bluuebunny/crossref_metadata_2025 huggingface dataset:
The fluid power: constructing the concept of power in community-based tourism in Indonesia
Authors: Rembulan Cicilia Larasati , Helmi Avin Fadilla , Riyono Bagus
Published: August 2020

Purpose

The concept of power in the literature is not conclusive yet and still contradictive. As contested concept, power have multi-definition in the literature. This study aims to construct a concept of power between organizations, state-owned enterprises (SOE) and communities in the context of community-based tourism in Borobudur, Indonesia.

Design/methodology/approach

Participants were 29 individuals representing SOEs (i.e. executive members) and local communities (e.g. village chiefs, community enterprise, managers and residents). Data collection was conducted through interviews, focus group discussions, field records and documents. Using grounded theory, the data were analyzed using open, axial and selective coding.

Findings

This study discovered that power was fluid. At first, power was a static resource then when it exchanged, it turned into relational/power interplay and at last, became output resource. There was a transformation of antecedent resources of power into a consequential source of power through relationship processes.

Research limitations/implications

This study should be replicated in other settings for further research, for example, in a business-to-business context and business-to-government to develop a general framework.

Practical implications

Policymakers should be aware of such fluid power to ensure that community-based tourism programs can benefit all parties involved.

Originality/value

Findings from this study make several contributions to current literature as follows: this study extends from the existing theories of power, the community-based tourism context where this study was conducted represents actual social situation allowing it to be transferrable to real environment and elaborating theory of power into a comprehensive framework.
Culture of assessment in academic libraries in Kuwait: investigating the current situation and future prospects
Authors: Alajmi Bibi M. , Kaisar Madiha
Published: August 2020

Purpose

Using the Association of Research Libraries' SPEC KIT 303 library assessment framework, this study examines and evaluates academic libraries' efforts toward establishing a culture of assessment.

Design/methodology/approach

A quantitative questionnaire is employed to collect data. The sample comprises 70 library staff working in eight academic libraries in public and private universities in Kuwait.

Findings

The findings document a readiness to create a culture of assessment in Kuwaiti academic libraries, though this was greater in private universities. Resources to develop this culture, such as assessment and analysis methods and the requisite skills and knowledge, are available, but commitment from academic leaders and plans for a shift toward culture of assessment were not evident. Overall, participating academic library staff acknowledged the value of developing a culture of assessment, but this seems not to be an institutional priority

Practical implications

The methodology and findings address gaps in library and information science education and library management on creating a culture of assessment and suggest future research avenues.

Originality/value

Library assessment is a core function of libraries, but guaranteeing the continuity and consistency of related activities requires an organizational culture that facilitates and supports such assessment. While many articles have focused on the requisites for building a culture of assessment in higher education, few, if any, have assessed academic libraries in the cultural context of the Middle East.
Minority shareholders dispute tang Plaza’s value
Authors: Jian Ming , Lim Rony
Published: August 2020

Theoretical basis

This case covers the framework and process to determine fair value as specified in International Financial Reporting Standards (IFRS) 13. It illustrates an instance in which auditors interpret the concept of fair value to be consistent with other principles in standards such as the principle of prudence in the conceptual framework. In addition, a lot of the discussion in the case is applicable to accounting education in any regulatory jurisdictions given the convergence of US generally accepted accounting principles (GAAP) and IFRS 13. In addition, while fair value accounting may have been designed to give investors more useful information, in practise it could involve highly subjective judgement and the resulting implementation may be affected by incentives of different stakeholders. The CK Tang’s case provides an excellent opportunity to discuss incentives of varies parties in determining the fair value in financial reporting decisions. In short, this case could be a good jumping-off point to talk about management and auditors’ incentives in financial reporting in general.

Research methodology

Publicly available information (e.g. financial reporting standards, corporate announcements and reports, news reports) was used as the basis for this case.

Case overview/synopsis

The case centres on an iconic Singaporean integrated retailing and property landlord entity: Tang holdings. As part of its succession planning, the company’s founding family decided to take its listing arm, C.K. Tang Limited (CK Tang hereafter), private in May 2006. The Tang brothers, who represented the controlling family, initiated several attempts to delist the company. The minority shareholders of CK Tang were unhappy that the offer price was below the net asset value of the company. The minority shareholders also highlighted that the reported fair value of the flagship Tang Plaza complex understated its highest and best use and might not possibly comply with International Financial Reporting Standards (IFRS) 13.

Complexity academic level

The case can be used for class discussions with undergraduate students or master students in intermediate accounting courses.
Vehicle for inclusion or costly illusion? A critical policy analysis of the Special Needs Assistant scheme in Ireland
Authors: Morrissey Barry
Published: August 2020

The Special Needs Assistant (SNA) scheme has been in existence in Ireland, in various different iterations, since 1979. This article presents a critical policy analysis of two iterations of the scheme, operational between 1998 and 2014, using a hybrid analytical framework. It highlights the contextual factors influencing those iterations, presents an interdiscursive analysis of the key policy texts and highlights the scheme's many consequences using secondary data from two key Irish Government agencies. It is postulated that cyclical analytical frameworks are most effective at evaluating iterative special education policies, like the SNA scheme, because they allow sufficient scope to demonstrate that the consequence of one iteration ultimately becomes the context for the next. This article also shows that, while the provision of inclusive education for children with special educational needs in mainstream classes may have been an objective of the scheme, the extent to which that was realised is arguable.
Whither Security Cooperation in the BRICS? Between the Protection of Norms and Domestic Politics Dynamics
Authors: Fracalossi de Moraes Rodrigo
Published: August 2020

