bluuebunny/crossref_metadata_2025 huggingface dataset:
A Follow-up Study of Postoperative DCM Patients Using Diffusion MRI with DTI and NODDI
Authors: Ma Xiaodong , Han Xiao , Jiang Wen , Wang Jinchao , Zhang Zhe , Li Guangqi , Zhang Jieying , Cheng Xiaoguang , Chen Huijun , Guo Hua , Tian Wei
Published: January 2018

Study Design.

A retrospective cohort study.

Objective.

The aim of this study was to investigate the relationship between spinal cord microstructures and spinal cord dysfunction in degenerative cervical myelopathy (DCM) patients; a follow-up study was carried out using diffusion tensor imaging (DTI) and neurite orientation dispersion and density imaging (NODDI), an advanced diffusion model.

Summary of Background Data.

DTI has been used for diagnosis of DCM. Although DTI has advantages of high sensitivity and quantitative features, it is limited by its low specificity for measuring microstructures.

Methods.

Fifty-eight postoperative DCM patients with 12 to 14 months of surgical recovery were recruited, as well as 14 healthy volunteers for control group. All DTI and NODDI metrics were measured at the most stenotic levels of patients and at all levels of control group. A t test was used to compare the metrics between patient and control groups, and Spearman correlation was used to test the relationship between the metrics and clinical assessment, modified Japanese Orthopedic Association (mJOA) scores.

Results.

t test showed that DTI metrics, neurite density Vic, and free water fraction Viso had significant differences between control group and the most stenotic levels in patients. For DTI metrics, fractional anisotropy (FA), radial diffusivity (RD), and mean diffusivity (MD) in patients were significantly correlated with mJOA. For NODDI metrics, only Vic is positively correlated with mJOA.

Conclusion.

The results of t test and correlation with mJOA suggest that DTI and NODDI are valuable for evaluating spinal cord function. Results of NODDI indicate that the reason for FA reduction in DCM may be decreased neurite density, not increased orientation dispersion.

Level of Evidence: 3
Effects of 20% Human Serum on Corneal Epithelial Toxicity Induced by Benzalkonium Chloride: In Vitro and Clinical Studies
Authors: Moon Jayoon , Ko Jung Hwa , Yoon Chang Ho , Kim Mee Kum , Oh Joo Youn
Published: January 2018

Purpose:

Benzalkonium chloride (BAK), the most commonly used preservative in ophthalmic solutions, is known to cause toxicity in the corneal epithelium. In this study, we investigated the effects of 20% human serum in cultures of BAK-damaged human corneal epithelial cells (hCECs) and in patients with toxic corneal epitheliopathy induced by BAK-containing eye drops.

Methods:

hCECs were exposed to various concentrations of BAK (0%, 0.002%, 0.02%, and 0.2%) in the presence or absence of 20% human serum. After 24 hours, the metabolic activity, proliferation, apoptosis, and proinflammatory cytokine expression were evaluated in the cells. Also, cell migration was assessed using a scratch test. In the clinical study, 24 patients with toxic corneal epitheliopathy secondary to BAK-containing antiglaucoma eye drops were treated with topical application of 20% autologous serum, and corneal epithelial integrity was evaluated.

Results:

BAK induced cytotoxicity in hCECs by inhibiting the metabolic activity, proliferation, and migration and by increasing apoptosis in a concentration-dependent manner. The level of proinflammatory cytokine IL-8 was elevated in BAK-treated cells. Addition of 20% human serum to the cultures significantly promoted the cell metabolic activity, proliferation, and migration while markedly reducing apoptosis. In line with the in vitro results, corneal punctate epithelial erosions were decreased from a National Eye Institute scale score of 4.2 ± 2.1 to 1.3 ± 1.7 in 20 of 24 patients (84%) after treatment with 20% autologous serum.

Conclusions:

Data demonstrate that 20% human serum is effective in treating BAK-induced cytotoxicity in hCECs and provides a basis for using 20% autologous serum for patients with preservative-induced corneal epitheliopathy.
Scheimpflug Densitometry After DMEK Versus DSAEK—Two-Year Outcomes
Authors: Droutsas Konstantinos , Lazaridis Apostolos , Giallouros Eleftherios , Kymionis Georgios , Chatzistefanou Klio , Sekundo Walter
Published: January 2018

Purpose:

To compare the course of Scheimpflug corneal densitometry (CD) after Descemet membrane endothelial keratoplasty (DMEK) versus Descemet stripping automated endothelial keratoplasty (DSAEK).

Methods:

Fifty-four DMEK and 25 DSAEK cases without previous corneal surgery, complicated intraoperative or postoperative course, or vision-limiting ocular comorbidities were included. Pseudophakic eyes of age-matched subjects were recruited as controls (n = 20). Scheimpflug CD of the optically relevant zones (0–2 and 2–6 mm), best-corrected visual acuity (BCVA), endothelial cell density, and central corneal thickness were evaluated preoperatively and at 3, 6, 12, and 24 months postoperatively.

