bluuebunny/crossref_metadata_2025 huggingface dataset:
Survival of Patients With Vancomycin-Resistant Enterococcus faecium Bacteremia Treated With Conventional or High Doses of Daptomycin or Linezolid Is Associated With the Rate of Bacterial Clearance*
Authors: Chuang Yu-Chung , Lin Hsin-Yi , Chen Pao-Yu , Lin Chi-Ying , Chen Yee-Chun , Wang Jann-Tay , Chang Shan-Chwen
Published: June 2018

Objectives:

Vancomycin-resistant enterococci are important pathogens for healthcare-associated infections. Although linezolid is bacteriostatic and daptomycin is rapidly bactericidal against vancomycin-resistant enterococci in vitro, it is not clear whether they differ in their effect on bacterial clearance in patients with vancomycin-resistant enterococci bloodstream infections.

Design:

Prospective observational study.

Setting:

Two university hospitals and research laboratory.

Patients:

Patients with vancomycin-resistant enterococci bloodstream infection proven by blood cultures were prospectively enrolled from January 2010 to July 2015.

Interventions:

Sequential blood samples were collected. Real-time quantitative polymerase chain reaction was used to monitor bacterial loads.

Measurements and Main Results:

One hundred eight patients with vancomycin-resistant enterococci bloodstream infection were enrolled. Quantitative polymerase chain reaction assays were performed on 465 blood isolates. We found this method to be closely correlated with colony-forming units and more sensitive than culture. Sixty-three patients (58.3%) received “conventional dose” daptomycin (6–9 mg/kg), 15 (13.9%) received high-dose daptomycin (≥ 9 mg/kg), and 30 (27.8%) were treated with linezolid (600 mg every 12 hr) as sole agents. The initial mean bacterial load was 1.03 log10 copies/mL and unrelated to survival. Survivors had a more rapid early bacterial clearance than nonsurvivors (Δ log10 copies/mL/d; –0.16 vs 0.31; p = 0.02). Multivariable logistic regression showed that a slower early bacterial clearance independently predicted increased mortality (odds ratio, 3.21; 95% CI, 1.03–10.02; p = 0.045). Conventional dose daptomycin was associated with a significantly slower rate of bacterial clearance than high-dose daptomycin (Δ log10 copies/mL/d; –0.04 vs –0.41; p < 0.001) and linezolid (–0.04 vs –0.56; p = 0.043).

Conclusions:

We found that survivors of vancomycin-resistant enterococci bloodstream infection had a significantly more rapid early bacterial clearance by quantitative polymerase chain reaction than nonsurvivors. High-dose daptomycin and linezolid were associated with more rapid bacterial clearance than conventional dose daptomycin. These results support recommendations that conventional dose daptomycin not be used for the treatment of patients with vancomycin-resistant enterococci bloodstream infection.
Microcirculatory Impairment Is Associated With Multiple Organ Dysfunction Following Traumatic Hemorrhagic Shock: The MICROSHOCK Study
Authors: Hutchings Sam D. , Naumann David N. , Hopkins Philip , Mellis Clare , Riozzi Paul , Sartini Stefano , Mamuza Jasna , Harris Tim , Midwinter Mark J. , Wendon Julia
Published: June 2018

Objectives:

To assess the relationship between microcirculatory perfusion and multiple organ dysfunction syndrome in patients following traumatic hemorrhagic shock.

Design:

Multicenter prospective longitudinal observational study.

Setting:

Three U.K. major trauma centers.

Patients:

Fifty-eight intubated and ventilated patients with traumatic hemorrhagic shock.

Interventions:

Sublingual incident dark field microscopy was performed within 12 hours of ICU admission (D0) and repeated 24 and 48 hours later. Cardiac output was assessed using oesophageal Doppler. Multiple organ dysfunction syndrome was defined as Serial Organ Failure Assessment score greater than or equal to 6 at day 7 post injury.

Measurements and Main Results:

Data from 58 patients were analyzed. Patients had a mean age of 43 ± 19 years, Injury Severity Score of 29 ± 14, and initial lactate of 7.3 ± 6.1 mmol/L and received 6 U (interquartile range, 4–11 U) of packed RBCs during initial resuscitation. Compared with patients without multiple organ dysfunction syndrome at day 7, patients with multiple organ dysfunction syndrome had lower D0 perfused vessel density (11.2 ± 1.8 and 8.6 ± 1.8 mm/mm2; p < 0.01) and microcirculatory flow index (2.8 [2.6–2.9] and 2.6 [2.2–2.8]; p < 0.01) but similar cardiac index (2.5 [± 0.6] and 2.1 [± 0.7] L/min//m2; p = 0.11). Perfused vessel density demonstrated the best discrimination for predicting subsequent multiple organ dysfunction syndrome (area under curve 0.87 [0.76–0.99]) compared with highest recorded lactate (area under curve 0.69 [0.53–0.84]), cardiac index (area under curve 0.66 [0.49–0.83]) and lowest recorded systolic blood pressure (area under curve 0.54 [0.39–0.70]).

