bluuebunny/crossref_metadata_2025 huggingface dataset:
Simultaneous isolation of Chryseobacterium gleum from bloodstream and respiratory tract: first case report from India
Authors: Jain Vidhi , Hussain Nayani Amrin Fatema Afzal , Siddiqui Tasneem , Sahu Chinmoy , Ghar Malay , Prasad Kashi Nath
Published: October 2017

Introduction. Species of the genus Chryseobacterium are emerging healthcare-associated pathogens, often colonizing the hospital environment. There are no clear guidelines available for antimicrobial susceptibility of this organism. In this report we present the first case, to our knowledge, of simultaneous central-line-associated bloodstream infection (CLABSI) and ventilator-associated pneumonia (VAP) due to Chryseobacterium gleum from India.

Case presentation. A 62 years old man with a history of a road traffic accident 1 month previously was referred to our center for further management. He developed features of sepsis and aspiration pneumonia on day 3 of admission. Four blood cultures (two each from central and peripheral lines) and two tracheal aspirate cultures grew pure yellow colonies of bacteria. Both matrix assisted laser desorption ionization time of flight mass spectrometry, (MALDI-TOF MS; bioMérieux, Marcy-L'Etoile, France,) and BD Phoenix (BD Biosciences, Maryland, USA) identified the organism as C. gleum. However, BD Phoenix failed to provide MIC breakpoints. The isolates of C. gleum both from blood and tracheal aspirate showed identical susceptibility patterns: resistant to cephalosporins and carbapenems and susceptible to ciprofloxacin, levofloxacin, amikacin, trimethoprim+sulfamethoxazole, piperacillin–tazobactam, cefoperazone–sulbactam, doxycycline, minocycline and vancomycin. Following levofloxacin therapy, the fever responded within 48 h and procalcitonin levels decreased without removal of the central line or endotracheal tube. However, the patient developed sudden cardiac arrest on day 10 of treatment and could not be resuscitated.

Conclusion. Rapid and accurate identification of C. gleum in the laboratory, preferably based on MALDI-TOF, is essential for guiding therapy. C. gleum responds well to fluoroquinolones without the need to remove indwelling catheters.
Whole genome transcriptomics reveals global effects including up-regulation of Francisella pathogenicity island gene expression during active stringent response in the highly virulent Francisella tularensis subsp. tularensis SCHU S4
Authors: Murch Amber L. , Skipp Paul J. , Roach Peter L. , Oyston Petra C. F.
Published: October 2017

During conditions of nutrient limitation bacteria undergo a series of global gene expression changes to survive conditions of amino acid and fatty acid starvation. Rapid reallocation of cellular resources is brought about by gene expression changes coordinated by the signalling nucleotides' guanosine tetraphosphate or pentaphosphate, collectively termed (p)ppGpp and is known as the stringent response. The stringent response has been implicated in bacterial virulence, with elevated (p)ppGpp levels being associated with increased virulence gene expression. This has been observed in the highly pathogenic Francisella tularensis sub spp. tularensis SCHU S4, the causative agent of tularaemia. Here, we aimed to artificially induce the stringent response by culturing F. tularensis in the presence of the amino acid analogue l-serine hydroxamate. Serine hydroxamate competitively inhibits tRNAser aminoacylation, causing an accumulation of uncharged tRNA. The uncharged tRNA enters the A site on the translating bacterial ribosome and causes ribosome stalling, in turn stimulating the production of (p)ppGpp and activation of the stringent response. Using the essential virulence gene iglC, which is encoded on the Francisella pathogenicity island (FPI) as a marker of active stringent response, we optimized the culture conditions required for the investigation of virulence gene expression under conditions of nutrient limitation. We subsequently used whole genome RNA-seq to show how F. tularensis alters gene expression on a global scale during active stringent response. Key findings included up-regulation of genes involved in virulence, stress responses and metabolism, and down-regulation of genes involved in metabolite transport and cell division. F. tularensis is a highly virulent intracellular pathogen capable of causing debilitating or fatal disease at extremely low infectious doses. However, virulence mechanisms are still poorly understood. The stringent response is widely recognized as a diverse and complex bacterial stress response implicated in virulence. This work describes the global gene expression profile of F. tularensis SCHU S4 under active stringent response for the first time. Herein we provide evidence for an association of active stringent response with FPI virulence gene expression. Our results further the understanding of the molecular basis of virulence and regulation thereof in F. tularensis. These results also support research into genes involved in (p)ppGpp production and polyphosphate biosynthesis and their applicability as targets for novel antimicrobials.
Genome sequencing reveals thatStreptococcus pneumoniaepossesses a large and diverse repertoire of antimicrobial toxins
Authors: Javan Reza Rezaei , van Tonder Andries J , King James P , Harrold Caroline L , Brueggemann Angela B
Published: October 2017

