bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of strategic management for employee engagement and skill development for start-ups
Authors: Kulkarni Praveen , Mutkekar Rohit , Ingalagi Sanjeev
Published: October 2020

Purpose

Start-ups are the new avenues for innovation and employment. Strategic management is critical for employee engagement and skill development of start-ups. This study aims to understand the impact of strategic management on employee engagement and skill development.

Design/methodology/approach

The study attempts to identify principal factors of strategic management influencing employee engagement and skill development. Structural equation modeling has been used to understand effects of the study.

Findings

The study results have shown the challenges concerning employee skill development and reflected on importance of the employee engagement programmes for the growth of the human resource in the start-ups.

Research limitations/implications

The study has confined to strategic management for employee engagement and skill development. However, studies related to challenges encountered by start-ups in the specific areas of marketing, operations and finance, etc. would provide more detailed impact on the growth of start-ups.

Practical implications

This study provides an insight into strategic management for employee engagement and skill development. The results would provide directions for improving strategy management from the perspective of employee engagement and skill development.

Social implications

The study on start-ups provides a direction to the owners of start-ups to understand the importance of strategic management and human resource management for building strong enterprising which can provide employment opportunity for the youth of the nation and improve the society at large.

Originality/value

This paper is an attempt to provide directions for managing challenges from the perspective of employees’ engagement and skill development, which is essential for growth and sustainability in the future.
Habitat and host associations of the fish‐burrowing parasite Artystone minima (Cymothoidae: Isopoda) in eastern Amazonia
Authors: Rosa Fabricio dos Anjos Santa , Baillie Charles , Medeiros Tatiane do Nascimento , Ready Jonathan Stuart
Published: October 2020

Cymothoid fish parasites settle on hosts in ways that may impact fish health and energetics. High abundances of Artystone minima observed in Nannostomus beckfordi from the Jeju River in eastern Amazonia were investigated to answer the following questions: (a) What factors are associated with the high prevalence at this locality?; (b) Is high abundance associated with co‐infestation of alternative hosts?; and (c) Is parasite presence associated with host species growth and/or reproduction? Fish assemblages were sampled quarterly (August 2017–May 2018) from five habitats along with environmental data. Parasitic indices were calculated, and parasite presence used to evaluate differences in growth of hosts using analysis of covariance considering host sex and sampling season (wet vs. dry). Parasites were only abundant in one of the habitats, a large, shallow backwater bay with macrophytes. Abiotic environmental factors (flow and depth) likely impact parasite transmission and are, therefore, particularly important in producing these local patterns. Two secondary hosts, Hyphessobrycon cf. rosaceus and Moenkhausia collettii, were found in the wet season. Based on host biology compared to other fish in the habitat, parasite infestation is inferred to be depth associated and long‐term infestation is apparently limited in alternative hosts. Parasite presence was significantly associated with reduced weight (standardized for length) of female Nannostomus beckfordi in the wet season. Furthermore, ovaries of non‐parasitized females from the wet season presented a range of maturation stages, while parasitized females were all immature, indicating a significant association of parasites with host reproductive capacity.

Abstract in Portuguese is available with online material
Roles of Src family kinase, Ras, and mTOR signaling in intestinal epithelial homeostasis and tumorigenesis
Authors: Matozaki Takashi , Kotani Takenori , Murata Yoji , Saito Yasuyuki
Published: October 2020

The turnover of intestinal epithelial cells (IECs) is relatively rapid (3‐5 days in mouse and human), and this short existence and other aspects of the homeostasis of IECs are tightly regulated by various signaling pathways including Wnt‐β‐catenin signaling. Dysregulation of IEC homeostasis likely contributes to the development of intestinal inflammation and intestinal cancer. The roles of receptor protein tyrosine kinases and their downstream signaling molecules such as Src family kinases, Ras, and mTOR in homeostatic regulation of IEC turnover have recently been evaluated. These signaling pathways have been found to promote not only the proliferation of IECs but also the differentiation of progenitor cells into secretory cell types such as goblet cells. Of note, signaling by Src family kinases, Ras, and mTOR has been shown to oppose the Wnt‐β‐catenin signaling pathway and thereby to limit the number of Lgr5+ intestinal stem cells or of Paneth cells. Such cross‐talk of signaling pathways is important not only for proper regulation of IEC homeostasis but for the development of intestinal tumors and potentially for anticancer therapy.
CD11c+ dendritic cells mediate antigen-specific suppression in extracorporeal photopheresis
Authors: Hackstein H , Kalina A , Dorn B , Keil I S , Baal N , Michel G , Brendel C , Neubauer A , Jakob T , Bein G
Published: October 2020

