bluuebunny/crossref_metadata_2025 huggingface dataset:
Luxury marketing in social media: the role of social distance in a craftsmanship video
Authors: Lee Jung Eun , Youn Song-Yi
Published: July 2020

Purpose

The purpose of this study is to examine the effect of craftsmanship content and social distance embedded in the craftsmanship content on luxury brand experiences, perceived luxury and brand purchase intentions using a social media video.

Design/methodology/approach

The authors conducted a single factor (close social distance vs great social distance vs control group) using a between-subjects experimental design. The social distance was manipulated by the presence (i.e. a close social distance) or absence (i.e. a great social distance) of a consumer scene in a craftsmanship video shown on social media. The control group watched a video with non-craftsmanship content. Then, brand experience, perceived luxury and purchase intentions were measured.

Findings

The results showed that the control group perceived less luxury and had lower brand experiences and purchase intentions than the group that watched the video without a consumer scene. In addition, participants who watched the craftsmanship video that included a consumer scene (i.e. a close social distance) had stronger brand experiences than those who watched the video without the scene (i.e. a great social distance). The brand experience increased perceived luxury and purchase intentions.

Originality/value

By manipulating social distance and providing better brand experiences in social media, experiential marketing allows luxury brands to reconcile two apparently incompatible goals: maintaining an exclusive image while increasing purchase intentions.
Modeling of crack repair using piezoelectric material: XFEM approach
Authors: Kumar Ritesh , Pathak Himanshu , Singh Akhilendra , Tiwari Mayank
Published: July 2020

Purpose

The purpose of this paper is to analyze the repair of a straight and angular crack in the structure using a piezoelectric material under thermo-mechanical loading by the extended finite element method (XFEM) approach. This provides a general and simple solution for the modeling of crack in the structure to analyze the repair.

Design/methodology/approach

The extended finite element method is used to model crack geometry. The crack surface is modeled by Heaviside enrichment function while the crack front is modeled by branch enrichment functions.

Findings

The effectiveness of the repair is measured in terms of stress intensity factor and J-integral. The critical voltage at which patch repair is most effective is evaluated and presented. Optimal patch shape, location of patch, adhesive thickness and adhesive modulus are obtained for effective repair under thermo-mechanical loading environment.

Originality/value

The presented numerical modeling and simulation by the XFEM approach are of great benefit to analyze crack repair in two-dimensional and three-dimensional structures using piezoelectric patch material under thermo-mechanical loading.
What drives customers' purchase behavior in a click-and-mortar retailing context: a value transfer perspective
Authors: Yeh Ching-Hsuan , Lin Hsin-Hui , Gau Yu-Ling , Wang Yi-Shun
Published: July 2020

Purpose

To examine the effectiveness of a multichannel strategy, this study mainly investigates two issues: (1) whether customers' five value perceptions (i.e. product quality, service quality, innovation, price and store image) extend from e-stores to physical stores and (2) whether customers' five value perceptions derived from e-stores/physical stores facilitate purchase intention within and beyond the channel context.

Design/methodology/approach

This study develops a research model to elaborate on the relationships between the focal constructs and collects 177 useable responses via an online community and personal contacts survey. Partial least squares structural equation modeling (PLS-SEM) methods and mediation analyses are conducted to validate the proposed hypotheses.

Findings

The results show that the values perceived in e-stores/physical stores generally motivate online/offline purchase intention, respectively. Next, based on Tversky's belief/feature matching process, the five value perceptions correlate with their counterparts across online and offline channels. The results of the mediation analyses suggest that the advantages established in online channels may be contagious to offline channels at the belief level. Specifically, four of the five online value perceptions may have different effects on offline purchase intention: (1) product quality perceived in e-stores directly (negative) and indirectly (positive) results in offline purchase intention, demonstrating cannibalization effects and (2) service quality, innovation and store image perceived in e-stores indirectly and positively contribute to offline purchase intention, indicating synergetic effects.

Originality/value

The findings of this study provide several important theoretical and practical implications for multichannel and omnichannel retailing strategies.
Role of demographic factors in economic growth of South Asian countries
Authors: Munir Kashif , Shahid Faqeer Syed Umaid
Published: July 2020

Purpose

This study examines the long-run and short-run impact of demographic factors, i.e. life expectancy, fertility rate and young dependency ratio in determining the economic growth of South Asian countries.

Design/methodology/approach

The theoretical foundation of the study relies on demographic transition theory and incorporates life expectancy, fertility rate and young dependency ratio into the production function by means of human capital component. The study uses annual panel data of four South Asian courtiers, i.e. Bangladesh, India, Pakistan and Sri Lanka from 1980 to 2018 and utilizes panel ARDL model to analyze the long run and short run impact of demographic factors on economic growth.

Findings

Results show that real stock of capital, fertility rate and life expectancy are positively related with economic growth, while an increase in young dependency ratio reduces economic growth in South Asian countries in the long run. Short-run dynamics show that real stock of capital and life expectancy have insignificant impact on economic growth, while young dependency ratio has negative and significant as well as life expectancy has positive and significant impact on economic growth in South Asian countries. Unidirectional causality exists from young dependency ratio and fertility rate to GDP per capita in the short run.

Practical implications

Government has to design policies for better health and education facilities to yield high economic growth as well as better infrastructure and macroeconomic stability to facilitate capital accumulation in the region to foster economic growth.

