bluuebunny/crossref_metadata_2025 huggingface dataset:
Managing engagement in an emerging economy service
Authors: Rabbanee Fazlul K. , Haque Mohammad Moinul , Banik Shanta , Islam Mohammad Majedul
Published: October 2019

Purpose

The purpose of this paper is to offer a better understanding of managing engagement in an emerging economy service. It explores the role of organisational climates for initiative and psychological safety as the key drivers of employee engagement (EE). It also examines the effects of EE on customer engagement (CE) and, in turn, on relationship commitment and switching intention.

Design/methodology/approach

Data were collected through a structured survey of service employees and customers of 69 bank branches in Bangladesh using two survey instruments. Responses were collected from 156 employees and 316 customers. A dyadic data set was created by matching customer data with the corresponding employee data collected from each bank branch. Structural equation modelling using AMOS (version 22.0) was employed for data analysis.

Findings

Organisational climates for initiative and psychological safety positively influence EE. In turn, EE significantly influences CE which has a significant impact on customer relationship commitment and switching intention.

Research limitations/implications

Future research could consider actual customer behaviour, such as repeat purchase, as the key outcome variable.

Practical implications

The findings emphasise that investment by service managers in organisational resources to facilitate favourable climates for initiative and psychological safety would engage employees at work, which would ultimately help to attain CE and commitment, and reduce switching intention.

Originality/value

This research extends the existing engagement literature with empirical evidence supporting two new EE drivers and two new CE outcomes. It offers a better understanding of managing engagement in the financial services industry of an emerging economy, focussing on the relationship chain from organisational climate to EE, CE and customer-based outcomes.
The nature of work-related problems: messy, co-produced and wicked
Authors: Fergusson Lee
Published: October 2019

Purpose

Work-based research is the applied form of work-based learning (WBL) and has been described as the systematic and methodical process of investigating work-related “problems”. Such problems can either be associated with specific workplaces and domains of practice or may more broadly be described as practical, social or real-world in nature. However, the specific characteristics of work-related problems for organisations and society have yet to be explained, and inadequate problem definition, multiple and competing goals, and lack of agreement on cause-effect relationships have hampered understanding. The purpose of this paper is to examine the nature of work-related problems and provides examples from real-world contexts in Australia.

Design/methodology/approach

The paper provides models and examples of standard and non-standard work-related problems based on prior research and current practice.

Findings

Research paradigms view work-related problems as either definable and solvable or ill-defined, complex, difficult to describe and not easily rectified. The former view is concerned with “high ground problems” associated with traditional research methods; the latter with “lowland, messy, confusing problems” more frequently associated with the social sciences. Irrespective of orientation and definition, work-related problems have one thing in common: they are typically messy, constantly changing and complex, and many are co-produced and wicked.

Originality/value

Despite difficulties with identifying and isolating the various types of work-related problem, the paper establishes the importance of doing so for the practitioner. The definition and examination of work-related problems contribute to an evolving formulation of WBL and its application to private organisations, government agencies and work more generally.
Patient visit forecasting in an emergency department using a deep neural network approach
Authors: Yousefi Milad , Yousefi Moslem , Fathi Masood , Fogliatto Flavio S.
Published: October 2019

Purpose

This study aims to investigate the factors affecting daily demand in an emergency department (ED) and to provide a forecasting tool in a public hospital for horizons of up to seven days.

Design/methodology/approach

In this study, first, the important factors to influence the demand in EDs were extracted from literature then the relevant factors to the study are selected. Then, a deep neural network is applied to constructing a reliable predictor.

Findings

Although many statistical approaches have been proposed for tackling this issue, better forecasts are viable by using the abilities of machine learning algorithms. Results indicate that the proposed approach outperforms statistical alternatives available in the literature such as multiple linear regression, autoregressive integrated moving average, support vector regression, generalized linear models, generalized estimating equations, seasonal ARIMA and combined ARIMA and linear regression.

Research limitations/implications

The authors applied this study in a single ED to forecast patient visits. Applying the same method in different EDs may give a better understanding of the performance of the model to the authors. The same approach can be applied in any other demand forecasting after some minor modifications.

Originality/value

To the best of the knowledge, this is the first study to propose the use of long short-term memory for constructing a predictor of the number of patient visits in EDs.
Resilience and risks of cross-border mergers and acquisitions
Authors: Hsu Ching-Chiu , Park Jeong-Yang , Lew Yong Kyu
Published: October 2019

Purpose

In cross-border mergers and acquisitions (M&As), acquirers often fail to achieve the expectations they held when they made the M&A deals. This paper aims to propose that the risks of cross-border M&As can be mitigated by building and cultivating organizational resilience as a prime means of risk management.

Design/methodology/approach

The research examines risks associated with cross-border M&A and how such risks can be mitigated by developing resilience. It presents dual cases of acquisitions of the biggest branded mobile phone manufacturer in Taiwan.

Findings

The authors find that the acquirer faces multiple risks in cross-border M&A transactions, including financial, strategic and organizational, and process risks that arise from misalignment between the goal of the M&As and the post-acquisition performance of the target firms.

