bluuebunny/crossref_metadata_2025 huggingface dataset:
Follow the complex bread crumbs: A review of autoinflammation for the general paediatrician
Authors: Tsoukas Paul , Laxer Ronald M
Published: July 2019

Autoinflammatory diseases have emerged as a group of disorders that have significant morbidity, and even mortality. Since their onset predominately occurs during childhood, it is important that paediatricians are aware of what these diseases are, how they present, when to include them in differential diagnoses, and when to refer to a specialist. This review will focus on the clinical indicators suggestive of autoinflammatory disease, how the presence of an autoinflammatory disease may influence routine care, indications for immediate referral, and both their acute and chronic complications.
Faculty Ability to Care and Caring Characteristics in School of Nursing Climate: A National Survey
Authors: Hayne Arlene N. , Schlosser Sharron P. , McDaniel Gretchen S.
Published: July 2019

AIM

This study surveyed faculty ability to care and perception of caring characteristics within school of nursing climate.

BACKGROUND

Caring within schools of nursing is not well understood.

METHOD

A stratified, random, multistage cluster national sample of 2,043 faculty were surveyed using the Caring Ability Inventory and the Caring Characteristics Within the School of Nursing Climate instruments.

RESULTS

No significant differences on the Caring Ability Inventory were identified by school type. Significant differences were noted in faculty perceptions of a caring climate by school type. State universities and community colleges scored lower on the Trust/Teamwork, Support, and Respect subscales and total Caring Characteristics Within the School of Nursing Climate. Community college scores were lower than private, not-for-profit, and state university scores (p < .05) on the Valued subscale.

CONCLUSION

Further research is needed to describe and evaluate the caring climate within schools of nursing and the effectiveness of specific strategies to facilitate caring in the school of nursing climate.
A Randomized Trial to Increase the Assessment Accuracy of Glaucoma and Optic Disc Characteristics by Orthoptists
Authors: Scheetz Jane , Koklanis Konstandina , McGuinness Myra , Long Maureen , Morris Meg E.
Published: July 2019

Introduction:

The aim of this study was to determine the accuracy of orthoptists when examining the optic disc for signs of glaucoma, and to explore the impact of targeted clinical education on accuracy.

Methods:

In this randomized controlled trial, 42 monoscopic color optic disc images were presented to 46 orthoptists who assessed the likelihood of glaucoma as well as optic disc size, shape, tilting, vertical cup-to-disc ratio, cup shape, depth, presence of hemorrhage, peripapillary atrophy, and retinal nerve fiber layer. The level of agreement with specialist ophthalmologists was assessed. Participants were then randomly assigned to an experimental group (targeted postgraduate education on optic disc assessment) or to no intervention. The educational program was designed to increase knowledge of the characteristic features associated with glaucomatous optic neuropathy. All participants re-examined the included optic disc images after a period of 6 to 8 weeks. The primary outcome measure was a change in agreement between attempts.

Results:

The education group showed significant improvements between attempts for identifying hemorrhages (P = .013), retinal nerve fiber layer defects (0.035), disc size (P = .001), peripapillary atrophy (P = .030), and glaucoma likelihood (P = .023). The control group did not show any statistically significant improvement. The intervention group showed significantly more improvement when identifying hemorrhages (P = .013), disc size (P = .001), disc shape (P = .033), and cup shape (P = .020) compared with the control group.

Discussion:

Orthoptists who received additional postgraduate online education based on principles of adult learning were more accurate at assessing the optic disc for glaucoma. These results highlight the value of continuing education to optimize clinical practice in allied health professionals.
Autoimmune Bell’s Palsy Following Immunotherapy For Metastatic Melanoma: A Report of 2 Cases
Authors: Zieman Daniel , Frankel Arthur E.
Published: July 2019

By targeting receptors that serve to downregulate the cellular immune system, monoclonal antibodies such as ipilimumab and nivolumab have transformed the management of metastatic melanoma, and their use is referred to as immune checkpoint therapy (ICT). However, because the antitumoral activity of these agents is achieved through the reversal of mechanisms that naturally serve to temper the immune response, the potential for adverse reactions secondary to autoimmunity is of clinical significance. Neurological immune-related adverse events (irAEs) may occur consequent to ICT, and the development of autoimmune Bell’s palsy is a specific, uncommon manifestation of the body’s immune response against the seventh cranial nerve, resulting in acute paresis of facial muscles. We describe 2 cases of autoimmune Bell’s palsy following the administration of combination ICT using ipilimumab and nivolumab in 2 patients with metastatic melanoma. The use of a steroid taper in addition to the cessation of combination immunotherapy resulted in resolution of symptoms for both patients. In the first case, the patient was subsequently started on nivolumab monotherapy but developed autoimmune polyneuropathy, and immunotherapy was discontinued indefinitely. In the second case, the initiation of nivolumab monotherapy following resolution of symptoms resulted in an inadequate antitumoral response. Subsequent transition to treatment with encorafenib/binimetinib initially provided a positive response but also required discontinuation secondary to irAEs. Both of these cases demonstrate the potential for autoimmune Bell’s palsy as a consequence of combination ICT and provide evidence of successful treatment of this irAE through temporary discontinuation of immunotherapy and administration of steroids.
A Novel Laparoscopic Technique With a Bladder Peritoneum Flap Closure for Pelvic Cavity for Patients With Rigid Pelvic Peritoneum After Neoadjuvant Radiotherapy in Laparoscopic Extralevator Abdominoperineal Excision
Authors: Yang Tinghan , Wei Mingtian , Deng Xiangbing , Meng Wenjian , Wang Ziqiang
Published: July 2019

