bluuebunny/crossref_metadata_2025 huggingface dataset:
Indicators of collaborative design management in construction projects
Authors: Savolainen Jussi Matias , Saari Arto , Männistö Anssi , Kähkonen Kalle
Published: August 2018

Purpose

Design management plays a significant role in value creation in a construction project. Within the last few decades, new design tools such as building information model have been introduced, which supposedly enhance design productivity and quality. However, no such revolution of design quality has emerged. Therefore, more research on how design management affects the quality of construction project is needed. The purpose of this paper is to better understand the connection between design management procedures and quality.

Design/methodology/approach

This is a case study with a mixed-method approach. The data collection strategies used are quantitative user satisfaction survey and qualitative analysis over the documentation of the case project.

Findings

A deductive analysis was conducted to four suggested indicators of beneficial collaboration. An explanation was found for how the quality of the project outcome can be forecasted from the management style and procedures.

Research limitations/implications

The research was conducted as single case study, and therefore, greater data would enable further development of the indicators.

Practical implications

The indicators have wide range of applicability: the clients can forecast the quality performance by evaluating the management procedures already during the project instead of waiting until the end of project. The indicator system also provides societal impact as it guides the clients to use the kind of managerial practices that improve the ability to create value in projects that are difficult to evaluate in money terms.

Originality/value

The research provides a novel way to gain a holistic view with analytical indicator tools. The research contributes to lean design management literature by providing insight to the underlying mechanism of beneficial collaboration.
Perceived supervisor support and turnover intention: moderating effect of authentic leadership
Authors: Arici Hasan Evrim
Published: August 2018

Purpose

The purpose of this paper is to investigate the moderating role of authentic leadership (AL) on the relationship between seasonal employee’s perception of supervisor support and turnover intention (TI) in the hospitality industry.

Design/methodology/approach

The data on perceived supervisor support (PSS), AL and TI were gathered from 305 seasonal employees of five-star hotels in Antalya, Turkey with a time lag of one month. Hierarchical linear regression and hierarchical linear modeling were performed to test the multi-level data.

Findings

The findings revealed direct significant effects of both supervisor support and AL on TI. In addition, AL moderated the negative influence of PSS on TI.

Research limitations/implications

This multi-level research highlights the significance of AL for comprehending the link between seasonal hotel employees’ PSS and their TI. Directions for future research include a cross-cultural study examining the validity of the conceptual framework. Confirmatory factor analysis was performed to check the common method variance.

Practical implications

AL through strengthening PSS works as a catalyst for keeping seasonal employees in the organization for the next season. Thus, practitioners should develop supervisors’ AL skills and they should encourage supervisors to be more efficient in improving themselves as a main source of support.

Originality/value

The research investigates the little-researched area of AL at the group level in relation to PSS and TI.
Vendor rating system for an Indian start-up: a combined AHP & TOPSIS approach
Authors: Singh Rohit Kumar , Kansara Surendra , Vishwakarma Niraj Kumar
Published: August 2018

Purpose

The aim of this paper is to identify the criteria that are used for vendor or supplier rating, prioritize these criteria based on the industry inputs and develop a vendor rating model. The data were collected from an Indian start-up working in product development using three-dimensional printing (3DP).

Design/methodology/approach

Factors of importance for vendor rating were identified through industry visits, and interacting with the industry experts from the start-up under consideration, substantiated by extensive review of relevant literature. A questionnaire-based survey was carried out to further narrow down the factors important to the industry, prioritizing them with a pairwise comparison analysis as envisaged in the analytical hierarchy process (AHP) technique along with the calculation of consistency ratios. Technique for order preference by similarity to ideal solution (TOPSIS) methodology was further used for data aggregation.

Findings

This research brought forward the criteria that are useful for rating vendors or suppliers with reference to 3DP sector.

Originality/value

This paper integrates AHP and TOPSIS to solve a multi-criteria vendor rating problem. The attempt was made to make vendor rating process universal so that it can encompass all the vendors of the firm.
The rapid diffusion of license plate readers in US law enforcement agencies
Authors: Lum Cynthia , Koper Christopher S. , Willis James , Happeny Stephen , Vovak Heather , Nichols Jordan
Published: August 2018

Purpose

The purpose of this paper is to document the diffusion of license plate readers (LPRs) in the USA, examining the variety, evolution and tracking of their uses through a national survey.

Design/methodology/approach

This study employs a national, stratified, representative survey of US law enforcement agencies with 100 or more officers.

Findings

LPR technology is currently used by at least two-thirds of larger police agencies, which represents a more than threefold increase in LPR acquisition in the last 10 years. The number of LPRs per agency, while small (about eight on average), has also more than doubled. Federal and state funding, advocacy by law enforcement leaders, and the intuitive appeal of LPRs have likely contributed to this rapid adoption. While LPRs are still primarily used to detect and recover stolen automobiles in patrol, their use has expanded into other types of investigative and security functions. Despite the increased use and numbers of LPRs in policing, their use is highly discretionary and infrequently tracked.

Practical implications

LPRs continue to be widely used in law enforcement, despite a lack of strong research evidence for their crime prevention benefits. Further studies are needed on the most effective ways for agencies to utilize small numbers of LPRs and the potential return on investment for acquiring larger numbers of the devices.