Streptococcus pneumoniae(‘pneumococcus’) is a leading cause of morbidity and mortality worldwide and a frequent coloniser of the nasopharynx. Competition among bacterial members of the nasopharynx is believed to be mediated by bacteriocins: antimicrobial toxins produced by bacteria to inhibit growth of other bacteria. Bacteriocins are also promising candidates for novel antimicrobials. Here, 14 newly-discovered bacteriocin gene clusters were identified among >6,200 pneumococcal genomes. The molecular epidemiology of the bacteriocin clusters was investigated using a large global and historical pneumococcal dataset. The analyses revealed extraordinary bacteriocin diversity among pneumococci and the majority of bacteriocin clusters were also found in other streptococcal species. Genomic hotspots for the integration of bacteriocin genes were discovered. Experimentally, bacteriocin genes were transcriptionally active when the pneumococcus was under stress and when two strains were competing in broth co-culture. These findings fundamentally expand our understanding of bacteriocins relative to intraspecies and interspecies nasopharyngeal competition.
Csde1 binds transcripts involved in protein homeostasis and controls their expression in erythropoiesis
Authors: Moore Kat S , Yagci Nurcan , van Alphen Floris , Paolini Nahuel A , Horos Rastislav , Held Ntsiki M , Houtkooper Riekelt H , van den Akker Emile , Meijer Alexander B , ‘t Hoen Peter A.C. , von Lindern Marieke
Published: October 2017

Expression of the RNA-binding protein Csde1 (Cold shock domain protein e1) is strongly upregulated during erythropoiesis compared to other hematopoietic lineages. In the severe congenital anemia Diamond Blackfan Anemia (DBA), however, Csde1 expression is impaired. Reduced expression of Csde1 in healthy erythroblasts impaired their proliferation and differentiation, which suggests an important role for Csde1 in erythropoiesis. To investigate the cellular pathways controlled by Csde1 in erythropoiesis, we identified the transcripts that physically associate with Csde1 in erythroid cells. These mainly encoded proteins involved in ribogenesis, mRNA translation and protein degradation, but also proteins associated with the mitochondrial respiratory chain and mitosis. Crispr/Cas9-mediated deletion of the first cold shock domain of Csde1 affected RNA expression and/or protein expression of Csde1-bound transcripts. For instance, protein expression of Pabpc1 was enhanced while Pabpc1 mRNA expression was reduced indicating more efficient translation of Pabpc1 followed by negative feedback on mRNA stability. Overall, the effect of reduced Csde1 function on mRNA stability and translation of Csde1-bound transcripts was modest. Clones with complete loss of Csde1, however, could not be generated. We suggest that Csde1 is involved in feed-back control in protein homeostasis and that it dampens stochastic changes in mRNA expression.
Oil, gold, US dollar and stock market interdependencies: a global analytical insight
Authors: Arfaoui Mongi , Ben Rejeb Aymen
Published: October 2017

Purpose

The purpose of this paper is to examine, in a global perspective, the oil, gold, US dollar and stock prices interdependencies and to identify instantaneously direct and indirect linkages among them.

Design/methodology/approach

A methodology based on simultaneous equations system was used to identify direct and indirect linkages for the period 1995-2015. The authors try initially to find theoretical answers to main question of the study by discussing causal bilateral relationships while focusing on multilateral interactions.

Findings

The results show significant interactions between all markets. The authors found a negative relation between oil and stock prices but oil price is significantly and positively affected by gold and USD. Oil price is also affected by oil futures prices and by Chinese oil gross imports. Gold rate is concerned by changes in oil, USD and stock markets. The US dollar is negatively affected by stock market and significantly by oil and gold price. Indirect effects always exist which confirm the presence of global interdependencies and involve the financialization process of commodity markets.

Originality/value

Motivation of this research paper is the substantial implications of price movements on real economy and financial markets. Understanding that co-movement has great value for investors, policy makers and portfolio managers. This paper differs from previous studies in several aspects. First, most of the research papers focus on bilateral linkages solely, while the authors’ investigation was implemented on all the four markets simultaneously. Second, the study was developed in a global framework using international data. The global analysis allows avoiding country specific effects.
Distributed control technology for management of roads with autonomous cars
Authors: Sapaty Peter Simon
Published: October 2017

Purpose

The purpose of this paper is to develop advanced ideology and technology for effective management of future road networks with massive use of autonomous cars.

Design/methodology/approach

High-level distributed control technology has been developed, already used in many civil and defence areas. It has a controlled super-virus nature capable of coping with highly dynamic and unpredictable situations in large distributed systems.

Findings

Exemplary road scenarios written in a special high-level language, the core of the technology, show suitability of the approach offered for solving a variety of dynamic and crisis situations on future roads with numerous driverless cars.

Originality/value

The approach offered is unique, without any known analogies.
Simplified atmospheric model for UAV simulation and evaluation
Authors: Da Costa Siqueira Jessica , Perhinschi Mario G. , Al-Sinbol Ghassan
Published: October 2017

Purpose

The purpose of this paper is to develop a simplified atmospheric model including constant wind, turbulence, gusts, and wind shear to provide simulation tools for unmanned aerial vehicle (UAV) design, testing, and evaluation within the West Virginia University (WVU) UAV simulation environment.

