bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimal design of spherical roller bearings based on multiple tasking operating requirements
Authors: Tiwari Rajiv , Jat Ashish
Published: May 2020

Purpose

The fatigue, thermal and wear-based bearing lives are the most important factors in the design of spherical roller bearings (SRBs). The main novelty of the present work is consideration of thermal effects as an additional objective function. The dynamic capacity (Cd), the elasto-hydrodynamic minimum film thickness (hmin) and the maximum bearing temperature (Tmax) are related directly with overall lives of the bearing, and these constitute the multiple tasking operating requirements for the design of bearings.

Design/methodology/approach

These tasks depend upon various bearing design variables and associated constraints to help in formulating the realistic design optimization problem and in the present work these have been used to get optimal designs of SRBs in the form of Pareto-optimum fronts by using genetic algorithms.

Findings

The optimized lives show higher values as compared to the standard lives and better design choices as compared to that are available in the literature. The robustness of obtained designs are shown by conducting the sensitivity analysis of optimized operating requirements by perturbing optimum bearing variables.

Research limitations/implications

The robustness of the design could be improved by optimizing tolerances of design variables based on desired variation in multiple tasking operating requirements.

Practical implications

For the aerospace and space applications such critical design of bearings are required based on multiple tasking operating requirements. For example for higher temperature application in gearboxes, turbines and drilling equipment.

Originality/value

In critical applications, multiple tasking operating requirements are essential and often bearings put limit to the life of satellites and aircraft, and bearing design methodology proposed and implemented in the present paper addresses these issues, especially addition of thermal issue in bearing design.
MHD micropolar nanofluid flow through an inclined channel with entropy generation subjected to radiative heat flux, viscous dissipation and multiple slip effects
Authors: Roja A. , Gireesha B.J. , Prasannakumara B.C.
Published: May 2020

Purpose

Miniaturization with high thermal performance and lower cost is one of the advanced developments in industrial science chemical and engineering fields including microheat exchangers, micro mixers, micropumps, cooling microelectro mechanical devices, etc. In addition to this, the minimization of the entropy is the utilization of the energy of thermal devices. Based on this, in the present investigation, micropolar nanofluid flow through an inclined channel under the impacts of viscous dissipation and mixed convection with velocity slip and temperature jump has been numerically studied. Also the influence of magnetism and radiative heat flux is used.

Design/methodology/approach

The nonlinear system of ordinary differential equations are obtained by applying suitable dimensionless variables to the governing equations, and then the Runge–Kutta–Felhberg integration scheme is used to find the solution of velocity and temperature. Entropy generation and Bejan number are calculated via using these solutions.

Findings

It is established to notice that the entropy generation can be improved with the aspects of viscous dissipation, magnetism and radiative heat flux. The roles of angle of inclination (α), Eckert number (Ec), Reynolds number (Re), thermal radiation (Rd), material parameter (K),  slip parameter (δ), microinertial parameter (aj), magnetic parameter (M), Grashof number (Gr) and pressure gradient parameter (A) are demonstrated. It is found that the angle of inclination and Grashof number enhances the entropy production while it is diminished with material parameter and magnetic parameter.

Originality/value

Electrically conducting micropolar nanofluid flow through an inclined channel subjected to the friction irreversibility with temperature jump and velocity slip under the influence of radiative heat flux has been numerically investigated.
The impact of CSR perceptions on workers’ turnover intentions
Authors: Gaudencio Pedro , Coelho Arnaldo , Ribeiro Neuza
Published: May 2020

Purpose

The study aims to show how organisational corporate social responsibility (CSR) can influence workers’ attitudes, especially in terms of turnover intentions (TI). A second aim is to explore the social exchange process that may underlie this relationship, by examining the mediating role of leader–member exchange (LMX) and the moderation role of perceived external prestige (PEP).

Design/methodology/approach

The authors use structural equation modelling based on survey data obtained from 315 Portuguese individuals.

Findings

The findings show that the perceptions of CSR predict TI through the mediating role of LMX. Seemingly PEP appears to be moderating the relationship between TI and its determinants. These findings suggest that managers should implement CSR practices because these can contribute towards reducing TI.

Originality/value

This study enriches the existing knowledge about relationships in organisational contexts and responds to the need of understanding the underlying mechanisms linking CSR with workers’ organisational outcomes, by analysing CSR practices in a holistic stakeholder perspective.
Preservice teachers’ perceptions of teaching news media literacy
Authors: McAnulty Joseph
Published: May 2020

Purpose

This study explores social studies preservice teacher’s orientation toward teaching news media literacy in the era of fake news. Previous literature indicates that many social studies teachers express a desire to maintain neutrality in the classroom. As such, this study focuses on the preservice teachers’ articulated pedagogical practices around news media literacy, as well as the described forces and factors that influence their described stances.

Design/methodology/approach

This study uses work from the field of political communication to analyze course assignments, semi-structured interviews and survey responses in order to consider the ways 39 preservice social studies teachers articulated their anticipated and enacted pedagogical practices around news media literacy.

Findings

Findings suggest a prevalent desire among the participants to pursue neutrality by presenting “both sides,” echoing traditional journalistic pursuits of objectivity. The possible consequences of this desire are also explored. Additionally, the study suggests that parents, administrators and the content standards are viewed as forces, which will constrain their practices.

