bluuebunny/crossref_metadata_2025 huggingface dataset:
Surgical treatment of chondrosarcoma of the sacrum with cement augmentation
Authors: Liu Shuzhong , Zhou Xi , Song An , Huo Zhen , Wang Yipeng , Liu Yong
Published: December 2019

Rationale:

Chondrosarcoma of the sacrum is a highly unusual disease without standard curative managements yet. The objective of this study is to report a very rare case of chondrosarcoma of the sacrum successfully operated by percutaneous vertebroplasty. The management of these unique cases has yet to be well-documented.

Patient concerns:

A 45-year-old woman presented with a five-month history of continuous and progressive pain and numbness of left extremity. A lytic, expanding lesion of the sacrum and paraspinal region with severe epidural spinal cord compression was identified.

Diagnosis:

MRI of spine showed spinal cord compression secondary to the epidural componant of the giant mass, with increased marrow infiltration of the left S2 vertebral and paravertebral region, which presented as a solid tumor. Post-operative pathology confirmed the diagnosis of sacral well-differentiated chondrosarcoma (stage I B).

Interventions:

The patient underwent percutaneous vertebroplasty and cement augmentation of sacrum via a posterior approach.

Outcomes:

The patient's neurological deficits improved significantly after the surgery, but the patient died of multiple systemic metastases at the 2-year follow-up visit. There were no complications associated with the operation during the follow-up period.

Lessons:

Taken together, the lesion's clinical features, imaging results, and pathological characteristics are unique. Combined efforts of specialists from orthopedics, radiology, neurosurgery, pathology, and medical oncology led to the successful diagnosis and management of this patient. Giant sacral chondrosarcoma, although rare, should be part of the differential diagnosis when the patient presents with back pain and radiculopathy. We recommend the posterior approach for spinal decompression of the sacral chondrosarcoma when the tumor has caused neurological deficits or other severe symptoms. Osteoplasty by cement augmentation is also a good choice for surgical treatment.
Obstructive uropathy associated with rheumatoid arthritis successfully treated with steroids and immunosuppressive therapy
Authors: Chen Ru-Xuan , Cao Siyan “Stewart” , Zhao Li-Dan , Yang Hua-Xia
Published: December 2019

Rationale:

Urinary obstruction are relatively rare complications of autoimmune diseases including systemic lupus erythematosus and systemic vasculitis. It has never been reported in rheumatoid arthritis (RA).

Patient concerns:

We report a case of a female patient with seropositive RA who presented with gross hematuria associated with worsening joint symptoms, found to have acute kidney injury (AKI), bilateral hydronephrosis with bilateral renal pelvis, and ureteral wall thickening. Uroscopy with biopsy demonstrated inflammation without evidence of malignancy.

Diagnoses:

Rheumatoid arthritis related inflammation and obstruction of the urinary tract.

Interventions:

Prednisone 50 mg daily (tapering began 1 month later), iguratimod 50 mg daily, and leflunomide 20 mg daily were prescribed.

Outcomes:

The patient responded well to steroids and immunosuppressive therapy with complete resolution of hematuria, renal injury, and hydronephrosis.

Lessons:

Our case showed that RA might cause local inflammation involving the urinary tract which leads to obstruction and AKI.
Emergence of KRAS p.G13D mutation and acquired resistance to cetuximab in colorectal cancer with vulvar metastasis
Authors: Qiang Weiguang , Wu Qinqin , Ni Xuefeng , Zhang Chu , Zhao Jiemin
Published: December 2019

Rationale:

Vulvar metastasis of colorectal cancer (CRC) and acquired resistance to cetuximab is a very rare phenomenon. To our knowledge, few cases have been reported in the English literatures.

Patient concerns:

A 55-year-old woman was diagnosed as adenocarcinoma of the rectum and the primary tumor was detected to be Kirsten-RAS (KRAS) wild type.

Diagnoses:

The patient was diagnosed with rectal adenocarcinoma by colonoscopy. Positron emission tomography/computed tomography (PET-CT) revealed multiple lymph node and bone metastases.

Interventions:

The patient received a first-line course of palliative chemotherapy with FOLFOX combined with cetuximab.

Outcomes:

After an initial response, acquired resistance to cetuximab occurred and vulvar metastasis was established by a second biopsy. Further molecular analysis showed that the KRAS mutation was detected in plasma samples and tumor tissues.

Lessons:

Vulvar metastasis from CRC is relatively rare and indicates a poor prognosis. Routine physical examinations of cutaneous and subcutaneous may facilitate early detection of metastases and timely intervention of medical technology. Moreover, combining serial tumor biopsy, liquid biopsy, and radiologic imaging could help to define mechanisms of drug resistance and to guide selection of therapeutic strategies.
Characteristics of Trials Associated With Drugs Approved by the Food and Drug Administration in 2015 and 2016
Authors: Eckert Joy C.
Published: December 2019

Introduction:

New drug products are tested for safety and efficacy in clinical trials before being approved for use in medical practice. Clinical trial data are often misreported or underreported to ClinicalTrials.gov and in the medical literature. There is limited research on clinical trial characteristics for Food and Drug Administration (FDA) approved drugs, particularly examining differences in characteristics across different approval pathways or therapeutic indications.

