bluuebunny/crossref_metadata_2025 huggingface dataset:
Financial constraints and the interdependence of corporate financial decisions
Authors: Kirch Guilherme , Terra Paulo Renato
Published: June 2019

Purpose

This paper aims to examine the interdependence of financial decisions (investment, financing, dividends and cash-holding) under financial constraints.

Design/methodology/approach

The authors specify and estimate a system of simultaneous equations with panel data and firm fixed effects by three-stage least squares in a sample of firms from 62 countries from 1996 to 2010.

Findings

The main findings largely corroborate previous studies regarding the interdependence of financial decisions. The authors also find evidence suggesting that financial constraints have a major impact on firms’ financial decisions. The results also suggest that financial constraints manifest themselves in virtually all firms, indicating that such constraints are a matter of degree and not of kind.

Research limitations/implications

Implications regarding the impact of cash flows on investment and cash-holding decisions are only partially confirmed.

Practical implications

The results are consistent with the hypothesis that financial constraints distort the financial policies of firms. For the purpose of formulating policies that reduce these distortions, the authors emphasize the role of the availability of internal funds and the recoverable fraction of assets in easing financial constraints, thus allowing for greater investment on the part of firms.

Social implications

The results suggest that regulators should promote policies that reduce the dependence of corporate investment on internally generated cash flows.

Originality/value

Unlike previous studies, the authors account for the direct impact endogenous variables could have on each other. In addition, they explore the impact of each country’s particular legal environment on the pledgeability of assets at the company level.
Influence of demographics and motivational factors on US consumer clothing and shoes disposal behavior
Authors: Rezaei Arangdad Shaghayegh , Thoney-Barletta Kristin , Joines Jeff , Rothenberg Lori
Published: June 2019

Purpose

The purpose of this paper is to study clothing and shoes disposal behavior of US consumers in an attempt to understand how to divert more clothing and shoes from the landfill.

Design/methodology/approach

A survey was administered to 209 consumers from the general US population. The survey includes questions on demographics, methods of disposal and factors that motivate or prevent consumers from choosing methods other than throwing unwanted clothing in the trash.

Findings

Analysis of demographic data from the survey indicates that gender, income, marital status, living arrangement and type of dwelling have an effect on whether consumers recycle textiles. Other survey results indicate that helping factors are more influential in motivating consumers to recycle clothing and shoes than economic factors. The condition of clothes and shoes and lack of awareness are the most prominent reasons preventing consumers from recycling more textiles. The results also show that there are statistically significant differences between households with and without children when it comes to disposing adults’ clothing and shoes.

Originality/value

These results may help policymakers who want to motivate consumers to recycle or develop recycling programs.
A design for additive manufacturing case study: fingerprint stool on a BigRep ONE
Authors: Novak James I. , O’Neill Jonathon
Published: June 2019

Purpose

This paper aims to present new qualitative and quantitative data about the recently released “BigRep ONE” 3 D printer led by the design of a one-off customized stool.

Design/methodology/approach

A design for additive manufacturing (DfAM) framework was adopted, with simulation data iteratively informing the final design.

Findings

Process parameters can vary manufacturing costs of a stool by over AU$1,000 and vary print time by over 100 h. Following simulation, designers can use the knowledge to inform iteration, with a second variation of the design being approximately 50 per cent cheaper and approximately 50 per cent faster to manufacture. Metrology data reveal a tolerance = 0.342 per cent in overall dimensions, and surface roughness data are presented for a 0.5 mm layer height.

Research limitations/implications

Led by design, this study did not seek to explore the full gamut of settings available in slicing software, focusing predominantly on nozzle diameter, layer height and number of walls alongside the recommended settings from BigRep. The study reveals numerous areas for future research, including more technical studies.

Practical implications

When knowledge and techniques from desktop 3 D printing are scaled up to dimensions measuring in meters, new opportunities and challenges are presented for design engineers. Print times and material costs in particular are scaled up significantly, and this study provides numerous considerations for research centers, 3 D printing bureaus and manufacturers considering large-scale fused filament fabrication manufacturing.

Originality/value

This is the first peer-reviewed study involving the BigRep ONE, and new knowledge is presented about the practical application of the printer through a design-led project. Important relationships between material volume/cost and print time are valuable for early adopters.
Aquatic and terrestrial resources are not nutritionally reciprocal for consumers
Authors: Twining Cornelia W. , Brenna J. Thomas , Lawrence Peter , Winkler David W. , Flecker Alexander S. , Hairston Nelson G.
Published: June 2019

Aquatic and terrestrial ecosystems are connected through reciprocal fluxes of energy and nutrients that can subsidize consumers. Past research on reciprocal aquatic–terrestrial subsidies to consumers has generally focused on subsidy quantity while ignoring major differences in the nutritional composition of aquatic and terrestrial resources. Because aquatic resources contain substantially more highly unsaturated omega‐3 fatty acids (HUFAs) than terrestrial resources, aquatic subsidies may play a unique role by supplying these critical compounds to both aquatic and terrestrial consumers.

