bluuebunny/crossref_metadata_2025 huggingface dataset:
Gender diverse board and earnings management: evidence from French listed companies
Authors: Triki Damak Sana
Published: May 2018

Purpose

The purpose of this paper is to investigate the influence of board gender diversity on earnings management level and strategy.

Design/methodology/approach

This study is conducted in the French context where firms are pressured since 2010 to appoint more women on boards. More specifically, this research is based on a sample of 85 companies listed in the SBF120 over 2010-2014. A number of econometric techniques are used including generalized least squares to test the panel regressions.

Findings

The results suggest that women on boards are effective in their monitoring role. Indeed, the findings show a significant negative effect of board women presence on earnings management practices level. However, there is no empirical evidence that board gender diversity affects the earnings management strategy. Moreover, the results reveal that some control variables influence significantly the earnings management level and strategy.

Practical implications

The findings support the efforts made by French political bodies to increase gender diversity on corporate boards, and might inspire political actors of other countries to take initiatives to regulate the promotion of women’s appointment on boards of directors.

Social implications

This paper contributes to the issue of discrimination against women in law and in practice. Indeed, the findings highlight the beneficial effects of women participation in power and decision-making positions.

Originality/value

This research contributes to the debate around gender diversity on boards. Most prior studies that have analyzed the relationship between gender diversity and earnings management were conducted in a voluntary context of appointing women on boards. This paper extends prior research by addressing this issue differently and in a regulated context: where the government set mandatory quotas for female board representation.
The importance of measuring food safety and quality culture: results from a global training survey
Authors: Emond Bertrand , Taylor Joanne Zaida
Published: May 2018

Purpose

This paper aims to present Campden BRI’s viewpoint on the implementation of the Culture Excellence Program, which includes an assessment tool that measures the safety and quality culture within food businesses. It is the seventh paper in a theme issue of Worldwide Hospitality and Tourism Themes, discussing the importance of measuring food safety and quality culture.

Design/methodology/approach

A viewpoint is put forward by the Campden BRI Head of Membership and Training, supported by the results from a global training survey which was sent to over 25,000 food businesses worldwide by Campden BRI and collaborating companies.

Findings

Food safety and quality culture is of increasing importance to Campden BRI members and the food industry as a whole. It is seen as one of the main purposes of training, and as a means of measuring the effectiveness of training. The Culture Excellence Program has met with a highly positive reaction from Campden BRI industry members, showing the importance and value of culture and its measurement.

Originality/value

This paper shows insights into trends in the food industry within the UK and globally. It will be of value to food safety and quality practitioners, trainers, auditors and other stakeholders involved in the food industry.
Depression‐related behavioural and neuroendocrine changes in the Spontaneously Diabetic Torii (SDT) fatty rat, an animal model of type 2 diabetes mellitus
Authors: Sakimura Katsuya , Maekawa Tatsuya , Sasagawa Kazuo , Ishii Yukihito , Kume Shin‐ichi , Ohta Takeshi
Published: May 2018

Depression is one of the most common psychiatric diseases and is commonly comorbid with type 1 or 2 diabetes mellitus (DM). However, the pathophysiology underlying the depressive state in DM remains poorly understood. Animal models are useful tools to investigate the association between depression and DM. In the present study we investigated whether the Spontaneously Diabetic Torii (SDT) fatty rat, a novel animal model of type 2 DM, shows depression‐related features. We assessed depression‐like behaviour, hyperactivation of the hypothalamic‐pituitary‐adrenal (HPA) axis, and neurotransmitter levels in the brain. Behaviour was evaluated using a forced swimming test, and the HPA axis was evaluated with changes in plasma corticosterone levels after a swimming stress exposure or dexamethasone challenge. In addition, serotonin (5‐hydroxytryptamine; 5‐HT), noradrenaline, glutamate and γ‐aminobutyric acid (GABA) concentrations in the frontal cortex, hippocampus and brain stem were measured. In the forced swimming test, SDT fatty rats exhibited increased duration of immobility compared with control Sprague–Dawley (SD) rats. Moreover, basal corticosterone levels were significantly elevated in SDT fatty compared with control SD rats. However, there were no stress‐induced increases or changes in dexamethasone‐induced suppression of corticosterone in SDT fatty compared with control SD rats. Furthermore, there were significant changes in 5‐HT concentrations in the prefrontal cortex, and in GABA and glutamate concentrations in the hippocampus in SDT fatty compared with controls. The results of the present study suggest that the SDT fatty rat may be an appropriate model for diabetes with comorbid depression associated with neurotransmitter impairments and aberrant basal HPA hyperactivity.
Work, Leisure, and Care: A Gender Perspective on the Participation Income
Authors: Zelleke Almaz
Published: May 2018

In ‘The case for a participation income’, Anthony Atkinson identified unconditionality as an obstacle to support for a citizen's income. He advocated prioritising the universality and individuality of a citizen's income but replacing its unconditionality with a ‘participation’ requirement. At the time, Atkinson's critique read as political realism: to eliminate means‐testing, make a concession to the fear of free‐riding. Ironically, Atkinson remained opposed to unconditionality despite his own critical contributions to documenting the growing income and wealth inequality that have increased support for an unconditional basic income. In this article I consider the ‘participation’ requirement from a gender perspective in order to uncover the problematic notions of ‘dependence’, ‘independence’, reciprocity, and free‐riding that underlie normative arguments for conditional over unconditional benefits. Employing such a perspective demonstrates the superiority of unconditional benefits in achieving more efficient and effective income support and reducing inequality—Atkinson's core commitments throughout his distinguished career.
‘No one to trust’: the cultural embedding of atomism in financial markets
Authors: Ailon Galit
Published: May 2018