Originality/value

This study considerably adds into the existing literature by providing better understanding of various demographic aspects and their economic inference by highlighting the demographic changes that South Asia has endured. This study is also beneficial for policymakers and growth analysts in generating effective and sustainable policies regarding population dynamics and economic development of the region.
Exploring the mediating influences of total quality management and just in time between green supply chain practices and performance
Authors: Agyabeng-Mensah Yaw , Afum Ebenezer , Agnikpe Carin , Cai Jiaxin , Ahenkorah Esther , Dacosta Essel
Published: July 2020

Purpose

The desire for firms to gain competitive advantage and improve performance has resulted in the adoption of several practices. Green supply chain practices (GSCPs), just in time (JIT) and total quality management (TQM) are some of the practices adopted by firms to improve operational performance (OP) and business performance (BP). This study examines the direct influence of GSCPs, JIT and TQM on operational performance and BP. The study further analyzes the synergy of GSCPs, JIT and TQM on OP and BP.

Design/methodology/approach

This study employs the quantitative approach of research by using questionnaire to gather data from manufacturing managers and supply chain managers of 140 manufacturing firms in Ghana. The research uses partial least square structural equation modeling (PLS–SEM) to analyze the survey data.

Findings

The results of the analysis show that GSCPs, TQM and JIT positively influence both OP and BP. The findings reveal that GSCPs combine with JIT and TQM to improve OP and BP significantly. However, the synergy between green supply chain and TQM creates more value for both OP and BP than the synergy between GSCPs and JIT.

Originality/value

The study proposes a research model that examines both the individual and combined influence of GSCPs, TQM and JIT on both OP and BP from the developing country perspective. The study models GSCPs as an antecedent of JIT and TQM, which has not been explored.
The impact of intellectual capital in organizational innovation: case study at Kuwait Petroleum Corporation (KPC)
Authors: Almutirat Hanan Ali
Published: July 2020

Purpose

The purpose of this paper is to study the relationship between intellectual capital and organizational innovation in Kuwait Petroleum Corporation (KPC) through a case study at KPC on the employees of the corporation (The study population was 2,180 respondents and the sample size was 335 respondents).

Design/methodology/approach

The statistical package for social science was used to analyze the data. While trying to explore the relationship between intellectual capital and innovation, the researcher used the descriptive analytical method and the case study methodology using various references, periodicals, internal and external documents and data, in addition to conducting a field study on a sample of employees of KPC, through a questionnaire form containing the axes that reflect the study variables.

Findings

There is a relative approval between the sample of the research on the existence of a good role for training in the corporation in terms of availability for all employees and the compatibility of training programs with the actual needs of employees, and linking the training paths and career paths for promotions in the corporation. The researcher attributed this to the employees' awareness to the importance of training and its role in raising their performance levels, and the awareness of the corporation to the importance of training and capacity building of the human element.

Originality/value

The research, in general, demonstrated the importance of human capital as the organization's most valuable assets, especially as it supports creativity and innovation, thus enabling competitiveness. The research stressed that human capital is the most important element in the formation of intellectual capital, which requires decision-makers to support it and give the intellectual and human aspects a strategic content that meets the needs to develop innovation and institutional education and to recruit systems and indicators to measure the performance objectively to achieve the goal of survival of the corporation in a competitive sustainable environment, through providing material and moral potentials that can support the implementation of organizational innovation at various levels.
Retaining top talent: an introduction to the midlife review
Authors: Butler Steve
Published: July 2020

Purpose

This paper aims to explore the emerging HR practice of midlife reviews which are being implemented as the mechanism to stimulate a conversation between employers and employees about next steps, second careers and flexible career solutions.

Design/methodology/approach

This paper considers the approaches taken by Legal & General and AVIVA to implementing a midlife review programme within their organisation by interviews with senior managers involved in the implementation.

Findings

A midlife review helps employees plan the important second phase of their career and enables employers to work with them to decide how they can best be supported. The midlife review includes deciding what kind of training or upskilling they might need, considering any changes to working patterns and tailoring the benefits package to suit older workers.

Originality/value

The midlife review was introduced by the National Institute of Adult Continuing Education in 2015 and is only just starting to gain traction as a HR practice to retain older talent within an organisation. This paper attempts to raise awareness for the purpose of future research.
An initial assessment of Lean Management methods for Industry 4.0
Authors: Saxby Robert , Cano-Kourouklis Michele , Viza Evi
Published: July 2020

Purpose

The purpose of this paper is to present the results of an assessment into how well the Lean Management method will support continuous improvement in the world of Industry 4.0.

Design/methodology/approach

Using thematic analysis of literature, the Lean Management method and Industry 4.0 were deconstructed into their constituent elements. Semi-structured interviews were then carried out with five Quality Specialists in manufacturing to gather opinions on how well each Lean element supported each theme of Industry 4.0.

Findings

This initial research highlighted that the Lean method can integrate new technologies, to allow it to better support continuous improvement in the world of Industry 4.0. It was found the supportive elements of Lean in the world of Industry 4.0 would include Continual Improvement, Engaging the Supply Chain, Pull Systems and having a Customer Focus.

Research limitations/implications

This was a scoping study as a precursor to further research and was based on the opinions of five Quality/Lean Specialists. However, the results determine that Lean can be supported by Industry 4.0 technologies.