Here, we first characterized nutritional quality in terms of HUFA content in aquatic and terrestrial insect prey. We then used bulk stable isotope analyses to estimate subsidy use by stream and riparian consumers coupled with compound‐specific stable isotope analyses, which allowed us to document consumer HUFA sources. Finally, in order to understand the nutritional importance of aquatic‐derived HUFAs for riparian consumers, we conducted manipulative diet experiments on Eastern Phoebe (Sayornis phoebe) chicks in the laboratory.

Aquatic insects were significantly enriched in HUFAs, mainly in terms of eicosapentaenoic acid (EPA), compared with terrestrial insects. Stream fishes relied mainly upon aquatic resources, while insectivorous birds varied in their use of aquatic subsidies across sites. However, like stream fishes, Eastern Phoebe chicks received HUFAs from aquatic insects, even when they were heavily reliant upon terrestrial insects for their overall diet. In the laboratory, dietary HUFAs, such as those supplied by aquatic insects, increased the growth rate and condition of Eastern Phoebe chicks.

This study demonstrates that aquatic and terrestrial subsidies are not nutritionally reciprocal from the perspective of consumers because aquatic resources are the main source of critical fatty acids for both stream and riparian consumers. It also confirms previous findings on the nutritional importance of HUFAs for riparian birds, demonstrating that an insectivorous riparian lifestyle influences avian nutritional needs. Finally, our findings raise the possibility that birds and other riparian insectivores may experience nutritional mismatches with terrestrial prey if they do not have access to high‐quality aquatic subsidies as a consequence of aquatic habitat degradation or shifts in consumer and resource phenology.

A free Plain Language Summary can be found within the Supporting Information of this article.
Organic farming positively affects honeybee colonies in a flower‐poor period in agricultural landscapes
Authors: Wintermantel Dimitry , Odoux Jean‐François , Chadœuf Joël , Bretagnolle Vincent
Published: June 2019

Conventional farming has been implicated in global biodiversity and pollinator declines and organic farming is often regarded as a more ecological alternative. However, the effects of organic farming on honeybees remain elusive, despite honeybees’ importance as pollinators of crops and wild plants.

Using 6 years of data from a large‐scale study with fortnightly measurements of honeybee colony performance traits (10 apiaries per year distributed across a 435 km2‐large research site in France), we related worker brood area, number of adult bees and honey reserves to the proportions of organic farmland in the surroundings of the hives at two spatial scales (300 m and 1,500 m).

We found evidence that, at the local scale, organic farming increased both worker brood production and number of adult bees in the period of flower scarcity between the blooms of oilseed rape and sunflower (hereafter ‘dearth period’). At the landscape scale, organic farming increased honey reserves during the dearth period and at the beginning of the sunflower bloom.

The results suggest that worker brood development benefitted from organic farming mostly through a more diverse diet due to an increase in the availability of diverse pollen sources in close proximity of their hives. Reduced pesticide drift may have additionally improved bee survival. Honey reserves were possibly mostly affected by increased availability of melliferous flowers in foraging distance.

Synthesis and applications. Organic farming increases honeybee colony performance in a period of resource scarcity, likely through a continuous supply of floral resources including weeds, cover crops and semi‐natural elements. We demonstrate how worker brood area increases in the critical dearth period (between the blooms of oilseed rape and sunflower). This has previously been linked to winter colony survival, suggesting that organic farmland may mitigate repercussions of intensive farming on colony vitality. We conclude that organic farming benefits a crucial crop pollinator with potential positive implications for agriculture in the wider landscape.
Decoupling of nutrient cycles in a Eucalyptus woodland under elevated CO2
Authors: Ochoa‐Hueso Raúl , Piñeiro Juan , Power Sally A.
Published: June 2019

Elevated atmospheric [CO2] (eCO2) is currently altering nutrient cycling and availability in ecosystems worldwide. If the availabilities and turnover rates of macro‐ and micronutrients are differentially affected, then nutrient cycles may become out of sync (i.e., decoupled).

We evaluated the impacts of 3 years of eCO2 (550 µmol CO2/mol) on the availability, stability and coupling of eleven essential macro and micronutrients in a mature, P‐limited Eucalyptus woodland from Eastern Australia (EucFACE).

Despite increases in N and P availability in the first 18 months of study, nutrient availabilities and their stoichiometric ratios were unaffected by eCO2 across the study period (26–57 months of experimental duration). In contrast, the stability of nutrient availability increased under eCO2, which was concomitant with a reduction in the degree of biogeochemical coupling.

Synthesis. We demonstrate that macro‐ and micro‐nutrient cycles can quickly become out of sync (i.e., decoupled) under eCO2 in a low‐nutrient Australian eucalypt woodland, despite the lack of consistent effects on nutrient availability; such decoupling of nutrient cycles may have unpredicted consequences in terms of ecosystem functioning under the widely assumed positive relationship between biogeochemical coupling and ecosystem functioning.
Home level bureaucracy: moving beyond the ‘street’ to uncover the ways that place shapes the ways that community public health nurses implement domestic abuse policy
Authors: Cuthill Fiona , Johnston Lesley
Published: June 2019