Extracorporeal photopheresis (ECP) represents one of the most widespread and effective cell therapies for graft-versus-host disease and other T cell-mediated disorders. However, the key factors affecting the therapeutic efficacy of ECP remain unclear. We hypothesized that therapeutic effects are mediated by ECP-treated antigen-presenting dendritic cells (DC). To test this hypothesis, we used the experimental model of contact hypersensitivity (CHS). The ECP's therapeutic activity improved when the total cell dose of the ECP-treated cells was increased. We used different haptens during sensitization to demonstrate that the anti-inflammatory activity of ECP is antigen-specific. This confirmed the hypothesis that professional antigen-presenting cells are involved in the mode of action. Also, the ECP's therapeutic activity was abrogated by the depletion of CD11c+ DC, which represents fewer than 1% of all the ECP-exposed cells. Finally, we confirm the critical importance of CD11c+ DC for ECP activity by showing that only a few purified CD11c+ DC are sufficient to mediate its therapeutic effect. The finding that ECP-treated, physiological antigen-presenting DC alone mediate antigen-specific modulation of a pathological immune response may result in better-targeted interventions when treating patients.
A colorectal straight‐to‐test cancer pathway with general‐practitioner‐guided triage improves attainment of the 28‐day diagnosis target and increases outpatient clinic capacity
Authors: Sagar Alex , Mai Dinh Van Chi , Divya G. S. , Al‐Habsi Ruqaiya , Wothers Tracy , Ni Bhroin Orna , Singh Sandeep , O’Hara Richard , Keeler Barrie D.
Published: October 2020

Aim

This study investigates whether a straight‐to‐test (STT) colorectal cancer pathway improves attainment of the National Health Service (NHS) England 28‐day Faster Diagnosis Standard and the effect of the pathway on reducing face‐to‐face outpatient clinic appointments. Patient satisfaction and the safety of a novel general practitioner (GP) led patient triage system regarding suitability for colonoscopy are also evaluated.

Methods

This is an observational study of all patients managed via an STT colorectal cancer pathway between 1 September 2019 and 19 March 2020. Comparison is made with all patients referred on the suspected colorectal cancer pathway prior to implementation of the STT pathway from 1 January 2019 to 30 July 2019. Patient satisfaction with the STT pathway was assessed with a telephone‐based questionnaire.

Results

Attainment of the 28‐day diagnosis target for all suspected colorectal cancer referrals improved following the establishment of the STT pathway (88% vs. 82%, P < 0.0001). From a potential total of 548 outpatient colorectal clinic appointments for patients on the STT pathway, 504 (92%) were avoided. In those eligible for the STT pathway, GP assessment of patients suitable for colonoscopy agreed with that of the colorectal department in 93% of cases. Of the 50 patients who undertook the satisfaction survey, 86% were satisfied or very satisfied with the pathway. No patient suffered adverse events as a result of their STT investigations.

Conclusion

An STT pathway for suspected colorectal cancer referrals with novel GP‐led patient triage safely streamlines patients through the suspected colorectal cancer diagnostic pathway and significantly reduces requirement for face‐to‐face outpatient clinic attendance. This is achieved with high patient satisfaction.
Computational materials design: recent advances and open challenges related to colorimetry
Authors: Trémeau Alain , Colantoni Philippe , Hébert Mathieu
Published: October 2020

Computational materials design aims at designing, simulating and predicting innovative materials. This paper reviews a few open challenges in the domain of computational materials design related to the colour appearance of materials. These relatively recent fields of research necessitate revisiting the fundamentals of colorimetry, such as reflectance models. First, we address the virtual design and the simulation of innovative materials, which requires modelling their appearance and fundamental properties. Then we discuss the latest advancements in the machine‐learning domain that have highly revolutionised computational and data‐minded methodologies, which are used for the design innovation, discovery and optimisation of materials.
WAGES AND LABOR PRODUCTIVITY: EVIDENCE FROM INJURIES IN THE NATIONAL FOOTBALL LEAGUE
Authors: Gregory‐Smith Ian
Published: October 2020

Empirical studies face severe difficulties when identifying the relationship between wages and labor productivity. This paper presents a novel identification strategy and demonstrates that the connection between wages and labor productivity is remarkably robust even when institutional constraints serve to distort the relationship. Identification is achieved by considering injuries to professional football players as an exogenous shock to labor productivity. This is an ideal empirical setting because injured players in the National Football League cannot be replaced easily because franchises are constrained by the salary cap. Injuries are shown to play a major role in franchise success and a tight connection between wages and marginal productivity emerges. This is in spite of regulatory frictions that serve to hold down wages for some workers. (JEL J24, J31, Z22)
Is freezing of gait correlated with postural control in patients with moderate‐to‐severe Parkinson’s disease?
Authors: Coelho Daniel Boari , Ribeiro de Souza Caroline , de Lima‐Pardini Andrea Cristina , Treza Renata de Castro , Shida Thiago Kenzo Fujioka , Silva‐Batista Carla , Teixeira Luis Augusto
Published: October 2020

Freezing of gait (FoG) is one of the main reasons for movement initiation disorders and abnormal coupling of posture and gait in Parkinson's disease (PD). Patients with FoG have poor postural control when compared to patients without FoG. However, the nature of the interrelationship between FoG and domains of postural control remains unknown. The aim of this study was to estimate the association between different domains of postural control and severity of FoG in patients with moderate‐to‐severe PD. Thirty patients with idiopathic PD with FoG (age range 45–80 years, Hoehn & Yahr stages 3 and 4) participated in the study. We evaluated objective (FoG‐ratio during turning task) and subjective (New Freezing of Gait Questionnaire, NFoG‐Q) measures of FoG severity, reactive postural adjustments in response to an external perturbation, first step anticipatory adjustment for step initiation and quiet standing stability. In the multiple regression analysis, step initiation was the strongest significant correlation of the NFoG‐Q score explaining 23% of the variance of the assessment. For the objective FoG measure, mediolateral CoP amplitude in quiet standing and mediolateral CoP amplitude in step initiation explained 39% of the variance of the FoG‐ratio. As main conclusions, this study identified the association between objective and subjective measure for FoG severity and postural control domains. The results support conducting step initiation training during rehabilitation of individuals with FoG.
Experimental (co)evolution in a multi‐species microbial community results in local maladaptation
Authors: Castledine Meaghan , Padfield Daniel , Buckling Angus
Published: October 2020

