bluuebunny/crossref_metadata_2025 huggingface dataset:
Rare instances of individuals with autism supporting or engaging in terrorism
Authors: Faccini Lino , Allely Clare S.
Published: May 2017

Purpose

The prevalence of individuals with an autism spectrum disorder (ASD) being associated with terroristic threats, lone wolf terrorism or affiliating with terroristic groups is rare. This paper aims to discuss this issue.

Design/methodology/approach

However, several cases are presented, where individuals with autism are involved in making a naïve, empty terroristic threat or uttering serious serial terroristic threats. Other cases are also presented of individuals being at risk for an abduction or being used by a terrorist group, and finally committing an act of domestic lone wolf terrorism.

Findings

Essential to the analysis was establishing a functional connection between autism-based deficits and the terroristic threats, terrorism, and when to not criminalize naïve, empty terroristic threats or acts.

Originality/value

Currently, tools available to law enforcement and prosecutors exploit the vulnerabilities and liabilities which arise as a result of group interactions, a “preventive” approach to terrorism that is not applicable to the solitary, “lone wolf” terrorist. There has been relatively little research (including case studies) examining individuals with ASD who engage in terrorism. For instance, when dealing with an individual with ASD who is charged with terrorism, it is crucial to consider how the diagnosis of autism may have presented as a contextual vulnerability, and to make sure that justice, rehabilitation and management, are informed by an understanding of the person’s diagnosis of ASD.
Autoregressive-based outlier algorithm to detect money laundering activities
Authors: S. Kannan , K. Somasundaram
Published: May 2017

Purpose

Due to the large-size, non-uniform transactions per day, the money laundering detection (MLD) is a time-consuming and difficult process. The major purpose of the proposed auto-regressive (AR) outlier-based MLD (AROMLD) is to reduce the time consumption for handling large-sized non-uniform transactions.

Design/methodology/approach

The AR-based outlier design produces consistent asymptotic distributed results that enhance the demand-forecasting abilities. Besides, the inter-quartile range (IQR) formulations proposed in this paper support the detailed analysis of time-series data pairs.

Findings

The prediction of high-dimensionality and the difficulties in the relationship/difference between the data pairs makes the time-series mining as a complex task. The presence of domain invariance in time-series mining initiates the regressive formulation for outlier detection. The deep analysis of time-varying process and the demand of forecasting combine the AR and the IQR formulations for an effective outlier detection.

Research limitations/implications

The present research focuses on the detection of an outlier in the previous financial transaction, by using the AR model. Prediction of the possibility of an outlier in future transactions remains a major issue.

Originality/value

The lack of prior segmentation of ML detection suffers from dimensionality. Besides, the absence of boundary to isolate the normal and suspicious transactions induces the limitations. The lack of deep analysis and the time consumption are overwhelmed by using the regression formulation.
Finite element analysis of fire-damaged flexible pavement deterioration
Authors: van Staden Rudi , Fragomeni Sam
Published: May 2017

Purpose

This research aims to use the finite element method to examine critical distress modes in the pavement layers due to changes in the structural properties brought upon by fire damage.

Design/methodology/approach

A full dynamic analysis is performed to replicate heavy vehicle axle wheel loads travelling over a pavement section.

Findings

Results show a 72 per cent decrease in the number of load repetitions which a fire-damaged pavement can experience before fatigue cracking of the asphalt. Further, there is a 51 per cent decrease in loading cycles of the subgrade before rutting of the fire-damaged system.

Originality/value

Fatigue of asphalt and deformation of subgrade from repeated vehicular loading are the most common failure mechanisms, and major attributors to pavement maintenance and rehabilitation costs. Pavement analysis has always been concentrated on evaluating deterioration under regularly occurring operational conditions. However, the impact of one-off events, such as vehicle petroleum fires, has not been evaluated for the effects on deterioration.
Customer engagement with a service provider and context: an empirical examination
Authors: Sim Max , Plewa Carolin
Published: May 2017

Purpose

Customer engagement is of critical interest to both academics and practitioners. Extant literature focusses primarily on customer engagement with a single focal object, usually brands; this study takes another view to consider customer engagement with multiple focal objects (service provider and context). In addition to testing the relationship of the individual dimensions of engagement with the service provider and engagement with the context, this research elaborates on their drivers, with a particular focus on distinct engagement platforms. The paper aims to discuss these issues.

Design/methodology/approach

A survey captures customer engagement with a service provider and a context in a higher education setting, with 251 responses collected across first- and third-year marketing courses in an Australian, mid-sized university.

Findings

Engagement with the service provider can drive engagement with the context. In turn, engagement with the service provider can be stimulated through the use of engagement platforms that enable customer-to-service provider interactions. The results show limited effects of customer-to-customer engagement platforms on engagement with the context though. The results are consistent across gender and student grade levels; some differences arise between international and domestic students.

Originality/value

This unique study broadens understanding of customer engagement with various focal objects and also details the flow of effects, from engagement with a service provider to engagement with the context. This research builds on conceptual discussions of engagement platforms and empirically examines their ability to facilitate affective, cognitive and behavioural engagement.
Usage center – value cocreation in multi-actor usage processes
Authors: Kleinaltenkamp Michael , Plewa Carolin , Gudergan Siegfried , Karpen Ingo Oswald , Chen Tom
Published: May 2017

Purpose

The purpose of this paper is to advance extant theorizing around resource integration by conceptualizing and delineating the notion of a usage center. A usage center consists of a combination of interdependent actors that draw on resources across their individual usage processes to create value.

