bluuebunny/crossref_metadata_2025 huggingface dataset:
Three dimensional numerical simulation of polymer electrolyte membrane fuel cell
Authors: Peng Yeping , Bahrami Ghasem , Khodadadi Hossein , Karimi Alireza , Soleimani Ahmad , Karimipour Arash , Rostami Sara
Published: December 2019

Purpose

The purpose of this study is simulation of of polymer electrolyte membrane fuel cell. Proton-exchange membrane fuel cells are promising power sources for use in power plants and vehicles. These fuel cells provide a high level of energy efficiency at low temperature without any pollution. The convection inside the cell plays a key role in the electrochemical reactions and the performance of the cell. Accordingly, the transport processes in these cells have been investigated thoroughly in previous studies that also carried out functional modeling.

Design/methodology/approach

A multi-phase model was used to study the limitations of the reactions and their impact on the performance of the cell. The governing equations (conservation of mass, momentum and particle transport) were solved by computational fluid dynamics (CFD) (ANSYS fluent) using appropriate source terms. The two-phase flow in the fuel cell was simulated three-dimensionally under steady-state conditions. The flow of water inside the cell was also simulated at high-current density.

Findings

The simulation results suggested that the porosity of the gas diffusion layer (GDL) is one of the most important design parameters with a significant impact on the current density limitation and, consequently, on the cell performance.

Originality/value

This study was mainly focused on the two-phase analysis of the steady flow in the fuel cell and on investigating the impacts of a two-phase flow on the performance of the cell and also on the flow in the GDL, the membrane and the catalyst layer using the CFD.
An integrated fuzzy-AHP and TOPSIS approach for maintenance policy selection
Authors: Hemmati Narges , Rahiminezhad Galankashi Masoud , Imani D.M. , Mokhatab Rafiei Farimah
Published: December 2019

Purpose

The purpose of this paper is to select the best maintenance policy for different types of equipment of a manufacturer integrating the fuzzy analytic hierarchy process (FAHP) and the technique for order of preference by similarity to ideal solution (TOPSIS) models.

Design/methodology/approach

The decision hierarchy of this research includes three levels. The first level aims to choose the best maintenance policy for different types of equipment of an acid manufacturer. These equipment pieces include molten sulfur ponds, boiler, absorption tower, cooling towers, converter, heat exchanger and sulfur fuel furnace. The second level includes decision criteria of added-value, risk level and the cost. Lastly, the third level comprises time-based maintenance (TBM), corrective maintenance (CM), shutdown maintenance and condition-based maintenance (CBM) as four maintenance policies.

Findings

The best maintenance policy for different types of equipment of a manufacturer is the main finding of this research. Based on the obtained results, CBM policy is suggested for absorption tower, boiler, cooling tower and molten sulfur ponds, TBM policy is suggested for converters and heat exchanger and CM policy is suggested for a sulfur fuel furnace.

Originality/value

This research develops a novel model by integrating FAHP and an interval TOPSIS with concurrent consideration of added-value, risk level and cost to select the best maintenance policy. According to the highlights of the previous studies conducted on maintenance policy selection and related tools and techniques, an operative integrated approach to combine risk, added-value and cost with integrated fuzzy models is not developed yet. The majority of the previous studies have considered classic fuzzy approaches such as FAHP, FANP, Fuzzy TOPSIS, etc., which are not completely capable to reflect the decision makers’ viewpoints.
Balanced centricity and triads: strategies to reach ecosystem equilibrium in the arts sector
Authors: Quero Gervilla María José , Díaz-Mendez Montserrat , Gummesson Evert
Published: December 2019

Purpose

The purpose of this paper is to analyze whether triad structures, as the smallest unit of a network, can facilitate or inhibit the evolution into a service ecosystem. According to SD logic literature, the triad structure and the institutions that dominate the triads determine the evolution into ecosystem, remain as triad or die. “Balanced centricity” is considered a desirable institution that increases the possibility of transforming triads into ecosystems through marketing equilibrium.

Design/methodology/approach

The authors apply a conceptual approach to develop a framework for deepening understanding about triads’ structures from the institution’s perspective (balanced centricity). Qualitative case study research was conducted using different methods of data generation including personal interviews and netnography analysis in the arts sector. Three case studies were developed, one for each triad structure: Sothebýs, Patreon and Vibuk.

Findings

New business models start being a triad, and it is a strategic option to evolve into an ecosystem. In this sense, authors argue for considering balanced centricity as an institution that enables the ecosystems to arise. From this perspective, balanced centricity can be considered a strategy that helps to balance and reach positive relationships among actors, enabling the process to become a “balance triad structure”.

Research limitations/implications

The paper is a conceptual work that combines with an empirical approach. The empirical approach considers three success cases on the arts context. Considering other contexts as different from arts industry would be useful to add new perspectives to the theory development.