Street‐level bureaucracy is an increasingly useful way to understand how strategic policy is implemented in day‐to‐day practice. This approach has uncovered the ways that individual health and social care practitioners work within institutional constraints to influence policy implementation at the micro‐level. Nonetheless, despite the diversity of settings where these street‐level bureaucrats (SLBs) work, little attention has been focused on the impact of place on policy delivery. This paper draws on empirical research to examine the ways that delivering government domestic abuse policy in the intimate space of the family home shapes the delivery of strategic policy in the everyday. Drawing on qualitative research with Health Visitors (HVs) in the UK in 2016, the study findings illuminate the ways that the material, socio‐spatial and idealised boundaries of the family home shape the implementation of policy. Key themes in the HV's narratives emerged as they described themselves as both a danger and in danger in the family home. In challenging the ontological security of the home (Giddens 1990) – privacy, security and control are key concepts here – HVs described how they shape their actions to achieve policy outcomes while simultaneously managing threats to the home, to professional identity and to self.
Validity and reliability of the Assessment of Spondyloarthritis International Society Health Index in English‐speaking patients with axial spondyloarthritis in Singapore
Authors: Kwan Yu Heng , Aw Fang Fang , Fong Warren , Phang Jie Kie , Kiltz Uta , Lim Ka Keat , Chew Eng Hui , Lui Nai Lee , Tan Chuen Seng , Thumboo Julian , Østbye Truls , Leung Ying Ying
Published: June 2019

Objectives

To assess the validity and reliability of the Assessment of Spondyloarthritis International Society Health Index (ASAS HI) among patients with axial spondyloarthritis (axSpA) in Singapore.

Methods

We collected data from English‐speaking patients with axSpA seen at a dedicated axSpA clinic in a Singapore tertiary referral hospital from 2017 to 2018. Face validity of the English version of ASAS HI was assessed through cognitive debriefing interviews (CDIs). Structural validity was assessed with confirmatory factor analysis. Convergent construct validity was assessed with 12 a priori hypotheses about the magnitude and direction of correlations between the ASAS HI summary score and other patient‐reported outcome measures. Internal consistency was assessed using Cronbach's alpha. Test‐retest reliability was assessed by intraclass correlation coefficient (ICC). Measurement error was assessed by analyzing smallest detectable change (SDC).

Results

Ten patients (age range 22‐46 years, 50% male) participated in CDIs and face validity was supported. Among 108 patients (median age: 37 [21‐77], 80.6% males), unidimensionality was confirmed (comparative fit index = 0.960, Tucker‐Lewis Index = 0.952, root mean square error of approximation = 0.038, standardized root mean residuals = 0.068, model Chi‐square test P = 0.1251) in the 17‐item ASAS HI. The ASAS HI showed good internal consistency of 0.83 and excellent test‐retest reliability (ICC = 0.95; 95% CI 0.91‐0.98) when baseline was compared with week 2. SDC was 1.02. Convergent validity was supported as hypotheses were confirmed in 100% of the results.

Conclusions

This study supports the ASAS HI as a valid and reliable measure of health status for use in patients with axSpA in Singapore.
Delayed cord clamping was not associated with an increased risk of hyperbilirubinaemia on the day of birth or jaundice in the first 4 weeks
Authors: Rana Nisha , Ranneberg Linda Jarawka , Målqvist Mats , KC Ashish , Andersson Ola
Published: June 2019

Aim

Our aim was to investigate the effects of timing of cord clamping on the risk of hyperbilirubinaemia.

Methods

We recruited 540 normal vaginal deliveries at the Paropakar Maternity and Women’s Hospital in Kathmandu, Nepal, from October 2 to November 21, 2014. They were randomised into two groups: 257/270 were cord clamped within 60 seconds and 209/270 after 180 seconds. Transcutaneous bilirubin was measured at discharge and 24 hours. At 4 weeks, 506 mothers were successfully contacted by phone, and the health status of the baby and their history of jaundice and treatment was recorded.

Results

Based on transcutaneous bilirubin at discharge, 22/261 (8.4%) in the early group and 25/263 (9.5%) in the delayed group (P = 0.76) were at high risk of subsequent hyperbilirubinemia. At the 4‐week follow‐up, jaundice was reported in 13/253 (5.1%) in the early and 17/253 (6.7%) in the delayed group (P = 0.57) and 3/253 (1.2 %) of the early and 1/253 (0.4%) of the delayed group (P = 0.62) received treatment. All analyses were based on intention‐to‐treat.

Conclusion

Delayed cord clamping was not associated with an increased risk of hyperbilirubinaemia during the first day of life or risk of jaundice within 4 weeks compared with the early group.
Echocardiographic evaluation of univentricular physiology and cavopulmonary shunts
Authors: Buber Jonathan , Schwaegler Rebecca Gibbons , Mazor Dray Efrat
Published: June 2019

Since the surgical palliation of a univentricular congenital heart defect was first described in the early 1970s, thousands of lives were saved by this groundbreaking operation. Although initially described for the palliation of tricuspid valve atresia, the Fontan operation is now utilized for many other univentricular heart defects involving either hypoplastic right or left ventricles, and the number of babies who survive the surgery and the postsurgical hospitalization continues to grow. Echocardiography constitutes the mainstay follow‐up imaging modality for patients with a Fontan system. In order to obtain all the needed information from the echocardiographic studies, close familiarity with the native congenital heart defects, the build of the Fontan systems, and the potential long‐term complications is required. Detailed studies provide valuable information on the various components of the Fontan circulation such as the function of the single ventricle and the valves, flow in the Glenn and Fontan pathways, and possible sources of cyanosis and shunts. Three‐dimensional and transesophageal echocardiogram studies can assist in delineating the Fontan anatomy and to evaluate smaller intracardiac structures.
Falling behind and catching up: India's transition from a colonial economy
Authors: Gupta Bishnupriya
Published: June 2019