Originality/value

This study tracks the history of LPR diffusion and use and goes beyond prior law enforcement surveys by examining specific uses of LPRs and the extent to which agencies track their uses and outcomes.
Predicting credit risk on the basis of financial and non-financial variables and data mining
Authors: Khemakhem Sihem , Boujelbene Younes
Published: August 2018

Purpose

Data mining for predicting credit risk is a beneficial tool for financial institutions to evaluate the financial health of companies. However, the ubiquity of selecting parameters and the presence of unbalanced data sets is a very typical problem of this technique. This study aims to provide a new method for evaluating credit risk, taking into account not only financial and non-financial variables, but also the class imbalance.

Design/methodology/approach

The most significant financial and non-financial variables were determined to build a credit scoring model and identify the creditworthiness of companies. Moreover, the Synthetic Minority Oversampling Technique was used to solve the problem of class imbalance and improve the performance of the classifier. The artificial neural networks and decision trees were designed to predict default risk.

Findings

Results showed that profitability ratios, repayment capacity, solvency, duration of a credit report, guarantees, size of the company, loan number, ownership structure and the corporate banking relationship duration turned out to be the key factors in predicting default. Also, both algorithms were found to be highly sensitive to class imbalance. However, with balanced data, the decision trees displayed higher predictive accuracy for the assessment of credit risk than artificial neural networks.

Originality/value

Classification results depend on the appropriateness of data characteristics and the appropriate analysis algorithm for data sets. The selection of financial and non-financial variables, as well as the resolution of class imbalance allows companies to assess their credit risk successfully.
Learning-structure fit part I
Authors: Sitar Aleša Saša , Škerlavaj Miha
Published: August 2018

Purpose

The purpose of this study, which consists of two parts, is to bring together literature on organizational design and learning of individuals in organizational settings. The literature suggests that learning takes place in organic and less-structured organizational designs, whereas empirical research provides conflicting evidence. This first part theorizes about the influence of mechanistic vs organic designs on three different aspects of employees’ learning behavior: knowledge sourcing, learning styles and learning loops.

Design/methodology/approach

This paper is built on previous research on the impact of structure on learning and theorizes about the relationship between mechanistic/organic design and specific learning behavior at work.

Findings

Four propositions are developed in this paper, regarding how a different structure leads to a different learning behavior. Mechanistic structure is associated with internal learning, independent learning and single-loop learning, whereas organic design leads to external learning, collaborative learning and double-loop learning.

Research limitations/implications

Because the paper is conceptual in nature, the propositions are in need of empirical validation. Some directions for empirical testing are proposed.

Practical/implications

For an organization design practice, managers should be aware of the distinct impact different structures have on individual learning at work. Furthermore, the appropriate organizational structure for learning must be considered in the broader context of contingencies.

Originality/value

This paper contributes to the organizational design literature and to the organizational learning theory by conceptualizing the relationship between structure and learning of individuals at work.
Venom of prey‐specialized spiders is more toxic to their preferred prey: A result of prey‐specific toxins
Authors: Pekár Stano , Líznarová Eva , Bočánek Ondřej , Zdráhal Zbyněk
Published: August 2018

In specialized predators, a variety of adaptations have evolved to such a level of specificity that they allow very effective exploitation of focal prey. Venom is an essential adaptive trait of predatory venomous species, such as spiders, yet our knowledge of spider venom is incomplete.

In agreement with the prey preference hypothesis, we expected that the venom of spider specialists should be more toxic to focal than to alternative prey, because it is composed of prey‐specific toxins.

Here we used spiders with three types of trophic specializations: specialists that were ant‐eating, termite‐eating and spider‐eating. We compared the efficacy of prey capture of preferred and alternative prey (measured as paralysis latency) with that of related generalists and profiled the venom of the studied species using proteomic methods. We used 22 spider species: six myrmecophagous, two termitophagous, three araneophagous and 11 euryphagous generalist species belonging to different families.

We found that ten of the eleven specialist species induced significantly shorter paralysis latency in preferred prey than in alternative prey. Generalists exhibited either similar efficiency on both prey types or slightly higher efficiency on preferred prey.

Multivariate analysis of proteomic profiles (peptides and proteins) revealed significant differences between trophic specializations, particularly in peptides. Specialists appear to have venom composed of unique specific compounds as revealed by the multivariate ordination and indicator analysis. These components are likely prey‐specific toxins.
The basic helix–loop–helix transcription factor Crf1 is required for development and pathogenicity of the rice blast fungus by regulating carbohydrate and lipid metabolism
Authors: Cao Huijuan , Huang Pengyun , Yan Yuxin , Shi Yongkai , Dong Bo , Liu Xiaohong , Ye Lidan , Lin Fucheng , Lu Jianping
Published: August 2018

