE to measure peak RVFWS, GLS, 4DEEF. After a median follow-up period of 36 months, 61 (83%) patients reached the primary composite end point of all-cause death/Heart transplantation. Median RVFWS was −12.3% (interquartile range, −20.3% to −9.4%). Median RVGLS was −15.3% (interquartile range, −21.3% to −10.54%). Median RV4DEF was 31.6% (interquartile range, 21,1% to 36,2%). By Kaplan–Meier plot, RVFWS > -15%, (p < 0,02), GLS >-20%, (p < 0,04), 4DETomtecEF <30% (p < 0,0001) were an independent predictor of outcome in patients with HFpHF. Conclusions: In patients with HFpEF the fast and accurate quantification of RV free-wall strain and 4DTomtecEF provides incremental prognostic information and improved risk stratification.
Online media use and HPV vaccination intentions in mainland China: integrating marketing and communication perspectives to improve public health
Authors: Yang Guolan , Myrick Jessica Gall
Published: January 2020

This study investigates the role of media in shaping human papilloma virus vaccination intentions in mainland China by applying both communication and marketing-focused theoretical frameworks in order to better understand ways to increase vaccine uptake across young men and women in China. An online survey (N = 359) revealed direct effects of online information consumption on perceived scarcity of the vaccine, as well as an indirect effect via perceived influence of media on others. Scarcity perceptions, in turn, predicted vaccine attitudes and behavioral intentions. Additionally, gender differences emerged in the data. Compared with women, men’s intent to be vaccinated were not high, even if they realized the vaccine shortage. Implications for theory and practice are discussed.
Fundamental Rights in European Union Policy-making: The Effects and Advantages of Institutional Diversity
Authors: Dawson Mark
Published: January 2020

This article investigates how the European Union’s political process affects the level of rights protection afforded by European Union (EU) law. It does so in two steps, firstly by analysing how institutional politics plays an important role in the evolution of the EU fundamental rights framework and secondly by demonstrating empirically how legislative interaction affects the level of protection provided by three important EU legislative acts. As the article will demonstrate, this interaction tends to result in the overall level of rights protection being increased. Analysing this finding, the article uses institutionalist theory to argue that the EU’s political process carries certain positive effects: the diversity of the legislative process (both within and between institutions) makes the explicit overlooking of rights-based concerns difficult. These findings carry implications for the increasing tendency to channel EU law and policy outside of the ‘ordinary’ legislative process.
Recent Trends in the Incidence and Survival of Stage 1A Pancreatic Cancer: A Surveillance, Epidemiology, and End Results Analysis
Authors: Blackford Amanda L , Canto Marcia Irene , Klein Alison P , Hruban Ralph H , Goggins Michael
Published: January 2020

Background

Rapid access to pancreatic imaging and regular pancreatic surveillance may help identify stage I pancreatic cancer. We investigated recent trends in the stage of newly diagnosed pancreatic ductal adenocarcinoma (PDACs), age at diagnosis, and survival.

Methods

Trends in age-adjusted incidence of stage IA PDAC between 2004 and 2016 were determined from the National Cancer Institute’s Surveillance, Epidemiology and End Results database. All tests were two-sided.

Results

The incidence of stage IA PDAC cases diagnosed increased statistically significantly from 2004 to 2016 (annual percent change = 14.5, 95% confidence interval [CI] = 11.4 to 17.7; P < .001). During the study period, average age at diagnosis for stage IA and IB casesAQ3 declined by 3.5 years (95% CI = 1.2 to 5.9; P = .004) and 5.5 years (95% CI = 3.4 to 7.6; P < .001), whereas average age increased for higher-stage cases (by 0.6 to 1.4 years). Among stage IA cases, the proportion of blacks was smaller (10.2% vs 12.5%), and the proportion of other non-Caucasians was higher compared with higher-stage cases (11.9% vs 8.4%; P < .001). Stage IA cases were more likely to carry insurance (vs Medicaid or none) than higher-stage cases (cases aged younger than 65 years; odds ratio = 2.45, 95% CI = 1.96 to 3.06; P < .001). The 5-year overall survival for stage IA PDAC improved from 44.7% (95% CI = 31.4 to 63.7) in 2004 to 83.7% (95% CI = 78.6% to 89.2%) in 2012; 10-year survival improved from 36.7% (95% CI = 24.1 to 55.8) in 2004 to 49.0% (95% CI = 37.2% to 64.6%) in 2007.

