bluuebunny/crossref_metadata_2025 huggingface dataset:
ISM–ANP hybrid approach to prioritize the barriers in green lean Six Sigma implementation in construction sector
Authors: Thomas Dain , Khanduja Dinesh
Published: October 2021

Purpose

The purpose of this paper is to prioritize and establish relationships among the barriers that affect green, lean and Six Sigma (GLSS) implementation in the Indian construction sector.

Design/methodology/approach

A hierarchal model consisting of several levels is generated by the interpretive structural modelling (ISM) methodology. For establishing the priority weights and the ranking of the barriers, the relationships among barriers from the model in ISM are used to provide an output from the analytic network process (ANP). The 12 vital barriers that affect implementation of GLSS adoption were shortlisted from literature and then finalized in consultation with experts belonging from both industry and academia.

Findings

Based on the ISM model “Lack of awareness for green products, Lack of top management commitment and involvement as well as Lack of funds along with an improper estimation” are at the highest level. Similar results were found while ranking the barriers through ISM–ANP integration.

Originality/value

This study identified and prioritized the barriers that affect GLSS implementation using ISM–ANP approach, such a study has not been attempted previously for the construction sector. The ISM model and ANP ranks are based on the inputs gathered from experts and academicians so as to ensure practical validity. This approach is assists decision-makers to focus on the key barriers priority basis and enables them to implement GLSS smoothly.
Psychological empowerment and employees' creativity in Vietnam telecommunications enterprises: the mediating role of creative process engagement and intrinsic motivation
Authors: Nguyen Thi Phuong Linh , Doan Hau Xuan
Published: October 2021

Purpose

The objective of this study is to investigate the relationship between psychological empowerment and employee creativity with the mediating role of creative process engagement and intrinsic motivation by testing the research model.

Design/methodology/approach

Data were collected from in-depth interviews and surveys of 420 Vietnamese telecommunications enterprises employees. To test models and hypotheses, the collected data has been processed through Cronbach's alpha analysis, exploratory factor analysis (EFA), confirmatory factor analysis (CFA) and structural equation modeling (SEM) using SPSS 22.0 and AMOS 24.0 tools.

Findings

The results confirm that psychological empowerment has a positive direct and indirect relationship through creative process engagement and intrinsic motivation with employee creativity.

Research limitations/implications

The main limitation of this paper is that a full study of the impact of leadership style on psychological empowerment and psychological empowerment to employee creativity should be conducted in the future at Vietnamese telecommunications enterprises.

Practical implications

Telecommunications enterprises managers who want to stimulate employee creativity need to pay attention to empowering workers and creating conditions for them to participate in the creative process when doing work.

Originality/value

The main contribution of this research is to apply theories of psychological empowerment, self-determination and composition theory of creativity to understand the relationship between psychological empowerment, creative process engagement, intrinsic motivation and employee creativity of telecommunications enterprises employees in the context of a developing country in Asia.
The impact of board composition and ownership structure on dividend payout policy: evidence from Saudi Arabia
Authors: Boshnak Helmi A.
Published: October 2021

Purpose

This study examines the impact of board composition and ownership structure variables on dividend payout policy in Saudi Arabian firms. In particular, it aims to determine the effect of board size, independence and meeting frequency, in addition to chief executive officer (CEO) duality, and state, institutional, managerial, family, and foreign ownership on both the propensity to pay dividends and dividend per share for Saudi-listed firms over the period 2016–2019.

Design/methodology/approach

The paper captures dividend policy with two measures, propensity to pay dividends and dividend per share, and employs a range of regression methods (logistic, probit, ordinary least squares (OLS) and random effects regressions) along with a two-stage least squares (2SLS) model for robustness to account for heteroscedasticity, serial correlation and endogeneity issues. The data set is a large panel of 280 Saudi-listed firms over the period 2016 to 2019.

Findings

The results underline the importance of board composition and the ownership structure in explaining variations in dividend policy across Saudi firms. More specifically, there is a positive relationship between the propensity to pay dividends and board-meeting frequency, institutional ownership, firm profitability and firm age, while the degree of board independence, firm size and leverage exhibit a negative relation. Further, dividend per share is positively related to board meeting frequency, institutional ownership, foreign ownership, firm profitability and age, while it is negatively related to CEO duality, managerial ownership, and firm leverage. There is no evidence that family ownership exerts an impact on dividend payout policy in Saudi firms. The findings of this study support agency, signalling, substitute and outcome theories of dividend policy.

Research limitations/implications

This study offers an important insight into the board characteristic and ownership structure drivers of dividend policy in the context of an emerging market. Moreover, the study has important implications for firms, managers, investors, policymakers, and regulators in Saudi Arabia.

Originality/value

This paper contributes to the existing literature by providing evidence on four board and five ownership characteristic drivers of dividend policy in Saudi Arabia as an emerging stock market, thereby improving on less comprehensive previous studies. The study recommends that investors consider board composition and ownership structure characteristics of firms as key drivers of dividend policy when making stock investment decisions to inform them about the propensity of investee firms to pay dividends and maintain a given dividend policy.
Online university education is the new normal: but is face-to-face better?
Authors: Stevens Garry John , Bienz Tobias , Wali Nidhi , Condie Jenna , Schismenos Spyros
Published: October 2021

Purpose

Following the rapid shift to online learning due to COVID-19, this paper aims to compare the relative efficacy of face-to-face and online university teaching methods.

