bluuebunny/crossref_metadata_2025 huggingface dataset:
Contractual challenges for BIM-based construction projects: a systematic review
Authors: Abd Jamil Ahmad Huzaimi , Fathi Mohamad Syazli
Published: August 2018

Purpose

Building information modeling (BIM) has been proven to enable outstanding results in construction processes by enhancing knowledge sharing with regard to a building or facility throughout its life cycle from the conceptual design to facility management. The purpose of this paper is to investigate the extent to which the use of BIM has impacted the legal and contractual implications of the existing construction contracts for aligning the three sets of relevant development domains: BIM functionality, contract procurement methods, and BIM legal and contractual issues to enhance the efficient use of valuable resources.

Design/methodology/approach

This exploratory study was undertaken by analyzing the literature using a novel approach involving a matrix that juxtaposes BIM functionalities for each project life cycle with contract procurement methods. As part of the study, 28 interactions of BIM legal and contractual issues have been identified, as representing positive and negative interactions.

Findings

The interaction matrix framework that juxtaposes BIM functionalities and procurement methods highlights the theoretical and practical relationships identified between the methods. It also simultaneously recognizes the constructive and destructive interactions between these development domains by means of critically identifying the possible interactions of the legal and contractual aspects of both the BIM project procurement and the practical aspects of BIM project delivery.

Originality/value

The present study contributes to the existing literature by extensively identifying the probable interactions of contractual issues within BIM functionality with contract procurement methods throughout the life cycle of a building construction project.
Consumer segmentation based on health-related motive orientations and fruit and vegetable consumption
Authors: Raaijmakers Ireen , Sijtsema Siet , Labrie Caroline , Snoek Harriette
Published: August 2018

Purpose

More tailored interventions and campaigns are needed to increase fruit and vegetable consumption to recommended levels. The purpose of this paper is to explore which consumer groups exist based on both their fruit and vegetable consumption level and their health-related motive orientations (HRMO), and to compare the revealed consumer clusters regarding their fruit and vegetable product attribute importance.

Design/methodology/approach

In the Netherlands an online panel survey was carried out resulting in 1,296 respondents. The clusters based on HRMO and fruit and vegetable intake are profiled with respect to demographics and product attribute importance.

Findings

Cluster analysis revealed six homogeneous consumer clusters with different HRMO and fruit and vegetable consumption levels. In addition, these clusters show a different socio-demographic profile and differ in their importance ratings of fruit and vegetable product attributes.

Practical implications

The results show that health is a multidimensional construct suggesting that there is a need for addressing health in interventions and campaigns in a more tailored approach.

Originality/value

This study shows that the combination of both usage- and psychographic segmentation variables provide valuable and interesting information that give insights in addressing different target groups. Moreover, this study elaborates on previous research by showing that health is a multidimensional construct and that Dutch consumers differ in their HRMO.
Risk behaviours and practices of food handlers in norovirus transmission
Authors: Watson Sinead , Gong Yun Yun
Published: August 2018

Purpose

Food handlers are often a major source of norovirus transmission in the UK. Considering key behaviours of food handlers that lead to norovirus transmission would help prevent the spread. The purpose of this paper is to examine the key risk behaviours of food handlers that lead to norovirus transmission, and to recognise important prevention strategies.

Design/methodology/approach

A narrative review of the literature summarising the main risk behaviours of food handlers that lead to norovirus transmission.

Findings

Suboptimal personal hygiene such as poor hand washing compliance, working while ill or returning to work too early and not adhering to cleaning and disinfecting protocols were the main risk behaviours of food handlers identified. To prevent the transmission of norovirus within UK food establishments, environmental barriers such as limited access to cleaning products and facilities, workload and pay concerns should be resolved, and a theory-based approach should be used when developing training programmes to improve food handlers’ knowledge and behaviour. Systematic monitoring adhered to ensure food safety protocols should be regularly carried out.

Research limitations/implications

A limited number of qualitative studies assessing food handlers’ attitudes and beliefs concerning norovirus transmission are available. Gaining more detailed and in-depth information on what food handlers perceive are the main barriers when it comes to adhering to food safety guidelines, would aid in the development of effective norovirus mitigation strategies.

Originality/value

This review discusses the main risk behaviours of food handlers associated with norovirus transmission. It highlights the need for more qualitative research on exploring the attitudes and beliefs of food handlers with regard to norovirus transmission.
Knowledge transfer in open innovation
Authors: Secundo Giustina , Toma Antonio , Schiuma Giovanni , Passiante Giuseppina
Published: August 2018

Purpose

Despite the abundance of research in open innovation, few contributions explore it at inter-organizational level, and particularly with a focus on healthcare ecosystem, characterized by a dense network of relationships among public and private organizations (hospitals, companies and universities) as well as other actors that can be labeled as “untraditional” player, i.e. doctors, nurses and patients. The purpose of this paper is to cover this gap and explore how knowledge is transferred and flows among all the healthcare ecosystems’ players in order to support open innovation processes.