Conclusions

In recent years, the proportion of patients diagnosed with stage IA PDAC has increased, their average age at diagnosis has decreased, and their overall survival has improved. These trends may be the result of improved early diagnosis and early detection.
International Trends in the Incidence of Cancer Among Adolescents and Young Adults
Authors: Gupta Sumit , Harper Andrew , Ruan Yibing , Barr Ronald , Frazier A Lindsay , Ferlay Jacques , Steliarova-Foucher Eva , Fidler-Benaoudia Miranda M
Published: January 2020

Background

Although adolescent and young adult (AYA) cancers represent a unique spectrum of malignancies, epidemiological studies of cancer incidence often group AYAs together with younger or older populations, obscuring patterns specific to this population.

Methods

We examined AYA cancer incidence trends in 41 countries over a 15-year period using the CI5plus database. Truncated age-standardized incidence rates were calculated and the annual percentage change was assessed, with statistical significance corresponding to a 95% confidence interval that does not include zero.

Results

From 1998 to 2012, the 41 included countries contributed a total of 1 846 588 cancer cases and 3.1 billion person-years among AYAs. Although statistically significant increases in the overall cancer burden were observed in 23 countries, the magnitude varied considerably, with the greatest increase in incidence observed in South Korea (annual percentage change2002–2012 = 8.5%, 95% confidence interval = 7.6% to 9.4%) due to thyroid cancer. Notable trends included sharp increases in the incidence of obesity-related malignancies among AYAs; indeed, statistically significant increases were observed among AYAs for 10 of 11 and 9 of 11 obesity-related cancer sites in the US and UK, respectively, with at least five obesity-related cancers statistically significantly increasing in Canada, Japan, South Korea, Australia, and the Netherlands. Other striking trends were noted for thyroid and testicular cancer, with statistically significantly increasing rates observed in 33 and 22 countries, respectively, whereas statistically significant declines in incidence were observed for smoking-related cancers, cervical cancer, and Kaposi sarcoma in many countries.

Conclusions

Our results highlight the future health-care needs related to treatment as well as the urgency for public health initiatives that can mitigate the increasing burden of cancer in AYAs.
Dynamics of strand slippage in DNA hairpins formed by CAG repeats: roles of sequence parity and trinucleotide interrupts
Authors: Xu Pengning , Pan Feng , Roland Christopher , Sagui Celeste , Weninger Keith
Published: January 2020

DNA trinucleotide repeats (TRs) can exhibit dynamic expansions by integer numbers of trinucleotides that lead to neurodegenerative disorders. Strand slipped hairpins during DNA replication, repair and/or recombination may contribute to TR expansion. Here, we combine single-molecule FRET experiments and molecular dynamics studies to elucidate slipping dynamics and conformations of (CAG)n TR hairpins. We directly resolve slipping by predominantly two CAG units. The slipping kinetics depends on the even/odd repeat parity. The populated states suggest greater stability for 5′-AGCA-3′ tetraloops, compared with alternative 5′-CAG-3′ triloops. To accommodate the tetraloop, even(odd)-numbered repeats have an even(odd) number of hanging bases in the hairpin stem. In particular, a paired-end tetraloop (no hanging TR) is stable in (CAG)n = even, but such situation cannot occur in (CAG)n = odd, where the hairpin is “frustrated’’ and slips back and forth between states with one TR hanging at the 5′ or 3′ end. Trinucleotide interrupts in the repeating CAG pattern associated with altered disease phenotypes select for specific conformers with favorable loop sequences. Molecular dynamics provide atomic-level insight into the loop configurations. Reducing strand slipping in TR hairpins by sequence interruptions at the loop suggests disease-associated variations impact expansion mechanisms at the level of slipped hairpins.
Mothers and Fathers in Parliament: MP Parental Status and Family Gaps from a Global Perspective
Authors: Joshi Devin K , Goehrung Ryan
Published: January 2020

Studies of Western parliaments find women experience greater difficulty than men in combining parenting with a career in parliament. Is it the same worldwide? Addressing this issue, we compared the marital and parental status of legislators in 25 diverse parliaments around the world while theoretically exploring whether parliamentary family gaps are due to individual, family, institutional, societal or global-level conditions. Through a fuzzy-set qualitative comparative analysis, we find institutional- and societal-level factors matter. Namely, family gaps between men and women members of parliament (MPs) were narrower under conditions of higher female employment, women in parliamentary leadership and lower rates of child mortality. Thus, motherhood penalties for women MPs are likely to diminish with increases in women’s paid employment, better social welfare provisions and more women in parliamentary leadership positions. Our findings also point to the importance of public policies, parliamentary rules and critical actors in reducing time demands on parents who are MPs.
The Political Economy of Debt and Entitlements
Authors: Bouton Laurent , Lizzeri Alessandro , Persico Nicola
Published: January 2020