Originality/value

The present paper defines a new form of triad “balanced triad structure” (BTS) and identifies categories depending on the way balanced centricity institution is adopted, facilitating or inhibiting the future evolution into an ecosystem. Hitherto, previous papers have not put together these concepts that build on the triads and ecosystems theory to better understand triads management and facilitate the evolution of three-actor networks into ecosystems.
No longer a family
Authors: Plakhotnik Maria S. , Volkova Natalia V.
Published: December 2019

Purpose

The purpose of this paper is to examine the impact of a perceived organizational culture on organizational identification and commitment of employees of a Russian university that is transforming to become an English-medium instruction (EMI) university.

Design/methodology/approach

Data were collected between February and March 2018, via an online survey that was disseminated among 115 new employees; 90 were completed and used for analyses. The survey included three scales.

Findings

Employees of the EMI university perceived its culture as market, which is not a common characteristic of universities that usually have a clan culture. The study has also demonstrated a discrepancy between the perceived (market) and the preferred (clan) organizational culture. The study has also showed that a clan, and not a market, culture strengthens employee organizational commitment and identification.

Originality/value

Most research has examined EMI universities from the perspectives of teaching and learning. This study contributes to the limited conceptual and theoretical base around these universities by examining their processes from a perspective of management. This paper suggests that the adoption of English as a medium of instruction requires organizational change that leads to change in organizational culture.
Understanding organizational aspects for managing crisis situations
Authors: Gabrielli Giorgio , Russo Vincenzo , Ciceri Andrea
Published: December 2019

Purpose

The uncertainty of the current economic environment increases the risk of organizational failure. The traditional approach intends the crisis as a phenomenon that can be managed according to some predetermined and well-defined procedures. Although this traditional approach emphasizes on the technical dimension, it does not take into account the organizational dimension, which instead plays a crucial role in the circumstances of today’s crisis. The purpose of this paper is to investigate which are the most effective organizational practices able to promote an adequate culture prevent or manage effectively crisis situations.

Design/methodology/approach

A group of Italian military and civil opinion leaders took part in the study. Authors hypothesized that the military organizations, being defined as “High Reliability Organization,” have organizational characteristics that allow them to manage crisis situations more effectively, and, for this reason, they can be taken as a reference by civil organizations.

Findings

The results show noticeable differences about organizational attributes concerning the two organizations. According to the results, military organization has the most appropriate organizational dimensions to prevent and manage the crisis situations.

Practical implications

Based on the results, military organization is suggested to be taken as an example by civil organizations in the process of organizational change necessary to obtain reliable performance.

Originality/value

The originality of this paper lies in the empirical and theoretical framework provided to analyze risk and crisis management, based on the comparison between military and civil organizations. The paper aims to be a starting point from which a positive process of cultural osmosis between the two organizations can be promoted.
Impact of a leadership development programme for physicians in India
Authors: Gulati Kamal , Singh Angel Rajan , Kumar Sachin , Verma Vivek , Gupta Shakti Kumar , Sarkar Chitra
Published: December 2019

Purpose

The purpose of this study was to evaluate the impact of leadership development programme on enhancing leadership competencies of physicians in India. Assessment of leadership competencies of physicians is critical for designing suitable leadership development programmes. The previous studies of authors have revealed significant gaps in leadership competencies among physicians in India. Hence, authors have designed a programme incorporating various facets of health-care leadership and evaluated its impact on improvement of leadership competencies of top- and mid-career level professionals.

Design/methodology/approach

A six-day offsite residential programme incorporating a three-day component of leadership development was organized, in which 96 physicians participated. A mix of pedagogical approaches was used. A pre- and post-assessment of 30 medical leadership competencies was done using a self-administered questionnaire.

Findings

Majority of participants (69%) scored their competencies at Level 3 and Level 4 (Average to Good) with a mean score ranging from 3.20 ± 0.85 to 4.12 ± 0.71 in the pre-assessment group. In contrast, in post-assessment, this shifted to Level 4 and Level 5 (Good to Very good) in 72% with mean scores ranging from 3.8 to 4.24. Statistically significant differentiation was noted in pre- and post-assessment mean scores for all 30 competencies. The maximum improvement was noted in Competency 29 “Information management system planning and implementation”, whereas the least improvement was noted in Competency 12 “Holding self and others accountable and responsible for organizational goal attainment”.

Originality/value

The authors believe that this is the first study from India to assess effectiveness of leadership development programmes on enhancing medical leadership competencies demonstrating positive outcome. The findings of this study can provide a roadmap for designing of future medical leadership development programmes for physicians in India.
Should leading emerging market companies chase globalization?
Authors: Chakravarthy Bala , Abraham P.C. , Sorell Michael
Published: December 2019

Purpose

This research study compares the financial success of emerging market companies that have globalized with similar sized EMNC companies that have stayed home.

Design/methodology/approach

One target cohort for this study was the short list of emerging market multinationals (EMNCs) that the Boston Consulting Group (BCG) published yearly from 2006 to 2016. 212 EMNCs were divided into three types: 10;1. Global Leaders – 19 from this list 10;2. Persistent Challengers – 78 companies on the BCG list. 10;3. Challengers – 115 companies were on BCG’s lists in various years. 10; Their financial results were compared with a group of 26 “Local Leaders,” emerging market companies that had revenues of over $10 billion but had not appeared even once on BCG’s list of global challengers. 10;

Findings

Local Leaders show superior financial performance when compared to Global Leaders.