Interspecific coevolutionary interactions can result in rapid biotic adaptation, but most studies have focused only on species pairs. Here, we (co)evolved five microbial species in replicate polycultures and monocultures and quantified local adaptation. Specifically, growth rate assays were used to determine adaptations of each species’ populations to (1) the presence of the other four species in general and (2) sympatric vs. allopatric communities. We found that species did not show an increase in net biotic adaptation:ancestral, polyculture‐ and monoculture‐evolved populations did not have significantly different growth rates within communities. However, 4/5 species’ growth rates were significantly lower within the community they evolved in relative to an allopatric community. ‘Local maladaptation’ suggests that species evolved increased competitive interactions to sympatric species’ populations. This increased competition did not affect community stability or productivity. Our results suggest that (co)evolution within communities can increase competitive interactions that are specific to (co)evolved community members.
Associative nitrogen fixation linked with three perennial bioenergy grasses in field and greenhouse experiments
Authors: Wewalwela Jayani J. , Tian Yuan , Donaldson Janet R. , Baldwin Brian S. , Varco Jac J. , Rushing Brett , Lu Haoliang , Williams Mark A.
Published: October 2020

Associative nitrogen (N2)‐fixation (ANF) by bacteria in the root‐zone of perennial bioenergy grasses has the potential to replace or supplement N fertilizer and support sustainable production of biomass, but its application in marginal ecosystems requires further evaluation. In this study, we first combined both greenhouse and field experiments, to explore the N2 fixation effects of three temperate feedstocks Miscanthus × giganteus (giant miscanthus, Freedom), Panicum virgatum (switchgrass, Alamo), and Saccharum sp. (energycane, Ho 02‐147). In field studies across three growing seasons, plant and soil pools of candidate feedstocks were partially composed of N derived from the atmosphere (Ndfa). Energycane, giant miscanthus, and switchgrass were estimated to derive >30%, %Ndfa. Greenhouse studies were also performed to trace isotopically labeled 15N2 into plant biomass and soil pools. Evidence for Ndfa was detected in all three feedstock grasses (using reference 15N of soil, chicory, and sorghum, δ15N~+7.0). Isotopically labeled 15N2 was traced into biomass (during grass elongation stage) and soil pools. Extrapolation of rates during the 24 hr labeling period to 50 days estimated 30%–55% of plant Ndfa, with the greatest Ndfa for energycane. The findings of the field natural abundance and greenhouse 15N2 feeding experiments provided complementary evidence that perennial bioenergy grasses have the potential to support relatively high rates of ANF, and accumulate diazotroph‐derived N into biomass when grown on non‐fertilized soil.
Duplication 1q is highly correlated with poor prognosis in high hyperdiploid pediatric B‐acute lymphoblastic leukemia
Authors: El Ashry Mona S. , Elsayed Ghada M. , Madney Youssef , Arafah Omar , Allam Rasha M. , Rasekh Eman O.
Published: October 2020

Background

The role of structural abnormalities in high hyperdiploidy (HeH) has been debatable, with few studies that addressed recurrent translocations with concurrent HeH (t‐HeH). We aimed at the characterization of HeH cases in pediatric B‐acute lymphoblastic leukemia (B‐ALL) patients with special emphasis on the structural abnormalities including t‐HeH.

Patients and methods

Our study included all patients diagnosed with HeH over the period from January 2016 to April 2019 presenting to the Pediatric Oncology Department, National Cancer Institute, Cairo University.

Results

Among 480 de novo B‐ALL pediatric patients, HeH was detected in eighty (16.7%) cases with a median age of 5 years. t‐HeH was identified in 17/480 (3.5%) cases: 9(1.9%) with t(12;21), 7(1.5%) with t(9;22), and 1(0.2%) with t(4;11). Duplication (1q) was the most prevalent structural abnormality in c‐HeH (hyperdiploidy without recurrent translocations) (n = 12,15%). Children ≥10 years or presenting with white blood cells (WBC) ≥50 × 109/L) had an inferior 3 year‐overall survival as compared to younger children (P = .003), and to lower WBC (P = .02). Duplication (1q) was an independent adverse parameter on the disease‐free survival (DFS) of c‐HeH patients (P = .004).

Conclusions

Older age and WBC ≥ 50 × 109/L were adverse prognostic factors. Duplication (1q) is correlated with lower DFS in c‐HeH patients. t‐HeH has distinct patterns of chromosomal gain.
A Conversation With Paul Embrechts
Authors: Genest Christian , Nešlehová Johanna G.
Published: October 2020