Design/methodology/approach

A scoping review was conducted to examine the learning outcomes within and between online and face-to-face (F2F) university teaching programmes.

Findings

Although previous research has supported a “no significant difference” position, the review of 91 comparative studies during 2000–2020 identified 37 (41%) which found online teaching was associated with better learning outcomes, 17 (18%) which favoured F2F and 37 (41%) reporting no significant difference. Purpose-developed online content which supports “student-led” enquiry and cognitive challenge were cited as factors supporting better learning outcomes.

Research limitations/implications

This study adopts a pre-defined methodology in reviewing literature which ensures rigour in identifying relevant studies. The large sample of studies (n= 91) supported the comparison of discrete learning modes although high variability in key concepts and outcome variables made it difficult to directly compare some studies. A lack of methodological rigour was observed in some studies.

Originality/value

As a result of COVID-19, online university teaching has become the “new normal” but also re-focussed questions regarding its efficacy. The weight of evidence from this review is that online learning is at least as effective and often better than, F2F modalities in supporting learning outcomes, albeit these differences are often modest. The findings raise questions about the presumed benefits of F2F learning and complicate the case for a return to physical classrooms during the pandemic and beyond.
Nature of frauds in Nigeria’s banking ecosystem, 2015-2019
Authors: Tade Oludayo
Published: October 2021

Purpose

This paper aims to examine the nature of frauds and insider involvement in the perpetration of frauds in Nigeria’s banking ecosystem. It probes the payment platforms mostly vulnerable to fraud attacks since the role-out of cashless policy in Nigeria in 2014.

Design/methodology/approach

Using secondary data on frauds and forgeries in Nigeria Deposit Insurance Corporation annual report of 2019, the study engaged the data on frauds and forgeries to unpack the complex dynamics in relation to bank frauds in Nigeria.

Findings

Findings show that fraud attacks on deposit money banks increased year in year out although the actual monetary loss dropped in 2019 as against 2018. Technology mediated transactions such as the use of automated teller machine and internet-based transactions experienced the most fraud. In relation to the role of insiders, all cadres of staff were involved in the fraud but majority of those involved were temporary staff.

Practical implications

Arising from this, it is suggested that banks should continue to strengthen security system and governance structures. Employing temporary staff should be phased out while online and offline vigilance should be mounted.

Originality/value

The study contributes to knowledge by examining the nature of frauds and unveiling the insider dimensions of fraud and the possible factors increasing the vulnerability of casual staff to perpetrate fraud.
Informal learning effort and attitude toward knowledge sharing in times of workplace conflict: curious case of joyous exploration and deprivation sensitivity
Authors: Baburaj Sharath , Kumar Manish
Published: October 2021

Purpose

The study examined the impact of two dimensions of curiosity: joyous exploration (JE) and deprivation sensitivity (DSv) on informal learning effort (ILE) and attitude toward knowledge sharing (ATKS). The authors further explored the mediating effect of learning culture (LC) in the organization on the relationship of the two curiosity dimensions with ILE and ATKS. Additionally, the authors investigated the moderating effect of group dynamics in the form of intragroup task conflict (ITC) and relationship conflict (IRC) on the relationship of curiosity variables with LC, ILE and ATKS.

Design/methodology/approach

Survey instrument was distributed to 790 knowledge workers in various organizations through their HR managers. 403 responses were returned and used in the study.

Findings

JE, the self-determined manifestation of curiosity, impacts all elements of ILE and ATKS, while DSv influences a few aspects of ILE. The effect of JE on the dependent variables is, however, more substantial at low levels of ITC. ITC and IRC independently impact ILE, but only ITC moderates the relationships involving JE (but not DSv). LC emerges from JE (but not from DSv) and partially mediates its association with ILE and ATKS.

Originality/value

Through this work, we demonstrate the differential relevance of the curiosity dimensions and the intragroup conflict types – and their interaction effect – on learning effort and attitude toward knowledge sharing. The findings of the study open new avenues for interventions within the workplace learning and knowledge sharing domain.
Dynamic frequency relationships between bitcoin, oil, gold and economic policy uncertainty index
Authors: Hazgui Samah , Sebai Saber , Mensi Walid
Published: October 2021

Purpose

This paper aims to examine the frequency of co-movements and asymmetric dependencies between bitcoin (BTC), gold, Brent crude oil and the US economic policy uncertainty (EPU) index.

Design/methodology/approach

The authors use a wavelet approach and a quantile-on-quantile regression (QQR) method.

