bluuebunny/crossref_metadata_2025 huggingface dataset:
Implementing a step down intermediate care service
Authors: Levin Kate A. , Miller Martine A. , Henderson Marion , Crighton Emilia
Published: June 2019

Purpose

The purpose of this paper is to explore implementation and development of step-down intermediate care (IC) in Glasgow City from the perspective of staff.

Design/methodology/approach

The study used qualitative methods. Nine key members of staff were interviewed and three focus groups were run for social work, rehabilitation and care home staff. Framework analysis was used to identify common themes.

Findings

The proposed benefits of IC were supported anecdotally by staff. Perceived enablers included: having a range of engaged stakeholders, strong leadership and a risk management system in place, good relationships, trust and communication between agencies, a discharge target, training of staff, changing perception of risk and risk aversion, the right infrastructure and staffing, an accommodation-based strategy for patients discharged from IC, the right context of political priorities, funding and ongoing adaptation of the model in discussion with frontline staff. Potential improvements included a common recording system shared across all agencies, improving transition of patients from hospital to IC, development of a tool for identifying suitable candidates for IC, overcoming placement issues on discharge from IC, ensuring appropriate rehabilitation facilities within IC units, attachment of social work staff to IC units and finding solutions to issues related to variation in health and social care systems between sectors and hospitals.

Originality/value

The findings of this study help the ongoing refinement of the IC service. Some of the recommendations have already been implemented and will be of value to similar services being developed elsewhere.
Place development for international retirement migrants: a decision-making process model
Authors: Ashton Ann Suwaree , Scott Noel , Choibamroong Therdchai
Published: June 2019

Purpose

This study aims to investigate the decision-making processes of international retirement migrants. The development of a place in response to the high demand for international retirement migration has become an important strategy for stakeholders within host destinations; of particular interest is international retirement migrant behaviour and intention to stay and retire in a foreign country.

Design/methodology/approach

This research presents the results of a qualitative study using face-to-face interview techniques. Content analysis technique was used to analyse data from interviews with 33 international retirees in Thailand.

Findings

Destination stakeholders must consider creating awareness of the destination through WOM, trustworthy websites and government channels, which migrants evaluate a destination based on pre-retirement visits that create attachment and emotional feelings for the place, and finally, the decision-making processes of short stay, semi-permanent and permanent migrants.

Research limitations/implications

This qualitative study investigated migrants from Europe, Australia and the USA. An understanding of IR migrants from Asia needs further research.

Practical implications

The results can be used as guidelines for government, hospitality and tourism stakeholders. IR migrants want different destination attributes to mainstream tourists, especially a peaceful environment, mild weather (not too cold or hot), and to live among locals.

Originality/value

This study examines migrant decision-making processes. The results provide a theoretical foundation for how IR migrants decide to retire overseas. This comprises three components: destination awareness, secondly, evaluation of the destination’s resources, and finally, the decision and implementation of their plans.
An assessment of impact of globalization on Indian IT and ITES exports
Authors: Malik Manzoor Hassan , Velan Nirmala
Published: June 2019

Purpose

The purpose of this paper is to present the growth trends in IT industry after the period of globalization in 1990s and to investigate the short-run and long-run dynamics between IT software and service exports, globalization and economic growth in India.

Design/methodology/approach

Annual time series data on IT exports, net national product and openness index have been collected from National Association of Software and Service Companies, the Reserve Bank of India database on Indian economy and the World Bank for the present study. The methodology adopted for studying the first objective are growth trend models, descriptive statistics and graphs prepared on the basis of data from the IT sector. Growth trends in key performance variables, such as total output, export, domestic output and employment have been analyzed. In the case of second objective, vector auto regression model has been used based on variance decomposition and impulse response function to capture the short-run and long-run dynamics between IT exports, globalization and economic growth in India.

Findings

Results of the growth trend model show the relative growth performance of software services receipts shows its strong advancement compared to the other sub-components of current account of balance of payments of India. It is found that economic growth responds positively to the shocks in IT exports and openness of economy. Further, IT software and service exports and openness index contribute to economic growth more in the long-run rather than in the short run.

Research limitations/implications

The IT software and service exports is dynamic field of economic activity amid heavy dependence on both domestic and external economic and political environment; hence, the rate of change is so rapid, and the relevance of factors may change over time.

Practical implications

The paper has implications for achieving sustainability in IT software and service exports growth. It is recommended that economic growth can be enhanced by implementing policies that not only improve the efficiency of the sector but also focus on optimization of the potential of the Indian IT industry.

Originality/value

This paper focuses on originality in delineating the growth trends and analysis of capturing the short-run and long-run dynamics between IT exports, globalization and economic growth in India.
Development and validation of servant leadership scale in Spanish higher education
Authors: Latif Khawaja Fawad , Marimon Frederic
Published: June 2019

Purpose

The purpose of this paper is twofold. First is the validation of a scale to measure the servant leadership of the university leaders. Second is to analyze how servant leadership affects the career satisfaction and life satisfaction of the academics.