Practical implications

Using theorizing about the civil sphere, this paper considers implications for teacher educators. The civil sphere may provide a lens with which to analyze news media and may help preservice teachers adopt practices they view as risky.

Originality/value

This study aims to extend conversations around the teaching of news media, controversial political and social issues and the preparation of social studies teachers in the current social and political ecology by working to align the field with growing conversations in the field of political communication and journalism.
Design of experiments in the service industry: a critical literature review and future research directions
Authors: Antony Jiju , Viles Elisabeth , Torres Alexandre Fonseca , Paula Taynara Incerti de , Fernandes Marcelo Machado , Cudney Elizabeth A.
Published: May 2020

Purpose

The purpose of the article is to present the results of a critical literature review (CLR) on Design of experiments (DoE) in the service industry.

Design/methodology/approach

A critical review of existing literature review across various databases including Scopus, Web of Science, Google Scholar and Emerald Insight were searched for the identification of relevant papers. The authors searched relevant journal articles for a time period of 25 years (1994–2019).

Findings

A total of 29 industry case studies of DoE applications were identified spanning healthcare, retail, logistics, education, marketing, after sales and catering business. The industrial experimentation strategies adopted by the case study organisations were screening, factorial designs, Taguchi, response surface method and split-plot. It was apparent that there are only a handful number of papers showing the applications of DoE across the service sector and this motivates for pursuing further research into this topic by the authors.

Practical implications

The findings of the study can be very useful for middle and senior managers to understand the benefits of implementing this powerful technique for increased understanding of service processes, as well as for optimising service performance. Moreover, the paper presents some of the fundamental challenges, as well as skills needed for the successful application of DoE.

Originality/value

To the best of our knowledge, this is the first CLR on DoE and its applications in the service sector. The findings of the study can be beneficial to both academic and industrial communities to understand some of the challenges and fundamental gaps which need to be tackled in the future.
Strangers in a strange land: Globally unusual thermal tolerance in Collembola from the Cape Floristic Region
Authors: Liu W. P. Amy , Phillips Laura M. , Terblanche John S. , Janion‐Scheepers Charlene , Chown Steven L.
Published: May 2020

Specific trait–environment interactions have led to globally unusual botanical radiations in the Cape Floristic Region (CFR) of South Africa. Yet it is unclear whether such interactions have similarly resulted in the diversification of the fauna independently of associations with plants.

We explore this question for the Collembola genusSeira, which includes 89 species in the CFR, and appears to have diversified substantially into warm, dry fynbos shrublands—habitats atypical of those usually occupied by Collembola. Specifically, we determine whether thermal tolerance is higher for members of the genus in these shrublands compared with congeners in cooler, moister Afrotemperate Forests in the region, and with Collembola globally.

Fynbos‐inhabitingSeiraspecies have remarkable critical thermal maxima (CTmax) of on average 43°C, 5–6°C higher than congeners occupying the Southern Afrotemperate Forests, and Collembola globally, even when taking CTmaxvariation associated with regional climate into consideration.

Thermal tolerance trait variation among theSeiraspecies from different habitats is likely the consequence of variation in habitat temperature: fynbos shrublands are on average ~17°C warmer than Afrotemperate Forests. Moreover, periodic fires in the fynbos have a large effect on microhabitat temperatures, increasing them substantially (by ~7.5°C) in the year after fire, which may be especially relevant in selecting for higher thermal tolerance in species from this habitat.

These results suggest that the remarkable richness ofSeirain the CFR may in part be due to the evolution of very high CTmaxvalues which have enabled them to take advantage of a hot, dry habitat that is unusual for Collembola.

A freePlain Language Summarycan be found within the Supporting Information of this article.
Multi‐parameter reflection waveform inversion for acoustic transversely isotropic media with a vertical symmetry axis
Authors: Li Yuanyuan , Alkhalifah Tariq
Published: May 2020

Full waveform inversion in transversely isotropic media with a vertical symmetry axis provides an opportunity to better match the data at the near and far offsets. However, multi‐parameter full waveform inversion, in general, suffers from serious cycle‐skipping and trade‐off problems. Reflection waveform inversion can help us recover a background model by projecting the residuals of the reflected wavefield along the reflection wavepath. Thus, we extend reflection waveform inversion to acoustic transversely isotropic media with a vertical symmetry axis utilizing the proper parameterization for reduced parameter trade‐off. From a radiation patterns analysis, an acoustic transversely isotropic media with a vertical symmetry axis is better described by a combination of the normal‐moveout velocity and the anisotropic parameters η and δ for reflection waveform inversion applications. We design a three‐stage inversion strategy to construct the optimal resulting model. In the first stage, we only invert for the background by matching the simulated reflected wavefield from the perturbations of and δ with the observed reflected wavefield. In the second stage, the background and η are optimized simultaneously and the far‐offset reflected wavefield mainly contribute to their updates. We perform Born modelling to compute the reflected wavefield for the two stages of reflection waveform inversion. In the third stage, we perform full waveform inversion for the acoustic transversely isotropic media with a vertical symmetry axis to delineate the high‐wavenumber structures. For this stage, the medium is described by a combination of the horizontal velocity , η and ε instead of , η and δ. The acoustic multi‐parameter full waveform inversion utilizes the diving waves to improve the background as well as utilizes reflection for high‐resolution information. Finally, we test our inversion algorithm on the modified Sigsbee 2A model (a salt free part) and a two‐dimensional line from a three‐dimensional ocean bottom cable dataset. The results demonstrate that the proposed reflection waveform inversion approach can recover the background model for acoustic transversely isotropic media with a vertical symmetry axis starting from an isotropic model. This recovered background model can mitigate the cycle skipping of full waveform inversion and help the inversion recover higher resolution structures.
Can multi‐species shark longline fisheries be managed sustainably using size limits? Theoretically, yes. Realistically, no
Authors: Smart Jonathan J. , White William T. , Baje Leontine , Chin Andrew , D'Alberto Brooke M. , Grant Michael I. , Mukherji Sushmita , Simpfendorfer Colin A.
Published: May 2020