The paper ethnographically explores the cultural embedding of atomistic indifference in online, global financial markets: arenas that have been digitally designed according to economic ideals and that demand an extreme form of relational and social dissociation from the partners to exchange and from those affected by the transactions. Its case‐study is lay financial‐trading in Israel, a country undergoing extensive neoliberalization. The study shows that dissociation is embedded in an economic culture marked by constant, multi‐sited declarations that economic‐Others are cold, uncaring and manipulative. It takes shape as traders convert the distrust towards Others into distrust towards portions of the Self that represent links to these Others, namely their own social‐psychology and social concern. Acting atomistically and selfishly in the market thus entails considerable reflexive work. The paper contributes to an ongoing debate on the moral and cultural embeddedness of markets in general and of the expanding financial markets in particular.
Evaluating Behavioral Economic Models of Heavy Drinking Among College Students
Authors: Acuff Samuel F. , Soltis Kathryn E. , Dennhardt Ashley A. , Berlin Kristoffer S. , Murphy James G.
Published: May 2018

Background

Heavy drinking among college students is a significant public health concern that can lead to profound social and health consequences, including alcohol use disorder. Behavioral economics posits that low future orientation and high valuation of alcohol (alcohol demand) combined with deficits in alternative reinforcement increase the likelihood of alcohol misuse. Despite this, no study has examined the incremental utility of all 3 variables simultaneously in a comprehensive model.

Methods

This study uses structural equation modeling to test the associations between behavioral economic variables—alcohol demand (latent), future orientation (measured with a delay discounting task and the Consideration of Future Consequences [CFC] scale), and proportionate substance‐related reinforcement—and alcohol consumption and problems among 393 heavy drinking college students. Two models are tested as follows: (i) an iteration of the reinforcer pathology model that includes an interaction between future orientation and alcohol demand; and (ii) an alternative model evaluating the interconnectedness of behavioral economic variables in predicting problematic alcohol use.

Results

The interaction effects in Model 1 were nonsignificant. Model 2 suggests that greater alcohol demand and proportionate substance‐related reinforcement are associated with greater alcohol consumption and problems. Furthermore, CFC was associated with alcohol‐related problems and lower proportionate substance‐related reinforcement but was not significantly associated with alcohol consumption or alcohol demand. Finally, greater proportionate substance‐related reinforcement was associated with greater alcohol demand.

Conclusions

Our results support the validity of the behavioral economic reinforcer pathology model as applied to young adult heavy drinking.
Reducing the standard serving size of alcoholic beverages prompts reductions in alcohol consumption
Authors: Kersbergen Inge , Oldham Melissa , Jones Andrew , Field Matt , Angus Colin , Robinson Eric
Published: May 2018

Aims

To test whether reducing the standard serving size of alcoholic beverages would reduce voluntary alcohol consumption in a laboratory (study 1) and a real‐world drinking environment (study 2). Additionally, we modelled the potential public health benefit of reducing the standard serving size of on‐trade alcoholic beverages in the United Kingdom.

Design

Studies 1 and 2 were cluster‐randomized experiments. In the additional study, we used the Sheffield Alcohol Policy Model to estimate the number of deaths and hospital admissions that would be averted per year in the United Kingdom if a policy that reduces alcohol serving sizes in the on‐trade was introduced.

Setting

A semi‐naturalistic laboratory (study 1), a bar in Liverpool, UK (study 2).

Participants

Students and university staff members (study 1: n = 114, mean age = 24.8 years, 74.6% female), residents from local community (study 2: n = 164, mean age = 34.9 years, 57.3% female).

Interventions and comparators

In study 1, participants were assigned randomly to receive standard or reduced serving sizes (by 25%) of alcohol during a laboratory drinking session. In study 2, customers at a bar were served alcohol in either standard or reduced serving sizes (by 28.6–33.3%).

Measurements

Outcome measures were units of alcohol consumed within 1 hour (study 1) and up to 3 hours (study 2). Serving size condition was the primary predictor.

Findings

In study 1, a 25% reduction in alcohol serving size led to a 20.7–22.3% reduction in alcohol consumption. In study 2, a 28.6–33.3% reduction in alcohol serving size led to a 32.4–39.6% reduction in alcohol consumption. Modelling results indicated that decreasing the serving size of on‐trade alcoholic beverages by 25% could reduce the number of alcohol‐related hospital admissions and deaths per year in the United Kingdom by 4.4–10.5% and 5.6–13.2%, respectively.

Conclusions

Reducing the serving size of alcoholic beverages in the United Kingdom appears to lead to a reduction in alcohol consumption within a single drinking occasion.
Non‐operative management of isolated single abdominal stab wound: is it safe?
Authors: Lee Hong Xiang , Hauser Matthew , Jog Shivangi , Bautz Peter , Dobbins Christopher
Published: May 2018

Background

This is a retrospective review of prospectively collected data on our hospital, a Level 1 trauma centre, where stable patients with single abdominal stab wounds are considered for non‐operative (conservative) management if they fulfil the criteria with the aid of computed tomography. The aim is to review our current approach in managing these patients.