India fell behind during colonial rule. The absolute and relative decline of Indian GDP per capita with respect to Britain began before colonization and coincided with the rise of the textile trade with Europe. However, the fortunes of the traditional textile industry cannot explain the decline in the eighteenth century and stagnation in the nineteenth century as India integrated into the global economy of the British Empire. Inadequate investment in agriculture and consequent decline in yield per acre stalled economic growth. Modern industries emerged and grew relatively fast. The reversal began after independence. Policies of industrialization and a green revolution in agriculture increased productivity in agriculture and industry. However, India's growth in the closing decades of the twentieth century has been led by services. A concentration of human capital in the service sector has origins in colonial policy. Expenditure on education prioritized higher education, creating an advantage for the service sector. At the same time, the slow expansion of primary education lowered the accumulation of human capital and put India at a disadvantage in comparison with the fast‐growing economies of East Asia.
Transforming youth mental health care in a semi‐urban and rural region of Canada: A service description of ACCESS Open Minds Chatham‐Kent
Authors: Reaume‐Zimmer Paula , Chandrasena Ranjith , Malla Ashok , Joober Ridha , Boksa Patricia , Shah Jai L. , Iyer Srividya N. , Lal Shalini
Published: June 2019

Aim

This study describes how mental health services for youth are being transformed within the context of a semi‐urban and rural region of Canada (Chatham‐Kent, Ontario), based on the framework of ACCESS Open Minds (ACCESS OM), a pan‐Canadian youth mental health research and evaluation network.

Methods

Transformation has focused on the five key objectives of ACCESS OM, namely early identification, rapid access, appropriate care, continuity of care, and youth and family engagement. A community mapping process was conducted at the beginning of the transformation to help develop a comprehensive inventory of services, identify challenges and optimize partnerships to address the five key objectives.

Results

The following strategies represent key elements in the transformation: coordination and partnerships between hospital, community and voluntary organizations, as well as different sectors of the community (e.g., Child and Youth Services, Education, Community Safety and Correctional Services, CSCS); working with local champions (e.g., Youth Diversion Officer and the Mental Health and Addictions Nurse in the school sectors); establishing a youth‐friendly space in a central part of the community, where services are co‐located and operate within an open‐concept design; training of ACCESS Clinicians to conduct an initial assessment; engaging youth and family in service‐level recruitment, planning, daily operations, and evaluation, including hiring of youth and family peer navigators; and, engaging the community through awareness and educational events.

Conclusions

The success of this transformation needs to be measured on various outcome parameters, but it is notable that neighbouring communities are already beginning to implement a similar model.
A multicenter, matched case‐control analysis comparing burden‐of‐illness in Dravet syndrome to refractory epilepsy and seizure remission in patients and caregivers in Germany
Authors: Strzelczyk Adam , Schubert‐Bast Susanne , Bast Thomas , Bettendorf Ulrich , Fiedler Barbara , Hamer Hajo M. , Herting Arne , Kalski Malin , Kay Lara , Kieslich Matthias , Klein Karl Martin , Kluger Gerhard , Kurlemann Gerhard , Mayer Thomas , Neubauer Bernd A. , Polster Tilman , von Spiczak Sarah , Stephani Ulrich , Trollmann Regina , Wiemer‐Kruel Adelheid , Wolff Markus , Irwin John , Carroll Joe , Pritchard Clive , Rosenow Felix
Published: June 2019

Objective

To compare direct and indirect costs and quality of life (QoL) of pediatric and adult patients with Dravet syndrome (DS), with drug‐resistant epilepsy (DRE) and in seizure remission (SR), and their caregivers, in Germany.

Methods

Questionnaire responses from 93 DS patients and their caregivers were matched by age and gender with responses from 93 DRE and 93 SR patients collected in independent studies, and were compared across main components of QoL, direct costs (patient visits, medication use, care level, medical equipment, and ancillary treatments), and indirect costs (quitting job, reduced working hours, missed days).

Results

Mean total direct costs were highest for DS patients (€4864 [median €3564] vs €3049 [median €1506] for DRE [excluding outliers], P = 0.01; and €1007 [median €311], P < 0.001 for SR). Total lost productivity over 3 months was highest among caregivers of pediatric DS (€4757, median €2841), compared with those of DRE (€1541, P < 0.001; median €0) and SR patients (€891, P < 0.001; median €0). The proportions of caregivers in employment were similar across groups (62% DS, 63% DRE, and 63% SR) but DS caregivers were more likely to experience changes to their working situation, such as quitting their job (40% DS vs 16% DRE and 9% SR, P < 0.001 in both comparisons). KINDL scores were significantly lower for DS patients (62 vs 74 and 72, P < 0.001 in both comparisons), and lower than for the average German population (77). Pediatric caregiver EQ‐5D scores across all cohorts were comparable with population norms, but more DS caregivers experienced moderate to severe depressive symptoms (24% vs 11% and 5%). Mean Beck Depression Inventory (BDI‐II) score was significantly higher in DS caregivers than either of the other groups (P < 0.001).