Design/methodology/approach

Analytical methods and experimental data are used to develop the simplified model for air mass motion as a superposition of four major components. Spatial gradients of relative air velocity vector projections are considered for modeling wind shear effects. The total contribution to relative air velocity from the four components in vehicle body axes is used within the WVU UAV simulation environment to calculate aerodynamic forces and moments. The simplified wind model is also interfaced with aircraft sub-system upset conditions models and different autonomous flight scenarios.

Findings

The simplified wind model developed provides simulation of different upset environment flight conditions with desirable levels of realism. It allows the testing, comparison, and evaluation of different trajectory tracking solutions for autonomous flight.

Research limitations/implications

The proposed simplified wind model facilitates the investigation of the effects of different atmospheric scenarios on the performance of trajectory generation algorithms and trajectory tracking control laws.

Practical implications

The proposed simplified wind model has been proved to be a high flexibility tool for simulation of UAVs under normal and abnormal flight conditions. It is expected to provide valuable support for the design and analysis of autonomous flight control laws.

Originality/value

This research effort provides a new capability for the advanced simulation of UAV autonomous flight with practically no additional computational cost. It adds an unprecedented level of detail and versatility to the UAV simulation toolkit within a very user-friendly framework aimed at supporting UAV design and analysis for optimal performance and safety under normal and abnormal flight conditions.
Profitability and risk in interest-free banking industries: a dynamic panel data analysis
Authors: Trabelsi Mohamed Ali , Trad Naama
Published: October 2017

Purpose

The purpose of this paper is to examine whether Islamic finance could replace or complement the traditional financial system and could guarantee stability in times of crisis.

Design/methodology/approach

To achieve the aim, the authors examined both risk-taking and profitability of 94 Islamic banks (IBs) operating in 18 countries observed during the 2006-2013 financial crisis period. A series of bank-specific and other country-specific indicators are combined to explain profitability of IBs as measured by return on assets and return on equity, and risk divided into credit risk measured by impaired loans/gross loans and total equity/net loans, and insolvency risk measured by Z-score. Indeed, a bank is stronger than another if it is stable with a higher capacity to absorb risks, on the one hand, and increased performance on the other.

Findings

Using dynamic panel data econometrics (generalized moment method system), the authors estimated five regressions and found the following results: bank capital is found to be the main indicator that contributes to maximizing profitability and stability of IBs and reducing their credit risk. However, the study of liquidity and asset quality determinants often leads to inconclusive results. Nevertheless, they found that Gulf region-operating IBs are more profitable, more solvent and less risky than those operating in the South East Asian region. At the macroeconomic level, the authors could not find a significant relationship between inflation rate and IBs profitability. However, unlike for IBs in Southeast Asia, the authors found that inflation rate improves IBs stability and reduces their credit risk level.

Practical implications

The results of this study have numerous implications for bank management and the different stakeholders (investors, customers). This study identified several factors that may help bank managers to improve their financial outlook by controlling risk level and profitability. These factors could as well help to understand how macroeconomic indicators affect both banking risk and profitability, in particular Islamic banking. Likewise, portfolio managers can use these results to support their decisions to include IBs in their assets portfolios to mitigate potential risk.

Originality/value

This study contributes to the existing literature in two ways. First, this paper provides fresh data and recent information on Islamic banking in Gulf Cooperation Council and South East Asian countries. Second, the obtained results helped us to conclude that the Islamic financial system cannot replace but rather supplements the traditional system. This result may be explained by the fact that Muslims look for Islamic banking products, which conventional banks are not offering.
Market challenges, learning and customer orientation, and innovativeness in IJVs
Authors: Park Chansoo , Oh Chang Hoon , Kasim Azilah
Published: October 2017

Purpose

The purpose of this paper is to advance a theoretical framework that incorporates the relationship between market challenge and learning and customer orientations, and the influence of these orientations on innovativeness in an international joint venture (IJV) context.

Design/methodology/approach

The authors estimate a structural equation model utilizing survey data collected from 199 IJVs in the Republic of Korea.

Findings

The authors found that while market challenge does not influence learning orientation in IJVs, it does have a significant positive influence on customer orientation. Further, the authors’ findings support that both learning orientation and customer orientation have positive impacts on IJV innovativeness. Another interesting finding shows that the impact of learning orientation on IJV innovativeness is significant only when IJVs have high levels of interaction with parent firms. The study also reveals that having a strong learning orientation amplifies the impact of customer orientation on innovativeness in IJVs.

Originality/value

Despite increased interest in IJVs, there has been relatively little work linking IJV innovativeness with learning and customer orientations. The study contributes to recent streams of research that seek to understand the role of these orientations in IJV innovativeness.
Role of brand story on narrative engagement, brand attitude, and behavioral intention
Authors: Lee Seonjeong Ally , Jeong Miyoung
Published: October 2017

Purpose

This study aims to investigate antecedents and outcomes of customers’ narrative engagement on hotels’ social networking sites (SNSs). Four different types of brand story were explored as antecedents for brand story.