Results:

CD of the optical zone decreased from 34.4 ± 9.4 grayscale units (GSU) before to 19.2 ± 2.7 GSU at 24 months after DMEK. Respectively, CD decreased from 34.0 ± 13.4 GSU before to 21.2 ± 2.5 GSU at 24 months after DSAEK. Mean central CD in group 3 was 18.1 ± 1.3 GSU. Compared with DSAEK, DMEK cases showed lower central CD at 3 and 6 months (P ≤ 0.012) but not at 12 and 24 months postoperatively. DSAEK showed higher CD values throughout the postoperative period compared with healthy controls (P < 0.001). DMEK showed higher CD compared with controls at 3, 6, and 12 but not at 24 months after surgery (P = 0.152). Postoperative BCVA was significantly better after DMEK for every examination time point. No difference in endothelial cell density was found between DMEK and DSAEK at any time point.

Conclusions:

DMEK showed lower CD and better BCVA compared with DSAEK in the first 6 postoperative months. Notably, although CD reached similar levels in the midterm after both DMEK and DSAEK, BCVA remained significantly better after DMEK.
Accelerated Corneal Cross-Linking With Photoactivated Chromophore for Moderate Therapy-Resistant Infectious Keratitis
Authors: Knyazer Boris , Krakauer Yonit , Baumfeld Yael , Lifshitz Tova , Kling Sabine , Hafezi Farhad
Published: January 2018

Purpose:

To evaluate the effect of accelerated corneal cross-linking with photoactivated chromophore (PACK-CXL) as additional treatment for therapy-resistant infectious keratitis.

Methods:

In this interventional cohort study, 20 patients (11 men and 9 women), aged 65.5 (interquartile range = 21.5–78.5) years, who were hospitalized for moderate-sized therapy-resistant bacterial corneal ulcers (11/20 microbiologically confirmed) were treated with hypoosmolar 0.1% riboflavin solution and Ultraviolet A (UVA) irradiation for 3 minutes at 30 mW/cm2 (5.4 J/cm2) as additional therapy to standard antimicrobial treatment.

Results:

We did not observe any adverse effects of accelerated PACK-CXL on the corneal stroma or limbus. The median ulcer size was 3.00 (2.63–4.50) mm, the median time to reepithelialization was 6.50 (5.00–18.0) days, and the mean hospitalization period was 8.5 ± 4.5 days. Tectonic keratoplasty became necessary in 1 patient (5%).

Conclusions:

Our results suggest that accelerated PACK-CXL may provide an antimicrobial effect similar to the 1 low-intensity, slow setting (30 minutes at 3 mW/cm2) and may be used as additional treatment in moderate-sized therapy-resistant infectious keratitis.
Proactive Risk Mitigation: Using Failure Modes and Effects Analysis for Evaluating Vascular Access
Authors: Polancich Shea , Rue Loring , Poe Terri , Miltner Rebecca
Published: January 2018

This department column highlights translation of research into healthcare quality practice. Achieving the highest quality in healthcare requires organizations to understand care delivery and to proactively mitigate risks in care delivery processes. The purpose of this article was to describe the process for using the failure modes and effects analysis process to provide evidentiary support and proactive risk mitigation for the establishment of a comprehensive vascular access team within an academic medical center.
Evaluating an Art-Based Intervention to Improve Practicing Nurses’ Observation, Description, and Problem Identification Skills
Authors: Nease Beth M. , Haney Tina S.
Published: January 2018

Astute observation, description, and problem identification skills provide the underpinning for nursing assessment, surveillance, and prevention of failure to rescue events. Art-based education has been effective in nursing schools for improving observation, description, and problem identification. The authors describe a randomized controlled pilot study testing the effectiveness of an art-based educational intervention aimed at improving these skills in practicing nurses.
Nurses’ Responses and Reactions to an Emergent Pediatric Simulation Exercise
Authors: Hoffman Kenneth , von Sadovszky Victoria
Published: January 2018

Pediatric nurses’ responses and reactions in emergent simulations are understudied. Using authority gradient theory as a guide, the purpose of this study was to examine nurses’ reactions during an emergency simulation exercise when directed to give an incorrect medication dose. Ten groups of noncritical care nurses were videotaped from the beginning of the simulation through debriefing. Although errors were made during the simulation event, all groups responded correctly during debriefing, indicating that authority gradient may play a role in clinical decision-making.
Sexually Transmitted Infection Prevalence among Homeless Adults in the United States: A Systematic Literature Review
Authors: Williams Samantha P. , Bryant Kenneth L.
Published: January 2018

Background

Homelessness significantly affects health and well-being. Homeless adults often experience co-occurring and debilitating physical, psychological, and social conditions. These determinants are associated with disproportionate rates of infectious disease among homeless adults, including tuberculosis, HIV, and hepatitis. Less is known about sexually transmitted infection (STI) prevalence among homeless adults.

Methods

We systematically searched 3 databases and reviewed the 2000–2016 literature on STI prevalence among homeless adults in the United States. We found 59 articles of US studies on STIs that included homeless adults. Of the 59 articles, 8 met the inclusion criteria of US-based, English-language, peer-reviewed articles, published in 2000 to 2016, with homeless adults in the sample. Descriptive and qualitative analyses were used to report STI prevalence rates and associated risk factors.