Significance

This first comparative study of Dravet syndrome to difficult‐to‐treat epilepsy and to epilepsy patients in seizure remission emphasizes the excess burden of DS in components of QoL and direct costs. The caregivers of DS patients have a greater impairment of their working lives (indirect costs) and increased depression symptoms.
Dissolution kinetics of calcined kaolinite and montmorillonite in alkaline conditions: Evidence for reactive Al(V) sites
Authors: Garg Nishant , Skibsted Jørgen
Published: June 2019

Calcined clays are attracting significant research attention because of their potential to partially replace CO2‐intensive portland cement. This potential depends largely on their reactivity, especially dissolution under alkaline conditions. Identification and characterization of reactive sites in these amorphous calcined clays has so far not been reported. Here, we investigate kaolinite (1:1 clay) and montmorillonite (2:1 clay) calcined at different temperatures under alkaline conditions (0.1 mol/L NaOH). Solution compositions are determined in batch dissolution experiments, whereas 27Al and 29Si MAS and CP/MAS NMR are used to investigate the structure of the undissolved residues to identify sites that are reactive and undergo preferential dissolution. The highest Si and Al dissolution rates for kaolinite are observed for calcination at 700°C, corresponding to the temperature of optimum reactivity, whereas the rates decrease and become increasingly incongruent at higher temperatures. The Si and Al dissolution rates for optimally calcined kaolinite are 4 and 12 times larger than the corresponding rates for optimally calcined montmorillonite, in accord with the much higher reactivity of calcined kaolinite compared to calcined 2:1 clays. This superior performance of kaolinite is explained by novel 27Al NMR results, which show strong evidence for preferential dissolution of highly reactive pentahedral aluminum sites.
Relationships among psychological capital, creative tendency, and job burnout among Chinese nurses
Authors: Li Yuli , Wu Qiong , Li Yan , Chen Lijun , Wang Xiuli
Published: June 2019

Aims

To evaluate relationships among psychological capital, creative tendency, and job burnout among Chinese nurses.

Background

Nurses are particularly susceptible to job burnout and kinds of factors related to their burnout. However, limited studies focus on the relationships among nurses' psychological capital, creative tendency, and job burnout in China.

Design

A cross‐sectional design.

Methods

A convenience sample of 200 female nurses was recruited from a grade A tertiary hospital in Shandong province from December 2016–January 2017. Data were collected using self‐reported questionnaires, including the Chinese version of the Maslach Burnout Inventory‐General Survey, Creativity Assessment Packet, Psychological Capital Questionnaire, and the socio‐demographic questionnaire.

Results

Nurses' psychological capital and creative tendency was negatively related to job burnout and psychological capital was positively related to creative tendency. Moreover, creative tendency partially mediated the relationship between psychological capital and job burnout.

Conclusions

Interventions aimed at strengthening nurses' creative tendencies and psychological capital could reduce the occurrence of job burnout.

Impact

This study identified the psychological capital and creative tendency affecting job burnout among Chinese nurses. The psychological capital and creative tendency was negatively related to job burnout; creative tendency partially mediated the relationship between psychological capital and job burnout among Chinese nurses. Nurses should pay attention to their own creative personality and take the advantage of it to release job burnout. Nurse managers are called on to strengthen nurses' psychological capital and creativity in this study by designing effective strategies for preventing job burnout among nurses.
Arrhythmias and fasciculoventricular pathways in patients with Danon disease: A single center experience
Authors: Jhaveri Simone , Herber Joshua , Zahka Kenneth , Boyle Gerard J. , Saarel Elizabeth V. , Aziz Peter F.
Published: June 2019

Background

Danon disease is a rare X‐linked storage disorder characterized by hypertrophic cardiomyopathy leading to arrhythmias and heart failure. A preexcitation pattern on electrocardiogram (ECG) has been described in these patients, however, invasive studies to distinguish between Wolff‐Parkinson‐White syndrome syndrome and fasciculoventricular pathways (FVP) are limited.

Objectives

The purpose of this study was to delineate the electrophysiological cardiac abnormalities in patients with Danon disease and to describe the presence of FVP in this population.

Methods

We performed a retrospective study of all patients with a confirmed diagnosis of Danon disease presenting to a single center from May 2005 to May 2018. Baseline demographics, clinical characteristics, ECG findings, and electrophysiology study (EPS) results were collected.

Results

Ten patients with Danon disease (30% male, average age 17.4 years) were identified. Seven patients (70%) had tachyarrhythmias including five with atrial arrhythmias and six with nonsustained ventricular tachycardia. Preexcitation pattern on ECG was found in four (40%) patients. Of these, two underwent an EPS which confirmed the presence of an FVP. One patient underwent an adenosine challenge which supported a FVP. Implantable cardioverter defibrillator was placed in five patients for primary prevention with no patients receiving an appropriate discharge. Over a follow‐up of 5.3 years, five underwent heart transplantation.

