bluuebunny/crossref_metadata_2025 huggingface dataset:
Incubator or accelerator – a tech start-up’s dilemma
Authors: Shankar Raj K.
Published: March 2017

Subject area

Entrepreneurship; Technology Transfer; Incubators; Accelerators

Study level/applicability

Postgraduate, Faculty Development Programs (FDP) and Management Development Programs (MDP) in areas of Technology Entrepreneurship, Entrepreneurship Education, Incubator and Accelerator Management.

Case overview

Madras Mind Works Private Limited (MMW) is an entrepreneurial venture set up by four friends in Chennai (earlier known as Madras) in Tamil Nadu, India. MMW intends to use the emerging trends in virtual reality and exploit opportunities that arise from its application. MMW has received invitations to join both an incubator as well as an accelerator. After detailed deliberations among the four co-founders that yielded no conclusion, the team left the responsibility of taking the decision to its Chief Executive Officer (CEO), Srinivasan Krish (Srini). Srini now has to decide whether MMW must join the incubator or the accelerator.

Expected learning outcomes

At least five factors will be learnt based on which tech start-ups can decide whether they should join an incubator or accelerator. Two important players in the entrepreneurship ecosystem are incubators and accelerators. You will learn to define them, describe their characteristics and services and learn their similarities and differences. You will learn what constitutes an entrepreneurial ecosystem using the BEEP framework. You will learn about many ecosystem players including but not limited to – incubators, accelerators, co-working spaces, technology transfer offices, research parks, angels, venture capitalists, government support schemes, university research centres, etc.

Supplementary materials

Board Plans, YouTube Video Links.

Subject code

CSS 3: Entrepreneurship.
Measuring perception about sustainability of building materials in Kosovo
Authors: Hoxha Visar , Haugen Tore , Bjorberg Svein
Published: March 2017

Purpose

The purpose of this paper is to develop the empirically tested framework about the knowledge and perception about sustainability of building materials in Prishtina, Kosovo from the perspective of users, construction industry and facility managers.

Design/methodology/approach

A survey of representative sections of the population was designed and carried out in the capital city of Kosovo to determine the knowledge and perception of the population about the sustainability of building materials and to determine the main criteria of selection of sustainable building materials. The study may be used as guidelines for sustainable real estate developers in Prishtina during the materials selection process. Qualitative interviews were conducted with architects, consulting engineering companies, construction companies and facility managers from the region of Prishtina with open-ended questions also being used.

Findings

Results of quantitative research find that embodied energy, durability and low energy consumption are used as key criteria that influence the materials selection process on the part of users. The results of the cross-case analysis of qualitative measure the perceptions of construction industry and facility managers, according to which durability to a large degree is the main criterion for selection of sustainable building materials followed by embodied energy and low energy consumption.

Research limitations/implications

The study of measurement of level of knowledge and perception about sustainability of building materials in Kosovo focuses only on one pilot city; hence, further research is needed throughout Kosovo to validate the empirically tested tool within other geographical settings in Kosovo.

Originality/value

This survey represents the first quantification of knowledge and perception regarding the sustainability of building materials among users, construction sector and facility managers.
The impact of public investments in facilities on the potential housing market for older persons
Authors: Drobne Samo , Bogataj Marija
Published: March 2017

Purpose

This paper aims to analyse the impact of public investments in facilities on the potential housing market for older persons by expanding the generally used approach of modelling working-age population to the approach of modelling the cohort of older population.

Design/methodology/approach

The paper introduces an asymmetric approach and normalization to the special case of spatial interaction models, i.e. the Lowry-like model, to analyse significant factors that influence migration flows structured by age cohorts. The model uses publicly available and free databases at the mezzo level in a state. The analysis was performed for inter-municipal interactions of migrants structured by age cohorts.

Findings

The results show the different influences of Lowry’s main factors that influence the migration flows in industrial societies. The higher the average age of migrants, the lower the influences in the Lowry model. But, this is also valid for the impact of investments in public facilities and their management at the mezzo level on older migrants. Furthermore, institutional care facilities in a local community were proven to be an important factor to attract older persons.

Research limitations/implications

The results show that there are other important factors that influence the migration flows of older persons. So, for better results, more structured data on investments and management of the facilities and other more subjective factors should be included in the model.

Practical implications

The paper gives suggestions for further development of the models to analyse the potential housing market for older persons.

Originality/value

In addition to the suggested approach to study the impact of investments in facilities on the older population, this paper also identifies a need for more in-depth studies into this topic in the near future.
Segmenting female consumers: high-involvement personal services
Authors: Milfelner Borut , Vidergar Kikel Tanja , Mumel Damijan , Pisnik Aleksandra
Published: March 2017

Purpose

The purpose of this paper is to measure attitudes towards cosmetic surgery services among women and to determine the potential segments of women according to their attitudes towards cosmetic surgery services and discover the main differences among them.

Design/methodology/approach

The research was implemented on a sample of 258 women in Slovenia. A quota sample was chosen for this research following the age characteristics of the Slovenian female population. The data collection method used was personal interviews. Convergent validity for the attitudes towards cosmetic surgery services was assessed with exploratory factor analysis. The segmentation analysis procedure was implemented in two phases. First, hierarchical clustering with Ward’s method was deployed, and in the second step K-means cluster analysis was used.