Design/methodology/approach

A cross-sectional, self-administered, online survey was conducted with customers who have stayed at a hotel and have used hotel SNSs within the past 12 months.

Findings

Results identified authenticity and humor brand story influenced customers’ narrative engagement, which further influenced their brand attitudes and behavioral intentions. However, reversal and conciseness types of a hotel’s brand story did not lead to customers’ narrative engagement.

Research limitations/implications

The role of SNSs in the hotel industry is evolving; however, the use of a hotel’s brand story has not been closely examined to date. This study investigated the importance of a hotel’s brand story that influenced customers’ narrative engagement on SNSs.

Practical implications

The prevalence of SNSs has changed hotel management practices. Hotels are suggested to pay attention to create persuasive brand stories that encourage customers’ visits to the hotel.

Originality/value

This study is an original attempt to propose a conceptual framework, explaining the relationships among different types of hotel brand stories, customers’ narrative engagements, their attitudes and their behavioral intentions in the SNSs context.
Factors affecting customers’ intention to use of location-based services (LBS) in the lodging industry
Authors: Kim Jungsun (Sunny) , Yoon Sungsik , Zemke Dina Marie V.
Published: October 2017

Purpose

The purpose of this study is to investigate the determinants of customers’ intentions to use location-based services (LBS) offered by a hotel. The study examined whether hotel customers’ coupon proneness, trust, privacy concerns and familiarity with LBS are significant determinants of their intentions to use LBS.

Design/methodology/approach

An online survey using a scenario-based narrative was administered to collect data from participants who have smartphones and have stayed at a full-service hotel within the previous 12 months. A research model tested data collected from 402 hotel customers, using confirmatory factor analysis and structural equation modeling.

Findings

Three proposed determinants (i.e. familiarity, coupon proneness and trust) positively influenced customers’ intentions to use LBS. Out of the four dimensions of privacy concerns (concerns of collection, error, unauthorized secondary use and improper access), only concerns about data collection negatively influenced customers’ intentions to use a hotel’s LBS.

Originality/value

This study extends the literature on LBS adoption and other technology with privacy issues by modifying existing models and empirically testing it in the new context of hotels.
The impact of cognitive style, entrepreneurial attitudes and gender on competitive price responses
Authors: Estelami Hooman , Nejad Mohammad G.
Published: October 2017

Purpose

While existing research has established various methods for pricing, the impact of a manager’s individual psychological profile on his/her price setting behavior is relatively unexamined. This is especially critical in the context of pricing decisions implemented in response to competitive forces. This paper aims to explore how a manager’s price responses to price cuts by a competitor are affected by his/her cognitive style, gender and entrepreneurial attitudes.

Design/methodology/approach

In the first study, a simulation-based pricing environment is used in a lab setting to capture the dynamics of pricing decisions made in response to competitive price cuts. Participants’ price responses are captured in the form of the magnitude of price change implemented in a simulated environment in response to a competitor’s price reduction. The second study extends the scope of inquiry by using a national sample of business professionals and replicates and reinforces the findings of the first study by capturing participants’ attitudinal response on the decision to reduce prices in reaction to competitive price reductions.

Findings

The results of both studies indicate significant effects for cognitive style, gender and entrepreneurial attitudes. Individuals with stronger entrepreneurial attitudes and analytical cognitive styles, and females are less likely to engage in reactive price reductions.

Research limitations/implications

The findings of this study indicate that managers’ propensity to engage in price changes in reaction to competitors can be linked to their psychological profile and gender.

Practical implications

Given the existence of the relationship between price reactions of managers and their cognitive style and entrepreneurial attitudes, the training and development of pricing professionals may need to take these individual-level factors into account.

Originality/value

This is the first study that has linked managers’ propensity to engage in price changes in reaction to competitors to their gender and psychological profile.
Digital booking services: comparing online with phone reservation services
Authors: Schaarschmidt Mario , Höber Björn
Published: October 2017

Purpose

Many booking services in traditional people-processing service areas such as gastronomy were recently transformed into online reservation services. While advantages for platform providers (i.e. a share of the respective business) and merchants (i.e. increased operational efficiency) seem obvious, it is less known about how customers respond to these new forms of online services. This paper aims to illustrate how booking traditional people-processing services online is different from booking it via phone.

Design/methodology/approach

This study conceptualized a 2 × 2 experimental survey design by manipulating users’ booking channel (online vs low) and the service complexity of different, less digitized people-processing services (high: dentist vs low: restaurant). After conducting several pretests, the authors surveyed 282 respondents familiar with online booking and reservation.

Findings

The results show that the booking channel (online reservation vs phone reservation) affects associated perceived booking risk and negatively affects users’ intention to use the reservation service. Additionally, users’ attitudes toward online reservation moderate the influence of booking channel on perceived booking risk.