Conclusions

This study reports a high incidence of FVP in patients with Danon disease and preexcitation. It underscores an alternate etiology of preexcitation in this population which can potentially be diagnosed without invasive EPS testing. Future multicenter studies are needed to expand this experience.
Management of acute cardiac tamponade by direct autologous blood transfusion in interventional electrophysiology
Authors: Beyls Christophe , Hermida Alexis , Duchateau Josselin , Maury Philippe , Taieb Jérôme , Laurent Gabriel , Kubala Maciej , Ben Amar Amar , Sacher Frederic , Jais Pierre , Hermida Jean‐Sylvain
Published: June 2019

Aims

Acute cardiac tamponade (ACT) is the most common life‐threatening complication of interventional electrophysiology. Urgent drainage by percutaneous pericardiocentesis and anticoagulation reversal are required. Immediate direct transfusion of the blood volume aspirated from the pericardial space to the patient has been rarely described. This study was designed to assess the efficacy and safety of immediate direct autologous blood transfusion (AutoBT).

Methods

A retrospective case series of direct AutoBT performed for ACT was collected. Urgent drainage by percutaneous pericardiocentesis and immediate direct AutoBT were performed to achieve hemodynamic stabilization without a cell‐saver system.

Results

Twenty‐two electrophysiology centers were contacted to participate in the case series. Fourteen centers reported not to use direct AutoBT. Three centers reported using direct AutoBT with the cell‐saver system. Fourteen cases of immediate direct AutoBT without cell‐saver system were included from the five remaining centers. Electrophysiological procedures were performed for ventricular tachycardia (n = 5), atrial fibrillation (n = 5), atrial tachycardia (n = 2), left accessory pathway (n = 1), and premature ventricular contraction (n = 1) with transseptal (n = 9), retroaortic (n = 4), and/or epicardial access (n = 4). Pericardial drainage was performed by percutaneous pericardiocentesis for 13 patients and via the transseptal sheath for one patient. Surgical hemostasis was required for seven patients. The mean volume of autologous blood directly transfused was 1207 ± 963 mL. Direct AutoBT permitted to resume the procedure in four patients. No major complication related to the use of AutoBT occurred.

Conclusion

Direct AutoBT without a cell‐saver system is a feasible, safe, and useful technique for salvage therapy in ACT in interventional electrophysiology.
Acellular dermal matrix and coronally advanced flap or tunnel technique in the treatment of multiple adjacent gingival recessions. A 12‐year follow‐up from a randomized clinical trial
Authors: Tavelli Lorenzo , Barootchi Shayan , Di Gianfilippo Riccardo , Modarressi Marmar , Cairo Francesco , Rasperini Giulio , Wang Hom‐Lay
Published: June 2019

Aim

To evaluate the long‐term outcomes of Acellular Dermal Matrix (ADM) with Coronally Advanced Flap (CAF) or Tunnel technique (TUN) in the treatment of multiple adjacent gingival recessions (MAGRs).

Material and methods

Nineteen of the original 24 patients contributing to a total number of 33 sites for CAF and 34 for TUN were available for the 12 years follow‐up examination. Recession depth, mean root coverage (mRC), keratinized tissue width (KTW), gingival thickness (GT) were evaluated and compared with baseline values and 6‐months results. Regression analysis was performed to identify factors related to the stability of the gingival margin.

Results

A highly significant drop in mRC was observed for both groups from the 6 months timepoint to the 12 years recall (p < .001). While there were no statistically significant differences between the two groups in terms of Clinical Attachment Level (CAL), KTW, GT changes and Root Coverage Esthetic Score at each timepoint (p > .05). KTW ≥ 2 mm and GT ≥ 1.2 mm at 6‐months were two predictors for stability of the gingival margin (p = .03 and p = .01, respectively).

Conclusions

A significant relapse of the gingival margin of MAGRs treated with CAF or TUN + ADM was observed after 12 years.
Legal Uniformity in American Courts
Authors: Beim Deborah , Rader Kelly
Published: June 2019

Intercircuit splits occur when two or more circuits on the U.S. Courts of Appeals issue different legal rules about the same legal question. When this happens, federal law is applied differently in different parts of the country. Intercircuit splits cause legal nonuniformity, are an impediment to lawyering and judging, and have practical consequences for U.S. law. Despite intercircuit splits’ importance, there is almost no quantitative research about them. We created a unique original dataset that includes intercircuit splits that arose between 2005 and 2013. For each intercircuit split, we identified every circuit and every case involved. These data reveal that one‐third of intercircuit splits are resolved by the Supreme Court. Two‐thirds are not. We show that those that will be resolved are resolved within three years after they arise and that splits are more likely to be resolved when they exhibit contemporaneous and growing disagreement. However, many such splits are never resolved by the Supreme Court. Those that are not resolved by the Supreme Court continue to yield litigation and do not dissipate on their own. The likelihood of resolution does not rise as time passes.
Association between waist circumference and risk of colorectal neoplasia in normal‐weight adults
Authors: Jung Yoon Suk , Kim Nam Hee , Yang Hyo‐Joon , Park Soo‐Kyung , Park Jung Ho , Park Dong Il , Sohn Chong Il
Published: June 2019

Background and Aim

Abdominal obesity, measured using waist circumference (WC), is associated with the colorectal neoplasia (CRN) risk. We examined whether WC is associated with the CRN risk even in normal‐weight individuals.

