bluuebunny/crossref_metadata_2025 huggingface dataset:
Overground exoskeletons may boost neuroplasticity in myotonic dystrophy type 1 rehabilitation
Authors: Portaro Simona , Naro Antonino , Leo Antonino , Cimino Vincenzo , Balletta Tina , Buda Antonio , Accorinti Maria , Calabrò Rocco Salvatore
Published: November 2019

Rationale:

Myotonic dystrophy type 1 (DM1) is a slowly progressive multisystem neuromuscular disease characterized by myotonia and muscle weakness and wasting of distal and axial muscles. People with DM1, due to the disease progression, are often concerned about their ability to carry out and participate in the activities of daily living. Rehabilitation approaches in DM1, including moderate-to-intense strength training, have shown not univocal efficacy to face such difficulties. Aim of this case-study was to demonstrate the effects of a combined approach by using conventional plus robotic training in rare neuromuscular diseases, such as DM1.

Patient concerns:

A 46-year-old woman came to our observation complaining of difficulty in opening fist after strong voluntary muscle contraction for about 20 years. Over the years, she referred swallowing difficulties for solid foods, balance impairment complicated by tendency to stumble and falls, fatigability, hand muscle weakness with difficulty to open bottles and lifting weights, and daytime sleepiness

Diagnosis:

Paraparesis in DM1.

Interventions:

The patient underwent 2 different trainings. The first period of treatment was carried out by using conventional physiotherapy, 6 times a week (twice a day) for 4 weeks. Then, she underwent a two-month specific task-oriented robotic rehabilitation training for the gait impairment using an overground exoskeleton, namely Ekso-GT, combined to the conventional therapy.

Outcomes:

The patient, after the EKSO training, gained a significant improvement in walking, balance and lower limbs muscle strength, as per 10-meter walking test and Left Lower Limb Motricity Index. Neurophysiological data (electroencephalography and surface electromyography) were also collected to more objectively assess the functional outcomes.

Lessons:

Rehabilitation approaches in DM1, including moderate-to-intense strength training, have shown not univocal efficacy. Emerging and advancing robotic technologies can enhance clinical therapeutic outcomes by allowing therapists to activate and/or modulate neural networks to maximize motor and functional recovery.
The expression of ubiquitin-conjugating enzyme E2C and KAI1 in ovarian carcinoma and their clinical significance
Authors: Gong Yingying , Wang Danna , Lin Lu , Dai Junjun , Yu Lan
Published: November 2019

Ubiquitin-conjugating enzyme E2C (UBE2C) is considered to play an important role in the tumorigenesis of many cancers and promote cell cycle progression. Kangai 1 (KAI1) is considered as a suppressor gene of tumor metastasis. However, the clinicopathological significance and their each relationship of UBE2C and KAI1 in epithelial ovarian carcinoma (EOC) are not widely reported. The purpose of this study is to detect the expression of UBE2C and KAI1 in EOC and their clinical significance.

The expression of UBE2C and KAI1 in 180 cases of EOC tissues, 60 cases of normal ovarian epithelial tissues, and 60 cases of ovarian benign tumor tissues were detected by immunohistochemistry. Patients data were also collected.

Positive expression of UBE2C in EOC (38.9%) was significantly higher than that both in the normal group (0%) and benign tumors group (10.0%). Furthermore, the expression of UBE2C was positively associated with grades of differentiation, implants, lymph node metastasis (LNM), as well as the International Federation of Gynecology and Obstetrics (FIGO) stages. Positive expression of KAI1 in EOC (25.0%) was significantly lower than that both in the normal group (100%) and benign tumors group (75.0%). And the expression of KAI1 was inversely associated with grades of differentiation, implants, LNM, and FIGO stages. Kaplan–Meier survival analyses demonstrated that UBE2C positive expression for patients with EOC had unfavorably overall survival (OS) time when compared with negative UBE2C for patients. And KAI1 positive expression for patients had favorably OS time when compared with negative KAI1 for patients. Multivariate analysis showed that positive expression of UBE2C and KAI1, implants, and FIGO stages were considered as independently prognostic factors for OS in patients with EOC. Moreover, UBE2C expression was significantly higher in high grade serous adenocarcinoma (SA) when compared with low grade SA; and KAI1 expression was significantly lower in high grade SA when compared with low grade SA. High grade SA patients had higher rates of implants, LNM, and high FIGO stages when compared with low grade SA. High grade SA patients had unfavorably OS time when compared with low grade SA.

UBE2C and KAI1 should be considered as potential biomarkers of EOC prognosis.
Comparison of the effect of propofol and desflurane on S-100β and GFAP levels during controlled hypotension for functional endoscopic sinus surgery
Authors: Jang Ji Su , Kwon Youngsuk , Hwang Sung Mi , Lee Jae Jun , Lee Jun Suck , Lee Soo Kyoung , Lee Ho Seok
Published: November 2019

Background:

Although surgical field visualization is important in functional endoscopic sinus surgery (FESS), the complications associated with controlled hypotension for surgery should be considered. Intraoperative hypotension is associated with postoperative stroke, leading to subsequent hypoxia with potential neurologic injury. We investigated the effect of propofol and desflurane anesthesia on S-100β and glial fibrillary acidic protein (GFAP) levels which are early biomarkers for cerebral ischemic change during controlled hypotension for FESS.

