bluuebunny/crossref_metadata_2025 huggingface dataset:
Numerical investigation of high pressure turbine blade tip-shaping effects on the aerothermal and dynamic performance
Authors: Tong Fujuan , Gou Wenxuan , Li Lei , Yue Zhufeng , Gao Wenjing , Li Honglin
Published: August 2019

Purpose

In order to improve the engine reliability and efficiency, an effective way is to reform the turbine blade tip conformation. The paper aims to discuss this issue.

Design/methodology/approach

The present research provides several novel tip-shaping structures, which are considered to control the blade tip loss. Four different tip geometries have been studied: flat tip, squealer tip, flat tip with streamwise ribs and squealer tip with streamwise ribs. The tip heat transfer and leakage flow are both analyzed in detail, for example the tip heat transfer coefficient, tip flow and local pressure distributions.

Findings

The results show that the squealer seal and streamwise rib can reduce the tip heat transfer and leakage loss, especially for the squealer tip with streamwise ribs. The tip and near-tip flow patterns at the different locations of axial chord reflect that both the squealer seal and streamwise rib structure can control the tip leakage flow loss. In addition, the analysis of the aerodynamic parameters (the static pressure and turbine efficiency) also indicates that the squealer tip with streamwise ribs obtains the highest adiabatic efficiency with an increase of 2.34 percent, compared with that of the flat tip case.

Originality/value

The analysis of aerothermal and dynamic performance can provide a reference for the blade tip design and treatment.
Optimization of internal thread structure of force sensor considering fatigue performance
Authors: Sun Hongchun , Wang Tianlu , Zhang Xindong
Published: August 2019

Purpose

Fatigue damage of internal threads has gradually become the main failure mode of force sensor. To make the internal thread structure of force sensor meet the fatigue performance requirements, the design criteria of static strength and fatigue life are comprehensively considered in this paper.

Design/methodology/approach

The variation of static stress and fatigue life with the size of the main structure is obtained by simulation. By changing the number of thread turns, the hub height and outer diameter of the hub, the optimized design of the spoke force sensor is determined.

Findings

The experiment was carried out based on the determined optimized structure, and the results showed that the fatigue life meets the design requirements.

Originality/value

This research has certain guiding significance for the design and developments of high-cycle fatigue force sensors.
Corporate sustainability disclosure’s importance in China: financial analysts’ perception
Authors: Zhang Jhunru , Djajadikerta Hadrian Geri , Trireksani Terri
Published: August 2019

Purpose

Corporate sustainability in China has become a subject of increasing international concern. Corporate sustainability disclosure (CSD) is considered a useful tool to facilitate the empowerment and acknowledgement of stakeholders in the quest for sustainability. However, the degree of cultural and political influences for being sustainably orientated can be significantly different between countries. This study aims to examine the perception of financial analysts, as CSD report users, in China about the level of importance of various indicators of corporate sustainability described in the Global Reporting Initiative (GRI) Sustainability Reporting Guidelines.

Design/methodology/approach

A set of questionnaires was developed based on GRI G4 guidelines to measure the perception of financial analysts in China on the level of importance of each sustainability indicator described in the GRI G4. A five-point Likert scale was used to measure the report users’ perceptions of each of the indicators.

Findings

The findings of this study increase our understanding of how Chinese CSD report users perceive corporate sustainability differently from the GRI guidelines. The main results show that the environmental aspect of sustainability was seen to be important in China, followed by the social and economic aspects. Indicator-wise, “water”, “effluents and waste”, “emissions”, “compliance” and “energy” were perceived as vital in the environmental category, while “customer health and safety”, “customer privacy” and “compliance” were considered significant in the social category.

Originality/value

This study addresses the need for differing corporate sustainability guidelines for different nations and cultures, specifically within the Chinese context. It also contributes to the corporate sustainability literature by adding to our understanding of how financial analysts in China, as CSD report users, perceive aspects of sustainability.
Clarifying absorptive capacity and dynamic capabilities dilemma in high dynamic market IT SMEs
Authors: Senivongse Chulatep , Bennet Alex , Mariano Stefania
Published: August 2019

Purpose

The purpose of this study is to investigate absorptive capacity and dynamic capabilities dilemma in high dynamic market IT small medium enterprises (SMEs). Absorptive capacity and dynamic capabilities have a conflict in theoretical stance. Those in favor of dynamic capabilities regard absorptive capacity as a part of dynamic capabilities, and there are many arguments regarding treating absorptive capacity as a part of dynamic capabilities. One major deficit of dynamic capabilities is that it requires adjusting the firm’s dynamic resources when responding to change, requiring some investment and time. Thus, dynamic capabilities then have a problem in instantaneously responding to a highly dynamic market. With the requirement to adjust organizational resources, absorptive capacity, as a part of dynamic capabilities, cannot have direct impact on a firm’s performance.

Design/methodology/approach

To show that absorptive capacity, by itself, can have a direct impact on a firm’s performance in a highly dynamic market, quantifiable variables are identified to measure the level of effort in developing absorptive capacity. The relationships between the absorptive capacity development effort and the firm’s financial performance is then explored and evaluated.

Findings

It is confirmed that absorptive capacity in a high dynamic market such as IT SMEs have direct and positive impact to the firm’s financial performance, without having to configure its resource to interact with changes.

