bluuebunny/crossref_metadata_2025 huggingface dataset:
Genomic analyses underpin the feasibility of concomitant genetic improvement of milk yield and mastitis resistance in dairy sheep
Authors: Banos Georgios , Clark Emily L. , Bush Stephen J. , Dutta Prasun , Bramis Georgios , Arsenos Georgios , Hume David A. , Psifidi Androniki
Published: March 2019

Milk yield is the most important dairy sheep trait and constitutes the key genetic improvement goal via selective breeding. Mastitis is one of the most prevalent diseases, significantly impacting on animal welfare, milk yield and quality, while incurring substantial costs. Our objectives were to determine the feasibility of a concomitant genetic improvement programme for enhanced milk production and resistance to mastitis. Individual records for milk yield and four mastitis-related traits were collected monthly throughout lactation for 609 ewes of the Chios breed. All ewes were genotyped with a mastitis specific custom-made 960 single nucleotide polymorphism array. We performed genomic association studies, (co)variance component estimation and pathway enrichment analysis, and characterised gene expression levels and the extent of allelic expression imbalance. Presence of heritable variation for milk yield was confirmed. There was no significant genetic correlation between milk yield and mastitis. Environmental factors appeared to favour both milk production and udder health. Four Quantitative Trait Loci (QTLs) affecting milk yield were detected on chromosomes 2, 12, 16 and 19, in locations distinct from those previously identified to affect mastitis resistance. Pathways, networks and functional gene clusters for milk yield were identified. Seven genes (DNAJA1, DNAJC10, FGF10, GHR, HMGCS1, LYPLA1, OXCT1) located within the QTL regions were highly expressed in both the mammary gland and milk transcriptome, suggesting involvement in milk synthesis and production. Furthermore, the expression of four genes (DNAJC10, FGF10, OXCT1, EMB) was enriched in immune tissues implying a favourable pleiotropic effect or likely role in milk production during udder infection. In conclusion, the absence of genetic antagonism between milk yield and mastitis resistance suggests that simultaneous genetic improvement of both traits be achievable. The detection of milk yield QTLs with the mastitis array underpins the latter’s utility as a breeding tool for the genetic enhancement of both traits.
Treatment Failure among People living with HIV taking Antiretroviral Therapy in Ethiopia
Authors: Getaneh Yimam , Egziabhier Atsbeha G , Zealiyas Kidist , Tilahun Rahel , Girma Mulu , Michael Gebremedihin G , Deressa Tekalign , Abate Ebba , Kassa Desta , Assefa Yibeltal
Published: March 2019

Background

Although treatment failure (TF) among population on antiretroviral therapy (ART) become a major public health threat, its magnitude of and factors leading to it are poorly defined. Hence, we aimed to estimate the magnitude of TF and its determinants in Ethiopia.

Methods

A follow-up study was conducted from March 2016 to 2017. Clinical and laboratory data were captured from paticipants’ medical record. Socio-demographics and explanatory variables were collected using structured questionnaire. Participants with baseline viral load (VL) >1000 copies/ml were followed for three to six month to clasify virologic failure (VF). Logistic regression was conducted to assess associated risk factors and statistical significance was set at P-value < 0.05.

Results

A total of 9,284 adults from 63 health facilities were included in the study.Viral load suppression (VLS) were found to be 8,180 (88.1%). Thirty-five percent of the study participants with VL>1000 copies/ml at baseline of the study were re-suppressed after three to six month of adherence counseling and hence VF was found to be 983 (11%). Immunologic and clinical failure was significantly improved from 21.5% and 16.5% at ART initiation to 576 (6.2%) and 470 (5.0%) at baseline of the study, respectively. Adherence, disclosure of HIV status, missed appointment to ART, history of ART exposure prior to initiation, residency and marital status had significant association with VLS.

Conclusions

VLS (88.1%) could explain the success of ART program in Ethiopia towards the UNAIDS global target. Eleven percent of the population is maintained on a failed first-line regimen. Improving adherence, ensuring disclosure of HIV status and appointment follow-up could improve treatment outcome.
Maintaining arm control during self-triggered and unpredictable unloading perturbations
Authors: Reschechtko Sasha , Johansson Anders S. , Pruszynski J. Andrew
Published: March 2019

We often perform actions where we must break through some resistive force, but want to remain in control during this unpredictable transition; for example, when an object we are pushing on transitions from static to dynamic friction and begins to move. We designed a laboratory task to replicate this situation in which participants actively pushed against a robotic manipulandum until they exceeded an unpredictable threshold, at which point the manipulandum moved freely. Human participants were instructed to either stop the movement of the handle following this unloading perturbation, or to continue pushing. We found that participants were able to modulate their reflexes in response to this unpredictable and self-triggered unloading perturbation according to the instruction they were following, and that this reflex modulation could not be explained by pre-perturbation muscle state. However, in a second task, where participants reactively produced force during the pre-unloading phase in response to the robotic manipulandum to maintain a set hand position, they were unable to modulate their reflexes in the same task-dependent way. This occurred even though the forces they produced were matched to the first task and they had more time to prepare for the unloading event. We suggest this disparity occurs because of different neural circuits involved in posture and movement, meaning that participants in the first task did not require additional time to switch from postural to movement control.
SMAUG: Analyzing single-molecule tracks with nonparametric Bayesian statistics
Authors: Karslake J.D. , Donarski E.D. , Shelby S.A. , Demey L.M. , DiRita V.J. , Veatch S.L. , Biteen J.S.
Published: March 2019

