bluuebunny/crossref_metadata_2025 huggingface dataset:
Validity and reliability of the Ankylosing Spondylitis Disease Activity Score with C‐reactive protein (ASDAS‐CRP) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) in patients with axial spondyloarthritis (axSpA) in Singapore
Authors: Kwan Yu Heng , Tan Jun Jie , Phang Jie Kie , Fong Warren , Lim Ka Keat , Koh Hwee Ling , Lui Nai Lee , Tan Chuen Seng , Østbye Truls , Thumboo Julian , Leung Ying Ying
Published: November 2019

Introduction

The Ankylosing Spondylitis Disease Activity Score with C‐reactive protein (ASDAS‐CRP) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) are commonly used instruments for measuring disease activity. However, few studies have assessed their psychometric properties in patients with axial spondyloarthritis (axSpA). We aimed to assess the validity and reliability of ASDAS‐CRP and BASDAI in patients with axSpA in Singapore.

Methods

Cross‐sectional data from 280 patients with axSpA from a dedicated axSpA clinic in a Singapore tertiary referral hospital from 2011 to 2019 were used. Internal consistency was assessed using Cronbach's alpha. Construct validity was assessed through 12 a priori hypotheses by correlation of overall ASDAS‐CRP and BASDAI score with other patient‐reported outcomes measures (PROMs). Structural validity was evaluated via confirmatory factor analysis using maximum‐likelihood method, where Comparative Fit Index (CFI) >0.95, Tucker‐Lewis Index (TLI) >0.95, Root Mean Square Error of Approximation (RMSEA) <0.06 and Standardized Root Mean Residuals (SRMR) <0.08 were indicative of good fit.

Results

Among 280 patients (78.2% Male; 92.5% Chinese), ASDAS‐CRP showed poor internal consistency of 0.33, while BASDAI showed high internal consistency of 0.87. Convergent and divergent construct validity were demonstrated by fulfillment of 11 out of 12 a priori hypotheses when ASDAS‐CRP and BASDAI were compared with other PROMs. Our proposed ASDAS‐CRP and BASDAI model showed good fit for a 1‐factor structure respectively (CFI = 0.993, TLI = 0.984, RMSEA = 0.036, SRMR = 0.026 for ASDAS‐CRP; CFI = 0.993, TLI = 0.985, RMSEA = 0.057, SRMR = 0.022 for BASDAI), demonstrating structural validity.

Conclusion

This study supports the use of both ASDAS‐CRP and BASDAI in measuring disease activity in patients with axSpA in Singapore.
Interannual population dynamics of the green spruce aphid Elatobium abietinum (Walker) in France
Authors: Lemperiere Guy , Day Keith R. , Petit‐Berghem Yves , Robinet Nicolas , Portier Pérrine , Leather Simon R. , Marage Damien
Published: November 2019

The hypothesis that similar processes govern interannual dynamics of green spruce aphid in the UK and France, is generally supported by the application of a general discrete model. A simple model based on relatively few parameters was able to closely characterise interannual population dynamics from completely independent aerial and arboreal samples of aphids. Long‐term field population estimates of the green spruce aphid Elatobium abietinum (Walker) in France have provided the opportunity to select and evaluate the generality of a model, which was developed in the UK to explain the year‐to‐year variations in peak abundance of the aphid. The objective was to observe the influence of the local climates and disturbing climate factors on the population densities of the insect in two regions of France. The model uses climate variables and aphid population data from regular samples in the two regions that were investigated. A general discrete model was used to predict aphid population densities. The model performed well in tracking the interannual patterns of population but was less likely to predict absolute population density. To improve predictions, further account would need to be taken of additional site‐specific climate variables and the strength of overcompensating density dependence. Nevertheless, it is clear that broadly similar processes are at work in the population dynamics of this insect across its biogeographical range.
Cost analysis comparison between peripherally inserted central catheters and implanted chest ports in patients with cancer—A health economic evaluation of the PICCPORT trial
Authors: Taxbro Knut , Hammarskjöld Fredrik , Juhlin David , Hagman Helga , Bernfort Lars , Berg Sören
Published: November 2019

Background

A reliable central venous access device is a cornerstone in the treatment of cancer. Both peripherally inserted central catheters (PICC) and totally implanted chest ports (PORT) are commonly used for the delivery of chemotherapy. Both types of catheter can cause adverse events such as catheter‐related deep venous thrombosis (CR‐DVT), infection and mechanical complications.

Method

We conducted a randomized controlled trial including 399 patients with cancer and performed a health economic evaluation investigating the cost related to PICCs and PORTs using several clinically relevant dimensions from a healthcare perspective. The cost was determined using process and cost estimate models.

Result

PICCs are associated with a higher total cost when compared with PORTs. Combining the costs of all categories, the prize per inserted device was 824.58 EUR for PICC and 662.34 EUR for PORT. When adjusting for total catheter dwell time the price was 6.58 EUR/day for PICC and 3.01 EUR/day for PORT. The difference in CR‐DVT was the main contributor to the difference in cost. The daily cost of PICC is approximately twice to that of PORT.