Methods:

For controlled hypotension during FESS, anesthesia was maintained with propofol/remifentanil in propofol group (n = 30) and with desflurane/remifentanil in desflurane group (n = 30). For S-100β and GFAP assay, blood samples were taken at base, 20 and 60 minutes after achieving the target range of mean arterial pressure, and at 60 minutes after surgery.

Results:

The base levels of S-100β were 98.04 ± 78.57 and 112.61 ± 66.38 pg/mL in the propofol and desflurane groups, respectively. The base levels of GFAP were 0.997 ± 0.486 and 0.898 ± 0.472 ng/mL in the propofol and desflurane groups, respectively. The S-100β and GFAP levels were significantly increased in the study period compared to the base levels in both groups (P ≤ .001). There was no significant difference at each time point between the 2 groups.

Conclusion:

On comparing the effects of propofol and desflurane anesthesia for controlled hypotension on the levels of S-100β and GFAP, we noted that there was no significant difference in S-100β and GFAP levels between the 2 study groups.

Clinical trial registration:

Available at: http://cris.nih.go.kr, KCT0002698.
Integrative Korean medicine treatment for temporomandibular joint disorder-induced dysphagia leading to aspiration pneumonia
Authors: Park Ji Eun , Lee Seunghoon
Published: November 2019

Introduction:

Severe temporomandibular joint disorder (TMD) could induce dysphagia, which could lead to aspiration pneumonia. However, no clinical study has reported that TMD-related dysphagia could result in aspiration pneumonia. Integrative Korean medicine (KM) is suggested to be an effective treatment for patients with severe TMD.

Patient concerns:

A 76-year-old female could not open her mouth because of TMD and subsequently experienced dysphagia. To clearly identify the cause of dysphagia and to treat the symptoms, she was admitted to the neurology department. However, she eventually developed aspiration pneumonia. Despite the inpatient treatment and even after pneumonia was cured, TMD symptoms and dysphagia persisted.

Diagnosis:

Based on the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) and the magnetic resonance imaging findings, the patient was diagnosed as having severe TMD with disc displacement without reduction and with limited opening.

Interventions:

Integrative KM treatment, including acupuncture, herbal acupuncture, cupping therapy, Chuna manual therapy, and herbal medicine, was performed during the admission period (23 days).

Outcomes:

The following clinical improvements were detected: maximal unassisted opening from 8 to 28 mm, right lateral movement from 3 to 11 mm, left lateral movement from 10 to 15 mm, and protrusion movement from 5 to 7 mm. Dysphagia disappeared when the TMD symptoms improved.

Conclusion:

Patients with severe TMD might experience dysphagia, which could lead to aspiration pneumonia. Symptoms of severe TMD could be treated with integrative KM treatment.
Reconstruction of midface defects using local flaps
Authors: Chang Jung Woo , Lim Jung Han , Lee Jang Hyun
Published: November 2019

Background:

Local flap surgery is commonly performed to cover defects with appropriate skin color and texture match. The purpose of this study was to present an algorithm for choosing an appropriate flap when reconstructing a midface defect using a local flap.

Methods:

Between February 2013 and February 2019, 38 patients with midface defects underwent local flap surgery. All defects larger than 3 cm in diameter were reconstructed with perforator-based transposition flaps. Defects smaller than 3 cm in diameter were reconstructed differently depending on their location. Defects near the nasolabial fold (NLF) were reconstructed with perforator-based transposition flaps, whereas defects just on the NLF were reconstructed with VY advancement flaps. Defects distant from the NLF were also reconstructed with VY advancement flaps.

Results:

Perforator-based transposition flaps were used in 22 cases and VY advancement flaps were used in 16 cases according to our new algorithm. All flaps survived without any complications. The aesthetic results were superior for VY advancement flaps, with higher patient satisfaction scores. The skin color match was similar for both flaps, but the contour was more natural in advancement flaps than in transposition flaps. However, transposition flaps had the benefits of being able to cover relatively large defects and allowing the donor scar to be hidden in a wrinkle line.

Conclusion:

The most suitable local flap for coverage of a midface defect can be chosen based on the patient's condition. By following our algorithm, appropriate reconstructions can be performed, with satisfactory results.
Irritability and Perceived Expressed Emotion in Adolescents With Iron Deficiency and Iron Deficiency Anemia: A Case-Control Study
Authors: Uçar Halit Necmi , Aydin Köker Sultan , Tekin Uğur
Published: November 2019