Methods

Patients' data were obtained from January 2005 to June 2016. All injuries classed as assault or self‐harm by sharp object in Injury Severity Score body region 4 were included. Patients were excluded from this study if they had haemodynamic instability, peritonism, significant findings on computed tomography, intoxicated, sustained head injury, sedated and intubated or evisceration of bowel, impalement of the stabbed object, potential thoraco‐abdominal injury and multiple stab wounds. The patients were divided into non‐operative and delayed operative groups for analysis.

Results

One hundred and sixty‐six of the 313 patients who presented with abdominal stab wounds matched our criteria. One hundred and sixty‐three patients (98.2%) from the non‐operative group were discharged without complications following period of observation, while three patients underwent operative intervention following trial of non‐operative management. The mean length of stay for the successful non‐operative group and the group which required delayed operative intervention were 2.8 and 6 days, respectively. No morbidity or mortality was recorded in either group.

Conclusion

Our observational study showed that in a Level 1 trauma centre, patients with single anterior abdominal stab wound and normal vital signs can potentially be safely managed with non‐operative approach provided that these patients are cooperative for close observation.
Impact of serious mental illness on surgical patient outcomes
Authors: McBride Kate E. , Solomon Michael J. , Young Jane M. , Steffens Daniel , Lambert Tim J. , Glozier Nick , Bannon Paul G.
Published: May 2018

Background

People with comorbid mental illness have poorer health status and disparate access to healthcare. Several studies internationally have reported mixed findings regarding the association between mental illness and surgical patient outcomes. This study examines the surgical outcomes in people with decompensated serious mental illness (SMI) within the setting of the Australian universal healthcare system.

Methods

Retrospective cohort study involving elective overnight surgical patients aged 18 years and above who attended a large public tertiary referral hospital in Sydney, Australia, between 2010 and 2014. Patients were identified using ICD‐10‐AM diagnosis codes. Outcomes measure including in‐hospital mortality, post‐operative complications, morbidity, admission and time in intensive care, length and cost of hospitalization, discharge destination and 28‐day re‐admission rates were examined.

Results

Of 23 343 surgical patient admissions, 451 (2%) patients had decompensated comorbid SMI with a subset of 47 (0.2%) having a specific psychotic illness. Patients with SMI comorbidity had significantly higher in‐hospital mortality (2% versus 0%), post‐operative complications (22% versus 8%), total comorbidity (7.6 versus 3.4 secondary codes), admissions (29% versus 9%) and time in intensive care (34.6 h versus 5.0 h), stay in hospital (12.2 days versus 4.6 days), admission costs ($24 162 versus $12 336), re‐admission within 28 days (14% versus 10%) and discharges to another facility (11% versus 3%).

Conclusion

Patients with comorbid SMI had significantly worse surgical outcomes and incur much higher costs compared with the general surgical population. These results strongly highlight that specific perioperative interventions are needed to proactively improve the identification, management and outcomes for these disadvantaged patients.
Nightscapes of Play: Enjoyment of Architecture and Urban Space through Bicycling
Authors: Morhayim Lusi
Published: May 2018

Anti‐automobile, anti‐capitalist, and pro‐environmental worldviews are known to shape bicyclists’ right to the city demands. This research uncovers another layer of their radical engagement with the city: playful enjoyment of architectural structures and urban space, using the case study of Midnight Mystery Ride, a community bicycle ride taking place in the middle of the night once a month in several cities around the world. Through theoretical lenses of play and rhythmanalysis, I argue that bicyclists at night take over spaces built with exchange vale in mind and introduce use value in the same spaces. Interviews with bicyclists demonstrate how their unconventional use of space questions separation from natural rhythms and nature. I demonstrate that their nighttime use of the city is also a critique of how urban space is organised largely for profit and discipline and of how the human and playful potential of urban space are not fully realised.
Comparative optimism in older adults’ future health expectations
Authors: Vanderzanden Karen , Ruthig Joelle C.
Published: May 2018

Objectives

Despite a common belief that health declines with age, many older adults remain optimistic about their future health. However, the longitudinal impact of personal and comparatively optimistic future health estimates (FHEs) is unclear.

Method

Among 408 older adults (Mage = 70.32 years), this study identified the prevalence, source, and two‐year stability of comparatively optimistic FHEs; examined demographic, psychosocial, and health correlates of comparative FHEs; and assessed the role of comparative FHEs in predicting eight‐year survival odds.

Results

Nearly half of participants were comparatively optimistic due to interpersonal pessimism more so than personal optimism. Regarding stability, comparative optimism declined over the two‐year period. Being younger and having more perceived control, dispositional optimism, and recent positive emotions were associated with better FHEs for oneself and a similar other. Beyond effects of age, gender, relationship status, and dispositional optimism, optimistic personal FHEs predicted eight‐year survival odds.

Conclusions

Findings have implications for predicting survival and advancing the conceptual understanding of comparative FHEs.

Statement of contribution

What is already known on the subject?

Previous research has demonstrated that older adults tend to believe diminished health accompanies increasing age. Despite this notion, older adults remain comparatively optimistic about their health.

What does this study add?

The longitudinal results of the current study indicated that nearly half of participants were categorized as comparative optimists, primarily due to interpersonal pessimism.

The current study demonstrated that there is little distinction between personal FHEs and those for a similar other in terms of demographic, psychosocial, and health correlates.