Conclusion

We have demonstrated that the cost from a healthcare perspective is higher in cancer patients receiving a PICC than to those with a PORT. The difference is driven mainly by the cost related to the management of adverse events. Our findings are relevant to anaesthetists, oncologists and vascular access clinicians and should be considered when choosing vascular access device prior to chemotherapy.
Clinical impact of data feedback at lung cancer multidisciplinary team meetings: A mixed methods study
Authors: Stone Emily , Rankin Nicole M. , Vinod Shalini K. , Nagarajah Mohan , Donnelly Candice , Currow David C. , Fong Kwun M. , Phillips Jane L. , Shaw Tim
Published: November 2019

Aim

Multidisciplinary team (MDT) meetings can facilitate optimal lung cancer care, yet details of structured data collection and feedback remain sparse. This study aimed to investigate data collection and the impact of feedback to lung cancer MDTs.

Methods

A mixed‐methods study using pre and post‐test surveys, semistructured interviews, and observation to evaluate data collection and response to modeled data feedback in three Australian lung cancer MDTs at different locations and development stage (site A: outer metropolitan, established; site B, outer metropolitan, new; and site C, inner metropolitan, established).

Results

MDT attendees (range 13‐25) discussed 5‐8 cases per meeting. All sites collected data prospectively (80% prepopulated) into local oncology medical information systems. The pretest survey had 17 respondents in total (88% clinicians). At sites A and C, 100% of respondents noted regular data audits, occasional at site B. Regular audit data included number of cases, stage, final diagnosis, and time to diagnosis and treatment. The post‐test survey had 25 respondents in total, all clinicians. The majority (88‐96%) of respondents found modeled data easy to interpret, relevant to clinical practice and the MDT, and welcomed future regular data presentations (as rated on a 5‐point Likert scale mean weighted average 4.5 where > 4 demonstrates agreement). Semistructured interviews identified five major themes for MDTs: current practice, attitudes, enablers, barriers, and benefits for the MDT.

Conclusions

MDT teams exhibited positive responses to modeled data feedback. Key characteristics of MDT data were identified and may assist with future team research and development.
The value of blood biomarkers of progression and prognosis in ALK‐positive patients with non–small cell lung cancer treated with crizotinib
Authors: Yang Yaning , Xu Haiyan , Yang Guangjian , Yang Lu , Li Junling , Wang Yan
Published: November 2019

Aim

Valuable and convenient prognostic predictors are essential for targeted therapy of non–small cell lung cancer (NSCLC). Patients with early‐stage cancer and EGFR mutations who's neutrophils‐to‐lymphocytes rate (NLR) could be prognostic factor to evaluate efficacy. However, the prognostic role of NLR in patients receiving ALK inhibitors has not been established. Additionally, the relation between the efficacy of ALK inhibitors and derived NLR (dNLR), platelets‐to‐lymphocytes rate (PLR), white blood cells (WBC) and hemoglobin (HGB) are still unknown.

Methods

This is a retrospective single‐center study and enrolled 113 staged IIIB–IV ALK‐positive NSCLC patients who had received crizotinib treatment. Pretreatment NLR, dNLR, PLR, WBC, HGB were collected and calculated. Cox regression analysis were conducted to study the prognostic roles of NLR, dNLR, PLR, WBC, and HGB on progression‐free survival (PFS) and overall survival (OS). Z‐test was utilized to identify the difference among all predictive factors’ receiver‐operating characteristics (ROC) curves.

Results

The median PFS and OS were 10.1 and 23.4 months. Elevated NLR, dNLR, PLR and decreased HGB were associated with worse PFS (95% confidence interval [CI], 1.078–2.304, P = 0.018; 95% CI, 1.043–2.222, P = 0.028; 95% CI, 1.257–2.757, P = 0.002; 95% CI, 0.368–0.843, P = 0.005, respectively) and OS (95% CI, 1.698–5.721, P < 0.001; 95% CI, 1.273–3.984, P = 0.005; 95% CI, 2.174–6.347, P < 0.001; 95% CI, 0.246–0.710, P = 0.001, respectively). Z‐test revealed there were no significant differences between single factors or combination of them to predict the efficacy.

Conclusions

Trend of NLR, dNLR, PLR and WBC could be used to identify patients progress status in ALK‐positive NSCLC patients receiving crizotinib. Combination of all biomarkers is no superior to single biomarker.
Minimally invasive major hepatectomies: a Southeast Asian single institution contemporary experience with its first 120 consecutive cases
Authors: Goh Brian K. P. , Lee Ser‐Yee , Koh Ye‐Xin , Kam Juinn‐Huar , Chan Chung‐Yip
Published: November 2019

Background

The role of minimally invasive major hepatectomy (MIMH) remains controversial and questions remain about its safety and reproducibility outside expert centres. This study examines the changing trends, safety and outcomes associated with the adoption of MIMH based on a contemporary single institution experience.

Methods

This study is a review of 120 consecutive patients who underwent MIMH between 2011 and 2018. To determine the evolution of MIMH, the study population was stratified into four equal groups of patients. Both conventional major hepatectomies (CMHs) (≥3 segments) and technical major hepatectomies (right anterior and posterior sectionectomies) were included.

Results

There were 70 CMHs and 50 technical major hepatectomies. Seven MIMHs were laparoscopic‐assisted and 113 (94.2%) were totally laparoscopic/robotic. There were 10 (8.3%) open conversions. Comparison across the four groups demonstrated that with increasing experience, there was a significant trend in a higher proportion of higher American Society of Anesthesiologists score patients, increasing frequency of CMH performed, increasing frequency of multifocal tumours resected, decreasing use of laparoscopic‐assisted approach and decrease in blood loss.