This article presents a dynamic political-economic model of total government obligations. Its focus is on the interplay between debt and entitlements. In our model, both are tools by which temporarily powerful groups can extract resources from groups that will be powerful in the future: debt transfers resources across periods; entitlements directly target the future allocation of resources. We prove the following results. First, the presence of endogenous entitlements dampens the incentives of politically powerful groups to accumulate debt, but it leads to an increase in total government obligations. Second, fiscal rules can have perverse effects: if entitlements are unconstrained, and there are capital market frictions, debt limits lead to an increase in total government obligations and to worse outcomes for all groups. Analogous results hold for entitlement limits. Third, our model sheds some lights on the influence of capital market frictions on the incentives of governments to adopt fiscal rules, and implement entitlement programs. Finally, we identify preference polarization as a possible explanation for the joint growth of debt and entitlements.
Post‐ERCP Pancreatitis in Pediatric Patients
Authors: Iqbal Corey W , Baron Todd H , Moir Christopher R , Ishitani Michael B
Published: January 2020

Objectives:

Pancreatitis is a known complication of endoscopic retrograde cholangiopancreatography (ERCP). Our aim was to assess the prevalence and severity of ERCP‐associated pancreatitis using established criteria.

Materials and Methods:

Retrospective review of patients younger than 18 years undergoing ERCP complicated by post‐ERCP pancreatitis defined by the 1991 consensus statement. Patients with chronic pancreatitis were studied separately using modified criteria. Risk factors for post‐ERCP pancreatitis were analyzed.

Results:

Three hundred forty‐three ERCPs were performed in 224 patients. Two hundred seventy‐six ERCPs were performed in patients without chronic pancreatitis, 7 of which were complicated by post‐ERCP pancreatitis (prevalence 2.5%). Patients undergoing diagnostic‐only ERCP were less likely to develop post‐ERCP pancreatitis (P < 0.01). Sixty‐seven procedures were performed on patients with chronic pancreatitis; 10 developed postprocedure pain requiring or prolonging hospitalization (prevalence 14.9%). Pancreatic duct stenting was a risk factor for post‐ERCP pain in this subset of patients (P = 0.02).

Conclusions:

The prevalence of post‐ERCP pancreatitis is low—2.5% excluding patients with chronic pancreatitis and 4.96% overall. Therapeutic procedures and the presence of chronic pancreatitis are risk factors for post‐ERCP pancreatitis.
Late Treatment of Displaced Intra-Articular Calcaneus Fractures: Successful Management With Anatomic Reduction
Authors: Swords Michael , Shank John , Fraticelli Nicole , Benirschke Stephen
Published: January 2020

Introduction:

The aim of this study was to evaluate the results of displaced intra-articular calcaneus fractures treated more than 25 days after injury by open reduction and internal fixation (ORIF) using a lateral extensile surgical approach.

Methods:

Twenty patients identified by retrospective review of our trauma database were treated with ORIF for a displaced intra-articular calcaneus fracture more than 25 days after injury. OTA/AO 82-B and 82-C fracture patterns were included. All had ORIF by a lateral extensile approach. Bohler's angle was measured on injury radiographs, after operative fixation and the final follow-up and compared with the Bohler's angle of the contralateral uninjured extremity. Patients completed a Musculoskeletal Function Assessment (MFA) to evaluate the functional outcome.

Results:

The mean number of days from injury to fixation was 33.4 days (range, 26–58 days). A total of 18/20 patients were available for follow-up (mean 26.1 months; range 12.5–100 months). Eleven injuries were joint depression (82-C), and 7 injuries were tongue type (82-B) fracture patterns. The reason for delayed presentation was delayed transfer to our institution (11 patients), hemodynamic instability from polytrauma (2 patients), excessive fracture blisters (2 patients), and sepsis (1 patient). Bohler's angle at the time of injury was a mean of 10.9 degrees, which corrected to a mean of 33.3 after operative fixation but decreased to a mean of 28.1 at the time of the final follow-up. The mean Bohler angle was 32.3 on the contralateral uninjured side. The mean MFA score was 16.5 (range, 1–34). There were no wound infections or subtalar arthrodesis procedures performed.

Conclusions:

ORIF by a lateral extensile approach is a safe and viable option for patients presenting in a delayed fashion with a displaced intraarticular calcaneus fracture. Marked improvement in the Bohler angle, acceptable functional outcome, and low complication rates can be expected when surgery is performed by an experienced surgeon.