Originality/value

The study discusses the paradoxical dilemma of the role of absorptive capacity under the light of dynamic capability. The finding indicates that in high dynamic market when the spontaneous respond to market change is crucial to firm's survival, absorptive capacity can direly deliver the result to leverage the firm's performance without having to reconfigure its resources as indicated in the theoretical stance of dynamic capability.
Preliminary analysis of crustal shear‐wave splitting in the Sanjiang lateral collision zone of the southeast margin of the Tibetan Plateau and its tectonic implications
Authors: Gao Yuan , Chen Anguo , Shi Yutao , Zhang Ziqi , Liu Lanbo
Published: August 2019

The collision of the Indian and Eurasian plates, to the east of the eastern Himalayan syntaxes, forms the Sanjiang lateral collision zone in the southeast margin of the Tibetan Plateau, where there are intense crustal deformation, active faults, earthquakes, as well as a metallogenic belt. Given the lack of adequate seismic data, shear‐wave splitting in this area has not been studied. With seismic data from a temporary seismic linear array, as well as permanent seismic stations, this paper adopts the identification on microseismic event to pick more events and obtains shear‐wave splitting parameters from local earthquakes. From the west to the east, the study area can be divided into three subzones. The “fast” polarization (i.e. the polarization of the fast shear wave) varies gradually from NNW to NS to NNE in these three subzones. The time delay of the slow shear wave (i.e. the time difference between the two split shear waves) also increases in the same direction, indicating the presence of seismic anisotropy above 25 km in the crust. Both shear‐wave splitting parameters are closely related to stress, faults and tectonics. The scatter and the “dual” (i.e. two) dominant orientations of the fast polarizations at several stations indicate strong distortions caused by nearby faults or deep tectonics. The anisotropic parameters are found to be related to some degree to the metallogenic belt. It is worth to further analyse the link between the anisotropic pattern and the metallogenic area, which suggests that shear‐wave splitting could be applied to study metallogeny. This paper demonstrates that the identification on microseismic event is a useful tool in detecting shear‐wave splitting details and exploring its tectonic implications.
Causes and consequences of inverse density‐dependent territorial behaviour and aggression in a monogamous mammal
Authors: Mayer Martin , Frank Shane C. , Zedrosser Andreas , Rosell Frank
Published: August 2019

Territoriality is an important process shaping population dynamics, and the defence of a territory is crucial for individuals to increase the duration of territory occupancy and, consequently, reproductive success. However, little is known about how the frequency of territory intrusions and subsequent territorial behaviours and aggression by territory owners are affected by external factors, such as population density. This is important because it can affect mate change (the replacement of one pair member) and dispersal, a key ecological process.

The aim of this study was to investigate the behavioural and spatial response of territory owners to intruder pressure as a function of population density in a territorial, monogamous mammal, the Eurasian beaver (Castor fiber).

Using a combination of GPS technology, scent experiments, camera trap data and tail scar observations from an individual‐based long‐term study, we investigated the factors influencing spatial movement patterns by territory owners in response to a simulated intruder and the factors affecting territory intrusions.

We found consistent inverse density‐dependent patterns in territorial behaviours and evidence of conspecific aggression. At lower densities, territory owners detected more simulated intrusions, showed more territorial reactions and experienced increased conspecific aggression as indicated by tail scars, suggesting increased intruder pressure.

Inverse density‐dependent territorial behaviour and aggression suggest a potential mechanistic link between inverse density‐dependent natal dispersal and mate change. At low population densities, increased dispersal amplifies intruder pressure, leading to the observed increases in territorial behaviours, conspecific aggression and previously observed mate turnover, which in turn might increase natal dispersal. Our study demonstrates how population density can affect the behaviour and space use of individuals, which is important for territory occupancy and fitness.
Fungal community demonstrates stronger dispersal limitation and less network connectivity than bacterial community in sediments along a large river
Authors: Chen Juan , Wang Peifang , Wang Chao , Wang Xun , Miao Lingzhan , Liu Sheng , Yuan Qiusheng , Sun Shenghao
Published: August 2019

Despite the essential functions of sedimentary bacterial and fungal communities in biogeochemical cycling, little is known about their biogeographic patterns and driving processes in large rivers. Here we investigated the biogeographic assemblies and co‐occurrence patterns of sedimentary bacterial and fungal communities in the Jinsha River, one of the largest rivers in southwestern China. The mainstream of river was divided into upstream, midstream and downstream. The results showed that both bacterial and fungal communities differed significantly among three sections. For both communities, their composition variations in all sites or each river section were controlled by the combination of dispersal limitation and environmental selection, and dispersal limitation was the dominant factor. Compared with bacteria, fungi had stronger dispersal limitation. Co‐occurrence network analyses revealed higher network connectivity but a lower proportion of positive interaction in the bacterial than fungal network at all sites. In particular, the keystone species belonging to bacterial phyla Proteobacteria and Firmicutes and fungal phyla Ascomycota and Chytridiomycota may play critical roles in maintaining community function. Together, these observations indicate that fungi have a stronger dispersal limitation influence and less network connectivity than bacteria, implying different community assembly mechanisms and ecological functions between bacteria and fungi in large rivers.
Adoption of LGBT‐friendly practices: The effect of institutional pressures and strategic choice
Authors: Roumpi Dorothea , Giannakis Panagiotis , Delery John E.
Published: August 2019