The objective of this study was to assess the difference in irritability and perceived expressed emotion (EE) between adolescents with iron deficiency (ID) or iron deficiency anemia (IDA) and their healthy peers. In addition, we aimed to investigate the relationship between hemogram parameters, irritability, and perceived EE in adolescents with ID and IDA. The sample of this single-center cross-sectional case-control study consisted of 89 adolescents from 12 to 17 years of age. Of the participants, 19 had been diagnosed with ID, 31 had IDA, and 39 were healthy controls. Significant differences in the self-reported and parent-reported irritability scores were observed between the ID group and the control group and between the IDA group and the control group. There was also a significant difference in the subscale of irritability between the ID group and the control group. The difference between the IDA and control groups in the intrusiveness subscale was found to be significant as well. Adolescents with IDA and ID exhibited significantly perceived irritability compared with the control group. In terms of irritability, adolescents with IDA and ID revealed greater irritability than their healthy peers. The results of this study suggest that irritability and perceived EE should be investigated in cases of ID, whether with or without anemia. As chronic diseases may benefit substantially from psychiatric consultation, psychosocial evaluation and intervention should be considered a complementary treatment option in the management of ID and IDA.
Closing Nursing's Experience-Complexity Gap
Authors: Virkstis Katherine , Herleth Anne , Rewers Lauren
Published: November 2019

Hospitals and health systems are facing a new kind of shortage among the nursing workforce: a shortage of experience. As older nurses retire and the influx of new nurses continues to grow, the net effect is a decline in the overall experience of the nursing workforce. At the same time, care delivery is becoming more complex. We call this phenomenon “the experience-complexity gap.” If left unaddressed, the experience-complexity gap will widen and could put quality and safety at risk. In this article, the authors explore this new challenge and suggest 3 key strategies for addressing it.
Lymphoid Neoplasms With Plasmablastic Differentiation: A Comprehensive Review and Diagnostic Approaches
Authors: Chen Bo-Jung , Chuang Shih-Sung
Published: November 2019

Plasmablastic neoplasms encompass several entities including plasmablastic lymphoma, plasmablastic plasmacytoma/multiple myeloma, primary effusion lymphoma and its extracavitary variant, anaplastic lymphoma kinase–positive large B-cell lymphoma, and Kaposi sarcoma–associated herpesvirus/human herpesvirus 8 (HHV8)-positive diffuse large B-cell lymphoma, not otherwise specified. Morphologically, the tumor cells are large with eccentrically located nuclei, prominent nucleoli, and basophilic/amphophilic cytoplasm. Immunophenotypically, the tumor cells express plasma cell–related antigens including CD38, CD138, interferon regulatory factor-4 (IRF4)/MUM1, PR domain zinc finger protein-1 (PRDM1), and/or X-box binding protein-1 (XBP1), with frequent loss of CD20. These tumors are diagnostically challenging for general pathologists due to their overlapping morphology and immunophenotype, and due to their rarity, and particularly so when clinical and radiologic information is insufficient. We also discuss HHV8-negative effusion-based lymphoma due to its overlapping features with primary effusion lymphoma. In this review, we focus on the useful diagnostic markers and pertinent molecular findings in these distinct entities and propose a practical diagnostic algorithm using anaplastic lymphoma kinase, HHV8, in situ hybridization for Epstein-Barr virus–encoded small RNA, immunoglobulin M, light chain stains, and clinicoradiologic criteria to avoid misdiagnosis. At the molecular level, MYC protein overexpression with or without MYC rearrangement and PRDM1-inactivating mutations or deletions are noted in a subset of such tumors, especially in plasmablastic lymphoma. Prognosis in these entities is dismal with conventional CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) chemotherapy. Therefore, novel target therapies, such as anti-CD30 agents, and/or immune blockade therapy, are potential treatment options in the future.
Biomarkers of Inflammation and Lung Recovery in Extracorporeal Membrane Oxygenation Patients With Persistent Pulmonary Hypertension of the Newborn: A Feasibility Study
Authors: Pais Paolo , Robinson Simon , Majithia-Beet Gavin , Lotto Attilio , Kumar Tracy , Westrope Claire , Sullo Nikol , Eagle Hemming Bryony , Joel-David Lathishia , JnTala Maria , Corazzari Claudio , Grazioli Lorenzo , Smallwood Dawn , Murphy Gavin J. , Lai Florence Y. , Woźniak Marcin J.
Published: November 2019

Objectives:

Extracorporeal membrane oxygenation is a treatment for Persistent Pulmonary Hypertension of the Newborn with high mortality. Hypothesis: the extracorporeal membrane oxygenation circuit results in inflammatory responses that mitigate against successful weaning.

Design:

Single-center prospective observational feasibility study.

Setting:

PICU.

Patients:

Twenty-four neonates requiring extracorporeal membrane oxygenation support for Persistent Pulmonary Hypertension of the Newborn.

Interventions:

None.

Measurements and Main Results:

The reference outcome was death or more than 7 days of extracorporeal membrane oxygenation support. Other outcomes included serial measures of plasma-free hemoglobin and markers of its metabolism, leucocyte, platelet and endothelial activation, and biomarkers of inflammation. Of 24 participants recruited between February 2016 and June 2017, 10 died or required prolonged extracorporeal membrane oxygenation support. These patients were sicker at baseline with higher levels of plasma-free hemoglobin within 12 hours of cannulation (geometric mean ratio, 1.92; 95% CIs, 1.00–3.67; p = 0.050) but not thereafter, versus those requiring less than 7 days extracorporeal membrane oxygenation. Serum haptoglobin concentrations were significantly elevated in both groups. Patients who died or required prolonged extracorporeal membrane oxygenation support demonstrated elevated levels of platelet-leucocyte aggregation, but decreased concentrations of mediators of the inflammatory response: interleukin-8, C-reactive protein, and tumor necrosis factor α.