Design/methodology/approach

The paper is conceptual in nature and adopts a narrative literature review approach. In particular, insights gathered from open innovation literature at the inter-organizational network level, with a particular attention to healthcare ecosystems, and from the knowledge transfer processes, are analyzed in order to propose an interpretative framework for the understanding of knowledge transfer in open innovation with a focus on healthcare ecosystem.

Findings

The paper proposes an original interpretative framework for knowledge transfer to support open innovation in healthcare ecosystems, composed of four main components: healthcare ecosystem’s players’ categories; knowledge flows among different categories of players along the exploration and exploitation stages of innovation development; players’ motivations for open innovation; and players’ positions in the innovation process. In addition, assuming the intermediary network as the suitable organizational model for healthcare ecosystem, four classification scenarios are identified on the basis of the main players’ influence degree and motivations for open innovation.

Practical implications

The paper offers interpretative lenses for managers and policy makers in understanding the most suitable organizational models able to encourage open innovation in healthcare ecosystems, taking into consideration the players’ motivation and the knowledge transfer processes on the basis of the innovation results.

Originality/value

The paper introduces a novel framework that fills a gap in the innovation management literature, by pointing out the key role of external not R&D players, like patients, involved in knowledge transfer for open innovation processes in healthcare ecosystems.
Arbitrary movement simulation using 3D NC-FVM for electromagnetic problems
Authors: Amrani Ishaq , Cheriet Ahmed , Feliachi Mouloud
Published: August 2018

Purpose

The purpose of this paper is to propose to simulate an arbitrary movement in electromagnetic problems by means of a 3D nonconforming finite volume method (NC-FVM). The moving part can be displaced according to the x, y and/or z direction.

Design/methodology/approach

The 3D nonconforming mesh technique coupled to the FVM is used to handle arbitrary displacement of moving parts. Accordingly, the whole problem domain is divided into two parts: moving part and fixed part. Both parts are meshed independently. By using a suitable connection between both fixed and moved meshes, the movement can be performed according to the three axes.

Findings

The TEAM Workshop Problem No. 23 is used to test the proposed method. The calculated values of the magnetic force applied to the permanent magnet for different positions of the magnet show the efficiency of the proposed method.

Originality/value

This paper introduces the NC-FVM to solve electromagnetic problems which contain moving parts. Here, the movement can be performed according to the three axes.
The influence of laser treatment and industrial washing on denim fabric tension properties
Authors: Juciene Milda , Urbelis Virginijus Vytautas , Juchneviciene Žaneta , Saceviciene Virginija , Dobilaite Vaida
Published: August 2018

Purpose

The purpose of this paper is to determine the influence made by complex finishing of denim fabrics, i.e. laser treatment and industrial washing, on the change in tension properties of fabric.

Design/methodology/approach

Test specimens were treated by a laser JG-10050. Lasers main technological parameters: maximum laser beam power is 65 W, laser types are hermetic and detached CO2, laser tube wavelength is 10.62 µm. The test specimens processed by different laser energy density have been exposed to industrial washing and their tensile characteristics have been investigated.

Findings

The results of the research have demonstrated that complex finishing reduces the breaking force; however, material extensibility remains almost unchanged. Mechanical behaviour and composition characteristics of fabric are determined both by laser motion direction in respect of warp or weft and laser energy density.

Originality/value

The carried-out analysis of scientific literature has shown that the effect of laser on the fabric surface is relevant both in scientific and practical terms: the scientific literature contains studies on absorptive properties of laser treated materials; however, the behaviour of materials after complex finishing has not been widely investigated thus far.
Selling yourself: a preliminary analysis of political candidates as marketers and entrepreneurs
Authors: Roth M. Garrett
Published: August 2018

Purpose

The purpose of this paper is to view political candidates as products in a market competing over quality via advertising. Consequently, the Austrian argument against restrictions on product advertising can be applied to political markets as well. The foremost conclusion is a disproportionately negative effect of campaign finance restrictions on lesser-known incumbents and third-party candidates. A counterargument is also presented that campaign finance restrictions may solve a prisoner’s dilemma.

Design/methodology/approach

The author provides an initial test of these hypotheses with data from US Senate races occurring before and after the passage of the McCain-Feingold Act of 2002.

Findings

Empirical results show a strong incumbency advantage, but no disproportionate harm to lesser-known candidates or third parties from the passage of the act.

Originality/value

The paper provides a new perspective on the role of the political candidate and purpose of campaign advertising. The first pass empirics suggest, however, that only a major revision in campaign advertising rules could significantly alter the predictors of challenger vote shares.
Creating social value through orchestration processes in innovation networks
Authors: Ozeren Emir , Saatcioglu Omur Yasar , Aydin Erhan
Published: August 2018

Purpose

Social entrepreneurs innovatively exploit opportunities and create, in this way, social change and value by bringing together different resources to meet social needs and solve social problems. To achieve this, given their limited size and financial resources, the personal ties and social networks that social entrepreneurs build in this process play a crucial role in developing relationships and enabling their ventures to succeed. The purpose of this paper is to examine the role of network processes in innovative activities carried out by social entrepreneurs and to stress the importance of network processes rather than network structure/design for social innovation.