Methods:

Data from the Aggregate Analysis of ClinicalTrials.gov (AACT) were used to compare the characteristics of completed clinical trials for drugs approved by the FDA in 2015 and 2016 across different approval pathways (expedited vs. nonexpedited) and therapeutic indications (oncology vs. nononcology).

Results:

There were 59 novel therapeutic drugs approved by the FDA in 2015 and 2016. A search of the AACT database yielded 955 studies that were associated with these 59 drugs. Median Phase 2 trial enrollment was smaller for drugs granted expedited approval compared with drugs without expedited approval (60 vs. 94; P=0.0079) and for oncology drugs compared with nononcology drugs (53 vs. 92; P<0.001). In general, trials across all phases were less likely to be blinded for drugs that received expedited approval compared with drugs without expedited approval and for oncology drugs compared with nononcology drugs.

Conclusions:

The characteristics of clinical trials differ across different approval pathways and therapeutic indications. More research is needed to determine whether the information from clinical trials of approved drugs is sufficient to adequately inform the public regarding their potential benefits and harms.
Where Is the Break-even Point for Community Health Workers? Using National Data and Local Programmatic Costs to Find the Break-even Point for a Metropolitan Community Health Worker Program
Authors: Gurley-Calvez Tami , Williams Jessica A.R.
Published: December 2019

Background:

Community health worker (CHW) programs take many forms and have been shown to be effective in improving health in several contexts. The extent to which they reduce unnecessary care is not firmly established.

Objectives:

This study estimates the number of hospitalizations and emergency department (ED) visits that would need to be avoided to recoup program costs for a CHW program that addressed both medical and social needs.

Research Design:

A programmatic cost analysis is conducted using 6 different categories: personnel, training, transportation, equipment, facilities, and administrative costs. First, baseline costs are established for the current program and then estimate the number of avoided ED visits or hospitalizations needed to recoup program costs using national average health care estimates for different patient populations.

Measures:

Data on program costs are taken from administrative program records. Estimates of ED visit and hospitalization costs (or charges in some cases) are taken from the literature.

Results

To fully offset program costs, each CHW would need to work with their annual caseload of 150 participants to avoid almost 50 ED visits collectively. If CHW participants also avoided 2 hospitalizations, the number of avoided ED visits needed to offset costs reduces to about 34.

Conclusions:

Estimates of avoided visits needed to reach the break-even point are consistent with the literature. The analysis does not take other outcomes of the program from the clients’ or workers’ perspectives into account, so it is likely an upper bound on the number of avoided visits needed to be cost-effective.
Prevalence of Children With Complex Chronic Conditions in PICUs of Argentina: A Prospective Multicenter Study*
Authors: Arias López María del P. , Fernández Ariel L. , Fiquepron Karina , Meregalli Claudia , Ratto María E. , Siaba Serrate Alejandro
Published: December 2019

Objectives:

To determine the prevalence of children with complex chronic conditions in PICUs in Argentina. To describe the demographic profile, clinical course and outcomes in PICU of children with complex chronic condition in comparison to previously healthy children.

Design:

Prospective, observational multicenter study.

Setting:

Nineteen PICUs located in Argentina belonging to public and private institutions.

Patients:

All children admitted to the participating PICUs between March 1, 2015, and February 28, 2016.

Interventions:

None.

Measurement and Main Results:

We analyzed 3,483 PICU admissions. The prevalence of complex chronic condition was 48.06% (95% CI, 46.39–49.72). Cardiovascular complex chronic condition was predominant (22.24% [421/1,893]), followed by neuromuscular complex chronic condition (18.75% [355/1,893]) and malignant disease 17.7% (335/1,893). Technologic dependence was present in 22.22% of the patients (372 of 1,674). Predominant admission diagnosis was postoperative (36.6%) and respiratory disease (28.32%). Children with complex chronic condition had higher mortality than previously healthy patients (odds ratio, 2.74; 95% CI, 2.01–3.73). The risk of prolonged stay (≥ 26 d) was also higher (odds ratio, 1.44; 95% CI, 1.10–1.89). Rate utilization of the following devices was higher in patients with complex chronic condition: mechanical ventilation (odds ratio, 1.35; 95% CI, 1.12–1.63), central venous catheter (odds ratio, 1.24; 95% CI, 1.04–1.48), and arterial monitoring (odds ratio, 1.33; 95% CI, 1.09–1.63).