Design/methodology/approach

This paper provides a conceptual inquiry into the usage center.

Findings

This paper delineates the notion of a usage center by way of focal and peripheral resource integrators, as well as focal and peripheral resources that form part of interdependent resource usage processes. The conceptual analysis reveals the need for resources to be accessible and shareable to focal and peripheral actors, with rivalry and emergence central factors influencing the actor’s usage processes.

Originality/value

Responding to recent calls for research developing insights into multi-actor value cocreation, this paper is the first to comprehensively and coherently conceptualize the notion of a usage center. In doing so, the authors build an important foundation for future theorizing related to the potential emergence of usage centers as well as the cocreation of individual and collective value.
Cosac Naify: a small Brazilian publishing house goes abroad
Authors: Pacheco Henrique , da Rocha Angela , da Silva Jorge Ferreira
Published: May 2017

Synopsis

The case describes the efforts of a small Brazilian publishing house to export its products to foreign markets. In fact, after several years of losses, the firm has undergone substantial restructuring and hired a new CEO, reaching modest profitability. The challenge faced by the new management team includes, in addition to keeping the firm financially healthy, to develop an international orientation, to mobilize the resources, and to develop a new strategy to go international.

Research methodology

The case uses primary and secondary sources, including articles from business magazines and newspapers, company site, and data from Brazilian trade organizations, Brazilian federal government, International Trade Center, International Publishers Association, and an interview with the new CEO of the firm, in charge of developing its international activities. The use of different sources permitted triangulation.

Relevant courses and levels

The case is designed for use in undergraduate and graduate programs in courses related to international marketing, international business, entrepreneurship, and international entrepreneurship.

Theoretical bases

The case can be used to discuss the role of networks in the internationalization of the firm and the issue of distance to foreign markets (Ghemawat, 2001), using Ghemawats CAGE model. The case can also be utilized to examine barriers to the internationalization of smaller firms (Leonidou et al., 2007; Kahiya, 2013).
Milky Moo: spreading the Milk Mantra
Authors: Mohapatra Subhalaxmi , Roy Subhadip
Published: May 2017

Synopsis

Srikumar Misra founded Milk Mantra as a milk producing and selling company in the state of Odisha, India in 2010. The company subsequently diversified into milk-based products such as yogurt and cottage cheese and spread its foray into the neighboring states. In 2014, the company had to overcome a few challenges from the macro environment as well as think of a marketing and communication strategy to gain competitive advantage.

Research methodology

The case is based on the primary research and has been developed using interviews of the company representatives and documents made available from the company. Wherever required, written permission has been obtained from the company representatives.

Relevant courses and levels

This case could be a part of the Marketing Management course in a graduate/undergraduate program in Business Management. The case could also be a part of a Brand Management or Integrated Marketing Communications course in the same program for specialized subjects such as branding a generic product or brand communications. This case could also be used for a short discussion in a distribution and logistics course.

Theoretical bases

The specific topics, which could be facilitated through this case, are the 4 Ps of marketing, distribution and marketing strategy. The case also relies on the theories of branding and marketing communication.
Evaluating Links Between Forest Harvest and Stream Temperature Threshold Exceedances: The Value of Spatial and Temporal Data
Authors: Groom Jeremiah D. , Johnson Sherri L. , Seeds Joshua D. , Ice George G.
Published: May 2017

We present the results of a replicated before‐after‐control‐impact study on 33 streams to test the effectiveness of riparian rules for private and State forests at meeting temperature criteria in streams in western Oregon. Many states have established regulatory temperature thresholds, referred to as numeric criteria, to protect cold‐water fishes such as salmon and trout. We examined across‐year and within‐year patterns of exceedance at control and treatment stream temperature probes. Determining whether an exceedance at the downstream end of a harvest was unambiguously related to harvest proved surprisingly difficult. The likelihood of a site exceeding its numeric criterion appeared related, in part, to the site's preharvest temperature range. Four control reaches as well as three preharvest treatment reaches exceeded their numeric criteria, necessitating additional analysis to evaluate timber harvest impacts. Nine percent of sites (3 of 33) both exceeded their numeric criteria and exhibited a potential harvest effect (16.7% of private sites [3 of 18], 0% of State sites [0 of 15]). After harvest, exceedances were typically observed in only the first of the two post‐harvest years. These findings highlight the importance of including temporal and spatial controls in temperature assessments of numeric criteria when the assessment's purpose is to determine whether exceedances are related to human activities.
Policy Utopias for Nutrient Credit Trading Programs with Nonpoint Sources
Authors: Hoag Dana L.K. , Arabi Mazdak , Osmond Deanna , Ribaudo Marc , Motallebi Marzieh , Tasdighi Ali
Published: May 2017