Pyricularia oryzae is a plant pathogen causing rice blast, a serious disease spreading in cultivated rice globally. Transcription factors play important regulatory roles in fungal development and pathogenicity. Here, we characterized the biological functions of Crf1, a basic helix–loop–helix (bHLH) transcription factor, in the development and pathogenicity of P. oryzae with functional genetics, molecular and biochemical approaches. We found that CRF1 is necessary for virulence and plays an indispensable role in the regulation of carbohydrate and lipid metabolism in P. oryzae. Deletion of CRF1 led to defects in utilization of lipids, ethanol, glycerol and L‐arabinose, and down‐regulation of many important genes in lipolysis, β‐oxidation, gluconeogenesis, as well as glycerol and arabinose metabolism. CRF1 is also essential for peroxisome and vacuole function, and conidial cell death during appressorium formation. The appressorium turgor, penetration ability and virulence in Δcrf1 were restored by supplementation of exogenous glucose. The virulence of Crf1 mutant was also recovered by adding exogenous D‐xylose, but not by addition of ethanol, pyruvate, leucine or L‐arabinose. These data showed that Crf1 plays an important role in the complex regulatory network of carbohydrate and lipid metabolism that governs fungal development and pathogenicity.
Selective decontamination of aflatoxin M1 in milk by molecularly imprinted polymer coated on the surface of stainless steel plate
Authors: Bodbodak Samad , Hesari Javad , Peighambardoust Seyed Hadi , Mahkam Mehrdad
Published: August 2018

The aim of the present study was to develop new molecularly imprinted polymers (MIPs) to coat stainless steel plates for the removal of aflatoxin M1 (AFM1), which is a serious concern in the safety of milk and dairy products. Scanning electron microscopy, energy dispersive spectroscopy, and Fourier‐transform infrared spectroscopy tests confirmed that MIPs successfully coated the stainless steel plates. The MIPs were applied to extract AFM1 from milk spiked with 0.5 to 50 ng/mL AFM1. The MIPs removed 87.3–96.2% of the AFM1 without any notable effects on the milk composition. The results also showed that the imprinting factors of DMC, AFM1, AFB1, and AFG1 were 5.93, 4.61, 3.41, and 2.72, respectively.
Aortic dissection detection risk score has high sensitivity with moderate inter‐rater reliability
Authors: Rotella Joe‐Anthony , Goel Vishal , Chan Thomas , Yeoh Michael , Taylor David McD
Published: August 2018

Objective

To retrospectively assess the accuracy and inter‐rater reliability of the aortic dissection detection risk score (ADD‐RS).

Methods

Single‐centre, observational, diagnostic accuracy study undertaken in a university‐affiliated, tertiary hospital ED.

Results

Two hundred patients were enrolled. Five patients were diagnosed with acute aortic dissection and had an elevated ADD‐RS >0. The ADD‐RS was 100% sensitive with a negative and positive predictive values of 100% (if ADD‐RS ≥1). Inter‐rater reliability was moderate (Kappa = 0.55).

Conclusion

The ADD‐RS was highly sensitive in our cohort. Further work to evaluate the score prospectively and in combination with a D‐Dimer is required.
Structured Interdisciplinary Bedside Rounds in an Australian tertiary hospital emergency department: Patient satisfaction and staff perspectives
Authors: Chow Maria YK , Nikolic Slaven , Shetty Amith , Lai Kevin
Published: August 2018

Objectives

To compare patient satisfaction levels, staff perspectives and the time required using Structured Interdisciplinary Bedside Rounds (SIBR; Emory University, Atlanta, GA, USA) versus traditional medical ward rounds (TR) in the ED.

Methods

We conducted an observational cross‐sectional study. Ward rounds were categorised into a modified SIBR and TR at a tertiary ED in Australia according to predefined criteria. We compared the duration of ward rounds, invited patients and staff to complete anonymous questionnaires to compare patient satisfaction and staff perspectives.

Results

During the study period, SIBR group took significantly longer time than TR per patient (122 vs 88 s, P < 0.001). Patient questionnaires were completed for 320 encounters (101 SIBR, 219 TR). Patient satisfaction scores across all measured domains were significantly higher in SIBR than in the TR group. Patients often pointed out a lack of communication with medical staff during TR. Based on 131 completed staff questionnaires, nurses reported SIBR to be more useful than TR (nurses 78% vs doctors 44%, P = 0.001). The SIBR group had increased instances of staff introductions to patients (91% vs 66%, P < 0.001) and patients’ involvement in discussion of management plans (98% vs 53%, P < 0.01). SIBR only weakly correlated with the overall positive experience in the ED (r = 0.19, P = 0.001). Organisational implementation issues raised through qualitative methods are reported in the paper.

Conclusions

Our study highlights the benefits that could be gained through SIBR technique over the TR method. Better workforce and resource planning is needed to support the sustainable implementation of SIBR in ED.
Amrubicin monotherapy for elderly patients with relapsed extensive‐disease small‐cell lung cancer: A retrospective study
Authors: Sone Hideyuki , Igawa Satoshi , Kasajima Masashi , Ishihara Mikiko , Hiyoshi Yasuhiro , Hosotani Shinji , Ohe Shuntaro , Ito Hiroki , Kaizuka Nobuki , Manaka Hiroya , Fukui Tomoya , Mitsufuji Hisashi , Kubota Masaru , Katagiri Masato , Sasaki Jiichiro , Naoki Katsuhiko
Published: August 2018

Background

Previous studies have shown amrubicin (AMR) to be an effective second‐line treatment option for small‐cell lung cancer (SCLC). However, the efficacy of AMR in elderly patients with relapsed SCLC has not been sufficiently evaluated.

Methods

The medical records of elderly patients with relapsed SCLC who received AMR as second‐line chemotherapy were retrospectively reviewed, and their treatment outcomes were evaluated.