Findings

The results show that four clusters were clearly distinctive according to three dimensions, namely, intrapersonal, social and consider component. In further analysis, four segments of women were analysed regarding the fear of ageing, the importance of appearance, body image and self-esteem. Results show that all four segments are unique and distinguish one from another.

Practical implications

Through segmentation analysis, authors of this study indicate two segments (target groups) that are possibly interesting for providers of cosmetic services. Marketing communication activities should mainly be focussed on the woman’s appearance.

Originality/value

Based on a theoretical hypothesis and use a quantitative method, the aim of this paper is to provide a deeper analysis and understanding of attitudes and views of different woman profile regarding cosmetic surgeries. It presents a more structured view on differences that exist among segments of female consumers while also adding new insights into the factors that influence attitudes towards cosmetic procedures.
Institutional change and economic development: a conceptual analysis of the African case
Authors: Adanu Kwami
Published: March 2017

Purpose

The purpose of this paper is to explain the African socio-economic development and policy design problems using the new institutional economics methodology. The paper emphasizes the importance of carefully considering the policy environment setting before changing the rules of the society (institutional change) and making policy choices.

Design/methodology/approach

A conceptual approach is used to explain why major economic development policies fail in Africa and the developing world as a whole. To illustrate policy-environment-dependent institutional and policy change decision making, examples of potential institutional and policy changes are examined for Ghana’s financial, retail, and land resource sectors.

Findings

It is argued that the concept of institutional efficiency must be looked at quite differently from the Pareto-optimal concept in the neoclassical economic theory. This is because institutional analysis leans more toward normative rather than positive economics. The paper explains the counterintuitive findings that although the African business environment is low on trust due to high ethnic diversity, African business depends more on trust than contracts –weak enforcement of institutions accounts for such twists. Potential institutional changes that can help address specific socio-economic developmental challenges are suggested based on the characteristics of the African business environment.

Research limitations/implications

The paper lays bare several research hypotheses that can now be tested using the available data. These include hypotheses that strong economic growth precedes growth in the stock market activity (not the other way round); an asymmetric Tobin tax that taxes conversion into foreign currencies more than conversion into local currency reverses local currency depreciation; and for import-dependent countries, strengthening the local currency provides a positive shock to local production and budget balance.

Originality/value

The paper illustrates the pitfalls associated with blanket application of theoretical frameworks without proper contextualization. A promising way out for weak African economies is to adapt the theoretical economic predictions to local environments and help refine general economic theory through their experiences.
Disparity in family status attainment between the majority and minority ethnic groups in Bangladesh
Authors: Uddin Md. Emaj
Published: March 2017

Purpose

Structural sociological framework suggests that sociopolitical and economic factors exert independent effects on variations in family status attainment (FSA) across the social/ethnic groups. The purpose of this paper is to analyze and predict how social-political-economic factors exert effects on disparity in FSA between the majority and minority ethnic groups in Bangladesh.

Design/methodology/approach

This study used the cross-cultural survey design to analyze the research objective. In doing so, 585 men (Muslim n=150, Hindu n=145, Santal n=145, and Oraon n=145) who were randomly selected through cluster sampling from the Rasulpur union of Bangladesh were interviewed with a semi-structured questionnaire.

Findings

The results of Pearson’s χ2 test have shown that FSA was significantly different (p<0.01) associated with social-political-economic factors between the majority and minority groups. The results of the linear regression analysis (coefficients of β) suggested that social, political, and economic factors were the best predictors (significant at p<0.01 level) to perpetuate disparity in FSA between the majority and minority ethnic groups in Bangladesh. In addition, the results of coefficients of determination (R2) suggested that unequal distribution of social-political-economic resources perpetuates 10-14 percent disparities in FSA between the majority and minority groups in Bangladesh.

Research limitations/implications

Although the findings of the study are suggestive to understand the disparity in FSA associated with social-political-economic factors, further cross-cultural research is needed on how the social psychological factor affects variations in FSA between the groups in Bangladesh. In spite of the limitation, social policymakers may apply the findings with caution to design social policy and practice to reduce the disparity in FSA between the majority and minority ethnic groups in Bangladesh.

Originality/value

The cross-cultural findings are original in linking structural sociological theory and comparative family welfare policy to reduce the disparity in FSA between the majority and minority groups in Bangladesh.
Intersectionality in LGBT fiction
Authors: Moulaison Sandy Heather , Brendler Beth M. , Kohn Karen
Published: March 2017

Purpose

The purpose of this paper is to evaluate characters and scenarios reflecting varied lesbian, gay, bisexual, and transgender (LGBT) identities in fiction in two library acquisitions platforms: a traditional library vendor (Coutts’ OASIS) and a freely available platform for self-published eBooks (Smashwords).

Design/methodology/approach

Using intersectionality as an approach, 200 LGBT fiction titles were examined in OASIS and in Smashwords with the goal of assessing the characters and scenarios represented. The hypothesis was that Smashwords’s titles, because they were self-published, would include more variety.

