bluuebunny/crossref_metadata_2025 huggingface dataset:
SFC reminding sponsors of the need to adopt an attitude of “professional scepticism”
Authors: Hughes Gareth , Comber James
Published: July 2017

Purpose

To remind sponsors to adopt an attitude of “professional skepticism” in Hong Kong IPOs.

Design/methodology/approach

Explains the Securities and Futures Commission (“SFC”)'s sanction on BOCOM International (Asia) Limited (“BIAL”) as a sign of determination to hold sponsors to account as gatekeepers to the Hong Kong capital markets.

Findings

The SFC has reprimanded and fined BIAL HK$15 million for failing to discharge its duties as a sole sponsor in a listing application for China Huinong Capital Group Company Limited (“China Huinong”), a company established in the PRC. This substantial fine reinforces the need for sponsors to ensure that they fully and properly discharge all of their duties, and that they will be held responsible for any failure to do so, even if the listing is not ultimately approved.

Practical implications

If sponsors fail to fulfil the requirements required under the sponsors’ regulatory regime, the SFC will be proactive and impose tough sanctions, even if the listing application is eventually withdrawn or returned by the SEHK.

Originality/value

Practical guidance from experienced regulatory, financial and commercial dispute resolution lawyers.
Selling structured products to retail investors in the US
Authors: Sheehan Margaret
Published: July 2017

Purpose

To explain the inherent risks, draw attention to SEC and FINRA guidance, and suggest ways to limit and control the sale of structured securities to retail investors.

Design/methodology/approach

Explains potential problems with the sale of structured securities to retail investors; recommends marketing, disclosure, training, suitability, and supervision guidelines; summarizes the results of an SEC sweep examination; draws conclusions.

Findings

Both the SEC and FINRA have stopped short of saying that retail sales of structured products is unsuitable per se, but both have demonstrated unease about this activity and clearly indicated that firms who engage in it have heightened and specific disclosure, training, suitability and supervisory obligations.

Practical implications

Although firms certainly can sell these products in the retail market in a responsible and compliant manner, they should do so with thought, preparation and caution, because the regulatory agencies are watching.

Originality/value

Practical guidance from experienced financial services and securities lawyer concentrating on investment advisers and broker-dealers.
Money laundering: further clarity provided by the Court of Appeal on the operation of the consent regime
Authors: Allen Daren
Published: July 2017

Purpose

To summarise a key development that provides clarity for banks on the operation of the money laundering provisions in the UK Proceeds of Crime Act 2002.

Design/methodology/approach

The article provides the background leading up to the UK Court of Appeal hearing, the key issues in the appeal, the decision of the court and what this means for banks in the UK.

Findings

The Court of Appeal held that (i) where a bank suspects that money in its customer’s account is criminal property, freezes the account and seeks consent to deal with the money, the court should not intervene during the course of the seven-working-day notice period and 31-day Moratorium Period and (ii) in most cases the discretion to grant an interim declaration is unlikely to be exercised.

Practical implications

This decision is important for banks and brings much-needed clarity. Prior to the Court of Appeal decision, it was open to customers to challenge a bank’s decision to freeze an account (pending a response from the NCA to a consent request) on the basis that, on a balance of convenience, payments from a bank account should be permitted to be made.

Originality/value

Practical guidance from an experienced lawyer specialising in complex investigations, litigation dispute resolution and regulatory enforcement proceedings for financial institutions and large corporations.
Evolving skills for emerging technologies: a collaborative approach
Authors: Brown Jennifer , Crocamo James Thomas , Bielskas Amanda , Ransom Ellie , Vanti William B. , Wilfong Krystie
Published: July 2017

Purpose

The purpose of this paper is to discuss the implementation of a skills development project aimed at increasing the technology competencies of participating librarians in Columbia University’s Science & Engineering Libraries, in response to changing instructional needs.

Design/methodology/approach

Adopting a DIY or Maker learning model gave librarians a perfect opportunity to experience learning new technology skills just as their users encounter them.

Findings

The authors conclude that this collaborative project methodology could potentially fit a large variety of different library environments, providing other institutions with an excellent opportunity to reassess and revamp staff skills, no matter their instructional focus.

Originality/value

The literature notes that previous library staff training models were largely devised for newly matriculated Library and Information Science graduates preparing to enter the workforce. Burgeoning technology developments require libraries to explore novel methods to expose staff to new technology skills; this case study applies the programmatic lens of the Maker Movement to a collaborative staff learning model.
Middle management involvement in handling variable patient flows
Authors: Olsson Olle Viktor , Aronsson Håkan , Sandberg Erik
Published: July 2017

Purpose

This study aims to explore the involvement of middle management in forming strategies to manage variable acute patient flows at a hospital.

Design/methodology/approach

Empirical evidence from a university hospital was gathered via interviews, internal documents, observation and participation in meetings. The role of middle management in the development of strategies was analyzed using literature on middle management involvement.

Findings

In managing variable acute patient flows, middle management adopts a number of roles and behavioral characteristics that have been previously described in research. The role of facilitator is the most prominent, with middle managers prioritizing individual goals and strategies for the clinical departments that they manage before their collective responsibility for hospital performance. Unclear responsibilities and mandates within the organization, together with a lack of hospital-wide strategies concerning how the acute patient flow should be managed, are contributing factors to this behavior.