This paper argues that the BRICS are status quo powers concerning two core norms of the international society: sovereignty and hierarchy, what conditions both the scope and depth of their security cooperation. On the one hand, this enables cooperation, as they can use the group to protect these norms and reinforce state control on transnational flows. In addition, this facilitates the formation of ties among foreign policy and bureaucratic elites across the BRICS who share a preference for protecting these norms. On the other hand, the importance attached to these norms constrains cooperation: differences of regime type are associated to higher levels of distrust; and intragroup power asymmetries raise fears of potential unequal agreements. The paper then applies these ideas to indicate the potential for cooperation on anti‐drug and cybersecurity policies. On the one hand, different regime types and power inequalities are likely to hinder cooperation. On the other hand, interests from foreign policy, political and bureaucratic elites in protecting norms, as well as in increasing state control on transnational flows and expand repression against new threats are likely to facilitate cooperation.
Distribution of the mutant allele of the DMRT3 gene associated with ambling gaits in Japanese native horse populations
Authors: Chandra Paul Ripon , Ba Nguyen Trung , Okuda Yu , Nu Anh Le Thu , Mosese Dau Tabuyaqona Jovilisi , Konishi Yuri , Kawamoto Yoshi , Nozawa Ken , Kunieda Tetsuo
Published: August 2020

There are currently eight native horse populations in Japan, namely, Hokkaido, Kiso, Noma, Taishu, Misaki, Tokara, Miyako, and Yonaguni horses. Since locomotion traits, including gaitedness, are important for riding and packing horses, the genetic properties associated with these traits could be informative for understanding the characteristics and history of these horses. In this study, we investigated the distribution of the mutant allele of DMRT3 gene (DMRT3:p.Ser301Ter) associated with ambling gaits in the Japanese native horse. We also examined haplotypes of SNPs in the 83‐kb region including DMRT3 gene by genotyping four SNPs in this region. The results revealed the presence of DMRT3:p.Ser301Ter in the Hokkaido and Yonaguni populations at allele frequencies of 0.18 and 0.02, respectively, and the observed haplotype associated with DMRT3:p.Ser301Ter was estimated as the most common haplotype in the horses in the world. Since DMRT3:p.Ser301Ter has been hypothesized to spread across Eurasian continent from Medieval England after 850 to 900 CE, our findings of the presence of DMRT3:p.Ser301Ter with the common haplotype in the Japanese native horses will provide a new insight into the history of the Japanese native horse, such as considerable level of gene flow from Eurasian continent after 850 to 900 CE.
Essential oil spray reduces clinical signs of insect bite hypersensitivity in horses
Authors: Cox A , Wood K , Coleman G , Stewart AJ , Bertin F‐R , Owen H , Suen WW , Medina‐Torres CE
Published: August 2020

Objective

To assess the efficacy of an herbal spray combining various essential oils, with a claim of mast cell stabilisation, antipruritic, anti‐inflammatory, and insect repellent effects on the clinical presentation of insect bite hypersensitivity (IBH) in horses.

Design

Double‐blinded, placebo‐controlled, randomised, cross‐over clinical trial.

Methods

Twenty adult horses with clinical IBH were treated with a daily application of herbal spray or placebo for 28 days in a randomised, cross‐over fashion, separated by a>28‐day washout period. Horses were examined and scored prior to and after the completion of each treatment. Histopathology was performed on four horses. Owners kept daily diaries of observations.

Results

The herbal spray significantly reduced the severity of all assessed parameters (pruritus, excoriations, lichenification and alopecia; P < 0.05) compared with baseline values (pretreatment) and with placebo. Owners reported improvement of pruritus in 19/20 horses (95%) with complete resolution in 17 horses (85%) following treatment. Skin biopsies showed resolution of orthokeratosis in 4/4 horses, reduced thickness of the stratum spinosum in 2/4 horses and complete resolution of histopathological abnormalities in 1/4 horses after treatment, compared with either no change or deterioration of histopathologic lesions after placebo. No side effects were observed.

Conclusions

The tested herbal spray may be an effective treatment for the management of equine IBH.
Palaeogene stratigraphy and chronology of the western Sivas Basin, central Anatolia (Turkey): Tectono‐sedimentary evolution of a well‐preserved basin along the northern Neotethys suture zone
Authors: Darin Michael H. , Umhoefer Paul J.
Published: August 2020