Findings

The results show a positive interdependence between BTC and commodity price returns at both medium and low frequencies over the sample period. In contrast, the dependence is negative between BTC and EPU index at both medium and low frequencies. Furthermore, the co-movements between markets are more pronounced during crises. The results show that strategic commodities and EPU index have the ability to predict BTC price returns at both medium- and long-terms. The QQR method reveals that higher gold returns tend to predict higher/lower BTC returns when the market is in a bullish/bearish state. Moreover, lower gold returns tend to predict lower (higher) BTC returns when the market is in a bearish (bullish) state (positive (negative) relationship). The lower Brent returns tend to predict higher/lower BTC returns when the market is in a bullish/bearish state. High Brent quantiles tend to predict the lower BTC returns in its extremely bearish states. Finally, higher and lower EPU changes tend to predict lower and higher BTC returns when the market is in a bearish/bullish state (negative relationship).

Originality/value

There is generally a lack of understanding of the linkages between BTC, gold, oil and uncertainty index across multiple frequencies. This is, as far as the authors know, the first attempt to apply both the wavelet approach and a QQR method to examine the multiscale linkages among markets under study. The findings should encourage the relevant policymakers to consider these co-movements which vary over time and in duration when setting up regulations that deem to enhance the market efficiency.
From public to commercial service: State‐market hybridization in the UK visa and immigration permit infrastructure, 1997–2021
Authors: Nehring Daniel , Hu Yang
Published: October 2021

This article charts the transformation, between 1997 and 2021, of the family visa and immigration permit infrastructure from a public into a commercial service in the United Kingdom. In doing so, it reveals a process of state‐market hybridization underpinning the commercialization of migration regulation. Drawing on the analysis of legal archives, policy reports, and marketing materials directed at family migrants spanning 1997–2021, it presents fresh, systematic evidence of how, since 2007, a commercialized state‐market hybrid migration infrastructure for visas and immigration permits has developed in the UK. We show how the trend of state‐market hybridized commercialization has cascaded through three dimensions of migration infrastructure, as follows: (1) state and public immigration agencies, (2) outsourcing visa application firms, and (3) private immigration advisers. Predicated on this hybrid public–private commercial infrastructure, application procedures for visas and immigration permits have become increasingly reconstituted as commercial, rather than public, services. This transformation has created a new transactional logic that stratifies individuals' right to family life along socioeconomic lines.
Recent progress on graphene quantum dots‐based fluorescence sensors for food safety and quality assessment applications
Authors: Sharma Arumugam Selva , Ali Shujat , Sabarinathan Devaraj , Murugavelu Marimuthu , Li Huanhuan , Chen Quansheng
Published: October 2021

The versatile photophysicalproperties, high surface‐to‐volume ratio, superior photostability, higher biocompatibility, and availability of active sites make graphene quantum dots (GQDs) an ideal candidate for applications in sensing, bioimaging, photocatalysis, energy storage, and flexible electronics. GQDs‐based sensors involve luminescence sensors, electrochemical sensors, optical biosensors, electrochemical biosensors, and photoelectrochemical biosensors. Although plenty of sensing strategies have been developed using GQDs for biosensing and environmental applications, the use of GQDs‐based fluorescence techniques remains unexplored or underutilized in the field of food science and technology. To the best of our knowledge, comprehensive review of the GQDs‐based fluorescence sensing applications concerning food quality analysis has not yet been done. This review article focuses on the recent progress on the synthesis strategies, electronic properties, and fluorescence mechanisms of GQDs. The various GQDs‐based fluorescence detection strategies involving Förster resonance energy transfer‐ or inner filter effect‐driven fluorescence turn‐on and turn‐off response mechanisms toward trace‐level detection of toxic metal ions, toxic adulterants, and banned chemical substances in foodstuffs are summarized. The challenges associated with the pretreatment steps of complex food matrices and prospects and challenges associated with the GQDs‐based fluorescent probes are discussed. This review could serve as a precedent for further advancement in interdisciplinary research involving the development of versatile GQDs‐based fluorescent probes toward food science and technology applications.
Drying dynamics of meat highlighting areas of relevance to dry‐aging of beef
Authors: Álvarez Sara , Álvarez Carlos , Hamill Ruth , Mullen Anne Maria , O'Neill Eileen
Published: October 2021

Drying of foods is a processing step, which has a variety of outcomes from improving shelf life and product stability, to reducing weight, or to achieving a targeted product eating quality. Drying is key step in the manufacturing of some dried meat products, such as jerky. It is also a major event that occurs when beef is dry‐aged, where beef is exposed to air under defined conditions for an extended aging period. Although the conditions typically used to produce dried meat products are significantly different from those that prevail during dry‐aging, both involve a gradual removal of water from muscle. As there is a paucity of research on the kinetics of the dehydration process occurring during dry‐aging of beef, this paper comprehensively reviews models used to describe drying kinetics in other beef products, in order to gain insights regarding the key factors that impact water removal from meat. Consideration is given as to how the specific conditions during dry‐aging such as air flows used (approximately 2 m/s), high air relative humidity, low temperature, and meat geometry will influence the kinetics of the drying. With regard to modeling, equations derived from Fick's second law of diffusion (e.g., thin‐layer models) have been used to describe the drying kinetics of small‐sized meat products. However, to apply Fick's law to dry‐aging, some different considerations may need to be evaluated such as: tridimensional geometry (i.e., whole muscle); uniform initial moisture content; isotropic diffusion; negligible shrinkage;and a combination of internal and external resistances.
Hidden diversity revealed in the freshwater snails, Bythinella and Pseudamnicola, in the Island of Crete
Authors: LAMPRI Paraskevi Niki , BOURANTA Christina , RADEA Canella , PARMAKELIS Aristeidis
Published: October 2021