Conclusions:

We observed a high prevalence of patients with complex chronic condition in this sample of argentine PICUs. These patients presented higher mortality and resource use than previously healthy children. This information is valuable to understand the impact that patients with complex chronic condition have on PICU performance and enables proper planning of care.
Severe Complications From Infectious Mononucleosis After Prolonged Steroid Therapy
Authors: Zamor Ronine , Edmunds Katherine , Orscheln Emily , Duma Elena
Published: December 2019

Infectious mononucleosis (IM) is a disease common among adolescents in the United States. Frequently, symptoms include sore throat, malaise, fevers, lymphadenopathy, and abdominal pain. Severe complications have been reported such as splenic rupture, acute upper airway obstruction, hepatitis, acute renal failure, and hematological and neurological complications. The mainstay of treatment is supportive care. Steroids are recommended for impending airway obstruction and hematological complications. However, steroids are commonly used in uncomplicated cases of IM, with insufficient evidence on the efficacy of steroids for symptom control. Furthermore, there is a lack of research on the adverse effects and long-term complications of steroid use for IM. We present a case of an adolescent boy who presented to his primary care physician with symptoms consistent with uncomplicated IM that was treated with a prolonged course of steroids. Subsequently, he developed worsening symptoms, including fevers, headache, vomiting, and left-sided facial swelling. He presented to a pediatric emergency department in decompensated septic shock as a result of polymicrobial bacteremia. During his hospital course, he developed pulmonary septic emboli, a sinus thrombus, an empyema, and orbital cellulitis complicated by Pott puffy tumor. In this case report, we summarize the current literature on steroid treatment of uncomplicated IM and highlight how our case addresses the use and possible complications of prolonged steroid use in uncomplicated IM.
Impact of a Pediatric-Focused Communication Course on Patient/Caregiver-Perceived Physician Communication Skills in a Pediatric Emergency Department
Authors: Leaming-Van Zandt Katherine J. , Zhu Huirong , Banuelos Rosa C. , Lopez Michelle A. , Hsu Deborah C.
Published: December 2019

Objectives

To evaluate the impact of a pediatric-focused, relationship-centered communication course on patient/caregiver assessment of emergency department (ED) physician communication skills.

Methods

This was a prospective study; a previously validated assessment tool (Pediatric Physician Interpersonal Communication Skills Assessment [P-PICSA]) was used to collect pediatric patient/caregiver evaluation of ED physician communication skills. Emergency department physicians were required to attend a 5.5-hour communication course. Differences in precourse/postcourse P-PICSA and top-box scores were analyzed to determine course impact on ED physician communication skills.

Results

From July 2016 to August 2017, 49 pediatric ED physicians participated in the course, and 24 physicians (49%) had 6-month precourse/postcourse P-PICSA data. Postcourse scores were higher for all 13 items, with 3 items achieving statistical significance: (1) the doctor used words I could understand; (2) the way the doctor involved me in making decisions about my child's care in the ED; (3) how the doctor discussed next steps and/or follow-up plans for my child's care after we leave the ED (P < 0.05). Additionally, postcourse, top-box score percentages were higher for 12 items, with 1 item achieving statistical significance (P = 0.0386).

Conclusions

An organization-wide, pediatric-focused, relationship-centered communication course improved patient/caregiver-perceived ED physician communication. Further research is necessary to assess long-term sustainability.
The Practice of Obtaining a Chest X-Ray in Pediatric Patients Presenting With Their First Episode of Wheezing in the Emergency Department
Authors: Patel Nishit H. , Hassoun Ameer , Chao Jennifer H.
Published: December 2019

Background

Routine use of chest X-ray (CXR) in pediatric patients presenting with their first episode of wheezing was recommended by many authors. Although recent studies conclude that a CXR is not routinely indicated in these children, there continues to be reports of overuse.

Objective

To examine the attitudes of practicing physicians in ordering CXRs in pediatric patients presenting with their first episode of wheezing to an emergency department (ED) and the factors that influence this practice by surveying ED physicians.

Methods

A survey targeting pediatric emergency medicine (PEM) and general emergency medicine attending physicians was distributed electronically to the nearly 3000 members of the PEM Brown listserve and the Pediatric Section of American College of Emergency Physicians listserve. The 14-item survey included closed ended and free text questions to assess the respondent's demographic characteristics, their belief and current practice of obtaining a CXR in pediatric patients presenting with their first episode of wheezing. Data were analyzed using descriptive statistics and χ2 test.

Results

Of the 537 attending physicians who participated, their primary residency training was: 42% pediatrics, 54% emergency medicine, and 4% other. Seventy-two percent of participating physicians supervise residents, 54% were board-eligible or -certified in PEM. Thirty percent (95% confidence interval [CI], 26–34) of participants indicated that they would always obtain a CXR in pediatric patients presenting with their first episode of wheezing. Eighty-one percent (95% CI, 75–87) of those who always obtain a CXR believe that it is the standard of care. Of the 376 physicians who do not always obtain a CXR, 18% (95% CI, 15–23) always obtain a CXR under certain age (2 weeks to 12 years, median of 1 year). Physicians who report a primary residency in pediatrics, who supervise residents, who were board-eligible or -certified in PEM, and who were practicing for greater than 5 years were less likely to obtain a CXR (P < 0.001, P < 0.001, P < 0.001, P = 0.001).