Originality/value

The research provides theoretical insights on organizational resilience and how it can mitigate the specific risks involved in cross-border M&As, thereby developing coherent organizational resilience processes.
Income diversification and financial performance of commercial banks in Vietnam
Authors: Luu Hiep Ngoc , Nguyen Loan Quynh Thi , Vu Quynh Huong , Tuan Le Quoc
Published: October 2019

Purpose

The purpose of this paper is to investigate the impact of income diversification on the financial performance of commercial banks in Vietnam over the period 2007–2017. It then provides additional analysis to examine whether the diversification–performance nexus is conditioned upon bank experience and ownership structure.

Design/methodology/approach

The financial information of each bank were manually collected from bank annual reports. In the empirical model, a number of modern econometric techniques, including panel OLS with fixed effects and a two-step system GMM estimator, were utilised to achieve the research objectives.

Findings

The empirical results show that income diversification has a positive impact on banks’ performance. However, the effect varies across different types of banks. Specifically, the authors find that while diversification benefits state-owned and foreign banks, it exhibits a detrimental effect on the financial performance of other non-state owned domestic banks. In addition, the authors further find that the positive impact of diversification is more prominent for banks with more experience in the market.

Originality/value

This study is among the first to empirically investigate the relationships between income diversification and the financial performance of commercial banks in Vietnam. In this sense, the findings of this study could draw important inferences for researchers, policy makers and bank managers towards more appropriate diversification strategies, to ensure the safety and soundness of the whole banking system.
Ac-counting for carbon emissions: simulating absence through experimental sites of material politics
Authors: Revellino Silvana
Published: October 2019

Purpose

Most carbon accounting consists of valuing what has not happened; such absent entities and their materialisation through simulated calculations can enact political participation, however. By using Marres’s (2012) notion of an “experimental site of material politics”, this paper aims to investigate the mediating role of simulated calculations of prevented carbon emissions in deploying environmental politics’ discourses. Here, such calculations become seductive forces for public engagement and help performing engaging spaces for supporting the diffusion of innovation technologies.

Design/methodology/approach

The empirical analysis concerns a simulated calculative device developed by Autostrade, a motorway management firm, in its work to translate questions about capacity utilisation, through the fluidity of traffic, into reductions in CO2emissions. These reductions took the form of a simulation that required an apparatus to be performed and involved alternative scenarios focussing on hypothetical rather than absolute CO2reductions.

Findings

The Autostrade case highlights how simulated calculations of absent CO2emissions participate in the construction of a collective experience by interfacing concerns that encompass the rationalities of the domestication of technological innovation and make motorway mobility a responsible and ac-countable action.

Practical implications

The paper shows how simulated and experimental calculations on absent carbon emissions act as mediators between public engagement and the deployment of environmental politics discourses. They both extend political participation and propagate and reproduce the trials, which, from time to time, challenge the enticement and forcefulness of a technological innovation.

Social implications

The paper suggests a different dimension of politics that relies on material politics. Rather than considering human centric discursive acts, it looks at the power of technical objects and their augmented calculative devices in engaging the public in environmental politics. This is where absence, which is made visible and materialised through simulations, deploys affordances that reframe power relationships.

Originality/value

This is the first case study that addresses the issue of the role of accounting calculation on absent carbon emissions in enabling innovation and engaging publics in environmental politics.
The impact of board composition on the level of ESG disclosures in GCC countries
Authors: Arayssi Mahmoud , Jizi Mohammad , Tabaja Hala Hussein
Published: October 2019

Purpose

This paper aims to investigate the impact of board composition on environmental, social and governance (ESG) reporting in the Gulf countries. Despite the vast literature on the significance of ESG disclosure on firms’ performance, trust and reputation, there are relatively few studies on the influence of board structure on ESG disclosure in the Gulf Cooperation Council (GCC) countries. Gulf countries are witnessing a fast growing capital markets and having serious efforts to attract foreign investments to divert their economies from the oil and gas reliance. This could be facilitated by illustrating firms’ good citizenship and communicating the fulfillment of their social obligation.

Design/methodology/approach

The study examines publically listed companies between 2008 and 2017. Thomson Reuter’s database is used to collect the ESG disclosure scores and governance information. The authors apply multiple panel data regressions and sensitivity testing to ensure the robustness of the results.

Findings

Examining publically listed companies for a 10-year period shows that higher board independence and female board participation facilitate the transmission of a firm’s positive image by improving social responsibility. Independent boards of directors and participation among women serve as catalysts to strike an effective balance between firms’ financial targets and social responsibilities. In contrast, boards chaired by chief executive officers are less supportive in executing a social agenda and consequently reporting their ESG activities.

Practical implications

The results suggest that firms that appoint a sustainability and/or governance committee tend to engage in more impactful social and environmental activities and communicate their societal engagements more effectively.

Social implications

The paper recommends that policymakers, executives and shareholders in the GCC countries support board participation among women, independent directors and formation of sustainability committees to facilitate engaging in effectual social activities.