Crete with its complex geomorphological history is the island with the highest number of endemism observed in animal and plant taxa throughout the Aegean archipelago. While other groups of organisms within Crete are well‐studied, the freshwater gastropod fauna still remains poorly investigated. Bythinella and Pseudamnicola, are 2 genera of freshwater springsnails, both present on the island, inhabiting springs and other freshwater habitats. Here, we conduct a comprehensive study on the distribution of the different genetic lineages of the 2 gastropod genera in order to assess the mode of their differentiation on the island and infer the actual number of species present in the island. Towards these aims, sequence data from the mitochondrial gene were used and analyzed within a phylogenetic framework. For Bythinella, our results strongly support at least 5 delineated Bythinella spp. inhabiting Crete, which correspond to the already described species from previous studies with the addition of a new one. Bythinella analyses reveal an old time‐frame of differentiation with vicariant phenomena being more likely the main drivers shaping the present‐day distribution of the genus’ genetic lineages. For Pseudamnicola, our data indicate the presence of at least 2 delineated Pseudamnicola spp. with a differentiation more consistent to an isolation‐by‐distance pattern of a relatively recent origin. Dispersion processes followed by isolation of the populations and/or recent speciation, seem to be the underlying process for the current distribution of Pseudamnicola lineages.
Bladder filling volume variation between the first and second day of planning computed tomography for prostate cancer radiation therapy and correlation with renal function
Authors: Ishibashi Naoya , Maebayashi Toshiya , Sakaguchi Masakuni , Aizawa Takuya , Okada Masahiro
Published: October 2021

Aim

During radiation therapy (RT) for prostate cancer, bladder filling helps exclude the organ from irradiation and reduces adverse effects. For RT planning, we performed computed tomography (CT) for 2 consecutive days to evaluate inter‐day variations in organs such as the bladder. However, the patient factors that are associated with large intra‐patient variations in bladder filling volume prior to RT are not known.

Methods

This was a retrospective study of 97 prostate cancer patients who underwent CT for 2 consecutive days for RT planning between March 2015 and March 2020 and with confirmed water intake volume before the scans. Patients consumed 500 ml of water immediately after urination and underwent CT 30 min after the start of water intake; CT was performed under similar conditions over 2 consecutive days. Patient information was collected from the medical records taken before CT.

Results

The median bladder filling volume was 102.8 cm3 (range: 31.7–774.0), and the median intra‐patient bladder filling volume variation was 23.4 cm3 (range: 0.4–277.7). Univariate analysis revealed that the intra‐patient variation was significantly larger in patients with an eGFR higher than the median (p = 0.003). No other factor showed correlations with the variation. As the larger bladder filling volume of the 2 consecutive days in patients increased (median 121.5 cm3, range: 47.8–774.0), the intra‐patient variation also increased.

Conclusion

Patients with a higher eGFR show greater variation in bladder filling volume, and caution should be exercised when applying RT in these patients.
Specific T cells targeting Staphylococcus aureus fibronectin‐binding protein 1 induce a type 2/type 1 inflammatory response in sensitized atopic dermatitis patients
Authors: Farag Ahmed K. , Roesner Lennart M. , Wieschowski Susanne , Heratizadeh Annice , Eiz‐Vesper Britta , Kwok William W. , Valenta Rudolf , Werfel Thomas
Published: October 2021

Background

Atopic dermatitis (AD) is one of the most common inflammatory skin diseases worldwide and Staphylococcus aureus colonization and secondary infections occur in the majority of AD patients. Allergic sensitizations against microbial antigens have been discussed as possible trigger factors of AD. Recently, we reported IgE sensitization against fibronectin‐binding protein 1 (FBP1), an essential virulence component in S. aureus, in a subgroup of patients suffering from AD. To expand these findings by investigating delayed‐type immune reactions, the objective of this study was to detect and phenotypically characterize FBP1‐specific T cells as possible trigger factors in AD.

Methods

Immunodominant T‐cell epitopes were mapped by proliferation testing of patient‐derived FBP1‐specific T‐cell lines after stimulation with single 15mer peptides, which were derived from different functional domains of the FBP1 sequence. Major histocompatibility complex class II tetramers carrying immunodominant epitopes successfully stained T helper cells in 8 out of 8 HLA‐matched, IgE‐sensitized AD patients.

Results

Cytokine profiling of multimer‐sorted cells revealed that predominantly the type 2 cytokines IL‐13 and IL‐4 were secreted by these cells. In contrast, IL‐17, the marker cytokine for response to extracellular pathogens, was scarcely detectable.

