bluuebunny/crossref_metadata_2025 huggingface dataset:
Entrepreneurial intentions and perceived barriers to entrepreneurship among youth in Uttarakhand state of India
Authors: Sharma Lalit
Published: October 2018

Purpose

The purpose of this paper is to investigate the role of gender and regional cultures on entrepreneurial intentions and perceived barriers to entrepreneurship in two diverse regions of a state. Authors in the past have consistently expressed the need for studies on entrepreneurial intentions that would encompass both the gender and cultural dimensions, as there is a potential interactive effect between sex and culture, which remains largely unstudied despite its potential to provide an explanation for the contradictory findings that have emerged when either sex or culture was studied separately.

Design/methodology/approach

This is a quantitative study. The primary data were derived from the students of professional courses. The sampling method used was proportionate stratified sampling. The scales used were tested with regard to validity and reliability. The chi-square test, Fisher’s exact test and Mann–Whitney U test were used to draw relationships between the variables.

Findings

The findings indicated significant gender differences in perceptions of barriers and entrepreneurial intentions among youth. The findings also showed that the barrier perceptions and the entrepreneurial intentions between genders vary with change in culture at the regional level.

Originality/value

This paper adds to the very limited research available on perceived barriers and entrepreneurial intentions that focuses on the effect of gender from a cross-cultural perspective. This paper further contributes by testing the results in two culturally diverse regions of a single state of India, which has helped us understand the impact of regional cultures while controlling for the effects of the entrepreneurship support systems provided by the governments in different nations.
Profile of academic entrepreneurship in Brazil
Authors: Bin Adriana , de Oliveira Gavira Muriel , Botelho Figueira Jessica , Mariano Bezerra de Carvalho Taynan , Monteiro Salles-Filho Sergio Luiz , Basile Colugnati Fernando Antonio
Published: October 2018

Purpose

This paper aims to understand, in the state of São Paulo academic environment, the differences between the profiles of academic entrepreneurs, nonacademic entrepreneurs and non-entrepreneurs.

Design/methodology/approach

The authors collected data from a more comprehensive research, whose objective was to evaluate the scholarship programmes of São Paulo Research Foundation (FAPESP). For data collection, the authors used an online questionnaire, pre-filled with information from the Lattes Curriculum of the sample individuals, as well as information obtained from FAPESP and from coordination for the improvement of higher education personnel. The response rate of the questionnaires was 21 per cent. The authors sought to explore the variables regarding entrepreneurial activities carried out by former scholarship holders, by relating them to other key variables identified in the literature review and explained in the hypotheses.

Findings

The results indicate that entrepreneurship rates decrease with the higher academic level of the researcher; in general, academic entrepreneurs come from families with a good financial situation, and applied sciences are the areas of knowledge with more entrepreneurs.

Originality/value

Despite the great number of theoretical and empirical studies found in the literature on entrepreneurship and academic entrepreneurship, there is still a shortage of practical studies on this latter topic in Brazil. This gap is even more evident when the authors consider the significant growth of entrepreneurial activity in the country in the past years. This paper contributes to fill this gap, and it aims to understand, in the state of São Paulo academic environment, the differences between the profiles of academic entrepreneurs, nonacademic entrepreneurs and non-entrepreneurs.
How can challenger marketers target the right customer organization? The A-C-O-W customer organization profiling matrix for challenger marketing
Authors: Lim Weng Marc
Published: October 2018

Purpose

This paper aims to help challenger marketers identify and target the right customer organization.

Design/methodology/approach

This paper adopts a customer organization profiling route to targeting for challenger marketing that is predicated on a thematic analysis of key findings of customer organization profiles from an international case study.

Findings

This paper introduces and explains the concepts of aggressiveness to succeed, compatibility of offerings, openness to new ideas and willingness to take action (or A-C-O-W) as components of a newly developed customer organization profiling matrix for challenger marketing.

Research limitations/implications

The A-C-O-W customer organization profiling matrix offers a fresh conceptual outlook for targeting customer organizations using a challenger marketing approach in the contemporary business-to-business (B2B) marketplace.

Practical implications

The A-C-O-W customer organization profiling matrix illuminates how challenger marketers can target the right customer organizations in the contemporary B2B marketplace.

Originality/value

The A-C-O-W customer organization profiling matrix is a pioneering concept for challenger marketing in B2B theory and practice.
Port performance measurement in the context of port choice: an MCDA approach
Authors: Rezaei Jafar , van Wulfften Palthe Linde , Tavasszy Lori , Wiegmans Bart , van der Laan Frank
Published: October 2018

Purpose

Port performance and port choice have been treated as separate streams of research. This hampers the efforts of ports to anticipate on and respond to possible future changes in port choice by shippers, freight forwarders and carriers. The purpose of this paper is to develop and demonstrate a port performance measurement methodology, extended from the perspective of port choice, which includes hinterland performance and a weighting of attributes from a port choice perspective.

Design/methodology/approach

A review of literature is used to extend the scope of port performance indicators. Multi-criteria decision analysis is used to operationalize the context of port choice, presenting a weighted approach using the Best-Worst Method (BWM). An empirical model is built based on an extensive port stakeholder survey.