Findings

The titles in both platforms were roughly similar, with a pronounced focus on white gay males.

Research limitations/implications

This research relied on limited metadata provided in each system. Additional research should evaluate the quality of the titles and the nature of the publishers.

Practical implications

Although the Smashwords eBook platform provides access to eBooks, a convenient way to consume genre fiction, the titles available do not represent more diverse LGBT identities than the titles available through a traditional library vendor platform, OASIS.

Originality/value

As libraries struggle with practical implications for selecting materials representing varied viewpoints, the question of self-published or indie eBooks has emerged as a potential option for providing these perspectives. The findings of this study indicate, however, that instead of reflecting a more diverse readership, the sample of Smashwords LGBT fiction eBooks examined largely resembles the materials that a library vendor provides.
Does accumulated knowledge impact academic performance in cost accounting?
Authors: Alanzi Khalid A. , Alfraih Mishari M.
Published: March 2017

Purpose

This quantitative study aims to examine the impact of accumulated knowledge of accounting on the academic performance of Cost Accounting students.

Design/methodology/approach

The sample consisted of 89 students enrolled in the Accounting program run by a business college in Kuwait during 2015. Correlation and linear least squares regression analyses tested the study’s hypothesis.

Findings

Results indicated significant impact of accumulated knowledge on academic performance, with and without controls for other factors.

Practical implications

The findings provide administrators, academic advisors, accounting educators and researchers with a useful benchmark for the development of accounting curriculum, teaching plans and strategies and future academic research, and it forms the basis for comparative work aimed at the harmonization of international accounting education.

Originality/value

The study provides empirical support for the theoretical prediction that quantitative accumulated knowledge in accounting has an impact on the academic performance of students, especially in Cost Accounting. Internationally, it provides a foundation for future comparative studies, potentially leading to the harmonization of international accounting education. Regionally, it attempts to fill some of the gaps in the regional accounting education literature. Locally, the study seeks to improve the performance of the accounting students in Cost Accounting within the college where data were collected.
The learning organization and the level of consciousness
Authors: Chiva Ricardo
Published: March 2017

Purpose

The purpose of this paper is to analyze learning organization by comparing with other types of organizations. This typology is based on the levels of consciousness and relates each type of organization with a level of learning and an organizational structure.

Design/methodology/approach

This is a conceptual paper based on the concept of levels of consciousness.

Findings

The paper proposes that learning organization requires the highest level of consciousness.

Originality/value

The paper uses the levels of consciousness to compare learning organization with other types of organizations.
The mediation role of intention in knowledge sharing behavior
Authors: Mafabi Samuel , Nasiima Sentrine , Muhimbise Edgar Mutakirwa , Kasekende Francis , Nakiyonga Caroline
Published: March 2017

Purpose

This paper aims to examine the mediation role of behavioral intention in the relationship between attitude, subjective norm, perceived behavioral control and knowledge sharing behavior.

Design/methodology/approach

The study adopted a cross-sectional design to collect data used to carry out mediation analysis. Structural equation modeling was used to test for the mediation effect based on the theory of planned behavior.

Findings

The results reveal positive and significant relationships between attitude, subjective norm, perceived behavioral control and behavioral intention. There is a full mediation effect of behavioral intention between attitude, subjective norm, perceived behavioral control and knowledge sharing behavior. This implies that behavioral intention wholly processes planned behavior prediction.

Research limitations/implications

The sample size was small, covering only two referral hospitals which affects the generalization of findings across all the hospitals in Uganda. The study was cross-sectional focusing on a one-off perception, which does not examine knowledge sharing behavior over time. This may necessitate follow-up studies in a longitudinal design to capture the trend of results.

Practical implications

Managers in referral hospitals should create opportunities for health professionals to enhance knowledge sharing behavior. Knowledge sharing practices should be embedded in the performance appraisal and reward systems which should promote positive knowledge sharing attitudes and norms and develop self-efficacy.

Originality/value

The study generates empirical evidence on less studied phenomena in the health sector focusing on behavioral intention mediation in predicting knowledge sharing behavior.
Utilizing a systematic literature review to develop an integrated framework for information and knowledge management systems
Authors: Senivongse Chulatep , Bennet Alex , Mariano Stefania
Published: March 2017

Purpose

The purpose of this paper is to demonstrate the value of using a systematic literature review to develop an integrated framework for information and knowledge management systems.

Design/methodology/approach

First, the systematic literature review method is introduced, differentiating it from traditional literature reviews in terms of value-added and limitations. Second, this methodology is used in a research application focused on absorptive capacity internal capabilities with regard to the processes of acquisition, assimilation, transformation and exploitation. Third, an integrated framework for information and knowledge management systems is developed from this application.

Findings

The systematic literature review approach provides a rigor that can assist in reducing researcher bias while simultaneously enabling the definition of a precise scope of review, with a clear explanation of selection criteria with the objective to find and review all the studies that are relevant to the search definitions. As a research method, it effectively supports a qualitative, quantitative or mixed methodology.