Conclusions

We demonstrate that FBP1 contains immunodominant peptides that induce a specific pro‐inflammatory T helper cell response with increased Th2 levels that can drive an allergic inflammation in sensitized AD patients.
Laparoscopy as a Facilitator in the Early Diagnosis of a Mullerian Aplasia During Ordinary Surgery
Authors: Costa Eduardo Corrêa , Hemesath Tatiana Prade , Rombaldi Marcelo Costamilan , Carvalho Clarissa Gutierrez , Leite Julio Cesar Loguercio , Guaragna‐Filho Guilherme
Published: October 2021

Laparoscopy was introduced more than 100 years ago. However, in some fields its use still meets resistance. Technology such as laparoscopy may help to identify rare and complex disorders, even in very ordinary procedures, such as inguinal hernia repair. This report highlighted the importance of early diagnosis of a complex condition using commonly available technology. To the best of our knowledge, there has not been a similar reported case in such a young patient during laparoscopic inguinal hernia repair.
Sentinel 2 images enable reliable prediction of fine‐scale habitat dynamics of narrow endemic plant species in serpentine soils
Authors: Ponce‐Fontenla Sara , Serrano Miguel , Carballal Roi , Regos Adrián
Published: October 2021

Aims

Serpentine soils are rare globally, covering <1% of the land surface, but frequently harbouring large numbers of narrow endemic species. Many serpentine areas are endangered and would benefit from actions informed by species distribution models (SDMs). Here, we assessed, for the first time, the potential use of remotely sensed descriptors of water and carbon cycles derived from Copernicus Sentinel 2 images for fine‐scale habitat characterization and mapping of narrow endemic serpentine‐tolerant species.

Location

We focused on three endemic species with a very limited distribution in the Serra de Careón ultramafic outcrop, a regional plant biodiversity hotspot in Spain.

Methods

We developed SDMs based solely on remotely sensed descriptors of plant water content and habitat dynamics estimated from multitemporal Sentinel 2 images.

Results

The predictive capacity of the models was very high (area under the receiver operating characteristic curve (AUC) > 0.9, sensitivity > 90 and specificity > 84), even for projections beyond the range of data used for calibration (AUC > 0.8, sensitivity > 77 and specificity > 81). Overall, the suitable habitat areas predicted by the models were similar for all three species (Schoener’s D metric > 0.7). The annual mean and coefficient of variation of the Normalized Difference of Water Index provided a good representation of the hydromorphic soils with serpentine clay minerals and characterized by the formation of temporary pools during winter months. The annual mean and coefficient of variation of the Modified Soil Adjusted Vegetation Index were also important predictors owing to their capacity to capture the serpentine habitat conditions, characterized by open vegetation and highly exposed soil.

Conclusions

These findings confirm the potential of ecosystem functioning descriptors derived from spectral Sentinel 2 indices as a cost‐effective means of characterizing the ecological niche of endemic plant species in serpentine habitats and as a promising tool to support their conservation and monitoring.
No significant influence of OCT1 genotypes on the pharmacokinetics of morphine in adult surgical patients
Authors: Kuhlmann Ida , Hjelmar Petersen Rasmus , Overgaard Morten , Dornonville de la Cour Kenn , Zwisler Stine , Bjerregaard Stage Tore , Hougaard Christensen Mette Marie , Bergmann Troels K. , Damkier Per , Gadegaard Jensen Anders , Nielsen Flemming , Brøsen Kim
Published: October 2021

We investigated the impact of genetic variants in OCT1 (SLC22A1) on morphine, morphine‐3‐glucuronide (M3G) and morphine‐6‐glucuronide (M6G) pharmacokinetics in adult patients scheduled for major surgery. Blood samples were taken before and 5, 10, 15, 30, 45, 60 and 90 min after a bolus of morphine (0.15 mg/kg). Patients were genotyped for the genetic variants (rs12208357, rs34059508, rs72552763 and rs34130495) in OCT1.

Eighty‐six patients completed the trial. The mean difference (95% confidence interval) for dose adjusted morphine, M3G and M6G AUC was 0.9 (−0.7–2.4), −5.9 (−11.8 to −0.03) and −1.1 (−2.5–0.4) h/L*10−6, respectively, in patients with two reduced function alleles compared to patients with no reduced function alleles in OCT1. Accordingly, the (AUCM3G/Dose)/(AUCmorphine/Dose) and (AUCM6G/Dose)/(AUCmorphine/Dose) ratio was reduced, −1.8 (−3.2 to −0.4) and −0.4 (−0.7 to −0.03), respectively, when comparing the same groups. OCT1 variants had no influence on the experience of pain, adverse events or the number of PCA doses used. In conclusion, genetic variants in OCT1 had a small and clinically unimportant impact on the exposure of morphine after intravenous administration. Our results do not support pre‐emptive genotyping for OCT1 prior to morphine administration in patients scheduled for major surgery.
Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) recommendations for the management of patients with bipolar disorder with mixed presentations
Authors: Yatham Lakshmi N. , Chakrabarty Trisha , Bond David J. , Schaffer Ayal , Beaulieu Serge , Parikh Sagar V. , McIntyre Roger S. , Milev Roumen V. , Alda Martin , Vazquez Gustavo , Ravindran Arun V. , Frey Benicio N. , Sharma Verinder , Goldstein Benjamin I. , Rej Soham , O’Donovan Claire , Tourjman Valerie , Kozicky Jan‐Marie , Kauer‐Sant’Anna Marcia , Malhi Gin , Suppes Trisha , Vieta Eduard , Kapczinski Flavio , Kanba Shigenobu , Lam Raymond W. , Kennedy Sidney H. , Calabrese Joseph , Berk Michael , Post Robert
Published: October 2021

Objectives

The 2018 Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) guidelines provided clinicians with pragmatic treatment recommendations for bipolar disorder (BD). While these guidelines included commentary on how mixed features may direct treatment selection, specific recommendations were not provided—a critical gap which the current update aims to address.