Practical implications

Those constituent elements of Lean which might be updated to better support quality improvement in the world of Industry 4.0 have been identified. A methodology by which expanded research may be undertaken has been demonstrated.

Originality/value

The findings contribute to knowledge by providing a focus on the key supporting elements of Lean implementation for Industry 4.0 in the manufacturing sector.
Some have it all: multicellularity, magnetotaxis and photokinesis in one bacterium
Authors: Wettstadt Sarah
Published: July 2020

Bacteria developed many different ways to orient themselves in the environment. Magnetoreception with following motility along Earth's magnetic field lines and photoreception with subsequent positive or negative phototaxis allow bacteria to optimally position themselves for survival and growth. Some bacteria show both magnetotactic and photoresponsive behaviour and additionally live in a multicellular organism adding another layer of complexity. A novel study by Qian and colleagues visualized different species of multicellular magnetotactic bacteria and shed light on their reproductive as well as photoresponsive behaviour. This study paves the way towards understanding the evolutionary advantage of multicellular lifestyle of prokaryotes.
Future shock 2020
Authors: Thorp John M
Published: July 2020

Deputy Editor‐in‐Chief John Thorp discusses the latest thinking in women’s health and highlights articles from this issue in an audio podcast available at: https://soundcloud.com/bjog/aug-editorial-2020
Do Plant Clinics Improve Household Food Security? Evidence from Rwanda
Authors: Tambo Justice A. , Uzayisenga Bellancile , Mugambi Idah , Bundi Mary
Published: July 2020

One of the main drivers of food insecurity is pests, which are estimated to cause around 40% of crop losses worldwide. We examine the food security effects of plant clinics, a novel agricultural extension model that aims to reduce crop losses due to pests through the provision of demand‐driven plant health diagnostic and advisory services to smallholder farmers. The study is based on survey data from maize‐growing households in Rwanda, where 66 plant clinics have been established. Using switching regression and matching techniques as well as various food security metrics, including the food insecurity experience scale, we find evidence that participation in plant clinics is significantly associated with a reduction in household food insecurity. For instance, among the participating households, plant clinics contribute to a decrease in the period of food shortage by one month and a reduction in the severity of food insecurity by 22 percentage points. We also show that these effects are more pronounced for female‐headed households. Overall, our findings suggest that plant clinics can play an important role in achieving the Sustainable Development Goal 2 of zero hunger.
Intramyocardial haematoma causing right ventricular outflow obstruction after brown snake (Pseudonaja species) envenomation in a dog
Authors: Kang K , Sharp CR , Boyd CJ , Turner K
Published: July 2020

A 15‐month‐old, male neutered Staffordshire Bull Terrier cross was presented to its referring veterinarian collapsed and agonal. He was immediately intubated, manually ventilated, and treatment commenced for presumptive snake envenomation with two vials of Tiger/Multi‐Brown Snake Antivenom (minimum 7000 units/vial). The dog was transferred to a referral hospital intubated. Additional diagnostics performed following arrival at the referral hospital included a urine snake venom detection kit test, which was positive for brown snake immunotype. Three additional vials of Tiger/Multi‐Brown Snake Antivenom (minimum 7000 units/vial) were administered until the dog was extubated and able to stand. Venom‐induced consumptive coagulopathy (VICC) was diagnosed based on prolonged clotting times and scleral haemorrhage. Paroxysms of right ventricular outflow tract (RVOT) origin ventricular arrhythmias were treated with lignocaine and sotalol. Four days after presentation, a new‐grade IV/VI systolic heart murmur was auscultated, prompting an echocardiogram. An anechoic and compartmentalised mass measuring 43 mm × 19 mm was visualized within the right ventricular wall at the RVOT, immediately adjacent to the pulmonic valve. The mass was causing a RVOT obstruction. Its appearance was suggestive of an intramyocardial haematoma, most likely secondary to VICC. The dog remained cardiovascularly stable, and treatment consisted of supportive care. Recheck echocardiograms at 2 and 7 weeks after discharge revealed progressive improvement of the intramyocardial mass and resolution of the associated heart murmur. Although intramyocardial haematomas are rare, it should be considered as a differential in dogs that develop a newly diagnosed heart murmur and/or cardiac arrhythmia following brown snake envenomation.
Patients' perceptions of implant therapy and maintenance: A questionnaire‐based survey
Authors: Brunello Giulia , Gervasi Marika , Ricci Sara , Tomasi Cristiano , Bressan Eriberto
Published: July 2020

Objectives

To evaluate patients' perceptions regarding implant treatment and maintenance.

Material and methods

A semi‐structured questionnaire was developed focusing on 4 main domains: (a) information regarding possible complications received before implant therapy; (b) information received after treatment regarding maintenance; (c) self‐performed daily home care; and (d) implant maintenance received at the dental office. Adult patients, restored with implant‐supported prosthesis by at least 6 months, were recruited between June 2016 and December 2017.

Results

The study population consisted of 522 patients with a mean age of 61 years. The majority of the participants referred to have received information about the need of periodical check‐ups (91.6%). However, only 58.9% declared to have been informed about complications and failures before treatment commencement. Even though 91.2% of the participants declared to have received instruction about cleaning measures around implants, less than half of the sample reported to have been asked to try the cleaning tools at the office (40.4%). Even though patients' awareness about implant treatment and maintenance resulted to be low in a consistent part of the sample, patients' satisfaction level about information received regarding implant care was high (Visual Analogue Scale 8.18).