Design/methodology/approach

“Çöp(m)adam” (Garbage Ladies), a social development project and business in Ayvalik, Turkey (which aims to provide opportunities for women who have never had the chance to work and earn regular salaries in the course of their lifetimes), was explored qualitatively as a case study within the framework of the network orchestration theory. In-depth, semi-structured interviews and observations were conducted. Relevant documents about Çöp(m)adam were also collected at the time of the interview to provide the triangulation of reference material for thematic analysis and post-research inquiry.

Findings

It has been found that Çöp(m)adam dynamically manages the network process in the course of realizing social innovation and builds a win-win environment that creates value both for the future of the social enterprise and for all the actors in the network by integrating the relationships among the actors it is in a relationship with.

Originality/value

In contrast to traditional studies dealing with the network theory, this research focuses on network processes rather than network structure. Also, since the literature provides evidence for profit-based organizations, the study differentiates into two main reasons. First, the authors adopt a case study approach in social entrepreneurship for social value creation, and second, based on the case study, the authors provide a conceptual enrichment through proposing the sub-categories of knowledge mobility, innovation appropriability and network stability in orchestration processes. This paper seeks to broaden the existing understanding of how social entrepreneurial processes and innovative outcomes are shaped by social networks and orchestration processes in a network-centric innovation from the viewpoint of a hub/focal firm by undertaking research on a less examined type of enterprise and context – namely, a social entrepreneurial venture in Turkey.
The impact of external audit on the accountability of the common fund of the Mozambique National Institute of Statistics
Authors: Cumbe Luís Leonardo , Inácio Helena
Published: August 2018

Purpose

The purpose of this paper is to evaluate the impact of external audit on the management of the Common Fund of the Mozambique National Institute of Statistics (INE).

Design/methodology/approach

This paper followed a case study approach of the INE Common Fund that was based on the qualitative evidence from the content analysis of the external audit reports, annual plans of activities and budget for the past seven years and interviews with middle managers of the INE.

Findings

The research found that external audit has a relatively significant impact on the management of the INE Common Fund. The authors attribute the positive impact to the high concern of management to implement the external audit recommendations, associated with the financial dependence between the agent (the National Institute of Statistics) and the principal (Fund Donors), explained through Laughlin’s Model of Accountability.

Practical implications

The results indicate that external audit associated with the financial dependence of the agent on the principal has a significant impact on the accountability. Thus, it contributes to assist in the formulation of public policies on external financing to developing countries.

Originality/value

Most of the studies on external audit and accountability are from countries with more developed economies than Mozambique’s, without heavy reliance on external financing, and these studies analyse the audits carried out by public audit institutions. This research explores the phenomenon in the context of external financing to the State Budget by governments and international organisations.
The NICE classification for ‘Ultra‐radical (extensive) surgery for advanced ovarian cancer’ guidance does not meaningfully predict postoperative complications: a cohort study
Authors: Phillips A , Sundar S , Singh K , Pounds R , Nevin J , Kehoe S , Balega J , Elattar A
Published: August 2018

Objective

To determine which descriptors of cytoreductive surgical extent in advanced ovarian cancer (AOC) best predict postoperative morbidity.

Design

Retrospective notes review.

Setting

A gynaecological cancer centre in the UK.

Population

Six hundred and eight women operated on for AOC over a period of 114 months at a tertiary cancer centre, between 16 August 2007 and 16 February 2017.

Methods

Outcome data were analysed by six approaches to classify the extent of surgery: standard/ultra‐radical surgery; standard/radical/supra‐radical surgery; presence/absence of gastrointestinal resections; low/intermediate/high surgical complexity score (SCS); presence of bowel anastomoses and/or diaphragmatic surgery; and the presence/absence of multiple bowel resections.

Main outcome measures

Major (grades 3–5) postoperative morbidity and mortality.

Results

Forty‐three (7.1%) patients experienced major complications. Grade‐5 complications occurred in six patients (1.0%). Patients who underwent multiple bowel resections had a relative risk (RR) of 7.73 (95% confidence interval, 95% CI 3.92–15.26), patients with a high SCS had an RR of 6.12 (95% CI 3.25–11.52), patients with diaphragmatic surgery and gastrointestinal anastomosis had an RR of 5.57 (95% CI 2.65–11.72), patients with ‘any gastrointestinal resection’ had an RR of 4.69 (95% CI 2.66–8.24), patients with ultra‐radical surgery had an RR of 4.65 (95% CI 2.26–8.79), and patients with supra‐radical surgery had an RR of 4.20 (95% CI 2.35–7.51) of grades 3–5 morbidity, compared with patients undergoing standard surgery as defined by the National Institute for Health and Care Excellence (NICE) in the UK. No significant difference was seen in the rate of major morbidity between standard (6/59, 10.2%) and ultra‐radical (9/81, 11.1%) surgery within the cohort who had intermediate complex surgery (P > 0.05).

Conclusions

The numbers of procedures performed significantly correlate with major morbidity. The number of procedures performed better predicted major postoperative morbidity than the performance of certain ‘high risk’ procedures. We recommend using SCS to define a higher risk operation. NICE should re‐evaluate the use of the term ‘ultra‐radical’ surgery.