Originality/value

To the best of the authors’ knowledge, this is the first research that investigates adoption of online reservation in people-processing services.
How is the consumer passion for authenticity impacting holidaying?
Authors: Kasriel-Alexander Daphne
Published: October 2017

Purpose

The paper aims to provide a general review on the importance of authenticity tourism options and on what makes an experience authentic.

Design/methodology/approach

Using statistical data provided from agencies and brands, the author takes a critical look at the evolution and importance of authenticity and experiences for the travel and tourism industry today.

Findings

Part and parcel of the pursuit of authenticity is a conscious debate about what actually counts as authentic; although in tourism, it typically involves an emphasis on experience. However, authenticity is a complex idea – with perceptions differing between people. The author also found that new technologies and social media can bring tourists nearer to the real.

Originality/value

Visual culture in an age of digital communications is unsurprisingly prominent in discussions about the authentic. While social media and selfie culture have affected insecurity about appearance, we are seeing a parallel interest in what is genuine.
The tourist experience in Portugal – how to maintain authenticity?
Authors: Costa Jorge , Carvalho Silva , Rodrigues Daniela
Published: October 2017

Purpose

This paper aims to identify the importance of authenticity of the tourist experience, based on the main conclusions of the International Tourism Forum Round Table, attended by representatives of the main entities of the tourism sector in Portugal.

Design/methodology/approach

The main conclusions resulting from the International Tourism Forum Round Table are presented and discussed. The event was organised by the Institute for Tourism Planning and Development, under the theme “Tourism in 2017: trends and opportunities for businesses and destinations”.

Findings

The International Tourism Forum Round Table concluded that the tourism industry worldwide and in Portugal in particular, is facing major challenges that call for innovative ways of managing the tourist experience. Several questions regarding the negative impacts of tourism have been discussed, with authenticity being one of the major concerns.

Originality/value

The profiling of the current state of Portuguese tourism, its opportunities and challenges allows the design of more effective strategies to improve the Portuguese tourist offer and the experience of tourists visiting Portugal.
Portuguese tourism strategy 2027 Leading the tourism of the future
Authors: Araújo Luís
Published: October 2017

Purpose

The purpose of this paper is to present the Portuguese Tourism Strategy for 2027.

Design/methodology/approach

The main political decisions related to tourism are analysed and are related to the sector’s present performance.

Findings

Current tourism results show the sector’s capacity in generating more revenue, more employment and the ability to increasingly spread out the activity throughout the year and across the territory.

Originality/value

This article concludes that there remain some challenges that the tourism sector faces, including the need to minimize the effects of seasonality, increase territorial cohesion, capitalize tourism companies, increase innovation and entrepreneurship, among others. All these are part of the main issues for Portuguese tourism in the next decade.
How are companies and destinations “surfing the wave” of global tourism?
Authors: Costa Jorge
Published: October 2017

Purpose

This paper aims to introduce the papers in this issue and explain the pertinence of the strategic question.

Design/methodology/approach

A brief context for the strategic question is provided, as well as the issue alignment and a content analysis of the papers selected.

Findings

From the analysis of the papers selected for this theme issue, it becomes clear that tourism has become one of the major players in international commerce, and represents at the same time one of the main income sources for developed and many developing countries.

Originality/value

The papers selected for this issue shed light on an important problem: the maintenance of authenticity in tourist destinations and also the preservation of the quality of life for local inhabitants.
Are We Being Served? Emotional Labour in Local Government in Victoria, Australia
Authors: Rayner Julie , Lawton Alan
Published: October 2017

This paper explores how front‐line street‐level bureaucrats (SLBs) cope with the expectations of citizens, clients, or ‘customers’ in daily work and how SLBs may be impacted by emotional labour. The study analyses data from 41 interviews with SLBs in local councils in Victoria, Australia. Although exploratory, it builds awareness and understanding of the emotional labour associated with public service. The situations that SLBs engage with on a daily basis are many and varied and take the form of increased expectations and intense encounters. Respondents experienced abuse, threats, violence, but also ‘sparkle moments’. Resources that helped SLBs cope are diverse and located both within and outside organisations. Implications are discussed and issues that merit additional investigation are raised concerning how SLBs can be supported to better meet the demands of the public. The research is of value to public managers and SLBs operating in a changing society with increased ‘customer’ expectations.
Hybrid bodies and the materiality of everyday life: how people living with pacemakers and defibrillators reinvent everyday routines and intimate relations
Authors: Oudshoorn Nelly
Published: October 2017

Technologies inside bodies pose new challenges in a technological culture. For people with pacemakers and defibrillators, activities such as passing security controls at airports, using electromagnetic machines, electrical domestic appliances and electronic devices, and even intimate contacts with their loved ones can turn into events where the proper functioning of their device may be at risk. Anticipation of potentially harmful events and situations thus becomes an important part of the choreography of everyday life. Technologies inside bodies not only pose a challenge for patients living with these devices but also to theorising body‐technology relations. Whereas researchers usually address the merging of bodies and technologies, implants ask us to do the opposite as well. How are we to understand human‐technology relations in which technologies should not entangle with bodies because they serve other purposes? Based on a study of the daily life practices of people with pacemakers and defibrillators in the Netherlands and the US, I argue that disentanglement work, i.e. work involved to prevent entanglements with objects and people that may inflict harm upon implanted devices, is key to understanding how hybrid bodies can survive in today's densely populated technological landscape.
A randomized trial of automated intermittent ropivacaine administration vs. continuous infusion in an interscalene catheter
Authors: Oxlund J. , Clausen A. H. , Venø S. , Nielsen M. D. , Pall M. , Strøm T. , Toft P.
Published: October 2017

