bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy and Safety of Vernakalant for Cardioversion of Recent-onset Atrial Fibrillation in the Asia–Pacific Region: A Phase 3 Randomized Controlled Trial
Authors: Beatch Gregory N. , Bhirangi Kiran , Juul-Moller Steen , Rustige Jörg
Published: November 2016

Atrial fibrillation (AF) is a common clinically significant cardiac arrhythmia. This phase 3 randomized, double-blind, placebo-controlled trial assessed the efficacy and safety of vernakalant hydrochloride for the pharmacological conversion of AF to sinus rhythm in patients with recent-onset (>3 hours to ≤7 days) symptomatic AF from the Asia–Pacific region. Patients received an infusion of vernakalant (3 mg/kg) or placebo for 10 minutes. If AF had not been terminated 15 minutes later, a second infusion of vernakalant (2 mg/kg) or placebo for 15 minutes was administered. The primary efficacy end point was conversion of AF to sinus rhythm for >1 minute within 90 minutes. The study was terminated early for administrative reasons; 123 patients from Korea, Taiwan, and India were randomized to receive vernakalant (n = 55) or placebo (n = 56). A greater proportion of patients who received vernakalant (52.7%) than placebo (12.5%) met the primary end point (P < 0.001), and cardioversion was faster in the vernakalant group than in the placebo group (P < 0.001). Vernakalant was generally well tolerated; the incidence of treatment-emergent adverse events was similar between the groups. We conclude that vernakalant is efficacious in the rapid cardioversion of recent-onset AF in patients from the Asia–Pacific region.
DIFFERENT SURGICAL MODALITIES FOR MANAGEMENT OF PERSISTENT GLAUCOMA AFTER SILICONE OIL REMOVAL IN VITRECTOMIZED EYES
Authors: El-Saied Heba Magdy , Abdelhakim Mohamad Amr Salah Eddin
Published: November 2016

Purpose:

Aim of this study was to compare outcome of four different surgical modalities for management of persistent glaucoma after silicone oil removal in vitrectomized eyes.

Methods:

This is a prospective comparative study, carried out on a cohort of 41 eyes (41 patients). Patients were randomly allocated to Group A (trabeculectomy), Group B (deep sclerectomy), Group C (Ahmed valve), or Group D (Ex-Press Minishunt). Postoperatively, all patients were followed regularly at 1 day, 1 week, 1, 3, and 6 months, and 1 year for intraocular pressure evaluation.

Results:

Postoperatively, there was significant drop in intraocular pressure in each group, and significant difference between the four groups regarding drop and percentage drop in intraocular pressure, with Group C showing the highest mean percentage drop in intraocular pressure, whereas Group B with the least. Success rate was 100% with Ex-Press minishunt, 80% with Ahmed valve, and 50% for each of trabeculectomy and deep sclerectomy. Hypotony occurred in 50% with Ahmed valve and 40% with trabeculectomy, whereas glaucoma occurred in 50% with deep sclerectomy and 30% with trabeculectomy.

Conclusion:

For controlling persistent glaucoma after silicone oil removal in our work, Ex-Press minishunt had the highest complete success rate with no postoperative complications.
ULTRA-WIDE-FIELD FUNDUS IMAGING IN THE DIAGNOSIS AND FOLLOW-UP OF SUSAC SYNDROME
Authors: Salvanos Panagiotis , Moe Morten C. , Utheim Tor P. , Bragadóttir Ragnheiður , Kerty Emilia
Published: November 2016

Purpose:

To present the use of ultra-wide-field (UW) fundus imaging in the diagnosis and follow-up of a patient with Susac syndrome.

Methods:

Case report of a myopic patient presenting initially with rhegmatogenous retinal detachment. A significant portion of the retina was found to be avascular bilaterally at presentation. Surgery was performed with scleral buckle. Then, UW color and autofluorescent imaging and UW fluorescein angiography were obtained.

Results:

Successful retinal reattachment was obtained. Enlargement of the avascular area with neovascularization was observed at eight-month follow-up. In addition, the patient presented severe neurosensory hearing loss and clinical depression postoperatively. The results of UW fluorescein angiography revealed hyperfluorescent macular spots, arteriolar wall hyperfluorescence, leakage from retinal neovascularization, and confirmed the avascularity of two thirds of the retina, whereas the results of UW autofluorescence showed absence of the normal hypofluorescent retinal vessels outside the posterior pole. Findings of UW imaging in combination with systemic involvement led to the diagnosis of Susac syndrome. Appropriate treatment stopped the disease progress, ameliorated symptoms, and some of the occluded retinal vessels were reperfused.

Conclusion:

In conclusion, UW fundus imaging is a valuable modality in the diagnosis and follow-up of patients with Susac syndrome. Early diagnosis and treatment is critical, particularly as it can lead to reperfusion of occluded retinal vessels.
BILATERAL METASTATIC CUTANEOUS MELANOMA TO RETINA AND VITREOUS AFTER IPILIMUMAB TREATED WITH PARS PLANA VITRECTOMY AND RADIOTHERAPY
Authors: Kanavati Sam , Ottensmeier Christian , Foria Vipul , Krishnan Radhika
Published: November 2016

Purpose:

To report a patient with bilateral metastatic cutaneous melanoma to the retina and vitreous presenting as a right panuveitis.