The Sivas Basin overlaps the northern Neotethys suture zone in central Anatolia (Turkey) and contains a ca. 12‐km thick succession of Cenozoic strata that provides an exceptional record of major tectonic transitions from subduction to continental assembly and tectonic escape. Consensus regarding the tectonic and palaeogeographic evolution of this segment of the Arabia‐Eurasia collision zone has been hindered by uncertainty in the tectonic setting of the early (Palaeogene) Sivas Basin, which has been variably interpreted as a remnant ocean, forearc, foreland, wedge‐top or intracontinental extensional basin. Here we integrate new geologic mapping (>5,000 km2), stratigraphy, facies analysis and U‐Pb geochronology from the western Sivas Basin to produce a detailed time‐stratigraphic framework and a refined Palaeogene tectono‐sedimentary model for the Sivas Basin. Earliest marine sedimentation occurred during the Maastrichtian‐Palaeocene in a remnant ocean setting due to incomplete closure of the northern Neotethys Ocean. Rapid accumulation of >2 km of basin floor turbidites during the middle to late Eocene reflect a transition to a foreland setting. A major late Eocene unconformity (ca. 38–34 Ma) coincides with the initiation of the north‐vergent southern Sivas fold‐thrust belt, which inverted and structurally partitioned the basin into a southern wedge‐top and a northern evaporitic foreland basin; the entire basin was dominantly nonmarine after this unconformity. Published palaeomagnetic data integrated with a newly discovered tuff dated at 31.9 Ma reveal that the 2.8‐km thick Altinyayla Formation was deposited from ca. 34 to 26 Ma in an unconfined braided fluvial system. Close stratigraphic correlations between the western, central and northern Sivas Basin suggest that the entire basin evolved from a remnant ocean to peripheral retro‐foreland basin during the middle to late Eocene, and finally a fragmented foreland basin since the Oligocene. This general evolution may be a characteristic of such sedimentary basins formed on suture zones across Anatolia and in other collisional orogens globally.
Sedimentary response to a collision orogeny recorded in detrital zircon provenance of Greater Caucasus foreland basin sediments
Authors: Tye Alexander R. , Niemi Nathan A. , Safarov Rafig T. , Kadirov Fakhraddin A. , Babayev Gulam R.
Published: August 2020

The Greater Caucasus orogen on the southern margin of Eurasia is hypothesized to be a young collisional system and may present an opportunity to probe the structural, sedimentary and geodynamic effects of continental collision. We present detrital zircon U‐Pb age data from the Caucasus region that constrain changes in sediment routing and source exposure during the late Cenozoic convergence and collision between the Greater Caucasus orogen and the Lesser Caucasus, an arc terrane on the lower plate of the system. During Oligocene to Middle Miocene time, following the initiation of deformation within the Greater Caucasus, marine sandstones and shales were deposited between the Greater and Lesser Caucasus, and detrital zircon age data suggest no mixing of Greater Caucasus and Lesser Caucasus detritus. During Middle to Late Miocene time, Greater Caucasus detritus was deposited onto the Lesser Caucasus basin margin, and terrestrial, largely conglomeratic, sedimentation began between the Greater and Lesser Caucasus. Around 5.3 Ma, upper plate exhumation rates increased and shortening migrated to pro‐ and retro‐wedge fold‐thrust belts, coinciding with the initiation of foreland basin erosion. Sediment composition, provenance and structural data from the orogen together suggest the existence of a wide (230–280 km) marine basin that was progressively closed during Oligocene to Late Miocene time, probably by subduction/lithospheric underthrusting beneath the Greater Caucasus, followed by initiation of collision between the Lesser Caucasus arc terrane and the Greater Caucasus in Late Miocene to Pliocene time. The pace of the transition from hypothesized subduction to collision in the Caucasus is consistent with predictions from numerical modeling for a system with moderate convergence rates (<13 mm/yr) and hot lower plate continental lithosphere. Basement crystallization histories implied by our detrital zircon age data suggest the presence of two pre‐Jurassic sutures between stable Eurasia and the Lesser Caucasus, which likely guided later deformation.
Rate of environmental change across scales in ecology
Authors: Pinek Liliana , Mansour India , Lakovic Milica , Ryo Masahiro , Rillig Matthias C.
Published: August 2020

The rate of change (RoC) of environmental drivers matters: biotic and abiotic components respond differently when faced with a fast or slow change in their environment. This phenomenon occurs across spatial scales and thus levels of ecological organization. We investigated the RoC of environmental drivers in the ecological literature and examined publication trends across ecological levels, including prevalent types of evidence and drivers. Research interest in environmental driver RoC has increased over time (particularly in the last decade), however, the amount of research and type of studies were not equally distributed across levels of organization and different subfields of ecology use temporal terminology (e.g. ‘abrupt’ and ‘gradual’) differently, making it difficult to compare studies. At the level of individual organisms, evidence indicates that responses and underlying mechanisms are different when environmental driver treatments are applied at different rates, thus we propose including a time dimension into reaction norms. There is much less experimental evidence at higher levels of ecological organization (i.e. population, community, ecosystem), although theoretical work at the population level indicates the importance of RoC for evolutionary responses. We identified very few studies at the community and ecosystem levels, although existing evidence indicates that driver RoC is important at these scales and potentially could be particularly important for some processes, such as community stability and cascade effects. We recommend shifting from a categorical (e.g. abrupt versus gradual) to a quantitative and continuous (e.g. °C/h) RoC framework and explicit reporting of RoC parameters, including magnitude, duration and start and end points to ease cross‐scale synthesis and alleviate ambiguity. Understanding how driver RoC affects individuals, populations, communities and ecosystems, and furthermore how these effects can feed back between levels is critical to making improved predictions about ecological responses to global change drivers. The application of a unified quantitative RoC framework for ecological studies investigating environmental driver RoC will both allow cross‐scale synthesis to be accomplished more easily and has the potential for the generation of novel hypotheses.
Counting to Infinity: Does Learning the Syntax of the Count List Predict Knowledge That Numbers Are Infinite?
Authors: Chu Junyi , Cheung Pierina , Schneider Rose M. , Sullivan Jessica , Barner David
Published: August 2020