Methods

A cross‐sectional study was performed on asymptomatic normal‐weight (body mass index 18.5–23 kg/m2) individuals who underwent colonoscopy as health checkups.

Results

Of 63 057 examinees, 30 498 were men (mean age, 41.1 years) and 32 559 were women (mean age, 41.7 years). The prevalence of overall CRN in WC quartiles 1, 2, 3, and 4 was 14.2%, 15.5%, 15.5%, and 18.7%, respectively, in men and 7.4%, 8.9%, 9.4%, and 11.5%, respectively, in women. The prevalence of advanced CRN (ACRN) in WC quartiles 1, 2, 3, and 4 was 1.5%, 1.3%, 1.6%, and 2.1%, respectively, in men and 1.0%, 1.3%, 1.2%, and 1.3%, respectively, in women. Among men, the overall CRN risk in quartile 4 (> 82 cm) was higher than that in quartiles 1, 2, and 3 (adjusted odds ratio, OR [95% confidence interval, CI], 1.22 [1.11–1.34], 1.12 [1.05–1.23], and 1.18 [1.07–1.29], respectively); the ACRN risk in quartile 4 was also higher than that in quartiles 1, 2, and 3 (adjusted OR [95% CI], 1.41 [1.09–1.81], 1.56 [1.19–2.03], and 1.50 [1.16–1.94], respectively). Among women, the overall CRN risk in quartile 4 (> 77 cm) was higher than that in quartiles 1 and 3; the ACRN risk was not different among all groups.

Conclusions

Even with a normal weight, a large WC was associated with the CRN risk, especially with the ACRN risk in men.
Ascitic fluid total protein, a useful marker in non‐portal hypertensive ascites
Authors: Zhu Shenghua , Du Li , Xu Dong , Lu Zhiwen , Xu Ting , Li Jin , Xu Keshu , Ye Jin , Song Yuhu
Published: June 2019

Background and Aims

Diagnostic performance of ascitic fluid total protein (AFTP) concentration remained unsettled. Our aim was to determine diagnostic value of AFTP in differential diagnosis of causes of ascites.

Methods

Seven hundred four consecutive patients with new‐onset ascites were prospectively enrolled in this study.

Results

In the training cohort, diagnostic performance of quantitative AFTP assay was superior to that of Rivalta test in differential diagnosis of ascites. At the predetermined cut‐off value of 25 g/L, quantitative AFTP assay was more useful in the differentiation of non‐portal hypertensive ascites from portal hypertensive ascites compared with the exudate–transudate classification, area under curve of receiver operating characteristic curve was 0.958. Quantitative AFTP assay was superior to serum–ascites albumin gradient in the detection of non‐portal hypertensive ascites, especially malignant ascites and tuberculous peritonitis. In mixed ascites, AFTP was useful in identifying peritoneal lesions.

Conclusions

Ascitic fluid total protein is a useful marker in non‐portal hypertensive ascites; thus, it should be determined in diagnostic work‐up of the patients with ascites.
Contrasting patterns of ERK activation in the tail of the striatum in response to aversive and rewarding signals
Authors: Gangarossa Giuseppe , Castell Laia , Castro Liliana , Tarot Pauline , Veyrunes Frederic , Vincent Pierre , Bertaso Federica , Valjent Emmanuel
Published: June 2019

The caudal part of the striatum, also named the tail of the striatum (TS), defines a fourth striatal domain. Determining whether rewarding, aversive and salient stimuli regulate the activity of striatal spiny projections neurons (SPNs) of the TS is therefore of paramount importance to understand its functions, which remain largely elusive. Taking advantage of genetically encoded biosensors (A‐kinase activity reporter 3) to record protein kinase A signals and by analyzing the distribution of dopamine D1R‐ and D2R‐SPNs in the TS, we characterized three subterritories: a D2R/A2aR‐lacking, a D1R/D2R‐intermingled and a D1R/D2R‐SPNs‐enriched area (corresponding to the amygdalostriatal transition). In addition, we provide evidence that the distribution of D1R‐ and D2R‐SPNs in the TS is evolutionarily conserved (mouse, rat, gerbil). The in vivo analysis of extracellular signal‐regulated kinase (ERK) phosphorylation in these TS subterritories in response to distinct appetitive, aversive and pharmacological stimuli revealed that SPNs of the TS are not recruited by stimuli triggering innate aversive responses, fasting, satiety, or palatable signals whereas a reduction in ERK phosphorylation occurred following learned avoidance. In contrast, D1R‐SPNs of the intermingled and D2R/A2aR‐lacking areas were strongly activated by both D1R agonists and psychostimulant drugs (d‐amphetamine, cocaine, 3,4‐methyl enedioxy methamphetamine, or methylphenidate), but not by hallucinogens. Finally, a similar pattern of ERK activation was observed by blocking selectively dopamine reuptake. Together, our results reveal that the caudal TS might participate in the processing of specific reward signals and discrete aversive stimuli.