Conclusions:

Clinical status at baseline and not levels of plasma-free hemoglobin or the systemic inflammatory response may determine the requirement for prolonged extracorporeal membrane oxygenation support in neonates.
A Preliminary Dynamic Investigation on Velopharyngeal Movements During Blowing: A New Approach for Evaluation
Authors: Qiu Qiu , Yuchen Wang , Chenghui Jiang , Binbing Wang , Lili Qi , Sheng Li , Hongbing Jiang , Xinghui Shi
Published: November 2019

Purpose:

To explore an alternative approach to evaluate velopharyngeal function on those speakers with compensatory misarticulation.

Method:

Nasopharyngeal endoscopy was used to observe the velopharyngeal movement on 26 adult Mandarin speakers during articulation and different nonverbal state, including SCPS, DCPS, and ABS.

Results:

There were significant differences for the rate of velopharyngeal incompetence (RVPI) among the 4 different states. The RVPI was least for the Articulation State, followed by the Air Blowing and DCPS. The RVPI was largest for the SCPS.

Conclusion:

The result indicated that the ABS may be used as an alternative approach to evaluate the velopharyngeal function instead of the articulation samples while patients cannot make clear articulation due to compensatory misarticulation habits. It merits further study on nonverbal activities, which could lay a foundation for exploring more effective approach for evaluation of the velopharyngeal function.
Novel transformer networks for improved sequence labeling in genomics
Authors: Clauwaert Jim , Waegeman Willem
Published: November 2019

In genomics, a wide range of machine learning methodologies have been investigated to annotate biological sequences for positions of interest such as transcription start sites, translation initiation sites, methylation sites, splice sites and promoter start sites. In recent years, this area has been dominated by convolutional neural networks, which typically outperform previously-designed methods as a result of automated scanning for influential sequence motifs. However, those architectures do not allow for the efficient processing of the full genomic sequence. As an improvement, we introduce transformer architectures for whole genome sequence labeling tasks. We show that these architectures, recently introduced for natural language processing, are better suited for processing and annotating long DNA sequences. We apply existing networks and introduce an optimized method for the calculation of attention from input nucleotides. To demonstrate this, we evaluate our architecture on several sequence labeling tasks, and find it to achieve state-of-the-art performances when comparing it to specialized models for the annotation of transcription start sites, translation initiation sites and 4mC methylation inE. coli.
Single-cell repertoire tracing identifies rituximab refractory B cells during myasthenia gravis relapses
Authors: Jiang Ruoyi , Fichtner Miriam L. , Hoehn Kenneth B. , Stathopoulos Panos , Nowak Richard J. , Kleinstein Steven H. , O’Connor Kevin C.
Published: November 2019

Rituximab, a B cell-depleting therapy, is indicated for treating a growing number of autoantibody-mediated autoimmune disorders. However, relapses can occur after treatment and autoantibody-producing B cell subsets may be found during relapses. It is not understood if these autoantibody-producing B cell subsets emerge from the failed depletion of pre-existing B cells or are re-generated de novo. To further define the mechanisms that cause post-rituximab relapse, we studied patients with autoantibody-mediated muscle-specific kinase (MuSK) myasthenia gravis (MG) who relapsed after treatment. We carried out single-cell transcriptional and B cell receptor (BCR) profiling on longitudinal B cell samples. We identified clones present prior to therapy that continued to persist during relapse. Persistent B cell clones included both antibody-secreting cells and memory B cells characterized by gene expression signatures associated with B cell survival. A subset of persistent antibody-secreting cells and memory B cells were specific for the MuSK autoantigen. These results demonstrate that rituximab is not fully effective at eliminating autoantibody-producing B cells and provide a mechanistic understanding of post-rituximab relapse in MuSK MG.
Detection of pre-microRNA with Convolutional Neural Networks
Authors: Cordero Jorge , Menkovski Vlado , Allmer Jens
Published: November 2019

MicroRNAs (miRNAs) are small non-coding RNA sequences that have been implicated in many physiological processes and diseases. The experimental discovery of miRNAs is complicated because both miRNAs and their targets need to be expressed for the confirmation of functional interactions, but expression is under spatiotemporal control. This has motivated the development of computational methods for miRNA detection. This typically involves feature design by domain experts followed by machine learning. While handcrafted features can encode domain knowledge, feature engineering is a time-consuming task. Additionally, some of the currently most successful features for pre-miRNA detection, such as p-value based ones, require comparably large computations. In contrast, advances of representation learning methods such as deep learning can discover relevant features directly from data. Here, we propose a method that uses domain knowledge to create an efficient graphical representation of pre-miRNAs, encoding sequence, structure, and implicitly some thermodynamic information. A suitable convolutional neural network architecture for pre-miRNA detection was used to train a model. This model achieves state-of-the-art performance on all previously used datasets. Additionally, computations succeed in real time thereby overcoming current speed limitations. Finally, our strategy promises future interpretability of the trained models and in turn novel biological interpretations of pre-miRNA characteristics.
Rapid Ultrastructural Changes of PSD and Extrasynaptic Axon-spine Interface Membrane during LTP Induced in Single Dendritic Spine
Authors: Sun Ye , Smirnov Michael , Kamasawa Naomi , Yasuda Ryohei
Published: November 2019