Level of Evidence:

Level IV. See Instructions for Authors for a complete description of levels of evidence.
Current Global Bioethical Dilemmas in Corneal Transplantation
Authors: Córdoba Andrea , Mejía Luis F. , Mannis Mark J. , Navas Alejandro , Madrigal-Bustamante José A. , Graue-Hernandez Enrique O.
Published: January 2020

Purpose:

To analyze some of the bioethical dilemmas that may arise during the process required for corneal transplantation.

Methods:

We conducted a narrative review based on the available literature and the experience of cornea specialists from 3 different countries.

Results:

Bioethical dilemmas related to informed consent for organ and tissue donation, allocation of corneal tissues, transplant tourism, corneal tissue exportation and importation, and for-profit eye banking were analyzed and discussed.

Conclusions:

Around the world, the number of required corneal transplants exceeds the number of donated corneas that are available and suitable for transplantation. This shortage of corneal tissue has led to the emergence of practices that may put the 4 basic principles of bioethics at risk: autonomy, beneficence, nonmaleficence, and justice. Therefore, it has been necessary to create ethical guidelines such as the Barcelona Principles and the World Health Organization Principles of Transplantation that attempt to regulate these practices.
Retrospective Multicenter Matched Controlled Comparison of Endoscopic Retrograde Cholangiopancreatography in Pediatric Patients
Authors: Shah Rushikesh , Cohen Reuven Zev , Mekaroonkamol Parit , Taylor Alexis , Freeman Alvin Jay , Fritzen Christopher , Sauer Cary , Chawla Saurabh , Keilin Steven , Cai Qiang , Nieto Jose , Willingham Field F.
Published: January 2020

Introduction:

This study was designed to evaluate outcomes in pediatric patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) as compared with an American Society of Gastrointestinal Endoscopy (ASGE) complexity grade‐matched adult cohort.

Method:

In this retrospective case‐control study, ERCPs performed in pediatric patients from January 2008 to December 2018 in 2 tertiary referral hospitals were compared with a complexity‐matched adult control group with similar procedural indications. Primary outcomes included the clinical success rate, technical success rate, and complication rate. Secondary outcomes included postprocedural admission rates, mode of sedation, procedure time, fluoroscopy time, hospitalization length, and the number of repeat procedures.

Results:

Two hundred thirty‐two ERCPs performed in 110 pediatric patients (average age 13.3) and 318 ERCPs performed in 160 ASGE grade‐matched adult controls (average age 47.2 years) were analyzed. All procedures were therapeutic. There was no difference in the technical success rate (P = 0.2), clinical success rate (P = 0.5), complication rates (P = 0.1), and fluoroscopy time (P = 0.4), between the pediatric and adult cohorts. General anesthesia use and length of stay were significantly higher in the pediatric group (P = 0.0001). In subgroup analysis, technical (P = 0.2) and clinical success (P = 0.2) as well as complication rates (P = 0.6) were comparable between patients 10 years or less and patients 11 to 18 years within pediatric cohort.

Conclusions:

ERCP in pediatric cohorts appears to be safe and effective with equivalent outcomes relative to an ASGE complexity‐matched adult cohort. Pediatric patients are more likely to require general anesthesia and have a longer average length of stay relative to adult controls.
Low Radiation Dose and High Image Quality of 320-Row Coronary Computed Tomography Angiography Using a Small Dose of Contrast Medium and Refined Scan Timing Prediction
Authors: Shirasaka Takashi , Nagao Michinobu , Yamasaki Yuzo , Kojima Tsukasa , Kondo Masatoshi , Hamasaki Hiroshi , Kamitani Takeshi , Kato Toyoyuki , Asayama Yoshiki
Published: January 2020

Objective

The aim of the study was to investigate the feasibility of coronary computed tomography (CT) angiography with a low kilovoltage peak scan and a refined scan timing prediction using a small contrast medium (CM) dose.

Methods

In protocol A, 120-kVp scanning and a standard CM dose were used. The scan timing was fixed. In protocol B, 80 kVp and a 60% CM dose were used. The scan timing was determined according to the interval from the CM arrival to the peak time in the ascending aorta. We measured the CT number and recorded the radiation dose.

Results

Higher CT numbers were observed in the left circumflex (proximal, P = 0.0235; middle, P = 0.0007; distal, P < 0.0001) in protocol B compared with protocol A. The radiation dose in protocol B was significantly lower than in protocol A (2.2 ± 0.9 vs 4.3 ± 1.7 mSv).