A promising program to address water contamination from nutrients is water quality trading (WQT), whereby entities with high abatement costs purchase credits from entities with lower abatement costs. The concept has found some success with point source water pollution, but very few trades have occurred in over 50 programs in the United States (U.S.) that have focused on nonpoint sources (NPSs). To understand why success has been slow, we identified three environments needed for programs to succeed: physical, economic, and institutional. We estimate that only 5% of watersheds in the U.S. currently listed as nutrient impaired provide a viable physical environment for trading nitrogen; 13% are suitable for phosphorus. Economic and institutional challenges would shrink that domain even further. Therefore, we find places with the ideal physical, economic, and institutional environments necessary for feasible WQT programs are virtual policy utopias — rare places with ideal environments. Fortunately, a growing literature provides the tools necessary to identify where these policy utopias are and to expand that domain through a better understanding about how to manage WQT programs more effectively.
De novo transcriptome assembly and polymorphism detection in two highly divergent evolutionary units of Bosca's newt (Lissotriton boscai) endemic to the Iberian Peninsula
Authors: Nourisson Coralie , Muñoz‐Merida Antonio , Carneiro Miguel , Sequeira Fernando
Published: May 2017

This article reports the de novo transcriptome assemblies of two highly divergent evolutionary units of the Iberian endemic Bosca's newt, Lissotriton boscai. These two units are distributed mostly allopatrically but overlap in the central–southwestern coastal region of Portugal. The resources we provide include the raw sequence reads, the assembled transcripts, the annotation and SNPs called for both lineages.
Harnessing the power of digital droplet PCR to conduct real‐world microbial competitions
Authors: Murphy Helen A.
Published: May 2017

The budding yeast, Saccharomyces cerevisiae, has a long and storied history as a model organism for genetic, cellular and molecular biological research. More recently, researchers have sought to understand the ecology and evolution of its sister species, Saccharomyces paradoxus, in part to put our vast knowledge of the model yeast into its natural context (Replansky et al. ). However, the research tools have been limited, and most investigations into natural populations have either been descriptions of patterns of biogeography or taken the organism back into the laboratory for mating, growth and competition assays (Kuehne et al. ; Miller & Greig ; Murphy & Zeyl ; Samani et al. ). The link between what occurs out in the real world and what is measured in the laboratory has not yet been made, as so much is still unknown about the natural history of these yeasts. In this issue of Molecular Ecology Resources, Boynton et al. () take a major step towards bridging laboratory studies with field ecological research. By isolating a panel of S. paradoxus strains from a wooded area, culturing them in the laboratory, reintroducing pairs back into their habitat on natural substrate and monitoring the frequency of individual strains using digital droplet PCR, the researchers were able to use the framework of laboratory‐based microbial competitions, but conduct them in a natural setting. While there is still more to learn about how to optimize this approach, it represents an exciting step in microbial ecological research and should prove an important tool for other species and numerous ecological questions.
Segmental resection is a safe oncological alternative to total proctocolectomy in elderly patients with ulcerative colitis and malignancy
Authors: Khan N. , Cole E. , Shah Y. , Paulson E. C.
Published: May 2017

Aim

The standard approach for the surgical management of colorectal cancer (CRC) in the setting of ulcerative colitis (UC) involves total proctocolectomy (TPC). However, some patients also undergo a partial resection (PR). This may be an attractive option in older patients with a high risk for surgery. The aim of this study was to compare the risk of metachronous cancer after PR or TPC for CRC in the setting of UC.

Method

This was a retrospective cohort study conducted through the Nationwide Veterans Affairs Healthcare System (VA). Patients who had UC and underwent a PR or TPC for CRC were followed from the time of their surgery to their most recent clinical follow‐up. The primary outcome was development of metachronous cancer in the PR group. Secondary outcomes included surgical and medical outcomes.

Results

Fifty‐nine patients were included: 24 (40.7%) underwent PR and 35 (59.3%) underwent TPC. The median age at cancer diagnosis was 73.0 and 61.7 years in PR and TPC groups, respectively (P < 0.0005). Amongst patients undergoing PR, 15 (60%) had no active UC at the time of surgery, whereas in patients undergoing TPC, at the time of surgery eight (23.5%) had no active UC (P = 0.005). No patient who underwent a partial colectomy developed a metachronous cancer in the retained colonic segment during the follow‐up period (median 7 years).

Conclusion

Our study suggests that PR for CRC in the setting of UC may be a viable option in a selected cohort of patients, especially among the elderly.
Diabetes distress is linked with worsening diabetes management over time in adults with Type 1 diabetes
Authors: Hessler D. M. , Fisher L. , Polonsky W. H. , Masharani U. , Strycker L. A. , Peters A. L. , Blumer I. , Bowyer V.
Published: May 2017

Aim

To determine the cross‐sectional and longitudinal associations between diabetes distress and diabetes management.

Methods

In a non‐interventional study, 224 adults with Type 1 diabetes were assessed for diabetes distress, missed insulin boluses, hypoglycaemic episodes, and HbA1c at baseline and 9 months.

Results

At baseline, greater distress was associated with higher HbA1c and a greater percentage of missed insulin boluses. Longitudinally, elevated baseline distress was related to increased missed insulin boluses, and decreases in distress were associated with decreases in HbA1c. In supplementary analyses, neither depression symptoms nor a diagnosis of major depressive disorder was associated with missed insulin boluses, HbA1c or hypoglycaemic episodes in cross‐sectional or longitudinal analyses.