By around the age of 5½, many children in the United States judge that numbers never end, and that it is always possible to add 1 to a set. These same children also generally perform well when asked to label the quantity of a set after one object is added (e.g., judging that a set labeled “five” should now be “six”). These findings suggest that children have implicit knowledge of the “successor function”: Every natural number, n, has a successor, n + 1. Here, we explored how children discover this recursive function, and whether it might be related to discovering productive morphological rules that govern language‐specific counting routines (e.g., the rules in English that represent base‐10 structure). We tested 4‐ and 5‐year‐old children’s knowledge of counting with three tasks, which we then related to (a) children’s belief that 1 can always be added to any number (the successor function) and (b) their belief that numbers never end (infinity). Children who exhibited knowledge of a productive counting rule were significantly more likely to believe that numbers are infinite (i.e., there is no largest number), though such counting knowledge was not directly linked to knowledge of the successor function, per se. Also, our findings suggest that children as young as 4 years of age are able to implement rules defined over their verbal count list to generate number words beyond their spontaneous counting range, an insight which may support reasoning over their acquired verbal count sequence to infer that numbers never end.
Impact of COVID‐19 outbreak in reperfusion therapies of acute ischaemic stroke in northwest Spain
Authors: Tejada Meza H. , Lambea Gil Á. , Sancho Saldaña A. , Martínez‐Zabaleta M. , Garmendia Lopetegui E. , López‐Cancio Martínez E. , Castañón Apilánez M. , Herrera Isasi M. , Marta Enguita J. , Gómez‐Vicente B. , Arenillas J.F. , Arenaza Basterrechea N. , Timiraos Fernández J.J. , Sánchez Herrero J. , Maciñeiras Montero J.L. , Castellanos Rodrigo M. , Fernández‐Coud D. , Casado Menéndez I. , Temprano Fernández M.T. , Freijo M. , Luna A. , Palacio Portilla E.J. , Jiménez López Y. , Rodríguez‐Castro E. , Rodríguez‐Yáñez M. , Tejada García J. , Beltrán Rodríguez I. , Julián‐Villaverde F. , Moreno García M.P. , Trejo Gabriel‐Galán J.M. , Echavarría Iñiguez A. , Pérez Lázaro C. , Navarro Pérez M.P. , Marta Moreno J. ,   the NORDICTUS Investigators
Published: August 2020

Background and purpose

Spain has been one of the countries more heavily stricken by SARS‐CoV‐2, which has had huge implications for stroke care. The aim was to analyse the impact of the COVID‐19 epidemic outbreak on reperfusion therapies for acute ischaemic stroke in the northwest of Spain.

Methods

This was a Spanish multicentre retrospective observational study based on data from tertiary hospitals of the NORDICTUS network. All patients receiving reperfusion therapy for ischaemic stroke between 30 December 2019 and 3 May 2020 were recorded, and their baseline, clinical and radiological characteristics, extra‐ and intra‐hospital times of action, Code Stroke activation pathway, COVID‐19 status, reperfusion rate, and short‐term outcome before and after the setting of the emergency state were analysed.

Results

A total of 796 patients received reperfusion therapies for ischaemic stroke. There was a decrease in the number of patients treated per week (46.5 patients per week vs. 39.0 patients per week, P = 0.043) and a delay in out‐of‐hospital (95.0 vs. 110.0 min, P = 0.001) and door‐to‐needle times (51.0 vs. 55.0, P = 0.038). Patients receiving endovascular therapy obtained less successful reperfusion rates (92.9% vs. 86.6%, P = 0.016). COVID‐19 patients had more in‐hospital mortality.

Conclusion

A decrease in the number of patients benefiting from reperfusion therapies was found, with a delay in out‐of‐hospital and door‐to‐needle times and worse reperfusion rates in northwest Spain. COVID‐19 patients had more in‐hospital mortality.
Selective sweep analysis reveals extensive parallel selection traits between large white and Duroc pigs
Authors: Zhang Saixian , Zhang Kaili , Peng Xia , Zhan Huiwen , Lu Jiahui , Xie Shengsong , Zhao Shuhong , Li Xinyun , Ma Yunlong
Published: August 2020