Conclusions:

Microcirculatory hypoperfusion immediately following traumatic hemorrhagic shock and resuscitation is associated with increased multiple organ dysfunction syndrome. Microcirculatory variables are better prognostic indicators for the development of multiple organ dysfunction syndrome than more traditional indices. Microcirculatory perfusion is a potential endpoint of resuscitation following traumatic hemorrhagic shock.
Evaluation of Effect of Probiotics on Cytokine Levels in Critically Ill Children With Severe Sepsis: A Double-Blind, Placebo-Controlled Trial*
Authors: Angurana Suresh K. , Bansal Arun , Singhi Sunit , Aggarwal Ritu , Jayashree Muralidharan , Salaria Manila , Mangat Navdeep K.
Published: June 2018

Objectives:

To evaluate the effect of probiotics on cytokines in children with severe sepsis.

Design:

Randomized, double-blind, placebo-controlled trial.

Setting:

ICU of a tertiary care teaching hospital in North India.

Patients:

Children 3 months to 12 years old with severe sepsis.

Interventions:

Enrolled children were randomized to probiotic (n = 50) and placebo (n = 50) groups. Probiotic group received VSL#3 (Danisco-Dupont USA, Madison, WI) (Lactobacillus paracasei, L. plantarum, L. acidophilus, L. delbrueckii, Bifidobacterium longum, B. infantis, B. breve, Streptococcus salivarius; maltose and silicon dioxide), and placebo group received maltose and silicon dioxide. Dose was 1 sachet twice daily for 7 days. Blood was collected on days 1 and 7 for estimation of interleukin-6, interleukin-12p70, interleukin-17, tumor necrosis factor-α, interleukin-10, and transforming growth factor -β1. “Primary outcome”: Change in cytokine levels in probiotic and placebo groups from day 1 to 7. “Secondary outcomes”: Sequential Organ Failure Assessment score, healthcare-associated infections, ICU stay, and mortality.

Measurements and Main Results:

On day 7, probiotic group had significantly lower levels of proinflammatory cytokines (interleukin-6 [80 vs 186 pg/mL, p = 0.001]; interleukin-12p70 [44 vs 79 pg/mL, p = 0.001]; interleukin-17 [217 vs 293 pg/mL, p = 0.01]; and tumor necrosis factor-α [192 vs 348 pg/mL, p = 0.01]) and higher levels of antiinflammatory cytokines (interleukin-10 [320 vs 240 pg/mL, p = 0.02] and transforming growth factor-β1 [311 vs 221 ng/mL, p = 0.01]) than placebo group. From day 1 to 7, probiotic group showed significant decrease in proinflammatory cytokines (interleukin-6 [196–80 pg/mL, p = 0.001]; interleukin-12p70 [71–44 pg/mL, p = 0.01]; interleukin-17 [258–217 pg/mL, p = 0.01]; and tumor necrosis factor-α [347–192 pg/mL, p = 0.001]) and increase in antiinflammatory cytokines (interleukin-10 [198–320 pg/mL, p = 0.001] and transforming growth factor-β1 [216–311 ng/mL, p = 0.001]) as compared to placebo group. Sequential Organ Failure Assessment score on day 7 was significantly less in probiotic group (1 vs 3). There was a nonsignificant trend toward lower incidence of healthcare-associated infections (14% vs 20%) and duration of ICU stay (6.5 vs 9 d) in probiotic group. Mortality was similar in two groups.

Conclusions:

Probiotics supplementation for 7 days resulted in significant decrease in proinflammatory and increase in antiinflammatory cytokines in children with severe sepsis.
Liquid Biopsies to Monitor Solid Organ Transplant Function: A Review of New Biomarkers
Authors: Verhoeven Jeroen G. H. P. , Boer Karin , Van Schaik Ron H. N. , Manintveld Olivier C. , Huibers Manon M. H. , Baan Carla C. , Hesselink Dennis A.
Published: June 2018

Despite modern immunosuppressive therapy, allograft rejection remains a major cause of solid organ transplant dysfunction. For clinical care, organ transplant function is routinely monitored by measuring biomarkers that, depending on the organ transplanted, include serum creatinine, N-terminal pro-hormone of brain natriuretic peptide (NT-proBNP), and aspartate aminotransferase. All can be measured easily in clinical chemistry laboratories. The main problem with these biomarkers is that they have a low sensitivity for the detection of allograft damage and are nonspecific for the detection of allograft rejection. To diagnose rejection, histologic examination of grafted tissue is necessary, which requires an invasive biopsy procedure. There is thus an unmet need in transplantation medicine for biomarkers that are specific for rejection, identify graft injury at an early stage, and may eventually overcome the need for a transplant biopsy. Recently, tremendous progress in the field of biomarkers has been made. In this narrative review, the potential of donor-derived cell-free DNA (ddcfDNA), cell-free nucleosomes, and extracellular vesicles to act as next-generation biomarkers for solid organ transplant is discussed. Based on the fact that cell content is released during rejection, these markers could serve as very specific biomarkers for allograft injury and rejection. These markers have the potential to improve rejection monitoring, evaluate the response to antirejection therapy, and may decrease the need for invasive procedures.
Individual and organizational psychosocial predictors of hospital doctors’ work-related well-being: A multilevel and moderation perspective
Authors: Teoh Kevin R.H. , Hassard Juliet , Cox Tom
Published: June 2018

Background:

The high prevalence of burnout and depression among doctors highlights the need to understand the psychosocial antecedents to their work-related well-being. However, much of the existing research has been atheoretical, operationalized a narrow measurement of well-being, and predominantly examined such relationships at the individual level.