BACKGROUND:

In laparoscopic extralevator abdominoperineal excision, reconstruction of the pelvic peritoneum helps to prevent the small intestine from adhering to pelvic wall tissues, thus avoiding small-bowel obstruction and perineal complications. However, there are difficulties in pelvic peritoneum closure if the patient has received preoperative radiotherapy and has a rigid pelvis. We report a novel laparoscopic method for pelvic peritoneum reconstruction using the bladder peritoneum flap in laparoscopic extralevator abdominoperineal excision after neoadjuvant radiotherapy.

TECHNIQUE:

After transection of the rectum, if the patient had a rigid pelvis, we chose to perform the novel technique for the pelvic peritoneum closure in a 3-step approach. The flap has an arch shape with the bottom at the anterior wall of the pelvic cavity entrance. The height of the arched flap is equal to the distance from the bladder to the sacral promontory. The peritoneum was incised with electrocautery at the planned level and peeled off the bladder. The bladder peritoneum flap was then rotated to cover the entrance of the pelvic cavity and sutured to the brim of the pelvis.

RESULTS:

Acceptable postoperative short-term and long-term outcomes (5- to 22-month follow-ups) were achieved in 3 patients who underwent bladder peritoneum flap closure.

CONCLUSIONS:

The bladder peritoneum flap appears to be safe and feasible for intracorporeal closure of the pelvic cavity in laparoscopic extralevator abdominoperineal excision after neoadjuvant radiotherapy. The procedure provides a novel option for patients with severe fibrosis of the pelvis when another peritoneum reconstruction method is not feasible.
Increased Arbekacin Clearance in Patients With Febrile Neutropenia
Authors: Nakayama Takahiro , Chuma Masayuki , Tochikura Naohiro , Iwabuchi So , Suzuki Shinichiro , Matsumoto Chiaki , Imai Toru , Hamada Takashi , Nakagawa Masaru , Takahashi Hiromichi , Uchino Yoshihito , Miura Katsuhiro , Iriyama Noriyoshi , Hatta Yoshihiro , Takei Masami , Kimura Takahisa
Published: July 2019

Background:

Arbekacin (ABK) is used to treat infections caused by methicillin-resistant Staphylococcus aureus and is used widely for the treatment of febrile neutropenia (FN). As ABK has a narrow therapeutic concentration window, the dosage must be adjusted via therapeutic drug monitoring. However, the influence of the physiology of patients with FN on the pharmacokinetic (PK) parameters of ABK remains unclear. Therefore, we examined this influence on ABK PK parameters.

Method:

We performed a retrospective cohort study using data from patients with a hematologic malignancy who were ≥18 years and had been administered ABK. We excluded patients who did not receive therapeutic drug monitoring and had an estimated glomerular filtration rate (eGFR) of <30 mL/min, because clinically sufficient data would not be available.

Result:

Of the 99 enrolled patients, 25 did not have FN and 74 had FN. Arbekacin clearance (CLabk) was shown to correlate with eGFR in patients with FN (r = 0.32, P = 0.0062) and without FN (r = 0.50, P = 0.01). CLabk was higher in patients with FN than in those without FN. In addition, in the eGFR of <100 mL/min group (normal renal function), CLabk and CLabk/eGFR were also higher in patients with FN than in those without FN.

Conclusions:

CLabk was increased in patients with FN and normal renal function; therefore, we propose an increased ABK dose for patients with FN and normal renal function.
Teledermatology Viewpoint
Authors: Martin Kari L.
Published: July 2019

Teledermatology is a term to describe the provision of dermatologic medical services through telecommunication technology. In store-and-forward teledermatology, patient medical information (including history and visual data) obtained in one location is transferred electronically to a provider who is in another location (Roman & Jacob, 2014). The construct of this column is such that cases are presented in a standardized teledermatology reader format. This is a case of erythematous plaques with scattered erosions in the perineum.
Evaluation of the Effect of Diclofenac Sodium and 5-Fluourasil in a 3D Cholesteatoma Cell Culture Model
Authors: Kara Ahmet , Duman Busra Oncel , Yazır Yusufhan , SinanYilmaz Mahmut , Halbutogulları Zehra Seda Unal , Demir Deniz , Kara Rabia Oztas , Bayraktar Hakan , Guven Mehmet
Published: July 2019

Introduction:

Middle ear cholesteatoma is a benign disease with invasive and destructive clinical behaviors. It increases the rate of both chronic otitis media complications and revision surgeries. The most effective treatment of middle ear cholesteatoma is surgical excision, and there is no medical treatment for this disease. Exploring new medical treatment options may help to create treatment alternatives instead of surgery.