Results

Overall, STI prevalence ranged from 2.1% to 52.5%. A composite STI prevalence was most often reported (n = 7), with rates ranging from 7.3% to 39.9%. Reported prevalence of chlamydia/gonorrhea (7.8%) was highest among younger homeless adult women. Highest reported prevalence was hepatitis C (52.5%) among older homeless men. Intimate partner violence, injection and noninjection substance use, incarceration history, and homelessness severity are associated with higher STI prevalence.

Conclusions

Homeless adults are a vulnerable population. Factors found to be associated with sexual risk were concurrently associated with housing instability and homelessness severity. Addressing STI prevention needs of homeless adults can be enhanced by integrating sexual health, and other health services where homeless adults seek or receive housing and other support services.
A Network Analysis of Sexually Transmitted Diseases and Online Hookup Sites Among Men Who Have Sex With Men
Authors: Chan Philip A. , Crowley Christina , Rose Jennifer S. , Kershaw Trace , Tributino Alec , Montgomery Madeline C. , Almonte Alexi , Raifman Julia , Patel Rupa , Nunn Amy
Published: January 2018

Background

Sexually transmitted diseases (STDs) are increasing among gay, bisexual, and other men who have sex with men (MSM). Little is known about the use of websites and mobile phone applications to meet sexual partners (“hookup sites”) and association with STD diagnoses.

Methods

We performed a demographic and behavioral assessment of 415 MSM presenting to the Rhode Island STD clinic. Bivariate and multivariable analyses assessed associations between using hookup sites and testing positive for syphilis, gonorrhea, or chlamydia. Venue-based affiliation networks were created to evaluate hookup sites and their association with STD diagnoses.

Results

Among 415 MSM, 78% reported meeting a partner online in the last 12 months, and 25% tested positive for at least one STD. Men who met partners online were more likely to be white (67% vs. 54%, P = 0.03) and have more than 10 lifetime partners (87% vs. 58%, P < 0.05). The most commonly used hookup sites included Grindr (78%), Scruff (35%), and Tinder (22%). In the multivariable analysis, only Scruff use was associated with testing positive for an STD (odds ratio, 2.28; 95% confidence interval, 1.09–4.94). However, among men who met partners online, 75% of men diagnosed as having an STD had met a sexual partner on Grindr, including 100% of those who were diagnosed as having gonorrhea.

Conclusions

Use of hookup sites was nearly ubiquitous among MSM undergoing STD screening. Specific hookup sites were significantly associated with STD diagnoses among MSM. Greater efforts are needed to promote STD screening and prevention among MSM who meet partners online.
Brief Report: “Give Me Some Time”: Facilitators of and Barriers to Uptake of Home-Based HIV Testing During Household Contact Investigation for Tuberculosis in Kampala, Uganda
Authors: Armstrong-Hough Mari , Ggita Joseph , Ayakaka Irene , Dowdy David , Cattamanchi Adithya , Haberer Jessica E. , Katamba Achilles , Davis J. Lucian
Published: January 2018

Background:

Integrating home-based HIV counseling and testing (HCT) with tuberculosis (TB) evaluation could improve the uptake of HIV testing among household contacts of patients with active TB. We sought to identify the facilitators of and barriers to HCT during household contact investigation for TB in Kampala, Uganda.

Methods:

We nested semi-structured interviews with 28 household contacts who were offered home-based HCT in a household-randomized trial of home-based strategies for TB contact investigation. Respondents reflected on their experiences of the home visit, the social context of the household, and their decision to accept or decline HIV testing. We used content analysis to identify and evaluate facilitators of and barriers to testing, then categorized the emergent themes using the Capability, Opportunity, Motivation, and Behavior (COM-B) model.

Results:

Facilitators included a preexisting desire to confirm HIV status or to show support for the index TB patient; a perception that home-based services are convenient; and positive perceptions of lay health workers. Key barriers included fear of results and feeling psychologically unprepared to receive results. The social influence of other household members operated as both a facilitator and a barrier.

Conclusions:

Preexisting motivation, psychological readiness to test, and the social context of the household are major contributors to the decision to test for HIV at home. Uptake might be improved by providing normalizing information about HCT before the visit, by offering a second HCT opportunity, by offering self-tests with follow-up counseling, or by introducing HCT using “opt-out” language.
Effectiveness of Assessing Ureteral Patency Using Preoperative Phenazopyridine
Authors: Strom Elizabeth M. , Chaudhry Zaid Q. , Guo Rong , Maisonet Axeline J. , Holschneider Christine H. , Wieslander Cecilia K.
Published: January 2018

Objectives

The aims of this study were to determine the efficacy of phenazopyridine when used intraoperatively to assess ureteral patency and to investigate factors that may influence its efficacy.