Research limitations/implications

The research is based on an explorative, single case study methodology. Future research assessing the extent of different middle management roles in health care, in which more empirical data and quantitative analysis is conducted, is encouraged.

Practical implications

There is a need for top management to establish long-term goals to enhance middle management roles when developing strategies for managing variable patient flows.

Originality/value

Middle management involvement in developing strategies for managing variable patient flows is a novel topic for research. The interface and division of tasks between top and middle management is crucial for successful strategies in managing variable patient flows.
Microlevel antecedents of absorptive capacity in joint project engineering teams
Authors: Ojo Adedapo Oluwaseyi , Raman Murali , Chong Chin Wei
Published: July 2017

Purpose

This paper aims to investigate the micro-level antecedents of absorptive capacity (ACAP) based on the multilevel perspective of learning capabilities in asymmetric joint project engineering teams constituted by local employees and expatriates.

Design/methodology/approach

The authors integrated the micro-foundational and multilevel learning theories to delineate the individual and team dimensions of ACAP. Using structural equation modelling, the authors tested the hypothesized relationships among the underlying individual determinants and multilevel dimensions of ACAP. The data were collected from a sample of 248 local employees from 76 joint project engineering teams in the Nigerian upstream oil industry.

Findings

ACAP entails individual and team capabilities, which depend on prior experience and need for cognition. The creation of shared understanding is essential for the transition of an individual’s knowledge assimilation capability into team’s knowledge utilization capability.

Originality/value

This study contributes to extant understanding of the multilevel perspective of learning capabilities, i.e. ACAP in a knowledge intensive team like joint project engineering.
Maximizing the strategic value of corporate reputation: a business model perspective
Authors: Ma Qiaoling “Amy” , Osiyevskyy Oleksiy
Published: July 2017

Purpose

The article emphasizes the importance of corporate reputation as a firm’s key intangible asset leading to tangible shareholder benefits, such as increased profit and market evaluation for established companies, or higher growth rate, lower risk and ease access to funding for new ventures. However, the benefits of corporate reputation do not follow automatically; rather, “the reputational rent” is created and appropriated through a proper, deliberately designed business model. We discuss the link of a firm’s corporate reputation and its business model, proposing a typology of approaches for reaping the rewards of corporate reputation.

Design/methodology/approach

The study is presented as a conceptual paper with illustrative case examples

Findings

For practical purposes, particularly important are two distinct perspectives on corporate reputation: the utilitarian dimension, and the social dimension. The future may turn out to be “either 5-stars or 1-star” world, with Yelp and similar platforms critically disadvantaging the middle-ground of many markets, keeping only top performers and the ones whose business model is insensitive to reputational erosion. This increases the likelihood that the distribution of possible reputation levels will become increasingly bimodal - either high or low, with almost nothing in between - and can be properly mapped on a 2x2 matrix forming the basis of the study.

Originality/value

We introduce the link between a firm’s corporate reputation and its business model, proposing a typology of approaches for reaping the rewards of corporate reputation.
SRI’s turnaround: how four principles guided high-value, market-creating innovation
Authors: Denning Steve
Published: July 2017

Purpose

The article explores the leadership strategies of a CEO who defied the odds against culture change and accomplished a storied turnaround, Curt Carlson who introduced a culture of innovation at SRI International.

Design/methodology/approach

Under Carlson’s leadership, SRI developed a methodology for rapid, large-scale, serial innovation, starting with a focus on important customer and market needs. The innovation proposals had to develop compelling hypotheses for both the product offering and the business model.

Findings

Need, Approach, Benefits per costs and Competition (NABC). the methodology Carlson and his team developed, contains the fundamental framework for creating customer value, it applies to the entire enterprise. It brings all functions together using a short, easy to remember meme that starts every conversation with a focus on customer need.

Practical implications

One of the most spectacular and best-known SRI innovation wins was Siri, the intelligent personal computer assistant and on-line knowledge navigator, an integral part of the iPhone. As a case example, Siri illustrates the power of the NABC approach.

Originality/value

Carlson stresses that the key element in SRI’s success with Siri was not just the technology. It was getting the entire value proposition right. “One of the things that changed at SRI was the realization that we needed to have really solid working hypotheses, both for the product and the business model, before we started spending significant money on technology. That’s one of the biggest mistakes firms make. They rush ahead and want to build the product before they de-risk their value propositions.
Pharmacokinetic evaluation of oral itraconazole for antifungal prophylaxis in children
Authors: Allegra Sarah , Fatiguso Giovanna , De Francia Silvia , Favata Fabio , Pirro Elisa , Carcieri Chiara , De Nicolò Amedeo , Cusato Jessica , Di Perri Giovanni , D'Avolio Antonio
Published: July 2017