Single-molecule fluorescence microscopy probes nanoscale, subcellular biology in real time. Existing methods for analyzing single-particle tracking data provide dynamical information, but can suffer from supervisory biases and high uncertainties. Here, we introduce a new approach to analyzing single-molecule trajectories: the Single-Molecule Analysis by Unsupervised Gibbs sampling (SMAUG) algorithm, which uses nonparametric Bayesian statistics to uncover the whole range of information contained within a single-particle trajectory (SPT) dataset. Even in complex systems where multiple biological states lead to a number of observed mobility states, SMAUG provides the number of mobility states, the average diffusion coefficient of single molecules in that state, the fraction of single molecules in that state, the localization noise, and the probability of transitioning between two different states. In this paper, we provide the theoretical background for the SMAUG analysis and then we validate the method using realistic simulations of SPT datasets as well as experiments on a controlled in vitro system. Finally, we demonstrate SMAUG on real experimental systems in both prokaryotes and eukaryotes to measure the motions of the regulatory protein TcpP in Vibrio cholerae and the dynamics of the B-cell receptor antigen response pathway in lymphocytes. Overall, SMAUG provides a mathematically rigorous approach to measuring the real-time dynamics of molecular interactions in living cells.

Statement of Significance

Super-resolution microscopy allows researchers access to the motions of individual molecules inside living cells. However, due to experimental constraints and unknown interactions between molecules, rigorous conclusions cannot always be made from the resulting datasets when model fitting is used. SMAUG (Single-Molecule Analysis by Unsupervised Gibbs sampling) is an algorithm that uses Bayesian statistical methods to uncover the underlying behavior masked by noisy datasets. This paper outlines the theory behind the SMAUG approach, discusses its implementation, and then uses simulated data and simple experimental systems to show the efficacy of the SMAUG algorithm. Finally, this paper applies the SMAUG method to two model living cellular systems—one bacterial and one mammalian—and reports the dynamics of important membrane proteins to demonstrate the usefulness of SMAUG to a variety of systems.
Chromothripsis during telomere crisis is independent of NHEJ, and consistent with a replicative origin
Authors: Cleal Kez , Jones Rhiannon E. , Grimstead Julia W. , Hendrickson Eric A. , Baird Duncan M.
Published: March 2019

Telomere erosion, dysfunction, and fusion can lead to a state of cellular crisis characterized by large-scale genome instability. We investigated the impact of a telomere-driven crisis on the structural integrity of the genome by undertaking whole-genome sequence analyses of clonal populations of cells that had escaped crisis. Quantification of large-scale structural variants revealed patterns of rearrangement consistent with chromothripsis but formed in the absence of functional nonhomologous end-joining pathways. Rearrangements frequently consisted of short fragments with complex mutational patterns, with a repair topology that deviated from randomness showing preferential repair to local regions or exchange between specific loci. We find evidence of telomere involvement with an enrichment of fold-back inversions demarcating clusters of rearrangements. Our data suggest that chromothriptic rearrangements caused by a telomere crisis arise via a replicative repair process involving template switching.
The accounting and market consequences of the JOBS Act of 2012: an early study
Authors: Yu Ji , Rezaee Zabihollah , Zhang Joseph H.
Published: March 2019

Purpose

Jumpstart Our Business Startups Act 2012 (the JOBS Act) was passed in 2012. JOBS Act enables emerging growth companies (EGCs) to go public without being subject to the full vigorous range of regulations applicable to publicly traded companies. The purpose of this paper is to study financial performance, Tobin’s Q-ratio and value relevance of EGCs.

Design/methodology/approach

The sample includes 620 IPOs during the period from April 5, 2009 to April 5, 2015. The analyses use firm-quarter observations.

Findings

The results show that EGCs have both lower financial performance, and a lower Tobin’s Q-ratio compared to the financial performance and Tobin’s Q-ratio of non-EGCs. Moreover, the value relevance of accounting information for EGCs is lower than the value relevance of accounting information for non-EGCs.

Originality/value

This study contributes to the accounting regulation literature by documenting the inferior market performance and financial information quality of EGCs, i.e., the unintended consequences of the JOBS Act.
The authenticity of place-making
Authors: Furlan Raffaello , Petruccioli Attilio , Jamaleddin Mohuiddin
Published: March 2019

Purpose

Urban theorists argue that in the post-Second World War period cities faced the increasing development of homogeneous and soullessness urban spaces. This led to the formulation of urban design’s theories for addressing issues of space and place, as a means of correction to the built environment of modern cities. The purpose of this paper is to investigate the significance and authenticity of placemaking for Msheireb, which is the regenerated historic district of Doha in Qatar.