Practical implications

Opportunistic moves to globalize without a sound underlying strategy have backfired on many emerging market companies, resulting in lagging financial performance and sometimes huge write-downs.

Originality/value

A carefully done study that indicates that globalization is not the magic bullet that improves the financial performance of an emerging market company.
Long‐term safety and efficacy of delgocitinib ointment, a topical Janus kinase inhibitor, in adult patients with atopic dermatitis
Authors: Nakagawa Hidemi , Nemoto Osamu , Igarashi Atsuyuki , Saeki Hidehisa , Murata Ryusei , Kaino Hironobu , Nagata Takeshi
Published: December 2019

Previous studies demonstrated that delgocitinib ointment, a novel topical Janus kinase inhibitor, rapidly improved clinical signs and symptoms of atopic dermatitis (AD) in Japanese adult patients. We sought to evaluate the long‐term safety and efficacy of delgocitinib 0.5% ointment in a 52‐week study (QBA4‐2). Japanese patients aged 16 years or older with AD received delgocitinib 0.5% ointment b.i.d. for up to 52 weeks. Topical corticosteroids for the treatment of worsening of AD could be used at the investigators’ discretion during the treatment period. Safety end‐points included the incidence and severity of adverse events (AEs). Pooled safety analyses included the data from the other long‐term study (QBA4‐1). Efficacy end‐points included the percentage change from baseline in the modified Eczema Area and Severity Index (mEASI). A total of 506 patients were included in the pooled safety population. Overall, AEs were reported in 69.0% of patients; most AEs were mild and unrelated to delgocitinib ointment. The most common AE was nasopharyngitis, followed by contact dermatitis, acne, and application site folliculitis. No skin atrophy or telangiectasia was found at the application sites of delgocitinib ointment. Application site irritation symptoms were infrequent (<2%) and mild. The incidence of AEs did not increase over time, except for seasonal diseases. The improvement effects on AD as assessed by mEASI were maintained throughout the treatment period. Delgocitinib 0.5% ointment was well tolerated and effective when administrated to Japanese adult patients with AD for up to 52 weeks.
Heat tolerance is more variable than cold tolerance across species of Iberian lizards after controlling for intraspecific variation
Authors: Herrando‐Pérez Salvador , Monasterio Camila , Beukema Wouter , Gomes Verónica , Ferri‐Yáñez Francisco , Vieites David R. , Buckley Lauren B. , Araújo Miguel B.
Published: December 2019

The widespread observation that heat tolerance is less variable than cold tolerance (‘cold‐tolerance asymmetry’) leads to the prediction that species exposed to temperatures near their thermal maxima should have reduced evolutionary potential for adapting to climate warming. However, the prediction is largely supported by species‐level global studies based on single estimates of both physiological metrics per taxon.

We ask whether cold‐tolerance asymmetry holds for Iberian lizards after accounting for intraspecific variation in critical thermal maxima (CTmax) and minima (CTmin). To do so, we quantified CTmaxand CTminfor 58 populations of 15 Iberian lizard species (299 individuals). Then, we randomly selected one population from each study species (population sample = 15 CTmaxand CTminvalues), tested for differences between the variance of both thermal metrics across species, and repeated the test for thousands of population samples as if we had undertaken the same study thousands of times, each time sampling one different population per species (as implemented in global studies).

The ratio of variances in CTmaxto CTminacross species varied up to 16‐fold depending on the populations chosen. Variance ratios show how much CTmaxdeparts from the cross‐species mean compared to CTmin, with a unitary ratio indicating equal variance of both thermal limits. Sampling one population per species was six times more likely to result in the observation of greater CTmaxvariance (‘heat‐tolerance asymmetry’) than cold‐tolerance asymmetry. The probability of obtaining the data (given the null hypothesis of equal variance being true) was twice as likely for cases of cold‐tolerance asymmetry than for the opposite scenario.

Range‐wide, population‐level studies that quantify heat and cold tolerance of individual species are urgently needed to ascertain the global prevalence of cold‐tolerance asymmetry. While broad latitudinal clines of cold tolerance have been strongly supported, heat tolerance might respond to smaller‐scale climatic and habitat factors hence go unnoticed in global studies. Studies investigating physiological responses to climate change should incorporate the extent to which thermal traits are characteristic of individuals, populations and/or species.

A freePlain Language Summarycan be found within the Supporting Information of this article.
Marine omega‐3 (n‐3) phospholipids: A comprehensive review of their properties, sources, bioavailability, and relation to brain health
Authors: Ahmmed Mirja Kaizer , Ahmmed Fatema , Tian Hong (Sabrina) , Carne Alan , Bekhit Alaa El‐Din
Published: December 2019