The current study identified factors that predicted eight‐year survival among older adults, such as being female, younger, in a committed relationship, and better personal FHEs.
Loss of protein phosphatase 6 in mouse keratinocytes enhances K‐rasG12D‐driven tumor promotion
Authors: Kurosawa Koreyuki , Inoue Yui , Kakugawa Yoichiro , Yamashita Yoji , Kanazawa Kosuke , Kishimoto Kazuhiro , Nomura Miyuki , Momoi Yuki , Sato Ikuro , Chiba Natsuko , Suzuki Mai , Ogoh Honami , Yamada Hidekazu , Miura Koh , Watanabe Toshio , Tanuma Nobuhiro , Tachi Masahiro , Shima Hiroshi
Published: May 2018

Here, we address the function of protein phosphatase 6 (PP6) loss on K‐ras‐initiated tumorigenesis in keratinocytes. To do so, we developed tamoxifen‐inducible double mutant (K‐rasG12D‐expressing and Ppp6c‐deficient) mice in which K‐rasG12D expression is driven by the cytokeratin 14 (K14) promoter. Doubly‐mutant mice showed early onset tumor formation in lips, nipples, external genitalia, anus and palms, and had to be killed by 3 weeks after induction by tamoxifen, while comparably‐treated K‐rasG12D‐expressing mice did not. H&E‐staining of lip tumors before euthanasia revealed that all were papillomas, some containing focal squamous cell carcinomas. Immunohistochemical analysis of lips of doubly‐mutant vs K‐rasG12D mice revealed that cell proliferation and cell size increased approximately 2‐fold relative to K‐rasG12D‐expressing mutants, and epidermal thickness of lip tissue greatly increased relative to that seen in K‐rasG12D‐only mice. Moreover, AKT phosphorylation increased in K‐rasG12D‐expressing/Ppp6c‐deficient cells, as did phosphorylation of the downstream effectors 4EBP1, S6 and GSK3, suggesting that protein synthesis and survival signals are enhanced in lip tissues of doubly‐mutant mice. Finally, increased numbers of K14‐positive cells were present in the suprabasal layer of doubly‐mutant mice, indicating abnormal keratinocyte differentiation, and γH2AX‐positive cells accumulated, indicating perturbed DNA repair. Taken together, Ppp6c deficiency enhances K‐rasG12D‐dependent tumor promotion.
Evaluation of the basophil activation test and skin prick testing for the diagnosis of sesame food allergy
Authors: Appel M. Y. , Nachshon L. , Elizur A. , Levy M. B. , Katz Y. , Goldberg M. R.
Published: May 2018

Background

The prevalence of sesame food allergy (SFA) has increased over recent years, with the potential of anaphylactic reactions upon exposure. Oral food challenge (OFC) remains the diagnostic standard, yet its implementation may be risky. Commercial skin prick tests (SPT) have a low sensitivity. Investigation of alternate diagnostic methods is warranted.

Objective

To evaluate the utility of SPT and the basophil activation test (BAT) for SFA diagnosis.

Methods

Eighty‐two patients with suspected SFA completed an open OFC to sesame or reported a recent confirmed reaction. Patients were administered skin prick tests (SPT) with commercial sesame seed extract (CSSE) and a high protein concentration sesame extract (HPSE) (100 mg/mL protein). Whole blood from 80 patients was stimulated with sesame seed extract (40‐10 000 ng/mL protein) for BAT), assessing CD63 and CD203c as activation markers.

Results

Sixty patients (73%) had IgE‐mediated reactions to sesame, and 22 (27%) did not react. Receiver operating characteristic (ROC) curve analysis demonstrated an area under the curve (AUC) of 0.87 for HPSE‐SPT and 0.66 for CSSE‐SPT. At 1000 ng/mL of sesame protein, induction of CD63 and CD203c was weakly but significantly associated with OFC eliciting dose by rank (Spearman's rho = −.42 (P < .01) and −.35 (P < .05) for CD63 and CD203c, respectively). By ROC analysis, the AUC was 0.86 for CD63 and was 0.81 for CD203c sesame‐induced basophil expression. Using HPSE‐SPT as a first test to definitively diagnose (n = 24) or rule‐out (n = 5) SFA and BAT as a second test to diagnose the remainder results in the correct classification of 73 of 80 (91%) patients, leaving one false negative and 4 false positive patients. Two BAT non‐responders remain unclassified by this algorithm.

Conclusions & Clinical Relevance

While prospective cohort validation is necessary, joint utilization of BAT and SPT with HPSE extract may obviate the need for OFC in most SFA patients.
Diagnostic approach to low‐renin hypertension
Authors: Monticone Silvia , Losano Isabel , Tetti Martina , Buffolo Fabrizio , Veglio Franco , Mulatero Paolo
Published: May 2018