Itraconazole is a first‐generation triazole agent with an extended spectrum of activity; it is licensed in adults for superficial and systemic fungal infections; no recommendation has been yet established for use in children patients. Its variable and unpredictable oral bioavailability make it difficult to determine the optimal dosing regimen. Hence, therapeutic drug monitoring, highly available in clinical practice, may improve itraconazole treatment success and safety. The aim of the study was to describe in paediatrics the oral itraconazole pharmacokinetics, used for prophylaxis. Moreover, we evaluated the utility of its therapeutic drug monitoring in this cohort. A fully validated chromatographic method was used to quantify itraconazole concentration in plasma collected from paediatric patients, at the end of dosing interval. Associations between variables were tested using the Pearson test. Mann‐WhitneyUtest has been used to probe the influence of categorical variables on continuous ones. Any predictive power of the considered variables was finally evaluated through univariate and multivariate linear and logistic regression analyses. A high inter‐individual variability was shown; ethnicity (beta coefficient, β −0.161 and interval of confidence at 95%,IC−395.035; −62.383) and gender (β 0.123 andIC9.590; 349.395) remained in the final linear regression model withPvalue of .007 and .038, respectively. This study highlights that therapeutic drug monitoring is required to achieve an adequate target itraconazole serum exposure.
Effects of combination of mitiglinide with various oral antidiabetic drugs in streptozotocin‐nicotinamide‐induced type 2 diabetic rats and Zucker fatty rats
Authors: Akahane Kenji , Ojima Kazuma , Yokoyama Ayaka , Inoue Toshihiro , Kiguchi Sumiyoshi , Tatemichi Satoshi , Takeda Hiroo , Imai Yohsuke
Published: July 2017

We examined the effects of combining the rapid insulin secretagogue, mitiglinide, with various oral hypoglycaemic drugs including biguanides, pioglitazone, α‐glucosidase inhibitors, and sodium‐glucose co‐transporter 2 inhibitors in a rat model of type 2 diabetes. The oral glucose tolerance test (OGTT) using glucose, sucrose, or a liquid meal was used to compare the effects of mitiglinide with those of the four oral hypoglycaemic drugs and examine their combined effects on blood glucose levels and insulin secretion in the rat model. The combination of mitiglinide with other oral hypoglycaemic drugs suppressed the plasma glucose levels more than either agent did alone. Furthermore, the combination of these agents decreased insulin secretion more than mitiglinide did alone. These results indicate that mitiglinide is suitable for use in combination with other hypoglycaemic drugs because it inhibits postprandial hyperglycaemia by rapidly stimulating insulin secretion.
A new political system model: Semi‐parliamentary government
Authors: GANGHOF STEFFEN
Published: July 2017

Semi‐parliamentary government is a distinct executive‐legislative system that mirrors semi‐presidentialism. It exists when the legislature is divided into two equally legitimate parts, only one of which can dismiss the prime minister in a no‐confidence vote. This system has distinct advantages over pure parliamentary and presidential systems: it establishes a branch‐based separation of powers and can balance the ‘majoritarian’ and ‘proportional’ visions of democracy without concentrating executive power in a single individual. This article analyses bicameral versions of semi‐parliamentary government in Australia and Japan, and compares empirical patterns of democracy in the Australian Commonwealth as well as New South Wales to 20 advanced parliamentary and semi‐presidential systems. It discusses new semi‐parliamentary designs, some of which do not require formal bicameralism, and pays special attention to semi‐parliamentary options for democratising the European Union.
Resourcing International Organisations: So What?
Authors: Michaelowa Katharina
Published: July 2017

The changes observed in resourcing international organisations over the last decades may have dramatic consequences for their ability to fulfil their mandates. This paper investigates into how far reaching the expected changes really are, and whether the new types and sources of financial and human resources can really be considered as causal for these developments. It appears that resourcing may not be the initial cause, but contributes to the centrifugal dynamics currently observed in the multilateral system. Administrative cost related to the new and complex funding structures are considerable, and ensuring transparency over resource flows represents a major challenge. Official decision‐making bodies lose power to sub‐groups of members or external actors that fund parts of the organisations’ activities through separate channels. Given the large volume of non‐core funding and the lack of transparency, they cannot easily adjust their own priorities. It can thus not be expected that the funding of certain activities through external channels will simply be compensated by a corresponding reduction of core funding in this area. Whether this negatively affects the ability of the organisations to fulfil their mandates – and hence, eventually their legitimacy – depends on the motivations of those actors empowered in this process.
Gemcitabine combined with cisplatin as adjuvant chemotherapy for non‐small cell lung cancer: A retrospective analysis
Authors: Ma Di , Wang Jing , Hao Xuezhi , Wang Yan , Hu Xingsheng , Xing Puyuan , Li Junling
Published: July 2017

Background

This study was conducted to evaluate the value of gemcitabine combined with cisplatin as adjuvant chemotherapy for radical resection of non‐small cell lung cancer.

Methods

Data of 100 patients who had undergone radical resection of non‐small cell lung cancer and were treated with cisplatin/gemcitabine as adjuvant chemotherapy between June 2007 and December 2010 at the Chinese Academy of Medical Sciences were reviewed.