For several decades, there has been considerable interest in marine‐derived long chain n‐3 fatty acids (n‐3 LCPUFAs) due to their outstanding health benefits. n‐3 LCPUFAs can be found in nature either in triglycerides (TAGs) or in phospholipid (PL) form. From brain health point of view, PL n‐3 is more bioavailable and potent compared to n‐3 in TAG form, as only PL n‐3 is able to cross the blood–brain barrier and can be involved in brain biochemical reactions. However, PL n‐3 has been ignored in the fish oil industry and frequently removed as an impurity during degumming processes. As a result, PL products derived from marine sources are very limited compared to TAG products. Commercially, PLs are being used in pharmaceutical industries as drug carriers, in food manufacturing as emulsifiers and in cosmetic industries as skin care agents, but most of the PLs used in these applications are produced from vegetable sources that contain less (without EPA, DPA, and DHA) or sometimes no n‐3 LCPUFAs. This review provides a comprehensive account of the properties, structures, and major sources of marine PLs, and provides focussed discussion of their relationship to brain health. Epidemiological, laboratory, and clinical studies on n‐3 LCPUFAs enriched PLs using different model systems in relation to brain and mental health that have been published over the past few years are discussed in detail.
Arthropod community composition along snowmelt gradients in snowbeds in the Snowy Mountains of south‐eastern Australia
Authors: Green Ken , Slatyer Rachel
Published: December 2019

Environmental gradients drive variation in community composition across a range of spatial scales. In alpine regions, areas of long‐lasting snow (‘snow patches’) create snowmelt gradients that drive considerable change in vegetation structure and composition over small spatial scales. This study examined whether there is parallel variation in arthropod communities using snowmelt gradients in the Australian Alps. Mites (Acarina) were the most common arthropods in snow patches, followed by springtails while, among the insects, the orders Hymenoptera (primarily Formicidae), Diptera, Coleoptera (primarily Carabidae) and Hemiptera (primarily Cicadellidae) dominated. Along the snowmelt gradient, arthropod assemblages changed from having equal proportions of predators and herbivores in early‐melting zones to being predator‐dominated in late‐melting zones, particularly early in the growing season. This followed a transition in vegetation cover and composition and was driven by higher numbers of predacious carabid beetles in later‐melting zones. Overall, however, our results suggest that snowbed arthropod communities in the Australian alpine zone are more sensitive to short‐term effects, such as time since snowmelt, than to differences in vegetation structure and composition or long‐term patterns of snowmelt. Continued advancement of snowmelt timing due to warmer spring temperatures is therefore likely to have more impact on the seasonality of snowbed arthropod communities than on the overall community composition.
Velvet worm (Phylum Onychophora) on a sand island, in a wetland: Flushed from a Pleistocene refuge by recent rainfall?
Authors: Marshall Jonathan C. , Martin Hailey
Published: December 2019

Velvet worms (Onychophora) are restricted to moist, humid microclimates, but are poorly known from south‐east Queensland, Australia, where they are typically rainforest fauna. We made the unlikely observation of one of these invertebrates clinging to floating debris in a wetland on North Stradbroke Island. Palaeoecology of this wetland reveals that it once was within rainforest and has remained moist for at least the past 80 000 years, thus potentially harbouring an onychophoran population as a relic of a past broader, rainforest distribution. The presence of this animal, floating in the wetland, can be explained by recent climate, since the wetland filled following heavy rainfall shortly before the observation. This highlights the importance of groundwater‐fed wetlands as evolutionary refugia for moisture‐dependent biota.
Effects of redistributing policy support on farmers’ technical efficiency
Authors: Bonfiglio Andrea , Henke Roberto , Pierangeli Fabio , Pupo D'Andrea Maria Rosaria
Published: December 2019

The objective of this article is twofold: first, investigating the relationship between technical efficiency and decoupled direct payments of a sample of Italian farms prior to the application of the 2014–2020 Common Agricultural Policy reform; second, evaluating possible implications of alternative scenarios about distribution of direct payments on technical efficiency. To these aims, a stochastic frontier analysis is adopted. Results indicate that direct payments produce significant effects on technical efficiency in specialized farms, which received higher levels of support. However, effects are contrasting. Moreover, results show that redistribution of policy subsidies may negatively impact on technical efficiency to an extent depending upon the criterion of redistribution applied. Finally, some policy suggestions are given.
Risks of genetic damage in offspring conceived using spermatozoa produced during chemotherapy or radiotherapy
Authors: Meistrich Marvin L.
Published: December 2019

Background

Men who have just started cytotoxic therapy for cancer are uncertain and concerned about whether spermatozoa collected or pregnancies occurring during therapy might be transmitting genetic damage to offspring. There are no comprehensive guidelines on the risks of different doses of the various cytotoxic, and usually genotoxic, antineoplastic agents.

Objectives

To develop a schema showing the risks of mutagenic damage when spermatozoa, exposed to various genotoxic agents during spermatogenesis, are collected or used to produce a pregnancy.

Materials and methods

A comprehensive literature review was performed updating the data on genetic and epigenetic effects of genotoxic agents on animal and human spermatozoa exposed during spermatogenic development.

Results

Relevant data on human spermatozoa and offspring are extremely limited, but there are extensive genetic studies in experimental animals that define sensitivities for specific drugs and times. The animal data were extrapolated to humans based on the stage when the cells were exposed and the relative kinetics of spermatogenesis and were consistent with the limited human data. In humans, alkylating agents and radiation should already induce a high risk of mutations in spermatozoa produced within 1 or 2 weeks after initiation of therapy. Topoisomerase II inhibitors and possibly microtubule inhibitors produce the greatest risk at weeks 5‐7 of therapy. Nucleoside analogs, antimetabolites, and bleomycin exert their mutagenic effects on spermatozoa collected at 7‐10 weeks of therapy.