Findings

Transport costs and times along the transport chain are the dominant factors for port competitiveness. Satisfaction, reputation and flexibility criteria are the other important decision criteria. The results also show how the availability of different modal alternatives impact on the position of a port. A ranking of routes for hinterland regions is done.

Originality/value

The paper focuses on two extensions of port performance measurement. So far, not all factors that determine port choice have been included in port performance studies. Here, first, factors related to hinterland services are included. Second, a weighting of port performance measures is proposed. The importance of factors is assessed using BWM. The approach is demonstrated empirically for a case of the European contestable hinterland regions, which so far have lacked quantitative analysis.
Influence of basic research investment on corporate performance
Authors: Song Malin , Pan Xiongfeng , Pan Xianyou , Jiao Zhiming
Published: October 2018

Purpose

The purpose of this paper is to add to the existing research about how corporate performance is influenced by their basic research (BR) investment. On this basis, the authors examined the moderating effect of human capital structure (HCS) on the relationship between BR investment and corporate performance.

Design/methodology/approach

Hypotheses were tested using static and dynamic models to analyze a large-scale data of Chinese A-share listed companies.

Findings

This study provides empirical evidence that contributes to the research about how private BR investment influences corporate performance in the digital age. In addition, human resource is an important dynamic ability for enterprise development. Based on the dynamic capability theory, further research finds that the human resources practice on the knowledge stock can enhance the company’s dynamic capability, thereby enhancing the company’s core competitiveness.

Research limitations/implications

The results may be affected by the context of the data set. This study considers the influence of private research investment type on corporate performance, further studies considering the influence of specific contextual variables, such as corporate industry differences, could yield richer insights that would help validate the results of this study.

Practical implications

This study provides useful information for managers. As well as increasing the investment in the BR of enterprise and creating the necessary conditions to increase the competitiveness of enterprise, they should strive to adjust the structure and quality of researchers involved in BR projects.

Originality/value

This research contributes to the enterprise’s BR investment and the management of human capital resource. It points that the investment of BR positively influences the corporate performance. In addition, the increasing of high-skilled labor’s proportion positively promotes the promotion of BR investment on corporate performance.
Multicriteria methodology and hierarchical innovation in the energy sector
Authors: Storch de Gracia M. Dolores , Moya Perrino David , Llamas Bernardo
Published: October 2018

Purpose

The purpose of this paper is to state a hierarchy methodology to select the most promising innovative projects, based on the processes defined by the successful Project Management Institute.

Design/methodology/approach

Open innovation is a new option for companies to acquire knowledge; however, in a changing and global market, it is necessary to define and select properly the proposals to be financially supported. A proven multicriteria decision methodology (MCDM) is recommended in this case to hierarchize alternatives. Moreover, analytical hierarchy process (AHP) has been considered in this study as a proven and simple MCDM.

Findings

AHP has been demonstrated as a suitable option to evaluate innovative project proposals, thanks to its integration with the Project Management Institute methodology. A process example has been included to demonstrate its application.

Research limitations/implications

Innovative projects and project proposal selection have always implied subjective criteria. Moreover, some of the processes defined in the methodology were not well defined in the project proposal.

Practical implications

The management of a project portfolio in a rational way would help decision makers to fund the most promising projects/alternatives under consideration. In this way, the inherent risk of R&D projects would be minimized.

Originality/value

The management of a portfolio of innovative proposals is less often addressed in the literature. This paper focuses on the hybridization of the criteria and processes described in the PMBOK Guide and an MCDM.
Isogeometric analysis of Mindlin nanoplates based on the integral formulation of nonlocal elasticity
Authors: Norouzzadeh Amir , Ansari Reza , Rouhi Hessam
Published: October 2018

Purpose

It has been revealed that application of the differential form of Eringen’s nonlocal elasticity theory to some cases (e.g. cantilevers) leads to paradoxical results, and recourse must be made to the integral version of Eringen’s nonlocal model. The purpose of this paper, within the framework of integral form of Eringen’s nonlocal theory, is to study the bending behavior of nanoscale plates with various boundary conditions using the isogeometric analysis (IGA).

Design/methodology/approach

The shear deformation effect is taken into account according to the Mindlin plate theory, and the minimum total potential energy principle is utilized in order to derive the governing equations. The relations are obtained in the matrix-vector form which can be easily employed in IGA or finite element analysis. For the comparison purpose, the governing equations are also derived based on the differential nonlocal model and are then solved via IGA. Comparisons are made between the predictions of integral nonlocal model, differential nonlocal model and local (classical) model.

Findings

The bending analysis of nanoplates under some kinds of edge supports indicates that using the differential model leads to paradoxical results (decreasing the maximum deflection with increasing the nonlocal parameter), whereas the results of integral model are consistent.