Conclusions

Low-contrast, low–radiation dose, high–image quality coronary CT angiography can be performed with low kilovoltage peak scanning and a refined scan timing prediction.
Postnatal Intracranial Findings Following Fetal Repair of Spinal Dysraphisms
Authors: Calle Susana , Bonfante Eliana , Simmons Garrett , Rogers Jason , Sitton Clark , Hughes Katrina , Papanna Ramesh M. , Riascos Roy , Patel Rajan
Published: January 2020

Objective

Our objective is to document the imaging appearance in the intracranial compartment at the time of the infants' first postnatal brain MR imaging after fetal repair for spinal dysraphisms.

Methods

Twenty-nine patients were evaluated on fetal and postnatal magnetic resonance imaging for a series of features of Chiari II malformation.

Results

Of the 29 infants, 55% had resolution of tonsillar ectopia, and 62% showed a dorsal outpouching of the near the foramen magnum on postnatal magnetic resonance imaging. The majority had persistence of Chiari II features including: prominent massa intermedia (93%), tectal beaking (93%), towering cerebellum (55%), flattening of the fourth ventricle (90%), hypoplastic tentorium (97%), and tonsillar hypoplasia (59%).

Conclusions

Normally positioned or minimally descended, oftentimes hypoplastic tonsils in the presence of a posterior fossa configuration typical of Chiari II, was the most common presentation. An additional documented feature was an outpouching of the dorsal thecal sac between the opisthion and the posterior arch of C1.
Computed Tomography Angiography Combined With Knowledge-Based Iterative Algorithm for Transcatheter Aortic Valve Implantation Planning: Image Quality and Radiation Dose Exposure With Low-kV and Low-Contrast-Medium Protocol
Authors: Ippolito Davide , Riva Luca , Talei Franzesi Cammillo , De Vito Andrea , Cangiotti Cecilia , Crespi Andrea , Corso Rocco , Sironi Sandro
Published: January 2020

Objective

To evaluate image quality and radiation dose exposure of low-kV setting and low-volume contrast medium (CM) computed tomography angiography (CTA) protocol for transcatheter aortic valve implantation (TAVI) planning in comparison with standard CTA protocol.

Methods

Sixty-patients were examined with 256-row MDCT for TAVI planning: 32 patients (study group) were evaluated using 80-kV electrocardiogram-gated protocol with 60 mL of CM and IMR reconstruction; 28 patients underwent a standard electrocardiogram-gated CTA study (100 kV; 80 mL of CM; iDose4 reconstruction). Subjective and objective image quality was evaluated in each patient at different aortic levels. Finally, we collected radiation dose exposure data (CT dose index and dose-length product) of both groups.

Results

In study protocol, significant higher mean attenuation values were achieved in all measurements compared with the standard protocol. There were no significant differences in the subjective image quality evaluation in both groups. Mean dose-length product of study group was 56% lower than in the control one (P < 0.0001).

Conclusion

Low-kV and low-CM volume CTA, combined with IMR, allows to correctly performing TAVI planning with high-quality images and significant radiation dose reduction compared with standard CTA protocol.
In Vitro, In Vivo, and In Silico Methods for Assessment of Muscle Size and Muscle Growth Regulation
Authors: Rupert Joseph E. , Jengelley Daenique H. A. , Zimmers Teresa A.
Published: January 2020

Trauma, burn injury, sepsis, and ischemia lead to acute and chronic loss of skeletal muscle mass and function. Healthy muscle is essential for eating, posture, respiration, reproduction, and mobility, as well as for appropriate function of the senses including taste, vision, and hearing. Beyond providing support and contraction, skeletal muscle also exerts essential roles in temperature regulation, metabolism, and overall health. As the primary reservoir for amino acids, skeletal muscle regulates whole-body protein and glucose metabolism by providing substrate for protein synthesis and supporting hepatic gluconeogenesis during illness and starvation. Overall, greater muscle mass is linked to greater insulin sensitivity and glucose disposal, strength, power, and longevity. In contrast, low muscle mass correlates with dysmetabolism, dysmobility, and poor survival. Muscle mass is highly plastic, appropriate to its role as reservoir, and subject to striking genetic control. Defining mechanisms of muscle growth regulation holds significant promise to find interventions that promote health and diminish morbidity and mortality after trauma, sepsis, inflammation, and other systemic insults. In this invited review, we summarize techniques and methods to assess and manipulate muscle size and muscle mass in experimental systems, including cell culture and rodent models. These approaches have utility for studies of myopenia, sarcopenia, cachexia, and acute muscle growth or atrophy in the setting of health or injury.
The Use of GLP1R Agonists for the Treatment of Type 2 Diabetes in Kidney Transplant Recipients
Authors: Kukla Aleksandra , Hill Jennifer , Merzkani Massini , Bentall Andrew , Lorenz Elizabeth C. , Park Walter D. , D’Costa Matthew , Kudva Yogish C. , Stegall Mark D. , Shah Pankaj
Published: January 2020

Background.