Methods

This is a retrospective chart review performed at the Olive View–UCLA Medical Center, a Los Angeles County teaching hospital, from January 2014 through July 2016. Patients undergoing cystoscopy at the time of gynecologic surgery were identified via department case logs. All women receiving preoperative oral phenazopyridine were included. If ureteral flow was unable to be visualized with phenazopyridine alone, the medication was deemed ineffective, and sodium fluorescein was given intraoperatively. Patients were divided into a phenazopyridine effective or phenazopyridine ineffective group. Patient demographics, renal function, intraoperative fluids and urine output, estimated blood loss, timing and dose of medication administration, and complications were gathered from the chart and compared between groups using Fisher exact test, 2-sample t test, Wilcoxon test, and logistic regression for multivariable analysis. P < 0.05 was determined to be significant.

Results

Preoperative phenazopyridine was effective in 190 (91.8%) of 207 patients. It was ineffective in 17 patients who then required intraoperative sodium fluorescein. The group in which phenazopyridine was effective was more likely to have been given a 200-mg (vs 100-mg) dose (P = 0.02) and had lower intraoperative urine output (median, 450 vs 800 mL; P = 0.002).

Conclusions

Preoperative oral phenazopyridine is effective in more than 90% of cases to detect during gynecologic surgery. A higher phenazopyridine dose and lower intraoperative urine output were associated with increased efficacy.
Postoperative Catheter Management After Pelvic Reconstructive Surgery: A Survey of Practice Strategies
Authors: Boyd Sarah S. , Tunitsky-Bitton Elena , O'Sullivan David M. , Steinberg Adam C.
Published: January 2018

Objective

The aim of this study was to evaluate practice preferences in catheter management after a failed inpatient voiding trial after pelvic reconstructive surgery.

Methods

This is a cross-sectional study of postoperative catheter management after pelvic reconstructive surgery after failed voiding trial. Physicians practicing at ACGME-accredited residencies and fellowships in Obstetrics and Gynecology (Ob/Gyn), Urology, and Female Pelvic Medicine and Reconstructive Surgery (FPMRS) within the United States completed a Web-based questionnaire in March 2017. Respondents were asked about voiding trial protocols, definitions of abnormal postvoid residual (PVR), type of catheterization used after failed voiding trials, and antibiotic use. Primary outcome was type of catheterization after failure of an inpatient voiding trial. Data were analyzed using χ

2
statistical tests.

Results

One hundred five respondents had a mean age of 36.5 years (range, 36 years). A total of 45.9% of participants practiced in FPMRS, 36.5% in Ob/Gyn, and 17.6% in Urology. Catheters were discontinued most frequently by postoperative day 1 after all procedures. Distribution of catheterization by specialty differed. Clean-intermittent straight catheterization had the greatest prevalence in all specialties and was the highest, by percentage, in Urology (33% Ob/Gyn, 40.6% FPMRS, and 69% Urology); P = 0.026. Type of catheterization differed significantly between Ob/Gyn and FPMRS respondents (P = 0.045). A total of 77.7% measured PVR by ultrasound and 22.3% performed catheterization. This distribution was similar across the specialties (70% Ob/Gyn, 79% FPMRS, and 100% Urology; P = 0.092). Abnormal PVR was defined most frequently as 150 mL or greater (30.5%). A minority of respondents routinely administer antibiotics during catheterization (17.1%). Duration and time until repeat voiding trial varied from 1 day to 2 weeks.

Conclusions

Practice variability in catheterization after pelvic reconstructive and incontinence surgery is high. Distribution of catheterization type by specialty varies significantly, with clean-intermittent straight catheterization most prevalent. Future studies are necessary to establish a consensus on optimal catheterization management technique for patients with acute postoperative voiding dysfunction.
Contemporary management of high-grade renal trauma: Results from the American Association for the Surgery of Trauma Genitourinary Trauma study
Authors: Keihani Sorena , Xu Yizhe , Presson Angela P. , Hotaling James M. , Nirula Raminder , Piotrowski Joshua , Dodgion Christopher M. , Black Cullen M. , Mukherjee Kaushik , Morris Bradley J. , Majercik Sarah , Smith Brian P. , Schwartz Ian , Elliott Sean P. , DeSoucy Erik S. , Zakaluzny Scott , Thomsen Peter B. , Erickson Bradley A. , Baradaran Nima , Breyer Benjamin N. , Miller Brandi , Santucci Richard A. , Carrick Matthew M. , Hewitt Timothy , Burks Frank N. , Kocik Jurek F. , Askari Reza , Myers Jeremy B.
Published: January 2018

BACKGROUND

The rarity of renal trauma limits its study and the strength of evidence-based guidelines. Although management of renal injuries has shifted toward a nonoperative approach, nephrectomy remains the most common intervention for high-grade renal trauma (HGRT). We aimed to describe the contemporary management of HGRT in the United States and also evaluate clinical factors associated with nephrectomy after HGRT.