Background

Ultrasound‐guided interscalene nerve block with ropivacaine as local anesthetic agent given as boluses or continuous infusion is the preferred pain management after major shoulder surgery. The use of automated intermittent boluses has been shown to be superior to continuous infusion in sciatic and epidural nerve block. Hypothesis: Automated intermittent boluses reduce pain after major shoulder surgery.

Methods

Seventy patients aged 18–75 years, scheduled for major shoulder surgery under general anesthesia with interscalene nerve block were included in this randomized controlled trial. Patients were allocated to either automated intermittent boluses with 16 mg ropivacaine every 2 h combined with patient‐controlled administration or to a conventional regimen of continuous infusion of 8 mg/h (4 ml/h) of ropivacaine combined with patient controlled administration (2 ml, lockout time 30 min). Pain (Visual Analog Scale, VAS) was assessed every 8 h postoperatively.

Results

Fifty‐seven patients completed the study, 29 in the continuous infusion group and 28 in the automated intermittent bolus group. Shoulder arthroplasty was performed in 49 (86%) of the cases. There were no significant differences in VAS score from 8 to 48 h post‐operatively. No significant difference in opioid usage was observed. The automated intermittent bolus group reported significantly less force on coughing and more hoarseness. A significantly lower volume of ropivacaine was used in the automated intermittent bolus group.

Conclusion

Automated intermittent boluses did not reduce pain or rescue opioid consumption compared with continuous infusion of ropivacaine. The automated intermittent bolus group had significantly less force on coughing and more hoarseness.
Modification of Automatic Alcohol‐Approach Tendencies in Alcohol‐Dependent Patients with Mild or Major Neurocognitive Disorder
Authors: Loijen Anke , Rinck Mike , Walvoort Serge J. W. , Kessels Roy P. C. , Becker Eni S. , Egger Jos I. M.
Published: October 2017

Background

To examine the applicability of an alcohol‐avoidance training procedure in patients with alcohol dependence and alcohol‐induced neurocognitive disorders (NDs), we trained 2 groups that differed in the degree of cognitive impairment: One group fulfilled the DSM‐5 criteria for alcohol‐induced mild ND, and 1 group was diagnosed with Korsakoff's syndrome (KS) (alcohol‐induced major ND, confabulatory/amnesic subtype; DSM‐5). The intervention is assumed to match the preserved cognitive capacity for implicit learning in both groups.

Methods

Fifty‐one inpatients with a mild ND and 54 inpatients with KS were trained. Six training sessions (including pre‐ and posttests) of a computerized implicit alcohol approach‐avoidance task were applied. Neurocognitive variables were available from the standard assessment procedure of the clinic.

Results

Training of alcohol‐avoidance tendencies is feasible in a population with alcohol‐related NDs. The alcohol‐approach bias decreased for both groups in each session. Better learning results over time were obtained in participants with a larger baseline alcohol‐approach tendency. Learning effects were positively related to age and implicit (nondeclarative) memory functioning. No relation between training effects and executive or explicit memory functions was found.

Conclusions

Training of an alcohol‐avoidance tendency can be successfully applied in patients with alcohol dependence including those with alcohol‐induced NDs.
Effect of Chronic Alcohol Abuse on Anabolic and Catabolic Signaling Pathways in Human Skeletal Muscle
Authors: Shenkman Boris S. , Belova Svetlana P. , Zinovyeva Olga E. , Samkhaeva Nudlya D. , Mirzoev Timur M. , Vilchinskaya Natalia A. , Altaeva Erzhena G. , Turtikova Olga V. , Kostrominova Tatiana Y. , Nemirovskaya Tatiana L.
Published: October 2017

Background

Animal studies showed that alcoholic myopathy is characterized by the reduction in myofiber cross‐sectional area (CSA) and by impaired anabolic signaling. The goal of this study was to compare changes in CSA and fiber type composition with modifications in anabolic and catabolic signaling pathways at the early stages of alcohol misuse in humans.

Methods

Skeletal muscle samples from 7 male patients with chronic alcohol abuse (AL; 47.7 ± 2.0 years old; alcohol misuse duration 7.7 ± 0.6 years) were compared with muscle from a control group of 7 healthy men (C; 39.7 ± 5.0 years old). Biopsies from vastus lateralis muscles were taken and analyzed for the changes in fiber type composition, fiber CSA, and for the alterations in anabolic and catabolic signaling pathways.