Research limitations/implications

This methodology was applied to one specific area of research. Specific limitations include the availability of articles in subscribed databases and the analytical capabilities of the tools used for text mining and analytics.

Originality/value

This paper demonstrates the usefulness of the systematic literature review methodology in developing an integrated framework for analysis.
Contextual factors in knowledge reuse
Authors: Cheuk Ka Po , Baškarada Saša , Koronios Andy
Published: March 2017

Purpose

This paper aims to answer calls for more research on how contextual factors influence the effectiveness of knowledge reuse.

Design/methodology/approach

The findings are based on an in-depth case study conducted in the sales department of a large white goods company in Australia.

Findings

Six contextual factors identified include purpose, time pressure, language, accessibility, author and date. A mismatch in purpose between knowledge creation and reuse is most likely to reduce knowledge reuse effectiveness. Time pressures may lead to an increase in errors associated with search question definition as well as knowledge search and selection, while unfamiliar language is likely to lead to misinterpretations of content. Knowledge accessibility issues are of particular concern in time-sensitive situations. Authorship and creation date information may facilitate knowledge reuse by allowing consumers to filter unwanted knowledge.

Originality/value

This study contributes to knowledge management theory by providing an exploration of the ways in which contextual factors influence knowledge and reuse effectiveness, and of the possible relationships between those factors. The paper also provides knowledge management practitioners with tangible guidelines on how to increase the effectiveness of organizational knowledge reuse.
Keratoacanthoma en plaque/nodule: A brief report of the clinicopathological features of five cases
Authors: Misago Noriyuki , Ansai Shin‐ichi , Fukumoto Takaya , Anan Takashi , Nakao Tomokazu
Published: March 2017

Keratoacanthoma (KA) is characterized by exoendophytic growth with a central keratin‐filled crater, representing the crateriform architecture. We herein report five rare cases of KA without a central keratin‐filled crater. These KA cases histopathologically showed that one or a few infundibular structures/isthmic lobules had their own open keratotic pores on the surface without a common merged keratotic plug/horn, clinically representing verrucous (keratotic) plaque/nodule, namely, “KA en plaque/nodule”. KA rarely but on occasion does show verrucous plaque (or nodular) lesions without a central keratin‐filled crater, as the notion that KA invariably shows crateriform architecture is nonsensical.
Efficacy and safety of luliconazole 5% nail solution for the treatment of onychomycosis: A multicenter, double‐blind, randomized phase III study
Authors: Watanabe Shinichi , Kishida Hiroshi , Okubo Akihiro
Published: March 2017

Onychomycosis is a highly prevalent and intractable disease. The first‐line treatment agents are oral preparations, but an effective topical medication has long been desired. The objective was to investigate the efficacy and safety of luliconazole 5% nail solution, an imidazole antifungal agent, for the treatment of patients with onychomycosis. A multicenter, double‐blind, randomized phase III study was conducted in Japanese patients with distal lateral subungual onychomycosis affecting the great toenails, with 20–50% clinical involvement. Patients were randomized (2:1) to luliconazole or vehicle once daily for 48 weeks. The primary end‐point was the complete cure rate (clinical cure [0% clinical involvement of the nail] plus mycological cure [negative results on direct microscopy]). The adverse event incidence was monitored to evaluate safety. The complete cure rate significantly favored luliconazole (14.9%, 29/194 subjects) versus vehicle (5.1%, 5/99) (P = 0.012). Similarly, the negative direct microscopy rate was significantly higher with luliconazole (45.4%, 79/174) than with vehicle (31.2%, 29/93) (P = 0.026). There were no serious adverse drug reactions. We conclude that once daily topical luliconazole 5% nail solution demonstrated clinical efficacy and was confirmed to be well tolerated.
Mechanisms of resistance to quinolones in Salmonella Typhimurium from patients with infectious diarrhea
Authors: Yuan Jing , Guo Wei
Published: March 2017

This study investigated the mechanisms of resistance of 36 quinolone‐resistant Salmonella Typhimurium strains isolated from outpatients with infectious diarrhea in Beijing Tian Tan Hospital between 2013 and 2015. The resistance spectrum of the 36 strains was measured using a broth dilution method. Class 1 integrons harboring the β‐lactamase gene and mutations in quinolone resistance determining regions were also investigated. All 36 quinolone‐resistant Salmonella Typhimurium strains were found to be multidrug‐resistant and the majority of these strains harbored Class 1 integrons. These findings study suggests that strategies for determining resistance spectrums should be implemented with greater urgency.
A probabilistic model for ghost delay time estimation based on recording geometry
Authors: Rickett James , Cecílio Inês
Published: March 2017

In order to deconvolve the ghost response from marine seismic data, an estimate of the ghost operator is required. Typically, this estimate is made using a model of in‐plane propagation, i.e., the ray path at the receiver falls in the vertical plane defined by the source and receiver locations. Unfortunately, this model breaks down when the source is in a crossline position relative to the receiver spread. In this situation, in‐plane signals can only exist in a small region of the signal cone.