Design/methodology/approach

Oral and visual data are collected via: interviews with urban planners and consultants from Msheireb Properties and the Ministry of Municipality and Environment; walk-through studies; site visits and observations about the spatial form of buildings, streets and open spaces; on-site interviews; and a survey conducted during the walk-through studies.

Findings

The findings reveal that the urban regeneration of the historic district – envisioned through a socio-spatial process (public realm) based on conservation (built heritage) and modernization (contemporary architectural language) – contribute to defining the authenticity of placemaking (space and character) of the renewed historic district of Msheireb.

Practical implications

The insights provided through this research study contribute to the development of a framework for conceiving urban conservation projects in Qatar, which aim to preserve heritage value and revitalize deteriorating districts, to encourage the current trend for decentralization toward the creation of lively and vibrant urban district quarters by promoting a rediscovery of community life and cultural values.

Originality/value

The identified key factors have made the research original and unique.
Influential factors of life cycle management in education PFI projects
Authors: Hartwell James Christian , Upadhyay Yog , Sourani Amr
Published: March 2019

Purpose

It has been claimed that the private finance initiative (PFI) provides value for money in the overall life of the project through the lifecycle costing (LCC) process under the umbrella of lifecycle management (LCM). The available literature points to the fact that LCC is very important in getting value for money from PFI projects. However, there is no literature available on the effect of the use of LCM in PFI projects in the UK. Therefore, the purpose of this paper is to explore the factors that influence the success of LCM in educational PFI projects.

Design/methodology/approach

The paper adopts a post-positivist approach to literature review. Purposive sampling is utilised with a mixed methodological approach. 6 qualitative inductive interviews offer key themes, which are further investigated using quantitative deductive questionnaires, of which 35 were issued and 26 were returned.

Findings

The paper provides empirical insights about the key success factors of LCM in the education sector. The results highlight the necessity of quality standardized data collection in a big data form. It highlights the need for a cultural shift from short- to long-term profit maximisation and service provision by the use of LCM in the PFI education sector.

Research limitations/implications

A purposive sample was used to maximise the validity of data collection. Although this method has garnered concise and clear results, it is understood that this study is limited into a niche sector and a set of subsequently niche professionals. It is recommended that a larger sample be utilised and the spectrum of PFI sectors be opened up to further explore the topic.

Practical implications

Further investigations across different sectors of PFI project may be viewed as a good comparison, sectors such as health, accommodation and prisons. Gathering responses across all sector types could have resulted in a greater number of responses received and offer greater validity to this study.

Social implications

While key success factors are clearly identified, fragmentation is seen as a barrier to the wholesale collection of such data. The responsibility, obligation to collect data for the benefit of future projects is not a priority for SMEs with little or no incentive to consider the progression of the sector. Albeit, there is evidence of one particular successful constructor/SPV, which is consolidating their business and are experiencing greater and sustained success.

Originality/value

This paper identifies previously unknown key influencing factors of success for educational PFI projects in relation to LCM.
Profiles of entrepreneurship students: implications for policy and practice
Authors: Sá Creso , Holt Christopher
Published: March 2019

Purpose

While much research seeks to determine the impacts of entrepreneurship education on students, far less attention has been paid to students’ motivations and interests. Understanding students’ perspectives is useful, particularly as governments support the expansion of campus entrepreneurship. The purpose of this paper is to develop a deeper understanding of students’ reasoning in relation to pursuing entrepreneurship education.

Design/methodology/approach

Specifically, the key questions driving this study were: Why do students join experiential learning entrepreneurship programs? How do they define their goals for entrepreneurship education, and what outcomes do they value? Data were collected through interviews with 38 students participating in a range of experiential entrepreneurship programs in Ontario.

Findings

Four different patterns in students’ reasoning and sense making emerged from the analysis. First, “venture creators” are the prototypical student entrepreneurs who are set on creating and launching a venture. Second, “experience seekers” aim at gaining practical work experience but do not see themselves as nor intend to become entrepreneurs. Third, “explorers” aim at developing familiarity with basic concepts and opportunities in entrepreneurship, as a means to consider whether this is an attractive career option. Finally, “engagers” are actively experimenting with entrepreneurship as they gauge their “fit” and potential as entrepreneurs.