This study explores contextual and organisational factors that influence the likelihood of adopting lesbian, gay, bisexual, and transgender (LGBT)‐friendly practices. Drawing on institutional theory, we hypothesise that state laws, state conservativism, and localised LGBT‐friendliness density will have a direct effect on the adoption of LGBT‐friendly practices. Given the observed variation in the adoption of these practices, we also draw on strategic choice and the upper echelons perspective and hypothesise that the effect of institutional mechanisms is moderated by the beliefs and values of powerful organisational agents (chief executive officers and boards of directors). Our sample consists of 201 U.S.‐based Fortune 1000 companies over a period of seven years, and we test our hypotheses using a Cox proportional hazards survival analysis. Our results offer support for the role of state conservativism and localised LGBT‐friendliness density in the likelihood of LGBT‐friendly practices adoption, as well as for the moderating role of chief executive officer and board of directors' political orientation.
Public Perceptions of California's Exceptional Drought
Authors: Heeren Alexander , Pathak Tapan B. , Matlock Teenie , Conklin Martha
Published: August 2019

While the exceptional drought in California ended in 2017, the state is expected to experience similar droughts in the future. Understanding how individuals perceive the causes and consequences of drought will help frame future communication and planning efforts. We surveyed a panel of Californian residents about their perceptions of the 2012–2017 drought. We found a major disconnect in how our respondents perceived drought and water use. Respondents perceived the drought as being caused primarily by climatic factors and underestimated the role human water use, particularly agricultural use, had in exacerbating drought. Comparing our respondents across the state and across socio‐demographics, there were few differences in concern about drought but several differences in how residents thought drought should be managed. Such research can help water managers communicate about the specific concerns the public has about future droughts, as well as address misperceptions about the relationship between drought and water use.
Evaluating the Impact of the US–China Trade War
Authors: Itakura Ken
Published: August 2019

We evaluate the impact of the US–China trade war using a dynamic computable general equilibrium (CGE) model of global trade. We conduct ex ante simulation analysis exploring three scenarios to understand how the trade war affects import tariffs, investment, and productivity. The escalation of the trade war reduces gross domestic product (GDP) in China and the USA by −1.41% and −1.35%, respectively. The trade war reduces nearly all sectoral imports and outputs in both countries. To reflect the important role of global value chains (GVCs), we modify the dynamic CGE model with agent‐specific import demands, and we explore the difference between the results for the two models relating to the trade war impacts on GDP and bilateral trade. When GVCs are accounted for, the negative impacts on bilateral trade are more widespread across countries, and world GDP in the modified model is reduced by −$US450 billion. These results suggest that the GVCs play substantial role in determining trade responses at the disaggregated level.
Progress in understanding hypersensitivity reactions to nonsteroidal anti‐inflammatory drugs
Authors: Doña Inmaculada , Pérez‐Sánchez Natalia , Eguiluz‐Gracia Ibon , Muñoz-Cano Rosa , Bartra Joan , Torres María José , Cornejo‐García José Antonio
Published: August 2019

Nonsteroidal anti‐inflammatory drugs (NSAIDs), the medications most commonly used for treating pain and inflammation, are the main triggers of drug hypersensitivity reactions. The latest classification of NSAIDs hypersensitivity by the European Academy of Allergy and Clinical Immunology (EAACI) differentiates between cross‐hypersensitivity reactions (CRs), associated with COX‐1 inhibition, and selective reactions, associated with immunological mechanisms. Three phenotypes fill into the first group: NSAIDs‐exacerbated respiratory disease, NSAIDs‐exacerbated cutaneous disease and NSAIDs‐induced urticaria/angioedema. Two phenotypes fill into the second one: single‐NSAID‐induced urticaria/angioedema/anaphylaxis and single‐NSAID‐induced delayed reactions. Diagnosis of NSAIDs hypersensitivity is hampered by different factors, including the lack of validated in vitro biomarkers and the uselessness of skin tests. The advances achieved over recent years recommend a re‐evaluation of the EAACI classification, as it does not consider other phenotypes such as blended reactions (coexistence of cutaneous and respiratory symptoms) or food‐dependent NSAID‐induced anaphylaxis. In addition, it does not regard the natural evolution of phenotypes and their potential interconversion, the development of tolerance over time or the role of atopy. Here, we address these topics. A state of the art on the underlying mechanisms and on the approaches for biomarkers discovery is also provided, including genetic studies and available information on transcriptomics and metabolomics.
Ulipristal acetate vs gonadotropin‐releasing hormone agonists prior to laparoscopic myomectomy (MYOMEX trial): Short‐term results of a double‐blind randomized controlled trial
Authors: de Milliano Inge , Huirne Judith A. F. , Thurkow Andreas L. , Radder Celine , Bongers Marlies Y. , van Vliet Huib , van de Lande Jonas , van de Ven Peter M. , Hehenkamp Wouter J. K.
Published: August 2019

Introduction

Laparoscopic myomectomy can be difficult when fibroids are large and numerous. This may result in extensive intraoperative bleeding and the need for a conversion to a laparotomy. Medical pretreatment prior to surgery might reduce these risks by decreasing fibroid size and vascularization of the fibroid. We compared pretreatment with ulipristal acetate (UPA) vs gonadotropin‐releasing hormone agonists (GnRHa) prior to laparoscopic myomectomy on several intra‐ and postoperative outcomes.