Conclusion

MIMH can be adopted safely today with a low open conversion rate. Over time with increasing experience, we performed MIMH with increasing frequency in higher risk patients and in patients with multifocal tumours but with a decrease in median estimated blood loss.
Antimicrobial use and stewardship practices on Australian beef feedlots
Authors: Badger SM , Sullivan KF , Jordan D , Caraguel CGB , Page SW , Cusack PMV , Frith D , Trott DJ
Published: November 2019

Objective

Improving antimicrobial stewardship in the livestock sector requires an understanding of the motivations for antimicrobial use and the quantities consumed. However,detailed information on antimicrobial use in livestock sectors is lacking. This cross‐sectional study aimed to better understand antimicrobial use in the beef feedlot sector in Australia.

Design

A self‐administered questionnaire asking about antimicrobial use and reasons for use was designed and mailed to beef feedlot operators in Australia. Respondents were asked to report the percentage of animals treated, purpose of use, and disease conditions targeted for 26antimicrobial agents.

Results

In total, 83 of 517 (16.1%) beef feedlot operators completed the survey. Monensin (61.0%of respondents) and virginiamycin (19.5%of respondents) were the most commonly reported in‐feed antimicrobials. In‐feed antimicrobial agents were most frequently used by respondents for treatment of gastrointestinal diseases (52.8%). Antimicrobials were used for growth promotion by 42.1% of respondents, with most (85.7%) reporting the use of ionophores(a group of compounds not used in human medicine). Short‐acting penicillin(69.1%), short‐acting oxytetracycline, and tulathromycin (both 57.3%) werethe most common injectable antimicrobial agents used. Injectable antimicrobials were most frequently used to treat respiratory (72.3%) and musculoskeletal (67.5%) conditions.

Conclusion

Overall,the use of antimicrobials was appropriate for the purpose indicated, and there was a strong preference for drugs of low‐importance in human medicine. The data described here stand to be a strong influence on the implementation of an antimicrobial stewardship program in the sector.
Comorbidities and sex differences in causes of death among mantle cell lymphoma patients – A nationwide population‐based cohort study
Authors: Glimelius Ingrid , Smedby Karin E. , Eloranta Sandra , Jerkeman Mats , Weibull Caroline E.
Published: November 2019

The prognosis for mantle cell lymphoma (MCL) remains poor. Our aim was to assess the impact of comorbidities on survival and causes of death. For 1,385 MCL patients (1,009 males, 376 females) diagnosed in 2000–2014 (median age 71 years, range 22–96) comorbidities ≤ 10 years of diagnosis were classified according to the Charlson comorbidity index (CCI; 0, 1, 2+). Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated to compare lymphoma‐specific and all‐cause mortality rates. Model‐based predictions were used to obtain probabilities of death. Overall, 44% had any comorbidity (CCI 1+) and 28% severe comorbidity (CCI 2+). Over a median follow‐up of 3·7 years (range 0–16), 633 (46%) died, the majority (76%) from lymphoma. Severe comorbidity was independently associated with higher all‐cause [hazard ratio (HR) = 1·52; 95% CI: 1·24–1·85) and lymphoma‐specific mortality (HR = 1·31; 95% CI: 1·04–1·65). Particularly among patients with connective tissue, renal and psychiatric diseases, and dementia. Among females with any comorbidity, non‐lymphoma deaths represented a larger proportion of all deaths, compared to males with any comorbidity. In general, more efficient lymphoma treatments need to be considered also for patients with severe comorbidity. However, among females with any comorbidity, the likelihood of non‐lymphoma death was still considerable, perhaps favouring a more liberal use of a “wait and watch” approach.
The brain‐penetrating, orally bioavailable, ghrelin receptor agonist HM01 ameliorates motion‐induced emesis in Suncus murinus (house musk shrew)
Authors: Tu Longlong , Lu Zengbing , Ngan Man P. , Lam Francis F.Y. , Giuliano Claudio , Lovati Emanuela , Pietra Claudio , Rudd John A.
Published: November 2019

Background and Purpose

HM01, a novel, orally bioavailable, brain‐penetrating agonist of ghrelin receptors, ameliorates emesis in Suncus murinus. This study compared HM01's activity against motion sickness with that of the less brain‐penetrating ghrelin receptor agonist, HM02.

Experimental Approach

The potential of HM01 and HM02 to relax isolated mesenteric arteries and to increase feeding was investigated. Radio telemetry was used to record gastric slow waves and body temperature. Plethysmography was used to measure respiratory function. HM01 and HM02 were administered p.o. 1 hr prior to provocative motion, and c‐Fos expression in brain sections was assessed.

Key Results

HM01 and HM02 both relaxed precontracted arteries, yielding EC50 values of 2.5 ± 0.5 and 3.5 ± 0.4 nM respectively. HM01 increased feeding, but HM02 did not. Both compounds caused hypothermia and bradygastria. Motion induced 123 ± 24 emetic events. HM01, but not HM02, reduced motion‐induced emesis by 67.6%. Motion increased c‐Fos expression in the nucleus tractus solitarius (NTS), dorsal motor nucleus of the vagus (DMNV), medial vestibular nucleus (MVe), central nucleus of the amygdala, and paraventricular hypothalamic nucleus (PVH). HM01 alone increased c‐Fos expression in the area postrema, NTS, DMNV, PVH, and arcuate hypothalamic nucleus; HM02 had a similar pattern except it did not increase c‐Fos in the PVH. Both compounds antagonized the motion‐induced increases in c‐Fos expression in the MVe.