Results

Thirty‐one patients with a median age of 72 years (22 patients with sensitive relapse and 9 with refractory relapse) were analyzed. The median number of treatment cycles was four (range: 1–10), and the response rate was 29%. The median progression‐free survival (PFS) and overall survival (OS) were 5.4 and 11.6 months, respectively. The OS of 22 patients who received third‐line chemotherapy was 15.5 months. The PFS (6.2 vs. 3.2 months; P = 0.002) and OS (14.8 vs. 5.7 months; P = 0.004) were significantly longer in patients with sensitive relapse than those with refractory relapse. The frequency of grade 3 or higher neutropenia was high (n = 18, 58%), while febrile neutropenia was only observed in five patients (16%). Non‐hematological toxic effects were relatively mild, and pneumonitis and treatment‐related deaths were not observed.

Conclusion

AMR may be a feasible and effective regimen for elderly patients with relapsed SCLC.
Apatinib monotherapy for advanced non‐small cell lung cancer after the failure of chemotherapy or other targeted therapy
Authors: Liu Zui , Ou Wei , Li Ning , Wang Si‐Yu
Published: August 2018

Background

Apatinib, a small‐molecule inhibitor of vascular endothelial growth factor receptor 2 (VEGFR‐2), has proven to be effective and safe for treating patients with advanced gastric cancer after second‐line chemotherapy failure. As VEGFR‐2 targeted therapy has made encouraging progress for the treatment of a broad range of malignancies, we explored the efficacy and safety of apatinib for the treatment of advanced non‐small cell lung cancer after the failure of chemotherapy or other targeted therapy.

Methods

We retrospectively analyzed the data of 34 patients (11 with squamous carcinoma and 23 with adenocarcinoma) who were treated with apatinib alone in a daily oral dose of 250 mg in the second‐line or third‐line setting from January 2016 to July 2017. The primary endpoint was progression‐free survival (PFS).

Results

EGFR mutation or amplification was detected in 15 patients. The median PFS of the whole group was four months (95% confidence interval 0.3–7.7). A partial response was observed in 2 patients (5.88%) and stable disease in 19 (55.88%). The disease control rate was 61.76%. Common side effects of apatinib were hypertension (n = 12), hand‐foot syndrome (n = 8), and proteinuria (n = 5), which accounted for 35.30%, 23.53%, and 14.71%, respectively, and no grade 3/4 adverse reactions occurred. Apatinib toxicity was controllable and tolerable.

Conclusions

Apatinib appears to be effective and safe for advanced non‐small cell lung cancer after the failure of chemotherapy or other targeted therapy.
Neutrophil‐to‐lymphocyte ratio after four weeks of nivolumab administration as a predictive marker in patients with pretreated non‐small‐cell lung cancer
Authors: Takeda Takayuki , Takeuchi Mayumi , Saitoh Masahiko , Takeda Sorou
Published: August 2018

Background

Although phase III trials have shown improved overall and progression‐free survival (PFS) using nivolumab compared to docetaxel in patients with non‐small‐cell lung cancer, the progressive disease ratio of nivolumab is higher than docetaxel. Furthermore, nonconventional response patterns of nivolumab make it difficult to determine the time point for nivolumab discontinuation. Therefore, a method to detect non‐responders to nivolumab at an early time point is crucial. This retrospective study was conducted to identify immunological and nutritional markers, including neutrophil‐to‐lymphocyte ratios (NLR), which would predict the efficacy of nivolumab treatment. Because the expression of these markers fluctuates dramatically during treatment, repeat evaluation was performed.

Methods

We retrospectively investigated 30 patients with non‐small‐cell lung cancer who were treated with nivolumab. The stratified data of each marker obtained during four weeks after nivolumab treatment were evaluated by Cox proportional hazards regression to verify the differences in PFS.

Results

One and four patients experienced progressive disease within two and four weeks, respectively. Therefore, 29 and 26 patients were analyzed two and four weeks after nivolumab administration, respectively. The results showed that the NLR after four weeks could predict PFS. The median PFS in 21 patients with NLR < 5 after four weeks of nivolumab administration was 95 days (95% confidence interval [CI] 50–NA), while the mPFS in five patients with NLR ≥ 5 was 10 days (95% CI 6–NA). NLR ≥ 5 showed a hazard ratio of 5.995 (95% CI 1.225–29.35).

Conclusion

Clarifying NLR four weeks after nivolumab administration may be useful to predict outcomes in nivolumab‐treated patients.
Undergraduate dentistry students’ perception of difficulties regarding endodontic treatment
Authors: Tavares Lorrane G. , Lima Stella M. F. , Lima Miriane G. , Arruda Marcos P. , Menegazzi Thiago C. , Rezende Taia M. B.
Published: August 2018

The present study aimed to identify students’ perceptions of endodontic treatment at a Brazilian university through a survey, which analysed student profiles and their difficulties in 2016. One hundred and two students who had experienced endodontic, laboratory or clinical procedures answered a survey based on their experiences, regarding their perceptions, experience and self‐confidence levels. Results demonstrated that there was no significant difficulty among students regarding anaesthesia, rubber dam use, chamber access, working length determination, instrumentation, root filling and temporary restoration procedures during endodontic treatment. However, problems were observed regarding radiographic examination (mainly in separating root canals) and the choice of intracanal medication. The present study also raised a question regarding dental education: how can endodontic education be improved by addressing students' perceived difficulties? Evaluating the major student difficulties during root canal therapy can help the improvement of teaching strategies during preclinical and clinical teaching.
High prevalence of early onset anaemia amongst Aboriginal and Torres Strait Islander infants in remote northern Australia
Authors: Aquino Danielle , Leonard Dympna , Hadgraft Nyssa , Marley Julia V.
Published: August 2018

Objectives

To describe baseline growth and prevalence of anaemia in Aboriginal and Torres Strait Islander infants and young children enrolled in a nutrition promotion and anaemia prevention program in remote northern Australia.