Material and methods

We performed a non‐inferiority double‐blind randomized controlled trial in nine hospitals in the Netherlands. Women were randomized between daily oral UPA for 12 weeks and single placebo injection or single intramuscular injection with leuprolide acetate and daily placebo tablets for 12 weeks. The primary outcome was intraoperative blood loss. Secondary outcomes were reduction of fibroid volume, suturing time, total surgery time and surgical ease.

Results

Thirty women received UPA and 25 women leuprolide acetate. Non‐inferiority of UPA regarding intraoperative blood loss was not demonstrated. When pretreated with UPA, median intraoperative blood loss was statistically significantly higher (525 mL [348‐1025] vs 280 mL[100‐500]; P = 0.011) and suturing time of the first fibroid was statistically significantly longer (40 minutes [28‐48] vs 22 minutes [14‐33]; P = 0.003) compared with GnRHa. Pretreatment with UPA showed smaller reduction in fibroid volume preoperatively compared with GnRHa (−7.2% [−35.5 to 54.1] vs −38.4% [−71.5 to −19.3]; P = 0.001). Laparoscopic myomectomies in women pretreated with UPA were subjectively judged more difficult than in women pretreated with GnRHa.

Conclusions

Non‐inferiority of UPA in terms of intraoperative blood loss could not be established, possibly due to the preliminary termination of the study. Pretreatment with GnRHa was more favorable than UPA in terms of fibroid volume reduction, intraoperative blood loss, hemoglobin drop directly postoperatively, suturing time of the first fibroid and several subjective surgical ease parameters.
Colour vision testing in young children with reduced visual acuity
Authors: Pfäffli Oliver Andreas , Tamási Bálint , Hanson James V. M. , Gerth‐Kahlert Christina
Published: August 2019

Purpose

To investigate feasibility, reliability and discriminative validity of pseudoisochromatic (PIC) colour vision tests, the Mollon–Reffin minimalist (MRM) test and the Cambridge Colour Test (CCT) among children (3–10 years) with reduced visual acuity.

Methods

Thirty‐three patients with reduced visual acuity and 38 healthy control subjects with age‐related normal visual acuity were recruited for this prospective study. Visual acuity in patients was reduced due to amblyopia, binocular maculopathy, or optic neuropathy. Tests were performed in a single 1‐hr session.

Results

All but two children successfully completed the PIC and MRM tests. Success rate for the CCT was lower, 87%, CI [72%, 96%] for control subjects and 79%, CI [61%, 91%] for patients, with a strong positive effect of age on the odds of successful completion (OR 5.63, p = 0.007). Reliability was high in PIC and MRM tests but comparably lower in CCT. The rate of correct answers in PIC tests was between 88% and 100%. One proband was diagnosed with deuteranomaly with an average Ishihara score of 21%. All children (with the exception of one daltonian) scored at least two points in the MRM test. Sensitivity thresholds in CCT decreased with age with a strong effect size in control subjects and weak to moderate effect size in patients.

Conclusions

Pseudoisochromatic and MRM tests show sufficient feasibility in young children with reduced visual acuity. For CCT feasibility in 3–5‐year olds is reduced, most probably due to the longer test duration. Consistent with earlier findings, colour discrimination thresholds decrease with age independent on visual acuity status.
Analysis of the location of retinal lesions in central retinographies of patients with Type 2 diabetes
Authors: Munuera‐Gifre Eduardo , Saez Marc , Juvinyà‐Canals Dolors , Rodríguez‐Poncelas Antonio , Barrot‐de‐la–Puente Joan‐Francesc , Franch‐Nadal Josep , Romero‐Aroca Pere , Barceló Maria Antonia , Coll‐de‐Tuero Gabriel
Published: August 2019

Purpose

To describe the distribution of Type 2 DM retinal lesions and determine whether it is symmetrical between the two eyes, is random or follows a certain pattern.

Methods

Cross‐sectional study of Type 2 DM patients who had been referred for an outpatients’ ophthalmology visit for diabetic retinopathy screening in primary health care. Retinal photographic images were taken using central projection non‐mydriatic retinography. The lesions under study were microaneurysms/haemorrhages, and hard and soft exudates. The lesions were placed numerically along the x‐ and y‐axes obtained, with the fovea as the origin.

Results

From among the 94 patients included in the study, 4770 lesions were identified. The retinal lesions were not distributed randomly, but rather followed a determined pattern. The left eye exhibited more microaneurysms/haemorrhages and hard exudates of a greater density in the central retina than was found in the right eye. Furthermore, more cells containing lesions were found in the upper temporal quadrants, (especially in the left eye), and tended to be more central in the left eye than in the right, while the hard exudates were more central than the microaneurysms/haemorrhages.