Methods:

A 63-year-old woman with metastatic malignant cutaneous melanoma treated with ipilimumab and prolonged high-dose steroids presented with a right panuveitis and right blurred vision. Dilated fundus examination revealed bilateral, off-white, large, globular vitreous opacities and bilateral retinal lesions. These retinal lesions had a pale yellow appearance with a cuff of haemorrhage. The unpigmented appearance of the vitreous opacities raised the suspicion of candida endophthalmitis.

Results:

Bilateral, sequential pars plana vitrectomy with pathomorphologic examination of the vitreous specimen demonstrated metastatic melanoma. Ocular radiotherapy followed by cataract surgery resulted in the regression of retinal lesions in both eyes and no recurrence of the vitreous metastases.

Conclusion:

The development of vitreous and retinal metastases despite a systemic response to ipilimumab identifies the challenge of immunotherapy in an immune privileged site. Treatment is challenging, and outcomes are variable. A local approach of bilateral pars plana vitrectomy, external beam radiotherapy, and subsequent bilateral cataract surgery provided an excellent visual result with no recurrence at 12 months.
THE “DOUBLE-RING SIGN” IN ANEMIC RETINOPATHY EVALUATED BY SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY
Authors: Goel Neha
Published: November 2016

Purpose:

To describe three cases of anemic retinopathy who demonstrated premacular hemorrhage with a “double-ring sign.”

Methods:

Three patients with anemia were found to have a premacular hemorrhage and a double-ring sign either at presentation or after laser membranotomy. Spectral domain optical coherence tomography was performed to ascertain the level of the hemorrhage.

Results:

To the best of the author's knowledge, there is no report of a double-ring sign in anemic retinopathy. In two eyes, spectral domain optical coherence tomography revealed that the double-ring sign consisted of an outer subhyaloid and inner sub-internal limiting membrane hemorrhage. However, in the third case, spectral domain optical coherence tomography confirmed that the double-ring sign consisted of a sub-internal limiting membrane hemorrhage only.

Conclusion:

Spectral domain optical coherence tomography evaluation is essential to determine the level of hemorrhage in premacular hemorrhage with a double-ring sign. It may not always indicate concurrent occurrence of a subhyaloid and sub-internal limiting membrane hemorrhage, as was previously believed.
MACULAR TELANGIECTASIA TYPE 2 IN AN OTHERWISE HEALTHY TEENAGE BOY WITH CONSANGUINEOUS PARENTS
Authors: Ryu Christina L. , Mikhail Mikel , Khan Ayesha , Chen John C. , Omar Amer
Published: November 2016

Purpose:

To report a case of macular telangiectasia Type 2 in a teenage boy with consanguineous parents.

Method:

Clinical case report and literature review.

Results:

A healthy 14-year-old boy presented with mildly reduced vision in both eyes. Visual acuity was 20/30 in the right eye and 20/25 in the left eye. Fundus examination revealed intraretinal crystals in both eyes and an intraretinal pigment plaque temporal to the fovea in the left eye. Neither eye showed evidence of choroidal neovascular membrane or peripheral telangiectasia. Fluorescein angiography revealed temporal juxtafoveal leakage in both eyes. Spectral-domain optical coherence tomography showed ellipsoid layer and external limiting membrane disruption in the right eye and an inner retinal pigment plaque with shadowing in the left eye. The patient was of South Asian descent, and his parents were first cousins. His younger brother and parents were unaffected with a normal fundus examination.

Conclusion:

This is the youngest reported case of a healthy individual with MacTel Type 2, which usually manifests in the fifth or sixth decade. This is also the only reported case of MacTel Type 2 with consanguineous parents. This proband offers a unique opportunity to study possible monogenic etiologies of the condition.
Recurrent Mycobacterium avium Complex Infection
Authors: Grippen Goddard Amanda , Bathla Girish , Petts Jennifer , Ballas Zuhair K.
Published: November 2016

A 64-year-old white female presented with 4 years of episodic, productive cough, fevers, chills, night sweats, and weight loss. Over this period, she had documented recurrent Mycobacterium avium complex in the bronchiolar lavage and sputum despite taking antibiotics for 2 years. Result of extensive immune evaluation including genetic testing was negative. Physical examination revealed dentures covered in a gray film. Cultures taken from the dentures grew Mycobacterium avium complex. The patient's symptoms, inflammatory markers, and chest imaging significantly improved after removing the dentures. Additionally, the sputum cultures became negative. Biofilms are known to be detrimental to public health via colonization of medical devices or naturally occurring reservoirs in the human body. This case highlights important clinical points: the necessity of taking a thorough history and physical examination, considering dentures as foreign bodies, especially if pulmonary infections recur, and the difficulty of treating biofilms short of removing the reservoir.
Osteomyelitis and Hip Abscess Caused by Gardnerella vaginalis
Authors: Shah Niel Nitin , Nanjappa Sowmya , Greene John N.
Published: November 2016