Conclusions

Most patients appeared to be informed about the importance of specific oral hygiene measurements and recall programs. However, an unsatisfactory level of knowledge about implant‐related complications was evidenced. Improvements in time and energy employed by dentists and hygienist in communication with patients are needed, in order to enhance health outcomes and compliance both to the treatment and to the maintenance.
Morroniside attenuates high glucose–induced BMSC dysfunction by regulating the Glo1/AGE/RAGE axis
Authors: Sun Yi , Zhu Yu , Liu Xuanzhe , Chai Yimin , Xu Jia
Published: July 2020

Objectives

High glucose (HG)–mediated bone marrow mesenchymal stem cell (BMSC) dysfunction plays a key role in impaired bone formation induced by type 1 diabetes mellitus (T1DM). Morroniside is an iridoid glycoside derived from the Chinese herb Cornus officinalis, and it has abundant biological activities associated with cell metabolism and tissue regeneration. However, the effects and underlying mechanisms of morroniside on HG‐induced BMSC dysfunction remain poorly understood.

Materials and methods

Alkaline phosphatase (ALP) staining, ALP activity and Alizarin Red staining were performed to assess the osteogenesis of BMSCs. Quantitative real‐time PCR and Western blot (WB) were used to investigate the osteo‐specific markers, receptor for advanced glycation end product (RAGE) signalling and glyoxalase‐1 (Glo1). Additionally, a T1DM rat model was used to assess the protective effect of morroniside in vivo.

Results

Morroniside treatment reverses the HG‐impaired osteogenic differentiation of BMSCs in vitro. Morroniside suppressed advanced glycation end product (AGEs) formation and RAGE expression by triggering Glo1. Moreover, the enhanced osteogenesis due to morroniside treatment was partially blocked by the Glo1 inhibitor, BBGCP2. Furthermore, in vivo, morroniside attenuated bone loss and improved bone microarchitecture accompanied by Glo1 upregulation and RAGE downregulation.

Conclusions

These findings suggest that morroniside attenuates HG‐mediated BMSC dysfunction partly through the inhibition of AGE‐RAGE signalling and activation of Glo1 and may be a potential treatment for diabetic osteoporosis.
Atypical cells on reflectance confocal microscopy may not represent melanoma: A case of axillary pigmented extramammary Paget disease
Authors: Chuchvara Nadiya , Reilly Catherine , Haroon Attiya , Wassef Cindy , Maghari Amin , Rao Babar
Published: July 2020

Pigmented extramammary Paget disease (PEMPD) is a rare intraepithelial carcinoma which can clinically resemble other pigmented neoplasms. Similarities to melanoma on dermoscopy, histopathology, and reflectance confocal microscopy (RCM) increase the risk of misdiagnosis and, consequently, mismanagement. Here, we describe a case of a 67‐year‐old African American woman with a large, pigmented axillary patch that exhibited features of melanoma on RCM, guiding the clinician to perform an excisional biopsy. While traditional histopathology resembled melanoma, immunohistochemistry staining was performed and revealed PEMPD. We highlight an uncommon clinical presentation of PEMPD disease and identify morphologic mimickers of melanoma on RCM—as well as differentiating features.
Anti‐dopamine D2 receptor antibodies in chronic tic disorders
Authors: Addabbo Francesco , Baglioni Valentina , Schrag Anette , Schwarz Markus J , Dietrich Andrea , Hoekstra Pieter J , Martino Davide , Buttiglione Maura ,   Emtics Collaborative Group
Published: July 2020

Aim

To investigate the association between circulating anti‐dopamine D2 receptor (D2R) autoantibodies and the exacerbation of tics in children with chronic tic disorders (CTDs).

Method

One hundred and thirty‐seven children with CTDs (108 males, 29 females; mean age [SD] 10y 0mo [2y 7mo], range 4–16y) were recruited over 18 months. Patients were assessed at baseline, at tic exacerbation, and at 2 months after exacerbation. Serum anti‐D2R antibodies were evaluated using a cell‐based assay and blinded immunofluorescence microscopy scoring was performed by two raters. The association between visit type and presence of anti‐D2R antibodies was measured with McNemar’s test and repeated‐measure logistic regression models, adjusting for potential demographic and clinical confounders.

Results

At exacerbation, 11 (8%) participants became anti‐D2R‐positive (‘early peri‐exacerbation seroconverters’), and nine (6.6%) became anti‐D2R‐positive at post‐exacerbation (‘late peri‐exacerbation seroconverters’). The anti‐D2R antibodies were significantly associated with exacerbations when compared to baseline (McNemar’s odds ratio=11, p=0.003) and conditional logistic regression confirmed this association (Z=3.49, p<0.001) after adjustment for demographic and clinical data and use of psychotropic drugs.