In the process of pig genetic improvement, different commercial breeds have been bred for the same purpose, improving meat production. Most of the economic traits, such as growth and fertility, have been selected similarly despite the discrepant selection pressure, which is known as parallel selection. Here, 28 whole‐genome sequencing data of Danish large white pigs with an approximately 25‐fold depth each were generated, resulting in about 12 million high‐quality SNPs for each individual. Combined with the sequencing data of 27 Duroc and 23 European wild boars, we investigated the parallel selection of Danish large white and Duroc pigs using two complementary methods, Fst and iHS. In total, 67 candidate regions were identified as the signatures of parallel selection. The genes in candidate regions of parallel selection were mainly associated with sensory perception, growth rate, and body size. Further functional annotation suggested that the striking consistency of the terms may be caused by the polygenetic basis of quantitative traits, and revealing the complex genetic basis of parallel selection. Besides, some unique terms were enriched in population‐specific selection regions, such as the limb development‐related terms enriched in Duroc‐specific selection regions, suggesting unique selections of breed‐specific selected traits. These results will help us better understand the parallel selection process of different breeds. Moreover, we identified several potential causal SNPs that may contribute to the pig genetic breeding process.
Does protein unfolding play a functional role in vivo?
Authors: Sharma Sabita , Subramani Smrithika , Popa Ionel
Published: August 2020

Unfolding and refolding of multidomain proteins under force have yet to be recognized as a major mechanism of function for proteins in vivo. In this review, we discuss the inherent properties of multidomain proteins under a force vector from a structural and functional perspective. We then characterize three main systems where multidomain proteins could play major roles through mechanical unfolding: muscular contraction, cellular mechanotransduction, and bacterial adhesion. We analyze how key multidomain proteins for each system can produce a gain‐of‐function from the perspective of a fine‐tuned quantized response, a molecular battery, delivery of mechanical work through refolding, elasticity tuning, protection and exposure of cryptic sites, and binding‐induced mechanical changes. Understanding how mechanical unfolding and refolding affect function will have important implications in designing mechano‐active drugs against conditions such as muscular dystrophy, cancer, or novel antibiotics.
Roles of nurses and National Nurses Associations in combating COVID‐19: Taiwan experience
Authors: Huang L.H. , Chen C.M. , Chen S.F. , Wang H.H.
Published: August 2020

As the COVID‐19 pandemic continues to expand worldwide, Taiwan has effectively contained the spread domestically and protected its citizens after registering its first case relatively early on 21 January 2020. Proactive preparedness and deployment by the national government, timely evidence and experience‐based judgements and decision‐making, information transparency, rapid response, and effective communication and measures have all been critical to combating COVID‐19 in Taiwan. Nurses play a pivotal role in providing direct health care as well as providing contact tracing and care for the quarantined clients and community care services. The Taiwan Nurses Association and other nurses’ associations serve a vital leadership role in advocating for nurses, raising public awareness, enhancing nursing’s professional profile, and sharing experiences via national and international platforms. The implications for nursing and health policy are that we need to well prepare for any unpredicted emerging pandemic in the future. Providing adequate personal protective equipment and safe staffing should be the highest priority for the governments and policymakers around the world to combat pandemic successfully.
Adenovirus infection in children hospitalized with pneumonia in Guangzhou, China
Authors: Zou Lirong , Yi Lina , Yu Jianxiang , Song Yinchao , Liang Lijun , Guo Qianfang , Zhuang Xue , Zhang Yunqiang , Kang Min , Wu Jie
Published: August 2020

Background

HAdV infection can cause a variety of diseases. Although infections with HAdVs often are mild, life‐threatening respiratory disease can occur. Pneumonia is one of the more serious types of HAdV‐induced respiratory disease in children. In this study, we determined the prevalence and genotype of HAdVs among children hospitalized with pneumonia in Guangzhou, China.

Methods

Nasopharyngeal swabs (NPSs) were collected from children hospitalized with pneumonia in Guangzhou, China, from January 2013 to June 2019. HAdVs were detected by real‐time polymerase chain reaction assay, and hexon, fiber, and penton gene were amplified and used for phylogenetic analysis. Epidemiological data were analyzed using SPSS16.0 software.

Results and Conclusions

A total of 1778 children hospitalized with pneumonia were enrolled. The overall HAdV detection rate was 3.26%. And the yearly detection rate varied from around 2.5% in 2013‐2017 to around 6% in 2018‐2019. Children >5 years had the highest HAdV infection rate. 92.86% of HAdV sequences obtained in this study were belonged to species B, and no recombination was observed. HAdV‐B7 and HAdV‐B3 were the common types detected in the study period, with the predominant HAdV genotype shifted from HAdV‐B3 in 2015‐2016 to HAdV‐B7 in 2017‐2018. The discrepancies in HAdV detection rates in different study period and changes of HAdV predominant types over time highlighted the importance of continued surveillance.
Potentially Inappropriate Medications Are Associated with Increased Healthcare Utilization and Costs
Authors: Clark Collin M. , Shaver Amy L. , Aurelio Leslie A. , Feuerstein Steven , Wahler Robert G. , Daly Christopher J. , Jacobs David M.
Published: August 2020

BACKGROUND/OBJECTIVES

To examine the prevalence of potentially inappropriate medication (PIM) prescribing and its association with healthcare utilization and related expenditures utilizing nationally representative data from the United States.

DESIGN

Retrospective cohort study.

SETTING

The 2011–2015 Medical Expenditure Panel Survey (MEPS).

PARTICIPANTS

Community‐dwelling sample of U.S. adults aged 65 and older during the first round of each MEPS cycle.