Purpose:

This study uses a multilevel perspective to examine individual (i.e., job demands and resources) and organizational-level psychosocial predictors of three measures of work-related well-being: perceived stress, presenteeism, and work engagement. The job demands–resources theory underpins the postulated relationships.

Methodology:

The 2014 National Health Service Staff Survey was analyzed using multilevel modeling in MPlus. The data set involved 14,066 hospital-based doctors grouped into 157 English hospital organizations (i.e., Trusts).

Results:

Congruent with job demands–resources theory, job demands (workplace aggression and insufficient work resources) were stronger predictors of perceived stress and presenteeism than job resources. Equally, job resources (job control and manager support) were generally stronger predictors of work engagement than job demands. At the organizational level, bed occupancy rates and number of emergency admissions predicted work engagement. No hypothesized individual or multilevel interactions were observed between any of the job demands and resources.

Practical Implications:

The findings emphasize that a broader perspective of work-related well-being among hospital doctors should be employed and the empirical value of examining such relationships from a multilevel perspective. Successful health intervention should target the appropriate antecedent pathway and recognize the role of organizational-level factors when trying to manage hospital doctors’ work-related well-being.
Impact of Acetic Acid on HPV Testing Using Hybrid Capture 2
Authors: Pina Annick , Sauthier Philippe , Coutlée François , Trottier Helen , Mayrand Marie-Hélène
Published: June 2018

Objectives

As per the American Society for Colposcopy and Cervical Pathology guidelines, human papillomavirus (HPV) testing is currently used as part of cervical cancer screening and during colposcopy follow-up. The present project evaluated if the application of acetic acid (AA) impacts HPV test results.

Methods

We conducted a prospective nonrandomized interventional study. Participants referred for colposcopy were eligible if immunocompetent, older than 18 years, and not pregnant. Women in group A (controls) received 2 consecutive HPV tests without application of AA. Women in group B had a first HPV sample collected before the application of AA and a second sample collected 3 minutes after application of AA. Samples were tested for HPV DNA with Hybrid Capture 2 (HC2) according to the manufacturer’s instructions.

Results

From October 17, 2012, to January 10, 2013, approximately 101 women were recruited in 2 colposcopy clinics. In each group, concordance was 98%, with only 1 participant having discordant results (testing negative on the first sample and positive on the second sample). We found no statistically significant difference in relative light units(RLUs) between groups (median of difference, − 0.02 vs −0.05 RLU;p= .93).

Conclusions

The results of this study suggest that acetic acid at concentrations of 3% to 5% and sequential cervical sampling do not modify the result of HPV testing by Hybrid Capture 2.
Constructing Item Banks for Measuring Quality of Life in Refractive Error
Authors: Kandel Himal , Khadka Jyoti , Fenwick Eva K. , Shrestha Mohan Krishna , Sharma Sadhana , Sharma Binita , Kafle Kopila , Kharal Anish , Kaiti Raju , Dhungana Purushottam , Nepal Bhagavat Prasad , Thapa Suman , Lamoureux Ecosse , Pesudovs Konrad
Published: June 2018

SIGNIFICANCE

Existing patient-reported outcome instruments in refractive error are paper-based questionnaires. They are not comprehensive and psychometrically robust. This study has identified the content of the refractive error–specific item banks that aim to provide comprehensive and scientific measurement of refractive error–specific quality of life.

PURPOSE

The purpose of this study was to identify minimally representative, optimally informative, and efficient sets of items for measuring quality of life in people with refractive error.

METHODS

First, items were identified from existing patient-reported outcome instruments. Second, items were developed from qualitative studies with people with refractive error (48 and 101 in-depth interviews in Australia and Nepal, respectively). Third, classification and selection of items were done based on a set of systematic criteria using an iterative process of binning and winnowing. The resulting items underwent cognitive testing with people with refractive error in Australia and in Nepal. Each step was guided by an expert panel consensus.

RESULTS

We retrieved 792 items from the existing patient-reported outcome instruments. From the interviews conducted in Australia, a total of 2367 comments were coded into 807 initial items. Similarly, from the interviews conducted in Nepal, 3477 comments were coded into 914 initial items. After binning and winnowing, followed by cognitive testing, a final set of items comprising 337 items for the Item-pool (Australia) and 308 items for the Item-pool (Nepal), both spanning 12 domains, was obtained. Forty-seven percent of items were common across the two item pools. In the Item-pool (Nepal), 65% items were common for corrected and uncorrected refractive error.

CONCLUSIONS

We identified the content of two different sets of item banks to comprehensively measure the impact of refractive error on quality of life for people in Australia and Nepal, which may be applicable to high-income country settings and low- and middle-income country settings, respectively. Future work aims to develop computer-adaptive testing system to administer the item banks, resulting in useful measurement tools for researchers, clinicians, and policy planners.
Gender Differences in the Professional and Personal Lives of Plastic Surgeons
Authors: Furnas Heather J. , Garza Rebecca M. , Li Alexander Y. , Johnson Debra J. , Bajaj Anureet K. , Kalliainen Loree K. , Weston Jane S. , Song David H. , Chung Kevin C. , Rohrich Rod J.
Published: June 2018

Background:

Although the number of women becoming plastic surgeons has increased during the past six decades, in comparison with the current gender parity in medical schools, plastic surgery still attracts disproportionately more men. Previous studies have shown disparities in the professional and personal lives of female and male plastic surgeons. A survey study was conducted to identify current challenges women and men encounter in the pursuit of a plastic surgical career to guide remedial strategies.