Design/methodology/approach

Using a survey of 148 academics at universities located in Spain collected in May 2018, a couple of models were conducted using structural equation model techniques: a confirmatory factor analysis of second order in order to assess the leadership scale and a mediation model to assess how servant leadership impacts on the life satisfaction through career satisfaction.

Findings

Results reveal that leadership is a multi-dimensional construct having dimensions namely: behaving ethically, development, emotional healing, empowerment, pioneering, relationship building and wisdom. The total effect of servant leadership on life satisfaction is null due to a competitive mediation of career satisfaction.

Originality/value

Research on servant leadership has primarily focused on business organizations through extensive search in peer-reviewed databases the authors could not find a scale to measure servant leadership behavior in higher education. Additionally, the study assesses the role of career satisfaction as mediator between servant leadership and life satisfaction. Existing research has called for further research into both career and life satisfaction. Life satisfaction research has been criticized on the grounds that it has mainly overlooked the work/organizational settings. Moreover, the authors could only find little research into life satisfaction in higher education, that too in context of students.
The antecedents and consequences of psychological capital: a meta-analytic approach
Authors: Wu Wann-Yih , Nguyen Khanh-Van Ho
Published: June 2019

Purpose

The purpose of this paper is to focus on psychological capital (PsyCap) – one of the emerging topics of human resource management, by examining its antecedents and outcomes through the lens of social exchange theory.

Design/methodology/approach

A meta-analytic approach was applied to validate the proposed hypotheses. Altogether, 105 primary studies published between 2000 and 2018 were collected and used.

Findings

Results show that leadership styles (authentic leadership, ethical leadership, abusive leadership) and organizational support are antecedents and desirable work attitudes (job satisfaction, organizational commitment, organizational citizenship behavior) are consequences of PsyCap. Employee’s characteristics significantly moderated the relationship between PsyCap and work attitudes.

Originality/value

This was the first attempt to examine PsyCap in a theoretical framework with its antecedents and outcomes and furthermore, to apply a meta-analytic method. The moderating role of employee characteristics in the relationship between PsyCap and work attitudes is also explored.
Institutional incentives and pressures in Chinese manufacturing firms’ innovation
Authors: Tang Yongli , Hu Xinyue , Petti Claudio , Thürer Matthias
Published: June 2019

Purpose

The purpose of this paper is to investigate how Chinese firms’ innovation is related to their perceived incentives and pressures from the transitioning institutional environment.

Design/methodology/approach

A sample of 166 manufacturing firms located in Guangdong Province (China) is analyzed using binomial and moderated multiple regression models.

Findings

The results show that institutional incentives are more effective in promoting incremental innovations than radical ones, whereas institutional pressures are more pronounced in facilitating radical innovations than incremental ones. In addition, the interaction between the two divergent institutional forces is negatively related to innovation performance.

Practical implications

The findings inform managers and policy makers in institutional transition environments to consider and balance the effects of institutional forces. Firms should match the institutional incentives and pressures with their own innovation objectives in terms of incremental or radical goals, and take caution to deal with the divergent institutional directions, so as to avoid the negative interaction effects. Policy makers should take a systems approach when considering the incentive-based and/or command-and-control designs of innovation policies and regulations.

Originality/value

The study contributes to existing literature on institutions and innovation by disentangling incentive and pressure effects of institutions, regulation and innovation policies, as well as the combined and interaction effects intrinsic within institutional mixes.
Shelf life study of handmade and industrially processedMinas frescalcheese
Authors: Silva Thamiris Evangelista , Santos Priscila Alonso dos , Silva Thamara Evangelista , Silva Kamilla Soares , Machado André Luiz Borges , Garcia Lismaíra Gonçalves Caixeta
Published: June 2019

Purpose

The purpose of this study is to characterize and compare the results of the inspection mark of handmade and industrially processedMinas frescalcheese. It is one of the most commonly made and consumed cheeses in Brazil, and its production processes range from handmade cheeses produced in small household production sites to cheeses manufactured in large dairy factories subject to federal inspection.

Design/methodology/approach

The samples were stored for 10 days at 4°C in a biochemical oxygen demand chamber. Cheeses were analyzed using physicochemical analyzes, yield and syneresis indices and microbiological analyses.

Findings

The cheese A met the criterion of regulatory classification for very high humidity (65.32 g/100 g), while cheese B did not meet the criterion (54.38 g/100 g). Cheeses A (19.01 g/100 g) and B (24 g/100 g) showed average fat contents that did not comply with current legislation. The most probable number per g of thermotolerant coliforms was outside the acceptable range (>24 × 102 MPN/g), andSalmonellaspp. were present in the tested samples. The highest yield was observed for handmade cheese (an average of 5.35 L of milk to produce 1 kg of cheese), which had the highest syneresis during the storage period (p = 0.004), reaching 14.26% on the 10th day of storage.