Tweetable abstract

Multiple bowel resection is the best predictor of morbidity and is more predictive than ‘ultra‐radical surgery’.
Relationship Between Prison Length of Stay and Recidivism: A Study Using Regression Discontinuity and Instrumental Variables With Multiple Break Points
Authors: Rhodes William , Gaes Gerald G. , Kling Ryan , Cutler Christopher
Published: August 2018

Research Summary

In this study, we use both a regression discontinuity design and an instrumental variable identification strategy to examine the relationship between prison length of stay and recidivism among a large sample of federal offenders. We capitalize on the U.S. Sentencing Guidelines structure to apply these strong inference, quasi‐experimental approaches. We find that average length of stay can be reduced by 7.5 months with a small impact on recidivism. We also examine whether there is treatment heterogeneity. We find that length‐of‐stay effects do not vary by criminal history, offense seriousness, sex, race, and education level.

Policy Implications

We show that reducing the average length of stay for the federal prison population by 7.5 months could save the Bureau of Prisons 33,203 beds once the inmate population reaches steady state. This back‐of‐the‐envelope estimate reveals how reductions in time served can have a much larger impact on prison reductions compared with diverting low‐level offenders from prison to probation. Prison length‐of‐stay reductions can impact the entire prison population, whereas diversion typically affects a small subset of offenders whose consumption of prison beds is a small fraction of the total number of beds. We also discuss the potential impact of reducing levels of imprisonment on other collateral consequences.
Pharmacokinetics of Phosphatidylethanol 16:0/20:4 in Human Blood After Alcohol Intake
Authors: Lopez‐Cruzan Marisa , Roache John D. , Hill‐Kapturczak Nathalie , Karns‐Wright Tara E. , Dougherty Donald M. , Sanchez Jesus J. , Koek Wouter , Javors Martin A.
Published: August 2018

Background

The purpose of this study was to characterize the pharmacokinetics of the phosphatidylethanol (PEth) 16:0/20:4 homolog in uncoagulated human blood samples taken from 18 participants in a clinical laboratory setting after consumption of 2 standard doses of ethanol (EtOH).

Methods

Male and female participants received either 0.4 or 0.8 g/kg oral doses of EtOH during a 15‐minute period. Blood samples were collected before and throughout 6 hours immediately after alcohol administration and then again at days 2, 4, 7, 11, and 14 of the follow‐up period. PEth 16:0/20:4 levels were quantified by high‐performance liquid chromatography with tandem mass spectrometry detection.

Results

(i) The increase in PEth 16:0/20:4 from baseline to maximum concentration was less than that of PEth 16:0/18:1 or PEth 16:0/18:2 homologs during the 6‐hour period after EtOH administration; (ii) the mean half‐life of PEth 16:0/20:4 was 2.1 ± 3 (SD) days, which was shorter than the mean half‐life of either PEth 16:0/18:1 or PEth 16:0/18:2, 7.6 ± 3 (SD) or 6.8 ± 4 (SD) days, respectively.

Conclusions

The pharmacokinetics of PEth 16:0/20:4 in whole blood samples is detectable after alcohol consumption and differs in amount synthesized and rate of elimination versus PEth 16:0/18:1 and 16:0/18:2. Measuring the concentrations of these 3 homologs has the potential to provide more information about the amount and time frame of alcohol consumption than any one alone.
Comparative analysis of decidual and peripheral immune cells and immune‐checkpoint molecules during pregnancy in wild‐type and PACAP‐deficient mice
Authors: Lajko Adrienn , Meggyes Matyas , Fulop Balazs Daniel , Gede Noemi , Reglodi Dora , Szereday Laszlo
Published: August 2018

Problem

PACAP is a neuropeptide having a major relevance in the nervous system and in several peripheral organs including those of the reproductive system. PACAP‐deficient mice have several morphological, biochemical, behavioral defects, and show reduced fertility. Female reproductive functions such as fertility, mating behavior, maternal behaviors, and implantation alterations have been widely investigated, but no comparative immune analyses are available in pregnant wild‐type (WT) and PACAP knockout (KO) mice.

Methods of study

Therefore, we performed a detailed immunophenotyping of decidual and peripheral immune cells and investigated the expression of two immune‐checkpoint molecules by immune cells together with immunohistochemistry detecting Galectin‐9 in placental tissues. We investigated the percentage of numerous immune cell populations in the periphery and in the decidua of pregnant mice.

Results

We demonstrated a significant increase in the frequency of decidual Gal‐9+ Th cells obtained from PACAP KO mice compared to the decidua of WT mice. We could not determine statistical differences in TIM‐3 and programmed cell death‐1 expression by different immune cells in the decidua and in the periphery between WT and KO mice. In conclusion, we could not find any significant alteration either in the distribution or in the cytotoxicity of the investigated decidual immune cells which could elucidate any reproductive alterations in PACAP KO mice.