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Understanding the Relationship Between Staff and Job Satisfaction, Stress, Turnover, and Staff Outcomes in the Person‐Centered Care Nursing Home Arena
Authors: Rajamohan Santhiny , Porock Davina , Chang Yu‐Ping
Published: June 2019

Background

The provision of quality care in nursing home (NH) facilities is an ongoing challenge, and the literature indicates that the quality of care (QOC) is often suboptimal. While it is highly recommended that NH facilities adopt a culture of person‐centered care (PCC) to ensure quality care, the outcomes of this shift on staff working in NH settings has not been well studied. The purpose of this article was to understand the theoretical relationship between staff and job satisfaction, stress, turnover, and staff outcomes in PCC NH settings, by utilizing Cohen‐Mansfield's (1995) comprehensive occupational stress model.

Methods

An integrative review of the electronic databases of research published in English between 2000 and 2015 was conducted.

Results

A review of 11 papers suggested that job satisfaction in the nursing workforce is positively related to consistency in QOC delivery and increased quality of life among residents in NHs. Management support and PCC practices positively correlate with improved QOC, staff satisfaction, and staff retention.

Conclusions

This review showed that PCC intervention and training representing the key concept of workplace resources has a positive impact on NH staff job stress and satisfaction.

Clinical Relevance

Supporting the NH workforce through PCC training is essential for promoting job satisfaction and reducing job‐related stress as well as turnover, which in turn will improve QOC delivered to the residents living in NHs.
Response pattern analysis of IBD‐KID: A knowledge assessment tool for children with inflammatory bowel disease
Authors: Vernon‐Roberts Angharad , Otley Anthony , Frampton Chris , Gearry Richard B , Day Andrew S
Published: June 2019

Aim

Paediatric inflammatory bowel disease (IBD) is a chronic relapsing condition requiring adherence to complex treatment regimens to achieve best outcomes. Adherence is frequently low in this population but can be improved by increasing disease‐ and treatment‐related knowledge. The IBD‐knowledge inventory device (IBD‐KID) is a knowledge assessment tool specifically developed and validated for children with IBD. To analyse IBD‐KID participant response patterns in order to review the strength of the tool.

Methods

A cohort of children with IBD completed IBD‐KID, and their responses were used to assess the tool's validity and feasibility. Item response analysis assessed the item difficulty and the ability of items to discriminate between high/low scorers. The analysis considered item structure, readability and the effectiveness of multiple choice items.

Results

A total of 105 completed IBD‐KID assessments showed that 12 items (52%) had an acceptable difficulty level, and 17 (74%) were effective at discriminating between high/low scorers. Nine (61%) had good readability, but comprehension levels ranged from 5 to 18 years. Seven (30%) had elevated ‘don't know’ responses, highlighting the need for content and construction review. Of the 10 multiple choice items, 9 were complex and not functioning efficiently. Internal consistency was acceptable but could be improved by removing two items.

Conclusions

The response analysis metrics were reviewed by an expert panel and provided a framework for IBD‐KID improvements with the aim of increasing discrimination and reducing difficulty without adversely affecting reliability. The proposed revisions will address components that may have caused children to answer incorrectly due to confusion rather than lack of knowledge.
Baseline risk factors determine lack of biochemical response after SVR in chronic hepatitis C patients treated with DAAs
Authors: Tacke Frank , Boeker Klaus H.W. , Klinker Hartwig , Heyne Renate , Buggisch Peter , Pathil Anita , Wiegand Johannes , Cornberg Markus , Lange Christian , Berg Thomas , Zeuzem Stefan , Mauss Stefan
Published: June 2019

Background and Aims

Liver function tests (alanine aminotransferase, ALT; gamma‐glutamyltransferase, GGT) not always normalize after elimination of hepatitis C virus (HCV) by direct acting antivirals (DAAs), possibly indicating concomitant non‐viral liver diseases. We analysed factors determining the biochemical response (normalized ALT/GGT) of DAA therapy in a large real‐world cohort.

Method

The German Hepatitis C‐Registry is a national multicenter registry study. Normal ALT was defined ≤35 U/L (female) and ≤50 U/L (male) or, according to AASLD, ≤19 U/L (female) and ≤30 U/L (male), normal GGT ≤40 U/L (female) and ≤60 U/L (male).

Results

At baseline, ALT was elevated in 3705/4946 (74.9%), ALT (AASLD) in 4669/4946 (94.4%) and GGT in 3018/4906 (61.5%). In this study, 97% of patients achieved SVR12. At week 12 after end of therapy, ALT was elevated in 451/4946 (9.1%), ALT according to AASLD in 1906/4946 (38.5%) and GGT in 863/4879 (17.7%). Persistently elevated ALT after DAA therapy was independently associated with high body mass index (BMI), age <70 years, liver cirrhosis, diabetes, alcohol consumption and not achieving SVR12. Using the stricter AASLD criteria, opioid substitution and male sex were additional predictors. Higher GGT at week 12 was associated with high BMI, age >70 years, liver cirrhosis, diabetes, alcohol consumption, opioid substitution and non‐SVR. Importantly, persistently elevated liver tests after treatment, particularly GGT, were associated with hepatic decompensation and mortality during 4‐years follow‐up.

Conclusion

Risk factors at baseline (obesity, diabetes, liver cirrhosis, alcohol consumption) are independently associated with persistently elevated liver function tests after SVR, indicating that these patients warrant further hepatological follow‐up. Clinical trial registration: German Clinical Trials Register (DRKS; ID DRKS00009717).