Methods:

An anonymous electronic survey was distributed to American Society of Plastic Surgeons members and candidates for comparison between sexes. Differences were tested by the Fisher’s exact and chi-square tests.

Results:

Women were more likely than men to have experienced sexism or bias. Women were less likely to be married; be satisfied with work-life balance; or feel recognized for ideas, authorship, promotions, or raises. Women felt that their sex was a disadvantage in career advancement, with one exception: unlike men, women felt many patients chose them because of their sex. Despite these challenges, over 80 percent of all plastic surgeons were satisfied with their choice of career.

Conclusions:

Traditions and gender bias create disparities in the personal and professional lives of female and male plastic surgeons. Our specialty must make concrete changes to promote all plastic surgeons, both women and men, to thrive personally and professionally.
Fournier Gangrene: Association of Mortality with the Complete Blood Count Parameters
Authors: Demir Canser Yilmaz , Yuzkat Nureddin , Ozsular Yavuz , Kocak Omer Faruk , Soyalp Celaleddin , Demirkiran Hilmi
Published: June 2018

Background:

The authors studied the alterations in mean platelet volume, neutrophil-to-lymphocyte ratio, and red blood cell distribution width values together with the platelet count in hospitalized patients diagnosed with Fournier gangrene to determine their association with disease prognosis.

Methods:

Records of patients diagnosed with Fournier gangrene were analyzed retrospectively.

Results:

Seventy-four patients (49 men and 25 women) with a mean age of 57.60 ± 15.34 years (range, 20 to 95 years) were included. Sixty-eight participants were discharged and six died during follow-up. In the discharged group, during hospitalization, there was a trend downward in neutrophil-to-lymphocyte ratio and mean platelet volume values, whereas platelet count increased significantly. In the nonsurvivor group, the neutrophil-to-lymphocyte ratio and mean platelet volume after first débridement and at the end of hospitalization were significantly higher; platelet counts at admission, after the first débridement, and at the end of hospitalization were significantly lower compared with the survivor group (p < 0.05). In correlation analysis, mortality rate was negatively correlated with platelet count at admission and after first débridement and positively correlated with the neutrophil-to-lymphocyte ratio and mean platelet volume after first débridement. Regarding the receiver operating characteristic curve analyses, a platelet count of 188,500/µl at admission and 196,000/µl after the first débridement, a neutrophil-to-lymphocyte ratio of 13.71, and a mean platelet volume of 9.25 fl after the first débridement were defined as the cutoff levels having the best sensitivities and specificities.

Conclusions:

This study suggests that platelet count at admission and platelet count, mean platelet volume, and neutrophil-to-lymphocyte ratio after first débridement and during discharge may be included among the prognostic scores of Fournier gangrene. The authors defined some threshold values that can be used during patient follow-up. Larger prospective studies are warranted to determine the exact role of those parameters in the prognosis of Fournier gangrene.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Risk, III.
The Lumbar Artery Perforator Flap in Autologous Breast Reconstruction: Initial Experience with 100 Cases
Authors: Opsomer Dries , Stillaert Filip , Blondeel Phillip , Van Landuyt Koenraad
Published: June 2018

Background:

The lumbar artery perforator flap is an alternative flap in breast reconstruction for those patients who are not eligible for a deep inferior epigastric artery perforator (DIEAP) flap. Shaping of this flap is easier compared with other flaps because of the quality of the lumbar fat and the gluteal extension.

Methods:

Between October of 2010 and June of 2017, a total of 100 lumbar artery perforator free flap breast reconstructions were performed in 72 patients. Patient demographics, indications, flap specifics, and complications were reviewed retrospectively.

Results:

Twenty-eight bilateral and 44 unilateral breast reconstructions with a lumbar artery perforator flap were performed. Mean patient age was 48 years, and the average body mass index was 23.11 kg/m2. The authors report 43 preventive mastectomies for elevated cancer risk with subsequent immediate reconstruction, 34 secondary reconstructions, and 14 tertiary reconstructions. Mean operative time was 7 hours 4 minutes, including the mastectomy in primary cases. Mean flap weight was 499 g (range, 77 to 1216 g) and mean follow-up time was 30 months. The revision rate was 22 percent and nine flaps were lost.