Results

The median age was 59 years (range 36–73); 82% of the patients were male. Forty‐two percent had adenocarcinoma and 55% had squamous cell carcinoma. Most patients had pathologic IIB (29%) and IIIA (44%) stage disease. Eighty‐five percent of patients completed four cycles of chemotherapy, with 76% completing the planned full dose. The main reason for a reduced gemcitabine dose in 13 patients was grade 3/4 neutropenia or thrombocytopenia. The median dose and dose intensity were 8377.1 mg/m2 and 708 mg/(m2/week) for gemcitabine and 293.38 mg/m2 and 25.24 mg/(m2/week) for cisplatin, respectively. During follow‐up the median disease‐free survival was 33.8 months (95% confidence interval [CI] 15.938–51.676). Patients with squamous cell carcinoma (hazard ratio [HR] 0.404, 95% CI 0.241–0.676; P = 0.001) and pathologic stage I (HR 4.379, 95% CI 1.721–11.142; P = 0.002) achieved better disease‐free survival. The survival rates at one, two, and five years were 94%, 77%, and 55%, while the survival rates without recurrence were 64%, 53%, and 39%, respectively.

Conclusion

As an adjuvant chemotherapy regimen, gemcitabine with cisplatin is well tolerated. Patients with squamous cell carcinomas or pathologic stage I achieve better results.
The central role of mean‐variance relationships in the analysis of multivariate abundance data: a response to Roberts (2017)
Authors: Warton David I. , Hui Francis K. C.
Published: July 2017

The mean‐variance relationship is a central property of multivariate abundances – it has been shown that when not accounted for, potentially serious artifacts can be introduced to analyses. One such effect is the confounding of location and dispersion.

Roberts (in press) recently argued that mean‐variance relationships are not important in understanding properties of distance‐based analyses, and that row standardisation fixes the problem of apparent location‐dispersion confounding. We use simulation to disprove both statements.

In situations where there is a shift in total abundance from one location to the next, the effects of location‐dispersion confounding can be considerable. But we also show that even if there is no systematic difference in total abundance between two communities, and no change in dispersion, distance‐based analysis may falsely claim that there is a change.

We agree that multivariate abundance data are hierarchical, and that it is helpful to study effects at both the species‐level and the community level. However, disentangling species‐level from community‐level effects is not possible without a hierarchical method of analysis. Recently proposed model‐based approaches to ordination offer a way forward to resolve the issues discussed here.
Stadiums and Scheduling: Measuring Deadweight Losses in the Victorian Football League, 1920–70
Authors: Frost Lionel , Borrowman Luc , Halabi Abdel K.
Published: July 2017

Over a 50 year period, Australian Rules football's major league, the Victorian Football League, did not always use its largest and best‐equipped stadium for regular season games between its most popular teams or schedule those teams to play twice in a regular season. We calculate deadweight losses from the use of capital goods (stadiums) and effects of match scheduling in this professional sports league. Such analysis has not been attempted previously because of the absence of a counterfactual. The welfare losses were significant but not sufficient to threaten the survival of a distance‐protected cartel.
Design and Hemocompatibility Analysis of a Double‐Suction Injection Suspension Blood Pump Using Computational Fluid Dynamics Methods
Authors: Wu Yue , Zhu Liangfan , Luo Yun
Published: July 2017

The blood pump has become a possible solution to heart diseases. For the prevention of device failure and hemocompatibility problems, a rotary pump with suspended bearing is a preferred solution. In our previous work, a novel injection suspension method has been introduced to levitate the rotor. The suspension method is totally passive. This study aims to apply this suspension method to a double‐suction pump, and the property of the pump was investigated using computational fluid dynamics (CFD) methods. The flow field of the pump is simulated based on the SST k–ω turbulent model. The characteristic curves of the pump were calculated. At the nominal working point of 5 L/min, 100 mm Hg, the suspension force acting on the rotor was detected, which could reach 0.46 N with a gap of 150 µm. We compared the pump with a previously developed single‐suction injection pump to evaluate the blood compatibility of the double‐suction design. The average scalar shear stress values were 3.13 Pa for the double‐suction pump and 7.10 Pa for the single‐suction pump. Larger volumes in the single‐suction pump were exposed to shear stresses higher than 10 Pa. Thresholds for the von Willebrand factor cleavage, platelet activation, and hemolysis were defined to be 9 Pa, 50 Pa, and 150 Pa, respectively. The volume fractions for the double‐suction pump are lower for all thresholds. The normalized index of hemolysis (NIH) values for the two pumps were calculated to be 0.008 g/100 L and 0.016 g/100 L. Results proved that the double‐suction pump has a better hemocompatibility compared with the single‐suction pump.
Removal of Cell‐Activating Substances Using Dialyzers With Various Permeability Profiles
Authors: Latosinska Agnieszka , Hulko Michael , Speidel Rose , Mischak Harald , Storr Markus , Krause Bernd
Published: July 2017