Originality/value

Empirical evidence regarding the relationship between board composition and ESG disclosure in the Gulf countries is limited. Prior literature mainly provides results on developed countries in which the governance system is mature and well structured. This study provides useful evidence regarding the Gulf countries that lack privatization and where corporate boards tend to be dominated by families and governments.
Smart ways of hospital wastewater management, regulatory standards and conventional treatment techniques
Authors: Khan Nadeem Ahmad , Ullah Khan Saif , Ahmed Sirajuddin , Farooqi Izharul Haq , Hussain Arshad , Vambol Sergij , Vambol Viola
Published: October 2019

Purpose

The purpose of this paper is to cover some aspects about the disposal and regulatory standard around the world toward hospital effluent discharge, its managements and treatment technologies that are adopted and best suitable nowadays.

Design/methodology/approach

Due to large and variety of antibiotics available in the market nowadays it is difficult to control its use, thereby risking the whole ecosystem and its components. The regulation pattern is variable depending upon the various factors in different countries. The permissible limit of these emerging pollutants found in sewage as compared to in hospital effluent streams having active pharmaceutical ingredients is very narrow and is a debatable issue.

Findings

The disparity in the available legislation for hospital waste management in different countries makes it difficult to compare pro’s and con’s of methods adopted. Strict laws need to be framed for hospital wastewater management and its treatment, as it contains harmful compounds in higher concentrations resulting in development of resistant genes. The guideline applicable nowadays makes it clear that, specific management guidelines with respect to HWW, but also indicate certain characteristics that can be represented to specify their nature and indicator.

Research limitations/implications

Determination of effluent characteristic for each specialized treatment need to be analyzed for meeting the framed regulatory standards. Up-gradation of existing treatment facilities, adopting new technologies and improving operation, maintained is a viable option. As there are no specific treatment schemes available hence combination and optimization of treatment methods may solve the problem to certain extent.

Practical implications

There is some flexibility also there so that law framework can be modified accordingly. For any health facilities direct discharges into natural water bodies it effluent need to follow national discharge standards. These are quite strict as compared to indirect standards and generally not meet by such facilities. This is quite logical because they are not being monitored or treated by municipal systems.

Social implications

The law indicates that hospital needed to collect and treat effluent according to the treatment standards. But on other hand the law was made making it consideration about the HWW collection in water bodies.

Originality/value

The best way of management as described, is to treat HWW onsite-dividing into primary, secondary and tertiary. The document also provides details about sludge disposal, possible reuse, including the application of new and innovative treatment technologies for HWW. It also provides guidance for minimum approach for HWW management because developing countries patients do not have proper sanitation facilities.
Evidence for the coexistence of direct and riboflavin‐mediated interspecies electron transfer in Geobacter co‐culture
Authors: Huang Lingyan , Liu Xing , Ye Yin , Chen Man , Zhou Shungui
Published: October 2019

Geobacter species can secrete free redox‐active flavins, but the role of these flavins in the interspecies electron transfer (IET) of Geobacter direct interspecies electron transfer (DIET) co‐culture is unknown. Here, we report the presence of a new riboflavin‐mediated interspecies electron transfer (RMIET) process in a traditional Geobacter DIET co‐culture; in this process, riboflavin contributes to IET by acting as a free‐form electron shuttle between free Geobacter species and serving as a bound cofactor of some cytochromes in Geobacter co‐culture aggregates. Multiple lines of evidence indicate that RMIET facilitates the primary initiation of syntrophic growth between Geobacter species before establishing the DIET co‐culture and provides additional ways alongside the DIET to transfer electrons to achieve electric syntrophy between Geobacter species. Redox kinetic analysis of riboflavin on either Geobacter species demonstrated that the Gmet_2896 cytochrome acts as the key riboflavin reduction site, while riboflavin oxidation by Geobacter sulfurreducens is the rate‐limiting step in RMIET, and the RMIET makes only a minor contribution to IET in Geobacter DIET co‐culture. The discovery of a new RMIET process in Geobacter DIET co‐culture suggests the complexity of IET in syntrophic bacterial communities and provides suggestions for the careful examination of the IET of other syntrophic co‐cultures.
Restraint minimisation in mental health care: legitimate or illegitimate force? An ethnographic study
Authors: McKeown Mick , Thomson Gill , Scholes Amy , Jones Fiona , Downe Soo , Price Owen , Baker John , Greenwood Paul , Whittington Richard , Duxbury Joy
Published: October 2019

Coercive practices, such as physical restraint, are used globally to respond to violent, aggressive and other behaviours displayed by mental health service users.1 A number of approaches have been designed to aid staff working within services to minimise the use of restraint and other restrictive practices. One such approach, the ‘REsTRAIN Yourself’ (RYS) initiative, has been evaluated in the UK. Rapid ethnography was used to explore the aspects of organisational culture and staff behaviour exhibited by teams of staff working within 14 acute admission mental health wards in the North West region of the English NHS. Findings comprise four core themes of space and place; legitimation; meaningful activity; and, therapeutic engagement that represent characteristics of daily life on the wards before and after implementation of the RYS intervention. Tensions between staff commitments to therapeutic relations and constraining factors were revealed in demarcations of ward space and limitations on availability of meaningful activities. The physical, relational and discursive means by which ward spaces are segregated prompts attention to the observed materialities of routine care. Legitimation was identified as a crucial discursive practice in the context of staff reliance upon coercion. Trauma‐informed care represents a potentially alternative legitimacy.
Drivers of the great housing boom‐bust: Credit conditions, beliefs, or both?
Authors: Cox Josue , Ludvigson Sydney C.
Published: October 2019