Conclusions

Significant cross‐sectional and longitudinal associations were found between diabetes distress and management; in contrast, no parallel associations were found for major depressive disorder or depression symptoms. Findings suggest that elevated distress may lead to more missed insulin boluses over time, suggesting a potential intervention target. The covarying association between distress and HbA1c points to the complex and likely interactive associations between these constructs. Findings highlight the need to address distress as an integral part of diabetes management in routine care.
Beneficiaries’ participation in development organizations through local partners: A case study in Southern Africa
Authors: Wellens Lore , Jegers Marc
Published: May 2017

In a case study of one European non‐governmental organization (NGO) (data obtained from 10 staff members in Europe and Southern Africa, and 19 representatives of local partner organizations) we investigate whether the involvement of the partners in local and ‘northern’ policy‐making affects their perception of the governance quality of their organizations and that of the European donor organization, as well as the perception of the NGO's staff members.

The answer is positive as to the local organizations, but local partners (as representatives of the eventual beneficiaries) are hardly involved in decision‐making at donor level.

Finally, the presence of specific participation mechanisms seems to be more affected by beneficiary country factors than by activity‐related influences.
The impact of body weight on the diagnosis of aortic dilation—misdiagnosis in overweight and underweight groups
Authors: Braley Katherine T. , Tang Xinyu , Makil Elizabeth S. , Borroughs‐Ray Desiree , Collins Ronnie T.
Published: May 2017

Background

Body surface area (BSA)‐indexed Z‐scores are used to assess the ascending aorta (AAo) and diagnose aortic dilation (AoD) in children. BSA is directly related to body weight and corresponds to body mass index (BMI). We hypothesized extremes in BMI alter interpretation of aortic size in pediatric patients with AoD.

Methods

We reviewed all echocardiograms with a diagnosis of AoD performed at our institution from January 2013 through June 2013. Those with an age <2 or >20 years, history of aortic root surgery, or inadequate images were excluded. The aorta was measured by standard methods at the sinus of Valsalva, sinotubular junction, and proximal AAo. Using subject age, height, and gender, hypothetical weights for each subject were calculated to provide BMIs corresponding to the 5th, 50th, 85th, and 95th percentiles. The derived weights were then used to determine hypothetical BSA, and Z‐scores were calculated for the subject's aortic diameters in each BMI group.

Results

A total of 153 patients met inclusion criteria. Mean age was 11.1±4.6 years (68% male). Mean height was 142.7±27.9 cm, mean weight 44.6±24.8 kg, and mean true BMI was the 62nd centile. Significant differences in all aortic dimension Z‐scores were found among normal and underweight, overweight, and obese BMI groups (P<.001 for all comparisons), respectively.

Conclusion

Using current recommended methods, AoD will be missed in overweight and obese patients and overdiagnosed in underweight patients. For children of normal weight, a Z‐score based on BSA may be reliable. As obesity rates increase, weight‐independent Z‐scores must be developed.
MANDATORY RETIREMENT AND THE CONSUMPTION PUZZLE: DISENTANGLING PRICE AND QUANTITY DECLINES
Authors: Dong Yingying , Yang Dennis Tao
Published: May 2017

This study investigates changes in household consumption at retirement based on a comprehensive, diary‐based household survey from China. We focus on disentangling price changes from quantity changes at retirement. The mandatory retirement policy in China provides a quasi‐experimental setting for nonparametric identification of the true causal effects of fully anticipated retirement. Using a regression discontinuity design, we find that food expenditure declines at retirement, particularly among the less‐educated group. We further show that this decline is driven by a reduction in prices rather than quantities. These findings, along with a documented increase in shopping time for food upon retirement among the less‐educated households, are consistent with a time allocation model in which education enhances the value of leisure. (JEL J26, C21)
Modified Moran's I for Small Samples
Authors: Carrijo Tomaz Back , da Silva Alan Ricardo
Published: May 2017

The most common indicator used to measure spatial dependence is Moran's I proposed by statistician Patrick A. P. Moran in 1950. The index is simple to use and applies the principle of the Pearson correlation coefficient, although it incorporates a proximity measure between elements. However, Moran's I tends to underestimate real spatial autocorrelation when the number of locations are few. This study aims to present a modified version of Moran's I that can measure real spatial autocorrelation even with small samples and check for spatial dependence.
Transient Recharge Estimability Through Field‐Scale Groundwater Model Calibration
Authors: Knowling Matthew J. , Werner Adrian D.
Published: May 2017