Gardnerella vaginalis (G. vaginalis) is a facultative anaerobic gram-variable pleomorphic rod most commonly associated with infection of the genital tract in women, especially bacterial vaginosis, but recognition of extravaginal G. vaginalis infection is becoming more frequent. We report a case of osteomyelitis hip abscess caused by G. vaginalis in a young female patient with a history of left hip Ewing sarcoma treated with surgical resection, chemotherapy, and hardware placement. We discuss previously reported cases of osteoarticular infections due to G. vaginalis in the medical literature and management of our unique case despite the lack of antimicrobial susceptibility for G. vaginalis.
Clostridium cadaveris Septic Arthritis After Total Right Hip Arthroplasty in an Immunocompetent Host
Authors: McKenzie Paula , Cuevas Jose , Sotello David , Fuhrmann Kristen , Winn Richard , Brindley George
Published: November 2016

An elderly woman underwent an uncomplicated right hip replacement (total hip arthroplasty) in 2005 and returned 5 years later with cellulitis of the right hip. Treatment with oral antibiotics was initiated. Septic arthritis of the right hip joint was diagnosed ultimately, and she had surgical removal (explant) of the right hip prosthesis in 2011. Recurrent right hip infections ensued on several occasions with multiple antibiotic courses over the next 4 years. Although she had intermittent infections with methicillin-susceptible Staphylococcus aureus and methicillin-resistant Staphylococcus aureus, she had consistent and persistent isolation of Clostridium cadaveris from the hip beginning in 2013. After prolonged surgical interventions and several courses of antibiotics, C. cadaveris was eradicated; she has undergone implantation for a second stage implant (total hip arthroplasty) of the affected hip and remains stable to date.
Approach to Management of Coccidioidomycosis in Patients Receiving Inhibitors of Tumor Necrosis Factor-α
Authors: Blair Janis E. , Wack Elizabeth E. , Mertz Lester E. , Galgiani John N.
Published: November 2016

Inhibitors of tumor necrosis factor-α (TNFIs) have revolutionized the treatment for patients with a variety of inflammatory illnesses, including rheumatoid arthritis, psoriasis and psoriatic arthritis, ankylosing spondylitis, and other inflammatory diseases, and have improved the outcomes and quality of life for such patients. Endemic fungal infections, such as coccidioidomycosis, are observed to occur in persons who are treated with these agents and who live in the Coccidioides-endemic area with similar frequency as persons in the general, healthy public but with an increased likelihood of symptomatic infection and extrapulmonary dissemination. Because the control of coccidioidal infections requires the formation and maintenance of granuloma, it is not unexpected that TNFIs, which inhibit granuloma formation, seem to increase the risk of clinical disease. No guidelines exist to address the prevention and management of disease in patients whose treatment course with TNFIs is complicated by subclinical or clinical coccidioidal infection. Therefore, we reviewed the available medical literature and offer suggestions to the approach and treatment of patients with various forms of coccidioidomycosis before and during therapy with TNFIs.
Fluid and Electrolyte Imbalances: Interpretation and Assessment
Authors: Walker Mandi D.
Published: November 2016

Maintaining the balance of fluid and electrolytes is crucial to the care of patients across the continuum. To do this, a practitioner must be cognizant of key monitoring and assessment parameters. Key electrolytes, their function within the body, normal values, signs and symptoms of imbalances, key treatment modalities, and other considerations are discussed.
Successful Infusion Therapy in Older Adults
Authors: Coulter Kay
Published: November 2016

Older adults are a special patient population who require attention to a variety of issues and considerations related to infusion therapy. The need to alter practice approaches includes vascular access techniques and the administration of intravenous medications, fluids, and blood components. In addition, older adults will manifest very different signs and symptoms related to development of an infection in the body. This article reviews the normal physical changes that occur in their major body systems and discusses recommendations to accomplish successful venous access and correct administration of infusates.
Antiretroviral Drug Use in a Cross-Sectional Population Survey in Africa: NIMH Project Accept (HPTN 043)
Authors: Fogel Jessica M. , Clarke William , Kulich Michal , Piwowar-Manning Estelle , Breaud Autumn , Olson Matthew T. , Marzinke Mark A. , Laeyendecker Oliver , Fiamma Agnès , Donnell Deborah , Mbwambo Jessie K. K. , Richter Linda , Gray Glenda , Sweat Michael , Coates Thomas J. , Eshleman Susan H.
Published: November 2016

Background:

Antiretroviral (ARV) drug treatment benefits the treated individual and can prevent HIV transmission. We assessed ARV drug use in a community-randomized trial that evaluated the impact of behavioral interventions on HIV incidence.

Methods:

Samples were collected in a cross-sectional survey after a 3-year intervention period. ARV drug testing was performed using samples from HIV-infected adults at 4 study sites (Zimbabwe; Tanzania; KwaZulu-Natal and Soweto, South Africa; survey period 2009–2011) using an assay that detects 20 ARV drugs (6 nucleoside/nucleotide reverse transcriptase inhibitors, 3 nonnucleoside reverse transcriptase inhibitors, and 9 protease inhibitors; maraviroc; raltegravir).

Results:

ARV drugs were detected in 2011 (27.4%) of 7347 samples; 88.1% had 1 nonnucleoside reverse transcriptase inhibitors ± 1–2 nucleoside/nucleotide reverse transcriptase inhibitors. ARV drug detection was associated with sex (women>men), pregnancy, older age (>24 years), and study site (P< 0.0001 for all 4 variables). ARV drugs were also more frequently detected in adults who were widowed (P= 0.006) or unemployed (P= 0.02). ARV drug use was more frequent in intervention versus control communities early in the survey (P= 0.01), with a significant increase in control (P= 0.004) but not in intervention communities during the survey period. In KwaZulu-Natal, a 1% increase in ARV drug use was associated with a 0.14% absolute decrease in HIV incidence (P= 0.018).