Discussion and conclusions

A schema showing the time from initiation of therapy at which specific antineoplastic agents can cause significant levels of genetic damage in conceptuses and live offspring was developed. The estimates and methods for computing the level of such risk from an individual patient's treatment regimen will enable patients and counselors to make informed decisions on the use of spermatozoa or continuation of a pregnancy.
Comparison of outcomes of single‐incision and conventional laparoscopic cholecystectomy for cholecystitis requiring percutaneous transhepatic gallbladder drainage
Authors: Funamizu Naotake , Harada Eriko , Ishiyama Satoshi
Published: December 2019

Introduction

Single‐incision laparoscopic cholecystectomy (SILC) has been accepted as a less invasive alternative to conventional laparoscopic cholecystectomy (CLC). However, the feasibility and safety of SILC for acute cholecystitis, especially in cases with percutaneous transhepatic gallbladder drainage (PTGBD), are still limited because of the technical difficulty of SILC. The aim of this study was to retrospectively evaluate the safety and feasibility of SILC compared to CLC for cholecystitis requiring PTGBD.

Methods

From 1 July 2017 to 8 June 2019, eight patients underwent SILC with PTGBD, and nine underwent CLC with PTGBD. The patients' data, including the operative time, total blood loss, conversion rate to laparotomy, and perioperative complications, were compared.

Results

In seven of eight patients, SILC was successfully performed. Only one patient required conversion to open surgery because necrosis prevented the cystic duct from being clipped. However, bile leakage occurred in this patient and was successfully treated with percutaneous drainage and antibiotics. In the CLC group, one patient required laparotomy but had no postoperative complications due to strong adhesion. One patient underwent reoperation for bile duct injury after the first operation. One other complication (ie, wound infection) was seen in the CLC group. There was no significant difference in the mean operative time and estimated blood loss between the SILC and CLC groups.

Conclusion

With our gallbladder retraction method, SILC may be a relatively safe and feasible alternative to CLC for cholecystitis, even in cases requiring PTGBD.
FLT3 mutations in acute myeloid leukemia: Therapeutic paradigm beyond inhibitor development
Authors: Kiyoi Hitoshi , Kawashima Naomi , Ishikawa Yuichi
Published: December 2019

FMS‐like tyrosine kinase 3 (FLT3) is a type III receptor tyrosine kinase that plays an important role in hematopoietic cell survival, proliferation and differentiation. The most clinically important point is that mutation of the FLT3 gene is the most frequent genetic alteration and a poor prognostic factor in acute myeloid leukemia (AML) patients. There are two major types of FLT3 mutations: internal tandem duplication mutations in the juxtamembrane domain (FLT3‐ITD) and point mutations or deletion in the tyrosine kinase domain (FLT3‐TKD). Both mutant FLT3 molecules are activated through ligand‐independent dimerization and trans‐phosphorylation. Mutant FLT3 induces the activation of multiple intracellular signaling pathways, mainly STAT5, MAPK and AKT signals, leading to cell proliferation and anti–apoptosis. Because high‐dose chemotherapy and allogeneic hematopoietic stem cell transplantation cannot sufficiently improve the prognosis, clinical development of FLT3 kinase inhibitors expected. Although several FLT3 inhibitors have been developed, it takes more than 20 years from the first identification of FLT3 mutations until FLT3 inhibitors become clinically available for AML patients with FLT3 mutations. To date, three FLT3 inhibitors have been clinically approved as monotherapy or combination therapy with conventional chemotherapeutic agents in Japan and/or Europe and United states. However, several mechanisms of resistance to FLT3 inhibitors have already become apparent during their clinical trials. The resistance mechanisms are complex and emerging resistant clones are heterogenous. Further basic and clinical studies are required to establish the best therapeutic strategy for AML patients with FLT3 mutations.
The effects of age and obesity on postprandial dynamics of serum testosterone levels in men
Authors: Van de Velde Frederique , Reyns Tim , Toye Kaatje , Fiers Tom , Kaufman Jean‐Marc , T'Sjoen Guy , Lapauw Bruno
Published: December 2019

Objective

Guidelines recommend using fasting samples to evaluate testosterone (T) levels in men, as free and total T levels decrease postprandially. However, it is not clear whether these dynamics are affected by age or obesity. This could be relevant given the obesity epidemic, ageing population and the barrier for screening which fasting could impose.

Design/Participants

A total of 43 men underwent a solid mixed meal tolerance test. Serum samples were taken fasting, and at 30, 60 and 120 minutes postprandially. A commercial immunoassay was used to determine sex hormone‐binding globulin (SHBG) levels, liquid chromatography coupled to tandem mass spectroscopy for total T concentrations and free T levels were calculated.