Originality/value

A new nonlocal formulation is developed for the IGA of Mindlin nanoplates. The nonlocal effects are captured based on the integral model of nonlocal elasticity. The formulation is developed in matrix-vector form which can be readily used in finite element method. Comparisons are made between the results of differential and integral models for the bending problem. The proposed integral model is capable of resolving the paradox appeared in the results of differential model.
Gravity signature and physical properties of copper deposit in the Curaçá Valley, northern Bahia/Brazil – case study
Authors: Vasconcelos Marcos , da Purificação Robson Santos , Conceição Daniel , Sena Florivaldo
Published: October 2018

This paper aims at analysing the application of the gravimetric method in the search for copper ore in the Valley of Curaçá River in northern Bahia, Brazil. The area where this study was carried out is known as Angico Farm, one of the claims of Caraíba S.A., a copper producer in the northern Bahia, Brazil. There are 18 drill holes at the Angico Farm target, drilled in order to investigate the mineralizations in depth. We have obtained information such as geographic coordinates and chemical results from the company in order to test the geophysical response and the correlation with geology. A 3D inverse gravimetric model was generated in order to verify the validity of the method in exploring for copper ore associated with hydrothermally altered mafic and ultramafic. Both mafic/ultramafic rocks and copper ore present high density, therefore the gravity method may not be effective for identification. We have shown, however, that copper ore from the Curaçá Valley presents a fairly good gravity response, and 3D inverse mathematical model pointed out a well‐delimited copper orebody in the regions where drill holes intersect the ore and coincide with the positive gravity anomaly. The ore contents were overlapped on cross‐sections of density extracted from the inverse model and such information helped us to check out the consistency of the gravimetric method in mapping and modelling mineralized bodies associated with mineral occurrence. Additionally, magnetic susceptibility and gammaspectrometric data were acquired along 18 drillcores to investigate their possible correlation with orebodies.
The role of sexual and vegetative reproduction in the population maintenance of a monocarpic perennial herb,Cardiocrinum cordatumvar.glehnii
Authors: Nishizawa Miyuki , Ohara Masashi
Published: October 2018

Because monocarpic perennial plants have only one reproductive opportunity in their entire life, they need to ensure offspring production. Some plants reproduce both sexually and vegetatively, and vegetative reproduction could possibly compensate for seed production. Therefore, the role and significance of these reproductive modes is likely to differ between monocarps and polycarps, which can reproduce many times.Cardiocrinum cordatumvar.glehniiis a monocarpic perennial that reproduces both sexually and vegetatively (bulblet formation). Here, we investigated the characteristics and contribution to population maintenance of sexual and vegetative reproduction to reveal the significance of these two reproductive modes in this species. First, we found that bulblet formation occurred in plants after the three‐leaved rosette stage. Second, resource allocation experiments revealed that although resources were mainly invested in fruit maturation after the flowering season, resource allocation was switched from sexual reproduction to vegetative reproduction if seed production was insufficient. Third, the outcrossing rate in this species varied greatly according to the environment surrounding the population. However, reproductive assurance by selfing kept seed production stable even if flowers did not receive sufficient pollen for full seed setviaoutcross pollination, and moreover, there was no intensive inbreeding depression. Finally, genotypic identification of ramets suggested that daughter ramets derived from vegetative reproduction received the space that the mother flowering ramet had occupied until the previous year.
The relation between syntactic awareness and contextual facilitation in word reading: What is the role of semantics?
Authors: Mimeau Catherine , Laroche Annie , Deacon S. Hélène
Published: October 2018

Objective

Our objective was to examine the role of semantics in the relation between syntactic awareness and contextual facilitation in word reading.

Methods

Grade 3 children (N = 77) completed a syntactic awareness task in which we manipulated the possible reliance on semantic information. They also completed a task of word reading in isolation and in context from which we calculated a score of contextual facilitation.

Results

We found an association between children's performance in the syntactic awareness task and contextual facilitation in word reading. Importantly, however, we found an association only when children could rely on semantic information in the syntactic awareness task and not when the semantic information was limited.

Conclusions

These findings suggest that syntactic awareness acts together with semantics to foster the use of context in word reading, which has important implications for theories of reading development.
Co‐evolving supportive networks and perceived community resilience across disaster‐damaged areas after the Great East Japan Earthquake: Selection, influence, or both?
Authors: Lim Seunghoo , Nakazato Hiromi
Published: October 2018

After the Great East Japan Earthquake and Tsunami in March 2011, the new community currency experiment for supporting disaster recovery,Fukkou Ouen Chiiki Tsuka, was introduced by community‐based organizations in these earthquake‐damaged areas. However, little is known about how perceived community resilience coevolves with interactions in the disaster recovery process. Using Simultaneous Investigation for Empirical Network Analysis techniques, this study shows the coevolutionary dynamics between perceptions of community resilience and the formation of supportive links among residents through a community currency (“Domo”) in Kamaishi. This study also provides policy implications for how mutual reinforcement between community residents’ engagement in network establishments and building a sense of community resilience among those affected functions as a potential mechanism for facilitating disaster recovery.
Mutations in the NOD2 gene are associated with a specific phenotype and lower anti‐tumor necrosis factor trough levels in Crohn's disease
Authors: Schäffler Holger , Geiss David , Gittel Nicole , Rohde Sarah , Huth Astrid , Glass Änne , Brandhorst Gunnar , Jaster Robert , Lamprecht Georg
Published: October 2018

Objective

Nucleotide‐binding oligomerization domain‐containing protein 2 (NOD2) gene mutations are known to be an important risk factor in the pathogenesis of Crohn's disease (CD). Specific disease phenotypes are associated with the presence of NOD2 gene mutation. One treatment option is to use an anti‐tumor necrosis factor (TNF)‐α agent. Therapeutic drug monitoring (TDM) is usually performed in cases of a loss of response. Our aim was to explore whether NOD2 gene mutations have an effect on the disease phenotype, vitamin D levels, and on TDM in CD patients.