Despite multiple efforts to target an improvement in clinical outcomes of patients with end‐stage renal disease, several challenges must still be addressed. Dialysis patients are at a high risk for complications, as reflected by increasing mortality rates. The objective of this study is to assess the impact of the application of dialyzers with varying permeability profiles on the removal of cell‐activating substances from the blood of hemodialysis (HD) patients. Dialysate samples were collected using Revaclear 400 (RC) and MCO‐Ci400 (MCO‐CI). Total protein and solute marker concentrations were determined for the concentrated sample. The response of tubular epithelial cells (TECs) to the dialysate samples was assessed via measurement of interleukin 6, cell viability, and morphology. Proteomic analysis of the dialysate samples was performed using liquid chromatography coupled to tandem mass spectrometry. Treatment of TECs with the MCO‐CI dialysate resulted in significantly decreased cell viability compared with the RC dialysate. TECs incubated with samples from MCO‐CI lost their typical brick‐like shape and cell–cell connections. Proteomic analysis of dialysate samples indicated multiple pro‐apoptotic and pro‐inflammatory proteins, supporting the observed phenotype. Additionally, application of the MCO‐CI dialyzer allowed for more efficient removal of proteins associated with advanced chronic kidney disease stages. Collectively, the use of dialyzer with a higher permeability profile enabled more efficient removal of cell‐activating and toxic substances from the blood of HD patients. However, a further large‐scale study is needed to address benefits and associated risks for patients.
Extensive and intensive margins and exchange rate regimes
Authors: Hamano Masashige , Picard Pierre M.
Published: July 2017

This paper studies the costs and benefits of fixed and flexible exchange rate regimes in the presence of endogenous intensive and extensive margins of trade. The net benefit depends on the levels and volatilities of those margins as well as on their correlation with consumers’ preferences. A fixed exchange rate regime is preferred for sufficiently high labour supply elasticities and lower love for product diversity. Delays between entry and production make fixed exchange rate regimes less attractive.
Health beliefs regarding pediatric cerebral palsy among caregivers in Botswana: A qualitative study
Authors: Patel P. , Baier J. , Baranov E. , Khurana E. , Gambrah‐Sampaney C. , Johnson A. , Monokwane B. , Bearden D. R.
Published: July 2017

Background

Cerebral palsy (CP) is the most common motor disability worldwide with an incidence of 2.5 per 1,000 births globally. Health beliefs among caregivers may be major drivers of health‐related behaviours and service utilization, but little is known regarding health beliefs around CP in Africa.

Methods

Between July 2013 and September 2015, children with CP were identified in Gaborone, Botswana, and their caregivers were invited to participate in a qualitative study utilizing semistructured in‐person one‐on‐one interviews. Interview questions addressed their understanding of CP, challenges of caring for a handicapped child, and community response to children with CP.

Results

Sixty‐two caregivers participated in the study. Common themes elicited were variable knowledge about CP, financial and physical burden, lack of therapies and educational resources, and the impact of stigma. Caregivers in Botswana generally subscribed to a biomedical explanation of CP but expressed concerns regarding more stigmatizing folks beliefs expressed in the community.

Conclusion

Health beliefs regarding CP in Botswana likely have a significant impact on utilization of healthcare resources. Information from this study should inform future educational interventions for caregivers of children with CP.
Outcomes of patients with metastatic phaeochromocytoma and paraganglioma: A systematic review and meta‐analysis
Authors: Hamidi Oksana , Young William F. , Gruber Lucinda , Smestad John , Yan Qi , Ponce Oscar J. , Prokop Larry , Murad Mohammad Hassan , Bancos Irina
Published: July 2017

Objective

The outcomes of patients with metastatic phaeochromocytoma (PHEO) and paraganglioma (PGL) are unclear. We performed a systematic review and meta‐analysis of baseline characteristics and mortality rates of patients with metastatic PHEO and PGL (PPGL).

Design

Ovid MEDLINE In‐Process & Other Non‐Indexed Citations, Ovid MEDLINE, Ovid EMBASE, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, Scopus, Web of Science, and references of key articles were searched from inception to 2016.

Patients

Studies comprised ≥20 patients with metastatic PPGL and reported baseline characteristics and follow‐up data.

Measurements

Reviewers extracted standardized data and assessed risk of bias using a modified Newcastle‐Ottawa tool. Random‐effects meta‐analysis was used to pool event rates across studies.

Results

Twenty retrospective noncomparative studies reported on 1338 patients with metastatic PHEO (685/1296, 52.9%) and PGL (611/1296, 47.1%), diagnosed at a mean age of 43.9 ± 5.2 years. Mean follow‐up was 6.3 ± 3.2 years. Of 532 patients with reported data, 40.4% had synchronous metastases. Five‐year (7 studies, n = 738) and 10‐year (2 studies, n = 55) mortality rates for patients with metastatic PPGL were 37% (95% CI, 24%‐51%) and 29% (95% CI, 17%‐42%), respectively. Higher mortality was associated with male sex (RR 1.50; 95% CI, 1.11‐2.02) and synchronous metastases (RR 2.43; 95% CI, 1.01‐5.85).