Results

Postprandially, both total and free T were lower at all‐time points compared with fasting (all, P < .005). At 60 minutes, maximum mean decreases of 15 ± 15% and 17 ± 16% were seen for total and free T levels, respectively. Younger men had greater decreases in both total and free T levels compared with men older than 40 years (all, P < .05). A greater decrease at 30 and 60 minutes postprandially was observed for both total and free T levels in nonobese vs obese men (all, P < .05).

Conclusions

After a mixed meal, total and free T serum levels decreased whereas SHBG levels did not change. Interestingly, postprandial decreases were less pronounced in men older than 40 years and/or with obesity. Although this study indicates less pronounced decreases in certain men, fasting samples remain a prerequisite for establishing correct diagnosis of male hypogonadism.
Relationship between heart rate variability and carotid intima‐media thickness in the Brazilian Longitudinal Study of Adult Health – ELSA‐Brasil
Authors: Hoshi Rosangela A. , Santos Itamar S. , Dantas Eduardo M. , Andreão Rodrigo V. , Mill José G. , Goulart Alessandra C. , Lotufo Paulo A. , Bensenor Isabela
Published: December 2019

Background

Both increased carotid intima‐media thickness (cIMT) and low heart rate variability (HRV) have been associated with cardiovascular mortality and morbidity. Thus, the aim of this study was to investigate whether cardio autonomic alterations are accompanied or not by subclinical atherosclerosis in participants of the Brazilian Longitudinal Study of Adult Health (ELSA‐Brasil).

Methods

cIMT measures and 5‐min HRV analyses were performed in apparently healthy adults. Heart rate variability was evaluated by linear time and frequency domain analyses. cIMT was defined as the average between the mean left and mean right cIMT values and was analysed as continuous and categorized variables (P≥75 or P<75). Multiple linear models using continuous variables and multivariate logistic regression with categorized cIMT and HRV quartiles were performed.

Results

Out of 7256 participants eligible for analyses, 23·4% presented cIMT ≥ 75th percentile. Heart rate variability variables were reduced in cIMT ≥ P75 in comparison with cIMT < P75: SDNN 33·0 versus 37·0 ms, P<0·001; RMSSD 22·0 versus 26·0 ms, P<0·001; LF 191·0 versus 260·0 ms2, P<0·001; HF 164·0 versus 238·5 ms2, P<0·001. In crude analysis, an increased odds ratio for cIMT ≥ P75 was verified within the lowest two quartiles of LF and HF, but significances did not remain after adjustments for anthropometric and clinical variables.

Conclusions

Considering the entire sample, subjects with cIMT ≥ P75 presented lower HRV values, but no independent relationships were detected between cIMT and HRV after multivariate adjustment.
A novel method to improve the osteogenesis capacity of hUCMSCs with dual‐directional pre‐induction under screened co‐culture conditions
Authors: Rong Qiong , Li Shuyi , Zhou Yang , Geng Yuanming , Liu Shangbin , Wu Wanqiu , Forouzanfar Tim , Wu Gang , Zhang Zhiyong , Zhou Miao
Published: December 2019

Objectives

Mesenchymal stem cells (MSCs) based therapy for bone regeneration has been regarded as a promising method in the clinic. However, hBMSCs with invasive harvesting process and undesirable proliferation rate hinder the extensive usage. HUCMSCs of easier access and excellent performances provide an alternative for the fabrication of tissue‐engineered bone construct. Evidence suggested the osteogenesis ability of hUCMSCs was weaker than that of hBMSCs. To address this issue, a co‐culture strategy of osteogenically and angiogenically induced hUCMSCs has been proposed since thorough vascularization facilitates the blood‐borne nutrition and oxygen to transport in the scaffold, synergistically expediting the process of ossification.

Materials and methods

Herein, we used osteogenic‐ and angiogenic‐differentiated hUCMSCs for co‐culture in screened culture medium to elevate the osteogenic capacity with in vitro studies and finally coupled with 3D TCP scaffold to repair rat's critical‐sized calvarial bone defect. By dual‐directional induction, hUCMSCs could differentiate into osteoblasts and endothelial cells, respectively. To optimize the co‐culture condition, gradient ratios of dual‐directional differentiated hUCMSCs co‐cultured under different medium were studied to determine the appropriate condition.

Results

It revealed that the osteogenic‐ and angiogenic‐induced hUCMSCs mixed with the ratio of 3:1 co‐cultured in the mixed medium of osteogenic induction medium to endothelial cell induction medium of 3:1 possessed more mineralization nodules. Similarly, ALP and osteogenesis/angiogenesis‐related genes expressions were relatively higher. Further evidence of bone defect repair with 3D printed TCP of 3:1 group exhibited better restoration outcomes.