Conclusions:

The lumbar artery perforator flap is a valuable alternative to the DIEAP flap in breast reconstructive surgery. It is an excellent flap for BRCA-positive patients who are typically young and have limited excess tissue at the conventional donor sites. Despite higher revision rates compared with the DIEAP flap, the lumbar flap is superior in mimicking the shape and feel of native breast tissue. Scarring at the donor site remains a sore point but can be easily treated and used to an advantage to contour the flanks.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.
Strategies for Prevention of Mother-to-Child Transmission Adopted in the “Real-World” Setting: Data From the Italian Register for HIV-1 Infection in Children
Authors: Chiappini Elena , Galli Luisa , Lisi Catiuscia , Gabiano Clara , Esposito Susanna , Giacomet Vania , Giaquinto Carlo , Rampon Osvalda , Badolato Raffaele , Genovese Orazio , Buffolano Wilma , Osimani Patrizia , Cellini Monica , Bernardi Stefania , Maccabruni Anna , Dodi Icilio , Salvini Filippo , Faldella Giacomo , Quercia Michele , Gotta Cristina , Rabusin Marco , Natale Fabio , Mazza Antonio , Merighi Mara , Tovo Pier-Angelo , de Martino Maurizio
Published: June 2018

Background:

Strategies for prevention of HIV-1 mother-to-child transmission (PMTCT) have been continuously optimized. However, cases of vertical transmission continue to occur in high-income countries.

Objectives:

To investigate changes in PMTCT strategies adopted by Italian clinicians over time and to evaluate risk factors for transmission.

Methods:

Data from mother–child pairs prospectively collected by the Italian Register, born in Italy in 1996–2016, were analyzed. Risk factors for MTCT were explored by logistic regression analyses.

Results:

Six thousand five hundred three children (348 infections) were included. In our cohort, the proportion of children born to foreign mothers increased from 18.3% (563/3078) in 1996%–2003% to 66.2% (559/857) in 2011–2016 (P < 0.0001). Combination neonatal prophylaxis use significantly (P < 0.0001) increased over time, reaching 6.3% (56/857) after 2010, and it was largely (4.2%) adopted in early preterm infants. The proportion of vaginal deliveries in women with undetectable viral load (VL) increased over time and was 9.9% (85/857) in 2011–2016; no infection occurred among them. In children followed up since birth MTCT, rate was 3.5% (96/2783) in 1996–2003; 1.4% (36/2480) in 2004–2010; and 1.1% (9/835) in 2011–2016. At a multivariate analysis, factors associated with MTCT were vaginal delivery with detectable or missing VL or nonelective caesarean delivery, prematurity, breastfeeding, lack of maternal or neonatal antiretroviral therapy, detectable maternal VL, and age at first observation. Previously described increased risk of offspring of immigrant women was not confirmed.

Conclusions:

Risk of MTCT in Italy is ongoing, even in recent years, underling the need for implementation of the current screening program in pregnancy. Large combination neonatal prophylaxis use in preterm infants was observed, even if data on safety and efficacy in prematures are poor.
Women’s Rehabilitation Experiences Following Breast Cancer Surgery
Authors: Reigle Beverly S. , Zhang Bin
Published: June 2018

Background

Breast cancer survivors represent 23% of the 15.5 million cancer survivors in the United States. Treatment-related morbidities such as adhesive capsulitis and lymphedema impact functional ability and quality of life. Postoperative exercises have been recommended for years. However, few studies exist that describe the postoperative rehabilitation experience of breast cancer survivors.

Purpose

The purpose of the study was to examine the rehabilitation experiences of women following breast cancer surgery.

Methodology

The study used a descriptive–correlational design. A convenience sample of 594 breast cancer survivors completed and returned a mailed questionnaire.

Findings

Results indicated that 61% reported that postoperative exercises were prescribed. Forty-eight percent reported performing the exercises as instructed. Performing exercises as instructed was significantly associated with increased functional ability (p < .0001).

Conclusion

Breast cancer survivors who perform postoperative rehabilitation exercises as instructed may improve functional ability.

Clinical Implication

Rehabilitation nurses can have an instrumental role in the postoperative rehabilitation care of this population.
The Intersection of Rehabilitation and Palliative Care: Patients With Advanced Cancer in the Inpatient Rehabilitation Setting
Authors: Padgett Lynne S. , Asher Arash , Cheville Andrea
Published: June 2018

Background

Patients diagnosed with advanced cancer often differ from the traditional patient typically seen in the inpatient rehabilitation setting.

Purpose

To identify differences in care while highlighting the considerable similarities between the complementary specialties of palliative care and rehabilitation, and to provide rehabilitation clinicians with knowledge and skills to enhance care for palliative care patients and their families.

Methodology

Narrative literature review describing common functional losses in patients diagnosed with advanced cancer, followed by articulation of the intersection of palliative care with traditional rehabilitation approaches and goals.

Conclusion

The evidence supports implementation of a distinct body of skills and knowledge, referred to as “palliative rehabilitation,” among inpatient rehabilitation providers.