Conclusions:

This study used an objective, biomedical approach to assess ARV drug use on a population level. This analysis identified factors associated with ARV drug use and provided information on ARV drug use over time. ARV drug use was associated with lower HIV incidence at 1 study site.
Elevated Markers of Vascular Remodeling and Arterial Stiffness Are Associated With Neurocognitive Function in Older HIV+ Adults on Suppressive Antiretroviral Therapy
Authors: Montoya Jessica L. , Iudicello Jennifer , Fazeli Pariya L. , Hong Suzi , Potter Michael , Ellis Ronald J. , Grant Igor , Letendre Scott L. , Moore David J. ,   the HIV Neurobehavioral Research Program (HNRP) Group
Published: November 2016

Background:

HIV is associated with elevated markers of vascular remodeling that may contribute to arterial fibrosis and stiffening and changes in pulse pressure (PP). These changes may, in turn, deleteriously affect autoregulation of cerebral blood flow and neurocognitive function.

Methods:

To evaluate these mechanisms, we studied markers of vascular remodeling, PP, and neurocognitive function among older (≥50 years of age) HIV-infected (HIV+, n = 72) and HIV-seronegative (HIV−, n = 36) adults. Participants completed standardized neurobehavioral and neuromedical assessments. Neurocognitive functioning was evaluated using a well-validated comprehensive battery. Three plasma biomarkers of vascular remodeling (ie, angiopoietin 2, Tie-2, and vascular endothelial growth factor, VEGF) were collected.

Results:

HIV+ and HIV− participants had similar levels of plasma angiopoietin 2 (P = 0.48), Tie-2 (P = 0.27), VEGF (P = 0.18), and PP (P = 0.98). In a multivariable regression model, HIV interacted with Tie-2 (β = 0.41, P < 0.01) and VEGF (β = −0.43, P = 0.01) on neurocognitive function, such that lower Tie-2 and higher VEGF values were associated with worse neurocognitive function for HIV+ participants. Greater Tie-2 values were associated with increased PP (r = 0.31, P < 0.01). In turn, PP demonstrated a quadratic association with neurocognitive function (β = −0.33, P = 0.01), such that lower and higher, relative to mean sample, PP values were associated with worse neurocognitive function.

Conclusions:

These findings indicate that vascular remodeling and altered cerebral blood flow autoregulation contribute to neurocognitive function. Furthermore, HIV moderates the association between vascular remodeling and neurocognitive function but not the association between PP and neurocognitive function.
Incomplete control and concessions explain mating skew in male chimpanzees
Authors: Bray Joel , Pusey Anne E. , Gilby Ian C.
Published: November 2016

Sexual selection theory predicts that because male reproductive success in mammals is limited by access to females, males will attempt to defend access to mates and exclude rivals from mating. In mammals, dominance rank is correlated with male reproductive success; however, the highest-ranking (alpha) male rarely monopolizes reproduction completely. To explain why, incomplete control models propose that alpha males simply cannot control other males' access to mates. If true, then dominance rank should be a key factor influencing subordinate (non-alpha) male mating success. Alternatively, the concession model states that alpha males can prevent other males from gaining access to mates but posits that they concede matings to subordinates in exchange for social favours. This predicts that a male's grooming interactions with the alpha should mediate his access to females. We test these predictions using 36 years of data, encompassing the tenures of eight alpha male chimpanzees at Gombe National Park, Tanzania. Incomplete control models were most strongly supported. At a given copulation event, the probability that the alpha was the male that mated was negatively associated with the number of males and sexually receptive females in the party. Additionally, as the number of males increased, high dominance rank was associated with an increased likelihood that a particular non-alpha male mated. The concession model, however, was also supported. The amount of time a male spent grooming with the alpha was positively associated with his likelihood of mating when the alpha was present in the party. As grooming is a major affiliative component of male social relationships, our results suggest that social bonds with dominant individuals are leveraged for mating access, particularly in species in which males form coalitions.
Complete avian malaria parasite genomes reveal features associated with lineage specific evolution in birds and mammals
Authors: Böhme Ulrike , Otto Thomas D. , Cotton James , Steinbiss Sascha , Sanders Mandy , Oyola Samuel O. , Nicot Antoine , Gandon Sylvain , Patra Kailash P. , Herd Colin , Bushell Ellen , Modrzynska Katarzyna K. , Billker Oliver , Vinetz Joseph M. , Rivero Ana , Newbold Chris I. , Berriman Matthew
Published: November 2016