Originality/value

Municipal and state inspection certificates do not ensure the microbiological quality of Minas frescal cheese, indicating flaws in the good manufacturing practices and/or in the milk pasteurisation stage.
Public management institutions’ alignment: the case of Egypt
Authors: Abdellatif Lobna Mohamed , Atlam Baher Mohamed , Emara Ola Abdel Moneim El Sayed
Published: June 2019

Purpose

This paper aims to show the aligned development that took place in public administration and public financial management toward serving public values. By analyzing the mode of institutions’ interaction, the paper attempts to pinpoint the changing trends in budget institutions in Egypt, probing the extent to which they can be read from an administrative perspective and the possibility of enhancing budgetary outcomes under the existing administrative arrangements.

Design/methodology/approach

An analytical framework for public management administrative and budgetary institutions’ alignment is presented. A ladder analysis is developed to highlight the consistency of rationale between the two sets of institutions. The alignment is demonstrated at three consecutive levels: control and discipline, efficiency and effectiveness and openness and communication.

Findings

The international experience reveals that the alignment of administrative and budgetary institutions is both theoretically traceable and practically applicable in the case of developed economies. Whereas, in the case of Egypt, both sets of institutions have been exposed to best practices; yet, they are not seen as complementary and enforcing each other. The internalization of the benefits of reforms in the two tracks into an integrated public management context in the case of Egypt is not reached.

Practical implications

Egypt needs to ensure the alignment of both dimensions to maximize the benefits of reform.

Originality/value

The ladder approach sorts the developments in both administrative and budgetary institutions into three levels to help assessing the maturity and conformity in countries’ public management systems.
Innovation and economic performance in MENA region
Authors: Omar Noha Sami
Published: June 2019

Purpose

Innovation has become the engine of economic growth, especially with the Fourth Industrial Revolution. This paper aims at studying the association between innovation – measured by gross expenditure on research and development (GERD) – and economic performance – represented by real gross domestic product (GDP) – in MENA region over the period 1996-2016.

Design/methodology/approach

The paper uses the panel corrected standard error method to account for heteroskedacity and possible contemporaneous correlation across panels, and the first order autocorrelation within panel for unbalanced datasets.

Findings

The study concludes that R&D expenditure is positive and statistically significant in explaining GDP, but their relationship is weak. Specifically, a 10 per cent increase in R&D expenditure raises GDP by 4 per cent. In addition, human capital, labor force and fixed capital accumulation are found positive and statistically significant. These findings highlight on the importance of innovation and education on fostering economic growth, urging MENA governments to further invest in R&D and innovation sector.

Originality/value

To the best of the author’s knowledge, this paper is the first to investigate the relationship between GERD and GDP in MENA region within the endogenous-growth model framework.
Process stability for GTAW-based additive manufacturing
Authors: Wang Xiaolong , Wang Aimin , Wang Kaixiang , Li Yuebo
Published: June 2019

Purpose

Traditional gas tungsten arc welding (GTAW) and GTAW-based wire and arc additive manufacturing (WAAM) are notably different. These differences are crucial to the process stability and surface quality in GTAW WAAM. This paper addresses special characteristics and the process control method of GTAW WAAM. The purpose of this paper is to improve the process stability with sensor information fusion in omnidirectional GTAW WAAM process.

Design/methodology/approach

A wire feed strategy is proposed to achieve an omnidirectional GTAW WAAM process. Thus, a model of welding voltage with welding current and arc length is established. An automatic control system fit to the entire GTAW WAAM process is established using both welding voltage and welding current. The effect of several types of commonly used controllers is examined. To assess the validity of this system, an arc length step experiment, various wire feed speed experiments and a square sample experiment were performed.

Findings

The research findings show that the resented wire feed strategy and arc length control system can effectively guarantee the stability of the GTAW WAAM process.

Originality/value

This paper tries to make a foundation work to achieve omnidirectional welding and process stability of GTAW WAAM through wire feed geometry analysis and sensor information fusion control model. The proposed wire feed strategy is implementable and practical, and a novel sensor fusion control method has been developed in the study for varying current GTAW WAAM process.
Surface enhancement of FDM patterns to be used in rapid investment casting for making medical implants
Authors: Tiwary Vivek Kumar , P. Arunkumar , Deshpande Anand S. , Rangaswamy Nikhil
Published: June 2019

Purpose

Due to intrinsic limitations, fused deposition modelling (FDM) products suffer from the bad surface finish and inaccurate dimensional accuracies restricting its usage in many applications. Hence, there is a need for processing polymer patterns before, during and after their productions. This paper aims to highlight the importance of pre- and post-processing treatments on the FDM-based acrylonitrile butadiene styrene patterns improving its surface quality so, that it can be used in rapid investment casting process for making medical implants and other high precision components.

Design/methodology/approach

As a part of pre-processing treatment, the machine parameters affecting the surface quality were identified and optimised using design of experiments. The patterns developed after the first stage of optimisation were given different post-processing treatments, which included vapour smoothening, chemical treatment and sand paper polishing. The results were compared and the best ones were used for making patterns for making medical implants via rapid investment casting technique. The surface quality was checked while the dimensional changes happening during the stages of this hybrid technique were recorded using a three-dimensional optical scanner.