Conclusions

Available low‐quality evidence from heterogeneous studies suggests low mortality rates of patients with metastatic PPGL. Male sex and synchronous metastases correlated with increased mortality. The outcomes of patients with metastatic PPGL have been inadequately assessed, indicating the need for carefully planned prospective studies.
Serum glypican 4 level in obese children and its relation to degree of obesity
Authors: Leelalertlauw Chutima , Korwutthikulrangsri Manassawee , Mahachoklertwattana Pat , Chanprasertyothin Suwannee , Khlairit Patcharin , Pongratanakul Sarunyu , Poomthavorn Preamrudee
Published: July 2017

Objective

Previous adult studies have demonstrated associations of serum glypican 4 (Gpc4) and obesity parameters and insulin sensitivity. However, an association of serum Gpc4 and glucose metabolism remains contradictory. Study of serum Gpc4 in obese children has not been conducted. We aimed to determine serum Gpc4 levels in obese children with various degrees of obesity.

Design, Patients and Measurements

Up to 370 overweight and obese children, aged 6‐18 years were enrolled in this cross‐sectional study. Oral glucose tolerance test (OGTT) was performed with fasting serum Gpc4, lipid profiles, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) measured. Insulin sensitivity and β‐cell function indices were calculated from plasma glucose and serum insulin levels derived from the OGTT. Bioelectrical impedance analysis was performed for body fat determination. Comparisons of serum Gpc4 levels among the groups of children with various degrees of obesity were performed.

Results

Serum Gpc4 levels progressively increased in children with increasing body mass index standard deviation score (BMI SDS) tertiles [median (interquartile range, IQR): 2.3 (1.8, 3.2), 2.6 (1.9, 3.4) and 3.2 (2.4, 3.8) μg/L, P<.001]. There were no differences in serum Gpc4 levels among children in the different glucose metabolism categories. Log serum Gpc4 levels were positively correlated with SDSs of weight and BMI, cholesterol, AST and ALT. No associations of log serum Gpc4 and insulin sensitivity and β‐cell function indices were demonstrated.

Conclusions

Serum Gpc4 levels were increased with increasing degrees of obesity. There were no differences in serum Gpc4 levels among glucose metabolism categories.
Patient experiences of adjusting to life in the first 2 years after bariatric surgery: a qualitative study
Authors: Graham Y. , Hayes C. , Small P. K. , Mahawar K. , Ling J.
Published: July 2017

There is currently little research into the experiences of those who have undergone bariatric surgery, or how surgery affects their lives and social interactions. Adopting a constructivist grounded theory methodological approach with a constant comparative analytical framework, semi‐structured interviews were carried out with 18 participants (11 female, 7 male) who had undergone permanent bariatric surgical procedures 5‐24 months prior to interview. Findings revealed that participants regarded social encounters after bariatric surgery as underpinned by risk. Their attitudes towards social situations guided their social interaction with others. Three profiles of attitudes towards risk were constructed: Risk Accepters, Risk Contenders and Risk Challengers. Profiles were based on participant‐reported narratives of their experiences in the first two years after surgery. The social complexities which occurred as a consequence of bariatric surgery required adjustments to patients' lives. Participants reported that social aspects of bariatric surgery did not appear to be widely understood by those who have not undergone bariatric surgery. The three risk attitude profiles that emerged from our data offer an understanding of how patients adjust to life after surgery and can be used reflexively by healthcare professionals to support both patients pre‐ and post‐operatively.
Linguistic Constraints on Statistical Word Segmentation: The Role of Consonants in Arabic and English
Authors: Kastner Itamar , Adriaans Frans
Published: July 2017

Statistical learning is often taken to lie at the heart of many cognitive tasks, including the acquisition of language. One particular task in which probabilistic models have achieved considerable success is the segmentation of speech into words. However, these models have mostly been tested against English data, and as a result little is known about how a statistical learning mechanism copes with input regularities that arise from the structural properties of different languages. This study focuses on statistical word segmentation in Arabic, a Semitic language in which words are built around consonantal roots. We hypothesize that segmentation in such languages is facilitated by tracking consonant distributions independently from intervening vowels. Previous studies have shown that human learners can track consonant probabilities across intervening vowels in artificial languages, but it is unknown to what extent this ability would be beneficial in the segmentation of natural language. We assessed the performance of a Bayesian segmentation model on English and Arabic, comparing consonant‐only representations with full representations. In addition, we examined to what extent structurally different proto‐lexicons reflect adult language. The results suggest that for a child learning a Semitic language, separating consonants from vowels is beneficial for segmentation. These findings indicate that probabilistic models require appropriate linguistic representations in order to effectively meet the challenges of language acquisition.
864. BERBERIS BOWASHANENSIS
Authors: Harber Julian
Published: July 2017

A new species of Berberis from Sichuan, Berberis bowashanensis Harber, is described and illustrated.
External national validation of the Leicester Self‐Assessment score for Type 2 diabetes using data from the English Longitudinal Study of Ageing
Authors: Barber S. R. , Dhalwani N. N. , Davies M. J. , Khunti K. , Gray L. J.
Published: July 2017

Aims

To validate the Leicester Self‐Assessment score using a representative English dataset for detecting prevalent non‐diabetic hyperglycaemia or undiagnosed Type 2 diabetes (defined as HbA1c ≥6.0%) and for identifying those who may go on to develop Type 2 diabetes within 10 years.