Avian malaria parasites are prevalent around the world, and infect a wide diversity of bird species. Here we report the sequencing and analysis of high quality draft genome sequences for two avian malaria species,Plasmodium relictumandPlasmodium gallinaceum. We identify 50 genes that are specific to avian malaria, located in an otherwise conserved core of the genome that shares gene synteny with all other sequenced malaria genomes. Phylogenetic analysis suggests that the avian malaria species form an outgroup to the mammalianPlasmodiumspecies and using amino acid divergence between species, we estimate the avian and mammalian-infective lineages diverged in the order of 10 million years ago. Consistent with their phylogenetic position, we identify orthologs of genes that had previously appeared to be restricted to the clades of parasites containingP. falciparumandP. vivax- the species with the greatest impact on human health. From these orthologs, we explore differential diversifying selection across the genus and show that the avian lineage is remarkable in the extent to which invasion related genes are evolving. The subtelomeres of theP. relictumandP. gallinaceumgenomes contain several novel gene families, including an expandedsurfmultigene family. We also identify an expansion of reticulocyte binding protein homologs inP. relictumand within these proteins, we detect distinct regions that are specific to non-human primate, humans, rodent and avian hosts. For the first time in thePlasmodiumlineage we find evidence of transposable elements, including several hundred fragments of LTR-retrotransposons in both species and an apparently complete LTR-retrotransposon in the genome ofP. gallinaceum.
Synthetic hypermutation: gene-drug mutation rate synergy reveals a translesion synthesis mechanism
Authors: Segovia Romulo , Shen Yaoqing , Lujan Scott A. , Jones Steven , Stirling Peter C.
Published: November 2016

Gene-gene or gene-drug interactions are typically quantified using fitness as readout because the data is continuous and easily measured in high-throughput. However, to what extent fitness captures the range of other phenotypes that show synergistic effects is usually unknown. UsingSaccharomyces cerevisiae, and focusing on a matrix of DNA repair mutants and genotoxic drugs, we quantify 76 gene-drug interactions based on both mutation rate and fitness and find that these parameters are not necessarily overlapping. Independent of fitness defects we identified six cases of synthetic hypermutation, where the combined effect of the drug and mutant on mutation rate was greater than predicted. One example occurred when yeast lackingRAD1were exposed to cisplatin and we characterized this interaction using whole-genome sequencing. Our sequencing results indicate mutagenesis by cisplatin inrad1Δ cells appeared to depend almost entirely on interstrand crosslinks at GpCpN motifs. Interestingly, our data suggests that the 3’ base in these motifs templates the addition of the mutated base. This result differs from cisplatin mutation signatures in XPF-deficientC. elegansand supports a model in which translesion synthesis polymerases perform a slippage and realignment extension across from the damaged base. Accordingly, DNA polymerase ζ activity was essential for mutagenesis in cisplatin treatedrad1Δ cells. Together these data reveal the potential to gain new mechanistic insights from non-fitness measures of gene-drug interactions and extend the use of mutation accumulation and whole-genome sequencing analysis to define DNA repair mechanisms.
Decomposition of agricultural productivity growth in Africa
Authors: Mohamed Abdinur Ali , Rangkakulnuwat Poomthan , Paweenawat Sasiwimon Warunsiri
Published: November 2016

Purpose

The purpose of this paper is to decompose total factor productivity (TFP) changes of the agriculture sector in ten African countries.

Design/methodology/approach

A fixed-effects estimation is applied to estimate the translog production function.

Findings

The study results are consistent with previous studies, indicating low TFP. Furthermore, of the TFP components, only technical change (TC) is positive. This study proposes that credit be made available to farmers in Egypt, Morocco, Algeria, and Tunisia. Furthermore, agricultural development programs should be implemented in South Africa and Senegal to improve TFP in these countries.

Originality/value

This study measures the following TFP components for the African agriculture sector: TC, technical efficiency, and scale effects.
Determinants of portfolio equity flows to Sub-Saharan Africa
Authors: Osei-Assibey Eric , Adu Seth Obeng
Published: November 2016

Purpose

The purpose of this paper is to investigate the determinants of portfolio equity flows to the Sub-Saharan African (SSA) region over the period 1996-2010.

Design/methodology/approach

The study uses a sample of 14 SSA countries to estimate the baseline regression through employing the system generalized methods of moment dynamic panel estimation framework. To check the robustness of the estimation results, the study further analyses the data set using the random effects-generalized least squares (EGLS) estimator. The Random effects-generalized least squares estimator is also referred to a the Estimated Generalized least Squares (EGLS) estimator.

Findings

The paper finds a significant positive relationship between financial development and portfolio equity flows. Furthermore, while the study surprisingly finds trade openness to have a significant negative relationship, political stability is found to have a significant positive relationship with portfolio equity. To check for the robustness of these results, the authors further analyse the data set using the random EGLS estimator. The result of the EGLS estimator confirms that there is a robust positive relationship between financial development and portfolio equity flows to SSA. However, the results suggest that neither trade openness nor political stability is a robust determinant of portfolio equity flows to the sub-region.

Practical implications

Policy measures should aim at enhancing financial sector development, political stability and rule of law. A transparent judicial system that enhances rule of law and deepens democratic governance in countries in the sub-region is critical, but even more critical is deepening the financial sector, given the important role financial development plays in portfolio equity flows as suggested by the findings. A range of measures and appropriate policy responses are therefore needed for countries that have to manage macroeconomic and financial stability risks to deepen the financial sector.