Originality/value

This study’s findings provide an empirically grounded check on the assumptions guiding government policy for entrepreneurship education and institutional practice. Policy and institutional attention is overly focused on venture creation, even as other outcomes are commonly espoused. Recognizing different profiles of entrepreneurship students may lead to more purposefully designed programs that have different objectives, and help distinct segments of students achieve their goals.
A test for multigroup comparison using partial least squares path modeling
Authors: Klesel Michael , Schuberth Florian , Henseler Jörg , Niehaves Bjoern
Published: March 2019

Purpose

People seem to function according to different models, which implies that in business and social sciences, heterogeneity is a rule rather than an exception. Researchers can investigate such heterogeneity through multigroup analysis (MGA). In the context of partial least squares path modeling (PLS-PM), MGA is currently applied to perform multiple comparisons of parameters across groups. However, this approach has significant drawbacks: first, the whole model is not considered when comparing groups, and second, the family-wise error rate is higher than the predefined significance level when the groups are indeed homogenous, leading to incorrect conclusions. Against this background, the purpose of this paper is to present and validate new MGA tests, which are applicable in the context of PLS-PM, and to compare their efficacy to existing approaches.

Design/methodology/approach

The authors propose two tests that adopt the squared Euclidean distance and the geodesic distance to compare the model-implied indicator correlation matrix across groups. The authors employ permutation to obtain the corresponding reference distribution to draw statistical inference about group differences. A Monte Carlo simulation provides insights into the sensitivity and specificity of both permutation tests and their performance, in comparison to existing approaches.

Findings

Both proposed tests provide a considerable degree of statistical power. However, the test based on the geodesic distance outperforms the test based on the squared Euclidean distance in this regard. Moreover, both proposed tests lead to rejection rates close to the predefined significance level in the case of no group differences. Hence, our proposed tests are more reliable than an uncontrolled repeated comparison approach.

Research limitations/implications

Current guidelines on MGA in the context of PLS-PM should be extended by applying the proposed tests in an early phase of the analysis. Beyond our initial insights, more research is required to assess the performance of the proposed tests in different situations.

Originality/value

This paper contributes to the existing PLS-PM literature by proposing two new tests to assess multigroup differences. For the first time, this allows researchers to statistically compare a whole model across groups by applying a single statistical test.
Stock market reaction to cash dividends: evidence from the Nigerian stock market
Authors: Ozo Friday Kennedy , Arun Thankom Gopinath
Published: March 2019

Purpose

Very little is known about the effect of dividend announcements on stock prices in Nigeria, despite the country’s unique institutional environment. The purpose of this paper is, therefore, to provide empirical evidence on this issue by investigating the stock price reaction to cash dividends by companies listed on the Nigerian Stock Exchange.

Design/methodology/approach

Standard event study methodology, using the market model, is employed to determine the abnormal returns surrounding the cash dividend announcement date. Abnormal returns are also calculated employing the market-adjusted return model as a robustness check and to test the sensitivity of the results toβestimation. The authors also examine the interaction between cash dividends and earnings by estimating a regression model where announcement abnormal returns are a function of both dividend changes and earnings changes relative to stock price.

Findings

The study find support for the signaling hypothesis: dividend increases are associated with positive stock price reaction, while dividend decreases are associated with negative stock price reaction. Companies that do not change their dividends experience insignificant positive abnormal returns. The results also suggest that both dividends and earnings are informative, but dividends contain information beyond that contained in earnings.

Research limitations/implications

The sample for the study includes only cash dividend announcements occurring without other corporate events (such as interim dividends, stock splits, stock dividends, and mergers and acquisitions) during the event study period. The small firm-year observations may limit the validity of generalizations from these conclusions.

Practical implications

The findings are useful to researchers, practitioners and investors interested in companies listed on the Nigerian stock market for their proper strategic decision making. In particular, the results can be used to encourage transparency and good governance practices in the Nigerian stock market.

Originality/value

This paper adds to the very limited research on the stock market reaction to cash dividend announcements in Nigeria; it is the first of its kind employing a unique cash dividends data.
Football clubs’ social media use and user engagement
Authors: Aichner Thomas
Published: March 2019

Purpose

The purpose of this paper is threefold: to measure and compare the degree of social media use (SMU) by football clubs, to assess football fans’ engagement with content posted by football clubs (FCs) and to evaluate differences in user engagement with commercial social media advertisement targeting football fans, based on the advertisements’ appeal.

Design/methodology/approach

This paper employs three approaches. First, it uses the corporate social media use (CSMU) model to analyse 20,954 Facebook, YouTube, Instagram and Twitter postings from 78 European FCs. Second, it develops a categorisation for social media postings and uses ANOVA and Scheffè tests to conduct a pairwise comparison. Third, it uses a fictional hedonic low-involvement product (chocolate bar) to conduct an experiment by creating a Facebook advertising campaign with three advertisements that are manipulated regarding their general appeal.

Findings

Study 1 demonstrates that individual FCs show big differences between their degree of SMU. There are, however, no differences between European leagues, social media platforms, or more/less successful FCs. The results of Study 2 indicate that social media users like, comment and share postings by FCs independently of the content of the posting. Study 3 reveals that both user engagement and reach of advertisements can be substantially increased by employing football-related appeals.