Materials and Methods:

Required cholesteatoma tissues for cell culture were excised from 4 different participants who underwent surgery in our clinic and agreed to give tissue for the study. Cholesteatoma-derived keratinocytes and fibroblasts were cocultured in temperature-sensitive culture dishes to make a three-dimensional (3D) cholesteatoma model. Then, the effects of 1% and 2% diclofenac sodium on viability and cell proliferation rates were examined using WST-1 and annexin-V tests.

Results:

Cell viability and proliferation rates were found to be lower and apoptosis rates were higher in the diclofenac sodium group versus the negative and positive control groups.

Conclusion:

In this present study, we described a new 3D cholesteatoma cell culture model developed using cell sheet technology and demonstrated the efficacy of diclofenac sodium on cholesteatoma for the first time in the literature. It may be used in patients with chronic otitis media with cholesteatoma, but further studies investigating ototoxic and neurotoxic effects of this molecule are needed.
Mentoring Clinical Nurses Toward a Just Culture
Authors: Korkis Leah , Ternavan Kimberly , Ladak Anila , Maines Michele , Ribeiro Denise , Hickey Sharron
Published: July 2019

The nursing peer-review process is an effective and underutilized method to enhance nurse accountability and ownership of patient care and nursing practice. This article describes how 1 hospital created a clinical nurse–driven, nonpunitive, peer case review structure and mentorship processes. This innovative structure provides a framework to support nurses through shared governance and supports organizational efforts including Magnet® and Just Culture initiatives.
Custom Optical Coherence Tomography Parameters for Distinguishing Papilledema from Pseudopapilledema
Authors: Pardon Laura P. , Cheng Han , Tang Rosa A. , Saenz Roberto , Frishman Laura J. , Patel Nimesh B.
Published: July 2019

SIGNIFICANCE

Causes of papilledema can be life-threatening; however, distinguishing papilledema from pseudopapilledema is often challenging. The conventional optical coherence tomography (OCT) scan for assessing the optic nerve often fails to detect mild papilledema. Our study suggests that parameters derived from volumetric OCT scans can provide additional useful information for detecting papilledema.

PURPOSE

Optical coherence tomography analysis of the optic nerve commonly measures retinal nerve fiber layer thickness (RNFLT) along a 1.73-mm-radius scan path. This conventional scan, however, often fails to detect mild papilledema. The purpose of this study was to evaluate additional OCT-derived measures of the optic nerve head (ONH) and peripapillary retina for differentiating papilledema (all grades and mild) from pseudopapilledema.

METHODS

Cirrus OCT ONH volume scans were acquired from 21 papilledema (15 mild papilledema), 27 pseudopapilledema, and 42 control subjects. Raw scan data were exported, and total retinal thickness within Bruch’s membrane opening (BMO) plus RNFLT and total retinal thickness at the following eccentricities were calculated using custom algorithms: BMO to 250, 250 to 500, 500 to 1000, and 1000 to 1500 μm. Minimum rim width was calculated, and BMO height was measured from a 4-mm Bruch’s membrane reference plane centered on the BMO.

RESULTS

Retinal nerve fiber layer thickness from BMO to 250 μm, minimum rim width, and BMO height had significantly greater areas under the receiver operating characteristic curve than did conventional RNFLT for differentiating mild papilledema from pseudopapilledema (P < .0001) and greater sensitivities at 95% specificity. Using cutoff values at 95% specificity, custom parameters detected 10 mild papilledema patients, and conventional RNFLT detected only 1. Bruch’s membrane opening heights above the reference plane were observed in papilledema only, although many papilledema cases had a neutral or negative BMO height.

CONCLUSIONS

Using OCT volumetric data, additional parameters describing peripapillary tissue thickness, neuroretinal rim thickness, and ONH position can be calculated and provide valuable measures for differentiating mild papilledema from pseudopapilledema.
Workplace Homicides in Northern Tunisia
Authors: Ben Khelil Mehdi , Belghith Meyssa , Chraiti Ahmed , Gharbaoui Meriem , Laadhari Nizar , Hamdoun Moncef
Published: July 2019

Background

Death in workplaces remains a public health issue. However, data regarding workplace homicides are scarce in most of regions, especially in the Arab world. The aim of our study was to analyze the epidemiological features of workplace homicides in northern Tunisia.

Materials and Methods

This is a descriptive study with retrospective data collection over a 15-year period (January 2003 to December 2017).

Results

We recorded 50 workplace homicide cases. Sex ratio was 49:1 (male/female). The mean age was 41.6 ± 15.13 years. Occupations the most at risk were security guards (odds ratio, 8.25; 95% confidence interval, 4.28–15.91; P < 0.0001) and taxi drivers (odds ratio, 5.61; 95% confidence interval, 2.39–13.18; P < 0.00001). The motive of the aggression was either interpersonal conflict or robbery (47.9% and 43.8%, respectively). Victims working as security guards or taxi drivers were most frequently assaulted by an unknown perpetrator, the motive being robbery. Death was most frequently secondary to blunt trauma (n = 20) or stab wounds (n = 15).

Conclusions

Workplace homicides represent a substantial phenomenon in Tunisia. The application of prevention measures is required based on improving environmental measures targeting, in priority, security guards and taxi drivers.
Validation of an Assessment Instrument for Pediatric Basic Life Support
Authors: Binkhorst Mathijs , Hogeveen Marije , Benthem Yvet , van de Pol Eva M. , van Heijst Arno F. J. , Draaisma Jos M. Th.
Published: July 2019

Objectives

To develop a valid and reliable instrument for the assessment of pediatric basic life support (PBLS).