Conclusions

In our study, a significant number of practicing ED physicians routinely obtain a CXR in children with their first episode of wheezing presenting to the ED. The factors influencing this practice are primary residency training, fellowship training, resident supervision, and years of independent practice. This identifies a target audience that would benefit from education to decrease the overuse of CXRs in children with wheezing.
Paraganglioma of the Vagina Associated With Germline SDHB Mutation: Report of a Case With Review of the Literature
Authors: Wong Richard Wing-Cheuk , Liu Anthony Pak Yin , Choi Carmen Ka Man , Chan Angel On Kei
Published: December 2019

Paragangliomas are rare neuroendocrine neoplasms in the vagina, and their molecular pathogenesis has not been documented. We report a case of vaginal paraganglioma in a 15-yr-old adolescent girl who presented with irregular heavy menses and anemic symptoms. Examination under anesthesia revealed a polypoid mass of 3 cm size in the left anterior vaginal wall, which was resected piecemeal. Histology showed a circumscribed nodular tumor with typical nested morphology of paraganglioma and no significant nuclear atypia. Immunohistochemically the tumor cells were diffusely positive for synaptophysin and chromogranin while being negative for cytokeratin, accompanied by S100-positive sustentacular cells. SDHB immunohistochemistry demonstrated the absence of cytoplasmic staining in the tumor cells with preserved staining in sustentacular cells, raising the possibility of a germline mutation in the genes encoding subunits of succinate dehydrogenase. Sanger sequencing for all the exons and exon-flanking intronic regions of theSDHBgene revealed no mutation, but further investigation with multiplex ligation-dependent probe amplification identified a heterozygous deletion of exon 1 of theSDHBgene in the patient and her mother, confirming the diagnosis ofSDHB-related hereditary paraganglioma-pheochromocytoma syndrome. The patient had no evidence of disease upon imaging surveillance and follow-up for 56 mo. A review of the published cases of vaginal paraganglioma seems to suggest a relatively young age of presentation, commonly encountered as incidental findings in asymptomatic patients or presenting with abnormal vaginal bleeding. The association between vaginal paraganglioma and germlineSDHBmutation has not been reported. We believe this case illustrates the clinical significance of SDHB immunohistochemistry and genetic testing for this rare vaginal neoplasm.
Case Report and Review of the Literature of a Rare Entity of a Uterine Fibroid: A Genital Rhabdomyoma
Authors: Huesmann Sophia T. , Wiegand Miriam , Barth Thomas F. , Mian Elisabeth , Widschwendter Peter , Janni Wolfgang , Hancke Katharina
Published: December 2019

Extracardiac rhabdomyomas are rare benign tumors. According to histopathologic and clinical characteristics, they are divided into 3 subgroups: adult, fetal, and genital rhabdomyomas. Various adult extracardiac rhabdomyomas have been reported in the head and neck region, whereas genital rhabdomyomas are uncommon. Here, we report on a uterine genital rhabdomyoma in a 32-yr-old woman with secondary sterility. After myomectomy, the histopathologic analysis showed a slow cycling tumor with striated muscle differentiation and without any evidence of malignancy. Immunohistochemical staining proved coexpression of actin, caldesmon, and desmin. To the best of our knowledge, this is the first case of a uterine-based genital rhabdomyoma.
The Randomized Controlled Trials Rehabilitation Checklist
Authors: Negrini Stefano , Armijo-Olivo Susan , Patrini Michele , Frontera Walter R. , Heinemann Allen W. , Machalicek Wendy , Whyte John , Arienti Chiara
Published: December 2019

Background

One of the goals of Cochrane Rehabilitation is to strengthen methodology relevant to evidence-based clinical practice. Toward this goal, several research activities have been performed in rehabilitation literature: a scoping review listed the methodological issues in research, a study showed the low clinical replicability of randomized controlled trials, two systematic reviews showed the relevant items in reporting guidelines, and a series of articles discussed main methodological issues as a result of the first Cochrane Rehabilitation Methodological Meeting (Paris 2018). The need to improve the quality of conduct and reporting of research studies in rehabilitation emerged as a relevant task. The aim of this article is to present the Randomized Controlled Trial Rehabilitation Checklists (RCTRACK) project to produce a specific reporting guideline in rehabilitation.

Methods

The project followed a combination of the CONsolidated Standards of Reporting Trials and EQUATOR Network methodologies. The project includes five phases. The first is kick-off, first consensus meeting and executive and advisory committee identification. The second is literature search and synthesis, where eight working groups will produce knowledge synthesis products (systematic or scoping reviews) to compile items relevant to reporting of randomized controlled trials in rehabilitation. The topics will be as follows: patient selection; blinding; treatment group; control group and co-interventions; attrition, follow-up, and protocol deviation; outcomes; statistical analysis and appropriate randomization; and research questions. The third is guidelines development, which means drafting of a document with the guidelines through a consensus meeting. The fourth is Delphi process consensus, a Delphi study involving all the rehabilitation research and methodological community. The fifth is final consensus meeting and publication.