Findings

The surface roughness of the FDM based ABS patterns reduced from 21.63 to 14.40µm with pre-processing treatments. Chemical treatment (post-processing treatment) turned to be the most suitable technique for reducing the surface roughness further down to 0.30µm. Medical implants that used these pre- and post-processing treatments gave an average surface roughness of 0.68µm. Cost and lead time comparisons showed that rapid investment casting technique can be a better method for low volume, customised and with specific requirements.

Originality/value

FDM parts/medical implants produced by rapid investment casting technique suffer from the inferior surface finish and inaccurate dimensional accuracies limiting its applications. A systematic approach to overcome this issue is presented in this research paper. This will directly help the end users and the manufacturers of medical implants, wherein, better surface finish and dimensionally accurate components are expected.
Strategic analysis of medal markets at the Winter Olympics
Authors: Weber Andreas Christoph , De Bosscher Veerle , Shibli Simon , Kempf Hippolyt
Published: June 2019

Purpose

This paper aims to propose the concept of market potential analysis, which is commonly applied in economics, as a method to enable these investment decisions to be based on sound evidence.

Design/methodology/approach

The markets for Olympic awards, i.e. medals (top three places) and diplomas (i.e. top eight places) are compared in alpine skiing, biathlon, cross country, speed skating, freestyle skiing, short track and snowboarding from 1992 to 2018.

Findings

The most notable changes are identified in cross country (2002), biathlon (2006), freestyle skiing (2014), snowboarding (2006 and 2014) and speed skating (2018).

Originality/value

In spite of the evidence of nations investing strategically in their elite sport systems to produce Olympic success, there is a lack of knowledge on how national-level decision makers can use a strategy to analyse the competitive environment concerning sports contested in the Olympic Winter Games.
Historical development of tourism journals – a milestone in 75 years: a perspective article
Authors: Kozak Metin
Published: June 2019

Purpose

The historical background of journals in today's current form dates back to seventeenth century. However, the birth of tourism journals is dated to 1940s. This coincides with the emergence of tourism as an academic part of tourism studies and education. Thus, the paper aims to indicate the progress of tourism journals since their first induction in early 1940s.

Design/methodology/approach

The study is based on an overview of secondary sources through desk research and personal communication with several scholars in the field of tourism.

Findings

Tourism Review is the first academic journal in tourism dating back its origin to 1943. Since then, the journey of tourism journals has completed three full quarters. Looking at the progress recorded and reality observed in this milestone, the journey is taken into consideration under three periods: involvement, development and internalization. This paper briefly examines the characteristics of these three periods.

Research limitations/implications

Based on the outputs of this study, tourism research has accomplished a milestone making itself as a recognised field at the international level of research and education. There has been also a significant increase in the number of cross-citations exported to non-tourism journals. Such developments have allowed tourism to stand on its own two feet, and it seems that tourism is likely to have gained its independence as a field of academic studies and education.

Practical implications

An increase in the number of tourism journals and calibre research outputs is likely to make a wider impact on tourism services to produce better and more prolific outcomes for the sake of businesses and customers.

Originality/value

The originality of this study comes from the fact that there are limited attempts to look at how tourism journals have progressed since their induction in 1940s.
Evaluating the use of multiteam systems to manage the complexity of inpatient falls in rural hospitals
Authors: Jones Katherine J. , Skinner Anne , Venema Dawn , Crowe John , High Robin , Kennel Victoria , Allen Joseph , Reiter‐Palmon Roni
Published: June 2019

Objective

To evaluate the implementation and outcomes of evidence‐based fall‐risk‐reduction processes when those processes are implemented using a multiteam system (MTS) structure.

Data Sources/Study Setting

Fall‐risk‐reduction process and outcome measures from 16 small rural hospitals participating in a research demonstration and dissemination study from August 2012 to July 2014. Previously, these hospitals lacked a fall‐event reporting system to drive improvement.

Study Design

A one‐group pretest‐posttest embedded in a participatory research framework. We required hospitals to implement MTSs, which we supported by conducting education, developing an online toolkit, and establishing a fall‐event reporting system.

Data Collection

Hospitals used gap analyses to assess the presence of fall‐risk‐reduction processes at study beginning and their frequency and effectiveness at study end; they reported fall‐event data throughout the study.

Principal Findings

The extent to which hospitals implemented 21 processes to coordinate the fall‐risk‐reduction program and trained staff specifically about the program predicted unassisted and injurious fall rates during the end‐of‐study period (January 2014‐July 2014). Bedside fall‐risk‐reduction processes were not significant predictors of these outcomes.