Methods

An assessment instrument for PBLS was developed, based on 3 existing scoring systems and the European Resuscitation Council PBLS guideline. We tested if experienced PBLS instructors performed better than medical students on a standard PBLS examination on a low-fidelity pediatric manikin (construct validity). To pass the examination, 15 penalty points or less were required. The examinations were videotaped. One researcher assessed all videos once, and approximately half of them twice (intrarater reliability). A second researcher independently assessed part of the videos (interrater reliability). The time needed to assess 1 examination was determined.

Results

Face and content validity were established, because PBLS experts reached consensus on the instrument and because the instrument incorporated all items of the European Resuscitation Council algorithm. Of the 157 medical students that were scored, 98 (62.4%) passed the examination. Fourteen PBLS instructors were scored; all passed (100%). Pass rate (62.4% vs 100%) and median penalty points (15 [interquartile range, 10–22.5] vs 7.5 [interquartile range, 1.25–10]) were significantly different between students and instructors (P = 0.005 and <0.001, respectively). Reassessment demonstrated a κ for intrarater reliability of 0.62 (95% confidence interval, 0.45–0.81) (substantial agreement); κ for interrater reliability was 0.51 (95% confidence interval, 0.09–0.93) (moderate agreement). It took approximately 3 minutes to assess 1 videotaped examination.

Conclusions

Our instrument for the (video-based) assessment of PBLS is valid and sufficiently reliable. It is also designed to be practical, time-efficient, and applicable in various settings, including resource limited.
The Hidden Burden of Mental Health Outcomes Following Firearm-related Injures
Authors: Joseph Bellal , Hanna Kamil , Callcut Rachael A. , Coleman Jamie J. , Sakran Joseph V. , Neumayer Leigh A.
Published: July 2019

Objectives:

Examine the effect of different types of firearms on readmission due to acute stress disorder (ASD) and/or post-traumatic stress disorder (PTSD) in firearm-injury victims.

Background:

Survivors of firearm-related injuries suffer long-term sequelae such as disability, work loss, and deterioration in the quality of life. There is a paucity of data describing the long-term mental health outcomes in these patients.

Methods:

We performed a 5-year (2011–2015) analysis of the Nationwide Readmission Database. All adult patients with firearm injuries were stratified into 3 groups by firearm type: handgun, shotgun, and semiautomatic rifle. Outcome measures were the incidence and predictors of ASD/PTSD.

Results:

A total of 100,704 victims of firearm-related injuries were identified, of which 13.3% (n = 13,393) were readmitted within 6 months of index hospitalization, 6.7% (n = 8970) of these due to ASD/PTSD. Mean age was 34 ± 14 years, 88% were men. Of those readmitted due to ASD/PTSD, 24% (n = 2153) sustained a handgun-related injury on index hospitalization, 12% (n = 1076) shotgun, and 64% (n = 5741) semiautomatic gun (P = 0.039). On regression analysis, semiautomatic gun and shotgun victims had higher odds of developing ASD/PTSD upon readmission [odds ratio (OR): 2.05 (1.10–4.12) and OR: 1.41 (1.08–2.11)] compared to handgun. Female sex [OR: 1.79 (1.05–3.05)] and younger age representing those younger than 25 years [OR: 4.66 (1.12–6.74)] were also independently associated with higher odds of ASD/PTSD.

Conclusions:

Apart from the lives lost, survivors of semiautomatic rifle- and shotgun-related injuries suffer long-term mental health sequalae. These secondary and debilitating mental health outcomes are important considerations for capturing the overall burden of the disease.
The structural proteome for the primordial glycolysis/gluconeogenesis
Authors: do Ó Isabela Jerônimo Bezerra , Rego Thais Gaudêncio , José Marco V. , de Farias Sávio Torres
Published: July 2019

Comprehending the constitution of early biological metabolism is indispensable for the understanding of the origin and evolution of life on Earth. Here, we analyzed the structural proteome before the Last Universal Common Ancestor (LUCA) based in the reconstruction of the ancestral sequences and structure for proteins involved in glycolysis/gluconeogenesis. The results are compatible with the notion that the first portions of the proteins were the areas homologous to the present-day catalytic sites. Those “proto-proteins” had a simple function: binding to cofactors. Upon the accretion of new elements to the structure, the catalytic function could have emerged. Also, the first structural motifs might have been related to the emergence of the different proteins that work in modern organisms.
The relationship between sport involvement, perceived event prestige, and the intention to attend annual spectator events
Authors: Chiu Weisheng , Won Doyeon , Leng Ho Keat
Published: July 2019

Purpose

The purpose of this paper is to examine the relationship between sport involvement, perceived event prestige and attendance intention of annual sporting events. In addition, it examines the moderating effects of gender and past experience on the proposed model.

Design/methodology/approach

Data were collected, using an on-site survey, from spectators (n=349) who attended the men’s or women’s basketball tournaments of the 2016 William Jones Cup held in Taiwan.