Design

Retrospective review of most recent growth parameters and haemoglobin records during the 3 months prior to and 1 month after recruitment into a prospective study conducted between 25 May 2010 and 6 May 2012.

Setting

Primary health care clinics in six remote Aboriginal communities (east Kimberley, Western Australia (n = 1); Northern Territory (n = 4); Cape York, Queensland (n = 1)).

Participants

Two hundred and sixty‐two of the estimated 311 (84%) Aboriginal and Torres Strait Islander infants and young children aged 6–24 months residing in participating communities.

Main outcome measures

Prevalence of anaemia, stunting, underweight and overweight at recruitment.

Results

At recruitment, 42% of participants were anaemic, 18% stunted, 5% underweight and 5% overweight. Anaemia prevalence was higher than estimates (26–27%) in routine surveillance programs in remote communities and substantially higher than estimates (1.8–4.9%) in the general Australian population. One‐quarter of participants were anaemic prior to 6 months of age.

Conclusions

The unexpectedly high prevalence of anaemia and stunting in these communities highlight the need for continued preventive health programs focused on ensuring adequate nutrition amongst infants, young children and their mothers. The early onset of anaemia and stunting suggests a comprehensive anaemia prevention approach is needed, including greater emphasis on maternal and pre‐pregnancy health and nutrition to increase infants’ iron stores at birth and sustain these to 6 months of age.
Quality of life in coeliac disease: item reduction, scale development and psychometric evaluation of the Coeliac Disease Assessment Questionnaire (CDAQ)
Authors: Crocker Helen , Jenkinson Crispin , Peters Michele
Published: August 2018

Background

A better understanding of coeliac disease can be achieved by assessing health‐related quality of life alongside clinical factors. Existing patient‐reported outcome measures (PROMs) evaluating quality of life in coeliac disease have not been developed in accordance with the US Food and Drug Administration guidelines.

Aim

To develop a PROM in accordance with best practice guidelines, capturing all aspects of quality of life important to adults with coeliac disease.

Methods

Candidate items for the Coeliac Disease Assessment Questionnaire (CDAQ) were refined through item appraisal, expert review, cognitive interviews, and a translatability assessment. A cross‐sectional survey determined further item reduction and the CDAQ's structure. The final CDAQ was administered alongside the Short Form Health Survey Version 2 (SF?36v2) in a second survey to assess construct validity and test‐retest reliability.

Results

Pre‐testing the 64 candidate items revealed a range of issues which guided their refinement and reduction, resulting in the final CDAQ with 32 items representing 5 subscales: stigma (eight items), dietary burden (eight items), symptoms (five items), social isolation (five items), and worries and concerns (six items). Cronbach's alpha ranged between 0.82 and 0.88 for all domains. Further results showed CDAQ scores were more strongly correlated with the SF‐36v2's mental health dimensions, as expected. Intraclass correlation coefficients ranged from 0.79 to 0.89.

Conclusion

The CDAQ is a reliable and valid coeliac‐specific measure that captures all aspects of quality of life important to adults with coeliac disease. Further work is underway to assess the CDAQ's responsiveness to change.
Emicizumab‐mediated haemostatic function in patients with haemophilia A is down‐regulated by activated protein C through inactivation of activated factor V
Authors: Yada Koji , Nogami Keiji , Shinozawa Keiko , Kitazawa Takehisa , Hattori Kunihiro , Amano Kagehiro , Fukutake Katsuyuki , Shima Midori
Published: August 2018

Activated protein C (APC) inactivates activated factor V (FVa) and moderates FVIIIa by restricting FV cofactor function. Emicizumab is a humanized anti‐FIXa/FX bispecific monoclonal antibody that mimicks FVIIIa cofactor function. In recent clinical trials in haemophilia A patients, once‐weekly subcutaneous administration of emicizumab was remarkably effective in preventing bleeding events, but the mechanisms controlling the regulation of emicizumab‐mediated haemostasis remain to be explored. We investigated the role of APC‐mediated reactions in these circumstances. APC dose‐dependently depressed thrombin generation (TG) initiated by emicizumab in FVIII‐deficient plasmas, and in normal plasmas preincubated with an anti‐FVIII antibody (FVIII‐depleted). FVIIIa‐independent FXa generation with emicizumab was not affected by the presence of APC, protein S and FV. The results suggested that APC‐induced down‐regulation of emicizumab‐dependent TG was accomplished by direct inactivation of FVa. The addition of APC to emicizumab mixed with FVIII‐depleted FV‐deficient plasma in the presence of various concentrations of exogenous FV demonstrated similar attenuation of TG, irrespective of specific FV concentrations. Emicizumab‐related TG in FVIII‐depleted FVLeiden plasma was decreased by APC more than that observed with native FVLeiden plasma. The findings indicated that emicizumab‐driven haemostasis was down regulated by APC‐mediated FVa inactivation in plasma from haemophilia A patients without or with FV defects.
Consensus on BCR‐ABL1 reporting in chronic myeloid leukaemia in the UK
Authors: Cross Nicholas C. P. , White Helen E. , Evans Paul A. S. , Hancock Jeremy , Copland Mhairi , Milojkovic Dragana , Mason Joanne , Craine Sandra , Mead Adam J.
Published: August 2018