Conclusions

Multiteam systems that effectively coordinate fall‐risk‐reduction processes may improve the capacity of hospitals to manage the complex patient, environmental, and system factors that result in falls.
Antecedents of psychological empowerment: the effects of developmental experience, learning goal orientation and authenticity
Authors: Matsuo Makoto
Published: June 2019

Although considerable research has explored the antecedents of psychological empowerment, few studies have examined the combined effects of personal factors and task characteristics. Building on self‐determination theory, this study examines the relative and interactive effects of developmental job experience, learning goal orientation and authenticity on psychological empowerment, using a longitudinal survey of 260 nurses in Japanese hospitals. Results suggest that developmental job experience and authenticity have positive effects on psychological empowerment, yet learning goal orientation has no significant direct influence on psychological empowerment. There was a positive interaction effect for developmental job experience and learning goal orientation on psychological empowerment, while there was a negative interaction effect for authenticity and learning goal orientation in predicting psychological empowerment. The main contribution of this study to the literature is to identify the separate and combined influences of the personal factors and task characteristics on psychological empowerment.Keywords:
Impact of spray‐drying on the pili of Lactobacillus rhamnosus GG
Authors: Kiekens Shari , Vandenheuvel Dieter , Broeckx Géraldine , Claes Ingmar , Allonsius Camille , De Boeck Ilke , Thys Sofie , Timmermans Jean‐Pierre , Kiekens Filip , Lebeer Sarah
Published: June 2019

The preservation of the viability of microorganisms in probiotic formulations is the most important parameter ensuring the adequate concentration of live microorganisms at the time of administration. The formulation and processing techniques used to produce these probiotic formulations can influence the preservation of the microbial viability. However, it is also required that the bacteria maintain their key probiotic capacities during processing, formulation and shelf life. In this study, we investigated the impact of spray‐drying on different cell wall properties of the model probiotic strain Lactobacillus rhamnosus GG, including its adherence to intestinal epithelial cells. The dltD gene knock‐out mutant, L. rhamnosus GG CMPG5540, displaying modified cell wall lipoteichoic acids, showed significantly increased colony‐forming units after spray‐drying and subsequent storage under standard conditions compared to wild‐type L. rhamnosus GG. In contrast, disruption of the biosynthesis of exopolysaccharides or pili expression did not impact survival. However, spray‐drying did significantly affect the adherence capacity of L. rhamnosus GG. Scanning electron microscopy confirmed that the pili, key surface factors for adherence to intestinal cells and mucus, were sheared off during the spray‐drying process. These data thus highlight that both the functionality and viability of probiotics should be assessed during the spray‐drying process and subsequent storage.
A cost per responder analysis of secukinumab vs adalimumab for the treatment of ankylosing spondylitis from the Korean perspective
Authors: Kim Dam , Kim Hyojin , Cho SeongHa , Park Min‐Chan
Published: June 2019

Aim

To compare the cost‐effectiveness of secukinumab vs adalimumab at 1 and 2 years of treatment in patients with ankylosing spondylitis (AS) by analyzing the cost per responder reported in randomized controlled trials (RCTs) from the Korean perspective.

Method

A systematic literature search was performed via PubMed for relevant RCTs for comparing the response rate in patients with AS. The response rates in anti‐tumor necrosis factor‐naive subjects were extracted from RCTs and cost per responder analyses were calculated in case of both with or without a loading dosage of secukinumab compared with adalimumab.

Results

The Assessment in AS International Working Group (ASAS) 20 and 40 response rates of secukinumab from the MEASURE 2 trial and those of adalimumab from the ATLAS trial were comparable. The cost per ASAS 20 responder was lower by 40% in secukinumab compared to adalimumab: USD9637 vs 16 129 at 52 weeks and USD20 051 vs 32 699 at 104 weeks for secukinumab (in maintenance dosing) vs adalimumab, respectively. The cost per ASAS 40 responder was also lower by 40% in secukinumab: USD12 179 vs 22 395 at 52 weeks and USD27 338 vs 41 655 at 104 weeks for secukinumab vs adalimumab, respectively. With a loading dosage of secukinumab at 52 and 104 weeks, secukinumab showed lower costs per responder by 25% compared to adalimumab.

Conclusion

The costs per responder associated with ASAS 20 and 40 response rates were consistently lower for secukinumab compared with adalimumab. The treatment with secukinumab for patients with AS could be a cost‐saving treatment option in South Korea.
Joint modelling of multi‐scale animal movement data using hierarchical hidden Markov models
Authors: Adam Timo , Griffiths Christopher A. , Leos‐Barajas Vianey , Meese Emily N. , Lowe Christopher G. , Blackwell Paul G. , Righton David , Langrock Roland
Published: June 2019

Hidden Markov models are prevalent in animal movement modelling, where they are widely used to infer behavioural modes and their drivers from various types of telemetry data. To allow for meaningful inference, observations need to be equally spaced in time, or otherwise regularly sampled, where the corresponding temporal resolution strongly affects what kind of behaviours can be inferred from the data.

Recent advances in biologging technology have led to a variety of novel telemetry sensors which often collect data from the same individual simultaneously at different time‐scales, for example step lengths obtained from GPS tags every hour, dive depths obtained from time‐depth recorders once per dive, or accelerations obtained from accelerometers several times per second. However, to date, statistical machinery to address the corresponding complex multi‐stream and multi‐scale data is lacking.

We propose hierarchical hidden Markov models as a versatile statistical framework that naturally accounts for differing temporal resolutions across multiple variables. In these models, the observations are regarded as stemming from multiple connected behavioural processes, each of which operates at the time‐scale at which the corresponding variables were observed.