Clinical Implications

Implementing palliative rehabilitation skills can improve the quality of care within the inpatient rehabilitation setting for patients with advanced cancer.
Regulation of checkpoint kinase signalling and tumorigenesis by the NF-κB regulated gene, CLSPN
Authors: Hunter Jill E. , Butterworth Jacqueline A. , Sellier Helene , Luli Saimir , Floudas Achilleas , Moore Adam J. , Thomas Huw D. , Campbell Kirsteen J. , Kenneth Niall S. , Chiremba Robson T. , Tiniakos Dina , Knight Andrew M. , Gewurz Benjamin E. , Oakley Fiona , Garrett Michelle D. , Collins Ian , Perkins Neil D.
Published: June 2018

Inhibition of the tumour promoting activities of NF-κB by cell signalling pathways has been proposed as a natural mechanism to limit the development of cancer. However, there has been a lack of evidence for these effects in vivo. Here we report that RelAT505A mice, where a CHK1 targeted Thr505 phosphosite is mutated to alanine, display earlier onset of MYC driven lymphoma than wild type littermates. We describe a positive feedback loop in which the NF-κB subunits RelA and c-Rel, in a manner dependent upon RelA Thr505 phosphorylation, drive the expression of the ATR checkpoint kinase regulator Claspin in response to DNA replication stress in cancer cells. This in turn is required for maintenance of CHK1 activity. Loss of a single allele of the Clspn gene in mice is sufficient to drive earlier tumorigenesis and low levels of CLSPN mRNA expression are associated with worse survival in some forms of human cancer. We propose that loss of this pathway early in tumorigenesis promotes cancer development through increased genomic instability. However, in malignant cancer cells it can help promote their addiction to the checkpoint kinase signalling required for the maintenance of genomic integrity. Importantly, disruption of this pathway leads to resistance of cells to treatment with CHK1 inhibitors. Claspin expression could therefore act as a biomarker for responsiveness of patients to CHK1 inhibitors and provide a potential pathway for the development of tumour resistance.
Corrosion protection performance of reinforced steel coated with paints based on waste materials
Authors: Mohamed Mostafa G. , Ahmed Nivin M. , Abd El-Gawad Walaa M.
Published: June 2018

Purpose

Using organic coatings serves as a key method to protect metal structures against corrosion. Attempts have been made to improve the corrosion inhibition of the coatings using novel types of pigments. This study aims to study the application of organic coatings containing rice straw (RS) waste as anticorrosive pigment for corrosion protection of reinforced steel. The RS was used by precipitating a thin layer of ferrite pigments on its surface to improve their characteristics and corrosion resistance activity.

Design/methodology/approach

The evaluation of corrosion behavior of coated reinforced steel with paints containing these novel pigments is reported using different electrochemical methods.

Findings

The coatings containing the new prepared RS-ferrite pigments offered good corrosion protection, and coatings containing RS-ZnFe showed the best protection performance.

Originality/value

This paper introduces novel method to prepare treated RS without any burning and to play the role of pigments in anticorrosive paint formulations based on its silica content.
Towards establishing an Islamic retail bank in a Muslim-minority country
Authors: Rassool Najmul Hussein
Published: June 2018

Purpose

The purpose of this research study is to explore and analyze the factors that will favour or constrain the introduction of an Islamic Retail bank in a Muslim-minority country such as Mauritius. This research attempts to fill the gap in the empirical literature on the setting up of an Islamic Retail bank in a Muslim-minority country. It recognizes upfront that Islamic banking offers an alternative banking system that is attractive to both Muslims and non-Muslims.

Design/methodology/approach

The research adopts a mixed approach to address the prospects and challenges of establishing an Islamic Retail bank in Mauritius.

Findings

The research finds that there are various prospects for an Islamic retail bank in Mauritius for Muslims and non-Muslims, including enabling legal, fiscal and regulatory framework, the financing of small- and medium-sized enterprises and the issuance ofṣukūk(Islamic investment certificates). The research also finds that the development of an Islamic retail bank in Mauritius face various challenges. Some of these challenges are lack of Sharīʿah-compliant liquidity instruments and inter-bank deposits, lack of knowledge and understanding of Sharīʿah-compliant products and the enforcement of Islamic contracts in court.

Originality/value

This in-depth study appears to be comprehensive and will help in developing a solid foundation for establishing an Islamic retail bank in Mauritius.
Has the efficiency of foreign exchange markets in India evolved over time?
Authors: Datta Radhika Prosad , Bhattacharyya Ranajoy
Published: June 2018

Purpose

The purpose of this paper is to determine whether foreign exchange markets in India have become more efficient over time. There were two major developments in India’s foreign exchange market since the 1980s: first, a shift in foreign exchange management regime from a basket peg to a free float; and second, a rapid phase of economic liberalization since the mid-1990s. The paper attempts to find out whether the market efficiency of foreign exchange markets is affected by these developments. The paper mainly uses the well-known Hurst exponent calculated through corrected empirical R over S analysis to determine whether the exchange rates possess long memory. The robustness of the method is tested by calculating the Hurst exponent through two other prevalent methods in the literature.

Design/methodology/approach

The authors apply the corrected empirical Hurst exponent which employs the Anis Lloyd correction with the modification suggested by Weron. The sensitivity of the results is then tested by replicating the calculations using the detrended fluctuation analysis and Robinson’s method.

Findings

All the methods show that: first, there is no significant change in the overall efficiency of the foreign exchange marketvis a visthe US$ for the time period from 1980 to 2017. Second, neither regime shifts nor calculations over sub-time periods is able to identify significant change in the efficiency level of the market for the US$ exchange rate. Third, efficiency of different exchange rate markets are different over the time period 1999–2017. The US$ market has unequivocally more long run memory compared to the GBP, Yen and EURO markets. Fourth, the results are robust to the method used for calculations.