Originality/value

Most studies on private capital flows to SSA have focussed on foreign direct investment flows with no or scanty evidence on the drivers of portfolio equity flows. This study fills this gap in the literature.
A spatio-temporal analysis of non-farm enterprise performance in Uganda: 2010-2012
Authors: Owoo Nkechi Srodah
Published: November 2016

Purpose

Recent research into enterprise performance has focussed on the importance of firm proximity to total productivity. Using spatial correlation of firm performance as a proxy for knowledge transfers and diffusion, the purpose of this paper is to examine the evidence for these spatial effects in non-farm enterprise performance in Uganda, across space and time.

Design/methodology/approach

The author uses data from the geo-referenced Uganda National Panel Survey from 2010 to 2012, and employs explicit spatial techniques in the analysis of rural non-farm enterprise performance. Spatial autocorrelation of firm performance are used as proxies for knowledge transfers and information flows among enterprises across space and over time.

Findings

The study finds evidence of spatial spillover effects across space and time in Uganda. This implies that, as existing studies of developed countries have found, social infrastructure and firm proximity contribute significantly to the performance of rural economies, through information exchange and knowledge transfers.

Practical implications

Given the communal nature of rural households in the African setting, knowledge exchange and transfers among neighbouring firms should be encouraged as studies have found they have strong effects on business performance. Additionally, business “leaders” could also be useful in disseminating useful new technologies and applications to neighbouring enterprises in order to boost performance and productivity.

Social implications

There should be better targeting of policy interventions to clusters of particularly needy enterprises.

Originality/value

To the best of the author’s knowledge, this is the first time that spatio-temporal effects of business performance have been explored. While spatial analyses of business performance have been carried out in developed countries, studies using explicit spatial techniques in the developing country setting have been conspicuously absent.
Double-sided moral hazard, information screening and the optimal contract
Authors: Xue Jin , Fei Yiwen
Published: November 2016

Purpose

In the practice of venture capital investment, the venture capital will not only claim the share of the enterprise’s future output, but also a certain amount of fixed income. The purpose of this paper is to examine the optimal contract which blends the variable ownership income and the fixed income theoretically so as to provide a keen insight into the venture capital practice.

Design/methodology/approach

This paper establishes an extended principal-agent model and researches on the design of optimal contract dominated by venture capital with double-sided moral hazard and information screening.

Findings

By establishing theoretical models, the main findings are: first, high-quality enterprise tends to relinquish less ownership but give more fixed return to the venture capital as compensation in order to obtain the venture capital financing; second, low-quality enterprise is willing to relinquish more ownership but give less fixed return to the venture capital for financing; third, due to the existence of double-sided moral hazard, neither of the venture capital and the enterprise will exert their best effort.

Originality/value

This paper furthers the application of principal-agent model in the field of venture capital investment and researches on the optimal contract, considering double-sided moral hazard and adverse selection at the same time originally.
Securitization of longevity risk – survivor swap perspective
Authors: Zou Xiaopeng , Ye Zihan , Zhang Qiuzi
Published: November 2016

Purpose

The purpose of this paper is to present a clear path to securitize the longevity risk with two distinct swaps in order to inspire a new Chinese life market.

Design/methodology/approach

Studies on longevity risk securitization consist of three aspects, respectively, instrument design, pricing methodology and mortality projection. The swaps designed are referenced, respectively, to vanilla and complex survivor swaps (Dowd et al., 2006; Lin and Cox, 2005). Methods applied are RHH model and Gompertz law for mortality projection, as well as two-factor Wang transformation for pricing.

Findings

This paper figures out the market price of risk in Chinese annuity market, checks for the sensitivity of the price to parameters and tests the hedging effects by Monte Carlo simulation.

Originality/value

Based on the theoretical and numerical results, this paper suggests an effective way to possibly witness the birth of New Life Market in China.
Crop‐dominated landscapes have higher vector‐borne plant virus prevalence
Authors: Claflin Suzi B. , Jones Laura E. , Thaler Jennifer S. , Power Alison G.
Published: November 2016

Landscape composition affects local arthropod biodiversity, including herbivorous insects and their predators, yet to date landscape effects on insect‐vectored plant diseases have received little attention. Here, we examine how landscape composition affects the prevalence of a viral pathogen in host plants, and the role the arthropod vector assemblage plays in mediating landscape effects.

We measured the effect of landscape composition (measured as percentage of cropland and unmanaged land) on the plant virus Potato virus Y (PVY), its aphid vectors, and their coccinellid predators during the 2012 and 2013 field seasons at 19–21 farms.

In both years, we found a positive relationship between final virus prevalence and percentage of cropland within 500, 1000 and 1500 m surrounding study sites. Percentage of cropland also had a significant negative effect on aphid species richness, and the aphid community composition in turn affected PVY prevalence. By contrast, landscape composition had no measurable effect on coccinellid abundance or species richness in this study.