The estimation of recharge through groundwater model calibration is hampered by the nonuniqueness of recharge and aquifer parameter values. It has been shown recently that the estimability of spatially distributed recharge through calibration of steady‐state models for practical situations (i.e., real‐world, field‐scale aquifer settings) is limited by the need for excessive amounts of hydraulic‐parameter and groundwater‐level data. However, the extent to which temporal recharge variability can be informed through transient model calibration, which involves larger water‐level datasets, but requires the additional consideration of storage parameters, is presently unknown for practical situations. In this study, time‐varying recharge estimates, inferred through calibration of a field‐scale highly parameterized groundwater model, are systematically investigated subject to changes in (1) the degree to which hydraulic parameters including hydraulic conductivity (K) and specific yield (Sy) are constrained, (2) the number of water‐level calibration targets, and (3) the temporal resolution (up to monthly time steps) at which recharge is estimated. The analysis involves the use of a synthetic reality (a reference model) based on a groundwater model of Uley South Basin, South Australia. Identifiability statistics are used to evaluate the ability of recharge and hydraulic parameters to be estimated uniquely. Results show that reasonable estimates of monthly recharge (<30% recharge root‐mean‐squared error) require a considerable amount of transient water‐level data, and that the spatial distribution of K is known. Joint estimation of recharge, Sy and K, however, precludes reasonable inference of recharge and hydraulic parameter values. We conclude that the estimation of temporal recharge variability through calibration may be impractical for real‐world settings.
Efficacy and safety of telaprevir with natural human interferon‐β and ribavirin in Japanese chronic hepatitis C patients with depression
Authors: Kumada Hiromitsu , Mochida Satoshi , Nakamuta Makoto , Suzuki Fumitaka , Yagi Takashi , Takasaki Ryuji , Okai Masao , Kamiya Naohiro , Okada Yasushi , Hirota Saya , Orihashi Madori , Ochi Miyoko , Chayama Kazuaki
Published: May 2017

Aim

To assess the efficacy and safety of telaprevir (TVR) when used in combination with natural human interferon‐β (IFN‐β) and ribavirin (RBV) for genotype 1 patients with depression compared to IFN‐β/RBV therapy in Japan. We also examined the efficacy of the TVR/IFN‐β/RBV therapy in treatment failure genotype 2 patients with depression.

Methods

For the genotype 1 patients, 30 patients received TVR (750 mg every 8 h) for 12 weeks combined with IFN‐β and RBV for 24 weeks (Group A), and 30 received IFN‐β and RBV for 48 weeks (Group B). For the genotype 2 patients, 14 patients were dosed only with the TVR‐based regimen.

Results

The sustained virologic response (SVR) rates for Group A and Group B were 63.3% and 20.0%, respectively (P = 0.001, likelihood ratio test). The SVR rate for genotype 2 patients previously treated with pegylated IFN and/or RBV was 71.4%. No patient dropped out due to exacerbation of depression. The trend of platelet counts after the drugs were given was similar in the TVR/IFN‐β/RBV therapy group and the IFN‐β/RBV therapy group. Common resistance‐associated variants of TVR were identified in 4 of the 13 patients who did not achieve SVR.

Conclusion

This study showed that an addition of TVR to IFN‐β/RBV therapy raised SVR in previously treated and untreated genotype 1 patients and previously treated genotype 2 patients with chronic hepatitis C and depression.
Preparation, characterisation and antioxidant activities of litchi (Litchi chinensis Sonn.) polysaccharides extracted by ultra‐high pressure
Authors: Gao Wenhong , Lin Pingzhou , Zeng Xin‐an , Brennan Margaret A.
Published: May 2017

Litchi (Litchi chinensis Sonn.) is a fruit containing many nutrients. Based on a three level, three‐variable Box‐Behnken design, response surface methodology, was used to optimise the process of ultra‐high pressure (UHP) assisted extraction of litchi polysaccharides (LCP). The optimal extraction conditions were as follows: pressure 460 MPa, treatment time 17 min and liquid–solid ratio 15. The experimental yield for extracting LCP was 12.01% under the optimal conditions. The LCP had a high polysaccharide and low protein content. GC results showed that LCP was composed of rhamnose, fucose, mannose and galactose with the corresponding molar percentages of 7.89, 46.45, 9.71 and 19.63. Infrared analysis showed that LCP had a typical spectrum of an α‐configuration pyranose ring. Antioxidant activity analysis revealed that LCP possessed a strong reducing power and 2,2‐diphenyl‐1‐picrylhydrazyl (DPPH) scavenging activity and could protect against the damage of hydroxyl radicals. The investigations demonstrated that UHP could be a valuable way to separate polysaccharides from litchi pulp, and LCP may be potentially developed to an antioxidant for food industries.
ICSH recommendations for modified and alternate methods measuring the erythrocyte sedimentation rate
Authors: Kratz A. , Plebani M. , Peng M. , Lee Y.K. , McCafferty R. , Machin S.J. ,   the International Council for Standardization in Haematology (ICSH)
Published: May 2017

Introduction

The gold standard for the determination of the erythrocyte sedimentation rate (ESR) is the Westergren method. Other methods to measure the ESR have become available. They range from modest modifications of the Westergren method to very different methodologies. The ICSH therefore established a Working Group to investigate these new approaches and compile recommendations for their validation and verification.

Methods

A panel of six experts in laboratory hematology examined the peer‐reviewed literature and EQA surveys from over 6000 laboratories on four continents performing ESR testing. This information was used to create lists of ESR instrument manufacturers and their methods.

Results

Only 28% of laboratories surveyed used the unmodified Westergren method, while 72% of sites used modified or alternate methods. Results obtained with the new instruments could differ from results obtained with the Westergren method by up to 142%. Different non‐Westergren methods showed differences from each other of up to 42%. The new methods were often significantly faster, safer, and less labor‐intensive. They reduced costs and often used standard EDTA tubes, eliminating the need for a dedicated ESR tube.