Paul Embrechts was born in Schoten, Belgium, on 3 February 1953. He holds a Licentiaat in Mathematics from Universiteit Antwerpen (1975) and a DSc from Katholieke Universiteit Leuven (1979), where he was also a Research Assistant from 1975 to 1983. He then held a lectureship in Statistics at Imperial College, London (1983–1985) and was a Docent at Limburgs Universitair Centrum, Belgium (1985–1989) before joining ETH Zürich as a Full Professor of Mathematics in 1989, where he remained until his retirement as an Emeritus in 2018. A renowned specialist of extreme‐value theory and quantitative risk management, he authored or coauthored nearly 200 scientific papers and five books, including the highly influential ‘Modelling of Extremal Events for Insurance and Finance’ (Springer, 1997) and ‘Quantitative Risk Management: Concepts, Techniques and Tools’ (Princeton University Press, 2005, 2015). He served in numerous editorial capacities, notably as Editor‐in‐Chief of the ASTIN Bulletin (1996–2005). Praised for his natural leadership and exceptional communication skills, he helped to bridge the gap between academia and industry through the foundation of RiskLab Switzerland and his sustained leadership for nearly 20 years. He gave numerous prestigious invited and keynote lectures worldwide and served as a member of the board of, or consultant for, various banks, insurance companies and international regulatory authorities. His work was recognised through several visiting positions, including at the Oxford‐Man Institute, and many awards. He is, inter alia, an Elected Fellow of the Institute of Mathematical Statistics (1995) and the American Statistical Association (2014), an Honorary Fellow of the Institute and the Faculty of Actuaries (2000), Honorary Member of the Belgian (2010) and French (2015) Institute of Actuaries and was granted four honorary degrees (University of Waterloo, 2007; Heriot‐Watt University, 2011; Université catholique de Louvain, 2012; City, University of London, 2017). The following conversation took place in Paul's office at ETH Zürich, 17–18 December 2018.
A case study of consistent vehicle routing problem with time windows
Authors: Lespay Hernán , Suchan Karol
Published: October 2020

We develop a heuristic for the consistent vehicle routing problem with time windows (ConVRPTW), which is motivated by a real‐world application at a food company's distribution center. Besides standard VRPTW restrictions, ConVRPTW assigns each customer just one driver to fulfill his or her orders during the whole multiperiod planning horizon. For each driver and period, a route is sought to serve all their customers with positive demand. For each customer, the number of periods between consecutive orders and the ordered quantities is highly irregular. This causes difficulties in the daily routing, negatively impacting the service level of the company. Similar problems have been studied as ConVRP, where the number of drivers is fixed a priori, and only the total travel time is minimized. Moreover, the clients present no time window constraints, but the visits should be scheduled with a small arrival time variation. In our model, the objective is to minimize the number of drivers. We impose hard time windows but do not consider time consistency in more detail. We compare solutions given by the heuristic with solutions of a mixed‐integer linear programming model on a set of small artificial instances and solutions used by the food company on real‐world instances. The results show the effectiveness of the heuristic. For the company, we obtain significant improvements in the routing plans, with a lower number of vehicles and a higher rate of orders delivered within the prescribed time window.
Oxidation behavior and mechanism of aluminum oxynitride (AlON) at elevated temperatures
Authors: Yang Shuixian , Chen Hetuo , Li Jianmin , Guo Hao , Mao Xiaojian , Tian Run , Zhang Jian , Wang Shiwei
Published: October 2020

The oxidation behavior and mechanism of aluminum oxynitride (AlON) powder exposed to air at elevated temperatures between 800°C and 1300°C was investigated by X‐ray diffractometry (XRD), scanning electron microscope (SEM), electron spin resonance (ESR), nuclear magnetic resonance (NMR), and simultaneous thermogravimetry, differential thermal analysis, and mass spectrometry techniques (TG‐DTA‐MS). The weight of AlON gradually increases to a maximum value at 1150°C and then decreases with further heating. Meanwhile, AlON powder undergoes chemical changes, as evidenced by lattice expansion, and turns eventually into alumina. ESR spectra reveal the occurrence of lone pair electrons in the oxidized products and the intensity of corresponding resonance signal increases before disappearing with the increase in temperature. Combined with the results of NMR and TG‐DTA‐MS, the measured data suggest that Al‐N in [AlO3N] tetrahedron and [AlO5N] octahedron are gradually oxidized into Al‐O‐N group with lone pair electrons, which causes continuous weight gain and lattice expansion. Further oxidation at higher temperatures results in alumina and N2.
Diurnal timing of nonmigratory movement by birds: the importance of foraging spatial scales
Authors: Mallon Julie M. , Tucker Marlee A. , Beard Annalea , Bierregaard Richard O. , Bildstein Keith L. , Böhning‐Gaese Katrin , Brzorad John N. , Buechley Evan R. , Bustamante Javier , Carrapato Carlos , Castillo‐Guerrero José Alfredo , Clingham Elizabeth , Desholm Mark , DeSorbo Christopher R. , Domenech Robert , Douglas Hayley , Duriez Olivier , Enggist Peter , Farwig Nina , Fiedler Wolfgang , Gagliardo Anna , García‐Ripollés Clara , Gil Gallús José Antonio , Gilmour Morgan E. , Harel Roi , Harrison Autumn‐Lynn , Henry Leeann , Katzner Todd E. , Kays Roland , Kleyheeg Erik , Limiñana Rubén , López‐López Pascual , Lucia Giuseppe , Maccarone Alan , Mallia Egidio , Mellone Ugo , Mojica Elizabeth K. , Nathan Ran , Newman Scott H. , Oppel Steffen , Orchan Yotam , Prosser Diann J. , Riley Hannah , Rösner Sascha , Schabo Dana G. , Schulz Holger , Shaffer Scott , Shreading Adam , Silva João Paulo , Sim Jolene , Skov Henrik , Spiegel Orr , Stuber Matthew J. , Takekawa John Y. , Urios Vicente , Vidal‐Mateo Javier , Warner Kevin , Watts Bryan D. , Weber Nicola , Weber Sam , Wikelski Martin , Žydelis Ramunas , Mueller Thomas , Fagan William F.
Published: October 2020