For patients with chronic myeloid leukaemia (CML), treatment guidelines recommend monitoring response to treatment with tyrosine kinase inhibitors (TKIs) by testing the BCR‐ABL1 fusion gene transcript level using reverse transcriptase quantitative polymerase chain reaction. Despite recent efforts to standardise protocols for BCR‐ABL1 testing, some variability remains among laboratories in the UK regarding the techniques used and the approach to reporting results. This increases the risk of misinterpretation of results by both clinicians and patients. An expert panel met to discuss current issues surrounding BCR‐ABL1 testing in the UK and to develop guidance for laboratories, with emphasis on the optimal approach to reporting laboratory results. Topics included the minimum required information to include in the laboratory report, units of measurement, test sensitivity and BCR‐ABL1 transcript variants. To aid communication between laboratories and clinics, standard forms were generated that could be used by (i) clinics when submitting samples to laboratories, and (ii) laboratories when reporting results to clinics. Standardising the way in which BCR‐ABL1 test results are reported from laboratories to clinics should help to improve communication, interpretation of results and patient care.
Implementation of multiparametric magnetic resonance imaging technology for evaluation of patients with suspicion for prostate cancer in the clinical practice setting
Authors: Shah Paras H. , Patel Vinay R. , Moreira Daniel M. , George Arvin K. , Alom Manaf , Kozel Zachary , Joshi Vidhu , Ben‐Levi Eran , Villani Robert , Yaskiv Oksana , Kavoussi Louis R. , Vira Manish , Olsson Carl O. , Rastinehad Ardeshir R.
Published: August 2018

Objectives

To investigate the impact of implementing magnetic resonance imaging (MRI) and ultrasonography fusion technology on biopsy and prostate cancer (PCa) detection rates in men presenting with clinical suspicion for PCa in the clinical practice setting.

Patients and Methods

We performed a review of 1 808 consecutive men referred for elevated prostate‐specific antigen (PSA) level between 2011 and 2014. The study population was divided into two groups based on whether MRI was used as a risk stratification tool. Univariable and multivariable analyses of biopsy rates and overall and clinically significant PCa detection rates between groups were performed.

Results

The MRI and PSA‐only groups consisted of 1 020 and 788 patients, respectively. A total of 465 patients (45.6%) in the MRI group and 442 (56.1%) in the PSA‐only group underwent biopsy, corresponding to an 18.7% decrease in the proportion of patients receiving biopsy in the MRI group (P < 0.001). Overall PCa (56.8% vs 40.7%; P < 0.001) and clinically significant PCa detection (47.3% vs 31.0%; P < 0.001) was significantly higher in the MRI vs the PSA‐only group. In logistic regression analyses, the odds of overall PCa detection (odds ratio [OR] 1.74, 95% confidence interval [CI] 1.29–2.35; P < 0.001) and clinically significant PCa detection (OR 2.04, 95% CI 1.48–2.80; P < 0.001) were higher in the MRI than in the PSA‐only group after adjusting for clinically relevant PCa variables.

Conclusion

Among men presenting with clinical suspicion for PCa, addition of MRI increases detection of clinically significant cancers while reducing prostate biopsy rates when implemented in a clinical practice setting.
Prognostic evaluation of perinephric fat, renal sinus fat, and renal vein invasion for patients with pathological stage T3a clear‐cell renal cell carcinoma
Authors: Shah Paras H. , Lyon Timothy D. , Lohse Christine M. , Cheville John C. , Leibovich Bradley C. , Boorjian Stephen A. , Thompson R. Houston
Published: August 2018

Objective

To investigate the prognostic significance of various patterns of extrarenal extension that comprise pathological stage T3a clear‐cell renal cell carcinoma (ccRCC) amongst patients undergoing nephrectomy for non‐metastatic disease.

Patients and Methods

A retrospective review of 563 patients who underwent radical nephrectomy for pathologically confirmed T3aN0/NxM0 ccRCC between 1970 and 2011 was performed. All pathological slides were re‐reviewed by one urological pathologist. Associations of patterns of extrarenal extension (perinephric fat [PF], renal sinus fat [SF], and renal vein [RV], in isolation or in any combination) with disease progression, cancer‐specific mortality (CSM), and all‐cause mortality were evaluated on multivariable analyses.