Structural plasticity of dendritic spines is considered to be the basis of synaptic plasticity, learning and memory. Here, we performed ultrastructural analysis of spines undergoing LTP using a novel high throughput correlative light-electron microscopy approach. We found that the PSD displays rapid (< 3 min) reorganization of its nanostructure, including perforation and segmentation. This increased structural complexity is maintained over intermediate and late phases of LTP (20 and 120 min). In a few spines, segmented PSDs are connected to different presynaptic terminals, producing a multi-innervated spine in the intermediate and late phases. In addition, the area of extrasynaptic axon-spine interface (eASI) displayed a pronounced, rapid and sustained increase. Finally, presynaptic vesicle number increased slowly and became significantly higher at late phases of LTP. These rapid ultrastructural changes in PSD and surrounding membrane, together with the slow increase in presynaptic vesicle number, likely support the rapid and sustained increase in synaptic transmission during LTP.
Learning cis-regulatory principles of ADAR-based RNA editing from CRISPR-mediated mutagenesis
Authors: Liu Xin , Sun Tao , Shcherbina Anna , Li Qin , Kappel Kalli , Jarmoskaite Inga , Ramaswami Gokul , Das Rhiju , Kundaje Anshul , Li Jin Billy
Published: November 2019

Adenosine-to-inosine (A-to-I) RNA editing catalyzed by ADAR enzymes occurs in double-stranded RNAs (dsRNAs). How the RNA sequence and structure (i.e., the cis-regulation) determine the editing efficiency and specificity is poorly understood, despite a compelling need towards functional understanding of known editing events and transcriptome engineering of desired adenosines. We developed a CRISPR/Cas9-mediated saturation mutagenesis approach to generate comprehensive libraries of point mutations near an editing site and its editing complementary sequence (ECS) at the endogenous genomic locus. We used machine learning to integrate diverse RNA sequence features and computationally predicted structures to model editing levels measured by deep sequencing and identified cis-regulatory features of RNA editing. As proof-of-concept, we applied this integrative approach to three editing substrates. Our models explained over 70% of variation in editing levels. The models indicate that RNA sequence and structure features synergistically determine the editing levels. Our integrative approach can be broadly applied to any editing site towards the goal of deciphering the RNA editing code. It also provides guidance for designing and screening of antisense RNA sequences that form dsRNA duplex with the target transcript for ADAR-mediated transcriptome engineering.
Depicting the crystal structure of fibrous ferrierite from British Columbia using a combined synchrotron techniques approach
Authors: Giacobbe Carlotta , Wright Jonathan , Dejoie Catherine , Tafforeau Paul , Berruyer Camille , Vigliaturo Ruggero , Gieré Reto , Gualtieri Alessandro F.
Published: November 2019

The ferrierite crystal structure has often been subject to discussion because of the possible lowering of symmetry from the space group Immm. It mainly occurs in nature with a fibrous crystal habit, and because of the existence of line/planar defects in the framework, texture and preferred orientation effects it has been difficult to obtain an exact crystallographic model based only on the results from powder diffraction data. Therefore, nano-single-crystal diffraction and tomography data have been combined in order to improve the refinement with a meaningful model. High-quality single-crystal data, providing reliable structural information, and tomography images have been used as input for a Rietveld refinement which took into account a phenomenological description of stacking disorder and the analytical description of the preferred orientation, by means of spherical harmonics for strong texture effects. This is one of the first examples of application of synchrotron nano-diffraction for the structure solution of fibrous minerals of micrometre to nanometre size. The high quality of the crystals allowed collection of single-crystal X-ray diffraction data of up to 0.6 Å resolution, leading to an unambiguous solution and precise anisotropic refinement. Nano-single-crystal diffraction and phase contrast tomography data were collected at ID11 and the high-resolution powder diffraction patterns at ID22 of the European Synchrotron Radiation Facility. This detailed crystallographic characterization provides a basis for understanding the potential of ferrierite for toxicity and carcinogenicity.
Is party factionalism harmful or beneficial to party development
Authors: Hung Chung Fun Steven
Published: November 2019

Purpose

The purpose of this paper is to assess the intra-party conflicts in Hong Kong’s Democratic Party (DP) and their implications for broader democratic processes in the territory. It also examines some other thematic issues including: the party’s policy decision-making process, candidate selection, party membership and mergers, and their overall relevance for democratisation in Hong Kong.