METHODS

From 2014 to 2017, data on HGRT (American Association for the Surgery of Trauma grades III-V) were collected from 14 participating Level-1 trauma centers. Data were gathered on demographics, injury characteristics, management, and short-term outcomes. Management was classified into three groups—expectant, conservative/minimally invasive, and open operative. Descriptive statistics were used to report management of renal trauma. Univariate and multivariate logistic mixed effect models with clustering by facility were used to look at associations between proposed risk factors and nephrectomy.

RESULTS

A total of 431 adult HGRT were recorded; 79% were male, and mechanism of injury was blunt in 71%. Injuries were graded as III, IV, and V in 236 (55%), 142 (33%), and 53 (12%), respectively. Laparotomy was performed in 169 (39%) patients. Overall, 300 (70%) patients were managed expectantly and 47 (11%) underwent conservative/minimally invasive management. Eighty-four (19%) underwent renal-related open operative management with 55 (67%) of them undergoing nephrectomy. Nephrectomy rates were 15% and 62% for grades IV and V, respectively. Penetrating injuries had significantly higher American Association for the Surgery of Trauma grades and higher rates of nephrectomy. In multivariable analysis, only renal injury grade and penetrating mechanism of injury were significantly associated with undergoing nephrectomy.

CONCLUSION

Expectant and conservative management is currently utilized in 80% of HGRT; however, the rate of nephrectomy remains high. Clinical factors, such as surrogates of hemodynamic instability and metabolic acidosis, are associated with nephrectomy for HGRT; however, higher renal injury grade and penetrating trauma remain the strongest associations.

LEVEL OF EVIDENCE

Prognostic/epidemiologic study, level III; Therapeutic study, level IV.
MRI of the Optic Nerves and Chiasm in Patients With Leber Hereditary Optic Neuropathy
Authors: Blanc Christelle , Heran Françoise , Habas Christophe , Bejot Yannick , Sahel José , Vignal-Clermont Catherine
Published: January 2018

Background:

The aim of this study was to characterize brain and orbital MRI features of patients with Leber hereditary optic neuropathy (LHON), with particular attention to the optic nerves and chiasm.

Method:

We studied a patient cohort with genetically confirmed LHON followed at 2 ophthalmologic hospitals in France between 2013 and 2015. High-resolution brain and orbital MRI studies were analyzed for each patient during the first 12 months after the onset of visual loss was analyzed.

Results:

Our study included 20 men and 8 women with a mean age of 38.3 years at diagnosis, and all had genetic mutations for LHON. Nineteen patients (67.9%) had T2 hyperintensity in the posterior portion of both optic nerves and in the optic chiasm, and enlargement of the chiasm was found in 16 patients (59.3%). No enhancement of the optic nerves or chiasm was detected. The T2 hyperintensity lesions were not associated with the time between symptom onset and obtaining MRI, the mutation type, or sex of the patient. Nonspecific T2 white matter lesions were found in MRI of 6 patients, but without the characteristics of those found in patients with multiple sclerosis.

Conclusions:

Involvement of the posterior portions of the optic nerves has been described previously in case reports of patients with LHON. Our results support this observation with neuroimaging performed within 1 year of onset of visual loss. Enlargement of the optic chiasm also may occur in patients with LHON. The pathophysiology of the MRI changes is not yet understood.
Electrophysiology of Extraocular Cranial Nerves: Oculomotor, Trochlear, and Abducens Nerve
Authors: Hariharan Praveen , Balzer Jeffery R. , Anetakis Katherine , Crammond Donald J. , Thirumala Parthasarathy D.
Published: January 2018

The utility of extraocular cranial nerve electrophysiologic recordings lies primarily in the operating room during skull base surgeries. Surgical manipulation during skull base surgeries poses a risk of injury to multiple cranial nerves, including those innervating extraocular muscles. Because tumors distort normal anatomic relationships, it becomes particularly challenging to identify cranial nerve structures. Studies have reported the benefits of using intraoperative spontaneous electromyographic recordings and compound muscle action potentials evoked by electrical stimulation in preventing postoperative neurologic deficits. Apart from surgical applications, electromyography of extraocular muscles has also been used to guide botulinum toxin injections in patients with strabismus and as an adjuvant diagnostic test in myasthenia gravis. In this article, we briefly review the rationale, current available techniques to monitor extraocular cranial nerves, technical difficulties, clinical and surgical applications, as well as future directions for research.
A Barley Powdery Mildew Fungus Non-Autonomous Retrotransposon Encodes a Peptide that Supports Penetration Success on Barley
Authors: Nottensteiner Mathias , Zechmann Bernd , McCollum Christopher , Hückelhoven Ralph
Published: January 2018