Methods

Data were taken from the English Longitudinal Study of Ageing, a nationally representative dataset of people aged ≥50 years. The area under the receiver–operator curve and performance metrics for the score at the recommended score threshold (≥16), were calculated for the outcomes of HbA1c ≥42 mmol/mol (6.0%) at baseline and self‐reported Type 2 diabetes within 10 years in those aged 50–75 years at baseline.

Results

A total of 3203 individuals had a baseline HbA1c measurement, of whom 247 (7.7%) had an HbA1c concentration ≥42 mmol/mol (6.0%). The area under the receiver–operator curve was 69.4% (95% CI 66.0–72.9) for baseline HbA1c ≥42 mmol/mol. A total of 3550 individuals had diabetes status recorded at 10 years, of whom 324 (9.1%) were diagnosed with Type 2 diabetes within this time; the area under the receiver–operator curve for this outcome was 74.9% (95% CI 72.4–77.5). The score threshold of ≥16 had a sensitivity of 89.2% (95% CI 85.3–92.4) and a specificity of 42.3% (95% CI 40.5–44.0) for Type 2 diabetes within 10 years.

Conclusions

The Leicester Self‐Assessment score is validated for use across England to identify people with non‐diabetic hyperglycaemia or undiagnosed Type 2 diabetes. Those with a high score are at high risk of developing diabetes in the future.
Impact of rurality and substance use on young people at ultra high risk for psychosis
Authors: Stain Helen J. , Halpin Sean A. , Baker Amanda L. , Startup Mike , Carr Vaughan J. , Schall Ulrich , Crittenden Kylie , Clark Vanessa , Lewin Terry J. , Bucci Sandra
Published: July 2017

Background

Longitudinal research into early intervention for youth at ultra high risk (UHR) for psychosis demonstrates beneficial outcomes including increased treatment compliance and greater participation in education and the workforce. Despite known barriers for rural youth accessing mental health services, research comparing urban and rural UHR youth is lacking. The study included an examination of the impact of substance use on functioning of UHR youth.

Methods

Youth aged 12 to 25 years were recruited from the urban area of Newcastle or the rural area of Orange, New South Wales, Australia, and identified as UHR by the Comprehensive Assessment of At Risk Mental States. Rural and urban youth were compared on clinical profiles, social and occupational functioning and substance use.

Results

The rural youth showed different help‐seeking behaviours and had greater functional impairment than urban youth. Substance use was common across the sample of 57 youth (mean age 16.5 years, 56% female) and a history of hazardous substance use was associated with higher levels of depression. Rural youth (n = 32) were more likely than urban youth to be taking antidepressants at baseline (44% compared with 16%).

Conclusion

Different patterns of help seeking by rural UHR youth suggest a need for greater access to psychosis informed primary care early intervention services. Interventions should target functional decline to prevent adverse outcomes such as reduced community participation and unemployment. In addition, interventions for substance use should be a priority for UHR youth, who should also be screened and monitored for depressive symptoms and treated for depression if indicated.
Enhancing prevention and intervention for youth concurrent mental health and substance use disorders: The Research and Action for Teens study
Authors: Henderson Joanna L. , Brownlie E. B. , McMain Shelley , Chaim Gloria , Wolfe David A. , Rush Brian , Boritz Tali , Beitchman Joseph H.
Published: July 2017

Background

Concurrent mental health and substance use disorders among youth are associated with functional impairment in developmentally salient domains, yet research on prevention and intervention for this vulnerable population is sparse. This paper describes the rationale and design of the Research and Action for Teens study, an initiative designed to strengthen the evidence base for prevention, screening, treatment and service delivery for youth concurrent mental health and substance use concerns.

Methods

Four sub‐studies were developed: (1) a cohort study examining the emergence of mental health and substance use concerns from early to mid‐adolescence; (2) a screening and diagnosis study validating screening tools with a diagnostic interview; (3) a treatment study examining the feasibility and effectiveness of dialectical behaviour therapy skills training interventions for youth and family members; and (4) a systems study implementing cross‐sectoral collaborative networks of youth‐serving agencies using a common screening tool.

Results

Multiple stakeholders, including service providers from youth‐serving agencies across sectors, consumer groups and family members participated in an initial consultation, and in the implementation of 4 sub‐studies.

Conclusions

Collaboration with community stakeholders across sectors and disciplines throughout the research process is challenging but feasible, and is important for the production of applicable knowledge across the continuum of care.
Utilization of Western medicine and traditional Chinese medicine among patients with Alzheimer's disease in Taiwan: a nationwide population‐based study
Authors: Lai C.‐Y. , Wu M.‐Y. , Chiang J.‐H. , Sun M.‐F. , Chen Y.‐H. , Chang C.‐T. , Lin J.‐G. , Yen H.‐R.
Published: July 2017

Background and purpose

Large‐scale studies of utilization of medical services among patients with Alzheimer's disease (AD) are lacking. We aimed to investigate the usage of Western medicine and traditional Chinese medicine (TCM) among these patients in Taiwan.

Methods

We analyzed one million samples from the National Health Insurance Research Database in Taiwan. Patients (n = 1814) newly diagnosed with AD in 2001–2010 were divided into TCM users (n = 528) and non‐TCM users (n = 1286).