Originality/value

Does the efficiency of asset markets evolve over time? This paper attempts to answer this question. In the process, the paper studies the effect of regime shifts and progressive globalization on the ability of the market to internalize information.
Vaccine promotion: impact of risk level on attitudes
Authors: Lemanski Jennifer L. , Villegas Jorge
Published: June 2018

Purpose

The purpose of this paper is to examine the impact of personal relevance, source credibility and advertising appeal type on the emotional and cognitive processing of a direct to consumer pharmaceutical ad for a meningitis vaccine.

Design/methodology/approach

A 2 × 2 experiment was used, and path analysis was undertaken to test the hypotheses.

Findings

Resultant models indicated that unvaccinated (more at risk) and vaccinated (less at risk) participants are persuaded through different pathways. More specifically, vaccinated participants rely more on message credibility than creative strategy to form their cognitive evaluation of the message, whereas non-vaccinated subjects’ cognitive evaluations of the message depend on creative strategy (advertising appeal type) more than message credibility. Differences between individuals who were certain of the vaccine status and those who were not certain of their vaccine status were also apparent. Implications and areas for future research are also presented.

Practical implications

When using direct to consumer pharmaceutical ad for a vaccine, advertisers should take into account the perceived risk level of and relevance to audience members.

Originality/value

Personal relevance and risk are issues which impact the effectiveness of different types of advertising appeals, but less prior research has focused on this aspect of the target audience for direct to pharmaceutical vaccine advertisements.
Development of master-slave magnetic anchoring vision robotic system for single-port laparoscopy (SPL) surgery
Authors: Feng Haibo , Zhai Yanwu , Fu Yili
Published: June 2018

Purpose

Surgical robot systems have been used in single-port laparoscopy (SPL) surgery to improve patient outcomes. This study aims to develop a vision robot system for SPL surgery to effectively improve the visualization of surgical robot systems for relatively complex surgical procedures.

Design/methodology/approach

In this paper, a new master-slave magnetic anchoring vision robotic system for SPL surgery was proposed. A lighting distribution analysis for the imaging unit of the vision robot was carried out to guarantee illumination uniformity in the workspace during SPL surgery. Moreover, cleaning force for the lens of the camera was measured to assess safety for an abdominal wall, and performance assessment of the system was performed.

Findings

Extensive experimental results for illumination, control, cleaning force and functionality test have indicated that the proposed system has an excellent performance in providing the visual feedback.

Originality/value

The main contribution of this paper lies in the development of a magnetic anchoring vision robot system that successfully improves the ability of cleaning the lens and avoiding the blind area in a field of view.
Strengthening the stability of exports through GVC participation
Authors: Díaz-Mora Carmen , Gandoy Rosario , Gonzalez-Diaz Belen
Published: June 2018

Purpose

Drawing on the literature that has shown the prevalence of short-lived trade relationships, the purpose of this paper is to provide further understanding about this issue by exploring the impact of engaging in Global Value Chains (GVCs) on the chance of export survival at product-country level, paying special attention to the differences between advanced and developing countries. The authors also investigate whether the type of GVC participation (backward or forward) matters for export survival.

Design/methodology/approach

To capture to what extent a country’s exports are integrated in GVCs, the authors use the OECD Inter-Country Input-Output database to estimate value added incorporated in exports. Through the estimation of a discrete-time duration model, the authors explore the impact of engaging in GVCs on export survival using highly disaggregated trade data from the CEPII’s BACI database.

Findings

The findings endorse the hypothesis that deeper participation in GVCs is a key factor in explaining stability in trade relationships, mainly for developing countries where the trade flows are especially fragile. The authors also find different effects depending on the type of GVC involvement and on whether the value chain partners are advanced or developing.

Originality/value

The paper contributes to the literature by extending the understanding on the factors that promote the stability of exports, including among them, involvement on GVCs (and its forms) which is one of the most relevant factors to explain recent behavior of trade.
Linking bank regulatory capital buffer to business cycle fluctuations
Authors: Adesina Kolade Sunday , Mwamba John Muteba
Published: June 2018

Purpose

The purpose of this paper is to assist bank regulators in Africa who are currently considering the implementation of Basel III countercyclical capital buffer (CCB) requirement.

Design/methodology/approach

Using a panel data set of 129 commercial banks operating in 14 African countries over the period 2004–2014, this paper estimates the system generalized method of moments regression to examine the impact of business cycle on banks’ regulatory capital buffers and attempts to identify the influence of bank revenue diversification, market power and cost of funding (CF) on bank regulatory capital buffers. It further carries out some robustness analyses using a panel data set of 257 commercial banks in 23 African countries over the period 2004–2014.

Findings

The results show that higher regulatory capital buffers are associated with higher market power, higher revenue diversification and higher CF. Additionally, the results show significant evidence of procyclical behavior of bank capital buffers (BUFs) in the sampled countries.

Practical implications

The results of this study suggest that African banking systems are not exposed to contagion and systemic risks arising from countercyclical movements of BUFs to the real economy. Therefore, this study does not support the implementation of the Basel III CCB requirement in the sampled African countries.