Results

Overall, PF invasion, renal SF invasion, and RV tumour thrombus were present in 144 (26%), 51 (9%), and 163 (29%) patients, respectively, with multiple patterns of extrarenal extension identified in 205 (36%) patients. There were no significant differences in survival outcomes for isolated involvement of PF, renal SF, or RV. However, patients with multiple patterns of extrarenal extension were at significantly increased risk of disease progression (hazard ratio [HR] 1.31, 95% confidence interval [CI] 1.04–1.65; P = 0.020), CSM (HR 1.64, 95% CI 1.27–2.12; P < 0.001), and all‐cause mortality (HR 1.32, 95% CI 1.08–1.61; P = 0.008).

Conclusions

The presence of multiple patterns of extrarenal extension is associated with a higher risk of disease progression and cancer‐related death after radical nephrectomy compared to isolated involvement of the PF, renal SF, or RV, which carry similar prognostic weight. If validated, these findings may help refine risk stratification of non‐metastatic T3a RCC by distinguishing patients with multiple vs one pattern of extrarenal extension.
Mothers, daughters, and learning to labour: Framing work through gender and generation
Authors: Worth Nancy
Published: August 2018

This paper presents a qualitative case study of millennial women in Canada, focusing on how they build meaning and understand “success” in their working lives through a gendered and generational lens. I draw on daughter‐mother interview dyads to offer the framing of an intergenerational labour geography, situating mothers as an important source of work values and expectations for their millennial daughters. I argue that different generations of women have their own sense of “normative competence” or an awareness of expected skills and behaviours around work and family life. Invoking a relational perspective, different definitions and expectations for success in one's working life are grounded not just in the workplace, but also the home, as mothers and daughters endeavour to understand each other. Here, issues of recognition become paramount, as daughters’ beliefs, choices, and experiences may be more or less recognizable to their mothers. My aim is to reveal the complexity within worker identities of millennial women, moving beyond the “factory gates” of the workplace, to think about how young women build meaning and understand “success” at this stage in their working lives.
Quality of goal setting in pediatric rehabilitation—A SMART approach
Authors: Bexelius Annemarie , Carlberg Eva Brogren , Löwing Kristina
Published: August 2018

Background

Setting goals for treatment is often the core of the rehabilitation process. The quality of the set goals has however rarely been evaluated. The aims of this study were therefore to assess the quality of goals set in clinical practice of pediatric rehabilitation using SMART criteria (Specific, Measurable, Achievable, Relevant, and Timed) and to assess if the goals were considered relevant from both a client perspective and expertise perspective.

Methods

In a retrospective multicase study, a total of 161 goals from 42 children with disabilities (cerebral palsy, n = 22; Down syndrome, n = 16; and developmental disability, n = 4) were assessed. The children were 1.5–5.5 years and had previously participated in goal‐directed, activity‐focused therapy at four pediatric rehabilitation centers. Collaborative goal setting had been used to define the desired treatment outcome. The quality of the goals was assessed using defined SMART criteria.

Results

Specific: All goals could be reliably linked to International Classification of Functioning, Disability and Health—Children and Youth version chapters within the Activity/Participation domain. Measurable: A total of 75% of the goals were rated as having a well‐defined scaling; in 20%, the scaling was less clear, and in 5%, a scaling could not be determined. Achievable: A total of 80% of the goals were attained. Relevant: All goals were set in collaboration with the family and could therefore be considered relevant from a client perspective. Relevancy judged from a professional perspective was strengthened by the fact that age, baseline status, and diagnosis had an influence on the choice of goals. Timed: All goals were set within a specific time frame.

Conclusions

The goals set in clinical practice showed high quality with respect to the SMART criteria. The most difficult part was the construction of the goal attainment scale. The goals settled in clinical practice were considered relevant from both a client perspective and expertise perspective.
A replicable, low‐burden mechanism for observing, recording, and analysing mother–child interaction in population research
Authors: Levickis Penny , Reilly Sheena , Girolametto Luigi , Ukoumunne Obioha C. , Wake Melissa
Published: August 2018

Background

There is growing evidence that specific styles of parent–child interaction benefit child development, particularly child language development. Direct observational techniques help clarify the behaviours and styles within parent–child interactions that may influence child language outcomes; however, these techniques tend to be labour‐intensive and costly. We report on the development of a replicable, low‐burden mechanism for observing and coding specific maternal linguistic behaviours in a population‐based cohort of 2‐year‐olds.

Methods

The coding scheme was developed as part of a prospective, longitudinal study examining the associations between maternal responsive behaviours and child language outcomes in slow‐to‐talk toddlers. In the first phase of the study, three coding systems were tested by coding five sample parent–toddler interactions and then comparing them based on (a) the ease of method and thus likely intrarater and interrater reliability and (b) the number of data points. The second phase was to demonstrate how the chosen method could be used in practice with a large at‐risk group of toddlers.

Results

Of the three coding systems explored, the Observer® XT software was selected for ease of use and because detailed coding of free‐play videos could be achieved in close to real time. Intrarater and interrater reliability were established in 251 mother–child free‐play videos, producing high intraclass correlation coefficients of 0.95 to 0.99 for the six behaviours.