In this paper, we use Bayes' theory to model the posterior probability distribution functions for the vertical component of the ray vector given the known source–receiver azimuth and the measured inline component of the ray vector. This provides a model for the ghost delay time based on the acquisition geometry and the dip of the wave in the plane of the streamer. The model is fairly robust with regard to the prior assumptions and controlled by a single parameter that is related to the likelihood of in‐plane propagation.

The expected values of the resulting distributions are consistent with the deterministic in‐plane model when in‐plane likelihood is high but valid everywhere in the signal cone. Relaxing the in‐plane likelihood to a reasonable degree radically simplifies the shape of the expected‐value surface, lending itself for use in deghosting algorithms. The model can also be extended to other plane‐wave processing problems such as interpolation.
Micromonas versus virus: New experimental insights challenge viral impact
Authors: Ruiz Eliana , Baudoux Anne‐Claire , Simon Nathalie , Sandaa Ruth‐Anne , Thingstad T. Frede , Pagarete António
Published: March 2017

Viruses have recurrently been hypothesized as instrumental in driving microbial population diversity. Nonetheless, viral mediated co‐existence of r/k‐strategists, predicted in the Killing‐the‐Winner (KtW) hypothesis, remains controversial and demands empirical evidence. Therefore, we measured the life strategy parameters that characterize the relevant system Micromonas‐Micromonas Virus (MicV). A large number of host and viral strains (37 and 17, respectively) were used in a total of 629 cross‐infectivity tests. Algal and viral abundances were monitored by flow cytometry and used to calculate values of growth rate, resistance capacity, and viral production. Two main assumptions of the KtW model, namely (1) a resistance‐associated cost on growth and (2) a negative correlation between resistance and viral production capacity, were mildly observed and lacked statistical significance. Micromonas strains infected by more MicV strains presented higher lysis and viral production rates as the number of infectious virus strains increased, suggesting a ‘one‐gate’ regulation of infection in this system. MicV strains demonstrated a vast range of virion production capacity, which unexpectedly grew with increasing host‐range. Overall, the significant trends observed in here demonstrate strong co‐interactions at different levels between Micromonas and MicV populations, however, the role of viruses as major driving force in phytoplankton fitness wasn't explicitly observed.
Ownership Structure and Capital Structure: A Study of Vietnamese Listed Firms
Authors: Le Thi Phuong Vy , Tannous Kathy
Published: March 2017

This paper examines the relationships between ownership structure and capital structure for non‐financial listed firms in Vietnam during the period 2007–2012. Although different approaches are applied in this research, all results from those models are consistent. The study finds that while foreign ownership has a negative impact on leverage, state ownership has a positive influence. Managerial ownership has a positive relation with debt level, while the effect of large ownership on debt level is not conclusive.
A Note on a Conversation with Geoff Harcourt
Authors: Tran‐Nam Binh , Harcourt Geoff
Published: March 2017

In this note Geoff Harcourt offers his views, via a face to face interview, on a wide range of issues relating to the discipline of economics. He recalls his time as a student at University of Melbourne, his choice of doctoral study and experiences at University of Cambridge, his original intellectual influences and affiliation, and his contributions to economics. He also discusses how economics have evolved over the years, comments on the current status of economic teaching, research and policy advice in Australia, and makes some recommendations to early career researchers. The note also includes a brief bio sketch of Professor Harcourt.
Music‐making for health and wellbeing in youth justice settings: mediated affordances and the impact of context and social relations
Authors: Daykin Norma , de Viggiani Nick , Moriarty Yvonne , Pilkington Paul
Published: March 2017

Young people in the criminal justice system experience significant health and wellbeing issues that often stem from poverty and disadvantage and, in turn, are linked with offending and reoffending behaviour. There is ongoing interest in interventions such as participatory music programmes that seek to foster social reintegration, support mental wellbeing and equip young offenders with life skills, competencies and emotional resilience. However, there is a need for a situated understanding of both positive and negative experiences that shape potential outcomes of music projects. This article reports on a research study undertaken between 2010 and 2013 with 118 young people aged 13–21 years across eight youth justice settings in England and Wales. Using mixed methods we explored the experiences of young people and their responses to a participatory music programme led by a national UK arts charity. Here, we explore the impact of young people's encounters with music and musicians with reference to the notion of ‘musical affordances’ (DeNora , ). We examine the ways that such affordances, including unintended outcomes, are mediated by features of the youth justice environment, including its rules and regulations, as well as issues of power, identity and social relations.
Paediatric high‐flow nasal cannula therapy in children with bronchiolitis: A retrospective safety and efficacy study in a non‐tertiary environment
Authors: Davison Michelle , Watson Mike , Wockner Leesa , Kinnear Frances
Published: March 2017

Objective

The objective was to examine the safety and efficacy of high‐flow nasal cannula (HFNC) therapy for children with bronchiolitis in a non‐tertiary paediatric setting.

Methods

This was a single‐centre retrospective study conducted over 26 months (March 2013–April 2015) on children aged 1–23 months with suspected bronchiolitis, who commenced on HFNC therapy in either the ED or the ward. Changes with respect to baseline data were analysed for effect on work of breathing (WOB), heart rate (HR) and respiratory rate (RR). Data was analysed using a linear mixed effects model and adjusted for age (≤12 months and >12 months) and location (ED vs ward). Transfer to a tertiary environment, escalation of care and adverse event rates were also recorded.