By jointly modelling multiple data streams, collected at different temporal resolutions, corresponding models can be used to infer behavioural modes at multiple time‐scales and in particular, help to draw a much more comprehensive picture of an animal's movement patterns, for example with regard to long‐term versus short‐term movement strategies.

The suggested approach is illustrated in two real‐data applications, where we jointly model (a) coarse‐scale horizontal and fine‐scale vertical Atlantic cod Gadus morhua movements throughout the English Channel, and (b) coarse‐scale horizontal movements and corresponding fine‐scale accelerations of a horn shark Heterodontus francisci tagged off the Californian coast.
Pharmacokinetics and safety of tadalafil in a paediatric population with pulmonary arterial hypertension: A multiple ascending‐dose study
Authors: Small David , Ferguson‐Sells Lisa , Dahdah Nagib , Bonnet Damien , Landry John , Li Baohui
Published: June 2019

Aims

To evaluate the pharmacokinetics and safety of once‐daily (QD) tadalafil in paediatric patients with pulmonary arterial hypertension (PAH) to establish an appropriate dose range for further research.

Methods

This was an open‐label, multicentre, international, multiple‐ascending‐dose study. Patients aged ≥2 years were enrolled into 1 of 3 cohorts based on body weight: heavy‐weight (≥40 kg), middle‐weight (25 to <40 kg), and light‐weight (<25 kg). Each patient received tadalafil QD for 10 weeks: 5 weeks at a low dose, then 5 weeks at a high dose. The doses for each cohort were intended to produce plasma tadalafil concentrations within the range produced by 5–10 mg (for the low dose) or 20–40 mg (for the high dose) of tadalafil in adults with PAH. Area under the plasma concentration–time curve during 1 dosing interval (AUCτ), maximum concentration, and apparent clearance were assessed throughout the trial, as were safety and tolerability.

Results

The study enrolled 19 patients aged 2–17 years, weighing 9.9–76.0 kg. Tadalafil's median (range) steady‐state AUCτ at the high dose was 7243 (3131–13 088) ng•h/mL across all patients. Concentrations were higher in no bosentan‐treated patients than in bosentan‐treated patients, but both populations were within the range of respective adult patients taking 20–40 mg QD. Tadalafil had an acceptable safety profile consistent with the known safety profile of tadalafil in adults.

Conclusions

Tadalafil 40 mg QD for patients ≥40 kg, and 20 mg QD for patients <40 kg and aged ≥2 years, are suitable for further research in paediatric patients with PAH.
Essential role of PTPN11 mutation in enhanced haematopoietic differentiation potential of induced pluripotent stem cells of juvenile myelomonocytic leukaemia
Authors: Shigemura Tomonari , Matsuda Kazuyuki , Kurata Takashi , Sakashita Kazuo , Okuno Yusuke , Muramatsu Hideki , Yue Fengming , Ebihara Yasuhiro , Tsuji Kohichiro , Sasaki Katsunori , Nakahata Tatsutoshi , Nakazawa Yozo , Koike Kenichi
Published: June 2019

We established mutated and non‐mutated induced pluripotent stem cell (iPSC) clones from a patient with PTPN11 (c.226G>A)‐mutated juvenile myelomonocytic leukaemia (JMML). Both types of iPSCs fulfilled the quality criteria. Mutated iPSC colonies generated significantly more CD34+ and CD34+CD45+ cells compared to non‐mutated iPSC colonies in a culture coated with irradiated AGM‐S3 cells to which four growth factors were added sequentially or simultaneously. The haematopoietic differentiation potential of non‐mutated JMML iPSC colonies was similar to or lower than that of iPSC colonies from a healthy individual. The PTPN11 mutation coexisted with the OSBP2 c.389C>T mutation. Zinc‐finger nuclease‐mediated homologous recombination revealed that correction of PTPN11 mutation in iPSCs with PTPN11 and OSBP2 mutations resulted in reduced CD34+ cell generation to a level similar to that obtained with JMML iPSC colonies with the wild‐type of both genes, and interestingly, to that obtained with normal iPSC colonies. Transduction of the PTPN11 mutation into JMML iPSCs with the wild‐type of both genes increased CD34+ cell production to a level comparable to that obtained with JMML iPSC colonies harbouring the two genetic mutations. Thus, PTPN11 mutation may be the most essential abnormality to confer an aberrant haematopoietic differentiation potential in this disorder.
BRD4 inhibitor and histone deacetylase inhibitor synergistically inhibit the proliferation of gallbladder cancer in vitro and in vivo
Authors: Liu Shilei , Li Fengnan , Pan Lijia , Yang Ziyi , Shu Yijun , Lv Wenjie , Dong Ping , Gong Wei
Published: June 2019