Plant immunity is overcome by pathogens by the means of secreted effectors. Host effector targets might be proteins acting in pathogen defense or serve demands of the pathogen. The barley ROP GTPase HvRACB is involved in entry of the powdery mildew fungusBlumeria graminisf.sp.hordei (Bgh)into barley epidermal cells. We found that HvRACB interacts with theROP-interactive peptide 1 (ROPIP1) that is encoded on the active non-long terminal repeat retroelement Eg-R1 ofBgh. Over-expression of ROPIP1 in barley epidermal cells and host-induced post-transcriptional gene silencing (HIGS) ofROPIP1suggested that ROPIP1 is involved in virulence ofBgh. Bimolecular fluorescence complementation and co-localization supported that ROPIP1 can interact with activated HvRACB in planta. We show that ROPIP1 is expressed byBghon barley and translocated into the cytoplasm of infected barley cells. ROPIP1 is recruited to microtubules upon co-expression of MICROTUBULE ASSOCIATED ROP GTPase ACTIVATING PROTEIN (HvMAGAP1) and can destabilize cortical microtubules.BghROPIP might target HvRACB and manipulate host cell microtubule organization for facilitated host cell entry. Data suggest a possible neo-functionalization of retroelement-derived transcripts for the evolution of a pathogen virulence effector.
Glocalizing cures for China’s brain drain ills
Authors: Kim Hanna , Allen Ryan Michael
Published: January 2018

Purpose

The purpose of this paper is to examine how the Chinese Central Government’s plan to alleviate brain drain, called the Thousand Talents Plan, has been glocalized by three major local governments: Shanghai, Tianjin, and Guangdong.

Design/methodology/approach

The lens of glocalization pays special attention to the impact of local reactions to global forces. Materials from the Recruitment Program of Global Experts for three major cases were examined for glocal characteristics. An analysis of each case was carried out to compare the strategies and implementations to explore the individual glocalizations and larger national similarities.

Findings

The findings show that each of the localities has distinct regional variations in their strategies: Shanghai utilized its economic prowess, Tianjin focused on clustering experts, and Guangdong maximized its geographic proximity to Hong Kong. At the same time, all three policies were still rooted in human capital development theory, with a keen emphasis to attracting migrants with greater propensity for staying long term in China.

Originality/value

The study of brain drain is important because it is a problem that plagues communities around the world, especially non-western societies. While China’s tactics to combat brain drain have been examined, the consideration of glocalization in the cases of Shanghai, Tianjin, and Guangdong have not been carried out.
Resilient urban planning process in question: Istanbul case
Authors: Yaman Galantini Zeynep Deniz , Tezer Azime
Published: January 2018

Purpose

This paper aims to describe an updated urban planning process to expose a theoretical model bridging the resilience concept and urban planning, and then it explains this process through Istanbul case.

Design/methodology/approach

A hypothetical framework is proposed based on the three different but complementary aspects of resilience which are identified as “resilience to what”, “resilience where” and “resilience how”, as well as “five elements process” referring the upgraded components of urban planning processes. Additionally, the methodology conducted to figure out a resilient urban planning process is listed as an expert opinion survey, a two-stage policy Delphi survey, public opinion survey and multi-criteria analysis.

Findings

It is possible to apply this process in many different case studies for various scales and temporalities for coping with the key vulnerabilities and promote the administrative response capacity.

Research limitations/implications

Considering size of the study area and the unclarified roles of urban authorities, it is difficult to have a consensus on the key vulnerabilities and the prior urban policies.

Originality/value

The proposed process is beneficial in addressing the most prominent vulnerabilities and developing capacity to manage unexpected changes, through the collaborative decisions of a wide range of urban planning authorities. Depending on the severity of the disturbances, applying this process to identify changing priorities can be a crucial policy, both for long- or short-term urban policy-making, for further studies.
An improved model for seismic risk assessment in Portugal
Authors: Marques Mário , Monteiro Ricardo , Delgado Raimundo
Published: January 2018

Purpose

Portugal experienced very destructive earthquakes in the past, such as the well-known “Lisbon earthquake” in 1755. With such in mind, accurate estimates of human and economic losses can play a significant role in providing various societal key players with objective information for response strategies. This paper aims to present the contribution of the most recent study in Portugal (PRISE) concerning comprehensive seismic risk assessment, which can be used as good practice and reproduced in different contexts.

Design/methodology/approach

PRISE (earthquake loss assessment of the Portuguese building stock) covered three main lines of research, corresponding to the three components typically considered in any seismic risk assessment study: the characterization of the seismic hazard, the identification of the exposure to earthquakes and loss potential and the vulnerability of the exposed assets. Each of these components has been fully characterized through the collection of census and local data (exposure), used to carry out nonlinear analysis (hazard and fragility).

Findings

By involving different research institutions and partners with extensive knowledge and expertise in the earthquake domains, the developed model is capable of producing economic and human earthquake loss estimates in real time (through an innovative Web-based platform) or for specific event scenarios, considering exposed population, residential and industrial buildings. The platform uses open-source tools and hence, it can be reproduced in other countries or contexts.

Research limitations/implications

Research wise, the hazard, vulnerability and exposure models can still be significantly improved, e.g. by adding critical infrastructure (hospitals, school buildings and bridges) or updating the nonlinear models, for more accurate loss predictions.

Practical implications

The findings and loss estimates for different earthquake scenarios show that planned interventions are required. Decision-makers and other relevant stakeholders (Civil Protection) can make use of the developed platform to produce specific estimates, to test the effect of different retrofitting interventions or to plan for emergency scenarios.