Results

A total of 61 children commenced on HFNC therapy, with flow rates ranging from 0.6 to 3.3L/kg/min. The proportion of patients with higher WOB scores appeared to reduce within 60 min of initiation of therapy. There was also a progressive reduction in surrogate markers of respiratory distress (HR and RR), with significant reductions evident by 60 min (P < 0.05). There were no adverse events related to HFNC therapy. The transfer rate was 13%. It was predominantly due to lack of improvement of physiological parameters post initiation of HFNC therapy. None of the transferred patients required escalation of care.

Conclusion

Within the limitations of this study it appears HFNC therapy may be safely commenced in both age groups in a non‐tertiary ED or ward, with an appropriate level of observation and robust transfer criteria.
Differentiation of patented crystalline glucosamine sulfate from other glucosamine preparations will optimize osteoarthritis treatment
Authors: Saengnipanthkul Sukit , Waikakul Saranatra , Rojanasthien Sattaya , Totemchokchyakarn Kitti , Srinkapaibulaya Attarit , Cheh Chin Tai , Mai Hong Nguyen , Bruyère Olivier , Cooper Cyrus , Reginster Jean‐Yves , Lwin Myat
Published: March 2017

Symptomatic slow‐acting drugs for osteoarthritis (SYSADOAs) are recommended for the medium‐ to long‐term management of knee osteoarthritis (OA) due to their abilities to control pain, improve function and delay joint structural changes. Among SYSADOAs, evidence is greatest for the patented crystalline glucosamine sulfate (pCGS) formulation (Mylan). Glucosamine is widely available as glucosamine sulfate (GS) and glucosamine hydrochloride (GH) preparations that vary substantially in molecular form, pharmaceutical formulation and dose regimen. Only pCGS is given as a highly bioavailable once‐daily dose (1500 mg), which consistently delivers the plasma levels of around 10 μmol/L required to inhibit interleukin‐1‐induced expression of genes involved in the pathophysiology of joint inflammation and tissue destruction. Careful consideration of the evidence base reveals that only pCGS reliably provides a moderate effect size on pain that is higher than paracetamol and equivalent to non‐steroidal anti‐inflammatory drugs (NSAIDs), while non‐crystalline GS and GH fail to reach statistical significance for pain reduction. Chronic administration of pCGS has disease‐modifying effects, with a reduction in need for total joint replacement lasting for 5 years after treatment cessation. Pharmacoeconomic studies of pCGS demonstrate long‐term reduction in additional pain analgesia and NSAIDs, with a 50% reduction in costs of other OA medication and healthcare consultations. Consequently, pCGS is the logical choice, with demonstrated medium‐term control of pain and lasting impact on disease progression. Physician and patient education on the differentiation of pCGS from other glucosamine formulations will help to improve treatment selection, increase treatment adherence, and optimize clinical benefit in OA.
Post‐cardiac arrest level of free‐plasma DNA and DNA‐histone complexes
Authors: Jeppesen A. N. , Hvas A.‐M. , Grejs A. M. , Duez C. H. V. , Sorensen B. S. , Kirkegaard H.
Published: March 2017

Background

Plasma DNA‐histone complexes and total free‐plasma DNA have the potential to quantify the ischaemia‐reperfusion damages occurring after cardiac arrest. Furthermore, DNA‐histone complexes may have the potential of being a target for future treatment. The aim was to examine if plasma DNA‐histone complexes and the levels of total free‐plasma DNA were elevated in post‐cardiac arrest patients compared with healthy individuals, and to examine if these biomarkers were capable of predicting mortality.

Methods

We included 42 comatose out‐of‐hospital cardiac arrest patients and collected blood samples after 22, 46 and 70 h. Samples for DNA‐histone complexes were quantified by Cell Death Detection ELISAplus. The total free‐plasma DNA analyses were quantified with qPCR by analysing the Beta‐2 microglobulin gene. The control group comprised 40 healthy individuals.

Results

We found no difference in the level of DNA‐histone complexes between the 22‐h sample and healthy individuals (P = 0.10). In the 46‐h sample, there was an increased level of DNA‐histone complexes in non‐survivors compared with survivors 30 days after the cardiac arrest (P < 0.01) and the area under the ROC curve was 0.78 (95% confidence interval: 0.59;0.96). The level of total free‐plasma DNA was increased in the 22‐h sample compared with healthy individuals (P < 0.001) but no significant difference was found between non‐survivors and survivors 30 days after the cardiac arrest (all P ≥ 0.06).

Conclusion

An increased level of DNA‐histone complexes was associated with increased mortality and that the level of total free‐plasma DNA was elevated post‐cardiac arrest.
The mortality rate of electroconvulsive therapy: a systematic review and pooled analysis
Authors: Tørring N. , Sanghani S. N. , Petrides G. , Kellner C. H. , Østergaard S. D.
Published: March 2017

Objective

Electroconvulsive therapy (ECT) remains underutilized because of fears of cognitive and medical risks, including the risk of death. In this study, we aimed to assess the mortality rate of ECT by means of a systematic review and pooled analysis.