Size limits are a common fisheries management strategy that are applied to many fisheries and species. Most size limits use a minimum legal size to protect adult fish as per the ‘reproduce at least once’ paradigm, where stock collapse becomes impossible if every adult can produce one spawner prior to harvest. These approaches can be useful in fisheries where determining catch is difficult and therefore catch limits can be ineffective and potentially cause stock decline.

Shark longline fisheries can be complicated to manage due to a deficiency of species‐level reporting. Catch limits are therefore difficult to determine, creating a need for other management measures. Here, three different size‐based management approaches were tested using the shark longline fishery from Papua New Guinea as a case study. These approaches included minimum size, maximum size and harvest slot approaches.

Age‐structured Leslie matrix models revealed a broad range of productivities for 12 commonly caught species, ranging from low population growth rates of 1% per year for pelagic thresher sharks Alopias pelagicus to >33% per year for blue sharks Prionace glauca. Therefore, different harvest strategies were required for each species to be fished sustainably. However, management could be applied by grouping similar and easily distinguishable groups of species together.

Synthesis and applications. The most pragmatic harvest strategy for all shark species included in this study was to limit harvest to mature individuals using minimum legal sizes. This provided sufficient resilience for all species to tolerate higher levels of fishing mortality than the Papua New Guinea (PNG) longline fishery could impose. Legal minimum lengths were derived from the largest length‐at‐maturity within each species group. However, while this produced a sustainable harvest strategy, issues with selectivity, post‐release mortality, interactions with other fisheries, economic viability and illegal, underreported and unregulated fishing were challenges to restricting fishing to the correct size classes and overall management efficacy. Therefore, while theoretically viable harvest strategies were outlined, it is apparent that size limits would not ensure that these shark species are fished sustainably. Therefore, the PNG longline fishery cannot operate sustainably if it were to reopen using size limits as its sole management strategy.
Plant traits, biotopes and urbanization dynamics explain the survival of endangered urban plant populations
Authors: Planchuelo Greg , Kowarik Ingo , von der Lippe Moritz
Published: May 2020

With accelerating urbanization, the urban contribution to biodiversity conservation becomes increasingly important. Previous research shows that cities can host many endangered plant species. However, fundamental questions for urban nature conservation remain open: to what extent and where can endangered plant species persist in the long term and which mechanisms underlie population survival?

We evaluate the survival of 858 precisely monitored populations of 179 endangered plant species in Berlin, Germany, by assessing population survival throughout different urban ecosystems over a period of 7.6 years on average. By linking population survival to various landscape variables and plant traits, we unravel the underlying drivers.

More than one–third of populations went extinct during the observation period. Population survival was inversely correlated to the increase in impervious surfaces in the vicinity following the first 11 years after the fall of the Berlin wall. Additionally, populations in semi‐natural habitats like forests and bogs were surprisingly more prone to local extinction than populations in anthropogenic habitats. Survival was highest for competitive species with a preference for drier soils (Ellenberg indicator for soil humidity).

Synthesis and applications. Considerable levels of local population extinction demonstrate that the presence of endangered plants cannot be directly linked with their long‐term survival in cities. However, the survival of remaining populations indicates opportunities for urban biodiversity conservation both within and outside conservation areas. The elucidated links between population survival, urbanization dynamics, biotope class and species traits support urban conservation strategies that reduce the proportion of impervious surface, prioritize conservation management in forests and grasslands and explore the opportunities of green spaces and built‐up areas.
A feeding guild indicator to assess environmental change impacts on marine ecosystem structure and functioning
Authors: Thompson Murray S. A. , Pontalier Hugo , Spence Michael A. , Pinnegar John K. , Greenstreet Simon P. R. , Moriarty Meadhbh , Hélaouët Pierre , Lynam Christopher P.
Published: May 2020

Integrating food web indicators into ecological status assessments is central to developing effective management measures that can improve degraded ecosystems. This is because they can reveal how ecosystems respond to environmental change that cannot be inferred from studying habitat, species or assemblages alone. However, the substantial investment required to monitor food webs (e.g. via stomach contents analysis) and the lack of internationally agreed approaches to assessing them has hampered their development.