Results

Compared with non‐TCM users, TCM users were younger, had a higher female:male ratio and higher utilization rate of Western medicine. The median interval between diagnosis and the first TCM consultation was 7.92 months. Donepezil and rivastigmine were commonly prescribed medications. Chinese herbal medicine was the most popular treatment among TCM users.

Conclusions

This study revealed the specific usage patterns of TCM and non‐TCM medical services among patients with AD. The information could be used for improving the healthcare of patients with AD.
Standing intraoral extractions of cheek teeth aided by partial crown removal in 165 horses (2010–2016)
Authors: Rice M. K. , Henry T. J.
Published: July 2017

Background

Diseased cheek teeth in horses often require invasive extraction techniques that carry a high rate of complications. Techniques and instrumentation were developed to perform partial crown removal to aid standing intraoral extraction of diseased cheek teeth in horses.

Objectives

To analyse success rates and post‐surgical complications in horses undergoing cheek teeth extraction assisted by partial crown removal.

Study design

Retrospective cohort study.

Methods

This study included 165 horses with 194 diseased cheek teeth that were extracted orally assisted by partial crown removal between 2010 and 2016. Medical records were analysed, including case details, obtained radiographs, surgical reports and follow‐up information. Follow‐up information (≥2 months) was obtained for 151 horses (91.5%). There were 95 horses examined post‐operatively by the authors and, 16 horses by the referring veterinarian; in 40 horses, post‐operative follow up was obtained by informal telephone interviews with the owner.

Results

Successful standing intraoral extraction of cheek teeth was obtained in 164/165 horses (99.4%). Twenty‐five of these horses (15.2%) required additional intraoral extraction methods to complete the extraction, including minimally invasive transbuccal approach (n = 21) and tooth sectioning (n = 4). There was one (0.6%) horse with intraoral extraction failure that required standing repulsion to complete the extraction. The intraoperative complication of fractured root tips occurred in 11/165 horses (6.7%). Post‐operative complications occurred in 6/165 horses (3.6%), including alveolar sequestra (n = 4), mild delay of alveolar healing at 2 months (n = 1), and development of a persistent draining tract secondary to a retained root tip (n = 1).

Main limitations

Specialised instrumentation and additional training in the technique are recommended to perform partial crown removal in horses.

Conclusion

Horses with cheek teeth extraction by partial crown removal have an excellent prognosis for a positive outcome. The term partial coronectomy is proposed for this technique.
Threshold values for very high cycle fatigue failure of high‐strength steels
Authors: Spriestersbach D. , Grad P. , Kerscher E.
Published: July 2017

Cracks leading to failure in very high cycle fatigue (VHCF) of high‐strength steels mostly initiate at subsurface inclusions at stress intensity factors (SIF) below the classical threshold value Kth for long cracks, especially for negative stress ratios. Here, a characteristic fine granular area (FGA) can be observed at the fracture surface in the vicinity of these initiating inclusions. According to various researchers, the FGA formation might be responsible for the late initiation of a propagable long crack. This study aims to clarify the threshold values of SIF for crack initiation for VHCF failure with FGA formation at nonmetallic inclusions. For this purpose, ultrasonic fatigue tests (R = −1) with the high‐strength steel 100Cr6 (SAE 52100) were carried out until an ultimate number of cycles of 109. In addition, very high cycle stress increase tests were performed. A serial grinding investigation of fatigued specimens acted as a technique to evaluate the distribution of unharmful inclusion in the tested volume. By the combination of these tests, a threshold value of the SIF for the VHCF by FGA formation at inclusions can be derived. This threshold value depends on the size of the crack initiating inclusion.
Effect of chewing or compressing food on autonomic nervous activity in older adults
Authors: Ohta Midori , Ueda Takayuki , Sakurai Kaoru
Published: July 2017

Objective

To determine if autonomic nervous activity increases in older people during mastication and how this activity is related to the softness of food. We hypothesised that the coefficient of variation of R‐R intervals (CVRR), high‐frequency (HF) power, low‐frequency (LF) power, LF/HF ratio and total power increase during chewing foods within the range of softness from moderate food to extremely soft food in older adults.

Materials and methods

Participants were 20 older volunteers (71‐90 year old). CVRR and HF on the electrocardiogram (ECG) were used as indices of parasympathetic nervous activity. LF and the LF/HF ratio on the ECG were used as indices of sympathetic nervous activity. Total power, reflecting the level of autonomic nervous activity, was also measured. Participants were asked to chew gum with three different degrees of softness, or to compress extremely soft gum between their palate and tongue.

Results

There were significant differences in HF between at resting and all chewing/compressing conditions, but no significant differences relating to food softness. There were significant differences in total power between at resting and all chewing/compressing conditions, but no significant differences relating to food softness. There were no significant differences in LF, LF/HF and CVRR among all conditions.

Conclusion

Autonomic nervous activity, especially parasympathetic activity in older adults, increased during chewing and compressing food when compared to activity while at rest. Within the range of food's softness from moderate to extreme soft, food's softness had no measurable effect on autonomic nervous activity.