Renin‐angiotensin‐aldosterone system (RAAS) plays a crucial role in maintaining water and electrolytes homoeostasis, and its deregulation contributes to the development of arterial hypertension. Since the historical description of the “classical” RAAS, a dramatic increase in our understanding of the molecular mechanisms underlying the development of both essential and secondary hypertension has occurred. Approximatively 25% of the patients affected by arterial hypertension display low‐renin levels, a definition that is largely arbitrary and depends on the investigated population and the specific characteristics of the assay. Most often, low‐renin levels are expression of a physiological response to sodium‐volume overload, but also a significant number of secondary hereditary or acquired conditions falls within this category. In a context of suppressed renin status, the concomitant examination of plasma aldosterone levels (which can be inappropriately elevated, within the normal range or suppressed) and plasma potassium are essential to formulate a differential diagnosis. To distinguish between the different forms of low‐renin hypertension is of fundamental importance to address the patient to the proper clinical management, as each subtype requires a specific and targeted therapy. The present review will discuss the differential diagnosis of the most common medical conditions manifesting with a clinical phenotype of low‐renin hypertension, enlightening the novelties in genetics of the familial forms.
Experimental autoimmune neuritis
Authors: Fujioka Toshiki
Published: May 2018

Experimental autoimmune (allergic) neuritis (EAN), which is induced in various animal strains by immunization with peripheral nerve constituents, has been recognized as an animal model of human immune‐mediated neuritis; that is, Guillain–Barré syndrome or chronic inflammatory demyelinating neuritis. At first, EAN was reported in rabbits, and soon thereafter, in mice and rats. Various antigens relating to the peripheral nervous system (PNS) have also been reported. Symptomatic characteristics of EAN are quite similar despite different strains/antigens; that is, acute, self‐limiting, monophasic flaccid paralysis. However, modification of the antigen or administration of immune suppressants to EAN animals are able to induce chronic, relapsing demyelinating neuropathy. The cellular response and humoral kinetics, such as cytokine/chemokine/cell adhesion molecules in PNS of EAN animals, have been extensively studied. In the early 1990s, the dichotomy of type 1 T helper cells and type 2 T helper cells cellular response, along with the cytokine/chemokine milieu in EAN were investigated robustly; thereafter, type 17 T helper cells and regulating T cells followed. This sequence is very similar to what had been observed in human multiple sclerosis and experimental autoimmune encephalomyelitis, an animal model for multiple sclerosis and somewhat counterpart of EAN. However, the PNS and central nervous system have several differences in respect to their cellular components, thus, the immune response that appears in EAN has some unique aspects. Investigation of these differences, and the mechanism of recovery and regeneration of PNS might provide us with better therapeutic options for PNS diseases, especially inflammatory neuropathy.
Evaluation of right ventricular myocardial strains by speckle tracking echocardiography after percutaneous device closure of atrial septal defects in children
Authors: Xu Qiuqin , Sun Ling , Zhou Wanping , Tang Yunjia , Ding Yueyue , Huang Jie , Wang Hui , Hou Cui , Lv Haitao
Published: May 2018

Objectives

The aim of this study was to clarify the influence of the ASD closure by occluder device on right ventricular acute and long‐term changes in longitudinal systolic strains, by evaluating right ventricular wall deformation in children using speckle tracking echocardiography (STE).

Methods and Materials

We enrolled 30 children with ASDs and 40 controls in our study. The Amplatzer atrial defect occluder was used to close the ASDs. Transthoracic echocardiographic examinations were performed at 3 points in time: the day before closure, 1 day after closure, and 3 months after closure. The dimensions of the right atrium (RA) and the right ventricle (RV) were measured in apical four‐chamber view. RV segmental longitudinal systolic strains (SLSs) and global longitudinal systolic strain (GLS) were obtained by two‐dimensional STE.

Results

Before ASD closure, the RV SLSs and GLS were significantly higher than those of the controls. At 1 day after closure, the diameters of RA and RV decreased. All the RV SLSs and GLS decreased accordingly and were lower than the control values. At 3 months after closure, the apical free wall strain, all segments of septal strains, and GLS increased significantly compared with the values obtained at 1 day after closure. The diameters of the RA and RV decreased further as well. There were no significant differences in the strains compared with the control values, except for the free wall basal strain.

Conclusions

Transcatheter device closure of ASDs improves RV strain indices and RV function recover to normal over 3 months.
A rare case of mitral valve dissection and aortic‐left ventricular tunnel associated with possible autoimmune vasculitis
Authors: Wu Weichun , Hsi David H. , Wang Haiping , Dong Chao , Niu LiLi , Wang Hao
Published: May 2018

We report a very rare case of mitral valve dissection and aortic‐left ventricular tunnel caused by possible autoimmune vasculitis. We suspected Behcet's disease in this patient. There was no obvious clinical evidence of infective endocarditis. Echocardiography is the diagnostic tool of choice to recognize valvular dysfunction, related pathology, and possible complications. The patient may require immunosuppressive therapy due to the high likelihood of recurrence in the perioperation period.
Isolated premature restriction or closure of foramen ovale in fetuses: Echocardiographic characteristics and outcome
Authors: Gu Xiaoyan , Zhang Ye , Han Jiancheng , Liu Xiaowei , Ge Shuping , He Yihua
Published: May 2018

Background

Premature restriction or closure of foramen ovale (FO) in otherwise structurally normal hearts may be associated with right ventricular dilation, tricuspid regurgitation, pericardial effusion, heart failure, even poor perinatal outcomes. Data about these rare conditions are lacking.

Methods

We retrospectively reviewed the echocardiographic records of 9704 fetuses seen from 2010 to 2014 in Beijing Anzhen Hospital, a regional and national referral center, to ascertain the presence of restriction or closure of FO. We collected the fetal echocardiography and perinatal outcome data for this group of fetuses with restriction or closure of FO.