Methods

This was a retrospective genotype–phenotype association study on NOD2 gene mutations in 161 patients with CD.

Results

Altogether 55 (34.2%) patients carried at least one mutant allele of NOD2. NOD2 gene mutations were associated with ileocecal disease, ileocecal resection, stricturing and perianal disease, and patients with NOD2 gene mutation had significantly less frequent colonic disease and received an ostomy less frequently. TDM in patients with NOD2 gene mutation showed more frequent anti‐TNF trough levels in the subtherapeutic range and lower anti‐TNF trough levels than in NOD2 wild‐type (WT) patients.

Conclusions

CD patients with NOD2 gene mutation have a specific clinical phenotype and they may require higher doses of anti‐TNF agents to achieve sufficient anti‐TNF trough levels. They may therefore benefit from a proactive TDM than a reactive approach. This could be another step in the direction of personalized medicine.
Health 2.0 2018
Authors: Kurian Martin J. , Rentzepis Peter J. , Carracher Ann M. , Close Kelly L.
Published: October 2018

Martin J. Kurian, Peter J. Rentzepis, Ann M. Carracher, and Kelly L. Close are of Close Concerns (http://www.closeconcerns.com), a healthcare information company focused exclusively on diabetes and obesity care. Close Concerns publishes Closer Look, a periodical that brings together news and insights in these areas. Each month, the Journal of Diabetes includes this News feature, in which Kurian, Rentzepis, Carracher, and Close review the latest developments relevant to researchers and clinicians.
Assessment of tumour response after stereotactic ablative radiation therapy for lung cancer: A prospective quantitative hybrid 18F‐fluorodeoxyglucose‐positron emission tomography and CT perfusion study
Authors: Yang Dae‐Myoung , Palma David , Louie Alexander , Malthaner Richard , Fortin Dalilah , Rodrigues George , Yaremko Brian , Laba Joanna , Gaede Stewart , Warner Andrew , Inculet Richard , Lee Ting‐Yim
Published: October 2018

Introduction

Stereotactic ablative radiotherapy (SABR) is a guideline‐recommended treatment for inoperable stage I non‐small cell lung cancer (NSCLC), but imaging assessment of response after SABR is difficult. The goal of this study was to evaluate imaging‐based biomarkers of tumour response using dynamic 18F‐FDG‐PET and CT perfusion (CTP).

Methods

Thirty‐one patients with early‐stage NSCLC participated in this prospective correlative study. Each underwent dynamic 18F‐FDG‐PET/CTP studies on a PET/CT scanner pre‐ and 8 weeks post‐SABR. The dynamic 18F‐FDG‐PET measured the tumour SUVmax, SUVmean and the following parameters: K1, k2, k3, k4 and Ki, all using the Johnson–Wilson–Lee kinetic model. CTP quantitatively mapped BF, BV, MTT and PS in tumours and measured largest tumour diameter. Since free‐breathing was allowed during CTP scanning, non‐rigid image registration of CT images was applied to minimize misregistration before generating the CTP functional maps. Differences between pre‐ and post‐SABR imaging‐based parameters were compared.

Results

Tumour size changed only slightly after SABR (median 26 mm pre‐SABR vs. 23 mm post‐SABR; P = 0.01). However, dynamic 18F‐FDG‐PET and CTP study showed substantial and significant changes in SUVmax, SUVmean, k3, k4 and Ki. Significant decreases were evident in SUVmax (median 6.1 vs. 2.6; P < 0.001), SUVmean (median 2.5 vs. 1.5; P < 0.001), k3 (relative decrease of 52%; P = 0.002), Ki (relative decrease of 27%; P = 0.03), whereas there was an increase in k4 (+367%; P < 0.001).

Conclusions

Hybrid 18F‐FDG‐PET/CTP allowed the response of NSCLC to SABR to be assessed regarding metabolic and functional parameters. Future studies are needed, with correlation with long‐term outcomes, to evaluate these findings as potential imaging biomarkers of response.
Radiotherapy patterns of care for stage I and II non‐small cell lung cancer in Sydney, Australia
Authors: Nguyen Andrew D. , Wong Wenchang , Beydoun Nadine , Mohan Sharanya , Shafiq Jesmin , Vinod Shalini K.
Published: October 2018

Introduction

Curative radiotherapy is guideline treatment for inoperable patients of good performance status with Stage I & II Non‐Small Cell Lung Cancer (NSCLC). The aim of this study was to evaluate radiotherapy patterns of care in these patients, the reasons for palliative treatment and the proportion of patients suitable for curative stereotactic ablative body radiotherapy (SABR).

Methods

Electronic oncology databases at three institutions were queried to retrieve data on patients with inoperable Stage I & II NSCLC seen in radiation oncology clinics between 1/1/2008 and 31/12/2014. Suitability for SABR was defined as peripheral tumours less than 5 cm in size. Factors associated with curative treatment were determined using univariate and multivariate analyses.