Conclusion

Based on the consensus of the Working Group, recommendations for manufacturers for the validation of new ESR methods were developed. In addition, a list of recommendations for laboratories that are moving to modified or alternate methods was compiled, addressing instrument performance verification and communications of results to clinical users.
Replacing warfarin with a novel oral anticoagulant: Risk of recurrent bleeding and stroke in patients with warfarin ineligible or failure in patients with atrial fibrillation (The ROAR study)
Authors: Turagam Mohit K. , Parikh Valay , Afzal Muhammad R. , Gopinathannair Rakesh , Lavu Madhav , Kanmanthareddy Arun , Pillarisetti Jayasree , Reddy Madhu , Atkins Donita , Bommana Sudharani , Jaeger Melissa , Jeffery Courtney , Mohanty Sanghamitra , Santangeli Pasquale , Cheng Jie , Di Biase Luigi , Narasimhan Calambur , Natale Andrea , Lakkireddy Dhanunjaya
Published: May 2017

Background

A significant proportion of patients treated with warfarin for atrial fibrillation (AF) become warfarin ineligible (WI) due to major bleeding events (MBE) or systemic thromboembolism (STE). We report a large multicenter real‐world experience of the use of direct oral antagonists (DOACs) in these WI patients.

Methods

We report the outcomes of 263 WI patients treated with DOACs. The primary objective was to evaluate clinical outcomes of STE and MBE with DOACs. Secondary objective was to assess clinical predictors of repeat MBE and STE on DOACs.

Results

Note that 63% (166 of 263) patients had a repeat MBE on DOACs. Repeat MBE was significantly higher in patients with prior gastrointestinal bleeding (74.5% vs. 30%, P < 0.0001). Five percent (12 of 263) developed repeat STE. Higher mean CHA2DS2VASC (6.5 ± 1.7 vs. 3.3 ± 1.6 = 0.001) score was associated with repeat STE. About 34% (57 of 166) of patients had an intervention to manage repeat MBE. LAAO devices were successfully used in 67% (12 of 18) high‐risk patients who underwent major interventions to manage MBE.

Conclusion

In WI patients rechallenged with DOACs, a significant proportion developed repeat MBE. LAAO devices seem reasonable in those patients who undergo major interventions to manage MBE with cautious and temporary continuation of DOAC.
Polymorphism of receptor‐type tyrosine‐protein phosphatase delta gene in the development of non‐alcoholic fatty liver disease
Authors: Nakajima Shunsuke , Tanaka Hiroki , Sawada Koji , Hayashi Hidemi , Hasebe Takumu , Abe Masami , Hasebe Chitomi , Fujiya Mikihiro , Okumura Toshikatsu
Published: May 2017

Background and Aim

Some single‐nucleotide polymorphisms (SNPs) are associated with the development of non‐alcoholic fatty liver disease (NAFLD). As one of the genetic factors, PNPLA3 rs738409 (I148M) is important to associate with pathogenesis of NAFLD. Because other SNPs remain unclear in Japan, we performed a high‐throughput sequencing that targeted more than 1000 genes to identify a novel genetic variant in Japanese patients with NAFLD.

Methods

The present study in 36 NAFLD patients and 27 healthy volunteers was performed. A high‐throughput sequencer was used to detect the gene variations. Candidate genes were validated by TaqMan SNP genotyping assay in 53 NAFLD patients and 41 healthy volunteers. To investigate the function of candidate gene, we performed biochemical analyses in cultured hepatocytes and liver tissues.

Results

EXO1 rs1047840, PTPRD rs35929428, IFNAR2 rs2229207, CPOX rs1131857, IL23R rs1884444, IL10RA rs2228055, and FAM3B rs111988437 were identified as candidate genetic variants, and PTPRD rs35929428 was only extracted as a SNP predicting to cause protein dysfunction. In validation analysis, PTPRD rs35929428 associated with the development of NAFLD (P = 0.015, odds ratio = 5.00, 95% confidence interval: 1.33–18.70). In addition, PTPRD rs35929428 was associated with Fib‐4 index and with hepatic fat droplets. Biochemical analyses indicated that PTPRD rs35929428 promoted dephosphorylation of tyrosine 705 signal transducer and activator of transcription 3 (Tyr 705) in hepatocytes.

Conclusion

PTPRD rs35929428 was a novel SNP in patients with NAFLD. Through exacerbation of the dephosphorylation of signal transducer and activator of transcription 3 (Tyr 705) in hepatocytes, PTPRD rs35929428 might play a role in hepatic lipid accumulation and fibrosis, followed by the development of NAFLD.
Peptic ulcer bleeding patients with Rockall scores ≥6 are at risk of long‐term ulcer rebleeding: A 3.5‐year prospective longitudinal study
Authors: Yang Er‐Hsiang , Cheng Hsiu‐Chi , Wu Chung‐Tai , Chen Wei‐Ying , Lin Meng‐Ying , Sheu Bor‐Shyang
Published: May 2017

Background and Aim

Patients with high Rockall scores have increased risk of rebleeding and mortality within 30 days after peptic ulcer bleeding, but long‐term outcomes deserve follow‐up after cessation of proton pump inhibitors. The paper aimed to validate whether patients with high Rockall scores have more recurrent ulcer bleeding in a 3.5‐year longitudinal cohort.