Gallbladder cancer (GBC) is the most common malignancy of the bile duct and has a high mortality rate. Here, we demonstrated that BRD4 inhibitor JQ1 and histone deacetylase inhibitor suberoylanilide hydroxamic acid (SAHA) synergistically inhibited the GBC cells in vitro and in vivo. Our results showed that cotreatment with JQ1 and SAHA significantly inhibited proliferation, cell viability and metastasis, and induced apoptosis and G2/M arrest in GBC cells, with only minor effects in benign cells. In vivo, tumor volumes and weights of GBC xenograft models were significantly decreased after treatment with JQ1 or SAHA; meanwhile, the cotreatment showed the strongest effect. Further study indicated that the above anticancer effects was associated with the downregulation of BRD4 and suppression of PI3K/AKT and MAPK/ERK pathways. These findings highlight JQ1 and SAHA as potential therapeutic agents and their combination as a promising therapeutic strategy for GBC.
Interstitial lung disease in patients with common variable immunodeficiency disorders: several different pathologies?
Authors: Patel S , Anzilotti C , Lucas M , Moore N , Chapel H
Published: June 2019

Various reports of disease-related lung pathologies in common variable immunodeficiency disorder (CVID) patients have been published, with differing histological and high-resolution computed tomography (HRCT) findings. Data were extracted from the validated Oxford Primary Immune Deficiencies Database (PID) database (1986–2016) on adult, sporadic CVID patients with suspected interstitial lung disease (ILD). Histology of lung biopsies was studied in relation to length of follow-up, clinical outcomes, HRCT findings and chest symptoms, to look for evidence for different pathological processes. Twenty-nine CVID patients with lung histology and/or radiological evidence of ILD were followed. After exclusions, lung biopsies from 16 patients were reanalysed for ILD. There were no well-formed granulomata, even though 10 patients had systemic, biopsy-proven granulomata in other organs. Lymphocytic infiltration without recognizable histological pattern was the most common finding, usually with another feature. On immunochemistry (n = 5), lymphocytic infiltration was due to T cells (CD4 or CD8). Only one patient showed B cell follicles with germinal centres. Interstitial inflammation was common; only four of 11 such biopsies also showed interstitial fibrosis. Outcomes were variable and not related to histology, suggesting possible different pathologies. The frequent nodules on HRCT were not correlated with histology, as there were no well-formed granulomata. Five patients were asymptomatic, so it is essential for all patients to undergo HRCT, and to biopsy if abnormal HRCT findings are seen. Internationally standardized pathology and immunochemical data are needed for longitudinal studies to determine the precise pathologies and prognoses in this severe complication of CVIDs, so that appropriate therapies may be found.
How far we have come: A review of the evolution of posterior approach ptosis surgery
Authors: Ullrich Katja , Malhotra Raman
Published: June 2019

We revisit the evolution of posterior approach ptosis surgery. We address the early attempts at ptosis surgery, assess the more modern approach by de Blaskovics, followed by the division into “open sky” and “closed” techniques. The simultaneous developments occurring in America and Europe are described, along with refinement of surgical approaches such as conjunctival‐sparing posterior approach ptosis surgery.
Tests for latent tuberculosis in candidates for solid organ transplantation: A systematic review and meta‐analysis
Authors: Maung Myint Thida , Rogerson Thomas E. , Noble Kristy , Craig Jonathan C. , Webster Angela C.
Published: June 2019

Reactivation of latent tuberculosis following solid organ transplantation has serious consequences for the recipient. The most useful diagnostic test for latent TB is not clear. We conducted a systematic review and meta‐analysis to assess the relative test performance of interferon gamma release assays (IGRAs) and the tuberculin skin test (TST) in people undergoing solid organ transplantation. The clinical or radiological risk factors were used as the proxy reference standard. Test performance was expressed as an odd ratio (OR). We identified 24 studies (N = 7811), 12 studies compared IGRAs with TST directly, nine studies evaluated only TST and three studies only IGRAs. Direct comparison between tests and clinical risk factors indicated both tests were strongly associated with the presence of clinical risk factors for TB (TST: OR 3.17; 95%CI 1.55‐6.48, IGRA: OR 2.78; 95%CI 1.55‐5.01), and radiological evidence of past TB (TST: OR 3.26; 95%CI 1.85‐5.73, IGRA: OR 3.85; 95%CI 2.16‐6.86). Relative comparison indicated IGRAs positivity was more strongly associated with presence of radiological evidence of TB than TST (relative OR: 3.24; 95%CI 1.10‐9.56). While there is no strong evidence in supporting use of IGRAs over TST for diagnosing latent TB, IGRAs positivity is more associated with the presence of radiological evidence of previous TB.
Safety, Tolerability, and Pharmacokinetics of the β‐Site Amyloid Precursor Protein‐Cleaving Enzyme 1 Inhibitor Verubecestat (MK‐8931) in Healthy Elderly Male and Female Subjects
Authors: Forman Mark , Palcza John , Tseng Jack , Stone Julie A. , Walker Brittany , Swearingen Dennis , Troyer Matthew D. , Dockendorf Marissa F.
Published: June 2019