Results

AL patients did not have detectable clinical myopathy symptoms or muscle fiber atrophy, but the relative proportion of fast fibers was increased. There was a significant decrease in IGF‐1 in plasma and IRS‐1 protein content in muscle of AL group. Levels of total and phosphorylated p70S6K1, GSK3β, and p90RSK1 were not different between AL and C groups. Muscle of AL patients had increased mRNA expression of HSP70 and HSP90. A marker of anabolic pathway p‐4E‐BP1 was decreased, while catabolic markers (MuRF‐1, MAFbx, ubiquitinated proteins) were increased in AL patients when compared with C group.

Conclusions

At the early stages of alcohol misuse in humans, changes in the regulation of anabolic and catabolic signaling pathways precede the development of skeletal muscle atrophy and manifestation of clinical symptoms of alcoholic myopathy.
Interindividual patterns of resource use in three subtropical Atlantic Forest frogs
Authors: Carvalho‐Rocha Vítor , Lopes Benedito Cortês , Neckel‐Oliveira Selvino
Published: October 2017

Studies with disparate taxa suggest that generalist populations are composed of relatively specialist individuals that use a narrow part of a population's resource pool. Models based on optimum diet theory (ODT) can be used to predict different patterns of variation in resource use among individuals. In this work, we investigated the diet and measured the degree of individual specialization of three anuran species, Hypsiboas leptolineatus, Pseudis cardosoi and Scinax granulatus, from the Atlantic Forest of southern Brazil. The study is based on gut content obtained using a stomach‐flushing technique. Additionally, we tested for a correlation between the individuals’ diet and morphological variation. Furthermore, we applied methods based on network theory to investigate patterns of resource use among individuals of each species. All three study species showed generalized diets and significant values of individual specialization. However, we did not find any correlation between diet and morphology, indicating that diet variation is not a consequence of morphological trade‐offs. The individual‐resource networks of H. leptolineatus and S. granulatus showed a nested pattern. This result indicates the presence of individuals with more diverse diets than others, and the diets of the more specialist individuals are a predictable subset of the diets of the more generalist ones. The individual‐resource network of P. cardosoi did not show a distinct pattern, diverging from what was predicted by optimal diet theory‐based models. Although nested or modular patterns are commonly found in individual‐resource networks, our results indicate that they are not ubiquitous and that random patterns can also be found.
Rotary versus reciprocating shaping files in bacterial elimination from long oval canals
Authors: Krokidis Andreas , Bonfanti Carlo , Cerutti Antonio C. , Barabanti Nicola , Panopoulos Panos
Published: October 2017

A comparison of the abilities of rotary versus reciprocating files to eliminate viable Enterococcus faecalis populations from the long oval root canals of extracted human teeth. Fifty teeth were contaminated and randomly distributed into two groups (n = 25 each): BT‐RaCe group and WaveOne group. Two microbial samples were obtained from each tooth before (S1) and after (S2) instrumentation. The CFUs from the S1 and S2 measurements were calculated and compared between the groups. Both groups showed significantly fewer CFUs in the S2 samples (P < 0.001). In the S2 intragroup comparison, BT‐RaCe resulted in significantly fewer CFUs than WaveOne (P = 0.010). In the direct comparison between the rotary multiple file shaping system and the reciprocating single‐file system, the multiple file system was more efficient at reducing the microbiological load of viable E. faecalis from long oval root canals.
Sealer penetration and adaptation in root canals with the butterfly effect
Authors: Russell Assil , Friedlander Lara , Chandler Nicholas
Published: October 2017

The butterfly effect is a phenomenon seen in some roots and is related to density of dentinal tubules. The aim was to investigate penetration depth and adaptation quality of root canal sealers and ProRoot MTA into bucco‐lingual and mesio‐distal aspects of roots with and without the effect. One hundred and twenty teeth were decoronated at the cemento‐enamel junction. Canals were prepared and assigned to obturation groups: gutta‐percha with a sealer (AH Plus, EndoREZ, Kerr Pulp Canal Sealer, MTA Fillapex) or ProRoot MTA alone (each containing 10 butterfly and 10 non‐butterfly roots). Root sectioning yielded coronal and middle samples. Confocal laser scanning and scanning electron microscopy were used to assess penetration and adaptation. Teeth with the effect had greater mean penetration bucco‐lingually (766 μm) than mesio‐distally (184 μm, P = 0.003). Coronal sections had greater penetration (430 μm) compared with middle (247 μm, P = 0.006). In conclusion, greater penetration in roots with the effect may improve treatment outcomes.
Higher taxa can be effective surrogates for species‐level data in detecting changes in invertebrate assemblage structure due to disturbance: a case study using a broad range of orders
Authors: Driessen Michael M , Kirkpatrick James B
Published: October 2017