Inventories of trophic interactions have been collated world‐wide and across biomes, and can be applied to infer food web structure and energy flow. Here, we compile a new marine dataset containing 8,092 unique predator–prey interactions from 415,294 fish stomachs. We demonstrate how feeding guilds (i.e. groupings based on diet and life stage) could be defined systematically and in a way that is conducive to their application internationally across ecosystems; and apply them to the North Sea fish assemblage to demonstrate their responsiveness to anthropogenic pressures.

We found evidence for seven distinct feeding guilds. Differences between guilds were related to predator size, which positively correlated with piscivory, phylogeny, with multiple size classes of a species often in the same guild, and habitat, as pelagic, benthic and shallow‐coastal foraging was apparent.

Guild biomasses were largely consistent through time at the North Sea‐level and spatially aggregated at the regional level with change relating to changes in resource availability, temperature, fishing and the biomass of other guilds. This suggests that fish biomass was partitioned across broad feeding and environmental niches, and changes over time were governed partly by guild carrying capacities, but also by a combination of covariates with contrasting patterns of change. Management of the North Sea ecosystem could therefore be adaptive and focused towards specific guilds and pressures in a given area.

Synthesis and applications. We propose a food web indicator which has been explicitly called for to inform policy via food web status assessment as part of the European Union's Marine Strategy Framework Directive and the indicator toolkit supporting The Convention for the Protection of the Marine Environment of the North‐East Atlantic (the ‘OSPAR Convention’).
Differential impacts of nitrogen addition on rhizosphere and bulk‐soil carbon sequestration in an alpine shrubland
Authors: Zhu Xiaomin , Zhang Ziliang , Liu Dongyan , Kou Yongping , Zheng Qian , Liu Mei , Xiao Juan , Liu Qing , Yin Huajun
Published: May 2020

Due to complex root–soil interactions, the responses of carbon (C) dynamics in the rhizosphere to elevated nitrogen (N) deposition may be different from those in bulk soil. However, the potentially different response of C dynamics in the rhizosphere and bulk soils and their contributions to soil C sequestration under N deposition is still not elucidated.

We conducted an N addition experiment in an alpine shrubland dominated by Sibiraea angustata located on the eastern Qinghai‐Tibet Plateau (QTP). We measured the soil organic C (SOC) contents and density fractions in the rhizosphere and bulk soils in the top 15 cm of mineral soil and then employed a numerical model based on the rhizosphere extent to evaluate how the rhizosphere modulates soil C sequestration under N addition. We also measured the microbial gene abundance and C‐acquisition enzyme activities to assess microbial community responses to N addition.

The results showed that nitrogen addition had opposite effects on the rhizosphere and bulk‐soil C stocks. Specifically, N addition decreased the rhizosphere SOC content by increasing bacterial abundance, β‐glucosidase activity, and thus accelerating the loss of free light fraction C (FLF‐C). However, N addition increased the bulk‐soil C content, which was corresponding with the reduced oxidase activities and the accelerated accumulation of heavy fraction C (HF‐C) under N addition. Numerical model analysis showed that the decrease induced by N addition in rhizosphere SOC stock ranged from 0.11 to 3.01 kg C/m2 as root exudation diffusion distance extended from 0.5 to 2 mm, while the corresponding increase in the bulk‐soil C stock ranged from 1.91 to 4.08 kg C/m2. By synthesizing the dynamics of the SOC stocks in these two soil compartments under N addition, the SOC stock at the ecosystem level exhibited an increase in range of 0.73–2.44 kg C/m2.

Synthesis. Our results suggest that alpine shrublands on the eastern QTP have great potential for soil C sequestration under N deposition, and the magnitude of the sequestration would depend closely on the responses of rhizosphere microbial C processes and the rhizosphere extent. Our results highlight the importance of integrating rhizosphere processes into land surface models to accurately predict ecosystem functions in the background of elevated N deposition.
Managing healthcare worker well‐being in an Australian emergency department during the COVID‐19 pandemic
Authors: Poonian Jasmine , Walsham Nicola , Kilner Thomas , Bradbury Elizabeth , Brooks Kristen , West Emma
Published: May 2020

Emergency Medicine staff in Australia and New Zealand are at the forefront of the healthcare response to COVID‐19. This article describes a well‐being plan for ED staff that has been devised to mitigate against the negative psychological impact of the COVID‐19 pandemic.
COVID‐19 and medical litigation: More than just the obvious
Authors: Kelly Anne‐Maree
Published: May 2020

COVID‐19 has massively changed the health landscape around the world. Wide‐ranging changes to healthcare delivery have occurred, especially in hospitals and EDs. Health services have made local decisions about care pathways, in some cases deviating from what would, until recently, have been considered widely accepted care. These changes bring with them new medicolegal risk for clinicians. In Australia, civil liability Acts provide protection for professionals when the criterion of having undertaken ‘competent’ practice that would be ‘widely accepted’ ‘in the circumstances’ is met. There is doubt how courts, and the medical experts who advise them, will evaluate clinical care provided during the pandemic when health services have developed local care pathways and there is no nationally accepted standard.
Biochemical analysis of cross‐feeding behaviour between two common gut commensals when cultivated on plant‐derived arabinogalactan
Authors: Munoz Jose , James Kieran , Bottacini Francesca , Van Sinderen Douwe
Published: May 2020