Methods

Between August 2011 and July 2014, 368 patients with peptic ulcer bleeding were prospectively enrolled after endoscopic hemostasis to receive proton pump inhibitors for at least 8 to 16 weeks. These subjects were categorized into either a Rockall scores ≥6 group (n = 257) or a Rockall scores <6 group (n = 111) and followed up until July of 2015 to assess recurrent ulcer bleeding.

Results

The proportion of patients with rebleeding during the 3.5‐year follow‐up was higher in patients with Rockall scores ≥6 than in those with scores <6 (10.51 vs. 3.63 per 100 person‐year, P = 0.004, log–rank test). Among patients with Rockall scores ≥6, activated partial thromboplastin time prolonged ≥1.5‐fold (P = 0.045), American Society of Anesthesiologists physical status class ≥III (P = 0.02), and gastric ulcer (P = 0.04) were three additional independent factors found to increase rebleeding risk. The cumulative rebleeding rate was higher in patients with Rockall scores ≥6 with more than or equal to any two additional factors than in those with fewer than two additional factors (15.69 vs. 7.63 per 100 person‐year, P = 0.012, log–rank test).

Conclusions

Patients with Rockall scores ≥6 are at risk of long‐term recurrent peptic ulcer bleeding. The risk can be independently increased by the presence of activated partial thromboplastin time prolonged ≥1.5‐fold, American Society of Anesthesiologists class ≥III, and gastric ulcer in patients with Rockall scores ≥6.
Fundamentals of Clinical Pharmacology With Application for Pregnant Women
Authors: Patil Avinash S. , Sheng Jessica , Dotters‐Katz Sarah K. , Schmoll Maria S. , Onslow Mitchell , Pierson Rebecca C.
Published: May 2017

Medication use is common in pregnancy, yet for most medications the optimal formulation and dosage have not been described specifically for pregnant women. Often, adverse effects are only discovered anecdotally or after extensive off‐label use occurs. Since pharmacologic research that includes pregnant women is sparse and animal studies are often not applicable to the human fetus, providers must use knowledge of drug behavior and normal physiologic changes of pregnancy to personalize treatment for pregnant women. In this review, we present an overview of the basic concepts of clinical pharmacology: pharmacokinetics, pharmacodynamics, and pharmacogenomics. The normal physiologic changes of pregnancy are presented as a framework to understand alterations in drug behavior. A clinical vignette that addresses 4 pregnancy scenarios involving medications—preterm birth, vaccination, herpes simplex virus infection, and codeine toxicity—is provided to illustrate application of core clinical pharmacologic concepts. Discussion of relevant literature illustrates the challenges of offering individualized pharmacologic therapy in pregnancy.
Elaborating Faith
Authors: Snarr C. Melissa
Published: May 2017

Emerging from participant observation fieldwork in varied interfaith organizations, this essay argues that intentional interfaith engagement in the United States is a decidedly classed phenomenon that too rarely includes the presence and concerns of persons who are working poor. This dynamic is particularly problematic given religious entanglements with free‐market capitalism and the specific political economic vulnerability and religious diversity of recent immigrants and refugees. Interfaith organizing models, especially with their inclusion of labor unions, offer an important balance in the ecology of interfaith engagement and resistance to the civil religion of neoliberalism. Through these place‐based, consociational collaborations, labor organizations help faith communities historicize, conceptualize, and navigate complex economic dynamics while expanding labor's value‐frameworks, forms of organizing, and apprehension of worker's faith‐filled identities.
Holiness in the Making
Authors: van Erp Stephan
Published: May 2017

In this essay, I will argue that a political theology of human work can provide the sacramental principle underlying the theology of labor. This principle could complement the foundations of Catholic social teaching, since the sacramental aspects of work have not been made very explicit in the ethical framework of the Church's theology of work. The view of labor as the active participation in God's future is an important aspect of such a theology. In order to serve as a foundation for faith‐based labor organizing, I will claim that it needs to be complemented by a sacramental view of labor as art, a labor‐aesthetic that undergirds a labor‐ethic, in which labor itself becomes a sign and instrument of the way the Church becomes God's work in the world. First, I will sketch an outline of some of the major positions on labor in modern Catholic theology. Then, I will draw on the writings of the British poet and painter David Jones to explore a sacramental view of human work, arguing that a sacramental view of work could support the Church's social criticism of laborer's circumstances.
The Refusal of Work in Christian Ethics and Theology
Authors: Posadas Jeremy
Published: May 2017

Reviewing major accounts in Christian ethics and theology concerning work reveals a set of assumptions that together form the field's current “common sense” regarding this central human activity: work is part of what it fundamentally means to be a human; there is an aspect of work that is intrinsically good, because it reflects God's work; and work that is degrading can be transformed into this intrinsic good. An emerging body of social thought, however, interrogates work from an anti‐work perspective, rejecting capitalism's demand that people be integrated as fully as possible into the profit‐generating modern‐day work structure. After exploring core tenets of the anti‐work perspective, this essay reconsiders the assumptions often made about work in Christian ethics and theology and delineates some contours of anti‐work Christian normative interpretations of work.
Two Rival Interpretations of Xunzi's Views on the Basis of Morality
Authors: Slater Michael R.
Published: May 2017