Conclusion

The distribution of DR lesions is neither homogeneous nor random but rather follows a determined pattern for both microaneurysms/haemorrhages and hard exudates. This distribution means that the areas of the retina most vulnerable to metabolic alteration can be identified. The results may be useful for automated DR detection algorithms and for determining the underlying vascular and non‐vascular physiopathological mechanisms that can explain these differences.
Optimal indications for an intercostal port for the superior segments in laparoscopic partial liver resection
Authors: Araki Kenichiro , Harimoto Norifumi , Ishii Norihiro , Tsukagoshi Mariko , Igarashi Takamichi , Watanabe Akira , Kubo Norio , Shirabe Ken
Published: August 2019

Introduction

Intercostal port is useful for the superior segments in laparoscopic liver resection, but optimal indications for its use remain unclear. This study analyzed the surgical outcomes in patients undergoing laparoscopic partial liver resection for superior segments to determine the optimal indications.

Methods

A total of 30 cases of laparoscopic partial liver resection for superior segments were retrospectively reviewed. First, comparison of cases according to use of the intercostal port was performed. Second, cases were classified into two groups according to the branch of the hepatic vein in the superior segments: superior‐ventral group (S4a/S8vent: Svent group, n = 18) and superior‐dorsal group (S7/S8dor: Sdor group: n = 12). The surgical outcomes were then compared to assess the performance of intercostal ports.

Results

No differences in surgical outcomes were observed between patients with or without intercostal port. In this series, no complication due to the intercostal port, and no major complication were observed. In the comparison between Svent and Sdor, similar values of the operation time (Svent: 275 minutes vs Sdor: 316 minutes, P = .161) and blood loss (Svent: 30 mL vs Sdor: 17 mL, P = .718) were observed in both groups. The tumor size tended to be smaller in Sdor (Svent: 20 mm vs Sdor: 17 mm, P = .018), but use of the intercostal port was significantly more frequent in Sdor (58%) compared to Svent (33%) (P < .001).

Conclusion

The lesion located at Sdor or that close to this location was considered as optimal indication for placement of intercostal port in patients undergoing laparoscopic partial liver resection.
A phase II study of addition of pracinostat to a hypomethylating agent in patients with myelodysplastic syndromes who have not responded to previous hypomethylating agent therapy
Authors: Yalniz Fevzi F. , Berdeja Jesus G. , Maris Michael B. , Lyons Roger M. , Reeves James A. , Essell James H. , Patel Prapti , Sekeres Mikkael , Hughes Amanda , Mappa Silvia , Garcia‐Manero Guillermo
Published: August 2019

Hypomethylating agents (HMAs) are standard of care for higher‐risk myelodysplastic syndromes (MDS). However, less than half of patients achieve objective responses and most eventually lose their response. Pracinostat is a pan‐histone deacetylase inhibitor with demonstrated activity in advanced myeloid malignancies. This phase II study explored the benefit of adding pracinostat to HMAs in MDS patients who did not respond to single‐agent HMA treatment. The goal was to estimate the clinical improvement rate [complete remission (CR), marrow CR, partial response (PR) and haematological improvement]. Group 1 included patients with primary/secondary HMA failures; Group 2 included those who did not achieve response but had stable disease (SD) after single‐agent HMAs. Forty‐five patients (39 Group 1, 6 Group 2) received a median of 3 cycles. Among all patients, 1 (2%) had CR, 7 (16%) had marrow CR and 18 (40%) had SD; disease progression occurred in 3 (7%). Median overall survival was 5·7/5·6 months for Group 1/2. Grade ≥3 adverse events occurred in 38 patients (84%) leading to treatment discontinuation in 12 (33%). Adding pracinostat to HMAs did not improve outcomes in patients previously treated with HMAs. Frequent dose modifications/early discontinuation resulted in suboptimal drug exposure. A reduced pracinostat dose may improve tolerability and efficacy.
Food protein‐induced enterocolitis syndrome
Authors: Caubet Jean‐Christoph , Cianferoni Antonella , Groetch Marion , Nowak‐Wegrzyn Anna
Published: August 2019

Food protein‐induced enterocolitis syndrome (FPIES) is a non‐IgE‐mediated gastrointestinal food allergic disorder that has gained a major interest the past decade. FPIES prevalence, which still needs to be accurately determine in different populations, appears to be higher than previously thought (ie up to 0.7% in infants in the 1st year of life). FPIES to seafood in adults is also increasingly reported; limited data suggest that adult FPIES is most commonly triggered by shellfish, tends to affect females more than men, is characterized by a significant delay in diagnosis and a prolonged course. The first international consensus guidelines on diagnosis and management of FPIES have been published in 2017, proposing new diagnostic criteria as well as new criteria for a positive oral food challenge. However, there is a need to develop new biomarkers to improve the diagnosis and management of FPIES patients, and this requires a better understanding of the pathophysiology. Recently, the role of T cells has been questioned and a major role of innate immune cells has been suggested in acute FPIES. Regarding the treatment of acute FPIES reaction, ondansetron has emerged as an adjunct to intravenous rehydration in moderate‐severe reactions and as a first‐line treatment in mild reactions. Important information regarding the nutritional management of FPIES patients that might be complex has also been provided in the international guidelines. In this review, we discuss recent advances regarding all those different aspects.
Oral administration of recombinant Bacillus subtilis spores expressing Helicobacter pylori neutrophil‐activating protein suppresses peanut allergy via up‐regulation of Tregs
Authors: Mai Jialiang , Liang Bingshao , Xiong Zhile , Ai Xiaolan , Gao Fei , Long Yan , Yao Shuwen , Liu Yunfeng , Gong Sitang , Zhou Zhenwen
Published: August 2019

Background

Helicobacter pylori neutrophil‐activating protein (NAP) is an immune modulator with anti‐Th2 inflammation activity that can be used to prevent IgE‐mediated allergic reactions. Cholera toxin B (CTB) is a mucosal adjuvant that can induce antigen tolerance. Bacillus subtilis spores are an ideal vehicle for the oral delivery of heterologous antigens.