Conclusions and Implications

HM01 is more effective than HM02 in preventing motion‐induced emesis. The difference in potency may relate to activation of ghrelin receptors in the PVH.
The Second Gaddum Lecture: its origins and outcomes
Authors: Bakhle Y.S.
Published: November 2019

Fifty years ago, the BJP published the Second Gaddum Lecture, given by John Vane to the British Pharmacological Society. This article assesses the origins of the experiments described in the Lecture, linking them directly to Gaddum's use of bioassay, a defining feature of pharmacology. The outcomes of those experiments are also assessed, tracking those results that have survived the past five decades. Two of the major advances in cardiovascular medicine, the ACE inhibitors, as anti‐hypertensives, and low‐dose aspirin, to prevent thrombosis were initiated by the work in this Lecture. Physiologically significant outcomes include a new non‐respiratory function of the lung, based on the metabolism of endogenous vasoactive substrates in the pulmonary circulation and the recognition of the endothelium as a highly interactive component of blood vessels. The present state of the art in pharmacology, physiology and medicine owes much to the work described in the Second Gaddum Lecture.
Prevalence of hereditary breast and ovarian cancer (HBOC) predisposition gene mutations among 882 HBOC high‐risk Chinese individuals
Authors: Shao Di , Cheng Shaomin , Guo Fengming , Zhu Changbin , Yuan Yuying , Hu Kunling , Wang Zhe , Meng Xuan , Jin Xin , Xiong Yun , Chai Xianghua , Li Hong , Zhang Yu , Zhang Hongyun , Liu Jihong , Ye Mingzhi
Published: November 2019

Identification of deleterious variants in hereditary breast and ovarian cancer (HBOC) susceptibility genes allows for increased clinical surveillance and early detection, and could predict the response to poly (ADP‐ribose) polymerase (PARP) inhibitor in patients with advanced ovarian carcinomas. To determine the prevalence and clinical prediction factors for HBOC syndrome, 882 selected individuals underwent multigene panel testing for HBOC risk assessment during the period from January 2015 to March 2018. Overall, 176 deleterious mutations were observed in 19.50% (n = 172) of individuals. Twenty‐six of 176 mutations could not be retrieved in related public databases and were considered to be novel. Among patients with ovarian cancer, 115 deleterious mutations were identified in 429 patients (48.6%) with significant enrichment for a family history of breast or ovarian cancer syndrome (P < .05). In the breast cancer subgroup, 31 deleterious mutations were identified in 261 patients. Besides BRCA1 (8; 25.8%) and BRCA2 (11; 35.5%), the most frequently occurring genes, an additional 12 deleterious mutations (38.7%) were found in seven other susceptibility genes. Higher mutation incidence (57.9%) was observed in subjects with histories of breast and ovarian cancer. Our results highlighted the genetic heterogeneity of HBOC and the efficiency of a multigene panel in carrying out risk assessment.
Remission of hypertension after surgical cure of Cushing's syndrome
Authors: Jha Smita , Sinaii Ninet , McGlotten Raven N. , Nieman Lynnette K.
Published: November 2019

Context

Hypertension associated with Cushing's syndrome (CS) increases cardiovascular risk. The time‐course of improvement after cure is unclear.

Objective

To describe the time‐course and predictors of blood pressure (BP) normalization during one year after surgical cure of CS.

Design

Retrospective chart review of 75 hypertensive adults cured of CS (72 with ACTH‐dependent CS; 3 with adrenal adenoma). Hypertension was defined as current use of antihypertensives, a systolic BP >130 mm Hg, or diastolic BP >80 mm Hg.

Main Outcome Measure(s)

Remission of hypertension: BP ≤130/80 mm Hg and no antihypertensive medications. Improvement in hypertension: BP >130/80 mm Hg and decreased number or dose of medications, or blood pressure ≤130/80 with continued use of medications at constant dose.

Results

At postoperative discharge, 17 (23%, P < .001), 51 (68%, P < .001) and 7 (9%) patients had remission, improvement in hypertension or no change. Twenty‐nine had no follow‐up. Others achieved remission at 3 (n = 5), 6 (n = 6), or 12‐months (n = 5). At the last evaluation, 33/75 (44%) had remission, 36/75 (48%) had improved hypertension and 6 were unchanged. Patients with improvement discontinued a median of one medication (P < .001). At 12‐months, 27/42 (64%) patients had normal BP (P < .002). Longer estimated duration of CS (P = .0106), younger age (P = .0022), and lower baseline body mass index (P = .0413) predicted hypertension remission.