Method

The study was conducted in adherence with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guideline. The ECT‐related mortality rate was calculated as the total number of ECT‐related deaths reported in the included studies divided by the total number of ECT treatments.

Results

Fifteen studies with data from 32 countries reporting on a total of 766 180 ECT treatments met the inclusion criteria. Sixteen cases of ECT‐related death were reported in the included studies yielding an ECT‐related mortality rate of 2.1 per 100 000 treatments (95% CI: 1.2–3.4). In the nine studies that were published after 2001 (covering 414 747 treatments), there was only one reported ECT‐related death.

Conclusion

The ECT‐related mortality rate was estimated at 2.1 per 100 000 treatments. In comparison, a recent analysis of the mortality of general anesthesia in relation to surgical procedures reported a mortality rate of 3.4 per 100 000. Our findings document that death caused by ECT is an extremely rare event.
Global brain asymmetry is increased in schizophrenia and related to avolition
Authors: Núñez C. , Paipa N. , Senior C. , Coromina M. , Siddi S. , Ochoa S. , Brébion G. , Stephan‐Otto C.
Published: March 2017

Objective

Schizophrenia may be the result of a failure of the normal lateralization process of the brain. However, whole‐brain asymmetry has not been assessed up to date. Here, we propose a novel measure of global brain asymmetry based on the Dice coefficient to quantify similarity between brain hemispheres.

Method

Global gray and white matter asymmetry was calculated from high‐resolution T1 structural images acquired from 24 patients with schizophrenia and 26 healthy controls, age‐ and sex‐matched. Some of the analyses were replicated in a much larger sample (n = 759) obtained from open‐access online databases.

Results

Patients with schizophrenia had more global gray matter asymmetry than controls. Additionally, increased gray matter asymmetry was associated with avolition, whereas the inverse relationship was found for anxiety at a trend level. These analyses were replicated in a larger sample and confirmed previous results.

Conclusion

Our findings suggest that global gray matter asymmetry is related to the concept of developmental stability and is a useful indicator of perturbations during neurodevelopment.
PAI‐1 in granulosa cells is suppressed directly by statin and indirectly by suppressing TGF‐β and TNF‐α in mononuclear cells by insulin‐sensitizing drugs
Authors: Yamada‐Nomoto Kaori , Yoshino Osamu , Akiyama Ikumi , Iwase Akira , Ono Yosuke , Nakamura Tomoko , Harada Miyuki , Nakashima Akitoshi , Shima Tomoko , Ushijima Akemi , Osuga Yutaka , Chang Russell Jeffrey , Shimasaki Shunichi , Saito Shigeru
Published: March 2017

Problem

Plasminogen activator inhibitor‐1 (PAI‐1) is elevated in women with polycystic ovary syndrome (PCOS), but the regulation in granulosa cells (GCs) is unclear.

Method of study

PAI‐1 expression in PCOS ovaries was investigated immunohistologically. PAI‐1 expressions in HGrC1, a human GC cell line, were investigated at mRNA and activity levels. The expressions of TGF‐β and TNF‐α in peritoneal fluid mononuclear cells (PFMCs) were measured with quantitative PCR.

Results

Little PAI‐1 expression is observed in healthy GCs, whereas GCs of PCOS and atretic follicle exhibit distinct expression in vivo. In vitro study using HGrC1 shows that TGF‐β and TNF‐α increase PAI‐1 mRNA and its activity, and both together exhibit a synergistic effect. The expression of PAI‐1 mRNA is suppressed by simvastatin. Moreover, insulin‐sensitizing drugs (metformin, pioglitazone, and rosiglitazone) suppress LPS‐induced TGF‐β and TNF‐α mRNA expression in PFMC.

Conclusion

Statin and insulin‐sensitizing drugs may provide a potential therapy for PCOS via down‐regulation of PAI‐1 expression in GCs and down‐regulation of TGF‐β and TNF‐α expression in PFMC, respectively.
Caesarean risk in obese women at term: A retrospective cohort analysis
Authors: Nugent Rachael , de Costa Caroline , Vangaveti Venkat
Published: March 2017

Background

Obesity in pregnancy is a growing health problem conferring higher risk to both the woman and her infant. Internationally, peak bodies offer little guidance regarding the method and timing of delivery in these patients. Our hypothesis is that induction of labour (IOL) at term will not increase the caesarean section (CS) rate when compared to expectant management.

Aims

To compare perinatal outcomes between IOL and expectant management in obese women at term.

Methods

A retrospective cohort study of all term, singleton, vertex deliveries at the Townsville Hospital and Health Service from January 2011 to June 2015 in women with a body mass index (BMI) ≥ 35. Women undergoing IOL at 37 weeks were compared with women expectantly managed at that gestational age. Similar comparisons were made at 38, 39 and 40 weeks. χ2 tests and binary logistic regression were used for statistical comparison. The primary outcome measure was mode of delivery, with secondary measures of perinatal morbidity also considered.