Results

Three‐hundred‐and‐twelve patients were identified of whom 178 (57%) received curative radiotherapy, 58 (19%) palliative radiotherapy and 76 (24%) no radiotherapy. The main reason for receiving palliative rather than curative treatment was COPD or poor pulmonary function (26%). Method of diagnosis (P = 0.031), Simplified Comorbidity Score (P = 0.003), ECOG performance status (P = 0.016), FEV1% (P = 0.040), treating institution (P < 0.0001) and time period (P = 0.016) were associated with curative radiotherapy on multivariate analysis. In patients with T1‐2N0M0 NSCLC, 19 (31%) who did not receive treatment and 7 (21%) who underwent palliative radiotherapy were technically and clinically suitable for SABR.

Conclusion

Only 57% of patients with Stage I‐II NSCLC were treated with curative radiotherapy. Patient factors were the predominant reason for palliative treatment, however, treating institution also played a role. A considerable proportion of patients who underwent palliative or no radiotherapy were suitable for SABR treatment.
An improved method for utilizing high‐throughput amplicon sequencing to determine the diets of insectivorous animals
Authors: Jusino Michelle A. , Banik Mark T. , Palmer Jonathan M. , Wray Amy K. , Xiao Lei , Pelton Emma , Barber Jesse R. , Kawahara Akito Y. , Gratton Claudio , Peery M. Zachariah , Lindner Daniel L.
Published: October 2018

DNA analysis of predator faeces using high‐throughput amplicon sequencing (HTS) enhances our understanding of predator–prey interactions. However, conclusions drawn from this technique are constrained by biases that occur in multiple steps of the HTS workflow. To better characterize insectivorous animal diets, we used DNA from a diverse set of arthropods to assess PCR biases of commonly used and novel primer pairs for the mitochondrial gene, cytochrome oxidase C subunit 1 (COI). We compared diversity recovered from HTS of bat guano samples using a commonly used primer pair “ZBJ” to results using the novel primer pair “ANML.” To parameterize our bioinformatics pipeline, we created an arthropod mock community consisting of single‐copy (cloned) COI sequences. To examine biases associated with both PCR and HTS, mock community members were combined in equimolar amounts both pre‐ and post‐PCR. We validated our system using guano from bats fed known diets and using composite samples of morphologically identified insects collected in pitfall traps. In PCR tests, the ANML primer pair amplified 58 of 59 arthropod taxa (98%), whereas ZBJ amplified 24–40 of 59 taxa (41%–68%). Furthermore, in an HTS comparison of field‐collected samples, the ANML primers detected nearly fourfold more arthropod taxa than the ZBJ primers. The additional arthropods detected include medically and economically relevant insect groups such as mosquitoes. Results revealed biases at both the PCR and sequencing levels, demonstrating the pitfalls associated with using HTS read numbers as proxies for abundance. The use of an arthropod mock community allowed for improved bioinformatics pipeline parameterization.
Creation and Location‐Specific Revision of a Core Nursing Outcomes Evaluation System Based on Nursing Outcomes Classification for Stroke Inpatients in China
Authors: Hou Shuxiao , Li Baohua , Luo Yongmei , Shang Shaomei
Published: October 2018

PURPOSE

To screen and create a core nursing outcomes evaluation index system based on NOC for stroke inpatients in China.

METHODS

This study adopted the method of Delphi expert consultation, with the degree of consent >4.0 points and the coefficient of variation <0.25 as the standard for inclusion of indexes.

RESULTS

The evaluation index system established in this study includes five first‐grade indexes, 15 second‐grade indexes, and 58 third‐grade indexes.

CONCLUSION

The evaluation index system of core nursing outcomes for stroke inpatients in China has good specificity and reliability.

PRACTICE IMPLICATIONS

The evaluation index system of core nursing outcomes provides a standardized location‐specific tool for clinical nurses to evaluate the nursing quality and intervention effect for stroke inpatients in China.
Using DNA methylation to validate an electronic medical record phenotype for smoking
Authors: McGinnis Kathleen A. , Justice Amy C. , Tate Janet P. , Kranzler Henry R. , Tindle Hilary A. , Becker William C. , Concato John , Gelernter Joel , Li Boyang , Zhang Xinyu , Zhao Hongyu , Crothers Kristina , Xu Ke ,   For the VACS Project Group
Published: October 2018

A validated, scalable approach to characterizing (phenotyping) smoking status is needed to facilitate genetic discovery. Using established DNA methylation sites from blood samples as a criterion standard for smoking behavior, we compare three candidate electronic medical record (EMR) smoking metrics based on longitudinal EMR text notes. With data from the Veterans Aging Cohort Study (VACS), we employed a validated algorithm to translate each smoking‐related text note into current, past or never categories. We compared three alternative summary characterizations of smoking: most recent, modal and trajectories using descriptive statistics and Spearman's correlation coefficients. Logistic regression and area under the curve analyses were used to compare the associations of these phenotypes with the DNA methylation sites, cg05575921 and cg03636183, which are known to have strong associations with current smoking. DNA methylation data were available from the VACS Biomarker Cohort (VACS‐BC), a sub‐study of VACS. We also considered whether the associations differed by the certainty of trajectory group assignment (<0.80/≥0.80). Among 140 152 VACS participants, EMR summary smoking phenotypes varied in frequency by the metric chosen: current from 33 to 53 percent; past from 16 to 24 percent and never from 24 to 33 percent. The association between the EMR smoking pairs was highest for modal and trajectories (rho = 0.89). Among 728 individuals in the VACS‐BC, both DNA methylation sites were associated with all three EMR summary metrics (p < 0.001), but the strongest association with both methylation sites was observed for trajectories (p < 0.001). Longitudinal EMR smoking data support using a summary phenotype, the validity of which is enhanced when data are integrated into statistical trajectories.
Physical activity and sedentary behaviour in a residential aged care facility
Authors: Parry Sharon , Chow Marilyn , Batchelor Frances , Fary Robyn E
Published: October 2018