Design/methodology/approach

The study gives a historical review of intra-party conflicts. The concept of factionalism is applied to better understand the DP in Hong Kong’s political space.

Findings

Hong Kong is unique and popular models of party conflicts are hardly applicable to the country. Intra-party conflict is an obvious, expected conflict because of differences in formation, leadership, manifestoes and ideologies. The present author tries to examine the case with a view to making a novel contribution.

Originality/value

The study of political factionalism is not uncommon in Hong Kong but this paper intends to study intra-party elite conflicts and self-democratisation of the Hong Kong DP as a case study which is seldom addressed. Consolidation is a possible scenario and its presence is evident when political elites increasingly demonstrate commitment towards creating a democratic regime and when they hold strong beliefs in democratic procedures and institutions as crucial to governing public life.
Influence of “health” versus “commercial” physical activity message on snacking behavior
Authors: Kergoat Marine , Meyer Thierry , Legal Jean-Baptiste
Published: November 2019

Purpose

This study aims to investigate whether the effect of exposure to video communication displaying physical activity (PA) would affect viewers’ snacking behavior depending on the type of message. Specifically, it is expected that food intake would be significantly higher when the message is labeled as a “commercial message” rather than a “health message”.

Design/methodology/approach

Two experimental studies are conducted that manipulate the type of message (commercial message vs health message). In Study 1, the participants’ level of involvement (low vs high) is also manipulated. In Study 2, the intensity of the PA displayed in the videos (low vs high) is manipulated, and a control group is included. The main dependent variable is the number of sweets eaten while watching the ad.

Findings

Results from both studies show that the influence of a PA exposure on food intake is influenced by the nature of the communication. Participants exposed to the commercial message eat more sweets than those exposed to the health message (ηp2= 0.06). Being exposed to a health message elicits self-regulated eating behaviors with no more sweets eaten than in the control group. In addition, the effect of the type of message is moderated by the intensity of the PA displayed. The difference of sweets consumed depending on the type of message is significant only when the physical intensity displayed is low.

Research limitations/implications

The present research emphasizes the moderating role of the type of communication on food intake when recipients are exposed to a PA message. Further research must be conducted to enlarge the understanding of the phenomenon considering other critical variables such as inter-individual differences (e.g. body mass index and self-regulation skills), types of food (e.g. healthy vs unhealthy) and other contexts (e.g. watching sports events on television).

Practical implications

The present findings have implications for marketers, health practitioners, policymakers and consumers. They stress the significance of how the implicit goals of the messages are taken into account within consumers’ information processing and how this can affect subsequent consumption behaviors. PA displayed through a commercial message has the most negative impact on food intake, especially when the intensity of PA is low. PA displayed through a health message shows no impact on food intake, whatever the intensity of the PA. It emphasizes the importance of combining exposure to PA through advertising or sporting events to a message promoting healthy and balanced eating behaviors.

Originality/value

The value of the present research lies in an additional understanding of the complex effect of passive exposure to a PA message on subsequent food consumption. Furthermore, the present study expands research on persuasive communication and has critical implications for public health issues.
Collaborative governance as a policy strategy in healthcare
Authors: Frankowski Andrea
Published: November 2019

Purpose

The purpose of this paper is to examine the enactment of collaborative governance as a policy strategy in healthcare – in particular its effects in coordinating multiple collaborative initiatives dedicated to improve the performance of health organizations. It studies overarching governance mechanisms that serve as platforms at a meta-level between policy and frontline practice.

Design/methodology/approach

Four collaborative governance arrangements dedicated to improve health outcomes in the Netherlands are analyzed in a comparative case-study design, based on extensive document analysis (n=121) and interviews (n=56) with key stakeholders in the field, including the Dutch Ministry of Health, health organizations and other actors.

Findings

The studied policy-based governance mechanisms for the coordination of multiple micro-level collaborative initiatives function partly as platforms in bringing actors and resources together successfully. They do so, by fostering evolvability (the capacity to generate diversity in emergent ways) in relation to goal-setting and intermediation between actors. Yet, they marginalize open access to participants through high selectivity and deliberate exclusion strategies for certain actors, contrary to a platform logic of action.

Research limitations/implications

While the collaborative governance literature focuses on these dimensions as independent elements, findings reveal both trade-offs and interdependencies between studied dimensions of coordination associated with platforms, that need to be negotiated and managed.

Practical implications

Selectivity and exclusion in collaborative arrangements may negatively affect relational bonds and ties between actors, which challenges the application of collaborative governance as a policy strategy in pursuit of health objectives.

Originality/value

Responding to recent calls in the literature, this study applies ideas from public administration to the field of health organization and management to avert failures in the translation of policy ambitions into health practice.
An estimation of the underground economy and tax evasion
Authors: Amoh John Kwaku , Adafula Babonyire
Published: November 2019

Purpose

This paper aims to use an econometric model to estimate tax evasion from the size of the underground economy and examined the factors that trigger it.

Design/methodology/approach

The study used time series data sourced from world development indicators and Bank of Ghana covering the period 1990-2015 to estimate tax evasion from the underground economy using an autoregressive distributed lag model drawing on the currency demand approach.