Interpretation

There is a potential association between immune mechanisms and the severity course of tics in adolescents with CTDs.
Time and Performance in Online Learning: Applying the Theoretical Perspective of Metacognition
Authors: Zhao Lin , Ye Chen
Published: July 2020

Educational psychologists have found that metacognitive calibration predicts learning outcomes in self‐regulated learning. In this research the authors apply theories of metacognition from educational psychology and postulate that metacognitive calibration influences learning time and performance in online learning. Data gathered from 230 college students who completed online self‐regulated assignments in an introductory information systems course confirms that higher calibration accuracy leads to better performance on assignments, which contributes to higher exam grades. In addition, higher calibration accuracy also reduces the amount of time students spent on the online assignments. However, time spent on the assignments is not a mediator of the effect of calibration on learning performance. This research presents pioneering work in examining a holistic model that assesses the impact of metacognition in online learning on both assignment and exam level learning outcomes using field data collected through a natural learning setting. The findings highlight the need to include metacognitive calibration as one of the learner characteristics in research models addressing student performance in online learning.
Structural characteristics, physicochemical properties and prebiotic potential of modified dietary fibre from the basal part of bamboo shoot
Authors: Fang Dongya , Wang Qi , Chen Canhui , Li Zhengyi , Li Shuting , Chen Wen , Zheng Yafeng
Published: July 2020

The basal part of bamboo shoot is a novel resource to produce dietary fibre (BDF). However, its insolubility in water, stiff texture and low degradability limit its applicability in foods. This study explored the feasibility of improving the structural and functional properties of BDF by enzymatic hydrolysis and dynamic high‐pressure micro‐fluidisation (DHPM). Both methods are efficient to reduce the fibre particle size and caused significantly increased roughness on the fibre surface, especially for the porous structure after DHPM treatment. Crystallinity of DHPM‐modified fibres was increased from 23.01% to 33.53%, due to the disruption of lignin and hemicellulose, which was further confirmed by the FT‐IR spectra. The modified fibres exhibited significantly enhanced swelling capacity and holding water/oil capacities. Moreover, the modified fibres exhibited improved in vitro prebiotic property, which could constantly supply the carbon source and stimulate the growth of Lactobacillus acidophilus ATCC 4356 and Bifidobacterium longum ATCC 15707.
Characterization of the phenolic acid profile and in vitro bioactive properties of white beetroot products
Authors: Sawicki Tomasz , Wiczkowski Wiesław , Hrynkiewicz Monika , Bączek Natalia , Hornowski Andrzej , Honke Joanna , Topolska Joanna
Published: July 2020

The impact of boiling, baking and fermentation treatment on the phenolic acid profile, antioxidant capacity (AC) and angiotensin‐1 converting enzyme (ACE) activity of white beetroot was investigated. The phenolic acids were analysed by liquid chromatography–mass spectrometry (micro‐HPLC‐MS/MS), while AC and ACE were determined by in vitro assays. Phenolic acids concentration was between 87.55 and 100.98 ng g−1 d.m. Ferulic and p‐coumaric acids were the main compounds among the nine phenolic acids identified. Boiling increased the phenolic acid content by 3%; however, baking and fermentation reduced the level of these acids by approximately 6% and 11%, respectively. A significant positive correlation was observed between the results of all AC assays and sinapic and caffeic acid content. The ACE inhibitory activity of white beetroot products may be attributable to the combined effect of the syringic, 4‐hydroxybenzoic, ferulic and p‐coumaric acids. Our study indicates that white beetroot as a novel product may be a valuable source of phenolic acids and functional properties.
Predicting externalizing behavior in toddlerhood from early individual differences in empathy
Authors: Paz Yael , Orlitsky Tal , Roth‐Hanania Ronit , Zahn‐Waxler Carolyn , Davidov Maayan
Published: July 2020

Background

From middle childhood onward, there is often a negative link between empathy and externalizing behavior problems. Patterns at younger ages are still unclear, with mixed findings of no association, negative associations, and positive associations. This study examines links between empathy and externalizing problems, beginning in infancy.

Methods

A community sample of infants (N = 165) was assessed for empathy at 3, 6, 12, 18, and 36 months, using behavioral observations. Externalizing problems were reported at 18 months (by mothers) and 36 months (by mothers and daycare teachers).

Results

Boys showed more externalizing problems than girls. For boys, negative associations between empathy and externalizing appeared, particularly with teacher reports. For girls, there were positive associations between empathy and externalizing, which weakened with age. For both genders, empathy at ages 3, 6, and 18 months appeared to protect against increases in externalizing from 18 to 36 months.

Conclusions

The role of empathy in the development of early externalizing depends on both gender and age; toddler boys’ externalizing may more typically stem from low empathy, whereas girls’ early externalizing appears to be underlain by heightened sensitivity and unregulated or assertive approach attempts.
Relationships between the National Early Warning Score 2, clinical worry and patient outcome at discharge: Retrospective observational study
Authors: Hwang Jee‐In , Chin Ho Jun
Published: July 2020

Aims and objectives

To examine the performance of the National Early Warning Score 2 and composite score for clinical worry in identifying patients at risk of clinical deterioration, and to determine relationships between National Early Warning Score 2, clinical worry score and patient outcome at discharge.

Background

The efficacy of early warning systems depends on patient population and care settings. Based on a theoretical framework on factors affecting clinical deterioration and patient outcomes, studies exploring the relationship between early warning systems and patient outcomes at discharge are sparse.

Design

Retrospective observational study.