Originality/value

A real-time Web-based framework to estimate building damage and economic/human losses because of seismic events has been developed, aiming to provide the Portuguese Civil Protection and other playmakers with a unique platform for planning and preparing for emergency scenarios.
How does embodiment work in dark tourism “field”? Based on visitors’ experience in Memorial Hall of the victims in Nanjing Massacre
Authors: Xie Yanjun , Sun Jiaojiao
Published: January 2018

Purpose

The purpose of this paper is to explore the actions of different senses on visitors’ embodied experience in dark tourism “field,” including embodied emotions/cognitions.

Design/methodology/approach

This research uses qualitative analysis by applying tourists’ reviews from two main Chinese tourism websites and the software of MAXQDA. It identifies the senses applied in the embodiment process in dark tourism “field” and matches these senses to the specific types of embodied emotions/cognitions.

Findings

This research identifies four main senses. The visual sense has the greatest influence on 27 embodied emotions and 7 embodied cognitions. Auditory and temperature sense create particular emotions. This research also points out the phenomenon of “banned behavior.” At last, to achieve accessibility/acceptability, Nanjing Memorial Hall applies two strategies to distance the extreme historical events from visitors: the construction of aesthetic elements and the way it shows historical objects.

Research limitations/implications

It uses both qualitative and quantitative data to identify the classifications and degrees of senses, emotions and cognitions as well as the relations between them. However, there are difficulties in the coding process because of the language differences, which requires a good understanding of the context of the tourism experience.

Practical implications

The research results could be used as a psychological reference and in the design of dark tourism product.

Social implications

It provides a specific understanding of the way in which visitors interact with dark tourism objects and environment.

Originality/value

This is the first research that explains the dark tourism experience from the perspective of embodiment. It provides conceptual as well as empirical reference for a new research topic.
Openness, ICT and entrepreneurship in sub-Saharan Africa
Authors: Asongu Simplice A. , Nwachukwu Jacinta C.
Published: January 2018

Purpose

The purpose of this paper is to examine how information and communication technology (ICT) influences openness to improve the conditions of doing business in sub-Saharan Africa.

Design/methodology/approach

The data were collected for the period 2000-2012. ICT is proxied with internet and mobile phone penetration rates whereas openness is measured in terms of financial and trade globalisation. Ten indicators of doing business are used, namely: cost of business start-up procedures; procedure to enforce a contract; start-up procedures to register a business; time required to build a warehouse; time required to enforce a contract; time required to register a property; time required to start a business; time to export; time to prepare and pay taxes; and time to resolve an insolvency. The empirical evidence is based on generalised method of moments with forward orthogonal deviations.

Findings

While the authors find substantial evidence that ICT complements openness to improve conditions for entrepreneurship, the effects are contingent on the dynamics of openness, ICT and entrepreneurship. Theoretical and practical policy implications are discussed.

Originality/value

The inquiry is based on two contemporary development concerns: the need for policy to leverage on the ICT penetration potential in the sub-region and the relevance of entrepreneurship in addressing associated issues of population growth such as unemployment.
A comparison of high-speed internet service in Ghana: an analytical hierarchy approach
Authors: Frimpon Michael F. , Adaku Ebenezer
Published: January 2018

Purpose

The rising proportion of internet users in Sub-Saharan Africa and the lack of analytical techniques, as decision support systems, in choosing among alternative internet service providers (ISPs) by consumers underpin this study. The purpose of this paper is to propose an approach for evaluating high-speed internet service offered by ISPs in a sub-Saharan African country.

Design/methodology/approach

Using a sample size of 150, pairwise comparisons of two ISPs along five criteria of cost, usability, support, reliability and speed were performed by ten person groups of university students working in various organizations in Ghana and undertaking an online Six Sigma Course. Geometric means were employed to aggregate the scores in 15 groups, and these scores were then normalized and used as input into an analytical hierarchy process grid.

Findings

The results show that consumers of internet services highly emphasize the cost attribute of internet provision in their decision making. On the other hand, it was realized that consumers least emphasize the support provided by ISPs in their decision making among alternative ISPs.

Originality/value

This study has sought to provide an analytical framework for assessing the quality of service provided by alternative ISPs in a developing economy’s context. The evaluating criteria in this framework also reveal the key consumer requirements in internet service provision in a developing economy’s environment. This, to a large extent, will inform the marketing strategies of existing ISPs in Ghana as well as prospective ones intending to enter the Ghanaian market. Besides, the National Communication Authority, a regulator of communication services provision in Ghana, will be informed about the performances of the ISPs along five performance criteria. This is expected to aid in their regulatory functions.
Understanding microblogging continuance intention
Authors: Mirkovski Kristijian , Jia Yanli , Liu Libo , Chen Kun
Published: January 2018

Purpose

The purpose of this paper is to explain how individuals form microblogging habits and why they continue to use microblogs from the perspective of direction social networks.

Design/methodology/approach

Drawing on the social network theory and the social presence theory, the authors develop a theoretical framework to explain how individuals form microblogging habits and why they continue to use microblogs. To test the proposed model and examine its external validity, the authors collected data from two microblogs: Twitter and Sina Weibo.