Findings

The results confirmed the existence of a large underground economy and a high incidence of tax evasion in Ghana. The Ghanaian situation has been aggravated by an underground economy-triggering factor of mobile money activities, which increased by 83.1 per cent in 2015. Tax evasion averaged 20.78 per cent of GDP over the period. The study, thus, concludes that the increased number of mobile money activities, high tax burden and unemployment contribute to the worsening of the tax evasion problem in Ghana.

Originality/value

The study is one of the premier attempts to introduce electricity power consumption variables in the currency demand model to estimate tax evasion from the size of the underground economy. The authors hypothesize that the emergence of mobile money activities in its current form triggers underground and tax-evading activities. The study, thus, calls for the formalization and regulation of the operations of mobile money activities in emerging economies as a way of managing the underground economy, which incubates tax evasion.
An operating environment-based preventive maintenance decision model
Authors: Jiang Aiping , Li Qingxia , Yan Jinyi , Huang Leqing , Wu Haining
Published: November 2019

Purpose

The purpose of this paper is to focus on finding the optimal maintenance interval and the minimum maintenance cost for redundant system, considering environment factors.

Design/methodology/approach

The authors propose a decision model with environment-based preventive maintenance for the repairable redundant system. Referring to the k-out-of-n model and Proportional Hazard Model, the reliability analysis is completed for the redundant system affected by internal and external issues. Meanwhile, the maintenance cost for the redundant system is divided into two categories: the fixed maintenance cost involving whole system replacement at the time of system failure, and the cost to replace failure components when the system still functions.

Findings

Upon the required reliability analysis, an optimal maintenance interval that minimizes the average maintenance cost per unit time is identified. The simulation results indicate that the optimal maintenance interval with consideration of environmental factors is significantly shorter than that without consideration of these factors, with the maintenance cost increase within 10 percent.

Practical implications

The redundant systems have widely been used in industries including the aero craft control system and warship power system. The model could be applied in the more real case considering the types of components and the operation environment, and help production managers better maintain machines by increasing the safety and reliability of the redundant model with the more frequent inspection.

Originality/value

Previous research of redundant system always focuses on internal degradation, while ignoring the reliability analysis for a redundant system with various multiple components under the influence of environment. However, this work could fill the theoretical gap, i.e. simultaneously consider both environmental and internal factors for a redundant system with non-homogeneous components. Meanwhile, the proposed superior model increases the reliability and safety of the k-out-of-n model with reasonable cost. Production managers could benefit a lot from this as well.
Health-care marketing in an omni-channel environment
Authors: Swan Eric L. , Dahl Andrew J. , Peltier James W.
Published: November 2019

Purpose

Consumers have increased access to digital health tools such as social media, websites and marketer-controlled platforms for information sharing. Telemedicine (TM) represents an emerging omni-channel touchpoint for consumers to exchange information and inform health decision-making at a time and place of their choosing. While TM offers great potential, consumer adoption has been slower than expected. This paper aims to investigate attitudinal factors that influence adoption and usage of TM within consumers’ omni-channel decision-making environment.

Design/methodology/approach

Surveys from 869 patients were analyzed using multiple linear regression to examine the relationships between health decision-making, TM access benefits and omni-channel touchpoints (social media, website and internal health digital channels usage) on TM usage likelihood.

Findings

Attitudinal constructs related to TM’s benefits including access and health decision-making have the strongest impact on future TM usage. The study also empirically demonstrates a link between consumers’ omni-channel information seeking and TM usage.

Research limitations/implications

Increasing consumers’ involvement across omni-channel touchpoints has an additive effect on perceived benefits for engaging consumers in using digital offerings like TM. Future research is needed that examines the interrelationships on consumers’ health decision-making across generational cohorts and the post-adoption effects of digital service offerings.

Practical implications

Omni-channel touchpoints such as TM provide new opportunities to enhance shared decision-making. However, marketers need to adopt strategies that accommodate consumers’ evolving omni-channel preferences for access and information exchange to synergize digital service offerings with interpersonal touchpoints.

Originality/value

This study integrates shared decision-making, technology acceptance and omni-channel marketing literature to explore TM acceptance and usage within the context of consumers’ omni-channel decision process.
The relationship between dietary intakes during pregnancy and incidence of postpartum depression: a case-control study
Authors: Amini Shirin , Jafarirad Sima , Amani Reza , Sayyah Bargard Mehdi , Cheraghian Bahman , Hemmati Ali Asghar
Published: November 2019

Purpose

Post-partum depression (PPD) is a mood disorder that affects 20-40 per cent of women in their post-delivery period worldwide. The purpose of this paper is to compare dietary intakes of energy, macronutrients, cholesterol, saturated fatty acids (SFAs), mono-unsaturated fatty acids (MUFAs), poly-unsaturated fatty acids (PUFAs), some micronutrients and antioxidants in PPD patients with healthy controls.