Findings

The results showed that perceived event prestige partially mediated the relationship between sport involvement and attendance intention of sporting events. Moreover, the moderating effects of gender and experience were found in the proposed model. Specifically, male spectators’ involvement had a significantly stronger influence on perceived event prestige, and, in turn, their perception of event prestige played a more significant role in influencing attendance intention. Also, sport involvement was more important in predicting attendance intention for experienced spectators whereas the prestige of the event was more important for first-time spectators.

Originality/value

This study suggests that sport event organizers need to employ different strategies in developing the subsequent editions of the event and retaining fans’ interest in the sport. Specifically, event organizers need to enhance the prestige of the sporting event through effective marketing communication to attract first-time spectators to the event.
Evolution of German corporate governance (1995-2014): an empirical analysis
Authors: Rühmkorf Andreas , Spindler Felix , Samanta Navajyoti
Published: July 2019

Purpose

This paper aims to address the evolution of corporate governance in Germany with a particular regard to whether there can be observed a gradual convergence to a shareholder primacy corporate governance system.

Design/methodology/approach

To investigate a potential shift of the German corporate governance system to an Anglo-American tiled corporate governance system, the authors have empirically assessed on a polynomial base 52 separate company and corporate governance variables for 20 years (1995-2014).

Findings

This research suggests that a gradual convergence has taken place prior to the global financial crisis. However, the results suggest that the convergence process experienced a slowdown in the aftermath of the global financial crisis, which may be linked to the stability of the German corporate governance system during the global financial crisis and the political environment during this time.

Originality/value

This paper contributes to the research by not only analysing the development of the German corporate governance system but also identifying new reasons for this development and explaining why a new convergence process may be observed in the future again.
Understanding open innovation in small and medium-sized museums and exhibition halls
Authors: García-Muiña Fernando E. , Fuentes-Moraleda Laura , Vacas-Guerrero Trinidad , Rienda-Gómez Juan José
Published: July 2019

Purpose

The hostile environments in which museums operate force them to be innovative. Most of them have fewer resources and are publicly owned. Because these factors may hinder their innovative potential, this paper aims to propose an open innovation model adapted to this type of organization to improve visitors’ experience.

Design/methodology/approach

A qualitative method based on a thematic analysis is carried out. Data sources are: (i) focus group with stakeholders from the destination and (ii) in-depth interviews with museums experts.

Findings

This new framework is important because it brings something new to a field that previous research had barely considered. The study of the implementation of open innovation in publicly owned small and medium-sized museums brings to light the growing importance of the relational, organizational, technological and experiential dimensions, their interactions and their main constituent factors.

Research limitations/implications

The study is limited to a specific type of institution, and results should not be extrapolated to other contexts. The construct of open innovation is highly complex, and that advises future research to include other players. Quantitative methods and longitudinal techniques will contribute to tackling new challenges in future research works.

Practical implications

Results are helpful for museum managers and policymakers. Stakeholders improve their comprehension of how an open innovation model works because the paper offers a few guidelines for its active designing. A solid networking based on trust and the emphasis on improving the visitor experience determine making-decision processes.

Originality/value

The paper provides a systemic innovation management model for museums, where there is almost no previous research. It is theoretically supported in the open innovation paradigm, as well as the absorptive capacity framework. The emerging and central role of the experiential dimension constitutes another notable contribution to literature.
Wind energy potential assessment for KPT with a comparison of different methods of determining Weibull parameters
Authors: Hulio Zahid Hussain , Jiang Wei
Published: July 2019

Purpose

The purpose of this paper is to investigate wind power potential of site using wind speed, wind direction and other meteorological data including temperature and air density collected over a period of one year.

Design/methodology/approach

The site-specific air density, wind shear, wind power density, annual energy yield and capacity factors have been calculated at 30 and 10 m above the ground level (AGL). The Weibull parameters have been calculated using empirical, maximum likelihood, modified maximum likelihood, energy pattern and graphical methods to determine the other dependent parameters. The accuracies of these methods are determined using correlation coefficient (R²) and root mean square error (RMSE) values.

Findings

The site-specific wind shear coefficient was found to be 0.18. The annual mean wind speeds were found to be 5.174 and 4.670 m/s at 30 and 10 m heights, respectively, with corresponding standard deviations of 2.085 and 2.059. The mean wind power densities were found to be 59.50 and 46.75 W/m² at 30 and 10 m heights, respectively. According to the economic assessment, the wind turbine A is capable of producing wind energy at the lowest value of US$ 0.034/kWh.

Practical implications

This assessment provides the sustainable solution of energy which minimizes the dependence on continuous supply of oil and gas to run the conventional power plants that is a major cause of increasing load shedding in the significant industrial and thickly populated city of Pakistan. Also, this will minimize the quarrel between the local power producer and oil and gas supplier during the peak season.

Social implications

This wind resource assessment has some important social implications including decreasing the environmental issues, enhancing the uninterrupted supply of electricity and decreasing cost of energy per kWh for the masses of Karachi.