This essay examines the textual evidence and arguments for two rival ways of interpreting Xunzi's accounts of the origins and normative bases of ritual and the Way: a human‐centered line of interpretation which maintains that the moral order constituted by the Confucian Way and its ritual tradition was the artificial creation of a group of ancient sages, and a Heaven‐centered line of interpretation which maintains, in contrast, that those same sages based the Confucian Way and its ritual tradition on a cosmic moral order that they discovered already existing in the world. It argues that the weight of textual evidence best supports a version of the former view, and shows that three representative versions of the latter view do not withstand critical scrutiny.
Workforce diversity in dentistry – current status and future challenges
Authors: Garcia Raul I. , Blue Spruce George , Sinkford Jeanne C. , Lopez Michael J. , Sullivan Louis W.
Published: May 2017

The racial and ethnic diversity of the US oral health care workforce remains insufficient to meet the needs of an increasingly diverse population and to address persistent health disparities. The findings from a recent national survey of underrepresented minority dentists are reviewed and recommendations are made for enhancing diversity in the dental profession.
L2 Utterance Fluency Development Before, During, and After Residence Abroad: A Multidimensional Investigation
Authors: Huensch Amanda , Tracy–Ventura Nicole
Published: May 2017

This study investigated second language fluency development over a nearly 2‐year period which included an academic year abroad and the year immediately following the participants' return to their home university. Data from 24 L1 English learners of Spanish were collected 6 times: once before, 3 times during, and 2 times after a 9‐month stay abroad. Participants were recorded orally retelling a picture‐based narrative, and data were coded for 9 measures of utterance fluency. Results indicated different developmental trends: Gains in speed fluency appeared quickly and were maintained after the return from study abroad, whereas gains in breakdown fluency often took longer and were more sensitive to attrition after returning home. There were no changes over time in repair fluency. These results appear to indicate that some fluency improvements are more robust and less likely to be affected by the change in context (study abroad vs. home country). The findings fill a gap in our understanding of the relationship between oral fluency development and second language speech production processes, and have implications for study abroad researchers as well as post‐study abroad instruction.
Nitrous oxide for procedural analgesia at home in a child with epidermolysis bullosa
Authors: Ingelmo Pablo , Wei Andrew , Rivera Gonzalo
Published: May 2017

Epidermolysis bullosa comprises a range of conditions characterized by fragile skin with painful blistering induced by minor trauma and friction. The Dowling‐Meara variant is a severe form characterized by disseminated painful blistering requiring lifelong skin and wound care. The natural history of the disease is characterized by a chronic course that tends to improve with advancing age. Various multimodal analgesic strategies have been proposed for painful procedures in children with epidermolysis bullosa. In this case report, we describe the use of nitrous oxide for pain control at home of blister treatments in a 4‐year‐old child with the Dowling‐Meara variant.
Surviving moment to moment: The experience of living in a state of ambivalence for those with recurrent suicide attempts
Authors: Bergmans Yvonne , Gordon Evelyn , Eynan Rahel
Published: May 2017

Objective

This qualitative study aimed to capture the experience of living in the ambivalent space between life and death for adults with recurrent suicide attempts (RSA). It sought to expand upon an earlier study that explored the processes involved in transitioning away from RSA among adults, which revealed that occupying this ambivalent space is a crucial part of this process.

Design

Interpretive phenomenological analysis (IPA) was used. This methodology was designed to explore the lived experiences and meaning making and enabled interpretation of the multidimensional subjective experiences of RSA participants.

Methods

In‐depth semi‐structured interviews were conducted with eight adult women with a history of RSA who had participated in a therapeutic intervention at the research site (Skills for Safer Living: A Psychosocial/Psychoeducational Intervention for People with Recurrent Suicide Attempts [SfSL/PISA]). The six stages of IPA were followed to analyse the interview data.

Results

Analysis revealed the superordinate theme, ‘surviving moment to moment’, which refers to a precarious state of making decisions about one's life and destiny on a moment‐to‐moment basis without clear commitment to either life or death. Two subordinate themes were identified: ‘deciding not to die in the moment’ when the participants were more invested in dying than living and ‘deciding to live in the moment’ when they were more invested in living than dying.

Conclusion

The study illuminated the complex process of making decisions about ones’ destiny on a moment‐to‐moment basis. It revealed the torment experienced when occupying this state, while paradoxically, also revealing how indecision about life and death provided a lifeline opportunity for those with RSA. Clinicians who recognize the subtle distinctions associated with this in‐between state can tailor their interventions accordingly.

Practitioner points

Surviving moment to moment is characterized by a state of emotional flux and uncertainty about one's destiny, where the person has not fully committed to either life or death.

Within this state, there are two interlinked subprocesses, whereby the person is leaning more towards death or life.

A critical feature in working with this client group is to recognize their ambiguity and the fragility and temporality of their decisions about their destiny.

The practitioner has an opportunity to be a catalyst in the momentum towards life by demonstrating understanding of this survival struggle and tailoring intervention to fit with the nuanced processes within this state.