Results

In this large, single‐institution cohort (n = 9704), 6707 fetuses seen between 23 and 37 weeks of gestation had normal heart structures; of these, 60 (0.89%) had restrictive FO (rFO) and 5 (0.07%) had closure of FO (cFO). Fetal echocardiographic images showed right atrial dilation in 48 (73.84%), right ventricular dilation in 38 (58.46%), tricuspid regurgitation in 19 (29.23%), and pericardial effusion in 10 (15.38%). Also in this group, 50 (83.3%) with rFO and 4 (80.0%) with cFO had follow‐up data. No prenatal deaths occurred in either the rFO or the cFO group, but the neonatal mortality included 1 in the rFO group and 2 in the cFO group.

Conclusion

Premature rFO/cFO are rare in fetuses with otherwise structurally normal hearts. The fetal echocardiographic characteristics include right atrial and ventricular dilated, tricuspid regurgitation, and pericardial effusion. Most fetuses had a good outcome, although there was an association between rFO, especially cFO, with neonatal morality and complications (prematurity, maternal preeclampsia and placental abruption, hydrops fetalis, and necrotizing enterocolitis with perforation).
Reference values and correlates of right atrial volume in healthy adults by two‐dimensional echocardiography
Authors: Ferrara Francesco , Gargani Luna , Ruohonen Saku , Vriz Olga , Scalese Marco , Russo Valentina , Marra Alberto M. , Stanziola Anna Agnese , Cittadini Antonio , D’Andrea Antonello , Naeije Robert , Bossone Eduardo
Published: May 2018

Background

Right atrial (RA) volume is an important parameter in the evaluation of patients with pulmonary hypertension. Aim of this study was to define reference ranges for RA volume by two‐dimensional echocardiography (2DE) in healthy adults.

Methods

A total of 596 healthy subjects [mean age 45.7 ± 14.6 years, range 18–88 years; 60.1% women] underwent a transthoracic echocardiography. In addition, a meta‐analysis was performed of published studies measuring RA volume in healthy subjects, using 2DE single plane area‐length (A‐L) and/or method of disks (MOD) at end‐systole in apical four‐chamber view.

Results

In our cohort, RA volume was higher in men than women but did not vary with age. Body surface area (BSA), stroke volume (SV), and tricuspid annular plane systolic excursion (TAPSE) were the only independent variables associated with RA volume (β coefficient 0.569, 0.123, and 0.131, respectively; all P < .001). In the pooled analysis, normalized RA volume was 25.7 ± 7.0 mL/m2 in men and 21.2 ± 5.8 mL/m2 in women for A‐L, 21.6 ± 5.6 mL/m2 in men and 18.2 ± 5.4 mL/m2 in women for MOD (all P values < .0001). The upper limit was about 36 mL/m2 in men and 31 mL/m2 in women for A‐L and 31 mL/m2 in men and 27 mL/m2 in women for MOD.

Conclusions

RA volume was found to be higher in men but not influenced by age. It was mainly correlated with larger BSA, indices of preload (SV) and RV longitudinal function (TAPSE). A statistically significant difference was found between A‐L and MOD.
Echocardiographic parameters to identify sickle cell patients with cardio‐pathology
Authors: Chiadika Simbo , Lim‐Fung Mary , Llanos‐Chea Fiorella , Serauto Canache Astrid , Yang Wei , Paruthi Christina , Zhang Xu , McPherson David D. , Idowu Modupe
Published: May 2018

Background

Sickle cell disease (SCD) affects millions of people and causes chronic hemolytic anemia leading to vasculopathies such as pulmonary hypertension and abnormalities in cardiac function that increase complications and mortality. It is therefore crucial to identify cardiac abnormalities in SCD. We aimed to assess the prevalence of echocardiographic parameters in SCD to help identify cardiopulmonary risk.

Methods

Ninety‐one patients (53% male), median age of 30, body surface area (BSA) of 1.79 m2, hemoglobin of 8.8 g/dL, and creatinine of 0.7 mg/dL identified. We retrospectively measured laboratory and echocardiographic parameters in patients with SCD : left ventricular (LV) dimensions, LV ejection fraction (LVEF), LV Myocardial Performance Index (MPI), LV Mass Index (MI), Left Atrial Volume Index (LAVI), Tricuspid Regurgitation Velocity (TRV), tricuspid annular plane systolic excursion (TAPSE), right heart dimensions.

Results

Prevalence of left heart abnormalities was 32%: increased LV end‐diastolic diameter (EDD), 78%: LV MPI, 21%: diastolic dysfunction, 38%: decreased LVEF, 24%: increased LVMI, and 47%: increased LAVI. Right heart abnormalities were 39%: TAPSE, 38%: increased TRV, and 59%: increased pulmonary systolic pressure (PASP). Multivariate logistic regression analysis was significant for increased LVMI and LAVI in those with hemoglobin ≤8 g/dL (odds ratio (OR) 7.4, 95% confidence interval (CI) 2.23–24.6, P = .001) and (OR 3.32, 95% CI 1.18–9.33, P = .023).

Conclusions

We confirmed increased prevalence of abnormal LVEDD, LVMI, diastolic function, LAVI, and PASP in SCD. In addition, we identified abnormal LV MPI (78%), TAPSE (29%). These parameters may be useful and readily accessible echocardiographic prognostic tools in this population.
Hemostasis biomarkers in multiple sclerosis
Authors: Ziliotto N. , Bernardi F. , Jakimovski D. , Baroni M. , Marchetti G. , Bergsland N. , Ramasamy D. P. , Weinstock‐Guttman B. , Schweser F. , Zamboni P. , Ramanathan M. , Zivadinov R.
Published: May 2018

Background and purpose

The aim was to investigate the plasma levels of hemostasis components in multiple sclerosis (MS) and their association with clinical and magnetic resonance imaging (MRI) outcomes.