Conclusions

About 80% of CS patients experienced BP normalization or improvement within 10 days of cure, but about half failed to normalize BP by one year. BP should be monitored after cure, and antihypertensive medications adjusted to avoid unwanted cardiovascular effects.
Play enhances visual form perception in infancy–an active training study
Authors: Schröder Elin , Gredebäck Gustaf , Gunnarsson Jessica , Lindskog Marcus
Published: November 2019

Motor experiences and active exploration during early childhood may affect individual differences in a wide range of perceptual and cognitive abilities. In the current study, we suggest that active exploration of objects facilitates the ability to process object forms and magnitudes, which in turn impacts the development of numerosity perception. We tested our hypothesis by conducting a preregistered active exploration intervention with 59 8‐month‐old infants. The minimal intervention consisted of actively playing with and exploring blocks once a day for 8 weeks. In order to control for possible training effects on attention, we used book reading as a control condition. Pre‐ and post‐test assessments using eye‐tracking showed that block play improved visual form perception, where infants became better at detecting a deviant shape. Furthermore, using three control tasks, we showed that the intervention specifically improved infants' ability to process visual forms and the effect could not be explained by a domain general improvement in attention or visual perception. We found that the intervention did not improve numerosity perception and suggest that because of the sequential nature of our hypothesis, a longer time frame might be needed to see improvements in this ability. Our findings indicate that if infants are given more opportunities for play and exploration, it will have positive effects on their visual form perception, which in turn could help their understanding of geometrical concepts.
Long‐term follow‐up of a randomized controlled trial of a text‐message diabetes self‐management support programme, SMS4BG
Authors: Dobson R. , Whittaker R. , Jiang Y. , McNamara C. , Shepherd M. , Maddison R. , Cutfield R. , Khanolkar M. , Murphy R.
Published: November 2019

Aims

To determine the long‐term effectiveness of an individually tailored text‐message diabetes self‐management support programme, SMS4BG, on glycaemic control at 2 years in adults with diabetes with an HbA1c concentration > 64 mmol/mol (8%).

Methods

We conducted a 2‐year follow‐up of a two‐arm, parallel, randomized controlled trial across health services in New Zealand. Participants were English‐speaking adults with type 1 or 2 diabetes and with an HbA1c >64 mmol/mol (8%). In the main trial participants randomized to the intervention group (N=183) received up to 9 months of an automated tailored text‐message programme in addition to usual care. Participants in the control group (N=183) received usual care for 9 months. In this follow‐up study, 293 (80%) of 366 randomized participants in the main trial were included. The primary outcome measure was change in glycaemic control (HbA1c) from baseline to 2 years. Mixed‐effect models were used to compare the group differences at 3, 6, 9 and 24 months, adjusted for baseline HbA1c and stratification factors (health district category, diabetes type and ethnicity).

Results

The decrease in HbA1c at 2 years was significantly greater in the intervention group [mean (sd) –10 (18) mmol/mol or –0.9 (1.6)%] compared with the control group [mean (sd) –1 (20) mmol/mol or –0.1 (1.8)%], with an adjusted mean difference of –9 mmol/mol (95% CI –14, –5) or –0.8% (95% CI –1.2, –0.4; P<0.0001).

Conclusions

Improvements in glycaemic control resulting from a text‐message diabetes self‐management support programme were sustained at 2 years after randomization. These findings support the implementation of SMS4BG in current practice.
Students’ Perceptions of Learning in an Online Multiround Business Simulation Game: What Can We Learn from Them?
Authors: Brazhkin Vitaly , Zimmerman Honey
Published: November 2019

Multiround business simulation games have been gaining popularity in higher education. However, certain aspects of experiential learning of individual students in the game remain unaddressed in research literature. Team assessments, such as team papers, appear a common, “natural” choice given the team‐based nature of the games but may potentially mask individual learning outcomes. In this study we use a qualitative method to glean from individual students’ papers a deeper understanding of the process of learning of individual students in a team‐based, multiround business simulation game. Our findings indicate that individual and timely assessments are necessary to identify cases of not meeting the expected individual learning outcomes for the instructor's corrective intervention. This study contributes to the understanding of the process and outcomes of student learning in a multiround business simulation game, methods of teaching a supply chain and operations class with a simulation, and methods for better aligning course goals and assessments.
A Learning Curve‐Based Assembly Game
Authors: Robbins Thomas R.
Published: November 2019

This article describes a game used in an MBA‐level operations management course to help students understand the concept of the learning curve. Student teams participate in an interactive, hands‐on Lego assembly exercise, measuring their times through repeated trials after which they calculate their team's learning curve rate. The exercise is oriented to illustrate the mechanisms by which learning occurs both individually and organizationally. After students complete their work in groups, the data is aggregated across the class and analyzed to further illustrate key principles of the learning curve. A modified version of the game based on cup‐stacking has been developed for online students.
Effects of Using Thinking Routines on the Academic Results of Business Students at a Chilean Tertiary Education Institution
Authors: Sepulveda Larraguibel Yerko , Venegas‐Muggli Juan I.
Published: November 2019

The present study investigates the effects of using thinking routines to promote interactive learning environments on the academic results of tertiary education students enrolled in the Cost and Budgeting course at a Chilean higher education institution during 2016. Using the quasi‐experimental methodologies Propensity Score Matching and Differences in Differences, student grade averages and exam grade averages were compared using information from both the year this initiative was implemented (2016) and the previous year (2015) to control for preexisting differences between the comparison groups. The results show that students taught using thinking routines obtain better academic results than their counterparts taught using traditional methods.
Newsvendor Game: A Behavioral Exercise in Decision Making under Risk
Authors: Surti Chirag , Celani Anthony
Published: November 2019