In this paper, we reveal and characterize cross‐feeding behaviour between the common gut commensal Bacteroides cellulosilyticus (Baccell) and certain bifidobacterial strains, including Bifidobacterium breve UCC2003, when grown on a medium containing Larch Wood Arabinogalactan (LW‐AG). We furthermore show that cross‐feeding is dependent on the release of β‐1,3‐galacto‐di/trisaccharides (β‐1,3‐GOS), and identified that the bga gene cluster of B. breve UCC2003 allows β‐1,3‐GOS metabolism. The product of bgaB is presumed to be responsible for the import of β‐1,3‐GOS, while the bgaA gene product, a glycoside hydrolase family 2 member, was shown to hydrolyse both β‐1,3‐galactobiose and β‐1,3‐galactotriose into galactose monomers. This study advances our understanding of strain‐specific syntrophic interactions between two glycan degraders in the human gut in the presence of AG‐type dietary polysaccharides.
Adverse respiratory outcomes following conventional long‐course radiotherapy for non‐small‐cell lung cancer in patients with pre‐existing pulmonary fibrosis: A comparative retrospective study
Authors: Bajraszewski Clare , Manser Renee , Chu James , Cox R Ashley , Tran Phillip , Duffy Mary , Irving Louis , Herschtal Alan , Siva Shankar , Ball David
Published: May 2020

Introduction

There is some evidence to suggest that patients with underlying pulmonary fibrosis (PF) have increased risk of adverse respiratory and survival outcomes, when treated with conventional, long‐course radiotherapy (RT) for non‐small‐cell lung cancer (NSCLC). We performed a retrospective analysis to determine the size of these risks.

Methods

Data from 21 patients with PF (cases) were retrospectively analysed for respiratory toxicity and mortality outcomes, and compared with 84 patients without PF (non‐cases). Age and mean lung dose were included as covariates in regression analyses. The additional predictive value of other patient, disease and treatment characteristics on radiation pneumonitis (RP) risk and severity was explored.

Results

There was a numerical (though not statistically significant) increase in grade ≥ 2 RP among PF cases (OR 2.74, P = 0.074). Cases were significantly more likely to discontinue radical treatment early (OR 6.10, P = 0.015). There was a significant association between increased RP severity and underlying PF (P = 0.039), with RP strongly implicated in the death in 3 of 21 cases (14.3%) compared to 1 non‐case (1.2%). Cases experienced increased grade ≥ 2 respiratory toxicity otherwise (OR 4.35, P = 0.020) and poorer median overall survival (0.6 versus 1.7 years, P < 0.001). Two cases, and no non‐cases, died during the proposed RT period. None of the analysed patient, disease or treatment factors, was a significant additional predictor of RP risk/severity.

Conclusion

Patients with PF are at increased risk of treatment discontinuation, respiratory morbidity and mortality, and poor survival following conventional RT for NSCLC. Caution should be exercised when offering high‐dose RT to these patients.
Words and Numbers: Financialization and Accounting Standard Setting in the United Kingdom
Authors: Chahed Yasmine
Published: May 2020

How is it possible that British policymakers resisted market‐based measurement for decades while financial economic concepts of decision making and valuation still gained widespread acceptance as a justification for accounting standard setting? This study introduces the concept of “technologies of financialization” to develop the theorizing of the rise of finance in the domain of accounting. Based on a genealogical history of narrative reporting in the United Kingdom, it demonstrates how references to qualitative reporting techniques helped to address recurring crises of measurement from 1969 to 1993, and ultimately contributed to the practical acceptance of market‐based measurement in the UK standard‐setting context. The data are interpreted through a cultural economy framework that directs attention to the power of referring to financial reporting as a combination of words and numbers in sustaining its theoretical redefinition “from below”—that is, by relating it to the experience of practicing accountants rather than accounting theory. As a technology of financialization, narrative reporting made financial economic ideals of market‐based measurement, decision usefulness, and future orientation appear operable in a real‐life reporting context. Whenever measurement reached its practical limits, narratives were relied on to explain the impact of price‐level changes, frame economic decisions, and relate unobservable future cash flows to present‐day strategies and resources. The insight into how narrative reporting practices have been laced into the reasoning of capital markets for over 40 years is timely because it illustrates that narratives can also play a more encompassing role and drive the turn toward wider corporate accountability on social and environmental impacts while hard measurements in this area are still being figured out.
Long‐term mortality in the Intermediate care after emergency abdominal surgery (InCare) trial—A post‐hoc follow‐up study
Authors: Hansted Anna K. , Møller Morten H. , Møller Ann M. , Wetterslev Jørn , Rosenberg Jacob , Jorgensen Lars N. , Waldau Tina , Vester‐Andersen Morten ,   the InCare trial Group
Published: May 2020

Background

Patients undergoing emergency abdominal surgery are at high risk of post‐operative complications. Although post‐operative treatment at an intermediate care unit may improve early outcome, there is a lack of studies on the long‐term effects of such therapy. The aim of this study was to assess the long‐term effect of intermediate care versus standard surgical ward care on mortality in the Intermediate Care After Emergency Abdominal Surgery (InCare) trial.