Conclusions

The RCTRACK will be an important contribution to the rehabilitation field and will impact several groups of rehabilitation stakeholders worldwide. The main goal is to improve the quality of the evidence produced in rehabilitation research. The RCTRACK also wants to improve the recognition and understanding of rehabilitation within Cochrane and the scientific and medical community at large.
Dissociable roles of cortical excitation-inhibition balance during patch-leaving versus value-guided decisions
Authors: Kaiser Luca F. , Gruendler Theo O.J. , Speck Oliver , Luettgau Lennart , Jocham Gerhard
Published: December 2019

In a dynamic world, it is essential to decide when to leave an exploited resource. Such patch-leaving decisions involve balancing the cost of moving against the gain expected from the alternative patch. This is in contrast with value-guided decisions that typically involve maximizing reward by selecting the current best option. Patterns of neuronal activity pertaining to patch-leaving decisions have been reported in the dorsal anterior cingulate cortex (dACC), whereas competition via mutual inhibition in the ventromedial prefrontal cortex (vmPFC) is thought to underlie value-guided choice. Here, we show that the balance between cortical excitation and inhibition (E/I balance), measured by the ratio of GABA and glutamate concentrations, plays a dissociable role for the two kinds of decisions. Patch-leaving decision behaviour was related to E/I balance in dACC. In contrast, value-guided decision making was related to E/I balance in vmPFC. These results support previous mechanistic accounts of value-guided choice and provide novel evidence for a role of dACC E/I balance in patch-leaving decisions.
Temporal changes in post-alighting resistance toRhopalosiphum padi(bird cherry-oat aphid) in ancestral wheats
Authors: Simon Amma L. , Smart Lesley E. , Hammond-Kosack Kim E. , Field Linda M. , Aradottir Gudbjorg I.
Published: December 2019

Aphids reduce wheat yield through feeding on phloem sap, inflicting direct and indirect damage to the plant. Currently no commercial wheat varieties have been bred for resistance toRhopalosiphum padi(bird cherry-oat aphid). However, post-alighting resistance has been identified inTriticum monococcumlines at the seedling stage.

To further characterise the resistance inT. monococcumat plant ages, we have investigated the development, survival and reproductive success ofR. padion two susceptible wheatsTriticum aestivum(variety Solstice) andT. monococcumMDR037, as well as on the partially resistantT. monococcumMDR045 and MDR049, using one, two, 12 (flag leaf) and 20 week-old (inflorescence) plants.

We found that the host plant resistance reduced development and reproductive success in aphids. However, the effect decreased with plant age on MDR045 but increased with plant age on MDR049.

The observed resistance to aphids has strong potential for introgression into commercial wheat varieties, which could have an important role in Integrated Pest Management strategies to reduce aphid populations and virus transmission.
Physiological networks governing salinity tolerance potentials inGossypium hirsutumgermplasm
Authors: Cushman Kevin R. , Pabuayon Isaiah C. M. , Hinze Lori L. , Sweeney Megan E. , de los Reyes Benildo G.
Published: December 2019

Toxic ions begin to accumulate in tissues of salt-stressed plants after the initial osmotic shock. In glycophytes, the ability to mobilize or sequester excess ions define tolerance mechanisms. Mobilization and sequestration of excess Na+involves three transport mechanisms facilitated by the plasma membrane H+/Na+antiporter (SOS1), vacuolar H+/Na+antiporter (NHX1), and Na+/K+transporter in vascular tissues (HKT1). While the cultivatedGossypium hirsutum(upland cotton) is significantly more tolerant to salinity relative to other crops, the critical factors contributing to the observed variation for tolerance potential across the germplasm has not been fully scrutinized. In this study, the spatio-temporal patterns of Na+accumulation at different severities of salt stress were investigated across a minimal comparative panel representing the spectrum of genetic diversity across the improved cotton germplasm. The goal was to define the importance of integrative or network effects relative to the direct effects of Na+homeostasis mechanisms mediated byGhHKT1, GhSOS1,andGhNHX1.Multi-dimensional physio-morphometric attributes were investigated in univariate and multivariate statistical contexts, as well as the relationship between variables using structural equation modeling. Results showed that mobilized or sequestered Na+may contribute to the baseline salinity tolerance, but the observed variance in overall tolerance potential across a meaningful subset of the germplasm were more significantly associated to antioxidant capacity, maintenance of stomatal conductance, chlorophyll content, and divalent cations, and other physiological interactions occurring through complex networks.

One-Sentence Summary

Variation in salinity tolerance potential across the tetraploid cultivatedGossypiumgermplasm is better explained by complex physiological networks rather than just cellular Na+homeostasis.
Effects of Endophytic Fungus MF23 onDendrobium nobileLindl. in an artificial primary environment
Authors: Xu Xiaolin , Li Qing , Ding Gang , Li Biao , Guo Shunxing
Published: December 2019

The quality ofDendrobium nobileLindl. is related to the endophytic fungus. It had reported that the mycorrhizal fungus MF23 helps to increase the content of dendrobine, but few studies had explained the mechanism of the phenomenon. In previous study, we verified the symbiotic mechanism of the mycorrhizal fungus MF23 withD. nobileon the agar medium. In this study, the research carried on the bark medium, nearly like the natural environment, which had special meaning because of its benefits for the widely application. As a result, it showed a significant effect especially in the later period of the cultivation, suggesting that mycorrhizal fungus MF23 had a promotion forD. nobilein the natural environment, which enabled the application of the technique in the experimental field. It also implied that post-modification enzyme genes might play an important role in stimulating biosynthesis of dendrobine.
The secretory fate of flavivirus NS1 in mosquito cells is influenced by the caveolin binding domain
Authors: Ramirez Romel Rosales , Ludert Juan E.
Published: December 2019