Conclusions

The study provides evidence that numerous parent–child interactions can be rigourously yet efficiently coded without substantial information loss. The observational mechanism in the current study has been fully developed and is shown to be feasible for research purposes focusing on parent–toddler interactions. However, further testing of the observational mechanism is required to examine whether the same results could be produced if coding was conducted “live” and for shorter duration thereby making it readily useable for clinicians.
Mixed‐methods content and sentiment analysis of adolescents’ voice diaries describing daily experiences with asthma and self‐management decision‐making
Authors: Mammen Jennifer R. , Java James J. , Rhee Hyekyun , Butz Arlene M. , Halterman Jill S. , Arcoleo Kimberly
Published: August 2018

Background

Accurate symptom assessment remains challenging in teen populations. Little is known of usual symptom/response patterns, and self‐reported paper diaries have traditionally low compliance rates. Therefore, we used concurrent digital voice diaries to capture daily asthma experiences.

Objective

(a) To qualitatively explore usual symptom patterns and self‐management responses and (b) to quantitatively explore relationships between symptom severity and sentiment scores (a marker of emotional response to events).

Methods

Fourteen minority and nonminority teenagers (age 13‐17) with controlled (50%) and uncontrolled asthma used digital recorders to report about their asthma once daily over 14 days. Dairy entries were coded for symptom frequency, severity, type, and self‐management responses, while sentiment analysis was used to evaluate the emotional valence of diary entries and to explore whether increased symptom levels correlated with greater negative sentiment.

Results

Symptom frequency and severity recorded in voice diaries were much higher than teens indicated at baseline and were discordant with clinical assessments of asthma control. Of 175 entries, teens had symptoms 69.1% of days (121/175) and severe symptoms on one‐third of these. Atypical symptoms (coughing, throat clearing) were reported twice as often as traditional symptoms (wheezing, chest tightness) and often not recognized as asthma, but rather attributed to being “sick” (25.6% of symptom days). Teens frequently minimized symptoms, used rescue and controller medication inconsistently, and resorted to alternative strategies to manage symptoms. Sentiment was not significantly correlated with assessed control (β = 0.14, P = 0.28), but for teens reporting severe symptoms, sentiment scores decreased by 0.31 relative to teens without symptoms (P = 0.006).

Conclusions and Clinical Relevance

Teens may minimize symptoms and have greater symptom frequency and severity than is recognized by themselves or providers. Screening for specific symptoms including coughing, throat clearing, and respiratory illness may be needed to identify those experiencing burden from asthma.
Value of protected areas to avian persistence across 20 years of climate and land‐use change
Authors: Peach Michelle A. , Cohen Jonathan B. , Frair Jacqueline L. , Zuckerberg Benjamin , Sullivan Patrick , Porter William F. , Lang Corey
Published: August 2018

Establishing protected areas, where human activities and land cover changes are restricted, is among the most widely used strategies for biodiversity conservation. This practice is based on the assumption that protected areas buffer species from processes that drive extinction. However, protected areas can maintain biodiversity in the face of climate change and subsequent shifts in distributions have been questioned. We evaluated the degree to which protected areas influenced colonization and extinction patterns of 97 avian species over 20 years in the northeastern United States. We fitted single‐visit dynamic occupancy models to data from Breeding Bird Atlases to quantify the magnitude of the effect of drivers of local colonization and extinction (e.g., climate, land cover, and amount of protected area) in heterogeneous landscapes that varied in the amount of area under protection. Colonization and extinction probabilities improved as the amount of protected area increased, but these effects were conditional on landscape context and species characteristics. In this forest‐dominated region, benefits of additional land protection were greatest when both forest cover in a grid square and amount of protected area in neighboring grid squares were low. Effects did not vary with species’ migratory habit or conservation status. Increasing the amounts of land protection benefitted the range margins species but not the core range species. The greatest improvements in colonization and extinction rates accrued for forest birds relative to open‐habitat or generalist species. Overall, protected areas stemmed extinction more than they promoted colonization. Our results indicate that land protection remains a viable conservation strategy despite changing habitat and climate, as protected areas both reduce the risk of local extinction and facilitate movement into new areas. Our findings suggest conservation in the face of climate change favors creation of new protected areas over enlarging existing ones as the optimal strategy to reduce extinction and provide stepping stones for the greatest number of species.
Hazardous cross‐reaction in a thyroid fine needle aspiration
Authors: Nobile Antoine , Ducry Julien , Vignot Lucie , Bongiovanni Massimo
Published: August 2018

Correlation of clinical, cytomorphology and ancillary test results is essential to maintain high diagnostic accuracy in thyroid fine‐needle aspiration cytology. Immunocytochemical cross reactivity among antibodies (in this case with Pax8 antibody) can lead to a false diagnosis if interpreted in isolation.
Disasters in conflict areas: finding the politics
Authors: Siddiqi Ayesha
Published: August 2018

Despite some 50 years of research, relatively little is known about how disasters in conflict areas are created and discursively framed, and how information on them is publicly consumed. The emphasis in disaster studies has remained on establishing causal linkages, demonstrating the way in which natural hazard‐related disasters result in deepening conflict, or ushering in peace. Furthermore, it has been accepted that disaster risk reduction is the state's responsibility. The strengths and limitations of these approaches are examined prior to a political reimagining of disasters in conflict areas. The absence of ‘politics’ from the wider debate on disasters in conflict areas is not just a benign oversight, but is in fact the politics of disasters in conflict areas. A politics that does not engage with the processes and outcomes of pursuing dominant agendas, such as neoliberal orthodoxy and state imperial control, in areas and communities vulnerable to natural hazards and political conflict needs to be recognised and challenged.