Objective

We investigated the therapeutic effect of recombinant NAP B subtilis spores on peanut allergies in a mouse model.

Methods

Female C3H/HeJ mice were sensitized and challenged with peanut extract by oral administration. Before challenge, recombinant NAP and CTB‐NAP (CNAP) spores were orally administered to sensitized mice for 4 weeks. Faecal peanut‐specific IgA and serum‐specific IgE, IgG1, and IgG2a levels were measured, and the intestinal microbiota was analysed. Mice were intraperitoneally injected with anti‐CD25 antibodies for regulatory T cell (Treg) depletion to evaluate the efficacy of Tregs in preventing peanut allergy. After challenge, anaphylactic reactions, plasma histamine, Tregs, and splenocyte interleukin (IL)‐10, IL‐4, IL‐5 and interferon‐γ (IFN‐γ) levels were evaluated.

Results

After 4 weeks of recombinant spore treatment, faecal IgA levels and serum IgG2a levels were increased, while serum IgG1 and IgE levels were reduced. Intestinal microbiota analysis revealed that CNAP spores increased the taxonomic abundance of Firmicutes at the phylum level and Clostridia at the class level. After challenge, the administration of NAP or CNAP spores to mice was found to ameliorate anaphylactic reactions and decrease plasma histamine levels. Administration of NAP or CNAP spores also enhanced IL‐10 and IFN‐γ secretion, and suppressed IL‐4 and IL‐5 secretion. The protective effect of CNAP spores was more pronounced than that of NAP spores; this therapeutic effect was lost after Treg depletion.

Conclusions and Clinical Relevance

Recombinant NAP spores successfully suppressed Th2 inflammation via the up‐regulation of Tregs; this may serve as a novel therapeutic approach for treating food allergies.
Urban Regimes in Small Russian Towns
Authors: Ledyaev Valeri , Chirikova Alla
Published: August 2019

This article presents the outcomes of a research project conducted in five small Russian towns. Different coalitions between local actors take place in all communities. However, coalitions that meet the criteria of the urban regime (in Stone's classical interpretation) have been discovered, with certain reservations, only in two towns. For a number of characteristics, these coalitions differed from regimes in American and European towns: often not quite voluntary nature of coalitions, prevalence of egoistic motives in the coalition–building, strong dependence of the regimes on the personal factor (personal qualities and resources of local administrators, their experience, relations with regional elites, etc.), absence of formal organizations able to coordinate the interests of coalition members, etc. In the three other local communities, urban regimes have not been built due to personal factors, frequent changes in the local government leadership, or the role of external factors (the nature of the relationship of local elites with regional and federal authorities, methods of influence of regional authorities on local politics). In the public agenda of the regimes (quasi–regimes), the elements of the status quo and, to a lesser extent, growth, prevail. The outcomes of study allow us to conclude that despite the authoritarian nature of the Russian politics and the differences between Russian and American contexts, urban regimes analysis is quite applicable for the study of power in Russian local communities.
Functional parameter measurements in children with ataxia telangiectasia
Authors: Shenhod Efrat , Benzeev Bruria , Sarouk Ifat , Heimer Gali , Nissenkorn Andreea
Published: August 2019

Aim

To collect preliminary functional data on ataxia telangiectasia and create a disease specific scale: the Ataxia Telangiectasia Functional Scale (ATFS).

Method

Retrospective information on patients with ataxia telangiectasia referred to the Assistive Technology Unit was included. Functional mobility scales (the Gross Motor Function Classification System [GMFCS] and the Functional Mobility Scale [FMS]‐5, FMS‐50, FMS‐500) and activities of daily living [ADL] parameters were recorded. We created a 51‐point ATFS, that consisted of three ambulation items adapted for ataxia telangiectasia in the frame of FMS (home, school, outdoors), five ADL items, and one schooling item.

Results

Twenty‐seven participants (17 males, 10 females; mean age 10y 8mo [SD 5y 1mo], range 1y 9mo–25y 6mo), were enrolled; 168 measurements were recorded. Patients walked at a mean age of 1 year 4 months (SD 5y 4mo) and lost ambulatory capacity at 8 years 8 months (SD 2y 1mo). GMFCS level and FMS‐5, FMS‐50, FMS‐500 assessments correlated with age (Spearman's correlations r=0.555, −0.617, −0.639, −0.662 respectively, p<0.01 for all), but plateaued after 12 years of age. ATFS mean score was 37.46 (SD 7.88) and increased with age (Spearman's correlation r=0.585, p<0.01). The scale showed three stages of disease progression.