Findings

Satisfaction and habit have a significant influence on microblogging continuance intention. Whereas, users’ microblogging habits are developed by two key factors – satisfaction and frequency of past behavior – that are further determined by social presence and social network centrality.

Research limitations/implications

Larger sample size with diverse populations is highly recommended for future studies. In addition, exploring the distinct technical functionalities of microblogs when conceptualizing habit formation would be of benefit in future studies.

Practical implications

In this study, it was found that social presence increases both the satisfaction of users and the frequency of past use behavior. Hence, microblog designers should provide users with greater freedom to modify the form and content of their interface, and enable these modifications to be visible in real time to increase the interactivity of microblogs.

Originality/value

In contrast to past studies that have largely neglected the impacts of the directed social network structure, this study aims to focus on microblogging continuance intention from the directed social network perspective. The results from two independent data sets converge on the conclusion that users’ continuance intention to use is affected by both their conscious evaluations (i.e. satisfaction) and unconscious reactions (i.e. habit).
Using member checking in interpretive research practice
Authors: Iivari Netta
Published: January 2018

Purpose

In recent years, there has been a growing desire to more fully integrate informants into the overall research process. In response to this trend, the purpose of this paper is to scrutinize the usage and outcomes of the member checking technique for enabling more participatory interpretive research practices. Information systems (IS) research has utilized this technique, but it has not yet undergone a thorough analysis in this context. Additionally, interpretive IS research is in need of means and tools for engaging with informants during the data analysis and interpretation process.

Design/methodology/approach

The data for this study originated from an inquiry into the position of usability work within its cultural context, and this study has adopted a hermeneutic lens to make sense of the member checking technique, which positions informants as co-analysts and co-interpreters to make sense of both their organizational realities and researchers’ interpretations of those realities.

Findings

The analysis shows that during the research process, the informants reproduced, questioned, and cultivated the researcher-crafted texts that they were given to interpret, both individually and collaboratively. The study shows that member checking contributes to fulfilling the criteria set for interpretive IS research in a variety of ways.

Research limitations/implications

The study contributes to interpretive IS research method practice by offering IS researchers insights into and guidelines on the usage and potential outcomes of the member checking technique.

Originality/value

The examination of the member checking technique through a hermeneutic lens is a novel approach. For IS research, the study explicates the usages and outcomes of member checking in more participatory interpretive research practice. Also novel in this study is that member checking is examined as a collective endeavor.
A conceptual framework highlighting e-learning implementation barriers
Authors: Ali Samnan , Uppal M. Amaad , Gulliver Stephen R.
Published: January 2018

Purpose

E-learning has gained much focus from educators and researchers, with many extolling e-learning over traditional learning. Despite this focus, implementation of e-learning systems often fails. The purpose of this paper is to consider a range of barriers, impacting the success of e-learning implementations, yet to the best of the authors’ knowledge no conceptual framework is able to consolidate existing research.

Design/methodology/approach

This paper undertook an in-depth review of literature concerning e-learning implementation barriers. Papers were extracted from established peer-reviewed journals and open sources. Articles not related to e-learning implementation barriers were discarded. A total of 259 papers were identified, published between 1990 and 2016. Hermeneutics and data-driven qualitative content analysis was used to define 68 unique barriers.

Findings

The 68 unique barriers were thematically grouped into four conceptual categories, i.e. Technology (T), Individual (I), Pedagogy (P), and Enabling Conditions (EC). These four categories led to the conceptualization of “TIPEC” framework, which highlights the key concepts hindering e-learning implementation and delivery. Results show that most articles only consider a narrow range of success barriers.

Practical implications

The proposed TIPEC framework acts as a guide for education practitioners, system developers, policy makers, and researchers. It provides stakeholders with a summary of e-learning barriers.

Originality/value

This paper fulfils an identified need for a conceptual framework that consolidates all current research related to e-learning implementation barriers.
Integrated care
Authors: Warwick-Giles Lynsey , Checkland Kath
Published: January 2018

Purpose

The purpose of this paper is to try and understand how several organisations in one area in England are working together to develop an integrated care programme. Weick’s (1995) concept of sensemaking is used as a lens to examine how the organisations are working collaboratively and maintaining the programme.

Design/methodology/approach

Qualitative methods included: non-participant observations of meetings, interviews with key stakeholders and the collection of documents relating to the programme. These provided wider contextual information about the programme. Comprehensive field notes were taken during observations and analysed alongside interview transcriptions using NVIVO software.

Findings

This paper illustrates the importance of the construction of a shared identity across all organisations involved in the programme. Furthermore, the wider policy discourse impacted on how the programme developed and influenced how organisations worked together.

Originality/value

The role of leaders from all organisations involved in the programme was of significance to the overall development of the programme and the sustained momentum behind the programme. Leaders were able to generate a “narrative of success” to drive the programme forward. This is of particular relevance to evaluators, highlighting the importance of using multiple methods to allow researchers to probe beneath the surface of programmes to ensure that evidence moves beyond this public narrative.