Cost‐effective assessment tools are needed to manage the impacts of natural and human disturbances on communities. Higher taxa are widely used as surrogates for species‐level identification in invertebrates; however, few studies have compared their effectiveness with species‐level data for terrestrial invertebrates or assessed the mechanistic basis for their performance, and none of these studies have used a broad range of orders. Here, a terrestrial invertebrate dataset comprising 21 orders, 197 families and 751 species was used to investigate whether order‐ and family‐level identifications were effective surrogates for species‐level identification in representing patterns in assemblage structure and detecting the effects of fire. Factors potentially influencing the performance of surrogates among invertebrate orders were also investigated. Family‐level identification of invertebrates in moorland sites with a wide range of fire history was found to be an effective surrogate for species‐level identification. Order‐level identification was also an effective surrogate, but the level of discrimination among sites was typically lower than for species‐ or family‐level identification. Higher taxonomic surrogates performed well for invertebrate orders comprising a few species that were abundant and with a small mean and variance in the number of species per higher taxon. Use of higher taxa as surrogates for species‐level identification can be a cost‐effective approach to monitoring impacts of disturbance, but outcomes are influenced by taxonomic diversity and community structure.
The effect of head‐up tilt upon markers of heart rate variability in patients with atrial fibrillation
Authors: Patel Hitesh C. , Hayward Carl , Wardle Andrew J. , Middleton Lee , Lyon Alexander R. , Di Mario Carlo , Salukhe Tushar V. , Sutton Richard , Rosen Stuart D.
Published: October 2017

Background

Heart rate variability (HRV) analysis is uncommonly undertaken in patients with atrial fibrillation (AF) due to an assumption that ventricular response is random. We sought to determine the effects of head‐up tilt (HUT), a stimulus known to elicit an autonomic response, on HRV in patients with AF; we contrasted the findings with those of patients in sinus rhythm (SR).

Methods

Consecutive, clinically indicated tilt tests were examined for 207 patients: 176 in SR, 31 in AF. Patients in AF were compared to an age‐matched SR cohort (n = 69). Five minute windows immediately before and after tilting were analyzed using time‐domain, frequency‐domain and nonlinear HRV parameters. Continuous, noninvasive assessment of blood pressure, heart rate and stroke volume were available in the majority of patients.

Results

There were significant differences at baseline in all HRV parameters between AF and age matched SR. HUT produced significant hemodynamic changes, regardless of cardiac rhythm. Coincident with these hemodynamic changes, patients in AF had a significant increase in median [quartile 1, 2] DFA‐α2 (+0.14 [−0.03, 0.32], p < .005) and a decrease in sample entropy (−0.17 [−0.50, −0.01], p < .005).

Conclusion

In the SR cohort, increasing age was associated with fewer HRV changes on tilting. Patients with AF had blunted HRV responses to tilting, mirroring those seen in an age matched SR group. It is feasible to measure HRV in patients with AF and the changes observed on HUT are comparable to those seen in patients in sinus rhythm.
The albumin‐bilirubin grade uncovers the prognostic relationship between hepatic reserve and immune dysfunction in HIV‐associated hepatocellular carcinoma
Authors: Pinato D. J. , Sharma R. , Citti C. , Platt H. , Ventura‐Cots M. , Allara E. , Chen T.‐Y. , Dalla Pria A. , Jain M. , Mínguez B. , Kikuchi L. , Kaufman West E. , Merli M. , Kaplan D. E. , Hasson H. , Marks K. , Nelson M. , Núñez M. , Aytaman A. , Bower M. , Bräu N. ,   The Liver Cancer in HIV Study Group
Published: October 2017

Background

Hepatocellular carcinoma (HCC) is a leading cause of liver‐related mortality in people living with HIV, where co‐infection with hepatotropic viruses accelerates the course of chronic liver disease.

Aim

To evaluate whether the albumin‐bilirubin (ALBI) grade, a more accurate marker of liver dysfunction in HCC, might identify patients with progressive liver dysfunction in the context of HIV/hepatitis co‐infection.

Methods

Using uni‐ and multi‐variable analyses, we studied the albumin‐bilirubin grade as a predictor of overall survival (OS) in a large, multi‐center cohort of patients with HIV‐associated HCC recruited from 44 centres in 9 countries within the Liver Cancer in HIV study group. Patients who underwent liver transplantation were excluded.

Results

A total of 387 patients, predominantly HCV co‐infected (78%) with balanced representation of all Barcelona Clinic Liver Cancer (BCLC) stages (A = 33%, B = 18%, C = 37%, D = 12%) were recruited. At HCC diagnosis, 84% had been on anti‐retrovirals for a median duration of 8.8 years. The albumin‐bilirubin grade identified significant differences in median survival of 97 months for grade 1 (95% CI 13‐180 months), 17 months for grade 2 (95% CI 11‐22 months) and 6 months for grade 3 (95% CI 4‐9 months, P < .001). A more advanced albumin‐bilirubin grade correlated with lower CD4 counts (464/373/288 cells/mm3 for grades 1/2/3) and higher HIV viraemia (3.337/8.701/61.845 copies/mL for grades 1/2/3, P < .001).

Conclusions

In this large, multi‐center retrospective study, the albumin‐bilirubin grade highlights the interplay between liver reserve and immune dysfunction as prognostic determinants in HIV‐associated HCC.