Synthesis and applications. Our work demonstrates that landscape composition plays an important role in vector‐borne pathogen spread, and that pathogen spread appears to be mediated by the effects of the landscape on the insect vector community. The small spatial scale (≤1500 m) of the effects seen in our study indicates that on‐farm management practices have the potential to reduce virus prevalence on small‐scale farms. Farmers may be able to reduce Potato virus Y prevalence by on‐farm diversification, by isolating potato fields from other agricultural crops, and by not using saved potato seed.
Research assistants, reflexivity and the politics of fieldwork in urban Pakistan
Authors: Anwar Nausheen H , Viqar Sarwat
Published: November 2016

In this paper, we discuss the politics of fieldwork in urban Pakistan and in doing so draw attention to the role of research assistants (RAs) in the production of knowledge. The discussion explores how the roles, reflexivity and positionality of our three Muslim female RAs adds depth to our understanding of fieldwork in a culturally and politically charged urban setting where everyday violence combined with wealth asymmetries and anxieties over religious identity add layers of complexity in researcher–respondent working relationships. This generates a process of negotiation over ethical dilemmas that are not easily surmounted and complicates how we think about transformations in the production of knowledge. We use the notion of the ‘triple subjectivity’ of fieldwork to problematise the positionality of researchers and the people they seek to represent through translations of language, contexts and encounters. Moreover, we underscore that the positionality of our RAs was strongly influenced by religion, ethnicity and class. Notably, state directives have played an important role in the way relationships are forged in the field, whereby ethnic–religious minorities have been categorised and treated in distinct ways. Our RAs’ knowledge of marginalised communities increased significantly with time spent in the field, but they still retained specific understandings of difference. This awareness was a crucial learning experience and prompted our RAs to become mindful of their own investment and contribution to the process of ethnographic engagements. Our objective in this paper is to reveal the tensions and possibilities generated by the triple subjectivities involved in our fieldwork in terms of their implications for transformations of research. Above all, our RAs’ reflections demonstrate that we as researchers must remain sensitive to the emotions and anxieties of those we work alongside.
Synthesis and studies of two proton–receptor fluorescent probes based on 1,8‐naphthalimide
Authors: Aderinto Stephen Opeyemi , Zhang Han , Wu Huilu , Chen Chengyong , Zhang Jiawen , Peng Hongping , Yang Zaihui , Wang Fei
Published: November 2016

Two isomeric proton–receptor fluorescent probes 1 and 2 were designed and synthesised by employing the photoinduced electron transfer (PET) principle of a ‘fluorophore–spacer–receptor’ module. Their photophysical characteristics were investigated in organic solvents and Britton–Robinson buffer/EtOH (1:1, v/v) solution. Probe 1 was sensitive in the stronger acidic region of 2.21–4.56, while probe 2 displayed a good response towards protons within the pH scope of 4.10–6.09. The specificity of the probes toward protons in commonly used buffer solutions and in the presence of metal cations, Na(i), K(i), Ca(ii), Mg(ii), Al(iii), Pb(ii), Fe(iii), Ni(ii), Zn(ii), Cu(ii), Hg(ii), Ag(i), Co(ii), Cr(iii), Mn(ii), and Cd(ii) ions, was studied by monitoring the changes in their fluorescence intensity. The tested metal ions exerted no noticeable influence. The results obtained show that the synthesised proton–receptor fluorescent probes have the capability to act as pH‐sensitive probes for monitoring pH variations in the range 2.21–6.09.
On the Invention of an “Essentialist View of Culture”: Thinking outside the Prevalent Cultural Studies Discourse on Culturally and Ethnically Heterogeneous Germany
Authors: Albrecht Monika
Published: November 2016

This paper identifies and challenges some prevailing scholarly assumptions concerning Germany's relationship to multiculturalism. The last years have seen increasingly harmonized narratives revolving around the central idea that the Germans assume an “essentialist view of culture” and believe in the “cultural homogeneity” of their country. This paper argues that these narratives not only essentialize the very groups of people they criticize but also create a false construct of culture that inaccurately represents the intricate dynamics of German society. Beginning with the premise that perception and representation of minorities are subject to historical transformation, a discussion of the 1976 filmShirins Hochzeit, by director Helma Sanders‐Brahms, will form the backdrop for a consideration of how the complex phenomenon of German cultural heterogeneity might be addressed in new ways and from fresh perspectives.
A Renewed Look at Christa Wolf's “Neue Lebensansichten eines Katers”: Authority, Parody, and Readers as Scientists
Authors: Martz Brett
Published: November 2016

Through a close analysis of rhetorical strategies, specifically the parodistic arrangement of satire, in Christa Wolf's “Neue Lebensansichten eines Katers,” this article posits discursive authority as the primary object of the story's criticism. The story's composition and its careful avoidance of authorial intrusion encourage readers to challenge the exaggerated scientific discourse that the main figures in the story not only parrot but also take advantage of in order to advance their own agendas. By allowing readers to come to their own conclusions, Wolf's text avoids actualizing the authority that compromises the science‐in‐making on display. This authority assumes patriarchal underpinnings and, therefore, opens itself to feminist critiques of science, which, though normally reserved for Wolf's other short story about scientific experiments, “Selbstversuch,” are equally applicable to “Neue Lebensansichten eines Katers.”
What's Wrong with this Picture? Image‐Ethics in Christian Petzold's Films
Authors: Buhanan Kurt
Published: November 2016