Conclusion

The only remarkable finding is the recruitment of Gal‐9+ Th cells to the decidua promoting local immune homeostasis in PACAP KO mice, which nevertheless cannot explain the reduced fertility observed in these mice.
The Implications of Right‐Wing Authoritarianism for Non‐Muslims’ Aggression toward Muslims in the United States
Authors: Beck Chloe L. , Plant E. Ashby
Published: August 2018

Following 9/11 and the wars in Iraq and Afghanistan, anti‐Muslim antipathy dramatically escalated in the United States. We argue that a major contributor to this hostility is endorsement of Right‐Wing Authoritarianism (RWA) because people high in RWA tend to respond aggressively toward groups that they view as threatening particularly when they perceive that such aggression is supported by authority figures. We posit that Americans high in RWA view Muslims as threatening traditional American norms and perceive that the U.S. government is at war with Islam. Across three studies, we present consistent support for our hypothesis that RWA is associated with endorsing and engaging in hostile behavior toward Muslims. In addition, this hostility is mediated by the perception that Muslims threaten societal norms and that the government is actively at war with Islam (Study 3). The implications for the reduction of aggression toward Muslims and the impact of RWA on hostility toward other outgroups are discussed.
Incidence, risk factors and prevention of stoma site incisional hernias: a systematic review and meta‐analysis
Authors: Lambrichts D. P. V. , de Smet G. H. J. , van der Bogt R. D. , Kroese L. F. , Menon A. G. , Jeekel J. , Kleinrensink G‐J. , Lange J. F.
Published: August 2018

Aim

Stoma reversal might lead to a stoma site incisional hernia. Recently, prophylactic mesh reinforcement of the stoma site has gained increased attention, supporting the need for accurate data on the incidence of and risk factors for stoma site incisional hernia and to identify high‐risk patients. The aim of this study was to assess incidence, risk factors and prevention of stoma site incisional hernias.

Method

Embase, MEDLINE, Web of Science, Cochrane and Google Scholar databases were searched. Studies reporting the incidence of stoma site incisional hernia after stoma reversal were included. Study quality was assessed with the Newcastle–Ottawa Scale and Cochrane risk of bias tool. Data on incidence, risk factors and prophylactic mesh reinforcement were extracted.

Results

Of 1440 articles found, 33 studies comprising 4679 reversals were included. The overall incidence of incisional hernia was 6.5% [range 0%–38%, median follow‐up 27.5 (17.54–36) months]. Eleven studies assessed stoma site incisional hernia as the primary end‐point, showing an incidence of 17.7% [range 1.7%–36.1%, median follow‐up 28 (15.25–51.70) months]. Body mass index, diabetes and surgery for malignant disease were found to be independent risk factors, as derived from eight studies. Two retrospective comparative cohort studies showed significantly lower rates of stoma site incisional hernia with prophylactic mesh reinforcement compared with nonmesh controls [6.4% vs 36.1% (P = 0.001); 3% vs 19% (P = 0.04)].

Conclusion

Stoma site incisional hernia should not be underestimated as a long‐term problem. Body mass index, diabetes and malignancy seem to be potential risk factors. Currently, limited data are available on the outcomes of prophylactic mesh reinforcement to prevent stoma site incisional hernia.
Who is More Injury‐Prone? Prediction and Assessment of Injury Risk
Authors: Gupta Ashish , Wilkerson Gary B. , Sharda Ramesh , Colston Marisa A.
Published: August 2018

Injuries are the primary determinant of an individual's mobility, which affect not just their workplace productivity in intensive environments such as manufacturing, but also their decision‐making ability and quality of life. Managers typically assign workers to projects or tasks without having knowledge about their functional capabilities or current state of injury risk as injuries remain highly underreported at workplaces for fear of reprisal and other reasons. Therefore, high‐quality research on injury prevention is nearly nonexistent. Procedures that we use in this study for developing a prediction model for identification of college football players at an elevated injury risk could also be used to quantify injury risk in various occupational settings. Using a number of measurements and models, we arrive at an estimate of an individual's injury likelihood. Our measures include ratings of movement efficiency through physical performance tests, acceleration using Internet of Things (IoT) devices, functional role classifications, and recorded exposures to high‐risk conditions. Findings prescribe several approaches and decision rules for prediction of injury risk and suggest that training programs need to consider an individual's injury risk rather than offer a ‘one‐size‐fits‐all’ approach. The analytics models derived from a combination of injury risk screening and surveillance data can be used for making decisions about targeting employee‐centric risk‐reduction interventions, improved matching of tasks to individuals, or deciding job rotation for improved performance, all while enhancing the quality of life of individuals and reducing the escalating costs of work‐related injuries borne by employers. These models can also be developed for smartphones.
Making dietary changes following a diagnosis of prediabetes: a qualitative exploration of barriers and facilitators
Authors: Abel S. , Whitehead L. C. , Coppell K. J.
Published: August 2018

Aim

To explore the experiences of people recently diagnosed with prediabetes and overweight or obese in making dietary changes following a six‐month primary care nurse‐delivered dietary intervention pilot.

Methods

Semi‐structured interviews were conducted with 20 participants, purposefully selected to ensure a mix of ethnicity, gender and glycaemic outcome. Thematic analysis of interview data was undertaken.