Results

There was no difference in outcome of CS, or other maternal secondary outcomes. There was no difference in rates of neonatal nursery admission. Expectant management at 38 weeks was associated with lower odds of post‐partum haemorrhage (odds ratio 0.371; 95% confidence interval 0.163–0.845).

Conclusions

In women with a BMI ≥ 35, IOL does not affect the CS rate, or the risk of neonatal adverse events, but may increase the rate of postpartum haemorrhage when compared with expectant management.
The number of CAG and GGN triplet repeats in the Androgen Receptor gene exert combinatorial effect on hormonal and sperm parameters in young men
Authors: Grigorova M. , Punab M. , Kahre T. , Ivandi M. , Tõnisson N. , Poolamets O. , Vihljajev V. , Žilaitienė B. , Erenpreiss J. , Matulevičius V. , Laan M.
Published: March 2017

Androgen receptor (AR) is a transcription factor that is activated upon binding to testosterone (T) and is implicated in regulating the expression of reproduction‐related genes. The human AR gene (Xq11‐12) spans 186,588 bp and eight exons. N‐terminal transactivation domain of the encoded AR protein harbours two polymorphic stretches of identical amino acids, a polyglutamine tract (encoded by 8‐37 CAG‐repeats) and a polyglycine tract (encoded by 10‐30 GGN‐repeats). We set forward to analyse independent and combinatory effects of the length of these repetitive tracts on male reproductive hormones, testicular and sperm parameters in a population‐based cohort of Baltic young men (n = 974; aged 20.1 ± 2.1 years). We designed an assay to amplify and detect simultaneously the variants of both polymorphic repeats. The study revealed that elongated AR CAG tract was associated with lower FSH (linear regression: p = 0.0002, effect per repeat −0.056 IU/L). As a novel finding, the carriers of GGN‐stretch with ≥24 repeats showed a trend for decreased sperm concentration (p = 0.027). Although neither of the variants exhibited an isolated effect on circulating T, their allelic combinations modulated serum T levels, as well as sperm concentration. The lowest T was measured for men carrying the AR gene with long CAG (n ≥ 25) and short GGN (n ≤ 21) repeat tracts (mean 18.8 vs. 25.5–28.6 nmol/L for the other AR variants, p = 0.017). The lowest sperm concentration was detected among individuals with both elongated repetitive stretches (CAG, n ≥ 25 and GGN, n ≥ 24; mean 49.0 vs. 68.4–72.1 mill/mL for the other variants; p = 0.00059). The innovative study design enabled to clearly demonstrate a combinatory impact of CAG and GGN repeat lengths at male reproductive parameters. As AR regulates transcription of over 900 genes in many tissues and organs, the combinatory effects of these common repeat‐length variants on male physiology in the wider context and across lifetime are still to be assessed.
Disturbed testicular expression of the estrogen‐metabolizing enzymes CYP1A1 and COMT in infertile men with primary spermatogenic failure: possible negative implications on Sertoli cells
Authors: Parada‐Bustamante A. , Molina C. , Valencia C. , Flórez M. , Lardone M. C. , Argandoña F. , Piottante A. , Ebensperguer M. , Orihuela P. A. , Castro A.
Published: March 2017

Estradiol (E2) is normally metabolized to hydroxyestradiols and methoxyestradiols by CYP1A1, CYP1B1 and COMT. However, an altered production of these metabolites by a disturbed expression of these enzymes is associated with reproductive and non‐reproductive pathologies. In vitro studies suggest that increased hydroxyestradiols and methoxyestradiols intratesticular generation is related to male infertility, but no studies have explored whether infertile men have a disturbed testicular expression of the enzymes that generate these E2 metabolites. The aim of this study was to assess CYP1A1, CYP1B1 and COMT testicular expression at mRNA and protein level in men with spermatogenic impairment. Seventeen men with primary spermatogenic failure (13 with Sertoli cell‐only syndrome and four with maturation arrest) and nine controls with normal spermatogenesis were subjected to testicular biopsy. mRNA was quantified using real‐time RT‐PCR and protein expression was evaluated using western blot and immunohistochemistry followed by integrated optic density analysis. Besides, the effects of hydroxyestradiols and methoxyestradiols on testosterone‐induced transcriptional activity were evaluated in TM4 cells using a luciferase reporter assay system. Our results show that patients with Sertoli cell‐only syndrome had significantly elevated COMT expression at the mRNA level, higher COMT immunoreactivity in their seminiferous tubules and increased protein expression of the soluble COMT isoform (S‐COMT), whereas patients with maturation arrest had significantly elevated CYP1A1 mRNA levels and higher CYP1A1 immunoreactivity in interstitial space. Finally, 2‐hydroxyestradiol decreased testosterone‐induced transcriptional activity in Sertoli cells in vitro. In conclusion, male infertility is related to disturbed testicular expression of the enzymes responsible for producing hydroxyestradiols and/or methoxyestradiols. If these changes are related with increased intratesticular hydroxyestradiols and methoxyestradiols concentrations, they could elicit an impaired Sertoli cell function. Our results suggest CYP1A1 and COMT as new potential targets in treating male infertility.