Through an analysis of Christian Petzold's films, this essay argues that there is an ethical dimension to images. The cinema of Christian Petzold is an important instance of the ethical function of images because it constantly negotiates and renegotiates the ethical intelligibility of the image and the ethical claims that images make on us. The essay's argument is developed in three stages: first, it outlines the theoretical concept of an image‐ethics of dilemma, centering on the essential ambiguity of images; second, it briefly considers the function of particular multistable images in Petzold's cinema and their role in ordering representation in his films; and, finally, it offers a close analysis of Petzold's recent filmBarbara().
Impact of genomic risk factors on survival after haematopoietic stem cell transplantation for patients with acute leukaemia
Authors: Pearce K. F. , Balavarca Y. , Norden J. , Jackson G. , Holler E. , Dressel R. , Greinix H. , Toubert A. , Gluckman E. , Hromadnikova I. , Sedlacek P. , Wolff D. , Holtick U. , Bickeböller H. , Dickinson A. M.
Published: November 2016

The EBMT risk score is an established tool successfully used in the prognosis of survival post‐HSCT and is applicable for a range of haematological disorders. One of its main advantages is that score generation involves summation of clinical parameters that are available pretransplant. However, the EBMT risk score is recognized as not being optimal. Previous analyses, involving patients with various diagnoses, have shown that non‐HLA gene polymorphisms influence outcome after allogeneic HSCT. This study is novel as it focuses only on patients having acute leukaemia (N = 458) and attempts to demonstrate how non‐HLA gene polymorphisms can be added to the EBMT risk score in a Cox regression model to improve prognostic ability for overall survival. The results of the study found that three genetic factors improved EBMT risk score. The presence of MAL (rs8177374) allele T in the patient, absence of glucocorticoid receptor haplotype (consisting of rs6198, rs33389 and rs33388) ACT in the patient and absence of heat‐shock protein 70‐hom (+2437) (rs2227956) allele C in the patient were associated with decreased survival time. When compared to the EBMT risk score, the scores combining EBMT risk score with the genetic factors had an improved correlation with clinical outcome and better separation of risk groups. A bootstrapping technique, involving repeated testing of a model using multiple validation sets, also revealed that the newly proposed model had improved predictive value when compared to the EBMT risk score alone. Results support the view that non‐HLA polymorphisms could be useful for pretransplant clinical assessment and provide evidence that polymorphisms in the recipient genotype may influence incoming donor cells, suppressing the initiation of the graft versus leukaemia effect and reducing survival.
Waiting‐time estimation in walk‐in clinics
Authors: Montecinos Julio , Ouhimmou Mustapha , Chauhan Satyaveer
Published: November 2016

Medical assistance is offered by walk‐in clinics (WC). These clinics must keep track of patients’ turn in line. Some private companies offer an extra follow‐up service to WC patients, which notifies them when their consultation approaches, so patients can use their free time elsewhere than in the waiting room. This paper aims to develop an applied forecasting approach for consultation service time estimation and waiting‐time estimation. A model based on particle filters and mixture models helps to estimate the waiting time for each consultation, using historical and new incoming data from patient consultations. The system considers two types of patients, namely, regular and follow‐up. Our method gives an estimate of the waiting time for consultation better than simple statistics.
Three‐Dimensional Electroanatomic Mapping System‐Enhanced Cardiac Resynchronization Therapy Device Implantation: Results From a Multicenter Registry
Authors: DEL GRECO MAURIZIO , MAINES MASSIMILIANO , MARINI MASSIMILIANO , COLELLA ANDREA , ZECCHIN MASSIMO , VITALI‐SERDOZ LAURA , BLANDINO ALESSANDRO , BARBONAGLIA LORELLA , ALLOCCA GIUSEPPE , MUREDDU ROBERTO , MARENNA BIONDINO , ROSSI PAOLO , VACCARI DIEGO , CHIANCA ROBERTO , INDIANI STEFANO , DI MATTEO IRENE , ANGHEBEN CARLO , ZORZI ALESSANDRO
Published: November 2016

Electroanatomic Mapping for CRT Implantation Registry

Introduction

Cardiac resynchronization therapy (CRT) device implantation guided by an electroanatomic mapping system (EAMS) is an emerging technique that may reduce fluoroscopy and angiography use and provide information on coronary sinus (CS) electrical activation. We evaluated the outcome of the EAMS‐guided CRT implantation technique in a multicenter registry.

Methods

During the period 2011–2014 we enrolled 125 patients (80% males, age 74 [71–77] years) who underwent CRT implantation by using the EnSite system to create geometric models of the patient's cardiac chambers, build activation mapping of the CS, and guide leads positioning. Two hundred and fifty patients undergoing traditional CRT implantation served as controls. Success and complication rates, fluoroscopy and total procedure times in the overall study population and according to center experience were collected. Centers that performed ≥10 were defined as highly experienced.

Results

Left ventricular lead implantation was successful in 122 (98%) cases and 242 (97%) controls (P = 0.76). Median fluoroscopy time was 4.1 (0.3–10.4) minutes in cases versus 16 (11–26) minutes in controls (P < 0.001). Coronary sinus angiography was performed in 33 (26%) cases and 208 (83%) controls (P < 0.001). Complications occurred in 5 (4%) cases and 17 (7%) controls (P = 0.28). Median fluoroscopy time (median 11 minutes vs. 3 minutes, P < 0.001) and CS angiography rate (55% vs. 21%, P < 0.001) were significantly higher in low experienced centers, while success rate and complications rate were similar.

Conclusions

EAMS‐guided CRT implantation proved safe and effective in both high‐ and low‐experienced centers and allowed to reduce fluoroscopy use by ≈75% and angiography rate by ≈70%.