Timing of activity can reveal an organism's efforts to optimize foraging either by minimizing energy loss through passive movement or by maximizing energetic gain through foraging. Here, we assess whether signals of either of these strategies are detectable in the timing of activity of daily, local movements by birds. We compare the similarities of timing of movement activity among species using six temporal variables: start of activity relative to sunrise, end of activity relative to sunset, relative speed at midday, number of movement bouts, bout duration and proportion of active daytime hours. We test for the influence of flight mode and foraging habitat on the timing of movement activity across avian guilds. We used 64 570 days of GPS movement data collected between 2002 and 2019 for local (non‐migratory) movements of 991 birds from 49 species, representing 14 orders. Dissimilarity among daily activity patterns was best explained by flight mode. Terrestrial soaring birds began activity later and stopped activity earlier than pelagic soaring or flapping birds. Broad‐scale foraging habitat explained less of the clustering patterns because of divergent timing of active periods of pelagic surface and diving foragers. Among pelagic birds, surface foragers were active throughout all 24 hrs of the day while diving foragers matched their active hours more closely to daylight hours. Pelagic surface foragers also had the greatest daily foraging distances, which was consistent with their daytime activity patterns. This study demonstrates that flight mode and foraging habitat influence temporal patterns of daily movement activity of birds.
Differential geographical and ecological dynamics allow diversification of morphologically convergent giant bromeliads in the Atlantic Forest
Authors: Maciel Jefferson Rodrigues , Zizka Georg , Alves Marccus
Published: October 2020

Aim

We investigate the evolutionary mechanisms that allow morphologically convergent lineages to share the same geographical space. We compared the evolutionary events that occurred along the diversification of Karawata and Aechmea subgen. Chevaliera in the Atlantic Forest by (a) verifying whether the climatic niches and habitats of Karawata and Chevaliera are similar; (b) testing whether the two groups had the same pattern of colonization in the Atlantic Forest; and (c) evaluating whether they had the same evolutionary dynamics of environmental space occupation.

Location

Brazilian Atlantic Forest

Taxon

Karawata and Aechmea subgen. Chevaliera (Bromeliaceae: Bromelioideae)

Methods

We explored differences in evolutionary dynamics between Karawata and Chevaliera by (a) analyzing their divergence times using Bayesian inference with a relaxed molecular clock; (b) estimating ancestral ranges and habitats with Dispersion Extinction Cladogenesis Lagrange and Statistical Dispersal Vicariance analyses; (c) testing climatic niche similarity, equivalency and overlap using principal component analysis; and, (d) evaluating shifts in speciation dynamics using Bayesian Analysis of Macroevolutionary Mixtures.

Results

Karawata and Chevaliera most likely originated in the Pliocene and diversified during the Pleistocene. The two clades originated in ombrophilous forests and shared a similar environmental space. However, Karawata and Chevaliera show different dynamics in the occupation of geographical and environmental spaces.

Main Conclusions

Our results suggest that the São Francisco and Jequitinhonha Rivers acted as geographical barriers for Karawata and Chevaliera. Differences in spatial and environmental evolutionary dynamics have allowed the two groups to occupy similar habitats as well as environmental and geographical spaces in the Brazilian Atlantic Forest.
Out‐of‐pocket expenditures in France to manage psoriasis in adult patients: results from an observational, cross‐sectional, non‐comparative, multicentre study
Authors: Richard M.‐A. , Paul C. , De Pouvourville G. , Jullien D. , Mahe E. , Bachelez H. , Seneschal J. , Misery L. , Aubert R. , Reguiai Z. , Shourick J. , Taieb C. , Joly P. , Ezzedine K.
Published: October 2020

Background

In 2018 in France, overall mean health‐related out‐of‐pocket (OOP) expenditures were 214.00€/year/patient.

Aim

To evaluate OOP expenditures for psoriasis patients in France.

Methodology

Observational, cross‐sectional, non‐comparative, multicentre study in 3000 patients with clinically confirmed psoriasis who responded to a specific digital questionnaire collecting demographic and socio‐economic characteristics, assessing the 3 domains (severity, psychosocial impact and past history and interventions) of the patient’s Simplified Psoriasis Index (sa‐SPI) and expenditures to manage psoriasis, including OOP. Multivariate linear regression was conducted to search for factors associated with higher OOP.

Results

In total, 2681 patients completed the questionnaire and, of those, 2562 provided clinically validated data. Overall, 60% were women; the mean age was 49.4 ± 14.8 years. 30% of the patients declared that they suffered from psoriatic arthritis. The final mean sa‐SPI core was 10.86 ± 9.70.

Of these 2562 patients, 243 (9.5%) had severe, 442 (17.3%) moderate and 1877 (73.3%) mild psoriasis. In addition, 932 (36.4%) patients reported facial involvement, 724 (28.25%) genital impairment and 1124 (43.8%) lesions on the limbs.