Glucagon-like peptide-1 receptor agonists (GLP1RA) have been shown to improve glucose control and diabetes-related comorbidities in patients without solid organ transplants. The effectiveness, safety, and tolerability of GLP1RA after kidney transplantation have not been adequately studied.

Methods.

We retrospectively reviewed data on kidney transplant recipients performed in our institution, who were initiated on GLP1RA either for the treatment of type 2 diabetes diagnosed before transplantation or posttransplant diabetes. We analyzed efficacy, safety, and the effect on kidney allograft function.

Results.

Seventeen kidney transplant recipients were initiated on GLP1RA therapy, 14 of which remained on the medication for at least 12 months. The use of GLP1RA had no significant impact on weight loss, but was associated with a significant reduction in the total daily insulin dose, from the median of 63 [interquartile range 43-113] IU to 44 [interquartile range 25-88] and reduction in the risk of hypoglycemia in patients who were on therapy for at least approximately 12 months. Kidney function remained stable and none of the recipients experienced acute rejection. Tacrolimus dose was not significantly changed. Five patients (29%) discontinued GLP1RA therapy—4 due to side effects and 1 due to uncontrolled hyperglycemia.

Conclusions.

GLP1RA may be a relatively safe and effective treatment for kidney transplant recipients with type 2 diabetes that allows for a reduction in insulin requirements. More studies are needed to determine whether the use of these agents will translate into an improvement in allograft and patient survival.
The ecology of human–nature interactions
Authors: Soga Masashi , Gaston Kevin J.
Published: January 2020

The direct interactions between people and nature are critically important in many ways, with growing attention particularly on their impacts on human health and wellbeing (both positive and negative), on people's attitudes and behaviour towards nature, and on the benefits and hazards to wildlife. A growing evidence base is accelerating the understanding of different forms that these direct human–nature interactions take, novel analyses are revealing the importance of the opportunity and orientation of individual people as key drivers of these interactions, and methodological developments are increasingly making apparent their spatial, temporal and socio-economic dynamics. Here, we provide a roadmap of these advances and identify key, often interdisciplinary, research challenges that remain to be met. We identified several key challenges, including the need to characterize individual people's nature interactions through their life course, to determine in a comparable fashion how these interactions vary across much more diverse geographical, cultural and socio-economic contexts that have been explored to date, and to quantify how the relative contributions of people's opportunity and orientation vary in shaping their nature interactions. A robust research effort, guided by a focus on such unanswered questions, has the potential to yield high-impact insights into the fundamental nature of human–nature interactions and contribute to developing strategies for their appropriate management.
Does product design stimulate customer satisfaction? Mediating role of affect
Authors: Sabir Sana S.
Published: January 2020

Purpose

Product design is a dynamic factor that triggers customers’ experiential value which eventually escalates their satisfaction. Therefore, the purpose of this paper is to examine the impact of product design dimensions on customer satisfaction with the mediating role of affect.

Design/methodology/approach

A survey on 225 smartphone users has been conducted to test the conceptualization empirically. Confirmatory factor analysis and structural equation modeling were performed using SPSS Amos-22.0 to confirm the hypotheses.

Findings

The results indicate that affect fully mediates the relationship between symbolic dimension and satisfaction. Whereas, partial mediation of affect is observed in the relation between functional dimension and satisfaction.

Practical implications

The framework of this research contributes towards the practice by facilitating managers in evaluating the impact of experiential value which product design dimensions create to influence customer satisfaction.

Originality/value

This study is first of its kind to analyze how design dimensions create experiential value to influence customer satisfaction. It contributes to the literature by giving empirical evidence that affective responses like pleasure and arousal play an important role in assessing product design dimensions that influence customer satisfaction.
Optimal heat induction treatment of titanium alloys
Authors: Smolyanov Ivan Alexandrovich , Kotlan Václav , Doležel Ivo
Published: January 2020

Purpose

This paper aims to propose a number of approaches to reduce the temperature gradient of titanium billets in the heat treatment process.

Design/methodology/approach

Modeling physical processes in the induction unit is calculated by the finite element method. Required power was calculated based on the fact that all the induced power is allocated in a certain layer and there are loss flows and heating flows. Also, an opportunity is offered to reduce temperature difference using numerical optimization, control system based on proportional-integral regulator and ballast blank.