Originality/value

This paper helps understanding consumer engagement in social media. The results presented are relevant and helpful for a multitude of actors, including FCs and other sports clubs, companies targeting football fans and researchers interested in social media and sports marketing.
Loyalty program activity: make B2B customers buy more
Authors: Kwiatek Piotr , Thanasi-Boçe Marsela
Published: March 2019

Purpose

Loyalty programs (LPs) in a business-to-business (B2B) context have been under-researched when compared to consumer markets. The purpose of this paper is to investigate if and to what extent the loyalty program activity (LPA) based on recency, frequency and monetary framework reflects the effectiveness of a specific LP.

Design/methodology/approach

Using the data obtained from 818 business customers enrolled in a LP, logistic regression models are run to find the impact of LPA on the company’s sales.

Findings

The results suggest that in a linear LP, the frequency of rewards impacts sales the most, compared to recency and amount of points redeemed. The intensity of a LPA is influencing the expected sales in a company.

Research limitations/implications

The current study is not focused on the redemption patterns and the value of the rewards offered in the program. Limitation of the study only to one country and in a single company does not allow to generalize presented findings.

Practical implications

Companies should focus their efforts on defining the best level of frequency rewards in their LPs. Reward timing should be considered as a factor that influences the change in customer purchasing behavior more than the amount of points accumulated.

Originality/value

The research provides empirical evidence to support the highest influence of frequency of rewards on sales, compared to recency and amount of points redeemed. This is one of the few LP studies conducted in the context of the B2B market.
Time orientation in complex B2B service relationships
Authors: Rodriguez Rocio , Svensson Göran
Published: March 2019

Purpose

The purpose of this paper is twofold. First, to examine, on the basis of a teleological time orientation, the differences and similarities between actions that take place before and after the sales and purchases of advanced service solutions; and second, to stress that an active consideration of time facilitates the development of satisfactory service solutions to the service provider (SP) and service receiver (SR) (both) and maintenance of the long-term and complex business-to-business (B2B) service relationships in contrast to a passive consideration of time.

Design/methodology/approach

The authors have applied a multi-method design based on: in-depth interviews with key informants at software providers and their customers; analysis of textual documents and structured observations of customer-software provider actions; and follow-up interviews. This study is based on four phases in an industry to examine different views to enable data triangulation.

Findings

Complex B2B service relationships are affected by time in an active way, namely, time in the present is linked to customer expectations and their perceptions through two points: the experience (from past) of the SP and the SR and the service solution, previsualized (from future) before the service is implemented. Each interaction between the seller and the buyer progressively changes the mindset of both from the initial position of each (active consideration of time).

Research limitations/implications

The paper highlights the importance of an active treatment of time and cross-functional SP teams, since the individual salesperson may not possess the knowledge or resources to successfully deal with SR demands in complex B2B service relationships.

Practical implications

SPs should train, support, supervise and evaluate the whole team so that it interacts properly and performs appropriate and timely actions toward a successful outcome with their SRs.

Originality/value

The paper contributes to enhance the understanding of time-oriented sales and purchases in complex B2B service relationships based on advanced service solutions, all of which have rarely been addressed in either previous studies or in theory.
An efficient positioning solution in urban canyons using enhanced extended Kalman particle filter
Authors: Xu Qimin , Jiang Rong
Published: March 2019

Purpose

This paper aims to propose a 3D-map aided tightly coupled positioning solution for land vehicles to reduce the errors caused by non-line-of-sight (NLOS) and multipath interference in urban canyons.

Design/methodology/approach

First, a simple but efficient 3D-map is created by adding the building height information to the existing 2D-map. Then, through a designed effective satellite selection method, the distinct NLOS pseudo-range measurements can be excluded. Further, an enhanced extended Kalman particle filter algorithm is proposed to fuse the information from dual-constellation Global Navigation Satellite Systems and reduced inertial sensor system. The dependable degree of each selected satellite is adjusted through fuzzy logic to further mitigate the effect of misjudged LOS and multipath.

Findings

The proposed solution can improve positioning accuracy in urban canyons. The experimental results evaluate the effectiveness of the proposed solution and indicate that the proposed solution outperforms all the compared counterparts.

Originality/value

The effect of NLOS and multipath is addressed from both the observation level and fusion level. To the authors’ knowledge, mitigating the effect of misjudged LOS and multipath in the fusion algorithm of tightly coupled integration is seldom considered in existing literature.
Beyond the responsibility binary: analysing maternal responsibility in the human papillomavirus vaccination decision
Authors: Albert Katelin
Published: March 2019