Objective

To evaluate sedentary behaviour and physical activity levels in independently mobile older adults with and without dementia living in residential aged care.

Methods

Sedentary behaviour and physical activity were measured in 37 residents of an aged care facility using an accelerometer worn during waking hours for five days.

Results

Participants with valid accelerometer data (n = 28) spent 85% of the time sedentary, and 12% in low‐intensity, 2% in light‐intensity and 1% in moderate‐to‐vigorous‐intensity physical activity. Over half of sedentary time was accumulated in bouts of greater than 30 minutes. Physical activity at any level of intensity was performed in bouts of less than 10 minutes.

Conclusion

Residents were highly sedentary and inactive. In particular, the short duration of each bout of activity amongst lengthy periods of sedentary behaviour was a substantial finding. The study suggests the need to develop innovative ways of breaking up sedentary behaviour in residential aged care.
RANZCOG Fellows’ adherence to guidelines following cytological prediction of cervical adenocarcinoma‐in‐situ: Cause for concern?
Authors: Powell Aime , Cohen Paul A. , Spilsbury Katrina , Steel Nerida , Blomfield Penny
Published: October 2018

Background

For Australian women with screen‐detected adenocarcinoma‐in‐situ (AIS), an excisional biopsy is mandatory for further assessment, treatment, and to exclude the presence of cervical adenocarcinoma. The only exclusion to this rule is if the woman has a clinically evident invasive cervical malignancy. Excisional treatments should be tailored according to a patient's age and future obstetric needs. To date, practitioner compliance with this recommendation has not been investigated.

Aims

To investigate clinical management for patients with a cytological test result predicting AIS. Secondary aims were to report the most severe histological findings of excisional biopsy specimens following cytological prediction of AIS and investigate treatment outcomes for conservatively managed patients with biopsy‐confirmed AIS.

Materials and Methods

A retrospective, population‐based cohort study was conducted. Cases were ascertained from the Tasmanian and Western Australia Cervical Screening Registries. Cytology and histology results for women with an index cervical smear reporting AIS from 2001 to 2012 were reviewed.

Results

Three hundred and twenty‐one women (age range 18–69 years) had an index smear reporting AIS. Cervical cancer was diagnosed in 62 (19.3%) patients within the study cohort. Twenty‐one of 321 patients (6.7%) were not initially managed according to the 2005 NHMRC Guidelines for the management of asymptomatic women with screen‐detected abnormalities, including two women diagnosed with an occult cancer following a total hysterectomy.

Conclusions

A minority of women were not managed in accordance with guidelines. This is of concern given that nearly one in five women with a smear predicting AIS had a final diagnosis of cervical cancer.
Hypothermic Machine Perfusion Versus Static Cold Storage in Deceased Donor Kidney Transplantation: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials
Authors: Peng Panxin , Ding Zhenshan , He Yuhui , Zhang Jun , Wang Xuming , Yang Zhihao
Published: October 2018

Static cold storage (SCS) and hypothermic machine perfusion (HMP) are two primary options for renal allograft preservation. Compared with SCS, HMP decreased the incidence of delayed graft function (DGF) and protected graft function. However, more evidence is still needed to prove the advantages of the HMP. In this study, the outcomes of kidney grafts from the two preservation methods were compared by conducting a systematic review and meta‐analysis. Randomized controlled trials (RCTs) comparing the effect of hypothermic machine perfusion and static cold storage in deceased donor kidney transplantation were identified through searches of the MEDLINE, EMBASE, and Cochrane databases between January 1, 1980 and December 30, 2017. The primary endpoints were delayed graft function and graft survival. Secondary endpoints included primary non‐function (PNF), graft renal function, duration of DGF, acute rejection, postoperative hospital stay and patient survival. Summary effects were calculated as risk ratio (RR) with 95% confidence interval (CI) or mean difference (MD) with 95% confidence intervals (CI). A total of 13 RCTs were included, including 2048 kidney transplant recipients. The results indicated that compared with SCS, HMP decreased the incidence of DGF (RR 0.78, 95% CI 0.69–0.87, P < 0.0001), and improved the graft survival at 3 years (RR 1.06, 95% CI 1.02–1.11, P = 0.009). There was no significant difference in other endpoints. HMP might be a more desirable method of preservation for kidney grafts. The long‐term outcomes of kidney allografts stored by hypothermic machine perfusion still need to be further investigated.
Venoarterial Extracorporeal Membrane Oxygenation Increased Immune Function of Spleen and Decreased Reactive Oxygen Species During Post‐Resuscitation
Authors: Zhang Qiang , Liu Bo , Zhao Lianxing , Lian Yong , Yuan Xiaoli , Zhang Yun , Lin Jiyang , Li Chunsheng
Published: October 2018