Method

Overview of research regarding mixed presentations in BD, with treatment recommendations developed using a modified CANMAT/ISBD rating methodology. Limitations are discussed, including the dearth of high‐quality data and reliance on expert opinion.

Results

No agents met threshold for first‐line treatment of DSM‐5 manic or depressive episodes with mixed features. For mania + mixed features second‐line treatment options include asenapine, cariprazine, divalproex, and aripiprazole. In depression + mixed features, cariprazine and lurasidone are recommended as second‐line options. For DSM‐IV defined mixed episodes, with a longer history of research, asenapine and aripiprazole are first‐line, and olanzapine (monotherapy or combination), carbamazepine, and divalproex are second‐line. Research on maintenance treatments following a DSM‐5 mixed presentation is extremely limited, with third‐line recommendations based on expert opinion. For maintenance treatment following a DSM‐IV mixed episode, quetiapine (monotherapy or combination) is first‐line, and lithium and olanzapine identified as second‐line options.

Conclusion

The CANMAT and ISBD groups hope these guidelines provide valuable support for clinicians providing care to patients experiencing mixed presentations, as well as further influence investment in research to improve diagnosis and treatment of this common and complex clinical state.
Can prolife theorists justify an exception for rape?
Authors: Blackshaw Bruce P.
Published: October 2021

Prolife theorists typically hold to the claim that all human beings possess equal moral status from conception and consequently possess a right to life. This, they believe, entails that abortion is impermissible in all circumstances. Critics characterize this as an extreme anti‐abortion position, as it prima facie allows no exceptions, even in cases of rape. Here, I examine whether the prolife claim regarding equal moral status is compatible with a more attractive moderate stance that permits an exception in the case of rape. I show that Judith Jarvis Thomson's analysis of rights can be used to modify the prolife position in this way, but that doing so involves concessions that prolife theorists are unlikely to find acceptable.
How competitors become collaborators—Bridging the gap(s) between machine learning algorithms and clinicians
Authors: Grote Thomas , Berens Philipp
Published: October 2021

For some years, we have been witnessing a steady stream of high‐profile studies about machine learning (ML) algorithms achieving high diagnostic accuracy in the analysis of medical images. That said, facilitating successful collaboration between ML algorithms and clinicians proves to be a recalcitrant problem that may exacerbate ethical problems in clinical medicine. In this paper, we consider different epistemic and normative factors that may lead to algorithmic overreliance within clinical decision‐making. These factors are false expectations, the miscalibration of uncertainties, non‐explainability, and the socio‐technical context within which the algorithms are utilized. Moreover, we identify different desiderata for bridging the gap between ML algorithms and clinicians. Further, we argue that there is an intriguing dialectic in the collaboration between clinicians and ML algorithms. While it is the algorithm that is supposed to assist the clinician in diagnostic tasks, successful collaboration will also depend on adjustments on the side of the clinician.
COVID‐19 as the tipping point for integrating e‐assessment in higher education practices
Authors: St‐Onge Christina , Ouellet Kathleen , Lakhal Sawsen , Dubé Tim , Marceau Mélanie
Published: October 2021

The COVID‐19 pandemic provoked an urgency for many educators to integrate digital information and communication technologies in their educational practices. We explored how faculty members tackled the task of adapting their assessment practices during the pandemic to identify what is required to sustain and favour future quality development and implementation of e‐assessment in higher education. Employing a qualitative descriptive approach, we conducted semi‐structured interviews with thirty‐one individuals six months into the COVID‐19 pandemic. We identified four major themes in participants' discourse about the integration of e‐assessment during the COVID‐19 pandemic: (a) the considerations they had for the potential consequences on students and how they considered this while deciding how to move forward, (b) the preoccupations for the potential for cheating, (c) the importance of pedagogical alignment, and (d) the affordances available to them. While the COVID‐19 pandemic highlighted the fact that higher education institutions were not prepared for a pivot to‐ or greater integration of‐ e‐assessment, it also provided the tipping‐point to do so. In other words, it offered an unprecedented opportunity to critically appraise and change assessment practices, this opportunity was also a very challenging balancing act of considering the social consequences of assessment, and the alignment within set affordances.

Practitioner notes

What is already known about this topic

The advantages of e‐assessment include the opportunity for rapid‐, even immediate‐, feedback.

The integration of digital information and communication technologies to assessment practices is a source of stress and anxiety for some students.

The move towards e‐assessment increases faculty members' workload.

What this paper adds

How cheating, anxiety and workload were considered in the context of a forced and rushed change to e‐assessment because of the COVID‐19 pandemic.

The COVID‐19 pandemic offered an opportunity to faculty members to take a critical look at their assessment practices and increase their alignment with learning outcomes.