Methods

We included adult patients undergoing emergency major laparoscopy or laparotomy with an Acute Physiology and Chronic Health Evaluation (APACHE) II score of 10 or more, who participated in the InCare trial from October 2010 to November 2012. In the InCare trial, patients were randomized to either post‐operative intermediate care or standard surgical ward care. The primary outcome was time to death within 6 years after surgery. We assessed mortality with Coxregression analysis.

Results

A total of 286 patients were included. The all‐cause 6‐year landmark mortality was 52.8% (76 of 144 patients) in the intermediate care group and 47.9% (68 of 142 patients) in the ward care group. There was no statistically significant difference in mortality risk between the two groups (hazard ratio 1.06 (95% confidence interval 0.76‐1.47), P = .73).

Conclusion

We found no statistically significant difference in 6‐year mortality between patients randomized to post‐operative intermediate care or ward care after emergency abdominal surgery. However, we detected an absolute mortality risk reduction of 5% in favour of ward care, possibly due to random error.
Kinetics of crystalloid fluid in hyperglycemia; an open‐label exploratory clinical trial
Authors: Hahn Robert G. , Svensson Robert , Zdolsek Joachim H.
Published: May 2020

Background

Infusion with 0.9% saline is a mainstay in the treatment of severe hyperglycemia, but the kinetics of the saline volume in this setting has not been studied.

Methods

An intravenous infusion of 1 L of 0.9% saline over 30 minutes was given on 31 occasions to 17 patients with hyperglycemia due to poorly controlled diabetes (mean age 51 years). A two‐volume kinetic model was fitted to serial data on the hemodilution and urinary excretion, using mixed‐effects modeling software.

Results

Plasma glucose was 36 ± 9 mmol/L on arrival to the hospital. The central volume of distribution (the plasma) was only 2.38 L (mean; 95% confidence interval 1.73‐3.04) on the day of admission. Uptake into a remote compartment, believed to be the cells, amounted to 300 mL of the first liter of saline, although only small amounts of insulin were given. Plasma glucose, plasma bicarbonate, urine glucose, and plasma creatinine served as covariates in the kinetic model and mathematically affected the urinary excretion. For example, elimination of the infused fluid tripled from an increase in plasma glucose from 5 to 35 mmol/L and doubled from a reduction in plasma bicarbonate from 24 to 5 mmol/L.

Conclusions

The excretion of 0.9% saline was increased depending on the degree of hyperglycemia. The kinetics was characterized by glucose‐accelerated diuresis, and an intracellular uptake that occurred at two thirds the urine flow rate. These data could help to determine appropriate volumes and rates of infusion of crystalloids in hyperglycemia.
The impact of local smoke‐free policies on smoking behaviour among adults in Indonesia: a quasi‐experimental national study
Authors: Septiono Wahyu , Kuipers Mirte A. G. , Ng Nawi , Kunst Anton E.
Published: May 2020

Aims

To investigate to what extent the adoption of local smoke‐free policies (SFPs) in Indonesia in 2007–13 was associated with changes in adult smoking behaviour.

Design

A quasi‐experimental study.

Setting

Indonesia, 2007 and 2013.

Participants

A total of 1 052 611 > 25‐year‐old adults. Data were derived from the 2007 and 2013 Indonesian national health survey.

Measurements

For both years, provincial and district SFPs were identified from government documents in 497 districts in 33 provinces. Multi‐level logistic regression analysis assessed the association of adoption of provincial and district SFPs between 2007 and 2013 with smoking continuation (among ever‐smokers), current smoking and high smoking intensity (among current smokers). We controlled for survey year, SFP in 2007, socio‐demographics and district characteristics.

Findings

Provincial SFP exposure was associated with lower odds of smoking continuation [strong SFP versus no SFP: odds ratio (OR) = 0.71, 95% confidence interval (CI) = 0.66–0.76] and smoking intensity (strong SFP: OR= 0.91, 95% CI = 0.86–0.97), but also with higher odds of current smoking (strong SFP versus no SFP: OR = 1.08; 95% CI = 1.04–1.12). District SFP exposure was associated with higher odds of smoking continuation (strong SFP versus no SFP: OR = 1.07, 95% CI = 1.01–1.14) and current smoking (strong SFP versus no SFP: OR = 1.09, 95% CI = 1.05–1.14), but with lower odds of smoking intensity (moderately strong SFP versus no SFP: OR = 0.95, 95% CI = 0.91–0.99).

Conclusions

There may be an association between the adoption of local smoke‐free policies in Indonesia and decreased adult smoking intensity. However, the evidence is inconsistent, which may reflect problems with policy implementation and enforcement,
Variants in ALX4 and their association with genitourinary defects
Authors: Chen Ching H. , Bournat Juan C. , Wilken Nathan , Rosenfeld Jill A. , Zhang Jason , Seth Abhishek , Jorgez Carolina J.
Published: May 2020

Background

Genitourinary anomalies occur in approximately 1% of humans, but in most cases, the cause is unknown. Aristaless‐like homeobox 4 (ALX4) is an important homeodomain transcription factor. ALX4 mutations in humans and mouse have been associated with craniofacial defects and genitourinary anomalies such as cryptorchidism and epispadias.