Flaviviruses of major medical importance worldwide such as dengue (DENV), Zika (ZIKV), and yellow fever (YFV) viruses are transmitted by mosquitoesAedes sp. The non-structural protein 1 (NS1) of these flaviviruses is secreted from the infected cells using different secretion routes depending on the cell and virus nature. The NS1 of DENV and ZIKV contain in the hydrophobic region a conserved caveolin binding domain (CBD) (ΦXXΦXXXXΦ), which is not conserved in YFV NS1. To ascertain the role of the CBD in the secretory route followed by flavivirus NS1, expression vectors for the NS1 of DENV2, ZIKV and YFV were constructed. Using site-directed mutagenesis, substitutions were made in the aromatic residues within CBD; in addition, the full domain was replaced by those of other flaviviruses, creating chimeras in the CBD of NS1. Substitutions of the aromatic residues to Ala or Thr, or CBD chimeras, results in increased sensitivity of NS1 secretion to brefeldin A treatment, indicating a change to a classical secretion pathway. Likewise, the insertion of the DENV/ZIKV CBD into the recombinantGaussia-Luciferase results in a loss of sensitivity to BFA treatment, in luciferase secretion. These results suggest that the CBD sequence is a molecular determinant for the unconventional secretory route followed by DENV and ZIKV NS1 in mosquito cells. However, the cellular components that recognize the CBD in the NS1 of DENV and ZIKV and redirect them to an unconventional route and if this secretion route confers unique functions to NS1 within the vector mosquito are aspects currently unknown.

Importance

Flaviviruses are an important cause of mosquito borne diseases to humans. We have previously demonstrated that the non-structural protein 1 from dengue and zika virus are secreted efficiently from mosquito cells using an unconventional route, that depends on caveolin and molecular chaperones. In this work, we show evidence indicating that a caveolin binding domain, well conserved and exposed in dengue and Zika virus NS1, but absent in other flaviviruses such as yellow fever virus or West Nile virus, is important in determining the unconventional secretion pathway followed by dengue and zika virus NS1 in mosquito cells. The unique secretory pathway followed by NS1 in mosquito cells may result in distinctive viral-cellular protein associations required to facilitate viral infection in the mosquito vector. To identify viral and cellular elements that could disturb the traffic of dengue and Zika virus NS1 may be important to design of strategies for vector control.
Crystal structure, Hirshfeld surface analysis and computational study of bis(2-{[(2,6-dichlorobenzylidene)hydrazinylidene]methyl}phenolato)cobalt(II) and of the copper(II) analogue
Authors: Manawar Rohit B. , Mamtora Mayank J. , Shah Manish K. , Jotani Mukesh M. , Tiekink Edward R. T.
Published: December 2019

The title homoleptic Schiff base complexes, [M(C14H9Cl2N2O)2], for M = CoII, (I), and CuII, (II), present distinct coordination geometries despite the Schiff base dianion coordinating via the phenolato-O and imine-N atoms in each case. For (I), the coordination geometry is based on a trigonal bipyramid whereas for (II), a square-planar geometry is found (Cu site symmetry \overline{1}). In the crystal of (I), discernible supramolecular layers in the ac plane are sustained by chlorobenzene-C—H...O(coordinated), chlorobenzene-C—H...π(fused-benzene ring) as well as π(fused-benzene, chlorobenzene)–π(chlorobenzene) interactions [inter-centroid separations = 3.6460 (17) and 3.6580 (16) Å, respectively]. The layers inter-digitate along the b-axis direction and are linked by dichlorobenzene-C—H...π(fused-benzene ring) and π–π interactions between fused-benzene rings and between chlorobenzene rings [inter-centroid separations = 3.6916 (16) and 3.7968 (19) Å, respectively] . Flat, supramolecular layers are also found in the crystal of (II), being stabilized by π–π interactions formed between fused-benzene rings and between chlorobenzene rings [inter-centroid separations = 3.8889 (15) and 3.8889 (15) Å, respectively]; these stack parallel to [10\overline{1}] without directional interactions between them. The analysis of the respective calculated Hirshfeld surfaces indicate diminished roles for H...H contacts [26.2% (I) and 30.5% (II)] owing to significant contributions by Cl...H/H...Cl contacts [25.8% (I) and 24.9% (II)]. Minor contributions by Cl...Cl [2.2%] and Cu...Cl [1.9%] contacts are indicated in the crystals of (I) and (II), respectively. The interaction energies largely arise from dispersion terms; the aforementioned Cu...Cl contact in (II) gives rise to the most stabilizing interaction in the crystal of (II).
Two isostructural 3-(5-aryloxy-3-methyl-1-phenyl-1H-pyrazol-4-yl)-1-(thiophen-2-yl)prop-2-en-1-ones: disorder and supramolecular assembly
Authors: Shaibah Mohammed A. E. , Yathirajan Hemmige S. , Manju Nagaraj , Kalluraya Balakrishna , Rathore Ravindranath S. , Glidewell Christopher
Published: December 2019