Results

Participants described feeling shocked when they received the diagnosis of prediabetes. Three core themes, each containing subthemes, emerged: (i) supportive factors ‐ determination not to develop diabetes, clear information and manageable strategies, and supportive relationships; (ii) barriers ‐ lack of family support, financial constraints, social expectations around food, and chronic health issues; and (iii) overcoming challenges ‐ growing and sharing food, using frozen vegetables and planning. Challenges related to cultural expectations around providing and partaking of food were more evident for indigenous Māori participants.

Conclusions

A diagnosis of prediabetes provides a window of opportunity for healthcare professionals to work with those diagnosed and their families to make healthful dietary changes. Dietary guidance is likely to be most effective when individuals’ life circumstances are taken into account. Clear information and supportive relationships to facilitate lifestyle change are extremely important.

(Clinical Trials Registry No; ANZCTR ACTRN1261500080656)
Impact of different glycaemic treatment targets on pregnancy outcomes in gestational diabetes
Authors: Abell S. K. , Boyle J. A. , Earnest A. , England P. , Nankervis A. , Ranasinha S. , Soldatos G. , Wallace E. M. , Zoungas S. , J Teede H.
Published: August 2018

Aim

With no current randomized trials, we explored the impact of tight compared with standard treatment targets on pregnancy outcomes in gestational diabetes mellitus (GDM).

Methods

This cohort study of singleton births ≥ 28 weeks’ gestation was conducted at two major Australian maternity services (2009–2013). Standardized maternal, neonatal and birth outcomes were examined using routine healthcare data and compared for women with GDM at Service One (n = 2885) and Service Two (n = 1887). Services applied different treatment targets: Service One (standard targets, reference group) fasting < 5.5 mmol/l, 2‐h postprandial < 7.0 mmol/l; Service Two (tight targets) fasting < 5.0 mmol/l, 2‐h postprandial < 6.7 mmol/l. Multivariable regression with propensity score adjustment was used to examine associations between targets and outcomes.

Results

GDM prevalence and insulin use were 7.9% and 31% at Service One, and 5.7% and 46% at Service Two. There were no differences in primary outcomes: birthweight > 90th centile [adjusted odds ratio (OR) 1.06, 95% confidence interval (CI) 0.87–1.30] and < 10th centile (OR 0.84, 95% CI 0.70–1.01), or secondary outcomes gestational hypertension, pre‐eclampsia, shoulder dystocia or a perinatal composite. Service Two with tight targets had increased induction of labour (OR 3.63, 95% CI 3.17–4.16), elective Caesarean section (OR 1.75, 95% CI 1.37–2.23) and Apgar scores < 7 at 5 min (OR 1.54, 95% CI 1.05–2.25), decreased hypoglycaemia (OR 0.76, 95% CI 0.61–0.94]), jaundice (OR 0.47, 95% CI 0.35–0.63) and respiratory distress (OR 0.68, 95% CI 0.47–0.98).

Conclusions

Tight GDM treatment targets were associated with greater insulin use and no difference in primary birthweight outcomes. The service with tight targets had higher obstetric intervention, lower rates of reported hypoglycaemia, jaundice, respiratory distress and lower Apgar scores. High‐quality interventional data are required before tight treatment targets can be implemented.
Negative spatial covariation in abundance of two European ticks: diverging niche preferences or biotic interaction?
Authors: Tkadlec Emil , Václavík Tomáš , Kubelová Michaela , Široký Pavel
Published: August 2018

1. Understanding the ecological niches of ticks is central to predicting the risk of tick‐borne disease occurrence. Despite considerable advances in describing species distributions over the last two decades, disentangling the differences in habitat preferences from biotic interactions still remains among the main challenges.

2. In boundary areas along the rivers Danube, Morava and Dyje, separating the Czech Republic, Slovakia and Austria, we studied ecological niche segregation between two European sympatric tick species, Dermacentor reticulatus and Ixodes ricinus, the abundances of which exhibited a negative spatial covariation. By applying ANCOVA analysis, we tested the effects of 19 climate, four moisture and two topographical variables derived through GIS on tick abundances.

3. Dermacentor reticulatus preferred warmer and wetter sites with greater diurnal and seasonal variation in temperature but with lower seasonality in precipitation than I. ricinus.

4. By adopting the static regression model based on a modified Lotka–Volterra model for interspecific competition, we examined the relative power of environmental variables to explain the negative relationship between tick log‐abundances. We found that nonzero estimates of competition coefficients α12 and α21 were not eliminated even if we included seven principal components derived from considered environmental variables.