Findings

The asymmetry of the magnetic field at the ends of the inductor significantly affects the temperature uniformity along the length of the workpiece. Increasing the length of the workpiece by adding ballast blanks reduces the temperature drop. Also, increasing the non-magnetic gap in some cases it is possible to improve the quality of through heating.

Research limitations/implications

The results of this study are verified only for a number of titanium alloys. Therefore, this knowledge is appropriate to apply for this type of materials. In future studies, it is possible to expand the possibilities of the considered approaches for other types of materials.

Practical implications

Part of the study will be used to industrial plant for purpose of heat treatment of titanium alloys workpiece. Especially, control system will be basically made based on the model.

Originality/value

A novel methodology of induction heating of titanium alloy Ti6Al4V in the form of cylindrical billets is presented that simplifies the process and improves temperature uniformity along the radius and length of the billet by optimizing the shape of the inductor and selecting suitable power modes.
The drama of corporate social responsibility communication
Authors: Ivanova-Gongne Maria , Lång Stefan
Published: January 2020

Purpose

This paper aims to investigate a company’s corporate social responsibility (CSR) communications in a business network with regard to the flow of critical events related to CSR.

Design/methodology/approach

The paper focuses on the drama that unfolded at a Nordic-based multinational corporation, Stora Enso, after a critical event related to CSR and the specific signs and codes applied by the company to justify its actions. To achieve the aims, the authors conducted a dramaturgical and semiotic analysis of the company’s corporate communications in connection with various actions prior to or following the major critical event.

Findings

The findings consist of a five-act drama that unfolded around certain CSR communication activities at the company. The authors followed the company’s shift in communication strategy as they were compelled to adopt a more responsive and involved approach. The results also show the roles of the various business network actors in shaping CSR communications.

Practical implications

This case has practical uses for providing the framework to create effective messages at different stages of the communication process related to a major CSR event.

Originality/value

The originality of the study lies in its application of a dramaturgical and semiotic approach to the analysis of CSR communication. It also contributes to the scarce literature on CSR communication within business networks.
The impact of teaching-research conflict on job burnout among university teachers
Authors: Li Yongzhan , Li Yongxin , Castaño Gloria
Published: January 2020

Purpose

To fill the previous research gap, focusing on two constructs, i.e. perceived supervisor support (PSS) and psychological capital (PsyCap), this study aims to explore the mechanism underlying the relationship between teaching–research conflict (TRC) and job burnout among university teachers using the lens of job demands–resources (JD-R) model.

Design/methodology/approach

First, theoretically grounded hypotheses linking teaching–research conflict, PSS and PsyCap to job burnout were formulated. Then, a cross-sectional design was used to test the theoretical model presented in this study.

Findings

The results showed that TRC was positively linked to emotional exhaustion (EE) and depersonalization (DP), but negatively linked to personal accomplishment; PSS moderated the effect of TRC on both EE and DP but did not act as a moderator in the relationship between TRC and personal accomplishment; and PsyCap moderated the effect of TRC on all the three dimensions of job burnout.

Research limitations/implications

Given that the data were collected from single-source, the study was vulnerable to the common method variance. Besides, the relative small sample size limits the representativeness of the sample. Moreover, the cross-sectional design cannot confirm causal relationship between variables. Despite these limitations, the findings of this research can potentially inform effective interventions aimed at reducing the effect of TRC on job burnout among university teachers.

Originality/value

Based on the JD-R model, PSS and PsyCap are used to explore the effect of TRC on job burnout for the first time.
Ethical leadership
Authors: Shakeel Fahad , Kruyen Peter Mathieu , Van Thiel Sandra
Published: January 2020

Purpose

The purpose of this paper is to offer a review of the selected literature in ethical leadership synthesizing findings from 45 articles selected from journals on leadership, public administration, organizational behavior, psychology and ethics.

Design/methodology/approach

Four themes are addressed: the conceptualization of ethical leadership theories, the existence of popular measurement instruments for ethical leadership, findings on ethical leadership in the public sector and outcomes of ethical leadership in terms of benefits and negative consequences.

Findings

The definition by Brownet al.(2005) is the most frequently used definition, even though recent criticism states that this definition may be too narrow. Ethical leadership is usually measured by means of a survey; however, there are at least three different questionnaires in use. In the public sector, ethical leadership has been linked to both positive outcomes and negative consequences.

Research limitations/implications

This paper only includes selected academic articles and does not include published books.