MEASUREMENTS

A qualified definition operationalized from the 2019 American Geriatrics Society Beers Criteria® was used to estimate the prevalence of PIM prescribing over the study period. Negative binomial models were assembled to examine associations between PIM exposure and healthcare utilization including hospitalizations, emergency department (ED) visits, and outpatient provider visits. Generalized linear models with the log link function and gamma distribution were used to analyze associations between PIM exposure and healthcare expenditures. Sensitivity analyses were conducted utilizing inverse probability treatment weighting using propensity scores for being prescribed a PIM.

RESULTS

The period prevalence of PIM prescribing over the 5‐year sample was 34.4%. PIM prescribing was positively associated with hospitalizations (adjusted incidence rate ratio [aIRR] = 1.17; 95 confidence interval [CI] = 1.08–1.26; P < .001), ED visits (aIRR = 1.26; 95% CI = 1.17–1.35; P < .001), and outpatient provider visits (aIRR = 1.18; 95% CI = 1.14–1.21; P < .001). PIM exposure was associated with higher marginal costs within outpatient visits ($116; 95% CI = $105–$243; P < .001), prescription medications ($128; 95% CI = $72–$199; P < .001), and total healthcare expenditures ($458; 95% CI = $295–$664; P < .001). Similar results were found in our propensity score analyses.

CONCLUSION

PIMs continue to be prescribed at a high rate among older adults in the United States. Our results suggest that receipt of PIMs is associated with higher rates of healthcare utilization and increased costs across the healthcare continuum. Further work is needed to implement evidence‐based deprescribing interventions that may in turn reduce unnecessary healthcare utilization.
Prenatal diagnosis of congenital portosystemic shunt: A single‐center study
Authors: Wang Yan , Yan Yani , Yang Zhenjuan , Wei Jun , Liu Guoli , Pei Qiuyan
Published: August 2020

Aim

To review our experience with the prenatal diagnosis of congenital portosystemic shunt (CPSS).

Methods

This is a retrospective study of CPSS cases examined at an ultrasonographic tertiary referral center from 2013 to 2019. The anatomical origin and drainage of the shunt were assessed. Feto‐maternal clinical characteristics and long‐term outcomes were investigated via medical files and telephone interviews with the mothers.

Results

Eleven cases were reviewed. Based on the anatomical origins, before or after portal vein division, cases were classified into extrahepatic portosystemic shunt (EHPSS, n = 3, 27.3%) and intrahepatic portosystemic shunt (IHPSS, n = 8, 72.7%). Additional abnormalities were also observed in the EHPSS (n = 2, 66.7%) and IHPSS (n = 3, 37.5%) groups. Intrauterine growth restriction was the most common abnormality (n = 4, 80%). The median age of the pregnant women was 31.9 years (range 26 ~ 43 years). Most cases (n = 8, 72.7%) were diagnosed in the third trimester, and the median gestational age was 31+5 weeks (range 24 ~ 36+6 weeks). Three cases underwent karyotype examinations, and one had trisomy 13. The median time after birth was 2 years (range 0.7 ~ 5.7 years). The overall postnatal live‐birth rate was 60% (6/10), not including one case with no data on pregnancy outcome. The mothers of the six live births indicated that their children were in excellent health.

Conclusion

This study indicates that prenatal CPSS diagnosis is feasible, especially in the third trimester. IHPSS is more common than EHPSS. Complicated cases most often occur with EHPSS. Intrauterine growth restriction is the most common concomitant abnormality. The prognosis of most cases is good.
Characterization of lignans in Forsythiae Fructus and their metabolites in rats by ultra-performance liquid chromatography coupled time-of-flight mass spectrometry
Authors: Zhang Feng-xiang , Li Zi-ting , Li Chang , Li Min , Yao Zhi-hong , Yao Xin-sheng , Dai Yi
Published: August 2020

Objectives

This study was designed to profile the chemical information of Forsythiae Fructus (FF) and investigate the in-vivo FF-related xenobiotics, especially for lignans.

Methods

Rats were oral administrated of FF and pinoresinol-4-O-glucoside, respectively. Blood and urine samples were collected after ingestion, and xenobiotics was profiled by an UPLC/Qtof MS method.

Key findings

A total of 19 lignans were identified or tentatively characterized in FF, and 63 lignan-related xenobiotics were found in rat plasma and urine after ingestion of FF. It was found that lignans could be transformed into metabolites by furan ring opening, hydrogenation, demethylation, dehydration and phase II reactions (sulfation and glucuronidation). The whole metabolic behaviour of bisepoxylignan was revealed by evaluating the metabolism of pinoresinol-4-O-glucoside in vivo. It was found that the configuration of C-8/C-8ʹ was retained after furan ring opening and metabolic reactions always occurred at position of C-3/C-4/C-5 or C-3ʹ/C-4ʹ/C-5ʹ. Additionally, other types components in FF and in vivo were also characterized.