With the human papillomavirus (HPV) vaccine positioned as the “right tool” to protect girls' health and sexual health, public discourse positions parents as “responsible” if they vaccinate, “irresponsible” if they do not. The problem with this binary, however, is that it cannot account for the full spectrum of responsibilities and social norms that parents enact in vaccine decisions. In this paper, and in the context of low HPV vaccination rates, I confront this binary and encourage a fuller view of adolescent health and sexual health. Using data from qualitative semi‐structured interviews with 28 Canadian mothers tasked with consenting to the HPV vaccine, I examine the complexity of this responsibility. I find HPV vaccine‐consenting mothers have normative conceptualisations of responsibility aligned with dominant interpretations of public health. Rather than expressing irresponsibility, some non‐HPV vaccine‐consenting mothers articulated alternate responsibilities, aligned with broad efforts to manage their teens' sexual health and sexuality. They extend responsibility beyond cancer protection vis‐à‐vis vaccines to a general responsibility for daughters' sexual health and self‐esteem. In conclusion, I recommend the need for a broader public health approach to HPV, which includes, and goes beyond vaccination. Moreover, I suggest that some of these alternate responsibilities be viewed as complementary to vaccination.
DAGDA score and its evidence‐based pneumonia‐prevention programme
Authors: Wong Kevin Ka‐Fai , Fung James Tak‐Kwan , Leung Siu‐Kee
Published: March 2019

Aim

The mortality rate of the postoperative pneumonia group is significantly higher than that of non‐pneumonia group. Five of 38 risk factors were found to be significantly related to postoperative pneumonia (P < 0.05) after univariable logistic regression and then multivariable logistic regression analysis: (i) Dependence of activity of daily living; (ii) presence of Ascites; (iii) General anaesthesia; (iv) preoperative Dyspnoea; and (v) ASA (American Society of Anesthesiologists) score ≥3. The DAGDA score was formulated by using these significant risk factors to predict high‐risk patients. The maximum DAGDA score is 18, with an area under the receiver operating characteristic curve of 0.774 (95 per cent confidence interval: 0.716–0.837). Sensitivity and specificity of the DAGDA score with a cut‐off point of 8 are 73.6 and 73.4 per cent, respectively. The external validation of the DAGDA score was examined by using other 4495 patients, which resulted in similar findings. A multidisciplinary team (MDT), including surgeons, respiratory physicians, surgical nursing staff and physiotherapists, was formed, and proactive measures were applied to patients at high risk of developing postoperative pneumonia.

Patients and Methods

The present study was a prospective cohort study to compare the postoperative pneumonia rate and pneumonia‐related mortality before and after this programme.

Results

After the implementation of the pneumonia‐prevention programme, there was a decrease in the postoperative pneumonia rate from 4.1 to 3.7 per cent. The 30‐day pneumonia‐related mortality rate significantly dropped from 31.9 to 4.8 per cent (P = 0.016).

Conclusion

The DAGDA score and the MDT‐led pneumonia‐prevention programme are useful to decrease postoperative pneumonia and prevent pneumonia‐related mortality.
Thinking about going wheat‐free? Evidence of nutritional inadequacies in the dietary practices of wheat avoiders
Authors: Golley Sinéad , Baird Danielle , Hendrie Gilly A. , Mohr Philip
Published: March 2019

Aim

To assess dietary intake and nutritional adequacy amongst self‐identified symptomatic wheat‐avoiders.

Methods

Thirty‐four self‐identified symptomatic avoiders of wheat‐based products without a diagnosis of coeliac disease or wheat allergy were recruited to participate in a dietary assessment study. Dietary intake was assessed via a three‐day weighed food record. Participants were aged 33 to 83 years, were predominantly women (n = 30) and had been avoiding wheat for a mean of six years. Nutrient intakes were compared with Nutrient Reference Values. Food group intakes were assessed and consumption of wheat‐containing and wheat‐free cereal‐based foods described.

Results

Inadequate intakes of key protective nutrients such as fibre and calcium were common; many participants reported avoiding dairy as well as wheat. Intakes of total and saturated fat exceeded recommendations. Although 85% of the sample reported avoiding all wheat products, at least one third of cereal products and dishes consumed in this group, comprising mostly discretionary‐type foods, were wheat based.

Conclusions

Dietary intake patterns and resulting nutrient imbalances in individuals restricting or eliminating wheat to manage symptoms are cause for concern. The situation is likely exacerbated by the tendency for many wheat avoiders to report also avoiding other foods, especially dairy products. A bi‐disciplinary approach from medical practitioners and dietitians to individuals experiencing unexplained gastro‐intestinal symptoms and strategies to support informed food choice is needed to combat longer‐term health consequences of a diet with this nutritional profile.
Consensus on technical procedures for simulation‐based training in anaesthesiology: A Delphi‐based general needs assessment
Authors: Bessmann Ebbe L. , Østergaard Helle T. , Nielsen Bjørn U. , Russell Lene , Paltved Charlotte , Østergaard Doris , Konge Lars , Nayahangan Leizl Joy
Published: March 2019

Background

Anaesthesiologists are expected to master an increasing number of technical procedures. Simulation‐based procedural training can supplement and, in some areas, replace the classical apprenticeship approach during patient care. However, simulation‐based training is very resource‐intensive and must be prioritised and optimised. Developing a curriculum for simulation‐based procedural training should follow a systematic approach, eg the Six‐Step Approach developed by Kern. The aim of this study was to conduct a national general needs assessment to identify and prioritise technical procedures for simulation‐based training in anaesthesiology.