Methods

A random sample of 732 medical records were reviewed. The area under the receiver operating characteristic curve was calculated to evaluate predictive abilities regarding the events of unanticipated in‐hospital mortality, unplanned intensive care unit/ higher dependency bed admission and cardiac arrest. Multiple logistic regression analyses were performed to determine relationships between National Early Warning Score 2, clinical worry score and patient outcome. Reporting followed the STROBE checklist.

Results

National Early Warning Score 2 and clinical worry score significantly predicted the events within 24 hr of the assessment. After controlling for other patient, treatment and organisational characteristics, National Early Warning Score 2 was a significant factor associated with patient outcome, but clinical worry score was not. Specifically, patients at high risk based on National Early Warning Score 2 were less likely to have improved outcome.

Conclusions

National Early Warning Score 2 and clinical worry score performed well for predicting deteriorating condition of patients. National Early Warning Score 2 was significantly associated with patient outcome. It can be used for efficient patient management for safe, quality care.

Relevance to clinical practice

National Early Warning Score 2 can be used for early assessment of not only clinical deterioration but also patient outcome and provide timely intervention, when coupled with clinical worry score.
Positive peritoneal cytology is an independent risk factor in endometrial cancer
Authors: Dong Yangyang , Wang Zhiqi , Wang Jianliu
Published: July 2020

Objective

We aimed to investigate whether positive peritoneal cytology could serve as a prognostic factor in endometrial cancer (EC).

Methods

From patients with EC surgically treated at Peking University People's Hospital between 2006 and 2016, 520 patients were selected for retrospective investigation. Clinical and pathologic factors associated with positive peritoneal cytology were assessed using univariate and multivariate logistic regressions model. Disease‐free survival (DFS) and overall survival (OS) were evaluated using Kaplan–Meier estimation and multivariate Cox regressions model.

Results

(i) The incidence of positive peritoneal cytology in EC patients was 9.0% (47/520). (ii) Multivariate analysis showed that the independent risk factors of positive peritoneal cytology were nonendometrioid carcinoma (odds ratio [OR] = 4.0, 95% confidence interval [CI], 1.8–8.8, P = 0.001), tumor diameter ≥2 cm (OR = 3.2, 95% CI, 1.2–8.7, P = 0.023), cervical stromal invasion (OR = 2.9, 95% CI, 1.3–6.6, P = 0.009) and distant metastasis (OR = 6.5, 95% CI, 1.7–25.4, P = 0.007). (iii) The 5‐year DFS and 5‐year OS of the positive peritoneal cytology group were significantly lower compared with the negative group (54.0% vs 93.2%, P < 0.001; 63.6% vs 94.6%, P < 0.001). (iv) After other contributing factors were adjusted in the multivariable model, positive peritoneal cytology remained an independent predictor of decreased DFS (OR = 2.8, 95% CI, 1.3–6.0, P = 0.007) and OS (OR = 2.8, 95% CI, 1.0–7.2, P = 0.035).

Conclusion

Positive peritoneal cytology was an independent risk factor in EC patients. Even though it is no longer an indicator according to the current International Federation of Gynecology and Obstetrics staging system, the peritoneal cytology status should still be considered for accurate risk stratification in EC.
Ovarian incision enhances folliculogenesis: A rat model
Authors: Takmaz Ozguc , Asoglu Mehmet Resit , Yuksel Bahar , Gungor Mete , Tokat Fatma , Kayhan Kerem Cavit , Ozaltin Selin , Dogan Murat , Buyru Faruk , Bastu Ercan
Published: July 2020

Aim

To determine whether performing incision on the surface of the ovarian cortex in rats advances follicular development.

Methods

Five to seven separate superficial incisions were performed on the surface of right ovaries of 6‐7–month‐old albino Wistar rats. Daily 40 IU of gonadotropins were administered for 14 days. On the 15th day, both ovaries of the rats were removed. The right (incised) ovaries were compared with the contralateral ovaries in terms of ovary's weight, numbers of primordial, primary, secondary and antral follicles, their mean percentages and mean Ki‐67 proliferation indices.

Results

A total of 22 ovaries were evaluated, with 11 right ovaries (incised) and 11 left ovaries (non‐incised). The mean weight of ovaries was greater in the right ovaries than in the left ovaries; however, no statistical difference was found between them (0.77 ± 1.22 vs. 0.22 ± 0.08 gr, P = 0.159). The numbers of secondary and antral follicle were statistically higher in the right ovaries than in the left ovaries (4.4 ± 1.5 vs. 2.1 ± 1.6, P = 0.003 and 18.6 ± 8.7 vs. 11.3 ± 7.5, P = 0.046, respectively). The right ovaries also significantly differed from the left ovaries in terms of mean percentages of primordial and antral follicles (P < 0.05 for both). The mean Ki‐67 proliferation index had a marginal difference between the groups (P = 0.064).