Conclusions

This work revealed the in-vivo metabolism of FF, and reported the characteristic metabolic reactions of lignans for the first time. It was also provided the foundation for the further investigation on pharmacodynamic components of FF or TCMs containing FF.
Potential proton pump inhibitor–related adverse effects
Authors: Perry Issac E. , Sonu Irene , Scarpignato Carmelo , Akiyama Junichi , Hongo Michio , Vega Kenneth J.
Published: August 2020

Proton pump inhibitors (PPIs) are one of the most common medications taken by patients worldwide. PPIs are used to treat acid‐related disorders, including gastroesophageal reflux disease, peptic ulcer disease, Helicobacter pylori infection, and nonsteroidal anti‐inflammatory drug/stress ulceration. For some of these diseases, long‐term treatment is necessary. With such prolonged use, concern and investigation into potential adverse effects has increased. In addition, data are available regarding potential anticancer effects of PPIs, especially regarding solid tumors. The aim of this review is to assess the literature on PPIs with regard to common concerns, such as drug–drug interactions, the intestinal microbiome, dementia and central nervous system disease, and osteoporosis, as well as to highlight potential negative and positive impacts of the drug in cancer.
Transcriptional profiling of lung macrophages during pulmonary injury induced by nitrogen mustard
Authors: Smith L. Cody , Venosa Alessandro , Gow Andrew J. , Laskin Jeffrey D. , Laskin Debra L.
Published: August 2020

Nitrogen mustard (NM) and sulfur mustard are cytotoxic alkylating agents that cause severe and progressive damage to the respiratory tract. Evidence indicates that macrophages play a key role in the acute inflammatory phase and the later resolution/profibrotic phase of the pathogenic response. These diverse roles are mediated by inflammatory macrophages broadly classified as M1 proinflammatory and M2 anti‐inflammatory that sequentially accumulate in the lung in response to injury. The goal of the present study was to identify signaling mechanisms contributing to macrophage activation in response to mustards. To accomplish this, we used RNA sequencing to analyze the gene expression profiles of lung macrophages isolated 1 and 28 days after intratracheal exposure of rats to NM (0.125 mg/kg) or phosphate‐buffered saline control. We identified 641 and 792 differentially expressed genes 1 and 28 days post‐NM exposure, respectively. These genes are primarily involved in processes related to cell movement and are regulated by cytokines, including tumor necrosis factor‐α, interferon‐γ, and interleukin‐1β. Some of the most significantly enriched canonical pathways included STAT3 and NF‐κB signaling. These cytokines and pathways may represent potential targets for therapeutic intervention to mitigate mustard‐induced lung toxicity.
Organoleptic assessment and median lethal dose determination of oral aldicarb in rats
Authors: Rice Nathaniel C. , Rauscher Noah A. , Moffett Mark C. , Myers Todd M.
Published: August 2020

Aldicarb, a carbamate pesticide, is an acetylcholinesterase inhibitor, with oral median lethal dose (LD50) estimates in rats ranging from 0.46 to 0.93 mg/kg. A three‐phase approach was used to comprehensively assess aldicarb as an oral‐ingestion hazard. First, the solubility of aldicarb in popular consumer beverages (bottled water, apple juice, and 2% milk) was assessed. Lethality was then assessed by administering aldicarb in bottled water via gavage. A probit model was fit to 24‐h survival data and predicted a median lethal dose of 0.83 mg/kg (95% CI: 0.54–1.45 mg/kg; slope: 4.50). Finally, organoleptic properties (e.g., taste, smell, and texture) were assessed by allowing rats to voluntarily consume 3.0 mL of the above beverages as well as liquid eggs adulterated with aldicarb at various concentrations. This organoleptic assessment determined that aldicarb was readily consumed at lethal and supralethal doses. Overt toxic signs presented within 5 min post‐ingestion, and all rats died within 20 min after consuming the highest concentration (0.542 mg/mL), regardless of amount consumed. Because rats have more developed chemoreceptive capabilities than humans, these results suggest that aldicarb may be consumed in toxic or even lethal concentrations by humans in a variety of beverages or foods.
Ultra‐processed foods and the nutrition transition: Global, regional and national trends, food systems transformations and political economy drivers
Authors: Baker Phillip , Machado Priscila , Santos Thiago , Sievert Katherine , Backholer Kathryn , Hadjikakou Michalis , Russell Cherie , Huse Oliver , Bell Colin , Scrinis Gyorgy , Worsley Anthony , Friel Sharon , Lawrence Mark
Published: August 2020

Understanding the drivers and dynamics of global ultra‐processed food (UPF) consumption is essential, given the evidence linking these foods with adverse health outcomes. In this synthesis review, we take two steps. First, we quantify per capita volumes and trends in UPF sales, and ingredients (sweeteners, fats, sodium and cosmetic additives) supplied by these foods, in countries classified by income and region. Second, we review the literature on food systems and political economy factors that likely explain the observed changes. We find evidence for a substantial expansion in the types and quantities of UPFs sold worldwide, representing a transition towards a more processed global diet but with wide variations between regions and countries. As countries grow richer, higher volumes and a wider variety of UPFs are sold. Sales are highest in Australasia, North America, Europe and Latin America but growing rapidly in Asia, the Middle East and Africa. These developments are closely linked with the industrialization of food systems, technological change and globalization, including growth in the market and political activities of transnational food corporations and inadequate policies to protect nutrition in these new contexts. The scale of dietary change underway, especially in highly populated middle‐income countries, raises serious concern for global health.
Medical ethics in the era of COVID‐19: Now and the future
Authors: Chew Christopher , Ko Danielle
Published: August 2020

See related Commentary
Older persons’ experiences of Reflective STRENGTH‐Giving Dialogues – ‘It's a push to move forward’
Authors: Åberg Cecilia , Berglund Mia , Hallgren Jenny , Gillsjö Catharina
Published: August 2020

Rationale

Experiences of the innovative method Reflective STRENGTH‐Giving Dialogue (STRENGTH), which is grounded in a lifeworld perspective and developed to improve quality of care, is described in this study. Innovative thinking in developing health and social care, which may include digital solutions, is required to ensure a meaningful and dignified life in old age.