5. These results suggest that habitat conditions can shape abundance patterns of the studied ticks but their overall power to explain negative spatial covariation is low. This indicates that other critical variables were not considered in the analysis. An alternative explanation suggests that competitive interaction is not yet supported by direct field evidence obtained for these ticks.
Snapshot of an early Paleoproterozoic ecosystem: Two diverse microfossil communities from the Turee Creek Group, Western Australia
Authors: Barlow Erica Victoria , Van Kranendonk Martin Julian
Published: August 2018

Eighteen microfossil morphotypes from two distinct facies of black chert from a deep‐water setting of the c. 2.4 Ga Turee Creek Group, Western Australia, are reported here. A primarily in situ, deep‐water benthic community preserved in nodular black chert occurs as a tangled network of a variety of long filamentous microfossils, unicells of one size distribution and fine filamentous rosettes, together with relatively large spherical aggregates of cells interpreted as in‐fallen, likely planktonic, forms. Bedded black cherts, in contrast, preserve microfossils primarily within, but also between, rounded clasts of organic material that are coated by thin, convoluted carbonaceous films interpreted as preserved extracellular polymeric substance (EPS). Microfossils preserved within the clasts include a wide range of unicells, both much smaller and larger than those in the nodular black chert, along with relatively short, often degraded filaments, four types of star‐shaped rosettes and umbrella‐like rosettes. Large, complexly branching filamentous microfossils are found between the clasts. The grainstone clasts in the bedded black chert are interpreted as transported from shallower water, and the contained microfossils thus likely represent a phototrophic community. Combined, the two black chert facies provide a snapshot of a microbial ecosystem spanning shallow to deeper‐water environments, and an insight into the diversity of life present during the rise in atmospheric oxygen. The preserved microfossils include two new, distinct morphologies previously unknown from the geological record, as well as a number of microfossils from the bedded black chert that are morphologically similar to—but 400–500 Ma older than—type specimens from the c. 1.88 Ga Gunflint Iron Formation. Thus, the Turee Creek Group microfossil assemblage creates a substantial reference point in the sparse fossil record of the earliest Paleoproterozoic and demonstrates that microbial life diversified quite rapidly after the end of the Archean.
Hospital discharge data under‐reports delirium occurrence: results from a point prevalence survey of delirium in a major Australian health service
Authors: Casey Penelope , Cross Wendy , Mart Melinda Webb‐St , Baldwin Cathryn , Riddell Kath , Dārziņš Pēteris
Published: August 2018

Background

Delirium in hospitalised patients is common, and a risk factor for adverse outcomes. Health services require accurate delirium data to monitor the impact of initiatives designed to improve detection and prevention of delirium.

Aim

To determine the extent to which International Classification of Disease codes represent delirium occurrence.

Methods

A cross‐sectional point prevalence survey was used to audit delirium occurrence in 25 inpatient wards of an Australian health service. All adult patients were eligible. Exclusion was for coma, end of life or behaviour that posed a risk to delirium assessors. Specially trained nurses and allied health professionals (AHP) screened patients for any cognitive impairment using the 4 A's Test (4AT). Those with abnormal screen test results were assessed using the ‘3‐Minute Diagnostic Interview for the Confusion Assessment Method’ (3D‐CAM). Delirium detected by 3D‐CAM was the reference standard.

Results

Of potentially eligible patients, 559 of 667 (83.8%) patients were assessed. The mean age was 73 years (±16.4), 54.5% were female and 43.8% (245/559) had cognitive impairment (4AT score ≥1). The occurrence of delirium during hospitalisation as identified by ICD codes was 10.4% (58/559; 95% confidence interval (CI), 7.9–12.7) compared with a point prevalence of 16.2% (91/559; 95% CI, 13.2–19.1). Only 31 of 91 (34.1%) of those with delirium had ICD delirium codes assigned.

Conclusion

ICD coding is inadequate to determine in‐hospital delirium incidence. Instead, a point prevalence detection of delirium using the methods described above could be used. Health services could apply the described survey method to evaluate their local initiatives for the improvement of delirium detection and prevention.
Outcomes of endovascular thrombectomy with and without bridging thrombolysis for acute large vessel occlusion ischaemic stroke
Authors: Maingard Julian , Shvarts Yasmin , Motyer Ronan , Thijs Vincent , Brennan Paul , O'Hare Alan , Looby Seamus , Thornton John , Hirsch Joshua A. , Barras Christen D. , Chandra Ronil V. , Brooks Mark , Asadi Hamed , Kok Hong K.
Published: August 2018

Background

Endovascular thrombectomy (EVT) for management of large vessel occlusion (LVO) acute ischaemic stroke is now current best practice.

Aim

To determine if bridging intravenous (i.v.) alteplase therapy confers any clinical benefit.

Methods

A retrospective study of patients treated with EVT for LVO was performed. Outcomes were compared between patients receiving thrombolysis and EVT with EVT alone. Primary end‐points were reperfusion rate, 90‐day functional outcome and mortality using the modified Rankin Scale (mRS) and symptomatic intracranial haemorrhage (sICH).

Results

A total of 355 patients who underwent EVT was included: 210 with thrombolysis (59%) and 145 without (41%). The reperfusion rate was higher in the group receiving i.v. tissue plasminogen activator (tPA) (unadjusted odds ratio (OR) 2.2, 95% confidence interval (CI): 1.29–3.73, P = 0.004), although this effect was attenuated when all variables were considered (adjusted OR (AOR) 1.22, 95% CI: 0.60–2.5, P = 0.580). The percentage achieving functional independence (mRS 0–2) at 90 days was higher in patients who received bridging i.v. tPA (AOR 2.17, 95% CI: 1.06–4.44, P = 0.033). There was no significant difference in major complications, including sICH (AOR 1.4, 95% CI: 0.51–3.83, P = 0.512). There was lower 90‐day mortality in the bridging i.v. tPA group (AOR 0.79, 95% CI: 0.36–1.74, P = 0.551).