Interpretation

In this pilot study we show longitudinal functional data of ambulation and ADL skills in ataxia telangiectasia, and created a framework for a functional scale. This functional scale closely approximated disease course, but further validation is required.

What this paper adds

The Gross Motor Function Classification System and the Functional Mobility Scale are ill‐suited for ataxia telangiectasia assessments.

Three functional mobility scales (home, school, outdoors) suited to ataxia telangiectasia were created.

The Ataxia Telangiectasia Functional Scale (ATFS) combines mobility and items of activities of daily living.

The ATFS closely approximates the three‐stage progression of the disorder.
Rituximab in children with myelin oligodendrocyte glycoprotein antibody and relapsing neuroinflammatory disease
Authors: Albassam Fahad , Longoni Giulia , Yea Carmen , Wilbur Colin , Grover Stephanie A , Yeh E Ann
Published: August 2019

The aim of this study was to evaluate tolerability of and response to rituximab in children with myelin oligodendrocyte glycoprotein (MOG) antibody‐positive relapsing neuroinflammatory disease. This was an observational study of prospectively collected data on 12 consecutive children (eight females, four males; median age at onset 10y 6mo [interquartile range {IQR} 7y 2mo–12y 5mo], median follow‐up 2y 1mo [IQR 1y 7mo–2y 6mo]) with central nervous system inflammation and persistent serum MOG immunoglobulin G positivity more than 12 weeks after clinical presentation. Patients received a standardized rituximab treatment protocol. MOG antibody testing was performed following standardized cell‐based methods. Median clinical follow‐up after rituximab induction was 2 years (IQR 1y 7mo–2y 10mo). The relapse rate in the first 12 months posttreatment was 0 (IQR 0–0). After rituximab, two patients relapsed during B‐cell suppression and four showed clinical or radiological disease recurrences at B‐cell reconstitution. Mild‐to‐moderate infusion related adverse events occurred in two patients. Leukopenia developed in seven patients and serum immunoglobulin suppression in five patients with no significant age effect on the risk of their development. None developed severe life‐threatening events. Rituximab‐induced B‐cell suppression was associated with absence of relapses in 10 patients who were MOG‐positive with recurrent disease. Rituximab was well tolerated. The most frequent adverse effects were hypogammaglobulinemia and leukopenia. We recommend monitoring of complete blood counts and immunoglobulins in this population.

What this paper adds

Rituximab appears to control disease in most anti‐myelin oligodendrocyte glycoprotein‐positive patients with relapsing neuroinflammatory disease.

Rituximab was associated with transitory, mild‐to‐moderate infusion‐related effects.

Half of patients treated with rituximab developed leukopenia or hypogammaglobulinemia.

No opportunistic infections were observed.
Health care service for families with children at early risk of developmental delay: an All Our Families cohort study
Authors: Russell Matthew J , Premji Shainur , Mcdonald Sheila , Zwicker Jennifer D , Tough Suzanne
Published: August 2019

Aim

This study examined children’s health care service use, mothers’ workforce participation, and mothers’ community engagement based on children’s risk of developmental delay.

Method

We used data from the All Our Families study, a prospective pregnancy cohort. Ages and Stages Questionnaire (ASQ) scores at year 2 indicated risk of developmental delay. To investigate the impact of risk of developmental delay when children were not diagnosed, a sensitivity analysis excluded reports of neurodevelopmental disorder (NDD) diagnosis at year 3. Outcomes were maternal reports of children’s health and allied health visits (and estimated costs), and maternal workforce participation and community engagement from year 2 to 3.

Results

Among 1314 mother–child dyads, 209 (16%) children were classified as being at risk of developmental delay by the ASQ, and 42 (3%) had a reported diagnosis of NDD. Risk of developmental delay was related to increased use of allied health care services (incidence risk ratio 5.04 [year 3]; 95% confidence interval 2.49–10.2) and health visits (incidence risk ratio 1.33 [year 3]; 95% confidence interval 1.14–1.54). The average expected allied health costs were greater for children at risk versus not at risk of developmental delay. However, when excluding children with reported diagnoses of an NDD from this analysis, increased service use and costs in the remaining at‐risk population were not observed. Community engagement and workplace participation among families did not differ on the basis of risk of developmental delay.

Interpretation

These results suggest increased health care service use by families of children at risk of developmental delay is driven by those receiving a diagnosis of an NDD in the subsequent year.

What this paper adds

Early developmental delay risk was related to health care service use and costs.

Diagnosis of neurodevelopmental disorder drove increased health care service use and costs.

Early developmental delay risk did not relate to parental workforce participation.

Early developmental delay risk did not relate to community engagement participation.
Factors associated with glycaemic control in adults with Type 1 diabetes: a registry‐based analysis including 7601 individuals from 34 centres in Norway
Authors: Cooper J. G. , Bakke Å. , Dalen I. , Carlsen S. , Skeie S. , Løvaas K. F. , Sandberg S. , Thue G.
Published: August 2019

Aims

To use data from the Norwegian Diabetes Registry for Adults and Statistics Norway to assess factors associated with glycaemic control in type 1 diabetes.

Methods

The analyses included all individuals aged ≥18 years who had a type 1 diabetes duration of >2 years and a recorded value in the registry between 2013 and 2015 (n=7601). Predicted mean HbA1c levels for subgroups of participants were assessed using linear regression analysis.