Aim

The aim of this study was to describe experiences of the intervention Reflective STRENGTH‐Giving Dialogue from the perspective of older persons living with long‐term health problems.

Method

Individual qualitative interviews were conducted with 27 older persons who participated in the intervention. The older persons wrote notes from each dialogue in booklets, and the booklets became part of the study data, analysed with a Reflective Lifeworld Research approach.

Results

STRENGTH is experienced as an opportunity to reflect upon life and identify small and large life projects. Dialogues that lead to change in thoughts and actions influence the older persons' well‐being, sense of balance, joy and meaning in life. There is an experience of STRENGTH as a starting point and a push to move forward in an effort to experience joy and meaning in life when living with long‐term health problems.

Conclusions

STRENGTH has the potential to contribute to quality improvement in person‐centred care and enhance meaning in life for older persons living with long‐term health problems. However, the use of a digital tool in this particular context poses challenges that must be considered.
Navigating the First Year of College: Siblings, Parents, and First‐Generation Students’ Experiences
Authors: Roksa Josipa , Silver Blake R. , Deutschlander Denise , Whitley Sarah E.
Published: August 2020

Although college education is a key to upward mobility, students from socioeconomically disadvantaged backgrounds are less likely to enter and complete college than their more advantaged peers. Prior literature has illuminated how cultural capital contributes to these disparities. An alternative conceptualization of cultural capital, however, suggests that it can also play a role in social mobility. In this study, we build on and extend the literature on cultural mobility by proposing that exposure to education can benefit not only individuals but also families. We examine the influence of older siblings who attended college on the experiences of younger college‐going siblings in families where neither parent has completed college (i.e., first‐generation families). We find that students rarely rely on their older siblings as sources of information and advice, except in a few instances where older siblings attended the same institution. However, both the topics and nature of conversations between parents and students differ between families with and without older college‐educated siblings. The primary benefit of having college‐educated siblings is thus related to students’ engagement with and support received from parents. These findings have important implications for cultural capital research and understanding experiences of first‐generation college students.
Committee Machine-Ensemble as a General Paradigm for Accurate Prediction of Bubble Point Pressure of Crude Oil
Authors: Rashidi Sina , Khajehesfandeari Mohammad
Published: August 2020

Bubble point pressure (BPP) not only is a basic pressure–volume–temperature (PVT) parameter for calculation nearly all of the crude oil characteristics, but also determines phase-type of oil reservoirs, gas-to-oil ratio, oil formation volume factor, inflow performance relationship, and so on. Since the measurement of BPP of crude oil is an expensive and time-consuming experiment, this study develops a committee machine-ensemble (CME) paradigm for accurate estimation of this parameter from solution gas-oil ratio, reservoir temperature, gas specific gravity, and stock-tank oil gravity. Our CME approach is designed using a linear combination of predictions of four different expert systems. Unknown coefficients of this combination are adjusted through minimizing deviation between actual BPPs and their associated predictions using differential evolution and genetic algorithm. Our proposed CME paradigm is developed using 380 PVT datasets for crude oils from different geological regions. This novel intelligent paradigm estimates available experimental databank with excellent accuracy i.e., absolute average relative deviation (AARD) of 6.06% and regression coefficient (R2) of 0.98777. Accurate prediction of BPP using our CME paradigm decreases the risk of producing from a two-phase region of oil reservoirs.
Comprehensive Studies on Hot Compaction and Vibration-Assisted Compaction Tests of Aluminum Powder
Authors: Zhou Qiang , Song Shutao , Chen Quanfang , Bai Yuanli
Published: August 2020

Aluminum powder compaction was studied using both test and simulation. Cold compaction, hot compaction, and vibration-assisted (cold) compaction tests were conducted to achieve different density ratios. First, the hot compaction test (at 300 °C, compression pressure 140 MPa) improved about 6% compared with cold compaction under the same compression pressure. Second, although the relative density ratio does not obviously improve at a vibration-assisted (cold) compaction, the strength of the specimens made under vibration loading is much better than those of cold compaction. Additionally, finite element models with well-calibrated Drucker–Prager Cap (DPC) material constitutive model were built in abaqus/standard to simulate the powder compaction process. The results of the finite element model have very good correlations with test results up to the tested range, and this finite element model further predicts the loading conditions needed to achieve the higher density ratios. Two exponential equations of the predicted density ratio were obtained by combining the test data and the simulation results. A new analytical solution was developed to predict the axial pressure versus the density ratio for the powder compaction according to DPC material model. The results between the analytical solution and the simulation model have a very good match.