Mean OOP expenditures to manage psoriasis per patient were 531.00€, 439.74€ ± 939.85€ for patients with mild, 791.06€ ± 1367.67€ with moderate and 1077.64€ ± 1680.14€ for patients with severe psoriasis. For patients with psoriasis in the genital area, the median amount of expenditures (251.17€; CI95% [138.35;363.99]) was significantly higher than that for the face (183.85€; CI95% [78.76;288.94]) or limbs (199.96€; CI95% [93.77;306.15); (P < 0.001).

More than 90% of the patients had OOP expenditures for over‐the‐counter products (97.5%) and alternative care (92.0%), especially for emollients and/or hydrating products.

Conclusion

In France, in 2019, OOP expenditures to manage psoriasis were on average more than twice as high as the overall mean health‐related OOP expenditures estimated by the French Health Agency in 2018. These results should lead health authorities to review certain standards of healthcare reimbursement.
Markers of long term silent carriers of Streptococcus equi ssp. equi in horses
Authors: Pringle John , Venner Monica , Tscheschlok Lisa , Waller Andrew S. , Riihimäki Miia
Published: October 2020

Background

Difficulty in detection of silent carriers of Streptococcus equi is a key reason for its continued spread to immunologically naïve groups of horses.

Objective

To determine whether clinical examination, markers of inflammation, or serology differentiate silent carriers of S. equi in recovered comingled horses.

Animals

Ninety‐eight warmblood yearlings and 72 unaffected mares on a large breeding farm (outbreak A), 38 mature Icelandic horses at a riding stable (outbreak B), and 27 mixed breed horses at a boarding stable (outbreak C).

Methods

Prospective observational study 6 months to 2 years after strangles outbreaks. Carriers were defined as any animal positive on culture or qPCR to S. equi from nasopharyngeal lavage or guttural pouch endoscopy and lavage. Most horses had complete physical exams and 1 group included evaluation of white blood cell counts and serum amyloid A. Sera from all horses was tested for antibodies to antigens A and C of S. equi using an enhanced indirect ELISA. Descriptive statistics were calculated. Data were compared using paired t tests, Wilcoxon ranked test, chi square, or the Fishers exact test. Significance was set at P < .05.

Results

Apart from weanlings at 6 months in outbreak A, there was no significant association between any clinical markers or serology with carrier state (P = .06‐1). Moreover, 3/12 culture positive carriers were seronegative to S. equi.

Conclusions and Clinical Importance

Silent carriers of S. equi do not differ clinically or on markers of inflammation to their noncarrier herd‐mates. Moreover, serology alone will not distinguish carriers in comingled horses.
Functional constipation is associated with alterations in thalamo‐limbic/parietal structural connectivity
Authors: Zhang Zhida , Hu Yang , Lv Ganggang , Wang Jia , He Yang , Zhang Lei , Li Hao , von Deneen Karen M. , Wang Huaning , Duan Shijun , Zhang Junwang , Hou Qiuqiu , Pan Yanan , Zhao Yu , Mao Kuanrong , Wang Fan , Zhang Yi , Cui Guangbin , Nie Yongzhan
Published: October 2020

Background

Functional constipation (FCon) is a common functional gastrointestinal disorder (FGID) with a high prevalence in clinical practice. Previous studies have identified that FCon is associated with functional and structural alterations in the primary brain regions involved in emotional arousal processing, sensory processing, somatic/motor‐control, and self‐referential processing. However, whether FCon is associated with abnormal structural connectivity (SC) among these brain regions remains unclear.

Methods

We selected the brain regions with functional and structural abnormalities as seed regions and employed diffusion tensor imaging (DTI) with probabilistic tractography to investigate SC changes in 29 patients with FCon and 31 healthy controls (HC).

Key Results

Results showed lower fractional anisotropy (FA) in the fibers connecting the thalamus, a region involved in sensory processing, with the amygdala (AMY), hippocampal gyrus (HIPP), precentral (PreCen) and postcentral gyrus (PostCen), supplementary motor area (SMA) and precuneus in patients with FCon compared with HC. FCon had higher mean diffusivity (MD) and radial diffusivity (RD) in the thalamus connected to the AMY and HIPP. In addition, FCon had significantly increased RD of the thalamus‐SMA tract. Sensation of incomplete evacuation was negatively correlated with FA of the thalamus‐PostCen and thalamus‐HIPP tracts, and there was a negative correlation between difficulty of defecation and FA of the thalamus‐SMA tract.

Conclusions and Inferences

These findings reflected that FCon is associated with alterations in SC between the thalamus and limbic/parietal cortex, highlighting the integrative role of the thalamus in brain structural network.
The Tourniquet Ischemia Test in the Diagnosis of Complex Regional Pain Syndrome
Authors: Lambeck Johann , Kesenheimer Eva M. , Kleinmann Barbara , Reinhard Matthias
Published: October 2020

Background

The tourniquet ischemia test (IT) is a hitherto rarely used tool for the diagnostic work‐up of patients with suspected complex regional pain syndrome (CRPS). This analysis aims to determine the sensitivity and specificity of this test, and elucidate factors that can influence the test result.

Methods

Consecutive data on clinical presentation, results of the IT and other diagnostic tests, and clinical characteristics were analyzed from patients presenting at our autonomic laboratory between 2000 and 2011. IT results were compared with the final clinical diagnosis at discharge, and statistical analysis was performed to determine specificity, sensitivity, and positive and negative predictive values of the IT.