Conclusions

Our work demonstrated a favourable and convenient approach of dual‐directional differentiated hUCMSCs co‐culture to improve the osteogenesis, establishing a novel way to fabricate tissue‐engineered bone graft with 3D TCP for large bone defect augmentation.
Chinese commercial paper: The bank lending channel of monetary transmission and beyond
Authors: Liu Kerry
Published: December 2019

China's commercial paper financing experienced dramatic growth in January 2019. This paper examines the bank lending channel of China's monetary transmission to commercial paper, and more broadly, the factors that affect the growth of commercial paper, which is the first of its kind in the academic literature. The main conclusions include: the bank lending channel to commercial paper exists; the performance of the real economy also has a significant effect on the growth of the commercial paper.
Revisiting the dimensionality of biological diversity
Authors: Nakamura Gabriel , Gonçalves Larissa Oliveira , Duarte Leandro da Silva
Published: December 2019

Biodiversity can be represented by different dimensions. While many diversity metrics try to capture the variation of these dimensions they also lead to a ‘fragmentation’ of the concept of biodiversity itself. Developing a unified measure that integrates all the dimensions of biodiversity is a theoretical solution for this problem, however, it remains operationally impossible. Alternatively, understanding which dimensions better represent the biodiversity of a set of communities can be a reliable way to integrate the different diversity metrics. Therefore, to achieve a holistic understand of biological diversity, we explore the concept of dimensionality. We define dimensionality of diversity as the number of complementary components of biodiversity, represented by diversity metrics, needed to describe biodiversity in an unambiguously and effective way. We provide a solution that joins two components of dimensionality – correlation and the variation – operationalized through two metrics, respectively: evenness of eigenvalues (EE) and importance values (IV). Through simulation we show that considering EE and IV together can provide information that is neglected when only EE is considered. We demonstrate how to apply this framework by investigating the dimensionality of South American small mammal communities. Our example evidenced that, for some representations of biological diversity, more attention is needed in the choice of diversity metrics necessary to effectively characterize biodiversity. We conclude by highlighting that this integrated framework provides a better understanding of dimensionality than considering only the correlation component.
Evaluation of the effect of laser salpingopharyngostomy on the guttural pouch environment in horses
Authors: Jukic Chantelle C. , Cowling Nicholas R. , Perkins Nigel R. , van Eps Andrew W. , Ahern Benjamin J.
Published: December 2019

Background

Laser salpingopharyngostomy has been used as an adjunct to primary medical therapy allowing for topical debridement, topical treatment or to potentially alter the guttural pouch environment in horses with guttural pouch disease.

Objectives

To evaluate the effect of a laser salpingopharyngostomy on the guttural pouch environment in healthy horses.

Study design

Experimental study.

Methods

In six adult Standardbred female horses, under standing sedation a stab incision was made ventral to the sternocephalicus tendon and a customised trocar inserted into the medial guttural pouch compartment. Baseline (day 0) temperature, humidity, oxygen (O2) and carbon dioxide (CO2) levels were recorded. A laser salpingopharyngostomy was subsequently made into the right guttural pouch. The guttural pouch environment was re‐sampled as above on days 7 and 14 to detect differences in the local environment of the guttural pouch caused by the laser salpingopharyngostomy.

Results

The guttural pouch environment was altered by the laser salpingopharyngostomy. Baseline recorded values within the guttural pouch were highly constant within each horse. Post laser salpingopharyngostomy there was considerable variation within the guttural pouch between horse and during the period of sampling. Specifically, CO2 levels post laser salpingopharyngostomy appeared to be linked directly to the horse's respiratory pattern with peaks and troughs recorded post laser salpingopharyngostomy. The variation in CO2 was significantly different at days 7 and 14 post laser salpingopharyngostomy compared with baseline levels (day 7 = 6 mm Hg, day 14 = 8.83 mm Hg). Oxygen levels were also more varied during sampling compared with baseline (day 7 = 3.4%, day 14 = 1.83%). There was no change in humidity or temperature during the study.

Main limitations

This study was conducted on horses with no evidence of guttural pouch abnormalities or disease.

Conclusions

Laser salpingopharyngostomy alters the guttural pouch environment and this may be useful in the treatment of guttural pouch disease where this alteration is desirable.
Morphological comparison of artificial teeth position utilising denture space in glossectomy patients
Authors: Awuti Shataer , Sumita Yuka I. , Hattori Mariko , Yoshi Shigen , Kelimu Shajidan , Ohbayashi Naoto , Kurabayashi Tohru , Taniguchi Hisashi
Published: December 2019

Objective

This study aimed to compare the denture space of edentulous glossectomy patients with that of a control group from the perspective of artificial teeth positioning by using three‐dimensional techniques.

Background

It is known that the shape of the denture space may be affected by tongue resection or reconstruction. However, the details of artificial teeth positioning in these patients remain unclear.

Materials and methods

Six edentulous glossectomy patients aged 73‐83 years and six normal participants aged 74‐85 years participated in the study. Piezography was used to elucidate the characteristics of the denture space. For visualisation, piezographic records were scanned using cone beam computed tomography and the data were converted into stereolithographic format. Three‐dimensional images of piezographic records were then constructed. Bucco‐lingual widths of the mandibular occlusal surface were reproduced, and the camber line of the occlusal surface was set so as to simulate the position of the artificial teeth. The maximum chord of the occlusal surface on the left and right sides was recorded and measured. The discrepancy and ratio of the larger chord to the smaller chord between the right and left sides was calculated and subjected to statistical analyses using the Mann‐Whitney U test.