Two new chalcones containing both pyrazole and thiophene substituents have been prepared and structurally characterized. 3-(3-Methyl-5-phenoxy-1-phenyl-1H-pyrazol-4-yl)-1-(thiophen-2-yl)prop-2-en-1-one, C23H18N2O2S (I), and 3-[3-methyl-5-(2-methylphenoxy)-1-phenyl-1H-pyrazol-4-yl]-1-(thiophen-2-yl)prop-2-en-1-one, C24H20N2O2S (II), are isomorphous as well as isostructural, and in each the thiophene substituent is disordered over two sets of atomic sites having occupancies 0.844 (3) and 0.156 (3) in (I), and 0.883 (2) and 0.117 (2) in (II). In each structure, the molecules are linked into sheets by a combination of C—H...N and C—H...O hydrogen bonds. Comparisons are made with some related compounds.
Accounting for Napoleonic imperialism in Tuscany and the Kingdom of Naples
Authors: Di Cimbrini Tiziana , Funnell Warwick , Bigoni Michele , Migliori Stefania , Consorti Augusta
Published: December 2019

Purpose

The purpose of this paper is to examine the role of accounting in the enactment of the Napoleonic imperial project in Tuscany and the Kingdom of Naples in the early nineteenth century.

Design/methodology/approach

The study adopts the Foucauldian theoretical framework of governmentality and a comparative approach to highlight similarities and differences between the two regions.

Findings

The presence of different cultural understandings and structures of power meant that in Tuscany accounting mirrored and reinforced the existing power structure, whereas in the Kingdom of Naples accounting practices were constitutive of power relations and acted as a compensatory mechanism. In the Kingdom of Naples, where local elites had been traditionally involved in ruling municipalities, control of accounting information and the use of resources “re-adjusted” the balance of power in favour of the French whilst letting local population believe that Napoleon was respectful of local customs.

Research limitations/implications

The ability of accounting technologies to act as compensatory mechanisms within governmentality systems paves the way to further investigations about the relationships between accounting and other governmentality technologies as well as the adjustment mechanisms leading to accounting resilience in different contexts.

Social implications

By identifying accounting as an adaptive instrument supporting less obvious practices of domination the study helps unmask a hidden mechanism underlying attempts to know, govern and control populations which still characterises modern forms of imperialism.

Originality/value

The comparative perspective leads to a new specification of the multifaceted roles that accounting plays in different cultural and political contexts in the achievement of the same set of imperial goals and enhances understanding of the translation of politics, rhetoric and power into a set of administrative tasks and calculative practices.
The microfoundations of innovation processes in Latin American firms
Authors: Barrera Jose Ignacio , Torres Juan Pablo , Valdés Gonzalo
Published: December 2019

Purpose

The purpose of this paper is to explore the microfoundations of innovation-enabling dynamic capabilities in Latin American firms and, in particular, their processes to: sense and shape opportunities; seize opportunities; and maintain competitiveness through reconfiguring assets.

Design/methodology/approach

The authors carried out a confirmatory factor analysis of survey data obtained from a sample of 721 firms located in Latin America, and employed a hierarchical analysis of linear regressions with robust standard errors to test the hypotheses.

Findings

The authors found that when firms manage their innovation processes based on sensing opportunities and reconfiguring their tangible and intangible assets, they are more likely to improve on four innovation-related outcomes: development of new products and services; profitability; market share; and diversification.

Research limitations/implications

The findings are limited to the specific context of Latin American countries. In particular, the authors took a random sample of firms from a business directory built by prestigious Latin American business schools, but that may not be representative. Therefore, the generalizability of the results is limited beyond the type of companies that are represented in that sampling frame.

Originality/value

Contributions are twofold. First, the authors test the applicability of an orchestration model of dynamic capabilities to the Latin American context. And, second, the authors relate specific microfoundations of dynamic capabilities to the ability of firms to innovate successfully.
Environmental sustainability of off-site manufacturing: a literature review
Authors: Hu Xin , Chong Heap-Yih
Published: December 2019

Purpose

Off-site manufacturing (OSM) is a modern method of construction that brings various environmental sustainability benefits for stakeholders. The increasing take-up of OSM in practice has attracted much research interest in its environmental sustainability. However, a holistic understanding of these previous research studies is still lacking. Therefore, the purpose of this paper is to critically review the existing body of knowledge regarding the environmental sustainability of OSM.

Design/methodology/approach

A qualitative content analysis was adopted to systematically and objectively review 55 related historical studies.

Findings

Three research themes were identified, including environmental sustainability assessment and performance, environmental sustainability strategies and critical environmental sustainability factors. A detailed discussion of the three themes was conducted to depict a whole picture of the current explorations in the research field. Additionally, a research framework was developed to articulate the interrelationship between the research themes and their specific research topics. Scientific research gaps were identified together with the future research directions in terms of sustainability strategies, performance impacting factors, sustainability indicators and drawbacks resulted from OSM application.