Methods

In all, 138 MS patients [85 with relapsing–remitting MS (RR‐MS) and 53 with progressive MS (P‐MS) with a mean age of 54 years; 72.5% female; median Expanded Disability Status Scale 3.5; mean disease duration 21 years] and 42 age‐ and sex‐matched healthy individuals (HI) were studied. All subjects were examined with 3 T MRI and clinical examinations. Plasma levels of hemostasis factors [procoagulant, factor XII (FXII)] and inhibitors [tissue factor pathway inhibitor (TFPI), thrombomodulin, heparin cofactor II, a disintegrin‐like and metalloprotease with thrombospondin type 1 motif 13 (ADAMTS13) and plasminogen activator inhibitor 1 (PAI‐1)] were evaluated by magnetic Luminex assays and enzyme‐linked immunosorbent assay. Associations between hemostasis plasma levels and clinical and MRI outcomes were assessed.

Results

Lower ADAMTS13 levels were found in MS patients compared to HI (P = 0.008) and in MS patients presenting with cerebral microbleeds compared to those without (P = 0.034). Higher PAI‐1 levels were found in MS patients compared to HI (P = 0.02). TFPI levels were higher in the P‐MS subgroup compared to RR‐MS patients (P = 0.011) and compared to HI (P = 0.002). No significant associations between hemostasis plasma levels and clinical or MRI outcomes were found.

Conclusions

Decreased ADAMTS13, particularly in MS patients with cerebral microbleeds, which deserves further investigation, and increased PAI‐1 and TFPI levels were observed in MS patients, which deserves further investigation. No relationship between hemostasis plasma levels and measures of disease severity was detected.
Posttraumatic Headache: Basic Mechanisms and Therapeutic Targets
Authors: Kamins Joshua , Charles Andrew
Published: May 2018

Frequent or continuous headache, often refractory to medical therapy, is a common occurrence after head trauma. In addition to being the most common acute symptom after traumatic brain injury (TBI), headache is also one of the most persistent and disabling symptoms. Different studies indicate that 18‐58% of those suffering a TBI will have significant headache at 1 year following the trauma. In addition to being disabling on its own, posttraumatic headache (PTH) is a predictor of overall outcome after concussion. Despite its remarkable prevalence and associated social and economic costs, many fundamental and important questions about PTH remain unanswered. The purpose of this review is to identify key questions regarding the clinical characteristics of posttraumatic headache, its basic mechanisms, and its optimal management. We discuss phenotypic features of PTH, pathophysiological mechanisms of TBI including potential overlaps with those of migraine and other primary headache disorders, and potential novel targets for treatment. We suggest different strategies to finding answers to the questions regarding PTH in order to advance the understanding of the disorder and develop more effective therapies.
Interobserver variation in CD30 immunohistochemistry interpretation; consequences for patient selection for targeted treatment
Authors: Koens Lianne , van de Ven Peter M , Hijmering Nathalie J , Kersten Marie J , Diepstra Arjan , Chamuleau Martine , de Jong Daphne
Published: May 2018

Aims

CD30 immunohistochemistry (IHC) in malignant lymphoma is used for selection of patients in clinical trials using brentuximab vedotin, an antibody drug‐conjugate targeting the CD30 molecule. For reliable implementation in daily practice and meaningful selection of patients for clinical trials, information on technical variation and interobserver reproducibility of CD30 immunohistochemistry (IHC) staining is required.

Methods and results

We conducted a three‐round reproducibility assessment of CD30 scoring for categorised frequency and intensity, including a technical validation, a ‘live polling’ pre‐ and post‐instruction scoring round and a web‐based round including individual scoring with additional IHC information to mimic daily diagnostic practice. Agreement in all three scoring rounds was poor to fair (κ = 0.12–0.35 for CD30‐positive tumour cell percentage and κ = 0.16–0.41 for staining intensity), even when allowing for one category of freedom in percentage of tumour cell positivity (κ = 0.30–0.61). The first round with CD30 staining performed in five independent laboratories showed objective differences in staining intensity. In the second round, approximately half the pathologists changed their opinion on CD30 frequency after a discussion on potential pitfalls, highlighting hesitancy in decision‐making. Using fictional cut‐off points for percentage of tumour cell positivity, agreement was still suboptimal (κ = 0.35–0.60).

Conclusions

Lack of agreement in cases with heterogeneous expression is shown to influence patient eligibility for treatment with brentuximab vedotin, both in clinical practice and within the context of clinical trials, and limits the potential predictive value of the relative frequency of CD30‐positive neoplastic cells for clinical response.
Erythrocytes from patients with myeloproliferative neoplasms and splanchnic venous thrombosis show greater expression of Lu/BCAM
Authors: Novitzky‐Basso I. , Spring F. , Anstee D. , Tripathi D. , Chen F.
Published: May 2018

Introduction

Lutheran/BCAM protein (Lu) on the surface of erythrocytes is key for their adhesion to the endothelium, and erythrocytes from individuals with JAK2V617F‐mutated myeloproliferative neoplasms (MPN) have increased endothelial adhesion. Splanchnic vein thrombosis (SVT) is a devastating thrombotic complication of MPN, and frequently, the only diagnostic feature is the JAK2V617F mutation. We sought to examine whether erythrocytes from patients with JAK2V617F mutated SVT (MPN‐SVT) exhibited increased Lu expression, thereby supporting a mechanistic contribution to the development of thrombosis.