Conclusion

Performing incisions on the surface of the ovarian cortex in rats may advance the ovarian follicular development. Future animal studies may provide more evidence regarding potential benefits of mechanical stimulation to the ovaries.
Recognition of rust grade and rust ratio of steel structures based on ensembled convolutional neural network
Authors: Xu Jie , Gui Changqing , Han Qinghua
Published: July 2020

Ensembled convolutional neural network (ECNN) was utilized to recognize the rust grade and rust ratio of steel structure to partially replace traditional visual inspection. The performance of ECNN was demonstrated by theoretical analysis and experimental verification, and the application scenarios of ECNN in the task of rust grade recognition and rust ratio recognition were discussed. The accuracy of ECNN classifier reached 93%, which improves upon the highest accuracy of 90% achieved by using a single classifier. By visualizing the misclassified images, it was found that the rust grade of misclassified image is indistinguishable and the classifiers show strong fault tolerance. The ensembled model is more robust than the single model in the task of rust ratio recognition. Gaussian blur was applied to the test images to study the effect of image blur on model performance, and the results show that the rust segmentation model was not susceptible to image blur.
A case of body dysmorphic disorder in an adolescent with hypohidrotic ectodermal dysplasia
Authors: Hammond Brittany Anne , Reeve Elizabeth A.
Published: July 2020

We report the case of an adolescent with hypohidrotic ectodermal dysplasia, who had obsessive‐compulsive disorder and was later diagnosed with body dysmorphic disorder (BDD). BDD is a highly distressing, adolescent‐onset disorder that may lead to social isolation, the development of comorbid mental health disorders and suicidality. Patients typically lack insight into their BDD and frequently present to dermatologists for medical treatment. In this paper, we address the challenges faced when working with patients with BDD.
Contemporary Land Questions in Sweden, Far‐Right Populist Strategies and Challenges for Inclusionary Rural Development
Authors: Alarcón Ferrari Cristián
Published: July 2020

This article analyses the rural politics and discursive strategies of the Sweden Democrats political party and contrasts them with the politics of movements proposing inclusionary rural development in Sweden. The article examines political and media documents on rural issues produced by the Sweden Democrats, uses documents of and interviews with representatives of rural development initiatives in Sweden and analyses relevant forest owners’ magazines. The results show that the defence of property rights and exclusionary politics are a prominent part of the populist strategy of the Sweden Democrats in rural areas and that technological development and mechanisation of forestry and agriculture become crucial challenges in articulating political efforts for inclusionary rural development in Sweden. The article concludes by highlighting differences between the Sweden Democrats’ populist strategies and the political efforts to build inclusionary rural politics in the context of contemporary land questions in Sweden.
Can interferons stop COVID-19 before it takes hold?
Authors: Wadman Meredith
Published: July 2020

Biology of infection supports early treatment with body's own viral defenses
HEM1 deficiency disrupts mTORC2 and F-actin control in inherited immunodysregulatory disease
Authors: Cook Sarah A. , Comrie William A. , Poli M. Cecilia , Similuk Morgan , Oler Andrew J. , Faruqi Aiman J. , Kuhns Douglas B. , Yang Sheng , Vargas-Hernández Alexander , Carisey Alexandre F. , Fournier Benjamin , Anderson D. Eric , Price Susan , Smelkinson Margery , Abou Chahla Wadih , Forbes Lisa R. , Mace Emily M. , Cao Tram N. , Coban-Akdemir Zeynep H. , Jhangiani Shalini N. , Muzny Donna M. , Gibbs Richard A. , Lupski James R. , Orange Jordan S. , Cuvelier Geoffrey D. E. , Al Hassani Moza , Al Kaabi Nawal , Al Yafei Zain , Jyonouchi Soma , Raje Nikita , Caldwell Jason W. , Huang Yanping , Burkhardt Janis K. , Latour Sylvain , Chen Baoyu , ElGhazali Gehad , Rao V. Koneti , Chinn Ivan K. , Lenardo Michael J.
Published: July 2020

An inherited disorder makes WAVEs

The WAVE regulatory complex (WRC) is a multiunit complex that regulates actin cytoskeleton formation. Although other actin-regulatory proteins modulate human immune responses, the precise role for the WRC has not yet been established. Cook
et al.
studied five patients from four unrelated families who harbor missense variants of the gene encoding the WRC component HEM1. These patients presented with recurrent infections and poor antibody responses, along with enhanced allergic and autoimmune disorders. HEM1 was found to be required for the regulation of cortical actin and granule release in T cells and also interacted with a key metabolic signaling complex contributing to the disease phenotype. By linking these interactions to immune function, this work suggests potential targets for future immunotherapies.

Science
, this issue p.
202
Poised for tissue repair
Authors: Harrison Oliver
Published: July 2020

Skin microbes interact with the immune system to aid wound healing
The cytoskeletal regulator HEM1 governs B cell development and prevents autoimmunity
Authors: Salzer Elisabeth , Zoghi Samaneh , Kiss Máté G. , Kage Frieda , Rashkova Christina , Stahnke Stephanie , Haimel Matthias , Platzer René , Caldera Michael , Ardy Rico Chandra , Hoeger Birgit , Block Jana , Medgyesi David , Sin Celine , Shahkarami Sepideh , Kain Renate , Ziaee Vahid , Hammerl Peter , Bock Christoph , Menche Jörg , Dupré Loïc , Huppa Johannes B. , Sixt Michael , Lomakin Alexis , Rottner Klemens , Binder Christoph J. , Stradal Theresia E. B. , Rezaei Nima , Boztug Kaan
Published: July 2020

HEM1 deficiency causes heritable autoimmunity and immunodeficiency.
Resistance to Ceftazidime/Avibactam plus Meropenem/Vaborbactam When Both Are Used Together Is Achieved in Four Steps in Metallo-β-Lactamase-Negative Klebsiella pneumoniae
Authors: Dulyayangkul Punyawee , Douglas Edward J. A. , Lastovka Filip , Avison Matthew B.
Published: July 2020