The newsvendor problem is a classic problem of decision making under risk that is taught in traditional Operations and Supply Chain Management classes as a single‐period inventory problem. We discuss the following three pedagogical points of interest to any instructor tasked with teaching this topic: a) why the newsvendor model is relevant in this day and age; b) how to make better sense of the newsvendor problem for students; and c) how to easily implement and administer an active learning exercise in either a traditional classroom, or an online setting. This active learning exercise is a quick, effective, and meaningful way of demonstrating a variety of concepts related to the newsvendor problem that include: a) the rational economic method of calculating optimal order quantity, b) the inherent risk in forecasting and ordering decisions as they relate to surpluses and shortages; and c) the cognitive limitations in decision making that often result in irrational but predictable decision‐making behavior as demonstrated by empirical research on newsvendor behavior. This exercise can help instructors and students transition into broader discussions on human behavior, cognitive limitations, and perceptions of risk. Overall, it should provide the student with an improved understanding of the operational and behavioral issues associated with decision making under risk.
Physiological development of the equine fetus during late gestation
Authors: Fowden A. L. , Giussani D. A. , Forhead A. J.
Published: November 2019

In many species, the pattern of growth and physiological development in utero has an important role in determining not only neonatal viability but also adult phenotype and disease susceptibility. Changes in fetal development induced by a range of environmental factors including maternal nutrition, disease, placental insufficiency and social stresses have all been shown to induce adult cardiovascular and metabolic dysfunction that often lead to ill health in later life. Compared to other precocious animals, much less is known about the physiological development of the fetal horse or the longer‐term impacts on its phenotype of altered development in early life because of its inaccessibility in utero, large size and long lifespan. This review summaries the available data on the normal metabolic, cardiovascular and endocrine development of the fetal horse during the second half of gestation. It also examines the responsiveness of these physiological systems to stresses such as hypoglycaemia and hypotension during late gestation. Particular emphasis is placed on the role of the equine placenta and fetal endocrine glands in mediating the changes in fetal development seen towards term and in response to nutritional and other environmental cues. The final part of the review presents the evidence that the early life environment of the horse can alter its subsequent metabolic, cardiovascular and endocrine phenotype as well as its postnatal growth and bone development. It also highlights the immediate neonatal environment as a key window of susceptibility for programming of equine phenotype. Although further studies are needed to identify the cellular and molecular mechanisms involved, developmental programming of physiological phenotype is likely to have important implications for the health and potential athletic performance of horses, particularly if born with abnormal bodyweight, premature or dysmature characteristics or produced by assisted reproductive technologies, indicative of an altered early life environment.
Did SFAS 166/167 decrease the information asymmetry of securitizing banks?
Authors: Oz Seda
Published: November 2019

Beginning in 2010, mandated Financial Accounting Standards No. 166 and 167 (SFAS 166/167) changed the consolidation rules of securitization entities and required more information about their securitization activities. I find that securitizing banks experienced a decrease in information asymmetry from the pre‐ to the post‐SFAS 166/167 periods, and that more visible securitizing banks are less sensitive to SFAS 166/167. These inferences are robust to a number of sensitivity analyses. This study is one of the first to provide evidence of the effects of SFAS 166/167 on the information asymmetry of securitizing banks.
Evolution of vestibular disorders in older adults: From young‐old to middle‐old to oldest‐old
Authors: Jeng Yu‐Jr , Young Yi‐Ho
Published: November 2019

Aim

This study investigated the evolution of vestibular disorders in dizzy older adults from young‐old to middle‐old to oldest‐old individuals, which has been less examined in detail so far.

Methods

A total of 3714 older patients with vertigo/dizziness in a university hospital were retrospectively reviewed and divided into three groups; namely, the young‐old group aged 65–74 years (n = 2307), the middle‐old group aged 75–84 years (n = 1176) and the oldest‐old group aged ≥85 years (n = 231). All patients underwent an inner ear test battery comprising audiometry, caloric test, cervical and ocular vestibular‐evoked myogenic potential tests, and foam posturography.

Results

The ratios between peripheral and central vestibular disorders ranged from the young‐old (60:40%) and middle‐old (36:64%) to the oldest‐old (25:75%) groups. These results show a decreasing sequence in the prevalence of peripheral vestibular disorders (i.e. benign paroxysmal positional vertigo or Meniereʼs disease), and an increasing sequence in that of central vestibular disorders (i.e. vertebrobasilar artery insufficiency) from young‐old to middle‐old to oldest‐old patients. Furthermore, the mean Romberg quotients (value from eyes closed divided by that from eyes open) of the sway area on the foam pad were 1.99 ± 0.93, 2.10 ± 1.06 and 2.62 ± 1.78 in the young‐old, middle‐old and oldest‐old groups, respectively, showing a significant difference among them.