Methods

A three‐round Delphi process was completed with anaesthesiology key opinion leaders. In the first round, the participants suggested technical procedures relevant to simulation‐based training. In the second round, a needs assessment formula was used to explore the procedures and produce a preliminary prioritised list. In the third round, participants evaluated the preliminary list by eliminating and re‐prioritising the procedures.

Results

All teaching departments in Denmark were represented with high response rates in all three rounds: 79%, 77%, and 75%, respectively. The Delphi process produced a prioritised list of 30 procedure groups suitable for simulation‐based training from the initial 138 suggestions. Top‐5 on the final list was cardiopulmonary resuscitation, direct‐ and video laryngoscopy, defibrillation, emergency cricothyrotomy, and fibreoptic intubation. The needs assessment formula predicted the final prioritisation to a great extent.

Conclusion

The Delphi process produced a prioritised list of 30 procedure groups that could serve as a guide in future curriculum development for the simulation‐based training of technical procedures in anaesthesiology.
Real‐world effectiveness and safety of glecaprevir/pibrentasvir for the treatment of chronic hepatitis C infection: data from the German Hepatitis C‐Registry
Authors: Berg Thomas , Naumann Uwe , Stoehr Albrecht , Sick Christoph , John Christine , Teuber Gerlinde , Schiffelholz Willibold , Mauss Stefan , Lohmann Kristina , König Bettina , Pangerl Andreas , Niederau Claus
Published: March 2019

Background

Glecaprevir/pibrentasvir is a pangenotypic direct‐acting antiviral regimen approved for treating adults chronically infected with hepatitis C virus (HCV). There are limited real‐world data on glecaprevir/pibrentasvir to date.

Aim

To evaluate the effectiveness and safety of glecaprevir/pibrentasvir under real‐world conditions in the German Hepatitis C‐Registry (DHC‐R).

Methods

The DHC‐R is an ongoing, non‐interventional, multicentre, prospective, observational cohort study that monitors patients with chronic HCV infection. Data were collected from patients who initiated glecaprevir/pibrentasvir and completed a screening visit on or after 2 August 2017. The primary effectiveness endpoint was sustained virological response at post‐treatment Week 12 (SVR12). Safety and tolerability were also assessed.

Results

As of 15 July 2018, 586 patients received glecaprevir/pibrentasvir and had documented SVR12 data, treatment discontinuation, loss to follow‐up or HCV reinfection. Five hundred and fifty‐two patients (94%) received on‐label treatment. At baseline, most on‐label patients were infected with HCV genotype 1 (53%) or 3 (33%), HCV treatment‐naïve (90%), without cirrhosis (94%), and treated for 8 weeks (93%). Five hundred and thirty‐four patients (96.7%) achieved SVR12 (intention‐to‐treat [ITT] analysis). By modified ITT analysis (excluding patients who discontinued and did not achieve SVR12 or patients lost to follow‐up), the SVR12 rate was 99.4% (n/N = 534/537). There was one documented virological failure (relapse) and two documented HCV reinfections. One hundred and forty‐two (26%) adverse events (AEs) and 9 (2%) serious AEs occurred; 2 (<1%) AEs led to treatment discontinuation. All patients treated off‐label (N = 34) achieved SVR12.

Conclusion

Glecaprevir/pibrentasvir was highly effective and well tolerated under real‐world conditions. Clinical trial number: DRKS00009717 (German Clinical Trials Register, DRKS).
Mood regulation and relationship quality predict change in homesickness during college
Authors: Landa Isidro , Bono Timothy J. , English Tammy
Published: March 2019

Recent theorizing has implicated affect regulation as central to the experience of homesickness. Conceptualized as grief due to losing social connections with close others when relocating, homesickness is associated with poor emotional and social adjustment. The present study examined how mood regulation and relationship quality – at home and in college – predict homesickness and negative affect among college students (N = 168). We assessed 16 mood regulation strategies as well as relationship quality each week over the first college term. As predicted, time‐lagged multilevel analyses demonstrate that avoidance‐oriented strategies were helpful in the short term (the following week), but chronic avoidance (across the college term) predicted higher levels of homesickness. Approach‐oriented regulatory strategies did not predict homesickness, however. Relationship quality demonstrated differential main effects at the between‐person level but did not predict fluctuations in homesickness from week to week. Across the college term, closer ties at home predicted greater homesickness, whereas closer ties in college predicted lower homesickness. Notably, there were distinct effects of mood regulation for homesickness compared to negative affect. The present study is among the first to examine effects of mood regulation on homesickness longitudinally, suggesting it is important to consider the type of regulation strategies being used as well as the time scale.
Depletion manipulations decrease openness to dissent via increased anger
Authors: Tsai Ming‐Hong , Li Norman P.
Published: March 2019