Two potential driving forces of house price fluctuations are commonly cited: credit conditions and beliefs. We posit some simple empirical calculations using direct measures of credit conditions and beliefs to consider their potentially distinct roles in house price fluctuations at the aggregate level. Changes in credit conditions are positively related to the fraction of riskier nonconforming debt in total mortgage lending, while measures of beliefs are unrelated to this ratio. Credit conditions explain quantitatively large magnitudes of the variation in quarterly house price growth and also predict future house price growth. Beliefs bear some relation to contemporaneous house price growth but have little predictive power. A structural vector autoregression analysis implies that exogenous changes in credit conditions have quantitatively important dynamic causal effects on house price changes.
Evaluating Bioinformatic Pipeline Performance for Forensic Microbiome Analysis*,†,‡
Authors: Kaszubinski Sierra F. , Pechal Jennifer L. , Schmidt Carl J. , Jordan Heather R. , Benbow Mark E. , Meek Mariah H.
Published: October 2019

Microbial communities have potential evidential utility for forensic applications. However, bioinformatic analysis of high‐throughput sequencing data varies widely among laboratories. These differences can potentially affect microbial community composition and downstream analyses. To illustrate the importance of standardizing methodology, we compared analyses of postmortem microbiome samples using several bioinformatic pipelines, varying minimum library size or minimum number of sequences per sample, and sample size. Using the same input sequence data, we found that three open‐source bioinformatic pipelines, MG‐RAST, mothur, and QIIME2, had significant differences in relative abundance, alpha‐diversity, and beta‐diversity, despite the same input data. Increasing minimum library size and sample size increased the number of low‐abundant and infrequent taxa detected. Our results show that bioinformatic pipeline and parameter choice affect results in important ways. Given the growing potential application of forensic microbiology to the criminal justice system, continued research on standardizing computational methodology will be important for downstream applications.
Why diversity and expectations matter
Authors: McCluskey Jill J.
Published: October 2019

This article was delivered in a session entitled Insights from a behavioral lens: why perceptions and diversity matter. In the article, I ask whether a diverse academic workforce is an asset to a University, and more generally to society, and conclude that it is. Although this conclusion is based on empirical data from US universities, the message is universal. Even when correcting for years of experience, rank, and nature of appointment and women's work‐life situation, there is still a negative expectation bias, whereby women and minority candidates are not expected to be as good as male researchers (a bias that also exists in the case of the appointment of female Chief Executive Officers). On the other hand, more women and minority appointments increase the productivity of women students.
The Impact of Appraisal Quality on the Voluntary Disclosure of Asset Revaluation
Authors: Song Younghyo , Pae Jinhan
Published: October 2019

In the wake of the global financial crisis, we compare Korean firms that voluntarily disclosed their revaluation in a timely manner with those that did not. We find that firms are more likely to disclose revaluation when they hire a large, reputable appraisal firm and when they have a large number of revaluation increments. We observe a significantly positive market reaction to the voluntary disclosure of the revaluation results. A positive market reaction is mainly observed for firms that hired a large, reputable appraisal firm, had a large number of revaluation increments, and were under greater financial distress before revaluation.
Pharmacokinetic basis for dosing high‐dose methotrexate in infants and young children with malignant brain tumours
Authors: Panetta John C. , Roberts Jessica K. , Huang Jie , Lin Tong , Daryani Vinay M. , Harstead K. Elaine , Patel Yogesh T. , Onar‐Thomas Arzu , Campagne Olivia , Ward Deborah A. , Broniscer Alberto , Robinson Giles , Gajjar Amar , Stewart Clinton F.
Published: October 2019

Aims

No population pharmacokinetic studies of high‐dose methotrexate (HDMTX) have been conducted in infants with brain tumours, which are a vulnerable population. The aim of this study was to evaluate HDMTX disposition in these children to provide a rational basis for MTX dosing.

Methods

Patients received 4 monthly courses of HDMTX (5 g/m2 or 2.5 g/m2 for infants aged ≤31 days) as a 24‐h infusion. Serial samples were analysed for MTX by an enzyme immunoassay method. Pharmacokinetic parameters were estimated using nonlinear mixed effects population modelling. Demographics, concomitant medications and genetic polymorphisms were considered as pharmacokinetic covariates while MTX exposure and patient age were considered as covariates for Grade 3 and 4 toxicities.