Conclusions

Older patients with central vestibular disorders might be more prone to imbalance and falls than those with peripheral vestibular disorders, partly because patients in the latter group retain other reflex systems; that is, the visuomotor reflex to stabilize the gaze and maintain balance. Hence, adequate vision is important in maintaining balance for older adults with vertigo/dizziness. Geriatr Gerontol Int 2020; 20: 42–46.
Human ATG2B possesses a lipid transfer activity which is accelerated by negatively charged lipids and WIPI4
Authors: Osawa Takuo , Ishii Yuki , Noda Nobuo N.
Published: November 2019

Atg2 is one of the essential factors for autophagy. Recent advance of structural and biochemical study on yeast Atg2 proposed that Atg2 tethers the edge of the isolation membrane (IM) to the endoplasmic reticulum and mediates direct lipid transfer (LT) from ER to IM for IM expansion. In mammals, two Atg2 orthologs, ATG2A and ATG2B, participate in autophagic process. Here we showed that human ATG2B possesses the membrane tethering (MT) and LT activity that was promoted by negatively charged membranes and an Atg18 ortholog WIPI4. By contrast, negatively charged membranes reduced the yeast Atg2 activities in the absence of Atg18. These results suggest that the MT/LT activity of Atg2 is evolutionally conserved although their regulation differs among species.
Favorable radiological antitumor response at 2 weeks after starting lenvatinib for patients with advanced hepatocellular carcinoma
Authors: Kuzuya Teiji , Ishigami Masatoshi , Ito Takanori , Ishizu Yoji , Honda Takashi , Ishikawa Tetsuya , Fujishiro Mitsuhiro
Published: November 2019

Aim

We aimed to investigate the radiological antitumor response at 2 weeks after starting lenvatinib for patients with advanced hepatocellular carcinoma in real‐world practice.

Methods

This retrospective study enrolled 40 patients who received lenvatinib. Radiological antitumor response was evaluated according to the modified Response Evaluation Criteria in Solid Tumors.

Results

The objective response rate at 2 weeks and best overall response on confirmation of complete response, partial response (PR), and stable disease required (confirmed response) were 57.5% and 32.5%, respectively. Based on confirmed response, the overall survival rate was significantly longer in patients with an objective response rate than in those with stable disease or progressive disease after 12 months (73.2% and 54.2%, P = 0.0358). All 13 patients with an objective response rate on confirmed response were evaluated as PR at 2 weeks. The alpha‐fetoprotein ratio at 2 weeks was a significant factor associated with PR of response rate at 2 weeks. The median relative dose intensity from 2 to 6 weeks was significantly lower than that from 0 to 2 weeks (69.6% vs. 100%, P < 0.0001). Stratified by the antitumor response at 6 weeks considering the image evaluation at 2 weeks, the median relative dose intensity from 2 to 6 weeks was significantly lower in patients with progressive disease than in those with PR or stable disease (45.2% vs. 72.6%, P = 0.0482).

Conclusions

The radiological antitumor response at 2 weeks was favorable. Information on a favorable visible therapeutic response very early after lenvatinib initiation can help patients maintain their motivation for treatment, and allow physicians to continue treatment effectively and safely.
Suitability of different tooth replicas for endodontic training: perceptions and detection of common errors in the performance of postgraduate students
Authors: Gancedo‐Caravia L. , Bascones J. , García‐Barbero E. , Arias A.
Published: November 2019

Aim

To compare the perceptions of students when using five different tooth replicas and to detect common errors in the performance of students that might be attributed to a specific type of tooth replica.

Methodology

Five groups (n = 10 each) of artificial first maxillary molars (DEPT, DRSK, Nissin, DENTALIKE and TrueTooth) were used. All 50 teeth were mounted individually in opaque containers, distributed in 10 packages containing a sample from each with an assigned random order for students to perform root canal treatments. Ten postgraduate students each performed a root canal treatment on the five replicas, in the assigned order, and completed a satisfaction questionnaire. Three trained and calibrated endodontic educators, each with more than 15 years of experience, evaluated their performance using a grading rubric and completed a questionnaire to detect common errors attributed to a specific tooth replica. Inter‐rater reliability was calculated with the interclass correlation coefficient for both consistency and absolute agreement. A two‐way related measures anova was used to assess the interaction amongst evaluators and tooth groups on the average scores of students. Post hoc T3 Dunnet was used to compare groups. The perceptions of students amongst groups were compared with chi‐square and linear‐by‐linear association tests.

Results

Inter‐rater reliability was very high for both consistency (ICCC = 0.939; 95% confidence interval (CI) 0.902–0.964) and absolute agreement (ICCA = 0.940; 95% CI 0.904–0.965). No significant differences were found amongst the ratings of evaluators; however, students performed differently when using the various tooth replicas (P < 0.05). Overall, 60% of students preferred the DRSK replica for root canal treatment training purposes, followed by DENTALIKE (30%). The least preferred was TrueTooth (70% responses) due to its complex anatomy and poor resistance to instruments and heat pluggers. Evaluators detected several common errors in specific tooth replicas and preferred tooth replicas manufactured based on microCT scans of natural teeth.