We investigated a potential outcome of ego depletion manipulations and an important factor behind cooperative failure: a lack of openness to others’ dissenting opinions. Across five studies in a variety of task settings, we examined the effect of depletion manipulations on openness to dissent and investigated two negative emotions as potential mediators of this process: fatigue and anger. The results demonstrated a negative effect of depletion manipulations on openness to dissent through increased anger rather than fatigue (Studies 1–5). In Studies 3 and 4, we also eliminated perceived trust towards a task counterpart as a significant mediator of the relationship between depletion manipulations and openness to dissent. These findings help clarify the nature of ego depletion manipulations and shed light on why individuals may fail to consider others’ dissenting opinions and, thus, fall short of achieving cooperation.
Impaired clearance of sunitinib leads to metabolic disorders and hepatotoxicity
Authors: Zhao Qi , Zhang Ting , Xiao Xue‐Rong , Huang Jian‐Feng , Wang Yan , Gonzalez Frank J. , Li Fei
Published: March 2019

Background and Purpose

Sunitinib is a small‐molecule TK inhibitor associated with hepatotoxicity. The mechanisms of its toxicity are still unclear.

Experimental Approach

In the present study, mice were treated with 60, 150, and 450 mg·kg−1 sunitinib to evaluate sunitinib hepatotoxicity. Sunitinib metabolites and endogenous metabolites in liver, serum, faeces, and urine were analysed using ultra‐performance LC electrospray ionization quadrupole time‐of‐flight MS‐based metabolomics.

Key Results

Four reactive metabolites and impaired clearance of sunitinib in liver played a dominant role in sunitinib‐induced hepatotoxicity. Using a non‐targeted metabolomics approach, various metabolic pathways, including mitochondrial fatty acid β‐oxidation (β‐FAO), bile acids, lipids, amino acids, nucleotides, and tricarboxylic acid cycle intermediates, were disrupted after sunitinib treatment.

Conclusions and Implications

These studies identified significant alterations in mitochondrial β‐FAO and bile acid homeostasis. Activation of PPARα and inhibition of xenobiotic metabolism may be of value in attenuating sunitinib hepatotoxicity.
Role of diet, gut microbiota, and metabolism in multiple sclerosis and neuromyelitis optica
Authors: Okuno Tatsusada , Kinoshita Makoto , Ishikura Teruyuki , Mochizuki Hideki
Published: March 2019

The prevalence of multiple sclerosis (MS) has been increasing over the past two decades, especially in certain areas, such as the Mediterranean regions and Japan. This increase might be attributed to an altered microbiota and metabolic status in accordance with a change in food habits. Studies on an animal model of MS have led to the hypotheses suggesting the pathogenic role of altered gut microbiota and cellular metabolism of immune cells in MS. Recent studies showed that patients with MS have a distinct gut microbiota composition compared with healthy controls. Furthermore, accumulating evidence highlights the critical role of dysregulated immune cell metabolism in autoimmunity. Regarding neuromyelitis optica (NMO), its microbiome has been reported to have distinct features in comparison with healthy controls and MS. Interestingly, molecular mimicry between aquaporin 4 and components of Clostridium perfringens, the second most significantly enriched taxon in NMO, is suggested. CD4+ T cells recognizing the dominant aquaporin 4 T‐cell epitope show the T helper 17 cell phenotype, and show cross‐reactivity to a homologous peptide sequence in NMO patients. These results raise the possibility that commensal bacteria in NMO patients might be involved in aquaporin 4 autoantibody production. In the present review, we introduce the current advances in the research of food habit and microbiota in MS and NMO in terms of intestinal immunity and immune‐metabolic interactions. In addition, we discuss the potential perspective of diet therapy and probiotics in terms of prophylactic or therapeutic treatment options for MS and NMO.
Brain volume decrease in patients with multiple sclerosis investigated by 3T magnetic resonance imaging scanner: A 4‐year observation study
Authors: Nakayama Takahiro , Sasaki Takuya , Kitamura Mizuki , Imafuku Ichiro
Published: March 2019

Objectives

For patients with multiple sclerosis (MS) with a high recurrence rate, treatment with disease‐modifying drugs from the early stage is recommended. Although a decrease in brain volume has been reported in such patients, long‐term and comparison studies with control participants have not been carried out in Japan.

Methods

Before this study, we built a cross‐sectional brain image database of control participants. Among 73 patients with MS treated at Yokohama Rosai Hospital from April 2005 to April 2018, 34 MS patients who had been examined by 3T magnetic resonance scanner over a period of 4 years were enrolled in this study. We calculated the total intracranial volume of each patient, and the total brain volume, and gray and white matter volumes were adjusted by the total intracranial volume. We also examined the age, sex, disease‐modifying drugs and type of MS.

Results

The brain volume of mild MS patients decreased with age at the same rate as that of control participants. However, the brain volume of all patients treated with fingolimod decreased faster than that of control participants. In some patients treated with interferon, the brain volume decreased faster than that of control participants. The brain volume of mild MS patients did not decrease more than that of control participants.

Conclusions

We could not determine the effect of fingolimod on brain volume decrease, because all patients treated with fingolimod were initially treated with interferon during the study period. The early administration of disease‐modifying drugs is recommended from the perspective of minimizing decreases in brain volume.