Faculty members considered the consequences of their decisions on students when making changes to their assessment.

Implications for practice and/or policy

Moving to e‐assessment is an opportunity to align the assessment practice with students' future professional practice, or in other words it is an opportunity to increase the authenticity of the assessment.

A better integration of information and communication technology to assessment practices will require to provide educators with skills, time, evidence‐informed recommendations, and institutional support among others.
Impact of donor telomere length on survival in patients undergoing matched sibling donor transplantation for aplastic anaemia
Authors: Barade Aruna , Aboobacker Fouzia , Korula Anu , Lakshmi Kavitha , Devasia Anup , Abraham Aby , Mathews Vikram , Edison Eunice , George Biju
Published: October 2021

Although telomere shortening is seen frequently in patients with aplastic anaemia (AA), there are no data on its association in matched sibling donor (MSD) transplants. We evaluated the effect of pre‐transplant telomere length of patients and donors, measured by quantitative real‐time polymerase chain reaction in 163 recipients undergoing MSD transplants. The median age of patients and donors was 24 and 26 years, respectively. Fludarabine and cyclophosphamide was the main conditioning regimen used and all received peripheral blood stem cell grafts. Engraftment occurred in 89% with graft failure (primary and secondary) in 6%. Acute and chronic graft‐versus‐host disease (GVHD) occurred in 28% and 24%, respectively. At a median follow‐up of 37 months, 117 patients (72%) were alive. All patients and donors were divided into short and long telomere length based on their median and quartile values. Patient telomere length was not associated with severity of AA, neutrophil recovery, graft failure, acute GVHD or chronic GVHD. Longer donor telomere length was associated with better overall survival [hazard ratio (HR) = 0·2, P = 0·006] but did not influence neutrophil recovery, graft failure, acute or chronic GVHD. The five‐year overall survival was significantly better (94·9 ± 3·5% vs 65·4 ± 4·3%, P = 0·002) for donors with long (highest quartile, DTL‐HQ) versus short (lower three quartiles, DTL‐LQ) telomeres, respectively. On multivariate analysis, longer donor telomere length, recipient age and acute GVHD continued to remain significant. This is the first study demonstrating an association of donor telomere length on overall survival following MSD transplant for AA but it needs to be confirmed in larger studies.
The NO signalling pathway in aortic aneurysm and dissection
Authors: Toral Marta , de la Fuente‐Alonso Andrea , Campanero Miguel R. , Redondo Juan Miguel
Published: October 2021

Recent studies have shown that NO is a central mediator in diseases associated with thoracic aortic aneurysm, such as Marfan syndrome. The progressive dilation of the aorta in thoracic aortic aneurysm ultimately leads to aortic dissection. Unfortunately, current medical treatments have neither halt aortic enlargement nor prevented rupture, leaving surgical repair as the only effective treatment. There is therefore a pressing need for effective therapies to delay or even avoid the need for surgical repair in thoracic aortic aneurysm patients. Here, we summarize the mechanisms through which NO signalling dysregulation causes thoracic aortic aneurysm, particularly in Marfan syndrome. We discuss recent advances based on the identification of new Marfan syndrome mediators related to pathway overactivation that represent potential disease biomarkers. Likewise, we propose iNOS, sGC and PRKG1, whose pharmacological inhibition reverses aortopathy in Marfan syndrome mice, as targets for therapeutic intervention in thoracic aortic aneurysm and are candidates for clinical trials.
Protein arginine methyltransferase 2 (PRMT2) promotes dextran sulfate sodium‐induced colitis by inhibiting the SOCS3 promoter via histone H3R8 asymmetric dimethylation
Authors: Li Jiahong , Pan Xiaohua , Ren Zhengnan , Li Binbin , Liu He , Wu Chengfei , Dong Xiaoliang , de Vos Paul , Pan Li‐Long , Sun Jia
Published: October 2021

Background and Purpose

There is emerging evidence for a critical role for epigenetic modifiers in the development of inflammatory bowel disease (IBD). Protein arginine methyltransferase 2 (PRMT2) is responsible for the methylation of arginine residues on histones and targets transcription factors involved in many cellular processes, including gene transcription, mRNA splicing, cell proliferation, and cell differentiation. In this study, the role and underlying mechanisms of PRMT2 in colitis were studied.

Experimental Approach

A mouse dextran sulfate sodium (DSS)‐induced experimental colitis model was used to study PRMT2 in colitis. Lentivirus‐induced PRMT2 silencing or overexpression in vivo was applied to address the role of PRMT2 in colitis. Detailed western blot and expression analysis were done to understand epigenetic changes induced by PRMT2 in colitis.

Key Results

PRMT2 is highly expressed in inflammatory bowel disease patients, in inflamed murine colon and in TNF‐α stimulated murine gut epithelial cells. PRMT2 overexpression aggravates, while knockdown alleviates DSS‐induced colitis, suggesting that PRMT2 is a pivotal mediator of colitis in mice. Mechanistically, PRMT2 mediates colitis by increasing repressive histone mark H3R8 asymmetric methylation (H3R8me2a) at the promoter region of the suppressor of cytokine signalling 3 promoter (SOCS3). Resultant inhibition of SOCS3 expression and inhibition of SOCS3‐mediated degradation of TNF receptor associated factor 5 (TRAF5) via ubiquitination led to elevated TRAF5 expression and TRAF5‐mediated downstream NF‐κB/MAPK activation.