Originality/value

The literature review promotes construction stakeholders’ in-depth understanding about the environmental sustainability of OSM, which offers valuable implications for green industry practice. Additionally, it highlights the future research trends, which facilitates further explorations in the research area.
Employability of fresh engineering graduates in India
Authors: Sinha Saitab , Ghosh Piyali , Mishra Ashutosh
Published: December 2019

Purpose

The purpose of this paper is to examine whether satisfaction of employers with skill competencies of fresh engineering graduates (EGs) in India is impacted by their expectations and perceptions. Applying Expectation Confirmation Theory (ECT), the authors have also proposed and tested whether such effects on employers’ satisfaction are mediated by (dis)confirmation.

Design/methodology/approach

Data were collected through a survey of employers’ representatives using a structured questionnaire. The proposed mediation model has been tested on a sample of 284 with Confirmatory Factor Analysis by applying structural equation modelling in AMOS.

Findings

The structural model has been constructed with six latent constructs in accordance with extant literature. Excluding some observed variables, the structural model was found to have a good model fit. The measurement model is in accordance with ECT. Three of the four independent variables (two related to employers’ expectations and one to employers’ perception) exert significant influence on employers’ satisfaction, with (dis)confirmation as a mediator.

Practical implications

Industry–academia partnerships need to be an integral feature of any curriculum to bridge the gap between course curricula on one hand and employers’ expectations and perceptions on the other.

Originality/value

Past research on employability of EGs has mostly explored a direct association between employers’ perception and satisfaction. The authors study contributes to literature by examining the role of employers’ expectations in addition to their perception as precursors of their satisfaction, using the framework of ECT. Outcomes reported are of relevance to multiple stakeholders in technical education.
External debt stock, foreign direct investment and financial development
Authors: Agyapong Daniel , Bedjabeng Kojo Asare
Published: December 2019

Purpose

The purpose of this paper is to examine the role external debt and foreign direct investment play in influencing financial development in Africa.

Design/methodology/approach

Annual data on external debt, foreign direct investment and financial development were extracted from the World Bank World Development Indicators from 2002 to 2015. The data employed were analysed within causal research design and the dynamic panel using generalized method of moment estimation approach.

Findings

The findings revealed that external debt and foreign direct investment have a significant positive relationship with financial development in African economies. Governments of the sampled economies should enact policies that would help attract high level of foreign direct investment as it contributes positively to financial development. Finally, governments of the sampled African economies should ensure foreign direct investment and external funds borrowed are channelled to productive sectors.

Originality/value

The paper analysed the relationship between external debt, FDI inflows and financial sector development. The paper is the first in terms of such analysis within the framework of the dual-gap framework, which is the first time in these kinds of studies. Previous studies have concentrated on the effect of financial sector on FDI and not the other way around.
Promoting collaboration in a competitive context: school improvement networks in Chile
Authors: Pino-Yancovic Mauricio , Gonzalez Parrao Constanza , Ahumada Luis , Gonzalez Alvaro
Published: December 2019

Purpose

Chile has developed the school improvement networks (SINs) strategy to support the work of school leaders. The purpose of this paper is to analyze the functioning and effect of the SINs strategy as perceived by principals and curriculum coordinators across the country.

Design/methodology/approach

An adapted version of the Educational Collaborative Network Questionnaire was applied to a sample of 1,723 participants from 1,375 schools distributed in 398 networks. Descriptive, factor and sub-group statistical analyses by school performance categories and by different roles within these schools and networks are presented.

Findings

Results indicate that school leaders perceive SINs as an opportunity to work effectively in shared projects that can later be implemented in their own schools. Participants indicate that they can share knowledge in their networks and use it to solve problems in their own schools, which is especially relevant for secondary school leaders who work in difficult circumstances. Results suggest that it is important to facilitate greater autonomy for school leaders in their networks, especially regarding decision making about network goals and activities that are more significant to their contexts.

Originality/value

This is a national study of a recent school improvement strategy, which provides evidence, from the perspective of school leaders, of its strengths and improvement areas. This study shows that despite being in a competitive context, principals and curriculum coordinators value the opportunities to learn from and with others. These results can be of value for other contexts attempting to promote school networks as a means for school and system improvement.
Medical tourism trends in the United Kingdom 2000-2016
Authors: Pagán Ricardo , Horsfall Daniel
Published: December 2019

Purpose

The purpose of this study is to investigate the inbound and outbound medical tourism in the UK to determine if the UK can be considered as a net exporter of health services as well as the impact of the 2007 global economic crisis, diaspora populations and the number of UK expats on medical tourism figures.

Design/methodology/approach

Using microdata drawn from the International Passenger Survey (2000-2016), the authors estimate the flows, number of nights and expenditure of tourists looking for medical treatment who complete international visits of less than 12 months’ duration to and from the UK. The authors also analyse the main destinations of UK residents, the country of origin of overseas residents and the particular case of British expats.

Findings

The results show the upward trend of inbound and outbound patients, the strong seasonality in outbound patients, and the significant increase in the levels of expenditure of overseas residents since 2005. Poland, France, Hungary and India are the chosen countries by UK residents to be treated, whereas Irish Republic, Spain, France, Gibraltar and the United Arab Emirates are the main countries providing inbound health patients. However, the processes of migration explain full or partly the inbound and outbound flows found for some countries.

Originality/value

This study offers a critical insight into inbound and outbound medical flows, demonstrating both the scope for and limitations to market development in this area.