Originality/value

The results are showing that the location can be used for installing the wind energy power plant at the lower cost per kWh compared to other energy sources. The wind energy is termed as sustainable solution at the lowest cost.
Inequity in the distribution of rural family physicians in Iran: a cross sectional study
Authors: Tabari-Khomeiran Rasoul , Ehsani-Chimeh Elham , Davoudi Kiakalayeh Ali , Homaie Rad Enayatollah , Delavari Sajad
Published: July 2019

Purpose

Equal distribution of health human resources is a major issue to achieve human rights in healthcare. Rural family physicians (RFPs) as a part of health human resources play an important role in delivering health services, so the purpose of this paper is to calculate amount of inequity in distribution of RFPs in Iran.

Design/methodology/approach

In this study, the authors tried to find inequity in the distribution of RFPs in the provinces of Iran. For this purpose, inequity indices containing concentration curves and indices were calculated by ranking health-adjusted life expectancy (HALE). Furthermore, a regression model was estimated to find the pattern and influencing factors of inequity in the distribution of RFPs.

Findings

The number of male RFPs was significantly higher in Sistan va Baloochestan, and in the same line, the number of female RFPs was higher in Zanjan province. Concentration index of total RFPs was 0.0568 (not significant) (males= 0.041, females= 0.0718). The results of regression model showed that HALE and per capita GDP did not have any significant relationship with RFPs distribution (HALE p=0.753, GDP p=0.792).

Originality/value

The RFP plan was successful in enhancing equal access to physician and health care services relatively. However, gender imbalance in distribution of RFPs was high especially in less-developed regions.
Driving performance in the public sector: what can we learn from Malaysia’s service delivery reform?
Authors: Siddiquee Noore Alam
Published: July 2019

Purpose

The purpose of this paper is to investigate the extent to which Malaysia’s most recent public service reform has improved service delivery and governmental performance. It also endeavors to identify critical success factors that explain reform performance and draw lessons based on the Malaysian experience.

Design/methodology/approach

The paper adopts a case study approach and draws on data from both primary and secondary sources. Besides a thorough review of official documents and existing literature, the author conducted 20 individual interviews with key informants representing government officials, academics and civil society organizations.

Findings

The study shows that despite some pitfalls and misgivings, the Government Transformation Program (GTP) has produced concrete improvements in service delivery areas where previous reforms failed. One of the factors that underpin GTP’s relative success is the detailed performance management framework, which helped foster inter-agency collaboration and enforce accountability for results at various levels.

Practical implications

The GTP success highlights the significance of adapting reform content to local situations especially when reforms are based on external models; sanctions from the highest political office; a dedicated unit to drive the implementation and an effective performance management framework through which individuals and agencies would be held to account for results achieved.

Originality/value

Despite many and varied reform initiatives attempted in the past, cases of successful reform are rare, especially in developing countries. Little is known on what makes a reform work, a gap exacerbated by notable absence of systematic research on this topic. The paper contributes to address this by reviewing Malaysia’s innovative approach to reform and the insights that the Malaysian experience offers.
The erosion of ethics: from citizen journalism to social media
Authors: Roberts Jessica
Published: July 2019

Purpose

The purpose of this paper is to consider the implications of the shift from citizen journalist to social media user by examining how ethics are addressed on social media sites compared to citizen journalism sites.

Design/methodology/approach

This paper applies the framework of a 2012 study of ethics on citizen journalism sites to social media sites’ guiding documents to compare how they discuss ethics and what they ask of the users, offering suggestions for how social media sites might imbue users with a sense of their responsibilities and obligations.

Findings

The analysis finds that ethics are largely ignored on social media sites, written in legalistic language and framed in negative terms, rather than in terms of responsibilities or obligations.

Originality/value

When citizen journalism was subsumed by social media, much of the language – lacking as it may have been – around users’ responsibilities to each other was lost. This paper suggests social media sites should seek to raise rather than lower the barriers to entry, and imbue users with a sense of the responsibility they accept when sharing information online.
Does alternative healthy eating index can predict the risk of prostate cancer?
Authors: Bagheri Amir , Nachvak Seyed Mostafa , Abdollahzad Hadi , Mohammadi Farzad
Published: July 2019

Purpose

Alternative Healthy Eating Index (AHEI)-2010, an index that determines the quality of a diet, was created to predict the risk of chronic diseases. Nevertheless, it is unclear whether this index can predict the risk of prostate cancer, one of the most prevalent cancers among men around the world. The study aims to investigate the association between adherence to the AHEI-2010 and the risk of prostate cancer in Iranian men.

Design/methodology/approach

The case–control study was conducted in Kermanshah, Iran in the year 2016. The study included 50 cases of Iranian men with prostate cancer and 150 healthy controls. Anthropometric indices were measured by bioelectric impedance analysis (BIA). The AHEI-2010 included 11 food components that were assessed by using a 147-item food frequency questionnaire. A multivariate logistic regression was performed to analyze the association of the AHEI-2010 (expressed as a dichotomous variable) with prostate cancer.

Findings

As per the analysis, there were no significant differences in age, body mass index (BMI) and waist-to-hip ratio (WHR) between case and control groups, statistically. After adjustment for potential confounders, the higher AHEI-2010 scores were associated with a lower risk of prostate cancer (OR AHEI > 55 vs ≤ 55 = 0.26; 95% CI: 0.11-0.63). Moreover, the Mean of AHEI scores was higher in controls than in the cases (p < 0.001).