Objectives

To investigate the presence and the functional impact of ALX4 variants in patients with genitourinary defects.

Materials and methods

Two separate patient cohorts were analyzed. One includes clinical exome‐sequencing (ES) data from 7500 individuals. The other includes 52 ALX4 Sanger‐sequenced individuals with bladder exstrophy‐epispadias complex (BEEC). Dual luciferase assays were conducted to investigate the functional transcriptional impact of ALX4 variants in HeLa cells and HEK293 cells.

Results

A total of 41 distinct ALX4 heterozygous missense variants were identified in the ES cohort with 15 variants present as recurrent in multiple patients. p.G369E and p.L373F were the only two present in individuals with genitourinary defects. A p.L373F heterozygous variant was also identified in one of the 52 individuals in the BEEC cohort. p.L373F and p.G369E were tested in vitro as both are considered damaging by MutationTaster, although only p.G369E was considered damaging by PolyPhen‐2. p.L373F did not alter transcriptional activity in HeLa and HEK293 cells. p.G369E caused a significant 3.4‐ and 1.8‐fold decrease in transcriptional activities relative to wild‐type ALX4 in HEK293 and HeLa cells, respectively.

Discussion and conclusions

Our study supports the idea that transcription factors like ALX4 could influence the normal development of the GU tract in humans as demonstrated in mouse models as ALX4 variant p.G369E (predicted pathogenic by multiple databases) affects ALX4 function in vitro. Variant p.L373F (predicted pathogenic by only MutationTaster) did not affect ALX4 function in vitro. Exon‐sequence information and mouse genetics provide important insights into the complex mechanisms driving genitourinary defects allowing the association of transcriptional defects with congenital disorders.
Public Health Agency of Sweden's Brief Report: Pregnant and postpartum women with severe acute respiratory syndrome coronavirus 2 infection in intensive care in Sweden
Authors: Collin Julius , Byström Emma , Carnahan AnnaSara , Ahrne Malin
Published: May 2020

The Public Health Agency of Sweden has analyzed how many pregnant and postpartum women with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection have been treated in intensive care units (ICU) in Sweden between 19 March and 20 April 2020 compared with non‐pregnant women of similar age. Cases were identified in a special reporting module within the Swedish Intensive Care Registry (SIR). Fifty‐three women aged 20‐45 years with SARS‐CoV‐2 were reported in SIR, and 13 of these women were either pregnant or postpartum (<1 week). The results indicate that the risk of being admitted to ICU may be higher in pregnant and postpartum women with laboratory‐confirmed SARS‐CoV‐2 in Sweden, compared with non‐pregnant women of similar age.
Comparison of the effectiveness of conbercept and ranibizumab treatment for retinopathy of prematurity
Authors: Cheng Yong , Zhu Xuemei , Linghu Dandan , Liang Jianhong
Published: May 2020

Purpose

To compare the effectiveness of intravitreal conbercept and ranibizumab treatment for retinopathy of prematurity (ROP).

Methods

In this retrospective study, the date of patients with ROP treated with intravitreal conbercept or ranibizumab from July 2012 to March 2018 with at least 12 months of follow‐up at the Eye Center in People’s Hospital of Peking University were analysed. Regression, progression or recurrence and peripheral retina vascularization were evaluated.

Results

In total, 283 eyes (145 infants) with conbercept treatment and 916 eyes (480 infants) with ranibizumab treatment were enrolled. In zone I ROP and aggressive posterior ROP (APROP), the recurrence prevalence was 49.09% (108/220 eyes) and 28.57% (10/33 eyes), and the recurrence interval was 7.87 ± 0.65 (5.5–9.5) weeks and 10.6 ± 1.53 (10.5–13) weeks in the ranibizumab and conbercept groups, respectively. In zone II ROP disease, the recurrence prevalence was 23.56% (164/696 eyes) and 13.31% (33/248 eyes), and the interval of recurrence was 8.40 ± 0.88 (6–10.5) weeks and 11.4 ± 1.35 (11–13.5) weeks in the ranibizumab and conbercept groups, respectively. The recurrence prevalence was significantly higher with ranibizumab in Zone I ROP and APROP (p = 0.006) and Zone II ROP (p < 0.001), and the recurrence interval was significantly longer in the conbercept group than that in the ranibizumab (p < 0.001). There was no significant difference in the rate of retinal vascularization (p = 0.441).

Conclusion

Conbercept and ranibizumab are effective for treating ROP. Compared with ranibizumab, conbercept resulted in less recurrence and longer treatment intervals.
Cystic fibrosis transmembrane conductance regulator‐dependent bicarbonate entry controls rat cardiomyocyte ATP release via pannexin1 through mitochondrial signalling and caspase activation
Authors: Wang Yongshun , Zhao Junjun , Cai Yin , Ballard Heather J.
Published: May 2020

Aim

Cystic fibrosis transmembrane conductance regulator (CFTR) is expressed in the heart, but its function there is unclear. CFTR regulates an ATP release pore in many tissues, but the identity and regulatory mechanism of the pore are unknown. We investigated the role of CFTR in ATP release from primary cardiomyocytes and ventricular wall in vivo.