Results

Young age (18–25 years), low education levels, smoking, living alone, exercising infrequently, monitoring glucose infrequently, high insulin requirements, low frequency of symptomatic hypoglycaemia, history of ketoacidosis and a BMI <18.5 kg/m2 were associated with a 2–12‐mmol/mol (0.2–1.1%) higher HbA1c level. Those with 10–15 years of diabetes duration had 5‐mmol/mol (0.5%) higher HbA1c level than those who had a diabetes duration of 2–5 years. Sex, participation (ever) in a diabetes education course, or ever experiencing serious hypoglycaemia were not associated with glycaemic control.

Conclusions

We present representative national data on factors that were associated with glycaemic control. A better understanding and awareness of these factors, together with technological advances in diabetes management, could lead to more personalized management strategies, better glycaemic control and a lower risk of diabetes complications.
Hormone‐substrate changes with exenatide plus dapagliflozin versus each drug alone: The randomized, active‐controlled DURATION‐8 study
Authors: Ferrannini Ele , Baldi Simona , Frías Juan P. , Guja Cristian , Hardy Elise , Repetto Enrico , Jabbour Serge A. , DeFronzo Ralph A.
Published: August 2019

Aim

To determine the effects of individual and combined therapies on plasma insulin, glucagon, β‐hydroxybutyrate (β‐OH) and associated metabolites.

Materials and Methods

In DURATION‐8, the combination of once‐weekly exenatide (EQW) + 10 mg dapagliflozin (Dapa) in patients with type 2 diabetes poorly controlled with metformin‐reduced HbA1c levels and body weight (at weeks 28 and 52) was compared with EQW + placebo (Plb) or Dapa + Plb. The study included 678 patients randomized 1:1:1 to EQW + Dapa, EQW + Plb, or Dapa + Plb. Plasma insulin and glucagon were measured at fasting and 2 hours after a mixed meal. Fasting plasma free fatty acids (FFA) and β‐OH concentrations were measured.

Results

The fasting insulin‐to‐glucagon molar ratio (I/Glg) increased with EQW + Plb only; postprandial I/Glg increased in all groups but significantly more with EQW + Plb. β‐OH, FFA, and glycerol concentrations showed a parallel response: larger increments with Dapa + Plb, larger decrements with EQW + Plb, and intermediate changes with EQW + Dapa. β‐OH levels and I/Glg were inversely related to one another. Patients in the top quartile of β‐OH changes from baseline [median (interquartile range): +207 (305) vs. −65 (−154) μmol/L; P < .0001] were more frequently treated with Dapa + Plb, had higher urine glucose‐to‐creatinine ratios, and lower fasting insulin [52 (51) vs. 68 (53) pmol/L; P = .0013) and I/Glg [1.76 (1.49) vs. 2.23 (1.70) mol/mol; P = .0020]. Haematocrit increased only in the Dapa group.

Conclusions

The EQW + Dapa combination abolished the Dapa‐induced rise in β‐OH, reduced the EQW‐induced increase in I/Glg, maintained glycosuria, and increased haematocrit in patients with poorly controlled type 2 diabetes. The drug combination may preserve any putative benefits while mitigating the risk of ketoacidosis.
COMMODITY PRICES AND BANK LENDING
Authors: Agarwal Isha , Duttagupta Rupa , Presbitero Andrea F.
Published: August 2019

We analyze the transmission of changes in commodity prices to bank lending in a large sample of developing countries. A bank‐level analysis shows that a fall in commodity net export prices is associated with a reduction of bank lending, particularly for commodity exporters and during episodes of terms‐of‐trade decline. We complement this analysis with loan‐level data from a credit register, which allows us to identify the effect of a commodity price shock on the supply of credit, controlling for unobserved factors that could drive borrowers' credit demand. Results show that banks with relatively lower deposits and poor asset quality transmit the changes in commodity prices to lending more aggressively. (JEL F30, F34, G21, Q02)
Monitoring vegetation recovery in the early stages of the Dirk Hartog Island Restoration Programme using high temporal frequency Landsat imagery
Authors: van Dongen Richard , Huntley Bart , Keighery Greg , Brundrett Mark
Published: August 2019

Dirk Hartog Island is the largest island off the West Australian coast. From the 1860s to 2008, the island was managed as a pastoral lease. In 2009, the island was gazetted as a National Park and the process of removing introduced animals, to allow for the reintroduction of a suite of 12 native mammal species, began. With the removal of high numbers of goats and sheep concerns were raised regarding the proliferation of weed species (which would no longer be controlled through grazing) and the ability of the island’s native vegetation to recover. A vegetation monitoring programme was developed which integrated detailed floristic surveys, repeated site photography and Landsat time series data to provide a comprehensive picture of how the island’s vegetation cover had changed since destocking. The integration of these elements has allowed present‐day observations to be put into context of longer term landscape dynamics. Through statistical analysis of temporal sequences of Landsat satellite imagery, the timing of changes to phenology and cover at monitoring sites was related directly to the management action of stock removal. With the use of field observations, the species responsible for the increase in cover were identified. These data sources, when analysed together, allowed management to have confidence that, following destocking, native vegetation cover is increasing.