Conclusion and Implications

Our study demonstrates that PRMT2 acts as a transcriptional co‐activator for proinflammatory genes during colitis. Hence, targeting PRMT2 may provide a novel therapeutic approach for colitis.
Established pulmonary hypertension in rats was reversed by a combination of a HIF‐2α antagonist and a p53 agonist
Authors: Zheng Qiuyu , Lu Wenju , Yan Han , Duan Xin , Chen Yuqin , Zhang Chenting , Luo Xiaoyun , Chen Jiyuan , Wang Chao , Liu Shiyun , Li Yi , Tang Haiyang , Rahimi Shamin , Rahimi Shayan , Yuan Jason X.‐J. , Zhong Nanshan , Yang Kai , Wang Jian
Published: October 2021

Background and Purpose

Recent studies reported therapeutic effects of monotherapy with either tumour suppressor p53 (p53) agonist or hypoxia‐inducible factor 2α (HIF‐2α) antagonist for pulmonary hypertension (PH). This study investigated whether a combined treatment of p53 agonist, Nutlin3a, and HIF‐2α antagonist, PT2385, would be more effective than monotherapy, based on the cell type‐divergent regulation of p53 in pulmonary arterial smooth muscle cells (PASMC) and endothelial cells (PAEC) in patients and animals with PH.

Experimental Approach

The SU5416/hypoxia‐induced PH (SuHx‐PH) rat model was used, along with cultured human PASMC and PAEC. Western blot, RT‐PCR, siRNA and immunohistochemical methods were used along with echocardiography and studies with isolated pulmonary arteries.

Key Results

Hypoxia‐induced proliferation of PASMC is associated with decreased p53, whereas hypoxia‐induced PAEC apoptosis is associated with increased p53, via a HIF‐2α‐dependent mechanism. Combined treatment with Nutlin3a and PT2385 is more effective by simultaneously inhibiting the hypoxia‐induced PASMC proliferation and PAEC apoptosis, overcoming the side‐effects of monotherapy. These are (i) Nutlin3a exacerbates hypoxia‐induced PAEC apoptosis by inducing p53 in PAEC and (ii) PT2385 inhibits PAEC apoptosis because HIF‐2α is predominantly expressed in PAEC but lacks direct effects on the hypoxia‐induced PASMC proliferation. In rats, combination treatment is more effective than monotherapy in reversing established SuHx‐PH, especially in protecting pulmonary arterial vasculature, by normalizing smooth muscle thickening, protecting against endothelial damage and improving function.

Conclusion and Implications

Combination treatment confers greater therapeutic efficacy against PH through a selective modulation of p53 and HIF‐2α in PASMC and PAEC.
The selective 5‐HT1F receptor agonist lasmiditan inhibits trigeminal nociceptive processing: Implications for migraine and cluster headache
Authors: Vila‐Pueyo Marta , Page Keith , Murdock Paul R. , Loraine Howard J. , Woodrooffe Amanda J. , Johnson Kirk W. , Goadsby Peter J. , Holland Philip R.
Published: October 2021

Background and Purpose

Lasmiditan is a novel selective 5‐HT1F receptor agonist, recently approved for acute treatment of migraine. 5‐HT1F receptors are widely expressed in the CNS and trigeminovascular system. Here, we have explored the therapeutic effects of 5‐HT1F receptor activation in preclinical models of migraine and cluster headache.

Experimental Approach

Electrical stimulation of the dura mater or the superior salivatory nucleus in anaesthetised rats evoked trigeminovascular or trigeminal–autonomic reflex activation at the level of the trigeminocervical complex. Additionally, cranial autonomic manifestations in response to trigeminal–autonomic reflex activation were measured, via anterior choroidal blood flow alterations. These responses were then challenged with lasmiditan. We explored the tissue distribution of mRNA for 5‐HT1F receptors in human post‐mortem tissue and of several 5‐HT1 receptor subtypes in specific tissue beds.

Key Results

Lasmiditan dose‐dependently reduced trigeminovascular activation in a preclinical model of migraine. Lasmiditan also reduced superior salivatory nucleus‐evoked activation of the trigeminal–autonomic reflex, but had no effect on cranial autonomic activation. mRNA profiling in human tissue showed expression of the 5‐HT1F receptor in several structures relevant for migraine and cluster headache.

Conclusion and Implications

Our data suggest that lasmiditan acts, at least in part, as an anti‐migraine agent by reducing trigeminovascular activation. Furthermore, our results highlight a clear action for lasmiditan in a preclinical model of cluster headache. Given the proven translational efficacy of this model, our data support the potential utility of lasmiditan as a therapeutic option for the acute treatment of cluster headache attacks.

LINKED ARTICLES

This article is part of a themed issue on Advances in Migraine and Headache Therapy (BJP 75th Anniversary). To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v179.3/issuetoc