Originality/value

Based on our findings, the authors present recommendations for future research, among others into a broader conceptualization of ethical leadership and the use of mixed methods.
Development of a conceptual auditing framework by integrating ISO 9001 principles within auditing
Authors: Abuazza Omran Ahmad , Labib Ashraf , Savage Barbara M.
Published: January 2020

Purpose

The purpose of this paper is to develop a conceptual auditing framework (CAF), which can help the organizations that experience difficulties with current ISO 9001 auditing to achieve their desired benefits with regard to the auditing of conformance, performance, risk management and improvement collectively.

Design/methodology/approach

A literature review was undertaken to identify the audit limitations and the program strategies that were reported in literature to overcome these limitations. The relevant audit standard (ISO 9001:2015) and guidelines (ISO 19011:2011 and ISO 19011:2018) have also been reviewed to determine the gap in relation to this purpose.

Findings

Most of the previous suggestions to overcome the difficulties of the current ISO 9001 auditing were to focus on processes in addition to ISO 9001 clauses and to apply the two principles of “Process Approach” and “Improvement” of ISO 9001, by having the manner of integration of their risk-based thinking concept and Lean Six Sigma (LSS) approaches, respectively, within audit. However, this integration also has limitations such as the desire for implementing risk management program and the necessity for applying LSS approach. Therefore, a CAF was developed to enhance the ISO 9001 quality audit. It suggests the integration of 12 management tools that are connected to the seven principles of ISO 9001:2015 severally and collectively. The selected tools ought to be linked to the audit limitations that have been previously reported in the literature, and connected with the complaints of the organizations that experience difficulties with current ISO 9001 auditing. Auditing of conformance/performance, risk management and improvement in combination can be assured by upgrading, testing and validating this CAF.

Originality/value

Utilizing the ISO 9001 quality audit in a way that helps organizations to audit performance, risk management and improvement in combination by changing the auditing approach from ISO 9001 elements to ISO 9001 principles and by learning from the experience of business excellence models implementers in development of the Performance measurement frameworks and in converting the concepts and principles into practice.
Women’s presence in top management and the performance of microfinance institutions in West Africa
Authors: Boubacar Hamadou
Published: January 2020

Purpose

The purpose of this paper is to investigate the relationship between the presence of women in senior management and the performance of microfinance organizations in the West African Economic and Monetary Union (WAEMU).

Design/methodology/approach

Using a data set of 266 microfinance institutions (MFIs) for the period 2013–2017, the study assesses the impact of women’s representation in senior management and on the boards of West African MFIs on these institutions’ financial and social performance.

Findings

The results indicate that board size and diversity positively and significantly affect the social performance of MFIs, particularly in relation to women’s participation in decision-making regarding expanding services to poor people. In essence, greater gender diversity at the board and management levels promotes the social orientation of MFIs.

Research limitations/implications

The low representation of women on boards and as managers makes it difficult to more accurately determine the true impact of women in senior positions on MFIs performance.

Practical implications

The author recommends minimum quotas for women in the top management of MFIs. This would help these institutions incorporate key skills and actively involve all members. Also, regulation places constraints on the ability of West African MFIs to mobilize deposits and this negatively impacts their financial performance.

Originality/value

This investigation highlights the importance of including women in the top management of MFIs to improve these institutions’ performance. It also underscores an interesting problem and answers questions raised in the existing literature by either rejecting or confirming the findings. As players in the microfinance sector recognize that board diversity is important for the success of any microfinance institution, this paper helps shed light on the situation of these organizations in the WAEMU.

Peer review

The peer review history for this article is available at:https://publons.com/publon/10.1108/IJSE-06-2019-0365
An improved stiffness model for line contact elastohydrodynamic lubrication and its application in gear pairs
Authors: Pei Jiaxing , Han Xu , Tao Yourui
Published: January 2020

Purpose

The purpose of this paper is to propose an simple and efficient stiffness model for line contact under elastohydrodynamic lubrication (EHL) and to investigate the gear meshing stiffness by the proposed model.

Design/methodology/approach

The method combines the surface contact stiffness and film stiffness as EHL contact stiffness. The EHL contact stiffness can be calculated by the external load and displacement of the load action point. The displacement is the sum of deformation of the film and contact surface and is equal to the distance of the mutual approach of two contact bodies.

Findings

The conclusion is drawn that the contact stiffness calculated by the proposed model is smaller than that by the minimum film model and larger than that by the mean film model. It is also concluded that the gear meshing stiffness under EHL is slightly smaller than that under dry contact.

Originality/value

The EHL contact stiffness can be obtained by the increment of external load and mutual approach directly. The calculation of oil film stiffness and surface contact stiffness separately is avoided.

Peer review

The peer review history for this article is available at: https://publons.com/publon/10.1108/ILT-11-2019-0465