Results

The population pharmacokinetics of HDMTX were estimated in 178 patients (age range 0.02–4.7 years) in 648 courses. The population clearance and volume were 90 mL/min/m2 and 14.4 L/m2, respectively. Significant covariates on body surface area adjusted MTX clearance included estimated glomerular filtration rate and co‐treatment with dexamethasone or vancomycin. No significant association was observed between MTX toxicity and MTX exposure, patient age, leucovorin dosage or duration. MTX clearance in infants ≤31 days at enrolment was 44% lower than in older infants, but their incidence of toxicity was not higher since they also received a lower MTX dosage.

Conclusions

By aggressively following institutional clinical guidelines, HDMTX‐related toxicities were low, and using covariates from the population pharmacokinetic model enabled the calculation of a rational dosage for this patient population for future clinical trials.
Neurotrophic interactions between neurons and astrocytes following AAV1‐Rheb(S16H) transduction in the hippocampus in vivo
Authors: Jeon Min‐Tae , Moon Gyeong Joon , Kim Sehwan , Choi Minji , Oh Yong‐Seok , Kim Dong Woon , Kim Hyung‐Jun , Lee Kea Joo , Choe Youngshik , Ha Chang Man , Jang Il‐Sung , Nakamura Michiko , McLean Catriona , Chung Won‐Suk , Shin Won‐Ho , Lee Seok‐Geun , Kim Sang Ryong
Published: October 2019

Background and Purpose

We recently reported that AAV1‐Rheb(S16H) transduction could protect hippocampal neurons through the induction of brain‐derived neurotrophic factor (BDNF) in the rat hippocampus in vivo. It is still unclear how neuronal BDNF produced by AAV1‐Rheb(S16H) transduction induces neuroprotective effects in the hippocampus and whether its up‐regulation contributes to the enhance of a neuroprotective system in the adult brain.

Experimental Approach

To determine the presence of a neuroprotective system in the hippocampus of patients with Alzheimer's disease (AD), we examined the levels of glial fibrillary acidic protein, BDNF and ciliary neurotrophic factor (CNTF) and their receptors, tropomyocin receptor kinase B (TrkB) and CNTF receptor α(CNTFRα), in the hippocampus of AD patients. We also determined whether AAV1‐Rheb(S16H) transduction stimulates astroglial activation and whether reactive astrocytes contribute to neuroprotection in models of hippocampal neurotoxicity in vivo and in vitro.

Key Results

AD patients may have a potential neuroprotective system, demonstrated by increased levels of full‐length TrkB and CNTFRα in the hippocampus. Further AAV1‐Rheb(S16H) transduction induced sustained increases in the levels of full‐length TrkB and CNTFRα in reactive astrocytes and hippocampal neurons. Moreover, neuronal BDNF produced by Rheb(S16H) transduction of hippocampal neurons induced reactive astrocytes, resulting in CNTF production through the activation of astrocytic TrkB and the up‐regulation of neuronal BDNF and astrocytic CNTF which had synergistic effects on the survival of hippocampal neurons in vivo.

Conclusions and Implications

The results demonstrated that Rheb(S16H) transduction of hippocampal neurons could strengthen the neuroprotective system and this intensified system may have a therapeutic value against neurodegeneration in the adult brain.
Combining designer receptors exclusively activated by designer drugs and neuroimaging in experimental models: A powerful approach towards neurotheranostic applications
Authors: Peeters Lore M. , Missault Stephan , Keliris Aneta J. , Keliris Georgios A.
Published: October 2019

The combination of chemogenetics targeting specific brain cell populations with in vivo imaging techniques provides scientists with a powerful new tool to study functional neural networks at the whole‐brain scale. A number of recent studies indicate the potential of this approach to increase our understanding of brain function in health and disease. In this review, we discuss the employment of a specific chemogenetic tool, designer receptors exclusively activated by designer drugs, in conjunction with non‐invasive neuroimaging techniques such as PET and MRI. We highlight the utility of using this multiscale approach in longitudinal studies and its ability to identify novel brain circuits relevant to behaviour that can be monitored in parallel. In addition, some identified shortcomings in this technique and more recent efforts to overcome them are also presented. Finally, we discuss the translational potential of designer receptors exclusively activated by designer drugs in neuroimaging and the promise it holds for future neurotheranostic applications.
Oral and dental health and health care for Māori with type 2 diabetes: A qualitative study
Authors: Reid Jennifer , Koopu Pauline , Burkhardt Natalie , Stewart Tereki , Anderson Anneka , Harwood Matire
Published: October 2019

Objectives

Type 2 diabetes mellitus (T2DM) and periodontal disease are two highly prevalent, directly and independently associated long‐term conditions that disproportionately impact Indigenous Māori in New Zealand (NZ). Although poorly understood, a number of social and biological mechanisms connect these conditions. This qualitative study explored experiences of T2DM and oral and dental (hereafter oral/dental) health; access to oral/dental health care; whether participants’ experiences supported or challenged existing evidence; and sought suggestions for improving oral/dental health in a high‐deprivation rural area of Northland, NZ.