Serine β-lactamases are dominant causes of β-lactam resistance in
Klebsiella pneumoniae
isolates. Recently, this has driven clinical deployment of the β-lactam–β-lactamase inhibitor pairs ceftazidime/avibactam and meropenem/vaborbactam. We show that four steps, i.e.,
ompK36
and
ramR
mutation plus carriage of OXA-232 and KPC-3-D178Y variant β-lactamases, confer ceftazidime/avibactam and meropenem/vaborbactam resistance when both pairs are used together.
Generation and Characterization of Typhoid Toxin-Neutralizing Human Monoclonal Antibodies
Authors: Jiao Xuyao , Smith Sarah , Stack Gabrielle , Liang Qi , Bradley Allan , Kellam Paul , Galán Jorge E.
Published: July 2020

Typhoid toxin is a virulence factor ofSalmonella entericaserovar Typhi, the causative agent of typhoid fever, and is thought to be responsible for the symptoms of severe disease. This toxin has a unique A2B5 architecture with two active subunits, the ADP ribosyl transferase PltA and the DNase CdtB, linked to a pentameric B subunit, which is alternatively made of PltB or PltC. Here, we describe the generation and characterization of typhoid toxin-neutralizing human monoclonal antibodies by immunizing genetically engineered mice that have a full set of human immunoglobulin variable region genes.
Pseudomonas aeruginosa PA14 Enhances the Efficacy of Norfloxacin against Staphylococcus aureus Newman Biofilms
Authors: Orazi Giulia , Jean-Pierre Fabrice , O’Toole George A.
Published: July 2020

Pseudomonas aeruginosa
and
Staphylococcus aureus
are frequently coisolated from multiple infection sites, including the lungs of individuals with cystic fibrosis (CF) and nonhealing diabetic foot ulcers. Coinfection with
P. aeruginosa
and
S. aureus
has been shown to produce worse outcomes compared to infection with either organism alone. Furthermore, the ability of these pathogens to form biofilms enables them to cause persistent infection and withstand antimicrobial therapy. In this study, we found that
P. aeruginosa
-secreted products dramatically increase the ability of the antibiotic norfloxacin to kill
S. aureus
biofilms. Understanding how interspecies interactions alter the antibiotic susceptibility of bacterial biofilms may inform treatment decisions and inspire the development of new therapeutic strategies.
What determines diagnostic resource consumption in emergency medicine: patients, physicians or context?
Authors: Hautz Wolf E , Sauter Thomas C , Hautz Stephanie C , Kämmer Juliane E , Schauber Stefan K , Birrenbach Tanja , Exadaktylos Aristomenis K , Stock Stephanie , Müller Martin
Published: July 2020

Objectives

A major cause for concern about increasing ED visits is that ED care is expensive. Recent research suggests that ED resource consumption is affected by patients’ health status, varies between physicians and is context dependent. The aim of this study is to determine the relative proportion of characteristics of the patient, the physician and the context that contribute to ED resource consumption.

Methods

Data on patients, physicians and the context were obtained in a prospective observational cohort study of patients hospitalised to an internal medicine ward through the ED of the University Hospital Bern, Switzerland, between August and December 2015. Diagnostic resource consumption in the ED was modelled through a multilevel mixed effects linear regression.

Results

In total, 473 eligible patients seen by one of 38 physicians were included in the study. Diagnostic resource consumption heavily depends on physicians’ ratings of case difficulty (p<0.001, z-standardised regression coefficient: 147.5, 95% CI 87.3 to 207.7) and—less surprising—on patients’ acuity (p<0.001, 126.0, 95% CI 65.5 to 186.6). Neither the physician per se, nor their experience, the patients’ chronic health status or the context seems to have a measurable impact (all p>0.05).

Conclusions

Diagnostic resource consumption in the ED is heavily affected by physicians’ situational confidence. Whether we should aim at altering physician confidence ultimately depends on its calibration with accuracy.
Next-generation sequencing demonstrates the rarity of short kinase variants specific to quadruple wild-type gastrointestinal stromal tumours
Authors: Wong Newton A C S , Giger Olivier T , ten Hoopen Rogier , Casey Ruth T , Russell Kirsty , Faulkner Claire
Published: July 2020

Aim

There is no known specific biomarker or genetic signal for quadruple wild-type (qWT) gastrointestinal stromal tumours (GISTs). By next-generation sequencing (NGS) of different GIST subgroups, this study aimed to characterise such a biomarker especially as a potential therapeutic target.

Methods and results

An NGS panel of 672 kinase genes was applied to DNA extracted from 11 wild-type GISTs (including three qWT GISTs) and 5KIT/PDGFRAmutated GISTs. Short variants which were present in qWT GISTs but no other GIST subgroup were shortlisted. After removing common population variants, in silico-classified deleterious variants were found inCSNK2A1,MERTK,RHEB,ROCK1,PIKFYVEandTRRAP. None of these variants were demonstrated in a separate cohort of four qWT GISTs.

Conclusions

Short kinase variants which are specific to qWT GISTs are rare and are not universally demonstrated by this whole subgroup. It is therefore possible that the current definition of qWT GIST still covers a heterogenous population.