We aimed to investigate the effect of venoarterial extracorporeal membrane oxygenation (VA‐ECMO) on immune function of the spleen and reactive oxygen species (ROS) during post‐resuscitation in a porcine model. After 8 min of untreated ventricular fibrillation and 6 min of basic life support, pigs were randomized into two groups: Group 1 received VA‐ECMO and Group 2 received conventional cardiopulmonary resuscitation. After successful return of spontaneous circulation, the hemodynamic status was determined and blood samples were collected at 0, 1, 2, 4, and 6 h. Surviving pigs were euthanized 6 h after return of spontaneous circulation, their spleens were harvested and the T‐cells were separated. Then, we investigated immune function parameters of the spleen and ROS levels. VA‐ECMO increased the return of spontaneous circulation and 6 h survival rate after return of spontaneous circulation. Compared with the conventional cardiopulmonary resuscitation group, the VA‐ECMO group showed increased superoxide dismutase and decreased malondialdehyde and ROS levels. Furthermore, VA‐ECMO was associated with a high rate of CD4+ and CD4+/CD8+, high levels of interleukin 2, interferon γ, and interferon γ/interleukin 4, as well as high proliferation of lymphocytes. The apoptotic rate of T‐cells was lower in the VA‐ECMO group than it was in the conventional cardiopulmonary resuscitation group. VA‐ECMO increased immune function of spleen and decreased ROS levels during post‐resuscitation. Further research is expected to illustrate whether the differences in immune responses are due to ROS or some other perfusion related effect on spleen.
Correlation of peripapillary retinal nerve fibre layer thickness with visual acuity in paediatric patients affected by optic pathway glioma
Authors: Parrozzani Raffaele , Miglionico Giacomo , Leonardi Francesca , Pulze Serena , Trevisson Eva , Clementi Maurizio , Opocher Enrico , Licata Viviana , Viscardi Elisabetta , Pilotto Elisabetta , Frizziero Luisa , Midena Edoardo
Published: October 2018

Purpose

To evaluate peripapillary retinal nerve fibre layer (RNFL) thickness, measured by spectral‐domain optical coherence tomography (SD‐OCT), as a surrogate of visual function in a population of paediatric patients affected by optic pathway glioma (OPG) associated with neurofibromatosis type 1 (NF1).

Methods

A total of 38 paediatric patients (66 eyes) affected by MRI‐proven OPG were included. Each patient underwent complete ophthalmological examination, including age‐appropriate visual acuity (VA) assessment and RNFL analysis by SD‐OCT. Visual acuity was classified as normal or pathologic using age‐based normative data. Visual acuity was correlated to mean RNFL thickness of the whole peripapillary area and of each single analyzed sector (nasal, superior, temporal, inferior).

Results

Visual acuity was normal in 43 (65%) and pathologic in 23 (35%) eyes. Mean parapapillary RNFL thickness of each analyzed sector was significantly lower in eyes with abnormal VA (p < 0.05). The best balanced cut‐off value of global RNFL thickness allowing to discriminate between eyes with normal and pathologic VA was 76.25 μm (91%, 76%, 67% and 94% of sensitivity, specificity, positive and negative predicting value, respectively). Considering best balanced cut‐off values of other analyzed RNFL sectors, the superior (p = 0.0029) and the inferior (p = 0.0024) sectors reached the higher sensitivity (87% and 87%, respectively) and specificity (81% and 79%, respectively).

Conclusion

Retinal nerve fibre layer thickness is directly related to VA in children affected by NF1‐related OPG, and should be considered as a potential surrogate marker of VA. Retinal nerve fibre layer thickness cut‐off values can be used in paediatric patients to discriminate false‐positive results obtained by VA measurement.
Disc haemorrhages in Polish Caucasian patients with normal tension glaucoma
Authors: Kosior‐Jarecka Ewa , Wróbel‐Dudzińska Dominika , Łukasik Urszula , Żarnowski Tomasz
Published: October 2018

Aim

The aim of this observational study was to evaluate the epidemiology of disc haemorrhages (DH) in Polish patients with normal tension glaucoma (NTG) and their association with some risk factors.

Material and methods

The group studied consisted of 274 Caucasian patients with NTG (410 eyes) divided into those with disk haemorrhages (DH+, = 94 eyes in 81 patients) and those without disc haemorrhages (DH−, = 316 eyes in 193 patients). Ophthalmic examinations with visual field (VF) testing were carried out in these patients every 3 months for at least 18 months. The medical history was recorded taking glaucoma, other ophthalmic diseases, chronic general disorders and vascular risk factors into account.