Methods

Participants (n = 33) meeting the study criteria: self‐identified Māori ethnicity, aged ≥ 18‐years with glycated haemoglobin (HBA1c) >65 mmol/L were recruited via the local primary care clinic in September‐December 2015; two left the study prior to data collection. During face‐to‐face semi‐structured interviews, participants (n = 31) were asked How does diabetes affect your teeth? and When did you last access dental care? Kaupapa Māori (KM) theory and methodology provided an important decolonizing lens to critically analyse the fundamental causes of Indigenous health inequities.

Results

Independent analysis of qualitative data by three KM researchers identified four themes: access barriers to quality care; pathways to edentulism; the ‘cost’ of edentulism; and, unmet need. Results contributed towards informing Mana Tū—an evidence‐based KM programme for diabetes in primary care—to be introduced in this and other communities from 2018.

Conclusions

Oral health is integral to diabetes management, and vice versa. Subsidized specialist referrals for oral‐dental health care for Māori with T2DM could improve glycaemic control and diabetes outcomes and reduce diabetes‐related complications among this population.
Mechanisms of glucocorticoid resistance in hypereosinophilic syndromes
Authors: Stokes Kindra , Yoon Pryscilla , Makiya Michelle , Gebreegziabher Meheret , Holland‐Thomas Nicole , Ware JeanAnne , Wetzler Lauren , Khoury Paneez , Klion Amy D.
Published: October 2019

Background

Glucocorticoids (GC) are considered first‐line therapy for most patients with hypereosinophilic syndrome (HES). Although response rates are generally high, many patients require moderate to high doses for control of eosinophilia and symptoms, and up to 15% of patients do not respond at all. Despite this, little is known about the mechanisms of GC resistance in patients with HES.

Objective

To explore the aetiology of GC resistance in HES.

Methods

Clinical data and samples from 26 patients with HES enrolled on a prospective study of GC responsiveness and 23 patients with HES enrolled on a natural history study of eosinophilia for whom response to GC was known were analysed retrospectively. Expression of GC receptor isoforms was assessed by quantitative RT‐PCR in purified eosinophils. Serum cytokine levels were quantified by suspension array assay in multiplex.

Results

Despite an impaired eosinophil response to GC after 7 days of treatment, the expected rise in absolute neutrophil count was seen in 7/7 GC‐resistant patients, suggesting that GC resistance in HES is not a global phenomenon. Eosinophil mRNA expression of glucocorticoid receptor (GR) isoforms (α, β, and P) was similar between GC‐sensitive (n = 20) and GC‐resistant (n = 9) patients with HES. Whereas geometric mean serum levels were also comparable between GC‐r (n = 11) and GC‐s (n = 19) for all cytokines tested, serum IL‐5 levels were >100 pg/mL only in GC‐r patients.

Conclusions and Clinical Relevance

These data suggest that the mechanism of GC resistance in HES is not due to a global phenomenon affecting all lineages, but may be due, at least in some patients, to impairment of eosinophil apoptosis by increased levels of IL‐5.
Contact dermatitis caused by glucose sensors in diabetic children
Authors: Herman Anne , Darrigade Anne‐Sophie , de Montjoye Laurence , Baeck Marie
Published: October 2019

Background

Allergic contact dermatitis caused by glucose sensors has been recently described in diabetics, mostly in adult patients. Isobornyl acrylate and N‐N dimethylacrylamide are the potent causative agents.

Objectives

To describe a child population with contact dermatitis caused by glucose sensors, determine the causative allergen, and assess the prevalence of isobornyl acrylate (IBOA) sensitization.

Patients and Methods

Overall, 12 children with a reaction to medical devices, either glucose sensors or insulin sets, were patch tested with the European baseline series, glues and rubber, (meth) acrylates series, and with piece of the adhesive part of the glucose sensor FreeStyle Libre. Isobornyl acrylate 0.1% pet. was patch tested in 11 patients, and N‐N dimethylacrylamide in two. Some patients were tested with adhesive parts of the infusion set.

Results

Overall, 10 children reacted to the adhesive part of the sensor FreeStyle Libre, and 10 children were sensitized to IBOA. One patient turned out to be negative in all patch tests.

Conclusion

Allergic contact dermatitis caused by glucose sensors is common in the pediatric diabetic patient population. Like in the adult patient population, IBOA was the culprit allergen, with 83.3% sensitization prevalence in children exhibiting adverse cutaneous reactions caused by FreeStyle Libre.
Novel Labels Increase Category Coherence, But Only When People Have the Goal to Coordinate
Authors: Suffill Ellise , Branigan Holly , Pickering Martin
Published: October 2019

From infancy, we recognize that labels denote category membership and help us to identify the critical features that objects within a category share. Labels not only reflect how we categorize, but also allow us to communicate and share categories with others. Given the special status of labels as markers of category membership, do novel labels (i.e., non‐words) affect the way in which adults select dimensions for categorization in unsupervised settings? Additionally, is the purpose of this effect primarily coordinative (i.e., do labels promote shared understanding of how we categorize objects)? To address this, we conducted two experiments in which participants individually categorized images of mountains with or without novel labels, and with or without a goal of coordination, within a non‐communicative paradigm. People who sorted items with novel labels had more similar categories than people who sorted without labels only when they were told that their categories should make sense to other people, and not otherwise. We argue that sorters' goals determine whether novel labels promote the development of socially coherent categories.
Aconitine induces cardiomyocyte damage by mitigating BNIP3‐dependent mitophagy and the TNFα‐NLRP3 signalling axis
Authors: Peng Fu , Zhang Nan , Wang Chunting , Wang Xiaoyun , Huang Wei , Peng Cheng , He Gu , Han Bo
Published: October 2019

Objectives

Aconitine, the natural product extracted from Aconitum species, is widely used for the treatment of various diseases, including rheumatism, arthritis, bruises, fractures and pains. However, many studies have reported cardiotoxicity and neurotoxicity caused by aconitine, but the detailed mechanism underlying aconitine's effect on these processes remains unclear.