Originality/value

The authors’ findings suggest that adherence to the dietary patterns with high scores of AHEI-2010 is associated with a reduced risk of prostate cancer, so this index may be used as an effective measure to predict prostate cancer.
Evaluation and development of antibacterial fabrics using Pongamia pinnata extracts
Authors: Andra Swetha , Muthalagu Murugesan , Jeevanandam Jaison , Sekar Durga Devi , Ramamoorthy Rajalakshmi
Published: July 2019

Purpose

A widespread focus on the plant-based antimicrobial cotton fabric finishes has been accomplished with notable importance in recent times. The antimicrobials prevent microbial dwelling in fabrics, which causes severe infections to the fabric users. Chemical disinfectants were conventionally used in fabrics to address this challenge; however, they were found to be toxic to humans. Thus, the present study aims to deal with the utilization of phytochemical extracts from different parts of Pongamia pinnata as antimicrobial coatings in cotton fabrics.

Design/methodology/approach

The root, bark and stem were collected and washed several times using tap water. Then, the leaves were dried at room temperature and the root and bark were dried using an oven at 40ºC. After drying, they were ground into fine powder and extracted with ethanol using the Soxhlet apparatus. After that the extract was coated on the fabric tested for antimicrobial studies.

Findings

The results reported that the leaf extract of P. pinnata-coated fabric exhibited enhanced antibacterial property towards gram-negative Escherichia coli bacteria, followed by root, bark and stem. The wash durability test in the extract-coated fabric samples revealed that dip-coating retained antibacterial activity until five washes. Thus, the current study clearly suggests that the leaf extract from P. pinnata is highly useful to develop antibacterial cotton fabrics as health-care textiles.

Originality/value

The novelty of the present work is to obtain the crude extract from the leaves, bark, root and stem of P. pinnata and evaluate their antibacterial activity against E. coli, upon being coated on cotton fibres. In addition, the extracts were subjected to wash durability analysis to study the coating efficiency of the phytochemicals in cotton fabrics and a probable mechanism for the antibacterial activity of P. pinnata extracts was also presented.
Digital maturity – the new competitive goal
Authors: Rader David
Published: July 2019

Purpose

The authors of “The Digital Fallacy” are interviewed by veteran strategist David Rader. They envision digital implementation as a learning journey rather than a time-boxed program. They name the journey “Digital Maturity.”

Design/methodology/approach

Explains how Digital Maturity is a way of applying digital technology – at first to promote efficiency and ultimately in creative ways to innovate new business models – an operation that continues to grow and evolve.

Findings

Digitally mature companies are more likely to be agile, experimental, risk tolerant, collaborative and learning organizations.

Practical implications

Getting started can begin with identifying leaders within the organization with characteristics exhibited by digitally mature organizations and tasking them and a team with an effort that allows them to test fast, learn fast and scale fast.

Originality/value

Companies often start by focusing on efficiency gains, then move to better use of data for decision making and then lastly to employ technology to transform their offerings and business models. The final stage is where the greatest value from digital maturity is achieved.
Opioid Use and Misuse Three Months After Emergency Department Visit for Acute Pain
Authors: Daoust Raoul , Paquet Jean , Gosselin Sophie , Lavigne Gilles , Cournoyer Alexis , Piette Eric , Morris Judy , Castonguay Véronique , Lessard Justine , Chauny Jean‐Marc
Published: July 2019

Background

Studies evaluating long‐term prescription opioid use are retrospective and based on filled opioid prescriptions from governmental databases. These studies cannot evaluate if opioids were really consumed and are unable to differentiate if they were used for a new pain or chronic pain or were misused. The aim of this study was to assess opioid use rate and reasons for consuming 3 months after being discharged from the emergency department (ED) with an opioid prescription.

Methods

This is a prospective cohort study conducted in the ED of a tertiary care urban center with a convenience sample of discharged patients ≥ 18 years who consulted for an acute pain condition (≤2 weeks). Three months post–ED visit, participants were interviewed by phone on their past 2‐week opioid consumption and their reasons for consuming: a) for pain related to the initial ED visit, b) for a new unrelated pain, or c) for another reason.

Results

Of the 524 participants questioned at 3 months (mean ± SD age = 51 ± 16 years, 47% women), 47 patients (9%, 95% confidence interval [CI] = 7%–12%) reported consuming opioids in the previous 2 weeks. Among those, 34 (72%) reported using opioids for their initial pain, nine (19%) for a new unrelated pain and four (9%) for another reason (0.8%, 95% CI = 0.3%–2.0%, of the whole cohort). Patients who used opioids during the 2 weeks after the ED visit were 3.8 (95% CI = 1.2–12.7) times more likely to consume opioids at 3 months.