Conclusions

Tooth replicas manufactured based on microCT scans of natural teeth (TrueTooth and DENTALIKE) had much better acceptance amongst evaluators, although students rated and performed less well in TrueTooth replicas due to their greater level of difficulty.
Partial safety factors for laminated glass
Authors: Bonati Antonio , Pisano Gabriele , Royer Carfagni Gianni
Published: November 2019

Glass plies can be bonded together by polymeric interlayers to form laminated glass. Thanks to the capacity in finding alternative stress paths after partial breakage, it is commonly accepted that the more the layers are, the higher the safety level is. However, a negative aspect is that the tensile strength of glass carries a size effect in terms of surface area, which increases with lamination. Here we evaluate these competing factors by calibrating the partial safety factors to be used in semi‐probabilistic (level‐I) design, through comparison with probabilistic (level‐III) methods in paradigmatic case‐studies under wind, snow, and dead weight. Starting from a two‐parameter Weibull distribution for glass strength, the “failure modes” approach determines the statistical distribution of strength for a multi‐laminate as a function of the number of plies, which interferes with the statistics for actions. As a function of the target probability of failure for the assigned class of consequence, we introduce a new coefficient in the verification formula of level‐I, to account for the effects of lamination with dependence upon the number of plies. We find that there is strong gain when passing from a monolith to a two‐ply laminate, but the advantage fades by increasing the number of layers. Verification formulas of this type could avoid overconservative design.
The effect of trade secrets protection on disclosure of forward‐looking financial information
Authors: Li Yan , Li Yutao
Published: November 2019

Using the recognition of the Inevitable Disclosure Doctrine (IDD) by US state courts as an exogenous shock to the risk of losing trade secrets, this study examines the effects of trade secrets on disclosure of forward‐looking financial information. We find that management earnings forecast frequency and forecast horizon increases after the US state where a firm is headquartered starts to recognize IDD. We also find that the effect of IDD recognition on management forecasts is more pronounced for firms that have larger market shares, higher product market competition, more intensive R&D, shorter distance to their industry rivals, and more employees who possess knowledge of the firms’ trade secrets.
Comparative genetic stock structure in three species of commercially exploited Indo‐Malay Carangidae (Teleosteii, Perciformes)
Authors: Mat Jaafar Tun N.A. , Taylor Martin I. , Mohd Nor Siti A. , Bruyn Mark de , Carvalho Gary R.
Published: November 2019

We examine genetic structuring in three commercially important species of the teleost family Carangidae from Malaysian waters: yellowtail scad Atule mate, bigeye scad Selar crumenophthalmus and yellowstripe scad Selaroides leptolepis, from the Indo‐Malay Archipelago. In view of their distribution across contrasting habitats, we tested the hypothesis that pelagic species display less genetic divergence compared with demersal species, due to their potential to undertake long‐distance migrations in oceanic waters. To evaluate population genetic structure, we sequenced two mitochondrial (mt)DNA [650 bp of cytochrome oxidase I (coI), 450 bp of control region (CR)] and one nuclear gene (910 bp of rag1) in each species. One hundred and eighty samples from four geographical regions within the Indo‐Malay Archipelago including a population of yellowtail from Kuwait were examined. Findings revealed that the extent of genetic structuring among populations in the semi‐pelagic and pelagic, yellowtail and bigeye were lower than demersal yellowstripe, consistent with the hypothesis that pelagic species display less genetic divergence compared with demersal species. The yellowtail phylogeny identified three distinct clades with bootstrap values of 86%–99% in mtDNA and 63%–67% in rag1. However, in bigeye, three clades were also observed from mtDNA data while only one clade was identified in rag1 dataset. In yellowstripe, the mtDNA tree was split into three closely related clades and two clades in rag1 tree with bootstraps value of 73%–99% and 56% respectively. However, no geographic structure appears in both mtDNA and rag1 datasets. Hierarchical molecular variance analysis (AMOVA), pair wise FST comparisons and the nearest‐neighbour statistic (Snn) showed significant genetic differences among Kuwait and Indo‐Malay yellowtail. Within the Indo‐Malay Archipelago itself, two distinct mitochondrial lineages were detected in yellowtail suggesting potential cryptic species. Findings suggests varying degrees of genetic structuring, key information relevant to management of exploited stocks, though more rapidly evolving genetic markers should be used in future to better delimit the nature and dynamics of putative stock boundaries.
Development of capacitance based nondestructive ripening indices measurement system for sapota (Manilkara zapota)
Authors: Raja Vijayakumar , Shanmugasundaram Saravanan
Published: November 2019

The study aimed to develop a nondestructive sensing system to determine the ripening indices of sapota fruit, based on the principle of dielectric capacitance measurement. The unripened sapota fruit contains starch, which gets converted to simple sugars during ripening. This conversion increases the electrical energy storability (i.e., electrical capacitance) of the fruit. A capacitance measurement system was developed, which consists of two standard copper‐coated printed circuit board (PCB) electrodes and a microprocessor. The capacitance of fruit was determined at 9 V D.C. input voltage. Physicochemical properties such as total soluble solids (TSS), titrable acidity, firmness during ripening were studied for the fruits stored at ambient condition (30 ± 2°C). The changes in physicochemical properties and their correlation with capacitance were studied during ripening. The capacitance of the fruit increases with the increase in total soluble solids content of the fruit. With the correlation observed (R2 = .9727), an algorithm has been developed for sensing the ripening stages (mature green, semi‐ripe, and ripe) of the fruit. The system shows an accuracy of 90.74% in determining the stages of fruit ripening.

Practical Applications

The developed system helps in nondestructively determining the ripening stages (mature green, semi‐ripe, ripe) of sapota at low cost. The detection process is less time‐consuming. Also, the fruit does not undergo any tissue damage since the fruit is not applied with any force in the capacitance measurement process.