Materials and methods

The effects of aconitine on the inflammation, apoptosis and viability of H9c2 rat cardiomyocytes were evaluated by flow cytometry, Western blot, RNA sequencing and bioinformatics analysis.

Results

Aconitine suppressed cardiomyocyte proliferation and induced inflammation and apoptosis in a dose‐ and time‐dependent manner. These inflammatory damages could be reversed by a TNFα inhibitor and BNIP3‐mediated mitophagy. Consistent with the in vitro results, overexpression of BNIP3 in heart tissue partially suppressed the cardiotoxicity of aconitine by inhibiting apoptosis and the NLRP3 inflammasome.

Conclusions

Our findings lay a foundation for the application of a TNFα inhibitor and BNIP3 to aconitine‐induced cardiac toxicity prevention and therapy, thereby demonstrating potential for further investigation.
Association between referral source and duration of untreated psychosis in pathways to care among first episode psychosis patients in Northern Malawi
Authors: Kaminga Atipatsa C. , Myaba Japhet , Dai Wenjie , Liu Aizhong , Chilale Harris K. , Kubwalo Paul F. , Madula Precious , Banda Richard , Pan Xiongfeng , Wen Shi W.
Published: October 2019

Aims

To examine the association between referral source and duration of untreated psychosis (DUP) and explore determinants of referral source; when adjusting for pathways to care, positive and negative symptoms, diagnosis and socio‐demographic characteristics.

Methods

A total of 140 subjects with first episode psychosis (FEP) were enrolled from a pilot early intervention service for psychosis in Northern Malawi between June 2009 and September 2012. Logistic regression analyses were used to quantify the associations between variables of interest.

Results

Age ranged between 18 and 65 at assessment, with median, 33. Median DUP was 12.5 months. First contact did not independently determine DUP. Long DUP (>6 months) was associated with referral from community based volunteer (CBV) or traditional healer (TH), a unit increase in severity of negative symptoms and having schizophrenia, which was also associated with referral from CBV or TH. Additionally, being unemployed was associated with referral from CBV or TH. However, a unit increase in the number of times religious advice (RA) was sought, GP was contacted and severity of positive symptoms was associated with referral by GP.

Conclusions

Mental health awareness is justified for this population and collaboration with THs in identifying and treating patients with psychosis may help reduce treatment delays. Access to mental health services ought to improve, particularly for the unemployed group. Future studies should consider adjusting for referral source when ascertaining first contact source as a predictor of DUP.
Metabolomic analysis of synovial fluid from Thoroughbred racehorses diagnosed with palmar osteochondral disease using magnetic resonance imaging
Authors: Graham R. J. T. Y. , Anderson J. R. , Phelan M. M. , Cillan‐Garcia E. , Bladon B. M. , Taylor S. E.
Published: October 2019

Background

Palmar osteochondral disease (POD) is a common cause of lameness in competition horses. Magnetic resonance imaging (MRI) is the most sensitive diagnostic modality currently available, however it may not be financially or logistically practical for routine screening of POD. There is increasing interest in the use of metabolomics for diagnosis prior to progression to irreversible damage.

Objectives

To determine metabolite levels in synovial fluid (SF) of horses with a clinical diagnosis of POD based on diagnostic analgesia and MRI, with the hypothesis that metabolomic profiles differ between diseased and healthy joints.

Study design

Prospective clinical study.

Methods

Synovial fluid was collected from metacarpo/tarsophalangeal joints (MC/TPJ) of 29 horses (n = 51 joints), including 14 controls (n = 26) and 15 cases (n = 25), the latter with lameness localised to the MC/TPJ and MR changes consistent with POD (n = 23). Spectra were produced using 1H‐nuclear magnetic resonance (NMR) spectroscopy and analysed.

Results

Twenty‐five metabolites were recognised associated with various biosynthetic and degradation pathways. The metabolite abundances within the controls demonstrated increased variability compared with the clinical group. The low level of variance between the spectra of the two groups was explained by five principal components. Cross‐validation of the cohort demonstrated modest separation of predictive power (R2 = 0.67; Q2 = 0.34). Although statistical significance was not achieved, the most influential metabolites were glucose and lactate.

Main limitations

The modest sample size and variation in signalment, background and presenting condition of the controls may have impacted the discriminative power of the constructed models. The lack of matched controls, differences in time of fluid collection and freezing times may have also reduced accuracy when representing metabolite profiles.