Results

A total of 78 patients were assessed. IT results were positive (≥50% reduction in pain during ischemia) in 26 cases and negative in 52 cases. CRPS was the final diagnosis in 45 cases, and in 33 cases, a different diagnosis was made. This results in a test sensitivity of 49% and a specificity of 88%, with a positive predictive value of 85% and a negative predictive value of 56%. Age, sex, the type and stage of CRPS, and the affected extremity did not influence the test result in a statistically significant manner. Specificity worsened to 76% if any pain reduction was rated as a positive test result.

Conclusions

A positive tourniquet IT has a high positive predictive value for the diagnosis of CRPS. It is thus useful as a confirmatory assay in patients with suspected CRPS. Low sensitivity rules out its use as a screening test.

Significance

This study retrospectively analyzed the clinical significance of the tourniquet IT that was routinely used in patients with suspected CRPS. It showed that a positive IT result is useful as a confirmatory assay in patients fulfilling the clinical criteria.
Host‐induced gene silencing for engineering resistance to Fusarium in soybean
Authors: Pérez Cristobal E. B. , Cabral Glaucia B. , Aragão Francisco J. L.
Published: October 2020

Soybean is one of the most economically important crops in the world. Its production is affected by several fungal diseases, such as those caused by Fusarium spp., causing significant losses in yield and seed quality. Management interventions are limited, costly, and associated with environmental problems. Host resistance provides a more convenient and cost‐effective approach. Host‐induced gene silencing (HIGS) has been demonstrated to be an alternative strategy to engineer fungus resistance in plants. We have generated transgenic soybean lines with an intron‐hairpin construction in order to express siRNA corresponding to the CYP51B gene from Fusarium oxysporum. Results showed the presence of siRNA corresponding to the F. oxysporum CYP51B gene in both leaves and roots of the transgenic lines. Plants (T3 generation) were challenged against F. oxysporum and F. graminearum. Disease severity was evaluated and revealed resistance to F. oxysporum with one line, named 3.22, presenting no symptoms. In addition, transgenic lines presented better plant development (height and root growth) when compared to the nontransgenic line. Moreover, transgenic lines revealed better development when inoculated with F. oxysporum.
Technology licensing, entry mode, and trade liberalization
Authors: Yang Ya‐Po , Tsai Ying‐Yi , Hsu Su‐Ying
Published: October 2020

This study considers the interactions among technology licensing, entry mode, and trade liberalization in a licensing model of strategic commitment. Prior to the licensing agreement, an insider innovator offers the licensee a contract that may restrict the innovator to the use of generic technology, while allowing the licensee to access state‐of‐the‐art technology. An insider innovator can enter the domestic market through either the export or foreign direct investment (FDI) channels. In this context, we characterize the optimal entry mode and the associated licensing schemes of the foreign firm in the presence of a tariff reduction. We show that a tariff reduction may switch the optimal entry mode of the foreign firm from exporting to FDI and can be detrimental to the domestic welfare of the host country and the profit of both firms.
Consociational Power‐Sharing in the Arab World: A Critical Stocktaking
Authors: Salloukh Bassel F.
Published: October 2020

The aim of this special feature is to reflect theoretically and normatively on consociational power‐sharing, take stock of its empirical record in Lebanon and Iraq, and interrogate its potential utility for other postwar states and societies in the Arab World following the popular uprisings. Allison McCulloch and Joanne McEvoy open the collection by deploying the ‘lifecycle’ heuristic to explain consociationalism’s mixed record as an institutional strategy to manage ethnic or sectarian conflict in different contexts. This process‐oriented approach allows them to shift the consociational debate towards greater sensitivity to contexts: how macro‐institutional types such as liberal and corporate consociation interact with formal and informal micro‐institutional rules in determining the success or failure of consociational power‐sharing arrangements. Paul Dixon and Ibrahim Halawi follow with critical evaluations of consociationalism’s embedded violence against alternative political economic choices. Dixon’s radical critique is chiefly aimed at how consociationalism precludes the emergence of alternative identities, political choices, and socioeconomic struggles. Halawi magnifies this critique and considers elite consociational arrangements in the Arab World to be exclusionary and counter‐revolutionary. The contributions by John Nagle and Toby Dodge converge on how the institutional architecture of consociational power‐sharing as observed in Lebanon and Iraq – whether through formal or informal rules, corporate or liberal arrangements – creates a host of distortions that ossify identities, shape modes of political mobilization, and eviscerate state institutions by turning them into clientelist platforms. Finally, Steven Heydemann and Simon Mabon explore prospects for consociational power‐sharing in Syria and Bahrain, respectively, with implications for postwar Libya and perhaps Yemen. Although in both cases prospects for power‐sharing may appear remote, both authors suggest that the reality is far more complex, and that ultimately some kind of consociational power‐sharing may prove necessary to secure postwar reconstruction and reintegration into the international community in Syria, and genuine representation and peace in Bahrain.
Protest, Sects, and the Potential for Power‐Sharing in Bahrain
Authors: Mabon Simon
Published: October 2020