Results

There were significant differences in discrepancy and ratio between the left and right in the control group and the glossectomy patients (P ˂ .01). The glossectomy patients showed a greater discrepancy and ratio than the control group.

Conclusions

The simulated artificial teeth positions on the occlusal surface between the right and left side were asymmetric in glossectomy patients.
Prevalence of violence against older adults and associated factors in Çanakkale, Turkey: A cross‐sectional study
Authors: Gürsoy Melike Yalçın , Kara Fatih
Published: December 2019

Aim

This study was designed to determine the prevalence of domestic violence against older adults and the associated risk factors in Çanakkale, Turkey.

Methods

A cross‐sectional, population‐based study was carried out, including 1230 individuals aged ≥65 years living in the city of Çanakkale, Turkey. The population of the study consisted of 73 367 individuals aged ≥65 years, living in Çanakkale. Sample selection was made with the one‐step cluster sampling method. The data were collected by face‐to‐face interview. The study was approved by the local ethics committee, and written consent was taken from the participants.

Results

Of the participants, 4.1% had experienced physical violence, 2.5% were subjected to sexual abuse, 23.5% had undergone psychological violence and 12.2% had a history of economic violence. The exposure to any of the given violence types was 28.5%. Risk factors related to violence were being married, having children, educated partner, lack of economic independence, poor self‐perceived health, administration of medications by others, feeling lonely, dissatisfaction with life, poor perception of family relations and not participating in family decisions.

Conclusions

These results show that violence against older adults is a significant problem in a city in western Turkey. Therefore, an in‐depth evaluation of the determined risk factors related to violence and actions for its prevention are warranted. Geriatr Gerontol Int 2020; 20: 66–71.
Assessing the association between optimal energy intake and all‐cause mortality in older patients with diabetes mellitus using the Japanese Elderly Diabetes Intervention Trial
Authors: Omura Takuya , Tamura Yoshiaki , Yamaoka Takuya , Yoshimura Yukio , Sakurai Takashi , Umegaki Hiroyuki , Kamada Chiemi , Iimuro Satoshi , Ohashi Yasuo , Ito Hideki , Araki Atsushi ,   The Japanese Elderly Diabetes Intervention Trial Research Group
Published: December 2019

Aim

Selecting optimal energy intake during diet therapy for older patients with diabetes mellitus is difficult because of the large differences in physical function and comorbid diseases. In Japan, although requirements for total energy intake are calculated by multiplying a person's standard bodyweight (BW) by the amount of physical activity, evidence supporting the application of this method among older people is limited. Therefore, we aimed to assess optimal energy intake by evaluating the relationship between energy intake and mortality in older patients.

Methods

We evaluated data from a 6‐year prospective follow up of 756 older patients with diabetes mellitus, and the association between baseline nutrient intake and mortality. Total energy intake and nutrients were evaluated, and energy intake per actual BW was categorized into quartiles (Q). Cox regression analysis was used for statistical analyses. Energy intake per standard BW or age‐related target BW was statistically analyzed using the same protocol.

Results

Analysis of energy intake per actual BW showed that hazard ratios for mortality was significantly higher in Q1 and Q4. Similar associations were found for energy intake per standard or target BW. Subgroup analysis showed that mortality rate was the lowest in Q2 in the young‐old population and in Q3 in the old‐old population.

Conclusions

A U‐shaped relationship was observed between energy intake per BW and mortality in older patients with diabetes mellitus, which suggests that the optimal energy intake per actual or target BW should encompass a wide range to prevent malnutrition and excessive nutrition in these patients. Geriatr Gerontol Int 2020; 20: 59–65.
How I investigate acute myeloid leukemia
Authors: Narayanan Damodaran , Weinberg Olga K.
Published: December 2019

Acute myeloid leukemia (AML) is a neoplasm of immature myeloid cells and is associated with a wide variety of clinical presentations, morphological features, immunophenotypes, and genetic findings. Recent advances in identification of cytogenetic abnormalities and mutations have provided novel insights into the pathogenesis of AML. Based on the above‐mentioned parameters, the World Health Organization (WHO) classified AML into 25 subtypes, including 2 provisional entities, which differ in prognosis and treatment. In addition, certain mutations are associated with germline predisposition and increase the risk of inherited AML, which warrants family screening. Therefore, precise diagnosis and classification of AML are the most important steps in patient management. Both these steps require incorporation of history, clinical presentation, and laboratory results with studies performed by a pathologist. Pathologist‐initiated studies include morphologic evaluation on the bone marrow aspirate and/or core biopsy, immunophenotyping by flow cytometry and/or immunohistochemistry, cytogenetic analysis by karyotyping and/or fluorescence in situ hybridization, and molecular testing using gene panels and/or next‐generation sequencing. A similar approach is employed during follow‐up of patients after beginning treatment. Here, we describe in detail the various aspects of the workup, including purpose, limitations, and practice guidelines for the different studies. The process of choosing appropriate materials for the different studies is also addressed. We also provide an algorithm for the workup and risk stratification of AML based on guidelines recommended by the WHO, College of American Pathologists, National Comprehensive Cancer Network, American Society of Clinical Oncology, European Society of Medical Oncology, and the European LeukemiaNet.