Conclusions

This study identified and quantified metabolites present in MC/TPJ SF of clinical cases with POD.
Evaluation of off‐target effects of gapmer antisense oligonucleotides using human cells
Authors: Yoshida Tokuyuki , Naito Yuki , Yasuhara Hidenori , Sasaki Kiyomi , Kawaji Hideya , Kawai Jun , Naito Mikihiko , Okuda Haruhiro , Obika Satoshi , Inoue Takao
Published: October 2019

Antisense oligonucleotide (ASO) has the potential to induce off‐target effects due to complementary binding between the ASO and unintended RNA with a sequence similar to the target RNA. Conventional animal studies cannot be used to assess toxicity induced by off‐target effects because of differences in the genome sequence between humans and other animals. Consequently, the assessment of off‐target effects with in silico analysis using a human RNA database and/or in vitro expression analysis using human cells has been proposed.

Our previous study showed that the number of complementary regions of ASOs with mismatches in the human RNA sequences increases dramatically as the number of tolerated mismatches increases. However, to what extent the expression of genes with mismatches is affected by off‐target effects at the cellular level is not clear. In this study, we evaluated off‐target effects of gapmer ASOs, which cleave the target RNA in an RNase H‐dependent manner, by introducing the ASO into human cells and performing microarray analysis. Our data indicate that gapmer ASOs induce off‐target effects depending on the degree of complementarity between the ASO and off‐target candidate genes. Based on our results, we also propose a scheme for the assessment of off‐target effects of gapmer ASOs.
Human leucocyte antigen diversity: A biological gift to escape infections, no longer a barrier for haploidentical Hemopoietic Stem Cell Transplantation
Authors: Andreani Marco , Gaspari Stefania , Locatelli Franco
Published: October 2019

Since the beginning of life, every multicellular organism appeared to have a complex innate immune system although the adaptive immune system, centred on lymphocytes bearing antigen receptors generated by somatic recombination, arose in jawed fish approximately 500 million years ago. The major histocompatibility complex MHC, named the Human leucocyte antigen (HLA) system in humans, represents a vital function structure in the organism by presenting pathogen‐derived peptides to T cells as the main initial step of the adaptive immune response. The huge level of polymorphism observed in HLA genes definitely reflects selection, favouring heterozygosity at the individual or population level, in a pathogen‐rich environment, although many are located in introns or in exons that do not code for the antigen‐biding site of the HLA. Over the past three decades, the extent of allelic diversity at HLA loci has been well characterized using high‐resolution HLA‐DNA typing and the number of new HLA alleles, produced through next‐generation sequencing methods, is even more rapidly increasing. The level of the HLA system polymorphism represents an obstacle to the search of potential compatible donors for patients affected by haematological disease proposed for a hematopoietic stem cell transplant (HSCT). Data reported in literature clearly show that antigenic and/or allelic mismatches between related or unrelated donors and patients influences the successful HSCT outcome. However, the recent development of the new transplant strategy based on the choice of haploidentical donors for HSCT is questioning the role of HLA compatibility, since the great HLA disparities present do not worsen the overall clinical outcome. Nowadays, NGS has contributed to define at allelic levels the HLA polymorphism and solve potential ambiguities. However, HLA functions and tissue typing probably need to be further investigated in the next future, to understand the reasons why in haploidentical transplants the presence of a whole mismatch haplotype between donors and recipients, both the survival rate and the incidence of acute GvHD or graft rejection are similar to those reported for unrelated HSCTs.
Factors influencing medication‐taking behaviour with adjuvant endocrine therapy in women with breast cancer: A qualitative systematic review
Authors: Xu Hui , Zhang Xiu‐jie , Wang Da‐qiu , Xu Lei , Wang Ai-ping
Published: October 2019

Aims

To explore the experience and feelings associated with the endocrine therapy treatment trajectory in women with breast cancer and what affects medication taking behaviour.

Design

Qualitative systematic review.

Data sources

Qualitative studies were extracted from PubMed, EMBASE, CINAHL, PsycINFO from inception of each database until February 2019.

Review methods

The systematic search method SPIDER (sample, phenomenon of interest, design, evaluation, research type) was used. Thematic synthesis of the qualitative data was used.

Results

A total of 478 were identified in the initial search. Only 17 articles met inclusion criteria and were included in this review. Five analytical themes and 17 descriptive subthemes were identified.

Conclusions

The systematic review highlights knowledge, balancing the scales, self‐efficacy and support influence medication taking behaviour to women with breast cancer.

Impact

The medication taking behaviour of breast cancer women can be classified into four types: acceptance/persistence, bearing/suffering, hesitation/adjustment, refusing/abandoning. The four types can switch from one to another. Medication taking behaviour is affected by knowledge, balancing the scales, self‐efficacy, and support. The medical institutions, communities, and families can gain knowledge of the treatment experiences of women to better understand medication taking behaviour and those at risk for non‐adherence. Women wanted different types and amounts of information. Healthcare providers should be aware of patient preferences and take targeted interventions to help them receive treatment.