β‐site amyloid precursor protein‐cleaving enzyme 1 (BACE1) is required for the production of β‐amyloid peptides, which are implicated in the etiology of Alzheimer's disease. The safety and pharmacokinetics of the BACE1 inhibitor verubecestat have previously been studied in young adults aged 19–45 years. In this randomized, placebo‐controlled, phase I study (protocol MK‐8931‐006), we investigated the safety, tolerability, and pharmacokinetics of a single dose (100 mg) or multiple doses (30, 80, and 120 mg) once daily for 28 days of verubecestat in healthy elderly subjects. Safety end points were assessed at baseline and during the duration of the study period and indicated that verubecestat was generally well tolerated. Verubecestat pharmacokinetics were similar between healthy elderly male and female subjects and similar to those reported in healthy young males in previous studies. These data supported subsequent studies to assess the potential efficacy of verubecestat in subjects with Alzheimer's disease.
Rethinking Soft Power in the Post‐Blockade Times: The Case of Qatar
Authors: al‐Horr Abdulaziz M. , Tok M. Evren , Gagoshidze Tekla
Published: June 2019

This study seeks to advance the understanding of the utility of “soft power” by exploring the case of Qatar. The country's approach is conceptualized as “nested power” through the examination of its political strategies before and after the regional blockade in 2017. The role of soft and nested power in Qatar has already been examined through various vantage points, such as small state diplomacy, mediation, and sports. Since the blockade has been for Qatar a great strategic dilemma, examination of how it affected power dynamics reveals the salience as well as the resilience of Qatar's soft and nested power. The article will discuss the concepts of “soft” and “nested” powers and their relevance to the state of Qatar in general and it will focus in the final section on the post‐blockade period. In doing so, we also seek useful approaches, which can be compatible with, and even advance “global international relations” (IR). The movement to make IR more global and inclusive is a welcome feature of the current century, reflective of the burgeoning role of the “Global South.”
Fistula between the right pulmonary artery and the left atrium coexisting with a secundum‐type atrial septal defect: An unusual case of cyanosis in a girl
Authors: Zhang Wei‐Min , Zhu Hai‐xu , Maimaitiaili Aizezi , Ayibieke Naibi , Ermek Tangsakar , Liu Jun , Zhang Zong‐gang , Li Shi‐guo
Published: June 2019

A fistula between the pulmonary artery (PA) and the left atrium (LA) is a rare congenital heart disease that usually presents with cyanosis, clubbing, and dyspnea, as well as the signs and symptoms of a right‐to‐left shunt. Herein, we report a 16‐year‐old girl with a fistula between the right PA and the LA. This type of fistula could lead to systemic desaturation. This patient also had an atrial septal defect of the secundum type and has been followed up without treatment. The clinical manifestations and treatment of fistulas located between the PA and LA are also reviewed in this report.
Goal Setting, Information, and Goal Revision: A Field Experiment
Authors: Lent Max van
Published: June 2019

People typically set goals in settings where they cannot be sure of how they will perform, but where their performance is revealed to them in parts over time. When part of the uncertainty is resolved, initial goals may have turned out to be unrealistic and hence they no longer work as a motivation device. Revising goals may increase performance by making goals realistic, but may also adversely affect performance through reduced goal commitment. We study the effects of motivating university students to set goals and inviting them to revise their goals later, using a field experiment involving nearly 2,100 students. We use courses containing two midterms and a final exam, where midterms reduce uncertainty about students’ potential performance. We find that motivating students to set goals does not affect performance on average. Students with midterm grades lower than their goal, decrease their performance. This effect is driven by students who were motivated to set goals without being made aware that they can revise their goals later. This finding may help explain why the evidence of the effectiveness of goals on study performance is mixed.
Trigeminal Neuralgia and Charcot‐Marie‐Tooth Disease: An Intriguing Association. Lessons From a Large Family Case Report and Review of Literature
Authors: Méreaux Jean‐Loup , Lefaucheur Romain , Hebant Benjamin , Guégan‐Massardier Evelyne , Grangeon Lou
Published: June 2019

We report a case of familial trigeminal neuralgia (TN) and Charcot‐Marie‐Tooth disease (CMT) caused by an identified MPZ mutation with a review of previous cases described in the literature.

Background

The association of TN in CMT patients has previously been reported in a few cases. The pathophysiological link can be detailed with recent use of genetic analysis in CMT.

Methods

We report a large family including 7 members affected by CMT, 4 of whom also presented with TN. We then performed a literature review of literature by search of Pubmed from 1950 to September 2018, using the search terms “trigeminal neuralgia” and “Charcot‐Marie‐Tooth” and the references of relevant articles.

Results

Overall, we found 29 previously published TN cases in 12 CMT families. Among them, only 7 families (69%) included several affected members, suggesting that not all mutations involved in CMT predispose to TN. TN in this context seems to present with specific characteristics, including earlier age of onset, bilateral presentation, and poor tolerance to preventive treatments with gait disturbance exacerbated by the underlying neuropathy.

Conclusion

This report of familial TN in CMT with identified MPZ mutation highlighted specific characteristics of this association. Considered as a rare association in the literature, it may be underestimated and the clinician should be aware of its specific pattern, including earlier age of onset, bilateral presentation, and poor tolerance to preventive treatments.