Design/methodology/approach

This case-control study was conducted on 163 women in postpartum period (81 PPD and 82 non-PPD) using Edinburgh questionnaire for the diagnosis of PPD. Dietary nutrients intake was assessed using 147-item semi-quantitative food frequency questionnaire (FFQ). Portion sizes of food items were converted to grams per day. Logistic regression models were used to estimate the association between tertiles of dietary intakes with the odds ratio (OR) of PPD.

Findings

According to the fully adjusted model, highest tertile compared to lowest tertile dietary intake of SFAs [OR = 0.01; 95 per cent confidence interval (CI) = 0.00, 0.01, p = 0.001], MUFAs (OR = 0.01; 95 per cent CI = 0.00, 0.02, p < 0.001), total fats (OR = 0.01; 95 per cent CI =0.00, 0.01, p < 0.001) and cholesterol (OR = 0.06 ; 95 per cent CI = 0.01, 0.08, p < 0.001), thiamine (OR = 0.01; 95 per cent CI = 0.00, 0.01, p < 0.001), riboflavin (OR = 0.10; 95 per cent CI = 0.02, 0.39, p < 0.001), pyridoxine (OR = 0.03; 95 per cent CI =0.01, 0.32, p < 0.001), folate (OR = 0.01; 95 per cent CI = 0.00, 0.01, p < 0.001), cobalamine (OR = 0.01; 95 per cent CI = 0.00, 0.01, p < 0.001) , selenium (OR = 0.79 ; 95 per cent CI =1.36, 3.32, p < 0.001), iron (OR =0.68; 95 per cent CI = 0.24, 0.94, p < 0.001) and iodine (OR = 0.36; 95 per cent CI =1.10, 1.38, p < 0.001) had a protective effect on the incidence of PPD. Furthermore, higher intake of vitamin A and beta-cryptoxanthin can increase the incidence of PPD (OR =114.29; 95 per cent CI =17.85, 118.12, p < 0.001) and (OR = 4.85; 95 per cent CI = 1.49, 15.69, p = 0.015), respectively.

Originality/value

PPD may have destructive effects on the relationship between mother and infant. Results of previous studies demonstrated nutrients are required for the synthesis of neurotransmitters and have biochemical role in the nervous system.
Induced phenological avoidance: A neglected defense mechanism against seed predation in plants
Authors: Sercu Bram K. , Moeneclaey Iris , Bonte Dries , Baeten Lander
Published: November 2019

Flowering phenology is an important life‐history trait affecting plant reproductive performance and is influenced by various abiotic and biotic factors. Pre‐dispersal seed predation and pollination are expected to impose counteracting selection pressure on flowering phenology, with pre‐dispersal seed predation expected to favour off‐peak flowering and pollination to favour synchronous flowering.

Here we studied the effect of pre‐dispersal seed predation by the beetle Byturus ochraceus, a specialist seed herbivore, on the flowering phenology of Geum urbanum. This forest understorey plant species is self‐pollinating, so that the influence of seed predation can be studied independent from pollination. We measured in detail the timing and predation rate of individual flowers during two consecutive years in more than 60 individuals. We tested the hypotheses that pre‐dispersal seed predation exerts selection for within‐season compensatory flowering as well as for induced phenological avoidance in the following season.

We found no indication for compensatory flowering within a growing season, but plants that experienced predation shifted their flowers to the end of the flowering season the subsequent year. This induced phenological avoidance points to a plastic response to pre‐dispersal seed predation that may be adaptive. Importantly, the delay in flower production came at a cost, since flowers later in the season had a reduced seed output, presumably because of increasing light limitation following forest canopy closure.

Synthesis. Herbivory by specialist enemies can cause serious fitness decline in hosts. We here show that induced shifts in phenology can form an important defense strategy against pre‐dispersal seed predation. The induced mismatches between herbivore and host phenology are anticipated to be adaptive when herbivory is predictable across successive flowering periods.
Histological and computed tomographic characteristics of the sinonasal structure of BALB/c mice
Authors: Wang Zhiyuan , Chang Lihong , Huang Jiancong , Huang Zizhen , Li Xia , Chen Xiaohong , Lai Xiaoping , Zhang Gehua
Published: November 2019

Mice models were used to study the pathogenesis of mice and human diseases. Although some mice models of allergic rhinitis and rhinosinusitis have been reported, no detailed anatomic, histological and computed tomographic comparative data of the normal murine sinus are available in the literature for new researchers to establish mice models. The purpose of this study was to clarify the histological and computed tomographic characteristics of the normal nasal sinus in BALB/c mice. Fifteen sinonasal specimens were collected. Five mice were subjected to micro‐computed tomography imaging, and then dissected to observe its anatomic landmarks, and 10 mice were subjected to haematoxylin and eosin staining. Important anatomic landmarks were clearly demonstrated, including the ethmoturbinates, nasoturbinal, maxilloturbinate, ethmoid sinus, maxillary sinus, nasopharyngeal duct, nasolacrimal duct and vomeronasal organ. Full and typical sinonasal landmarks can be visualized by gross anatomy, micro‐computed tomography imaging and haematoxylin and eosin staining, which will be useful for establishing the mouse models of nasal disease.