Methods

We report the validation of a novel flow cytometry assay for Lu expression on erythrocytes. We examined the expression of Lu on erythrocytes from a cohort of MPN patients with and without SVT, and healthy controls. Samples were obtained from 20 normal individuals, 22 with MPN (both JAK2V617F‐mutated and wild‐type) and 8 with JAK2V617F‐mutated MPN‐SVT.

Results

Lu expression by erythrocytes from patients with MPN and MPN‐SVT is significantly increased compared to erythrocytes from healthy individuals (P < .05), but there was no significant difference between patients with MPN‐SVT and MPN.

Conclusions

Patients with MPN have increased expression of the red cell Lu/BCAM adhesion molecule. Further work is required to determine the role of the increased Lu/BCAM adhesion to the endothelium in the development of thrombosis in MPN of all genotypes.
Acute arthritis: predictive factors and current practice in the approach to diagnosis and management across two hospitals in Sydney
Authors: Pavic Katrina , Pandya Jay , Sebak Sophie , Shetty Amith , Spencer David , Manolios Nicholas
Published: May 2018

Background

Literature pertaining to the predictive factors for septic arthritis is limited.

Aims

The primary objective was to investigate the predictive factors for septic arthritis. The secondary objectives were to investigate the predictive factors for crystal arthritis and to explore current practices in the management of acute arthritis.

Methods

A retrospective analysis was undertaken. All patients with an acute arthritis who underwent a joint aspiration for diagnostic and management purposes were considered for inclusion. The outcome measures were patient demographics, findings on physical examination, findings on blood and synovial fluid analysis and management.

Results

Of the patients who presented with an acute arthritis, 24 of the 172 joint aspirations undertaken were positive for bacteria (13.95%). Of the 172 joint aspirations, 90 were positive for crystals (52.33%). Investigated variables associated with increased risk for the presence of bacteria on synovial fluid included features of sepsis (P < 0.001), joint‐restricted range of motion (P = 0.048), elevated C‐reactive protein (P < 0.001) and elevated total leukocyte count on synovial fluid (P < 0.001). Of the 24 joint aspirations that were positive for bacteria, 13 had associated positive blood cultures (54.17%). Of the 172 joint aspirations, antibiotics were administered in 96 cases (55.81%). Of these, antibiotics were administered prior to joint aspiration in 41 cases (42.71%).

Conclusions

In our study, the most common cause of acute arthritis was crystal arthropathy. An accurate physical examination in conjunction with synovial fluid analysis is of particular importance in diagnosing septic arthritis. Blood cultures are not a reliable substitute for joint aspiration but should nevertheless be undertaken.
Improving adolescents’ periodontal health: evaluation of a mobile oral health App associated with conventional educational methods: a cluster randomized trial
Authors: Marchetti Gisele , Fraiz Fabian Calixto , Nascimento Willian Muniz do , Soares Geisla Mary Silva , Assunção Luciana Reichert da Silva
Published: May 2018

Background

Adolescence is a decisive period in the construction of new conduits. Objective: The influence of an App associated with conventional educational methods in adolescents’ oral health.

Study design

Randomized controlled trial including 291 participants (mean age = 16.1 years) in baseline. The study consisted of four phases. Interventions were evaluated through the knowledge score (KS) and oral indexes (OHI‐S/GBI). KS was obtained through five affirmations about periodontal diseases applied in different moments (pre‐test, post‐test, and follow‐up test). Phase I included pre‐test and oral clinical examination. Sample was randomly divided into two groups: oral (OG) and video orientation (VG) and post‐test (phase II). Phase III characterized the formation of groups: OG + App/OG without App/VG + App/VG without App. App consisted of reinforcement messages which was sent during 30 days. Phase IV comprised follow‐up test and clinical evaluation.

Results

There was no significant difference in KS between OG/VG. Overall, App improved KS (P < 0.001). VG + App showed a significant increase in KS in the follow‐up test compared to the post‐test (P = 0.046). There was a significant reduction in oral indexes for all methods.

Conclusion

App was effective in increasing knowledge, especially associated with video. The different methods were equally effective for a better standard in oral hygiene.
Production of near‐full density uranium nitride microspheres with a hot isostatic press
Authors: McMurray Jacob W. , Kiggans Jim O. , Helmreich Grant W. , Terrani Kurt A.
Published: May 2018

Depleted uranium nitride (UN) kernels with diameters ranging from 420 to 858 microns and theoretical densities (TD) between 87 and 91 percent were postprocessed using a hot isostatic press (HIP) in an argon gas media. This treatment was shown to increase the TD up to above 97%. Uranium nitride is highly reactive with oxygen. Therefore, a novel crucible design was implemented to remove impurities in the argon gas via in situ gettering to avoid oxidation of the UN kernels. The density before and after each HIP procedure was calculated from average weight, volume, and ellipticity determined with established characterization techniques for particle. Micrographs confirmed the nearly full densification of the particles using the gettering approach and HIP processing parameters investigated in this work.