In this short intervention I explore the scope for power‐sharing as a means of resolving conflict between rulers and ruled across Bahrain. Unlike other states in the Middle East where power‐sharing has been posited as a solution to violence and division, conflict in Bahrain is structural, erupting in violence sporadically, yet framed around ways of ensuring the survival of the ruling Al Khalifa family. This, I argue, poses challenges to the application of traditional power‐sharing approaches that have been deployed elsewhere. In spite of this, power‐sharing continues to be viewed by many opposition figures as a viable means through which peace can be realized between the regime and opposition figures. Such moves are seen by many Bahrainis to be a means through which equality and a vibrant form of citizenship can be realized. I examine and reflect on three moments of political possibility in Bahrain: 1973–75, 2000–02, and the 2011 Arab uprisings. I argue that while power‐sharing appears to offer a means through which to address tensions within divided societies, power asymmetries across the state mean that the Al Khalifa face little pressure to adopt this approach, choosing instead to exert sovereign power over social divisions with support from external backers.
Evaluating the Use of Leaned Stator Vanes to Produce a Non-Uniform Flow Distribution Across the Inlet Span of a Mixed Flow Turbine Rotor
Authors: Morrison Richard , Spence Stephen , Kim Sung In , Leonard Thomas , Starke Andre
Published: October 2020

Current trends in the automotive industry have placed an increased emphasis on downsized turbocharged engines for passenger vehicles. The turbocharger is increasingly relied upon to improve power output across a wide range of engine operating conditions, placing a greater emphasis on turbocharger off-design performance. An off-design condition of significant importance is performance at low turbine velocity ratios, since it is relevant to engine transient response and also to efficient energy extraction from pressure pulses in the unsteady exhaust flow. An increased focus has been placed on equipping turbochargers with mixed flow turbine rotors instead of conventional radial flow turbine rotors to improve off-design performance and to reduce rotor inertia.

A recognized feature of a mixed flow turbine is the spanwise variation of flow conditions across the blade leading edge. This is a consequence of the reduction in leading edge radius from shroud to hub, coupled with the increasing tangential velocity of the flow due to conserved angular momentum as the radius decreases. The result is increasingly positive incidence toward the hub side of the leading edge. The resulting region of highly positive incidence at the hub produces separation from the suction surface and generates significant loss within the rotor passage.

The aim of this study was to determine if the losses in a mixed flow turbine (MFT) could be reduced by the use of leaned stator vanes, which deliberately created a significant spanwise variation of flow angle between hub and shroud at rotor inlet, to reduce the positive incidence at the hub. The turbine performance with a series of leaned vanes was compared against that of a straight vane using a validated computational fluid dynamics (CFD) model. It was found that increasing vane lean improved turbine performance at all operating points considered. An increase of 3.2 percentage points in stage total-to-static efficiency was achieved at a key off-design operating point.

Experimental testing of a set of leaned vanes and the baseline vanes confirmed the advantage of the leaned vanes at all operating points, with an increase in measured efficiency of 2.6 percentage points at the key off-design condition. Unsteady CFD models confirmed the same level of improvement at this operating point.

The CFD and experimental results confirmed that the losses in an MFT can be reduced by the use of leaned stator vanes to shape the flow at rotor inlet.
Investigation of Heat Transfer Characteristics in a Rotating Convection System With Bi-Directional Thermal Gradients
Authors: Banerjee Ayan Kumar , Bhattacharya Amitabh , Balasubramanian Sridhar
Published: October 2020

A series of rotating convection experiments have been conducted in a novel configuration, which comprises a cylindrical annulus with spot heating on the bottom outer edge and uniform cooling on the inner surface. Such a system provides bi-directional thermal gradients in both radial and vertical directions, thereby reenacting the thermal gradient patterns encountered in the atmosphere. Bulk heat transfer characteristics are studied by quantifying the overall Nusselt number, Nu, for a range of Taylor number, Ta, heating rate, Q, and Rayleigh number, Ra. Temperature measurements are carried out at different locations with the help of thermocouples. The Nusselt number is found to be quite sensitive to the buoyancy and relatively insensitive to the rotation rate. The correlation for Nu as a function of Ra revealed different power law exponents for low and high Ta values. The varying exponent is attributed to the presence of baroclinic eddies at high Ta, which in turn is verified with the help of flow visualization. The heat transfer characteristics in this new configuration are significantly different compared to other conventional rotational convection systems, where thermal gradients are present in only one direction.
Life Prediction Model for Nuclear Power Plant Intake Structure Exposed to Chloride Environment Based on Similarity Principle
Authors: Chen Sen , Wang Zhen , Zhang Jiangtao , Cai Dahua , Zhou Jiyun
Published: October 2020

Three environmental simulation experiments for accelerating the chloride ingress were designed based on the similarity principle and the actual Nuclear Power Plant (NPP) intake structure service environment parameters including alternate drying-wetting condition, immersion condition and salt spray condition. Different experiment conditions were designed for each three-simulation experiment condition based on the similarity principle. The temperature, chloride ion concentration and dry-wet cycle time ratio were selected parameters for alternation wetting-drying experiments. The temperature and chloride ion concentration were selected parameters for the salt spray experiment and immersion experiment. The distribution of chloride ion concentration along the depth of the concrete samples were measured every 30 days. The testing results showed that chloride ion diffusion depth is maximum under the dry-wet cycle test, chloride ion diffusion depth is minimum under salt spray test. The curves of the chloride ion concentration along depth increased firstly and then decreased, which is consistent with the two-dimension diffusion law. Finally, a life prediction model that can be used to predict the concrete structure of the existing coastal nuclear power plant was developed based on the test results and field test results.