Results

Unilateral and bilateral DH were observed more frequently in women (p = 0.0010). Maximum IOP was significantly higher in the DH+ group (p = 0.000026). Notches and peripapillary atrophy were found with similar frequency in DH+ and DH− patients (p = 0.4631). The mean defect (MD) in the VF at the time of diagnosis was lower in the DH+ group (−6.27 dB) than in the DH group (−10.14 dB), (p = 0.000055). The initial MD in the DH+ group had a positive correlation with maximum initial IOP. A progressive loss of VF was observed in 206 eyes with NTG (50.2%), with a mean of 0.72 dB/year. The progression was more frequent in DH+ patients (78.4% versus 41.1%), but there were no statistically significant differences in the rate of progression between DH+ and DH− patients (p = 0.46). The morphology of early scotoma depended on the presence of DH (p < 0.00001), and early scotoma in the DH+ group was more frequently localized paracentrally. There was a significant difference in a number of antiglaucoma drops between DH+ and DH− patients (p < 0.00001). There were no differences in the frequency of migraines between both groups (p = 0.31). General hypotension was observed with similar frequency in the DH+ DH− groups (p = 0.3). General hypertension was less frequent in DH+ patients (p = 0.041), especially in women (p = 0.000027). Diabetes mellitus (DM) was significantly less frequent (21.3%) in patients with DH+ (3.7%) than in the DH− group (p = 0.000852), especially among the women (p = 0.000216).

Conclusion

In our study, DH were more frequent both unilaterally and bilaterally in women. Initial intraocular pressure (IOP) was higher in NTG patients with DH, and early scotoma was localized in the paracentral area of the VF. Disc haemorrhages (DH) were less frequent in women with general hypertension and with diabetes mellitus.
Short and long‐term effectiveness and safety of vedolizumab in inflammatory bowel disease: results from the ENEIDA registry
Authors: Chaparro María , Garre Ana , Ricart Elena , Iborra Marisa , Mesonero Francisco , Vera Isabel , Riestra Sabino , García‐Sánchez Valle , Luisa De Castro M. , Martin‐Cardona Albert , Aldeguer Xavier , Mínguez Miguel , de‐Acosta Manuel Barreiro , Rivero Montserrat , Muñoz Fernando , Andreu Montserrat , Bargalló Ana , González‐Muñoza Carlos , Pérez Calle Jose L. , García‐Sepulcre Mariana Fe , Bermejo Fernando , Huguet Jose Maria , Cabriada José L. , Gutiérrez Ana , Mañosa Míriam , Villoria Albert , Carbajo Ana Y. , Lorente Rufo , García‐López Santiago , Piqueras Marta , Hinojosa Esther , Arajol Clàudia , Sicilia Beatriz , Conesa Ana Macho , Sainz Empar , Almela Pedro , Llaó Jordina , Roncero Oscar , Camo Patricia , Taxonera Carlos , Domselaar Manuel Van , Pajares Ramón , Legido Jesús , Madrigal Rosa , Lucendo Alfredo J. , Alcaín Guillermo , Doménech Eugeni , Gisbert Javier P. ,   GETECCU study group
Published: October 2018

Background

Effectiveness of vedolizumab in real world clinical practice is unknown.

Aim

To evaluate the short and long‐term effectiveness of vedolizumab in patients with inflammatory bowel disease (IBD).

Methods

Patients who received at least 1 induction dose of vedolizumab were included. Effectiveness was defined based on Harvey‐Bradshaw index (HBI) in Crohn's disease (CD) and Partial Mayo Score (PMS) in ulcerative colitis (UC). Short‐term response was assessed at week 14. Variables associated with short‐term remission were identified by logistic regression analysis. The Kaplan‐Meier method was used to evaluate the long‐term durability of vedolizumab treatment. Cox model was used to identify factors associated with discontinuation of treatment and loss of response.

Results

521 patients were included (median follow‐up 10 months [interquartile range 5‐18 months]). At week 14, 46.8% had remission and 15.7% clinical response. CD (vs UC), previous surgery, higher CRP concentration and disease severity at baseline were significantly associated with impaired response. The rate of vedolizumab discontinuation was 37% per patient‐year of follow‐up (27.6% in UC and 45.3% in CD, P < 0.01). CD (vs UC), anaemia at baseline, steroids during induction and CRP concentration were associated with lower durability of treatment. Seven per cent of patients developed adverse events, infections being the most frequent.

Conclusions

Over 60% of IBD patients respond to vedolizumab. Many patients discontinue treatment over time. CD and disease burden impair both short‐ and long‐term response. Vedolizumab seems to be safe in clinical practice.
Investigating the factors that influence higher education instructors’ decisions to adopt a flipped classroom instructional model
Authors: Long Taotao , Cummins John , Waugh Michael
Published: October 2018

The flipped classroom is an instructional model which allows for more advanced learning activities during in‐class time while introduces subject knowledge to students prior to class. To address a gap in the recent research regarding higher education instructors’ experiences, perceptions and adoption decisions of the flipped classroom instruction, this study aimed at investigating the critical factors which were predictive of a higher education instructor’s decision to adopt a flipped classroom instructional model through exploratory factor analysis (EFA) and multiple regression in a US university. The results revealed that performance expectancy and technology self‐efficacy were significant predictors. Although facilitation condition was significantly correlated with instructors’ adoption decisions, it was not a significant predictor. This study suggests that in order to improve higher education instructors’ adoption decisions of the flipped classroom and other active learning instructional models, it is of priority for institutions to remove the internal barriers to instructors’ adoption decisions of these instructional models, such as improving their performance expectancy and technology self‐efficacy.