Conclusion

Opioid use at the 3‐month follow‐up in ED patients discharged with an opioid prescription for an acute pain condition is not necessarily associated with opioid misuse; 91% of those patients consumed opioids to treat pain. Of the whole cohort, less than 1% reported using opioids for reasons other than pain. The rate of long‐term opioid use reported by prescription‐filling database studies should not be viewed as a proxy for incidence of opioid misuse.
Alterations in lycopene concentration and Z‐isomer content in egg yolk of hens fed all‐E‐isomer‐rich and Z‐isomer‐rich lycopene
Authors: Honda Masaki , Ishikawa Hiroto , Hayashi Yoshiaki
Published: July 2019

Effects of feeding lycopene isomers to laying hens on egg qualities such as lycopene concentration and color of the yolk were investigated. Firstly, to evaluate the dietary transfer of lycopene to egg yolk, (all‐E)‐lycopene–rich diets (lycopene content, 100, 200, or 300 mg/kg diet) were fed to hens for 21 days. Lycopene in egg yolk could be detected after 4 days or more from the start of feeding, and the lycopene concentration increased according to the feed amount and period. Even though most of the dietary lycopene was the all‐E‐isomer, more than 65% of lycopene in egg yolk was present as Z‐isomers. Thus, the effect of lycopene Z‐isomer content in the diet (lycopene content, 200 mg/kg diet; lycopene Z‐isomer content, 35.1% or 61.3%) on egg qualities was investigated. As the Z‐isomer content increased, the lycopene concentration in the egg yolk increased, for example, when fed a diet rich in Z‐isomers (61.3%), the lycopene concentration in the egg yolk was approximately three times higher than when fed the (all‐E)‐lycopene–rich diet for 21 days. The results indicated that Z‐isomers of lycopene had higher bioavailability and/or higher transfer efficiency to the egg yolk than the all‐E‐isomer.
How the State Shaped the Nonprofit Sector: Public Funding in British Columbia
Authors: Clément Dominique
Published: July 2019

This article examines how the state has used its spending power to shape the nonprofit sector in British Columbia since the 1960s. The province's thriving nonprofit sector and its polarized political culture provide an ideal case study for exploring the relationship between the state and nongovernmental organizations. The following study documents changes in state policy, the trajectory of funding, funding patterns, and organizations that have received state funding. Although public funding for nonprofits in Canada has been pervasive for decades, there is little empirical evidence on the nature and scope of this funding. This article is based on an innovative new database that provides a comprehensive list of grants from the provincial government to nonprofit organizations between 1960 and 2014. Despite concerns regarding cuts to public funding in recent years, this study finds that there has been an overall increase in funding. However, there has also been a significant shift in funding from women's issues to Aboriginal peoples since the early 2000s.
Randomized controlled clinical trial on calcium phosphate coated and conventional SLA surface implants: 1‐year study on survival rate and marginal bone level
Authors: Ko Kyung‐A , Kim Seungmin , Choi Seong‐Ho , Lee Jung‐Seok
Published: July 2019

Background

Calcium phosphate (CaP)‐coated surface showed enhanced contact osteogenesis around dental implant and finally accelerate osseointegration in early healing phase.

Purpose

The aim of this randomized controlled trial was to compare the peri‐implant marginal bone level around uncoated and CaP‐coated sandblasted, large‐grit, acid‐etched (SLA) surface implants during the first year after placement.

Materials and Methods

This study was performed upon 34 patients with randomized and double‐blinded design. Clinical and radiographic examinations were performed immediately after implant placement, at re‐entry after 3 months, and after 12 months to evaluate the initial stability and change in the marginal bone level. The distance from the implant shoulder to the top of the bone‐to‐implant contact was defined as the marginal bone level, and its alteration was measured at 1 year after implant installation.

Results

None of the implants failed, and most of them showed a marginal bone loss of less than 1 mm. Small changes in the bone level were noted at all sites in the control and test groups, and there were no clinically significant differences in the changes in the marginal bone.

Conclusion

Both CaP‐coated and uncoated SLA surface implants showed comparably successful marginal bone stability without any complications during the first year after placement.
Misallocation in Chinese Manufacturing and Services: A Variable Markup Approach
Authors: Ge Jinfeng , Luo Jie , Yuan Yangzhou
Published: July 2019

Cross‐country comparison reveals an unusually small service sector in China. Using firm‐level data from China's 2008 economic census, we find two facts that speak to a novel mechanism of misallocation within service and between manufacturing and service sectors. First, compared with the manufacturing sector, there are more state‐owned enterprises and fewer entrants in the service sector. Second, markups increase with firm size, and the increase is more dramatic among service firms. We interpret these facts through the lens of a monopolistic competition model with heterogeneous firms and variable markups. A multisector model shows a new channel that translates asymmetric barriers to entry across sectors into sectoral markup differences, which in turn cause sectoral misallocation. Quantitative analysis shows that when reducing entry barriers to service firms to the extent observed for manufacturing firms, the model predicts a 12‐percentage‐point increase in the service employment share.
Interfaith etiquette in an age of Islamophobia
Authors: Green Todd
Published: July 2019

Islamophobia represents one of the greatest moral dilemmas of our time. Anti‐Muslim hostility and hatred, driven by racism, has manifested itself in exclusionary, discriminatory, and violent actions toward Muslims and those perceived as Muslims. By most metrics, Islamophobia in the United States is only getting worse. This article draws on Krister Stendahl's rules of interfaith engagement as a means of offering Christians a blueprint for how to reach out and engage with their Muslim neighbors in an age of Islamophobia.
Health‐related quality of life in children with neurodevelopmental disabilities: assessment of a scoping review
Authors: Butler Charlene
Published: July 2019

This commentary is on the scoping review by Lamsal et al. on pages 169–177 of this issue.