Methods

Proteins involved in the signalling pathway for ATP release during simulated ischaemia (lactic acid treatment) were investigated using inhibitors and siRNA; colocalization was identified by coimmunofluorescence and proximity ligation assays; changes in near‐membrane pH and calcium were identified with total internal reflection microscopy; in vivo ATP release was investigated using interstitial microdialysis of rat heart.

Results

Lactic acid‐induced CFTR‐dependent ATP release from cultured cardiomyocytes and left ventricle in vivo. Lactic acid entry elevated near‐membrane calcium, which involved Na/H‐ and Na/Ca‐exchangers colocalized with CFTR. Calcium entry‐induced CFTR activation, which involved cAMP, protein kinase A, FAK, Pyk2 and Src. Removal of extracellular bicarbonate abolished cardiomyocyte ATP release induced by lactic acid or CFTR activators. Bicarbonate stimulated cytochrome c expression, cytochrome c release and ATP release from isolated cardiomyocyte mitochondria. Pannexin 1 (Panx1) colocalized with CFTR. Lactic acid increased cardiomyocyte caspase activity: caspase inhibitors or Panx1 siRNA abolished cardiomyocyte ATP release, while pannexin inhibition abolished cardiac ATP release in vivo.

Conclusion

During simulated ischaemia, CFTR‐dependent bicarbonate entry stimulated ATP and cytochrome c release from mitochondria; in the cytoplasm, cytochrome c‐activated caspase 3, which in turn activated Panx1, and ATP was released through the opened Panx1 channel.
Drug monitoring for mycophenolic acid in graft‐vs‐host disease prophylaxis in cord blood transplantation
Authors: Muranushi Hiroyuki , Kanda Junya , Arai Yasuyuki , Shindo Takero , Hishizawa Masakatsu , Yamamoto Takashi , Kondo Tadakazu , Yamashita Kohei , Matsubara Kazuo , Takaori‐Kondo Akifumi
Published: May 2020

Aims

We performed the retrospective analysis to clarify the significance of drug monitoring for mycophenolic acid (MPA), the active form of mycophenolate mofetil (MMF), in prophylaxis for graft‐vs‐host disease (GVHD) in cord blood transplantation.

Methods

We retrospectively analysed the data of 46 patients who underwent first cord blood transplantation and received GVHD prophylaxis with tacrolimus plus MMF. MPA levels were measured on days 7 and 21, and 24‐hour areas under the curve (AUC0–24) were estimated.

Results

The engraftment and 3‐year overall survival rates of all patients were 94% and 78%, respectively. The cumulative incidence of sepsis before engraftment was higher in patients with AUC0–24 on day 7 of >60 μg h/mL than in other patients (33 vs 6%, P = .02). The cumulative incidence of grade II–IV acute GVHD was higher in patients with AUC0–24 on day 21 of ≤30 μg h/mL than in other patients (80 vs 50%, P = .04). The cumulative incidence of human herpesvirus 6 reactivation was higher in patients with AUC0–24 on day 21 of ≤48 μg h/mL (median) than in other patients (50 vs 19%, P = .03).

Conclusion

Blood level of MPA was associated with risk of acute GVHD and infection. A prospective trial evaluating the benefit of personalized MMF dosing using MPA levels is needed.
A pharmacokinetic‐pharmacodynamic study of a single dose of febuxostat in healthy subjects
Authors: Kamel Bishoy , Graham Garry G. , Stocker Sophie L. , Liu Zhixin , Williams Kenneth M. , Carland Jane E. , Pile Kevin D. , Day Richard O.
Published: May 2020

Aims

To examine the pharmacokinetic‐phamacodynamic (PK‐PD) relationships of plasma febuxostat and serum urate and the effect of a single dose of the drug on renal excretion and fractional clearance of urate (FCU).

Methods

Blood and urine samples were collected at baseline and up to 145 hours following administration of febuxostat (80 mg) to healthy subjects (n = 9). Plasma febuxostat and serum and urinary urate and creatinine concentrations were determined. Febuxostat pharmacokinetics were estimated using a two‐compartment model with first‐order absorption. An Emax PK‐PD model was fitted to mean febuxostat and urate concentrations. Urinary urate excretion and FCU were calculated pre‐ and post‐dose.

Results

Maximum mean plasma concentration of febuxostat (2.7 mg L−1) was observed 1.2 hours after dosage. Febuxostat initial and terminal half‐lives were 2.0 ± 1.0 and 14.0 ± 4.7 hours (mean ± SD), respectively. The majority (81%) of the drug was eliminated in the 9 hours after dosing. Serum urate declined slowly achieving mean nadir (0.20 mmol L−1) at 24 hours. The IC50 (plasma febuxostat concentration that inhibits urate production by 50%) was 0.11 ± 0.09 mg L−1 (mean ± SD). Urinary urate excretion changed in parallel with serum urate. There was no systematic or significant change in FCU from baseline.

Conclusion

The PK‐PD model could potentially be used to individualise febuxostat treatment and improve clinical outcomes. A single dose of febuxostat does not affect the efficiency of the kidney to excrete urate. Further investigations are required to confirm the present results following multiple dosing with febuxostat.