Fewer thrombectomy passes (2 versus 3, P = 0.012) were required to achieve successful reperfusion in the i.v. tPA group. Successful reperfusion (modified thrombolysis in cerebral infarction ≥2b) was the strongest predictor for 90‐day functional independence (AOR 10.4, 95% CI:3.6–29.7, P < 0.001).

Conclusion

Our study supports the current practice of administering i.v. alteplase before endovascular therapy.
Radial‐probe endobronchial ultrasound outcomes in the investigation of peripheral pulmonary lesions: a New Zealand perspective
Authors: Good William R. , Christensen Pernille M. , Herath Samantha , Dawkins Paul , Yap Elaine
Published: August 2018

Background

Radial‐probe endobronchial ultrasound (radial‐EBUS) is becoming an important investigation for peripheral pulmonary lesions (PPL). A key advantage of radial‐EBUS is the favourable risk profile compared with current gold‐standard computerised tomography‐guided biopsy.

Aim

To investigate the diagnostic yield, predictors of positive yield and radial‐EBUS safety in a New Zealand institution. We also determined whether molecular analysis was possible on the same tissue samples.

Methods

We performed a retrospective analysis of all patients (n = 68) from Middlemore Hospital, Auckland, undergoing radial‐EBUS with guide‐sheath for PPL from March 2015 to August 2016. Clinical, radiological and procedural data were collected. Radial‐EBUS diagnostic yield was determined for malignant and benign diagnoses, and molecular analysis yield was determined on appropriate malignant samples. Logistic regression was used to determine factors predicting successful radial‐EBUS.

Results

Overall diagnostic yield of radial‐EBUS was 55.9% (95% confidence interval (CI): 44.3–67.9). Malignant diagnostic sensitivity was 60.8% (95% CI: 46.1–74.2) and benign diagnostic sensitivity was 50% (95% CI: 23–77). Lesions close to the hilum (P = 0.039), concentric radial‐probe positioning (P = 0.008) and the use of forceps as first instrument (P = 0.0049) significantly predicted successful diagnostic yield. Of the malignant cases 81.0% (95% CI: 58.1–94.6) were sufficient for molecular analysis. Pneumothorax occurred in 4.4% (95% CI: 0.9–12.4), none required chest drain intervention. There were no cases of significant pulmonary haemorrhage.

Conclusion

Radial‐EBUS was shown to be safe with diagnostic yield similar to international reports. Important predictors of success include distance from hilum, probe position and forceps as first instrument. We also demonstrated that molecular analysis is possible in radial‐EBUS obtained samples.
Deep surgical site infection after ankle fractures treated by open reduction and internal fixation in adults: A retrospective case‐control study
Authors: Meng Jinghong , Sun Tao , Zhang Fengqi , Qin Shiji , Li Yansen , Zhao Haitao
Published: August 2018

Information on ankle fractures is limited. The purpose of this study was to investigate the incidence and risk factors for deep surgical site infection (DSSI) after open reduction and internal fixation (ORIF). Adult patients who underwent ORIF for an ankle fractures at 3 level‐I centres between January 2013 and June 2017 were included. Data on demographic, injury‐related, and surgery‐related variables and biochemical indexes from the laboratory were collected from patients' electronic medical records. Univariate analysis and multivariate logistic regression analysis model were used to perform the data analysis through SPSS 19.0. Within 1‐year postoperatively, 2.83% (74/2617) of cases developed DSSI, with the earliest occurring at the 4th and latest at 147th day. Pseudomonas aeruginosa, methicillin‐resistant Staphylococcus aureus, and methicillin‐susceptible Staphylococcus aureus were the top 3 bacteria, causing 73% (37/51) of all the cases. Age (45–64 and ≥65 years), current smoking status, chronic heart disease, lower preoperative albumin level, open injury, and prolonged surgical duration were identified to be independently associated with DSSI occurrence. Preoperative active supplementation of nutrition, immediate smoking cessation, and optimisation of an operative plan for the reduction of surgical duration were feasible measures for DSSI prevention following ORIF of ankle fractures.
Tunable broadband emission from red to blue by gamma radiation in multicomponent phosphate glasses
Authors: He Quanlong , Wang Pengfei , Li Weinan , Sun Mengya , Lu Min , Peng Bo
Published: August 2018

We demonstrate for the first time that the tunable broadband emission from red to blue can be obtained by gamma radiation in multicomponent phosphate glasses. Gamma radiation causes the increased phosphate‐related non‐bridging oxygen hole center and oxygen hole center defects, which lead to the enhanced emission peaking at 452 nm. Meanwhile, the vibration amplitude of O‐P‐O chain's internal decrease, resulting in the decreased emission at 660 nm. Besides, the increased isolated phosphate units (Q0 and Q1), as well as the gradual decrease in P atoms that make up the main phosphate chain contribute to the blue‐shift of the main emission peak at 616 nm, which directly results in the tunable broadband emission from 616 to 460 nm. The gamma radiation process endows this type of multicomponent phosphate glasses with promising applications in solid‐state lighting devices.