Originality/value

Considering that the results of existing studies on the cyclical behavior of BUFs are inconclusive, there is value in studying the cyclical movements of bank regulatory capital buffers in a set of countries that has not been analyzed before. Toward this direction, this is the first empirical study focusing on the cyclical behavior of bank regulatory capital buffers in Africa. Besides examining the cyclical behavior of bank regulatory capital buffers, this paper further investigates the effects of bank revenue diversification, market power and CF on bank regulatory capital buffers.
Factors affecting profitability in Malaysia
Authors: Alarussi Ali Saleh , Alhaderi Sami Mohammed
Published: June 2018

Purpose

The purpose of this paper is to examine the factors affecting profitability in Malaysian-listed companies. It has been argued that profitability is the main pillar for any company to survive in the long run. Although profitability is the primary goal of all business ventures, scant attention has been paid to the factors that affect profitability in developing countries. This study investigates the factors affecting profitability in Malaysian-listed companies.

Design/methodology/approach

This research is based on five independent variables that were empirically examined for their relationship with profitability. These variables are: firm size (as measured by total sales), working capital (WC), company efficiency (assets turnover ratio), liquidity (current ratio) and leverage (debt equity ratio and leverage ratio). Data of 120 companies listed on Bursa Malaysia covering the period from 2012 to 2014 were extracted from companies’ annual reports. Pooled ordinary least squares regression and fixed-effects were used to analyze the data.

Findings

The findings show a strong positive relationship between firm size (total sales), WC, company efficiency (assets turnover ratio) and profitability. The results also show a negative relationship between both debt equity ratio and leverage ratio and profitability. Liquidity (current ratio) has no significant relationship with profitability.

Research limitations/implications

Due to the time limitation, the data includes only 120 companies listed in bursa Malaysia and covers the period from 2012 to 2014.

Practical implications

These results benefit internal users (such as mangers, shareholders and employees). They can realize the determinants of enhancing the profitability of their company after the depreciation of the Malaysian currency and therefore concentrate more on the factors that enhance their companies’ profitability. On the other side, other external users (such as investors, creditors, new established companies, tax authority) also may get advantages of these results. It is clear that those users concern about the profitability of companies and the determinants of their profitability after the currency’s depreciation.

Originality/value

This study differs than previous studies in many ways: first, it focuses on non-financial listed companies in Malaysia. Previous studies have concentrated on companies in the financial sector, such as banking and financial institutions or on industrial organizations. Second, this study analyzes the data in companies’ annual reports for a three-year period from 2012 to 2014. During this period, the economy in Malaysia was fluctuating due to currency depreciation. Third, the study used both return on equity and earnings per share as indicators of profitability. Fourth, the results of the study provide empirical evidence that large size firms with efficiently managed assets can improve operating income and ultimately enhance profitability. Last but not least, this study applies the resource-based theory and the trade-off theory.
Firm opacity and informed trading around spinoffs
Authors: Wen Yuan
Published: June 2018

Purpose

This paper aims to examine the prevalence of informed trading around corporate spinoffs and the relation between firm opacity and informed trading using option market data.

Design/methodology/approach

The author investigates the prevalence of informed trading by examining the relationship between abnormal stock returns associated with spinoffs and the volatility spread/volatility skewness of options prior to the spinoffs. Furthermore, the author examines how opacity and organizational complexity prior to the spinoffs affect informed trading.

Findings

The study shows that option volatility spread and volatility skewness for the five days prior to the spinoffs can predict the abnormal stock returns on the spinoff announcement days, suggesting that there is informed trading in the options market prior to spinoffs. The study shows that informed trading is more prevalent for firms that are more opaque prior to the spinoff. Furthermore, informed trading decreases after spinoffs.

Originality/value

To the best of knowledge, this is the first empirical research that examines the prevalence of informed trading around spinoffs by using options volatility spread/skewness and the relation between firm opacity and informed options trading.
Testing for the burst of bubbles in dry bulk shipping market using log periodic power law model
Authors: Chen Shun , Zheng Shiyuan , Meersman Hilde
Published: June 2018

Purpose

The occurrence and unpredictability of speculative bubbles on financial markets, and their accompanying crashes, have confounded economists and economic historians worldwide. The purpose of this paper is to diagnose and detect the bursting of shipping bubbles ex ante, and to qualify the patterns of shipping price dynamics and the bubble mechanics, so that appropriate counter measures can be taken in advance to reduce side effects arising from bubbles.

Design/methodology/approach

Log periodic power law (LPPL) model, developed in the past decade, is used to detect large market falls or “crashes” through modeling of the shipping price dynamics on a selection of three historical shipping bubbles over the period of 1985 to 2016. The method is based on a nonlinear least squares estimation that yields predictions of the most probable time of the regime switching.

Findings

It could be concluded that predictions by the LPPL model are quite dependent on the time at which they are conducted. Interestingly, the LPPL model could have predicted the substantial fall in the Baltic Dry Index during the recent global downturn, but not all crashes in the past. It is also found that the key ingredient that sets off an unsustainable growth process for shipping prices is the positive feedback. When the positive feedback starts, the burst of bubbles in shipping would be influenced by both endogenous and exogenous factors, which are crucial for the advanced warning of the market conversion.

Originality/value

The LPPL model has been first applied into the dry bulk shipping market to test a couple of shipping bubbles. The authors not only assess the predictability and robustness of the LPPL model but also expand the understanding of the model and explain patterns of shipping price dynamics and bubble mechanics.